bluuebunny/crossref_metadata_2025 huggingface dataset:
Metal mixtures with longitudinal changes in lipid profiles: findings from the Manganese-exposed Workers Healthy Cohort
Authors: Ge Xiaoting , Ye Guohong , He Junxiu , Bao Yu , Zheng Yuan , Cheng Hong , Feng Xiuming , Yang Wenjun , Wang Fei , Zou Yunfeng , Yang Xiao Bo
Published: April 2022

The majority of epidemiological investigations on metal exposures and lipid metabolism employed cross-sectional designs and focused on individual metal. We explored the associations between metal mixture exposures and longitudinal changes in lipid profiles and potential sexual heterogeneity. We recruited 250 men and 73 women, aged 40 years at baseline (2012), and followed them up in 2020, from the manganese-exposed workers healthy cohort. We detected metal concentrations of blood cells at baseline with inductively coupled plasma mass spectrometry. Lipid profiles were repeatedly measured over 8 years of follow-up. We performed sparse partial least squares (sPLS) model to evaluate multi-pollutant associations. Bayesian kernel machine regression was utilized for metal mixtures as well as evaluating their joint impacts on lipid changes. In sPLS models, positive association was found between manganese and change in total cholesterol (TC) (beta = 0.169), while negative association was observed between cobalt (beta = -0.134) and change in low density lipoprotein cholesterol (LDL-C) (beta = -0.178) among overall participants, which were consistent in men. Furthermore, manganese was associated with increased risks of incident hyper-cholesterolemia or hyper-LDL cholesterolemia (odds ratio: 1.849 or 2.354). Interestingly, rubidium was positively associated with change in LDL-C (beta = 0.273) in women, while copper was negatively associated with change in TC (beta = -0.359) and LDL-C (beta = -0.267). Magnesium was negatively associated with change in TC (beta = -0.327). We did not observe the significantly cumulative effect of metal mixtures with lipid changes. In comparison to other metals, manganese had a more significant influence in lipid changes (posterior inclusion probability = 0.559 for TC in men). Furthermore, male rats exposed to manganese (20mg/kg) had higher level of LDL-C in plasma and more apparent inflammatory infiltration, vacuolation of liver cells, nuclear pyknosis, fatty change than the controls. These findings highlight the potential role of metal mixtures in lipid metabolism with sex-dependent heterogeneity. More researches are needed to explore the underlying mechanisms.
Reduced neural activity during volatile anesthesia compared to TIVA: evidence from a novel EEG signal processing analysis
Authors: Bickel Amitai , Maimon Neta B. , Molcho Lior , Intrator Nathan , Ivry Shimon , Gavrilov Alexey
Published: April 2022

Background
Post-operative cognitive dysfunction/decline is a well-known phenomenon and of crucial importance, especially in the elderly, emphasizing the significance of selecting the proper anesthetics. General anesthesia can be accomplished by inhalation-based (volatile) or total intravenous anesthesia (TIVA). While their effects on post-operative symptoms have been investigated, little is known about their influence on brain functionalities during the surgery itself.
Objective
To assess differences in brain activity between volatile and TIVA anesthetics during surgery.
Methods
Seventeen patients who were electively scheduled for laparoscopic cholecystectomy in Galilee Medical Center, Nahariya, gave written informed consent to participate in the study and were randomly divided to receive either volatile anesthesia (n = 9), or TIVA (n = 8). The level of anesthesia was kept equal in both groups. A single bipolar EEG electrode (Aurora by Neurosteer®) was placed on each participant’s forehead. The electrode presented real-time activity and collected participants’ data during the surgery. The dependent variables included frequency bands (delta, theta, alpha, and beta), and three features (VC9, ST4, and A0) previously extracted with the Aurora device and provided by Neurosteer®.
Results
All surgeries were uneventful, and all patients showed bispectral index (BIS) scores less than 60. Feature activity under volatile anesthesia (in comparison to TIVA) was significantly lower for the delta, theta, and alpha frequency bands and for the three features (VC9, ST4, and A0). Further analysis showed that the largest difference between anesthesia types was for feature A0.
Conclusions
Both EEG frequency bands and novel brain activity features provide evidence that volatile anesthesia further reduces components of brain activity in comparison to TIVA anesthesia. Specifically, A0, which previously showed a correlation with cognitive decline severity and cognitive load, exhibited the most prominent difference between anesthesia types. Together, this study suggests that measuring brain activity during anesthesia using sensitive features can reveal that different anesthesia types may affect brain activity differently, which could affect a patient’s recovery from anesthesia, and consequently reduce post-operative cognitive decline.
Characteristics of polypropylene biocomposites: effect of chemical treatment to produce cellulose microfiber
Authors: Moon Jaegwan , Lee Jong Hoon , Gwak Kiseob , Im Wanhee
Published: April 2022

In this study, cellulose microfibers were prepared by sulfuric acid hydrolysis, glyoxal crosslinking and acetylation followed by air classifying mill, and their properties including chemical structure, particle size, appearance and crystallinity were investigated. The effect of cellulose microfibers properties on characteristics of polypropylene (PP) biocomposite, such as physical, thermal and mechanical properties, was also examined. The glyoxal crosslinking enhanced the brittleness of pulp fiber, resulting in smallest particle size of microfiber and thus less entanglement in the polymer matrix. When cellulose microfibers were incorporated into PP, the crystallinity of biocomposite decreased, irrespective of microfiber type due to interference crystallization during crystal growth. Additionally, glyoxal crosslinked cellulose microfiber decreased the crystallization temperature of biocomposite, which is different from the other types of cellulose microfiber. The good dispersibility and brittleness of glyoxal crosslinked microfiber contributed to enhanced mechanical properties of biocomposite compared to the other microfiber added biocomposites.
Surveillance and Dietary Risk Assessment of Endocrine Disrupting Pesticides in Brinjal and Cauliflowers
Authors: Talat Farwa , Aslam Hina , Ahad Karam , Rafique Nazia
Published: April 2022

Several pesticides (used in vegetable production) have recently been identified as potential Endocrine Disruptors. The current study aimed to determine the consumer exposure risk associated with eating contaminated vegetables. The European Union-citrate buffered QuEChERS extraction protocol, validated in accordance with the European Union guidelines, was used to monitor selected endocrine disrupting pesticides and their metabolites in brinjal (Solanum melongena L.) and cauliflower (Brassica oleracea) marketed in Rawalpindi/Islamabad, Pakistan. A total of 88 and 69 percent of brinjal (n= 25) and cauliflower samples (n=26) were found contaminated among which 20 and 65 percent were exceeding the European Union maximum residue limits respectively. Both vegetables contained high levels of the androgen antagonist chlorpyrifos and the thyroid hormone inhibitor lambda-cyhalothrin. The acute health risk associated with dietary exposure to chlorpyrifos in brinjal and cauliflower was 1.88 and 22, respectively. The cumulative health index in cauliflower was found to be greater than one for both males and females (cumulative health index > 1). Thus, chlorpyrifos residues in brinjal and cauliflower pose both acute and chronic human health risks, whereas lambda-cyhalothrin residues in cauliflower samples only pose such an implication.
Engineering Surface Oxophilicity of Copper for Electrochemical CO2 Reduction to Ethanol
Authors: Li Minhan , Song Nan , Zhang Fangzhou , Luo Wei , Chen Jun , Jiang Wan , Yang Jianping
Published: April 2022

Copper-based materials is known for converting CO2 into deep reduction products via electrochemical reduction reaction (CO2RR). As the major multicarbon products (C2+), ethanol (C2H5OH) and ethylene (C2H4) are believed to share a common oxygenic intermediate according to theoretical studies, while the key factors that bifurcate C2H5OH and C2H4 pathways on Cu-based catalysts are not fully understood. Here, we propose a surface oxophilicity regulation strategy to enhance C2H5OH production in CO2RR, demonstrating by a Cu-Sn bimetallic system. Compared with bare Cu catalyst, the Cu-Sn bimetallic catalysts show improved C2H5OH but suppressed C2H4 selectivity. The experimental results and theoretical calculations demonstrate that the surface oxophilicity of Cu-Sn catalysts plays an important role in steering the protonation of the key oxygenic intermediate and guides the reaction pathways to C2H5OH. This study provides new insights into the electrocatalyst design for enhanced production of oxygenic products from CO2RR by engineering the surface oxophilicity of copper-based catalysts.
Circulating expression and clinical significance of LncRNA ANRIL in diabetic kidney disease
Authors: Zhu Yanting , Dai Lixia , Yu Xiangyou , Chen Xintian , Li Zhenjiang , Sun Yan , Liang Yan , Wu Bing , Wang Qiong , Wang Xiaoming
Published: April 2022

Background: Long noncoding RNA ANRIL has been found to be involved in the pathogenesis of diabetic kidney disease (DKD) and is expected to be a new target for prevention of DKD. However, the circulating expression and clinical significance of ANIL in DKD patients is uncertain. This study aims to explore this issue. Methods: The study consisted of 20 healthy controls, 22 T2DM patients (normalbuminuria) and 66 DKD patients (grouped as follows: microalbuminuria, n=23; macroalbuminuria, n=22 and renal dysfunction, n=21). The expressions of ANRIL in peripheral blood of all participants were measured by RT-qPCR. Results: The expression of ANRIL was significantly up-regulated in DKD patients (microalbuminuria, macroalbuminuria and renal dysfunction groups) than that in healthy control group. ANRIL was also over-expressed in macroalbuminuria and renal dysfunction groups in comparison with normalbuminuria group. ANRIL expression was positively correlated with Scr, BUN, CysC, urine β2-MG and urine α1-MG; while negatively correlated with eGFR in DKD patients. In addition, ANRIL was the risk factor for DKD with OR value of 1.681. The AUC of ANRIL in identifying DKD was 0.922, and the sensitivity and specificity of DKD diagnosis 83.3% and 90.5%, respectively. Conclusions: Our results indicated that highly expressed ANRIL in peripheral blood is associated with progression of DKD. Circulating ANRIL is an independent risk factor of DKD and has a highly predictive value in identifying DKD.
Advanced fabrication and multi-properties of recycled textile waste fibers aerogels
Authors: Dong Chunlei , Hu Yangzhao , Zhu Yuxuan , Wang Jiale , Jia Xuerui , Chen Jianbing , Li Jingliang
Published: April 2022

In recent years, the treatment of textile waste has been attracted more and more attention around the world. The reuse of textile waste can contribute to the reduction of carbon emissions and the sustainable development of the economy. Herein, we proposed a facile and cost-effective approach to fabricating aerogel by using textile waste fibers as the matrix and polyvinyl alcohol (PVA) and glutaraldehyde (GA) as crosslinking agents. After coated with methyltrimethoxysilane (MTMS) via chemical vapor deposition, both the interior and exterior of the whole textile waste aerogels surface exhibit a super-hydrophobic property with a water contact angle of up to 136.9°. A comprehensive investigation of its structure, thermal performance and oil absorption capacity has been carried out for high-value applications such as building insulation and oil spill cleanup. The textile waste fibers aerogels have ultra-low density and high porosity, good thermal stability and outstanding heat insulation properties (K avg = 0.049–0.061 W/m·K). It has a competitive commercial application value that the maximum oil absorption value reaches 18.6 g/g.
Boric Acid supplementation promoting the development of in vitro produced mouse embryos
Authors: Taskin Ali Cihan , Kocabay Ahmet , Gul Seref , Sahin Gizem Nur , Karahuseyinoglu Sercin , Kavakli Ibrahim Halil , Sogut Ibrahim
Published: April 2022

Boric acid (BA) is an important mineral for plants in nature, animals and human to help metabolic functions. Boric acid has both positive and negative effects on biological systems. In the literature, there is no publication about boric acid effect on preimplantation mouse embryo about in vitro developments. The aim of the present work was to investigate the effects of different concentrations of boric acid added to prior in vitro cytotoxicity for beneficial doses and later the mouse embryo culture media for antioxidant levels, the embryo quality, in vitro development rate and related genes. Superovulated C57Bl6/6j female mice were sacrificed ~18 hours after human chorionic gonadotropin (hCG) injection. Single cell stage embryos were collected from the oviducts and the embryos were divided experiment groups and cultured in embryo medium supplemented BA+ in 5% CO2, 37°C until 96-120 h at the blastocyst stage. The blastocyst development rates of 0, DMSO, 10-2, 10-3, 10-4, and 10-5 ppm BA were 51.52% (34/66), 45.00% (9/20), 72.62% (36/49), 77.48% (41/53) and 81.15% (43/53), respectively. The in vitro development rates were significantly higher in the 10-2, 10-3, 10-4 ppm compared with 0 (control) (p<0.05) and 10-5 ppm BA significantly higher compared with control group (p<0.01). With these results, after determining the non-cytotoxic doses of BA, low doses influence embryo development by positively affecting in vitro development rates, embryo cell numbers, biochemical parameters, development at molecular level. Therefore, boric acid seems to play an important role on the in vitro embryo development.
Fine mapping and candidate gene analysis of gummy stem blight resistance in cucumber stem
Authors: Han Jianan , Dong Shaoyun , Shi Yanxia , Miao Han , Liu Xiaoping , Beckles Diane M. , Gu Xingfang , Zhang Shengping
Published: April 2022

Gummy stem blight (GSB) is a serious fungal disease caused by Didymella bryoniae, that affects cucumber yield and quality worldwide. However, no GSB resistant genes have been identified in cucumber cultivars. In this study, the wild cucumber accession ‘PI 183967’ was used as a source of resistance to GSB in adult stems. An F2 population was mapped using resistant line ‘LM116’ and susceptible line ‘LM34’ derived from a cross between ‘PI 183967’ and ‘931’. By developing InDel and SNP markers, the gsb-s6.2 QTL on Chr. 6 was fine-mapped to a 34 kb interval harboring six genes. Gene Expression analysis after inoculation showed that two candidate genes (Csa6G046210 and Csa6G046240) were induced and differentially expressed between the resistant and susceptible parents, and may be involved in disease defense. Sequence alignment showed that Csa6G046210 encodes a Multiple myeloma tumor-associated protein, and it harbored two nonsynonymous SNPs and one InDel in the third and the fourth exons, and two InDels in the TATA-box of the basal promoter region. Csa6G046240 encodes a MYB transcription factor with six variants in the AP2/ERF and MYB motifs in the promoter. These two candidate genes lay the foundation for revealing the mechanism to GSB resistance, and may be useful for marker-assisted selection in cucumber disease-resistant breeding.
Successful creation of clinical AI without data scientists or software developers: radiologist-trained AI model for identifying suboptimal chest-radiographs
Authors: Dasegowda Giridhar , Bizzo Bernardo , Gupta Reya V. , Kaviani Parisa , Ebrahimian Shadi , Ricciardelli Debra , Abedi-Tari Faezeh , Neumark Nir , Digumarthy Subba R. , Kalra Mannudeep K. , Dreyer Keith J.
Published: April 2022

Objectives: Suboptimal chest radiographs(CXR) can limit interpretation of critical findings. Radiologist-trained AI models were evaluated for differentiating suboptimal(sCXR) and optimal(oCXR) chest radiographs.Methods: Our IRB-approved study included 3278 CXRs from adult patients (mean age 55 ± 20 years) identified from a retrospective search of CXR in radiology reports from 5 sites. A chest radiologist reviewed all CXRs for the cause of suboptimality. The de-identified CXRs were uploaded into an AI server application for training and testing 5 AI models. The training set consisted of 2202 CXRs(n= 807 oCXR; n= 1395 sCXR) while 1076 CXRs(n=729 sCXR; n=347 oCXR) were used for testing. Data were analyzed with the Area under the curve(AUC) for the model's ability to classify oCXR and sCXR correctly.Results: For the two-class classification into sCXR or oCXR from all sites, for CXR with missing anatomy, AI had sensitivity, specificity, accuracy, and AUC of 78%, 95%, 91%, 0.87(95% CI 0.82-0.92), respectively. AI identified obscured thoracic anatomy with 91% sensitivity, 97% specificity, 95% accuracy, and 0.94 AUC (95% CI 0.90-0.97). Inadequate exposure with 90% sensitivity, 93% specificity, 92% accuracy, and AUC of 0.91 (95% CI 0.88-0.95). The presence of low lung volume was identified with 96% sensitivity, 92% specificity, 93% accuracy, and 0.94 AUC(95% CI 0.92-0.96). The sensitivity, specificity, accuracy, and AUC of AI in identifying patient rotation were 92%, 96%, 95%, and 0.94 (95% CI 0.91-0.98), respectively.Conclusion: The radiologist-trained AI models can accurately classify optimal and suboptimal CXRs. Such AI models at the front end of radiographic equipment can enable radiographers to repeat sCXRs when necessary.
Influence of Personality and Concern for Health Information Privacy on PHR Adoption During COVID-19 Pandemic: An Empirical Investigation
Authors: Dutta Bireswar
Published: April 2022

The ongoing COVID-19 pandemic and changes imposed on the population enhanced the disparities among inhabitants' access to healthcare. Personal Health Record (PHR) allows individuals to access, manage, and share personal health-related information besides being active participants in personal care management. The study explores the relationship between personality traits and the threat of COVID-19 as antecedents of individuals' concern for health information privacy (CFHIP) and the subsequent relationship between individuals' CFHIP and behavioral intention to report their personal health information to healthcare providers concerning the use of PHR. This cross-sectional study employed a questionnaire to accumulate data from the individual in Taiwan. 265 valid responses were used for the final analysis. The research framework was evaluated by structural equation modeling (SEM) and represented by Smart-PLS and SPSS. The results suggested the proposed model explains about 64.2% of the variance of behavioral intention (R2 = 0.642). The findings supported that four personality traits: agreeableness, intellect, conscientiousness, neuroticism, and the threat of COVID-19 significantly influenced an individual's CFHIP. But concerning extraversion, an insignificant path coefficient was reported. Additionally, CFHIP mediates the relationship between threat of COVID-19 (PTD) and behavioral intention. Healthcare providers should consider these determinants in improving and endorsing principles concerning PHR adoption.
Influence of alkali-clay interactions on the shear strength and microstructure of alkaline-contaminated red clay
Authors: Wang Lianrui , Chen Jun , Wu Daoyong , Huang Yang , Wang Shuang
Published: April 2022

In recent years, the problem of soil contamination has become increasingly serious, which not only destroys the natural environment, but also may affect the stability of buildings because of the changes in the properties of contaminated soil. In this study, based on a practical alkaline-contaminated red clay engineering problem, the effects of alkaline-contamination on the mechanical properties and microstructure of red clay were investigated. The shear strength of alkaline-contaminated red clay obtained by unconsolidated undrained triaxial shear test (UU). The evolution of pore and particle characteristics of alkaline-contaminated red clay was analysed by mercury intrusion porosimetry (MIP), scanning electron microscope (SEM), X-ray diffraction (XRD), and thermal fractal dimension principle. The test results show that different concentrations of alkaline-contamination produce diverse new materials to change the microstructure of the clay; the variations in microstructure determine the changes in shear strength; the shear strength of alkaline-contaminated red clay decreases, then increases and then decreases with increasing the concentration, falling to a minimum at 3.5% concentration and rising to a maximum at 14% concentration; the internal mechanism of alkali-clay interactions can be divided into three processes: corrosion, cementation and dissolution; the changes in the engineering properties of alkaline-contaminated red clay are the result of the combined effect of these three processes. The results of this study can provide theoretical basis and reference value for the discussion of alkaline-contaminated soil engineering problems.
A radiomic nomogram based on CT images to predict survival outcomes in intrahepatic cholangiocarcinoma patients after resection
Authors: Wang Junli , He Mengye , Ni Jing , Zhang Xiaochen , Wei Yuguo , Sun Ke , Xiao Wenbo
Published: April 2022

Background: The purpose of this study was to establish a radiomics nomogram based on multiphase contrast-enhanced computed tomography (CT) to demonstrate the outcome of the patients after resection of intrahepatic cholangiocarcinoma (ICC).Methods: A cohort of 96 (7:3 in the training/validation cohort) ICC patients was enrolled in this study. All patients underwent a preoperative enhanced CT examination and then accepted the ICC resection. Radiomic features were extracted from arterial phase (AP) and portal venous phase (PVP) contrast-enhanced CT images. The least absolute shrinkage and selection operator (LASSO) Cox regression was used to select the features. Radiomic features and clinical data were combined to build the nomogram to predict the overall survival (OS). ICC patients were divided into high- and low- risk groups based on their probability of survival. The Kaplan–Meier analysis and the log-rank test were applied to analyze the patients, difference from different risk groups.Results: The C-index of the radiomics and clinical-nomogram for the prediction of OS in ICC patients was 0.869 and 0.632, 0.873 and 0.628 in the training and validation cohorts, respectively. The C-index of the combined nomogram for the prediction of OS in ICC patients was 0.912 and 0.696 in the training and validation cohorts, respectively. The calibration curve indicated that the predicted survival time was close to the actual survival time. Decision curve analysis showed that the combined nomogram has better clinical prediction than clinical or radiomics features alone. For ICC patients after surgical resection, the combined model showed that the low-risk group and high-risk group had a significant statistical difference in both the training cohort (p < 0.001) and the validation cohort (p = 0.01).Conclusion: Based on the application of preoperative enhanced CT radiomics in ICC, this study proposed a new personalized clinical decision nomogram, which can be used to predict the survival state of patients and play a certain role in assisting clinical treatment decision-making.
Can a failure in the error monitoring system explain unawareness of memory deficits in Alzheimer’s disease?
Authors: Razafimahatratra Solofo , Guieysse Thomas , Lejeune François-Xavier , Houot Marion , Medani Takfarinas , Dreyfus Gérard , Klarsfeld André , Villain Nicolas , Pereira Filipa Raposo , Corte Valentina La , George Nathalie , Pantazis Dimitrios , Andrade Katia
Published: April 2022

Unawareness of memory deficits is an early manifestation in patients with Alzheimer’s disease (AD). This intriguing behavior constitutes a form of anosognosia and has neural mechanisms that remain largely unknown. Here, we hypothesized that it may result from a failure in the error-monitoring system, which would prevent AD patients from being aware of their own memory impairment. To investigate, we measured event-related potentials (ERPs) evoked by erroneous responses during a memory task in two groups of amyloid positive individuals who had only subjective memory complaints at study entry: those who progressed to AD within the five-year study period (PROG group); and those who remained cognitively normal throughout the study (CTRL group). A significant reduction in the amplitude of the positivity error (Pe), an ERP related to error awareness, was observed in the PROG group at the time of AD diagnosis, in intra-group analysis, as well as when compared with the CTRL group, in inter-group analysis. To our knowledge, the results of this study reveal for the first time the emergence of a failure in the error-monitoring system from the very early stages of AD, strongly suggesting that a neurophysiological impairment in this system may be critical for the lack of awareness of memory deficits that often delays AD diagnosis. Hence, this study further suggests that a reduced Pe amplitude may constitute a potential neural biomarker of prodromal AD.
A Baseline Validation Study of the GALAD Model for Diagnosis of Hepatocellular Carcinoma Among Philippine Patients
Authors: Dating Mark Jay P. , Relente Marie Joy L. , Junio Dannah Zemirah G. , Tiangco Beatrice J. , Tripon Edhel S. , Albia Jason R.
Published: April 2022

Purpose
Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related death in the Philippines. Motivated by the lack of early-detection studies of HCC for Filipino cohorts, this study was designed to validate the GALAD model using a baseline dataset generated from a longitudinal study.
Methods
This study used 358 records collected from an ongoing study in the Philippines. The GALAD model was employed, and receiver operating characteristic (ROC) curve analyses were performed. The performance of the GALAD model and individual serum biomarkers in HCC detection were compared. Furthermore, the GALAD model was assessed in defined subgroups of patients.
Results
This study obtained an AUROC of 0.979 for the GALAD model with sensitivity and specificity ranging from 0.741 to 0.982. Its performance was also superior compared with the individual performance of AFP and DCP. Across the different subgroups, AUROCs were high, with the lowest being 0.821 on patients with cirrhosis.
Conclusion
This study found that the GALAD model was excellent for HCC detection in a Filipino cohort. It was also superior compared to AFP, AFP-L3, and DCP as individual tumor markers. Moreover, GALAD also exhibited remarkable performance in classifying HCC cases in all subgroups defined in the study.
Evaluation of Preoperative Fibrinogen/albumin Ratio and Carcinoembryonic Antigen: a New Prognostic Marker in Gastric Cancer
Authors: Hakseven Musluh , Çetindağ Özhan , Avşar Gökhan , Deryol Rıza , Sırgancı Gözde , Culcu Serdar , Akbulut Serkan , Ünal Ali Ekrem
Published: April 2022

Purpose Gastric cancer (GC) is one of the most common cancers that can result in death. Markers are needed to detect gastric cancer early and manage treatment. We aimed to reveal the relationship between carcinoembryonic antigen (CEA) level and Fibrinogen-Albumin ratio (FAR) and prognosis in gastric cancer, as well as to examine the relationship of these values with the number of metastatic lymph nodes and TNM stage.Methods The data of 805 consecutive gastrectomy patients were analyzed retrospectively. A total of 461 patients were included. The optimal cut-off values of CEA and FAR were 2.43 ng/mL and 1.26, respectively. Patients were stratified into three groups based on this cutoff value: CEA-FAR=0 (CEA <2.43 ng/mL and FAR <1.26), CEA-FAR=1 (CEA ≥2.43 ng/mL or FAR ≥1.26), and CEA-FAR=2 (CEA ≥2.43 ng/mL and FAR ≥1.26).Results There was a significant relationship between high CEA and stage (p=0.040), N status (p=0.017), and lymph node metastasis (p=0.004), and also there was a significant correlation between high FAR value and grade (p=0.003), stage (p<0.001), T status (p<0.001), N status (p<0.001) and metastatic lymph node count (p<0.001). Overall and disease-free survival were significantly different between the three CEA-FAR groupsConclusions We believe that pre-operative FAR and CEA values are independent predictors of survival. FAR and CEA are potential prognostic indicators for resectable gastric cancer due to their easy access and low cost. Considering survival and prognosis in patients with very high preoperative CEA and FAR values, neoadjuvant chemotherapy should also be considered.
Factors Associated with the Work-Self Balance of Nurses in an Advanced Medical Center
Authors: Okayasu Hiroaki , Sugawara Norio , Kawamata Yasushi , Yasui-Furukori Norio , Shimoda Kazutaka , Shinozaki Masataka , Tokumitsu Keita , Sato Yoshiteru , Sato Aoi , Uchibori Yumiko , Komatsu Tomie
Published: April 2022

Background
Maintaining a balance between one’s personal and working lives is important for nurses to increase their job satisfaction and continue their careers. Our purpose was to investigate the relationship of nurses’ characteristics, such as age, marital status and presence of cohabitating children, with work-self-balance (WSB) at different phases of life as well as the occupational factors that influence WSB that can be used to improve the work environment for nurses.
Methods
A cross-sectional survey of nurses was conducted from July to August 2020 using a self-administered questionnaire. We asked about gender, age, marital status, presence of children, working hours and night shift availability. The participants’ psychological distress was assessed with the Kessler 6, and occupational stresses, including WSB, were assessed with the New Brief Job Stress Questionnaire and the Organizational Justice Questionnaire. The total number of unmarried and married respondents was 819. We investigated whether marital status and presence of cohabitating children influenced WSB in three age groups (less than 30 years, from 31 to 40 years and more than 41 years) using a Mann–Whitney U test. In addition, we examined occupational factors affecting WSB using multiple regression analysis.
Results
The value of negative work-self balance was significantly greater in the group of married persons than in the group of unmarried persons (p < 0.05) and significantly greater in the group with cohabiting children than in the group without cohabiting children (P < 0.01) only in the group aged 31 to 40 years. Multiple regression analysis indicated that the significant occupational factors affecting WSB differed by age group.
Conclusions
This survey showed that the factors associated with WSB and the degree of WSB vary according to the generation and family environment of nurses.
Adequacy of post-surgical histopathology reports from a single center large cohort with differentiated thyroid cancer: The most important building block defining the management
Authors: Polat Sefika Burcak , Turan Kubra , İnce Nurcan , Topaloglu Oya , Ersoy Reyhan , Kilicarslan Aydan , Cakir Bekir
Published: April 2022

DTC is a group of malignant neoplasms composed of papillary thyroid carcinoma, follicular carcinoma and poorly differentiated thyroid carcinoma. Postsurgical histopathology enables the clinician to make the definitive staging and risk classification to determine the need for further treatments. Our primary outcome was to evaluate the adequacy of our center’s histopathology reports in large cohort of DTC patients. Our center is a high-volume tertiary center in our country specialized for DTCs with great experience. Data of 2114 patients were analyzed, 1407 patients who were operated in our center were included in the study. Maximum dimension of the tumor was absent in 2 (0.14%) patients, histological subtype was not reported in 688 (48.61%), the surgical margin was absent in 249 (17.69%). Of 153 patients with lymph node metastases, the size of the metastatic lymph node was not reported in 61 (39.86%) patients. Information on the number of involved lymph nodes, extranodal extension in the lymph node, and the size of the metastatic foci in the lymph nodes were missing in 4 patients (2.63%), 64 patients (42.10%), and 91 patients (59.47%), respectively. In conclusion the histopathology report is the backbone of the DTC management on what all risk determinations and treatment plans are built on. The pathology reports in our center are comprehensive but still the percentage of the patients whose histopathology report includes all criteria suggested by ATA guidelines was found to be %13.
Evaluating the value of a 3D printed model for hands-on training of gynecological pelvic examination
Authors: Kiesel Matthias , Beyers Inga , Kalisz Adam , Wöckel Achim , Quenzer Anne , Schlaiß Tanja , Wulff Christine , Diessner Joachim
Published: April 2022

Background: Simulation in the field of gynecological pelvic examination with educational purposes holds great potential. In the current manuscript we evaluate a 3D printed model of the female pelvis, which improves practical teaching of the gynecological pelvic examination for medical staff.Methods: We evaluated the benefit of a 3D printed model of the female pelvis (Pelvisio®) as part of a seminar (“skills training”) for teaching gynecological examination to medical students. Each student was randomly assigned to Group A or B by picking a ticket from a box. Group A underwent the skills training without the 3D printed model. Group B experienced the same seminar with integration of the model. Both groups evaluated the seminar by answering five questions on Likert scales (1-10, 1 = “very little” or “very poor”, 10 equals “very much” or “very good”). Additionally, both groups answered three multiple-choice questions concerning pelvic anatomy (Question 6 to 8). Finally, Group B evaluated the 3D printed model with ten questions (Question 9 to 18, Likert scales, 1-10).Results: Two of five questions concerning the students’ satisfaction with the seminar and their gained knowledge showed statistically significant better ratings in Group B (6.7 vs. 8.2 points and 8.1 vs. 8.9 points (p<0.001 and p<0.009). The other three questions showed no statistically significant differences between the traditional teaching setting vs. the 3D printed model (p<0.411, p<0.344 and p<0.215, respectively). The overall mean score of Question 1 to 5 showed 8.4 points for Group B and 7.8 points for Group A (p<0.001). All three multiple-choice questions, asking about female pelvic anatomy, were answered more often correctly by Group B (p<0.001, p<0.008 and p<0.001, respectively). The mean score from the answers to Questions 9 to 18, only answered by Group B, showed a mean of 8.6 points, indicating, that the students approved of the model.Conclusion: The presented 3D printed model Pelvisio® improves the education of female pelvic anatomy and examination for medical students. Hence, training this pivotal examination can be supported by a custom designed anatomical model tailored for interactive and explorative learning.
­­Forensic determination of shark species as predators and scavengers of sea turtles in Florida and Alabama
Authors: Aoki Derek M. , Perrault Justin R. , Hoffmann Sarah L. , Guertin Jeffrey R. , Page-Karjian Annie , Stacy Brian A. , Lowry Dayv
Published: April 2022

Sharks are the primary predator of large immature and mature sea turtles, yet the shark species responsible for both lethal and non-lethal injuries are rarely identified because attacks are infrequently observed. Forensic analysis of bite wounds can be used to accurately assess size and potential shark species, especially when combined with species-specific feeding behavior, geographic distribution, and habitat preference. The objective of this study was to use forensic analysis of bite damage on sea turtles to infer shark size and species. Photographs from thirteen cases of documented shark scavenging (N = 3) and predation (N = 10) attempts on sea turtles were retrospectively analyzed, including nesting, free-ranging, and/or dead stranded loggerhead (Caretta caretta), green (Chelonia mydas), Kemp’s ridley (Lepidochelys kempii), and leatherback (Dermochelys coriacea) sea turtles in Florida and Alabama, USA from 2010–2020. Mean interdental distance (IDD) and bite circumference (BC) of wound marks on sea turtles strongly suggest that the bite marks were generated by white sharks (Carcharodon carcharias) in three cases, tiger sharks (Galeocerdo cuvier) in three cases, and bull shark(s) (Carcharhinus leucas) in one case. For three cases with less distinct wound patterns, two likely shark species were identified, and thereafter narrowed down to a single species based on bite mark characteristics. Due to indistinct IDD and BC ranges of bite wound patterns, a single shark species was not identified in three cases. Forensic analysis enables more accurate evaluations of which shark species predate and scavenge sea turtles, and is a useful technique for studying the behavioral interactions of sharks and turtles more closely.
Simple within-stride changes in treadmill speed can drive selective changes in human gait symmetry
Authors: Browne Michael G. , Stenum Jan , Padmanabhan Purnima , Roemmich Ryan T.
Published: April 2022

Background: Millions of people worldwide are affected by clinical conditions that result in gait asymmetry (e.g., stroke, cerebral palsy, lower limb amputation). There is a need for customizable rehabilitation approaches that can flexibly target different aspects of gait asymmetry with minimal need for specialized equipment. Here, we studied how simple within-stride changes in treadmill speed could drive selective, predictable changes in human gait symmetry. Methods: In Experiment 1, ten healthy young adults walked on an instrumented treadmill with and without a closed-loop controller engaged. The controller changed the treadmill speed to 1.50 m/s or 0.75 m/s depending on whether the right or left leg generated propulsive (i.e., forward-directed) ground reaction forces, respectively. In Experiment 2, a separate group of ten healthy young adults walked on the treadmill with and without an open-loop controller engaged. This controller changed the treadmill speed to 1.50 m/s or 0.75 at a prescribed time interval. We used a metronome to guide the participants to step at a series of different time points relative to the controller-driven speed change. We collected kinematic and kinetic data in Experiments 1 and 2. Results: In Experiment 1, participants walked with asymmetric kinematics and ground reaction forces when the closed-loop controller was engaged. The leg that accelerated during propulsion (right leg) showed a smaller leading limb angle and a larger trailing limb angle than the leg that decelerated during propulsion (left leg). The right leg also generated smaller propulsive forces than the left leg. In Experiment 2, the patterns of asymmetry in spatiotemporal gait parameters, kinematics, and ground reaction forces depended on the timing of the speed change within the gait cycle. Step times, leading limb angles, and peak propulsion became asymmetric when the treadmill speed changed early in stance. When the treadmill speed changed later in stance, step lengths, step times, and propulsion impulses became asymmetric. Conclusions: Simple manipulations of treadmill speed can drive predictable, selective changes in human gait symmetry. Future work will explore this customizable technique as a potential approach for restoring gait symmetry in clinical populations.List of abbreviations: AP GRF – anteroposterior ground reaction force
A Nomogram for Predicting Recurrence-free Survival of intermediate and High risk Neuroblastoma
Authors: Sun Quan , Chen Yanmin , Jin Qianya , Yuan Xiaojun
Published: April 2022

Purpose
This study aimed to confirm the independent risk factors for recurrence-free survival (RFS) in intermediate and high-risk neuroblastoma (NB) patients, and set up an effective Nomogram model for predicting the recurrence of NB.
Methods
A total of 212 children with intermediate- and high-risk neuroblastoma, who had ever achieved complete remission (CR) or very good partial remission (VGPR) after standardized treatment in this hospital, were chosen as study objects. After retrospective analysis of the clinical data, Cox regression model was used to explore the factors related to the recurrence of neuroblastoma, to determine the variables to construct the Nomogram. The consistency index would predict the accuracy of this Nomogram.
Results
RFS rate in 1-year, 3-year, 5-year, and 10-year was 0.811, 0.662, 0.639, and 0.604, respectively. Children with MYCN amplification had a higher Neuron-specific Enolase (NSE) value (P = 0.031) at the initial diagnosis than MYCN non-amplification. The univariate analysis predicted that increased Vanilmandelic Acid (VMA) and NSE value, and Dehydrogenase (LDH) > 1000U/L were important adverse factors for the recurrence of NB. Multivariate analysis demonstrated that age at diagnosis, tumor localization, MYCN state, histologic subtype, and tumor capsule were significantly associated with RFS (all P values < 0.05). Nomograms were established for predicting the recurrence of NB according to the Cox regression analysis. Internal verification by the Bootstrap method showed that the prediction of the nomogram's consistency index (C-index) was 0.824 (P = 0.023).
Conclusion
Age at diagnosis, tumor localization, MYCN state, histologic category, and tumor capsule were independent risk factors for the recurrence of NB. The Nomogram model could accurately predict the recurrence of children with neuroblastoma.
The evaluation of regional lung function in COPD before and after pulmonary rehabilitation: a prospective clinical study
Authors: Ma Haiman , Dai Meng , Zhao Zhanqi , Wu Shuo , Zhang Yan , Zhao Feng , Ti Xinyu , Qu Shuoyao
Published: April 2022

BackgroundPulmonary rehabilitation (PR) is a widely recognized nonpharmacologic therapy for chronic obstructive pulmonary disease (COPD), but most of the current studies on whether PR can benefit COPD patients are based on the evaluation of symptoms and pulmonary function, which is limited to a certain extent. Therefore, based on the current study, this study evaluated the effects of individualized PR on the regional lung function in patients with stable COPD.MethodsThe patients with stable COPD were treated with PR for 2 weeks. The symptoms, global and regional lung function changes before and after 2-week program were evaluated using surveys, spirometry and electrical impedance tomography (EIT). The spatial coefficient of variation (CV) of regional spirometry parameters were calculated to quantified spatial heterogeneity of lung function. Temporal inhomogeneity was determined by the regional expiration time.ResultsAfter 2 weeks of intervention, the COPD assessment test score (CAT, 15.6±6.17 vs 11.1±5.85, P = 0.001), global spirometry forced expiratory volume in the first second (FEV1; 1.13±0.62 L vs 1.24±0.65 L, P = 0.006) and FEV1 % pred (43.3±21.34 % vs 48.3±24.22 %, P = 0.001) were improved. The CV for regional FEV1 / FVC (0.28±0.19 vs 0.17±0.06, P=0.012) differed significantly. Regional lung ventilation was more homogeneous and regional expiration time was shorter after PR.ConclusionThis study suggested that both spatial and temporal regional ventilation in COPD improved after the 2-week PR.
Effect of Butaphosphan and Cyanocobalamin on the Metabolic Profile, Oxidative Stress, Trace Minerals and Prophylaxis of Ovine Pregnancy Toxemia
Authors: Beigh Shafayat , Iqbal Raja , Mir Abdul , Shaheen Muzaffar , Hussain Syed , Nisar Mehak
Published: April 2022

The study was conducted to evaluate the effect of butaphosphan and cyanocobalamin (BTC) on the metabolic profile, oxidative stress and trace mineral profile in cross bred ewes and its effect on the prophylaxis of ovine pregnancy toxemia (PT). A total of 48 ewes were randomly divided into three groups, each consisting of sixteen ewes. High dose BTC (HBC): Ewes were given 0.2ml BTC/kg body weight, S/c weekly from 6 weeks prelambing to lambing. Low dose BTC (LBC): Ewes were given 0.1ml BTC/kg body weight, S/c weekly from 6 weeks prelambing to lambing. No BTC (CON): Ewes were given 0.2ml normal saline /kg body weight, S/c. weekly from 6 prelambing to lambing. A significant effect of treatment was observed on non esterified fatty acid (NEFA; p < 0.01), beta hydroxy butyric acid (β-HBA, p < 0.01), fructosamine (p < 0.05) and oxidative stress indices (OSI; p < 0.05) with less in NEFA, β-HBA, OSI and more fructosamine levels in HBC followed by LBC. No significant of treatment and treatment×time interactions were observed in glucose, protein, albumin, cholesterol, blood urea nitrogen, creatinine, total antioxidant capacity, calcium, phosphorus, cobalt, and copper levels however a significant difference was observed along the sampling time in all the three groups. While there was no significant effect of treatment on triglyceride, aspartate amino transferase, total oxidant capacity and zinc levels, a significant treatment×time interaction was observed. Taking 0.8mmol/l β-HBA as the cut off limit for subclinical PT, at four week before lambing, the effect of BTC in the prophylaxis of PT was higher in LBC (OR: 11.66; p < 0.05) compared to HBC (OR: 5.44; p > 0.05), however from three weeks onwards only HBC ewes showed significant effect of the BTC in the prophylaxis of PT at 3 weeks prelambing (OR; 5.57; p < 0.05), at 2 weeks prelambing (OR: 9.53; p < 0.01), at one week prelambing (OR: 6.60; p < 0.05) and at lambing (OR: 5.57; p < 0.05). In conclusion, there was a positive effect of BTC treatment on the energy metabolism in pregnant ewes and it helped in the amelioration of oxidative stress and hence can be used in the prophylaxis of pregnancy toxemia.
Debulking plus Drug-coated Balloon Angioplasty versus Drug-coated Balloon Angioplasty alone for Femoropopliteal Tosaka III In-stent Restenosis Runing
Authors: Li Liqiang , Tong Zhu , Cui Shijun , Guo Lianrui
Published: April 2022

Objectives: Femoropopliteal (FP) Tosaka Class III in-stent restenosis (ISR) Lesions remain a significant clinical problem and optimal revascularization management including the use of drug-coated balloon (DCB) and debulking devices have the potential to improve the outcomes for these patients. However, few studies have been published comparing the debulking plus DCB with DCB alone in Tosaka III FP-ISR treatment. Methods: This was a single-center retrospective study of patients Tosaka III FP-ISR who underwent endovascular interventions of debulking plus DCB or DCB alone for Tosaka III FP-ISR lesions. One-year primary patency was the main outcome. Other outcome measures are 12-month freedom from clinical-driven target lesion revascularization (f-CD-TLR), technical success rate, and periprocedural complications.Results: A total of 80 patients with Tosaka III FP-ISR were included; 39 were treated with debulking plus DCB, in which 22 were treated with laser atherectomy (LA) plus DCB and 17 were treated with rotational atherectomy (RA) plus DCB. 41 were treated with DCB alone. 12-month primary patency was significantly different in the comparison of debulking+DCB with DCB group (87.2% vs. 65.9%, p=0.039). in the subgroup comparison, no significant difference was found in the LA+DCB and RA+DCB group (86.4% vs. 88.2%, p=0.842). There were also no significant differences in the group and subgroup comparison of 12-month f-CD-TLR, technical success rate, and periprocedural complications.Conclusions: In this small preliminary experience, combined treatment with Debulking and DCB angioplasty is correlated with better outcomes in one-year primary patency for Tosaka III FP-ISR lesions.