bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of Work Efficiency of the Solar Power Plant Installed on the Roof of a House in Hanoi City
Authors: Nguyen T. N. , Sizov V. D. , Vu M. P. , Cu T. T. H.
Published: February 2020

Vietnam is a country of a great solar potential; solar technology is growing rapidly in Vietnam and investors are very interested in building solar power plants. Construction of the rooftop solar power stations can help owners reduce monthly electricity costs and even get economic benefits by selling excess electricity coming from a solar power plant (PV) to the utility grid. In this study, the design results of a rooftop grid-tied solar power station with the capacity of 26 kWp for a commercial building were introduced to have a basis to assess the operation ability of solar power station under solar radiation conditions in Hanoi city, Vietnam. The simulation results using the PVsyst program have made it possible to calculate the solar energy potential in Hanoi city, the power generation and efficiency of the grid-tied solar power station. Solar power has been applied in Vietnam since the 1990s but is mainly used for areas that were far from national power grid such as mountainous areas, islands. Small scale grid-tied solar power has been developed since 2010 and mainly is used for residential applications or small and medium scale consumers. The total capacity of electricity produced by solar power plants in Vietnam by 2017 was only about 8 MW; this value is very low as compared to the potential of solar power in Vietnam. This is due to the absence of the government support for the policy of developing solar power. In accordance with the current roadmap of raising electricity prices in Vietnam, construction investment of rooftop solar power stations is economically feasible while contributing to environmental protection and counteracting climate change phenomenon by reducing the amount of CO2 emitted into the environment.
Simulation of Thin-Film Solar Cells with a CuInSe2 Chalcopyrite Structure
Authors: Esman A. K. , Zykov G. L. , Potachits V. A. , Kuleshov V. K.
Published: February 2020

By using numerical simulation, the operating temperatures of a thin-film solar cell based on CuInSe2 have been determined and the solar radiation density values, at which stabilization of the temperature operating conditions of the thin-film solar cell is not required, have been optimized. The maximum possible efficiency value of ~14.8 % is achieved under actual operating conditions, and is maintained by the incoming thermal energy as both emitted in this cell and infrared radiation of the sun and the environment. A model of the proposed thin-film solar cell was implemented in the COMSOL Multiphysics program environment with the use of the Heat Transfer Module. The operating temperatures of the solar cell without thermal stabilization under conditions of the diurnal and seasonal variations of both the ambient temperature and the power density of the AM1.5 solar spectrum have been determined. The maximum value of this power density was varied from 1.0 to 500 kW/m2 when using concentrators. The obtained values of operating temperatures of the thin-film solar cell were used to determine its main parameters in the SCAPS-1D program. The graphs of the operating temperature, efficiency and fill factor of the thin-film solar cell versus the solar radiation density are provided. It is shown that in order to obtain the highest possible efficiency of a solar cell, it is necessary to use concentrated solar radiation with a power density, the maximum value of which should be 8 kW/m2 in July and 10 kW/m2 in January. In the case of lower and higher values of power density, an appropriate thermal stabilization of the cell under consideration is necessary. The dependencies of efficiency, fill factor and open-circuit voltage versus the stabilization temperature of the solar cell, temperature gradients at the interfaces of the thermoelectric layer were also calculated. It is shown that by choosing optimal values of the thermal stabilization, the efficiency of the proposed solar cell may be about 15 % or more.
Calculation of Heat Exchange on the Surface of a Flexible Heat Exchanger for Use in Mobile Hospitals
Authors: Lokova I. L. , Kalinichenko A. S.
Published: February 2020

Currently, the world is characterized by quite a large number of military conflicts, manmade disasters and natural disasters. Every year, about 50 thousand people die from various natural disasters in the world. The report of the UNISDR notes that natural disasters that occurred in the world between 1998 and 2017 led to the death of 1.3 million people (more than half of them – due to earthquakes). The analysis shows that human losses could be significantly less with rapid first aid. This requires the presence of a field hospital located as close as possible to the lesion. Currently, field hospitals for various purposes are produced. The heating system of the field hospital modules plays an important role in the operation. A heating system is proposed, which includes a vortex heat generator and heating devices made of polyvinyl chloride. The system is characterized by low weight and quick access to the operating mode. However, in the literature there is no method for calculating the heat exchange coefficient in a closed space, which is formed by flexible heater surface and an enclosing wall. Based on the analysis of criterion dependences and experimental data, new criterion equations for calculating the heat exchange coefficient for an arbitrary location of heaters in space are obtained. The following dependence is built lgNu = f(lg(Gr×Pr)), which allows to determine value of heat exchange coefficient for given range of temperature. A method of intensification of the heat exchange process by creating an artificial roughness is proposed. Graph is done to determine growth rate of heat exchange СK, which is included in criterion equation. The use of artificial roughness allowed increasing the heat transfer coefficient by 28 % and the thermal power of the heating device by about 26 %.
Effect of Corrosion of the Fuel Rod Construction Materials on the Radiation Safety of Nuclear Power Plants with PWR
Authors: Kravchenko V. V. , Tsygankova S. D.
Published: February 2020

The article considers the general concept of corrosion in accordance with GOST 5272–68 “Metal Corrosion”, the classification of the corrosion process, the stages of corrosion as energy function of the flow path of the corrosion process, the main indicators of the corrosion process. According to the forecasts of the International Monetary Fund and Focus Economics, the amount of funds that will be spent on counteracting corrosion and its consequences in selected industrialized countries has been estimated. The growth of funds invested in the counteracting the effects of metal corrosion in the Russian Federation for 2016–2019 is presented in the form of a diagram. The substantiation of the use of zirconium as a structural material for the shell of fuel rods has been fulfilled. The values of the thermal neutron absorption cross sections for various elements serving as structural elements for the core of a nuclear reactor are presented. Factors influencing the choice of alloying elements and their percentage in various alloys (Zr-2, Zr-4, ZIRLO™, M5®), which are the special development that reduce the corrosion rate, are also considered. The composition and mechanical properties of E110 and E635 alloys, which were used as materials for the fuel rods shell in the core of WWER-1200 reactors at the Belarusian NPP, are considered as well. The behavior of zirconium alloys E110 and E635 in the core is analyzed. The main factors that make a significant contribution to the corrosion process in actual operating conditions of zirconium alloys as fuel rods shell have been identified. The existing methods of preliminary special processing of fuel rods shells stored in the air for a long time before their receipt for assembly are presented. The structure of the oxide on the shells of alloys E110 and E635 oxidized in an autoclave is demonstrated.
Special theory of relativity: a view of an external observer
Authors: Sazonenko I. O. , Sazonenko V. I.
Published: February 2020

Based on the generally accepted presentation of the ideas of the private theory of relativity, examples of relative simultaneity and superluminal speed are considered. A variant of the ban on travel to the past in inertial reference systems is proposed.
Motivation of personnel at OJSC «BSW – Management Company of the Holding «BMC»
Authors: Rabinovich N. S. , Kulagina S. A.
Published: February 2020

Motivation is based on the principle of providing employees with opportunities to realize personal goals through a conscientious attitude to work. Motivation at the enterprise is connected, first of all, with a skillful combination of management methods, formation of the most effective management style. It is implemented in the process and forms of recruitment, contract terms, the system of remuneration and incentives, training and is the foundation of any organization, largely determining its competitiveness.
The influence of sample preparation quality on the results of spectral analysis
Authors: Lagoyskaya M. V.
Published: February 2020

Сonsiders the possibility of analyzing samples of small diameters without the use of special adapters for determining the chemical composition on spectrometers. Measurements are limited to the size of the hole on the analytical table, which is 12 mm. Accordingly, all analyzed samples must have a diameter of at least 14 mm to completely cover the sample cover of the discharge chamber in order to avoid air entering the chamber. The company manufacturer of spectral equipment offers to use special adapters for the analysis of small samples. But the use of such adapters has a number of drawbacks. These include additional cash costs for the purchase of adapters, the need for additional standardization procedures, the availability of special reference samples. In the laboratory of analytical support (LAS) of the Central Laboratory of the Factory (CLF), all samples of finished rolled products (wire rods or fittings) in size from 5.5 mm to 20 mm are prepared in the form of «blades». The compressed part of the «blade» is the analyzed surface of the sample, which is further processed on a disk grinder and transmitted to the spectral analysis. The article presents the results of comparative tests of valves class U500 between samples in the form of «blades» and in the form of «columns» and concluded that the necessity of use of special adapters.
Upgrading of die casting section as one of the directions to get new level of the manufacturing of high quality, innovative and competitive products for the Beloma – MMW named after S.I. Vavilov public corporation
Authors: Chachukha V. I.
Published: February 2020

The article considered the stages and the directionы of modernization of foundry production of BelOMA MMW named after S.I.Vavilov Public Corporation. The article described the activities, allowing to produce high-quality and competitive products.
Laser Research of the Fuel Atomization Process of Internal Combustion Engines
Authors: Stężycki P. , Kowalski M. , Jankowski A. , Sławinski Z.
Published: February 2020

The paper presents test methods (mechanical, electrical and optical) for the fuel spray research in combustion engines. Optical methods, imaging and non-imaging can be used in laboratory and engine tests. Imaging methods include flash photography and holography. Their use is limited to testing droplet dimensions larger than 5 µm. Imaging methods have an advantage over non-imaging ones because they allow the droplet to be seen at the point and time where its measurement is required. Non-imaging methods can be divided into two groups: the first, which counts and measures, individual droplets one at a time, and the second, which measures a large number of droplets simultaneously. Exemplary results of research of droplet size distribution in fuel sprays are shown. In tests of atomized fuel spray, in conditions reflecting the conditions of the internal combustion engine, the size of droplets, their distribution in the spray and the velocity of individual droplets are presented. To determine the quality of the fuel spray, two substitute diameters Sauter (D32) and Herdan (D43) were selected, the first of which refers to heat transfer and the second to combustion processes. Laser research equipment including Particle Image Velocimetry laser equipment (PIV), Laser Doppler Velocimeter (LDV) and Phase Doppler Particle Analyzer (PDPA) were applied for testing fuel spray distribution for two kind of fuel. The atomization process from the point of view of combustion and ignition processes, as well as emission levels, is characterized by the best substitute diameter D43, which value is close to the median volume. The most harmful droplets of fuel in the spray are large droplets. Even a few such droplets significantly change the combustion process and emission of toxic exhaust components, mainly NOx.
Child Characteristics and Early Intervention Referral and Receipt of Services: A Retrospective Cohort Study
Authors: McManus Beth , Richardson Zachary , Schenkman Margaret , Murphy Natalie , Everhart Rachel , Hambidge Simon , Morrato Elaine
Published: February 2020

Background Early Intervention (EI) is a federally mandated, state-administered system of care for children with developmental delays and disabilities under the age of three. Gaps exist in the process of accessing EI through pediatric primary care, and low rates of EI access are well documented and disproportionately affect poor and minority children. The aims of this paper are to examine child characteristics associated with gaps in EI (1) referral, (2) access and (3) service use. To our knowledge, this is the first study to leverage linked safety net health system pediatric primary care and EI records data to follow EI-referred children longitudinally to understand EI service use gaps from EI referral to EI service utilization. Methods In a retrospective cohort design (14,710 children with developmental disability or delay), we linked pediatric primary care records between a large, integrated safety net health system in metro Denver and its corresponding EI program (2014-2016). Using adjusted marginal effects [ME, (95% CI)], we estimated gaps in EI referral, access, and service type (i.e., physical [PT], occupational [OT], speech therapy [ST] and developmental intervention [DI]). Analyses accounted for child characteristics including socio-demographics, diagnosis, condition severity, and baseline function. Results Only 18.7% of EI-eligible children (N=2,726) received a referral; 26% of those (N=722) received services for a net enrollment rate of 5% among EI-eligible children. Having the most severe developmental condition was positively associated with EI referral [ME=0.334 [0.249, 0.420]) and Individualized Family Services Plan (IFSP) receipt [ME=0.156 [0.088, 0.223]). Children less likely to be EI-referred were Black, non-Hispanic (BNH) [ME=-0.029 (-0.054, -0.004)] and had a diagnosed condition ([ME=-0.046 (-0.087, -0.005)]. Children with a diagnosis and those with higher income were more likely to receive PT or OT. Higher baseline cognitive and adaptive skills were associated with lower likelihood of PT [ME=-0.029 (-0.054, -0.004)], OT [ME=-0.029 (-0.054, -0.004)], and ST [ME=-0.029 (-0.054, -0.004)]. Conclusions We identified and characterized gaps in EI referral, access, and service use in an urban safety-net population of children with high rates of developmental delay. Interventions are needed to improve integrated systems of care affecting primary care and EI processes and coordination.
Sugammadex versus neostigmine after rocuronium continuous infusion in patients undergoing liver transplantation.
Authors: DEANA CRISTIAN , Barbariol Federico , D’Incà’ Stefano , Pompei Livia , Rocca Giorgio Della
Published: February 2020

Background Rapid neuromuscular block reversal at the end of major abdominal surgery is recommended to avoid any postoperative residual block. To date, no study has evaluated sugammadex performance after rocuronium administration in patients undergoing liver transplantation. This is a randomized controlled trial with the primary objective of assessing the neuromuscular transmission recovery time obtained with sugammadex versus neostigmine after rocuronium induced neuromuscular blockade in patients undergoing orthotopic liver transplantation. Methods The TOF-Watch SX®, calibrated and linked to a portable computer equipped with TOF-Watch SX Monitor Software®, was used to monitor and record intraoperative neuromuscular block maintained with a continuous infusion of rocuronium. Anaesthetic management was standardized as per our institution's internal protocol. At the end of surgery, neuromuscular moderate block reversal was obtained by administration of 2 mg/kg of sugammadex or 50 mcg/kg of neostigmine (plus 10 mcg/kg of atropine). Results Data from 41 patients undergoing liver transplantation were analysed. In this population, recovery from neuromuscular block was faster following sugammadex administration than neostigmine administration, with mean times±SD of 9.4±4.6 min and 34.6±24.9 min, respectively (p<0.0001). Conclusion Sugammadex is able to reverse neuromuscular block maintained by rocuronium continuous infusion in patients undergoing liver transplantation. The mean reversal time obtained with sugammadex was significantly faster than that for neostigmine. It is important to note that the sugammadex recovery time in this population was found to be considerably longer than in other surgical settings, and should be considered in clinical practice. Trial registration: ClinicalTrials.gov NCT02697929. Keywords: rocuronium, neostigmine, reversal, recovery time, liver transplantation.
Mental distress, perceived need and barriers to receive professional mental health care among university students
Authors: Negash Assegid , Ahmed Matloob , Medhin Girmay , Wondimagegn Dawit , Araya Mesfin
Published: February 2020

Context: There is limited evidence on the extent of the perceived need for professional mental health care and barriers to the delivery of mental distress services among university students in low and middle-income countries. Objective: The current study was designed to assess the prevalence of mental distress, perceived need for professional mental health care and barriers to the delivery of the service for regular undergraduate university students. Methods: A multi-stage sampling technique was used to recruit 1135 regular undergraduate university students. Symptoms of mental distress were evaluated using the Self-Reported Questionnaire (SRQ-20) and a score of eight and above was used to identify positive cases. The perceived need for professional mental health care was assessed using one question with binary responses, whereas barriers to mental health care were assessed using Barriers to Access to Care Evaluation (BACE-30) tool. The association of demographic variables with total mean scores of BACE-III sub-scales was modeled using multiple linear regression. Results: The prevalence of mental distress symptoms was 34.6% and the perceived need for professional mental health care was 70.5%. The top five barriers to receiving professional mental health service were (a) thinking the problem would get better by itself, (b) being unsure where to go to get professional care, (c) wanting to solve the problem by own, (d) denying mental health problem, and (e) preferring to get alternative forms of mental care. Conclusions: The high prevalence of mental distress, mental health care gap, and the report of barriers to professional mental health care among Ethiopian regular undergraduate students is a call for action. Keywords: Mental distress, Perceived need, Barrier, and Professional mental health care.
­­Assessment of Viral RNA in Idiopathic Pulmonary Fibrosis Using RNA-seq
Authors: Yin Qinyan , Strong Michael J , Zhuang Yan , Flemington Erik K , Kaminski Naftali , de Andrade Joao , Lasky Joseph A
Published: February 2020

Background Numerous publications suggest an association between herpes virus infection and idiopathic pulmonary fibrosis (IPF). These reports have employed immunohistochemistry, in situ hybridization and/or PCR, which are susceptible to specificity artifacts. Methods We investigated the possible association between IPF and viral RNA expression using next-generation sequencing, which has the potential to provide a high degree of both sensitivity and specificity. We quantified viral RNA expression for 740 viruses in 28 IPF patient lung biopsy samples and 20 age-matched controls. Key RNA-seq results were confirmed using Real-time RT-PCR for select viruses (EBV, HCV, herpesvirus saimiri and HERV-K). Results We identified sporadic low-level evidence of viral infections in our lung tissue specimens, but did not find a statistical difference for expression of any virus, including EBV, herpesvirus saimiri and HERV-K, between IPF and control lungs. Conclusions To the best of our knowledge, this is the first publication that employs RNA-seq to assess whether viral infections are linked to the pathogenesis of IPF. Our results do not address the role of viral infection in acute exacerbations of IPF, however, this analysis patently did not support an association between herpes virus detection and IPF.
Neoadjuvant chemotherapy-induced decrease of prognostic nutrition index predicts poor prognosis in patients with breast cancer
Authors: Oba Takaaki , Maeno Kazuma , Takekoshi Daiya , Ono Mayu , Ito Tokiko , Kanai Toshiharu , Ito Ken-ichi
Published: February 2020

Background: The prognostic nutritional index (PNI), which is an easily calculated nutritional index, is significantly associated with patient outcomes in various solid malignancies. This study aimed to evaluate the prognostic impact of PNI changes in patients with breast cancer undergoing neoadjuvant chemotherapy (NAC). Methods: We reviewed patients with breast cancer who underwent NAC and a subsequent surgery for breast cancer between 2005 and 2016. PNI before and after NAC were calculated using the following formula: 10 × serum albumin (g/dl) + 0.005 × total lymphocyte count/mm 3 . The relationship between PNI and prognosis was retrospectively analyzed. Results: In total, 191 patients were evaluated. There was no significant difference in disease-free survival (DFS) between the pre-NAC PNI high group and the pre-NAC PNI low group (cutoff: 53.1). However, PNI decreased in 181 patients (94.7%) after NAC and the mean PNI also significantly decreased after NAC from 52.6 ± 3.8 pre-NAC to 46.5 ± 4.4 post-NAC ( p < 0.01). The mean ΔPNI, which was calculated as pre-NAC PNI minus post-NAC PNI, was 5.4. The high ΔPNI group showed significantly poorer DFS than the low ΔPNI group (cut off: 5.26) ( p = 0.015). Moreover, high ΔPNI was an independent risk factor of DFS on multivariate analysis ( p = 0.042). Conclusions: High decrease of PNI during NAC predicts poor prognosis. Thus, maintaining the nutritional status during NAC may result in better treatment outcomes in patients with breast cancer.
Prevalence Of Syphilis, Neurosyphilis And Associated Factors In a Cross-Sectional Analysis Of HIV Infected Patients Attending Bugando Medical Centre Mwanza Tanzania
Authors: Haule Adeodatus Richard , Msemwa Betrand , Mgaya Evarista , Masikini Peter , Kalluvya Samuel
Published: February 2020

BACKGROUND HIV-syphilis co-infection is a combination that enhances rapid progression of early syphilis or late latent syphilis to neurosyphilis and can cause catastrophic neurological complications. In studies in Mwanza, syphilis affects ~8% of healthy outpatients, and older studies have suggested that up to 23.5% of HIV-syphilis co-infected patients also have neurosyphilis
Resources Utilisation and Economic Burden of Percutaneous Vertebroplasty or Percutaneous Kyphoplasty for Treatment of Osteoporotic Vertebral Compression Fractures in China: A Retrospective Claim Database Study
Authors: Yang Dehong , Zhang Yanlei , Ma Xiao , Huo Li , Li Liran , Gao Yue , Xuan Jianwei
Published: February 2020

Background: Osteoporotic vertebral compression fractures (OVCF) is a common and often debilitating complication of osteoporosis, leading to significant morbidity and increased mortality. Percutaneous vertebroplasty (PVP) and Percutaneous kyphoplasty (PKP) are recommendable surgical treatments for OVCF.

Objective: To evaluate PVP/PKP utilisation and their related direct medical costs for OVCF treatment in China from the payer perspective.

Methods: A population-based medical claims database of a metropolitan city in China was analysed from the payer perspective, which included all inpatient claims from 01/01/2015 to 31/12/2017. All vertebral fractures patients that met the eligibility criteria (aged ≥50 years old, having vertebral fracture diagnosis, without unrelated diseases diagnoses such as tumour and scoliosis, received PVP/PKP) were deemed as OVCF patients. Baseline characteristics, surgery rate, length of stay in hospital, time to re-surgery, and costs (including costs per hospitalisation and annual costs) were described. Survival analysis function was used to estimate and re-surgery rate.

Results: Of the 50,686 patients with OVCF identified, 14,527 (28.66%) received a total number of 15,599 records of PVP/PKP surgeries from 2015 to 2017. Mean age was 75 at the first surgery captured in the database analysis period; females accounted for 79.54% of all cases. The median length of surgery stay was 9 days. Cumulative re-surgery rates were 1.22% in 30 days, 2.58% in 90 days, 3.61% in 183 days, 5.42% in one year, and 7.95% in two years. There was no significant difference in re-surgery rate between PVP and PKP (p=0.3897). The median time to the re-surgery was 139 days. Mean costs per PVP/PKP-related hospitalisation were 35,906 CNY/5,122 USD (34,195 CNY/4,878USD for PVP, 44,414 CNY/6,336 USD for PKP, p<0.01). The overall costs of hospitalisation averaged 186.61 million CNY (26.62 million USD) per year in this metropolitan city.

Conclusion: From 2015 to 2017, nearly one-third of OVCF inpatients received PVP/PKP and the re-surgery rate was 7.95%. PVP/PKP procedures for OVCF place a high economic burden for both the healthcare system and patients. Early detection and treatment of patients with osteoporosis are critical in China.

Keywords: OVCF; percutaneous vertebroplasty; percutaneous kyphoplasty; surgery; costs
Characterization of the Interleukin-17 Effect on Articular Cartilage in a Translational Model. An Explorative Study
Authors: Sinkeviciute Dovile , Aspberg Anders , He Yi , Bay-Jensen Anne-Christine , Önnerfjord Patrik
Published: February 2020

Background
Osteoarthritis (OA) is a progressive, chronic disease characterized by articular cartilage destruction. The pro-inflammatory cytokine IL-17 levels have been reported elevated in serum and synovial fluid of OA patients and correlated with increased cartilage defects and bone remodeling. The aim of this study was to characterize an IL-17-mediated articular cartilage degradation ex-vivo model and to investigate IL-17 effect on cartilage extracellular matrix protein turnover.
Methods
Full-depth bovine femoral condyle articular cartilage explants were cultured in serum-free medium for three weeks in the absence, or presence of cytokines: IL-17A (100 ng/ml or 25 ng/ml), or 10 ng OSM combined with 20 ng/ml TNFα (O+T). RNA isolation and PCR analysis were performed on tissue lysates to confirm IL-17 receptor expression. GAG and ECM-turnover biomarker release into conditioned media was assessed with dimethyl methylene blue and ELISA assays, respectively. Gelatin zymography was used for matrix metalloproteinase (MMP) 2 and MMP9 activity assessment in conditioned media, and shotgun LC-MS/MS for identification and label-free quantification of proteins and protein fragments in conditioned media. Western blotting was used to validate MS results.
Results
IL-17RA mRNA was expressed in bovine articular cartilage and the treatment with IL-17A did not interfere with metabolic activity of the model. IL-17A induced cartilage breakdown; conditioned media GAG levels were 3.6-fold-elevated compared to untreated. IL-17A [100 ng/ml] induced ADAMTS-mediated aggrecan degradation fragment release (14-fold increase compared to untreated) and MMP-mediated type II collagen fragment release (6-fold-change compared to untreated). MS data analysis revealed 16 differentially expressed proteins in IL-17A conditioned media compared to untreated. CHI3L1 upregulation in conditioned media in response to IL-17A was confirmed by Western blotting.
Conclusions
We showed that IL-17A has cartilage modulating potential. It induces collagen and aggrecan degradation indicating an upregulation of MMPs. This was confirmed by zymography and mass spectrometry data. We also showed that the expression of other cytokines is induced by IL-17A, which provide further insight to the pathways that are active in response to IL-17A. This exploratory study confirms that IL-17A may play a role in cartilage pathology and that the applied model may be a good tool to further investigate it.
Specific humoral response in cancer patients treated with a VEGF-specific active immunotherapy procedure within a compassionate use program.
Authors: Ramírez Javier Sánchez , Díaz Yanelys Morera , Bequet-Romero Mónica , Hernández-Bernal Francisco , Bauta Yenima Martín , Bernal Katty-Hind Selman-Housein , Santos Ana Victoria de la Torre , Iglesia Mariela Pérez de la , Lorenzo Lian Trimiño , Program Team of Investigators of Compassionate use , Avila Marta Ayala
Published: February 2020

Background: CIGB-247 is a cancer therapeutic vaccine that uses as antigen a variant of human vascular endothelial growth factor (VEGF) mixed with the bacterially-derived adjuvant VSSP. CIGB-247 has been already evaluated in two phase I clinical trials (CENTAURO and CENTAURO-2), showing to be safe and immunogenic in advanced cancer patients selected under well-defined and controlled clinical conditions. Surviving patients were submitted to monthly re-immunizations and some of them showed objective clinical benefits. Based on these results, a compassionate use program (CUP) with CIGB-247 was initiated for patients that did not meet the strict entry criteria applied for the CENTAURO and CENTAURO-2 clinical trials, but could potentially benefit from the application of this cancer therapeutic vaccine.
Results: Polyclonal IgM, IgA and IgG antibodies specific for VEGF were detected by ELISA in serum samples from patients vaccinated with 400 µg of antigen combined with 200 µg of VSSP. Polyclonal antibody response showed no cross reactivity for other VEGF family member molecules like VEGF-C and VEGF-D. Serum from immunized individuals was able to block the binding of VEGF to its receptors VEGFR2 and VEGFR1. IgG fraction purified from immune sera shared the aforementioned characteristics and also inhibited the interaction between VEGF and the therapeutic recombinant antibody bevacizumab, an anti-angiogenic drug approved for the treatment of different tumors. No serious adverse events attributable to CIGB-247 have been documented yet in participants of the CIGB-247 CUP.
The present paper is a first report of our findings concerning the humoral response and safety characteristics in treated CIGB-247 CUP cancer patients. The study has provided the unique opportunity of not only testing CIGB-247 in a broader clinical spectrum sample of Cuban cancer patients, but also within the context of the day-to-day clinical practice and treatment settings for these diseases in Cuban medical institutions.
Conclusions: The CIGB-247 CUP has demonstrated that immunization and follow-up of a variety of cancer patients, under day-to-day clinical practice conditions in several Cuban medical institutions, replicate our previous findings in clinical trials: CIGB-247 is safe and immunogenic.
In search of universal health coverage – highlighting the accessibility of health care to students with disabilities in Ghana: a qualitative study
Authors: Abodey Eric , Vanderpuye Irene , Mensah Isaac , Badu Eric
Published: February 2020

Background: Accessibility of health care to students with disabilities is a global concern. This is no less important in Ghana, however, to date, no study has been undertaken regarding access to health care to students with disabilities. This study, therefore, aims to explore the accessibility of health care to students with disabilities, in the quest of achieving universal health coverage in Ghana.
Methods: Qualitative methods, involving in-depth interviews were employed to collect data from 54 participants (29 students with disabilities, 17 health workers and 8 school mothers), selected through purposive sampling. Thematic analysis was used to analyze the data.
Results : The study identified three themes – accessibility, adequacy, and affordability. The study findings highlighted that universal health coverage for students with disabilities has not been achieved due to barriers in accessing health care. The barriers faced by students with disabilities were unfriendly physical environments, structures, equipment, limited support services and poor health insurance policy to finance health care.
Conclusion : The study concludes that the government should prioritize disability-related issues in health policy formulation, implementation and monitoring. The current provisions and requirements in the disability act should be prioritized, enforced and monitored to ensure adequate inclusion of disability issues in health services. Further, the current exemption policy under the National Health Insurance Scheme should be revised to adequately address the needs of people with disabilities.
Serum osteocalcin level is associated with the mortality in Chinese patients with Fibrodysplasia ossificans progressiva aged ≤18 years at diagnosis
Authors: She Dunmin , Li Ran , Fang Ping , Zong Guannan , Xue Ying , Zhang Keqin
Published: February 2020

Background Fibrodysplasia ossificans progressive (FOP) is an ultra-rare genetic disorder characterized by extraskeletal heterotopic ossification. It is well recognized that FOP can lead to a devastating condition of disability. However, the mortality rate of FOP patients in China and risk factors for mortality are still largely unclear.
Methods We conducted a retrospective research on a cohort of 65 cases of FOP patients in China from 2008 to 2018. We reviewed medical records of these FOP patients to retrieve information such as date of birth/death, gender, clinical features, genotypes and biochemical parameters and analyze the correlation of these parameters with the mortality.
Results 92.3% (60/65 cases) patients were classic FOP patients, 3.1% (2/65 cases) were FOP-plus and 4.6% (3/65 cases) were FOP variants. 9 cases of this cohort were dead during the ten-year period, and the overall mortality rate was 13.8%. c.617G>A mutation was confirmed in all non-survivors. In FOP patients≤18 years at diagnosis, non-survivors demonstrated significantly lower blood osteocalcin and alkaline phosphatase levels compared with survivors ( P <0.05), and spearman correlation and logistic regression analysis indicated that serum osteocalcin and alkaline phosphatase levels were negatively correlated with the mortality. Furthermore, the receiver-operating characteristic curve analysis showed serum osteocalcin had the largest area under the curve of 0.855 among four biochemical parameters, and serum osteocalcin < 65.9 ng/ml displayed a good capacity to discriminate the non-survivors from survivors in FOP patients aged 18 years and younger at diagnosis.
Conclusions Our findings showed that the mortality rate of FOP was 13.8% in China. Serum OC level was negatively correlated with the mortality in Chinese FOP patients ≤18 years at diagnosis.
【 Key words 】Fibrodysplasia ossificans progressive (FOP); mortality; risk factors; osteocalcin
Comparison of videolaryngoscopy and direct laryngoscopy by German paramedics during out-of-hospital cardiopulmonary resuscitation. An observational prospective study.
Authors: Risse Joachim , Volberg Christian , Kratz Thomas , Plöger Birgit , Jerrentrup Andreas , Pabst Dirk , Kill Clemens
Published: February 2020

Introduction: Videolaryngoscopy (VL) has become a popular method of intubation (ETI). Although VL may facilitate ETI in less-experienced rescuers there are limited data available concerning ETI performed by paramedics during CPR. The goal was to evaluate the impact VL compared with DL on intubation success and glottic view during CPR performed by German paramedics. We investigated in an observational prospective study the superiority of VL by paramedics during CPR compared with direct laryngoscopy (DL). Methods: In a single Emergency Medical Service (EMS) in Germany with in total 32 ambulances paramedics underwent an initial instruction from in endotracheal intubation (ETI) with GlideScope ® (GVL) during resuscitation. The primary endpoint was good visibility of the glottis (Cormack-Lehane grading 1/2), and the secondary endpoint was successful intubation comparing GVL and DL. Results: In total n = 97 patients were included, n = 69 with DL (n = 85 intubation attempts) and n = 28 VL (n = 37 intubation attempts). Videolaryngoscopy resulted in a significantly improved visualization of the larynx compared with DL. In the group using GVL, 82% rated visualization of the glottis as CL 1&2 versus 55% in the DL group (p = 0.02). Despite better visualization of the larynx, there was no statistically significant difference in successful ETI between GVL and DL (GVL 75% vs. DL 68.1%, p = 0.63). Conclusions: We found no difference in Overall and First Pass Success (FPS) between GVL and DL during CPR by German paramedics despite better glottic visualization with GVL. Therefore, we conclude that education in VL should also focus on insertion of the endotracheal tube, considering the different procedures of GVL.
A study of Capecitabine Metronomic Chemotherapy is noninferior to Conventional Chemotherapy as Maintenance Strategy in Responders After Induction Therapy in Metastatic Colorectal Cancer
Authors: Shi Min , Ma Tao , Xi Wenqi , Jiang Jingling , Wu Junwei , Zhou Chenfei , Yang Chen , Zhu Zhenggang , Zhang Jun
Published: February 2020

Background: The aim of this study is to demonstrate that capecitabine metronomic chemotherapy is non-inferior to capecitabine conventional chemotherapy as maintenance treatment, who have responded to 16-18 weeks first-line chemotherapy in metastatic colorectal cancer (mCRC).
Methods: The study design is a prospective, randomized, open label, phase II clinical trial. Those mCRC patients who respond well after 16-18 weeks of standard doublet chemotherapy as induction may enrolled into this study, randomly divided into capecitabine metronomic group or standard dosage group. The duration of disease control after randomization and progression free survival from enrollment are primary endpoints. Meanwhile, the overall survival, safety and quality of life are secondary endpoints. The sample size required to achieve the research objectives of this project is 79 cases in each group. The study recently started on 29-01-2018, and will last for 36 months.
Discussion: This project intends to study the efficacy and safety of capecitabine metronomic chemotherapy in the maintenance treatment of advanced colorectal cancer, and to explore the strategy of "low toxicity, high efficiency, economy and individualization" which is suitable for China's national conditions and pharmacoeconomics. It has great clinical application prospects and clear socio-economic value.
Clinicopathological variables influencing overall survival, recurrence and post-recurrence survival in resected stage I non-small-cell lung cancer
Authors: Wang Chengdi , Wu Yuxuan , Shao Jun , Liu Dan , Li Weimin
Published: February 2020

Background: To investigate clinicopathological variables influencing overall survival, overall recurrence, and post-recurrence survival (PRS) in patients who experienced curative-intent surgical resection of stage I non-small-cell lung cancer (NSCLC). Methods: We investigated a series of 1,387 patients with stage I NSCLC who underwent surgical resection from 2008 to 2015. The effect clinicopathological factors on death, recurrence, and PRS were evaluated by Kaplan-Meier estimates and cox regression analysis. Results: Among the 1,387 stage I patients, 301 (21.7%) experienced recurrence. The 5-year cumulative incidence of recurrence (CIR) for all patients was 20.2% and median PRS was 25.5 months. The older age ( P =0.036), p-stage IB ( P =0.001), sublobar resection( P ＜0.001), histology subtype ( P ＜0.001), and lymphovascular invasion (LVI) ( P =0.042) were significantly associated with worse overall survival. Among 301 recurrent patients, univariable analysis indicated that p-stage IB (versus IA) ( P ＜0.001), LVI ( P ＜0.001) and visceral pleural invasion (VPI) ( P ＜0.001) were remarkably correlated with the higher incidence of recurrence. Taking the effect of clinicopathological variables on PRS into consideration, smoking history ( P =0.043), non-adenocarcinoma ( P =0.013), high architectural grade of LUAD ( P =0.019), EGFR wild status ( P =0.002), bone metastasis ( P =0.042) and brain metastasis ( P =0.040) were substantially related with poorer PRS. Multivariate analysis demonstrated that high architectural grade of LUAD (P=0.008), brain metastasis ( P =0.010) and bone metastasis ( P =0.043) were independently associated with PRS. Conclusion: In patients with resected stage I NSCLC, the older age, p-stage IB (versus IA), sublobar resection, histology subtype, and LVI were significantly associated with worse overall survival. P-stage IB (versus IA), LVI, and VPI were significantly correlated with the higher incidence of recurrence. High architectural grade of LUAD, brain metastasis and bone metastasis were independent risk factors with PRS.
Characterization of the interactions between Codanin-1 and C15Orf41, two proteins implicated in Congenital dyserythropoietic anemia type I disease
Authors: Swickley Grace , Bloch Yehoshua , Malka Lidor , Meiri Adi , Noy-Lotan Sharon , Yanai Amiel , Tamary Hannah , Motro Benny
Published: February 2020

Background Congenital dyserythropoietic anemia type I (CDA I), is an autosomal recessive disease with macrocytic anemia in which erythroid precursors in the bone marrow exhibit pathognomonic abnormalities including spongy heterochromatin and chromatin bridges. We have shown previously that the gene mutated in CDA I encodes Codanin-1, a ubiquitously expressed and evolutionarily conserved large protein. Recently, an additional etiologic factor for CDA I was reported, C15Orf41, a predicted nuclease. Mutations in both CDAN1 and C15Orf41 genes results in very similar erythroid phenotype. However, the possible relationships between these two etiologic factors is not clear. Results We demonstrate here that Codanin-1 and C15Orf41 bind to each other, and that Codanin-1 stabilizes C15Orf41. C15Orf41 protein is mainly nuclear and Codanin-1 overexpression shifts it to the cytoplasm. Phylogenetic analyses demonstrated that even though Codanin-1 is an essential protein in mammals, it was lost from several diverse and unrelated animal taxa. Interestingly, C15Orf41 was eliminated in the exact same animal taxa. This is an extreme case of the Phylogenetic Profiling phenomenon, which strongly suggests common pathways for these two proteins. Lastly, as the 3D structure is more conserved through evolution than the protein sequence, we have used the Phyre2 alignment program to find structurally homologous proteins. We found that Codanin-1 is highly similar to CNOT1, a conserved protein which serves as a scaffold for proteins involved in mRNA stability and transcriptional control. Conclusions The physical interaction and the stabilization of C15Orf41 by Codanin-1, combined with the phylogenetic co-existence and co-loss of these two proteins during evolution, suggest that the major function of the presumptive scaffold protein, Codanin-1, is to regulate C15Orf41 activities. The similarity between Codanin-1 and CNOT1 suggest that Codanin-1 is involved in RNA metabolism and activity, and opens up a new avenue for the study of the molecular pathways affected in CDAI.
Identification of the regulatory networks and hub genes controlling alfalfa floral pigmentation variation using RNA-sequencing analysis
Authors: Duan Hui-Rong , Wang Li-Rong , Cui Guang-Xin , Zhou Xue-Hui , Duan Xiao-Rong , Yang Hongshan
Published: February 2020

Background: To understand the gene expression networks controlling flower color formation in alfalfa, flowers anthocyanins were identified using two materials with contrasting flower colors, namely Defu and Zhongtian No. 3, and transcriptome analyses of PacBio full-length sequencing combined with RNA sequencing were performed, across four flower developmental stages. Results: Malvidin and petunidin glycoside derivatives were the major anthocyanins in the flowers of Defu, which were lacking in the flowers of Zhongtian No. 3. The two transcriptomic datasets provided a comprehensive and systems-level view on the dynamic gene expression networks underpinning alfalfa flower color formation. By weighted gene coexpression network analyses, we identified candidate genes and hub genes from the modules closely related to floral developmental stages. PAL, 4CL, CHS, CHR, F3’H, DFR, and UFGT were enriched in the important modules. Additionally, PAL6, PAL9, 4CL18, CHS2, 4 and 8 were identified as hub genes. Thus, a hypothesis explaining the lack of purple color in the flower of Zhongtian No. 3 was proposed. Conclusions: These analyses identified a large number of potential key regulators controlling flower color pigmentation, thereby providing new insights into the molecular networks underlying alfalfa flower development.
Clinically useful prediction of hospital admissions in an older population
Authors: Marcusson Jan , Nord Magnus , Dong Huan-Ji , Lyth Johan
Published: February 2020

Background: The healthcare for older adults is insufficient in many countries, not designed to meet their needs and is often described as disorganized and reactive. Prediction of older persons at risk of admission to hospital may be one important way for the future healthcare system to act proactively when meeting increasing needs for care. Therefore, we wanted to develop and test a clinically useful model for predicting hospital admissions of older persons based on routine healthcare data.

Methods : We used the healthcare data on 40,728 persons, 75-109 years of age to predict hospital in-ward care in a prospective cohort. Multivariable logistic regression was used to identify significant factors predictive of unplanned hospital admission. Model fitting was accomplished using forward selection. The accuracy of the prediction model was expressed as area under the receiver operating characteristic (ROC) curve, AUC.

Results: The prediction model consisting of 38 variables exhibited a good discriminative accuracy for unplanned hospital admissions over the following 12 months (AUC 0·69 [95% confidence interval, CI 0·68–0·70]) and was validated on external datasets. Clinically relevant proportions of predicted cases of 40 or 45% resulted in sensitivities of 62 and 66%, respectively. The corresponding positive predicted values (PPV) was 31% and 29%, respectively.

Conclusion : A prediction model based on routine administrative healthcare data from older persons can be used to find patients at risk of admission to hospital. Identifying the risk population can enable proactive intervention for older patients with as-yet unknown needs for healthcare.