bluuebunny/crossref_metadata_2025 huggingface dataset:
Experimental Studies on Natural Convection Open and Closed Solar Drying Using External Reflector
Authors: Kabeel Abd Elnaby , Dharmadurai Paul Durai Leon , Vasanthaseelan Sathiyaseelan , Sathyamurthy Prof. Dr. Ravishankar , Ramani Bharathwaaj , Manokar Athikesavan Muthu , Chamkha Ali
Published: June 2021

This work presents the experimental investigation on a solar food dryer equipped with external reflectors to enhance the rate of drying efficiency by removing the moisture content available in the anchovy fish. A comparison on conventional open solar drying is carried out to assess the parameters such as drying efficiency, moisture removal rate, and heat energy required for drying the anchovy fish using the modified solar dryer using natural convection technique. The physical examination results on the dried products proved that using modified solar dryer, the dried product are free from insects, dust. Also, it is found that the loss of colour from the product is minimum while compared to conventional open solar drying. The results showed that the thermal efficiency of dryer 1 and dryer 2 are comparatively higher as compared to that of conventional open solar drying and found as 16.73 and 19.34 % respectively.
Water Quality and Trophic Status of a Lake (Mariut, Egypt) Eight Years After Diversion of Wastewater Effluents
Authors: Shaaban Nashwa A.
Published: June 2021

Water resource management and lake rehabilitation is a global interest, to overcome the acute water scarcity facing most urban areas, especially in developing countries. Lake Mariut (LM) is an Egyptian lake that lies south of Mediterranean Sea, and its management had a great interest in Alexandria’s future development and as a part of the environmental sustainability of the Mediterranean basin. LM consists of 4 major basins namely, main basin MB, NWB, SWB, and FB. The MB has deteriorated as it consistently received (sewage and industrial) wastewaters till 2010. This was the date of diversion of the polluting sources as a rehabilitation step. The present work is made after elapsing 8 years from the diversion and aims at monitoring and assessing the status of the water quality not only of MB but also for the other 3 basins too. This was carried out twice, one in cold winter and the other in warm summer. The parameters studied were physico-chemical ones including DO besides nutrient salts (N and P compounds). The results revealed that the waters of both MB and SW basin were depleted in DO to a level difficult to sustain fish life. Tropically, all the studied basins were in eutrophic-hypereutrophic condition. The depletion in the vital DO is catastrophic and needs urgent solution/s. One of the proposed solutions is the dredging of bottom spoiled organic-rich sediments. This and other suggested solutions are, however, discussed, evaluated, and presented.
Portal vein thrombosis associated with high 14-day and 6-week rebleeding in patients after oesophageal variceal band ligation: A retrospective, multicentre, nested case–control study
Authors: Gao Zhanjuan , Zhao Jingrun , Liu Xiaofeng , Li Senlin , Wang Minghui , Gao yanjing
Published: June 2021

Background and Aims: The association between prognosis of variceal bleeding and portal vein thrombosis (PVT) is unclear. In this multicentre study, we determined the effect of PVT on rebleeding and mortality in patients with acute variceal bleeding (AVB) after oesophageal variceal band ligation (EVL).Methods: Cirrhotic patients with AVB who had undergone EVL were included. The patients were allocated to either the PVT group or the control cirrhotic group (CCG) based on the presence or absence of PVT. One-year rebleeding episodes and mortality after EVL were recorded.Results: A total of 218 cirrhotic patients with AVB from 3 centres were included. Patients with PVT had a higher rate of 14-day and 6-week rebleeding than those without PVT (14-day: 8.26% vs. 1.83%, p = 0.03; 6-week: 11.92% vs. 1.83%, p = 0.003). The rates of 5-day failure (3.67% vs. 0.92%, p = 0.175), 1-year rebleeding (21.10% vs. 20.18%, p = 0.867), and 14-day, 6-week, and 1-year mortality were similar between the groups (14-day: 3.67% vs. 0.92%, p = 0.175; 6-week: 3.67% vs. 0.92%, p = 0.175; 1-year: 3.67% vs. 1.83%, p = 0.408). The Child-Pugh class [p = 0.022, hazard ratio (HR): 1.453; 95% confidence interval (CI): 1.056–1.998], PVT (p = 0.050, HR: 4.622, 95% CI: 0.999–21.395), albumin < 30 g/L (p = 0.023, HR: 5.886, 95% CI: 1.272–27.245), and number of bands (p = 0.010, HR: 1.207, 95% CI: 1.046–1.393) were identified as the predictors for 14-day rebleeding; the multivariate analysis revealed only the number of bands (p = 0.009, HR: 1.247, 95% CI: 1.056–1.473) as the independent factor. PVT (p = 0.012, HR: 6.732, 95% CI: 1.519–29.835) and albumin < 30 g/L (p = 0.027, HR: 3.643, 95% CI: 1.160–11.441) were identified as predictors for 6-week rebleeding; however, only PVT (p = 0.015, HR: 6.380, 95% CI: 1.427–28.515) was found to be the independent factor in the multivariate analysis. Further analysis showed that superior mesenteric vein (SMV) thrombosis is the only risk factor predicting 6-week rebleeding in patients with PVT (p = 0.032, HR: 3.405, 95% CI: 1.112–10.429). Conclusions: PVT was associated with high 14-day and 6-week rebleeding in patients after EVL. SMV thrombosis was the only risk factor for 6-week rebleeding in patients with PVT. High albumin levels may serve as a protective factor for the 14-day and 6-week rebleeding risk. PVT was not responsible for mortality after EVL during 1-year follow-up.
Parasite and host defense mechanisms: whenToxoplasma subjugates the brain
Authors: Mahmoud Motamed Elsayed , Salman Doaa , Igarashi Makoto
Published: June 2021

Brain is an immune-privileged organ for infection with the neurotropic protozoan parasite, Toxoplasma gondii. T. gondii escapes the immune system by establishing a dormant and lifelong bradyzoite cyst during chronic and latent phases within the brain and musculature of immunocompetent individuals. During acute stage T. gondii stimulates the host defense to display depressive behaviors over a background of sickness. Infection with T. gondii is initiated with its proliferative tachyzoite that acts on peripheral immune cells to produce the pro-inflammatory cytokines, most of them induce the behavioral signs of sickness. For instance, interleukin-(IL) 1β, tumor necrosis factor-α and IL-6 are triggering most of sickness symptoms. Whereas, the cardinal inflammatory cytokine interferon-γ activates, indoleamine 2,3 dioxygenase (IDO), an enzyme mainly synthesized by phagocytic cells like macrophages and microglia. IDO activation causes tryptophan depletion and precipitates the depressive symptoms. On other hand, brain encysting with the bradyzoite is characterized by immunosuppression in form of reduced pro-inflammatory and heightened anti-inflammatory responses as evidenced by increased phagocytic activity and release of IL-10 and TGF-β. To conclude, T. gondii has multiple strategies to harness the host’s immune mechanisms and behavior by the virtue of dual effects of tachyzoite-induced immune invasion intertwined with bradyzoite-induced immune evasion.
IGF-1 Promotes Epithelial-Mesenchymal Transition of Lens Epithelial Cells That is Conferred by miR-3666 Loss
Authors: Shi Zhan , Zhao Xiumei , Su Ying , Wang Chao , Ge Hongyan , Liu Ping
Published: June 2021

The abnormal proliferation, migration and epithelial-mesenchymal transformation (EMT) of lens epithelial cells (LECs) are the main reasons of vision loss caused by posterior capsular opacification (PCO) after cataract surgery. Insulin-like growth factor-1 (IGF-1) was found to be associated with the pathogenesis of cataract, but its biological role in PCO is poorly understood. In the present study, IGF-1 overexpression facilitated the proliferation, migration and EMT, whereas knockdown of IGF-1 markedly suppressed the proliferation, migration and TGF-β2-induced EMT of LECs. Additionally, To evaluate valuable microRNAs (miRNAs) which target IGF-1 to modulate LECs-EMT, we predicted miR-3666 might regulate IGF-1 by binding its 3’UTR according bioinformatics database. Furthermore, we verified that miR-3666 directly targeted to IGF-1 by luciferase reporter assay. By using miR-3666 mimics, cells proliferation, migration, and invasion were suppressed, while were enhanced by reduction of miR-3666. Knockout of IGF1 reverses the effect of miR-3666 inhibitor on the malignant behavior of LECs. These results indicate the role for miR-3666/IGF-1 in LECs-EMT that offer new strategies for the therapy and prevention of PCO.
Use case of no code machine learning tools for medical image classification.
Authors: Kalshetty Ashwini , Rakshit Sutapa
Published: June 2021

AI tools are making paradigm chanegs in the field of medical imaging. Currently, the development of AI tools and their validation for clinical use is heterogenously distributed with the end-users (i.e the physians or radiologists) adopting the software solution. As we are all progressing towards democratization of AI, no code tools offer a versatile and convenient; but largely under-utilized method for medical imaging tasks. Purpose: As a proof-of-concept study, we attempted to evaluate whether no-code machine learning (ML) tools like teachable machine could perform a basic medical image classification task. Methods: We selected 85 cases from our imaging database whose planar whole body Iodine-131 diagnostic scans were labelled into 2 classes as “No evidence of disease” (NED) and “abnormal for training and testing the model. Results: The model generated could accurately classify all NED cases (100%) and abnormal cases with 93% accuracy. Conclusion: We propose that no-code ML tools can perform simple medical image tasks easily. Validation on multiple source larger datasets may allow early adoption of this technology by imaging specialists.
Bidirectional Control of Coronary Vascular Resistance by Eicosanoids via a Novel GPCR
Authors: Alkayed Nabil , Cao Zhiping , Qian Zu Yuan , Nagarajan Shanthi , Methner Carmen , Liu Xuehong , Nelson Jonathan , Xie Fuchun , Li Bingbing , Fan Wei , Liu Lijuan , Grafe Marjorie , Xiao Xiangshu , Barnes Anthony , Kaul Sanjiv
Published: June 2021

Arachidonic acid metabolites epoxyeicosatrienoates (EETs) and hydroxyeicosatetraenoates (HETEs) are important regulators of myocardial blood flow and coronary vascular resistance (CVR), but their mechanisms of action are not fully understood. We identified G protein-coupled receptor 39 (GPR39) as a microvascular smooth muscle cell (mVSMC) receptor antagonistically regulated by two endogenous eicosanoids: 15-HETE, which stimulates GPR39 to increase mVSMC intracellular calcium and augment microvascular CVR, and 14,15-EET, which inhibits these actions. Furthermore, zinc ion acts as an allosteric modulator of GPR39 to potentiate the efficacy of the two ligands. Finally, GPR39 knockout mice are protected from myocardial ischemia compared to wild-type littermates. Our findings will have a major impact on understanding the roles of eicosanoids in cardiovascular physiology and disease, and provide an opportunity for the development of novel GPR39-targeting therapies for cardiovascular disease. One Sentence Summary: GPR39 is a microvascular smooth muscle cell receptor regulated by two vasoactive eicosanoids with opposing actions.
Prognostic Value of Survival−Associated Splicing Factor SNRPA1 Overexpression And Its Potential Mechanism In Liver Cancer
Authors: Liu Mengying , Lu Yueda , Wei Lei , Wang Xiaowo , Lu Yinying , Jia Xiaodong , Wang Shihui , An Wenlin
Published: June 2021

Background: Small nuclear ribonucleoprotein polypeptide A (SNRPA1) is a splicing factor (SF) responsible for the processing of pre−mRNA into mRNA. The purpose of this study was to explore the clinicopathological characteristics and prognostic significance of SNRPA1 mRNA expression in liver cancer and its potential mechanism as an SF.Methods: A total of 418 RNA−Seq and clinical data were downloaded from The Cancer Genome Atlas (TCGA) database. Alternative splicing (AS) profiles were downloaded from TCGA SpliceSeq. Wilcoxon rank-sum tests were used to compare normal tissues with tumor tissues and analyze subgroups. We used the Kaplan−Meier analysis method to draw the survival curves. Univariate and multivariate Cox analyses were employed to estimate the prognostic value of SNRPA1. Gene set enrichment analysis (GSEA) was performed to identify the signaling pathways. Then we used univariate and Pearson's correlation tests to analyze the correlation between SFs and exon skip (ES) events. Wilcoxon rank-sum tests were applied to analyze the relationships between different spliceosome and cancers. We also analyzed the relationship between the expression of SCP2 (related to SNRPA1) and clinical symptoms. We then evaluated the expression levels of these genes with clinical samples and The Clinical Proteomic Tumor Analysis Consortium (CPTAC). Results: The level of SNRPA1 mRNA expression in liver cancer was significantly up−regulated in tumor tissues compared with normal tissues (p = 1.411e−27) in liver cancer and was positively correlated with survival status (p = 0.035). In addition, we found that SNRPA1 mRNA levels can reflect the prognosis of liver cancer (hazard ratio [HR] = 1.08, 95% confidence interval [CI]: 1.02–1.14, p = 0.005). The enriched KEGG pathway by GESA revealed a splicesome as the main pathway of SNRPA1. Alternative splicing events of SNRPA1 was related to the expression of SCP2. SNRPA1 exon 6 skip and SCP2 exon 12 skip correlated with many cancer types. Finally, SNRPA1 and SCP2 percent−spliced−in (PSI) values positively correlated with survival status (p = 3.022e−04 and p = 2.932e−03). Conclusions: Splicing Factor SNRPA1 is superior to its mRNA expression in predicting the prognosis of liver cancer and correlates with the SCP2 spliceosome, which is consistent with that of SNRPA1 in clinical samples.
Effect of shRNA-Mediated Knockdown EBF1 Gene Expression on the Proliferation of Lung Cancer Cell Line A549 In Vitro and In Vivo
Authors: WANG Lin , Li Ding , REN Li , FENG Honglei
Published: June 2021

BackgroundThe incidence of lung cancer is increasing year by year. The study on the proliferation and metastasis of lung adenocarcinoma cells is of positive significance to improve the prognosis of patients with lung adenocarcinoma, but there is still a lack of more effective treatment for the proliferation and metastasis of lung adenocarcinoma cells .Here we find that a lymphocyte lineage specific transcription factor,EBF1, is frequently expressed in human lung cancer tissues and affects the proliferation of tumor cells , Objective to explore the possible mechanism of affecting the proliferation of lung adenocarcinoma cells.MethodsImmunohistochemistry and PCR were used to detect the expression of EBF1 in lung cancer tissues and lung cancer cell lines. According to the interference RNA (shRNA) sequence designed by our laboratory for EBF1 as the target sequence and a random sequence as the negative control, the recombinant retrovirus was constructed and transfected into A549 cells, which were used as A549-shRNA-EBF1 and A549-shRNA-control of experimental group and control group respectively; Knockdown of EBF1 gene was detected by PCR and Western blot. MTT and BrdU staining were used to detect the effect of EBF1-shRNA on the proliferation of A549 cells in vitro;flow cytometry was used to analyze the cell cycle of each group; subcutaneous inoculation of cells in axilla of nude mice was used to observe the effect of EBF1-shRNA on the tumorigenicity of A549 cells in nude mice; Western blot was used to detect the expression of CDK6, P21 and P27 proteins.ResultsEBF1 was not expressed in stromal cells of adjacent tissues and lung cancer tissues, but in nuclei of NSCLC and SCLC cancer cells. EBF1-shRNA knockdown EBF1 gene expression effectively; knockdown EBF1 gene expression can inhibit the proliferation of A549 cells in vitro and in vivo, and block the cell cycle of experimental group at G1 phase; after knockdown EBF1 gene expression, CDK6 protein expression in experimental group cells decreases, while P21 and P27 protein increase.ConclusionsEBF1-shRNA can inhibit the proliferation of lung adenocarcinoma A549 in vitro and in vivo by blocking cell cycle in G1 phase, which involves the decrease of CDK6 expression and the up-regulation of P21 and P27 expression. This study will supplement the theory that heterotopic expression of hematogenous transcription factors in lung cancer affects tumor proliferation and discover new molecular targets for cancer therapy.
The Influence of Sociocultural Factors on Shared Reading in Jordan.
Authors: Nasir Arwa , Bawaneh Saif , Alaraj Bayan , Kussad Sara , Nasir Laeth , Lyden Elizabeth , Badran Eman
Published: June 2021

Background: Shared reading has many benefits to children’s language and literacy development. The practice of shared reading varies widely among different cultural groups and is influenced by sociocultural factors. Promotion of shared reading in the healthcare setting has been shown to be effective in many western countries. Very little data are available from other nations, particularly those in the Middle East about parental experiences and attitudes towards shared reading with children. The aim of this study was to explore sociocultural factors that influence shared reading with children in Jordan, a low-middle income Arabic speaking country. Methods: We used survey methodology to collect information on shared reading from a sample of parents of children 3-8 years of age presenting to the Jordan University Hospital Pediatrics clinic in Amman, Jordan. Data were also gathered through solicitation of narrative unstructured comments from parents. Qualitative and statistical data analysis were performed. Findings: Mothers universally believed that shared reading is beneficial for children. However, only a small minority (16.4%) reported reading to their children daily. Shared reading behaviors correlated with frequency of mothers’ personal reading and with the number of books in the home. Mothers indicated a preference for culturally appropriate books, written in classical Arabic and books having a moral or a lesson. Barriers to shared reading included a perceived lack of encouragement of this practice from society and schools and lack of access to books and public libraries.Discussion: Promotion of shared reading is an effective way to enhance the literacy of children from varying ethnic and cultural backgrounds and represents an opportunity to reduce health disparities worldwide. Understanding regional sociocultural dynamics is an essential factor in planning successful interventions to promote literacy. We identified barriers to reading as well as cultural values that may be leveraged to enhance shared reading in Jordan.
A validated method to assess glutathione peroxidase enzyme activity
Authors: Hadwan Mahmoud H. , Ahmed Ahmed Yasser
Published: June 2021

This essay presents a reliable, effective and easy procedure for measuring glutathione peroxidase activity (Gpx). The enzyme samples were incubated with phosphate buffer, which included appropriate concentrations of glutathione and peroxide as substrates, to determine the Gpx activity. After a sufficient incubation time, the CUPRAC reagent (Cu(Nc) 2 2+ ) was added to stop the enzyme’s reaction. The unreacted substrates act to reduce Cu(II)-neocuproine complex (Cu(Nc) 2 2+ ) to strongly coloured Cu(I)-neocuproine complex (Cu(Nc) 2 + ) that was measured spectrophotometrically at 450 nm (CUPRAC method). The glutathione peroxidase activity was linked to a decrease in the absorbance of the coloured Cu(I)-neocuproine complex (Cu(Nc) 2 + ).
The procedure uses the Box–Behnken design (BBD) to optimise the formation of the Cu(I)-neocuproine complex (Cu(Nc) 2 + ). The response surface methodology (RSM) is used to determine the accuracy of the method. This new protocol was confirmed by applying a Bland–Altman plot analysis of Gpx activity in matched samples using the Gpx-DTNB assay. The correlation coefficient between the two protocols was 0.9967. This means that the new protocol was very accurate and on par with the comparison method.
Safety and Efficacy Studies of Kyphoplasty, Mesh-Container-Plasty and Pedicle Screw Fixation Plus Vertebroplasty for Thoracolumbar Osteoporotic Vertebral Burst Fractures
Authors: Li Yimin , Qian Yunfan , Shen Guangjie , Tang Chengxuan , Zhong Xiqiang , HE Shaoqi
Published: June 2021

Background
Percutaneous kyphoplasty (PKP), percutaneous mesh-container-plasty (PMCP) and pedicle screw fixation plus vertebroplasty (PSFV) were three methods for osteoporotic vertebral burst fractures (OVBF). The purpose of the current study was to evaluate the clinical safety and efficacy of PKP, PMCP, and PSFV for OVBFs.
Methods
This retrospective study included 338 consecutive patients with thoracolumbar OVBFs who underwent PKP (n = 111), PMCP (n = 109), or PSFV (n = 118) and compared their epidemiological data, surgical outcomes, and clinical and radiological features. Clinical evaluations of VAS and ODI and radiological evaluations of height restoration, deformity correction, cement leakage, and canal compromise were calculated preoperatively, postoperatively, and 2 years postoperatively.
Results
Cement leakage (31/111 vs. 13/109 and 16/118, P < 0.05) was significantly higher in group PKP than in groups PSFV and PMCP. VAS and ODI scores improved postoperatively from 7.04 ± 1.15 and 67.11 ± 13.49 to 2.27 ± 1.04 and 22.00 ± 11.20, respectively, in group PKP (P < 0.05); from 7.04 ± 1.29 and 67.26 ± 12.79 to 2.17 ± 0.98 and 21.01 ± 7.90, respectively, in group PMCP (P < 0.05); and from 7.10 ± 1.37 and 67.36 ± 13.11 to 3.19 ± 1.06 and 33.81 ± 8.81, respectively, in the PSFV group (P < 0.05). Moreover, postoperative VAS and ODI scores were significantly higher in group PSFV than in groups PKP and PMCP (P < 0.05). However, VAS scores were not significantly different in the three groups 2 years postoperatively (P > 0.05). Postoperative anterior (81.04 ± 10.18% and 87.51 ± 8.94% vs. 93.46 ± 6.42%, P < 0.05) and middle vertebral body height ratio (83.01 ± 10.16% and 87.79 ± 11.62% vs. 92.38 ± 6.00%, P < 0.05) were significantly higher in group PSFV than in groups PMCP and PKP. Postoperatively, Cobb angle (10.04 ± 4.26° and 8.16 ± 5.76° vs. 4.97 ± 4.60°, P < 0.05) and canal compromise (20.76 ± 6.32 and 19.85 ± 6.18 vs. 10.18 ± 6.99, P < 0.05) were significantly lower in group PSFV than in groups PMCP and PKP.
Conclusion
Despite relatively worse radiological results, PMCP is a safe and minimally invasive surgical method that can obtain better short-term clinical results than PKP and PSFV for OVBFs.
A Survey of Depression and Anxiety Disorders in Urban and Rural Suriname
Authors: Jadnanansing Raj , de Beurs Edwin , Etwaroo Kajal , Blankers Matthijs , Dwarkasing Rudi , Peen Jaap , Lumsden Vincent , Bipat Robbert , Dekker Jack
Published: June 2021

Background: Suriname is a Low-middle income country consisting of diverse population groups. Epidemiological studies concerning mental disorders like depression and anxiety had not been conducted until 2015. The treatment gap for mental disorders in Low and middle-income countries (LMICs) may reach 76-80% as treatment is not always readily available. In this study, we estimate and compare the prevalence of depression and anxiety, as well as the size of the treatment gap for these disorders, in a rural (Nickerie) and urban (Paramaribo) region of Suriname, a lower middle income country.Methods: Subjects were selected by a specific sampling method of the national census bureau. The Center for Epidemiological Studies-Depression (CES-D) was used to assess depression. Generalized anxiety disorder was assessed with the Generalized Anxiety Disorder 7 (GAD-7) and The Agoraphobic Cognitions Questionnaire (ACQ), the Body Sensations Questionnaire (BSQ) were used to assess Panic disorder. The treatment gap was calculated by estimating the percentage of subjects with depression or anxiety that did not seek out professional help.Results: About 18% of the respondents from Nickerie and 16% from Paramaribo were at risk of depression and the established cut-off values of the instruments used indicate that about 3-4 % in both regions may suffer from Generalized Anxiety Disorder. Women in both samples were most at risk of high anxiety about body sensations and maladaptive thoughts about panic. The treatment gap varies between 78 and 100% for the two disorders.Conclusions: A high depression rate has been found in both areas, especially among young females. In addition, a high treatment gap is noted which insinuates that more therapeutic strategies are required to tackle depression and anxiety in Suriname.
A Dedicated Paediatric [18F]FDG PET/CT Dosage Regimen
Authors: Cox Christina , Assema Daniëlle M.E. vas , Verburg Frederik A. , Brabander Tessa , Konijnenberg Mark , Segbers Marcel
Published: June 2021

BackgroundThe role of 2-[18F]fluoro-2-deoxy-D-glucose ([18F]FDG) Positron emission tomography / computed tomography (PET/CT) in children is still expanding. Dedicated paediatric dosage regimens are needed to keep the radiation dose as low as reasonably achievable and reduce the risk of radiation-induced carcinogenesis. The aim of this study is to propose a paediatric dosage regimen based on patient size that provides a constant and clinical sufficient image quality at a reasonable effective dose.MethodsIn this retrospective analysis 102 children (54 boys and 48 girls) were included that underwent a diagnostic [18F]FDG PET/CT scan. The image quality of the PET scans was measured by the signal-to-noise ratio (SNR) in the liver. The SNR liver was normalized (SNRnorm) for administered activity and acquisition time to apply curve fitting with body weight, body length, body mass index, body weight/body length and body surface area. Curve fitting was performed with two power fits, a non-linear 2-parameter model α p-d and a linear single parameter model α p-0.5. The fit parameters of the preferred model were combined with a user preferred SNR to obtain at least moderate or good image quality for the dosage regimen proposal.ResultsBody weight demonstrated the highest coefficient of determination for the non-linear (R2 = 0.81) and linear (R2 = 0.80) models. The non-linear model was preferred by the Akaike’s corrected information criterion. We decided to use a SNR of 6.5, based on the expert opinion of three nuclear medicine physicians. Comparison with the quadratic adult protocol confirmed the need for different dosage regimens for both patient groups. The amount of administered activity can be reduced with at least 41%when compared with the current paediatric guidelines. ConclusionBody weight has the strongest relation with [18F]FDG PET image quality in children. The proposed non-linear dosage regimen based on body mass will provide a constant and clinical sufficient image quality with a significant reduction of the effective dose compared to the current guidelines. A dedicated paediatric dosage regimen is necessary, as a universal dosing regimen for paediatric and adult is not feasible.
Polymorphisms of Mitochondrial COII and16S rRNA Gene in Meloidogyne enterolobii on Mulberry
Authors: Shao Hudie , Zhang Pan , You Chunping , LI Chuanren , Feng Yan
Published: June 2021

This study explores the genetic diversity and polymorphisms of Meloidogdyne enterolobii (M enterolobii) on mulberry in China. The sequence of cytochrome oxidase subunit II (COII) and 16S rRNA gene in M enterolobii populations in Guangdong, Guangxi, and Hunan Provinces were PCR-amplified, sequenced, and analyzed for genetic diversity. The haplotypes (Hap) numbers, the total number of mutations, the average number of nucleotide differences (K), haplotype diversity (Hd), and nucleotide diversity (π) of mtCOII gene were 14, 25, 3.563, 0.942 and 0.00429, respectively. The significant differences in Fst value (0.125) and a high level of gene flow (2.83) were detected among the 19 M enterolobii populations. High genetic variation within each population and a small genetic distance among populations was observed. Both phylogenetic analyses and network mapping of the 14 haplotypes revealed a dispersed distribution pattern of the 19 M enterolobii populations. There was an absence of branches strictly corresponding to the 19 range sampling sites. The analysis of molecular variance (AMOVA) revealed that the genetic differentiation of M enterolobii populations was mainly contributed by the variation within each of the defined geographical groups. No significant correlation was found between the genetic distance and geographical distance of 19 M enterolobii populations. This study provides theoretical basis for the future control of M enterolobii and also provides a guarantee for the production of other hosts of M enterolobii.
Cost Estimates of COVID-19 Clinical Management in Myanmar
Authors: Thant Phyu Win , Htet Khin Thu , Win Wit Ye , Htwe Ye Min , Htoo Thant Sin
Published: June 2021

Objective: This study aims to estimate the cost of clinical management of COVID-19 infected patients based on their severity by exploring the resources used in care provision in Myanmar. Methods: A multicenter retrospective cost analysis of COVID-19 patients treated was performed using the micro-costing approach from the perspective of the health system. It covered two cost components, namely Direct and Indirect cost of treating a patient. Input data and their quantities were obtained from COVID-19 Standard Treatment Guidelines of Ministry of Health and Sports, and administrative and financial record of resource utilization of three designated health facilities in Yangon Region. Valuation of these resources was based on the price list from the Procurement Section of the Ministry. Results: The analysis estimated the unit cost of clinical management of COVID-19 infected patients with no symptom to be 953,552 MMK(717 USD), with Mild-Moderate Symptoms to be 1,155,222 MMK(869 USD) and with Severe-Critically Ill conditions to be 5,705,052 MMK(4290 USD). Average cost for a patient par day was 86,687 MMK(65 USD) for asymptomatic patients, 105,020 MMK(79 USD) for Mild-Moderate patients and 283,252 MMK(214 USD) for severe-critically ill patients. Since the first case detected till December 31, 2020, COVID-19 clinical management cost was accounted for 139 Billion MMK (104 million USD) for total 124630 confirmed cases. Conclusions: The result of this study indicates that the COVID-19 Pandemic leads Myanmar Health System to incur the significant health care expenses. Timely implementation of the sustainable, affordable and efficient policy for COVID-19 responses is of utmost important for every nation especially in this situation of Pandemic. Specifically, the study results should be of value for strategic planning, for future economic evaluations of different policy interventions, and to contribute healthcare policy recommendations by analyzing the current cost of health care system and preparing for the potential state of COVID-19 infection.
Global Profiling of Proteome, Lysine Acetylome And Succinylome Identifying Silica Injuries In Mice Lung
Authors: Wang Mingyao , Liu Jiangfeng , Zhang Tiantian , Zhang Zhe , Pang Junling , Xing Yanjiang , Liu Ying , Song Meiyue , Li Baicun , Yang Juntao , Wang Jing , Wang Chen
Published: June 2021

The authors have requested that this preprint be removed from Research Square.
Pubertal And Gonadal Outcomes In 46,XY Individuals With Partial Androgen Insensitivity Syndrome Raised As Girls
Authors: Guaragna-Filho Guilherme , Guerra-Junior Gil , Tadokoro-Cuccaro Rieko , Hughes Ieuan A. , Barros Beatriz A. , Hiort Olaf , Balsamo Antonio , Guran Tulay , Holterhus Paul M. , Hannema Sabine , Poyrazoglu Sukran , Darendeliler Feyza , Bryce Jillian , Ahmed S. Faisal , Quigley Charmian A.
Published: June 2021

Purpose: Although it was common in the 1970s-1990s to assign female gender of rearing to 46,XY infants with limited virilisation of varying etiologies, including those with partial androgen insensitivity syndrome (PAIS), long-term data on outcomes for these individuals are sparse. Therefore, our goal was to use the power of an international registry to evaluate clinical features, surgical management and pubertal data in patients with a molecularly confirmed diagnosis of PAIS who were born before 2008 and were raised as girls. Methods: The current study interrogated the I-DSD Registry for available data on management and pubertal outcomes in individuals with genetically confirmed PAIS who were raised as girls. Results: Among the 11 individuals who fulfilled the key criteria for inclusion the external masculinization score at presentation (EMS) ranged from 2 to 6 (median 5); 7 girls underwent gonadectomy before the age of 9 years, whereas 4 underwent gonadectomy in the teenage years (≥ age 13). Clitoral enlargement at puberty was reported for 3 girls (27%) who presented initially at the time of puberty with intact gonads. In the 9 individuals (82%) for whom gonadal pathology data were provided, there was no evidence of germ cell tumor at median age of 8.1 years. All girls received estrogen replacement and 8/11 had attained Tanner stage 4-5 breast development at last assessment. Conclusion: In general, although it appears that female assignment in PAIS is becoming uncommon, our data provide no evidence to support the practice of prophylactic prepubertal gonadectomy with respect to the risk of a germ cell tumour.
Occurrence and Severity of Venous Air Embolism During Neurosurgical Procedures in Semi-Sitting Versus Supine Position
Authors: Konrad Franziska Magdalena , Mayer Angela S , Serna-Higuita Lina Maria , Hurth Helene , Tatagiba Marcos , Reutershan Jörg , Rosenberger Peter , Drexler Berthold
Published: June 2021

Background: Patients undergoing neurosurgical procedures in the posterior cranial fossa can be placed in different positions: the semi-sitting position or the supine position. The major risk of the semi-sitting positioning is venous air embolism (VAE). However, VAEs may also occur in the supine position.Objective: In a prospective study, we investigated the incidence of VAE based on the positioning of the patients (trial registration 553/2013BO1).Methods: In a single-center study with 137 patients, we prospectively evaluated the occurrence of VAEs in patients in the supine and semi-sitting position over the period from January 2014 to April 2015. All patients were monitored for VAE by the use of a transesophageal echocardiography (TEE).Results: 50% of all participating patients experienced a VAE (with 56% of these patients undergoing surgery in the semi-sitting position and 11% in the prone position). 86% of the VAEs were just detected by the use of a TEE. We only observed VAEs with a decrease in EtCO2 in the semi-sitting position. However, none of the patients had any hemodynamic changes due to the VAE. We found that surgeries in patients with a preexisting intracardial shunt such as a patent foramen ovale (PFO) less likely resulted in VAEs (42% vs. 58%).Conclusion: The semi-sitting position with TEE monitoring and a standardized protocol, including a deep central venous line is a safe and advantageous technique, taking also account of a significant rate of VAEs. VAEs also occur in the supine position, however, less frequently.
Assessment of Financial Toxicity Among Advanced Lung Cancer Patients in Western China
Authors: Xu Tianqi , Zhou Ying , Yang Wenhui , Xi Hangtian , Xing Liangliang , Zhang Yan , Zhang Jian
Published: June 2021

Background: Lung cancer is the primary reason of cancer-caused disability adjusted life years. Medical cost burden impacts patient’s well-being through decreasing income, cutting daily expenses, leisure activities and exhausting savings. De Souza and colleagues developed and validated the COmprehensive Score for Financial Toxicity (COST). Our study aims to quantify the financial burdens of cancer therapy, to explore the relationship between financial toxicity and HRQoL in advanced lung cancer population.Methods: Patients aged ≥ 18 years with confirmed stage III to IV lung cancer were eligible. The COST questionnaire verified by de Souza et al. was used to identify financial toxicity. Multivariable linear regression analysis with log transformation univariate analysis and Pearson correlations were used to performed the analysis.Results: Most of the patients had an income of < ¥50,000 ($7,775) annually (90.8%, n = 138/152). The insurance condition of the cohort was that the majority of the cohort had social insurance (64.5%), 20.4% of them had commercial insurance, 22.0% of them had both. Patients who were younger age (50 ~ 59, P < 0.001), employed but on sick leave, and lower income reported increased levels of financial toxicity (P < 0.05). The risk factors for high financial toxicity: (i) younger age (50 ~ 59), (ii) <1 month of savings, and (iii) being employed but on sick leave. Increased financial toxicity is moderately correlated with a decrease in QoL.Conclusion: Increased financial toxicity(lower COST) is related to poorer psychological status and certain demographics. Financial toxicity is moderately correlated with a HRQoL, and it may have a demonstrable correlation with HRQoL measures.
Effects of Reprocessing on Acrylonitrile–Butadiene–Styrene and Additives
Authors: Bai Xiaojuan , Liang Pin , Zhang Mei , Gong Shiqiong , Zhao Lihua
Published: June 2021

Acrylonitrile-butadiene-styrene (ABS) is one of the most extensively used engineering polymers and analysing the chemical structure changes during processing and recycling is extremely important. Hence, in this study, an ABS resin was processed using a torque rheometer at different temperatures and for different numbers of cycles. Pyrolysis gas chromatography mass spectrometry (Py-GC/MS) was used to study the effects of the processing parameters on additives. Fourier transform infrared spectroscopy (FTIR), hydrogen nuclear magnetic resonance (1H NMR) spectroscopy, and gel permeation chromatography (GPC) were used to analyse the structural changes in the resin. GPC results showed that after processing at 290 °C using the torque rheometer, large size soluble polymeric components increased. The increase in the large size soluble polymeric components after processing at 290 °C was probably related to the crosslinking reactions in the grafted polybutadiene (PB). Furthermore, chemical analysis of the ABS resin samples after multiple extrusion cycles in a twin-screw extruder indicated that reprocessing considerably affected the ABS resin.
Handgrip Strength During Admission for COPD Exacerbation: Impact on Further Exacerbation Risk
Authors: Lee Chi-Tai , Wang Ping-Huai
Published: June 2021

Background:
Low handgrip strength (HGS) is independently associated with a higher exacerbation risk in smokers with stable chronic obstructive pulmonary disease (COPD); however, the relationship between HGS on admission for COPD exacerbation admission and further exacerbation risk remains unclear. This study aimed to investigate the relationship between HGS and further exacerbation risk in patients admitted for COPD exacerbation.
Methods:
We enrolled patients admitted for COPD exacerbation between January 2018 and June 2019 who underwent HGS measurement within 3 days after admission. The primary endpoint was exacerbations within 12 months after the index admission. We analyzed the relationships among demographics, HGS, pulmonary function parameters, and acute exacerbation events.
Results:
Among 43 enrolled patients, 31 (72.1%) presented HGS weakness (22.1 ± 4.1 kg). Forced expiratory volume in one second (FEV1) and FEV1 percentage of predicted value (FEV1 predicted%) were significantly lower in patients with HGS weakness (0.82 ± 0.20 vs. 1.59 ± 0.77, p = 0.018; 36.2 ± 10.4% vs. 66.3 ± 22.2, p = 0.004, respectively). Moreover, patients with HGS weakness were more likely to have severe GOLD grade IV (19.4% vs. 8.3%, p = 0.002). Finally, patients with HGS weakness showed a significantly higher rate of emergency room visits within 6, 9, and 12 months after the index admission (0.81 ± 1.30 vs. 0.08 ± 0.29, p = 0.045; 1.26 ± 1.59 vs. 0.17 ± 0.38, p = 0.019; 1.48 ± 1.86 vs. 0.25 ± 0.62, p = 0.027, respectively).
Conclusions:
HGS weakness measured upon admission for COPD exacerbation was associated with a higher risk of further exacerbation.
Trial registration:
ClinicalTrials.gov Identifier: NCT04885933
Anomaly Detection and Classification of Physiological Signals in IoT- Based Healthcare Framework
Authors: Nawaz Menaa , Ahmed Jameel
Published: June 2021

Physiological signals retrieve the information from sensors implanted or attached to the human body. These signals are vital data sources that can assist in predicting the disease well before time and thus proper treatment can be made possible. With the addition of Internet of Things in healthcare, real-time data collection and pre-processing for signal analysis has reduced burden of in-person appointments and decision making on healthcare. Recently, Deep learning-based algorithms have been implemented by researchers for recognition, realization and prediction of diseases by extracting and analyzing the important features. In this research real-time 1-D timeseries data of on-body non-invasive bio-medical sensors have been acquired and pre-processed and analyzed for anomaly detection. Feature engineered parameters of large and diverse dataset have been used to train the data to make the anomaly detection system more reliable. For comprehensive real-time monitoring the implemented system uses wavelet time scattering features for classification and deep learning based autoencoder for anomaly detection of time series signals for assisting the clinical diagnosis of cardiovascular and muscular activity. In this research, an implementation of IoT based healthcare system using bio-medical sensors has been presented. This paper also aims to provide the analysis of cloud data acquired through bio-medical sensors using signal analysis techniques for anomaly detection and timeseries classification has been done for the disease prognosis in real-time. Wavelet time scattering based signals classification accuracy of 99.88% is achieved. In real time signals anomaly detection, 98% accuracy is achieved. The average Mean Absolute Error loss of 0.0072 for normal signals and 0.078 is achieved for anomaly signals.
Mixture Toxic Impacts and the Related Mechanism of Aflatoxin B1 and Deoxynivalenol on Embryonic Zebrafish (Danio Rerio)
Authors: Wang Yanhua , Wang Qiang , Ji Chun , Guo Xiaoxuan , Yang Guiling , Wang Dou , Weng Hongbiao , Qian Yongzhong , Chen Chen
Published: June 2021

BackgroundAlthough humans and animals are often simultaneously exposed to a variety of mycotoxins via feed and food consumption, in which aflatoxin B1 (AFB1) and deoxynivalenol (DON) is one of the most prevalent combination of mycotoxins. Many toxicological reports have merely focused on the impacts of single mycotoxins. In the present study, the combined toxicity and the related mechanism of AFB1 and DON to zebrafish (Danio rerio) were investigated. ResultsWe showed that DON had lower toxicity to embryonic zebrafish with a 7-day LC50 of 218.3 mg a.i. L-1 in comparison to AFB1 (0.031 mg a.i. L-1). The mixture of AFB1 and DON elicited an additive combined effect on zebrafish embryos. The levels of CAT, caspase-3, and T4 markedly varied in most single and mixture groups. The expressions of four genes (cas3, apaf-1, cc-chem, and cyp19a) associated with oxidative stress, cellular apoptosis, immune system, and endocrine system were markedly varied upon the mixture exposure in comparison to the corresponding single exposure of AFB1 or DON.ConclusionsOur results demonstrate that the impacts of a mixture could not be estimated solely based on toxicities of the single mycotoxins. Taken together, our comprehensive investigation on the mycotoxin mixtures and their potential mechanisms could better reflect the reality of mycotoxin contamination in food and feed.
Evaluation of Nutritional Practices in the Critical Care Patient (The ENPIC Study): Does Nutrition Really Affect ICU Mortality?
Authors: Servia-Goixart Lluís , Lopez-Delgado Juan Carlos , Grau-Carmona Teodoro , Trujillano-Cabello Javier , Bordeje-Laguna M Luisa , Mor-Marco Esther , Portugal-Rodriguez Esther , Cárdenas Carol Lorencio , Montejo-Gonzalez Juan C , Vera-Artazcoz Paula , Macaya-Redin Laura , Martinez-Carmona Juan Francisco , Iglesias-Rodriguez Rayden , Monge-Donaire Diana , Flordelis-Lasierra José L , Llorente-Ruiz Beatriz , Menor-Fernández Eva M , de Lagran Itziar Martínez , Yebenes-Reyes Juan C
Published: June 2021

Background: The importance of artificial nutritional therapy is underrecognized, typically being considered an adjunctive rather than a primary therapy. We aimed to evaluate the influence of nutritional therapy on mortality in critically ill patients.Methods: This multicenter prospective observational study included adult patients needing artificial nutritional therapy for >48 h if they stayed in one of 38 participating intensive care units for ≥72 h between April and July 2018. Demographic data, comorbidities, diagnoses, nutritional status and therapy (type and details for ≤14 days), and outcomes were registered in a database. Confounders such as disease severity, patient type (e.g., medical, surgical or trauma), and type and duration of nutritional therapy were also included in a multivariate analysis, and hazard ratios (HRs) and 95% confidence intervals (95%CIs) were reported.Results: We included 639 patients among whom 448(70.1%) and 191(29.9%) received enteral and parenteral nutrition, respectively. Mortality was 25.6%, with non-survivors having the following characteristics: older age; more comorbidities; higher Sequential Organ Failure Assessment (SOFA) scores (6.6±3.3 vs 8.4±3.7; P<0.001); greater nutritional risk (Nutrition Risk in the Critically Ill [NUTRIC] score: 3.8±2.1 vs 5.2±1.7; P<0.001); more vasopressor requirements (70.4% vs 83.5%; P=0.001); and more renal replacement therapy (12.2% vs 23.2%; P=0.001). Multivariate analysis showed that older age (HR: 1.023; 95% CI: 1.008–1.038; P=0.003), higher SOFA score (HR: 1.096; 95% CI: 1.036–1.160; P=0.001), higher NUTRIC score (HR: 1.136; 95% CI: 1.025–1.259; P=0.015), requiring parenteral nutrition after starting enteral nutrition (HR: 2.368; 95% CI: 1.168–4.798; P=0.017), and a higher mean Kcal/Kg/day intake (HR: 1.057; 95% CI: 1.015–1.101; P=0.008) were associated with mortality. By contrast, a higher mean protein intake protected against mortality (HR: 0.507; 95% CI: 0.263–0.977; P=0.042).Conclusions: Old age, higher organ failure scores, and greater nutritional risk appear to be associated with higher mortality. Patients who need parenteral nutrition after starting enteral nutrition may represent a high-risk subgroup for mortality due to illness severity and problems receiving appropriate nutritional therapy. Mean calorie and protein delivery also appeared to influence outcomes.Trial Registration: ClinicaTrials.gov NCT: 03634943.