bluuebunny/crossref_metadata_2025 huggingface dataset:
The financing need of equitable provision of paid maternal leave in the informal sector in Indonesia: a comparison of estimation methods
Authors: Siregar Adiatma Y. M. , Pitriyan Pipit , Hardiawan Donny , Zambrano Paul , Mathisen Roger
Published: April 2021

Background

Providing an enabling environment for breastfeeding is hampered by the inequitable implementation of paid maternity leave, primarily due to perceived or actual financial costs. To estimate the real cost of paid maternity leave requires using reliable methods. We compared methods utilized in two recent studies in Indonesia. Study A estimated the financial need of providing paid maternity leave in the formal sector with a 10-year forecast at 21% coverage of eligible mothers, while study B estimated similar costs for the informal sector at 100% coverage annually. Results are critical for guiding future application of either method to inform paid maternity leave policies.

Methods

We compared number of covered mothers working informally, total annual cost, and cost per mother. We modified some parameters used in study A (method A) to be similar to study B (method B) for comparison, namely the period of estimate (annual), coverage (100%), estimate of women potentially breastfeeding, exchange rate, female labor force participation rate, the percentage of women working in the informal sector, and adding administration cost.

Results

The methods differ in determining the number of mothers working in the informal sector who gave birth, the minimum wage as unit cost, and administrative cost. Both studies estimated the cost at various lengths of leave period. Method A requires more macro (e.g. national/regional) level data, while method B involves (e.g. individual) micro level data. We compared the results of method A with method B, respectively: 1) number of covered mothers working informally were 1,425,589 vs. 1,147,204; 2) total annual costs including administrative costs were US$650,230,167 vs. US$633,942,726, and; 3) cost/mother was US$456 vs US$553.

Conclusion

Certain flexibilities can be applied to both methods, namely using parameters specific to respective regions (e.g. provincial level parameters), flexible period of analysis, and the use of administrative cost. In a setting where micro data is scarce and not easily accessible, method A provides a feasible approach, while method B will be most appropriate if suitable micro data is available. Future comparison studies in other settings are needed to provide further evidence on the strengths and weaknesses of both methods.
Diagnostic performance of Oncuria™, a urinalysis test for bladder cancer
Authors: Hirasawa Yosuke , Pagano Ian , Chen Runpu , Sun Yijun , Dai Yunfeng , Gupta Amit , Tikhonenkov Sergei , Goodison Steve , Rosser Charles J. , Furuya Hideki
Published: April 2021

Background

Due to insufficient accuracy, urine-based assays currently have a limited role in the management of patients with bladder cancer. The identification of multiplex molecular signatures associated with disease has the potential to address this deficiency and to assist with accurate, non-invasive diagnosis and monitoring.

Methods

To evaluate the performance of Oncuria™, a multiplex immunoassay for bladder detection in voided urine samples. The test was evaluated in a multi-institutional cohort of 362 prospectively collected subjects presenting for bladder cancer evaluation. The parallel measurement of 10 biomarkers (A1AT, APOE, ANG, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) was performed in an independent clinical laboratory. The ability of the test to identify patients harboring bladder cancer was assessed. Bladder cancer status was confirmed by cystoscopy and tissue biopsy. The association of biomarkers and demographic factors was evaluated using linear discriminant analysis (LDA) and predictive models were derived using supervised learning and cross-validation analyses. Diagnostic performance was assessed using ROC curves.

Results

The combination of the 10 biomarkers provided an AUROC 0.93 [95% CI 0.87–0.98], outperforming any single biomarker. The addition of demographic data (age, sex, and race) into a hybrid signature improved the diagnostic performance AUROC 0.95 [95% CI 0.90–1.00]. The hybrid signature achieved an overall sensitivity of 0.93, specificity of 0.93, PPV of 0.65 and NPV of 0.99 for bladder cancer classification. Sensitivity values of the diagnostic panel for high-grade bladder cancer, low-grade bladder cancer, MIBC and NMIBC were 0.94, 0.89, 0.97 and 0.93, respectively.

Conclusions

Urinary levels of a biomarker panel enabled the accurate discrimination of bladder cancer patients and controls. The multiplex Oncuria™ test can achieve the efficient and accurate detection and monitoring of bladder cancer in a non-invasive patient setting.
Biologically consistent dose accumulation using daily patient imaging
Authors: Niebuhr Nina I. , Splinter Mona , Bostel Tilman , Seco Joao , Hentschke Clemens M. , Floca Ralf O. , Hörner-Rieber Juliane , Alber Markus , Huber Peter , Nicolay Nils H. , Pfaffenberger Asja
Published: April 2021

Background

This work addresses a basic inconsistency in the way dose is accumulated in radiotherapy when predicting the biological effect based on the linear quadratic model (LQM). To overcome this inconsistency, we introduce and evaluate the concept of the total biological dose, bEQDd.

Methods

Daily computed tomography imaging of nine patients treated for prostate carcinoma with intensity-modulated radiotherapy was used to compute the delivered deformed dose on the basis of deformable image registration (DIR). We compared conventional dose accumulation (DA) with the newly introduced bEQDd, a new method of accumulating biological dose that considers each fraction dose and tissue radiobiology. We investigated the impact of the applied fractionation scheme (conventional/hypofractionated), uncertainties induced by the DIR and by the assigned α/β-value.

Results

bEQDd was systematically higher than the conventionally accumulated dose with difference hot spots of 3.3–4.9 Gy detected in six out of nine patients in regions of high dose gradient in the bladder and rectum. For hypofractionation, differences are up to 8.4 Gy. The difference amplitude was found to be in a similar range to worst-case uncertainties induced by DIR and was higher than that induced by α/β.

Conclusion

Using bEQDd for dose accumulation overcomes a potential systematic inaccuracy in biological effect prediction based on accumulated dose. Highest impact is found for serial-type late responding organs at risk in dose gradient regions and for hypofractionation. Although hot spot differences are in the order of several Gray, in dose-volume parameters there is little difference compared with using conventional or biological DA. However, when local dose information is used, e.g. dose surface maps, difference hot spots can potentially change outcomes of dose-response modelling and adaptive treatment strategies.
Unusual complications following left ventricular assisted device implantation: case series
Authors: Shalabi Amjad , Kachel Erez , Kassif Yigal , Faqeeh Muin , Sergey Preisman , Sternik Leonid , Grosman-Rimon Liza , Kinany Wadi , Amir Offer , Ram Eilon , Lavee Jacob , Grupper Avishay
Published: April 2021

Background

While left ventricular assisted devices (LVAD) have revolutionized the treatment of advanced heart failure, they are associated with a wide range of complications, including bleeding and infection which are the most common complications reported in the literature. Our case series report four unusual complications not related to gastrointestinal bleeding and infections and their management.

Case presentation

A 61 year old female after LVAD implantation with late onset of severe symptomatic aortic regurgitation treated by transfemoral transcatheter valve implantation (TAVI) with good long term results.

A 75 year old male patient with acute pump failure secondary to cable damage, who underwent urgent pump replacement. A 49 year old female patient with a history of myoma who developed massive uterine bleeding which was treated with emergent open hysterectomy after failed gonadotropin-releasing hormone therapy replacement. A 57 year old male patient with device display failure 1 month after LVAD implantation without the ability to monitor speed, power consumption and blood flow.

Conclusions

LVAD patients can be presented with a great variety of complications. Physicians should be aware of their manifestations and the management options.
TREM2/PLCγ2 signalling in immune cells: function, structural insight, and potential therapeutic modulation
Authors: Magno Lorenza , Bunney Tom D. , Mead Emma , Svensson Fredrik , Bictash Magda N.
Published: April 2021

The central role of the resident innate immune cells of the brain (microglia) in neurodegeneration has become clear over the past few years largely through genome-wide association studies (GWAS), and has rapidly become an active area of research. However, a mechanistic understanding (gene to function) has lagged behind. That is now beginning to change, as exemplified by a number of recent exciting and important reports that provide insight into the function of two key gene products – TREM2 (Triggering Receptor Expressed On Myeloid Cells 2) and PLCγ2 (Phospholipase C gamma2) – in microglia, and their role in neurodegenerative disorders. In this review we explore and discuss these recent advances and the opportunities that they may provide for the development of new therapies.
Chemotherapy-elicited exosomal miR-378a-3p and miR-378d promote breast cancer stemness and chemoresistance via the activation of EZH2/STAT3 signaling
Authors: Yang Qianxi , Zhao Shaorong , Shi Zhendong , Cao Lixia , Liu Jingjing , Pan Teng , Zhou Dongdong , Zhang Jin
Published: April 2021

Background

Not all breast cancer (BC) patients who receive neoadjuvant chemotherapy achieve a pathologic complete response (pCR), but the reasons for this are unknown. Previous studies have shown that exosomes produced in the tumor microenvironment in response to chemotherapy promote a chemotherapy-resistant phenotype in tumors. However, the role of BC chemotherapy-elicited exosomes in regulating chemoresistance is poorly understood.

Methods

Using commercial kits, serum exosomes were extracted from patients before neoadjuvant chemotherapy, after one cycle of chemotherapy and after four cycles of chemotherapy consisting of doxorubicin (DOX) and paclitaxel (PTX). Their miRNAs were sequenced, and the correlation between the sequencing results and chemotherapy effects was further verified by RT-qPCR using patient serum exosomes. Cell Counting Kit-8 (CCK-8) was used to detect chemosensitivity. Stemness was assessed by CD44+/CD24- population analysis and mammosphere formation assays. Chromatin immunoprecipitation (ChIP) experiments were performed to verify the binding of signal transducer and activator of transcription 3 (STAT3) to the promoter of miRNAs.

Results

Here, we provide clinical evidence that chemotherapy-elicited exosomal miR-378a-3p and miR-378d are closely related to the chemotherapy response and that exosomes produced by BC cells after stimulation with DOX or PTX deliver miR-378a-3p and miR-378d to neighboring cells to activate WNT and NOTCH stemness pathways and induce drug resistance by targeting Dickkopf 3 (DKK3) and NUMB. In addition, STAT3, which is enhanced by zeste homolog 2 (EZH2), bound to the promoter regions of miR-378a-3p and miR-378d, thereby increasing their expression in exosomes. More importantly, chemotherapeutic agents combined with the EZH2 inhibitor tazemetostat reversed chemotherapy-elicited exosome-induced drug resistance in a nude mouse tumor xenograft model.

Conclusion

This study revealed a novel mechanism of acquired chemoresistance whereby chemotherapy activates the EZH2/STAT3 axis in BC cells, which then secrete chemotherapy-elicited exosomes enriched in miR-378a-3p and miR-378d. These exosomes are absorbed by chemotherapy-surviving BC cells, leading to activation of the WNT and NOTCH stem cell pathways via the targeting of DKK3 and NUMB and subsequently resulting in drug resistance. Therefore, blocking this adaptive mechanism during chemotherapy may reduce the development of chemotherapy resistance and maximize the therapeutic effect.
Falls in ED patients: do elderly patients on direct oral anticoagulants bleed less than those on vitamin K antagonists?
Authors: Müller Martin , Chanias Ioannis , Nagler Michael , Exadaktylos Aristomenis K. , Sauter Thomas C.
Published: April 2021

Background

Falls from standing are common in the elderly and are associated with a significant risk of bleeding. We have compared the proportional incidence of bleeding complications in patients on either direct oral anticoagulants (DOAC) or vitamin K antagonists (VKA).

Methods

Our retrospective cohort study compared elderly patients (≥65 years) on DOAC or VKA oral anticoagulation who presented at the study site – a Swiss university emergency department (ED) – between 01.06.2012 and 01.07.2017 after a fall. The outcomes were the proportional incidence of any bleeding complication and its components (e.g. intracranial haemorrhage), as well as procedural and clinical parameters (length of hospital stay, admission to intensive care unit, in-hospital-mortality). Uni- and multivariable analyses were used to compare the studied outcomes.

Results

In total, 1447 anticoagulated patients were included – on either VKA (n = 1021) or DOAC (n = 426). There were relatively more bleeding complications in the VKA group (n = 237, 23.2%) than in the DOAC group (n = 69, 16.2%, p = 0.003). The difference persisted in multivariable analysis with 0.7-fold (95% CI: 0.5–0.9, p = 0.014) lower odds for patients under DOAC than under VKA for presenting with any bleeding complications, and 0.6-fold (95% 0.4–0.9, p = 0.013) lower odds for presenting with intracranial haemorrhage. There were no significant differences in the other studied outcomes.

Conclusions

Among elderly, anticoagulated patients who had fallen from standing, those under DOACs had a lower proportional incidence of bleeding complications in general and an even lower incidence of intracranial haemorrhage than in patients under VKAs.
Simplitigs as an efficient and scalable representation of de Bruijn graphs
Authors: Břinda Karel , Baym Michael , Kucherov Gregory
Published: April 2021

de Bruijn graphs play an essential role in bioinformatics, yet they lack a universal scalable representation. Here, we introduce simplitigs as a compact, efficient, and scalable representation, and ProphAsm, a fast algorithm for their computation. For the example of assemblies of model organisms and two bacterial pan-genomes, we compare simplitigs to unitigs, the best existing representation, and demonstrate that simplitigs provide a substantial improvement in the cumulative sequence length and their number. When combined with the commonly used Burrows-Wheeler Transform index, simplitigs reduce memory, and index loading and query times, as demonstrated with large-scale examples of GenBank bacterial pan-genomes.
Stimulation of regulatory T cells with Lactococcus lactis expressing enterotoxigenic E. coli colonization factor antigen 1 retains salivary flow in a genetic model of Sjögren’s syndrome
Authors: Akgul Ali , Maddaloni Massimo , Jun Sang Mu , Nelson Andrew S. , Odreman Vanessa Aguilera , Hoffman Carol , Bhagyaraj Ella , Voigt Alexandria , Abbott Jeffrey R. , Nguyen Cuong Q. , Pascual David W.
Published: April 2021

Background

Sjögren’s syndrome (SjS), one of the most common autoimmune diseases, impacts millions of people annually. SjS results from autoimmune attack on exocrine (salivary and lacrimal) glands, and women are nine times more likely to be affected than men. To date, no vaccine or therapeutic exists to treat SjS, and patients must rely on lifelong therapies to alleviate symptoms.

Methods

Oral treatment with the adhesin from enterotoxigenic Escherichia coli colonization factor antigen I (CFA/I) fimbriae protects against several autoimmune diseases in an antigen (Ag)-independent manner. Lactococcus lactis, which was recently adapted to express CFA/I fimbriae (LL-CFA/I), effectively suppresses inflammation by the induction of infectious tolerance via Ag-specific regulatory T cells (Tregs), that produce IL-10 and TGF-β. To test the hypothesis that CFA/I fimbriae can offset the development of inflammatory T cells via Treg induction, oral treatments with LL-CFA/I were performed on the spontaneous, genetically defined model for SjS, C57BL/6.NOD-Aec1Aec2 mice to maintain salivary flow.

Results

Six-week (wk)-old C57BL/6.NOD-Aec1Aec2 mice were orally dosed with LL-CFA/I and treated every 3 wks; control groups were given L. lactis vector or PBS. LL-CFA/I-treated mice retained salivary flow up to 28 wks of age and showed significantly reduced incidence of inflammatory infiltration into the submandibular and lacrimal glands relative to PBS-treated mice. A significant increase in Foxp3+ and IL-10- and TGF-β-producing Tregs was observed. Moreover, LL-CFA/I significantly reduced the expression of proinflammatory cytokines, IL-6, IL-17, GM-CSF, and IFN-γ. Adoptive transfer of CD4+ T cells from LL-CFA/I-treated, not LL vector-treated mice, restored salivary flow in diseased SjS mice.

Conclusion

These data demonstrate that oral LL-CFA/I reduce or halts SjS progression, and these studies will provide the basis for future testing in SjS patients.
Biocompatibility and radioprotection by newly characterized melanin pigment and its production from Dietzia schimae NM3 in optimized whey medium by response surface methodology
Authors: Eskandari Sahar , Etemadifar Zahra
Published: April 2021

Purpose

To characterize and optimize the productivity of melanin using an extremotolerant actinobacterium, Dietzia schimae NM3, for the first time.

Methods

An extracellular brown pigment produced by D. schimae NM3 in the nutrient broth and cheese whey medium by adding L-tyrosine. The extracted melanin was analyzed by UV-visible, HPLC, and FTIR assays. The radical scavenging activity (by DPPH) and sun protection factor (SPF) of the extracted melanin were measured. The melanin cytotoxicity was assayed by MTT and chromate biosorption was measured by atomic absorption spectroscopy. Finally, melanin production by D. schimae NM3 was optimized by response surface methodology (RSM) using Box-Behnken design in the whey medium.

Result

The purified melanin showed similar peak to the standard melanin (SIGMA) at 3.5 min in HPLC, and C=O bands, NH2, CH, C-N, and aromatic groups by FTIR. The radical scavenging activity (by DPPH) and SPF of the extracted melanin were obtained 188.9% and 20.22, respectively. Using MTT assay, the melanin revealed non-toxic effect on the normal human fibroblast (HFB) cell culture. The melanin yield 790 mg l−1, and tyrosinase activity 3400 U ml−1 were obtained in the medium contained whey powder [5% (w v−1)], L-tyrosine 2.5 g l−1, CuSO4 0.013 g l−1, and pH 10.5, incubated at 32 °C for 3 days. The ANOVA results indicated significant P-value, model F-value, and probability, with insignificant lack of fit. After optimization with mono-factors, the nutrient broth came up with melanin yield as 1.2 g l−1 and tyrosinase activity as 4040 U ml−1.

Conclusion

This is the first report of melanin production by D. schimae NM3 and this natural melanin showed valuable biological properties such as high antioxidant activity and radioprotection (SPF) and the biocompatibility to human cell line.
Secretomes of human pluripotent stem cell-derived smooth muscle cell progenitors upregulate extracellular matrix metabolism in the lower urinary tract and vagina
Authors: Zhuang Guobing , Wen Yan , Briggs Mason , Shao Qingchun , Tran Darlene , Wang Hongbo , Chen Bertha
Published: April 2021

Background

Adult mesenchymal stem cells (MSCs) have been studied extensively for regenerative medicine; however, they have limited proliferation in vitro, and the long culture time induces cell senescence. MSCs also contribute to tissue repair through their paracrine function. In this study, we sought to examine the paracrine effects of human smooth muscle cell progenitors (pSMC) on the urethra and adjacent vagina of stress urinary incontinence rodents. We use human pluripotent stem cell (PSC) lines to derive pSMCs to overcome the issue of decreased proliferation in tissue culture and to obtain a homogenous cell population.

Method

Three human PSC lines were differentiated into pSMCs. The conditioned medium (CM) from pSMC culture, which contain pSMC secretomes, was harvested. To examine the effect of the CM on the extracellular matrix of the lower urinary tract, human bladder smooth muscle cells (bSMCs) and vaginal fibroblasts were treated with pSMC-CM in vitro. Stress urinary incontinence (SUI) was induced in rats by surgical injury of the urethra and adjacent vagina. SUI rats were treated with pSMC-CM and monitored for 5 weeks. Urethral pressure testing was performed prior to euthanasia, and tissues were harvested for PCR, Western blot, and histological staining. Kruskal-Wallis one-way ANOVA test and Student t test were used for statistical comparisons.

Results

pSMC-CM upregulated MMP-2, TIMP-2, collagen, and elastin gene expression, and MMP-9 activity in the human bladder and vaginal cells consistent with elastin metabolism modulation. pSMC-CM treatment in the SUI rat improved urethral pressure (increase in leak point pressure compared to intact controls, p < 0.05) and increased collagen and elastin expression in the urethra and the adjacent vagina.

Conclusion

Conditioned media from smooth muscle cell progenitors derived from human pluripotent stem cells improved urethral leak point pressure and collagen and elastin content in the SUI rat. These findings suggest a novel therapeutic potential for PSC-based treatments for SUI and pelvic floor disorders where tissues are affected by collagen, elastin, and smooth muscle loss.
Subconjunctival administration of low-dose murine allogeneic mesenchymal stromal cells promotes corneal allograft survival in mice
Authors: Treacy Oliver , Lynch Kevin , Murphy Nick , Chen Xizhe , Donohoe Ellen , Canning Aoife , Lohan Paul , Shaw Georgina , Fahy Gerry , Ryan Aideen E. , Ritter Thomas
Published: April 2021

Background

Systemic administration of mesenchymal stromal cells (MSCs) has been efficacious in many inflammatory disease settings; however, little data are available on the potential immunomodulatory effects following local MSC administration in the context of corneal transplantation. The purpose of this study was to assess the potential of subconjunctival injection of MSCs to promote corneal allograft survival.

Methods

MSCs were isolated from female C57BL/6 (H-2k) or Balb/c (H-2d) mice and extensively characterized. An allogeneic mouse corneal transplant model was used with Balb/c mice as recipients of C57BL/6 grafts. A dose-finding study starting with 5 × 105 MSCs injected subconjunctivally at day − 7 was tested first followed by a more clinically translatable low-dose single or dual injection strategy on day − 1 and day + 1 before/after transplantation. Graft transparency served as the primary indicator of transplant rejection while neovascularization was also recorded. Lymphocytes (from draining lymph nodes) and splenocytes were isolated from treatment groups on day 2 post-transplantation and characterized by flow cytometry and qRT-PCR.

Results

Both high- and low-dose injection of allogeneic MSCs on day − 7 led to 100% graft survival over the observation period. Moreover, low-dose dual subconjunctival injection of 5 × 104 allogeneic MSCs on day − 1 or day + 1 led to 100% allograft survival in transplant recipients (n = 7). We also demonstrate that single administration of allogeneic MSCs on either day − 1 or day + 1 promotes rejection-free graft survival in 100% (n = 8) and 86% (n = 7) of transplanted mice, respectively. Early time point ex vivo analysis suggests modulation of innate immune responses towards anti-inflammatory, pro-repair responses by local MSC administration.

Conclusion

This work demonstrates that low-dose subconjunctival injection of allogeneic MSCs successfully promotes corneal allograft survival and may contribute to refining future MSC immunotherapies for prevention of corneal allograft rejection.
Limits of temperature adaptation and thermopreferendum
Authors: Aslanidi K. B. , Kharakoz D. P.
Published: April 2021

Background

Managing the limits of temperature adaptation is relevant both in medicine and in biotechnology. There are numerous scattered publications on the identification of the temperature limits of existence for various organisms and using different methods. Dmitry Petrovich Kharakoz gave a general explanation for many of these experimental results. The hypothesis implied that each cycle of synaptic exocytosis includes reversible phase transitions of lipids of the presynaptic membrane due to the entry and subsequent removal of calcium ions from the synaptic terminal. The correspondence of the times of phase transitions has previously been experimentally shown on isolated lipids in vitro. In order to test the hypothesis of D.P. Kharakoz in vivo, we investigated the influence of the temperature of long-term acclimatization on the temperature of heat and cold shock, as well as on the kinetics of temperature adaptation in zebrafish. Testing the hypothesis included a comparison of our experimental results with the results of other authors obtained on various models from invertebrates to humans.

Results

The viability polygon for Danio rerio was determined by the minimum temperature of cold shock (about 6 °C), maximum temperature of heat shock (about 43 °C), and thermopreferendum temperature (about 27 °C). The ratio of the temperature range of cold shock to the temperature range of heat shock was about 1.3. These parameters obtained forDanio reriodescribe with good accuracy those for the planarianGirardia tigrina, the ground squirrelSermophilus undulatus, and forHomo sapiens.

Conclusions

The experimental values of the temperatures of cold shock and heat shock and the temperature of the thermal preferendum correspond to the temperatures of phase transitions of the lipid-protein composition of the synaptic membrane between the liquid and solid states. The viability range for zebrafish coincides with the temperature range, over which enzymes function effectively and also coincides with the viability polygons for the vast majority of organisms. The boundaries of the viability polygon are characteristic biological constants. The viability polygon of a particular organism is determined not only by the genome, but also by the physicochemical properties of lipids that make up the membrane structures of synaptic endings. The limits of temperature adaptation of any biological species are determined by the temperature range of the functioning of its nervous system.
Correction to: Obstetric anesthesia services in Israel snapshot (OASIS) study: a 72 hour cross-sectional observational study of workforce supply and demand
Authors: Schtrechman-Levi Gal , Ioscovich Alexander , Hart Jacob , Bar Jacob , Calderon-Margalit Ronit , Nir Eshel A. , Ginosar Yehuda
Published: April 2021

An amendment to this paper has been published and can be accessed via the original article.
Treatment outcomes of patients with multidrug and extensively drug-resistant tuberculosis in Zhejiang, China
Authors: Zhang Ming-Wu , Zhou Lin , Zhang Yu , Chen Bin , Peng Ying , Wang Fei , Liu Zheng-Wei , Wang Xiao-Meng , Chen Song-Hua
Published: April 2021

Background

The aim of this study was to assess the treatment outcomes of multidrug and extensively drug-resistant tuberculosis (M/XDR-TB) in Zhejiang, China and to evaluate possible risk factors associated with poor outcomes of M/XDR-TB.

Methods

Two-hundred-and-sixty-two patients having M/XDR-TB who received the diagnosis and treatment at nine referral hospitals from 1 January 2016 to 31 December 2016 in Zhejiang, China were included. All patients received second-line regimens recommended by WHO under the DOTS-Plus strategy.

Results

Among the 262 patients, the treatment success rate was 55.34% (n = 145) with 53.44% (n = 140) cured and 1.91% (n = 5) who completed treatment, 62 (23.66%) failed, 27 (10.31%) died, 16 (6.11%) defaulted and 12 (4.58%) transferred out. Forty (64.52%) of the 62 M/XDR-TB patients who failed treatment were due to adverse effects in the first 10 months of treatment. Eighteen patients (6.37%) had XDR-TB. Treatment failure was significantly higher among patients with XDR-TB at 50% than that among patients with non-XDR-TB at 21.72% (P = 0.006). Failure outcomes were associated with a baseline weight less than 50 kg (OR, 8.668; 95% CI 1.679–44.756;P = 0.010), age older than 60 years (OR, 9.053; 95% CI 1.606–51.027;P = 0.013), hemoptysis (OR, 8.928; 95% CI 1.048–76.923;P = 0.045), presence of cavitary diseases (OR, 10.204; 95% CI 2.032–52.631;P = 0.005), or treatment irregularity (OR, 47.619; 95% CI 5.025–500;P = 0.001).

Conclusion

Treatment outcomes for M/XDR-TB under the DOTS-Plus strategy in Zhejiang, China were favorable but still not ideal. Low body weight (< 50 kg), old age (> 60 years), severe symptoms of TB including cavitary disease, hemoptysis and irregular treatment were independent prognostic factors for failure outcomes in patients with M/XDR-TB.
Effect of sterilization on 3-point dynamic response to in vitro bending of an Mg implant
Authors: Becerra Luis Humberto Campos , Rodríguez Marco Antonio Loudovic Hernández , Arroyo Raúl Lesso , Solís Hugo Esquivel , Castro Alejandro Torres
Published: April 2021

Background

The aim of the study is to characterize a biomedical magnesium alloy and highlighting the loss of mechanical integrity due to the sterilization method. Ideally, when using these alloys is to delay the onset of degradation so that the implant can support body loads and avoid toxicological effects due to the release of metal ions into the body.

Methods

Standardized procedures according to ASTM F-1264 and ISO-10993-5 were used, respecting detailed methodological controls to ensure accuracy and reproducibility of the results, this testing methodology is carried out in accordance with the monographs of the Pharmacopoeia for the approval of medical devices and obtaining a health registration. An intramedullary implant (IIM) manufactured in magnesium (Mg) WE43 can support loads of the body in the initial period of bone consolidation without compromising the integrity of the fractured area. A system with these characteristics would improve morbidity and health costs by avoiding secondary surgical interventions.

Results

As a property, the fatigue resistance of Mg in aggressive environments such as the body environment undergoes progressive degradation, however, the autoclave sterilization method drastically affects fatigue resistance, as demonstrated in tests carried out under in vitro conditions. Coupled with this phenomenon, the relatively poor biocompatibility of Mg WE43 alloys has limited applications where they can be used due to low acceptance rates from agencies such as the FDA. However, Mg alloy with elements such as yttrium and rare earth elements (REEs) have been shown to delay biodegradation depending on the method of sterilization and the physiological solution used. With different sterilization techniques, it may be possible to keep toxicological effects to a minimum while still ensuring a balance between the integrity of fractured bone and implant degradation time. Therefore, the evaluation of fatigue resistance of WE43 specimens sterilized and tested in immersion conditions (enriched Hank’s solution) and according to ASTM F-1264, along with the morphological, crystallinity, and biocompatibility characterization of the WE43 alloy allows for a comprehensive evaluation of the mechanical and biological properties of WE43.

Conclusions

These results will support decision-making to generate a change in the current perspective of biomaterials utilized in medical devices (MDs), to be considered by manufacturers and health regulatory agencies. An implant manufactured in WE43 alloy can be used as an intramedullary implant, considering keeping elements such as yttrium-REEs below as specified in its designation and with the help of a coating that allows increasing the life of the implant in vivo.
Expert camouflage-breakers can accurately localize search targets
Authors: Branch Fallon , Lewis Allison JoAnna , Santana Isabella Noel , Hegdé Jay
Published: April 2021

Camouflage-breaking is a special case of visual search where an object of interest, or target, can be hard to distinguish from the background even when in plain view. We have previously shown that naive, non-professional subjects can be trained using a deep learning paradigm to accurately perform a camouflage-breaking task in which they report whether or not a given camouflage scene contains a target. But it remains unclear whether such expert subjects can actually detect the target in this task, or just vaguely sense that the two classes of images are somehow different, without being able to find the target per se. Here, we show that when subjects break camouflage, they can also localize the camouflaged target accurately, even though they had received no specific training in localizing the target. The localization was significantly accurate when the subjects viewed the scene as briefly as 50 ms, but more so when the subjects were able to freely view the scenes. The accuracy and precision of target localization by expert subjects in the camouflage-breaking task were statistically indistinguishable from the accuracy and precision of target localization by naive subjects during a conventional visual search where the target ‘pops out’, i.e., is readily visible to the untrained eye. Together, these results indicate that when expert camouflage-breakers detect a camouflaged target, they can also localize it accurately.
When and why do people act on flawed science? Effects of anecdotes and prior beliefs on evidence-based decision-making
Authors: Michal Audrey L. , Zhong Yiwen , Shah Priti
Published: April 2021

Today’s citizens are expected to use evidence, frequently presented in the media, to inform decisions about health, behavior, and public policy. However, science misinformation is ubiquitous in the media, making it difficult to apply research appropriately. Across two experiments, we addressed how anecdotes and prior beliefs impact readers’ ability to both identify flawed science and make appropriate decisions based on flawed science in media articles. Each article described the results of flawed research on one of four educational interventions to improve learning (Experiment 1 included articles about having a tidy classroom and exercising while learning; Experiment 2 included articles about using virtual/augmented reality and napping at school). Experiment 1 tested the impact of a single anecdote and found no significant effect on either participants’ evidence evaluations or decisions to implement the learning interventions. However, participants were more likely to adopt the more plausible intervention (tidy classroom) despite identifying that it was unsupported by the evidence, suggesting effects of prior beliefs. In Experiment 2, we tested whether this intervention effect was driven by differences in beliefs about intervention plausibility and included two additional interventions (virtual reality = high plausible, napping = low plausible). We again found that participants were more likely to implementhigh plausiblethanlow plausibleinterventions, and that evidence quality was underweighed as a factor in these decisions. Together, these studies suggest that evidence-based decisions are more strongly determined by prior beliefs than beliefs about the quality of evidence itself.
Preliminary numerical study on seismic response of ordinary long-span suspension bridges crossing active faults
Authors: Jia Hongyu , Jia Kang , Sun Caizhi , Li Yanqiang , Zhang Chao , Zheng Shixiong
Published: April 2021

The objective of this paper is to expediently expose the seismic performance pertinent to demand and capacity of general long-span suspension bridges crossing active faults. Firstly three dimensional finite element model of the ordinary long-span suspension bridge is established based on the powerful and attractive finite element software ANSYS. Secondly a series of appropriate fault ground motions with different target final permanent displacements (Tectonic displacements or ground offset) in the direction perpendicular to the fault plane are assumed and applied to the employed long-span suspension bridge. And then the Newmark method is utilized to solve the equation of motion of the long-span suspension bridge structure subjected to fault ground motions in the elastic range. Finally some important conclusions are drawn that the final permanent displacements in the direction perpendicular to the fault plane has significant influence on the seismic responses and demands of general long-span suspension bridges crossing active faults. And the resultant conclusions deliver explicitly and directly specifications and guidelines for seismic design of ordinary long-span suspension bridges across fault-rupture zones.
Multinational Study to Assess Stress Levels Among the Health Care Workers of Radiation Oncology Community at the Outset of the COVID-19 Pandemic
Authors: Wadasadawala Tabassum , Kumar Anuj , Laskar Sarbani Ghosh , Gondhowiardjo Soehartati , Mokal Smruti , Goswami Savita , Giselvania Angela , Kapoor Rakesh , Das Abhijit , Pradhan Satyajit , Pujari Lincoln , Acharya Bibek , Chapagain Sandhya , Mahantshetty Umesh , Vadgaonkar Rohit , Hussain Qazi Mushtaq , Akbarov Kamal , Agarwal Jai Prakash
Published: April 2021

PURPOSE

To evaluate stress levels among the health care workers (HCWs) of the radiation oncology community in Asian countries.

METHODS

HCWs of the radiation oncology departments from 29 tertiary cancer care centers of Bangladesh, India, Indonesia and Nepal were studied from May 2020 to July 2020. A total of 758 eligible HCWs were identified. The 7-Item Generalized Anxiety Disorder, 9-Item Patient Health Questionnaire, and 22-Item Impact of Events Scale-Revised were used for assessing anxiety, depression, and post-traumatic stress disorder. Univariate and multivariate analysis was done to identify the causative factors affecting mental health.

RESULTS

A total of 758 participants from 794 HCWs were analyzed. The median age was 31 years (IQR, 27-28). The incidence of moderate to severe levels of anxiety, depression, and stress was 34.8%, 31.2%, and 18.2%, respectively. Severe personal concerns were noticed by 60.9% of the staff. On multivariate analysis, the presence of commonly reported symptoms of COVID-19 during the previous 2 weeks, contact history (harzard ratio [HR], 2.04; CI, 1.15 to 3.63), and compliance with precautionary measures (HR, 1.69; CI, 1.19 to 2.45) for COVID-19 significantly predicted for increasing anxiety (HR, 2.67; CI, 1.93 to 3.70), depression (HR, 3.38; CI 2.36 to 4.84), and stress (HR, 2.89; CI, 1.88 to 4.43) ( P < .001). A significant regional variation was also noticed for anxiety, stress, and personal concerns.

CONCLUSION

This survey conducted during the COVID-19 pandemic revealed that a significant proportion of HCWs in the radiation oncology community experiences moderate to severe levels of anxiety, depression, and stress. This trend is alarming and it is important to identify and intervene at the right time to improve the mental health of HCWs to avoid any long-term impacts.
Shock wave structure of multi-temperature Grad 10-moment equations for a binary gas mixture
Authors: Bisi M. , Groppi M. , Macaluso A. , Martalò G.
Published: April 2021

A multi-temperature formal hydrodynamic limit of kinetic equations, based on Grad-type approximation of the distribution functions, is employed for the analysis of the steady shock problem in a binary mixture. The presence of a singular barrier and its effects on the occurrence of either smooth profiles or of weak solutions with a discontinuity is investigated for varying Mach number. Some numerical simulations of mixtures of two noble gases are presented and commented on, with reference also to analogous phenomena in different model descriptions.
Double band inversion in the topological phase transition of Ge1-x Snx alloys
Authors: Tan Rui , Yang Qirui , Chen Ruiyuan , Qiao Yu , Tan Shouqiao , Cao Yanqiang , Wang Peng , Chiang Tai-Chang , Wang Xiaoxiong
Published: April 2021

We use first-principles simulation and alchemical mixing approximation to reveal the unique double band inversion and topological phase transition in Ge

Sn

alloys. Wave function parity, spatial charge distribution and surface state spectrum analyses suggest that the band inversion in Ge

Sn

is relayed by its first valence band. As the system evolves from Ge to

-Sn, its conduction band moves down, and inverts with the first and the second valence bands consecutively. The first band inversion makes the system nontrivial, while the second one does not change the topological invariant of the system. Both of the band inversions yield surface modes spanning the individual inverted gaps, but only the surface mode in the upper gap associates with the nontrivial nature of tensile-strained

-Sn.
Nuclear magnetic resonance spectroscopy of nonequilibrium steady states in quantum dots
Authors: Schering P. , Uhrig G. S.
Published: April 2021

The optically induced polarization of localized electron spins in an ensemble of quantum dots (QDs) dephases due to the interaction with the surrounding nuclear spins. Despite this dephasing, the spins in the QDs can be controlled to respond coherently by applying periodic laser pulses, leading to a revival of the spin polarization before each pulse. This effect, known as spin mode locking, strongly depends on an emerging selection of certain polarizations of the nuclear spin bath which is driven to a steady state far from equilibrium. We investigate the influence of the nuclear composition in In
x
Ga

As QDs on this nonequilibrium behavior and demonstrate that nuclear magnetic resonances (NMR) appear as very sharp minima in the magnetic field dependence of the revival amplitude. This suggests a novel kind of NMR spectroscopy.
Marseille Exposed
Authors: Brown Stephanie J.
Published: April 2021

This article examines the representation of surveillance in Claude McKay’s Romance in Marseille and the influence of surveillance on the novel’s aesthetics. It uses McKay’s 1929 novel Banjo as a prior representation of Marseille that establishes the historical constraints under which characters in Romance navigate the social world of Quayside, the city’s international working-class quarter. The article argues that McKay depicts an important moment in which state and corporate actors create networks of transnational surveillance that aim at securing an advantageous global distribution of labor for capital. McKay’s novel examines the mechanisms through which surveillance controls the mobility of racialized and gendered bodies, and depicts the strategies of resistance that such characters deploy more and less successfully against these often-violent mechanisms.
Claude McKay’s Bad Nationalists
Authors: Cole Rich
Published: April 2021

This article examines Claude McKay’s 1928 journey to Africa under colonial occupation and uncovers how these true events partly inspired his late work of expatriate fiction, Romance in Marseille. By bringing together migration studies with literary history, the article challenges and expands existing research that suggests that McKay’s writings register the impulse for a nomadic wandering away from oppressive forms of identity control set up in the wake of World War I. The article contends that Claude McKay’s renegade cast of “bad nationalist” characters registers a generative tension between the imperial national forms the author encountered in North Africa and the Black nationalist vision of Marcus Garvey’s Back-to-Africa campaign. Reading the dialectics of bad nationalisms and Black internationalisms, the article explores how the utopian promise for Black liberation by returning back to Africa, central to the New Negro project of Black advancement, frequently becomes entangled in McKay’s transnational stowaway fiction with conflicting calls for reparations, liabilities, and shipping damages.
Mooring Aslima
Authors: Cheema Zainab
Published: April 2021

In Claude McKay’s Romance in Marseille, the entanglement of Spain and Morocco emerges through the diasporic figure of Aslima, the Moroccan sex worker. This essay examines McKay’s Maurophilia, which he circuitously refers to as “Afro-Orientalism” in his various writings. Maurophilia not only foregrounds Aslima’s associations with Spain and Morocco but also highlights McKay’s engagement with transhistorical Mediterranean diasporas, including the intra-African slave trade and Iberian Moriscos and conversos settling in North Africa following the Reconquista. This essay argues that while Aslima’s associations with Moorish-Iberian performance styles influence McKay’s modernist poetics and radical aspirations for a global pandiasporic Black alliance, Romance in Marseille ultimately forecloses the prospect of a pan-Mediterranean, Black Atlantic globalism because of contradictions of gender and religion.
Lyric Commodification in McKay’s Morocco
Authors: Hobbs David B.
Published: April 2021

Reassessing Claude McKay’s writing about North Africa, this article contends that McKay saw sites in this region as uniquely felicitous to staging conversations between global socialism and the Black diasporic avant-garde. His attention to site-specific interracial urban cultures serves as a counterpoint to the Depression-fueled Pan-Africanism that increasingly defined W. E. B. Du Bois’s editorials for the Crisis. At the same time, McKay’s persistent interest in the activities of the Liberator suggests a surprising resonance between their aesthetics to his locodescriptive verse. Bringing these strands together, the article finds that McKay did not seek a synesthetic resolution to the question of organizing an urban community or an integrationist racial future but, rather, sought to highlight the importance of dissensus despite global uncertainty. The article considers McKay’s formal poetics and fiction together, comparing his visual tactics with the French and British Colonial Expositions’ “panoramas.”
Afropessimism, Liminal Hotspots, and Claude McKay’s Aesthetic of Sovereign Rejection in Romance in Marseille
Authors: Collins Michael J.
Published: April 2021

This article considers Claude McKay’s Romance in Marseille through two emerging fields of study: “Afropessimism” and anthropological theories of the “liminal hotspot.” It suggests that McKay’s novel functions as a critique of positive Harlem Renaissance images of diasporic movement by highlighting how racial “Blackness” functions as a system for rejecting people of color from the benefits of modernity and sovereign rights-bearing status in an expanded temporal and spatial frame. To explore this hypothesis, the article turns to new anthropological work on the liminal hotspot as a site of sustained, unresolved transition, reading the affectivity of diaspora as a negative one in McKay’s work that places an unsustainable pressure on ritual and performative stylizations and renders them untenable as forms for cultivating a sovereign condition.