bluuebunny/crossref_metadata_2025 huggingface dataset:
Design and Fabrication of Sierpinski Square Fractal Microstrip Patch Antenna with Parasitic Elements for Wideband Applications
Authors: Kattimani Bharamappa Irappa , Patil Rajendra R
Published: May 2022

The narrow bandwidth of a microstrip antenna is one of its key drawbacks. This work shows how a dual-layer stacked and parasitic arrangement, together with the effect of fractal designs, can provide wide bandwidth and high gain qualities in a microstrip patch antenna. For wideband applications, the proposed antenna design in stacked construction has a total bandwidth of 750MHz for S11 -10dB. In order to reduce the antenna size, the Sierpinski square carpet fractal is used. This antenna exhibits a lower resonance frequency due to the space-filling property of fractal geometry. The resonance frequency of this patch antenna drops as iteration and iteration factors rise, according to experimental results. Wideband functioning is achieved with a size decrease of 70.1%. The proposed antenna design exhibits a 6.98dB gain. These qualities of wideband and higher gain make the proposed antenna an excellent one for wideband applications.
MacroH2A restricts melanoma progression via inhibition of inflammatory gene expression in cancer-associated fibroblasts
Authors: Filipescu Dan , Hasson Dan , Tung Navpreet , Carcamo Saul , Humblin Etienne , Goldberg Matthew , Vyas Nikki , Beaumont Kristin , Ghiraldini Flavia , Salmon Helene , Sebra Robert , Kamphorst Alice , Merad Miriam , Bernstein Emily
Published: May 2022

The histone variant macroH2A has been implicated as a tumor suppressor in melanoma and other cancers, yet its role in the tumor microenvironment remains unappreciated. Using an autochthonous, immunocompetent mouse model of melanoma, we demonstrate that mice devoid of macroH2A exhibit increased tumor burden compared to wild type counterparts. MacroH2A-deficient tumors display an accumulation of immunosuppressive monocytes and decreased functional cytotoxic T cells, and consistent with this compromised anti-tumor response, exhibit upregulation of pro-inflammatory cytokines including Ccl2, Cxcl1 and Il6. Through single cell transcriptomics of the entire melanoma microenvironment, we identify the source of these pro-tumor myeloid chemoattractants as cancer-associated fibroblasts (CAFs), whose frequency and activation increase in the absence of macroH2A. Furthermore, cytokine genes in CAFs lacking macroH2A are hyper-inducible and their regulatory elements present an altered epigenetic landscape. In sum, we reveal a tumor suppressive role for macroH2A variants through repression of inflammatory gene induction in the tumor stroma.
Interventional continuous negative pressure drainage for bronchopleural fistula: case series and literature review
Authors: Li Xiaobing , Wang Shuai , Liu Chao , Huang Lisha , Ni Ran , Li Xiangnan , Qi Yu , Yin Meipan , Ma Yaozhen , Zhu Ming , Wu Gang
Published: May 2022

Background: Bronchopleural fistula (BPF) is a serious complication of pulmonary resection. The purpose of this study was to evaluate the safety and efficacy of interventional continuous negative pressure drainage (CNPD) in the treatment of post-lobectomy bronchopleural fistula complicated by hydropneumothorax.Methods: A retrospective analysis of patients with BPF complicated by hydropneumothorax who underwent interventional CNPD was performed, in addition to a review of the literature. This study was registered in China clinical trial registry (Registration No.: chictr-ooc-15006036).Results: Among the 5 patients included, the one-time success rate of drainage catheter placement was 100%. No complications such as hemoptysis, hemothorax and asphyxia were reported. The patients' pneumonia severity index score significantly decreased from 99.8 ± 8.90 pre-intervention to 69.8 ± 14.03 three to seven days post-intervention (P < 0.001), with significant improvement and resolution of chest tightness, dyspnea and fever. The average indwelling time was 149.8 ± 56.059 days (95% CI: 39.72 –259.48).Conclusion: Interventional CNPD is minimally invasive, accurate and effective, allowing for rapid lung re-expansion, residual cavity elimination, and symptomatic relief. It thereby carries the potential as a novel treatment for BPF.
Evaluating keystroke dynamics as a biomarker for mental fatigue detection
Authors: Arroyo-Gallego Teresa , Ayala Alejandro Acien , Morales Aythami , Vera-Rodriguez Ruben , Fierrez Julian , Mondesire-Crump Ijah
Published: May 2022

In this paper we study the feasibility of employing keystroke biometrics for mental fatigue detection during natural typing. For this task, we employ TypeNet, a state-of-the-art deep neuronal network, originally intended for user authentication at large scale using keystroke dynamics. We adapted TypeNet for fatigue detection by leveraging the information embedded in TypeNet for person recognition, and applying that information to a different but related task as it is fatigue detection by employing domain adaptation techniques. All experiments were conducted using three keystroke databases that comprise different contexts and data collection protocols. Our preliminary results showed performances ranging between 72.2% and 80.0% for fatigue versus rested sample classification, which is aligned with previously published models on daily alertness and circadian cycles. This demonstrates the potential of our proposed system to characterize mental fatigue fluctuations via natural typing patterns. Finally, we studied the feasibility of an active detection approach that utilizes the continuous monitoring of keystroke biometric patterns for the real-time assessment of subject fatigue.
SARS-CoV-2 and its variants, but not Omicron, induces severe thymic atrophy and impaired T cell development
Authors: Rizvi Zaigham , Sadhu Srikanth , Dandotiya Jyotsna , Binayke Akshay , Sharma Puja , Singha Virendra , Das Vinayaka , Khatri Ritika , Kumar Rajesh , Samal Sweety , Kalia Manjula , Awasthi Amit
Published: May 2022

Pathogenic infections cause thymic atrophy, perturb thymic-T cell development and alter immunological response. Previous studies reported dysregulated T cell function and lymphopenia in coronavirus disease-19 (COVID-19) patients. However, immune-pathological changes, in the thymus, post severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection have not been elucidated. Here, we report SARS-CoV-2 infects thymocytes, depletes CD4 + CD8+ (double positive; DP) T cell population associated with an increased apoptosis of thymocytes, which leads to severe thymic atrophy in K18-hACE2-Tg mice. CD44 + CD25- T cells were found to be enriched in infected thymus, indicating an early arrest in the T cell developmental pathway. Further, Interferon gamma (IFN-γ) was crucial for thymic atrophy, as anti-IFN-g antibody neutralization rescued the loss of thymic involution. Therapeutic use of remdesivir (prototype anti-viral drug) was also able to rescue thymic atrophy. While Omicron variant of SARS-CoV2 caused marginal thymic atrophy, delta variant of SARS-CoV-2 exhibited most profound thymic atrophy characterized by severely depleted DP T cells. Recently characterized broadly SARS-CoV-2 neutralizing monoclonal antibody P4A2 was able to rescue thymic atrophy and restore thymic developmental pathway of T cells. Together, we provide the first report of SARS-CoV-2 associated thymic atrophy resulting from impaired T cell developmental pathway and also explains dysregulated T cell function in COVID-19.
First clinical application of cord blood mesenchymal stromal cells in children with multi-drug resistant nephrotic syndrome.
Authors: Morello William , Budelli Silvia , Bernstein Daniel Ari , Montemurro Tiziana , Montelatici Elisa , Lavazza Cristiana , Ghio Luciana , Edefonti Alberto , Peruzzi Licia , Molino Daniela , Benetti Elisa , Gianoglio Bruno , Mehmeti Florian , Catenacci Laura , Rotella Jessica , Tamburello Chiara , Moretta Antonia , Lazzari Lorenza , Giordano Rosaria , Montini Giovanni
Published: May 2022

Background and objectives. Children with multi-drug resistant idiopathic nephrotic syndrome (MDR-INS) usually progress to end-stage kidney disease with a consistent risk of disease recurrence after transplantation. New therapeutic options are needed for these patients. Mesenchymal stromal cells (MSCs) are multipotential non-hematopoietic cells with several immunomodulatory properties and growing clinical applications. Cord blood-derived MSC have peculiar anti-inflammatory and immunosuppressive properties.We aimed at assessing safety and efficacy of cord-blood derived MSCs (CB-MSCs) in children with MDR-INS.Design, setting, participants. Prospective, open-label, single arm phase I-II pilot study. Pediatric patients with MDR-INS, resistant to at least two lines of therapy, were enrolled. Allogenic CB-MSCs were administered intravenously on days 0, 14, and 21 at a dose of 1.5 x 106 cells/kg. Patients were followed for at least 12 months. The primary outcomes were safety and toxicity. The secondary outcome was remission at 12 months evaluated by urinary protein/urinary creatinine ratio (uPr/uCr). Circulating regulatory T cells (Tregs) were monitored.Results. Eleven pediatric patients with MDR-INS (10 females, median age 13 years) resistant to a median of 3 previous lines of therapy were enrolled. All patients completed the CB-MSC infusion schedule. No patient experienced any infusion-related adverse event or toxicity.Nine patients were assessable for efficacy. At the 12 months follow-up after the treatment, the median uPr/uCr did not change significantly from baseline (8.13 vs 9.07; p = 0.98), while 3 patients were in partial or complete remission. A lower baseline uPr/uCr was a predictor of remission (2.55 vs 8.74; p = 0.0238). Tregs count was not associated with CB-MSCs therapy.Conclusions CB-MSCs are safe and may have a role in the immunosuppressive therapy of pediatric patients with MDR-INS. This preliminary experience paves the way towards further phase II studies addressing MSC efficacy in immune mediated kidney diseases.
Effects of a comprehensive brain computed tomography deep-learning model on radiologist detection accuracy: a multireader, multicase study
Authors: Buchlak Quinlan , Tang Cyril , Seah Jarrel , Johnson Andrew , Holt Xavier , Bottrell Georgina , Wardman Jeffrey , Samarasinghe Gihan , Pinheiro Leonardo , Xia Hongze , Ahmad Hassan , Pham Hung , Chiang Jason , Ektas Nalan , Milne Michael , Chiu Christopher , Hachey Ben , Ryan Melissa , Johnston Benjamin , Esmaili Nazanin , Bennett Christine , Goldschlager Tony , Hall Jonathan , Vo Duc Tan , Oakden-Rayner Lauren , Leveque Jean-Christophe , Farrokhi Farrokh , Jones Catherine , Edelstein Simon , Brotchie Peter
Published: May 2022

Background: Non-contrast computed tomography of the brain (NCCTB) is commonly used in clinical practice to detect intracranial pathology but is subject to interpretation errors. Machine learning is capable of augmenting clinical decision making and there is an opportunity to apply deep learning to improve the clinical interpretation of NCCTB scans. This retrospective detection accuracy study assessed the performance changes of radiologists assisted by a deep learning model designed to identify many NCCTB clinical findings and also compared the standalone performance of the model with that of unassisted radiologists. Methods: A deep learning model was trained on 212,484 CT scan images of the brain. Thirty-two radiologists each reviewed 2,848 NCCTB cases in a test dataset with and without the assistance of the deep learning model. The consensus of three subspecialist neuroradiologists with access to reports and clinical history was used as a ground truth baseline for comparison. Performance metrics including area under the receiver operating characteristic curve (AUC) were calculated for the unassisted and assisted radiologists. Average assisted and unassisted radiologist performance was also compared to that of the model for each clinical finding. Findings: Use of the deep learning model by radiologists significantly improved interpretation performance. Assisted and unassisted radiologists demonstrated an average AUC of 0.79 and 0.73 across the 22 grouped parent findings and 0.72 and 0.68 across all 189 child findings combined, respectively. When the model was used as an assistant, change in radiologist AUC was positive and significant for 91 child findings and 158 findings were clinically non-inferior. AUC decrements were identified for 17 findings. The model alone demonstrated an average AUC of 0.93 across all 144 model findings. Interpretation: The assistance of a comprehensive NCCTB deep learning model in a non-clinical setting significantly improved radiologist detection accuracy across a wide range of clinical findings. This study demonstrated the potential of the evaluated model to improve NCCTB interpretation.
HDR Image-Based Deep Learning Approach for Automatic Detection of Split Defects on Sheet Metal Stamping Parts
Authors: Singh Aru Ranjan , Bashford-Rogers Thomas , Marnerides Demetris , Debattista Kurt , Hazra Sumit
Published: May 2022

Sheet metal stamping is widely used for high-volume production. Despite the wide adoption, it can lead to defects in the manufactured components, making their quality unacceptable. Because of the variety of defects that can occur on the final product, human inspectors are frequently employed to detect them. However, they can be unreliable and costly, particularly at speeds that match the stamping rate. In this paper, we propose an automatic inspection framework for the stamping process that is based on computer vision and deep learning techniques. The low cost, remote sensing capability and simple implementation mean that it can be easily deployed in an industrial setting. A particular focus of the framework is to account for the harsh lighting conditions found in manufacturing environments that affect optical sensing techniques by making it difficult to capture the details of a scene. To test the framework, sheet metal ’Nakajima’ samples were manufactured with an industrial stamping press. Then optimally exposed, sequence of exposures, tone-mapped and high-dynamic-range images of the samples were used to train convolutional neural network based detectors. Analysis of the resulting models showed that HDR-based models achieved substantially higher accuracy and minimal false-positive predictions.
Retrospective evaluation of CT-head scans for the association between posterior atlanto-occipital membrane ossification with cervicogenic headache and migraine
Authors: Sudip Kumar , Patil Utkarsh Chandrakant , Wasadikar Anajli Pravinkumar
Published: May 2022

Purpose- The objective of the study was to find the prevalence of arcuate foramen and its association with cervicogenic headache and migraine. To study various demographic parameters associated with the anomaly and to correlate the extent of ossification of posterior atlanto-occipital membrane with the severity of symptoms. Methods- A cross sectional study was done to analyze CT-head scans of patients with cervicogenic headache and migraine for the presence of arcuate foramen. Demographic parameters of the patients were collected from the detailed case report from achieves. The collected data was analyzed using SPSS, a p-value of <0.05 were considered significant. Results- Arcuate foramen was prevalent in 41.8% of symptomatic patients. No significant association between the incidence of arcuate foramen and age group was found. Incidence is increased incidence among the male patients (61%). Patients who are labourer by occupation showed increased incidence (34.78%). A positive correlation (0.755) was found between the extent of ossification and the severity of clinical symptoms. The foramen was more commonly found on the left side and majority of patients presented with unilateral anomaly (27.27%). Conclusion- Arcuate foramen is fairly prevalent among the symptomatic patients and is often neglected as an etiologic agent and leads delay in diagnosis and management. It can lead to injury to vertebral artery during screw placement if misidentified as broad posterior arch. Therefore, it must be screened in symptomatic patients and those patients undergoing lateral neck surgery using lateral cephalogram, if detected must be documented on health records of the patient.
Serum Lactate Monitoring Predict Neurological Function Impairment Caused by Acute Metabolism Crisis
Authors: Liu Dandan , Li Guanggang , Yao Qing , Song Bin , Sun Yue , Ju Hongyan
Published: May 2022

Objective: To investigate the predictive value of the serum lactate on neurological function impairment attributed to acute metabolism crisis (ACMC) .Methods: In this retrospective study, all the adult patients admitted to ICU more than 24h after general anesthesia elective neurosurgery from January 2018 to January 2019 were recruited. The data of the serum lactate every 8 h during the 24 h of ICU admission were acquired and analyzed.Results: 169 patients were included in the outcomes analysis. The average serum lactate after ICU admission was (3.7(0.7), mmol/L), higher than normal, suggesting that ACMC commonly existed. The serum lactate at ICU admission (lactateserum0h) was not correlated with the outcomes,but the predictive value increased with the extension of the monitoring time. The lactateserum8h, the lactateserum16h and the lactateserum24h were found to be associated with the primary outcome(difference of GCS scores before the surgery and after 24 h of ICU admission (ΔGCS24h)(p<0.05). The lactateserum16h and the lactateserum 24h were associated with all the outcomes except the hospital LOS. The ROC curve revealed that the lactateserum24h had the best predictive value. The graph of the dynamic changes of the serum lactate indicated that patients with serum lactate non-recovered trend after 24 h of ICU stay had decreased GCS scores, and vice versa. To find an index predicting ACMC earlier, the predictive value of the serum glucose/serum lactate ratio at ICU admission (G/Lserum) was analyzed and found to be associated with the ΔGCS24h(p<0.05), the G/Lserum can predict the ACMC earlier.Conclusions: Dynamic serum lactate monitoring and the G/Lserum at ICU admission have predictive value on neurological function impairment attributed to ACMC.
Efficacy of Enzalutamide for Patients with Castration-Resistant Prostate Cancer in Real-World Clinical Practice: A Retrospective Single Institutional Analysis with 5-Year Follow-up
Authors: Taniguchi Hisanori , Yanishi Masaaki , Saito Ryoichi , Kinoshita Hidefumi
Published: May 2022

Background
Enzalutamide’s efficacy and prognosis for patients with castration-resistant prostate cancer (CRPC) in real-world clinical practice have not been sufficiently examined.
Methods
We retrospectively investigated data on 135 consecutive CRPC patients who had received enzalutamide. Prostate-specific antigen (PSA) response ( > = 50% PSA decline from baseline), progression-free survival (PFS), overall survival (OS), and poor prognostic factors related to PFS and OS were analyzed.
Results
The median follow-up period was 63 months. Of all, 46 cases were post-chemo, 90 were metastatic, and 38 were prior-abiraterone acetate use. PSA responses were observed in 55.6% of patients, and no statistically significant differences between chemo-naive and post-chemo groups were noted. The median PFS of all CRPC patients was 301 days (95% CI, 239–363); in patients with prior abiraterone acetate use, PFS was shorter than the others (HR 0.56, 95% CI, 0.36–0.83, p = 0.010). Median OS from initiation of enzalutamide was 790 days and shorter in patients in the post-chemo and metastatic groups. On the other hand, the median OS from CRPC diagnosis was 1514 days and shorter only in the metastatic group (HR 0.44, 95% CI, 0.19–1.01, p = 0.0052). In multivariate analysis, the time between androgen deprivation therapy (ADT) initiation and CRPC diagnosis being < 20 months (i.e., time to CRPC < 20 mo.), prior-docetaxel use, and prior-abiraterone acetate use were risk factors for shorter PFS. Time to CRPC < 20 mo. and prior-docetaxel use were factors influencing shorter OS from initiation of enzalutamide, and only time to CRPC < 20 mo. was related to shorter OS from CRPC diagnosis.
Conclusions
This study revealed the efficacy of enzalutamide for CRPC patients in a real-world clinical setting. We could use enzalutamide at any time during CRPC treatment. These findings are valuable for clinical decision-making during CRPC patients’ treatment.
Cross-calibration of two dual-energy X-ray absorptiometry devices for the measurement of body composition in young children
Authors: Lyons-Reid Jaz , Kenealy Timothy , Albert Benjamin B. , Ward Kate A. , Harvey Nicholas , Godfrey Keith M. , Chan Shiao-Yng , Cutfield Wayne S.
Published: May 2022

Objectives: To cross-calibrate body composition measures from the GE Lunar Prodigy and GE Lunar iDXA in a cohort of young children. Methods: 28 children (mean age 3.4 years) were measured on the iDXA followed by the Prodigy. Prodigy scans were subsequently reanalysed using enCORE v17 enhanced analysis (“Prodigy enhanced”). Body composition parameters were compared across three measurement conditions (Prodigy, Prodigy enhanced, iDXA), and adjustment equations were developed. Results: There were significant differences in the three measurement conditions for all body composition parameters. Body fat percentage (%BF) from the iDXA was approximately 1.5-fold greater than the Prodigy, whereas bone mineral density (BMD) was approximately 20% lower. Reanalysis of Prodigy scans with enhanced software attenuated these differences (%BF: -2.7% [95% CI: -3.5, -1.9]; and BMD: 1.0% [95% CI: 0.0, 1.9]), although significant differences remained for all parameters except total body less head (TBLH) total mass and TBLH BMD, and some regional estimates. Conclusions: There were large differences between the Prodigy and iDXA, with these differences related both to scan resolution and software. Reanalysis of Prodigy scans with enhanced analysis resulted in body composition values much closer to those obtained on the iDXA, although differences remained. As manufacturers update models and software, researchers and clinicians need to be aware of the impact this may have on the longitudinal assessment of body composition, as results may not be comparable across devices and software versions.
Modelling and Planning Operation of Directly Coupled Solar PV Pump Operated Drip Irrigation System
Authors: HADOLE MAHESH Vinayak , Bajpai Prabodh , Tiwari Kamlesh Narayan
Published: May 2022

A dynamic simulation model of a directly coupled solar photovoltaic (SPV) pump operated drip irrigation (DI) system is presented in this study. The model is applied for preparing a plan of DI system operation to meet the irrigation schedule of the Okra crop considered in the case study. The fundamental mathematical expressions of the SPV array, variable frequency drive, submersible pump, and DI system are used to create a general model in the Matlab/Simulink. The hourly solar irradiation, temperature, and groundwater level are input parameters to the model. The SPV power output, pump discharge and pressure head, and emitter discharges are simulated on hourly basis. The simulated values of these parameters for the same time period are compared with the measured values to assess the model’s accuracy. The simulation accuracy of the model is tested using statistical indicators such as model efficiency (ME), coefficient of residual mass (CRM), root mean square error (RMSE), and normalized mean absolute error (NMAE). The higher ME values (close to 1) and lower NMAE and RMSE values indicated that the simulation model outputs are fairly accurate and within acceptable limits. The negative values of CRM indicate the model’s over-prediction tendency. However, the degree of over-prediction is minimal. The results indicated that the developed simulation model is capable of accurately predicting the system parameters. The developed simulation model is applied in a case study to operate different subunit manifolds of DI system installed in an Okra crop field of 1.2 ha. Based on the simulation results an additional area of 0.19 ha Okra crop can be brought under irrigation using the same SPV powered pumping system. A plan of operation of different sub-main manifolds of DI system are prepared using the simulation model for Okra crop. Similarly, the developed model can be applied to any SPV pump integrated DI system to evaluate and prepare the plan of operation of different sub-main manifolds in the field, thereby effective utilization of energy and water, which is the novelty of this study.
Analysis of the wear characteristics of multi-directional die forging and forming dies for a railway wagon bogie adapter
Authors: Ji Hongchao , Song Gang , Song Changzhe , Li Jingsheng , Pei Weichi , Wang Baoyu
Published: May 2022

This paper evaluates the influence of the combined die motion scheme and forging process parameters on the evolution of the wear pattern of forging dies for the railway wagon bogie adapter based on an improved Archard model The simulation results show that the distribution of die wear parts during the hot forging process of the railway wagon bogie adapter is uneven but symmetrical, and the maximum wear parts are mainly distributed in the ring belt part of the top die and the shoulder part of the bottom die, and the maximum wear amount of the top die is about 1.4 times that of the bottom die. In addition, the influence of the initial forging temperature (Tw) and the preheating temperature (Td) on the wear behaviour of the die during the forging and forming of the adapter was investigated, and a combination of high Tw and low Td was found to be more beneficial in reducing the wear of the die. In order to obtain the optimal process parameters, a response surface model of die wear was established and combined with a Genetic Algorithm-Artificial Neural Network (GA-BP) to optimize the forging process parameters and proposed an optimal strategy to reduce die wear.
Association of sarcopenia with endocrine therapy toxicity in patients with early breast cancer
Authors: Aleixo Gabriel , Valente Stephanie A. , Wei Wei , Moore Halle C. F.
Published: May 2022

BackgroundEndocrine therapy reduces recurrence risk and improves survival in women with hormone receptor-positive breast cancer; however, side effects can decrease quality of life, leading to reduced treatment adherence. Sarcopenia is the loss of skeletal muscle mass that happens with age; it is associated with reduced chemotherapy adherence in patients with breast cancer. The impact of sarcopenia on endocrine therapy tolerance has not been investigated. The current study evaluates the association of sarcopenia with endocrine therapy toxicity and treatment tolerance. Methods Skeletal muscle mass (SMM) was measured by bioelectrical impedance spectrometry. Skeletal Muscle Index (SMI) was calculated to assess for sarcopenia: SMI= (SMM kg)/ (patient height, m2). Patients with SMI < 6.75 kg/m2 were considered sarcopenic. A chart review was performed to obtain patient characteristics, endocrine therapy toxicity, and early treatment change or termination. Fisher's exact test was performed to associate patient characteristics and outcomes with sarcopenia status.ResultsFour hundred eighty-two patients with stage I-III breast cancer were prescribed endocrine therapy and had undergone sarcopenia evaluation. The median age was 61 years (29 to 88 years). Sarcopenia was identified in 35% of patients. On multivariable logistic analysis, sarcopenia was independently associated with increased odds of experiencing endocrine-related side effects (p=0.01). In addition, patients with sarcopenia stopped or changed their medication due to side effects more often than those without sarcopenia (p=0.05). Conclusion: The presence of sarcopenia in patients with EBC represents a potentially modifiable risk factor for more significant endocrine therapy side effects and reduced treatment tolerance.
Survival outcomes for breast conserving surgery verses mastectomy among elderly women with breast cancer
Authors: Xie Weimin , Cao Ming , Zhong Zhen , Huang Zongshuai , Gao Xiaqiu , Li Zicheng
Published: May 2022

Purpose Elderly patients have different physical condition and tumor biology of breast cancer. Surgical choices for older patients are complicated and several studies have reported that breast conserving surgery (BCS) had better survival than mastectomy in different patient population. The major object of this study was to compare the efficacy of BCS and mastectomy in the whole elderly cohort in SEER database.Methods Female patients aged over 70 years old and diagnosed with breast cancer between 2010 and 2015 were included from SEER database. Propensity score matching (PSM) was used to establish a cohort composing of similar characteristics. We compared the overall survival (OS) among patients undergoing BCS and mastectomy. Kaplan-Meier analysis and Cox proportional regression model were used to evaluate the associated factors of survival outcome.Results Of 44755 eligible patients, 30375 (67.9%) patients underwent breast conserving surgery (BCS) and 14380 (32.1%) patients underwent mastectomy. After PSM, 7222 patients in each group were analyzed and there was no significant difference between BCS and mastectomy in terms of the overall survival rate (85.8% in BCS group and 85.0% in mastectomy group, p = 0.135). Multivariable analysis also indicated that no significant difference between two surgical procedures after adjusting for covariates both in all patients (HR = 1.074, 95% CI 0.992-1.105, p = 0.098) and matched cohort (HR = 1.062, 95% CI 0.997-1.132, p = 0.063). Subgroup analysis demonstrated that postoperative radiotherapy and chemotherapy contributed to the survival benefit of BCS compared to mastectomy (p < 0.05).Conclusion For elderly breast cancer patients, BCS and mastectomy had similar overall survival rate. BCS might be a better surgical treatment with or without axillary surgery, radiotherapy and chemotherapy.
Prevalence, awareness, treatment, and control of hypertension and their risk factors in northwest China: Results from Serial Cross-Sectional Survey Data 2004–18
Authors: Wang Weihua , Sa Rina , Dang Shaonong , Qiu Lin , Liu Feng
Published: May 2022

Objective To investigate trends in the prevalence, awareness, treatment and control of hypertension and their demographic determinants in northwest China. Methods Six successive cross-sectional surveys on non-communicable chronic diseases and their risk factors were conducted between 2004 and 2018 in Shaanxi, northwest China. Complex multistage stratified sampling was adopted to select participants. The information was collected through face-to-face interviews and on-site health examinations. Changes in hypertension prevalence and its management across survey years were estimated. Demographics associated with hypertension prevalence and its management was explored by multivariable logistic regression using pooled data from 2004 to 2018. Results The prevalence of hypertension increased from 16.71% in 2004 to 31.96% in 2018 with an estimated increase of 1.09% (95%CI 0.31-1.87) per year. However, the rate of awareness, treatment and control among these with hypertension was unexpectedly low and there were no significant change from 2004 to 2018. The corresponding changes were -0.08% (95%CI -0.85-0.69) per year for awareness, -0.06% (95%CI-1.11-1.00) per year for treatment, and -0.23% (95%CI -0.53-0.07) per year for control, respectively. Sensitivity analysis showed the same trend. Adults who were old, male, divorced/Widowed/Separated, retired were more likely to develop hypertension. Among these with hypertension, those who were more educated and retired were more likely to manage their hypertension compared with their counterparts. Conclusions The overall hypertension prevalence from 2004 to 2018 increased rapidly, while awareness, treatment and control of hypertension remained unexpectedly low. This suggested urgent intervention should be implemented to improve hypertension control in northwest China.
Modification in implementation of the inferior alveolar nerve block technique
Authors: Lasemi Esshagh , Motamedi Mohammad Hosein Kalantar , Qaranizade Kamal , Hassani Zahra , Lasemi Reza
Published: May 2022

Purpose: The inferior alveolar nerve block (IANB) is a necessary and frequent local anesthetic injection in dental practice in which the conventional technique is generally applied. However, multiple studies reported that the failure rate of IANB is high, whereupon our study aimed to assess the modified and conventional IANB techniques, concerning the success rate. Methods: A split-mouth single-blind randomized clinical trial study was conducted on 42 patients (84 cases) as paired analyzing, between 18 to 55 years-old, who needed bilateral IANB for posterior mandibular teeth extraction. To apply the modified technique, the barrel of the syringe was located in the corner of the mouth; while mouth is open wide and the needle-penetrated mucosa exactly lateral (anterior) to the pterygomandibular fold (PMF). The needlepoint was 5–15 mm above the occlusal plane (OP) according to the digital panoramic radiography and parallel to OP. The outcomes were analyzed using the Cochran-Mantel-Haenszel test. Results: The success rates were 97.6% in the modified IANB and 83.3% in the conventional technique, evaluating in the first 10 minutes.Conclusion: The clinician can operate IANB by modified technique with fewer anatomical landmarks, clear injection points and the higher success rate upon which the performance will be easy by the beginners. Trial registration IRCT20150924024167N2, on 07.03.2020, was retrospectively registered.
Is small airway dysfunction an abnormality independently associated with aging? A cross-sectional analysis from the ECOPD cohort
Authors: Dai Cuiqiong , Wu Fan , Wang Zihui , Peng Jieqi , Yang Huajing , Zheng Youlan , Lu Lifei , Zhao Ningning , Deng Zhishan , Xiao Shan , Wen Xiang , Xu Jianwu , Zhou Kunning , Wu Xiaohui , Zhou Yumin , Ran Pixin
Published: May 2022

Background
Aging has been evidenced to bring about some structural and functional lung changes, especially in COPD. However, whether aging affects SAD, a possible precursor of COPD, has not been well characterized.
Objective
We aimed to comprehensively assess the relationship between aging and SAD from computed tomography, impulse oscillometry, and spirometry perspectives in Chinese.
Methods
We included 1859 participants from ECOPD, and used a linear-by-linear association test for evaluating the prevalence of SAD across various age subgroups, multivariate regression models for determining impact of age on the risk and extent of SAD. We then repeated the analyses in these subjects stratified by airflow limitation.
Results
The prevalence of SAD increases over aging regardless of definitional methods. After adjustment for other confounding factors, per 10-yrs increase in age was significantly associated with the risk of CT-defined SAD (OR = 2.57, 95% CI: 2.13 to 3.10) and the increase in the extent of air trapping (β: 2.09, 95% CI: -0.06 to 4.25 for LAA− 856), airway reactance (β: -0.02, 95%CI: -0.04 to -0.01 for X5; β: 0.30, 95%CI: 0.13 to 0.47 for AX; β: 1.75, 95% CI: 0.85 to 2.66 for Fres), as well as the decrease in expiratory flow rates (β: -3.95, 95% CI: -6.19 to -1.71 for MMEF%predicted; β: -5.42, 95% CI: -7.88 to -2.95 for FEF50%predicted) for SAD. All these associations were generally maintained in SAD defined by IOS or spirometry. After stratification of airflow limitation, we further found that the effect of age on LAA− 856 was the most significant among almost all the subgroups .
Conclusions
Aging is independently associated with the prevalence, risk, as well as worse extent of SAD. CT may be a more optimal measure to assess aging-related SAD. The molecular mechanisms for the role of aging in SAD need to be explored in the future.
Trial registration
: Chinese Clinical Trial Registry ChiCTR1900024643. Registered on 19 July 2019.
Participatory approaches to raise awareness among subsistence farmers in Tanzania about the spread of insecticide resistance in malaria vectors and the possible link to improper agricultural pesticide use
Authors: Matowo Nancy Stephen , Tanner Marcel , Temba Benigni Alfred , Finda Marceline , Mlacha Yeromin Paul , Utzinger Jürg , Okumu Fredros Oketch
Published: May 2022

Background
Insecticide resistance is a key barrier to long-term malaria control, and it may be exacerbated by poor agricultural pesticide use. Current practices, however, do not link public health and agricultural pesticide use. We investigated farmer’s awareness, stakeholder perspectives on integrating agricultural and public health measures to address resistance, and the feasibility of participatory workshops to increase subsistence farmers' understanding and participation in pesticide stewardship.
Methods
Five themes were investigated: pesticide awareness, practices, and opinions; insecticide resistance in malaria vectors; the effectiveness of current malaria prevention tools; and the links between agricultural and public health pesticide usage. Participatory workshops and field training were held with entomologists, farmers, and agricultural specialists, focusing on agro-ecosystem practices related to pest control; and local farmers were involved in live-testing for insecticides resistance of local Anopheles
Results
Most farmers (94%) considered pesticides effective, and nearly half of them (n = 198, 46.4%) could identify and name crop pests and diseases, mostly using local names. Three quarters were unaware of mosquito larvae in their fields, and only 7% considered their fields as potential sources of mosquitoes. Two thirds were unaware of any effects that agricultural pesticides may have on mosquitoes, and three quarters had never heard of resistance in malaria mosquitoes. Experts from various sectors acknowledged that agricultural pesticides might impact malaria control through increasing resistance. They did, however, emphasize the importance of crop protection and advocated for the use of pesticides sparingly and non-chemical approaches. Farmers learnt how to discriminate between malaria vectors and non-vectors, identify agricultural pests and diseases, choose and use pesticides effectively, and conduct resistance tests during the participatory workshops.
Conclusion
This study emphasizes the significance of enhancing subsistence farmers' awareness of mosquito ecology as well as merging public health and agricultural pest management measures. Participatory techniques have the potential to raise stakeholder awareness and engagement, resulting in more effective resistance management.
Reduced expression of transmembrane protein 43 during cardiac hypertrophy leading to deteriorating heart failure in mice
Authors: Gu Yang , Ding Ying , Hu Xiao , Wang Jing , Zhang Xi-Wen
Published: May 2022

Transmembrane protein 43 (TMEM43), a member of the transmembrane protein subfamily, was found to be associated with arrhythmogenic right ventricular cardiomyopathy. But it’s role in cardiac hypertrophy have not been elucidated. Here we used a pressure over load induced cardiac hypertrophy model to explore the role of TMEM43 on heart failure. Mice were subjected to aortic banding (AB) to induce cardiac hypertrophy. Mice were also randomly received injection of adeno-associated virus 9 (AAV9)-shTMEM43 or control AAV9 (ScRNA) to knockdown TMEM43 in cardiomyocytes. Four weeds after AB, mice were subjected to echocardiography to evaluate cardiac function. Neonatal rat cardiomyoctes (NRCMs) were stimulated with phenylephrine (PE) and transfected with adenovirus to overexpress TEME43. As a result, we found that TMEM43 was down-regulated in mice heart and cardiomyocytes post stimulus. Mice with TMEM43 knockdown showed deteriorated heart failure 4 weeks post AB with deteriorating cardiac function and aggregated cardiac hypertrophy and fibrosis. While, NRCMs with TMEM43 overexpression revealed ameliorated hypertrophy response. Moreover, we found that TMEM43 deficiency increased NF-κB activation in mice heart post AB, while TMEM43 overexpression reduced NF-κB activation in cardiomyocytes upon PE stimuli. Thus, we conclude that reduced expression of TMEM43 during cardiac hypertrophy leading to deteriorating heart failure in mice.
MiR-195-5p targets CDK1 to regulate new DNA synthesis and inhibit the proliferation of hepatocellular carcinoma cells
Authors: Zhou Chunhui , Zhu Sujuan , Li Haiping
Published: May 2022

Background
CDK1 is critical for cell viability and plays an important role in biological events. MiR-195 is pivotal in pathogenesis and development of hepatocellular carcinoma (HCC). But the association between CDK1 and miR-195 in HCC is underexplored.
Methods
Gene expression was assayed via qRT-PCR, and corresponding protein levels were assessed via Western blot. Cell cycle was assayed through flow cytometry. DNA replication was detected by EDU staining. Cell proliferation was determined via plate colony formation assay. Targeting relationship between miR-195-5p and CDK1 was analyzed by bioinformatics analysis and dual-luciferase gene assay. DNA damage was marked by immunofluorescence staining.
Results
CDK1 was overexpressed in HCC tissues and cells. Silencing CDK1 modulated cell cycle of HCC cells and inhibited DNA replication and proliferation. In HCC cells, miR-195-5p reduced CDK1 level, inhibited the G1 phase-to-S phase transition, induced DNA damage response, and inhibited DNA replication and proliferation.
Conclusion
MiR-195-5p targeted CDK1 and repressed synthesis of new DNA in HCC cells, thus restraining HCC cell proliferation.
Risk factors and haemato-biochemical parameters associated with Theileria equi infection in Central Italy
Authors: Nardini Roberto , Iacoponi Francesca , Cersini Antonella , Rosone Francesca , Scaramozzino Paola , Lai Olga , Barlozzari Giulia , Viola Maria Rita , Altigeri Alessia , Scicluna Maria Teresa
Published: May 2022

Background: Equine piroplasmosis is a tick-borne disease affecting equids caused by protozoa Theileria equi and Babesia caballi, causing losses in the horse industry for impaired performance and constraint to the international movement. In endemic areas, clinical diagnosis is difficult because the most frequent form is the asymptomatic carrier status and even in symptomatic cases, signs are not pathognomonic. Laboratory analyses are required to confirm the diagnosis and assess therapy.Methods: A total of 438 horse and donkey samples were collected by practitioners during their routine activities and for clinical suspicion of piroplasmosis. The anamnestic information as signs, individual data and management practises were collected by a standardized form. The samples were screened for piroplasmosis and other infectious diseases in differential diagnosis and haemato-biochemical parameters, and thus assigned to three groups: confirmed cases, unconfirmed suspects and controls. Univariate logistic regressions were performed using groups as outcome and anamnestic data as independent variables. Differences in haemato-biochemical parameters among groups were evaluated by Kruskal-Wallis H-test, followed, when significant (P < 0,05), by Bonferroni correction for multiple comparisons. Results: Nineteen confirmed T. equi cases and one B. caballi were detected, thus the study was focused only on the former parasite. Among anamnestic variables, only age (> 6 years) increases the probability of infection compared to the controls, while ectoparasiticide treatments seem to have a protective effect. A decrease in platelet count was the only haemato-biochemical parameter associated with T. equi infection. Comparing with healthy subjects, total and direct bilirubin, monocytes, basophils, MCH and gamma protein fraction showed higher values whereas CK, eosinophils, RBC, HGB, HCT, RDW, albumin and A/G ratio showed lower values, despite being mostly within physiological range. These findings resulted common to T. equi and other affections with similar signs. Conclusions: This study confirms the diagnosis of T. equi infection as an issue, for similarities regarding anamnesis and laboratory findings with other diseases; but still providing the practitioners with data useful for the laboratory results interpretation. Moreover, it focuses the attention on prevention measures, as external antiparasitic treatments and good management practices that, with regular laboratory checks, can reduce the spread of the disease.
Adjuvant treatment of Grade IV Glioma, outcomes at a UK tertiary centre
Authors: Price Louise , Ziff Charlotte , Elmasry Abdelfattah , Giridharan Selvaraj
Published: May 2022

PurposeThe 5 year overall survival (OS) for Glioblastoma multiforme (GBM) remains low.Our cohort had a lower percentage completing adjuvant treatment than those reported in trials. We assess those not completing planned 6 cycles of adjuvant treatment.We assess survival data for those who had Gliadel wafer insertion at the time of primary surgery. We go on to assess the combination of these factors on survival.MethodsCohort of 110 patients who had undergone neurosurgery followed by chemo-radiotherapy (CRT) 60 Gray in 30 fractions and adjuvant Temazolomide (TMZ) from 2007 to 2016. ResultsOS was 16 months and progression free survival (PFS) 11.9 months.57% of patients completed 4-6 cycles of adjuvant TMZ 43% received 3 or less cycles of TMZ. Those unable to complete planned adjuvant TMZ had a poorer OS (10 vs 20 months, Cox analysis P-value 0.0003).Those who had maximal safe debulking plus Gliadel wafer insertion, median OS was improved, 19.5 months P=0.06. The group with the combination of significant factors, median OS was 2 months greater than those that did not receive Gliadel wafers and could not complete 4 cycles of adjuvant TMZ.ConclusionsSurvival outcomes were improved with Gliadel wafer insertion, completing 4-6 cycles of TMZ. Consequently the combination of these factors led to improved outcomes. Second-line chemotherapy improved OS at relapse regardless of second line surgery.
Obliv-DB Framework: Secure Query Processing on Cloud-based Database Systems using Distributed Oblivious Access
Authors: Samaraweera G. Dumindu , Chang J. Morris
Published: May 2022

The explosion of big data along with cloud computing architecture has empowered cloud-based database infrastructures to efficiently manage large and distributed data volumes in the cloud by facilitating numerous data-driven applications. Recently, different systems have been proposed that can additionally protect the privacy of these data by keeping them encrypted at the database level, and enabling them to make trusted query executions over encrypted data. This approach has given the potential and much safer means to outsource private information to untrusted and distributed cloud platforms. However, regardless of their proficiency towards handling a large volume of private information , these techniques are exposed to different access pattern attacks. Oblivious Random Access Machine (ORAM) is a security primitive well known for mitigating such attacks; however, direct integration of ORAM into cloud-based database systems is much more challenging due to high-performance penalties and minimal query functionalities. In this paper, we propose a novel data processing framework for database systems in the cloud using distributed ORAM techniques and oblivious data structures, making database queries resilient to access pattern attacks. We implemented our framework on a practical database setup and evaluated the performance based on different industrial metrics. The experimental results demonstrate that our distributed approach has significant benefits for cloud-based database systems compared to the direct integration of ORAM primitives at the database level.