bluuebunny/crossref_metadata_2025 huggingface dataset:
The Relationship Between External and Internal Load Parameters in 3x3 Basketball Tournaments
Authors: Willberg Christina , Wieland Björn , Rettenmaier Lukas , Behringer Michael , Zentgraf Karen
Published: February 2022

Background: 3x3 basketball games are characterized by high-intensity accelerations and decelerations, and a high number of changes of direction and jumps. It is played in tournament form with multiple games per day. Therefore, optimal regeneration is crucial for maintaining a high performance level over the course of the tournament. To elucidate how load of a match affects the athletes' bodies (i.e., internal load), muscular responses to the load of 3x3 games were analyzed. We aimed to investigate changes in contractility of the m. rectus femoris (RF) and m. gastrocnemius medialis (GC) in response to the load of single 3x3 games and a 3x3 tournament.Methods: Inertial movement analysis was conducted to capture game load in 3x3. Changes in contractility were measured using tensiomyography (TMG). During a two-day tournament, TMG measurements were conducted in the morning and after each game. Additionally, off-game performance analysis consisting of jump and change-of-direction (COD) tests was conducted the day before the tournament.Results: External load correlated significantly to changes in contraction velocity in GC, but not in RF. There was no significant correlation between maximum radial displacement of the muscle and external load variables in GC and RF. Athletes of the RF group responded with either decreased or increased muscle contractility after a single 3x3 game. Concerning off-game performance, small to no correlations can be reported when analyzing TMG parameters, COD time, and jump height. No systematic changes in muscle contractility were found over the course of the tournament in RF and GC.Conclusion: The athletes' external 3x3 game load and their performance level did not affect muscular contractility after a single 3x3 game or a complete 3x3 tournament, indicating that elite athletes can resist external load without relevant local muscular fatigue. With respect to the course of the tournament, it can therefore be concluded that the breaks between games are sufficient to return to the initial level of muscle contractility.
Structural adhesive damage identification of hidden frame glass curtain wall based on discrete wavelet transform and vibration transmissibility
Authors: Yang G. , Long X.Y. , Wang X.X. , Liu X.M. , Li Huijian , Liu Z.L.
Published: February 2022

In order to establish a degumming damage identification method for hidden frame glass curtain wall (HFSGCW) which can be used in engineering practice. In this paper, a damage identification method based on discrete wavelet analysis (DWT) combined with vibration transmissibility is proposed to detect structural adhesive of HFSGCW. The vibration transmissibility is used as damage parameter to characterize the damage degree of structural adhesive. The results show that rubber hammer is an effective method to obtain accurate vibration spectrum of glass plate. In order to obtain accurate vibration transmissivity, it is suggested to select the edge of glass plate as the measuring point. Under six different structural adhesive damage conditions, the damage parameters of vibration transfer rate increase with the increase of structural adhesive damage degree. The damage parameters of vibration transmissibility obtained by DWT can identify the initial small damage of structural adhesive. A safety state evaluation model of HFSGCW glass plate based on vibration transfer rate is proposed. It is of great significance to evaluate the safety state of HFSGCW glass plate.
Analysis of Influencing Factors and a Prediction Model of Abnormal Serum Potassium in Patients with Chronic Kidney Disease
Authors: Li Rui , Wu Yue , Zheng Xiaofeng , Ma Lu , Song Hong
Published: February 2022

Objective
The high incidence of abnormal serum potassium in patients with chronic kidney disease have resulted in frequent cardiovascular adverse events and even death. Through a retrospective analysis of the clinical data of 273 patients with CKD, we analyzed the correlation between the general data of patients and serum potassium levels, and the risk factors for abnormal serum potassium, and constructed risk prediction models for abnormal serum potassium.
Methods
In this paper, 273 patients with CKD who were admitted to the Second Affiliated Hospital of Xuzhou Medical University were selected for this retrospective analysis. The subjects were divided into two groups based on the presence of abnormal serum potassium. Preliminary literature retrieval was conducted to extract the risk factors that might affect serum potassium. Independent sample t test was used to analyze the differences between two groups, Pearson or Spearman test was used to analyze the linear correlation of data, and Logistic regression equation was used to construct the multiple regression analysis.
Results
The use of diuretics (P = 0.046), the use of renin-angiotensin and aldosterone (RAAS) inhibitors (P = 0.040) and low score of Renal Adherence Questionnaire (RAAQ) (P < 0.001) were independent risk factors for abnormal serum potassium. There was a positive linear correlation between serum potassium and age, serum creatinine, blood urea nitrogen, anion gap and RAAQ score in patients with CKD; each influencing factor was independent. Subgroup analysis showed that the use of diuretics, low RAAQ score and peritoneal dialysis were more likely to lead to hypokalemia, while hypertension, diabetes, use of RAAS inhibitors, low RAAQ score and hemodialysis were more likely to result in hyperkalemia.
Conclusion
Poor compliance is a risk factor for abnormal serum potassium. On this basis, the use of diuretics and peritoneal dialysis may increase the risk of hypokalemia, and the use of RAAS, hypertension, diabetes, and peritoneal dialysis may increase the risk of hyperkalemia.
Transcriptomic analysis of bakanae disease resistant and susceptible rice genotypes in response to infection by Fusarium fujikuroi
Authors: Bashyal Bishnu Maya , Rawat Kirti , Parmar Pooja , Gupta Ashish Kumar , Gupta Sangeeta , Krishnanan S Gopala , Choudhary Ravish , Ercisli Sezai , Kovacevic Antonija , Aggarwal Rashmi
Published: February 2022

Background Fusarium fujikuroi causing bakanae is one of the most significant pathogen of rice and much responsible for yield losses thereby emerging as a major risk to food security.Methods In the present study transcriptomic analysis was conducted between two contrasting resistant (C101A51) and susceptible (Rasi) genotypes of rice with the combinations of C101A51 control (CC) vs C101A51 inoculated (CI); Rasi control (RC) vs Rasi inoculated (RI) and C101A51 inoculated (CI) vs Rasi inoculated (RI). Results In CC vs CI commonly expressed genes were 12,764. Out of them 567 (4%) were significantly upregulated and 1399 (9%) genes were down regulated. For the RC vs RI 14, 333 (79%) genes were commonly expressed. For CI vs RI 13,662 (72%) genes commonly expressed. Cysteine proteinase inhibitor 10, disease resistance protein TAO1-like, oleosin 16 kDa-like, pathogenesis-related protein (PR1), (PR4), BTB/POZ and MATH domain-containing protein 5-like, alpha-amylase isozyme 3D-like (LOC4345814), were upregulated in resistant genotype C101A51. Whereas, GDSL esterase/lipase At5g33370, serine glyoxylate aminotransferase, CASP-like protein 2C1, WAT1-related protein At4g08290, Cytoplasmic linker associated proteins, xyloglucan endotransglucosylase/hydrolase protein and β-D xylosidase 7 were upregulated in susceptible genotype Rasi. Gene ontology analysis showed functions related to defence response (GO:0006952), regulation of plant hypersensitive type response (GO:0010363), Potassium ion transmembrane activity (GO:0015079), chloroplast (GO:0009507), response to wounding (GO:0009611), xylan biosynthetic process (GO:0045492) were upregulated in resistant genotype C101A51 under inoculated conditions.Conclusions Real time PCR based validation of the selected DEGs showed that the qRT-PCR was consistent with the RNA-Seq results. This is the first transcriptomic study against bakanae disease of rice in Indian genotypes and will be helpful for the development of bakanae management strategies.
An algorithm based on quasi critical path strategy for exchanging adjacent parallel processes of the same device
Authors: xiaohuan Zhang , zhen Wang , dan Zhang , tao Xu
Published: February 2022

Aiming at the defect that quasi critical path algorithm can't take into account both vertical scheduling and horizontal scheduling when scheduling products, this paper proposes an algorithm based on quasi critical path strategy for exchanging adjacent parallel processes of the same device. The algorithm takes the scheduling scheme formed by the quasi critical path strategy as the basic scheduling scheme, proposes and applies the adjacent parallel processes interchange strategy and the adjacent parallel processes adjustment strategy, generates several new product scheduling schemes, and adds them to the product scheduling scheme set. Finally, according to the optimal product scheduling scheme selection strategy, the product scheduling scheme with the minimum total processing time is selected as the final scheduling scheme. The proposed algorithm ensures the compactness of the serial processes, improves the parallel processing of the parallel processes, and optimizes the scheduling results.
Automatic Brain Cancer Classification in MRI Images Based On Ensemble Light Weight Deep Learning Network
Authors: A Jayachandran , Khan N. Zafar Ali , Perumal Sudarson Rama
Published: February 2022

The brain tumor is one of the deadliest cancerous diseases and its severity has turned it to the leading cause of cancer related mortality. Automatic detection and classification of severity-level for a brain tumor using MRI is a complex process in multilevel classification and needs an improved learning method without computational complexity. In this research article, we propose a new encoder decoder model, which combines nested connection and efficient attention mechanism. The structure of the model consists of encoder, decoder and skip connection. By introducing the DropBlock regularization strategy, the local semantic information can be discarded more effectively to motivate the network to learn more robust and effective features. Efficient attention module uses appropriate cross channel interaction to capture richer global information. In the skip connection part, the nested connection strategy is adopted to effectively fuse the feature maps gathered from the intermediate decoder and the original feature maps from the encoder, which makes up for the semantic gap caused by direct simple connection. Finally, data augmentation is performed on the original image to improve the robustness and prevent the over-fitting problem caused by insufficient data. The proposed method is evaluated on different evaluation metrics such as sensitivity, specificity and accuracy. The experimental results show that this method shows the most competitive performance.
Risk factors for nasal polyps, a case-control study
Authors: Shoaib Salwan , Yaghi Ameer , Kahal Fares , Kadri Saeed , Nahas Louei Darjazini
Published: February 2022

Background : Nasal polyposis is considered one of the most common diseases that cause obstruction of the respiratory tract and impede the patient's quality of life.Aims : The aim is to determine if smoking and body mass index are risk factors for hyperplastic nasal polyps in patients with chronic obstructive rhinitis and allergic rhinitis, and thus conducting early diagnostic investigations to detect the disease early and limit its development.Methods : A cross-sectional case control study was conducted that includes patients who came to Damascus Hospital with complaints of chronic obstruction of the nose and chronic allergies that doesn’t respond to conventional treatments and who met the entry criteria and patients from ENT Division without symptoms of obstructive respiratory tracts .Results : 120 patients were included in the study and were distributed as follows: 60 patients with nasal polyps and 60 patients without nasal polyps. The arithmetic mean of age in the group of cases was 31 ± 16.7 years, while in the controls 32.2 ± 18.3, the BMI value was expressed as the arithmetic mean and it was 30.5 ± 4.16 years, while in the controls 23.6 ± 4.30, and the sex ratio was equal between cases and controls with A statistically non-significant value p = 1.000, while the proportion of smokers in cases was 70%, while in controls 37%, with a statistically significant value p = 0.0003.Conclusion : Smoking and body mass index had a statistically significant relation with the development of nasal polyposis.
Blocking TIGIT/CD155 Signal Reverses CD8+T Cell Exhaustion and Enhances the Anti-Tumor Ability of Cervical Cancer
Authors: Liu Lu , wang aihong , Liu Xiaoli , Han Sai , Sun Yu , Zhang Junhua , Guo Lingyu , zhang youzhong
Published: February 2022

Objective：TIGIT/CD155 has attracted widespread attention as a new immune checkpoint and a potential target for cancer immunotherapy. In our study, we evaluated the role of TIGIT/CD155 checkpoints in the progression of cervical cancer.Methods. Detect the expression of CD155 and TIGIT in cervical cancer tissues by flow cytometry, immunohistochemistry and gene expression profiling. In vivo and in vitro experiments have proved that blocking TIGIT/CD155 restores the ability of CD8+T cells to produce cytokines.Methods.：Detect the expression of CD155 and TIGIT in cervical cancer tissues by flow cytometry, immunohistochemistry (IHC) and gene expression profiling. In vivo and in vitro experiments have proved that blocking TIGIT/CD155 restores the ability of CD8+T cells to produce cytokines.Changes in NF-κB and ERK pathways detected by western blot (WB) after blocking TIGIT/CD155 signalingResults：We found that the expression of TIGIT is elevated in patients with cervical cancer. The high expression of TIGIT in CD8+T lymphocytes of cervical cancer patients promotes the failure of CD8+T lymphocytes. In addition, CD155 is highly expressed in cervical cancer tissues and negatively correlated with the infiltration level of CD8+ T cells. We showed that phosphorylated TIGIT binds to CD155 to inhibit NF-κB and ERK activation by recruiting SHIP-1, leading to down-regulation of cytokine production. Inactivated CD8+T cells, after blocking TIGIT, the inhibitory effect of SHIP-1 on CD8+T cells is weakened, and the activation of NF-κB and ERK is enhanced. In vivo and in vitro experiments have proved that blocking TIGIT/CD155 restores the ability of CD8+T cells to produce cytokines. Injecting blocking antibody TIGIT in vivo could inhibit tumor growth and promote CD8+T lymphocyte function. Combining blocking TIGIT and PD-1 further increased the effect of the blocking antibody TIGIT. Conclusions：Our research shows that TIGIT/CD155 is a potential therapeutic target for cervical cancer.
Risk factors for stroke recurrence in patients with hemorrhagic stroke
Authors: Ong Cheung-Ter , Wong Yi-Sin , Tsai Ching-Fang
Published: February 2022

BackgroundThe risk factors for recurrence of hemorrhagic or ischemic stroke in patients with intracranial hemorrhage (ICH) are inconclusive. This study was designed to investigate the risk factors for stroke recurrence in patients with ICH. MethodsThis population-based case-cohort study analyzed the data obtained from a randomized sample of 2 million subjects in the Taiwan National Health Insurance Research Database. The survival of patients with hemorrhagic stroke from January 1, 2000 to December 31, 2013 was included in the study. ResultsDuring the 5-year follow-up period, the recurrence rate of stroke was 12.2% (6.88% hemorrhagic stroke, 5.24% ischemic stroke). The recurrence rate of stroke was 14.2% in the without antiplatelet group and 7.9% in the antiplatelet group. The risk factors for hemorrhagic stroke were age (odds ratio [OR], 2.48), hypertension (OR: 2.24), atrial fibrillation (OR: 1.87), cardiovascular disease (OR: 1.41), and ischemic stroke history (OR: 1.56). The risk factors for ischemic stroke were age (OR: 2.57), hypertension (OR: 2.23), atrial fibrillation (OR: 1.87), cardiovascular disease (OR: 1.42), and ischemic stroke history (OR: 1.6). ConclusionThe risk factors of stroke recurrence were age, hypertension, atrial fibrillation, cardiovascular disease, and ischemic stroke history. Antiplatelet therapy may help prevent the recurrence of stroke.
Raising The Curtain On The “Equality Theatre” In Recruitment To The Healthcare Workforce
Authors: Hammond John , Davies Nigel , Morrow Elizabeth M , Ross Fiona , Vandrevala Tushna , Harris Ruth
Published: February 2022

Background: In the UK National Health Service (NHS) provider organisations are mandated to assure racial equality in job appointments and career opportunities. However, recruitment continues to discriminate against ethnically diverse candidates (British and overseas) and NHS providers are failing to attain the many benefits associated with an ethnically diverse workforce. Aim: To explore the extent to which an employer-led open market recruitment approach to first jobs in nursing and the allied health professions is perpetuating racial inequality.Methods: Survey data from newly qualifying students and qualitative interviews with 12 clinical recruiting managers in 2 NHS trusts. Semi-structured face-to-face interviews used a non-judgemental approach. A conceptual lens was developed, a healthcare workforce diversity lens, to explore racial equality issues by drawing on structured searches of the research and policy literature. Questions were devised to examine issues about organisational workforce diversity goals, workforce diversity data, recruitment diversity data, diversity-led recruitment practices, strategies for effective allyship, and transformative change.Results: While recruiting managers appreciated the benefits of an ethnically diverse workforce, they adhered to organisational policies for recruitment and selection that emphasise objectivity and standardization. Some recruiting managers sense there is “an uneven playing field” but lacked information about ethnic diversity in the workforce or recruitment to make informed judgements. In the context of a pressurised health system, recruiting managers prioritise candidate selection of those who can “fit in” and “hit the ground running” rather than taking the long view and building workforce diversity.Conclusion: A recruitment approach optimized for objectivity and standardization, masquerades as equality, while preserving racial inequality in first job success. Inadvertently, recruiting managers are unwittingly complicit in an ‘equality theatre’ that discriminates against candidates from diverse ethnic backgrounds. The lens could help get a grip on race equality and a shift towards asset-based and diversity-led recruitment approaches.
Medical Student Medium-Term Skill Retention Following Cardiac Point-of-Care Ultrasound Training Based on the American Society of Echocardiography Curriculum Framework
Authors: Jujo Satoshi , Sakka Brandan I , Lee-Jayaram Jannet J , Kataoka Akihisa , Izumo Masaki , Kusunose Kenya , Nakahira Atsushi , Oikawa Sayaka , Kataoka Yuki , Berg Benjamin W
Published: February 2022

Background
No studies have demonstrated medium- or long-term skill retention of cardiac point-of-care ultrasound (POCUS) curriculum for medical student. Based on the American Society of Echocardiography (ASE) curriculum framework, we developed a blended-learning cardiac POCUS curriculum with competency evaluation. The objective of this study was to investigate the curriculum impact on image acquisition skill retention 8 weeks after initial training.
Methods
This study was a prospective, pre-post education intervention study for first- and second-year medical students, with blinded outcome assessment. The curriculum included a pre-training ASE online module and healthy volunteer hands-on training to obtain 5 views: parasternal long-axis (PLAX), parasternal short-axis (PSAX), apical 4-chamber (A4C), subcostal 4-chamber (S4C), and subcostal inferior vena cava (SIVC) views. Students took 5-view image acquisition skill tests at pre-, immediate post-, and 8-week post-training, using a healthy volunteer. Three blinded assessors rated the image quality using a validated 10-point maximum scoring system. Students used a hand-held ultrasound probe (Butterfly iQ).
Results
Fifty-four students completed hands-on training, and pre- and immediate post-training skill tests. Twenty-seven students completed 8-week post-training skill tests. Skill test score improvement between pre- and 8-week post-training was 2.11 points (95% CI, 1.22–3.00; effect size, 1.13).
Conclusion
The cardiac POCUS curriculum demonstrated medium-term skill retention. Instructional design modifications or re-training for PLAX, PSAX, and A4C are needed to make the curriculum more effective for clinically relevant skill retention.
Diverse But Unique Astrocytic Phenotypes During Embryonic Stem Cell Differentiation, Culturing and Development
Authors: Freitag Kiara , Eede Pascale , Ivanov Andranik , Schneeberger Shirin , Borodina Tatiana , Sauer Sascha , Beule Dieter , Heppner Frank
Published: February 2022

Astrocytes are resident glia cells of the central nervous system (CNS) that play complex and heterogeneous roles in brain development, homeostasis and disease. Since their vast involvement in health and disease is becoming increasingly recognized, suitable and reliable tools for studying these cells in vivo and in vitro are of utmost importance. One of the key challenges hereby is to adequately mimic their context-dependent in vivo phenotypes and functions in vitro. To better understand the spectrum of astrocytic variations in defined settings we performed a side-by-side-comparison of embryonic stem cell (ESC)-derived astrocytes as well as primary neonatal and adult astrocytes, revealing major differences on a functional and transcriptomic level, specifically on proliferation, migration, calcium signaling and cilium activity. Our results highlight the need to carefully consider the choice of astrocyte origin and phenotype with respect to age, isolation and culture protocols based on the respective biological question.
The Atypical Functional Connectivity of Broca Area at Multiple Frequency Bands in Autism Spectrum Disorder
Authors: Zhan Linlin , Gao Yanyan , Huang Lina , Zhang Hongqiang , Sun Jiawei , Li Mengting , Huang Guofeng , Wang Yadan , Li Huayun , Jia Xize , Cheng Lulu
Published: February 2022

As a developmental disorder, autism spectrum disorder has drawn much attention due to its severe impacts on language capacity. Broca area, an important brain region of language network, has largely involved in language-related functions. Using Autism Brain Image Data Exchange (ABIDE) dataset, a total of 1454 participants (618 ASD and 836 HCs) were included in our research. In order to detect the pathophysiological mechanism of autism spectrum disorder from the perspective of language, we conducted a functional connectivity analysis with Broca as the seed in multiple frequency bands (conventional: 0.01–0.08 Hz; slow-4: 0.027–0.073 Hz; slow-5: 0.01–0.027 Hz). We found that compared with healthy controls, patients with autism spectrum disorder have demonstrated increased functional connectivity in left thalamus, left precuneus, left anterior cingulate and paracingulate gyri, and left medial orbital of the superior frontal gyrus in conventional frequency band (0.01-0.08Hz). The results of slow-5 frequency band (0.01-0.027Hz) presented increased functional connectivity values of left precuneus, left medial orbital of the superior frontal gyrus, right medial orbital of the superior frontal gyrus and right thalamus. No significant cluster was detected in the slow-4 frequency band (0.027-0.073Hz). In conclusion, the abnormal functional connectivity in patients with autism spectrum disorder has frequency-specific properties. Furthermore, the findings of conventional frequency bands (0.01-0.08Hz) were mainly contributed by slow-5 (0.01-0.027Hz). The current study might shed new light on the pathophysiological mechanism of language impairments in autism spectrum disorder.
Hla-A*32 Is Associated With Severity Of Covid-19 Patients
Authors: KANDEMİR Nefise , ANIL Belemir Nermin , ŞAKAR Cihad , SAAT Hanife , KAPUAĞASI Arif , ŞENCAN Irfan
Published: February 2022

Objective: Recent advances have contributed to a better understanding of the shared and specific roles of HLA alleles in outcome of Covid-19 disease. We aimed to determine if a severe prognosis could be predicted. Methods: Covid-19 patients were divided into severe (n=30) and non-severe (n=29) patient groups. All patients’ demographic, clinical, laboratory, and treatment data were collected and analyzed. Class I/II HLA loci (A, B, C and DRB1, DQB1, DQA1) alleles were studied in patients and healthy controls (n=30), and outcomes of data were compared. Results: From the demographic and clinical data, 28-day mortality, comorbidity, hypertension and coronary artery disease were found to be significantly higher in the severe group (SG) compared to the non-severe group (NSG). Of the parent-1 allele groups, A*26, A*32, B*41, C*14, C*16, DRB1*8, and DRB1*14 alleles were only present in the severe group and DQB1*4, B*27, B*52, and C*5 alleles were present in the severe and non-severe groups but not in controls. Also, while the presence of A*68, B*37, B*58, DRB1*16, DQB1*4, and C*14 alleles from parent-2 allele groups only in severe and non-severe groups may cause susceptibility to the disease, parent-2 allele groups A*1, DQB1*4, B*15 and B*54 were only present in healthy controls and may have a protective effect.Conclusion: Since only the A*32 allele was detected in both parents only in the severe group, this allele may be associated with Covid-19 disease. These data suggest that some HLA alleles may be associated with the occurrence of Covid-19.
Investigation on residents’ cognition of HFRS and related knowledge in Jining city of Shandong Province, Mainland China
Authors: Liu Miao-Miao , Wang Wen-Jun , Liu Wen , Guo Li-Yan
Published: February 2022

Background：Hemorrhagic fever with renal syndrome (HFRS) is a serious public health problem caused by Hantavirus. China is the most severe endemic country in the world, accounting for about 90% cases. However, there are relatively few studies on residents’ cognition of HFRS in the epidemic areas.Methods: 960 residents were selected from four districts of Jining city, Shandong province in 2020. Information on cognition of HFRS and related knowledge was obtained using a questionnaire. Chi-square test was used to compare the differences of the cognition rate between demographic characteristics. The stepwise logistic regression analysis was used to determine the association between personal variables and cognition.Results: The data from 892qualified questionnaires were analyzed. The result showed that the cognition rate of HFRS among residents in Jining is 50.00%. The cognition rate of the source of HFRS infection among residents is 42.60%. And the cognition rate of HFRS vaccine is only 17.71%.Further regression analysis result showed that the main factors affecting residents’ cognition of HFRS and related knowledge were age and education. Residents’ awareness of infectious source affected their behavior. The results showed that 18.95% of the residents who knew the infectious source took protective measures when sweeping the barns, while among the residents who did not know the infectious source, only 10.16% of them took protective measures. Conclusions: Residents’ cognition of HFRS and related knowledge were affected by education. Residents’ behavior would be affected by their cognition status.
Community Participatory Approach to Reverse Climate Change
Authors: Kumar Sampath , Kanwar Shweta Raj
Published: February 2022

The geography and economy of Meghalaya have some serious paradoxes. For instance, despite having high rainfall, many areas in the state are confronted with serious water scarcity, largely due to deforestation and soil erosion. Despite having a wealth of natural resources, almost 50% of the population lives below the poverty line [1]. Meghalaya as a state has a strong knit community, and this paper attempts to study the community participatory approach adopted by local people, who, in several instances, have come together to tap the tremendous potential of water conservation, especially in the Mawsynram C&RD block, hailed as one of the wettest places on earth. Alternatively, the research also delves deeper into how the State, in its attempt to reverse climate change with the help of a unique initiative called Community Conservation Corps, plans to engage and train a massive pool of young volunteers by raising at least one person from every household, motivated towards protecting the environment. Given that Meghalaya is largely an agrarian state and dependent on natural resources for livelihood [2], the implications of this study could be valuable to assess the potential opportunities of the collective community approach driven towards climate change reversal. Moreover, it will also be interesting to note how, in the course of community participation to reverse climate change, the State is also living up to its matrilineal status wherein women are seen to exercise authority and decision making at the local level, which, otherwise, is not the case in higher authoritative realms of the State.
Living with a Diagnosis of Placenta Accreta Spectrum: Mothers’ and Fathers’ Experience of the Antenatal Journey and the Birth
Authors: Bartels Helena C , Horsch Antje , Cooney Naomi , Brennan Donal J , Lalor Joan G
Published: February 2022

Background
Most research into Placenta Accreta Syndrome (PAS) has focussed on the associated maternal morbidity and mortality. However, mother’s and fathers’ lived experiences of the aftermath of a diagnosis of PAS up to the birth and beyond has received little attention. Consequently, this study focussed on couples’ experiences of PAS covering the period from the diagnosis, up to and including the birth.
Methods
In-depth interviews were conducted with 29 participants; 6 couples were interviewed together (n = 12), 6 couples were interviewed separately (n = 12), and 5 women were interviewed without their partner. Data from the antenatal and intrapartum periods are presented. Couples were eligible for inclusion if they had a diagnosis of PAS within the previous 5 years. An Interpretative Phenomenological Analysis approach was used to gather and analyse data. Virtual interviews were conducted over a 3-month period from February to April 2021.
Results
Themes emerged relating to two distinct timepoints, the antenatal period and birth. The antenatal period had two superordinate themes: the first antenatal superordinate theme was “Living with PAS”, which had two sub-themes: “Lack of knowledge/information” and “Experiences of care and planning for the birth”. The second antenatal superordinate theme was “Coping with uncertainty”, which had two sub-themes of “Getting on with it”, and “Emotional toll”. Relating to birth, two superordinate themes emerged. The first superordinate theme was “A traumatic experience”, with three sub-themes of “Saying goodbye”, “Experiencing trauma” and the “Witnessing of trauma” (by fathers). The second superordinate theme which emerged was “Feeling safe in the hands of experts”, with two subthemes of “Safety in expert team” and “Relief at surviving”.
Conclusions
This study highlights the significant psychological impact a diagnosis of PAS has on mothers and fathers, how they try to come to terms with the diagnosis and the experience of a traumatic birth, and how management within a specialist team can alleviate some of these fears.
Comparison of Freshly-Cultured versus Cryopreserved Mesenchymal Stem Cells in Animal Models of Inflammation: A Pre-Clinical Systematic Review
Authors: Dave Chintan , Mei Shirley H.J. , McRae Andrea , Hum Christine , Sullivan Katrina , Champagne Josee , Ramsay Tim , McIntyre Lauralyn
Published: February 2022

Background: Mesenchymal stem cells (MSCs) are multipotent cells that demonstrate therapeutic potential for the treatment of acute and chronic inflammatory-mediated conditions. Although controversial, some studies suggest that MSCs may lose their functionality with cryopreservation which could render them non-efficacious.Objective: In comparative pre-clinical models of inflammation, to determine if there are differences in in-vivo measures of pre-clinical efficacy (primary outcomes) and in-vitro potency (secondary outcomes) between freshly-cultured and cryopreserved MSCs. Methods: A systematic search on OvidMEDLINE, EMBASE, BIOSIS, and Web of Science (until June 5, 2020) was conducted. The primary outcome included measures of in-vivo pre-clinical efficacy; secondary outcomes included measures of in-vitro MSC potency. Risk of bias was assessed by the SYRCLE “Risk of Bias” assessment tool for pre-clinical studies. Results: 15 studies were included. A total of 194 in-vivo pre-clinical efficacy experiments represented 72 distinct outcome measures. 2.6% (5/194) of these outcomes were significantly different at the 0.05 level or less; 2 favoured freshly-cultured and 3 favoured cryopreserved MSCs. A total of 63 in-vitro experiments represented 26 different potency measures; 11.1% (7/63) of the experiments were significantly different at the 0.05 level or less, with 5 experiments favouring freshly-cultured MSC and 2 favouring cryopreserved MSCs.Conclusions: The majority of preclinical in-vivo outcomes and in-vitro potency outcomes did not detect significant differences (p<0.05) in pre-clinical efficacy between freshly-cultured and cryopreserved MSCs. Our systematic summary of the current evidence base may provide MSC research scientists as well as regulatory bodies additional rationale and justification for considering a cryopreserved MSC product in their clinical trials.Registration: Protocol has been registered with PROSPERO (CRD42020145833).
The Correlations of Different MRI Classifications with Preoperational Function in Refractory Lateral Epicondylitis
Authors: Li Xu , Zhao Yang , Zhang Zhijun , Zheng Tong , Li Shangzhe , Yang Guang , Lu Yi
Published: February 2022

Background
To evaluate the correlations of three magnetic resonance imaging (MRI) classifications and preoperative function in refractory lateral epicondylitis (LE) patients.
Methods
We retrospectively reviewed our refractory lateral epicondylitis patients who underwent arthroscopic treatment from June 2014 to December 2020. The signal changes of the origin of the extensor carpi radialis brevis(ERCB) were evaluated based on three different MRI classifications systems. Spearman's rank correlation analysis was used to analyze the correlations between each MRI classification and preoperative functional and visual analog scale (VAS). The lateral collateral ligament (LCL) in all patients was also evaluated by both MRI and arthroscopically. The Mann-Whitney U test was used for the comparison on preoperative VAS and all functional scores between the refractory LE patients combined with LCL lesions and those without.
Results
There were 51 patients with refractory LE included in present study. Spearman's rank correlation analysis did not find any significant correlation on all three MRI classifications and preoperative VAS or any functional scores (all P value > 0.05). There were no significant differences on VAS and functional scores between the patients with abnormal LCL signal on MRI and those without (P > 0.05).
Conclusions
There were no significant correlations between three different MRI classifications of the origin of the ERCB and the VAS and functional scores preoperatively. There were no significant differences on preoperative VAS or function scores between LE patients with concomitant LCL signal changes and those without.
Information Fusion for Colorectal Polyps Medical Image Segmentation
Authors: Huang Jun , Zhou Zhuo , Duan Yinghua , Huang Weilan , Pei Fengyun , Liu Bo
Published: February 2022

Training a deep neural network often requires a huge amount of annotated data, which is scarce in the medical image analysis domain. In this work, we present a simple yet effective strategy that relies on the information fusion to enhance existing neural networks. The proposed approach utilizes information from different spatial scales and combines them in a learnable way. Experimental results on two benchmark datasets demonstrate that the proposed fusion module improves the segmentation performance of state-of-the-art neural networks.
Real-world effectiveness of steroids in severe COVID-19: longer courses associated with lower risk of death or ICU admission
Authors: Wang Wenjuan , Snell Luke B , Ferrari Davide , Goodman Anna L , Price Nicholas M , Wolfe Charles D , Curcin Vasa , Edgeworth Jonathan D , Wang Yanzhong
Published: February 2022

Purpose
We aim to investigate the associations of steroid and length of steroid use with outcomes in severe COVID-19.
Methods
Severe cases of COVID-19, defined by hypoxia at presentation, and admitted to a multi-site healthcare institution in London were analysed between 02-Sep-2020 and 27-May-2021. The associations between duration of steroid treatment (prescription-days) and outcomes were explored using Cox proportional-hazards models adjusting for confounders. Length of steroid treatment was analysed as both a continuous variable and categorised into < 3, 3–10, and > 10 days. The primary outcome was in-hospital mortality and secondary outcome was in-hospital mortality or intensive care unit (ICU) level-3 admission.
Results
734 severe COVID-19 cases were included, with 137/734 (18.7%) treated with steroids for < 3 days, 497/734 (67.7%) for 3–10 days, and 100/734 (13.6%) for > 10 days. Cox modelling with continuous days showed increasing length of steroids decreased the hazard of in-hospital mortality by a factor of 0.98 [95% CI: 0.96-1.0] per additional day and in-hospital mortality or ICU admission by a factor of 0.91 [95% CI: 0.87–0.95] per additional day. Further, when taking 3–10 days steroid treatment group as the reference group, > 10 days steroid showed trends towards decreased hazards for death (HR 0.59 [95%CI: 0.30–1.14]) and was significantly protective for death/ICU outcome (HR 0.28 [95%CI: 0.11–0.68]).
Conclusion
The protective effect of steroid for severe COVID-19 reported in randomised clinical trials was replicated in this large real-world cohort. We found an association between longer steroid courses and lower risk of death or ICU admission that warrants further investigation.
In vivo antiviral efficacy and immune dampening effect of zapnometinib emphasize a dual therapeutic potential against COVID-19
Authors: Füll Yvonne , Waidele Lara , Hamza Hazem , Poetz Oliver , Steinhilber Andreas , Anselm Viktoria , Delany Mark , Brand Judith van den , Amerongen Geert van , de Waal Leon , Ludwig Stephan , Planz Oliver
Published: February 2022

Coronaviruses, in particular the current pandemic strains of SARS-CoV-2, represent an ever-evolving threat to human life. Currently available antiviral drugs are not suitable for severely infected patients in later hyperinflammatory stages of the disease. New therapeutics that inhibit virus propagation and target inflammation would be ideal. We demonstrate that the host targeted MEK inhibitor zapnometinib displays such a dual effect. The drug efficiently reduced virus titers of different SARS-CoV-2 variants and other highly pathogenic human coronaviruses such as SARS-CoV-1 and MERS-CoV in vitro. In a Syrian hamster infection model, zapnometinib reduced SARS-CoV-2 viral load and alleviated lung pathology. Drug safety biomarkers, body weight change and clinical observations, indicated that zapnometinib was well tolerated and showed no toxicity. Moreover, the immune dampening effect could be confirmed in an acute lung injury mouse model and in vitro experiments in primary human blood cells that demonstrated the reduction of disease related cytokines and chemokines. Thus, in contrast to direct-acting antivirals, zapnometinib displays a dual therapeutic effect highlighting its potential in the treatment of severe COVID-19 and other acute viral infections leading to hyperinflammation.
A Machine Learning Approach Applied to Gynecological Ultrasound to Predict Progression-Free Survival in Ovarian Cancer Patients
Authors: Arezzo Francesca , Cormio Gennaro , Forgia Daniele La , Santarsiero Carla Mariaflavia , Mongelli Michele , Lombardi Claudio , Cazzato Gerardo , Cicinelli Ettore , Loizzi Vera
Published: February 2022

In a growing number of social and clinical scenarios, machine learning (ML) is emerging as a promising tool for implementing complex multi parametric decision-making algorithms. Regarding ovarian cancer (OC), despite the standardization of features that can support the discrimination of ovarian masses into benign and malignant, there is a lack of accurate predictive modeling based on ultrasound (US) examination for progression-free survival (PFS). This retro-spective observational study analysed patients with epithelial ovarian cancer (EOC) who were followed in a tertiary centre from 2018 to 2019. Demographic features, clinical characteristics, information about the surgery and post-surgery histopathology were collected. Additionally, we recorded data about US examinations according to the International Ovarian Tumor Analysis (IOTA) classification. Our study aimed to realise a tool to predict 12-month PFS in patients with OC based on a ML algorithm applied to gynecological ultrasound assessment. Proper feature selection was used to determine an attribute core set. Three different machine learning algorithms, namely Logistic Regression (LR), Random Forest (RFF), and K-nearest neighbors (KNN), were then trained and validated with five-fold cross-validation to predict 12-month PFS. Our analysis included n. 64 patients. The attribute core set used to train machine learning algorithms included age, menopause, CA125 value, histotype, FIGO stage and US characteristics such as major lesion diameter, side, echogenicity, color score, major solid component diameter, presence of carcinosis. RFF showed the best performance (accuracy 93.7%, precision 90%, recall 90%, area under receiver operating characteristic curve (AUROC) 0.92). We developed an accurate ML model to predict 12-month PFS.
Mental Health of Korean Adolescents in the Era of COVID-19: Web-based Survey Focused on Suicide-related Factors
Authors: Jeong Yeong Mi , Park Hye Seon , Kim Sang Mi
Published: February 2022

Background: The coronavirus disease 2019 (COVID-19) pandemic has negatively impacted many aspects of life. In particular, measures for combatting the spread of the virus, such as quarantining and restrictions on social gatherings, may have led to psychological anxiety and depressive symptoms among adolescents. Such mental health impacts may increase the risk of suicidal ideation. This study aimed to examine mental health among adolescents amid the prolonged COVID-19 pandemic, and identify and analyze predictors of suicidal ideation, suicide planning, and suicide attempts.Methods: Data for 57,925 adolescents who participated in the 2020 Korea Youth Risk Behavior Web-based Survey were used for this research. Based on their responses to suicide-related questions, the sample was divided into a healthy group, suicide-ideation group, suicide-planning group, and suicide-attempt group, respectively. The groups’ descriptive statistics were then analyzed. An analysis of covariance, post-hoc tests, and multiple logistic regression were performed on the four groups.Results: Overall, 6.9% of the participants reported suicidal ideation, 2.2% reported planning suicide, and 1.9% reported attempting suicide in the previous 12 months. Stress, sadness and despair, loneliness, and generalized anxiety disorder were all highest in the suicide-attempt group and lowest in the healthy group. Sex, academic achievement, economic status, impact of COVID-19 on economic status, sleep, alcohol use, drug use, smartphone overdependence, and suicide-associated factors significantly predicted adolescents’ mental health status. Conclusions: Amid the prolonged COVID-19 pandemic, there is a strong need for various individualized programs that identify and intervene to support adolescents with a suicidal risk by accurately assessing their mental health risk factors, such as stress, sadness and despair, loneliness, and generalized anxiety disorder.
Quantitative Sodium (23Na) MRI in Pediatric Gliomas: Initial Experience
Authors: Bhatia Aashim , Lee Vincent Kyu , Qian Yongxian , Paladino Michael , Ceschin Rafael , Hect Jasmine , Mountz James M. , Sun Dandan , Kohanbash Gary , Pollack Ian F. , Jakacki Regina I. , Boada Fernando , Panigrahy Ashok
Published: February 2022

Introduction: The treatment of pediatric gliomas is typically assessed with proton (1H) MRI, which can have limitations. 23Na MRI has been shown in adult brain tumors to measure intra-tumoral total sodium concentration as a correlate of tumor proliferation. 23Na MRI sodium studies in pediatric patients are lacking. The purpose of the study included: (1) To compare total sodium concentration (TSC) between pediatric glioma and non-neoplastic brain tissue using 23Na MRI; (2) Compare tissue conspicuity of bound sodium concentration (BSC) using 23Na MRI dual echo relative to TSC imaging. Methods: TSC was measured in: (1) non-neoplastic brain tissues and (2) three types of manually segmented gliomas [diffuse intrinsic brainstem glioma (DIPG), recurrent supratentorial low-grade glioma (LGG), and high-grade glioma (HGG)] on sodium MRI images co-registered with proton MRI. In a subset of patients, serial changes in both TSC and BSC (dual echo 23Na MRI) were assessed for tissue conspicuity using voxel-based parametric maps. Results: Twenty-six pediatric patients with gliomas (median age of 12.0 years, range 4.9 – 23.3 years) were scanned with 23Na MRI. Uninvolved tissues demonstrated a range of TSC values similar to published adult values. DIPG treated with RT demonstrated higher TSC values than the uninvolved infratentorial tissues (P<0.001). Recurrent supratentorial LGG and HGG exhibited higher TSC values than the uninvolved white matter (WM) and gray matter (GM) (P<0.002 for LGG, and P<0.02 for HGG). The dual echo 23Na MRI suppresses the sodium signal within both CSF and necrotic foci, resulting in improved conspicuity of both non-neoplastic and neoplastic, compared to serial TSC imaging. Conclusion: Quantitative 23Na MRI of pediatric gliomas demonstrates a range of values that are higher than non-neoplastic tissues. Dual echo 23Na MRI of BCS improves tissue conspicuity relative to TSC imaging. Future studies are needed to determine the value of 23Na MRI in delineating therapeutic responses in pediatric gliomas.
Pembrolizumab in combination with tocilizumab in high-risk hospitalized COVID-19 patients (COPERNICO): A randomized proof-of-concept phase II study
Authors: Sánchez-Conde Matilde , Vizcarra Pilar , Pérez-García José Manuel , Gion María , Martialay María Pilar , Taboada Javier , Alonso-Fernández Alberto , Sampayo-Cordero Miguel , Malfettone Andrea , Tena Isabel , Torre Sergio De La , Llombart Antonio , Cortes Javier
Published: February 2022

IntroductionSevere coronavirus disease 2019 (COVID-19) is associated with immune dysregulation and hyperinflammation (lymphocyte exhaustion and elevated IL-6). Pembrolizumab (P; immune-activating anti-PD-1 antibody) plus tocilizumab (TCZ; anti-IL6 receptor antibody) might interrupt the hyperinflammation and restore the cellular immunocompetence. We assessed the efficacy and safety of P + TCZ + standard of care [SOC] in high-risk, hospitalized, COVID-19 pneumonia patients without mechanical ventilation.MethodsRandomized, controlled, open-label, phase 2 trial in patients with severe SARS-CoV-2-infection to assess the hospitalization period to discharge.ResultsTwelve patients were randomized (P + TCZ + SOC, n = 7; SOC, n = 5). Nine (75%) were males, with a median age of 68 (41–79) years. Median time to discharge with P + TCZ + SOC and SOC was 10 and 47.5 days (p = 0.03), with 0 (n = 1 patient had P–related grade 5 myositis) and 2 COVID-19-related deaths, respectively.ConclusionsThe addition of P and TCZ to SOC reduced the hospitalization period, with higher and faster discharges without sequelae than SOC alone.