bluuebunny/crossref_metadata_2025 huggingface dataset:
Dosimetric Comparison of IMRT, Hybrid IMRT and Hybrid VMAT For Early Stage Right-Sided Breast Cancer
Authors: Bi Suyan , Zhu Rui , Dai Zhitao
Published: July 2021

Purpose

This study aimed to evaluate the clinical impact of hybrid intensity-modulated radiotherapy (IMRT) and hybrid volumetric-modulated arc therapy (VMAT) for early-stage breast cancer, including plan quality and second cancer risk (SCR).
Methods

Three different plans were designed in full IMRT, hybrid IMRT, and hybrid VMAT for each of eight patients with early-stage breast cancer. Target quality, organs at risk (OARs) sparing, and SCR were compared among the three plans.
Results

Compared with the hybrid IMRT, full IMRT showed deterioration in terms of D2% of simultaneous integrated boost (SIB), V10 of ipsilateral lung, and excess absolute risk (EAR) to contralateral lung and esophagus. The homogeneity index (HI) of SIB, V5 of ipsilateral lung and combined lung, the Dmax and Dmean of the esophagus, the EAR to contralateral breast and lung, and the EAR to the esophagus with hybrid VMAT dramatically increased by 12.5%, 19.49%, 18.87%, 90.59%, 167.69%, 50.14%, 264.68%, and 160.95%, respectively (p = 0.022; 0.040; 0.044; 0.041; 0.003; 0.020; 0.000; 0.003). The EAR to contralateral breast and contralateral lung by full IMRT was significantly decreased compared with the hybrid VMAT (26.97%, p = 0.033; 50.01%, p = 0.026).
Conclusion

The results confirmed that hybrid IMRT could achieve better target quality and OARs sparing than full IMRT and hybrid VMAT for early-stage right breast cancer. Hybrid IMRT was the best treatment option, while hybrid VMAT performed the worst among the three plans in terms of SCR to peripheral OARs.
Divalent magnesium restores cytoskeletal storage lesions in cold-stored platelet concentrates
Authors: Aurich Konstanze , Wesche Jan , Ulbricht Martin , Otto Oliver , Greinacher Andreas , Palankar Raghavendra
Published: July 2021

Cold storage of platelet concentrates (PC) has become attractive due to the reduced risk of bacterial proliferation, but in vivo circulation time of cold-stored platelets is reduced. Ca2+ release from storage organelles and higher activity of Ca2+ pumps at temperatures < 15°C triggers cytoskeleton changes. This is suppressed by Mg2+ addition, avoiding a shift in Ca2+ hemostasis and cytoskeletal alterations. We report on the impact of 2–10 mM Mg2+ addition on cytoskeleton alterations of platelets from PC stored at room temperature (RT) or 4°C in additive solution (PAS), 30% plasma. Deformation of platelets was assessed by real-time deformability cytometry (RT-DC), a method for biomechanical cell characterization. Deformation was strongly affected by storage at 4°C and preserved by Mg2+ addition ≥ 4 mM Mg2+ (mean ± SD of median deformation 4°C vs. 4°C + 10mM Mg2+ 0.073 ± 0.021 vs. 0.118 ± 0.023, p < 0.01; n = 6, day 7). These results were confirmed by immunofluorescence microscopy, showing that Mg2+ ≥ 4mM prevents 4°C storage induced cytoskeletal structure lesion. Standard in vitro platelet function tests showed minor differences between RT and cold-stored platelets. Hypotonic shock response was reduced in cold-stored platelets (45.65 ± 11.59% vs. RT stored platelets 56.38 ± 29.36; p = 0.042) but normal at 4°C + 10 mM Mg2+ (55.22 ± 11.16%, all n = 6, day 1). CD62P expression and platelet aggregation response were similar between RT and 4°C stored platelets, with minor changes in the presence of higher Mg2+ concentrations. In conclusion, increasing Mg2+ up to 10 mM in PAS counteracts 4°C storage lesions in platelets, maintains platelet cytoskeletal integrity and biomechanical properties comparable to RT stored platelets.
Using Artificial Intelligence Reading Label System in Diabetic Retinopathy Grading Training of Junior Ophthalmology Residents and Medical Students
Authors: Han Ruoan , Yu Weihong , Chen Huan , Chen Youxin
Published: July 2021

Purpose
Evaluate the efficiency of using artificial intelligence reading label system in diabetic retinopathy grading training of junior ophthalmology resident doctors and medical students.
Methods
Loading 520 diabetic retinopathy patients’ color fundus images in the artificial intelligence reading label system. 13 participants (including 6 junior ophthalmology residents and 7 medical students) read the images randomly for 8 rounds. They evaluated the grading of images and labeled the typical lesions. The sensitivity, specificity and kappa score were determined by comparison with the participants’ results and expert golden standards.
Results
Through 8 round reading, average kappa score was elevated from 0.67 to 0.81. Average kappa score of round 1 to 4 was 0.77, and average kappa score of round 5 to 8 was 0.81. The participant was divided into two groups. Participants in group 1 were junior ophthalmology resident students and participants in group 2 were medical doctors. Average kappa score of group 1 was elevated from 0.71 to 0.76. Average kappa score of group 2 was elevated from 0.63 to 0.84.
Conclusion
The artificial intelligence reading label system was a useful tool in training resident doctors and medical students in doing diabetic retinopathy grading.
Study on Transport of Molecules in Gel by Surface-Enhanced Raman Spectroscopy
Authors: Kumar Samir , Taiga Taneichi , Fukuoka Takao , Namura Kyoko , Suzuki Motofumi
Published: July 2021

Surface-enhanced Raman spectroscopy (SERS)-based biosensors have recently been extensively developed because of their high sensitivity and non-destructive nature. Conventional SERS substrates are unsuitable for detecting biomolecules directly from human skin. As a result, significant effort is being put into developing a gel-type SERS sensor that can segregate and detect biomolecules due to differences in molecular transport phenomena in the gel. However, no comprehensive research studies on the transport processes of molecules in gels in gel-type SERS sensors have been reported. This paper reports the differences in the transport phenomena of different molecules based on the time change of SERS spectrum intensity. The Au nanorod array substrate was coated with HEC gel to prepare a sample cell to study diffusion. The SERS spectra of aqueous solutions of 9 types of molecules were measured using the prepared sample cells. The rate at which each molecule diffuses into the gel differs depending on the molecule. The time variation of the characteristic SERS peak of each molecule was investigated based on a one-dimensional diffusion model, and the diffusion coefficient D was calculated for each molecule. A comparative study was conducted on the relationship between the diffusion coefficient and the molecular weight and molecular size, and it was found that the larger the molecular weight and molecular size, the slower the diffusion, which is based on the molecular motion theory and the inhibitory effect of the gel substance.
An Intelligent Manufacturing Cell Based on Human-robot Collaboration of Frequent Task Learning for Flexible Manufacturing
Authors: Zhang Shuai , Li Shiqi , Wang Haipeng , Li Xiao
Published: July 2021

The manufacturing industry was moving towards the trend of short run production and personalized customization. That results in the challenge of the efficiency of task adjustment and the complexity of tasks for robots. Thus, this paper developed the intelligent manufacturing cell based on human-robot collaboration(HRC-IMC), combining the intelligence of cobot with that of human. And the intelligent manufacturing cell was composed with the modules of imitating learning, human-robot safety planning, task planning and visual inferring. Moreover, all modules were designed to provide a set of systematic and e ective method which can improve the efficiency of task planning and new task learning. The experimental results indicated that the the efficiency of task adjustment of HRC-IMC can be increased 42.8 % than that of Moveit. All in all, this study is of great significance for improving the efficiency of new task planning of cobots by digitizing the manipulation experience of human.
Variations in Microanatomy of the Human Modiolus: Implications for Cochlear Implants
Authors: Pietsch Markus , Schurzig Daniel , Salcher Rolf , Warnecke Athanasia , Erfurt Peter , Lenarz Thomas , Kral Andrej
Published: July 2021

Human cochlear anatomy is highly variable. The phenomenon has been first described qualitatively, followed by a quantitative variability assessment with detailed anatomical models of the human cochlea. However, all previous work focused on lateral cochlear wall. Few information is available on the variability of the modiolar wall. Modiolar variability, likely determined by variability in the spiral ganglion, provides key information on when during ontogenesis the individual cochlear morphology is established: before and/or after neuronal structures are formed. In the present study we analyzed 108 corrosion casts, 95 clinical cone beam computer tomographies and 15 µCTs of human cochleae and observed modiolar variability of similar and larger extent than the lateral wall variability. Lateral wall measures correlated with modiolar wall measures significantly. ~49% of the variability has a common cause, very likely established already during the time when the spiral ganglion is formed. Proximity of other neuronal and vascular structures, defining the remaining variability in scalar spaces, are determined later in ontogenesis, when the scalae are formed. The present data further allows implications for perimodiolar cochlear implants and their tip fold-overs. In particular, the data demonstrate that tip fold-overs of preformed implants likely result from the morphology of the modiolus (with radius changing from base to apex), and that optimal cochlear implantation of perimodiolar arrays cannot be guaranteed without an individualized surgical technique.
Azolla A Boon for the Growth of Gift Tilapia, Oreochromis Niloticus (Linnaeus, 1758)
Authors: BESLIN LEENA GRACE , Rajan Monisha
Published: July 2021

Understanding the nutritional requirements and production of fish feed is essential to the development and sustainability of aquaculture for the matured feed mill practices. Fish feed management includes choosing the right feed, using a correct feeding method, calculating the feeding cost and ensuring the cost effectiveness of fish farm. The purpose of the present study was to feed the fishes with four different feeds and assessment of growth performance by length weight relationships. The growth analysis was executed by measuring FCR and related indices in gift tilapia oreochromis niloticus. Four feed composition was selected without any chemical contamination. In the present study fishes were collected from the golden farm, Neyyattinkara, Thiruvananthapuram district, South India. Fishes were introduced into four different tanks of well oxygenated good quality water. In each experimental tank, 20 fishes were introduced. For each experimental container a specific feed was fixed from 4 different diets. Every day feed was given to the fishes. They were fed two times for the period of 3 months. They were maintained to assess their growth performance. Four types of feeds used for the present study are control diet, diet 1, diet 2 and diet 3. Measurement of length and weight was measured on every 15 days interval. Based on the length-weight data, growth analysis was carried out by calculating relative growth (RG), relative growth rate (RGR), specific growth rate (SGR), feed conversion ratio (FCR) and the Fulton’s condition factor. The results of mean length in diet3proved the highest length of 6.455 ± 0.46cm and diet one contain lowest length of 5.03 ± 0.68cm. Highest weight of 96.8 ± 0.37g was recorded in diet3 and lowest weight obtained for the control diet (3.645 ± 0.306 g). In growth analysis the relative growth of fish was estimated in diet 3 having high relative growth (11.91). Relative growth rate was elevated in diet 3(1.5597). The upper limit of specific growth rate was 1.9146% observed in diet 3. The feed conversion ratio was maximum in diet 3 (58.06) and minimum in control diet (36). The highest k value in Fulton's condition factor was noticed in diet 3(88.32).All experimental results proved that live Azolla [D3] was a superior feed for the present trials.
The Attributable Mortality of Sepsis for Acute Kidney Injury: A Propensity Score Matched Study
Authors: Jia Huimiao , Jiang Yijia , Zheng Xi , Li Wen , Wang Meiping , Xi Xiuming , Li Wenxiong
Published: July 2021

Background: Both sepsis and AKI are diseases of major concern in intensive care unit (ICU). This study aimed to evaluate the excess mortality attributable to sepsis for acute kidney injury (AKI).Methods: A propensity score-matched analysis of a prospective cohort study about sepsis epidemiology in 18 Chinese ICUs (January 2014-August 2015) was performed (registration number: ChiCTR-ECH-13003934). Propensity score model was sequentially conducted to match AKI patients with and without sepsis on day 1, day 2, and day 3-5. The primary outcome was hospital death of AKI patients. Propensity score-matched analyses were conducted to estimate the excess mortality attributable to sepsis for AKI. Results: A total of 2008 AKI patients (40.9%) were eligible for the study. Of the 1010 AKI patients with sepsis, 619 (61.3%) were matched to 619 AKI patients in whom sepsis did not develop during the screening period of the study. The hospital mortality rate of matched AKI patients with sepsis was 205 of 619 (33.1%) compared with 150 of 619 (24.0%) for their matched AKI controls without sepsis (p = 0.001). The attributable mortality of total sepsis for AKI patients was 9.1% (95% CI 4.8-13.3%). Matched AKI patients with and without sepsis were subgrouped according to the severity of sepsis (sepsis, septic shock). Of the matched patients with sepsis, 328 (53.0%) diagnosed septic shock. The mortality rate showed remarkably higher in matched AKI patients with septic shock (43.9%) than their controls of patients without sepsis (27.7%). The attributable mortality of septic shock for AKI was 16.2% (95% CI 11.3-20.8%, p < 0.001). Further, the attributable mortality of sepsis for AKI was 1.4% (95% CI 4.1-5.9%, p = 0.825), although there was no significant difference of mortality rate observed between matched AKI patients with and without sepsis (21.0% vs. 19.6%).Conclusions: The attributable hospital mortality of total sepsis for AKI were 9.1%. Septic shock contributes to major excess mortality rate for AKI than sepsis.
Knowledge, Practice and Psychological Symptoms Among the Nepalese Medical Laboratory Staff: An Online-Based Cross-Sectional Study During COVID-19 Pandemic
Authors: Basnet Buddha Bahadur , Satyal Deepa , Pandit Roshan , Basnet Til Bahadur , Khattri Sandeep , Mishra Shyam Kumar
Published: July 2021

IntroductionThe Coronavirus Disease 2019 (COVID-19) outbreak has spread globally causing a significant impact on the social and mental life of people across the world including frontline health care workers. The knowledge level, practice behaviour, and mental well-being of healthcare workers are the most important factors for tackling the COVID-19 pandemic. Nepal is a developing country lacking well-established health infrastructures and well-trained human resources to fight an outbreak. The continuous rise in the number of COVID-19 cases inside the country has left unanswered questions on the availability of health resources in Nepal. In this regard, we tried to assess the level of knowledge, practice and psychological symptoms among medical laboratory staff working in Nepal.MethodsAn online survey using a pre-validated questionnaire was conducted in late January 2021 among medical laboratory staff across Nepal. A total of 301 completely filled responses were used to assess knowledge, practice, and psychological distress. Different statistical tests were used to evaluate differences among variables, and p-value less than 0.05 was considered statistically significant.ResultsOf the total 301 respondents, 180 (59.8%) were male and 121 (40.2%) were female. The average score of knowledge obtained in this study was 32.4 ± 5.7 on a 56-point scale. Knowledge level was significantly different among age-groups (p value – 0.034). The average practice score obtained was 2.25 ± 0.91 on a 4-point scale. More than one psychological distress symptom was observed in nearly half (41.5%) of the participants enrolled in the study; mood change behavior being the most common symptom. ConclusionWe concluded that medical laboratory staff in Nepal has satisfactory levels of knowledge and practice and, larger number of them had psychological distress during the pandemic. The study recommends improvement in an effective information flow system, regular training social security and psychological support to the medical laboratory staff inside the country.
Predicting Fault Slip via Transfer Learning
Authors: Wang Kun , Johnson Christopher , Bennett Kane , Johnson Paul
Published: July 2021

Data-driven machine-learning for predicting instantaneous and future fault-slip in laboratory experiments has recently progressed markedly due to large training data sets. In Earth however, earthquake interevent times range from 10's-100's of years and geophysical data typically exist for only a portion of an earthquake cycle. Sparse data presents a serious challenge to training machine learning models. Here we describe a transfer learning approach using numerical simulations to train a convolutional encoder-decoder that predicts fault-slip behavior in laboratory experiments. The model learns a mapping between acoustic emission histories and fault-slip from numerical simulations, and generalizes to produce accurate results using laboratory data. Notably slip-predictions markedly improve using the simulation-data trained-model and training the latent space using a portion of a single laboratory earthquake-cycle. The transfer learning results elucidate the potential of using models trained on numerical simulations and fine-tuned with small geophysical data sets for potential applications to faults in Earth.
Electrometric Investigation of the Nature and Stability of Mixed Ligand Complexes of L-Ornithine and 1,10-Phenanthroline with Some Essential Metal Ions in Aqua-TBAB or PEG-400 Surfactant
Authors: Assefa Atnafu Guadie , Negash Molla Tefera , Akele Mulugeta Legesse , Workneh Bewketu Mehari , Mesfin Ayal Adugna , Shyamala Pulipaka , Rao Gollapalli Nageswara
Published: July 2021

Background

Despite the availability of information about the effect of aqua-surfactants media on the stability of binary complexes, data related to mixed ligand complexes of Phen and Orn with essential metals in aqua-surfactant medium is scarce. The aim of this study was, to determine the stabilities of the mixed ligand complexes of essential metal ions (Co2+, Ni2+, Cu2+) with Phen and Orn in aqua-TBAB and PEG-400 surfactants with an eye on the prediction of the bioavailability of the metal complexes.
Results

Complexes of some essential metal (M) ions (Co2+, Ni2+, Cu2+) of L-ornithine (L) and 1,10-phenanthroline (X) ligands in various concentrations (0.0–2.5% v/v) of aqueous tetrabutylammonium bromide (TBAB) or polyethylene glycol-400 (PEG-400) surfactant were synthesized pH-metrically at 298 K and 0.16 mol L− 1 ionic strength. The relative amounts of L:M:X were 2.5:1.0:2.5; 5.0:1.0:2.5; 2.5:1.0:5.0. The data acquisition of acid-base equilibria and determination of stability constants were performed using MINIQUAD75 algorithm. The distribution patterns of the complexes with varying pH and compositions of surfactants were presented from the plots of SIM run data.
Conclusions

The best fit chemical models were found to be MLXH, MLX2H in the lower pH, and MLX, ML2X in the higher pH ranges for all the metals. The logged values of stability constants decreased linearly with increasing concentrations of surfactants, indicating the dominance of electrostatic factors. The log of the disproportionation constant and the change in log values of the mixed ligand constant indicated additional stability of the mixed ligand complexes, compared to the parent binary complexes due to interactions outside the coordination sphere. This makes the mixed ligand complexes more amenable to metal ion storage and transport and threw light to have information on the less stable binary complexes easily bioavailability while the mixed ligand complexes could be stored and transported in the bio-fluids. Significant change on the magnitudes of the stability constants, high values of standard deviation and rejection of some of the proposed chemical models were observed due to pessimistic error, indicating the sufficiency of the models to represent the data and accuracy of the method employed.
The effectiveness of microwave endometrial ablation combined with hysteroscopic transcervical resection in treating submucous uterine myomas: A retrospective study
Authors: Kakinuma Toshiyuki , Kakinuma Kaoru , Shimizu Ayano , Kaneko Ayaka , Kagimoto Masataka , Okusa Takafumi , Suizu Eri , Saito Koyomi , Matsuda Yoshio , Yanagida Kaoru , Takeshima Nobuhiro , Ohwada Michitaka
Published: July 2021

Background

Submucous uterine myomas can be effectively and safely treated using microwave endometrial ablation (MEA). However, recurrence is common and requires additional treatment. This study investigated the efficacy of MEA combined with transcervical resection (TCR).
Methods

This retrospective study included 32 women who underwent MEA in addition to TCR for submucous uterine myomas at the International University of Medicine and Welfare Hospital between January 2016 and June 2020. All patients were followed up for ≥ 6 months after the procedure.
Results

The 32 women had a mean age of 45.2 ± 4.3 years. The myomas had a mean major diameter of 26.3 ± 12.3 mm and a protrusion degree of 51.3 ± 11.3%. The patients reported very severe hypermenorrhea/dysmenorrhea (10/10 points on the visual analogue scale) before the procedure. After the procedure, the hypermenorrhea scores decreased to 1.2 ± 1.3 and 0.9 ± 1.3 after 3 and 6 months, respectively (both p < 0.001). The dysmenorrhea scores also decreased to 1.3 ± 1.8 and 1.3 ± 1.8 after 3 and 6 months, respectively (both p < 0.001). Circulating hemoglobin concentrations improved significantly from 8.7 ± 1.9 g/dL to 13.5 ± 1.1 g/dL (p < 0.001). The mean follow-up duration was 33.8 ± 16.8 months and 10 women (31.3%) developed amenorrhea during this period, although none experienced recurrence of hypermenorrhea. No surgical complications were observed. The patients reported being highly satisfied with the ability of the combined treatment to relieve hypermenorrhea (mean visual analogue scale score: 9.5 ± 0.8).
Conclusion

Reducing the size of uterine fibroids via a combination of MEA and TCR can safely and effectively treat hypermenorrhea in patients with submucous myomas. Furthermore, the procedure’s effectiveness is complemented by the patients’ high satisfaction level.
Mathematical Model of Physiological and Biochemical Indexes to Plant Growth–Defense Tradeoff in Salvia Miltiorrhiza
Authors: Wang Ke , Yan Zhu-yun , Ma Yun-tong , Li Bo , Wang Wei , Qi Lu-ming , Jia Hong-mei , Li Na , Wang Zhun
Published: July 2021

Background: Enzyme activities play a very important role in metabolism. Carbon (C) and nitrogen (N) are the two most basic elements for plant growth and development, and their mutual coupling makes C:N become an important index to explore plant element allocation and adaptation strategies. Although the key enzymes activity in carbon and nitrogen metabolism, and defense enzymes are often used to indexes of the physiological and biochemical characteristics of plants, the relationship between them and biomass still lacks understanding. In this paper, under the control condition, the biomass and 18 kinds of physiological and biochemical indexes were obtained through 24 groups experiments of the regenerated seedlings of Salvia miltiorrhiza by 9 endophytic fungi strains grafted. Results: The data were analyzed by descriptive statistical analysis, Lasso variable screening analysis and MLP neural network regression analysis. Results show that many physiological and biochemical indexes are related to biomass, and glutamine synthetase ( GS ),glutamate synthase ( GLS ), glutamate dehydroge nase ( GDH ), peroxidases (POD), catalase (CAT), soluble protein are the key factors which affect the biomass synthesis of Salvia miltiorrhiza . Conclusion: In this paper, it discusses the relationship between physiological and biochemical indexes and biomass in a comprehensive and systematic way by the framework of "Build-Design-Calculate-Test". Through rigorous logical reasoning process, the factors affecting the growth of Salvia miltiorrhiza are selected, and the mathematical model is established. It also provides a powerful tool for the comprehensive and systematic study of plant growth and the synthesis of effective components.
Chinese ICU Physicians’ Knowledge of Antibiotic Pharmacokinetics/Pharmacodynamics (PK/PD): A Cross-Sectional Survey
Authors: Mao Wenchao , Lu Difan , Zhou Jia , zhen Junhai , Yan Jing , Li Li
Published: July 2021

Background: Patients with sepsis have a high mortality rate, accumulated evidences suggest that an optimal antibiotic administration strategy based on pharmacokinetics/pharmacodynamics（PK/PD）can improve the prognosis of septic patients. Therefore, we assessed Chinese intensive care unit (ICU) physicians’ knowledge about PK/PD.Methods: In December 2019, we designed a questionnaire focused on Chinese ICU physicians’ knowledge about PK/PD and collected the questionnaires after 3 months. The questionnaire was distributed via e-mail and WeChat, and was distributed to ICU doctors in 31 administrative regions of China except Hong Kong, Macao and Taiwan. The passing score was corrected by the Angoff method, and the ICU physicians’ knowledge about PK/PD was analysed accordingly.Results: We received a total of 1,309 questionnaires and retained 1,240 valid questionnaires. The passing score was 90.8, and the overall pass rate was 56.94%. The pass rate for tertiary and secondary hospitals was 59.07% and 37.19%, respectively. ICU physicians with less than 5 years of work experience and resident physician accounted for the highest pass rate, while those with between 5 to 10 years of work experience and attending accounted for the lowest pass rate. The majority of participants in the Chinese Critical Care Certified Course (5C) were from Jiangsu and Henan provinces, and they had the highest average scores (125.8 and 126.5, respectively). For Beijing and Shanghai, the average score was only 79.4 and 90.9, respectively.Conclusions: Chinese ICU physicians’ knowledge about PK/PD is unsatisfactory. Therefore, it is essential to strengthen ICU physicians’ knowledge about PK/PD.
Lobular Carcinoma in Situ During Preoperative Biopsy and the Rate of Upgrade
Authors: Lee Jeea , Ku Ga Yoon , Lee Haemin , Park Hyung Seok , Ku Ja Seung , Kim Jee Ye , Park Seho , Kim Seung Il , Park Byeong-Woo
Published: July 2021

Background: There is a potential risk that lobular carcinoma in situ (LCIS) on preoperative biopsy might be diagnosed as ductal carcinoma in situ (DCIS) or invasive carcinoma in the final pathology. This study aimed to evaluate the rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive carcinoma.Methods: Data of 55 patients with LCIS on preoperative biopsy were analyzed. All patients underwent surgery between 1991 and 2016 at Severance Hospital in Seoul, Korea. We analyzed the rate of upgrade of preoperative LCIS to DCIS or invasive cancer in the final pathology. The clinicopathologic features related to the upgrade were evaluated.Results: The rate of upgrade of LCIS to DCIS or invasive carcinoma was 16.4% (9/55). In multivariate analysis, microcalcification and progesterone receptor expression were significantly associated with the upgrade of LCIS (P = 0.023 and 0.044, respectively).Conclusions: The current study showed a relatively high rate of upgrade of LCIS on preoperative biopsy to DCIS or invasive cancer. The presence of microcalcification and progesterone receptor expression may be potential predictors of upgradation of LCIS on preoperative biopsy. Surgical excision of the LCIS during preoperative biopsy could be a management option to identify the concealed malignancy.
Cross-cultural Validation and Psychometric Testing of the Debriefing Experience Scale (DES): A Cross-sectional Study
Authors: Xie Ya Dian , Li Xin Yi , Liu Qian , Huang Run , Li Ting , Fang Ya Xuan , Luo Dan , Wan Yonghui , Yang Bing Xiang , Reed Shelly J.
Published: July 2021

Background: The Debriefing Experience Scale (DES) is a tool that is used to explore nursing students’ subjective experiences during a debriefing. Information obtained from completed scales can be used to help determine best debriefing practices. No Chinese version of the scale has been found verifying reliability and validity.Methods: The Chinese DES was completed by 34 undergraduate (second year) nursing students after debriefing six separate simulation scenarios. Eight experts were consulted to determine the content validity of the scale. Critical ratio method, Cronbach’s alpha and the correlation coefficient and factor analysis were used for data analysis.Results: 200 cases were included in the analysis, it showed that the simplified Chinese version DES scale held a good potential to discriminate nursing students’ experience of the debriefing.Conclusions: The simplified Chinese DES scale was effective in evaluating the experience of debriefing. A larger sample size and multicenter research is needed to confirm these findings.
Physiological Responses of Amaranthus Cruentus L. to Drought Stress Under Sufficient- and Deficient-Nitrogen Conditions
Authors: Cechin Inês , Silva Laura Prado da , Ferreira Elisa Teófilo , Barrochelo Sarah Corrêa , de Melo Fernanda Pereira de Souza Rosa , Dokkedal Anne Ligia , Saldanha Luiz Leonardo
Published: July 2021

Water and nitrogen availability are environmental factors that can impair plant growth, and when they are combined their effects can be intensified or reduced. The objective of this study was to analyse the influence of nitrogen availability on the responses of Amaranthus cruentus’s metabolisms to water stress. The plants were cultivated in plastic pots filled with vermiculite and kept under greenhouse conditions and were watered with 70% of full strength nitrogen-free Long Ashton solution, containing 1.97 or 9.88 kg N ha−1 as ammonium nitrate, three times a week. Photosynthetic parameter were evaluated in planta and leaves were harvested for chemical analysis of proline and phenolic contents. Higher nitrogen supply increased the shoot dry matter, photosynthetic pigments, photosynthesis, stomatal conductance, transpiration, total leaf nitrogen, proline, nitrate and ammonium but reduced the concentration of flavonoids and total phenols. Water stress for 6 days did not affect dry matter, photosynthetic pigments, leaf nitrogen, ammonium or specialized metabolites but increased the proline and affected negatively the other variables. The observed interactions between nitrogen and water supply resulted in no alleviation of the negative effects of drought on amaranth. Although the increase in nitrogen supply had benefits on plant performance, it intensified the negative effect of water stress. The study shows the importance of choosing the correct level of nitrogen fertilization in order to obtain satisfactory results in terms of plant growth under drought conditions.
Impact of B.1.617 and RBD SARS-CoV-2 Variants on Vaccine Efficacy: An In-silico Approach
Authors: Ranjan Prashant , Neha  , Devi Chandra , Jain Garima , Mallick Chandana Basu , Das Parimal
Published: July 2021

The existing panels of COVID-19 vaccines are based on the spike protein of earlier SARS-CoV-2 strain that emerged in Wuhan, China. However, the evolving nature of SARS-CoV-2 has resulted in emergence of new variants, thereby, posing a greater challenge in the management of the disease. India faced a deadlier second wave of infections very recently and genomic surveillance revealed that B.1.617 variant and its sub lineages are responsible for majority of the cases. These are highly infectious and possibly more lethal and therefore labelled as variants of concern by WHO. Hence, it’s crucial to determine if the current vaccines available can be effective against these variants. To address this, we performed molecular dynamics (MD) simulation on B.1.617 along with K417G variants and other RBD variants. We studied structural alteration of the spike protein and factors affecting antibody neutralization and immune escape. We found in seven of the 12 variants studied, there was a structural alteration in RBD region further affecting its stability and function. Docking analysis of RBD variants and wild type strain demonstrated increase in binding affinity with ACE2 (angiotensin 2 altered enzymes) receptor in these variants. Molecular interaction with CR3022 antibody revealed that binding affinity was less in comparison to wild type, with B.1.617 showing the least binding affinity. These findings from the extensive simulations provides novel mechanistic insights on the conformational dynamics and improves our understanding of the enhanced properties of these variants in terms of infectivity, transmissibility, neutralization potential, virulence and host-viral replication fitness.
Recapitulating aortic valve disease hemodynamics with a highly tunable bio-inspired soft robotic aortic sleeve
Authors: Rosalia Luca , Ozturk Caglar , Fan Yiling , Coll-Font Jaume , Chen Shi , Eder Robert , Kim Jo , Nagata Yasufumi , Levine Robert , Panagia Marcello , Guerrero Jose , Mauskapf Adam , Roche Ellen , Nguyen Christopher
Published: July 2021

Existing models of aortic stenosis (AS) are limited to inducing left ventricular pressure overload. As they have reduced control over the severity of aortic constriction, the clinical relevance of these models is largely hindered by their inability to mimic AS hemodynamics and recapitulate flow patterns associated with congenital valve defects, responsible for the accelerated onset and progression of AS. Here we report the development of a highly tunable bio-inspired soft robotic tool that enables the recapitulation of AS in a porcine model, in which customization of actuation patterns allows hemodynamic mimicry of AS and congenital aortic valve defects. In vitro and computational tools including lumped-parameter, finite element, and computational fluid dynamics platforms were developed to predict the hemodynamics induced by the bio-inspired soft robotic sleeve. The controllability of our in vivo model and its ability to replicate flow patterns of AS and congenital defects were demonstrated in swine through echocardiography, left ventricular catheterization, and magnetic resonance imaging. This work supports the use of soft robotics to simulate human physiology and disease, while paving the way towards the development of patient-specific models of AS and congenital defects that can guide clinical decisions to improve the management and treatment of these patients.
Prognostic Value of Characteristics of Plaque Combined With Residual Syntax Score Among Patients With STEMI Undergoing Primary PCI: an Intravascular Optical Coherence Tomography Study
Authors: Zhao Xiaoxiao , Wang Ying , Chen Runzhen , Li Jiannan , Zhou Jingying , Chen Liu , Zhou Peng , Sheng Zhaoxue , Chen Yi , Song Li , Zhao Hanjun , Yan Hongbing
Published: July 2021

AimThe present study aimed to explore these characteristics, particularly thin-cap fibroatheroma (TCFA), in relation to residual syntax score (rSS) in patients who presented with acute MI.Methods and outcomesA total of 434 consecutive patients with MI aged ≥18 years who had STEMI underwent primary PCI. Notably, compared with other subgroups, the presence of TCFA in culprit lesions and a higher level of rSS, were significantly associated with MACE. When rSS was divided into three groups, high rSS levels were associated with a higher incidence of MACE, in the subgroups of without TCFA (P= 0.005), plaque erosion (P= 0.045), macrophage infiltration (P= 0.026), and calcification (P= 0.002). AUC of ROC curve was 0.794 and 0.816, whereas the AUC of the survival ROC was 0.798 and 0.846.ConclusionThe results of this study could be used in clinical practice to support risk stratification.Trial registrationThis study was registered at ClinicalTrials.gov as NCT03593928.
If the Adjustment of Insertional Pedicle Screw Positions Will Affect the Risk of Adjacent Segment Diseases Biomechanically? An in-silico Study
Authors: Huang Chenyi , Liu Zongchao , Hu Huajun , Chen Xueyan , Chen Jingwen , Wei Zhangchao , Fang Zhongxin , Xi Zhipeng , Cai Ping , Li Jingchi
Published: July 2021

Background: The posterior fixation system (PFS) is extensively used in the treatment of spinal diseases. However, the fixation-induced pathological stress distribution pattern (e.g., stress concentration and motility compensation) will increase the risk of adjacent segment diseases (ASD). The accurate adjustment of insertional screw positions is possible under the guidance of the C-arm during percutaneous pedicle screw insertion. Although studies reported that the adjustment of insertional screw positions would affect the stiffness of the fusion segment, there were still no studies that clarified the issue that if the adjustment of insertional screw positions would affect the postoperative biomechanical environment and the risk of ASD. Methods: To investigate if the change of screw positions and related moment arm in adjacent segments will affect mechanical indicators related to ASD, an intact lumbosacral model has been constructed and validated based on our anteriorly constructed model, the oblique lumbar interbody fusion fixed by bilateral PFS with different insertional positions has been simulated in the L4-L5 segment. Models were computed under completely identical loading conditions, including flexion, extension, bending, and rotation. Motility parameters, stress distribution in the intervertebral disc (IVD), and zygapophyseal joints (ZJ) in both cranial and caudal sides of functional units were recorded. Results: Consist with anterior published studies, the change of fixation lengths has a more apparent biomechanical effect on the cranial than the caudal segment. Positive collections can be observed between the reduction of the moment arm in adjacent segments and the aggravation of motility compensation. Furthermore, which can also lead to stress concentration on ZJ facet cartilages. By contrast, no pronounced tendency of stress distribution on IVD can be observed with the change of moment arm. Conclusions: during LIF operations fixed by percutaneous PFS, reducing the fixation stiffness by adjusting the insertional screw positions on the sagittal plane could alleviate the biomechanical deterioration and may be an effective method to reduce the risk of ASD (adjacent segmental instability in the short term and spinal stenosis in the long term).
Evaluation of satellite sensors to compute Chlorophyll-a concentration in the Northeastern Arabian Sea: A validation approach
Authors: Vase Vinaya Kumar , Ajay Nakhawa , Kumar Rajan , Jayaraman Jayasankar , Rohit Prathibha
Published: July 2021

The primary productivity of an aquatic system like the Arabian Sea is broadly determined by the concentration of Chlorophyll-a (Chl-a/Ca) pigment. The present study is essaying to validate the Chl-a data set retrieved from the prominent ocean color sensors (OC3M - MODIS, OC-OCM2, and OC3V-VIIRS) with sea truth data, collected from 204 stations for a three year period (2015–2017). The in-situ concentrations of Chl-a depict the geographic region under the mesotrophic and eutrophic spans with a mean of 1.36 mg m-3 ((0.1 > Ca>1.0 mg m-3). The ratio of CaOCM2/CaIn-situ was 0.97 ± 0.27 mg m-3 (n = 199), but the ratios were higher with CaVIIRS/CaIn-situ is 1.75 ± 0.79 mg m-3 (n = 170) and CaMODIS/CaIn-situ is 2.53 ± 1.42 mg m-3 (n = 158). The coefficient of determination proclaims a moderate significant relationship for MODIS (R2 = 0.36; p < 0.001), followed OCM2 (R2 = 0.32; p < 0.001) and VIIRS (R2 = 0.19; p < 0.001). The OCM2 showed the lowest RMSE as 0.13, which is relatively lower than the reference error limit by global ocean color missions at 0.35. In overall performance among three algorithms, the OCM2 will provide a better estimation of Chl-a with a prediction of 32% accuracy and 34.37 % of bias. The log bias values for MODIS (0.35) and VIIRS (0.20) algorithms indicating the overestimation of Chl-a with in-situ Chl-a, but the OCM2 algorithm is suitable in the region with a negligible bias (-0.03). The biogeochemical processes and ecosystem characteristics are dynamic from region to region, as yet in its urgent need to validate global sensors to fine-tune the regional algorithms periodically.
What Should We Focus on Sepsis Fluid Resuscitation? – a Research Based on Scientometrics and Visual Analysis
Authors: He Xiaojun , Zhu Xiang , Ma Yuefeng , Liang Jun
Published: July 2021

Background: Sepsis is a life-threatening condition and a global disease burden. Intravenous fluid therapy has been one of the cornerstones of sepsis treatment for decades. Many of the current views and programs are still controversial. With the rapid development of data science and bibliometrics, it is possible to comprehensively review and discover future research trends by analyzing the temporal evolution of topics. Methods: In this paper, bibliometric method was used to get a comprehensive review and quantitatively analyze the global development trend, regional distribution and discipline layout of fluid resuscitation in sepsis. VOSviewer and SciMAT were used to analyze the research hotspots, strategic layout and theme changes of fluid resuscitation in sepsis, and to explore the future research direction. Results: With the development of multi-disciplinary research on fluid resuscitation of sepsis, more attention has been paid to the early prediction and treatment in the emergency medicine department, and the number of basic research (effects of different components of resuscitation fluid) has a downward trend, but the role of albumin is still worthy of further study. The key points of fluid resuscitation in sepsis are the timing of fluid resuscitation, early intervention in the emergency medicine department, looking for accurate and timely indexes of microcirculation perfusion, fluid resuscitation volume in different resuscitation stages and its effect on respiration, kidney and abdominal cavity. Conclusion: The method can identify hotspots and detect future directions conveniently, quickly and effectively. The clinical research of fluid resuscitation in sepsis, especially “the early intervention” and “the precise resuscitation”, is paid more attention, and even the recommendations of the consensus and guidelines need to be further confirmed by “multi center research”, which may become the development direction in the future. Trial registration: it was not registered, because it is an bibliometric analysis based on the published articles.
Benchmarking Prediction Skill in Binary El Niño Forecasts
Authors: Hu Xinjia , Eichner Jan , Faust Eberhard , Kantz Holger
Published: July 2021

Reliable El Niño Southern Oscillation (ENSO) prediction at seasonal-to-interannual lead times would be critical for different stakeholders to conduct suitable management. In recent years, new methods combining climate network analysis with El Niño prediction claim that they can predict El Niño up to 1 year in advance by overcoming the spring barrier problem (SPB). Usually this kind of method develops an index representing the relationship between different nodes in El Niño related basins, and the index crossing a certain threshold is taken as the warning of an El Niño event in the next few months. How well the prediction performs should be measured in order to estimate any improvements. However, the amount of El Niño recordings in the available data is limited, therefore it is difficult to validate whether these methods are truly predictive or their success is merely a result of chance. We propose a benchmarking method by new surrogate data for a quantitative forecast validation for small data sets. We apply this method to a naïve prediction of El Niño events based on the Oscillation Niño Index (ONI) time series, where we build a data-based prediction scheme using the index series itself as input. In order to assess the network-based El Niño prediction method, we reproduce two different climate network-based forecasts and apply our method to compare the prediction skill of all these. Our benchmark shows that using the ONI itself as input to the forecast does not work for moderate lead times, while at least one of the two climate network-based methods has predictive skill well above 30 chance at lead times of about one year.
Determination of crop water requirements and irrigation scheduling of wheat using CROPWAT at Koga and Rib irrigation scheme, Ethiopia
Authors: Tewabe Dires , Abebe Atklte , Tsige Amare , Enyew Alebachew , Worku Mulugeta
Published: July 2021

Background

Population growth, high water competition, and the effect of climate change have caused water shortage problems in the Nile basin, Ethiopia. Proper water management improves water efficiency; determining the water requirement of field crops is an option for improving water productivity.
Methods

In this study, the CROPWAT 8.0 model, local climate, and soil data were used to determine crop water requirement (CWR) and irrigation scheduling of wheat at Koga and Rib irrigation scheme, Nile basin. The Penman-Monteith and United States Department of Agriculture (USDA) soil conservation service methods were used to compute the reference evapotranspiration (ETo) and effective rainfall. Five levels of water depth (50%, 75%, 100%, 125%, and 150%) of the model and two irrigation intervals (14 and 21 days) were arranged in a Randomized Completely Block Design (RCBD).
Results

The results showed that at Koga, irrigating 75% of CROPWAT simulated water depth (9.3 mm, 22.9 mm, 44.1 mm, and 25.8 mm at initial, development, middle and late-stage respectively) gave 3.37 t ha− 1 wheat yield and 1.01 kg m− 3 water productivity. The result at Rib showed that irrigating 75% of the model (9.1 mm, 23.6 mm, 47.2 mm, and 34.2 mm at initial, development, middle, late-stage) respectively) gave 4.27 t ha− 1 yield and 1.81 kg m− 3 water productivity of wheat. The reference evapotranspiration was varied from 4.86 mm day− 1 to 3.14 mm day− 1 at Koga and from 4.67 mm day− 1 to 2.36 mm day− 1 at Rib scheme. The irrigation requirement of wheat at Koga was 376.9 mm dec− 1 while at Rib was 379.9 mm dec− 1.
Conclusions

This study showed that the CROPWAT model is an important tool to compute the crop water requirement of field crops in irrigated agriculture.