bluuebunny/crossref_metadata_2025 huggingface dataset:
The Prosocial Outgrowth of Filial Beliefs in Different Cultures: A Conditional Mediation Model Analysis
Authors: Zheng Wang , Guo Qingke , Huang Taian , Lu Jianli , Xie Chaoxiang
Published: October 2021

Filial piety is a concept originated from ancient China which contains norms of children’s feelings, attitudes, and behaviors toward their parents. The dual filial piety model (DFPM) differentiated two types of filial belief: reciprocal vs. authoritarian filial piety (RFP vs. AFP). Recent scholars suggest that the functions of filial piety may differ across cultures. This study examined the mediating effects of empathy, moral identity, gratitude, and sense of indebtedness in the relationship between filial piety and prosocial behavior (PB) and the moderating effects of nation. Questionnaires measuring filial piety, PB, moral identity, gratitude, and sense of indebtedness were administrated to Chinese and Indonesian participants. Moderated mediation modeling was conducted to analyze data. The results showed that empathy, moral identity, gratitude, and a sense of indebtedness have significant mediating effects in the association of filial piety and PB. And nation served as a moderator. (1) RFP could promote PB via enhanced empathy, moral identity, gratitude, and a sense of indebtedness, both among Chinese and Indonesian participants, while AFP did the same job only among Indonesian participants. (2) Among Chinese participants, AFP was not directly associated with PB, but was negatively associated with PB via reduced gratitude and a sense of indebtedness. (3) Nation (China vs. Indonesia) moderated the direct or indirect effect of RFP/AFP on PB, with RFP exerting stronger positive effects on outcome variables among Chinese (relative to Indonesian) participants and AFP exerting stronger positive effects on outcome variables among Indonesian (relative to Chinese) participants. These results showed that RFP can promote prosocial development by the cultivation of empathy, moral identity, gratitude, and a sense of indebtedness, regardless of whether the participants grew up in China or other cultural backgrounds. But the effect of AFP on PB was significantly conditioned by culture. This suggests that the function of RFP may be a cultural universal. However, the mechanisms that AFP influences PB can differ considerably across cultures. Findings of this study further indicate that filial piety beliefs may facilitate prosocial development in the ways conditioned by cultures.
Cognitive Impairment and Its Associated Risk Factors in the Elderly With Type 2 Diabetes Mellitus
Authors: Suain Bon Rosnadia , Ariaratnam Suthahar , Mat Saher Zanariah , Mohamad Mariam , Lee Fatt Soon
Published: October 2021

Cognitive impairment is not only common but may also act as a precursor for dementia. Moreover, diabetes mellitus has been shown to promote the progression of dementia. This study aims to determine the prevalence of cognitive impairment and its associated risk factors among the elderly patients having type 2 diabetes mellitus (T2DM) in Hospital Kuala Lumpur, Malaysia. This is a cross-sectional study involving 113 participants who were attending the physician clinic. The participants were selected using the universal sampling method. The tools included a sociodemographic questionnaire, the Montreal Cognitive Assessment, the Depression Anxiety Stress Scale, and the Mini-International Neuropsychiatry Interview. Descriptive analysis was performed and followed by multiple logistic regression. The prevalence of cognitive impairment, depressive disorder, and anxiety disorder was 46.9, 10.6, and 2.7%, respectively. Indians (aOR = 4.90, 95% CI = 1.57–15.27) as well as participants who had completed their secondary (aOR = 0.34; 95% CI = 0.12–0.96) and tertiary (aOR = 0.05; 95% CI = 0.01–0.26) levels of education were significantly associated with cognitive impairment. The prevalence of cognitive impairment was high as well as significantly associated with the ethnicity and education levels of the elderly participants. Indeed both secondary and tertiary education decreased the odds ratio of developing cognitive impairment when compared with no formal and primary education. To determine and reduce the potential risk factors which contribute to cognitive impairment, an early diagnosis of T2DM is crucial. The early detection and treatment of T2DM as well as its associated risk factors are key factors in protecting against cognitive impairment.
Mindfulness Awareness Is Associated With a Lower Risk of Anxiety and Depressive Symptoms in Older Adults With Neurocognitive Disorders
Authors: Lam Linda Chiu Wa , Lee Allen T. C. , Cheng Sheung Tak , Yip Benjamin H. K. , Chan Wai Chi , Fung Ada W. T. , Ma Suk Ling , Cheng Calvin P. W. , Kong Ryan , Chiu Henry T. S. , Lai Frank H. Y. , Wong Samuel Yeung Shan
Published: October 2021

Background: Apart from depressive disorders, there are great interests in adopting mindfulness based interventions (MBIs) for other mental health conditions. Depression and anxiety are common in people with neurocognitive disorders (NCD). The potential of MBIs as an adjuvant treatment in this cognitively at-risk group should be further explored.

Objectives: The current study explored the association between depression and anxiety symptoms with dispositional mindfulness in older adults, and if same association stays in the context of cognitive impairment.

Methods: The Hong Kong Mental Morbidity Survey for Older People (MMSOP) is an ongoing epidemiology study of the prevalence of neurocognitive and mental disorders in adults aged 60 years or over in Hong Kong. MMSOP evaluated cognitive function, psychiatric symptoms (Clinical Interview Schedule-revised, CIS-R), chronic physical disease burden, psychosocial support, and resilience factors, including dispositional mindfulness as measured by the Mindful Attention Awareness Scale (MAAS). We analyzed the impact of MAAS on CIS-R and potential moderation effects of mindfulness.

Results: In March 2021, 1,218 community dwelling participants completed assessments. The mean age of the sample is 69.0 (SD 6.9) years. Eight hundred and two participants (65.7%) were not demented (CDR 0) and 391 (32%) and 25 (2%) were categorized as having mild NCD (CDR 0.5) and major NCD (CDR 1 or more), respectively. One hundred forty-three (11.7%) satisfied ICD-10 criteria for anxiety or depressive disorder as measured by CIS-R. Linear regression analysis showed that female gender, CIRS, and MAAS scores were significant factors associated with CIS-R scores. MAAS scores moderated and attenuated the impact CIRS on CIS-R (adjusted R2 = 0.447, p < 0.001). MAAS scores remained as significant moderator for CIRS in patients with NCD (CDR ≥ 0.5) (adjusted R2 = 0.33, p < 0.001).

Conclusion: Interim findings of the MMSOP suggested that dispositional mindfulness is associated with lower level of mood symptoms in community dwelling older adults in Hong Kong. The interaction effects further suggested that high mindful awareness may reduce the adverse effects of chronic physical morbidity on mental health. The observation stayed in the participants with cognitive impairment. We should further explore MBIs as a non-pharmacological treatment for in older adults at-risk of physical morbidity and cognitive decline.
Sex-Specific Effect of Serum Lipids and Body Mass Index on Psychotic Symptoms, a Cross-Sectional Study of First-Episode Psychosis Patients
Authors: Gjerde Priyanthi B. , Simonsen Carmen E. , Lagerberg Trine V. , Steen Nils Eiel , Andreassen Ole A. , Steen Vidar M. , Melle Ingrid
Published: October 2021

Background: Schizophrenia is a disorder with considerable heterogeneity in course and outcomes, which is in part related to the patients' sex. Studies report a link between serum lipids, body mass index (BMI), and therapeutic response. However, the role of sex in these relationships is poorly understood. In a cross-sectional sample of first-episode psychosis (FEP) patients, we investigated if the relationship between serum lipid levels (total cholesterol, HDL-C, LDL-C, and triglycerides), BMI, and symptoms differs between the sexes.

Methods: We included 435 FEP patients (males: N = 283, 65%) from the ongoing Thematically Organized Psychosis (TOP) study. Data on clinical status, antipsychotics, lifestyle, serum lipid levels, and BMI were obtained. The Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS) were used to assess psychotic and depressive symptoms. General linear models were employed to examine the relationship between metabolic variables and symptomatology.

Results: We observed a female-specific association between serum HDL-C levels and negative symptoms (B = −2.24, p = 0.03) and between triglycerides levels (B = 1.48, p = 0.04) and BMI (B = 0.27, p = 0.001) with depressive symptoms. When controlling for BMI, only the association between serum HDL-C levels and negative symptoms remained significant. Moreover, the HDL-C and BMI associations remained significant after controlling for demography, lifestyle, and illness-related factors.

Conclusion: We found a relationship between metabolic factors and psychiatric symptoms in FEP patients that was sex-dependent.
Brain Tumor Segmentation From Multi-Modal MR Images via Ensembling UNets
Authors: Zhang Yue , Zhong Pinyuan , Jie Dabin , Wu Jiewei , Zeng Shanmei , Chu Jianping , Liu Yilong , Wu Ed X. , Tang Xiaoying
Published: October 2021

Glioma is a type of severe brain tumor, and its accurate segmentation is useful in surgery planning and progression evaluation. Based on different biological properties, the glioma can be divided into three partially-overlapping regions of interest, including whole tumor (WT), tumor core (TC), and enhancing tumor (ET). Recently, UNet has identified its effectiveness in automatically segmenting brain tumor from multi-modal magnetic resonance (MR) images. In this work, instead of network architecture, we focus on making use of prior knowledge (brain parcellation), training and testing strategy (joint 3D+2D), ensemble and post-processing to improve the brain tumor segmentation performance. We explore the accuracy of three UNets with different inputs, and then ensemble the corresponding three outputs, followed by post-processing to achieve the final segmentation. Similar to most existing works, the first UNet uses 3D patches of multi-modal MR images as the input. The second UNet uses brain parcellation as an additional input. And the third UNet is inputted by 2D slices of multi-modal MR images, brain parcellation, and probability maps of WT, TC, and ET obtained from the second UNet. Then, we sequentially unify the WT segmentation from the third UNet and the fused TC and ET segmentation from the first and the second UNets as the complete tumor segmentation. Finally, we adopt a post-processing strategy by labeling small ET as non-enhancing tumor to correct some false-positive ET segmentation. On one publicly-available challenge validation dataset (BraTS2018), the proposed segmentation pipeline yielded average Dice scores of 91.03/86.44/80.58% and average 95% Hausdorff distances of 3.76/6.73/2.51 mm for WT/TC/ET, exhibiting superior segmentation performance over other state-of-the-art methods. We then evaluated the proposed method on the BraTS2020 training data through five-fold cross validation, with similar performance having also been observed. The proposed method was finally evaluated on 10 in-house data, the effectiveness of which has been established qualitatively by professional radiologists.
Classification of Megathyrsus Maximus Accessions Grown in the Colombian Dry Tropical Forest by Nutritional Assessment During Contrasting Seasons
Authors: Carvajal-Tapia Juliana Isabel , Mazabel Johanna , Vivas-Quila Nelson Jose
Published: October 2021

The diversity and use of tropical forages for cattle feeding are the protagonists in livestock systems. The production and nutritional quality of forages represent a strategy of continuous research in animal feeding to help mitigate the environmental impact generated by tropical livestock. The objective of this study was to classify the nutritional behavior in contrasting seasons and the relationship with agronomic traits of a collection of 129 CIAT (Centro Internacional de Agricultura Tropical) accessions of Megathyrsus Maximus established in the Colombian dry tropics. By means of the near-infrared reflectance spectroscopy (NIRS) technique, crude protein (CP), neutral detergent fiber (NDF), acid detergent fiber (ADF), and in vitro dry matter digestibility (IVDMD) were determined under rainy and dry seasons as fixed effects. We measured plant height, dry matter biomass (DMB) and flowering in field. Aspects such as plant height and DMB did not show correlation with nutritional aspects, whereas flowering was correlated with the content of structural carbohydrates. Despite genotype and precipitation affecting nutritional value, there is relative nutritional steadiness in NDF, ADF, and IVDMD between seasons for some accessions. According to the cluster analysis carried out for each season, it was evidenced that from the total collection, 51.2% of the accessions during the dry season and 19.4% of the accessions during the rainy season were classified with a better nutritional profile, thus, showing a higher number of materials with better nutritional behavior in the dry season. Both the genotypic characteristics of M. maximus and environmental conditions during contrasting seasons are factors that might influence the variability of the nutritional content, productive parameters, and flowering. Additionally, fodder material classification under Hotelling's T-squared test and Nutritional Classification Index suggests accessions that might be promising for resilient nutritional quality and adequate DMB, which proves that M. maximus could become an alternative for animal feeding and sustainable livestock production during critical dry periods in tropical agroecosystems.
Reconnecting Grazing Livestock to Crop Landscapes: Reversing Specialization Trends to Restore Landscape Multifunctionality
Authors: de Faccio Carvalho Paulo César , de Albuquerque Nunes Pedro Arthur , Pontes-Prates Arthur , Szymczak Leonardo Silvestri , de Souza Filho William , Moojen Fernanda Gomes , Lemaire Gilles
Published: October 2021

Closely integrated crop and livestock production systems used to be the rule in agriculture before the industrial revolution. However, agricultural landscapes have undergone a massive intensification process in recent decades. This trajectory has led to uniform landscapes of specialized cropping systems or consolidated zones of intensive livestock production. Loss of diversity is at the core of increasing side effects on the environment from agriculture. The unintended consequences of specialization demand the reconciliation of food production with environmental quality. We argue that the reconnection of grazing livestock to specialized crop landscapes can restore decoupled biogeochemical cycles and reintroduce the necessary complexity to restore ecosystem functioning. Besides, the reconnection of crops and livestock promotes several ecosystem services underlying multifunctionality. We focus on the capacity of integrated crop-livestock systems to create biophysical and socioeconomic resilience that cope with weather and market oscillations. We present examples of redesigned landscapes that leverage grazing animals to optimize food production per unit of land while mitigating the externalities of specialized agriculture. We also debate mindset barriers to the shift of current specialization trends toward the design of multifunctional landscapes.
Primary Sleeve Gastrectomy and Leaks: The Impact of Fundus-Wall Thickness and Staple Heights on Leakage—An Observational Study of 500 Patients
Authors: Boeker Clara , Schneider Barbara , Markov Valentin , Mall Julian , Reetz Christian , Wilkens Ludwig , Hakami Ibrahim , Stroh Christine , Köhler Hinrich
Published: October 2021

Introduction: The most feared complication of laparoscopic sleeve gastrectomy (LSG) is staple-line leakage. Staple height and fundus-wall thickness might influence such leakage, and this study examined their possible impact on leak incidence. Factors including gender, age, comorbidities, and reinforcement of the staple line were also investigated.

Methods: A total of 500 patients between 17 and 71 years of age who were scheduled for LSG were selected to participate in the study. For technical reasons, 53 were excluded. The fundus-wall thickness of 447 patients after LSG was investigated. The impact of staple height, fundus-wall thickness, demographic and medical factors on leak incidence were investigated. Most of our patients (309) were female (69%), while 138 were male (31%).

Results: The mean thickness of the proximal fundus wall was 2,904 μm, 3,172 μm in men and 2,784 μm in women. The leak rate was 4.9%. Age, fundus-wall thickness, and BMI showed a strong influence on leak risk, but this effect was significant only for age (p = 0.01). Patient gender and staple size showed no significant influence on the correlation between fundus-wall thickness and leak risk. Gender displayed a small effect of influence on this correlation, with η2 = 0.05.

Discussion: Because older age had a significant effect on increasing the risk of staple-line leakage, there is a need for a more specific focus on these patients. Thinner fundus wall and female gender might predispose patients to staple-line leaks, but a significant value could not be reached. Therefore, staple size should remain the surgeon's choice based on clinical experience.
Prevalence and Molecular Characterization of Cystic Echinococcosis in Livestock Population of the Malakand Division, Khyber Pakhtunkhwa, Pakistan
Authors: Khan Jadoon , Basharat Nosheen , Khan Salman , Jamal Syed Muhammad , Rahman Sadeeq ur , Shah Aamer Ali , Khan Sanaullah , Ali Rehman , Khan Shahid Niaz , Ali Ijaz
Published: October 2021

Cystic echinococcosis (CE) is a neglected zoonotic disease prevalent in Pakistan, but the genetic diversity of the cestode is largely unexplored in the country. This study investigated the molecular epidemiology of CE infecting the livestock population of the Malakand division, Khyber Pakhtunkhwa, Pakistan. A total of 1,200 livestock, including buffaloes, cattle, goats, and sheep, were examined for echinococcosis from November 2017–2018 at different slaughterhouses in the Malakand division. Hydatid cysts were collected from different organs, and hydatid cyst fluid (HCF) was examined microscopically and used for DNA extraction. The LSU (rrnl) and NAD1 genes were amplified and sequenced. The overall prevalence of CE was 17% (204/1,200), including cows (21.7%), buffaloes (17.4%), goats (10%), and sheep (9.6%). The infection was relatively more prevalent among males (17%) than females (16.9%) and animals of older age (>5 years) (p = 0.710). Liver (63.2%) and lungs (25%) were more affected as compared to kidneys (6.8%) and heart (4.9%). HCF analysis indicated that 52.0% of the cysts were sterile and (48.0%) were fertile. Sequencing and phylogenetic analyses confirmed 80.0% of the isolates as Echinococcus granulosus sensu stricto (G1-G3) in all animal species, while Echinococcus equinus (G4) and Echinococcus ortleppi (G5) were present in buffaloes. The present study concluded that CE is prevalent in the livestock population of Malakand. Besides E. granulosus s. s. (G1-G3), E. ortleppi genotype (G5) and E. equinus (G4) in livestock were also reported.
Attitudes and Perspectives of People Living With Human Immunodeficiency Virus: Findings From the Positive Perspectives Survey in Slovakia
Authors: Sojak Lubomir , Simekova Katarina , Piesecka Lubica , Wiesinger Milos , Jarcuska Pavol
Published: October 2021

Objectives: To investigate the perspectives and attitudes of people living with human immunodeficiency virus (PLHIV) in Slovakia.

Methods: A cross-sectional, computer-assisted web survey on health status, emotional support, stigmatisation, communication with physician, treatment, perception, decision-making, concerns, and treatment history. A representative sample of >10% of all PLHIV (N = 895) in Slovakia was invited to participate.

Results: Mean age of the 117 respondents was 35.4 (±8.9) years, 52.8% had higher education, and 67.0% were in full-time employment. Most (89.4%) were receiving antiretroviral therapy (ART), and 81.8% had undetectable viral load. Most (85.1%) were satisfied with their ART, and side effects were the primary reason for switching therapies. Most (60.8%) had informed only close friends or relatives about their HIV status, only 3 (2.9%) spoke openly about it, and 60.0% hid their ART from others. Of the 31 respondents (31.6%) who experienced stigmatisation, it was primarily from dentists and other physicians who refused to treat them.

Conclusion: In general, PLHIV in Slovakia receive ART and are satisfied with it. They do not speak openly about their HIV status, and some have experienced discrimination.
Selection of Key Frames for 3D Reconstruction in Real Time
Authors: Koschel Alan , Müller Christoph , Reiterer Alexander
Published: October 2021

Cameras play a prominent role in the context of 3D data, as they can be designed to be very cheap and small and can therefore be used in many 3D reconstruction systems. Typical cameras capture video at 20 to 60 frames per second, resulting in a high number of frames to select from for 3D reconstruction. Many frames are unsuited for reconstruction as they suffer from motion blur or show too little variation compared to other frames. The camera used within this work has built-in inertial sensors. What if one could use the built-in inertial sensors to select a set of key frames well-suited for 3D reconstruction, free from motion blur and redundancy, in real time? A random forest classifier (RF) is trained by inertial data to determine frames without motion blur and to reduce redundancy. Frames are analyzed by the fast Fourier transformation and Lucas–Kanade method to detect motion blur and moving features in frames to label those correctly to train the RF. We achieve a classifier that omits successfully redundant frames and preserves frames with the required quality but exhibits an unsatisfied performance with respect to ideal frames. A 3D reconstruction by Meshroom shows a better result with selected key frames by the classifier. By extracting frames from video, one can comfortably scan objects and scenes without taking single pictures. Our proposed method automatically extracts the best frames in real time without using complex image-processing algorithms.
Genetics Responses to Hypoxia and Reoxygenation Stress in Larimichthys crocea Revealed via Transcriptome Analysis and Weighted Gene Co-Expression Network
Authors: Zhang Yibo , Ding Jie , Liu Cheng , Luo Shengyu , Gao Xinming , Wu Yuanjie , Wang Jingqian , Wang Xuelei , Wu Xiongfei , Shen Weiliang , Zhu Junquan
Published: October 2021

The large yellow croaker (Larimichthys crocea) is an important marine economic fish in China; however, its intolerance to hypoxia causes widespread mortality. To understand the molecular mechanisms underlying hypoxia tolerance in L. crocea, the transcriptome gene expression profiling of three different tissues (blood, gills, and liver) of L. crocea exposed to hypoxia and reoxygenation stress were performed. In parallel, the gene relationships were investigated based on weighted gene co-expression network analysis (WGCNA). Accordingly, the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analysis showed that several pathways (e.g., energy metabolism, signal transduction, oxygen transport, and osmotic regulation) may be involved in the response of L. crocea to hypoxia and reoxygenation stress. In addition, also, four key modules (darkorange, magenta, saddlebrown, and darkolivegreen) that were highly relevant to the samples were identified by WGCNA. Furthermore, some hub genes within the association module, including RPS16, EDRF1, KCNK5, SNAT2, PFKL, GSK-3β, and PIK3CD, were found. This is the first study to report the co-expression patterns of a gene network after hypoxia stress in marine fish. The results provide new clues for further research on the molecular mechanisms underlying hypoxia tolerance in L. crocea.
Comprehensive Analysis of miRNAs and Target mRNAs between Immature and Mature Testis Tissue in Chinese Red Steppes Cattle
Authors: Fang Xibi , Qin Lihong , Yu Haibin , Jiang Ping , Xia Lixin , Gao Zhen , Yang Runjun , Zhao Yumin , Yu Xianzhong , Zhao Zhihui
Published: October 2021

This study aims to screen potential regulators and regulate fecundity networks between microRNAs (miRNAs) and target genes. The bovine testes of immature and mature Chinese Red Steppes were performed by genome-wide analysis of mRNAs and miRNAs. Compared with testicular tissues of newborns, 6051 upregulated genes and 7104 downregulated genes in adult cattle were identified as differentially expressed genes (DEGs). The DEGs were significantly enriched in 808 GO terms (p < 0.05) including male gonad development, male genitalia development, spermatogenesis, and sperm motility. Moreover, DEGs were also significantly enriched in 105 KEGG pathways (p < 0.05), including cGMP-PKG signaling pathway and calcium signaling pathway. To explore the expression of miRNA-regulated gene expression, 896 differentially expressed target genes negatively regulated with the expression levels of 31 differentially expressed miRNAs (DERs) were predicted and analyzed, and a network-integrated analysis was constructed. Furthermore, real-time PCR was performed to verify the expression levels of DEGs and DERs. Our results identified novel candidate DEGs and DERs correlated with male reproduction and intricate regulating networks between miRNAs and genes, which will be valuable for future genetic and epigenetic studies of sperm development and maturity, as well as providing valuable insights into the molecular mechanisms of male fertility and spermatogenesis in cattle.
Postoperative Study of Bone Gain in Mandibular Alveolar Bone Reconstructed with Screw-Guided Bone Regeneration Technique and Porcine-Derived Xenograft in 42 Edentulous Patient Candidates for Implant-Prosthetic Therapy
Authors: Agop-Forna Doriana , Törok Roland , Törok Bianca , Dragomir Raluca , Ehrenfest David M. Dohan , Dascălu Cristina , Stelea Carmen Gabriela
Published: October 2021

This study aimed to test whether alveolar bone gain (width and osteodensity) in mandible implant sites, augmented by the screw-guided bone regeneration (S-GBR) technique and the porcine-derived xenograft, differ from that of the mandible sites reconstructed with S-GBR and the bovine-derived xenograft. Materials and method. A total of 42 edentulous patients (mean age 54.60 ± 14.90) were randomly divided into a test group (S-GBR + porcine-derived xenograft) and a control group (S-GBR + bovine-derived xenograft). The immediate implants were placed simultaneously with grafting procedures. The implant site width was measured before teeth extractions and 6 months after the augmentation procedures. Osteodensity bone values were evaluated immediately after the implant placement and at 6 months follow-up. The CBCT sections and Sidexis XG/DVT (Densply/Sirona) software were used to evaluate the changes of the width in the augmented alveolar bone. The NNT Viewer/CT (NewTom) software was used to record the osteodensity changes. Statistical comparisons between the groups were performed by the Mann–Whitney and t-tests (significance level p < 0.05). Results. The mean values of the bone gain at 6 months follow-up (control group vs. test group) were as follows: width (4.107 mm vs. 4.1624 mm); osteodensity (276.83 HU vs. 254.24 HU). The statistical analysis found the absence of statistically significant differences between the two groups regarding the bone gain (width and osteodensity) at 6 months after the augmentation and the immediate implant placement. Conclusions. The horizontal bone and osteodensity gains in the porcine-derived group were similar and without significant statistical differences when compared with the implant sites reconstructed with the bovine-derived xenografts group at 6 months postoperatively. The reconstruction of the mandibular alveolar bone by the S-GBR technique and the porcine-derived xenografts is a valid bone regeneration strategy for edentulous patients with moderate/severe horizontal resorption of the mandibular alveolar bone.
Enhancing Human Superorganism Ecosystem Resilience by Holistically ‘Managing Our Microbes’
Authors: Coleman Margaret E. , Dietert Rodney R. , North D. Warner , Stephenson Michele M.
Published: October 2021

Microbes in the 21st century are understood as symbionts ‘completing’ the human ‘superorganism’ (Homo sapiens plus microbial partners-in-health). This paper addresses a significant paradox: despite the vast majority of our genes being microbial, the lack of routine safety testing for the microbiome has led to unintended collateral side effects from pharmaceuticals that can damage the microbiome and inhibit innate ‘colonization resistance’ against pathobionts. Examples are discussed in which a Microbiome First Medicine approach provides opportunities to ‘manage our microbes’ holistically, repair dysbiotic superorganisms, and restore health and resilience in the gut and throughout the body: namely, managing nosocomial infections for Clostridioides difficile and Staphylococcus aureus and managing the gut and neural systems (gut–brain axis) in autism spectrum disorder. We then introduce a risk analysis tool: the evidence map. This ‘mapping’ tool was recently applied by us to evaluate evidence for benefits, risks, and uncertainties pertaining to the breastmilk ecosystem. Here, we discuss the potential role of the evidence map as a risk analysis methodology to guide scientific and societal efforts to: (1) enhance ecosystem resilience, (2) ‘manage our microbes’, and (3) minimize the adverse effects of both acute and chronic diseases.
Analysis of a Short-Term and a Seasonal Precipitation Forecast over Kenya
Authors: Miller Sara , Mishra Vikalp , Ellenburg W. Lee , Adams Emily , Roberts Jason , Limaye Ashutosh , Griffin Robert
Published: October 2021

Kenya is highly dependent on precipitation for both food and water security. Farmers and pastoralists rely on rain to provide water for crops and vegetation to feed herds. As such, precipitation forecasts can be useful tools to inform decision makers and potentially allow the preparation for such events as drought. This study assessed the predictability of a seasonal forecast (CFSv2) and a short-term precipitation forecast (CHIRPS-GEFS) over Kenya. The short-term forecast was assessed on its ability to predict the onset date of the rainy season, and the skill of the seasonal forecast in predicting abnormal precipitation patterns. CHIRPS-GEFS provided a useful starting point to estimate the onset date, but during the long rains in the southwest, where agriculture is concentrated, differences between the predicted and actual onset dates were large (over 20 days). Assessments for CFSv2 generally displayed lower forecast skill over highlands and coastal regions at a seasonal scale. The CFSv2 forecast skill varied widely over individual months and lead times, but over whole rainy seasons, CFSv2 was more skillful than a random forecast at all lead times in the major agricultural areas of Kenya. This research fills a critical research and application gap in understanding the forecast precipitation skill for onset and sub-seasonal prediction.
Comparison of Top-Down and Bottom-Up Road Transport Emissions through High-Resolution Air Quality Modeling in a City of Complex Orography
Authors: Cifuentes Felipe , González Carlos M. , Trejos Erika M. , López Luis D. , Sandoval Francisco J. , Cuellar Oscar A. , Mangones Sonia C. , Rojas Néstor Y. , Aristizábal Beatriz H.
Published: October 2021

Vehicular emissions are a predominant source of pollution in urban environments. However, inherent complexities of vehicular behavior are sources of uncertainties in emission inventories (EIs). We compare bottom-up and top-down approaches for estimating road transport EIs in Manizales, Colombia. The EIs were estimated using a COPERT model, and results from both approaches were also compared with the official top-down EI (estimated from IVE methodology). The transportation model PTV-VISUM was used for obtaining specific activity information (traffic volumes, vehicular speed) in bottom-up estimation. Results from COPERT showed lower emissions from the top-down approach than from the bottom-up approach, mainly for NMVOC (−28%), PM10 (−26%), and CO (−23%). Comparisons showed that COPERT estimated lower emissions than IVE, with higher differences than 40% for species such as PM10, NOX, and CH4. Furthermore, the WRF–Chem model was used to test the sensitivity of CO, O3, PM10, and PM2.5 predictions to the different EIs evaluated. All studied pollutants exhibited a strong sensitivity to the emission factors implemented in EIs. The COPERT/top-down was the EI that produced more significant errors. This work shows the importance of performing bottom-up EI to reduce the uncertainty regarding top-down activity data.
Characterizing Ice-Scattering Homogeneity in TRMM Microwave Imagers and Its Influence on Oceanic Rain-Rate Estimation Bias of TRMM Precipitation Radar
Authors: Sekaranom Andung Bayu , Nurjani Emilya , Wibowo Sandy Budi , Masunaga Hirohiko
Published: October 2021

Precipitation homogeneity is one of the main factors that contribute to the difference in the rain-rate estimation from meteorological satellites. Using the Tropical Rainfall Measuring Mission (TRMM) products, this paper aims to characterize the homogeneity of ice-scattering signals from TRMM Microwave Imagers (TMIs) as related to rain-rate estimation bias with TRMM Precipitation Radar (PR). Statistical information about the polarization-corrected brightness temperature (PCT) from the TMI 85 GHz band is obtained over the global ocean in the tropics. The characteristics are the fraction of PCT below a given threshold, the minimum value, and the standard deviation that are calculated at a 0.25° × 0.25°grid level. The average values of rain-rate estimation from TRMM PR and TMI in the same grid position and time are then compared. This result indicates that the rain-rate estimation bias is influenced by the homogeneity and organization of precipitation systems. Using the statistical signature of ice-scattering signals at the grid level, an adjustment was implemented for TMI rain-rate estimation. The results could produce rain-rate estimations that conform more to PR, particularly for the inhomogeneous precipitation system mostly affected by stratiform rain. The characterization of ice-scattering signals as a proxy to the precipitation homogeneity, as presented in this research, could be implemented in order to improve the accuracy of satellite rain-rate estimation in the future.
Improving Deep Segmentation of Abdominal Organs MRI by Post-Processing
Authors: Furtado Pedro
Published: October 2021

Today Deep Learning (DL) is state-of-the-art in medical imaging segmentation tasks, including accurate localization of abdominal organs in MRI images. But segmentation still exhibits inaccuracies, which may be due to texture similarities, proximity or confusion between organs, morphology variations, acquisition conditions or other parameters. Examples include regions classified as the wrong organ, some noisy regions and inaccuracies near borders. To improve robustness, the DL output can be supplemented by more traditional image postprocessing operations that enforce simple semantic invariants. In this paper we define and apply totally automatic post-processing operations applying semantic invariants to correct segmentation mistakes. Organs are assigned relative spatial location restrictions (atlas fencing), 3D organ continuity requirements (envelop continuity), and smoothness constraints. A reclassification is done within organ envelopes to correct classification mistakes, and noise is removed (fencing, enveloping, noise removal, re-classifying and smoothing). Our experimental evaluation quantifies the improvement and compares the resulting quality with prior work on DL-based organ segmentation. Based on the experiments, we conclude post-processing improved the Jaccard index over independent test MRI sequences by a sum of 12 to 25 percentage points over the four segmented organs. This work has an important impact on research and practical application of DL because it describes how to post-process, quantifies the advantages, and can be applied to any DL approach.
Intra-Subject and Inter-Subject Movement Variability Quantified with Muscle Synergies in Upper-Limb Reaching Movements
Authors: Zhao Kunkun , Zhang Zhisheng , Wen Haiying , Scano Alessandro
Published: October 2021

Quantifying movement variability is a crucial aspect for clinical and laboratory investigations in several contexts. However, very few studies have assessed, in detail, the intra-subject variability across movements and the inter-subject variability. Muscle synergies are a valuable method that can be used to assess such variability. In this study, we assess, in detail, intra-subject and inter-subject variability in a scenario based on a comprehensive dataset, including multiple repetitions of multi-directional reaching movements. The results show that muscle synergies are a valuable tool for quantifying variability at the muscle level and reveal that intra-subject variability is lower than inter-subject variability in synergy modules and related temporal coefficients, and both intra-subject and inter-subject similarity are higher than random synergy matching, confirming shared underlying control structures. The study deepens the available knowledge on muscle synergy-based motor function assessment and rehabilitation applications, discussing their applicability to real scenarios.
A Pilot Study Evaluating the Effects of Early Intervention for Italian Siblings of Children with Autism Spectrum Disorder
Authors: Riva Valentina , Riboldi Elena Maria , Urbani Barbara , Molteni Massimo , Villa Laura
Published: October 2021

Autism spectrum disorder (ASD) is a high-cost/high-burden problem. Early intervention may prevent development of the disorder, improving child outcomes and reducing long-term consequences. However, few studies have investigated the role of early intervention in children younger than two years. This study aims to examine the effect of early intervention in 18-month-old high-risk siblings of children with ASD (HR-ASD) with clinical signs of autism. The intervention is based on the principles of Applied Behavior Analysis and focuses on the development of early precursors to social and communicative competence (joint attention and imitation behaviors). After controlling for baseline differences, two comparison HR-ASD groups were included: 15 HR-ASD toddlers receiving behavioral intervention for 3 h per week for 5 months (INT+) and 15 HR-ASD toddlers who were only clinically monitored from age 18 months (INT−). Changes in social communication, restricted/repetitive behaviors, and language were assessed using standardized measures at pre- (T0) and post-intervention (T1). From T0 to T1, the INT+ group showed significant improvements in communication, social interaction, and language compared to INT− group. There was no effect on restricted/repetitive behaviors. Our findings highlighted the importance of early detection/intervention in autism and supported a positive impact of targeted interventions to improve outcomes in at-risk children.
Potential Diagnostic Value of the Differential Expression of Histone H3 Variants between Low- and High-Grade Gliomas
Authors: Hervás-Corpión Irati , Gallardo-Orihuela Andrea , Catalina-Fernández Inmaculada , Iglesias-Lozano Irene , Soto-Torres Olga , Geribaldi-Doldán Noelia , Domínguez-García Samuel , Luna-García Nuria , Romero-García Raquel , Mora-López Francisco , Iriarte-Gahete Marianela , Morales Jorge C. , Campos-Caro Antonio , Castro Carmen , Gil-Salú José L. , Valor Luis M.
Published: October 2021

Glioblastoma (GB) is the most aggressive form of glioma and is characterized by poor prognosis and high recurrence despite intensive clinical interventions. To retrieve the key factors underlying the high malignancy of GB with potential diagnosis utility, we combined the analysis of The Cancer Gene Atlas and the REMBRANDT datasets plus a molecular examination of our own collection of surgical tumor resections. We determined a net reduction in the levels of the non-canonical histone H3 variant H3.3 in GB compared to lower-grade astrocytomas and oligodendrogliomas with a concomitant increase in the levels of the canonical histone H3 variants H3.1/H3.2. This increase can be potentially useful in the clinical diagnosis of high-grade gliomas, as evidenced by an immunohistochemistry screening of our cohort and can be at least partially explained by the induction of multiple histone genes encoding these canonical forms. Moreover, GBs showing low bulk levels of the H3.1/H3.2 proteins were more transcriptionally similar to low-grade gliomas than GBs showing high levels of H3.1/H3.2. In conclusion, this study identifies an imbalanced ratio between the H3 variants associated with glioma malignancy and molecular patterns relevant to the biology of gliomas, and proposes the examination of the H3.3 and H3.1/H3.2 levels to further refine diagnosis of low- and high-grade gliomas in future studies.
Optimizing Adaptive Therapy Based on the Reachability to Tumor Resistant Subpopulation
Authors: Wang Jiali , Zhang Yixuan , Liu Xiaoquan , Liu Haochen
Published: October 2021

Adaptive therapy exploits the self-organization of tumor cells to delay the outgrowth of resistant subpopulations successfully. When the tumor has aggressive resistant subpopulations, the outcome of adaptive therapy was not superior to maximum tolerated dose therapy (MTD). To explore methods to improve the adaptive therapy’s performance of this case, the tumor system was constructed by osimertinib-sensitive and resistant cell lines and illustrated by the Lotka-Volterra model in this study. Restore index proposed to assess the system reachability can predict the duration of each treatment cycle. Then the threshold of the restore index was estimated to evaluate the timing of interrupting the treatment cycle and switching to high-frequency administration. The introduced reachability-based adaptive therapy and classic adaptive therapy were compared through simulation and animal experiments. The results suggested that reachability-based adaptive therapy showed advantages when the tumor has an aggressive resistant subpopulation. This study provides a feasible method for evaluating whether to continue the adaptive therapy treatment cycle or switch to high-frequency administration. This method improves the gain of adaptive therapy by taking into account the benefits of tumor intra-competition and the tumor control of killing sensitive subpopulation.
Surgical Treatment of Cerebellar Metastases: Survival Benefits, Complications and Timing Issues
Authors: Ersoy Tunc Faik , Mokhtari Neda , Brainman Daniel , Berger Björn , Salay Attila , Schütt Philipp , Weissinger Florian , Grote Alexander , Simon Matthias
Published: October 2021

We retrospectively studied 73 consecutive patients who underwent surgery 2015–2020 for removal of cerebellar metastases (CM). Median overall survival (medOS) varied widely between patients and compared favorably with the more recent literature (9.2, 25–75% IQR: 3.2–21.7 months vs. 5–8 months). Prognostic factors included clinical (but not radiological) hydrocephalus (medOS 11.3 vs. 5.2 months, p = 0.0374). Of note, a third of the patients with a KPI <70% or multiple metastases survived >12 months. Chemotherapy played a prominent prognostic role (medOS 15.5 vs. 2.3, p < 0.0001) possibly reflecting advances in treating systemic vis-à-vis controlled CNS disease. Major neurological (≥30 days), surgical and medical complications (CTCAE III–V) were observed in 8.2%, 13.7%, and 9.6%, respectively. The occurrence of a major complication markedly reduced survival (10.7 vs. 2.5 months, p = 0.020). The presence of extracerebral metastases did not significantly influence OS. Postponing staging was not associated with more complications or shorter survival. Together these data argue for individualized decision making which includes offering surgery in selected cases with a presumably adverse prognosis and also occasional urgent operations in cases without a preoperative oncological work-up. Complication avoidance is of utmost importance.
Upfront Surgery vs. Primary Chemoradiation in an Unselected, Bicentric Patient Cohort with Oropharyngeal Squamous Cell Carcinoma—A Matched-Pair Analysis
Authors: Zimmermann Philipp H. , Stuut Marijn , Wuerdemann Nora , Möllenhoff Kathrin , Suchan Malte , Eckel Hans , Wolber Philipp , Sharma Shachi J. , Kämmerer Fabian , Langer Christine , Wittekindt Claus , Wagner Steffen , Kremer Bernd , Speel Ernst Jan M. , Klussmann Jens P.
Published: October 2021

The two pillars of therapy for oropharyngeal squamous cell carcinoma (OPSCC) are upfront surgery and primary chemoradiotherapy. Substantial regional preferences exist with regard to the selection of treatment. Despite new therapeutic approaches, patient survival remains poor, with an approximate overall survival (OS) rate of 50% at five years. This study was conducted to investigate a potential survival benefit depending on the treatment modality in OPSCC patients. We retrospectively collected data of 853 patients with histologically confirmed OPSCC from the Giessen and Maastricht cancer databases. To identify risk factors affecting survival, a Cox-proportional hazard model was applied to 442 patients with complete data sets. Based on this cohort a matched-pair analysis with 158 patients was performed to compare OS rates of patients treated either with upfront surgery or primary chemoradiation. For the collective cohort, patients treated with upfront surgery had significantly improved OS rates compared to patients treated with primary chemoradiation. In the matched-pair analysis adjusted for patients’ T-, N- and HPV-status as well as risk profile, we observed that both treatment approaches offered equivalent OS rates. Our study emphasizes that treatment recommendations should be made whenever possible on the basis of side-effect profiles caused by the therapeutic approach used. To draw further conclusions, results of the ongoing “best of” (NCT2984410) study are eagerly awaited, investigating the functional outcome after treatment of OPSCC patients.
Adrenocortical Carcinoma in Childhood: A Systematic Review
Authors: Riedmeier Maria , Decarolis Boris , Haubitz Imme , Müller Sophie , Uttinger Konstantin , Börner Kevin , Reibetanz Joachim , Wiegering Armin , Härtel Christoph , Schlegel Paul-Gerhardt , Fassnacht Martin , Wiegering Verena
Published: October 2021

Adrenocortical tumors are rare in children. This systematic review summarizes the published evidence on pediatric adrenocortical carcinoma (ACC) to provide a basis for a better understanding of the disease, investigate new molecular biomarkers and therapeutic targets, and define which patients may benefit from a more aggressive therapeutic approach. We included 137 studies with 3680 ACC patients (~65% female) in our analysis. We found no randomized controlled trials, so this review mainly reflects retrospective data. Due to a specific mutation in the TP53 gene in ~80% of Brazilian patients, that cohort was analyzed separately from series from other countries. Hormone analysis was described in 2569 of the 2874 patients (89%). Most patients were diagnosed with localized disease, whereas 23% had metastasis at primary diagnosis. Only 72% of the patients achieved complete resection. In 334 children (23%), recurrent disease was reported: 81%—local recurrence, 19% (n = 65)—distant metastases at relapse. Patients < 4 years old had a different distribution of tumor stages and hormone activity and better overall survival (p < 0.001). Although therapeutic approaches are typically multimodal, no consensus is available on effective standard treatments for advanced ACC. Thus, knowledge regarding pediatric ACC is still scarce and international prospective studies are needed to implement standardized clinical stratifications and risk-adapted therapeutic strategies.