bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of Discontinuities on Rock Failure under Blasting at Shuangjiangkou Hydropower Station
Authors: Zhao Xi , Wu Bangbiao , Yu Liyuan , Zhao Tieshuan , Hu Zhonghua
Published: October 2021

The underground caverns of Shuangjiangkou hydropower station are under complex geological conditions. During excavation, the stability of the tunnels is severely affected by problems, such as blasting impact and excavation unloading, resulting in abnormal deformation at different locations. On the basis of on‐site measurement, the characteristics of rocks at the main powerhouse and the main transformer room are compared through dynamic tests, and a numerical model is established using discrete element method (DEM) to analyze the special influence of fault SPD9‐f1 on the deformation after excavation. It is revealed that the surrounding rock of the main powerhouse has stronger impact resistance than that of the main transformer room and that the existence of fault SPD9‐f1 accounts for the abnormal deformation. In this study, the failure characteristics and mechanism of surrounding rock deformation controlled by stress and fault are revealed, providing important references for the subsequent excavation and support design of underground projects.
Coordinate Descent-Based Sparse Nonnegative Matrix Factorization for Robust Cancer-Class Discovery and Microarray Data Analysis
Authors: Belachew Melisew Tefera
Published: October 2021

Determining the number of clusters in high-dimensional real-life datasets and interpreting the final outcome are among the challenging problems in data science. Discovering the number of classes in cancer and microarray data plays a vital role in the treatment and diagnosis of cancers and other related diseases. Nonnegative matrix factorization (NMF) plays a paramount role as an efficient data exploratory tool for extracting basis features inherent in massive data. Some algorithms which are based on incorporating sparsity constraints in the nonconvex NMF optimization problem are applied in the past for analyzing microarray datasets. However, to the best of our knowledge, none of these algorithms use block coordinate descent method which is known for providing closed form solutions. In this paper, we apply an algorithm developed based on columnwise partitioning and rank-one matrix approximation. We test this algorithm on two well-known cancer datasets: leukemia and multiple myeloma. The numerical results indicate that the proposed algorithm performs significantly better than related state-of-the-art methods. In particular, it is shown that this method is capable of robust clustering and discovering larger cancer classes in which the cluster splits are stable.
Investigation of Complex Characteristics of Waterjet Propulsion Device with Intake Grid
Authors: Luo Can , Lei Shuaihao , Wang Chuan , Cheng Li , Xia Chenzhi , Zhang Di , Guo Qiang
Published: October 2021

The intake grid is always installed technically to protect the impeller at the entrance of the waterjet propulsion device’s inlet duct affecting its performance. Therefore, this study discussed the complex features of the circular, rectangular, and streamlined intake grid. Consistent geometry size of the intake grid mentioned above is to be maintained to guarantee the identical flow capacity at the entrance of inlet duct. Using experimental and simulated method, the outcomes are drawn as below. Rather than the circular and rectangular intake grid, the streamlined intake grid can improve the hydraulic performance of the waterjet propulsion device. The numerical method is proved to be correct as the consistence of the hydraulic characteristic between the test and simulated results. The causes of hydraulic loss in the contraction segment and straight pipe segment are the intake grid and the inflow velocity, respectively; meanwhile, the loss in the belt pipe segment owes to the vortex, flow separation, and impact on the back. The intake grid has a positive effect on the depth of the inlet velocity profile, but a negative effect on the width of it. The intake grid installation results in thrust reduction, the progress of velocity‐weighted average angle, and the regress of axial velocity uniformity. The performance of waterjet propulsion device is complex and evaluated by the hydraulic performance index (HPI), thrust performance index (TPI), and characteristic of flow pattern index (CFPI). Based on the three evaluation indexes, the streamlined scheme is raised to be the recommended scheme.
On the Connected Safe Number of Some Classes of Graphs
Authors: Iqbal Rakib , Sardar Muhammad Shoaib , Alrowaili Dalal , Zafar Sohail , Siddique Imran
Published: October 2021

For a connected simple graph

G

, a nonempty subset

S

of

V

G

is a connected safe set if the induced subgraph

G

S

is connected and the inequality

S

≥

D

satisfies for each connected component

D

of

G∖S

whenever an edge of

G

exists between

S

and

D

. A connected safe set of a connected graph

G

with minimum cardinality is called the minimum connected safe set and that minimum cardinality is called the connected safe numbers. We study connected safe sets with minimal cardinality of the ladder, sunlet, and wheel graphs.
Notch3 Mutation Detection in Stroke Patients and Selective Nanoliposome in Stroke Alleviation in a Mouse Model
Authors: Wang Yanxia , Li Xinmeng , Liu Ying , Guo Wenjing , Chen Jiangpo , Lu Mengmeng , Huang Shuchun , Pang Tieliang , Chen Jinghong , Kong Xiangjun
Published: October 2021

This study analyzed the correlation between the Notch3 mutation and stroke by testing an effective nanoparticle-loaded aspirin in stroke therapy. Fifty patients with ischemic stroke were followed for two years, and fifty healthy persons served as the control group. By RT-PCR,
this study revealed that the Notch3 mutation existed in ischemic stroke patients who were more likely to have a family history, small vessel lesions, relatively frequent cerebral hemorrhage, and poor long-term prognosis. Liposome-aspirin-chitosan nanoparticle (LACN) was constructed
as a nano-composite for stroke treatment. Notch3 Arg170Cys knock-in mice were prepared as a mutant Notch3 mouse model to test the LACN infiltration efficiency and observe the anti-stroke capacity. We found that LACN could better transport aspirin into brain vessels than the Polyethyleneimine
(PEI) delivery system. However, in the Notch3 mutation mouse model, cerebral infarction and hemorrhage often occurred after being treated with aspirin. Still, LACN better prolongs the half-life of aspirin, rescues the pathological alteration of stroke in the brain, and reduces inflammatory
reaction and oxidative stress response. In conclusion, the Notch3 mutation is closely related to stroke occurrence, and LACN may be a better choice for stroke therapy in the future.
Overexpressed miR-375-Loaded Restrains Development of Cervical Cancer Through Down-Regulation of Frizzled Class Receptor 4 (FZD4) with Liposome Nanoparticle as a Carrier
Authors: Wang Suqin , Xu Lina , Zhang Zhiqiang , Wang Ping , Zhang Rong , He Hui , Chen Ling
Published: October 2021

Dysregulation expression of miR-375 is noted to correlate with progression of cervical cancer. This study attempted to investigate the impact of overexpressed miR-375-loaded liposome nanoparticles on proliferation of cervical cancer (CC), to provide an insight on pathogenesis of CC
disorder. CC cells were co-cultured with pure liposome nanoparticles (empty vector group), miR-375 agonist-loaded liposome nanoparticles, or transfected with miR-375 antagonist. Besides, some cells were exposed to TGF-β/Smads signaling pathway inhibitor or activator whilst cell
proliferation was assessed by MTT assay, and expressions of FZD4 and miR-375 were determined. Western blot analysis was carried out to detect the expression of TGF-β pathway factors (TGF-β, Smad2, Smad7, p-Smad2) and its downstream Smads pathway. The interaction between
miR-375 and FZD4 was evaluated by dual-luciferase reporter gene assay. Overexpression of miR-375 induced arrest at the G0/G1 phase of cell cycle and elevation of Smad2 protein expression (P <0.05), with lower expressions of TGF-β, Smad7, p-Smad2, and FZD4, while transfection
with miR-375 inhibitor exhibited opposite activity. Presence of miR-375 agonist-loaded liposome nanoparticles induced decreased cell proliferation. There was a targeting relationship between miR-375 and FZD4, and administration with TGF-β/Smads agonist resulted in increased miR-375
and Smad2 expressions, as well as decreased TGF-β, Smad7, p-Smad2, FZD4 protein expression, and the number of S phase and G2/M phase cells (P < 0.05). The signaling inhibitor oppositely suppressed cell proliferation decreasing miR-375 expression. miR-375-loaded liposome
nanoparticles activated TGF-β/Smads signaling pathway to restrain cell cycle and suppress cell division, and proliferation through targeting FZD4 in CC. Its molecular mechanism is related to activation of TGF-β/Smads signaling pathway.
Comparative Toxicity, Biodistribution and Excretion of Ultra-Small Gold Nanoclusters with Different Emission Wavelengths
Authors: Li Na , Chen Lina , Zeng Chujie , Yang Huanggen , He Silian , Wei Qingmin
Published: October 2021

The exponentially increased use of gold nanoclusters in diagnosis and treatment has raised serious concern about their potential threat to living organisms. However, the mechanisms of toxicity of gold nanoclusters in vitro and in vivo remain poorly understood. In this
work, comparative toxicity studies, including biodistribution and excretion, were carried out with mildly and chemically synthesized ultra-small L-histidine-protected and bovine serum albumin (BSA)-protected gold nanoclusters in an all-aqueous process. These nanoclusters did not induce a remarkable
impact on cell viability, even at relatively high concentrations (100 μg/mL). The haemolytic assay demonstrated that the gold nanoclusters could not destroy blood cell at 600 μg/mL. After intravenous injection with mice, the biocompatibility, biodistribution, and excretion were determined.
Quantitative analysis results showed that accumulation varied in the liver, spleen, kidney, and lung, though primarily in the liver and spleen. They were excreted in urine and faeces, but mainly excreted through urine. In our study, no obvious abnormalities were found in body weight, behavioral
changes, blood and serum biochemical indicators, and histopathology. These findings suggested that both gold nanoclusters showed similar effects in vivo and were safe and biocompatible, laying the foundation for safe biomedical application in the future.
Graphene Quantum Dots for Molecular Radiotherapy: Radiolabeled Graphene Quantum Dots with Radium (223Ra) Showed Potent Effect Against Bone Cancer
Authors: Yang Yang , Lima Ruana Cardoso , Gemini-Piperni Sara , Alencar Luciana Magalhães Rebelo , Santos-Oliveira Ralph
Published: October 2021

The necessity of new drugs with special attention for the therapy of cancer is increasing each day. Despite their properties, alpha therapeutic radiopharmaceuticals, especially based on the use of radium (223Ra) are good choices, due to the highest and differential cytotoxicity,
low adverse effects, and higher bioaccumulation on tumor sites. The use of graphene quantum dots as the carrier for 223Ra is a promising approach since graphene quantum dots has low toxicity, high biocompatibility, and adequate size for tumor penetration. In this study, we developed,
characterized, radiolabeled with 223Ra, and evaluated in vitro and in vivo graphene quantum dots radiolabeled with radium (223Ra) for bone cancer. The results showed that 223Ra is incorporated into the graphene quantum dot following the Fajans–Paneth–Hahn
Law. The cell viability showed a potent effect on osteosarcoma cells (MG63 and SAOS2) but a lower effect in normal fibroblast cells (hFB), corroborating the preferential targeting. Also, the results showed a more prominent effect on MG63 than SAOS2 cells, corroborating the targeting for more
undifferentiated cells. The in vivo results demonstrated a renal excretion, associated with fecal excretion and accumulation in bone. The results corroborate the efficacy of 223RaGQDs and open new perspectives for the use of use 223RaGQDs, in several other diseases.
COOH-Terminated Silicon Quantum Dots as a Highly Efficient Drug Nanocarrier for Targeted Tumor Cell Imaging
Authors: Zheng Xiaohui , Wu Hongyu , Shen Zhe , Wang Caihong , Ma Yunfei
Published: October 2021

Fluorescent silicon quantum dots (SiQDs) characterized by exceptional photostability and colloidal robustness as well as beneficial biocompatibility are fast becoming new pharmaceutical nanocarriers. With a view to efficiently loading cisplatin (CDDP) onto SiQDs, carboxylate group (COOH) terminated SiQDs were imperative because of chelate formation with CDDP. In this work, we employed a facial microwave irradiation route for rapidly synthesizing high-quality COOH-SiQDs through the use of 3-aminopropyl trimethoxy silane (APTMS) molecules to fulfil the role of silicon precursor and maleic acid (MA) as the agent for facilitating reduction. The SiQDs showed blue fluorescence with an associated photoluminescence quantum yield (PLQY) of 40.2%, the size of which was small at 3.2 ±0.6 nm, and long-lasting stability (an extensive range in pH (4-12) and concentrations of electrolytes reaching 3 Molarity of a solution of sodium chloride). As nanocarriers, carboxylic acids chelation generated a high loading of CDDP onto SiQDs (drug loading capacity, DLC up to 32.2% at pH = 9) and a drug release of CDDP up to 57.6% at pH = 5. Furthermore, the MTT assays demonstrated the non or low cytotoxicity of SiQDs and the role of the controlled release of SiQD-CDDP Finally, the prepared SiQD-CDDP were used for cell imaging, and further targeted labeling of some tumors after folic acid (FA) conjugation. These characteristics allow for the deployment of SiQDs as a highly efficient nanocarrier that facilitate the delivery of clinical drugs for the future.
Design and Stability Improvement of Pectin-Based Red Blood Cell-Mimicking Microcapsules for Oxygen Therapeutics
Authors: Phakousonh Damien , Wang Yale , Schlicht Sabrina , Wiskirchen Sam , Bos Trevor , Ren Lixia , Chen Junhong , Hua Xiaolin , Lee Jung , Krishnan Sasirekha , Suresh K. Shoma , Jaisankar Abinaya , Ramalingam Murugan , Zhang Wujie
Published: October 2021

A pectin-oligochitosan microcapsule system has recently been developed for novel oxygen therapeutic design. To improve the stability of the pectin-oligochitosan microcapsules in physiological conditions, both covalent (glutaraldehyde) and noncovalent (Mn2+ and Ca2+)
cross-linkers were tested. The chemistry and morphology of the microcapsules were studied using FTIR and SEM, respectively. Results showed that glutaraldehyde is an effective cross-linker, even at low concentrations and short incubation times, and the glutaraldehyde cross-linking does not
negatively impact the morphology of the microcapsules. Moreover, it was confirmed that the hemoglobin could be retained within the microcapsules with a minimal release.
Ophthalmic Delivery of Riboflavin Loaded Nanoparticulate Suspension in Keratoconus: A Preclinical Study in Rabbit Model
Authors: Zhang Ling , Fang Chunlai , Wu Qiong
Published: October 2021

The present investigation undertakes the formulation of nanoparticulate suspension of Riboflavin to treat keratoconus disease by applying it to the infected mice corneas. The nanoparticles of Riboflavin were prepared using single solvent evaporation method and later formulated as suspension
using continuous probe sonication method. Then, both riboflavin nanoparticles and suspension were evaluated for various parameters. The nanoparticles showed smooth and spherical surface with in vitro drug release up to 77.89%. The drug content was found to be 97.23%–98.89%. The
suspension was found to be visually clear with pH ranging from 6 to 7. The drug entrapment was found to be from 76.37% to 97.34%. Since there was no hemolytic activity, this formulation was suitable for ophthalmic administration. The Draize test confirmed the non-irritant, non-itchy nature
of formulation. The prepared formulations, such as nanoparticulate gel and suspension, were found to be significantly efficacious in experimental animals.
A Poly-Chitosan and Cis-Platinum Conjugated Composite Nanoparticle System for Liver Cancer Therapy
Authors: Fan Xiangyu , Wu Haiyun , Zhao Lisong , Guo Xu
Published: October 2021

The aim of this study was to test an effective nano-pole capsule loaded cis-platinum (CP) transplantation device for liver cancer (LC) therapy. A novel nano-pole capsule was designed as a new vector for storing CP. HepG2 cells and a B6/J mouse model were used to test the efficiency
of polyethyleneimine-cis-platinum (PEI-CP) and poly-chitosan-cis-platinum (PC-CP). Infiltration efficiency and transplantation efficiency tests were performed to study the performance of the delivery system, and fibroblast reactions and macrophage numbers were observed, to test for immune
rejection and foreign body reactions. The apoptosis rate and tumor diameter of hepatocellular carcinoma cells were used to evaluate the effect of the tumor therapy. We also studied the functional mechanism of different CP delivery systems. The infiltration and transplantation efficiencies
of PC-CP were higher than that of PEI-CP; Less foreign body reaction appeared in PC system, with less fibroblast reaction and lower macrophage reaction. The clinical efficacy of PC-CP in terms of tumor apoptosis and diameter reduction was superior to that of PEI-CP. We demonstrated that PC-CP
had a more significant alteration effect on mTOR, P-Ak, LC3 and P53. The PC system can better deliver and release drugs than PEI-CP, and may be a better choice for LC therapy in the future.
A New Recombinant Fibronectin/Cadherin Protein-Hydrophobically Modified Glycol Chitosan/Paclitaxel Layer-By-Layer Self-Assembly Strategy for the Postoperative Therapy of Osteosarcoma and Correlated Bone Injury
Authors: Liu Zaiyang , Wu Yiqun , Dai Hongjuan , Li Shasha , Zhu Ying , Chen Yuejian , Xu Zhonghua , Ge Liang , Zhang Yuan
Published: October 2021

Osteosarcoma is one of the most aggressive cancers which greatly threatens the health of adolescents and surgery is difficult to resect the whole piece of tumor tissue. The residual tumor cells might proliferate at the tumor site and invade into the blood circulation, leading to tumor
recurrence and metastasis. Besides, the invasion of tumor cells could also lead to bone injury. We designed a recombinant fibronectin-cadherin fusion protein/hydrophobically modified glycol chitosan-PTX nanoparticles (rFN-CDH/HGC-PTX) layer-by-layer self-assembly polymer based on biphasic
calcium phosphate ceramic (BCP) (BCP-PEI-(rFN/CDH-PTX/HGC)n-rFN/CDH). The SEM, FTIR, XPS and contact angle experiments proved the successful synthesis of the polymer. The chemotherapy drug PTX and bone-repairing-related rFN/CDH fusion protein could be stably released within one
week and the in vitro experiments exhibited the efficacy of the polymer to kill residual tumor cells and promote the proliferation of osteoblast, confirming that our polymer was a superior material for postoperative osteosarcoma therapy.
Strontium-Loaded Nanotubes of Ti–24Nb–4Zr–8Sn Alloys for Biomedical Implantation
Authors: Liu Fei , Wang Xinyu , Li Shujun , Liao Yiheng , Zhan Xinxin , Tao Anqi , Zheng Fu , Li Huazhi , Su Yucheng , Jiang Jiuhui , Li Cuiying
Published: October 2021

Ti–24Nb–4Zr–8Sn (Ti2448) alloys, with a relatively low elastic modulus and unique mechanical properties, are desirable materials for oral implantation. In the current study, a multifaceted strontium-incorporating nanotube coating was fabricated on a Ti2448 alloy (Ti2-NTSr) through anodization and hydrothermal procedures.In vitro,the Ti2-NTSr specimens demonstrated better osteogenic properties and more favorable osteoimmunomodulatory abilities. Moreover, macrophages on Ti2-NTSr specimens could improve the recruitment and osteogenic differentiation of osteoblasts.In vivo,dense clots with highly branched, thin fibrins and small pores existed on the Ti2-NTSr implant in the early stage after surgery. Analysis of the deposition of Ca and P elements, hard tissue slices and the bone-implant contact rate (BIC%) of the Ti2-NTSr implants also showed superior osseointegration. Taken together, these results demonstrate that the Ti2-NTSr coating may maximize the clinical outcomes of Ti2448 alloys for implantation applications.
Application of the 3′ mRNA-Seq using unique molecular identifiers in highly degraded RNA derived from formalin-fixed, paraffin-embedded tissue
Authors: Jang Jin Sung , Holicky Eileen , Lau Julie , McDonough Samantha , Mutawe Mark , Koster Matthew J. , Warrington Kenneth J. , Cuninngham Julie M.
Published: October 2021

Background

Archival formalin-fixed, paraffin-embedded (FFPE) tissue samples with clinical and histological data are a singularly valuable resource for developing new molecular biomarkers. However, transcriptome analysis remains challenging with standard mRNA-seq methods as FFPE derived-RNA samples are often highly modified and fragmented. The recently developed 3′ mRNA-seq method sequences the 3′ region of mRNA using unique molecular identifiers (UMI), thus generating gene expression data with minimal PCR bias. In this study, we evaluated the performance of 3′ mRNA-Seq using Lexogen QuantSeq 3′ mRNA-Seq Library Prep Kit FWD with UMI, comparing with TruSeq Stranded mRNA-Seq and RNA Exome Capture kit. The fresh-frozen (FF) and FFPE tissues yielded nucleotide sizes range from 13 to > 70% of DV200 values; input amounts ranged from 1 ng to 100 ng for validation.

Results

The total mapped reads of QuantSeq 3′ mRNA-Seq to the reference genome ranged from 99 to 74% across all samples. After PCR bias correction, 3 to 56% of total sequenced reads were retained. QuantSeq 3′ mRNA-Seq data showed highly reproducible data across replicates in Universal Human Reference RNA (UHR, R > 0.94) at input amounts from 1 ng to 100 ng, and FF and FFPE paired samples (R = 0.92) at 10 ng. Severely degraded FFPE RNA with ≤30% of DV200 value showed good concordance (R > 0.87) with 100 ng input. A moderate correlation was observed when directly comparing QuantSeq 3′ mRNA-Seq data with TruSeq Stranded mRNA-Seq (R = 0.78) and RNA Exome Capture data (R > 0.67).

Conclusion

In this study, QuantSeq 3′ mRNA-Seq with PCR bias correction using UMI is shown to be a suitable method for gene quantification in both FF and FFPE RNAs. 3′ mRNA-Seq with UMI may be applied to severely degraded RNA from FFPE tissues generating high-quality sequencing data.
Cardiovascular disease and its management among Pacific people: a systematic review by ethnicity and place of birth
Authors: Winter-Smith Julie , Selak Vanessa , Harwood Matire , Ameratunga Shanthi , Grey Corina
Published: October 2021

Background

Pacific people experience a disproportionate burden of cardiovascular disease (CVD), whether they remain in their country of origin or migrate to higher-income countries, such as Australia, Aotearoa New Zealand or the United States of America. We sought to determine whether the CVD health needs of Pacific people vary according to their ethnicity or place of birth.

Methods

We conducted a systematic review of medical research databases and grey literature to identify relevant data published up to 2020. Texts were included if they contained original data stratified by Pacific-specific ethnicity or place of birth on the burden or management of CVD, and were assessed as having good quality using a National Heart, Lung, and Blood Institute quality assessment tool. The protocol for this review was registered with the Open Science Forum (https://doi.org/10.17605/OSF.IO/X7NR6).

Results

Of 3679 texts identified, 310 full texts were reviewed and the quality of 23 of these assessed, using the pre-defined search strategy. Six items (four reports, one article, one webpage) of good quality met the review eligibility criteria. All included texts provided data on epidemiology but only one reported on the management of CVD. Four texts were of Pacific populations in Pacific Island countries and two were of Pacific diaspora in other countries. Data from the Global Burden of Disease study, which provided estimates for the greatest number of Pacific countries, showed substantial differences in mortality rates between Pacific countries for every CVD type. For example, the mortality rate per 100,000 for ischemic heart disease (IHD) ranged from 103.41 in the Cook Islands to 430.35 in the Solomon Islands. A New Zealand-based report showed differences in CVD rates by Pacific ethnicity (e.g. the age-standardised prevalence of IHD per 1,000 population in Auckland ranged from 107.8 (Niuean) to 138 among Cook Islands Māori (p < 0.001)).

Conclusions

This review of published studies reveals that the epidemiology of CVD among Pacific people varies by specific ethnic groups, place of birth, and country of residence. There is a critical need for high-quality contemporary ethnic-specific Pacific data to respond to the diverse CVD health needs in these underrepresented groups.
Risk factors and clinical characteristics for bronchopulmonary dysplasia associated pulmonary hypertension in very-low-birth-weight infants
Authors: Sun Junfang , Weng Bowen , Zhang Xiaoyue , Chu Xiaoyun , Cai Cheng
Published: October 2021

Background

Pulmonary hypertension (PH) is a common complication of bronchopulmonary dysplasia (BPD) in very-low-birth-weight infants (VLBWIs). Although recent studies have increased awareness that PH contributes significantly to the high morbidity and mortality of BPD, the risk factors and clinical characteristics for PH in VLBWIs are little known.

Objectives

To investigate the risk factors and clinical characteristics for BPD-associated pulmonary hypertension (BPD-PH) in VLBWIs.

Methods

A retrospective case–control observational study of VLBWIs with BPD admitted to a neonatal intensive care unit (NICU) over 4 years. According to echocardiograms confirming elevated pulmonary artery pressure after 28 days after birth, we divided BPD infants into PH group (n = 18) and non-PH group (n = 65). We compared pre- and postnatal characteristics between VLBWIs with or without PH. Multivariable logistic regression analysis was conducted with backward selection.

Results

A total of 83 infants with BPD were divided into PH group (n = 18) or non-PH group (n = 65). The average birth weight of the infants with BPD was 1078.1 g. Compared with those infants of the non-PH group, the birth weight of BPD-PH infants was significantly lower (968.1 ± 187.7 vs. 1108.5 ± 185.8,P = 0.006). Infants in the PH group had a higher incidence of patent ductus arteriosus (PDA) and underwent longer durations of oxygen therapy and mechanical ventilation compared to those in the non-PH group. In all subjects, birth weight (OR 0.995; 95% CI 0.991–0.999;P = 0.025) and PDA (OR 13.355; 95% CI 2.950–60.469;P = 0.001) were found to be specific risk factors for BPD-PH in this cohort.

Conclusions

The study shows PDA and birth weight are specific risk factors for BPD-PH in VLBWIs.
Direct oral anticoagulants increase bleeding risk after endoscopic sphincterotomy: a retrospective study
Authors: Masuda Sakue , Koizumi Kazuya , Nishino Takashi , Tazawa Tomohiko , Kimura Karen , Tasaki Junichi , Ichita Chikamasa , Sasaki Akiko , Kako Makoto , Uojima Haruki , Sugitani Ayumu
Published: October 2021

Background

Bleeding can be a serious adverse event of endoscopic sphincterotomy (EST). However, the risk of EST bleeding between direct oral anticoagulant (DOAC) users and those who received no antithrombotic agents has not been clarified. This study analyzed the risk factors for bleeding after EST in patients on DOAC and evaluated the Japan Gastroenterological Endoscopy Society (JGES) guidelines for gastroenterological endoscopy in patients undergoing antithrombotic treatment.

Methods

We retrospectively analyzed 524 patients treated with EST who received DOAC or no antithrombotic drug from May 2016 to August 2019. We investigated the risk factors for bleeding. DOAC was typically discontinued for ≤ 1-day based on the JGES guideline. Although DOAC therapy recommenced the next morning after EST in principle, the duration of DOAC cessation and heparin replacement were determined by the attending physician based on each patient’s status.

Results

The number of patients on DOAC (DOAC group) and those not on antithrombotic drug (no-drug group) was 42 (8.0%) and 482 (92.0%), respectively. DOAC was discontinued for ≤ 1-day in 17 (40.0%) patients and for > 1-day in 25 (60.0%). Of the 524 patients, 21 (4.0%) had EST bleeding. The bleeding rate was higher in the DOAC group (14.0%) (p = 0.004). Multivariate analysis showed that bleeding occurred more frequently in patients on DOAC (odds ratio [OR] 3.95, 95% confidence interval [CI] 1.37–11.4, p = 0.011), patients with low platelet counts (< 100,000/µl) (OR 6.74, 95% CI 2.1–21.6, p = 0.001), and elderly patients (> 80 years old) (OR 3.36, 95%CI 1.17–9.65, p = 0.024).

Conclusions

DOAC treatment, low platelet count, and old age (> 80 years old) are risk factors for EST bleeding. Although the bleeding incidence increased in patients on DOAC who received antithrombotic therapy according to the JGES guidelines, successful hemostasis was achieved with endoscopy in all cases, and no thrombotic events occurred after cessation of DOAC. Thus, the JGES guidelines are acceptable.
Demographic, clinical, and laboratory factors associated with renal parenchymal injury in Iranian children with acute pyelonephritis
Authors: Fahimi Daryoosh , Khedmat Leila , Afshin Azadeh , Jafari Mohsen , Bakouei Zakeyeh , Beigi Effat Hosseinali , Kajiyazdi Mohammad , Izadi Anahita , Mojtahedi Sayed Yousef
Published: October 2021

Background

The association between renal parenchyma changes on dimercaptosuccinic acid (DMSA) scans and demographic, clinical, and laboratory markers was assessed in pediatric patients with acute pyelonephritis.

Methods

A retrospective study of 67 Iranian babies and children aged 1-month to 12-year with APN was conducted between 2012 and 2018. The presence of renal parenchymal involvement (RPI) during APN was determined using technetium-99m DMSA during the first 2 weeks of hospitalization. The association of DMSA results with demographic data, clinical features (hospitalization stay, fever temperature and duration), and laboratory parameters such as pathogen type, and hematological factors (ESR, CRP, BUN, Cr, Hb, and WBC) was evaluated.

Results

92.5% of children with an average age of 43.76 ± 5.2 months were girls. Twenty-four children (35.8%) did not have renal parenchymal injury (RPI), while 26 (38.8%) and 17 (25.4%) patients showed RPI in one and both kidneys, respectively. There was no significant association between RPI and mean ESR, CRP, BUN, and WBC. However, there were significant associations between RPI and higher mean levels of Cr, Hb, and BMI.

Conclusions

Low BMI and Hb levels and increased Cr levels might be indicative of the presence of RPI in children with APN.
Gender differences among patients with drug resistant tuberculosis and HIV co-infection in Uganda: a countrywide retrospective cohort study
Authors: Baluku Joseph Baruch , Mukasa David , Bongomin Felix , Stadelmann Anna , Nuwagira Edwin , Haller Sabine , Ntabadde Kauthrah , Turyahabwe Stavia
Published: October 2021

Background

Gender differences among patients with drug resistant tuberculosis (DRTB) and HIV co-infection could affect treatment outcomes. We compared characteristics and treatment outcomes of DRTB/HIV co-infected men and women in Uganda.

Methods

We conducted a retrospective chart review of patients with DRTB from 16 treatment sites in Uganda. Eligible patients were aged ≥ 18 years, had confirmed DRTB, HIV co-infection and a treatment outcome registered between 2013 and 2019. We compared socio-demographic and clinical characteristics and tuberculosis treatment outcomes between men and women. Potential predictors of mortality were determined by cox proportional hazard regression analysis that controlled for gender. Statistical significance was set at p < 0.05.

Results

Of 666 DRTB/HIV co-infected patients, 401 (60.2%) were men. The median (IQR) age of men and women was 37.0 (13.0) and 34.0 (13.0) years respectively (p < 0.001). Men were significantly more likely to be on tenofovir-based antiretroviral therapy (ART), high-dose isoniazid-containing DRTB regimen and to have history of cigarette or alcohol use. They were also more likely to have multi-drug resistant TB, isoniazid and streptomycin resistance and had higher creatinine, aspartate and gamma-glutamyl aminotransferase and total bilirubin levels. Conversely, women were more likely to be unemployed, unmarried, receive treatment from the national referral hospital and to have anemia, a capreomycin-containing DRTB regimen and zidovudine-based ART. Treatment success was observed among 437 (65.6%) and did not differ between the genders. However, mortality was higher among men than women (25.7% vs. 18.5%, p = 0.030) and men had a shorter mean (standard error) survival time (16.8 (0.42) vs. 19.0 (0.46) months), Log Rank test (p = 0.046). Predictors of mortality, after adjusting for gender, were cigarette smoking (aHR = 4.87, 95% CI 1.28–18.58, p = 0.020), an increase in alanine aminotransferase levels (aHR = 1.05, 95% CI 1.02–1.07, p < 0.001), and history of ART default (aHR = 3.86, 95% CI 1.31–11.37, p = 0.014) while a higher baseline CD4 count was associated with lower mortality (aHR = 0.94, 95% CI 0.89–0.99, p = 0.013 for every 10 cells/mm3 increment).

Conclusion

Mortality was higher among men than women with DRTB/HIV co-infection which could be explained by several sociodemographic and clinical differences.
Reducing physical and emotional violence by teachers using the intervention Interaction Competencies with Children – for Teachers (ICC-T): study protocol of a multi-country cluster randomized controlled trial in Ghana, Tanzania, and Uganda
Authors: Scharpf Florian , Kirika Anette , Masath Faustine Bwire , Mkinga Getrude , Ssenyonga Joseph , Nyarko-Tetteh Emmanuel , Nkuba Mabula , Karikari Amoah Kwaku , Hecker Tobias
Published: October 2021

Background

Violence has severe and long-lasting negative consequences for children’s and adolescents’ well-being and psychosocial functioning, thereby also hampering communities’ and societies’ economic growth. Positive attitudes towards violence and the lack of access to alternative non-violent strategies are likely to contribute to the high levels of teachers’ ongoing use of violence against children in sub-Saharan African countries. Notwithstanding, there are currently very few school-level interventions to reduce violence by teachers that a) have been scientifically evaluated and b) that focus both on changing attitudes towards violence and on equipping teachers with non-violent discipline strategies. Thus, the present study tests the effectiveness of the preventative intervention Interaction Competencies with Children – for Teachers (ICC-T) in primary and secondary schools in Tanzania, Uganda, and Ghana.

Methods

The study is a multi-site cluster randomized controlled trial with schools (clusters) as level of randomization and three data assessment points: baseline assessment prior to the intervention, the first follow-up assessment 6 months after the intervention and the second follow-up assessment 18 months after the intervention. Multi-stage random sampling will be applied to select a total number of 72 schools (24 per country). Schools will be randomly allocated to the intervention and the control condition after baseline. At each school, 40 students (stratified by gender) in the third year of primary school or in the first year of secondary/junior high school and all teachers (expected average number: 20) will be recruited. Thus, the final sample will comprise 2880 students and at least 1440 teachers. Data will be collected using structured clinical interviews. Primary outcome measures are student- and teacher-reported physical and emotional violence by teachers in the past week. Secondary outcome measures include children’s emotional and behavioral problems, quality of life, cognitive functioning, academic performance, school attendance and social competence. Data will be analyzed using multilevel analyses.

Discussion

This study aims to provide further evidence for the effectiveness of ICC-T to reduce teacher violence and to improve children’s functioning (i.e., mental health, well-being, academic performance) across educational settings, societies and cultures.

Trial registration

The trial was registered at clinicaltrials.org under the ClinicalTrials.gov identifier NCT04948580 on July 2, 2021.
Acceptability of HIV oral self-test among truck drivers and youths: a qualitative investigation from Pune, Maharashtra
Authors: Rao Amrita , Patil Sandip , Kulkarni Pranali Pramod , Devi Aheibam Sharmila , Borade Suryakant Shahu , Ujagare Dhammasagar D. , Adhikary Rajatashuvra , Panda Samiran
Published: October 2021

Background

Ending AIDS by 2030 is a global target, to which India is a signatory. HIV-self-test (HIVST) coupled with counselling and AIDS-care, including antiretroviral therapy, has the potential to achieve this. However, national programs are at varying stages of acceptance of HIVST, as discussions around its introduction spark controversy and debates. HIV-self-test, as yet, is not part of the AIDS control program in India. Against this backdrop, we explored acceptability of an HIV oral self-test (HIVOST) among truckers and young men and women.

Methods

A qualitative investigation with 41 in-depth-interviews and 15 group discussions were conducted in the district of Pune, in the western state of Maharashtra, India. These interactions were built around a prototype HIVOST kit, helped in taking the discussions forward. The software N-vivo (version 11.0) was used to manage the volumes of data generated through the aforementioned process. The study was conducted during June through December, 2019.

Results

While the truckers belonged to the age bracket 21–67 year, the youths were in the age group 18–24 year. ‘Ease of doing HIVOST’ and ‘fear of needle pricks’ were the reasons behind acceptance around HIVOST by both the study groups. Truckers felt that HIVOST would encourage one to know one’s HIV status and seek help as appropriate. Accuracy of HIVOST result and disposal of the kits following use were concerns of a few. Most of the participants preferred saliva over blood as the specimen of choice. Instructions in local language reportedly would enable test-use by self. The truck drivers preferred undertaking HIVOST at the truckers-friendly ‘Khushi clinics’ or in the vehicle, while youths preferred the privacy of home. Some of the young men mis-perceived the utility of HIVOST by referring to doing a test on a partner immediately prior to sexual encounter. On the other hand, a few truckers had wrong information on HIV cure.

Conclusions

Overall, the study communities expressed their acceptance towards HIV-self-test. The National AIDS Control Program, India would benefit by drawing upon the findings of the current investigation. Existing myths and misconceptions around HIV test and treatment require program attention.
Factors related to preventive COVID-19 behaviors using health belief model among general population: a cross-sectional study in Iran
Authors: Karimy Mahmood , Bastami Fatemeh , Sharifat Robab , Heydarabadi Akbar Babaei , Hatamzadeh Naser , Pakpour Amir H. , Cheraghian Bahman , Zamani-Alavijeh Fereshteh , Jasemzadeh Mehrnoosh , Araban Marzieh
Published: October 2021

Background

Coronavirus disease (COVID-19) pandemic has become one of the biggest challenges to global health and economy. The present study aimed to explore the factors related to preventive health behaviors during the COVID-19 pandemic in Khuzestan Province, South of Iran, using the Health Belief Model (HBM).

Methods

The present cross-sectional study was conducted in the period between July 2020 and September 2020. A total of 1090 people from Khuzestan province participated in the study. The data collection method included a multistage cluster sampling method with a random selection of provincial of health centers. The questionnaire collected socio-demographic information and HBM constructs (e.g., perceived susceptibility, perceived severity, perceived benefits and barriers, cues to action, and COVID-19 preventive behaviors). Data were analyzed using ANOVA, t-test, hierarchical multiple linear regression, and SPSS version 22.

Results

The mean age of the participants was 35.53 ± 11.53, more than half of them were female (61.6%) and married (65.3). The results showed that 27% of the variance in the COVID-19 preventive behaviors was explained by HBM constructs. The regression analysis indicated that female gender (β = 0.11), perceived benefits (β = 0.10), perceived barriers (β = − 0.18), external cues to action (β = 0.25), and internal cues to action (β = 0.12) were significantly associated with COVID-19 preventive behaviors (p < 0.05).

Conclusion

Designing an educational intervention on the basis of HBM might be considered as a framework for the correction of beliefs and adherence to COVID-19 behavior. Health information campaigns need to (1) emphasize the benefits of preventive behaviors including avoiding the likelihood of getting a chronic disease and complications of the disease, (2) highlight the tips and advice to overcome the barriers (3) provide cues to action by means of showing various reminders in social media (4) focusing on adoption of COVID-19-related preventive behaviors, especially among men.
Extramedullary intracardiac multiple myeloma misdiagnosed as a thrombus: a case report
Authors: Peng Ling , Wang Rurong
Published: October 2021

Background

Extramedullary intracardiac multiple myeloma (MM) is extremely rare. Patients with extramedullary intracardiac MM may suffer from a poor prognosis. Experience in the diagnosis and therapy of cardiac involvement in MM is limited. Herein, we describe a 67-year-old male with extramedullary intracardiac MM who was initially misdiagnosed with a thrombus.

Case presentation

A 67-year-old male was admitted for exertional dyspnea and fatigue. The patient was diagnosed with MM one year earlier and had complete remission after chemotherapy. He was implanted with a permanent pacemaker two months prior due to sick sinus syndrome. After this admission, transthoracic echocardiography (TTE) and computed tomography (CT) confirmed the existence of a large right atrial mass extending to the superior and inferior vena cava. We initially considered the right atrial mass as a thrombus and performed surgical treatment for the patient. The surgical intervention partially relieved the obstruction of the superior and inferior vena cava and improved hemodynamics. Postoperative pathological examination of the right atrial mass suggested malignant plasmacytoma associated with MM. After recovery from the surgery, the patient received one cycle of chemotherapy. A follow-up of seven months revealed that our patient was still alive with a good general condition.

Conclusions

Increasing the awareness of extramedullary intracardiac lesions in patients with MM is warranted. Our case confirmed that surgical intervention followed by adjuvant chemotherapy could improve the patient’s hemodynamics and achieve remission of cardiac symptoms.
Characterization of a highly xylose tolerant β-xylosidase isolated from high temperature horse manure compost
Authors: Ndata Kanyisa , Nevondo Walter , Cekuse Bongi , van Zyl Leonardo Joaquim , Trindade Marla
Published: October 2021

Background

There is a continued need for improved enzymes for industry. β-xylosidases are enzymes employed in a variety of industries and although many wild-type and engineered variants have been described, enzymes that are highly tolerant of the products produced by catalysis are not readily available and the fundamental mechanisms of tolerance are not well understood.

Results

Screening of a metagenomic library constructed of mDNA isolated from horse manure compost for β-xylosidase activity identified 26 positive hits. The fosmid clones were sequenced and bioinformatic analysis performed to identity putative β-xylosidases. Based on the novelty of its amino acid sequence and potential thermostability one enzyme (XylP81) was selected for expression and further characterization. XylP81 belongs to the family 39 β-xylosidases, a comparatively rarely found and characterized GH family. The enzyme displayed biochemical characteristics (KM—5.3 mM; Vmax—122 U/mg; kcat—107; Topt—50 °C; pHopt—6) comparable to previously characterized glycoside hydrolase family 39 (GH39) β-xylosidases and despite nucleotide identity to thermophilic species, the enzyme displayed only moderate thermostability with a half-life of 32 min at 60 °C. Apart from acting on substrates predicted for β-xylosidase (xylobiose and 4-nitrophenyl-β-D-xylopyranoside) the enzyme also displayed measurable α-L-arabainofuranosidase, β-galactosidase and β-glucosidase activity. A remarkable feature of this enzyme is its ability to tolerate high concentrations of xylose with a Ki of 1.33 M, a feature that is highly desirable for commercial applications.

Conclusions

Here we describe a novel β-xylosidase from a poorly studied glycosyl hydrolase family (GH39) which despite having overall kinetic properties similar to other bacterial GH39 β-xylosidases, displays unusually high product tolerance. This trait is shared with only one other member of the GH39 family, the recently described β-xylosidases from Dictyoglomus thermophilum. This feature should allow its use as starting material for engineering of an enzyme that may prove useful to industry and should assist in the fundamental understanding of the mechanism by which glycosyl hydrolases evolve product tolerance.
Thyroid crisis caused by metastatic thyroid cancer: an autopsy case report
Authors: Takedani Kai , Notsu Masakazu , Adachi Naoko , Tanaka Sayuri , Yamamoto Masahiro , Yamauchi Mika , Yamauchi Naotake , Maruyama Riruke , Kanasaki Keizo
Published: October 2021

Background

Thyroid crisis is a life-threatening condition in thyrotoxic patients. Although differentiated thyroid cancer is one of the causes of hyperthyroidism, reports on thyroid crisis caused by thyroid cancer are quite limited. Here, we describe a case of thyroid crisis caused by metastatic thyroid cancer.

Case presentation

A 91-year-old woman was admitted to our hospital because of loss of appetite. Two years prior to this hospitalization, she presented with subclinical thyrotoxicosis and was diagnosed with histologically unidentified thyroid cancer with multiple metastases, and she refused aggressive medical interventions. On admission, she exhibited extreme thyrotoxicosis, and the presence of fever, severe tachycardia, impaired consciousness, and heart failure revealed the presence of thyroid crisis. All thyroid autoantibodies were negative. Multidisciplinary conservative treatment was initiated; however, she died on the fifth day after admission. Autopsy revealed the presence of primary anaplastic thyroid carcinoma and multiple metastatic foci arising from follicular thyroid carcinoma. Both primary and metastatic follicular thyroid carcinoma likely induced thyrotoxicosis, which could have been exacerbated by anaplastic thyroid carcinoma.

Conclusions

Even though the trigger of thyroid crisis in this patient is not clear, the aggravated progression of her clinical course suggests that careful monitoring of thyroid hormones and appropriate intervention are essential for patients with thyroid cancer.