bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Patient Experience Evaluation of a Gentle Atomizer for Nasal Drug Delivery
Authors: Khawaja Uzzam Ahmed , Rizvi Syed A. A. , Gong Boliang , Yeung Waiman , Sanchez-Gonzalez Marcos A. , Ferrer Gustavo
Published: April 2021

Background: Recently, nasal drug delivery has emerged as a convenient modality for the treatment of multiple, allergic, infectious, and inflammatory sinonasal conditions. Some patients report discomfort and irritation associated with the pressure and flow generated by using typical atomizers which may lead to decrease patient compliance and lower satisfaction. We sought to develop a rather gentle atomizer for nasal irrigation that would ameliorate the discomfort associated with nasal drug delivery. Herein, we report the development of an atomizer via fluid dynamics modeling and evaluating the patient experience.Methods: Using computational flow dynamics modeling, we assessed the distribution of atomized droplets to compare the conventional narrow-angle (NA) Vs a new open-angle swirling effect (OSE) atomizer. The goal for the new atomizer was to generate a swirling effect by opening a spray cone from a tapered nozzle bottle at different head tilted positions to determine the most efficient one that would enhance drug delivery and aid in patient comfort. Once the best computational model was generated and the atomizer developed, a group of 13 healthy volunteers consented to participate in the performance evaluation of the two atomizers (NA and OSE). Participants gauged both atomizers for ergonomics, pressure, and comfort for drug delivery (saline). The participants' feedback was collected using the nozzle tip sensory attributes questionnaire.Results: Atomizer Fluid Dynamics: The comparison was made between NA and OSE using the latest recommendation on the intranasal delivery angle of 45º with the nozzle 1.5 cm into the nose bypassing the nasal valve. The NA went 7cm into the nose, and hence generated high frictional pressure in the nasal mucosa. On the other hand, the OSE deliverd doses between 3 - 7 cm, thus generating less pressure. Patient Experience: 60% of the participants encountered irritation with the NA atomizer such as pain and a burning sensation. About 20% felt the OSE to be soft and pleasant, while 90% reported a misting sensation.Conclusion: The results of the present study suggest that OSE is a viable and more comfortable system to deliver intranasal therapies. These findings shed light on our understanding of the fluid flow dynamics to design extra efficient and comfortable atomizers to maximize drug delivery in the nasal cavity and potentially increase patient satisfaction as well as compliance.
Identification and Validation of Immune-Related Gene Prognostic Signature for breast cancer
Authors: Zhou Bing , Zhang Linyi , Wang Qinyu , Pu Changqin , Guo Sixuan , Lai Shuhui , Zhang Heming , Li Wenwei , Zhou Zhibing , Chen Yuexia , Zeng Liping , Zhou Yao
Published: April 2021

Background
Although the outcome of breast cancer patients has been improved by advances in early detection, diagnosis and treatment. Due to the heterogeneity of the disease, prognostic assessment still faces challenges. The accumulated data indicate that there is a clear correlation between the tumor immune microenvironment and clinical outcomes.
Objective
Construct immune-related gene pairs to evaluate the prognosis of breast cancer and patient survival rate.
Methods
From the Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) database, the Gene expression profiles and clinical data of breast cancer samples were downloaded. TCGA cohort were further divided into a training set (n = 764) and internal validation sets (n = 325). The GEO cohort was analyzed as an external validation cohort (n = 327). In the training set, differently expressed immune-relevant genes (IRGs) were screened firstly, and they were used to construct immune-relevant gene pairs (IRGPs). Then, the prognostic IRGPs were identified via univariate Cox regression analysis. Finally, least absolute shrinkage and selection operator (LASSO) Cox regression analysis was used to constituted the IRGP prognostic signature. Kaplan-Meier (KM) survival curves, receiver operating characteristic (ROC) curve analysis, univariate and multivariate Cox regression analysis were used to estimate the predictive value of the IRGP prognostic signature. And the IRGP prognostic signature was validated in the internal validation cohort and external validation cohort. We used gene set enrichment analysis (GSEA) to elucidate the biological functions of the IRGP prognostic signature.
Results
A total of 474 differently expressed IRGs and 2942 prognostic IRGPs were identified. Finally, we generated a IRGP prognostic signature consisting of 33 IRGPs. Subsequently, the 33 IRGPs grouped BRCA patients into high- and low-risk groups. Kaplan-Meier curves shown a significantly different overall survival in risk groups. Time-dependent ROC curves indicated that the IRGP prognostic signature possessed a high specificity and sensitivity in all the sets. Univariate and multivariate Cox regression analysis showed a statistical significance for the prognostic value of IRGP prognostic signature and the IRGP prognostic signature was a strong independent risk factor. The functional enrichment analysis indicated that low IRGP value was correlated with biological processes related to immune. Immune cell infiltration analysis indicated a significant difference in percentage of M2 macrophages between high- and low-risk groups.
Conclusion
The 33-IRGPs prognostic signature was developed to provide new insights for the identification of high-risk breast cancer and the evaluation of the possibility of immunotherapy in personalized breast cancer treatment.
Sensorimotor strategy selection under time constraints in the presence of two motor targets with different values
Authors: Onagawa Ryoji , Kudo Kazutoshi
Published: April 2021

Goal-directed movements often require choosing an option from multiple potential goals under time constraints. However, there are limited studies on how humans change their time spent on decision-making and their movement patterns in accordance with time constraints. Here, we examined how sensorimotor strategies are selected under time constraints when the value of targets is uncertain. In the double-target condition, the values were uncertain before the start of the task and presented at the start. The behavior in this condition was compared to the single-target condition. The movement kinematics showed beneficial difference of motor patterns between the conditions when the time constraint is long. Moreover, the participants frequently used the choice-reaction even under tight time constraints, and their performance was consistently lower than that in the single-target condition. Our results suggest that there is a consistent cognitive bias to choose a higher value when there are multiple alternatives with different values.
A follow-up study of fulminant type 1 diabetes mellitus
Authors: Wang Jie , Liu Bing-li , Li Zheng , Li Hui-qin , Yin Gu-ping , Ye Lei , Su Xiaofei , Ma Jian-hua
Published: April 2021

ObjectivesTo explore the possible mechanisms of glycol-metabolism and islet function in patients with fulminant type 1 diabetes (FT1DM).MethodsA follow-up study was conducted on 13 patients with FT1DM from September 2000 to March 2018. Patient general clinical data were collected and analyzed. The gene sequences of Human leukocyte antigen (HLA)-DRB1, HLA-DQA1 and HLA-DQB1 were analyzed by polymerase chain reaction (PCR).ResultsCompared with baseline, the waist-hip ratio was significantly increased at follow-up (P<0.05). Compared with baseline, HbA1c significantly increased; C-P0 and C-P120 significantly decreased, and the differences were statistically significant (P<0.05). Compared with baseline, White blood cell count (WBC), aspartate aminotransferase (AST), serum potassium (K), creatinine (Cr), glutamyl transpeptidase (GGT), creatine kinase (CK), alkalinity phospholipase (AKP) decreased significantly (P<0.05), while cholesterol (TC) and high-density lipoprotein (HDL) increased significantly (P<0.05). Viral antibody was detected in 13 cases of FT1DM: Coxsackie viral antibody was positive in 2 cases and herpes simplex viral antibody was positive in 3 cases. Gene detection: The higher frequency of HLA-DRB1 allele was DRB1*0301 (88.9%), DRB1*07 (44.4%), and the higher frequency of HLA-DQA1 allele was DQA1*0104 (55.6%), DQA1*0103 (44.4%), and the higher frequencies of HLA-DQB1 allele were DQB1*0201 (50.0%), DQB1*0502 (33.3%), and DQB1*0301 (25.0%).ConclusionsAlthough the β-cell function of FT1DM was progressively irreversibly destroyed with the progression of the disease, metabolic disorders and stress responses were relieved at the later stage. Viral infections (herpes simplex virus, Coxsackie virus), HLA-DQ, DR genes, GAD-Ab and other related antibodies may be involved in the occurrence of FT1DM.
An index to assess the health of Moso bamboo (Phyllostachys edulis) forest
Authors: Feng Huanying , Su Wenhui , Liu Guanglu , Du Manyi , Fan Shaohui
Published: April 2021

Background: The Moso bamboo (Phyllostachys edulis) forest is an important forest resource. The health status of the Moso bamboo forest are increasingly affected by a range of unscientific and irrational management, which may permanently alter the Moso bamboo forest economic value and ecological function and disrupt the long-term sustainable management. However, how to assess the health status of the Moso bamboo forest and guide the scientific management of the Moso bamboo forest are little known. Methods: The index system of Moso bamboo forest health assessment was identified and quantified by literature collection, indicators simplification, expert questionnaires, and mathematical analysis. The health index of Moso bamboo forest health assessment was calculated by the comprehensive health index method. The practicability and feasibility of the health index were verified in the Moso bamboo forest in Anhui and Fujian provinces of China.Results: An index system that included four layers and 19 indicators could comprehensively assess the health of the Moso bamboo forest. This index system assessed the ‘Health basis of the Moso bamboo forest’ and the ‘Value and function of the Moso bamboo forest’. The health index of the Moso bamboo forest in Anhui and Fujian provinces ranged from 0.50 to 0.83. Only2.35 % of the Moso bamboo forest showed a health index higher than 0.80, whereas the health index of 22.35 % of the forest was lower than 0.60. The health index of the Moso bamboo forest was higher under irrigation management and fertilization management than others. The treetop cutting was not recommended unless those areas had frequent occurrences of snow and ice disasters. Conclusions: These results suggest that the health status need to be improved in most of the Moso bamboo forest. Scientific management would be the important tool to keep and improve the health status of Moso bamboo forest. Our results can be adapted in the resource management and policy decisions for better management of the Moso bamboo forest.
Prognostic Value of CA125 Serum Levels in Female Patients with Acute Coronary Syndrome
Authors: Luo YanHong , Cheng YongRan , Zhang XiaoFu , Wang MingWei , Ni Bin , Yang ZhiQiang , Ge ZhongJun , Zhang XingWei , Pan ChunQi
Published: April 2021

Background: carbohydrate antigen 125 (CA125) is an increasingly promising biomarker of heart failure (HF), but its prognostic value in female patients with acute coronary syndrome (ACS) is unclear. We aimed to determine the short-term and mid-term prognostic value of CA125 serum levels in female ACS patients.Methods: A total of 131 consecutive female patients with ACS were retrospective enrolled. Their CA125 levels, B-type natriuretic peptide (BNP) levels and biochemical parameters were measured, and echocardiography was performed at admission. All-cause mortality during hospitalization and two-year follow-up was investigated for the prognosis.Results: The median value of CA125 serum level in the entire ACS patients was 13.85 U/mL. Patients in Killip Ⅲ had the highest values of CA125 level, followed by Killip Ⅱ and then Killip Ⅰ (p < 0.05). However, no statical difference was observed between Killip Ⅳ and Ⅰ-Ⅲ groups respectively (P > 0.05). The CA125 serum levels showed weak positive correlation with left ventricular end-diastolic diameter (LVEDD) (r = 0.3, P < 0.01) and a weak negative correlation with left ventricular ejection fraction (LVEF) (r = –0.23, p < 0.01). A receive operating characteristic (ROC) curve analysis showed that the AUC of CA125 in predicting acute heart failure (AHF) in ACS patients during hospitalization was 0.912, exhibiting higher sensitivity and specificity than BNP (0.846). The optimal cut-off value for CA125 in predicting AHF was 16.4 U/mL with a sensitivity of 0.916 and specificity of 0.893. The Kaplan-Meier survival analysis demonstrated that patients with high values of CA125 level had a poor overall survival than those with low values of CA125 level (log-rank, p < 0.001), whether during hospitalization or mid-term follow-up. Conclusion: Elevated CA125 level can be used to predict AHF in female ACS patients. Patients with elevated CA125 levels had higher mortality in short-term and mid-term than those with low CA125 levels.
The Correlation of Cycloplegic Refraction with Corneal Radius of Curvature-Adjusted Axial Length in Chinese Preschoolers
Authors: Zhou Xiao-hong , Li Yian , Wang Wei , Yang Chen-hao
Published: April 2021

Background: In order to master the refractive status and detect severe refractive errors quickly and effectively, this study aimed to investigate the association of axial length after adjusting for corneal radius of curvature with refraction in a group of Chinese preschoolers.
Methods: Retrospective review of 716 Chinese children aged from 3 to 6 years, who underwent cycloplegic optometry with 1% atropine eye gel in the ophthalmology department of Children’s Hospital of Fudan University, National Children’s Medical Center in Shanghai. Meanwhile axial length, corneal radius of curvature and cycloplegic autorefraction were obtained and axial length/corneal radius of curvature (AL/CR) ratio was calculated. The correlations of spherical equivalent refraction (SER) with axial length, corneal radius of curvature, AL/CR ratio and corneal radius of curvature-adjusted axial length were analyzed.
Results: Only data from the right eye were included in this analysis. Among 716 eyes of 716 Chinese preschoolers, the mean (±SD) SER was 2.28±2.41 diopters (D), of which hyperopia, emmetropia, myopia were 84.64%, 8.54%, 6.84%, respectively. The mean(±SD) axial length, corneal radius of curvature and AL/CR ratio were 21.89±1.01mm, 7.76±0.27 mm, and 2.82±0.13, respectively. The SER was highly negative correlated with both axial length (coefficient –0.722) and AL/CR ratio (coefficient-0.814), and weakly correlated with corneal radius of curvature (coefficient 0.090) and gender(coefficient 0.093). Axial length was weakly correlated with age and gender(coefficient 0.232 and 0.268, respectively), but moderately correlated with corneal radius of curvature (coefficient 0.424). After adjusting for corneal radius of curvature, the correlation coefficient between SER and axial length significantly increased to-0.918.
Conclusion: In the samples of 716 3-to 6-year-old Chinese children, axial length was moderately correlated with corneal radius of curvature. After adjusting for corneal radius of curvature, refraction was closely correlated with axial length than axial length alone and AL/CR ratio. Therefore, corneal radius of curvature-adjusted axial length might be a useful tool for pediatric ophthalmologists to detect refractive errors.
Key Words: spherical equivalent refraction; corneal radius of curvature; adjusted; axial length; preschoolers.
A Randomized, Double-Blind, Placebo-Controlled, Multicenter Study Assessing the Efficacy of Magnesium Oxide Monohydrate in the Treatment of Nocturnal Leg Cramps
Authors: Barna Olha , Lohoida Pavlo , Holovchenko Yurii , Bazylevych Andrii , Velychko Valentyna , Hovbakh Iryna , Bula Larysa , Shechter Michael
Published: April 2021

Background

Magnesium supplements are widely used for prophylaxis and treatment of nocturnal leg cramps (NLC). However, there is little evidence in support of their effectiveness. The main impediment stems from the lack of assessments of cellular absorption. In the current study, we tested the efficacy and safety of a magnesium supplement – magnesium oxide monohydrate (MOMH), for which increased cellular absorption rates were demonstrated in an ex-vivo setting.
Methods

A randomized, double-blind, placebo-controlled multicenter study was conducted in hospitals and outpatient clinics in Ukraine, from February to August 2018. Eligible subjects received a capsule with MOMH 226mg or placebo, once daily, at bedtime, for a 60day period. The assessed parameters included frequency and duration of NLC episodes, quality of sleep, NLC-induced pain and quality of life sub-scores. The Fisher's Exact Test for comparison of groups by categorical variables was used. The Student’s test or Mann-Whitney test were used for between-group comparison at different timepoints. ANCOVA followed by contrast analysis was used for comparison of groups at the end of the study.
Results

175 (81%) out of 216 initially screened subjects completed the study. The number of NLC episodes has significantly decreased by the end of the study period as compared to baseline in both groups (p < 0.001 for both). There was a significant between-group difference in the magnitude of reduction in NLC episodes (p = 0.01), indicating a higher decrease in the MOMH group as compared to the placebo group (-3.4 vs -2.6, respectively). In addition, MOMH treatment resulted in a greater reduction in NLC duration (p < 0.007) and greater improvement in sleep quality (p < 0.001) as compared to placebo.
Conclusions

MOMH was shown to be effective in the treatment of NLC as well as safe and well-tolerated.
ClinicalTrials.gov identification number:

NCT03807219, retrospectively registered on January 16, 2019.
Treatment with immunotherapy and other systemic therapies for patients with recessive dystrophic epidermolysis bullosa and cutaneous squamous cell carcinoma. A single institution experience.
Authors: Viñal David , Martinez-Fdez Sara , Ostios Lorena , Maseda Rocio , de Lucas Raul , Castelo Beatriz
Published: April 2021

Purpose. Cutaneous squamous cell carcinoma (CSCC) is a frequent complication in patients with recessive dystrophic epidermolysis bullosa (RDEB). Immunotherapy is a novel treatment approach for CSCC, however there is little experience in patients with RDEB. Methods. We included all the patients with a molecular-confirmed diagnosis of RDEB and advanced CSCC treated with systemic therapy between November 1988 and January 2021. Results. Five patients were treated with immunotherapy (n = 2), other systemic therapies (n = 2), or both (n = 1). The tolerability of immunotherapy was overall acceptable with no treatment-related serious adverse events. Radiological tumor response observed in one patient. The other patients were treated with a combination of chemotherapy and targeted therapy (EGFR inhibitors), with mixed tumor response. Median OS was 3 months (range, 1 to 11). Conclusions: Patients with RDEB and advanced CSCC benefit from immunotherapy and do not experience unexpected toxicity.
Kernel Density Estimation and Correntropy based Background Modeling and Camera Model Parameter Estimation for Underwater Video Object Detection
Authors: Panda Susmita , Nanda Pradipta Kumar
Published: April 2021

Underwater video object detection is challenging because of the complex background and the movement of the camera. In order to address this, we propose a novel scheme of simultaneously estimating the camera model parameters and detecting the object. The object detection phase includes background modeling and its learning. Background is modeled by the proposed Spatial Kernel Density Estimation (SKDE) model and the model learning happens in the SKDE feature space. Background modeling and its learning is pixel based approach. The model histograms learn the new pixel through its histogram representation. Our learning and classification strategy is different from the Heikkila et al. [17] in the context of similarity measure. We have proposed the correntropy based similarity measure that is used for model learning and pixel classification. The camera model parameters are estimated by 2D optimization method where we have used the corner features of an object at subpixel accuracy level. These subpixel level features are used in the proposed pipelining framework for model parameters estimation. The estimated model parameters are used to transform the input frame, which in turn is used for model learning and classification. The proposed scheme has been tested with underwater video frames from six data sets. The efficacy of the proposed scheme is compared with seven existing schemes and it is found that the proposed scheme exhibits improved performance as compared to the existing methods.
Diagnosis of Orthostatic Tremor Using Smartphone Accelerometry Running Head: Smartphone Accelerometry for Orthostatic Tremor
Authors: Calvo Nicholas E. , Ferrara Joseph M.
Published: April 2021

Background: Primary orthostatic tremor (OT) is a rare movement disorder characterized by a 13-18 Hz leg tremor, which arises when standing and is relieved by walking/sitting. Those affected generally do not fall, but experience fear of falling, lessened by ambulation. Because of its low amplitude, the tremor is not readily visible, and diagnosis requires confirmation with surface electromyography. Recently, applications using the accelerometer feature of smartphones have been used to detect and quantify tremors, including OT, though the accuracy of smartphone accelerometry in diagnosing OT is unknown. Methods: We completed SPA in consecutive adults (18+ years), who presented to our neurology clinic with either subjective leg shakiness upon standing or unsteadiness when standing that lessened with ambulation. We assessed tremor using the StudyMyTremor application on an iPhone 6s adhered with tape to the patient’s tibialis anterior. Surface electromyography was completed on the same muscle. The primary outcome of this study was to determine SPA’s sensitivity and specificity in detecting OT compared with surface electromyography. Results: Fifty-nine patients with the following diagnoses were included: OT (6), Parkinson’s disease, Hereditary Spastic Paraplegia, orthostatic hypotension, essential tremor, spinal cerebellar ataxia, sensory ataxia and functional movement disorder. Smartphone accelerometry detected a 13-18 Hz tremor in 5 of 6 patients diagnosed with OT by surface electromyography with no false positives in other conditions, yielding a sensitivity of 83%, specificity of 100% in the cohort we studied. Conclusions: Though a larger sample size is desirable, preliminary data suggest that smartphone accelerometry is an alternative to surface electromyography in diagnosing OT.
Laparoscopic Surgery in 3D Improves Results and Surgeon Convenience in Sleeve Gastrectomy for Morbid Obesity
Authors: Martinez-Ubieto Fernando , Barranco-Dominguez Ignacio , Tardós-Ascaso Lucía , Jiménez-Bernadó Teresa , Pascual-Bellosta Ana , Aragón-Benedí Cristian , Ramírez-Rodriguez Jose Manuel , Martínez-Ubieto Javier
Published: April 2021

Background. Advanced laparoscopic procedures are still challenging. One critical issue is the lack of stereoscopic vision. The aim of this surgical study is to evaluate whether 3D vision offers any advantages for surgical performance over 2D vision during sleeve gastrectomy for morbid obesity using a laparoscopic system that allows changing between 2D and 3D optics.Method. A total of 78 patients were analyzed, with 37 in the 2D group and 41 in the 3D group. Performance time, hospital stay, complications and early outcomes were collected. To assess the quality of the 2D and 3D techniques, visual analog scales (VASs) from 0 to 10 were designed, and image quality, depth of field, precision in performing tasks and general ergonomics were measured.Results. According to the vision system used, the mean duration of surgery was 85 ± 16.8 minutes for patients operated on with the 2D system and 69 ± 16.9 minutes for those operated on with the 3D system. There were no significant differences between the overall percentages of complications according to the type of vision used. However, postoperative complications were more severe in the 2D laparoscopy group. The average length of stay was shorter for patients in the 3D group. Regarding the differences perceived by the surgeon, the depth of field and the precision of tasks were better in the 3D vision group.Conclusion. The 3D system provided greater depth perception and precision in more complex tasks, enabling safer surgery. This led to a reduction in the operative time and hospital stay. Moreover, the severity of complications was less.
A Novel Approach to Predicting Interactions Between Microbes and Hosts
Authors: Li Jie , Chen Zhuo , Ma Dawei , Zhou Li , Wang Yadong
Published: April 2021

Increasing evidence shows that microbes are important for the protection of human health and the health of other living organisms. At the same time, microbes can cause other organisms to become sick or even die. Through microbe–host interaction, we can understand intuitively the process and mechanism of host infection by microbes. Several methods are developed to predict microbe–host interactions. However, current methods are limited by the cost of interaction verification experiments and accuracy. Therefore, there is still a need for a rapid and accurate method to predict microbe–host interaction. Here, we proposed a novel method based on Integrated Similarity, KATZ measure, and Within and Between Scores (ISKATZWBS) to predict microbe–host interactions. Experimental results show that the proposed method performs well and the AUCs are 0.946, 0.981, 0.954 on the PHI-base, HPIDB, and HMDAD datasets repectively. Compared with other four state-of the-art methods: KATZHMDA, WBSMDA , NGRHMDA and NCPHMDA, the proposed method has higher prediction accuracy.
Auditory Verbal Hallucination-Specific Functional Brain Networks in Schizophrenia: A Study Based on Graph Theory
Authors: Yang Weiliang , li Yan , Cao Haiyan , Qin Wen , Cheng Yongying , Xu Shuli , Chen Jiayue , Li Jie
Published: April 2021

Background

Although mounting previous studies have characterized auditory verbal hallucinations (AVH) related brain network abnormalities in the patients with schizophrenia, AVH related brain network alterations based on graph theory was rarely reported. In addition, the relationship between the features of AVH related brain networks based on graph theory and clinical features of schizophrenia patients with AVH is unclear. Our study to explore associations among network metrics, and clinical features in schizophrenia patients with AVH.
Method

Thirty-one schizophrenia patients without AVH, 17 patients with AVH, and 31 healthy controls were examined by functional magnetic resonance imaging. Graph theory method was performed to analyze the topological properties of functional network in three groups.
Results

Our results showed that schizophrenia patients with AVH displayed decreased local network efficiency, clustering coefficients, and nodal efficiency of the right dorsolateral prefrontal cortex. Local network efficiency was positively correlated with AVH characteristics.
Conclusion

The topological properties of brain functional networks are disrupted in schizophrenia patients with AVH, suggesting a role of functional brain networks in the pathogenesis of AVH.
Application of Multidisciplinary Team (MDT) in The Treatment of Severe Maxillofacial Trauma: A Retrospective Study
Authors: Sun Xu , Tong Shuang , Yang Shude , Guo Shu
Published: April 2021

Background: The severe maxillofacial injuries often involves multiple systems and locations, requiring multiple surgical specialties to participate in injury assessment, emergency surgery and follow-up planned staged surgery, thus requiring the participation and guidance of a multidisciplinary team. This study explores the treatment effect of this model on patients with severe maxillofacial trauma, so as to better promote the standard of severe maxillofacial trauma treatment, aiming to establish a scientific and standardized system of severe trauma treatment. Method: We retrospectively analyzed the treatment process of 173 patients with severe maxillofacial trauma, including timely, orderly, and efficient out-of-hospital emergency treatment. Maxillofacial surgery led the in-hospital treatment, and coordinated with other disciplines to relieve respiratory obstruction, control bleeding, correct shock and save lives. We summarized the experience in the treatment of jaw fracture reduction and internal fixation after the condition was stable. Result: With the specialist treatment and close multidisciplinary cooperation, the treatment effect was good, and the reduction and internal fixation of jaw fractures had achieved satisfactory results. Conclusion: Multidisciplinary coordinated emergency treatment of severe maxillofacial trauma is an effective measure to improve the success rate of treatment.
Concentrations of Oligosaccharides in Human Milk and Child Growth
Authors: Menzel Philipp , Vogel Mandy , Austin Sean , Sprenger Norbert , Grafe Nico , Hilbert Cornelia , Jurkutat Anne , Kiess Wieland , Binia Aristea
Published: April 2021

Background: The relationship between human milk oligosaccharides (HMO) and child growth has been investigated only insufficiently with ambiguous results. Therefore, this study examines potential influencing factors of HMO concentrations and how HMOs are associated with child growth parameters.Methods: Milk samples from the German LIFE Child cohort of healthy children were analyzed for 9 HMOs. Putative associations with maternal and child cofactors and child height, head circumference and BMI between three months and seven years of age were examined. Secretor status, defined as the presence of 2’-fucosyllactose, was investigated for associations with infant outcomes.Results: Our population consisted of 21 (14.7%) non-secretor and 122 (85.3%) secretor mothers. Maternal age was significantly associated with higher 3’SL concentrations; gestational age was associated with LNT, 6’SL and LNFP-I. Pre-pregnancy BMI was negatively associated with LNnT only in non-secretors. The growth velocity of non-secretors’ children was inversely associated with LNnT at 3 months to 1 year (R=0.95 [0.90, 0.99], p=0.014), 1 to 2 years (R=0.80 [0.72, 0.88], p<0.001) and 5 to 6 years (R=0.71 [0.57, 0.87], p=0.002). 2’FL was negatively associated with BMI consistently, reaching statistical significance at 3 months and 4 and 5 years. Children of non-secretors showed higher BMI at 3 months, 6 months, and 3, 6, and 7 years of age.Conclusion: We found that some associations between HMOs and infant growth may extend beyond the infancy and breastfeeding periods. They highlight the importance of both maternal and infant parameters in the understanding of the underlying associations.Trial registration: The study is registered with ClinicalTrial.gov: NCT02550236.
Regional Grey Matter Microstructural Changes and Volume Loss Regarding Disease Duration in Multiple Sclerosis Patients
Authors: Solana Elisabeth , Martinez-Heras Eloy , Montal Victor , Vilaplana Eduard , Lopez-Soley Elisabet , Radua Joaquim , Sola-Valls Nuria , Montejo Carmen , Blanco Yolanda , Pulido-Valdeolivas Irene , Sepúlveda Maria , Andorra Magi , Berenguer Joan , Villoslada Pablo , EH Martinez-Lapiscina , Prados Ferran , Saiz Albert , Fortea Juan , Llufriu Sara
Published: April 2021

The spatio-temporal characteristics of grey matter (GM) impairment in multiple sclerosis (MS) are poorly understood. We used a surface-based diffusion MRI processing tool to investigate regional modifications of microstructure and volume loss in GM at different time-points of the disease, and their relationship to disability. We studied 54 healthy controls and 247 MS patients classified according to disease duration: MS1 (less than 5 years, n=67); MS2 (5-15 years, n=107); and MS3 (more than15 years, n=73). We compared GM mean diffusivity (MD) and volume between groups, and estimated their clinical correlations. Regional modifications in MD and volume did not overlap early in the disease, and became widespread in later phases. We found higher MD in MS1 group, mainly in the temporal cortex, and volume reduction in right putamen. Additional MD changes were evident in cingulate and occipital cortices in the MS2 group, coupled to volume reductions in deep GM and parietal and frontal poles. Changes extended to more than 80% of regions in MS3 group. Clinical disability was correlated with GM changes. Microstructural integrity loss and atrophy present differential spatial predominance early in MS and accrual over time, probably due to distinct pathogenic mechanisms that underlie tissue damage.
The treatment of pectus carinatum with the bracing after surgery for congenital heart disease: experience from a single institution
Authors: He De-rong , Zha Jing-jing , Hong Song-ming , Hong Jun-jie , Huang Jin-xi , Cao Hua
Published: April 2021

Purpose:Secondary pectus carinatum (PC) after surgery for congenital heart disease(CHD) has its own clinical characteristics.Conservative treatment of PC with bracing is an attractive alternative to surgical repair.This study was to investigate the effects of the bracing on treating pediatric patients with PC after heart surgery.Methods:We conducted a retrospective study of all patients who had PC after surgery for CHD with median sternotomy from March 2019 to December 2020.Monthly follow-up with anterior–posterior(AP) width measurements.The size of bracing is designed based on the patient’s anterior chest wall.Result:Twenty four patients (3/2019–12/2020) were conducted into this retrospective study in the clinic,and 22 patients(91.66%) achieved excellent correction.The twenty four patients were distributed into three stages(stage 1: treated for 0 month,stage 2:treated for 3 months, stage 3: treated for 6 months).We found statistically significant differences in the AP between stage 2 and stage 1(AP p<0.01),stage 3 and stage 2(AP p<0.01).The main side effects were mild subcutaneous hematoma,petechial bleeding and chest tightness.There was no children complicated with hydropericardium or cardiac tamponade.Conclusion:The bracing has been shown to be a safe and effective approach for the treatment of the pediatric patients with PC after surgery for CHD.
Growth Responses of Agropyron Mongolicum Keng to Nitrogen Addition Is Linked to Root Morphological Traits and Nitrogen-Use Efficiency.
Authors: XU Aiyun , Wang Xing , Wang Xiaojia , Xu Dongmei , Cao Bing
Published: April 2021

Background and aimsNitrogen (N) is the primary limiting factors for plant growth and development, and increasingly N deposition alters plant composition, consequently affecting ecosystem function have been widely acknowledged. However, the effects of N fertilization on native species in desert grassland ecosystem and underlying mechanisms of these effects are still poorly understood. This study was conducted to examine the growth response of Agropyron mongolicum keng to N addition and potential mechanisms underlying this effect.MethodsA.mongolicum Keng was subjected to five N addition levels (0, 0.8,1.6, 2.4, and 4.0g N m−2 yr−1) for six months under greenhouse conditions. A combination of linear and structural equation modelling was used to examine growth response of A.mongolicum Keng to N addition and test whether its response related to root morphological traits and N-use efficiency.ResultsGrowth responses of A. mongolicum Keng to increasing N addition appeared a unimodal-shaped with a N saturation threshold at 3.2g N m-1 yr-1. Its response closely related to the root surface area, volume, length, and forks number, N uptake and utilization efficiency. Besides, N-induced changes in soil available nutrient have an indirect impaction biomass of A. mongolicum Keng via regulation of root morphological traits and N-use efficiency.ConclusionsThese findings highlight the sensibility of A. mongolicum Keng to N addition and the importance of root morphological traits and N-use efficiency in affecting biomass. Therefore, these can provide important insights into potential changes of native species survival and development in nutrient-limited desert grassland caused by N deposition.
Real-World Antibiotic Use in Treating Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) in China: Evidence From The ACURE Study
Authors: Ma Yiming , Huang Ke , Liang Chen , Mao Xihua , Zhang Yaowen , Zhan Zijie , Yang Ting , Chen Yan
Published: April 2021

Background: The evidence for real-world antibiotic use in treating acute exacerbations of chronic obstructive pulmonary disease (AECOPD) is insufficient. This study aimed to investigate real-world antibiotic use in the management of AECOPD in China.Methods: All hospitalized AECOPD patients from the acute exacerbation of chronic obstructive pulmonary disease inpatient registry (ACURE) study conducted at 163 sites between January 2018 and December 2019 were screened according to the eligible criteria. The eligible study population was divided into secondary and tertiary hospital groups. Patients’ baseline characteristics, antibiotic use, and bacterial pathogen characteristics were retrieved and analyzed using SPSS 23.0.Results: A total of 1663 patients were included in the study, including 194 patients from secondary hospitals and 1469 patients from tertiary hospitals. Among the 1663 AECOPD patients enrolled, 1434 (86.2%) received antibiotic treatment, comprising approximately 85.6% and 86.3% of patients in the secondary and tertiary hospital groups, respectively. The median antibiotic therapy duration was 9.0 (interquartile range [IQR]: 7.0 - 11.0) days. Regarding the routes of antibiotic use, 1400 (97.6%) patients received intravenous antibiotics, 18 (1.3%) patients received oral antibiotics, 15 (1.0%) patients received both intravenous and oral antibiotics, and one (0.1%) patient received both oral and nebulized antibiotic treatment. In addition, cephalosporin, penicillin, and quinolone were the most commonly prescribed antibiotics (43.6%, 37.0%, and 34.2%, respectively). In total, 990 (56.5%) patients underwent pathogen examinations; the proportion of patients receiving pathogen examinations in the second hospital group was significantly lower than that in the tertiary hospital group (46.4% vs 61.3%, p < 0.001).Conclusion: This study indicates that antibiotics are extensively prescribed to AECOPD patients in China and demonstrates the limited compliance to the AECOPD guidelines in real-world antibiotic use. More well-designed clinical trials are warranted to further help guide the rational antibiotic use in the treatment of AECOPD.
Reliability and Validity of the Persian Version of the Quality of Life in Autism Questionnaire (QoLA) - Parent Version in Iranian Mothers
Authors: Hosseini Seyed-Sirvan , Beheshti Seyedeh Zeinab , Eapen Valsamma , Almasi-Hashiani Amir , Maroufizadeh Saman
Published: April 2021

Background: Parents of children with autism spectrum disorder (ASD) are known to poorer quality of life. The Quality of Life in Autism Questionnaire (QoLA) is a commonly used instrument for measuring the quality of life in parents of children with ASD. The aim of this study was to evaluate the reliability and validity of the QoLA in Iranian mothers of children with ASD.Methods: The sample of this methodological study consisted of 88 mothers of children with ASD in Arak, Iran. The data were collected using convenience sampling method between September 2019 and January 2020. A battery of questionnaires was administered to mothers which included the QoLA, Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), and Perceived Stress Scale-4 (PSS-4). Factor structure and internal consistency of the QoLA were examined via confirmatory factor analysis (CFA) and Cronbach’s alpha, respectively. Convergent validity was examined by relationship with WHOQOL-BREF, PHQ-9, GAD-7 and PSS-4.Results: The mean total scores of QoLA Part A and Part B were 86.50 (SD=13.89) and 61.41 (SD=18.21), respectively. Both subscales exhibited good internal validity (with Cronbach’s alpha of 0.899 and 0.950 for Part A and Part B, respectively). The convergent validity of both subscales of QoLA was proved via moderate to strong correlations with measure of the WHOQOL-BREF. In addition, both QoLA Part A and Part B scores were negatively correlated with measures of PHQ-9, GAD-7, and PSS-4. The confirmatory factor analyses provided evidence for unidimensionality of both subscales of QoLA.Conclusion: The Persian version of QoLA displays satisfactory reliability and validity in Iranian mothers of children with ASD.
Neurophysiological and Spinal Cord Perfusion Changes at Dynamic Neck Positions in a Compressive Spinal Cord Injury Rat Model
Authors: Yu Zhengran , Cheng Xing , Chen Jiacheng , Lin Sixiong , Hu Hao , Huang Fangli , Zou Zhiyuan , Chen Bolin , Wan Yong , He Shaofu , Peng Xinsheng , Zou Xuenong
Published: April 2021

Background: Cervical spondylotic myelopathy (CSM) is a degenerative condition of the spine that caused by static and dynamic compression of the spinal cord. However, the pathophysiological changes at dynamic neck positions remain poor. This study investigated the interplay between neurophysiological and haemodynamic responses at dynamic neck positions in a chronic compressive spinal cord injury (CCSCI) rat model. Methods: Behavioural tests including Basso, Beattie, and Bresnahan scores and an inclined plane test were used to evaluate the motor function recovery. Combined examination of dynamic motor and somatosensory evoked potentials (DMEPs and DSSEPs, respectively) was performed regularly to evaluate the dynamic motor and sensory conduction of the cervical cord. At 4 weeks post-injury (wpi), dynamic magnetic resonance imaging (MRI) and dynamic laser Doppler flowmetry (LDF) were used to demonstrate the interstructure and spinal cord blood flow (SCBF) at the compression site at dynamic neck positions. Hematoxylin and eosin (HE) staining was performed to assess the cords' pathological changes.Results: Behavioural tests and combined DMEPs and DSSEPs examination showed that spinal cord neurological function and dynamic neural conduction deteriorated gradually within a 4-week compression period. The DMEPs were mainly deteriorated upon flexion, while DSSEPs were upon all neck positions after the compression. At 4 wpi, dynamic MRI showed increased T2-weighted image (T2WI) signal intensities. Also, dynamic LDF demonstrated decreased SCBF at the spinal cord compression site. Both of them altered especially upon cervical flexion. The dynamic change in SCBF was significantly correlated with the change in DMEP amplitude upon flexion. Conclusions: This exploratory study revealed that changes in axonal conduction in the motor and somatosensory tracts of the spinal cord were significantly related to chronic compression time and neck position. Furthermore, spinal cord ischaemia may be intimately related to motor conduction dysfunction upon flexion in CCSCI models. These results indicated the potential for therapies targeting dynamic spinal cord perfusion to prevent progression and functional loss in CSM.
Predicting Mechanical Ventilation for More Than 7 Days in the Emergency Department
Authors: Paik Jin Hui , Kim Jung-Soo , Lee Man-Jong , Park Mi Hwa , Durey Areum , Kim Ah Jin
Published: April 2021

Background The duration of mechanical ventilation (MV) required by patients admitted to the emergency department (ED) is difficult to predict. We investigated the duration of MV in ED-admitted patients, as well as their clinical progress.Methods We investigated the duration of MV in adult patients (aged ≥18 years) who were attached to ventilators in our ED between January and December 2017. The patients were divided into two groups; MV <7 days and MV ≥7 days. The patients’ demographic characteristics, diagnoses, clinical features, and underlying diseases were compared between two groups.Results The study comprised 282 patients including 142 in the MV <7 days group and 140 in the MV ≥7 days group. The MV ≥7 days group had more patients diagnosed with metabolic disorder, pneumonia, neurological disease, sepsis, and multiple trauma, and also had a greater proportion of patients with dementia or stroke as the underlying disease. The mean C-reactive protein level in the MV ≥7 days group was 6.4 mg/dL, which was higher than that in the MV <7 days group. The risk factors for requiring ≥7 days of MV were identified as a diagnosis of stroke as well as having the underlying diseases of cancer and stroke or dementia. Among the laboratory test results, pH, HCO3- , and albumin <3.5 g/dL were identified as factors influencing the duration of MV.Conclusion MV for ≥7 days is predicted to be required for patients admitted for a stroke; those with underlying cancer or stroke; and those with adverse pH, HCO3-, and albumin blood test results.
The status of dietary fatty acids intake in the autistic children: a case-control study
Authors: Gholamalizadeh Maryam , Rastgoo Samira , Torki Saheb Abbas , Bourbour Fatemeh , Shahdoosti Hosain , Ashoori Narges , Jarrahi Alireza Mosavi , Ebrahimi Kamal , Kalantari Naser , Teymoori Zohreh , Doaei Saeid
Published: April 2021

Background: Deficiencies or imbalances in dietary fat intake may influence on mental and neurological functions of children with Autism Spectrum Disorders (ASD). This study aimed to compare the amount of fatty acids intake in the autistic cases with the healthy controls.Methods: This case-control was carried out on 200 randomly selected children (100 autistic cases and 100 healthy controls) in Tehran, Iran. The food frequency questionnaire (FFQ) was used to assess the intake of calorie, macronutrients, and dietary fatty acids including saturated fatty acids (SFA), monounsaturated fatty acids (MUFAs), poly unsaturated fatty acids (PUFAs), linoleic acid (LA), α-Linolenic acid (ALA), eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and trans fatty acids.Results: No significant difference was found in the amount of dietary calorie, protein, carbohydrate, and total fat intake between two groups. In terms of the type of dietary fatty acids, the amount of MUFAs (OR: 3.18(1.13-4.56); p=0.04), PUFAs (OR: 4.12(2.01-6.25); p=0.01), and LA (4.76(1.34-14.32); p=0.01) were significantly higher in ASD children compared to the control group. The amounts of ALA, EPA, DHA, SFA, and trans fatty acid were not significantly different between two groups. Conclusions: The autistic children had higher unsaturated fatty acids intake except for omega-3 fatty acids. Future longitudinal studies are needed to confirm these findings and to determine the underlying mechanisms of possible associations between unsaturated fatty acids intake and ASD.