bluuebunny/crossref_metadata_2025 huggingface dataset:
Support for Lowering Cervical Cancer Screening Age To 25 for Women Living With HIV: Retrospective Cross-Sectional Programmatic Data From Botswana
Authors: Ramogola-Masire Doreen , Grover Surbhi , Mathoma Anikie , Monare Barati , Gabaitiri Lesego , Bazzett-Matabele Lisa , Hofmeyr G Justus , Morroni Chelsea , Luckett Rebecca
Published: September 2021

Background: Women living with human immunodeficiency virus (HIV) tend to develop cervical cancer at a younger age than HIV-negative women. The World Health Organization’s (WHO) new guidelines for screening and treatment of cervical pre-cancer lesions for cervical cancer prevention include a conditional recommendation for initiating screening at age 25 for women living with HIV (WLWH). This recommendation is based on low-certainty evidence, and WHO calls for additional data. We describe the association of age and HIV status with visual inspection with acetic acid (VIA) positivity and cervical intra-epithelial neoplasia grade two or higher (CIN2+) in Botswana. Methods: A retrospective cross-sectional study of 5,714 participants aged 25 through 49 years who underwent VIA screening. VIA-positive women received cryotherapy if indicated or were referred for colposcopy. Known cervical cancer risk factors, screening, and histological results were extracted from the program database. We compared the proportions and association of VIA positivity and CIN2+ by age and HIV status.Results: Median age was 35 years [IQR 31-39], and 18% of the women were aged 25-29. Ninety percent were WLWH; median CD4 count was 250 cells/µL [IQR 150-428], and 34.2% were on anti-retroviral treatment (ART). VIA-positivity was associated with younger age (OR 1.48, CI 1.28, 1.72 for 25-29 years versus age 30-49 years ), and HIV-positivity (OR 1.85, CI 1.51, 2.28). CIN2+ was associated with HIV positivity (OR 6.12, CI 3.39, 11.10), and proportions of CIN2+ were similar for both age groups in WLWH (12.1% versus 10.8%).Conclusions: Younger WLWH in Botswana had a significant burden of CIN2+. This finding further supports lowering the screening age for WLWH from 30 to 25.
Cold plasma enamel surface treatment to increase fluoride varnish uptake
Authors: Fathollah S. , Abbasi H. , Akhoundi S. , Naeimabadi A. , Emamjome S.
Published: September 2021

Enamel strengthening to prevent the first stage of caries has been an essential issue in oral health recently. Among the available methods to increase enamel strength, fluoride varnish treatment has relatively better results in preventing tooth decay. Cold plasma capabilities in sterilizing the environment, surface modification, and improving adhesion are well known. Accordingly, this study aims to increase the enamel layer's adhesion hoping that the intensity and time of enamel interaction with FV and the absorption of fluoride ions will increase. Accordingly, we randomly divided twenty bovine teeth into two groups A (consisting of four teeth) and B (composed of four subgroups, each containing four teeth). Samples of group A and one specimen of each subset B investigate the effect of using Helium-DBD (He-DBDJ), Argon (ArJ), and Air-DBD jet on the enamel surface. Other B specimens are devoted to the study of the release of FV fluoride ions from processed enamel. The scanning electron microscope (SEM) images show that although ArJ and Air-DBD have significantly damaged the enamel's hexagonal structures, they are only changed from convex to concave in the He-DBDJ case. For this reason, enamel effectively enhances the capacity to accept more FV. The energy-dispersive X-ray spectroscopy (EDX) indicates an increase in calcium ratio to phosphorus and the amount of fluoride and sodium absorption in the enamel layer in processing with He-DBDJ plasma. The latter helps restore the damaged parts of the enamel. Analysis of fluoride released from the FV did not show a significant change owing to plasma processing. The combination of Cold plasma and varnish fluoride on treatment enamel could be unique ability to improve reinforcement of tooth enamel against of tooth decay.
Impact of Type 2 Diabetes on the Association Between Neurodegenerative Diseases and Cancer in Elderly Koreans: A 10-year Retrospective Cohort Study Using the National Health Insurance Service Database
Authors: Kim Hee-Cheol , Kim Ji-Hun , Lee Ho-Jun , Kim Yang-Tae , Jang Byeong-Churl
Published: September 2021

BackgroundSome studies suggest that cancer and type 2 diabetes (T2D), as well as neurodegenerative diseases (NDs), are related to protein misfolding and possibly to each other. This study aimed to investigate the association between NDs and cancer, and to determine the impact of T2D on the association between NDs and cancer.MethodsA population-based 10-year follow-up study was conducted using the Korean National Health Insurance Service Database between 2002 and 2015. The study population included an ND group (n = 9,292) and control group (n = 46,742), aged ≥60 years. A multivariable Cox proportional hazards regression model was used to evaluate the hazard ratio (HR) and 95% confidence interval (CI) for cancer risk.ResultsVarious another NDs and/or T2D were newly diagnosed in ND and control groups during the 10-year follow-up periods. Newly developed another ND cases before cancer onset were 2,412 (26.0%) in the ND group and 15,435 (33.0%) in the control group (χ2 = 178.19, p < 0.01). Newly developed T2D cases before cancer onset were 4,691 (50.5%) and 25,695 (55.0%) in the ND and control groups, respectively (χ2 = 62.89, p < 0.01). As of December 31, 2015 (the end of the observation period), the number of cancer patients in the ND group was 2,040 (22.0%) and that in the control group was 8,628 (18.5%) (χ2 = 61.45, p < 0.01). The ND group was associated with an increased risk of cancer (HR, 1.25; 95% CI, 1.19–1.31). In both groups, newly diagnosed another NDs and T2D showed an additive effect on cancer incidence during the follow-up period. The additive effect on cancer incidence was higher in T2D than in ND.ConclusionThis study showed a positive association between NDs and cancer, and an additive effect of T2D on this association. Further replication studies are needed to address the association among NDs, cancer, and T2D.
Emerging Technology Innovation in Gaza Strip Municipalities: An Entrepreneurial Approach
Authors: AlAstal Ashraf
Published: September 2021

To boost corporate efficiency in both the public and private sectors, innovation is fundamental. Efficient technological transfer and the role of public-private sector collaboration play a major role in the modern growth of knowledge-based economies. As a public service organization, municipalities normally coordinate with all partners to draw up strategies and use them in communities. A new vision is needed for the Gaza Strip municipalities, where all public and private stakeholders work together to co-design and co-develop new cutting-edge products and services aimed at generating shared value through entrepreneurial behaviour. However, concrete examples of smart city projects revealed that municipalities often do not have the necessary capabilities as well as innovative approaches to collaborate with start-ups and other stakeholders’ ecosystems. So, this paper aims at analyzing (open) innovation in the municipal sector shedding lights on the barriers and challenges that municipalities in Gaza Strip face in smart city development. This study uses primary data gathered from various stakeholders through focus groups, semi-structured interviews and webinars to demonstrate how municipalities can work to address challenges in the smart city context, and to promote an ecosystem of entrepreneurship and innovation. Gaza Strip municipalities need to offer the necessary conditions for entrepreneurial talents who can bring their creative mindset, and technological experiences to the table, making it possible to build the best teams to solve any challenge. The research also concluded that Open Innovation Platforms can be seen as an important tool for enabling start-ups and researchers in developing emerging technologies.
Application of Objective Structured Clinical Examinations (OSCE) for The Evaluation of Kampo Medicine Training
Authors: Amitani Marie , Amitani Haruka , Suzuki Hajime , Kawazu Suguru , Mizuma Kimiko , Yamaguchi Kojiro , Oki Toshimichi , Nitta Hideaki , Sonoda Takuro , Kawano Keiko , Tanaka Yasuhiro , Uto Nanami , Ibusuki Rie , Arita Ryutaro , Takayama Shin , Mitsuma Tadamichi , Takezaki Toshiro , Asakawa Akihiro , Owaki Tetsuhiro
Published: September 2021

Background
The purpose of study was to develop an objective, valid, and reliable assessment method for Kampo medicine using an OSCE for the evaluation of clinical competence in Kampo medicine
Methods
We developed a blueprint followed by a list of 47 assessment items and three task scenarios related to clinical competence in Kampo medicine. An eight-member test committee checked the relevance and pass/fail criteria of the assessment items on a Likert scale. We calculated a content validity index and content validity ratio, and used the Angoff method to set the passing threshold. We trained a total of nine simulated patients with three assigned to each scenario. We conducted an OSCE for 11 candidates with varying medical abilities, and conducted three stations per person, and one evaluator in one room by direct observation evaluated. We used video recordings to test the inter-rater reliability of the three raters. We used the test results to verify the reliability of the evaluation scale.
Results
The inter-rater reliability (Cronbach’s α) was 0.92–1.00, intra-examinee reliability was 0.59–0.95, and the reliability of each task was 0.86, 0.89, and 0.86 for Scenarios 1, 2, and 3, respectively.
Conclusions
We developed a content-valid new OSCE assessment method for Kampo medicine and obtained high inter-rater and test reliabilities. Our findings suggest that this is one of the most reliable and valid evaluation methods for assessing clinical competence in Kampo medicine.
Skeletal Muscle Loss During Neoadjuvant Chemotherapy Predicts Poor Prognosis in Patients with Breast Cancer
Authors: Amitani Masatsugu , Oba Takaaki , Morikawa Hiroki , Chino Tatsunori , Soma Ai , Shimizu Tadafumi , Ohno Koichi , Ono Mayu , Ito Tokiko , Kanai Toshiharu , Maeno Kazuma , Ito Ken-ichi
Published: September 2021

Background: The skeletal muscle index (SMI), which is calculated as the ratio of skeletal muscle area at the third lumbar vertebral level divided by height squared, has been considered a prognostic factor in patients with breast cancer. However, the prognostic impact of changes in SMI during treatment remains unclear. This study aimed to evaluate the influence of SMI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC).Methods: We reviewed patients with breast cancer who underwent NAC and subsequent surgery for breast cancer between 2010 and 2017. The rate of SMI change during NAC was calculated, and the association between SMI changes and prognosis was retrospectively analyzed.Results: In total, 144 patients were evaluated. 48 (33.3%), 56 (38.9%), and 40 (27.8%) patients exhibited increased (≥ 3%), maintained (−3% <, < 3%), and decreased (−3% ≥) SMI during NAC, respectively. The decreased SMI group showed significantly poorer disease-free survival than the maintained and increased SMI groups (hazard ratio [HR] 8.82, p < 0.001 for the decreased vs. increased SMI groups; HR 3.72, p < 0.001 for the decreased vs. maintained SMI groups). Moreover, decreased SMI was an independent risk factor for disease-free survival in multivariate analysis (HR 4.20, p < 0.01).Conclusions: Skeletal muscle loss during NAC predicts poor prognosis. Our results underscore the importance of monitoring and maintaining skeletal muscle mass during NAC.
The PID Life Index: An Interactive Tool To Measure The Status of The PID Healthcare Environment in Any Given Country
Authors: Solis Leire , Nordin Julia , Prévot Johan , Mahlaoui Nizar , Sánchez-Ramón Silvia , Ali Adli , Cassignol Elodie , Seymour John , Pergent Martine
Published: September 2021

Background: The “Primary Immunodeficiencies (PIDs) principles of care” were published in 2014 as the gold standard for care of patients with PIDs. Since then, IPOPI, the International Patient Organisation for Primary Immunodeficiencies, has been working with national PID patient organisations as well as collaborating with scientific and medical institutions and experts to bring these principles closer to the day-to-day life of individuals with PIDs. Results: The PID Life Index was developed in 2020 to assess the status of the PID environment and the implementation of the 6 principles worldwide. The Index allows for benchmarking countries according to a set of principles and criteria or based on the user’s preferences. This can be displayed in an interactive map or through a data visualisation system. The 6 PID Principles of Care were reviewed to consider advances in the field of health and science, as well as to include political developments that had occurred since their initial publication in 2014. This resulted in the following 6 principles: PID diagnosis, treatments, universal health coverage, specialised centres, national patient organisations and registries for PIDs. All principles are given the same weight while the criteria have a specific weight. PID Life Index also includes documentation on each country, on PID specialised centres taking care of patients with PIDs (children or adults), on immunoglobulin replacement therapies registered in each country as well as a glossary of the terminology used. Conclusion: The PID Life Index aims at becoming a resource for patients with PIDs and their representatives, healthcare professionals, decision-makers and other relevant stakeholders interested in learning more about the concrete situation of patients with PIDs. With this tool IPOPI wants to increase awareness and information as well as support advocacy initiatives on PIDs nationally, regionally or globally.
Terahertz Time-domain Spectroscopy as a Novel Tool for Crystallographic Analysis in Cellulose: Cellulose I to Cellulose Ii, Tracing the Structural Changes Under Chemical Treatment
Authors: Wang Han , Kataoka Hiroki , Tsuchikawa Satoru , Inagaki Tetsuya
Published: September 2021

Terahertz time-domain spectroscopy (THz-TDS) has expanded possibilities in cellulose crystallography research, as THz radiation detects most intermolecular vibrations and responds to the phonons of crystalline lattices. In this study, we traced the transformation of the cellulose crystalline lattice from cellulose I to cellulose II by THz-TDS and X-ray powder diffraction. Cellulose II was obtained by treating cellulose I with NaOH of different concentrations (0 wt%–20 wt%, at 2 wt% intervals). The THz absorption coefficient spectra of cellulose II showed three characteristic peaks (at 1.32 THz, 1.76 THz, and 2.77 THz). The THz absorption coefficient spectra of cellulose II treated with 20-wt% NaOH and cellulose I without NaOH treatment were fitted by a seventh-order Fourier series. Thus, the THz absorption coefficient spectra of samples treated with NaOH of other concentrations could be considered a combination of these two fitted profiles of cellulose I and cellulose II, multiplied by different coefficients. Furthermore, the coefficients could reflect the relative contents of cellulose I and cellulose II in the samples.
Life Stage of Neighbors Determines Neighborhood Effect on Tree Mortality in a Subtropical Forest
Authors: He Yi , Liu Heming , Yang Qingsong , Cao Ye , Liang Mengfang , Zhou Shuangshuang , Wang Xihua
Published: September 2021

Neighborhood effects are a crucial ecological process that allow species to coexist in a forest. Conspecific and heterospecific neighbors, as major classified groups, affect tree mortality through various mechanisms associating with neighbor life stages. However, how neighbor life stages influence neighborhood effects and by what mechanisms remains a knowledge gap. Here we censused the mortality of 82,202 trees representing 30 species in a 20-ha subtropical forest and classified their neighbors into the following life stages: earlier, same and later. Then, we ran generalized linear mixed models to estimate the effect of neighbors at different life stages on tree mortality. Our results showed that conspecific later stage neighbors have effects on increasing tree mortality overall, whereas conspecific earlier stage neighbors have effects on decreasing. Furthermore, these opposing effects could offset each other so that the overall effect of conspecific neighbors on juvenile mortality seems small. In contrast, heterospecific neighbors have effects on decreasing tree mortality overall. These effects are consistent with those of later stage heterospecific neighbors. Our findings demonstrate that neighbors importantly impact tree mortality, and their specific effects are closely related to neighbor life stages. Any single effect from one neighbor life stage could disturb or dominate the total effects of the neighbors. Therefore, the neighbors must be divided into different life stages to best explain the neighborhood effect on forest dynamics.
Dual-gRNA Approach With Limited Off-Target Effect Corrects C9ORF72 Repeat Expansion In Vivo
Authors: Piao Xuejiao , Meng Dawei , Zhang Xue , Song Qiang , Lv Hailong , Jia Yichang
Published: September 2021

C9ORF72 GGGGCC repeat expansion is the most common genetic cause for amyotrophic lateral sclerosis and frontotemporal dementia, which generates abnormal DNA and RNA structures and produces toxic proteins. Recently, efficacy of CRISPR/Cas9-mediated editing has been proven in treatment of disease. However, DNA low complexity surrounding C9ORF72 expansion increases the off-target risks. Here we provide a dual-gRNA design outside of the low complexity region which enables us to remove the repeat DNA in a ‘cutting-deletion-fusion’ manner with a high fusion efficiency (50%). Our dual-gRNA design limits off-target effect and does not significantly affect C9ORF72 expression. In neurons carrying patient C9ORF72 expansion, our approach removes the repeat DNA and corrects the RNA foci in vitro and in vivo. Therefore, we conclude that our proof-of-concept design correct C9ORF72 repeat expansion, which may have potential therapeutic value for the patients.
Direct Phone Communication To Primary Care Physician To Plan Discharge From Hospital: Feasibility and Benefits
Authors: ENZINGER Lukas , DUMANOIR Perrine , BOUSSAT Bastien , COUTURIER Pascal , FRANCOIS Patrice
Published: September 2021

Background
The discharge summary is the main vector of communication at the time of hospital discharge, but it is known to be insufficient. Direct phone contact between hospitalist and primary care physician (PCP) at discharge could ensure rapid transmission of information, improve patient safety and promote interprofessional collaboration. The objective of this study was to evaluate the feasibility and benefit of a phone call from hospitalist to PCP to plan discharge.
Methods
This study was a prospective, single-center, cross-sectional observational study. It took place in an acute medicine unit of a French university hospital. The hospitalist had to contact the PCP by telephone within 72 hours prior discharge, making a maximum of 3 call attempts. The primary endpoint was the proportion of patients whose primary care physician could be reached by telephone at the time of discharge. The other criteria were the physicians' opinions on the benefits of this contact and its effect on readmission rates.
Results
275 patients were eligible. 8 hospitalists and 130 PCPs gave their opinion. Calls attempts were made for 71% of eligible patients. Call attempts resulted in successful contact with the PCP 157 times, representing 80% of call attempts and 57% of eligible patients. The average success rate for calls was 47%. The telephone contact was perceived by hospitalist as useful and providing security. The PCPs were satisfied and wanted this intervention to become systematic. Telephone contact did not reduce the readmission rate.
Conclusions
Despite the implementation of a standardized process, the feasibility of the intervention was modest. The main obstacle was hospitalists lacking time and facing difficulties in reaching the PCPs. However, physicians showed desire to communicate directly by telephone at the time of discharge.
Trial registration
French C.N.I.L. registration number 2108852. Registration date October 12, 2017.
Integration of a Task Strengthening Strategy for Hypertension Management into HIV Care in Nigeria: a Cluster Randomized Controlled Trial Study Protocol
Authors: Aifah Angela , Odubela Oluwatosin , Rakhra Ashlin , Onakomaiya Deborah , Hu Jiyuan , Nwaozuru Ucheoma , Oladele David , Odusola Femi , Idigbe Ifeoma , Musa Adesola Z. , Akere Ayodeji , Tayo Bamidele O. , Ogedegbe Gbenga , Iwelunmor Juliet , Ezechi Oliver
Published: September 2021

BackgroundIn regions with weak healthcare systems, critical shortages of the healthcare workforce, and increasing prevalence of dual disease burdens, there is an urgent need for the implementation of proven effective interventions and strategies to address these challenges. Our mixed-methods hybrid type II effectiveness-implementation study is designed to fill this evidence-to-practice gap. This study protocol describes a cluster randomized controlled trial which evaluates the effectiveness of an implementation strategy, practice facilitation (PF), on the integration, adoption, and sustainability of a task-strengthening strategy for hypertension control (TASSH) intervention within primary healthcare centers (PHCs) in Lagos State, NigeriaDesignGuided by the Consolidated Framework for Implementation Research (CFIR) and the Reach Effectiveness Adoption Implementation and Maintenance (RE-AIM), this study tests the impact of a proven effective implementation strategy to integrate hypertension management into the HIV care cascade, across 30 PHCs. The study will be conducted in three phases: 1) a pre-implementation phase that will use CFIR to develop a tailored PF intervention for integrating TASSH into HIV clinics; 2) an implementation phase that will use RE-AIM to compare the clinical effectiveness of PF vs. a self-directed condition (receipt of information on TASSH without PF) on BP reduction; and 3) a post-implementation phase that will use RE-AIM to evaluate the effect of PF vs. self-directed condition on adoption and sustainability of TASSH. The PF intervention components comprise: (a) an advisory board to provide leadership support for implementing TASSH in PHCs; (b) training of the HIV nurses on TASSH protocol; and (c) training of practice facilitators, who will serve as coaches, provide support, and performance feedback to the HIV nurses.DiscussionThis study is the first trial to evaluate the impact of an implementation strategy for integrating hypertension management into HIV care, on clinical and implementation outcomes. Findings from this study will advance implementation science research on the effectiveness of tailoring an implementation strategy for the integration of an evidence-based, systems level hypertention control intervention into HIV care and treatment.Trial registrationClinicalTrials.gov (NCT04704336). Registered on 11 January 2021.
Anti-Proliferative, Antioxidant And Anti-Inflammatory Potentials of Cassia Nemophila Flowers
Authors: Rehman Gauhar , Shahjeer Kiran , Hamayun Muhammad , Rahman Abdur , Safi Dawood , Lee In-Jung
Published: September 2021

Cancer is characterized by abnormal growth and uncontrolled growth of cells. Adverse effect on various body functions. It is a multifaceted disease with many causes. Medicinal plants have the potential to treat disorders. The study was designed to examine the properties of ethanolic and n-hexane flowering plants of Cassia and living flowers. C. Nophila was selected for this study because it has a long history of traditional and modern Cassia drug discovery. The contribution of oxidants was confirmed using the DPPH radical scavenging assay. Anti-inflammatory activities were tested by the HRBC membrane-strengthening membrane. Cytotoxic effects are being investigated with respect to the activity of the HCT115 cancer cell line. Efforts are being made to identify potential AMPK agonist operations. To adjust the crystal structure of AMPK and its ligand, AMBER18 software was used. ligands developed by the Molecular Operating Environment (MOE2018). Viewing and analysis of AMPK and its users using PyMOL. For authentication software packages, Chimera and AutoDock Vina were used. The results revealed the medicinal value of C flowers. Absolutely, flowers of C. and life have many active ingredients that can be used as effective anticancer drugs. More research needs to be done to explore the many properties of these plant species.
A Climate Perspective of the Quasi-Stationary Front in Southwestern China: Structure, Variation and Impact
Authors: Cai Danping , Yang Xiu-Qun , Tao Lingfeng , Wang Weiping , Yan Hongming
Published: September 2021

Yunnan-Guizhou quasi-stationary front (YGQSF) is a unique weather phenomenon that frequently occurs during winter half year over the Yunnan-Guizhou Plateau in southwestern China. Most of previous studies analyzed it only with synoptic cases. This study investigates the structure, variation, and impact of YGQSF from a climate perspective, using long-term high-resolution atmospheric reanalysis and high-density station records for 1981-2016. An objective method quantifying YGQSF is proposed and three indexes are defined to measure the intensity, frequency, and location of YGQSF, respectively, with the horizontal gradient of air potential temperature at a terrain-following level of sigma 0.995. With these indexes, climatological structure, subseasonal variability as well as climatic impact of YGQSF are comprehensively examined. In climatology, YGQSF as a north-south-oriented low-level front is found to occur the most frequently during January-February-March (JFM), determined predominately by the coldness from the east of the front. The structure of YGQSF identified essentially reflects an obstruction of high-terrain Yunnan (the western part of the plateau) to the low-level cold air mass, which makes near-surface cold northeasterly winds cease westward intruding and veer upward over relatively low-terrain Guizhou, transporting moisture upward and forming low clouds. A sharp climate contrast is thus formed between two sides of YGQSF: cold, sunless, and continuously rainy Guizhou versus warm and sunny Yunnan. Furthermore, YGQSF features significant subseasonal variations with periods at around 30d and 60d largely in its intensity. Anomalously strong YGQSF events which are caused 75% by the cold anomaly from the east but less than 17% by the warm anomaly from the west yield different anomalous structures, but consistently amplify the sharp climate contrast between Yunnan and Guizhou.
No Differences in the Long-Term Prognosis of Iris and Choroidal Melanomas when Adjusting for Tumor Thickness and Diameter
Authors: Sabazade Shiva , Herrspiegel Christina , Gill Viktor Torgny , Stålhammar Gustav
Published: September 2021

Objective:To assess the long-term prognosis for patients with iris melanomas and compare it with the prognosis for small choroidal melanomas.DesignRetrospective observational case seriesMethodsAll patients treated for iris melanomas at a single referral institution between January 1st 1986 and January 1st 2016 were included. Patients treated for small choroidal melanomas during the same period were included for comparison. The cumulative incidence of melanoma-related mortality was calculated. Patient and tumor characteristics and size-adjusted hazard ratio (HR) for melanoma-related mortality were compared between iris and small choroidal melanomas.ResultsForty-five iris melanomas and 268 small choroidal melanomas were included. Twenty-four iris melanomas (53 %) had been treated with local resection, 12 (27 %) with Ruthenium-106 brachytherapy, 7 (16 %) with enucleation and 2 (4 %) with proton beam irradiation. Twenty-three patients had deceased before the end of follow-up. Median follow-up for the 22 survivors was 13.3 years (SD 9.4, table 1). Patients with iris melanomas were more often asymptomatic at presentation and had a trend towards significantly lower age (59 versus 63 years, Student’s T-tests p=0.057). Further, iris melanomas had significantly smaller basal diameter (5.8 versus 8.0 mm, p< 0.0001) and tumor volume (79 mm3 versus 93 mm mm3, p< 0.0001) but greater thickness (3.0 versus 2.5 mm, p< 0.0001). The cumulative incidence of iris melanoma-related mortality was 5 % at 5 years after diagnosis, and 8 % at 10, 15 and 20 years. The incidence was not significantly different to small choroidal melanomas (Wilcoxon p=0.46). In multivariate Cox regression with tumor diameter and thickness as covariates, patients with choroidal melanomas did not have increased HR for melanoma-related mortality (HR 2.2, 95 % CI 0.5 – 9.6, p=0.29). Similarly, there were no significant survival differences in matched subgroups (Wilcoxon p=0.82).ConclusionsThere are no survival differences between iris and choroidal melanomas when adjusting for tumor size. The reason for the relatively favorable prognosis of iris melanomas compared to melanomas of the choroid and ciliary body is likely that they are diagnosed at a smaller size.
A synergistic strategy to develop photostable and bright dyes with long Stokes shift for super-resolution microscopy
Authors: jiang gangwei , Ren Tian-Bing , D’Este Elisa , xiong mengyi , Xiong Bin , Johnsson Kai , Zhang Xiaobing , wang Lu , Yuan Lin
Published: September 2021

The quality and application of super-resolution fluorescence imaging greatly lie in the properties of fluorescent probes. However, conventional fluorophores in a cellular environment often suffer from low brightness, poor photostability, and short Stokes shift (< 30 nm). Here we report a synergistic strategy to simultaneously improve such properties of regular fluorophores. Introduction of quinoxaline motif with fine-tuned electron density to conventional rhodamines generates new dyes with vibronic structure and inhibited twisted-intramolecular-charge-transfer (TICT) formation synchronously, thus increasing the brightness and photostability as well as Stokes shift. The new fluorophore BDQF-6 exhibits around twofold greater brightness (ε × Φ = 6.6 × 104 L·mol− 1·cm− 1) and Stokes shift (56 nm) than its parental fluorophore, Rhodamine B. Importantly, in Stimulated Emission Depletion (STED) microscopy, BDQF-6 derived probe possesses a superior photostability and thus renders threefold more frames than carbopyronine- and JF608-based probes, known as photostable fluorophores for STED imaging. More BDQF-6 derivatives were developed next, allowing us to perform wash-free organelles (mitochondria and lysosome) staining and protein labeling with ultrahigh signal-to-noise ratios (up to 106 folds) in confocal and STED microscopy of live cells, or two-photon and 3D STED microscopy of fixed cells. Furthermore, the strategy was well generalized to different types of dyes (pyronin, rhodol, coumarin, and Boranil), offering a new class of bright and photostable fluorescent probes with long Stokes shift (up to 136 nm) for bioimaging and biosensing.
Pneumococcal Meningitis in Adults in 2014-2018 After Introduction of Pediatric 13-valent Pneumococcal Conjugate Vaccine in Japan
Authors: Chang Bin , Tamura Kosuke , Fujikura Hiroyuki , Watanabe Hiroshi , Tanabe Yoshinari , Kuronuma Koji , Fujita Jiro , Oshima Kengo , Maruyama Takaya , Abe Shuichi , Kasahara Kei , Nishi Junichiro , Kubota Tetsuya , Kinjo Yuki , Serizawa Yusuke , Shimbashi Reiko , Fukusumi Munehisa , Shimada Tomoe , Sunagawa Tomimasa , Suzuki Motoi , Oishi Kazunori
Published: September 2021

We assessed the impact of pediatric 13-valent pneumococcal conjugate vaccine (PCV13) on pneumococcal meningitis in adults in Japan in 2014-2018 by comparing epidemiological characteristics of adults with invasive pneumococcal disease with (n=222) and without (n=1,258) meningitis. Pneumococcal meningitis annual incidence in 2016-2018 was 0.20–0.26 cases/100,000 population. Age (p<0.001) and case fatality rate (p=0.003) were significantly lower in patients with meningitis than in those without meningitis. Meningitis risk was higher in asplenic/hyposplenic or splenectomized patients (adjusted odds ratio [aOR] 2.29, 95% CI 1.27–4.14), for serotypes 10A (aOR 3.26, 95% CI 2.10–5.06) or 23A (aOR 3.91, 95% CI 2.47–6.19), but lower for those aged ³65 years (aOR 0.59, 95% CI 0.44–0.81). PCV13 had an indirect effect on nonmeningitis, but its impact on meningitis was limited because of an increase in non-PCV13 serotypes. Of meningitis isolates, 78 (35.1%) and 3 (1.4%) were penicillin G- and ceftriaxone-resistant. We also confirmed association of the pbp1bA641C mutation with meningitis (aOR 2.92, 95% CI 1.51–5.65).
Synthesis and Properties of MoAlB Composites Reinforced with SiC Particles
Authors: Zhang Weiwei , Li Shibo , Wu Shuang , Yao Boxiang , Fan Shukai , Bei Guoping , Yu Wenbo , Zhou Yang , Wu Ying , Ding Sun-an
Published: September 2021

To develop MoAlB advanced ceramic with improved mechanical properties and oxidation resistance, the use of SiC particles to reinforce MoAlB composites has been adopted. 5–15 vol.% SiC/MoAlB have been prepared and characterized. A flexural strength of 380 MPa and a Vickers hardness of 12.7 GPa were achieved in the 5 vol. %SiC/MoAlB composite, increased by 24% and 51%, respectively, as compared with those for MoAlB. Oxidation at 1200°C and 1300°C for 10 h in air showed that the 5 vol. %SiC/MoAlB composite has good oxidation resistance than MoAlB due to the formation of a dense and continuous scale composed of Al2O3 and SiO2, which prevents oxygen inward diffusion and the evaporation of oxides. We expect that the general strategy of second phase reinforcing for materials will help to widen the applications of MoAlB.
Utility of total cell-free DNA levels for surgical damage evaluation in patients with urological surgeries
Authors: Konishi Sakae , Narita Takuma , Hatakeyama Shingo , Yoneyama Tohru , Yoneyama Mihoko Sutoh , Tobisawa Yuki , Noro Daisuke , Sato Tendo , Togashi Kyo , Okamoto Teppei , Yamamoto Hayato , Yoneyama Takahiro , Hashimoto Yasuhiro , Ohyama Chikara
Published: September 2021

The evaluation of surgical damage is challenging because of the lack of specific biomarkers. Total cell-free DNA (cfDNA) levels have been reported to increase with external trauma and may be a biomarker for tissue damage. To investigate the utility of perioperative total cfDNA levels in evaluating surgical damage in urological surgeries. This multicenter, prospective, observational study included 196 patients scheduled for urological surgeries between September 2020 and July 2021. The primary outcome was the change in total cfDNA levels before and after urological surgery. The secondary outcome was the effect of surgical type on total cfDNA ratio before and after urological surgery. The postoperative median total cfDNA level of the 196 patients was significantly increased 2.5-fold compared to the preoperative level (185.2 ng/mL vs. 406.7 ng/mL, P < 0.001). The median total cfDNA before/after ratio was greater than four-fold for kidney transplantation, open cystectomy, and open adrenalectomy. The ratio was less than two-fold for laparoscopic adrenalectomy and robot-assisted radical prostatectomy. Major surgery showed a significant postoperative increase in total cfDNA levels, while minor surgery did not. Total cfDNA levels increased 2.5-fold after urological surgery and it can be used as an acute-phase biomarker for surgical damage.
Thiol-Ene Click Synthesis of Adsorption Functionalized Poly(Ionic Liquid)s: Influence of the Mole Fraction of Pendant Enes
Authors: Li Wen , Wang Aili , Ye Tingting , Li Siqiang , Wang Minghua , Zhou Qijie , Zheng Tanghong
Published: September 2021

Adsorption functionalized poly(ionic liquid)s could be thiol-ene click synthesized within surfactant-free ionic liquid microemulsions. However, the influence of the mole fraction of pendant enes on the as-prepared polymer is still unclear. Herein, the influence of the mole fraction of pendant enes on the molecular structure, surface morphology, thermostability and adsorption performance of poly(ionic liquid)s were investigated in detail. To characterize the as-prepared polymers, FTIR, NMR, TGA, DSC, SEM and UV–vis were used, and the adsorption isotherm/kinetics studies were carried out. The results show that the mole fraction of pendant enes had a significant difference on the characterization of poly(ionic liquid)s. The lower mole fraction of pendant enes donated lower T10% value, slower degradation rates and lower Tg, and the value of 0.30 was the boundary of forming structure with various beading sizes and structure with various irregularly shaped apertures. In addition, poly(ionic liquid)s with different mole fraction of pendant enes all showed excellent adsorption performance to DR, also indicate remarkable potential in the application of dying wastewater treatment.
Efficient Detection of Multiple FBG Wavelength Peaks using Matched Filtering Technique
Authors: Kumar Sunil
Published: September 2021

We propose an efficient technique for FBG peak detection based on matched filtering technique. The matched filtering process is based on resonance point estimation between a standard reference spectral signal and a reflected spectrum of FBG. The desired peak wavelength and corresponding peak intensity are predicted by determining of the cross-correlation between the FBG signal and 3rd derivative of the reference signal. The peak wavelength and intensity are found from the zero-crossing points of the cross-correlation function. The Mexican-hat wavelet function is chosen as the reference spectral signal due to its narrow shape. The proposed algorithm can suitably be used for multiple peak detection when several FBGs are cascaded and if the FBG signal is weak and noisy.
Itaconate Inhibits TET DNA Dioxygenases to Dampen Inflammatory Responses
Authors: Ye Dan , Chen Leilei , Morcelle Carmen , Cheng Zhouli , Chen Xiufei , Xu Yanping , Gao Yajing , Song Jun-Bin , Li Zhijun , Smith Matthew , Shi Miao , Zhu Yezhang , Zhou Neng , Cheng Meng , He Chenxi , Liu Kwei-Yan , Lu Guoping , Zhang Lei , Zhang Cheng , Zhang Jinye , Sun Yiping , Qi Tuan , Lyu Yingying , Ren Zhi-Zhong , Tan Xian-Ming , Lan Fei , Liu Ying , Yang Hui , Duan Caiwen , Chang Xing , Zhou Yufeng , Shen Li , Baldwin Albert , Guan Kun-Liang , Xiong Yue
Published: September 2021

The immune-response gene 1 (IRG1) plays a key role in anti-pathogen defense, as deletion of Irg1 in mice causes severe defects in response to bacterial and viral infection, and decreased survival1, 2. IRG1 transcription is rapidly induced by pathogen infection and inflammatory conditions primarily in cells of myeloid lineage3. IRG1 encodes a mitochondrial metabolic enzyme, aconitate decarboxylase 1 (ACOD1), that catalyzes the decarboxylation of cis-aconitate to produce the anti-inflammatory metabolite itaconic acid (ITA)4. Several molecular processes are affected by ITA, including succinate dehydrogenase (SDH) inhibition5, resulting in succinate accumulation and metabolic reprogramming6, 7, and alkylation of protein cysteine residues, inducing the electrophilic stress response mediated by NRF2 and IκBζ8, 9 and impairing aerobic glycolysis10. However, the mechanisms by which ITA exerts its profound anti-inflammatory effect still remains to be fully elucidated. Here, we show that ITA is a potent inhibitor of the TET family DNA dioxygenases, which catalyze the conversion of 5-methylcytosine (5mC) to 5-hydroxymethylcytosine (5hmC) during the process of active DNA demethylation. ITA binds to the same site of α-ketoglutarate (α-KG) in TET2, inhibiting its catalytic activity. Lipopolysaccharides (LPS) treatment, which induces Irg1 expression and ITA accumulation, inhibits Tet activity in macrophages. Transcriptome analysis reveals TET2 is a major target of ITA in suppressing LPS-induced genes, including those regulated by NF-κB and STAT signaling pathways. In vivo, ITA decreases 5hmC, reduces LPS-induced acute pulmonary edema and lung and liver injury, and protects mice against lethal endotoxaemia in a manner that is dependent on the catalytic activity of Tet2. Our study thus identifies ITA as an immune modulatory metabolite that selectively inhibits TET enzymes to dampen the inflammatory response.
Enhancement of concrete performance via mixed limestone and granite powders
Authors: Zeng Hao , Zhang Jin , Zhang Kai
Published: September 2021

The granite and limestone powders are commonly exploited as a replacement for cement; however, the effects of different mixing dosages of them on the mechanical properties and durability of concrete have not been scrutinized carefully. Under different environmental conditions, the compressive strength of the specimens is measured using cube compressive, splitting tensile, freeze-thaw cycles, and sulfate immersion tests. The phase composition of hydration products and microstructure is evaluated by SEM scanning analysis. The results indicate that the composite mixture of granite and limestone powders shows a complementary synergistic effect and improves the mechanical properties, freeze-thaw resistance, and sulfate erosion resistance of the concrete. The best values for the mechanical properties and freeze-thaw resistance are obtained when the dosages of granite and limestone powders in order are 10% and 5%. For the case of granite and limestone powders equal to 10% and 15%, respectively, the best sulfate erosion resistance is reported.
Spectral Detector CT-Derived Pulmonary Perfusion Maps And Pulmonary Parenchyma Characteristics For The Semiautomated Classification of Pulmonary Hypertension
Authors: Gertz Roman Johannes , Gerhardt Felix , Kröger Jan Robert , Shahzad Rahil , Caldeira Liliana , Kottlors Jonathan , Hokamp Nils Große , Maintz David , Rosenkranz Stephan , Bunck Alexander Christian
Published: September 2021

Objectives: To evaluate the usefulness of spectral detector CT (SDCT)-derived pulmonary perfusion maps and pulmonary parenchyma characteristics for the semiautomated classification of pulmonary hypertension (PH).Methods: A total of 162 consecutive patients with right heart catheter (RHC)-proven PH of different etiologies as defined by the Nice classification who underwent CT pulmonary angiography (CTPA) on SDCT and 20 patients with an invasive rule-out of PH were included in this retrospective study. Semiautomatic lung segmentation into normal and malperfused areas based on iodine content as well as automatic, virtual noncontrast-based emphysema quantification were performed. Corresponding volumes, histogram features and the ID SkewnessPerfDef-Emphysema-Index (O-index) accounting for the ratio of ID distribution in malperfused lung areas and the proportion of emphysematous lung parenchyma were computed and compared between groups.Results: Patients with PH showed a significantly greater extent of malperfused lung areas as well as stronger and more homogenous perfusion defects. In Nice class 3 and 4 patients, ID skewness revealed a significantly more homogenous ID distribution in perfusion defects than in all other subgroups. The b-index allowed for further subclassification of subgroups 3 and 4 (p < 0.001), identifying patients with chronic thromboembolic PH (CTEPH, subgroup 4) with high accuracy (AUC: 0.92, 95%-CI, 0.85-0.99).Conclusion: Abnormal pulmonary perfusion in PH can be detected and quantified by semiautomated SDCT-based pulmonary perfusion maps. ID skewness in malperfused lung areas, and the j-index allow for a classification of PH subgroups, identifying Nice class 3 and 4 patients with high accuracy, independent of reader expertise.
Ninety Days and In-Hospital Mortality after Gastrointestinal and Hepatopancreatic Biliary Surgery- A Case Series Analysis.
Authors: vasavada bhavin bhuendra , patel Hardik
Published: September 2021

Aim: The aim was to do a retrospective analysis and audit of our 90 days and in-hospital mortality after gastrointestinal and hepatopancreatic biliary surgery performed in our department and analyze factors predicting it.Patients and methods:All patients who underwent gastrointestinal and hepatopancreatic biliary surgery in our department in the last 3 years were evaluated for 90 days postoperative and in-hospital mortality and various factors affecting it. Categorical values were analyzed using the chi-square test or fisher's exact test wherever appropriate. Continuous variables were analyzed using the student t-test for parametric data and Mann Whitney U test for nonparametric data after skewness and kurtosis analysis. Multivariate analysis was done using logistic regression analysis. A p-value less than 0.05 was considered statistically significant. Statistical analysis was done using SPSS version 23(IBM).Results:412 patients underwent gastrointestinal and hepatobiliary surgery in the last 3 years at our institute. Ninety days all-cause mortality was 5.8%, all-cause in-hospital mortality was around 4.6%. 90 days mortality in elective and emergency surgeries were respectively 3.2% and 18%. In-hospital mortality in elective and emergency surgeries were respectively 2.35% and 15.2%. On multivariate analysis age, nontechnical complications, open surgery, and emergency surgery independently predicted 90 days mortality. On multivariate analysis age, acute kidney injury, non-procedural complications, and emergency surgeries independently predicted in-hospital mortalities.Conclusion:Age, non-technical complications, open surgery, and emergency surgeries are independently associated with 90 days mortality, and age, acute kidney injury, non-procedural complications, and emergency surgery independently predict in-hospital mortality.
Development and Evaluation of an Electronic Nursing Documentation System
Authors: Shafiee Mohsen , Shanbehzadeh Mostafa , Nassari Zeinab , Kazemi-Arpanahi Hadi
Published: September 2021

Introduction:
nursing documentation is a critical aspect of the nursing care workflow. There is a varying degree in how detailed nursing reporting is described in scientific literature and care practice, and no uniform structured documentation is given.
Aims
This study aimed to describe the process of designing and evaluating the content of an electronic nursing documentation system to provide consistent and unified reporting in this context.
Methods
A four-step sequential methodological approach was utilized. The Minimum Data Set (MDS) development process consisting of two phases, as follows: A literature review was performed to attain an exhaustive overview of relevant elements of nursing and map the available evidence underpinning the development of the MDS. Second, the data included from the literature review were analyzed using a two-round Delphi study with content validation by an expert panel. Next, the electronic nursing system (ENS) was developed according to the finalized MDS, and finally, its performance was evaluated by involved the end-users.
Results
The proposed MDS was divided into administrative and clinical sections; including nursing assessment and nursing diagnosis process. Then, a web-based system with modular and layered architecture was designed based on derived MDS. Finally, to evaluate it, a survey by participating 150 registered nurses (RNs) was conducted and the positive impacts and negative impacts of the system were identified.
Conclusion
The developed system is suitable for the documentation of patient care in nursing care plans. However, nurses need further training in documenting patient care according to the nursing process, and in using the standard reporting templates to increase patient safety and improve documentation.