bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimal Anesthesia Scheme for Transfer to Emergency Cesarean Section in Failed Labor Analgesia Trial Delivery
Authors: Bu Wen-hao , Wu Wei , Li Na , Chen Lin , Yue Lin-li
Published: June 2021

Objective： To explore the optimal anesthetic method of transferring to emergency cesarean section after the failure of labor analgesia. Methods: A retrospective study included 1154 patients who underwent cesarean section in Hubei Maternal and Child Health Hospital from January 2019 to January 2020, of which 586 patients were transferred to cesarean section after labor analgesia, They were divided into two groups according to the method of anesthesia: Epidural labor analgesia / Epidural anesthesia (ELA/EA) group : After the failure of natural labor during labor analgesia, local anesthetics continue to be added to the epidural(n=282);Epidural labor analgesia/Combined spinal and epidural anesthesia(ELA/CSEA) group: Combined spinal-epidural anesthesia was performed after spontaneous labor failure during epidural labor analgesia(n=304); Combined spinal and epidural anesthesia(CSEA) group: Patients who undergo emergency cesarean section without labor analgesia(n=568). The case data were reviewed and the anesthetic methods, basic vital signs, medication, time, maternal and infant outcome of the three groups were descriptively analyzed. Results: There was a difference in the time of admission to neonatal delivery, the maximum decrease of diastolic blood pressure and the difference of neonatal 1min apgar score between ELA/EA group and ELA/CSEA group. There was a difference in the dosage of spinal anesthesia between ELA/CSEA group and CSEA group. Conclusion: When the obstetrician anesthesiologist fails during labor analgesia and needs to be transferred to cesarean section, they can choose to re-perform combined spinal-epidural anesthesia, which is beneficial to the early outcome of newborns, but the long-term effect on newborns needs to be further studied.
Factors Associated With Post NICU Discharge Exclusive Breastfeeding Duration Amongst First Time Mothers of Preterm Infants In Shanghai: A Longitudinal Cohort Study
Authors: Jiang Xin , Jiang Hui
Published: June 2021

BackgroundBreastfeeding is crucial to the preterm infants. Breast milk is not only food but also medicine. Few studies focused on the longitudinal association with exclusive breastfeeding duration of preterm infants separated from their mothers after discharge, especially in Shanghai. We aimed to examine the exclusive breastfeeding duration amongst first time mothers of preterm infants after discharge and their determinants.MethodsAnalyses were based on 500 preterm infants separated from their mothers in a territory maternity and infant special hospital in Shanghai from September 2018 to September 2019.The self administered questionnaire, breastfeeding knowledge questionnaire, breastfeeding self-efficacy short form scale, Edinburgh postpartum depression scale and breastfeeding family support scale were used for the investigation, and the breastfeeding rate of premature infants was followed up 1 month, 3 months and 6 months after discharge. The changing trend of breastfeeding knowledge, breastfeeding self-efficacy, postpartum depression and family support were measured by ANOVA in different stages.The Kaplan Meier survival curve and Cox regression model were used to analyze the determinants of exclusive breastfeeding duration of premature infants after discharge. ResultsThrough the Cox regression model, we found that the maternal planned pregnancy (RR=0.68, 95%CI=0.53~0.87), delivering breast milk during hospitalization (RR=0.80, 95%CI=1.41~2.29),NICU feeding mode (RR=1.22, 95%CI=0.13~0.38) during hospitalization and family support (RR=0.56,95%CI=1.00~2.43) were the independent factors influencing the exclusive breastfeeding duration after discharge. ConclusionsThe exclusive breastfeeding duration of premature infants was affected by many factors, so we should focus on three levels of individual, family and society, and give targeted intervention measures to increase exclusive breastfeeding rate and prolong exclusive breastfeeding duration.Trial registration: Not applicable
Anti-Inflammatory and Analgesic Properties of Pulegone, a Major Component in Calamintha Nepeta
Authors: Charlet Alexandre , Petitjean Hugues , Hilfiger Louis , Triaux Zélie , Marcic Christophe , Emhemmed Fathi , Darbon Pascal , Marchioni Eric
Published: June 2021

Monoterpenes are small molecules, composed of two isoprene units, able to pass through the blood brain barrier, allowing to target both peripheral and central pain pathways. They are the main components of essential oils, responsible for their diverse well-known biological activities. Menthol, the main monoterpene found in Mentha piperita (L.) is known to modulate nociceptive threshold and is present in different curative preparations that reduces sensory hypersensitivities in pain conditions. While pulegone is a menthol-like monoterpene, only a limited number of studies focuses on its putative analgesic effects. Pulegone is the most abundant monoterpene presents in Calamintha nepeta (L.), a Laminaceae plant used in traditional medicine to alleviate rheumatic disorders, a chronic inflammatory disease. Here, we compared the impacts of menthol and pulegone on pain and inflammation. First, we described that both monoterpenes are anti-inflammatory compounds. Secondly, we found that while menthol is highly cytotoxic at anti-inflammatory concentrations, the cytotoxic effects of pulegone are limited, if not absent. Finally, in a model of peripheral inflammatory-induced pain a pulegone treatment exerts a significantly higher anti-hyperalgesic effect than menthol in response to mechanical stimuli, heat and cold thermal stimulations than a menthol treatment. In conclusion we demonstrated that pulegone is an anti-inflammatory compound and it is acting a potent pain-killer in acute inflammatory pain condition.
Who Manipulates Data During Pandemics? Evidence From Newcomb-Benford Law
Authors: Balashov Vadim S. , Yan Yuxing , Zhu Xiaodi
Published: June 2021

The COVID-19 pandemic has spurred controversies related to whether countries manipulate reported data for political gains. We study the association between accuracy of reported COVID-19 data and developmental indicators. We use the Newcomb-Benford law (NBL) to gauge data accuracy. We run an OLS regression of developmental indicators (EIU index, GDP per capita, healthcare expenditures, and universal healthcare coverage index) on goodness-of-fit measures to the NBL. We find that democratic countries, countries with the higher gross domestic product (GDP) per capita, higher healthcare expenditures, and better universal healthcare coverage are less likely to deviate from the Newcomb-Benford law. The relationship holds for the cumulative number of reported deaths and total cases but is more pronounced for the death toll. The findings are robust for second-digit tests, for a sub-sample of countries with regional data, and in relation to the previous swine flu (H1N1) 2009–2010 pandemic. The NBL provides a first screening for potential data manipulation during pandemics. Our study indicates that data from autocratic regimes and less developed countries should be treated with more caution. The paper further highlights the importance of independent surveillance data verification projects.JEL classification: F5, I10, I18, O1, O57, P52.
Prevalence and Factors Associated with Post-Traumatic Stress Disorder in Healthcare Workers Exposed to COVID-19 in Wuhan, China: A Cross-Sectional Survey
Authors: Pan Lingling , Xu Qiancheng , Kuang Xia , Zhang Xiancui , Fang Fengxia , Gui Liling , Li Mei , Tefsen Boris , Zha Lei , Liu Huan
Published: June 2021

Background: The COVID-19 pandemic has posed significant threats to both physical and psychological health of healthcare workers working in the front-line combating COVID-19. However, evidence regarding the long-term impact of COVID-19 is limited. Therefore, we conducted this cross-sectional survey to investigate the prevalence, factors and impact of post-traumatic stress disorder (PTSD) in healthcare workers exposed to COVID-19 eight months after end of outbreak in Wuhan, China. Methods: A web-based questionnaire was delivered as a link via the communication application WeChat to those healthcare workers who worked at several COVID-19 units in Wuhan during the outbreak (from November 2019 to April 2020). The questionnaire included questions on social-demographic data, the post-traumatic stress disorder checklist-5, the family care index questionnaire, and the quality of life scale. The prevalence, risk and protective factors, and impact of post-traumatic stress disorder healthcare workers were then analyzed with logistic regression.Results: Among the 659 participants, 90 healthcare workers were still suffering from PTSD eight months after the end of outbreak of COVID-19 in Wuhan, in which avoidance and negative impact were the most affected dimensions. Suffering from chronic disease, experiencing social isolation, and job dissatisfaction came up as independent risk factors of PTSD, while obtaining COVID-19 related information at an appropriate frequency, good family function, and working in well-prepared mobile cabin hospitals surfaced as protective factors. The impact of PTSD on COVID-19-exposed healthcare workers was apparent by shortened sleeping time, feeling of loneliness, poorer quality of life and intention to resign.Conclusions: Eight months after the end of the COVID-19 outbreak in Wuhan, the level of PTSD in healthcare workers exposed to COVID-19 was still high. Apart from the common recognized risk factors, comorbid of chronic disease was identified as the new independent risk factors of developing PTSD. For countries where the pandemic is still ongoing or in the case of future outbreaks of new communicable diseases, this research may contribute to preventing cases of PTSD in healthcare workers exposed to infectious diseases under such circumstances.
Influence of Preparation and Combustion Parameters of Coal-water Slurries on Gas Emission Chemistry
Authors: Sverchkov Ivan , Chukaeva Mariia , Matveeva Vera
Published: June 2021

The article presents the results of experimental studies performed for the comparative analysis of factors affecting the concentration of the main gas emissions during the combustion of fuel suspensions obtained from coal enrichment waste. The factors influencing the formation of anthropogenic emissions during the flaring of coal-water fuel suspensions were investigated. Experiments were carried out with coal processing waste, both with and without additives in the form of spent mineral oil. The article shows how the concentration of sulfur dioxide, nitrogen dioxide, and hydrocarbons is affected by the parameters of preparation (particle size, solid-liquid phase ratio, additives of used engine oil) and combustion (temperature in the combustion chamber, excess air coefficient, and droplet size after spraying) of fuel suspensions.
Design Of All-Normal Dispersion With Ge11.5As24Se64.5/Ge20Sb15Se65 Chalcogenide PCF Pumped At 1300nm For Supercontinuum Generation
Authors: Cheshmberah Alireza , Seifouri Mahmood , Olyaee Saeed
Published: June 2021

Supercontinuum spectrum generation is a process in which laser beam in femtoseconds and high power (kilowatts) is converted into a broad-spectrum beam of light after passing through a specific environment. Of course, achieving this range comes with many limitations. In this paper, photonic crystal fibers are used as a substrate for input pulse due to the ability to control dispersion and loss, and creating single-mode operating conditions. One of the main factors for the formation of supercontinuum spectra of injection pulses is maintaining the nonlinear performance of this type of fiber by controlling the effective mode area and also using chalcogenides (nonlinear coefficients about 100 times higher than silica) in their structure. In the proposed structure, a photonic crystal fiber with silica base element and air cavities with hexagonal structure with the center of Ge11.5As24Se64.5 chalcogenide element have been used to provide the nonlinear property of the structure. Also, in this structure, a ring of Ge20Sb15Se65 chalcogenide elements has been used to reduce the effective mode region and create a flat dispersion curve at a wavelength of 1300 nm (second telecommunication window). The input pulse power is 10 kW and its width is 50 femtoseconds, which has caused the range of the supercontinuum from 800 nm to 1900 nm. This structure can be used to provide the required wavelengths as a carrier in a wavelength division multiplexing (WDM).
Study of The Spectral Response of A Terahertz Antenna Detector When The Surrounding Dielectric Changes
Authors: Bani Mohammad Amin , Nazeri Majid , bidgoli Ahmad Sajedi
Published: June 2021

In this paper, the surface wave theory is used to study the spectral response of a terahertz antenna detector when the surrounding dielectric material is changed. As simulation shows, surrounding dielectrics affect the velocity of the current pulse propagation on electrodes. The propagation spectrum of the bow-tie and the dipole antenna on the LT-GaAs substrate is simulated through the FDTD method using the CST software. The current pulse generated in the antenna gap is also calculated with the Drude model. It is found that the type and the thickness of surrounding dielectrics affect the spectral responses of detector antennas as far as the peaks of the corresponding spectra shift down to one terahertz.
Effect of Liver Resection-induced Increases in Hepatic Venous Pressure Gradient on Development of Postoperative Acute Kidney Injury
Authors: Reiterer Christian , Taschner Alexander , Luf Florian , Hecking Manfred , Tamandl Dietmar , Zotti Oliver , Reiberger Thomas , Starlinger Patrick , Mandorfer Mattias , Fleischmann Edith
Published: June 2021

Background: The impact of changes in portal pressure before and after liver resection (defined as ΔHVPG) on postoperative renal function remains unknown. Therefore, we investigated the effect of ΔHVPG on (i) the incidence of postoperative AKI and (ii) the renin-angiotensin system (RAAS) and sympathetic nervous system (SNS) activity. Methods: We included 30 patients undergoing partial liver resection. Our primary outcome was postoperative AKI according to KDIGO criteria. For our secondary outcome we assessed the plasma renin, aldosterone, noradrenaline, adrenaline, dopamine and vasopressin concentrations prior and 2 hours after induction of anaesthesia, on the first and fifth postoperative day. HVPG was measured prior and immediately after liver resection.Results: ΔHVPG could be measured in 21 patients with 12 patients HVPG showing increases in HVPG (∆HVPG≥1mmHg) while 9 patients remained stable. AKI developed in 7/12 of patients with increasing HVPG, but only in 2/9 of patients with stable DHVPG (p=0.302). Noradrenalin levels were significantly higher in patients with increasing DHVPG than in patients with stable DHVPG. (p=0.009). Biomarkers reflecting RAAS and SNS activity remained similar in patients with increasing vs. stable DHVPG. Conclusions: Patients with increasing HVPG were more likely to develop postoperative AKI as compared those with stable HVPG values.
Establishment of Acute Liver Failure Model in Tibet Miniature Pig and Verified by a Non-bioartificial Liver
Authors: Feng Lei , Wang Yi , He Guo-lin , Li Ting , Cai Lei , Liu Shu-song , Jiang Ze-sheng , Xu Xiao-ping , Zhou Chen-jie , Gao Yi
Published: June 2021

Background and aims Acute liver failure (ALF) is a severe liver disease with high morbidity and mortality. Animal model is very important to research ALF. This study aimed to establish a reproducible, D-galactosamine-induced, Tibet miniature pig model of ALF and verified by a non-bioartificial liver (NBAL).Methods Thirteen Tibet miniature pigs were randomly divided into four groups (A, B, C, D) after central venous catheterization, then D-galactosamine (D-gal) at 0.45, 0.40 and 0.35g/kg body weight were injected through the central venous catheter in group A, B, C. While in group D, D-gal at 0.35g/kg body weight was injected and treated by a NBAL at 48 h after D-gal administration. Vital signs, blood index values were recorded at every 12 h after D-gal administration and every 2 h during NBAL treatemnt. Meanwhile, clinical manifestations, survival times and results of H&E staining, Tunel, Ki67, Masson assays and Picrosirius red staining were performed.Results Tibet miniature pigs developed different degrees of debilitation, loss of appetite and jaundice after D-gal administration. Survival times of groups A, B, C and D were 39.7±5.9 h, 53.0±12.5 h, 61.3±8.1 h and 61±7 h, respectively. Blood levels of ALT, AST, TBIL, Cr, BUN, Amm, PT and inflammation factors (such as TNF-α, IL-1β, IL-6) levels significantly increased compared with baseline in different groups (Ps < 0.05). Pathological results showed obvious liver cell necrosis positively correlated to the dose of D-gal. However, the NBAL did not increase the survival times of ALF, neither Amm and liver cell necrosis, it just decreased some biochemistry indexes (such as TBIL, ALT, AST).Conclusions: We successfully established a reproducible, D-galactosamine-induced, Tibet miniature pig model of ALF, the NBAL did not improve the survival times of ALF and we think the dosage of 0.35 g/kg is optimal.
Percutaneous pedicle screw fixation combined with percutaneous vertebroplasty for the treatment of thoracic and lumbar metastatic tumor
Authors: Ma Xiaowei , Zhao Yi , Zhao Jiazheng , Wu Hongzeng , Feng Helin
Published: June 2021

Background Evaluation of the clinical efficacy of percutaneous pedicle screw fixation (PPSF) combined with percutaneous vertebroplasty (PVP) in the treatment of thoracic and lumbar metastatic tumor.Methods 20 patients with thoracic and lumbar metastatic tumor were treated with PPSF combined with PVP and followed up 6–25 months. Using the visual analog scale (VAS) and the Barthel Index of Activities of Daily Living (BIADL) to evaluate pain intensity and quality of life before surgery and at 7 days, 3 months, 6 months after treatment.Results In this study, a total of 20 patients were followed up for 6–25 months (mean time was 14.10 months). The VAS scores of all patients were significantly decreased, while the BIADL scores were significantly increased. No patients suffered from complications such as infection, pedicle screw loosening or PMMA oozing. Spine stability was observed in all the surviving patients during the follow-up.Conclusions PPSF combined with PVP is a potentially viable treatment for thoracolumbar metastases in patients with poor systemic condition or patients who refuse to undergo a conventional open procedure such as en bloc corpectomy, and in the presence of vertebral instability or pathological fracture without significant spinal compression.
Delays in Epidemic Outbreak Control Cost Disproportionately Large Treatment Footprints to Offset
Authors: Severns Paul M. , Mundt Christopher C.
Published: June 2021

Epidemic outbreak control often involves a spatially-explicit treatment area (quarantine, inoculation, ring cull) which covers the outbreak area and adjacent regions where hosts are thought to be latently infected. Emphasis on space however neglects the influence of treatment timing on outbreak control. We conducted field and in-silico experiments with wheat stripe rust (WSR), a long-distance dispersed plant disease, to understand interactions between treatment timing and area interact to suppress an outbreak. Full-factorial field experiments with three different ring culls (outbreak area only to a 25-fold increase in treatment area) at three different disease control timings (1.125, 1.25, and 1.5 latent periods after initial disease expression), indicated that earlier treatment timing had a conspicuously greater suppressive effect than the area treated. Disease spread computer simulations over a broad range of influential epidemic parameter values (R0, outbreak disease prevalence, epidemic duration) suggested that potentially unrealistically large increases in treatment area would be required to compensate for even small delays in treatment timing. Although disease surveillance programs are costly, our results suggest that treatments early in an epidemic disease outbreak require smaller areas to be effective, which may ultimately compensate for the upfront costs of proactive disease surveillance programs.
Cell Spinpods: A Simple Inexpensive Device to Determine Suspension Culture and Toxicity Effects on Renal Proximal Tubular Cells
Authors: Hammond Timothy G. , Nislow Corey , Christov Ivan C. , Batuman Vecihi , Nagrani Pranay P. , Barandezeh Marjan , Upadhyay Rohit , Giaever Guri , Allen Patricia L. , Armbruster Michael , Raymond Allen , Birdsall Holly H.
Published: June 2021

Rotating forms of suspension culture allow cells to aggregate into spheroids, prevent the de-differentiating influence of adherence to plastic surfaces, and, perhaps most importantly of all, provide physiologically relevant, in vivo levels of shear stress. Suspension culture technology has not, however, been widely implemented, in large part because the vessels are prohibitively expensive, labor-intensive to use, and are difficult to scale for industrial applications. Our solution addresses each of these challenges in a new vessel called a cell spinpod. These small 3.5 mL capacity vessels are constructed from injection molded thermoplastic polymer components. They contain self-sealing axial silicone rubber ports, and fluoropolymer, breathable membranes. Here we report the development of injection molded cell spinpods with two-fluid modeling of the flow and stresses. Their validation was accomplished using immortalized human renal proximal tubular cells for functional assays, renal damage marker release, and differential gene expression analysis via next-generation sequencing. During exposure to myeloma immunoglobulin light chains, rotation increased both toxin-induced cell death, and release of clinically validated nephrotoxicity cytokine markers in a toxin-specific pattern. Cell spinpods are a sensitive tool for detecting nephrotoxicity in vitro.
Brain Tumor Segmentation Based on Region of Interest-Aided
Localization and Segmentation U-Net
Authors: Li Shidong , Liu Jianwei , Song Zhanjie
Published: June 2021

Since magnetic resonance imaging (MRI) has superior soft tissue contrast, contouring (brain) tumor accurately by MRI images is essential in medical image processing. Segmenting tumor accurately is immensely challenging, since tumor and normal tissues are often inextricably intertwined in the brain. It is also extremely time consuming manually. Late deep learning techniques start to show reasonable success in brain tumor segmentation automatically. The purpose of this study is to develop a new region-ofinterest-aided (ROI-aided) deep learning technique for automatic brain tumor MRI segmentation. The method consists of two major steps. Step one is to use a 2D network with U-Net architecture to localize the tumor ROI, which is to reduce the impact of normal tissue’s disturbance. Then a 3D U-Net is performed in step 2 for tumor segmentation within identified ROI. The proposed method is validated on MICCAI BraTS 2015 Challenge with 220 high Gliomas grade (HGG) and 54 low Gliomas grade (LGG) patients’ data. The Dice similarity coefficient and the Hausdorff distance between the manual tumor contour and that segmented by the proposed method are 0.876 ±0.068 and 3.594±1.347 mm, respectively. These numbers are indications that our proposed method is an effective ROI-aided deep learning strategy for brain MRI tumor segmentation, and a valid and useful tool in medical image processing.
A DFT Study of the Oxygen Reduction Reaction Mechanism on Be Doped Graphene
Authors: Kwawu Caroline , Aniagyei Albert , Konadu Destiny , Limbey Kenneth , Tia Richard , Adei Evans
Published: June 2021

Graphene despite its high surface area has very limited activity towards the oxygen reduction reaction (ORR), demonstrating selectivity towards the unfavorable two-electron mechanism. We have employed the spin polarized density functional theory (DFT) method to investigate the effect of the heteroatom p-type beryllium (Be) dopant on the oxygen reduction reaction activity of graphene. The preferred doping sites, active sites and reaction mechanism available on the doped graphene surfaces were investigated with increasing Be concentrations of 0.03 ML, 0.06 ML and 0.09 ML. Our results reveal that oxygen does not bind strongly to bare graphene, and Be at the lattice sites provides site for the oxygen adsorption and ORR. Oxygen binds dissociatively on the doped surfaces preferentially in the order 0.06 ML > 0.09 ML > 0.03 ML. From this studies introduction of Be impurities in a single honeycomb ring of graphene has significant impact on the binding and adsorbate-adsorbent interactions which leads to dissociative adsorption of oxygen, favouring the 4e- ORR pathway. The reaction is kinetically favoured most on the surface with a stronger O* binding and weaker OH* binding. Overall, the 0.03 ML and 0.06 ML doped surfaces are the most active facets for the ORR showing exergonic reaction energies at 0 V.
Significance of Immunohistochemical Biomarker in Breast Carcinoma from a Single Tertiary Care Hospital of Southern Assam
Authors: Momota Naiding , Biswadeep Choudhury , Babul Bezbaruah , Dasgupta Nivedita , Biman Deuri , Jyotika Sharma
Published: June 2021

Background: Breast carcinoma is the most common malignancy in female worldwide, leading cause of death in women.immunohistochemistry plays a very important role in the prognostication and treatment determination of breast carcinoma patients. Objective: To analyze the immunohistochemical markers in invasive carcinoma of breast and to correlate the expression of hormonal receptors with age of the patient, tumor size, histological grade and lymph node metastasis.Materials and method: The study was conducted on 88 infiltrating ductal breast carcinoma sample in a tertiary care hospital of Southern Assam for a period of two year (January2018- December 2019). Data including age, tumor size, and histologic grade and lymph node status retrieved from pathology department. Chi- square was used to determine the statistical significance between ER/PR status HER2/neu status along with their correlation with various clinicopathological parametres with respect to infiltrating ductal breast carcinoma.Result: The mean age of the patients was 56.6 years. We observed correlation between ER and PR expression with age, tumor size, tumor grade. There was correlation between HER2/neu expression and age only. None of the markers showed correlation with lymph node involvement (P>0.05).Conclusion: Our findings showed the importance of biomarkers (ER, PR, HER2/neu) expression as prognostic factors for therapeutic decision.
Development and Validation of Nutrition Literacy Scale for Middle School Students in Chongqing, China: A Cross-Sectional Study
Authors: Zeng Mao , Wang Tiankun , Xie Changxiao , Zhu Yuzhao , Shi Zumin , Sharma Manoj , Zhao Yong
Published: June 2021

Background: Nutrition literacy has a positive effect on health and its measurement has no consensus.This study was performed to develop the Chongqing Middle school student Nutrition Literacy Scale(CM-NLS)and measure its reliability and validity.Methods: Three experiments were conducted. Firstly, a theoretical framework and an initial item pool of CM-NLS were established based on the literature review. Secondly, the two-round Delphi method was used to explore the suitable acceptance indicators and items. Thirdly, item evaluation and reduction were performed using the classical test theory. In addition, the items in the final CM-NLS were tested for their validity and reliability amongst 462 middle school students.The construct validity was assessed using exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).The internal consistency reliability and split-half reliability were evaluated using Cronbach’s alpha coefficients.Results: The finalised CM-NLS consisting of 52 items that were based on three primary indicators (functional, interactive and critical) and six sub-indicators (obtain, understand, apply, interact, medial literacy and critical skill) was developed and validated. EFA suggested six factors explaining 69.44% of the total variance (Kaiser–Meyer–Olkin test = 0.916, Bartlett’s test χ2 = 5854.037, P < 0.001). CFA showed that the model fit the data adequately, with χ2/df = 1.911, root mean square error of approximation = 0.063, goodness-of-fit index (GFI) = 0.822 and adjusted goodness of fit index (AGFI) = 0.790. The total CM-NLS Cronbach’s alpha values of internal consistency and split-half reliability were 0.849 and 0.521, respectively, with reasonable reliability.Conclusions: CM-NLS is a valid and reliable instrument to measure nutrition literacy amongst middle school students. It provides the scientific basis for the evaluation of the nutrition literacy level of middle school students in Chongqing and the implementation of nutrition education strategies.
Process of Lymph Node Metastasis in Invasive Breast Cancer with Squamous Cell Differentiation: A Case Report
Authors: AOKI MAYU , Fujii Takaaki , HONDA CHIKAKO , NAKAZAWA YUKO , OGINO MISATO , OBAYASHI SAYAKA , YAJIMA REINA , SHIRABE KEN
Published: June 2021

BackgroundBreast cancer with squamous differentiation is a relatively rare condition. Clinically, lymph node metastasis is uncommon in metaplastic carcinoma We treated a patient with lymph node metastasis of the ductal carcinoma component of invasive ductal carcinoma with squamous cell differentiation. Case Report: An 84-year-old postmenopausal Japanese woman had a left-breast mass with an enlarged lymph node in the left axilla. A biopsy revealed an invasive ductal carcinoma with squamous cell differentiation. A left mastectomy with axillary lymph node dissection was performed. The Histological evaluation revealed invasive ductal carcinoma with squamous cell differentiation. One lymph node was positive for metastasis consisting of ductal carcinoma without squamous cell differentiation.Conclusion: This case suggests that lymph node metastasis in ductal carcinoma with squamous differentiation may first involve the ductal carcinoma component and then differentiation may occur in the in volved lymph nodes. This is an interesting case highlighting the process of the progression of lymph node metastasis in cases with breast cancer with squamous cell differentiation.
Does Seasonality of Leaf Terpene Content and Moisture Content Trigger Leaf Flammability Seasonal Variation?
Authors: Ganteaume Anne , Romero Bastien , Ormeño Elena , Lecareux Caroline , Fernandez Catherine
Published: June 2021

Given the importance of terpenes and fuel moisture content (FMC) on flammability, this work aims at checking how these parameters affect leaf flammability of different native and Wildland-Urban Interfaces species (Pinus halepensis, Cupressus sempervirens, Cupressocyparis leylandii, and Hesperocyparis arizonica) across seasons in the French Mediterranean region. We found that the highest terpene diversity and content seasonally varied according to the species, with diterpene content being lower in spring for C. leylandii, while monoterpene and diterpene content being higher in summer and winter, respectively, for P. halepensis. Flammability and FMC varied according to the season but the pattern differed among species. A significant correlation between the latters was rarely observed and occurred in only one season, differing among species. The correlations between flammability and terpenes were mostly highlighted using single compounds, compared to subgroups, and they presented seasonal patterns varying among species. Checking the seasonal effect of groups of terpene compounds on flammability, there were seasonal differences in these groups according to the species and the variable tested. Mostly, these significant compounds were not the most concentrated. The best flammability drivers of each model, mostly diterpenes, except for P. halepensis whose flammability was mostly drove by mono- and sesquiterpenes, changed among seasons according to the flammability variable considered. When a best driver remained the same in different seasons, its effect on flammability could be opposite. In contrast, FMC was generally not a significant explanatory parameter of leaf flammability or did not improve the fit of models.
Associated Factors and Utility of Bed-side Assessment Tools to Avoid Antibiotic Overuse in an Urban ICU of a Developing Country
Authors: Afroze Farzana , Faruk Md. Tanveer , Kamal Mehnaz , Kabir Farhad , Sarmin Monira , Sharifuzzaman Sharifuzzaman , Chakraborty Mithun , Hossain Md. Rezaul , Shikha Shamima Sharmin , Chowdhury Visnu Pritom , Islam Md. Zahidul , Ahmed Tahmeed , Chisti Mohammod Jobayer
Published: June 2021

Antibiotic exposure in the intensive care unit (ICU) is very high, although 50% of all antibiotics may be unnecessary. We aimed to determine predicting factors, outcomes, and the utility of simple screening tools to avoid antibiotic overuse in the ICU. We analyzed 510 young children who did not receive antibiotics during ICU stay to those treated with antibiotics. The logistic regression analysis revealed that cases were more often older and independently associated with hypernatremia. Cases less often had severe underweight, altered mentation, age-specific fast breathing, lower chest wall in-drawing, adventitious sound on lung auscultation, abdominal distension, developmental delay, hyponatremia, hypocalcemia, and microscopic evidence of invasive diarrhea (for all, p<0.05). The case-fatality rate was significantly higher among the cases than the controls. For predicting 'no antibiotic approach,' the sensitivity of a negative quick Sequential Organ Failure Assessment (qSOFA) was similar to quick Pediatric Logistic Organ Dysfunction-2 (qPELOD-2) and higher than Systemic Inflammatory Response Syndrome (SIRS). In conclusion, 'No antibiotic approach' could be safely adopted in PICU using some simple clinical and laboratory characteristics, particularly in poor resource settings. A negative qSOFA or qPELOD-2 score calculated during PICU admission is superior to SIRS to avoid antibiotic overuse in under-five children.
Detecting halfmetallic electronic structures of spintronic materials in a magnetic field
Authors: Fujiwara Hidenori , Umetsu Rie , Kuroda Fumiaki , Miyawaki Jun , Kashiuchi Toshiyuki , Nishimoto Kohei , Nagai Kodai , Sekiyama Akira , Irizawa Akinori , Takeda Yukiharu , Saitoh Yuji , Oguchi Tamio , Harada Yoshihisa , Suga Shigemasa
Published: June 2021

Band-gap engineering is one of the fundamental techniques in semiconductor technology and also applicable in the next generation spintronics using the spin degrees of freedom. To fully utilize the spintronic material, it is essential to optimize the spin-dependent electronic structures in the operando conditions by applying the magnetic and/or electric fields. Here we present a new spectroscopic technique to probe the spin-polarized electronic structures by using magnetic circular dichroism (MCD) in the resonant inelastic soft X-ray scattering (RIXS) under an external magnetic field. Thanks to the spin-selective dipole-allowed transitions in the RIXS-MCD, we have successfully demonstrated the direct evidence of the perfectly spin-polarized electronic structures for the prototypical halfmetallic Heusller alloy, Co2MnSi. The RIXS-MCD is a promising tool to probe the spin-dependent carriers and band-gap with element specific way induced in the buried magnetic layers under the operando conditions.
Paediatric Fungal Keratitis：A Case Series of 45 Children Presenting to a Tertiary Referral Centre
Authors: Zhang Jing , Chen Huabo , Wan Xiaomei , Jiang Mingming , Ding Yichao , Xie Lixin , Dong Yanling
Published: June 2021

Purpose：To analyze the etiology, characteristics, and treatment outcomes of paediatric fungal keratitis in northern China.Methods：The medical records of children (< 18 years old) diagnosed with fungal keratitis at the Shandong Eye Institute from 1996 to 2017 were reviewed for demographic features, risk factors, seasonal variation, clinical characteristics, laboratory findings, and treatment strategies.Results：Forty-five children (46 eyes) were included. Fungal keratitis in children accounted for 16.4% of all of the children with infectious keratitis, which was lower than that in adults (59.4%, p < 0.001). Unexplained fungal keratitis accounted for 26.1%. Plant trauma (23.9%) and wind and sand into the eyes (21.7%) ranked second and third, respectively. Fusarium fungi infection was found in 69.9%, and 31.0% were infected by Aspergillus fungi. The corneal ulcer area was positively correlated with a peripheral blood neutrophil/lymphocyte ratio (NLR) at the first visit (r = 0.310, p = 0.036). Voriconazole had the highest drug sensitivity rate. A total of 67.4% (31 eyes) underwent therapeutic keratoplasty (PKP 21 eyes; LKP 10 eyes). The recurrence rate was 3.2% (due to an Aspergillus infection). The best corrected visual acuity (BCVA) after treatment in children ≤ 8 years (median 20/60) was lower than the BCVA in children > 8 years (median 20/50, p = 0.035).Conclusions：Fungal keratitis are less common in children than in adults. The main infection was due to Fusarium fungi. The preferred antifungal drug was voriconazole. LKP treatment is preferred for Fusarium infection keratitis.
Efficacy and Safety of Qinggan Jieyu Herbal Formula Granule on Insomnia: A Prospective Randomized Controlled Trial
Authors: Han Fang , Feng Luda , Cao Kegang , Li Huanqin , Gao Ying
Published: June 2021

Background:Traditional Chinese Medicine (TCM) is widely used in China for insomnia treatment. The objective of this study was to evaluate the efficacy and safety of QingganJieyu (QGJY)Herbal Formula Granule for insomnia patients with liver depression of heat syndrome.Methods: In this randomized controlled clinical trial, 60patients were randomly assigned into the treatment group and the control group in a 1:1 ratio. Participants received QGJYHerbal Formula GranuleandWuling capsulerespectively for 4 weeksand were followed for another 4 weeks. The primary outcomes weresyndrome integral changes according to theliver depression of heat syndrome evaluation scaleand global and subscale score changes according to the Pittsburgh Sleep Quality Index (PSQI). The secondary outcome wasquality of life assessed by the Short-form 36 Questionnaire (SF-36). A correlation analysis was also done between syndrome integral and PSQI global score and subscale score. Results: Compared with pretreatment baseline, patients in both groups showed a decreasedtrend in TCM syndrome integral scores, especially for the main syndrome.There were significant differences in the total score of syndrome integral between the two groups at 2, 3, 4 weeks, and follow-up period (all Ps<0.05)).During the treatment period, patients in both groups experienced a lower trend and the differences in PSQI global score, sleep disturbance, sleep duration, and use of sleep medication between the two groups were statistically significant (all Ps<0.05).Concerning secondary outcome measure, quality of life was improved for patients in both groups and mental health on the SF-36 questionnaire improvement was significantly better for the treatment group (P<0.05). Additionally, a significant, positive correlation was found between sleep disorders and TCM syndrome integral change (Pearson r = 0.340, P < 0.001).Conclusions:Results of our study suggested that QGJY Herbal Formula Granule not only improved the liver depression of heat syndrome(syndrome) but also sleep disturbance, sleep duration, and use of sleep medication(disease). Additionally, QGJY Herbal Formula Granule promotes psychological health better. Considering therelationship between insomnia and adverse mental health, our findings may have important implications for the management of insomnia in the long run.Trial registration:ChiCTR, ChiCTR-TRC-14004469, Registered 24 January 2014- Retrospectively registered, http://www.chictr.org.cn/showproj.aspx?proj=5101.
Replicated, Urban-Driven Exposure to Metal Pollutants in Two Passerines
Authors: Chatelain Marion , Silva Arnaud Da , Celej Marta , Kurek Eliza , Bulska Ewa , Corsini Michela , Szulkin Marta
Published: June 2021

While there are increasing examples of phenotypic and genotypic differences between urban and non-urban populations of plants and animals, few studies identified the mechanisms explaining those dissimilarities. The characterization of the urban landscape, which can only be achieved by measuring variability in relevant environmental factors within and between cities, is a keystone prerequisite to understand the effects of urbanization on wildlife. Here, we measured variation in bird exposure to metal pollution within 8 replicated urbanization gradients and within 2 flagship bird species in urban evolutionary ecology: the blue tit (Cyanistes caeruleus) and the great tit (Parus major). We report on a highly significant, positive linear relationship between the magnitude of urbanization – inferred as either tree cover, impervious surface cover, or an urbanization score computed from several environmental variables, and copper, zinc and lead concentrations in bird feathers. The reverse relationship was measured in the case of Hg while Cd and As did not vary in response to the urbanization level. This result, replicated across multiple cities and two passerine species, strongly suggests that urban metal pollution is likely to trigger the emergence of parallel responses at the phenotypic and/or genotypic level between urban environments worldwide.
Flavonoids Kaempferol and Quercetin are Nuclear Receptor 4A1 (NR4A1, Nur77) Ligands and inhibit Rhabdomyosarcoma Cell and Tumor Growth
Authors: Shrestha Rupesh , Mohankumar Kumaravel , Martin Greg , Hailemariam Amanuel , Lee Syng-ook , Jin Un-ho , Burghardt Robert , Safe Stephen
Published: June 2021

BackgroundFlavonoid’s exhibit both chemopreventive and chemotherapeutic activity for multiple tumor types, however, their mechanisms of action are not well defined. Based on some of their functional and gene modifying activities as anticancer agents, we hypothesized that kaempferol and quercetin were nuclear receptor 4A1 (NR4A1, Nur77) ligands and confirmed that both compounds directly bound NR4A1 with KD values of 3.1 and 0.93 µM, respectively. MethodsThe activities of kaempferol and quercetin were determined in direct binding to NR4A1 and in NR4A1-dependent transactivation assays in Rh30 and Rh41 rhabdomyosarcoma (RMS) cells, flavonoid-dependent effects as inhibitors of cell growth, survival and invasion were determined in XTT, Annexin V and Boyden chamber assays respectively and changes in protein levels were determined by western blots. Tumor growth inhibition studies were carried out in athymic nude mice bearing Rh30 cells. ResultsKaempferol and quercetin bind NR4A1 protein and inhibit NR4A1-dependent transactivation in RMS cells. NR4A1 also regulates RMS cell growth, survival, and invasion and pro-oncogenic PAX3-FOX01 and G9a gene expression, mTOR signaling and gene products and, these pathways and genes are inhibited by kaempferol and quercetin. Moreover, at a dose of 50 mg/kg/d kaempferol and quercetin inhibited tumor growth in athymic nude mouse xenograft model bearing Rh30 cells. ConclusionThese results demonstrate the clinical potential for repurposing these flavonoids for clinical applications as precision medicine for treating RMS patients that express NR4A1 in order to increase the efficacy and decrease dosages of currently used cytotoxic drugs.
Easy Computation of the Bayes Factor to Fully Quantify Occam’s Razor: Least-squares Fitting and Policy Decisions
Authors: Dunstan D. J. , Crowne J. , Drew A. J.
Published: June 2021

The Bayes factor is the gold-standard figure of merit for comparing fits of models to data, for hypothesis selection and parameter estimation. However, it is little-used because it has been considered to be subjective, and to be computationally very intensive. A simple computational method has been known for at least 30 years, but has been dismissed as an approximation. We show here that all three criticisms are misplaced. The method should be used with all least-squares fitting, because it can give very different, better outcomes than classical methods. It can discriminate between models with equal numbers of parameters and equally good fits to data. It quantifies the Occam’s Razor injunction against over-fitting, and it demands that physically-meaningful parameters rejected by classical significance testing be included in the fitting, to avoid spurious precision and incorrect values for the other parameters. It strongly discourages the use of physically-meaningless parameters, thereby satisfying the Occam’s Razor injunction to use existing entities for explanation rather than multiplying new ones. More generally, being a relative probability, the Bayes factor combines naturally with other quantitative information to guide action in the absence of certain knowledge.
Highly photodegradation of organic dye pollutant RhB using TiO2-modified reduced graphene oxide
Authors: Hidayat Rahmat , Wahyuningsih Sayekti , Fadillah Ganjar , Ramelan Ari Handono
Published: June 2021

TiO2-modified reduced graphene oxide (TiO2-rGO) has been studied in one-process step synthesis via the hydrothermal method. In this study, the various concentrations of rGO were investigated and characterized by fourier transform infrared (FTIR), x-ray diffraction (XRD), scanning electron microscope (SEM), surface area analyzer (SAA), thermogravimetric analysis/differential thermal analysis (TGA/DTA), and spectroscopy UV-Vis. In addition, the photodegradation of rhodamine-B was studied by a batch system under visible light irradiation at wavelength 554 nm. The optimum experimental results showed that the presence of rGO in TiO2 nanostructures could improve the specific surface area until 248.58 m2 g− 1 and enhanced the photodegradation efficiency until 70.66% under visible light irradiation. The photocatalyst stability was evaluated for five cycles experiment and the performance have reduced 6.58% efficiency.
Plant lipid metabolism in response to Phytophthora sojae infection in susceptible and tolerant soybean cultivars
Authors: Adigun Oludoyin , Pham Thu , Grapov Dmitry , Nadeem Muhammad , JEWELL LINDA , Cheema Mumtaz , Galagedara Lakshman , Thomas Raymond
Published: June 2021

Soybean is one of the most cultivated crops globally and a staple food for much of the world's population. The annual global crop losses due to infection by the Phytophthora sojae are currently estimated at approximately $2B USD, yet we have limited understanding of the role of lipid metabolism in the adaptative strategies used to limit infection and crop loss. We employed a multi-modal lipidomics approach to investigate how soybean cultivars remodel their lipid metabolism to successfully limit infection by Phytophthora sojae. Both the tolerant and susceptible soybean cultivars showed alterations in lipid metabolism in response to Phytophthora sojae infection. Relative to non-inoculated controls, induced accumulation of stigmasterol was observed in the susceptible cultivar whereas, induced accumulation of phospholipids and glycerolipids occurred in tolerant soybean cultivar. We have generated a comprehensive metabolic map of susceptible and tolerant soybean root and stem lipid metabolism to identify lipid modulators of host immune or tolerance response to Phytophthora sojae infection and identified potential pathways and unique lipid biomarkers like TG(15:0/22:0/22:5), TG(10:0/10:0/10:0), TG(10:0/10:0/14:0), DG(18:3/18:3), DG(16:0/18:3) and DG(24:0/18:2) as possible targets for the development of future plant protection solutions.