bluuebunny/crossref_metadata_2025 huggingface dataset:
Potential Use of Distinct Biomarkers (Trace Metals, Micronuclei and Nuclear Abnormalities) in a Heterogeneous Sample of Birds in Southern Brazil.
Authors: TOMAZELLI JOANA , Rodrigues Gabriela Zimmermann Prado , Franco Danielle , de Souza Mateus Santos , Burghausen Jorge Henrique , Panizzon Jenifer , Kayser Juliana Machado , Loiko Márcia Regina , Schneider Anelise , Linden Rafael , Gehlen Gunther
Published: March 2021

The analysis of metal concentrations in feathers and the micronuclei (MN) and other nuclear abnormalities (NA) test in birds are tools used for evaluating the impacts that anthropogenic actions have been causing to the environment and organisms. Here we used these biomarkers to investigate the response of birds to disturbances observed in three areas with different environmental characteristics (natural, agricultural and urban) in southern Brazil. We obtained a diverse sample (108 individuals from 25 species and 17 families) without significant differences in metal concentrations, frequency of MN and AN between sampling points. The concentrations of zinc (Zn) and copper (Cu) were significantly different between trophic guilds (Zn: p = 0.0006, Cu: p = 0.04) and age classes (Zn: p = 0.01, Cu: p = 0.03). Omnivore birds contributed to the increase in the number of MN (∆AICc: 0.00; w = 0.40) and NA, which was also influenced by age classes and body condition index (BCI) (∆AICc: 0.00; w = 0.34; ∆AICc: 0.89; w = 0.22; ∆AICc: 1.15; w = 0.19; ∆AICc: 1.33; w = 0.18). We showed that in a diverse sample of birds, the variables analyzed affected each biomarker in distinct ways.
Role of Ki-67, MRE11, and PD-L1 As Predictive Biomarkers for Recurrence Pattern in Muscle Invasive Bladder Cancer Following Radical Cystectomy
Authors: Fossum Croix C. , Xiong Yin , Magliocco Anthony , Daneshmand Siamak , Aron Manju , Mouw Kent W. , Manojlovic Zarko , McCarthy Susan , Phuong Christina , Dorff Tanya , Bhanvadia Sumeet K. , Ballas Leslie K.
Published: March 2021

Background

Muscle invasive bladder (MIBC) cancer is an aggressive disease with high rates of local recurrence following radical cystectomy (RC). Currently, there are no clinically validated biomarkers to predict local only recurrence (LOR) and guide adjuvant treatment decisions. This pilot study evaluated the role of Ki-67, MRE11 and PD-L1 as predictive biomarkers for recurrence patterns in patients undergoing RC for MIBC.
Methods:

Our institutional cystectomy database containing cases of urothelial MIBC from 1992–2014 was queried for patients with LOR and case-matched with patients who had distant recurrence (DR) and no recurrence (NR). Clinical and histopathological data were collected from selected patients and a tissue microarray was built and analyzed for presence of Ki-67, MRE11 and PD-L1 using immunofluorescence (IF) and immunohistochemistry (IHC). Univariate, multivariate, and principal component analyses (PCA) were performed to evaluate association of these biomarkers with recurrence pattern.
Results:

Pathologic specimens from 42 patients (18 NR, 16 LOR and 8 DR) were reviewed. Compared to adjacent normal bladder tissue, tumors had increased expression of PD-L1 on both IHC and IF (p < 0.05) and higher Ki-67 H-score on IHC (33 vs 0, p < 0.01). A high Ki-67 was associated with recurrence pattern (local vs distant) on univariate analysis (p < 0.05) and on multivariate regression, having positive surgical margins was associated with local recurrence (p = 0.04). Ki-67 cell density varied by recurrence type: LR (1354 cells/mm2), DR (557 cells/mm2) and NR (1111 cells/mm2) p = 0.034. Several PCAs were unable to identify a signature associated with recurrence pattern.
Conclusion:

The biomarkers used in this study were helpful in distinguishing tumor from normal tissue and high Ki-67 may be associated with LOR, however, a useful molecular signature for recurrence pattern could not be identified.
Harmonious Coexistence of Cultural Heritage Protection and Tourism: The Mount Lushan Comprehensive Tourism Platform
Authors: Zhenrao Cai , Chaoyang Fang , Qian Zhang , Fulong Chen
Published: March 2021

The coordinated development of heritage protection and tourism is the goal of both cultural heritage sites and sustainable heritage tourism. However, the development of sustainable heritage tourism can be restricted due to insufficient resources for heritage tourism marketing as well as insufficient cultural heritage protection measures. This study uses digital methods such as oblique photography, 3D laser scanning technology and panoramic technology to digitize the cultural landscape heritage site. Using these methods, we build a virtual tourism subsystem to improve tourists’ experience of cultural heritage tourism resources and enhance the attraction of cultural heritage tourism. In addition, we build a tourist flow and environmental monitoring and management subsystem based on the Internet of Things technology. This subsystem can help managers adjust and regulate tourist flow according to the tourism carrying capacity threshold. We also conduct an ecological environment health assessment and management simulation according to the “Pressure-Status- Response” model, in doing so, we aim to enhance the protection of cultural heritage sites. Finally, we develop a comprehensive platform to integrate tourism marketing and heritage protection management functions. The results of this study provide a new approach for the coordination of and symbiosis between the protection of cultural heritage and tourism activity.
Investigation of the Problem Behaviors Emerging in Children During the COVID-19 Pandemic
Authors: Sancili Semanur , Tugluk Mehmet Nur
Published: March 2021

Background: This study aimed to evaluate the effect of the COVID-19 pandemic on the problem behaviors of children within the framework of parental opinions. It furthermore examined how certain variables such as contact with an individual infected with COVID-19, positive COVID-19 test results in the family and/or close community, and death from COVID-19 in the family and/or close community affected the changes in children’s habits and problem behaviors. Methods: The study was conducted using a case study design in accordance with the qualitative research method. Within the scope of the study, 20 parents with children between 4 and 6 years of age were interviewed. Research data were collected with semi-structured interview forms and were analyzed using the content analysis method.Results: The analysis of parental opinions revealed that some favorable and unfavorable changes occurred in the children’s playing, sleeping, eating, and hygiene habits during the COVID-19 pandemic. It has been determined that the children’s use of televisions, tablets, and phones increased during this period. Emotional problems such as boredom, fear, anxiety, tantrums, irritability, and impatience were found to be more common in children compared to the pre-pandemic period, together with behavioral problems such as non-obedience, desire to attract attention, aggression, excessive speaking, hyperactivity, conflicts between siblings, speaking loudly, and increased impulses. Conclusions: In line with the parental opinions, it is observed that the school closures, social isolation, and children’s inability to spend time with their peers affect the children particularly adversely. This study shows that children cannot burn their energy sufficiently due to their limited range of movement in the house. In addition, it is observed that some of the children had problems such as reluctance to sleep alone and fear of the dark from the beginning of the pandemic. It was found noteworthy that the children experienced fear and anxiety not only about the risk of being infected with the virus but also about losing their parents.
Optical emissions associated with narrow bipolar events in radio signals from thunderstorm clouds penetrating into the stratosphere
Authors: Liu Feifan , Lu Gaopeng , Neubert Torsten , Lei Jiuhou , Chanrion Olivier , Østgaard Nikolai , Li Dongshuai , Luque Alejandro , Vázquez Francisco J. Gordillo , Reglero Víctor , Lyu Weitao , Zhu Baoyou
Published: March 2021

Narrow bipolar events (NBEs) are signatures in radio signals from thunderstorms observed by ground-based receivers. They are electromagnetic waves radiated by impulsive currents of electrical discharges. They come with two polarities, the positive that brings negative charge aloft, and the negative, that brings negative charge towards the earth. The sources of negative NBEs are at the very top of thunderclouds, and positive NBEs are at the upper levels, but inside the clouds. NBEs may occur at the onset of lightning, but the discharge process is not well understood. Here, we present spectral measurements by the Atmosphere-Space Interactions Monitor (ASIM) on the International Space Station that are associated with nine negative and three positive NBEs observed by a ground‐based array of receivers at the closest distance of about 100 km. We found that both negative and positive NBEs are associated with emissions at 337 nm with weak or no detectable emissions at 777.4 nm, suggesting that NBEs are associated with fast streamer breakdown. The rise times of the emissions for negative NBEs are about 10 µs, consistent with source locations at cloud tops where photons undergo little scattering by cloud particles, and for positive NBEs are ~ 1 ms, consistent with locations deeper in the clouds. For negative NBEs, the amplitude of the emissions is almost linearly correlated with the peak current of the associated NBEs. Our findings suggest that ground-based observations of radio signals provide a new means to measure the occurrences and strength of cloud-top discharges with implications for studies of perturbations of greenhouse gas concentrations at the tropopause.
Comparative Study of Regional Development in Tehran and Sistan and Baluchestan
Authors: PILEHVAR ali asghar , Harasani Amin
Published: March 2021

The purpose of this article is to identify and analyze the extent of regional differences in terms of human development and economic development indices. In this study, the level of national-regional development in the two provinces of Tehran and Sistan and Baluchestan is measured by the above two indices to highlight discrepancies in regional development in Iran. In this applied research, a descriptive-analytical method has been adopted. The research data were obtained from the official Census of 2011 as well as the last official Census in 2016. The economic index was measured by Izard model and the conclusions were informed by the human development index. The results manifest that the studied indices have been affected by geographical factors and micro/macro policies of the government in the four decades since the 1979 Revolution, contributing to the widening of regional development gap. The HDI was 0.720 in Tehran and 0.494 in Sistan and Baluchestan. Also, the per capita income index of Tehran and Sistan and Baluchestan were 0.497 and 269.0, respectively, which indicates a marked difference. As for the average years of study, the index of Tehran (0.780) was nearly two-fold higher than that of Sistan and Baluchestan (0.439). However, the life expectancy index exhibited a smaller difference than the overall average. The results of the research based on the Izard model also demonstrate that Tehran and Sistan and Baluchestan with an average of 126% and 172% in economic sectors are above the national average (112%), the only difference being that the development process in Sistan and Baluchestan is changing rapidly.
Assessment of Life Cycle Environmental Benefits in Monosodium Glutamate Production in China
Authors: Yu Fei , Guan Dan , Zhang Zudong , Zhao Lei , Zang Lihua
Published: March 2021

Purpose

As a process with high water consumption, high energy consumption and high pollutant discharge, monosodium glutamate (MSG) production has long attracted the attention of environmental protection authorities. In view of its significant environmental influence and enormous output, life cycle environmental impacts of MSG should be assessed to identify environmental hot spots and promote environmental improvements, and to update the life cycle inventory database of MSG production.
Methods

A life cycle assessment (LCA) framework is conducted to evaluate the environmental impacts of MSG production by the use of eBalance software. In addition, the environmental impacts associated with the application of typical cleaner production techniques over the past decade in MSG production are evaluated by LCA to quantitatively demonstrate the importance of implementing cleaner production measures.
Results and discussion

The results indicate that maize planting and tail liquid utilization have the largest environmental impacts within the life cycle of MSG. The former is the most important driver of impacts such as eutrophication (90.37%), respiratory inorganic formation (34.04%) and primary energy demand (26.60%). The latter contributes to 96.72% of the photochemical oxide formation and 20.12% of the global warming potential. In addition, glutamate extraction and refining processes also contribute significantly to the global warming potential, acidification and respiratory inorganics. The results also show that the application of cleaner production technologies over the past decade has driven the reductions in photochemical oxide formation (92.40%) and water use (66.00%).
Conclusion

Based on the research findings, several suggestions, such as green raw material utilization, green supply chain construction and industrial symbiosis network establishment, are proposed to further reduce the overall environmental impacts of MSG.
Research on Deep-hole Drilling Quality of High-strength Steel With Slender Gun Drill
Authors: Liang Jiabin , Jiao Li , Yan Pei , Cheng Minghui , Qiu Tianyang , Wang Xibin
Published: March 2021

There are a lot of problems exist in the processing of long and thin deep hole gun drilling of high strength steel, such as insufficient of the machining mechanism and characteristics of gun drilling, difficulty in selecting machining parameters, unknown influence mechanism of machining parameters on drilling force, drilling temperature and machining quality. In this paper, 42CrMo high strength steel is selected as the workpiece material. A numerical model of cutting force is established based on the mechanism of gun drill, and then the finite element simulation and processing test are carried out. The results show that the cutting force decreases with the increase of cutting speed, and increases with the increase of feed speed; the error between the theoretical and actual value is less than 10%. Cutting speed and feed speed have a great influence on machining quality, and the cutting fluid pressure mainly affects the surface roughness.
Aquisphaera Insulae Sp. Nov., a New Member in Isosphaeraceae Isolated From the Floating Island of Loktak Lake and Emended Description of the Genus Aquisphaera
Authors: Kumar Gaurav , L Lhingjakim Khongsai , U Jagadeeshwari , A Shabbir , Kumar Dhanesh , Kashif Gulam Mohammad , Ch Sasikala , Ramana Ch. Venkata
Published: March 2021

Strain JC669T was isolated from a floating island of Loktak lake, Manipur, India and shared highest 16S rRNA gene sequence identity with Aquisphaera giovannonii OJF2T. The strain is an aerobe, Gram-stain-negative, yellowish orange coloured, non-motile, NaCl intolerant, spherical to oval shaped, grows in single or aggregates and produce structures which appear like fruiting bodies. Strain JC669T grows well up to pH 9.0, has MK6 as respiratory quinone, C18:1ω9c, C16:0 and C18:0 as major fatty acids and phosphatidylcholine, an unidentified amino lipid, an unidentified choline lipid (UCL) and six unidentified lipids (UL1,2,3,4,5,6) as polar lipids. The genome size of strain JC669T is 10.04 Mbp and genomic G+C content of 68.5 mol%. Based on phylogenetic, polyphasic including genomic analyses support strain JC669T as a novel species of the genus Aquisphaera, for which we propose the name Aquisphaera insulae sp. nov. Type strain is JC669T ( =KCTC 72672T = NBRC 114306T).
Antimicrobial compounds were isolated from the secondary metabolites of endophytic Gordonia in the intestinal tract of Periplaneta americana
Authors: Ma Yan , Xu Minhua , Liu Hancong , Yu Tiantian , Guo Ping , Liu Wenbin , Jin Xiaobao
Published: March 2021

Background: As we all know, bacterial and fungal infections have become one of the threats to human health. Microbial secondary metabolites are one of the main sources of bioactive natural products. It is estimated that around 60% of all foregone antibiotics are derived from secondary metabolites produced by filamentous actinomycete bacteria. Gordonia spp. are members of the actinomycete family, their contribution to the environment improvement and environmental protection by their biological degradation ability, but there are few studies on their antimicrobial activity of their secondary metabolites. Our team isolated a Gordonia strain WA 4-31 with anti-Candida albicans activity from the intestinal tract of Periplaneta americana in the early stage.Results: In this study, we firstly identified the strain WA 4-31 by the morphological characteristics and the phylogenetic analyses, and found that it homologous to a strain of Gordonia from the Indian desert (EU333873) by 100%. Then four compounds, Actinomycin D (1), Actinomycin X2 (2), Mojavensin A (3) and cyclic (leucine-leucne) dipeptide (4) were purified from the EtOH extract of the fermented broth of the strain. The compounds 1-4 had activities against Candida albicans, Aspergillus niger, Aspergillus fumigatus and Trichophyton rubrum. They also had activities against MRSA, S.aureus, K.peneumoniae and E.coli in different degree. The minimum inhibitory concentration of Actinomycin D and Actinomycin X2 on MASA was 0.25 μg/mL. Interestingly, we found that when Mojavensin A was mixed with compound 4 ratio of 1:1, the solution of the compounds was better than the single on anti-Candida albicans. Besides, compounds 1-3 had varying degrees of cytotoxicity on CNE-2 cells and HepG-2 cells.Conclusions: The present study firstly reported the antimicrobial compounds isolated from Gordonia. These indicated that rare actinomycetes from the intestinal tract of Periplaneta americana possessed a potential as a source of active secondary metabolites.
Study of Milling of Low Thickness Thermoplastic Carbon Fiber Composites in Function of Tool Geometry and Cutting Conditions
Authors: Sambruno Alejandro , Bañon Fermin , Salguero Jorge , Simonet Bartolome , Batista Moises
Published: March 2021

The application of Carbon Fiber Reinforced ThermoPlastic matrix composites (CFRTP) is constantly increasing in various industrial sectors. Their mechanical properties and advantages compared to thermoset composite materials make them very important materials. Nevertheless, CFRTP machining generates a current problem due to the anisotropy of these materials, the difficulty of impregnation of the reinforcement in the matrix and its low melting temperature. For this reason, the study of conventional operations such as milling to achieve geometries with a good surface quality and reduced cosmetic defects is a line of research of great interest. In this article, a comparison of five cutting tools with different geometries has been made in CFRTP milling. The surface quality and the formation of visual defects such as fiber pull-out have been evaluated for each tool and combination of cutting parameters. In this sense, 16.42 µm in terms of Rz is the minimum average value for the complete experiment obtained for a conventional tool (Tool A). However, surface qualities in terms of Rz close to 20 µm and minimum cosmetic defects have been obtained with a hybrid tool (Tool C) with -10° helix angle and 8 teeth with a combination of cutting parameters of 0.07 mm/tooth and 3000 rpm, being the most complete tool of the experiment.
Increased Pulmonary Embolism in Patients with COVID-19: A Case Series and Literature Review
Authors: Hesam-Shariati Sonia , Fatehi Poya , Abouzaripour Morteza , Fathi Fardin , Hesam-Shariati Negin , shariati mohamad bakhtiar hesam
Published: March 2021

Recently, there is evidence that the coronavirus disease 2019 (COVID-19) increases the risk of venous thromboembolism by creating a prothrombotic state. COVID-19 and pulmonary embolism (PE) are both associated with tachypnoea, hypoxemia, dyspnoea, and increased D-dimer. Diagnosis of pulmonary embolism in a patient with COVID-19 compared to a patient without it using the conventional clinical and biochemical evidence is challenging and somehow impossible. In this study, we report 4 male cases affected by COVID-19, admitted to hospitals in Sanandaj, Iran. The patients were all older adults (ranged between 56 and 95 years of age). Fever, chills, muscle aches, and cough were evident in all of them. Red blood cell levels were low, while pulmonary embolism was clearly seen on spiral computed tomographic (CT) angiography of the pulmonary circulation of all patients. These cases demonstrated that COVID-19 may lead to pulmonary embolism by causing blood coagulation problems. As COVID-19 continues to cause considerable mortality, more information is emerging which reveals its complicated pathogenicity. In the meantime, venous thromboembolism remains an uncommon finding in patients with COVID-19. It is essential that health care providers perform the necessary diagnostic evaluations and provide appropriate treatment for patients.
Chest wall resection and reconstruction for locally recurrent breast cancer: an experience of five cases over a five-Year period and literature review
Authors: Sun Qiang , Wang Yu-xin , Jin Shi-feng , Wang Chen-chao , Zhou You , Guo Shu
Published: March 2021

Background: Expanded local resection is suitable for recurrent breast cancer patients who have isolated local lesion and have not metastasized. The extend of chest wall resection must be overall radical resection of the tumors diagnosed by pathology. However, surgery often leads to huge defects, even full-thickness defects, and these defects are difficult to repair. Here, we reported our experience in chest wall resection and reconstruction of patients with locally recurrent breast cancer, and also did a comprehensive literature review.Case Presentation: We report five cases with locally recurrent breast cancer, followed by chest wall reconstruction with a pedicled rectus abdominis musculocutaneous flap or a pedicled latissimus dorsi musculocutaneous flap and, if necessary, a piece of titanium mesh. Chest wall resection and reconstruction were successfully achieved in all 5 patients. No complication and recurrence were observed, except one patient died of late lymphatic metastasis. Other patients reported good quality of life.Conclusion: For locally recurrent breast cancer, complete tumor resection is essential and ensures no recurrence. Appropriate material and the blood-rich flap or myocutaneous flap should be used to reconstruct the chest wall defect as an effective treatment for surgical procedure.
SbbHLH85, a bHLH Member, Modulates Resilience to Salt Stress By Regulating Root Hair Growth in Sweet Sorghum
Authors: Song Yushuang , Li Simin , Sui Yi , Zheng Hongxiang , Han Guoliang , Sun Xi , Yang Wenjing , Wang Hailian , Zhuang Kunyang , Kong Fanying , Meng Qingwei , Sui Na
Published: March 2021

Introduction: bHLH family proteins play an important role in plant stress response. However, the molecular mechanism regulating salt response of bHLH is largely unknown.Materials and Methods: Here, we investigated the function and regulating mechanism of the sweet sorghum SbbHLH85 during salt stress. Results: Results show that SbbHLH85, different from its homologs in other species, is a new atypical bHLH transcription factor and is a key gene for root development in sweet sorghum. Knockout of SbbHLH85 in sorghum by CRISPR-Cas9 results in the inhibition of root development. Overexpression of SbbHLH85 resulted in significantly increased number and length of root hairs by participating in ABA and auxin signaling pathways, which can increase the absorption of Na+. While SbbHLH85 plays a negative regulatory role in salt tolerance of sorghum. Through screening yeast two-hybrid library, we identified a potential interaction partner of SbbHLH85 that is phosphate transporter chaperone PHF1, which modulates the distribution of phosphate. Both yeast two-hybrid and BiFC experiments confirmed interaction between SbbHLH85 and PHF1. Discussion: Based on these results, we suggest that the increase of Na+ content and the decrease of Pi content result in the salt sensitivity of transgenic sorghum.
Amelioration of Oxidative Stress by Trans-anethole via Modulating Phase I and Phase II Enzymes Against Hepatic Damage Induced by Ccl4 in Male Wistar Rats
Authors: Pandit Kritika , Kumar Ajay , Kaur Sandeep , Kumar Vinod , Jain Subheet , Bhardwaj Renu , Kaur Satwinderjeet
Published: March 2021

The current study was designed to assess the in vivo hepatoprotective properties of trans-Anethole and it is a principal aromatic component of star anise possessed several therapeutic properties. Results showed that CCl4 treatment elevated the levels of different serum markers like serum glutamate oxaloacetate transaminase (SGOT) by 4.74 fold, serum glutamate pyruvate transaminase (SGPT) by 3.47 fold, aspartate alkaline phosphatase (ALP) by 3.55 fold, direct bilirubin by 3.48 fold and total bilirubin by 2.38 fold in contrast with control. It was observed that decreased levels of various liver antioxidant enzymes viz. CAT, GR, and GSH were significantly ameliorated by the pre-administration of rats with different doses (40, 80, and 160 mg kg-1 bw) of trans-Anethole. Furthermore, pre-treatment of trans-Anethole reduced phase I enzymes level, whereas elevated level of phase II detoxifying enzymes. Furthermore, histopathological examination showed that the treatment with trans-Anethole was potent in defending the liver from CCl4 toxic injury and restored normal hepatic architecture. Also, trans-Anethole regulated p53 and Cyclin D1 expressions in liver tissue relative to group II treated with CCl4. Collectively, the findings of the study showed a strong efficiency of trans-Anethole in ameliorating the effects caused by CCl4 through modulation of antioxidants and xenobiotic-metabolizing enzymes.
Urothelial Carcinoma of the Graft Kidney With Molecular Analyses: A Rare Case Report
Authors: Chen Joyce , Haines Kenneth , Lam William , Reddy Asha , Mehrotra Meenakshi , Houldsworth Jane , Si Qiusheng
Published: March 2021

BACKGROUNDMalignancy after transplantation is a leading cause of death in kidney transplant recipients. However, donor-derived malignancies are rarely reported. We herein report a high grade papillary urothelial carcinoma of the graft kidney, involving the graft ureter and native urinary bladder, invading one left obturator lymph node, and sparing the two native kidneys and ureters.CASE PRESENTATION62-year-old female with history of kidney transplantation more than 30 years ago, who presented with urinary tract infection, acute renal failure, and hydronephrosis of the transplant kidney. Anterograde nephrostogram showed a large filling defect in the lower pole of the transplant kidney and a filling defect in the proximal 3-4 cm of ureter. Biopsy taken from the renal pelvic mass showed a high grade urothelial carcinoma. She underwent hysterectomy, bilateral salpingo-oophorectomy, nephrectomy of native kidneys and transplant kidney, cystectomy and bilateral pelvic lymph node dissections. Histology showed a high grade papillary urothelial carcinoma of the graft kidney, involving the graft ureter, native urinary bladder and one left obturator lymph node and sparing the two native kidneys and ureters. Short tandem repeat (STR) analysis confirmed the tumor was of donor origin. The next-generation sequencing identified amplification of TERT and loss of CDKN2A/CDKN2B in the primary tumor.CONCLUSIONWhile it is known that transplant recipients have an increased risk of urothelial carcinoma compared to the general population, the lack of the well-documented risk factors, such as older age at transplantation, BK polyomavirus infection, and prolonged post-transplantation history and dissemination of the tumor in this case shed light on the de novo tumorigenesis of the graft kidney within the host microenvironment. Amplification of Telomerase reverse transcriptase (TERT) and loss of cyclin dependent kinase inhibitor 2A/2B (CDKN2A/CDKN2B) detected in the tumor by next gene sequencing suggests that they may play an important role in this case.
The Evaluation of Extracorporeal Membrane Oxygenation in Children with Acute Hypoxemic Respiratory Failure in China: A Five-year Single-center Retrospective Study
Authors: Ying Jiayun , Cheng Ye , Yan Gangfeng , Lu Guoping , Chen Weiming , Cai Xiaodi
Published: March 2021

Objective: To summarize the clinical features, laboratory parameters, and outcomes of children with acute hypoxemic respiratory failure supported by extracorporeal membrane oxygenation and explore the risk factors of the prognosis.Methods: It’s a retrospective study from one hospital the Pediatric Intensive Care Unit of Children’s Hospital of Fudan University in China. Patients, aged 28 days to 18 years, with acute hypoxemic respiratory failure supported by mechanical ventilation underwent extracorporeal membrane oxygenation from January 2015 to December 2019 were enrolled in this study. The primary outcome was defined as in-hospital mortality within 28 d after admission. Demographics, medical history, comorbidities, laboratory findings, vital signs, medications, need for continuous renal replacement therapy, need for other rescue therapy, need for transportation, ventilator settings, oxygenation indices were recoded. Appropriate data entry and statistical analysis were performed on access 2007 and SPSS software version 23.Results: Fifty patients with severe acute hypoxemic respiratory failure were enrolled in the study. We analyzed 45 patients (90%) after excluding 5 for missing data. Overall mortality was 53.5%. The PaO2 prior to extracorporeal membrane oxygenation was higher (64 cmH2O [51.9, 70.0 cmH2O] vs 55.1 cmH2O [43.8,60.1], p = 0.009) and OI prior to extracorporeal membrane oxygenation was lower (33.3 [30.1, 40.7] vs 41.2 [33.2 -55.1], p = 0.031) in survivors than nonsurvivors. In multivariate analysis, PaO2 prior to extracorporeal membrane oxygenation was significantly associated with survival (odds ratio 1.129, 95% Cl 1.022 -1.247).Conclusions: Extracorporeal membrane oxygenation might be an alternative strategy for pediatric patients with severe acute hypoxemic respiratory failure Low PaO2 prior to extracorporeal membrane oxygenation indicated a poor prognosis. Maybe we should consider that extracorporeal membrane oxygenation should be implemented earlier.Trial registration: This study was registered on the Clinical Trail. The number is NCT04709432.
Study on Minimum Rollable Thickness in Asymmetrical Rolling
Authors: Wang Ji , Liu Xianghua
Published: March 2021

A new model for the asymmetrical rolling is proposed to calculate the minimum rollable thickness simply and fast by the slab method. The calculation formulas of the rolling pressure, the rolling force, the critical roll speed ratio and the critical front tension under different deformation zone configurations are proposed, and the deformation zone configuration - rolling parameters relationship diagram is given and analyzed. The results show that the minimum rollable thickness can be reached when the rolling parameters keep the deformation zone configuration as cross-shear zone + backward-slip zone (C+B) or all cross-shear zone (AC). The calculation formulas of the minimum rollable thickness and the required rolling parameters for different deformation zone configurations are proposed respectively. The calculated value is in good agreement with the experimental results.
Using management coaching techniques is feasible and can be beneficial to strengthen health system in Western Kenya
Authors: Oluoch Prisca , doledec david , Mutea Fridah , Lelei Asa , Bruas Sophie
Published: March 2021

Background

To strengthen the health system in five counties of Western Kenya, the System Enhancement for Transformative Health (SETH) Project provided training on coaching to its officers and coordinators to build their capacity to support health management teams address the challenges they face in their daily work. Health management teams manage entire counties in kenya with limited management training and experience. Following 3 days of training, the project team provided coaching sessions to health management teams and was supervised by a professional coach over a 2-year period. This study aimed to evaluate the feasibility and acceptability of using professional coaching techniques to improve the capacity of project officers to support HMTs in Kenya.
Methods

(14) Key Informant Interviews (KII) and (5) Group interviews were conducted with all SETH project officers and coordinators trained on coaching and the HMTs members they supported to collect their perceptions on the feasibility and benefits of the intervention components. Respondents were also asked about the sustainability of the project.
Results

Results show that coaching improved the project officers’ self-reported skills and competencies to provide support to county HMTs. The project offers reported feeling better equipped to help HMTs identify lasting solutions to the challenges faced in their daily work. HMTs also reported having gained knowledge and skills to be used on their daily work thanks to the coaching sessions received.
Conclusions

The study indicates that integrating coaching in health system strengthening is feasible and appreciated by participants in the intervention. The potential impact of coaching on work performance and on health indicators remains to be evaluated.
Multi-modality Therapies for Advanced Small Cell Carcinoma of the Ovary, Hypercalcemic Type (SCCOHT): Three Case Reports and Literature Review
Authors: Han Qin , Guo Hongyan
Published: March 2021

BackgroundSmall-cell carcinoma of the ovary, hypercalcemic type (SCCOHT) is a rare but highly undifferentiated, aggressive malignancy that primarily affects young women. Due to the early onset, unclear familial history, and vague presenting symptoms, most SCCOHT patients present with advanced disease and have a very poor prognosis. Although several therapeutic regimens have been proposed, there is no consensus on the optimal strategy. Case presentationWe described three cases of advanced-stage SCCOHT treated with cytoreductive surgery and chemotherapy with or without immune checkpoint blockade treatment. The patients showed different survival rates.Conclusions﻿Given the almost universal mortality of advanced SCCOHT during long-term follow-up, we believe these cases highlight the importance of prompt diagnosis as well as early, aggressive, and combined modality treatment of SCCOHT. We also believe that improved therapies could result in more young patients surviving SCCOHT.
Acute Kidney Injury as Presenting Symptom of Primary Lymphoma of the Uterus: Uncommon Presentation of a Rare Disease
Authors: Snyder Alexandra , Dhanuka Ida , Li Haiyan , Shakil Fouzia , Han Liying , Bhardwaj Sushil , David-West Gizelka
Published: March 2021

Background: Primary uterine lymphoma is a rare disease, with diffuse large B cell lymphoma being the most common subtype. There are a limited number of reports, series, and reviews in the literature on this disease and its variable clinical presentations. Further data is needed to prevent delay in diagnosis and treatment.Case: We present the case of a 73-year-old with acute kidney injury secondary to severe bilateral hydronephrosis in setting of an enlarged uterus, confirmed to be primary uterine diffuse large B cell lymphoma.Conclusion: Acute kidney injury secondary to severe bilateral hydronephrosis is an uncommon clinical presentation of primary uterine lymphoma. This case highlights the importance of heightened awareness of such rare presentations so not to delay diagnosis and treatment of this disease, and emphasizes benefit of surgical resection in the diagnosis and treatment of this disease.
Student and Foundation Year Pharmacist Performance in the ‘UK Prescribing Safety Assessment’
Authors: Power Ailsa , Stewart Derek , Craig Gail , Boyter Anne , Reid Fiona , Stewart Fiona , Cunningham Scott , Maxwell Simon
Published: March 2021

BackgroundIncreasingly the global policy direction is for patient-facing pharmacist prescribers. The ‘UK Prescribing Safety Assessment’ (PSA) was developed for medical graduates to demonstrate prescribing competencies in relation to the safe and effective use of medicines.ObjectivesTo determine PSA performance of final year undergraduate student pharmacists (year 4) and pre-registration pharmacy graduates (year 5) and explore their opinions on its suitability. SettingScotland, UKMethodsFinal year undergraduates (n= 238) and pharmacy pre-registration graduates (n= 167) were briefed and undertook the PSA. PSA questions were mapped to specific thematic areas with 30 questions over 60 minutes. Data was analysed using descriptive statistics. A questionnaire was completed to gauge opinions on appropriateness of the PSA.Main Outcome Measure PSA scoresResultsMean total PSA score for pre-registration graduates (64.4, SD 10) was significantly higher than for undergraduates (51.2, SD 12.0,) (p<0.001). Pre-registration graduates performed significantly better across all question areas (all p<0.001 other than ‘adverse drug reactions’, p<0.01). Hospital pre-registration graduates performed statistically significantly better than community with higher overall scores (67.4, SD 9.8 v 63.2, SD 9.8, p<0.05). Positive views on the appropriateness of the approach and the usability of the online interface were obtained from participants. ConclusionHospital graduates performed better than the undergraduates, but there is a need to improve prescribing skills in all, most notably in diagnostic skills. The PSA is acceptable to the participants. These results will help inform pharmacy curricula development and provides a cross-disciplinary method of assessment of prescribing competence.
Cardiac Arrest Due to Pneumomediastinum following Esophagojejunal Anastomotic Fistula: A Case Report.
Authors: Ye Ruiling , Tang Wei , Luo Shiyu , Wan Dong
Published: March 2021

Background：Cardiac arrest due to pneumomediastinum following esophagojejunal anastomotic fistula is one of the most severe postoperative complications. However，It presents with insidious symptoms and easy to be ignored.Case presentation: A 59-year-old man had total laparoscopic radical gastrectomy for gastric cardia adenocarcinoma (GCA). Since then, He began to appear shortness of breath and dyspnea gradually. The image reported severe pneumomediastinum due to esophagojejunal anastomotic fistula. Sudden cardiac arrest developed. Immediate cardiopulmonary resuscitation (CPR) and epinephrine rescue were carried out. Stents were placed to plug the fistula and drainage was performed.Conclusions: Pneumomediastinum is easily overlooked as a complication of esophagojejunal anastomotic fistula after subtotal gastrectomy. A delay in diagnosis increases the rate of cardiac arrest. At present, the treatment of esophagojejunal anastomotic fistula mainly adopts conservative treatment such as drainage and interventional therapy. But the death rate is extremely high. Early positive identification is the life-saving procedure and should not be delayed.
Lack of Association Between Patients Characteristics and the Carriage of Extended-spectrum β-Lactamase Producing Enterobacteriaceae in Community Settings in Blantyre, Malawi
Authors: Onduru Onduru Gervas , Rumisha Susan Fred , Mkakosya Rajhab Sawasawa , Bunduki Gabriel Kambale , Aboud Said
Published: March 2021

Objective: This study examined factors associated with the carriage of extended-spectrum β-lactamase (ESBL) producing Enterobacteriaceae in community patients in Blantyre, Malawi. ResultsA total of 50 community patients with ESBL producing Enterobacteriaceae (ESBL-E) carriage were identified from 300 adults recruited in the study, which gave a prevalence of 16.67% (50/300, 95% CI=12.43-20.91%). The mean age ±SD was 32.41±12.07 years; range, 18-75 years and 54.33% (163/300) were women. The results of unadjusted logistic regression model fitted to identify factors associated with ESBL-E carriage in community patients showed that there was no any degree of association between carriage of extended-spectrum β-lactamase producing Enterobacteriaceae in community patients with either their demographic or clinical characteristics.
The Lived Experiences of Esophageal Cancer Patients With The Concept of Uncovering Pathways to Seeking Treatment and Follow-Up: A Qualitative Study in Arsi Zone, Oromia, Ethiopia
Authors: Deybasso Haji Aman , Roba Kedir Teji , Belachew Tefera
Published: March 2021

Objective: Esophageal cancer patients experience multifaceted challenges but studies often focus on the prevalence and risk factors of esophageal cancer with no documentation of the lived experiences of patients. This study aimed at exploring the lived experiences of esophageal cancer patients with the concept of uncovering pathways to seeking treatment, and follow-up. Results:- The experience of seeking care began with self-care followed by visiting traditional healers, and hierarchical layers of health care delivery systems. The barriers to treatment follow-up were inaccessibility, unaffordability of health care services, and negative attitudes towards treatment. Patients experienced distresses linked to food intakes, treatment side effects, reduced quality of life, psychological and physical impairments. Esophageal cancer patients in this study experienced complex pathways to seeking treatment, multidimensional obstacles to treatment follow-up, and live with unbearable challenges.
Snail Mucus From the Mantle and Foot of Two Land Snails, Lissachatina Fulica and Hemiplecta Distincta, Exhibits Different Protein Profile and Biological Activity
Authors: Noothuan Nattaphop , Apitanyasai Kantamas , Panha Somsak , Tassanakajon Anchalee
Published: March 2021

Objective: Snails secrete different types of mucus that serve several functions, and are increasingly being exploited for medical and cosmetic applications. In this study, we explored the protein pattern and compared the biological properties of the mucus secreted from the mantle collar and foot of two snail species, Lissachatina fulica and Hemiplecta distincta.Result: Protein profile showed a different pattern between the two species and between the two secretory parts. The mantle-specific protein bands were further characterized and among them was an antibacterial protein, achacin. Accordingly, the mucus from the mantle exhibited the higher antibacterial activity than that from the foot in both snail species. The mucus from H. distincta, first reported here, also showed antibacterial properties, but with a lower activity compared to that for L. fulica. Snail mucus also exhibited anti-tyrosinase activity and antioxidant activity but with no significant difference between the foot and mantle mucus. These results indicate some different protein compositions and biological activities of snail slime from the mantle and foot, which might be associated with their specific functions in the animal and are useful for medical applications.
H2S Exposure Induces Autophagy Injury in The Jejunum of Broilers Through miR-181a-PKC-δ Axis Mediated ER Stress
Authors: Zhu Wenjing , Guo Jinming , Chen Ting , Zheng Shufang , Xu Shiwen
Published: March 2021

Background:Hydrogen sulfide (H2S), as a toxic atmospheric and industrial pollutant, is one of the main components of haze. Air exposure to H2S can cause multiple organ and tissue damage. However, studies on the animal intestines of H2S toxicity are limited. To clarify the effect of H2S exposure on intestinal proteomics and the role of autophagy in intestinal injury, in the present study, effects of H2S exposure on jejunum damage of broilers were examined by establishing a 42-day H2S exposure broiler model. Results:We observed the morphological changes that arose, screened differentially expressed proteins (DEPS) and enriched related pathways via electron microscopy, proteomics and bioinformatics analyses, qRT-PCR, and western blot. We obtained 86 proteins that were significantly different under H2S exposure, including proteins related to autophagy and ER stress regulation. Meanwhile, protein-transcriptomics combined analysis found that autophagy and ER stress-associated pathways MAPK signaling pathway, FOXO signaling pathway, mTOR signaling pathway and Autophagy were significantly enriched. Besides, the expression of the autophagy-related indicators LC3II/I, Dynein, Beclin1, BNIP3, and ULK1 were remarkably up-regulated under H2S exposure (P < 0.05). In contrast, the activities of p62 and mTOR were significantly decreased (P < 0.05). Conclusions: The above results indicate that H2S induced autophagy in the jejunum via the miR-181a-PKC-δ axis activates ER stress to induce p38/JNK expression. In our study, the combined analysis of proteomics and transcriptomics on broiler intestines was described for the first time and verified the selected pathways related to ER stress and autophagy. These results provide novel insights into the toxicology of H2S and environmental research.
Multi-factor Evaluation of Tumor-infiltrating Lymphocytes in Laryngeal Squamous Cell Carcinoma and its Prognostic Value
Authors: miao susheng , wang xueying , Guo Erliang , Guo Lunhua , An Changming , Zhang Cong , Song Kaibin , Wang Guohui , Duan Chunbin , Zhang Xiwei , Yang Xianguang , Yuan Zhennan , Sun Ji , Yang Weiwei , Mao Xionghui , li xiaomei
Published: March 2021

Background: Laryngeal squamous cell carcinoma (LSCC) is a heterogeneous disease. In clinical practice, patients with similar clinicopathological characteristics often show different outcomes. This study evaluated the levels of primary LSCC intratumoral infiltrating lymphocytes (iTILs), tumor-infiltrating lymphocyte volume (TILV), frontier tumor-infiltrating lymphocytes (fTILs), and their relations to the patient's clinical outcome. Materials and methods: According to the 2017 study of the International TILs Working Group, hematoxyline and eosin-stained slides from 412 patients were evaluated for their morphology of tumor immune infiltration status.Results: Kaplan-Meier analysis showed that high levels of iTILs, TILV, and fTILs were significantly correlated with OS (all P<0.05). Cox regression model analysis showed that high levels of iTILs, TILV, and fTILs were independently associated with better OS (all P<0.05). Conclusion: Local inflammatory markers in patients with laryngeal squamous cell carcinoma, especially the levels of iTILs, TILV, and fTILs, are reliable prognostic factors.