bluuebunny/crossref_metadata_2025 huggingface dataset:
Exploration of Ion Sensitive Field-Effect Transistor With Dielectric Properties
Authors: Kumar Abhishek , Tripathi Suman Lata
Published: May 2021

Environmental changes and increased virus effects in COVID-19 like the situation is forcing the design and researchers to develop highly sensitive, low power and low cost mean to detect the presence of biomolecules of different shapes, sizes, and their effects on the human being. Ion-sensitive field-effect transistor (IS-FET) is a biological sensor based on the architecture of metal oxide semiconductor field-effect transistor (MOS-FET). The gate terminal is replaced with a hollow space filled by electrolyte solution and reference electrode at the external surface. The biomolecular enzyme in contact with membrane enters in solution induce net DC potential, alter the oxide surface. The alteration of surface puts variation in threshold voltage and maps on the deflection of drain current. ISFET measures the concentration of charged particles (ions) in the solution; variation into ion concentration produces deflection in the drain current. In this work numerical simulation of ISFET is performed with ENBIOS-2D Lab at Nanohub platform with dielectric SiO2, Al2O3, HfO2 with NaCl and KCl in solution. Channel resistance and capacitance with 3-different electric shows a large variation of capacitance, result in threshold voltage i.e. 318.2 mV with SiO2 and 319.2 mV with Al2O3.
Photophysical Investigation of A Benzimidazole Derivative and Its Applications In Selective Detection of Fe3+, Thermosensing and Logic gates.
Authors: Nadgir Aishwarya , Sidarai Ashok H
Published: May 2021

The fluorescence based applications such as chemosensing of Fe3+ ion, temperature sensing, NOR-gate molecular logic operations, and fluorescent ink were achieved using an expired medicine namely Pantoprazole (sensor1) which is a derivative of benzimidazole class. The phenomenon of quenching was a basic principle used in sensing Fe3+. We found that there was a combined effect of dynamic and static processes in quenching of fluorescence of sensor1. To confirm the selectiveness of sensor1, we performed interference experiments with other metal ions. There was no interference between these metal ions and Fe3+. The low LOD value of 1.032µM suggested that the molecule is highly sensitive towards Fe3+. A high quantum yield of 8.087% increased the possibility of using sensor1 for light applications. There was a 2:1 stoichiometric ratio between sensor1 and Fe3+. The FTIR data analysis confirmed the presence of functional groups S = O, C-O-C, etc. The average particle size found with the DLS method was 130.5nm. The zeta potential of -12.7mV indicated that sensor1 is quite stable in solution form. For logic gate application EDTA (Ethylenediaminetetraaceticacid) and Fe3+ were considered as inputs and fluorescence intensity was taken as an output. In thermal sensing application, the high value of activation energy i.e 908meV and relative sensitivity of 1.2% 0C−1 affirmed that sensor1 can be used for thermal applications. The sensor1 was also apt for fluorescent ink application. Hence this investigation deduced that sensor1 can be a potential candidate for such applications over other conventional synthesized fluorescent probes.
A Fatal Case of Streptococcal Toxic Shock Syndrome Developing in the Third Trimester of Pregnancy, China
Authors: Luo Yasha , Zheng Minling , Chen Yanyuan , Gu Chunming , Lv Lijuan , Mu Xiaoping
Published: May 2021

Background
Group A streptococcal (GAS) toxic shock syndrome (TSS) is a rare invasive disease, causing a high risk of maternal and fetal mortality during pregnancy. We report a fatal case of a female caused by GAS-TSS in the third trimester of pregnancy in Guangzhou, China.
Case presentation:
The patient is a 33-year-old female who presented at 37 weeks’ gestation with a history of three hours fever. She underwent an emergency cesarean section due to fetal bradycardia. The neonate survived after an aggressive anti-infection treatment. However, the patient’s condition deteriorated rapidly after the operation and the patient died of disseminated intravascular coagulation and septic shock within 24h after admission. She was finally diagnosed with GAS-TSS. The GAS strains were isolated from two bottles of blood cultures, which confirmed as Streptococcus pyogenes by 16S gene sequencing and identified as serotype M1 by molecular typing.
Conclusions
Dramatical clinical picture and laboratory characters of the pregnant woman presented here might help improve clinicians' awareness and recognition of Streptococcus pyogenes, which could be of great importance for the early diagnosis of GAS- TSS in pregnancy.
Testing the Agreement of Trees with Internal Labels
Authors: Fernández-Baca David , Liu Lei
Published: May 2021

Background: A semi-labeled tree is a tree where all leaves as well as, possibly, some internal nodes are labeledwith taxa. Semi-labeled trees encompass ordinary phylogenetic trees and taxonomies. Suppose we are given a collection P = {T1, T2, . . . , Tk} of semi-labeled trees, called input trees, over partially overlapping sets of taxa. The agreement problem asks whether there exists a tree T , called an agreement tree, whose taxon set is the union of the taxon sets of the input trees such that the restriction of T to the taxon set of Ti is isomorphic to i, for each i ε 1, 2, . . . , k . The agreement problems is a special case of the supertree problem, the problem of synthesizing a collection of phylogenetic trees with partially overlapping taxon sets into a single supertree that represents the information in the input trees. An obstacle to building large phylogenetic supertrees is the limited amount of taxonomic overlap among the phylogenetic studies from which the input trees are obtained. Incorporating taxonomies into supertree analyses can alleviate this issue. Results: We give a O(nk(i∈[k]di + log2(nk))) algorithm for the agreement problem, where n is the total number of distinct taxa in P, k is the number of trees in P, and di is the maximum number of children of a node in Ti. Our computational experience with the algorithm suggests that its performance in practice is much better than its worst-case bound indicates.
Halochromic Cellulose Textile Obtained via Dyeing With Biocolorant Isolated From Streptomyces Sp. Strain NP4
Authors: Kramar Ana Dragan , Ilic-Tomic Tatjana R. , Lađarević Jelena M. , Nikodinovic-Runic Jasmina B. , Kostic Mirjana M.
Published: May 2021

Halochromic (pH-responsive) material was obtained by dyeing functionalized viscose fabric with a crude extract from Streptomyces sp. strain NP4. The functionalization of the pristine fabric before dyeing was performed to make cellulose susceptible to coloration with NP4 extract. Two combined pre-treatment protocols were used, oxidation to obtain dialdehyde cellulose and chitosan deposition onto pristine and oxidized cellulose. Functionalization by both protocols made viscose susceptible to dyeing with the notion that the latter deposition of chitosan produced a darker shade on the material. Dyed fabrics showed visual pH responsiveness in the range pH 4-10, with a color change from pink to red (pH 4 to pH 7) and a major color change from red to blue (pH 7 to pH 10) whereby fabric was tested and could withstand 10 color-changing cycles. Cytotoxicity assay confirmed the non-toxic nature of dyed material, which indicates its possible use as wound dressing’s indicators.
Contrasting effects of the alkaloid ricinine on the capacity of Anopheles gambiae s.l. to transmit Plasmodium falciparum
Authors: Hien Domonbabele François de Sales , Paré Prisca S. L. , Cooper Amanda , Koama Benjamin K. , Guissou Edwige , Yaméogo Bienvenue K. , Yerbanga Rakiswendé S. , Farrell Ian W. , Ouédraogo Jean B. , Gnankiné Olivier , Ignell Rickard , Cohuet Anna , Dabiré Roch K. , Stevenson Philip , Lefèvre Thierry
Published: May 2021

Background: Besides feeding on blood, females of the malaria vector Anopheles gambiae s.l. readily feed on natural sources of plant sugars. The impact of toxic secondary phytochemicals contained in plant-derived sugars on mosquito physiology and on the development of Plasmodium parasites remains elusive. The focus of this study was to explore the influence of the alkaloid ricinine, found in the nectar of the castorbean Ricinus communis, on the mosquito ability to transmit Plasmodium falciparum. Methods: Females of Anopheles gambiae and its sibling species Anopheles coluzzii were exposed to ricinine through sugar feeding assays to assess the effect of this phytochemical on mosquito survival, the level of P. falciparum infection, and the growth rate of the parasite. Results: Ricinine induced a significant reduction in the longevity of both Anopheles species. Ricinine caused acceleration in the parasite growth rate with an earlier invasion of the salivary glands in both species. At a concentration of 0.04 g l-1 in An. coluzzii, ricinine had no effect on mosquito infection, while 0.08 g l-1 ricinine-5% glucose solution induced a 14% increase in An. gambiae infection rate. Conclusions: Overall, our findings reveal that consumption of certain nectar phytochemicals can have unsuspected and contrasting effects on key phenotypic traits that govern the intensity of malaria transmission. Further studies will be required before concluding on the putative role of ricinine as a novel control agent, including the development of ricinine-based toxic and transmission-blocking sugar baits. Testing other secondary phytochemicals in plant nectar will provide a broader understanding of the impact, which plants can have on the transmission of vector-borne diseases.
Construction of Biological Flame Retardant Layer on Cotton Fabric via Photografting of Nucleotide/Amino Acid Monomers
Authors: liu yutong , Wang Xiao , Li Zhenbao , Wei Ju , Du Bing
Published: May 2021

The 5’-adenylicacid (AMP-Na2) is modified to introduce unsaturated double bonds for photografting onto cotton fabrics together with L-cysteine (L-Cys) monomer to prepare synergistic flame-retardant cotton fabrics. The chemical structure of AMP-Na2/L-Cys monomers, the surface morphology, residual carbon morphology, thermal property and flame retardant property of photografted flame retardant cotton fabrics are analyzed. FT-IR and 1H NMR spectra verified the AMP-Na2 and L-Cys monomers with unsaturated double bonds. Scanning electron micrographs revealed the carbon residue of photografted fiber maintains a natural curled and fibers shape. TGA showed the major pyrolysis temperature of photografted cotton fabric declined by 42℃, with the weight loss reduced by 21.6%, proving that good charring effect. The continuous burning and smoldering time of photografted cotton fabric are decreased to 0s. The experimental results indicate that AMP-Na2/L-Cys monomers can reveal good durability and remarkable flame retardancy property to cotton fabrics via facile treatment of photografting.
Mild Progressive Osseous Heteroplasia Overlap Syndrome With PTH and TSH Resistance Appearing During Adolescence and Not Early Childhood
Authors: Ozaki Kayo , Mituboshi Akari , Nagai Masashi , Nishiyama Atushi , Nishimura Gen , Morisada Naoya , Iijima Kazumoto
Published: May 2021

Purpose: Progressive osseous heteroplasia (POH), a genetic disorder, is associated with Albright’s hereditary osteodystrophy (AHO), pseudohypoparathyroidism, and primary osteoma cutis and has common features of superficial ossification and GNAS-inactivating mutations. Disorders due to GNAS­-inactivating mutations are classified as “inactivating parathyroid hormone (PTH)/PTHrP signaling disorder type 2.” This study reports a case of mild POH overlap syndrome to improve understanding of genotype–phenotype correlations.Methods: A 13-year-and-6-month-old Japanese boy was referred to our hospital with a chief complaint of the lower limb length difference. He underwent clinical, biochemical, radiological, and genetic studies.Results: He showed sporadic GNAS mutation, deep ectopic ossification, small for gestational age (SGA), congenital tooth defect, and lack of AHO features; he met the diagnostic criteria for POH, and mild PTH and TSH resistance was detected. He had constant hyperphosphatasemia and hypocalciuria. At the age of 10 years, he occasionally experienced high iPTH levels. The pituitary stimulation test showed a normal response of all hormones at 3 years of age, but TSH response was decreased (previously 0.770, peak value 4.144 μIU/mL) in the TRH loading test at age 13 years and 6 months. DNA analysis showed a heterozygous p.D189MfsTer14 mutation of GNAS. The parents did not carry this mutation.Conclusion: We report a rare case of POH overlap syndrome with PTH/TSH resistance that appeared in adolescence rather than early childhood. Cases diagnosed with POH in early childhood also require reassessment during adolescence. Further studies of the GNAS heterozygous mutation p.D189MfsTer14 may reveal factors involved in POH overlap syndrome.
An Adaptive Trajectory Tracking Controller of a Multi-joint Snake Robot Considering Non-holonomic Constraints
Authors: Li Dongfang , Wang Chao , Deng Hongbin , Huang Jie
Published: May 2021

Multi-joint snake robot is a vital reconnaissance, surveillance and attack weapon in national defence and military in the future. To study the trajectory tracking problem of a multi-joint snake robot with high redundancy and multi-degree of freedom in the plane, an adaptive trajectory tracking controller of a multi-joint snake robot considering non-holonomic constraints is proposed in this paper. The adaptive trajectory tracking controller replaces unknown parameters in the environment wi t h estimated values, which effectively solves the negative effects caused by uncertain and time-varying environmental parameters in the process of the robot movement and realizes the stability of the controller. Firstly, a new dynamical model of a multi-joint snake robot is established through coordinate transformation. Secondly, the control objective of the controller of the multi-joint snake robot is established. Thirdly, the proposed controller of the multi-joint snake robot is designed by the Backsteppi n g method to realize the control of the joint angle tracking error, link angle tracking error, actuator torque error and motion speed error of the robot. Then, a suitable Lyapunov function is found to verify the stability of the controller. Finally, through the MATLAB simulation and prototype experiment, the motion process of the multi-joint snake robot is observed, the trajectory tracking performance of the robot is analyzed, and the effectiveness of the adaptive trajectory tracking controller is verified.
Cervical Ripening With Multiple Medical or Combined Induction Methods: Risks of Subsequent Preterm Birth in Nulliparous Women
Authors: Farago Naama , Ginsberg Yuval , Bachar Gal , Beloosesky Ron , Vitner Dana , Weiner Zeev , Ganem Nadir , Khatib Nizar
Published: May 2021

Objectives: Cervical ripening is one of the most frequently used procedures in modern obstetrics; it can be conducted with mechanical (single or double balloon), medical (PGE2), or combinations of both methods. We aimed to determine the impact of combined methods on the risk of preterm birth in subsequent pregnancy, in nulliparous women. Methods: A retrospective cohort study of term singleton gestations in nulliparous women, who were induced by mechanical, medical, or combined methods for any indication, managed at one tertiary medical center from 2019 to July 2019, and had their subsequent second birth in our institution. Study groups were compared to a control group of nulliparous women not induced. The primary outcome was risk of preterm labor in the second consecutive birth. Secondary outcomes included maternal and fetal complications, postpartum hemorrhage, chorioamnionitis, mode of delivery, and fetal Apgar score. Results: Our cohort included 1277 nulliparous women who underwent cervical ripening with mechanical, medical, or combined methods, and a subsequent singleton live birth in our institution. Our study group consisted of 942 women induced by one dose of PGE2, 248 women induced by multiple doses of PGE2 or combined methods, and 87 women induced by mechanical method. The study group was matched to 3903 women in the control group. Demographic data of the four groups were identical, including maternal age, body mass index, and maternal diseases. The rates of spontaneous pre-term birth in the subsequent births, defined as birth at < 37 weeks, did not differ among the four groups (4.9% in single dose group, 2% in multiple induction group, 6.9% in mechanical induced group, and 4.3% in the control group). Moreover, the rates of spontaneous early preterm birth at < 34 weeks did not differ among the groups. Conclusions: Cervical ripening with combined methods or multiple medical doses did not increase the rate of subsequent spontaneous preterm births in nulliparous women. The rate of maternal or fetal complications was identical in our study and control group.
Patterns of pre-operative opioid use affect the risk for complications after total joint replacement
Authors: Ravi Bheeshma , Pincus Daniel , Croxford Ruth , Leroux Timothy , Paterson Michael , Hawker Gillian , Redelmeier Donald A.
Published: May 2021

Background Preoperative opioid use has been shown to increase the risk for complications following total joint arthroplasty (TJA); however, these studies have not always accounted for differences in co-morbidities and socio-demographics between patients that use opioids and those that do not. They have also not accounted for the variation in degree of pre-operative use. The objective of this study was to determine if preoperative opioid use is associated with risk for surgical complications after TJA, and if this association varied by degree of use. Methods Population-based retrospective cohort study. Older adult patients undergoing primary TJA of the hip, knee and shoulder for osteoarthritis between 2002 and 2015 in Ontario, Canada were identified. Using accepted definitions, patients were stratified into three groups according to their preoperative opioid use: no use, intermittent use and chronic use. The primary outcome was the occurrence of a composite surgical complication (surgical site infection, dislocation, revision arthroplasty) or death within a year of surgery. Intermittent and chronic users were matched separately to non-users in a 1:1 ratio, matching on TJA type plus a propensity score incorporating patient and provider factors. Results Overall, 108,067 patients were included in the study; 10% (N=10,441) used opioids on a chronic basis before surgery and 35% (N=37,668) used them intermittently. After matching, neither intermittent nor chronic pre-operative opioid use were associated with an increased risk for complications after TJA. Conclusions Overall, less than half of patients undergoing TJA used opioids in the year preceding surgery; the majority used them only intermittently. Pre-operative opioid use is not associated with an increased risk for complications after TJA.
Assessment of the Prevalence and Associated Risk Factors of Pediatric Hydrocephalus in Diagnostic Centers in Addis Ababa, Ethiopia
Authors: Mulugeta Blein , Seyoum Girma Gedion , Mekonnen Abebe , Ketema Elbet
Published: May 2021

Background: Hydrocephalus (HCP) is defined as pathophysiology with disturbed cerebrospinal fluid. Neither qualitatively nor quantitatively are there adequate data to determine the prevalence and incidence of HCP in the developing world. HCP is a treatable condition that when left untreated, has fatal consequences.Objective: The objective of this study was to assess the prevalence of pediatric HCP and associated risk factors in diagnostic centers in Addis Ababa.Methods: A cross-sectional facility-based study was conducted over a retrospective and prospective data collection periods. Children aged 5 years and below who came to the four diagnostic centers for MRI/CT examination were studied. The collected data were analyzed using binary logistic regression. Result: The retrospective study included 639(58%) males, 462 (42%) females, and 753 (68.4%) infants were aged younger than 24 months. The mean age calculated was 22.3 months. Children diagnosed with HCP were 245 (22.3%); of these HCP cases, 153(62.4%) were classified as non-communicating HCP. This study identified infants aged younger than 24 months to be significantly associated with HCP (P<0.05). Regarding the gender and age distribution of the prospective study, 57(57.6%) males, 42 (42.4%) females; a mean age of 24.9 months and 60 (60.6%) infants aged younger than 24 months were included. Children diagnosed with HCP were 23 (23.2%); of these HCP cases, 13(56.5%) were classified as non-communicating HCP. Inadequate consumption of folic acid and the familial association of HCP were found to be statistically significant (P<0.05). Conclusion: The results of this study suggest that the high prevalence of HCP was due to the high prevalence of aqueductal stenosis and neural tube defects; with a small contribution of post-infectious causes. The majority of infants who present with HCP were aged younger than 24months.
Nintedanib in Idiopathic and Secondary Pleuroparenchymal Fibroelastosis
Authors: Nasser Mouhamad , Si-mohamed Salim , Turquier Ségolène , Traclet Julie , Ahmad Kais , Philit Francois , Bonniaud Philippe , Chalabryesse Lara , Thivolet-Béjui Francoise , Cottin Vincent
Published: May 2021

Background: Pleuroparenchymal fibroelastosis (PPFE) has a variable disease course with dismal prognosis in the majority of patients with no validated drug therapy. This study is to evaluate the effect of nintedanib in patients with idiopathic and secondary PPFE. Patients admitted to a tertiary care center (2010-2019) were included into this retrospective analysis if they had a multidisciplinary diagnosis of PPFE, had been followed-up for 3 months or more, and had lung function tests and chest CTs available for review. Changes in pulmonary function tests were assessed using non-parametric tests and linear mixed effect model. Lung volumes were measured with lobar segmentation using chest CT.Results: Out of 21 patients with PPFE, nine had received nintedanib, six had received another treatment and another six patients were monitored without drug therapy. Annual FVC (% of predicted) relative decline was -13.6 ±13.4 %/year before nintedanib and -1.6 ±6.02 %/year during nintedanib treatment (p=0.014), whereas no significant change in FVC% relative decline was found in patients receiving another treatment (-13.25 ±34 before vs -16.61 ±36.2 %/yr during treatment; p=0.343). Using linear mixed effect model, the slope in FVC was -0.97 %/month (95% CI: -1.42; -0.52) before treatment and -0.50 %/month (95% CI: -0.88; 0.13) on nintedanib, with a difference between groups of + 0.47%/month (95% CI: 0.16; 0.78), p=0.004. The decline in the upper lung volumes measured by CT was -233 mL/yr ± 387 mL/yr before nintedanib and -149 mL/yr ± 173 mL/yr on nintedanib (p= 0.327). Nintedanib tolerability was unremarkable.Conclusion: In patients with PPFE, nintedanib treatment might be associated with slower decline in lung function, paving the way for prospective, controlled studies.
Multiple metabolic phenotypes as screening criteria are correlated with the plant growth-promoting ability of rhizobacterial isolates
Authors: Shi Peng , Zhang Jianli , Li Xingyue , Zhou Liyun , Luo Hui , Wang Li , Zhang Yafan , Chou Minxia , Wei Gehong
Published: May 2021

Aims
Most preliminary screening criteria for plant growth-promoting (PGP) rhizobacteria (PGPR) are based on traditional knowledge of PGP mechanisms and do not always work well due to complex plant–microbe interactions. The aim of this study was to analyze the correlation between the metabolic phenotypes of rhizobacterial isolates and their PGP ability. The feasibility of using these phenotypes as preliminary screening criteria for PGPR was also evaluated.
Methods
Twenty-one rhizobacterial isolates were screened for their PGP ability, traditional PGP traits, and multiple metabolic phenotypes that are not directly related to PGP mechanisms, but are possibly related to rhizosphere colonization. Correlations between the PGP traits or metabolic phenotypes and increases in plant agronomic parameters were analyzed to find the indicators that are most closely related to PGP ability.
Results
The utilization of 11 nutrient substrates commonly found in root exudates, such as D-salicin, β-methyl-D-glucoside, D-cellobiose, D-maltose, D-trehalose, and dextrin, was significantly positively correlated with the PGP ability of the rhizobacterial isolates. The utilization of one amino acid and two organic acids, namely L-aspartic acid, α-keto-glutaric acid, and formic acid, was negatively correlated with PGP ability. There were no significant correlations between four PGP traits tested in this study and the PGP ability.
Conclusion
The ability of rhizobacterial isolates to metabolize nutrient substrates that are identical or similar to root exudate components may act as better criteria than PGP traits for the primary screening of PGPR, because rhizosphere colonization is a prerequisite for PGPR to affect plants.
Thymoquinone loading into hydroxyapatite/alginate scaffolds accelerated the osteogenic differentiation of the mesenchymal stem cells
Authors: Rahmani-Moghadam Ebrahim , Talaei-Khozani Tahereh , Zarrin Vahideh , Vojdani Zahra
Published: May 2021

Background: Hydroxyapatite (HA) can be loaded by some osteogenic inducing agents such as thymoquinone (TQ) and alginate. This study was performed to investigate the effect of TQ loading into HA/alginate scaffolds on osteogenic differentiation capability of mesenchymal stem cells.Methods: HA scaffolds were fabricated by casting and sintering method and impregnated by TQ containing alginate. The stem cells were loaded onto the scaffolds and induced to differentiate into osteoblasts. Alkaline Phosphatase (ALP) activity, Alizarin Red S, Real-Time qRT-PCR, and MTT assessments were done. Finally, the cells were examined with a light microscope, confocal microscope, and SEM.Results: The results showed that the presence of the alginate decelerates the degradation rate and reinforces the mechanical strength. while the presence of TQ had no significant influence on physical and mechanical properties of the HA/alginate scaffolds, it led to a significant increase in ALP activity and expression of collagen, osteopontin, and osteocalcin at early phase of differentiation. Also, TQ administration had no impact on calcium deposition and proliferation as well as bone-marker expression at long term differentiation.Conclusion: TQ accelerates the differentiation of the stem cells into the osteoblasts without changing the properties of the scaffolds, and the HA/alginate/TQ scaffold can be used as a scaffold with osteogenic properties in bone tissue engineering applications.
Knowledge, attitude and practice of clinicians about antimicrobial stewardship and resistance among hospitals of Pakistan: A multicenter cross-sectional study
Authors: Ashraf Sohaib , Ashraf Shoaib , Ashraf Moneeb , Imran Muhammad Ahmad , Ahmad Zawar , Hafsa Hadiqa tul , Awais Abeer Bin , Kalsoom Larab , Akmal Rutaba , Farooq Iqra , Ashraf Sidra , Habib Zaighum , Ghufran Muhammad , Sherazi Syed Sami Hussain , Akram Muhammad Kiwan , Rafique Sundas , Nawaz Khawar , Safdar Zartasha , Ashraf Muhammad , Saboor Qazi Abdul , Humayun Ayesha , Izhar Mateen , Consortium ONE Health
Published: May 2021

Considering that antimicrobial resistance (AMR) is a global challenge, there is a dire need to gauge the knowledge, attitude, and practice (KAP) of clinicians in endemic countries. The aim of the current multicenter, cross-sectional study was to highlight the knowledge, aptitude and practice gaps in antimicrobial (AM) stewardship and AMR among practicing doctors working in public tertiary care teaching hospitals of Lahore, Pakistan. A KAP survey, based on a self-administered questionnaire containing 45 questions, was conducted among 336 clinicians practicing in 6 randomly selected hospitals of Lahore, Pakistan. Overall, 92% of the clinicians considered AMR as a worldwide problem but only 66% disagreed that cold and flu symptoms require antibiotics. Moreover, around 68% doctors felt confident about their practice in AM but still 96% felt need to get more knowledge about AM. Need to establish courses on rational antibiotic use was demanded by 84% of participants. The main contributing factors considered for AMR by the doctors included excessive AM usage in medical profession (87.1%) and multiple antibiotics per prescription (76.4%). Pharmacologically, AM spectrum was accurately chosen by 1.4% (ampicillin), 0.003% (erythromycin) and 0% (levofloxacin). Clinically, a more than 50% of clinicians used miscellaneous AM for empirical therapy of respiratory tract infection and cholecystitis. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 25. The knowledge of clinicians is relatively poor in AM spectrum and drugs of choice for certain infections. However, they know about their short comings with positive approach towards improvement.
Cooling Strategies for Thermal Comfort in Cities: A Review of Key Methods in Landscape Design
Authors: Zou Mo , Zhang Heng
Published: May 2021

Under the climate change scenario, the negative impacts of urban heat island (UHI) will exacerbate due to unsustainable urban planning and human activities. Thermal comfort has close relationships with UHI in urban areas. This paper is based on the studies of urban heat island, thermal comfort, microclimate and urban planning in cities in the recent decade, combined with cross-analysis research method. The key topics include vegetation and water conditions, the albedo of materials, urban morphology and more. By the comparative case studies in landscape projects, the results further reveal that the density of tree canopies, the natural structure and density of ground cover, the form of water features, the colour and texture of materials, and the scale of shading structures have different cooling effect and performance in outdoor thermal comfort improvement with specific features in the landscape design. It is also found that there are some external conditions that can influence design determinations in real practices. The purpose of this study is to provide theoretical research methods and evaluation of thermal comfort landscape design elements, and to provide guidance for future sustainable city research and landscape design.
Correlation of Preoperative Gd-EOB-DTPA-Contrast-Enhanced MRI With TGF-β1 Expression in Hepatocellular Carcinoma
Authors: Mo Zhiqing , Long Liling , Zhou Xiaojiao , Ding Hao
Published: May 2021

Purpose: To investigate the feasibility of preoperative gadolinium ethoxybenzyl diethylenetriaminepentaacetic acid (Gd-EOB-DTPA) -enhanced magnetic resonance imaging (MRI) related signs in predicting transforming growth factor-β1(TGF-β1) gene expression in hepatocellular carcinoma (HCC).Materials and methods: Sixty patients with HCC (55 males, mean age 52.6±12 years) who underwent preoperative MRI enhancement were retrospectively analyzed. Qualitative and quantitative features of Gd-EOBDTPA-enhanced MRI in these pathologically confirmed HCC patients were analyzed. Reverse transcription-polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC) were performed to determine the mRNA and protein levels of TGF-β1 in HCC. The relationship between these imaging features and TGF-β1 expression level in HCC was evaluated by rank sum test, correlation analysis and logistic regression analysis.Results: RT-PCR indicated that the expression level of TGF-β1 mRNA was statistically significant with the change of hepatobiliary signal (P=0.009). Immunohistochemical results indicated that the apparent diffusion coefficient (ADC) value of tumor was statistically significant at the protein level (P=0.038).There was no statistical significance in the distribution of other image features. Binary logistic regression analysis suggested that heterogeneous signals in hepatobiliary phase were independent risk factors for high TGF-β1 expression in HCC (P=0.012,OR=5.333,95%CI:1.437-19.801). Multivariate logistic regression analysis showed that ADC value was not an independent risk factor for TGF-β1 expression.Conclusions: heterogeneous signal performance in the hepatobiliary phase and/or ADC values of HCC are potential indicators of high expression of TGF-β1. Gd-EOB-DTPA-enhanced MRI may be useful in the selection of targeted therapies for patients with HCC.
Expression of Immune Checkpoint Regulators, Cytotoxic T Lymphocyte Antigen 4 (CTLA-4) and CD137 in Cervical Carcinomas
Authors: Kassardjian Ari , Moatamed Neda
Published: May 2021

Introduction: Immune checkpoint inhibitors in cancer therapy has a significant role in oncology. One of these immune checkpoint mediators is cytotoxic T-lymphocyte associated protein 4 (CTLA-4). Inhibition of the CTLA-4 pathway has already led to the FDA approval of Ipilimumab (anti-CTLA-4), a targeted therapy for melanoma and other malignancies. CD137 is an inducible, costimulatory receptor of the tissue necrosis factor receptor superfamily expressed on activated immune cells. Clinical trials had also been set for anti-CD137 in several malignancies. We investigated the expression of CTLA-4 and CD137 antibodies in benign and malignant uterine cervical tissues. Method: We assessed CTLA-4 and CD137 expression on a tissue microarray (TMA) comprising of 100 normal, non-neoplastic, and neoplastic cervical tissues. When detected as strong granular cytoplasmic reaction in the epithelial cells, CTLA-4 expression was scored as positive. For CD137, the results were recorded based on the presence or absence of staining reaction on the cell membranes of the lymphoplasmacytic infiltrate. Result: Overall, CTLA-4 was positive in 30% (30/100) of the cervical malignancies. Subcategorically, 20% of invasive endocervical adenocarcinomas, 62.5% of adenosquamous carcinomas, and 31% of squamous cell carcinomas were positive for CTLA-4 with a tendency toward lower grades SCCs. CD137 was positive in lymphoplasmacytic infiltrates of all endocervical adenocarcinomas, 90.5% of squamous cell carcinoma, and 87.5% cores of adenosquamous carcinomas. Conclusion: This study has found a significant expression of CTLA-4 in cervical cancer cells and CD137 positivity of lymphoplasmacytic infiltrates with potentials for future targeted immunotherapy.
Clinical and biomarker analyses of sintilimab versus chemotherapy as second-line therapy for advanced or metastatic esophageal squamous cell carcinoma: a randomized, open-label phase 2 trial (ORIENT-2)
Authors: Xu Jian Ming , Li Yi , Fan Qingxia , Shu Yongqian , Yang Lei , Cui Tongjian , Gu Kangsheng , Tao Min , Wang Xiuwen , Cui Chengxu , Xu Nong , Xiao Juxiang , Gao Quanli , Liu Yunpeng , Zhang Tao , Bai Yuxian , Li Wei , Zhang Yiping , Dai Guanghai , Ma Dong , Zhang Jingdong , Bai Chun-Mei , Huang Yun-Chao , Liao Wangjun , Wu Lin , Chen Xi , Yang Yan , Wang Junye , Ji Shoujian , Zhou Hui , Wang Yan , Ma Zhuo , Wang Yanqi , Peng Bo , Sun Jiya , Mancao Christoph
Published: May 2021

This randomized, open-label, multi-center phase 2 study (ClinicalTrials.gov, number NCT03116152) assessed sintilimab, a PD-1 inhibitor, versus chemo in patients with advanced esophageal squamous cell carcinoma (ESCC) refractory to first-line (1L) chemotherapy. The primary endpoint was overall survival (OS), while exploratory endpoint was the association of biomarkers with treatment efficacy. The median OS in the sintilimab group was significantly prolonged compared with that of the chemotherapy group, (objective response rates 12.6% and 6.3 %, respectively). Incidence of treatment-related adverse events of grade 3–5 was lower with sintilimab than with chemotherapy (20.2 vs. 39.1 %). Patients with high TCR clonality and low mTBI showed the longest median OS (15.0 mo), while patients with low NLR at 6 wk post-treatment had a significantly prolonged median OS compared with those with high NLR. High expression of T-follicular helper cells or activated B-cell signature was significantly associated with longer progression-free survival in the sintilimab group.
Navigating the COVID-19 Data Landscape: Automated Hypothesis Generation using Topological Data Analysis
Authors: Kamruzzaman Methun , Bielskas Matthew , Krishnamoorthy Bala , Marathe Achla , Vullikanti Anil , Kalyanaraman Ananth
Published: May 2021

Background: There have been significant spatio-temporal variations in how the COVID-19 pandemic has unfolded in different parts of the country. While a huge amount of data related to the COVID-19 pandemic has become available including data on disease outcomes, different kinds of behaviors and diverse interventions, along with a number of co-variates, analyzing this data to characterize the spatio-temporal variations and gleaning actionable insights and hypotheses on different factors driving the pandemic remains a big challenge. The objective of this study is to identify in an unsupervised fashion the key spatio-temporal patterns, anomalies, and associated factors in the spread of COVID-19 in different regions that can be used in the development of models and the planning of public health policies. Methods: We present a topological data analysis (TDA) framework for exploring COVID-19 data that supports two types of analytical functions: i) discover disease epochs in the trajectories that reveal spatio-temporal events of interest; and ii) modeland better elucidate interactions between variables of different disease outcomes (e.g., number of cases, hospitalizations , deaths) and intervention mechanisms (e.g., social distancing, contract tracing). Results: Our TDA framework reveals several insights in an automated manner by identifying co-evolving and divergent cohorts of states with respect to various disease outcomes (e.g., number of new cases) and measures of behavior or interventions (e.g. social distancing, COVID exposure, hospital bed utilization). Our framework also identifies the branching points at which the different cohorts start evolving separately. Conclusions: The illustrative case studies show that our TDA-based analytical framework can help navigate the epidemic data landscape in an automated and guided manner, and can provide insights to formulate hypotheses and devise sound, data-aided public health policies.
Challenges of Emergency Medical Services utilization by the older adults in Tabriz, Iran
Authors: Azizi-Zeinalhajlou Akbar , Ghafouri Rouzbeh Rajaei , Sahebihagh Mohammad Hasan , Mohammadpoorasl Asghar , Parsian Zahra , Yousefi Mahmood
Published: May 2021

Background: As the number of older adults is increasing, the health care services such as Emergency Medical Services (EMS) should be promoted. One of the preconditions for the use of health services is awareness of these services and their terms of use. This study is conducted to evaluate the awareness of the older adults in Tabriz about EMS and the terms of services. Methods: This cross-sectional survey was conducted in a representative sample of over 60 years old noninstitutionalized population in Tabriz (Iran). It included 1062 participants (514 males and 548 females) who were selected using Probability Proportional to Size (PPS) sampling method. Service awareness is considered as being informed about the existence of the EMS. Knowledge about EMS is defined as knowing the EMS phone number and knowledge about its free and 24-hour service. After completing the informed consent, data collection was conducted in the households of the participants. Data analysis was conducted using logistic regression. Results: The findings showed that 47% of the older adults were not familiar with the EMS system. Awareness of EMS in males (63.4%) was higher than females (44.2%) and also it was higher among those born in cities (61.2%) than rural areas (46.1%). Holding primary, secondary, and higher education compared with illiteracy had higher chance of awareness of EMS by more than 2, 4, and 12 times respectively (OR= 2.53, OR= 4.69, and OR= 12.09). Conclusion: Due to high rate of illiteracy and low public awareness, older adults do not have appropriate knowledge about the facilities, conditions, and terms of using EMS and may not be able to demand some of their essential services; therefore, notifying and increasing awareness about the available services to older adults are necessary.
Analyzing the Impact of ATF3 in Tumorigenesis and Immune Cell Infiltration of Ovarian Tumor: A Bioinformatics Study
Authors: wu Xiujuan
Published: May 2021

ATF3 is an essential transcription activator in regulating cancer-related genetic expression. To identify the role of ATF3 in ovarian, we investigated the correlation between ATF3 expression and the clinicopathological properties using multiple database. The cBioPortal and GEPIA database displayed the clinical information of ovarian patients harboring or without harboring ATF3 mutation. Furthermore, we assessed the relationship between survival and ATF3 expression level using Kaplan-Meier plotter, which reveals that the ovarian patients with higher expression of ATF3 suffered the worse overall survival and progression-free survival. The differentially expressed genes were analyzed using Gene Ontology, protein-protein interaction network and gene set enrichment analysis to identify the hub gene and critical pathways, significantly affecting the tumorigenesis of ovarian tumor. Finally, we assessed the correlation between ATF3 and immune cell infiltration using Tumor Immunoassay Resource (TIMER) database. The results demonstrated that higher expression is positive correlation with macrophage infiltration, expression for M1 and M2 type macrophages. Our study suggests that ATF3 can regulate the cell cycle and heme-related oxidative phosphorylation process, and it may be a critical factor to regulate the macrophage cell to be infiltrated into ovarian cancer. ATF3 can be as a biomarker for diagnosis and therapy of ovarian.
Ultra-fast Tunable Optoelectronic Half Adder/subtractor based on Photonic Crystal Ring Resonators Covered by Graphene Nanoshells
Authors: Naghizade Saleh , Saghaei Hamed
Published: May 2021

This paper reports a new design of a tunable optoelectronic half adder/subtractor. Two photonic crystal (PhC) ring resonators are used to realize the proposed structure. Several silicon rods surrounded by silica rods covered with graphene nanoshells (GNSs) form every PhC ring resonator. Setting the chemical potential of GNS with an appropriate gate voltage, we can tune the PhC resonant mode as desired. The plane wave expansion technique is used to study the photonic band structure of the fundamental PC microstructure, and the finite-difference time-domain method is employed in the final design for solving Maxwell's equations to analyze the light propagation inside the structure. We systematically study the effects of physical parameters on the transmission reflection and absorption spectra. By optimizing the geometric dimensions, resonant absorption peaks can be excited at the same time for GNSs. Our numerical results also reveal the maximum time response is about 0.8 ps. The 200 µm2 area of the proposed half adder/subtractor makes it the building block of every photonic integrated circuit. Also, the design of various fast signal processing systems in optical communication networks is possible due to using tunable GNSs in PhC ring resonators. This study can introduce the use of two-dimensional materials in the design and implementation of logic circuits.
Early Pregnancy Human Decidua Gamma/Delta T Cells Exhibit the Tissue Resident and Specific Functional characteristics
Authors: Yang Shuo , Feng Ting , Ma Yong Cheng , Wang Hao Tie , Chen Qin Hong , Li Man Li , Liu Yuan , Zhou Bin , Zhou Rong , Li Hong
Published: May 2021

Background: A successful pregnancy is a complicated process that builds upon two aspects of the maternal immune system that needs to be balanced. As one of the dominant groups of cells at the maternal fetal interface, the decidual γδ T cells have attracted great research attention in normal pregnancy or miscarriage. However, the role of γδ T cells in fetal growth still remains poorly studied. Results: In this study, we identified γδ T cells were enriched and resident in decidua during early pregnancy, and early decidual γδ T cells were involved in the secretion of growth factors, including growth differentiation factor 15 (GDF15) and bone morphogenetic protein 1 (BMP1). Decrease of these growth factors could impaire fetal development, resulting in fetal growth restriction. We also observed that the early decidual γδ T cells exhibited stronger cytokine secretion characteristic, but its cytotoxicity against A549 cells was weaker, when compared with the γδ T cells in peripheral blood mononuclear cells (PBMCs). In addition, the functional abilities of early decidual γδ T cells in promoting trophoblast cell proliferation, migration, invasion and tube formation were also significantly stronger than those in γδ T cells of PBMCs. Conclusions: These findings highlighted the importance of γδ T cells in fetal growth and maternal immune tolerance during pregnancy, which is different from γδ T cells in PBMCs, and encouraged further research in this field.
COVID-19 and Medical Education in Africa: A Cross Sectional Analysis of the Impact on Medical Students
Authors: Bernard Alec , Indig Gnendy , Byl Nicole , Abdu Amani Nureddin , Menegesha Dawit Tesfagiorgis , Admasu Bereket Alemayehu , Holman Elizabeth
Published: May 2021

Background: The African continent currently experiences 25% of the global burden of disease with only 1.3% of the world’s healthcare workers. The COVID-19 pandemic has caused unprecedented disruption to medical education systems, increasing the strain on already-vulnerable regions. Our study examines the impact of COVID-19 on medical students across 33 countries in the African continent. Methods: A 39-item anonymous electronic survey was developed and distributed to medical students across Africa through social networks to assess the impact of the COVID-19 pandemic on medical education. The survey assessed the domains of: class structure changes and timing, patient interactions, exam administration, learning environment satisfaction, mental health impacts, and volunteer opportunities/engagement.Results: 694 students across 33 countries participated. 88% of respondents had their classes suspended for varied lengths of time during the pandemic, and from these students 51% of them resumed their classes. 83% of students felt they were in a supportive learning environment before the pandemic, which dropped to 32% since the start. The proportion of students taking exams online increased (6% to 26%, p<.001) and there was a corresponding decrease in the proportion of students seeing patients as a part of their education (72% to 19%, p<.001).Conclusion: COVID-19 is harming medical students in Africa and is likely to worsen the shortage of the future’s healthcare workforce in the region. Pandemic-related impacts have led to a degradation of the learning environment of medical students. Medical schools have shifted online to differing degrees and direct patient-care in training of students has decreased. This study highlights the urgent need for flexible and innovative approaches to medical education in Africa