bluuebunny/crossref_metadata_2025 huggingface dataset:
Eliciting Requirements for a Diabetes Self-Management Application for Underserved Populations: A Multi-Stakeholder Analysis
Authors: Bonet Olivencia Samuel , Rao Arjun , Smith Alec , Sasangohar Farzan
Published: November 2021

Medically underserved communities have limited access to effective disease management resources in the U.S. Mobile health applications (mHealth apps) offer patients a cost-effective way to monitor and self-manage their condition and to communicate with providers; however, current diabetes self-management apps have rarely included end-users from underserved communities in the design process. This research documents key stakeholder-driven design requirements for a diabetes self-management app for medically underserved patients. Semi-structured survey-interviews were carried out with 97 patients with diabetes and 11 healthcare providers from medically underserved counties in South Texas to elicit perspectives and preferences regarding a diabetes self-management app, and their beliefs regarding such an app’s usage and utility. Patients emphasized the need for accessible educational content and for quick access to guidance on regulating blood sugar, diet, and exercise and physical activity using multimedia rather than textual form. Healthcare providers indicated that glucose monitoring, educational content, and graphical visualization of diabetes data were among the top-rated app features. These findings suggest that specific design requirements for the underserved may improve the adoption, usability, and sustainability of such interventions. Designers should consider health literacy and numeracy, linguistic barriers, data visualization, data entry complexity, and information exchange capabilities.
Implementation Of Multicultural Education in Growing Tolerance Between Students in State Elementary School 2 Komet Banjarbaru
Authors: Barsihanor Barsihanor , Hafiz Abdul , Ansari Muhammad Iqbal , Mayangsari Rofam Galuh Nashrulloh , Liani Siti , Shalahudin Shalahudin
Published: November 2021

Abstract

Indonesia is a plural country with various ethnic groups, languages, religion, and culture. This is prone to friction such as conflicts between ethnicities, religion, and so on. This study aimed to know the implementation of multicultural education in growing tolerance between students in state Elementary School 2 Komet Banjarbaru. This study used qualitative approach with case study type of research. The study was done from January 2020 until March 2020. Data was collected by in-depth interview, participant observation, and documentation technique. The informants in this study were 11 samples including the headmaster, teacher, and students. After obtaining the data, analysis was done through the series of reduction, display, and data verification. Meanwhile, validity test was done by triangulation. The result showed that the implementation of multicultural education in growing tolerance between students in state Elementary School 2 Komet Banjarbaru through the school policy regulating that the rights of every student is equal, no obligation for non-Muslim female students to wear hijab, no obligation for non-Muslim students to attend Islamic religious activities, and religion subjects are customized to each religion, Muslim students learn Islamic studies, while non-Muslim students learn about their own religion, and they are free to learn religion studies in their own house of worship
Outpatient Shoulder Arthroplasty Patient Selection, Patient Experience, and Cost Analyses
Authors: O’Donnell Evan A. , Fury Matthew S. , Maier Stephen P. , Bernstein David N. , Carrier Robert E. , Warner Jon J.P.
Published: November 2021

Background:

The utilization of outpatient shoulder arthroplasty has been increasing. With increasing pressure to reduce costs, further underscored by the coronavirus (COVID-19) pandemic, many health-care organizations will move toward outpatient interventions to conserve inpatient resources. Although abundant literature has shown the advantages of outpatient total hip arthroplasty (THA) and total knee arthroplasty (TKA), there is a relative paucity describing outpatient shoulder arthroplasty. Thus, the purpose of this study was to summarize the peer-reviewed literature of outpatient shoulder arthroplasty with particular attention to patient selection, patient outcomes, and cost benefits.

Methods:

The PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Embase databases were queried according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. All articles on outpatient shoulder arthroplasty were included. Data on patient selection, patient outcomes, and cost analyses were recorded. Patient outcomes, including complications, reoperations, and readmissions, were analyzed by weighted average.

Results:

Twenty-three articles were included for analysis. There were 3 review articles and 20 studies with Level-III or IV evidence as assessed per The Journal of Bone & Joint Surgery Level of Evidence criteria. Patient selection was most often predicated on age <70 years, body mass index (BMI) <35 kg/m2, absence of active cardiopulmonary comorbidities, and presence of home support. Complications and readmissions were not common and either improved or were equivalent to those of inpatient shoulder arthroplasty. Patient satisfaction was high in studies of short-term and intermediate-term follow-up. The proposed cost benefit ranged from $747 to $53,202 with outpatient shoulder arthroplasty.

Conclusions:

The published literature to date supports outpatient shoulder arthroplasty as an effective, safe, and cost-reducing intervention with proper patient selection.

Level of Evidence:

Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Team Approach: Treatment of Shoulder Instability in Athletes
Authors: Wolf Brian R. , Tranovich Meaghan A. , Marcussen Britt , Powell Kammy J. , Fleming Jeffrey A. , Shaffer Michael A.
Published: November 2021

» Shoulder instability is a complex problem with a high rate of recurrence in athletes. Treatment of a first-time subluxation or dislocation event is controversial and depends on patient-specific factors as well as the identified pathology.

» Athletic trainers and physical therapists are an integral part of the treatment team of an in-season athlete who has experienced a shoulder instability event. Through comprehensive physiological assessments, these providers can effectively suggest modifications to the patient’s training regimen as well as an appropriate rehabilitation program.

» Surgical intervention for shoulder stabilization should use an individualized approach for technique and timing.

» A team-based approach is necessary to optimize the care of this high-demand, high-risk population.
Predictors of Spontaneous Rupture of Hepatocellular Carcinoma and Clinical Outcomes Following Hepatectomy
Authors: Chen Yiran , Zhao Jing , Guo Deliang , Xu Chang , Zhu Qian
Published: November 2021

Objective: To explore the independent predictive factors of spontaneous tumor rupture (STR) in patients undergoing curative resection of hepatocellular carcinoma (HCC), and to evaluate the impact of STRHCC on long-term survival after hepatectomy. Methods: The clinicopathological parameters of 106 patients with STRHCC and 201 patients with nonruptured HCC who underwent hepatectomy from January 2007 to November 2011 at the Eastern Hepatobiliary Surgery Hospital and Zhongnan Hospital of Wuhan University were analyzed using propensity score matching (PSM) and logistic regression model. Results: Factors including complicated hypertension, cirrhosis, total bilirubin (TB), tumor size, and seroperitoneum were independent predictors of STR. For all 307 HCC patients, the 1-, 3- and 5-year overall survival (OS) rates were 54.0%, 37.3% and 33.8% respectively. After propensity matching scores, the 1-, 3-, and 5-year OS rates in the ruptured group remained significantly lower at 41.5%, 23.5%, and 17.5% when compared with the nonruptured group at 70.8%, 47.1%, and 37.6% respectively, while the 1-, 3-, and 5-year Disease-free survival (DFS) rates between the groups did not differ significantly (50.4%, 35.1%, 27.1% vs 55.4%, 38.2%, 27.4%). STRHCC was significant associated with increased risk of OS, but not of shorter DFS. No signiﬁcant difference in postoperative morbidity or hospital death was observed between the groups. Conclusion: Factors including complicated hypertension, liver cirrhosis, higher TB levels, tumor size > 5cm, and seroperitoneum are significant predictors of STR. STR results in poorer OS but not DFS in patients undergoing curative resection for HCC. STRHCC has no impact on postoperative morbidity and mortality after hepatectomy.
Association between Subclavian Artery Plaques and Future Cardiovascular Events in a Hypertensive Cohort
Authors: Mu Liying , Chen Lu , Du Lijuan , Jiang Hua , Guo Caixia , Jin Zening
Published: November 2021

BackgroundAtherosclerosis is one of the leading contributors to cardiovascular diseases. Subclinical atherosclerosis could occur long time before the presence of clinical symptoms and may have predictive value for future cardiovascular events. Existing carotid subclinical atherosclerotic markers have limited value.Subjects and MethodsPatients admitted to the cardiac vascular center of Beijing Tiantan Hospital due to essential hypertension were prospectively consecutively enrolled. Those with histories of coronary artery disease (CAD), cerebrovascular diseases, and significant stenosis of main arteries were excluded. Patients diagnosed with carotid and/or subclavian artery stenosis were also excluded after admission. All participants received a series of routine blood test at admission into hospital and ultrasonic examinations of bilateral carotid arteries and right subclavian artery. All data were recorded. After discharged from hospital all participants were followed up with cardiovascular events, including death, hear failure, myocardial infarction, unstable angina pectoris and stroke.Results473 participants were finally involved in the study, including 284 men and 189 women.9/473 (8.2%, 95%C.I. [5.9-11.1%] participants suffered from endpoint events, including 19(4.0%) cases of myocardial infarction (15 undergoing PCI and 5 death), 4(0.8%) heart failure (all also involved in the myocardial infarction group), 3(0.6%) ischemic stroke (1 death), and 17(3.6%) angina pectoris (7 undergoing PCI). No death due to other reasons was recorded. After the adjustment of potential risk factors based on the results of univariate analyses, the prevalence of right subclavian plaque (RSP) (OR=2.428, 95%C.I. [1.098, 5.370], p=0.028) and both carotid and subclavian plaques (MPs) (OR = 3.539, 95%C.I. [1.547, 8.096], p = 0.003) were both significantly associated with endpoint events. Globulin and albumin had significantly correlations with future events despite the atherosclerotic marker used in the regression model.ConclusionThe prevalence of right subclavian plaques was independently significantly associated with the incidence of future cardiovascular events in the cohort. Higher level of globulin and lower level of albumin tended to be predictors for future events. Combination of both right subclavian artery and carotid artery atherosclerotic plaques may have strongest predictive value for future cardiovascular events in the hypertensive cohort without clinical atherosclerotic diseases.
Predictors of COVID-19 preventive behaviors based on the health belief model among pregnant women
Authors: Bayrami Roghieh , Didarloo Alireza , Masudi Sima , Nournezhad Homeira
Published: November 2021

Background
COVID-19 is an infectious disease caused by the new coronavirus, and its widespread epidemic has caused many deaths and health, social, and economic consequences in the world. The purpose of this study was to explain self-care behaviors against COVID-19 based on the health belief model (HBM) in pregnant women.
Method
The present study was conducted using a descriptive-analytical approach with the participation of 230 pregnant women referred to health centers in Urmia in 2021. The participants were selected using multi-stage random sampling. The data were collected using a valid and reliable questionnaire including participants’ demographic characteristics, the HBM items, and items relating to self-care behaviors against COVID-19. The data were analyzed using descriptive and inferential statistical methods (frequency, mean, standard deviation, Pearson correlation coefficient, and linear regression) in SPSS software (version 25).
Results
The results of this study showed that the rate of self-care behaviors against COVID-19 in the pregnant women participating in the present study was not very favorable. It was also shown that among the constructs of the HBM, awareness, self-efficacy, perceived barriers, and perceived severity were the most important predictors of self-care behaviors with a variance of 24% change among the pregnant women.
Conclusion
Awareness, self-efficacy, perceived barriers, and perceived severity were found in this study as the strongest predictors of self-care behaviors among pregnant women. The results of the study can be useful in planning educational and behavioral interventions to increase the adoption of self-care behaviors against COVID-19 and institutionalize health-promoting behaviors in women.
Watercraft Decontamination Practices to Reduce the Viability of Aquatic Invasive Species Implicated in Overland Transport.
Authors: Mohit Shrisha , Johnson Timothy B. , Arnott Shelley E.
Published: November 2021

Recreational boating activities enable aquatic invasive species (AIS) dispersal among disconnected lakes, as invertebrates and plants caught on or contained within watercraft and equipment used in invaded waterbodies can survive overland transport. Resource management agencies worldwide recommend decontaminating watercraft and equipment using high water pressure, rinsing with hot water, or air-drying for up to seven days to inhibit this mode of secondary spread. There is a lack of studies on the efficacy of these methods under realistic conditions and considering feasibility for recreational boaters. Hence, we conducted experiments addressing this knowledge gap using AIS present in Ontario, namely zebra mussels (Dreissena polymorpha), banded mystery snails (Viviparus georgianus), spiny waterfleas (Bythotrephes cederstroemi), Eurasian watermilfoil (Myriophyllum spicatum), Carolina fanwort (Cabomba caroliniana), and European frogbit (Hydrocharis morsus-ranae). Washing at high pressures of 900-1200 psi removed the most biological material (90%) from surfaces. Brief (<10s) exposure to water at ≥60°C caused nearly 100% mortality among all species tested, except snails. Acclimation to temperatures from 15°C to 30°C before hot water exposure had little effect on the minimum temperature required for no survival. Air-drying durations producing complete mortality were ≥60h for zebra mussels and spiny waterfleas, and ≥6 days among plants, whereas survival remained high among snails after a week of air-drying. Hot water exposure followed by air-drying was more effective than either method separately against all species tested, reducing either the minimum water temperature or air-drying duration necessary. These findings can inform best management strategies against AIS spread.
Deep Anterior Lamellar Keratoplasty Following Epikeratophakia: A Novel Two-Stage One-Graft Method To Treat Acute Corneal Hydrops
Authors: Liu Chunyu , Huang Xinyu , Liu Xin , Zhang Yushan , Shen Jiaqi , Zhang Li , Bi Yanlong
Published: November 2021

Purpose
To evaluate the clinical effects of deep anterior lamellar keratoplasty (DALK) using a single graft after epikeratophakia for the treatment of acute corneal hydrops.
Methods
This novel surgical procedure was performed on seven eyes of seven patients between 2019 and 2020. The procedure combines a first-stage surgery of epikeratophakia with intracameral sterile air injection and a second-stage surgery of DALK using the same corneal graft for both procedures. Main outcome measures included pre- and postoperative best-corrected visual acuity (BCVA) and anterior segment optical coherence tomography (AS-OCT) parameters. Corneal transparency, neovascularization and epithelization were observed at the 1-year follow-up.
Results
Corneal edema resolved rapidly in six of the seven cases. The group mean central corneal thickness was significantly reduced from baseline at 1 day, 1 week, 1 month, and 2 months after the first-stage surgery, respectively (P < 0.0001). At a mean of 2.1±0.7 months after the first-stage surgery, DALK was successfully performed in all cases. Six months later, the central corneal thickness was 611±31 µm and the thickness of the recipient’s residual stroma bed was 20±6 µm at the central corneal area. LogMAR BCVA was improved from 1.74±0.34 at baseline to 0.20±0.11 after DALK (P < 0.0001). No postoperative complications appeared in our case series during one years of observation.
Conclusion
A novel curative effect was found in the treatment of acute corneal hydrops with epikeratophakia followed by DALK using the same corneal graft.
Comparison of the Tidal Signatures in Sporadic E and Vertical Ion Convergence Rate, Using FORMASAT-3/COSMIC Radio Occultation Observations and GAIA Model
Authors: Sobhkhiz-Miandehi Sahar , Yamazaki Yosuke , Arras Christina , Miyoshi Yasunobu , Shinagawa Hiroyuki
Published: November 2021

Sporadic E or Es is a transient phenomenon where thin layers of enhanced electron density appear in the ionospheric E region (90-120 km altitude). The neutral wind shear caused by atmospheric tides can lead ions to converge vertically at E-region heights and form the Es layers. This research aims to determine the role of atmospheric solar and lunar tides in Es occurrence. For this purpose, radio occultation data of FORMASAT-3/COSMIC have been used, which provides complete global coverage of Es events. Moreover, GAIA model simulations have been employed to evaluate the vertical ion convergence induced by solar tides. The results show both migrating and non-migrating solar tidal signatures and the semidiurnal migrating lunar tidal signature in Es occurrence. The seasonal variation of the migrating solar tidal components of Es is in good agreement with those in the vertical ion convergence derived from GAIA. Furthermore, some non-migrating components of solar tides, including semidiurnal westward wavenumbers 1 and 3 and diurnal eastward wavenumbers 2 and 3, also significantly affect the Es occurrence rate.
Effects of Cerebellar Transcranial Direct Current Stimulation on Upper Limb Motor Function After Stroke: Study Protocol for the Pilot of a Randomized Controlled Trial
Authors: Yuasa Akiko , Uehara Shintaro , Ushizawa Kazuki , Toyama Takamichi , Gomez-Tames Jose , Hirata Akimasa , Otaka Yohei
Published: November 2021

Background: Transcranial direct current stimulation (tDCS) is a technique that can noninvasively modulate neural states in a targeted brain region. As cerebellar activity levels are associated with upper limb motor improvement after stroke, the cerebellum is a plausible target of tDCS. However, the effect of tDCS remains unclear. Here, we designed a pilot study to assess: 1) the feasibility of a study that aims to examine the effects of cerebellar tDCS combined with an intensive rehabilitation approach based on the concept of constraint-induced movement therapy (CIMT), and 2) the preliminary outcome of the combined approach on upper limb motor function in patients with stroke in the chronic stage.Methods: This pilot study has a double-blind randomized controlled design. Twenty-four chronic stroke patients with mild to moderate levels of upper limb motor impairment will be randomly assigned to an active or sham tDCS group. The participants will receive 20 min of active or sham tDCS to the contralesional cerebellum at the commencement of 4 hours of daily intensive training, repeatedly for 5 days per week for 2 weeks. The primary outcome is upper limb motor function which will be evaluated using the Action Research Arm Test. Secondary outcomes comprise scores of the Fugl-Meyer Assessment for the upper extremity and the Motor Activity Log. Additionally, neurophysiological and neuroanatomical assessments of the cerebellum will be performed using transcranial magnetic stimulation and magnetic resonance imaging. These assessments will be conducted before, at the middle, and after the 2-week intervention, and finally 1 month after the intervention. Any adverse events that occur during the study will be recorded.Discussion: Cerebellar tDCS combined with intensive upper limb training may increase the gains of motor improvement when compared to the sham condition. The present study should provide valuable evidence regarding the feasibility of the design and the efficacy of cerebellar tDCS for upper limb motor function in patients with stroke before a future large trial is conducted.Trial registration: This study has been registered at the Japan Registry of Clinical Trials (jRCTs042200078; https://jrct.niph.go.jp/en-latest-detail/jRCTs042200078). Registered 17 December 2020
Classification of Heart Sounds Associated With Murmur For Diagnosis of Cardiac Valve Disorders
Authors: Dawud Ahmed Ali , Lingaiah Bheema , Jemal Towfik
Published: November 2021

Background: Now a day, cardiovascular diseases have been a major cause of death in the world. The heart sound is still the primary tool used for screening and diagnosing many pathological conditions of the human heart. The abnormality in the heart sounds starts appearing much earlier than the symptoms of the disease. In this study, the Phonocardiography signal has been studied and classified into three classes, namely normal signal, murmur signal and extra sound signal. A total of 15 features from different domains have been extracted and then reduced to 7 features. The features have been selected on the basis of correlation based feature selection technique. The selected features are used to classify the signal into the predefined classes using multi- class SVM classifier. The performance of the proposed denoising algorithm is evaluated using the signal to noise ratio, percentage root means square difference, and root mean square error. For this work a publically available database for researchers, Partnership Among South Carolina Academic Libraries (PASCAL) and MATLAB 2018a was used to develop the proposed algorithm.Results: Our experimental result shows that the 4th level of decomposition for the Db10 wavelets shows the highest SNR values when using the soft and hard thresholding. The overall accuracy, Sensitivity and Specificity of the developed algorithm is 97.96%, 97.92 % and of 98.0% respectively.Conclusion: even if the proposed algorithm is useful for murmur detection mainly valve-related diseases and the efficiency of the proposed study is increased, future work will intend to generalize the algorithm by using hybrid classifiers on a larger dataset. Since all experiments used the PASCAL datasets, additional experiments will be needed using new datasets to be implemented using the latest mobile phones which can work as an electronic stethoscope or phonocardiogram. In addition, the case of continuous murmur and types of murmur has been included for classification in further studies.
Concentrated Growth Factors in Combination with Particulate Bio-Oss Graft: A Pilot Study on Beagle Dog Alveolar Bone Deficient
Authors: Chen Fei , Luo Qiang , Wang Lin , Pan Shao-xia , Xue Peng
Published: November 2021

Background: Alveolar bone related defect has emerged as a major challenge for clinician. Previous studies reported that concentrated growth factors (CGF), an autogenous product derived from venous blood, could enhance healing of grafts via releasing various growth factors. Methods: This study was designed to investigate the osteogenesis of CGF gel accompanied with Bio-Oss in canine alveolar defect socket model. CGF gel were prepared via variable speed centrifugation. Immunohistochemical staining and semi-quantitative analysis were performed to evaluate the content of transforming growth factor-β1 (TGF-β1) and vascular endothelial growth factor (VEGF) in the CGF gel and red blood cell (RBC) layer. The decay rate of TGF-β1 and VEGF were determined by ELISA assay. Next, mixture of Bio-Oss and CGF gel was implanted as graft to the alveolar defect socket. Three different fluorescent dyes and toluidine blue staining were utilized to track osteogenic progress, and mineral apposition rate (MAR) was calculated. Results: In the CGF gel, TGF-β1 occupied the dominant content with a higher decay rate than that of VEGF. Whereas, the concentration of TGF-β1 released from CGF gel still raised up rapidly within 14 days. In the animal study, combination of Bio-Oss and CGF gel not only accelerated wound healing, but also succussed to activate and sustain the bone formation at defect site represented as a higher MAR (2.21 ± 0.52 µm/day vs 1.43 ± 0.41 µm/day, Bio-Oss group and 1.04 ± 0.26 µm/day, control groups, P < 0.05). Conclusions: combination of Bio-Oss and CGF gel could promote osteogenesis and might provide a promising strategy against alveolar bone defect.
A Study of The Relationship Between Bioclimatic Comfort Zones And Land Use: The Case of Sivas Province (Turkey)
Authors: Karakuş Can Bülent , Demiroglu Demet
Published: November 2021

The aim of this study is to reveal the relationship between bioclimatic comfort zones and land use in Sivas province. In this context, the relationship between the climatic data of 1990 and 2018 and the land use data of Sivas province belonging to the same years was evaluated as seasonal and annual periods. The bioclimatic comfort zones in the study area were determined depending on environmental climatic parameters (ECP) [temperature (T), relative humidity (RH) and wind speed (WS)] and bioclimatic indices [Physiological Equivalent Temperature (PET), Thermo Hygrometric Index (THI), and Universal Thermal Climate Index (UTCI)]. The values of the environmental climate parameters of Sivas province for the relevant years were obtained from 9 meteorological stations, the height of which varies between 1121 m and 1528 m. With the help of the Geographical Information System (GIS), the spatial distribution of the bioclimatic comfort zones determined depending on the environmental climate parameters and bioclimatic indices were created. Land use maps of the study area for reference years were obtained by using CORINE land cover data. The relationship between bioclimatic comfort zones and land use was also determined with the help of GIS. According to the results of this study; It was determined that the land use type in which the bioclimatically comfortable areas overlap in Sivas province differs according to the used parameter/indexes, years and annual periods.
Masquelet Technique Combined with Tissue Flap Transplantation in The Treatment of Infectious Complex Tissue Defect: A Clinical Analysis
Authors: REN Zun , ZHANG Yubo , DU Jiafei , CAI Weijie , CHENG Pengfei , XU Zhengyu , HAN Pei
Published: November 2021

Background: Infectious complex tissue defects have been described as injuries with composite infectious bone defects and extensive soft tissue damage, which are still austere challenges for orthopedists all around the world. The study retrospectively evaluated the Masquelet technique combined with the tissue flap transplantation for the treatment of infectious complex tissue defects and assess key factors of success in this technique.Methods: From December 2016 to December 2019, 22 patients of infectious complex tissue defects were recruited for the study. All the cases experienced a two-stages treatment. Thorough debridement, stabilization of fracture by external fixation and implantation of a cement spacer mixed with antibiotics in the first stage. Simultaneously, suitable tissue flaps were designed and transplanted for the soft tissue defect. 6-8 weeks later, after the elimination of the infection, the cement spacer was removed carefully from the induced membrane and cancellous bone was grafted into the site of bone defect. The average duration of follow-up was 21 months.Results: Infection was eliminated after the first stage intervention without recurrence. All the transplanted tissue flaps were survived. Bone union was achieved in all patients in a period of 16-31 weeks following the second stage surgery. According to the Paley fracture healing score, 17 patients showed excellent results and 5 patients displayed good results regarding bone outcomes. When considering functional outcomes, 14 patients exhibited excellent results and 8 patients displayed good results.Conclusions: This study showed evidences that Masquelet technique combined with tissue flap transplantation was an effective method to repair the infectious complex tissue defects. We also demonstrate that a complete soft-tissue envelope plays an important role in the formation of the induced membrane which promote bone union and in the anti-infection treatment.
Apelin Alleviated Neuroinflammation And Promoted Endogenous Neural Stem Cell Proliferation and Differentiation After Spinal Cord Injury in Rats
Authors: Liu Qing , Wang Xiao , Gu Chengxu , Guo Qixuan , Li Xikai , Zhang Chunlei , Zhang Naili , Zhang Luping , Huang Fei
Published: November 2021

Background: Spinal cord injury (SCI) causes devastating neurological damage, including secondary injuries dominated by neuroinflammation. The role of apelin, an endogenous ligand that binds the G protein-coupled receptor angiotensin-like receptor 1, in SCI remains unclear. Thus, our aim was to investigate the effects of apelin in inflammatory responses and activation of endogenous neural stem cells (NSCs) after SCI.Methods: Apelin expression was detected in normal and injured rats, and roles of apelin in primary NSCs were examined. In addition, we used induced pluripotent stem cells (iPSCs) as a carrier to prolong the effective duration of apelin and evaluate its effects in a rat model of SCI.Results: Co-immunofluorescence staining suggested that apelin was expressed in both astrocytes and neurons. Following SCI, apelin expression decreased from 1–14 d and was re-upregulated at 28 d. Apelin promoted NSC proliferation and differentiation into neurons and oligodendrocytes. In vivo, lentiviral-transfected iPSCs were used as a carrier to prolong the effective duration of apelin. Transplantation of transfected iPSCs in situ immediately after SCI reduced activation of microglia and A1 astrocytes, facilitated recovery of motor function, and promoted the proliferation and differentiation of endogenous NSCs in rats.Conclusion: Apelin alleviated neuroinflammation and promoted the proliferation and differentiation of endogenous NSCs after SCI, suggesting that it might be a promising target for treatment of SCI.
The Accuracy of Blood Pressure Monitoring Using the Senbiosys Ring: A Study on Patients Undergoing Coronary Angiography and Patients in the Intensive Care Unit
Authors: Haddad Serj , Schukraft Sara , Boukhayma Assim , Barison Anthony , Faucherre Yannick , Cook Stéphane , Caizzone Antonino
Published: November 2021

The study NCT04379986 aims at evaluating the performance of the Senbiosys technology in monitoring blood pressure (BP) values for elderly patients: 25 patients undergoing coronary angiography, aged 68.92 ± 6.41 years, and 10 patients in the intensive care unit (ICU), aged 71.90 ± 8.56 years. The technology is based on pulse wave analysis (PWA) of low-power photoplethysmography (PPG) from the SBF2003 ring. The PPG recordings are processed by the PPG-based blood pressure monitoring (PPG-BPM) algorithm 1 to generate systolic BP (SBP) and diastolic BP (DBP) estimates. For the SBP, the mean difference ± standard deviation between the reference arterial line and the PPG-BPM values is 0 ± 5.06 mmHg for the patients undergoing coronary angiography and 0 ± 7.46 mmHg for the patients in the ICU. For the DBP, the mean difference ± standard deviation between the reference arterial line and the PPG-BPM values is 0 ± 1.85 mmHg for the patients undergoing coronary angiography and 0 ± 4.17 mmHg for the patients in the ICU. The results show that the accuracy of our algorithm is within the 5 ± 8 mmHg ISO/ANSI/AAMI protocol requirement.
Evaluation of Input Geological Parameters and Tunnel Strain for Strain-softening Rock Mass Based on GSI
Authors: Cui Lan , Sheng Qian , Xu Chen , dong youkou
Published: November 2021

The regression analysis method is being widely adopted to analyse the tunnel strain, most of which ignore the strain-softening effect of the rock mass and also fail to consider the influence of support pressure, initial stress state, and rock mass strength classification in one fitting equation. This study aims to overcome these deficiencies with a regression model used to estimate the tunnel strain. A group of geological strength indexes (GSI) are configured to quantify the input strength parameters and deformation moduli for the rock mass with a quality ranging from poor to excellent. A specific numerical procedure is developed to calculate the tunnel strain around a circular opening, which is validated by comparison with those using existing methods. A nonlinear regression model is then established to analyse the obtained tunnel strain, combining twelve fitting equations to relate the tunnel strain and the factors including the support pressure, the GSI, the initial stress state, and the critical softening parameter. Particularly, three equations are for the estimation of the critical tunnel strain, the critical support pressure, and the tunnel strain under elastic behaviour, respectively; and the other nine equations are for the tunnel strain with different strain-softening behaviours. The relative significance between the GSI, the initial stress and the support pressure on the tunnel strain is assessed.
TRIM22 Activates MAPK Signaling by Regulating the Transcription of SPHK2 and Accelerating the Degradation of Raf-1 in Glioblastoma
Authors: Fei Xiaowei , Dou Ya-nan , Sun Kai , Wei Jialiang , Guo Qingdong , Wang Li , Wu Xiuquan , Lv Weihao , Fei Zhou
Published: November 2021

Background

Tripartite motif (TRIM) 22 and mitogen-activated protein kinase (MAPK) signaling pathways play a critical role in tumor growth and therapeutic resistance of glioblastoma (GBM) respectively. However, the molecular mechanism between TRIM22 and MAPK signaling remains to be clarified.
Methods

We constructed TRIM22 knockout cell lines for molecular biology experiments, detected potential DNA fragments binding to TRIM22 by ChIP-Seq technology, and verified the sequencing results by ChIP-qPCR and CUT&Tag technology. In addition, we constructed different TRIM22 mutants to detect the binding of proteins in MAPK signaling pathway. Finally, the therapeutic effect was verified in NOD/SCID mice. The difference between the two groups of data conforming to the normal distribution was tested by Student t-test.
Results

Here, we found for the first time that TRIM22 acts as a transcription factor in the nucleus and binds to exon 2 of the transcript (NM_001204160) of SPHK2 gene to regulate its expression by ChIP-Seq technology, thus indirectly affecting the downstream MAPK signaling pathway. Knockout of TRIM22 using Cas9-sgRNAs resulted in decreased mRNA level of SPHK2 in GBM cells, while overexpression of TRIM22 enhanced it. The ERK1/2 driven luciferase reporter construct identified TRIM22 as a potential activator of MAPK signaling. Knockout and overexpression of TRIM22 regulate the inhibition and activation of MAPK signaling through its RING-finger domain. Co-immunoprecipitation demonstrated that TRIM22 bound to the negative regulator Raf-1 of MAPK signaling and accelerated its degradation by inducing K48-linked ubiquitination. The combination of the two is related to the CC domain and SPRY domain of TRIM22 and the C1D domain of Raf-1. TRIM22 also forms a complex with the downstream regulator ERK1/2 of MAPK and promotes K63-linked ubiquitination, resulting in the phosphorylation of ERK1/2. In addition, in vitro and in situ xenotransplantation models, SPHK2 inhibitor (K145), ERK1/2 inhibitor (Selumetinib) and non-phosphorylated mutant Raf-1S338A inhibited the growth promoting properties of TRIM22 in GBM cell line.
Conclusions

In conclusion, our study shows that TRIM22 regulates SPHK2 transcription as a transcription factor, indirectly affects MAPK signaling, and activates MAPK signaling through post-translational modification of two critical regulators of MAPK signaling in GBM cells.
Evaluation of Neuroprotective And Immunomodulatory Properties of Mesenchymal Stem Cells in An Ex-vivo Retinal Explant Model
Authors: Reboussin Élodie , Buffault Juliette , Brignole-Baudouin Françoise , Goazigo Annabelle Réaux Le , Olmiere Céline , Sahel José-Alain , Parsadaniantz Stéphane Mélik , Baudouin Christophe
Published: November 2021

Background: Mesenchymal stem cells (MSCs) have raised considerable hope for the treatment of glaucoma. Their neuroprotective and regenerative potentials are particularly interesting for this degenerative neuropathy in which retinal ganglion cell (RGC) death leads to a progressive loss of visual field and eventually vision. Yet, despite promising results in animal models, no definitive treatment has been developed, and safety concerns have been reported in human trials. Microglial immunomodulation represents a promising therapeutic approach in which MSCs might play a crucial role. In the present study, we investigated the neuroprotective and immunomodulatory properties as well as the safety of MSCs in an ex vivo neuroretina explant model.Methods: Labeled rat bone marrow MSCs were placed in co-culture with rat retinal explants after optic nerve axotomy. We analyzed the neuroprotective effect of MSCs on RGC survival by immunofluorescence using RBPMS, Brn3a and NeuN markers. Gliosis and retinal microglial activation were measured using GFAP, CD68 and ITGAM mRNA quantification and GFAP, CD68 and Iba1 immunofluorescence staining. We also analyzed the mRNA expression of both ‘M1’ or classically activated state inflammatory cytokines (TNFα, IL1β and IL6), and ‘M2’ or alternatively activated state microglial markers (Arginase 1, IL10, CD163, and TNFAIP6).Results: The number of RGCs was significantly higher in retinal explants cocultured with MSCs compared to the control group at Day 7 following optic nerve axotomy. Retinal explants co-cultured with MSCs showed decreased mRNA markers of gliosis and microglial activation, and immunostaining revealed that GFAP, Iba1 and CD68 were limited to the internal layers of the retina compared to controls showing expression of activated microglia throughout the retina. In addition, MSCs inhibited the M1 phenotype of the microglia. However, edema of the explants was observed in the MSC co-culture group, with an increase of fibronectin labelling at the surface of the explant corresponding to an epiretinal membrane-like phenotype. Conclusion: Using an ex vivo model, we demonstrated a neuroprotective and immunomodulatory effect of MSCs on RGCs. Unfortunately, the presence of MSCs also led to explant edema and epiretinal membrane formation, as described in human trials. Using the MSC secretome might offer the beneficial effects of MSCs without their potential adverse effects, through paracrine signaling.
Social and Housing Determinants of Dengue and Chikungunya in Indian Adults Aged 45 and Above: Analysis of a Nationally Representative Survey (2017-18)
Authors: Paulson Winnie , Balasubramani Karuppusamy , Dixit Rashi , Chellappan Savitha , Behera Sujit Kumar , Nina Praveen Balabaskaran
Published: November 2021

BackgroundDengue and chikungunya (CHIKV) are the two major vector-borne diseases of serious public health concern in India. Studies on socio-economic and housing determinants of dengue and CHIKV at a pan-India level are lacking. Here, we took advantage of the recently carried out Longitudinal Ageing Study in India (LASI) carried across all the States and Union Territories of India to study the social determinants of dengue and CHIKV in India.MethodsLASI-1 (2017-2018) data on the self-reported period prevalence of dengue and CHIKV from 70,865 respondents aged ≥45 years were used for this analysis. The State-wise distribution of dengue and CHIKV was mapped. Prevalence was estimated for each study variable, and the difference was compared using the χ2 test. The adjusted odds ratios (AOR) of the socio-economic and housing variables for dengue and CHIKV were calculated using a multiple logistic regression model.ResultsUrban residence is the major socio-economic determinant of dengue and CHIKV (dengue: AOR: 1.57, 95% CI: 1.17-2.10; CHIKV: AOR 1.56, 95% CI: 1.20-2.02). Wealth status (richest) and less than primary schooling are associated with dengue and CHIKV prevalence. In addition to these factors, social group (scheduled and forward castes) is also associated with CHIKV prevalence. Water-source outside the dwelling (AOR: 1.20, 95% CI: 0.96-1.50), pucca or semi- pucca house type are also associated with increased odds of CHIKV. ConclusionsDespite the limitation that the data is only from adults ≥ 45, this analysis provides important insights into the socio-economic and housing variables that increase the odds of dengue and CHIKV in India. Understanding these determinants may assist in the national planning of prevention and control strategies for dengue and CHIKV.
Three-dimensional Acetabular Bone Defect Classification System Aided with Rapid Prototyping Model and Reliability and Validity Test
Authors: Zhang Jingwei , Hu Yi , Ying Hua , Mao Yuanqing , Zhu Zhenan , Li Huiwu
Published: November 2021

Background: Accurately assessing acetabular defects and designing precise and feasible surgical plans are important before hip revision arthroplasty. With the development of three-dimensional printing, rapid prototyping is a novel technique used to print isometric physical object models. We aimed to propose a three-dimensional acetabular bone defect classification system aided with rapid prototyping and evaluated its reliability and validity.Methods: We reviewed 104 consecutive patients who underwent hip revision arthroplasty in our department between January 2014 and December 2019. Forty five of them had rapid prototyping and were included for reliability and validity test. Three doctors retrospectively evaluated bone defects of these 45 patients with this classification and made surgical plans, and repeated it after 2 weeks. The intra- and inter-observer reliability and the validity to surgical records were assessed using intraclass correlation coefficient or Kappa correlation coefficient.Results: The reliability and validity for classification results were high. The mean initial intraclass correlation coefficient for inter-observer reliability was 0.947, which increased to 0.972 when texted second time. As for inter-observer reliability, it ranged from 0.958 to 0.980. The validity showed high Kappa correlation coefficient of 0.951 to 0.967. When considering detailed surgical plans, the reliability and validity were also high with intraclass correlation coefficient and Kappa correlation coefficient all over 0.9.Conclusions: This three-dimensional acetabulum defect classification was of high reliability and convincing validity. With this classification and objective rapid prototyping models, accurate bone defect assessment and reliable surgical plans were achieved. This classification aided with rapid prototyping could serve as a promising tool for surgeons for preoperative evaluation.
Coexistence of ALK rearrangement in lung adenocarcinoma harbouring EGFR mutation: Real-World Data From a Single-Institution Experience
Authors: Zhong Wei-Xiang , Wei Xi-Feng
Published: November 2021

The authors have requested that this preprint be removed from Research Square.
The Gas and Aerosol Phase Composition of Smoke Plumes From The 2019-2020 Black Summer Bushfires and Potential Implications For Human Health
Authors: Simmons Jack B. , Paton-Walsh Clare , Mouat Asher P. , Kaiser Jennifer , Humphries Ruhi S. , Keywood Melita , Sutresna Adithya , Griffith David W.T. , Naylor Travis , Ramirez-Gamboa Jhonathan
Published: November 2021

The 2019-2020 Australian bushfire season was historically large, long, and intense. Smoke from fires burning in southeast Australia blanketed population centres for weeks to months. This study reports the chemical composition in the gas and aerosol phase of aged plumes measured near Wollongong, NSW in early 2020. Enhancement ratios to CO are presented for thirteen species. Plume composition is largely similar to that measured in fresh smoke during previous studies. It is hoped enhancement ratios reported here will assist in plume modelling of landscape scale fires and allow concentration estimates of infrequently measured atmospheric pollutants at monitoring stations. The relative toxicological contribution of species present in the plumes was determined for dilute plume exposure at the measurement site and for concentrated plumes at a heavily impacted population centre case study location. Similar results were determined for both sites. Respirable particles, formaldehyde and acrolein were found to contribute significantly to the toxicological loading, with respirable particles contributing approximately half of the loading. This is a reminder to consider not only the toxicological contributions of particles when studying health impacts of bushfire smoke exposure.
Simple Model to Predict Gestational Diabetes in Nulliparous Women in Early Pregnancy
Authors: ALBA Juan Jesus FERNANDEZ , LARA Maria CASTILLO , HERAS Jose Manuel JIMENEZ , CORTES Rocio MORENO , MACIAS CARMEN GONZALEZ , SANCHEZ Angel VILAR , LAUREANO Florentino CARRAL SAN , CORRAL Luis MORENO
Published: November 2021

BackgroundThe aim of this study was to develop a simple tool using anthropometric, clinical, and analytical variables to predict the risk of gestational diabetes mellitus in the first trimester of pregnancy.MethodsA historical cohort study was conducted with 1,946 Caucasian nulliparous pregnant women at the Department of Obstetrics and Gynecology of the University Hospital of Puerto Real (Cádiz/Spain). The predictive model used was a multivariate logistic regression evaluated by 10-fold cross-validation with five iterations. Receiver-operating characteristic and prediction recall curves were plotted with the predictions of the model. Optimal cut-off points of the receiver-operating characteristic curve were estimated using the Youden Index and minimum distance to point 1,1.ResultsThe final logistic regression model included both maternal weight and height, thyroid-stimulating hormone, family history of diabetes mellitus or hypertension, and the presence of chronic hypertension as predictive variables. The model showed an accuracy of 0.93 and a receiver-operating characteristic area under the curve of 0.791.ConclusionsThis report provides a tool to predict the onset of gestational diabetes mellitus in nulliparous women during the first trimester of pregnancy. This tool is more accurate than the currently available tools and can facilitate the implementation of preventative interventions.