bluuebunny/crossref_metadata_2025 huggingface dataset:
Changes in Lumbosacral Anatomy and Vertebral Numbering in Patients with Thoracolumbar and/or Lumbosacral Transitional Vertebrae
Authors: Tatara Yasunori , Niimura Takanori , Sekiya Tatsuhiro , Mihara Hisanori
Published: July 2021

Background:

The presence of a thoracolumbar transitional vertebra (TLTV) and/or lumbosacral transitional vertebra (LSTV) may cause wrong-site surgery and problems while measuring spinopelvic parameters, including pelvic incidence and lumbar lordosis. The Castellvi classification of LSTV addresses coronal images but not sagittal or axial images. Therefore, it is unclear how LSTV differs from the normal lumbosacral anatomy. We aimed to investigate the lumbosacral anatomy and vertebral numbering in patients with TLTV and/or LSTV. We performed computed tomography (CT) to identify TLTV, to number presacral vertebrae accurately, and to analyze morphological differences in each LSTV type.

Methods:

The medical records of 880 patients who underwent spinopelvic fixation between July 2014 and March 2020 were evaluated for TLTV and LSTV. Castellvi LSTVs (above the promontory on the arcuate line of the ilium) and our newly proposed LSTV (“S6 LSTV,” with 6 sacral vertebrae and 5 foramina below the promontory) were analyzed. The anatomical location of the lowest thoracic vertebra was defined, and TLTV with dysplastic ribs was identified. Each LSTV type was examined for its morphological features on sagittal and axial CT images.

Results:

LSTV was observed in 111 (12.6%) of 880 patients. Castellvi type-III LSTV was the most common (42 [37.8%] of 111), followed by S6 LSTV (37 [33.3%] of 111). TLTV was associated with LSTV (87 [78.4%] of 111) and was commonly identified at T13 (59 [67.8%] of 87). On sagittal CT images, the lumbosacral transitional anatomy of Castellvi LSTVs resembled that of normal L5-S1, and the lumbosacral transitional anatomy of S6 LSTV resembled that of normal S1-S2. When comparing the S1 upper segments on axial CT images, most Castellvi LSTVs exhibited S2-like appearances and most S6 LSTVs exhibited L5-like appearances.

Conclusions:

Although LSTV possesses L5 and S1 features, Castellvi LSTVs have more L5 elements than S1 elements. The converse is true for S6 LSTV. At least for the Castellvi type-IIIb LSTV, the vertebra below the Castellvi type-IIIb LSTV should be recognized as S1, but clinically it is better to recognize it as S2. Overlooking TLTV may cause problems in vertebral numbering due to coexisting LSTV.

Clinical Relevance:

Three-dimensional CT images are suitable for detecting transitional vertebrae. This study reveals their morphological features on axial CT images and their lumbosacral anatomy on sagittal CT images.
Metrics of Success for Nearshore Nourishment Projects Constructed with Dredged Sediment
Authors: McFall Brian C. , Krafft Douglas R. , McCaw Hande , Walker Brooke M.
Published: July 2021

This Regional Sediment Management Technical Note (RSM TN) provides practical metrics of success for nearshore nourishment projects constructed with dredged sediment. Clearly defined goals and performance metrics for projects will set clear expectations and will lead to longterm project support from local stakeholders and the public.
Tectonic–sedimentary interplay of a confined deepwater system in a foreland basin setting: the Pennsylvanian lower Atoka Formation, Ouachita Mountains, U.S.A.
Authors: Hou Pengfei , Wood Lesli J. , Jobe Zane R.
Published: July 2021

Submarine fans deposited in structurally complex settings record important information on basin evolution and tectonic–sedimentary relationships but are often poorly preserved in outcrops due to syndepositional and post depositional deformation. This study aims to understand the influence of tectonics on the deposition of the synorogenic Pennsylvanian lower Atoka submarine fan system deposited in a structurally complex foreland basin during the Ouachita orogeny. This study is a synthesis of new outcrop stratigraphic data as well as published stratigraphic and structural data. The lower Atoka crops out in the Ouachita Mountains and the southern Arkoma Basin and is divided into three structural–depositional zones: the foredeep, the wedge top, and the continental foreland. The mean paleoflow is axial, and each zone exhibits unique patterns in facies distribution. The foredeep consists of two fan systems, a large westward-prograding fan that exhibits significant longitudinal and lateral facies changes, and a small eastward-prograding fan on the western part. The wedge top consists of a westward-prograding fan that exhibits subtle longitudinal facies change. The continental foreland consists of small slope fan systems along the northern and western margins. By comparing to basin morphology and structural styles, we interpret the facies distribution patterns in the three zones as the result of different combinations of lateral structural confinement, axial and lateral sediment supply, and paleogeography. This study provides an improved and comprehensive understanding of the lower Atoka deepwater system and has implications for deciphering the tectonic–sedimentary relationships in laterally confined submarine fan systems.
Long-term analysis of River Tisza water level data with regard to the ecological water demand of floodplain water bodies
Authors: Dévai György , Gyöngy Martina , Berta Csaba , Bogár Ferenc , Bogár Imre , Varga György , Zoltán Lucza , Szabó László József , Somlyai Imre , Nagy Sándor Alex , Grigorszky István
Published: July 2021

One of the main threats of our time is the increasing water demand not only globally, but also locally. These are often met at the expense of ecological water demand, jeopardizing the structural and operational conditions necessary to maintain good ecological status in aquatic and wetland habitats. This is why it is of great importance to explore possible water retention options. In 2019, based on the long-term data series on the water level of River Tisza, we studied the frequency and extent of flooding in the floodplain between Tiszabercel and Gávavencsellő, where there are valuable wetlands, including a ‘sanctuary’-type backwater. This was necessary because recently the floodplains have undergone negative changes. Their water volume has gradually decreased, their valuable wildlife has become rarer, some of them have completely dried out in the autumn and even one of them has burned out. From the analysis of the examined 48-years data, it could be concluded that flooding was relatively frequent in the sampled area, but the extent of water coverage had no significant effect either in space or time. It was also found that only water levels above 700 cm (based on the water meter of Tiszabercel, 98.36 mBf) could adequately ensure that the water bodies are filled up and flushed out. However, there is little chance of this, because of four reasons: (1) water levels of this height are becoming rare; (2) the duration and height of high water levels are mostly short in time; (3) water levels of several water bodies are artificially decreased; (4) the drainage effect of the River Tisza – which has been significantly incised after the river regulation – prevails in the area. Due to all, in the future, there would be a great need to maintain the water levels in the floodplain wetlands as efficiently as possible after the floods – for which we have made specific proposals for the places and methods to preserve the ecologically necessary amount of water.
СТРАТЕГИЯ УСТОЙЧИВОГО РАЗВИТИЯ ЭНЕРГЕТИКИ РЕСПУБЛИКИ БЕЛАРУСЬ: АНАЛИЗ И ОСНОВНЫЕ ТЕНДЕНЦИИ
Authors: ЗОРИНА Т.
Published: July 2021

В статье проведен кластерный анализ 149 стран мира и выделены 12 кластеров по уровню энергетического потенциала данных стран. На основе изучения программно-нормативных документов, характеризующих их политику в области энергетики, определены стратегии каждой страны в области устойчивого развития отрасли. С помощью дискриминантного анализа выявлено соответствие стратегий устойчивого развития энергетическому потенциалу исследуемых стран. Выделены проблемы в области энергетической политики и предложены пути по ее совершенствованию. Определены основные направления реализации стратегии устойчивого развития энергетики Республики Беларусь.
ПРОБЛЕМЫ КЛАССИФИКАЦИИ И ОЦЕНКИ ТРАНСАКЦИОННЫХ ИЗДЕРЖЕК НА МИКРОЭКОМИЧЕСКОМ УРОВНЕ
Authors: КСЕНЗОВА В. , КСЕНЗОВ С. , БАКУМЕНКО И.
Published: July 2021

В последнее время возрастает интерес к проблемам измерения и оптимизации трансакционных издержек как на микро-, так и на макроэкономическом уровнях. Это обусловлено актуальностью такой
проблемы, как повышение конкурентоспособности как продукции отдельных фирм на внутреннем и внешнем рынках, так и в целом национальной экономики. Несомненная и объективная взаимосвязь микрои макроэкономического уровней в рамках национальной экономики позволяют сделать вывод, что оптимизация всех издержек, включая трансакционные, на микроэкономическом (или чуть более широко –
мезоэкономическом) уровне является условием и фактором оптимизации ТИ макроэкономического уровня. Однако оптимизация возможно при четком и желательно однозначном представлении о сущности
оптимизируемого объекта, что в случае с трансакционными издержками предполагает также и представление об их разновидностях, или классификации.
Incoherent at Heart: The EU’s economic and migration policies towards North Africa
Authors: Uzelac Sarah
Published: July 2021

Pre-pandemic, EU policies towards North Africa, especially Tunisia and Morocco, focused on two main paradigms: trade liberalization and the minimization of both regular and irregular migration. These agendas were incoherent and had overwhelmingly negative implications for the livelihoods and employment opportunities within the EU for the most vulnerable people in the Maghreb. As the coronavirus impacts continue to wreak havoc on world economies, any future negotiations on the Deep and Comprehensive Free Trade Areas (DCFTAs) ought to be geared towards supporting fair and inclusive recovery in North Africa based on reducing inequality and promoting shared prosperity and development.
Study of the Parametric Effects on Soliton Propagation in Optical Fibers through Two Analytical Methods
Authors: Islam Md. Ekramul , Akbar M. Ali
Published: July 2021

The dual-core optical fiber has significant applications in optical electronics for long-wave propagation, especially in telecommunication fibers. The aim of this article is to study the parametric effects on solitary wave propagation and characteristic aspects of long-wave traveling through optical fibers by establishing some standard and wide-spectrum solutions via the improved Bernoulli sub-equation function (IBSEF) method and the new auxiliary equation (NAE) approach. The investigated solitary wave solutions are ascertained as an integration of hyperbolic, exponential, rational and trigonometric functions and can be extensively applicable in optics. The physical significance of the solutions attained is illustrated for the definite values of the included parameters through depicting the 3D profiles. The solitons profile represents different types of waves associated with the free parameters which are related to the wave number and velocity of the solutions. It turns out that the obtained solutions through both the methods are potential and might be used in further works to interpret the various fields in telecommunication fiber which can reduce casualties that ensue in essence.
Comparing the Köppen-Geiger, Feddema, and UNEP Climate Classifications: An Application to Iran
Authors: Raziei Tayeb
Published: July 2021

This study introduces the climates of Iran defined by Köppen-Geiger, Feddema’s, and UNPEP classifications that applied to a high-resolution ground-based gridded data set relative to the 1985–2017 period. Ten Köppen-Geiger climate types were found for Iran, from which Bwh, Bsk, Csa, Bsh, and Bwk cumulatively account for more than 98% of the territory. Likewise, from 36 possible Feddema’s climate types, Iran possesses fifteen climate types from which the Dry Cool, Semiarid Torrid, Semiarid Hot, Semiarid Warm, Dry warm, Semiarid Cool, and Moist Cool climates collectively occupied approximately 93% of the country. Similarly, arid, semi-arid, humid, and sub-humid UNEP climate types characterized more than 98% of Iran. A few other vertically stratified climates appeared at the highlands of Iran just because of changes in elevation and slope aspects of the mountains. The combined effect of topography and vicinity to sea also creates very distinct climate types in northern Iran. The climate maps of the three used methods reflect the joint effects of topography, latitudinal variation, and land/sea surface contrast on the climate of Iran. A pairwise comparison made between the three classifications showed a satisfactory agreement between the three schemes in representing the main climate types of Iran.
Apelin Over-Expression Promotes Proliferation and Angiogenesis of Gastric Cancer Cells
Authors: Tian Li-Jun , Liu Hong-Zhi , Zhang Qiang , Geng Dian-Zhong , Yang Jing , Geng Hai-Tao , Zhai Yu-Jie , Huo Yu-Qing , Hao Yan-Zhang
Published: July 2021

Background: Apelin is a recently identified endogenous ligand associated with proliferation and angiogenesis of several cancers. However, only few studies have reported on the functions and the role of apelin in gastric cancer (GC). Therefore, in the present study, we investigated the association and the mechanisms underlying Apelin expression and proliferation of GC cells both in vitro and in vivo.Methods: We enrolled 178 postoperative care GC patients to investigate clinicopathological and immunohistochemical factors associated with Apelin expression. The relationship between Survival of patients and apelin expression was evaluated using Kaplan-Meier method and Cox regression analyses. The expression of apelin mRNA and its proteins in GC tissues and cell lines were analyzed using quantitative real-time reverse transcription-polymerase chain reaction (RT-PCR), western blot and ELISA. The role and mechanisms underlying regulation of Apelin expression in human GC cells were evaluated through several in vitro and in vivo experiments. Results: Apelin was over expressed in human GC cells, relative to adjacent normal tissues. The over expression of apelin was associated with vessel invasion (P <0.01), lymph node metastasis (P <0.01), late-staged tumor (T) (P <0.05), worse pathological type (P <0.05), nerve invasion (P <0.05). In addition, expression of apelin strongly and positively correlated with that of vascular endothelial growth factor (VEGF). Over-expression of apelin promoted proliferation and invasion of MGC-803 cell via the ERK/Cyclin D1/MMP-9 signaling pathway. Apelin over-expression also promoted angiogenesis of GC cells, accelerating growth of subcutaneous xenograft of the cancer cells in vivo.Conclusions: Over-expression of apelin promotes proliferation and metastasis of GC cells via the ERK/Cyclin D1/MMP-9 signaling pathway and is associated with adverse events of the cancer. Consequently, apelin is a potential therapeutic target for human GC.
Exploring the Association Between Prostate Cancer Diagnosis per se and use of GnRH Agonists and Diabetes Control in Men with type 2 Diabetes Mellitus: A Nationwide, Population-Based Cohort Study
Authors: Lin E , Garmo Hans , Hemelrijck Mieke , Adolfsson Jan , Stattin Pär , Zethelius Björn , Crawley Danielle
Published: July 2021

Background: Gonadotropin Releasing Hormones agonists (GnRH), which are first line treatment for metastatic prostate cancer (PCa), increase risk of type 2 diabetes mellitus (T2DM). This study aims to quantify the association of use of GnRH with diabetes control in PCa men with T2DM.Methods: Nationwide population-based cohort study in the Swedish National Diabetes Register and Prostate Cancer data Base Sweden 4.1, on the association between GnRH and diabetes control in T2DM men with PCa by comparing T2DM men with PCa vs. without PCa, as well as comparing T2DM men with PCa on or not on GnRH. The primary exposure was use of GnRH. Worsening diabetes control was the primary outcome, defined as: 1) increase of HbA1c to 58 mmol/mol or higher; 2) HbA1c increase by 10 mmol/mol or more; 3) Start of antidiabetic drugs or switch to insulin; 4) combine all definitions above. Cox proportional hazards regression was used to analyze the association. Results: There were 5,714 T2DM men with PCa of whom 692 were on GnRH and 28,445 PCa-free men with T2DM with similar baseline characteristics. Diabetes control was worse in men with GnRH vs. PCa-free men (HR: 1.24, 95% CI: 1.13-1.34) as well as compared with PCa men without GnRH (HR:1.58, 95% CI: 1.39-1.80). Conclusion: Use of GnRH in T2DM men with PCa was associated with worse glycemic control. The findings highlight the need to closely monitor diabetes control in men with T2DM and PCa starting GnRH agonists and to limit the duration of their use when possible.
Clinical Analysis of 47 Cases of Heterotopic Pregnancy After Assisted Reproductive Technology
Authors: Bei Qiaoli , Liu Huanrong , Xu Shaohua
Published: July 2021

Background: Heterotopic pregnancy is rare in natural pregnancy. In recent years, with the development of assisted reproductive technology, the incidence of heterotopic pregnancy is increasing. Heterotopic pregnancy not only affects the development of intrauterine embryo, but also threatens the life of patients. There is no unified standard for the treatment of heterotopic pregnancy until now. So we research the clinical features and the effect of different intervention time on pregnancy outcome in patients with heterotopic pregnancy (HP) after assisted reproductive technology (ART).Methods: A retrospective analysis was conducted on the patients who were diagnosed as HP in Shanghai first maternal and infant hospital after conception through ART from January 2014 to June 2019. We analyzed the clinical characteristics, therapeutic method and intervention time to explore their impact on the outcome of HP.Results：47 patients with HP after ART were treated in our hospital and have complete clinical data. Among them, 18 cases treated with conservative therapy and 29 cases treated with operation. 29 cases delivered (including 3 cases of pre-term birth and 26 cases of full-term birth) and 18 cases aborted. In HP patients, β Human chorionic gonadotropin (β-HCG, 0.617) and extrauterine mass size (0.242) are not much guiding significance for the treatment. Transvaginal ultrasonography (TVS) examination on admission found that different conditions of ectopic (anechoic area, adnexal mass, heart beat, yolk sac) was independent risk factors of different treatment methods (P=0.005). And the intervention time before six weeks can get better pregnancy outcome (p=0.034).Conclusions：Patients with ART should be examined by TVS as early as possible. If abnormal TVS (anechoic area, adnexal mass, heart beat, yolk sac) results are found, patients should be operated by laparoscopy. And the best intervention time of laparoscopy is before 6 weeks.
Characterization of W-Mn-Ce-Ti Oxides Catalysts Prepared by Different Methods for Selective Reduction of NO with NH3
Authors: Li Xiaodi , Han Zhitao , Shi Qingdong , Wu Xitian , Gao Yu , Li Chenglong , Liu Gang
Published: July 2021

Aiming to develop low cost and environmentally friendly SCR catalysts, various transition metals and rare earth elements have been used and combined to prepare polymetallic oxide catalysts in recent years, which generally exhibit excellent SCR performance. Here four typical metal elements (Mn, Ce, W and Ti) have been selected to prepare polymetallic oxides (WMnCeTiOx) catalysts, and the effects of preparation methods, such as coprecipitation (CP), sol-gel (SG), and deposition precipitation (DP), on the performance of selective catalytic reduction of NO with NH3 at 160~360 ºC have been investigated systematically. Some key techniques of XRD, BET, XPS, H2-TPR, NH3-TPD and in-situ DRIFTS were used to characterize the physicochemical properties of the prepared WMnCeTiOx catalysts. The SCR activity measurement results showed that NH3-SCR activities of WMnCeTiOx catalysts prepared through coprecipitation and deposition precipitation methods exhibited much better NO removal performance in the temperature range of 160~360 ºC than that prepared via sol-gel method. More importantly, WMnCeTiOx catalysts prepared through coprecipitation method exhibited superior SO2 and H2O tolerance compared with those prepared via deposition precipitation and sol-gel methods. It demonstrated that the preparation process imposed a crucial impact on the physicochemical properties of the prepared WMnCeTiOx catalysts, thus influencing on their SCR performance. According to the characterization results, the better performance of WMnCeTiOx(CP) catalyst could be ascribed to its higher concentrations of Mn4+ and Ce3+, larger surface area and highly-dispersed active species on catalyst surface. In addition, compared with WMnCeTiOx catalysts prepared by deposition precipitation and sol-gel methods, WMnCeTiOx(CP) catalyst possessed much more surface acid sites, stronger reduction capacity and better adsorption capacity for NH3 and NO, which might also play a key role in promoting its SCR performance.
Magnitude and Pattern of Associated Complications of Bladder Outlet Obstruction Secondary to Benign Prostatic Hyperplasia at Yekatit 12 Hospital, Ethiopia: A Retrospective Descriptive Study
Authors: Asefa Zelalem
Published: July 2021

Background: Benign prostatic hyperplasia (BPH) is the commonest cause of bladder outlet obstruction (BOO) in elderly males. It is characterised by lower urinary tract symptoms (LUTS) that include voiding/obstructive and storage/irritative symptoms. If untreated, patients could suffer from different associated complications such as hydronephrosis, urinary tract infection and even renal failure. Little is known about the magnitude and pattern of associated complications of BOO secondary to BPH.Objectives: To assess the clinical profile, magnitude and pattern of associated complications of BOO among patients with BPH at Yekatit 12 hospital, Addis Ababa, Ethiopia.Methods: A retrospective crossectional hospital based analysis of 225 patients who underwent prostatectomy for BOO secondary to BPH over a five year period, from January 1, 2015 to December 31, 2019 was done. Data were analysed using SPSS version 20. Results: Frequency of micturition, dysuria and nocturia were the commonest presenting symptoms observed in 94.2%, 89.3% and 84.9% of the patients, respectively. One hundred and thirty (57.8%) patients presented to the hospital 2 years after the onset of their symptoms. History of prehospital antibiotic treatment for recurrent urinary tract infection (UTI) was found in 64.4% of the patients. Associated complications of BOO secondary to BPH were observed in 44% of the patients. Acute urinary retention (AUR) and urinary tract infection (UTI) were the commonest associated complications observed in 50.7% and 30.7% of the patients, respectively. Hydronephrosis (21.8%), renal impairment (19.1%), urinary tract stones (13.3%) and frank haematuria (4.4%) were other complications observed in this series. Conclusion: Storage/irritative LUTS predominate among our patients with BPH. Associated complications of BOO secondary to BPH were prevalent in the study. Acute urinary retention (AUR) and urinary tract infection (UTI) were the commonest associated complications observed. In order to avoid late diagnosis and reduce the occurrence of possible complications, clinicians should be aware of the possibility of BPH even if the storage/ irritative symptoms predominate in elderly males.
The Influence of Varicocele and Microsurgical Varicocelectomy on Semen Quality, as Determined by Metabolic Analysis
Authors: Zhang Xinzong , Deng Cuncan , Liu Wujiang , Liu Huang , Zhou Yu , Li Qianyi , Zheng Houbin , Wang Qiling , Jiang Min , Pang Tao , Ma Chunjie , Huang Cheng , Zhao qingguo , Tang Yunge
Published: July 2021

The influence of varicocele and microsurgical varicocelectomy on semen quality remains unclear. No previous study has investigated the relationship between semen metabolism and the abnormalities in reproductive function caused by varicocele. Here, we used the non-targeted and targeted metabolic analysis to investigate the different metabolites in seminal plasma within normal, varicocele, and varicocelectomy groups. We clearly showed that varicocele significantly affects sperm metabolism, and microsurgical varicocelectomy can reverse this metabolic abnormality. Moreover, we characterized the landscape of three dipeptides in the seminal plasma of patients with varicocele that have not been identified previously in human tissues or biofluids. Interestingly, the levels of these three dipeptides decreased after microsurgical varicocelectomy coincident with an improvement in semen quality. Western blotting confirmed the downregulation of DPEP3 (dipeptidase 3) in the varicocele group and the upregulation of DPEP3 in the varicocelectomy group. Furthermore, we found that eight metabolites may be helpful to distinguish varicocele patients from normal subjects. Our results can be applied to earlier diagnosis or to predict the outcome of microsurgery for varicocele.
Computer Navigated Total Hip Arthroplasty Via The Direct Superior Approach: A Retrospective Study of The First 30 Consecutive Cases
Authors: Watanabe HIROSHI , Uematsu Takuya , Tabata Yusuke , Mizuno Yoshihiro , Akashi Yuki , Gondo Gaku , Oshima Yasushi , Majima Tokifumi
Published: July 2021

Background The direct superior approach (DSA), which is one of the muscle-sparing approaches for total hip arthroplasty (THA), has been recently reported with positive outcomes. However, in minimally invasive THA, it has been reported that the visual intraoperative estimation of the cup position is not reliable. Therefore, those minimally invasive approaches are associated with the increased risk of acetabular cup malposition due to the limited exposure. Although the positive effects of computer navigation system on the accuracy of cup positioning have been reported in many studies, those are not unknown in THA via the DSA. In the current study, we investigated the accuracy of acetabular cup positioning in navigated THA via the DSA in the first 30 consecutive cases.Methods We have retroactively included the first 30 consecutive cases of navigated DSA, and the consecutive control cases using conventional posterior approach (PA) were included retroactively up to 30 cases. This retrospective study divided the cases of navigated DSA into 15 initial and 15 recent cases. The postoperative data were assessed on plain computed tomography to measure the radiographic inclination and anteversion of the acetabular component. Statistical analyses were performed using Mann-Whiteney U test for comparison of the mean, and Levene's tests for equality of standard deviations (SD). Results We found no significant differences in the means between navigated DSA and conventional PA for anteversion and inclination. For anteversion, the accuracy of acetabular cup positioning in navigated DSA (SD, 6.9°), including the recent 15 cases (SD, 4.1°), was significantly improved than in conventional PA (SD, 11.7°). For inclination, there were no significant differences in the accuracy of the acetabular cup positioning between navigated DSA (SD, 5.3°) and conventional PA (SD, 6.5°).Conclusions The increased variances of cup anteversion would be due to the frequency of pelvic malposition and the wide variation in pelvic orientation with the patient in the lateral decubitus position. Navigated THA via the DSA could be performed with good accuracy of cup placement in the first 30 cases. The results suggest that computer navigated THA via the DSA as a suitable option for hip replacement.
A Deep CNN Approach For Predicting Cumulative Incidence Based On Pseudo-Observations
Authors: Ginestet Pablo Gonzalez , Weitz Philippe , Rantalainen Mattias , Gabriel Erin E
Published: July 2021

Background: Prognostic models are of high relevance in many medical application domains. However, many common machine learning methods have not been developed for direct applicability to right-censored outcome data. Recently there have been adaptations of these methods to make predictions based on only structured data (such as clinical data). Pseudo-observations has been suggested as a data pre-processing step to address right-censoring in deep neural network. There is a theoretical backing for the use of pseudo-observations to replace the right-censored response outcome, and this allows for algorithms and loss functions designed for continuous, non-censored data to be used. Medical images have been used to predict time-to-event outcomes applying deep convolutional neural network (CNN) methods using a Cox partial likelihood loss function under the assumption of proportional hazard. We propose a method to predict the cumulative incidence from images and structured clinical data by integrating (or combining) pseudo-observations and convolutional neural networks.Results: The performance of the proposed method is assessed in simulation studies and a real data example in breast cancer from The Cancer Genome Atlas (TCGA). The results are compared to the existing convolutional neural network with Cox loss. Our simulation results show that our proposed method performs similar to or even outperforms the comparator, particularly in settings where both the dependent censoring and the survival time do not follow proportional hazards in large sample sizes. The results found in the application in the TCGA data are consistent with the results found in the simulation for small sample settings, where both methods perform similarly. Conclusions: The proposed method facilitates the application of deep CNN methods to time-to-event data and allows for the use of simple and easy to modify loss functions thus contributing to modern image-based precision medicine.
Validation of HIV Risk Screening Tool To Identify Infected Adults And Adolescents >14 Years At Community Level
Authors: Yirdaw Kesetebirhan Delele , Mandala Justin
Published: July 2021

BackgroundThere are a number of risk factors being used to identify undiagnosed HIV infected adults. As the number of undiagnosed people gets lesser and lesser, it is important to know if existing risk factors and risk assessment tools are valid for use. In this study, we validate existing HIV risk assessment tools and see if they are worth using for HIV case finding among adults who remain undiagnosed. Methods The Tanzania and Zambia Population-Based HIV Impact Assessment (PHIA) household surveys were conducted during 2016. We used adult interview and HIV datasets to assess validity of different HIV risk assessment tools. We first included 12 risk factors (being divorced, separated or widowed (DSW); having an HIV+ spouse; having one of the following within 12 months of the survey: paid work, slept away from home for at least a month, had multiple sexual partners, paid for sex, had sexually transmitted infection (STI), being a tuberculosis (TB) suspect, being very sick for at least 3 months; had ever sold sex; diagnosed with cervical cancer; and had TB disease into a risk assessment tool and assessed its validity by comparing it against HIV test result. Sensitivity, specificity and predictive value of the tool were assessed against the HIV test result. A receiver operator characteristic (ROC) analysis was conducted to determine a suitable cut-off score in order to have a tool with better sensitivity, specificity, and PPV. ROC comparison statistics was used to statistically test equality between AUC (area under the curve) of the different scores. ROC comparison statistics was also used to determine which risk assessment tool was better compared to the tool that contained all risk factors. Results Of 14,820 study participants, 57.8% were men, and had a median age of 30 (IQR: 21-24). HIV prevalence was 2.3% (95% confidence interval (CI): 2.0-2.6). For the tool containing all risk factors, HIV prevalence was 1.0% when none of the risk factors were positive (Score 0) compared to 3.2% when at least one factor (Score ≥1) was present and 8.0% when ≥4 risk factors were present. Sensitivity, specificity, PPV, and NPV were 82.3% (78.6%-85.9%), 41.9% (41.1%-42.7%), 3.2% (2.8%-3.6%), and 99.0% (98.8%-99.3%), respectively. The use of a tool containing conventional risk factors (all except those related with working and sleeping away) was found to have higher AUC compared to the use of all risk factors (p value <0.001), with corresponding sensitivity, specificity, PPV, and NPV of 63.5% (58.9%-68.1%), 66.2% (65.5%-67.0%), 4.2% (3.6%-4.8%), and 98.7% (98.5%-98.9%), respectively. Conclusion Use of a screening tool containing conventional risk factors improved HIV testing yield compared to doing universal testing. Prioritizing people who fulfil multiple risk factors should be explored further to improve HIV testing yield.
What Do Pregnant Women Experiencing Intimate Partner Violence Expect of Their Health Providers and Hospital Systems?
Authors: Kyei-Onanjiri M , Koziol-McLain J , Spangaro J , Walsh J , Hegarty K
Published: July 2021

Background: Intimate partner violence is a pervasive public health and human rights problem with multidimensional effects on women’s physical, mental and reproductive well-being. The World Health Organization has recommended a first-line response to disclosures of intimate partner violence. However, a strong evidence base of which interventions work best is lacking and there is a greater need to listen to the voices of survivors to tailor responses. The primary purpose of this paper was to explore what pregnant women experiencing IPV wish for from their health providers and hospital systems.Methods: This paper is part of a broader study which included a survey of 1,067 pregnancy care patients at a large tertiary hospital in Melbourne. For this paper, we analysed an open-ended question related to victim/survivor women’s needs and what they wish for from health practitioners and the healthcare system. Overall, while 571 women responded to the open-ended questions, only those relating to women who screened positive on the composite abuse scale or responded ‘Yes’ to screening questions (n = 142) or had been afraid of their partner in the previous 12 months (n = 13) or had experienced reproductive coercion in the last 12 months (n = 6) were analysed for this paper, making a total of 161 respondents. Results: Four main themes emerged from the women in this study: 1) woman-centred care; 2) relationship and domestic violence-specific concerns; 3) male partner involvement and education; and 4) hospital system reform.Conclusions: This study shows that women experiencing intimate partner violence value care that is supportive of them, provides tailored health information, and involves their partner, as well as a health system that is well-organized, accessible and provides continuity of care. It is important to align maternal health services with attributes of care valued by women to meet the complex health needs of pregnant women experiencing intimate partner violence.
Effect of Tai Chi Combined With Kinesio Taping on Posture Control of Football Players With FAI: Protocol For a Randomized Controlled Trial
Authors: LI YH , Li Youhua
Published: July 2021

Background: Functional ankle instability (FAI) of college football players is an important risk factor affecting their training and competition. Physical therapy and appropriate sports intervention can improve the stability of FAI patients. Previous studies have shown that Tai Chi (TC) and Kinesio Taping (KT) can improve the posture control ability of FAI patients. However, whether Tai Chi combined with kinesio taping effect patch can be used as an effective exercise for the rehabilitation of college football players with FAI is not yet proven.Methods/design: 53 FAI college football players were randomly assigned to 3 groups: TC+KT (n=20); TC+KTp (Placebo Kinesio taping, KTp, placebo) (n=17); KT (N=16). The TC+KT group received TC and KT functional correction technical intervention, the TC+KTp group received TC and placebo KT technical intervention, and the KT group received KT functional correction technical intervention. Each of the three groups received 30 minutes each time, 3 times a week, for a total of 6 weeks of intervention training. Star Excursion Balance Test (SEBT) and UniPedal Stance Test (UST) at baseline (before), 4 weeks after intervention (middle) and 6 weeks after intervention (after) , Toe Touch Test (TTT) for evaluation.Discussion: For the first time in this trail, the impact will be evaluated. If the results are the same as expected, they will provide evidence that Tai Chi combined with kinesio taping sticking intervention can promote the posture control of college football players with FAI.。Trial registration: Chinese Clinical Trial Registry, ChiCTR1900027253.Registered on 6 November 2019.
Ki67 Assessment By qRT-PCR In OncotypeDx® Breast Recurrent Score®: Low Correlation With Immunohistochemistry Assessment of Ki67 And Prognostic Impact of Ki67 RNA Level of Expression.
Authors: Selmani Zohair , Molimard Chloé , Overs Alexis , Bazan Fernando , Chaigneau Loic , Dobi Erion , Meneveau Nathalie , Mansi Laura , Paillard Marie-Justine , Meynard Guillaume , Viot Julien , Algros Marie-Paule , Borg Christophe , Feugeas Jean-Paul , Pivot Xavier , Prétet Jean-Luc , Curtit Elsa
Published: July 2021

Breast cancers expressing high levels of Ki67 are associated with poor outcomes. Oncotype DX® test was designed for ER+/HER2- early-stage breast cancers to help adjuvant chemotherapy decision by providing a Recurrent Score® (RS®). RS® measures the expression of 21 specific genes from tumor tissue, including Ki67. The primary aim of this study was to assess the agreement between Ki67RNA obtained with Oncotype DX® RS® and Ki67IHC. Other objectives were to analyze the association between the event free survival (EFS) and the expression level of Ki67RNA; and association between RS® and Ki67RNA.Herein, we report a low agreement of 0.24 by Cohen’s kappa test between Ki67IHC and Ki67RNA in a cohort of 98 patients with early ER+/HER2- breast cancers. Moreover, Ki67RNAhigh tumors were significantly associated with the occurrence of events (p=0.02). On the other hand, we did not find any association between Ki67IHC and EFS (p=0.25).We observed of low agreement between expression level of Ki67RNA and Ki67 protein labelling by IHC. Unlike Ki67IHC and independently of the RS®, Ki67RNA could have a prognostic value. It would be interesting to better assess the prognosis and predictive value of Ki67RNA measured by qRT-PCR. The Ki67RNA in medical routine could be a good support in countries where Oncotype DX® is not accessible.
The Distribution of Giant Manta Rays In The Western North Atlantic Ocean Off The Eastern United States
Authors: Farmer Nicholas A. , Garrison Lance P. , Horn Calusa , Miller Margaret , Gowan Timothy , Kenney Robert D. , Vukovich Michelle , Willmott Julia Robinson , Pate Jessica , Webb D. Harry , Mullican Timothy J. , Stewart Joshua D. , Bassos-Hull Kim , Jones Christian , Adams Delaney , Kajiura Stephen , Waldron Jordan
Published: July 2021

In 2018, the giant manta ray (Manta birostris) was listed as threatened under the U.S. Endangered Species Act. We integrated decades of sightings and survey effort data from multiple sources in a comprehensive species distribution modeling (SDM) framework to evaluate the distribution of giant manta rays off the eastern United States, including the Gulf of Mexico. Manta rays were most commonly detected at productive nearshore and shelf-edge upwelling zones at surface thermal frontal boundaries within a temperature range of approximately 15–30 °C. SDMs predicted high nearshore concentrations off Northeast Florida during April, with the distribution extending northward along the shelf-edge as temperatures warm, leading to higher occurrences north of Cape Hatteras, North Carolina from June to October, and then south of Savannah, Georgia from November to March as temperatures cool. In the Gulf of Mexico, the highest nearshore concentrations were predicted near the Mississippi River delta from April to June and again from October to November. SDM predictions will allow resource managers to more effectively protect manta rays from fisheries bycatch, boat strikes, oil and gas activities, contaminants and pollutants, and other threats.
The Effect of Talus Osteochondral Defects of Different Area Size on Ankle Joint Stability: A Finite Element Analysis
Authors: Li Jia , Wang Yezhou , Wei Yu , Kong Dan , Lin Yuan , Wang Duanyang , Cheng Shi , Yin Pengbin , Wei Min
Published: July 2021

(1) Background: Osteochondral lesion of the talus (OLT) is one of the common ankle injuries, which will lead to biomechanical changes in the ankle joint and ultimately affect the ankle function. The finite element analysis (FEA) was used to clarify the effect of talus osteochondral defects in different depths on the stability of the ankle joint. However, there is no clear research about the area of talus osteochondral defects that should be intervened in time. In this research, FEA is used to simulate the effect of different areas size of talus osteochondral defect on the stress and stability of ankle joint under a certain depth defect.; (2) Methods: The different area size (Normal, 2 mm* 2 mm, 4 mm* 4 mm, 6 mm* 6 mm, 8 mm* 8 mm, 10 mm* 10 mm, 12 mm* 12 mm) of osteochondral defects three-dimensional finite element model was established to simulate and calculate joint stress and displacement of the articular surface of the distal tibia and the proximal talus while the ankle joint was in the push-off phase, midstance phase and heel-strike phase; (3) Results: When OLT occurred, the contact pressure of articular surface, the equivalent stress of the proximal talus, tibial cartilage and talus cartilage did not change significantly with the increase of osteochondral defect area size in heel-strike phase below 6 mm * 6 mm, it increased gradually from 6 mm * 6 mm in midstance phase and push-off phase, and reached the maximum when the defect area size is 12 mm * 12 mm. The talus displacement also has the same tendency.; (4) Conclusions: The effect of cartilage area size defects of the talus on the biomechanics of the ankle is obvious especially in the midstance phase and push-off phase. When the defect size reaches 6 mm * 6 mm, the most obvious change in the stability of the ankle joint occurs, and the effect does not increase linearly with the increase in the depth of the defect.
The Effects of Chemotherapeutic Drugs on PD-L1 Gene Expression in Breast Cancer Cell Lines
Authors: Majidi Misagh , Safaee Sahar , Amini Mohammad , Baghbanzadeh Amir , Hajiasgharzadeh Khalil , Hashemzadeh Shahriar , Shotorbani Siamak Sandoghchian , Mokhtarzadeh Ahad , Baradaran Behzad
Published: July 2021

Breast cancer is the most common cancer among women in terms of prevalence and mortality, and chemotherapy is one of the most effective treatments at higher stages. However, resistance to chemotherapy is the main obstacle in the treatment of this cancer. Accumulated evidence identified the PD-L1 protein as an essential protein in the development of different cancers. Abnormal expression of this protein in various tumor cells is linked to cancer development and inhibiting the function of immune cells, which correlated with reduced beneficial effects of chemotherapy drugs. In the present study, the effects of common chemotherapy drugs including doxorubicin, paclitaxel, and docetaxel on the expression of the PD-L1 gene were investigated by qRT-PCR before and after the treatment with these drugs in MD231, MD468, SKBR3 breast cancer cell lines. Also, the MTT test was applied to examine the effects of drugs on the growth and proliferation of cancer cells considering PD-L1 expression. The expression of the PD-L1 gene increased after 24 and 48 hours of treatment with chemotherapy drugs. The obtained results indicate the enhancing effects of chemotherapy drugs on PD-L1 gene expression, which have a suppressive effect on the immune system against breast cancer. The use of these drugs as the first line of chemotherapy in triple-negative breast cancer is not recommended. However, there is still a need for further experimental and clinical research on the exact effects of these drugs on undesired immune cells exhaustion in breast cancer therapy.
NeoSeq: A New Method of Genomic Sequencing for Newborn Screening
Authors: wang huaiyan , yang yuqi , zhou lignna , wang yu , long wei , Yu Bin
Published: July 2021

Objective
To explore the clinical application of NeoSeq in newborn screening.
Methods
Based on the results obtained from traditional newborn screening (NBS), three cohorts were recruited into the present study: 36 true positive cases (TPC), 60 false-positive cases (FPC), and 100 negative cases. The dried blood spots of the infants were analyzed with NeoSeq, which is based on multiplex PCR amplicon sequencing.
Results
Overall, the sensitivity of both NeoSeq and traditional NBS projects was 55.6% (20/36) in the detection of TPC. NeoSeq detected disease-related genes in 20 of 36 TPC infants, while it could not identify these genes in eight children. Five cases (3.1%) with disease risk were found in the FPC and NC cohorts. There was a significant time difference in the diagnostic result cycles between the two methods − 10 days for NeoSeq vs. 43 days for traditional NBS.
Conclusions
NeoSeq is an effective method of genomic sequencing for newborn screening. It can detect most inborn errors of metabolism, reduce the rate of false positive results, shorten the reporting cycles, and reduce the screening cost.
Model-free Control of Manipulator in Task Space Containing Mismatched Uncertainty
Authors: Yang Xiaohui , Xu Zhenghong , Zhang Wenjie , Zhang Wei , Liu Peter Xiaoping
Published: July 2021

In this paper, a novel trajectory tracking control method for manipulator task space containing mismatched uncertainty is proposed. This paper considers the mismatched uncertainty that exists in the signal conversion between joint space and task space in the robotic arm system. The time delay estimation is employed to approximate the dynamic and kinematic parameters of the system to achieve model-free control. The time delay estimation errors is treated as part of the system disturbances and a disturbance observer based on an auxiliary control system capable of estimating both matched and mismatched disturbances is designed, which does not require additional design of adaptive laws to compensate for disturbances or upper bounds on the derivatives of disturbances. We transform the control error by a prescribed performance function to accomplish transient control of the error, and design a fast terminal sliding surface for the virtual control variables based on the backstepping design method to improve the convergence speed of the controller. Based on the Lyapunov criterion, the closedloop stability of the whole system is demonstrated. The feasibility and superiority of the method in this paper is demonstrated by numerical simulation compared with other control methods.