bluuebunny/crossref_metadata_2025 huggingface dataset:
A machine learning predictive model of in-hospital mortality in patients with sepsis complicated by anemia: a retrospective study based on the MIMIC-III database
Authors: Liu Xiaobin , Zhao Yu , Qin Yingyi , Wang Dan , Yin Xi , Yao Renqi , Ma Qimin , Wang Yusong , Zhu Shihui , Ma Shaolin , Weng Zuquan , Zhu Feng
Published: August 2021

BackgroudPatients with sepsis complicated by anemia have a higher risk of mortality. It is clinically important to study the risk factors associated with the prognosis of this disease. The aim of this study was to establish a predictive model of mortality during hospitalization by extracting clinical data from the Medical Information Mart for Intensive Care III (MIMIC-III) database. MethodsThe clinical data of patients with sepsis complicated by anemia in the MIMIC-III database were retrospectively analyzed. Indexes were screened by stepwise logistic regression (LR), and machine learning predictive models such as Decision Tree (DT), Random Forests (RF), and eXtreme Gradient Boosting (XGBoost) were developed and compared, identifying advantages and disadvantages of each model. ResultsA total of 13,547 patients with sepsis complicated by anemia were included in the study, among which 1,827 died during hospitalization and 11,720 were still alive at discharge. The preliminary stepwise regression model selected 20 clinical indexes, including Elixhauser comorbidity index, maximum blood urea nitrogen (BUN), and maximum hemoglobin reduction. The predictive models showed good discriminative ability (area under the receiver operating characteristic curve [AUROC]:LR, 0.777; DT, 0.726; RF, 0.788; XGBoost, 0.815) and goodness of fit (area under the precision-recall curve [AUPRC]: LR, 0.350; DT, 0.290; RF, 0.400; XGBoost, 0.428). The Shapley Additive exPlanation (SHAP) values in the XGBoost model showed that Elixhauser comorbidity index, maximum BUN, maximum hemoglobin reduction, ventilator use within 24 hours of admission, and age were significant features for predicting in-hospital mortality in patients with sepsis complicated by anemia. ConclusionsThe XGBoost model had better discrimination ability and goodness of fit when compared with other models. Machine learning algorithms have significant practical value in the development of an early warning system for patients with sepsis complicated by anemia.
Modeling and Optimization of Phosphate Solubilizing Bacteria Isolated from Rhizospheric Soils of the Coffee Plant using Artificial Neural Network (ANN) and Response Surface Methodology (RSM).
Authors: aklilu ermias girma , Ahmed Yasin , Seid Mohammed , Ramayya Venkata
Published: August 2021

Phosphorus is often found inaccessible to plants, as it forms precipitates with cations and can be converted to accessible forms by using Phosphate solubilizing bacteria (PSB). In the present study, isolation and characterization of phosphate solubilizing bacteria from rhizospheric soil of coffee plants were performed. The influence of four independent variables (incubation temperature, incubation time, pH, and inoculum size) was investigated and optimized using an artificial neural network and response surface methodology on the solubility of phosphate and indole acetic acid production. The bacterium that can dissolve phosphate were isolated in Pikovskaya’s agar containing insoluble tricalcium phosphate. Total, six Phosphate Solubilizing Bacteria were isolated and three of them (PSB1, PSB3, and PSB4) were found to be effectively solubilizing phosphate. Based on phosphate solubilizing index results Pseudomonas bacteria (PSB1) was selected for modeling. The results showed that both models performed reasonably well, but properly trained artificial neural networks have the more powerful modeling capability compared to the response surface method. The optimum conditions were found to be incubation temperature of 37.5 oC, incubation time of 9 days, pH of 7.2, and inoculum size of 1.89 OD. Under these conditions, the model predicted solubility of phosphate of 260.69 µg/ml and production of IAA of 80.00µg/ml with a desirability value of 0.947. Generally, the isolated Pseudomonas bacteria is a promising Phosphate solubilizing capability that enhances plant growth and this research is a base for recommending the use of this bacterial strain for biofertilizer, as an alternative to synthetic fertilizer.
The Independent Prognostic Effect of Marital Status On Non-Small Cell Lung Cancer Patients: A Population-Based Study
Authors: Zhao Dechang , Zhang Rusi , Yang Longjun , Lin Yongbin , Wen Yingsheng , Wang Gongming , Huang Zirui , Guo Guangran , Zhang Lanjun
Published: August 2021

Background

Previous studies had demonstrated that marital status was an independent prognostic factor in multiple cancers. However, the impact of marital status on non-small cell lung cancer (NSCLC) patients was still highly controversial. In our research, we aimed to clarify the exact prognostic effect of marital status on NSCLC patients with a population-based database.
Method

: All NSCLC patients diagnosed between 2010–2016 were selected from the surveillance, epidemiology and end results (SEER) database. To control the confounding effect of related clinicopathological characteristics, propensity score matching (PSM) was conducted between married and unmarried groups. In addition, independent prognostic clinicopathological factors were evaluated via Cox proportional hazard regression. The survival curves of overall survival (OS) and cancer specific survival (CSS) were plotted and compared with Kaplan-Meier method and log-rank test.
Results

In total, 58424 NSCLC patients were enrolled according to the selection criteria. After PSM, 20148 patients were selected into each group for further analysis. The married group consistently demonstrated significantly better OS and CSS compared to unmarried group (OS median survival (95% CI): 25 (24–26) vs. 22 (21–23) months, P < 0.001; CSS median survival (95% CI): 31(30–32) vs. 27(26–28) months, P < 0.001). Moreover, single patients were associated with the worst OS (median survival (95% CI): 20 (19–22) months) and CSS (median survival (95%CI): 24(23–25) months) among unmarried subgroups. Besides, unmarried patients had a significantly worse prognosis compared to married patients in both univariate and multivariate Cox proportional hazard regressions. Furthermore, married group was associated with better survival in most subgroups.
Conclusion

This study demonstrated that unmarried NSCLC patients were associated with significantly worse OS and CSS compared to married NSCLC patients. Therefore, unmarried patients need not only closer surveillance, but also more social and family support, which may improve patients’ adherence and compliance, and eventually improve the survival.
Ethnobotanical Research of Plants Used in Traditional Medicine for The Treatment of Epilepsy in Southern Mozambique
Authors: Correia Helena , Emanuelson Maria Wanda , Nhantumbo Moisés , Andrassone Paulo , Cumbi Graça , Mataveia Adilencia , Bechel Aurélio , Boane Ernesto , Inroga Mércia , Cruz Odete da , Sambo Ana , Gaspar Felisbela
Published: August 2021

Background

Epilepsy is a chronic brain disease that affects about 50 million people worldwide, mainly in developing countries. It is treated with anticonvulsant drugs, but in some cases, conventional anticonvulsants have not been effective, leading patients to turn to alternative herbal treatments. The study aimed to identify plants used in traditional medicine for the treatment of epilepsy in southern Mozambique, record the parts used, the method of preparation as well as the mode of administration.
Methodology:

The study was conducted between April to June 2019. 53 Traditional Medicine Practitioners were interviewed using a semi-structured questionnaire. The data was analyzed by calculating the Percentage of Citation (%FC) and Informant Factor Consensus (IFC).
Results

A total of 32 medicinal plants belonging to 18 botanical families were identified for the treatment of epilepsy in the southern part of Mozambique. The species, Hugonia orientalis Engl (22.64%), Maclura africana Bur (16.98%), Strychnos spinosa Lam (13.21%), Terminalia sericea Bruch ex DC (13.21%) and Manilkara mochisia (Bark) Dubard (11.32%) were the most cited. The families Annonaceae and Menispermaceae (4 species) were the most representative in number of species. The root was the most commonly used plant part (54.2%), the frequently used preparation mode was decoction (71%), and administration of the remedies was often by oral route.
Conclusion

Medicinal plants still play an important role in primary health care in the study area. However there is a need to develop pharmacological studies based on these plants to understand the mechanism of action of the bioactive compounds and for the future development of new and more effective anticonvulsant drugs
Melatonin Ameliorates Axonal Hypomyelination of Periventricular White Matter by Transforming A1 to A2 Astrocyte via JAK2/STAT3 Pathway in Neonatal Rats Induced by Lipopolysaccharide Injection
Authors: Jiang Shuqi , Wang Huifang , Zhou Qiuping , Li Qian , Liu Nan , Li Zhenggong , Chen Chunbo , deng yiyu
Published: August 2021

Background: Astrocyte A1/A2 phenotypes may play differential role in the pathogenesis of periventricular white matter (PWM) damage in septic postnatal rats. In this study, we sought to determine whether melatonin(MEL) would improve the axonal hypomyelination and neurological dysfunction, and, if so, to ascertain whether this may be related to transformation of astrocyte A1 to A2 phenotype.Methods: One-day-old Sprague–Dawley rats were divided into control, LPS, and LPS+MEL groups. Immunofluorescence was performed to detect IBA1, GFAP, MAG, C3 and S100A10 in the PWM of neonatal rats. C1q, IL-1α and TNF-α expression were assessed by immunofluorescence and ELISA. Electron microscopy was conducted to observe alterations of axonal myelin sheath in the PWM, and the number of PLP and MBP positive oligdendrocytes was caculated using in situ hybridization. The effects of MEL on locomotor ability, spatial learning and memory were evaluated by behavioral testing. In vitro, A1 astrocyte was induced by IL-1α, C1q and TNF-α, the effect of MEL on C3 and S100A10 expression was determined by Western blot and immunofluorescence. JAK2/STAT3 signaling pathway was investigated to determine whether it was involved in modulation of A1/A2 phenotype transformation.Results: At 1 and 3 days after LPS injection, IBA1+ microglia in the PWM were significantly increased in cell numbers which generated excess amounts of IL-1α, TNF-α, and C1q. The number of A1 astrocytes was significantly increased at 7-28d after LPS injection. In rats given MEL treatment, the number of A1 astrocytes was significantly decreaed, but that of A2 astrocytes, PLP+, MBP+ and MAG+ cells was increased. By electron microscopy, ultrastructural features of axonal hypomyelination were attenuated by MEL. Furthermore, MEL improved neurological dysfunction as evaluated by different neurological tests. In vitro, MEL decreased the C3 significantly, and upregulated expression of S100A10 in primary astrocytes subjected to IL-1α, TNF-α and C1q treatment. Additionally, JAK2/STAT3 signaling pathway was found to be involved in modulation of A1/A2 phenotype transformation. Conclusions: MEL effectively alleviates PWMD of septic neonatal rats, and that it is most likely through modulating astrocyte phenotypic transformation from A1 to A2 via the MT1/JAK2/STAT3 pathway.
Novel Dual CAFs and Cancer Cell Targeting Nano-Drug Delivery System for Anti-Fibrosis Mechanism of Liver Cancer
Authors: Guo Chunjing , Hou Xiaoya , Liu Xue , Sun Changgang , Chen Daquan , Kong Ming
Published: August 2021

This study proposed the construction of a delivery system based on dual targeting cancer-associated fibroblasts (CAFs) and tumor cell for the treatment of liver cancer. (Z-Glycine-Proline)-Hyaluronic Acid-Sulcanidone-Ginger Anone, named as GHSO, was an amphiphilic carrier material with dual pH/ROS sensitive and dual targeting properties that could be used to load hydrophobic drug to improve their solubility and enhance biocompatibility. Consequently, we combined paclitaxel (PTX) with GHSO to design a novel nano-micelles, called GHSO@PTX micelles. Also, we prepared a single targeted nano-micelles (Hyaluronic Acid-Sulcanidone-Ginger Anone) named HSO@PTX. The GHSO@PTX micelles was 159.40±14.30 nm-sized in neutral water. The electron microscopy results showed that the two micelles were relatively uniform in size and spherical in shape. The results of in vitro release experiments shown that GHSO@PTX micelles had better pH sensitivity and ROS responsiveness. Under the conditions of low pH/high H2O2 concentration, the cumulative release of micelles was the largest, which could achieve better therapeutic effects. Cell uptake, cytotoxicity of GHSO@PTX micelles were examined at different concentrations by using SMMC-7721 cells and CAFs. The 3D tumor ball experiment showed that GHSO@Cur micelles were more permeable than HSO@Cur, and proved the superiority of GHSO carrier. It first targeted CAFs cells, opened the physical barrier of tumor cells, and achieved deep penetration of tumor sites. We conducted pathological studies and immunohistochemical studies on isolated tissues and tumor tissue sections of nude mice, and investigated the safety and effectiveness of the preparations H&E staining confirmed its safety, Ki 67 was down-regulated, proving that tumor cell proliferation was inhibited, and the down-regulation of α-SMA and Masson proved that CAFs were inhibited and the preparation GHSO@PTX has the effect of killing CAFs and reducing the fibrosis of the tumor. A promising hyaluronic acid-based nanomedicine platform acts as a new drug delivery system to enhance the deep penetration effect of the tumor, and reduce the degree of fibrosis.
A Toolkit for Implementation of Clinical Genomic Testing: Using a Combined Stakeholder and Evidence-Driven Approach
Authors: Taylor Natalie , Long Janet C , Gaff Clara , North Kathryn , Braithwaite Jeffrey , Best Stephanie
Published: August 2021

BACKGROUNDThe complexity of clinical genomics – testing your entire genetic information for health benefit – is a rapidly evolving field demanding swift clinical practice change at multiple levels as widespread testing in healthcare becomes a reality. We aimed to a) describe a combined stakeholder- and evidence-driven approach to developing a toolkit for implementing genomics into the Australian health system, and b) hypothesise key steps in the change to Theoretical Domains Framework (TDF) domains via coded implementation strategies and associated mechanistic links. METHODSThe TDF was used to analyse interview data from 16 nongenetic medical specialists using genomics in practice. Barriers and enablers were identified for three key target behaviour areas across the genomic testing process: 1) identifying patients, 2) test ordering/reporting, and 3) providing results. Barriers were grouped by distinct TDF domains, and, where barriers overlapped, ‘overarching’ domains were identified. Intuitive enabling strategies generated by clinicians were aligned with identified barriers, and retrospectively coded against evidence-based behaviour change techniques (BCTs). Additional theory-driven strategies were developed to address remaining identified barriers. Using structured expert consensus processes, members of the research team participated in a series of workshops to discuss and agree theory-informed links and propose mechanisms through which specific implementation strategies would address TDF-based barriers.RESULTSA total of 32 barriers were coded against TDF domains and constructs, and eight overarching TDF domains were identified on 13 occasions. Across all target behaviour areas, 21 BCTs were represented within the 30 intuitive enabling strategies generated by clinicians, found to be used on 49 occasions. Of these, nine (18%) aligned with a corresponding distinct TDF domain coded barrier that has previously demonstrated statistically significant mechanistic links. 20 new implementation strategies were developed to address nine remaining barriers using a theory-driven approach.CONCLUSIONThis study provides rich detail of crucial stages in intervention development, aiming to ensure implementation strategies are both evidence-informed and contextually appropriate. All barriers were mapped to the TDF, implementation strategies coded against BCTs, and standardised hypothesised behavioural pathways have been proposed, making potential underlying theory explicit. Next steps will be to test toolkit effectiveness for facilitating scale-up of genomics across Australia.
Probiotic characterization and in vitro functional properties of lactic acid bacteria isolated in Thailand
Authors: Sitdhipol Jaruwan , Niwasabutra Kanidta , Chaiyawan Neungnut , Teerawet Siritorn , Thaveethaptaikul Punnathorn , Phuengjayaem Sukanya , Taweechotipatr Malai , Tanasupawat Somboon , Phapugrangkul Pongsathon
Published: August 2021

Fourteen lactic acid bacteria from fermented foods and feces of healthy animals in Thailand were characterized for their potential as probiotics. All isolates could survive in simulated gastrointestinal fluid (pH 2) and bile salt solution (pH 8) more than 70% and 63%, when compare with initial cell concentration, respectively. Adhesion test showed more than 70% adhesive property an in vitro experiment. The susceptibility assay showed that all isolates were susceptible to amoxicillin, ampicillin, erythromycin, chloramphenicol, clindamycin, imipenem, kanamycin, norfloxacin, penicillin, tetracycline and vancomycin. Based on phenotypic and genetic characteristics, they belonged to the genera Lactiplantibacillus, Levilactobacillus, Capanilactobacillus, Pediococcus, Enterococcus, Limosilactobacillus and Lacticaseibacillus. The isolates exhibited antimicrobial ability against pathogenic bacteria; Gram positive strains (Staphylococcus aureus TISTR 1466 and Listeria monocytogenes TISTR 2196) and Gram negative (Escherichia coli TISTR 780, Salmonella enteritidis TISTR 2202 and Salmonella typhimurium TISTR 292). Limosilactobacillus reuteri MF67.1 and Companilactobacillus farciminis R7-1 showed bile salt hydrolase activity. Cell-free culture supernatants of all 14 isolates were screened for immunomodulating effects on Tumor Necrosis Factor Alpha (TNF-α) production. Twelve isolates were able to decrease TNF-α production at different levels, especially Lactiplantibacillus paraplantarum R26-3 and Lacticaseibacillus zeae M2/5 could high inhibit TNF-α production, showing 34 and 29% reduction, respectively. These results suggested that all 14 strains met the general criteria of probiotics and four strains, including Lacticaseibacillus zeae M2/5, Lactiplantibacillus paraplantarum R26-3, Limosilactobacillus reuteri MF67.1 and Companilactobacillus farciminis R7-1, represent interesting candidates for further studies as anti-inflammatory (M2/5, R26-3) or cholesterol reducing agents (MF67.1, R7-1) in vivo animal models.
Cardiac Effects of Treadmill Running With Different Intensities in a Rat Model
Authors: Yan Zhipeng , Zeng Ni , Li Jieting , Liao Tao , Ni Guoxin
Published: August 2021

Purpose: Exercise is an effective intervention for both the prevention and treatment of cardiovascular diseases. In this study, we investigated the structural and functional changes that occur in cardiac response and how they diﬀer with various exercise intensities, hence exploring the potential signal transduction.Methods: Male Sprague–Dawley rats were randomly divided into the sedentary (SED), low-intensity running (LIR), medium-intensity running (MIR), and high-intensity running (HIR) groups. Each exercise group had 3 different operation time subgroups for 1, 4, and 8 weeks, respectively, and all rats observed a daily 1 h treadmill routine 5 days per week. Echocardiographic measurements were performed at the end of the experimental program. Additionally, myocardium samples and blood were collected for histological and biochemical examinations. Changes in the extracellular signal-regulated kinases 1/2 (ERK1/2) signal pathway were detected by Western blotting.Results: After a week of running, ventricular myocyte size and the phosphorylation of ERK1/2 increased in the HIR group, while left ventricular (LV) diastolic diameter values and LV relative wall thickness increased in the LIR and MIR groups. In addition, we observed heart enlargement, cTnI decrease, and ERK1/2 signal activation in each of the exercise groups after 4 weeks of running. However, the HIR group displayed a substantial rupture and increased fibrosis in myocardial tissue. In addition, compared with the LIR and MIR groups, 8 weeks of HIR resulted in structural damage, fiber deposition, and increased cTnI. However, there was no difference in activation of ERK1/2 signaling between the exercise groups and SED group.Conclusions: The effect of running on cardiac hypertrophy was intensity dependent. In contrast to LIR and MIR, 8 weeks of HIR-induced cardiac hypertrophy was characterized by potential cardiomyocyte injury, which increased the risk of pathological development. Furthermore, the ERK signaling pathway was mainly involved in the compensatory hypertrophy process of the myocardium in the early stage of exercise and was positively correlated with exercise load. However, long-term exercise may attenuate ERK signaling activation.
The Importance of Apex Location and Proximal Hemi-Curve Morphology for the Surgical Tactic of Significant Convex Coronal Imbalance in Patients with Dystrophic Scoliosis Secondary to Type I Neurofibromatosis: Classification and Management
Authors: Mao Saihu , Li Song , Ma Yanyu , Shi Ben-long , Liu Zhen , Zhu Ze-zhang , Qiao Jun , Qiu Yong
Published: August 2021

Background. There was a paucity of valid information on how to discriminate between different patterns of convex coronal imbalance (CCI>3cm) in dystrophic scoliosis secondary to Type I neurofibromatosis (DS-NF1), while aggravated postoperative CCI occurred regularly with the causes being insufficiently investigated. We aimed to develop a new classification of CCI in DS-NF1, and to optimize the coronal rebalancing strategies.Methods. NF1-related scoliosis database was reviewed and different types of CCI were identified, and the outcomes of coronal rebalance were analyzed. Results. Two main CCI patterns were defined: thoracic CCI (Type 1) and thoracolumbar/lumbar CCI (Type 2), and were further subtyped by the compensatory behavior of the upper hemi-curve (straight or curved morphology). The incidence of immediate post-op CCI was 0.0% and 63.6% for Type1 and Type 2 groups, respectively. Mismatch of both translation and inclination correction between the upper and lower hemi-curve was significant in the post-op coronal imbalanced group (△Upper Arc Translation/△Lower Arc Translation: 109.6±60.0% vs. 31.8±34.4%, p=0.008; △Upper Arc Inclination/△Lower Arc Inclination: 89.8±36.6% vs. 33.5±37.3%, p=0.012). Multiple linear regression analysis revealed that △UAT/△LAT significantly correlated with the correction of coronal balance distance (β=-21.567; p=0.018). A surgical rebalancing algorithm was proposed to treat each subtype.Conclusion. Thoracolumbar/lumbar CCI in dystrophic scoliosis was prone to suffer high risk of persistent post-op CCI. Satisfying coronal rebalance should rely on maximal translational correction of lower hemi-curve, while the upper hemi-curve played the role of fine-tuning for coronal realignment rather than radical Cobb correction, straight morphology in particular.
Blood Serum Metabolite and Volatile Fatty Acid Profiles of Finishing Pigs Fed Diets with High and Low Levels of Energy and Crude Protein
Authors: Montoro Jordi Camp , Solà-Oriol David , Muns Ramon , Gasa Josep , Llanes Núria , Manzanilla Edgar Garcia
Published: August 2021

Background: Studying how dietary imbalances affect blood serum metabolite (BSM) and faecal volatile fatty acids (VFA) profiles may help to understand whether pigs are fed adequate diets in commercial farms. The present study aimed to evaluate the effect of high and low net energy (NE) and crude protein (CP) diets on performance, BSM and VFA profiles on finishing pigs.Results: Twenty pens of 11 pigs (87.0 ± 4.10 kg; 18 weeks old) were assigned to 1 out of 5 dietary treatments (DT): control (C; 10.03 MJ/kg NE, 160.0 g/kg CP, and 9.5 g/kg SID Lys), low CP (LCP; 10.03 MJ/kg NE, 132.0 g/kg CP, 7.5 g/kg SID Lys), high CP (HCP; 10.03 MJ/kg NE, 188.0 g/kg CP, 11.5 g/kg SID Lys), low NE (LNE; 9.61 MJ/kg NE, 160.0 g/kg CP, 9.5 g/kg SID Lys) and high NE (HNE; 10.45 MJ/kg NE, 160.0 g/kg CP, 9.5 g/kg SID Lys). Pigs were followed for 10 days and blood and faecal samples were collected at the end of the trial. Performance was not affected by DT (P > 0.05). Albumin and glucose did not differ between DT (P > 0.05). HNE pigs had higher triglycerides (0.42 ± 0.03 mmol/L) and creatinine (133.8 ± 3.97 µmol/L) than LNE pigs (0.28 ± 0.03; 117.2 ± 3.97; P < 0.05); however, HNE pigs had lower total protein (60.9 ± 1.51 g/L) than C pigs (67.4 ± 1.51; P = 0.033). LCP pigs had higher cholesterol (2.4 ± 0.08 mmol/L) than LNE pigs (2.0 ± 0.08; P = 0.015); while HCP pigs had higher serum urea nitrogen (13.6 ± 0.95 mg/dL) than the other DT (7.5 ± 0.95; P < 0.001). Total VFA (mmol/kg) did not differ among DT (P > 0.05), but C and HNE pigs had higher branched-chain fatty acids (6.3 ± 0.38% of total VFA) than LNE pigs (4.4 ± 0.38; P < 0.05).Conclusions: Dietary imbalances in energy and protein affect BSM and VFA profile. BSM and VFA analysis may be good indicators to detect unbalanced diets in pig farms, especially serum urea nitrogen, to detect an excess of protein.
Outcomes in Trauma Patients Undergoing Venovenous Extracorporeal Membrane Oxygenation for Adult Respiratory Distress Syndrome
Authors: Kim Seon Hee , Huh Up , Song Seunghwan , Kim Min Su , Wang Il Jae , Tak Young Jin
Published: August 2021

Background: Use of venovenous extracorporeal membrane oxygenation (VV ECMO) remains controversial in trauma patients with adult respiratory distress syndrome (ARDS). Here, we aimed to investigate its therapeutic benefits and the factors affecting patient outcomes.Methods: From 2017–2019, 21/1938 trauma patients (median age: 47 years; 20 men) at a level I trauma center received VV ECMO for post-traumatic ARDS. Demographic, injury-specific, ECMO, and outcome data were prospectively collected and retrospectively reviewed to analyze the factors affecting hospital mortality and ECMO results.Results: Nineteen patients (90.5%) were successfully weaned off ECMO; 16 patients (76.2%) survived to discharge. In the univariate analysis, there was a significant difference in survival between the groups with a Trauma and Injury Severity Score (TRISS) ≥0.5 and TRISS <0.5 (p=0.05). The area under the receiver operating characteristic curve (AUC) of both TRISS and Respiratory Extracorporeal Membrane Oxygenation Survival Prediction (RESP) scores in death was 0.78. In those who failed ECMO weaning, the AUCs of TRISS and RESP scores were 0.90 and 0.80, respectively.Conclusions: In patients with ARDS caused by severe trauma and supported by VV ECMO, survival is associated with TRISS; TRISS and RESP scores may be predictive of mortality and failure of ECMO weaning.
Mechanical properties of the Al-Mg/MWCNTs composite powders: The effects of ball milling process parameters
Authors: Ahmadian Hossein
Published: August 2021

The effects of multi-walled carbon nano-tubes (MWCNTs) and the ball milling parameters on the mechanical properties of the Al-Mg alloy powders were investigated. Three different composite powders were synthesized through ball-milling process at different time and milling rates. The microstructural and phase analyses were carried out via scanning electron microscopy and X-ray diffraction spectroscopy, respectively. The results indicated that increasing the ball-milling time and rate would lead to the formation of finer particles, which consequently intensifies the plastic deformation and then, results in lower crystallite size. The morphological investigations indicated that while the MWCNTs agglomerates in lower milling rates, increased milling rate not only improve the distribution of the MWCNTs, but also decreases the length of the nano-tubes and promotes their diffusion into Al-Mg matrix. The formation of Al-Mg intermetallic phases through the ball-milling process of the composite powders was also confirmed via microstructural investigations.
The effect of the head-up position in cardiopulmonary resuscitation – A systematic review and meta-analysis
Authors: Huang Cheng-Chieh , Chen Kuan-Chih , Lin Zih-Yang , Chou Yu-Hsuan , Chen Wen-Liang , Lee Tsung-Han , Lin Kun-Te , Chou Chu-Chung , Lin Yan-Ren
Published: August 2021

ObjectiveThe pros and cons of the head-up position (HUP) in cardiopulmonary resuscitation (CPR) have been controversial in previous studies. This study aims to clarify the effect of HUP CPR compared to supine position (SUP) CPR.MethodThree databases were comprehensively searched (PubMed, EMBASE and the Cochrane Library) for articles published from database inception to 10 May 2021. The primary outcome was cerebral perfusion pressure (CerPP). The secondary outcomes were mean intracranial pressure (ICP), mean artery pressure (MAP), coronary artery perfusion pressure (CoPP) and the return of spontaneous circulation (ROSC) rate.ResultA total of 7 studies including 138 animals were included. We found that CerPP (SMD, 1.58; 95% CI, 0.98–2.19; p < 0.01; I2 = 51%) and ICP (SMD, -3.59; 95% CI, -5.16– -2.02; p < 0.01; I2 = 87%) were decreased significantly in the HUP group. HUP had a similar MAP (SMD, -0.54; 95% CI, -1.75–0.66; p = 0.38; I2 = 87%) and ROSC rate (RR, 0.9; 95% CI, 0.31–2.60; p = 0.84; I2 = 65%) to SUP. In addition, there was an increased CoPP trend in HUP, but the difference was not statistically significant (SMD, 0.92; 95% CI, -0.24–2.08; p = 0.12; I2 = 84%)ConclusionThe HUP 30° in active compression-decompression CPR (ACD-CPR) with an impedance threshold device (ITD) can increase CerPP by significantly lowering ICP and maintaining MAP compared to SUP, and the effect is immediate and lasts the whole CPR duration. In addition, CoPP might also be increased compared to that with SUP.
Efficient Photonic Crystal Fiber Design for Higher OAM Modes with Low Loss Towards Next Generation THz Communication
Authors: Kuiri Bibhatsu , Dutta Bubai , Sarkar Nilanjana , Santra Saikat , Mandal Paulomi , Mallick Khaleda , Patra Ardhendu Sekhar
Published: August 2021

A newer and efficient solid core with air holes and ring based circular photonic crystal fiber (C-PCF) design is proposed, developed, and studied. The C-PCF structure with a ring core and three layers of air holes is developed to communicate terahertz frequency of the range of 1 THz to 3 THz. Finite element method (FEM) is used to optimize the position, shape and dimensions of air holes and refractive index (RI) of material for the proposed PCF design and check the efficiency to support different orbital angular momentum (OAM) modes for communication. Our novel designed C-PCF supports multiple stable modes with mode purity above 0.9. Confinement loss is in the range of 10-12 dB/cm, highest effective mode area in the order of 1 mm2 is achieved in the investigated study for 3 THz transmission. The study observes that the performance of PCF is strongly dependent on RI of core and cladding.
Distal Corneal Small Nerve Fibre Damage in Subjects With Obesity
Authors: Iqbal Zohaib , Ferdousi Maryam , Kalteniece Alise , Adam Safwaan , Ho Jan H. , Liu Yifen , Bashir Bilal , Donn Rachelle , Syed Akheel A. , Ammori Basil J. , Malik Rayaz A. , Soran Handrean
Published: August 2021

Background: We have previously shown that subjects with obesity have elevated vibration and thermal perception thresholds and central corneal nerve loss and patients with diabetic neuropathy have greater corneal nerve loss at the inferior whorl compared to the central cornea. In the current study, we assessed whether there is evidence for a dying-back neuropathy in subjects with obesity with and without diabetes. Methods: 57 obese subjects, with and without diabetes (DM+, n=30; DM-, n=27 respectively) and age- and sex‑matched controls (n=21) underwent venous blood sampling and assessment of the neuropathy symptom profile (NSP), neuropathy disability score (NDS), vibration, cold and warm threshold testing, cardiac autonomic function, and corneal confocal microscopy (CCM).Results: NSP and NDS were significantly elevated in obese DM+ (p<0.0001; p=0.001) and DM- (p<0.0001; p=0.001) subjects compared to controls. Vibration perception threshold was significantly higher in DM+ (p=0.001), but not in DM- (p=0.06), compared to controls, whilst cold (p = 0.87) and warm (p = 0.52) perception thresholds did not differ between groups. Deep breathing heart rate variability was significantly lower in DM+ (p=0.01), but not DM- (p=0.9) subjects compared to controls. Corneal nerve fibre density [26.8 ±6.22 vs 26.8 ±6.01 vs 35.3 ±7.41, p<0.0001], branch density [55.4 ±28.2 vs 58.4 ±28.5 vs 88.2 ±31.1, p<0.001], fibre length (CNFL) [17.6 ±4.43 vs 19.9 ±5.43 vs 26.7 ±5.31, p <0.0001], inferior whorl length (IWL) [17.9 ±6.10 vs 18.6 ±7.42 vs 35.3 ±9.70, p<0.0001] and total nerve fibre length (TNFL) [35.5 ±9.58 vs 38.5 ±11.0 vs 62.0 ±12.3, p<0.0001] were significantly lower in obese subjects without and with diabetes compared to controls. In comparison to controls, there was a greater relative reduction in IWL compared to CNFL in DM+ (47.3% vs 25.5%) and DM- (49.3% vs 34.1%).Conclusion: We demonstrate evidence of peripheral neuropathy characterised by neuropathic symptoms, neurological deficits, elevated vibration perception and autonomic dysfunction with a dying-back neuropathy affecting the corneal nerves in obese subjects with and without type 2 diabetes.
Circulating eNAMPT as a Diagnostic Biomarker in the Critically Ill: Acute Pancreatitis, Sepsis, Trauma, and Acute Respiratory Distress Syndrome
Authors: Bime Christian , Casanova Nancy Gonzalez , Camp Sara M. , Oita Radu C. , Ndukum Juliet , Hernon Vivian Reyes , Oh Dong Kyu , Li Yansong , Greer Phil J. , Whitcomb David C , Papachristou Georgios I. , Garcia Joe G. N.
Published: August 2021

Background: Nicotinamide phosphoribosyltransferase (NAMPT) is a protein that exhibits dual functionality – as an intracellular enzyme which regulates nicotinamide adenine dinucleotide metabolism and as an extracellular protein (eNAMPT) secreted into the blood and functions as a cytokine regulator of innate immunity by activating NF-κB via binding to Toll-Like receptor 4. In limited preclinical and clinical studies, eNAMPT was implicated in the pathobiology of acute respiratory distress syndrome (ARDS) suggesting that eNAMPT could be a potential diagnostic and prognostic biomarker. Our aim was to investigate the feasibility of circulating eNAMPT levels to serve as a biomarker in an expanded cohort of patients with ARDS and ARDS-predisposing conditions such as acute pancreatitis, sepsis, and trauma when compared to controls. Methods: 795 patients and 179 healthy controls were included in the discovery and validation cohorts. Plasma and serum eNAMPT levels were quantified using one of two complementary Enzyme-linked Immunosorbent Assays. After log base 2 variance stabilizing transformation of plasma/serum eNAMPT measurements, differences between healthy controls and each disease cohort were compared using linear regression or generalized estimating equation (GEE) model where applicable. Complementary analyses included sensitivity, specificity, positive predictive values, negative predictive values, and the area under the receiver operating curve. Results: Compared to controls, circulating eNAMPT levels were significantly higher in patients with acute pancreatitis, with sepsis, with trauma, and with ARDS (all p<0.01). In the acute pancreatitis cohort, circulating eNAMPT levels positively correlated with disease severity (p<0.01). Conclusions: Circulating eNAMPT levels are a potential novel diagnostic biomarker in the critically ill with acute pancreatitis, sepsis, trauma, and/or ARDS.
Exosomal MicroRNA-151a-3p Improves the Sensitivity to Radiotherapy via the Interaction between p53 and Histone Deacetylase 5
Authors: Lee Seung Min , yoon Bo Hyun , Kang Myoung-Hee , Kim Dong Ha , cho Yong-Hee , choi Min , Lee Jin Woo , Kim Tae Keun , ryu Je-Won , Kim Kyunggon , Sung Young Hoon , Pack Chan-Gi , rho Jin Kyung , Lee Sang-wook , Ha Chang Hoon
Published: August 2021

Background: Tumor-derived exosomal microRNAs are key elements of the cell-cell communications response to lots of stimuli. However, various functions of the exosome in tumor suppression by radiotherapy (RT) are not clearly understood. Our study showed a previously unknown interaction of p53 and histone deacetylase 5 (HDAC5) by radiation exposure in hepatocellular carcinoma (HCC). Methods: Using serial ultracentrifugation methods, radiation and non-radiation exosomes were purified to investigate the radioresistance of miRNA151a-3p. Radiation doses were treated in 2gy and 4gy using radiation equipment X-RAD 320 to observe the expression of HDAC5 and p53 in hepatic cancer cells. Exosomal miRNA bioinformatics analysis was conducted to find a variation in the miRNA configuration inside Exosome after radiation exposure.Results: HDAC5 and p53 interacted by exposure to radiation, which increased exosome release and altered microRNAs' composition within exosomes. Also, we have described the intercommunication occurring between irradiated and untreated cells via exosomal microRNAs that affect tumor proliferation. In particular, the expression of exosomal microR151a-3p was markedly reduced by radiation treatment. We confirmed that inhibition of exosomal microR151a-3p promotes suppression of non-irradiated cancer cells, thereby increasing RT sensitivity. Conclusion: our present findings demonstrated HDAC5 is a key component of the p53-mediated release of exosomes resulting in tumor suppression through exosomal microRNA-151a-3p in response to radiation. Finally, we highlight the important role of exosomal microRNA 151a-3p as a biomarker in enhancing RT sensitivity.
3D Brownian Motion Thin Film Fluid spraying nanoparticles impact of Convective Heat Phenomena over Stretchable Rotating Surface: Numerical Computation
Authors: Khan Zeeshan , Rasheed Haroon , Khan Waris
Published: August 2021

The purpose of this research is to examine thin-film nanomaterial movement in three dimensions over a stretchable rotating inclined surface. Similarity variables are used to transform fundamental systems of equations into a set of First-order Differential Equations. The Runge-Kutta Fourth Order approach is utilized for numerical purpose solution. Variable thickness., Unsteadiness parameter., Prandtl number., Schmidt number., Brownian-motion parameter., and Thermophoretic parameter have all been seen to have an impact. Physically and statistically, the indispensable terms namely Nusselt as well as Sherwood numbers are also investigated. As the dimensionless factor \(S\) grows, the temperature field decreases. The momentum boundary layer is cooled when the parameter \(S\) is improved, and the opposite effect is observed for Nusselt number. A greater Schmidt number Sc reduces the Sherwood number by increasing the kinematic viscosity as well as Concentration of the chemical species. Further, the RK4 method is also validated with the HAM approach. Furthermore, we verified the acquired results by establishing a comparison with previous literature, and we discovered an outstanding match, confirming the accuracy of the current communication.
Inference and Validation of The Structure of Lotka-Volterra Models
Authors: Voit Eberhard , Davis Jacob , Olivenca Daniel
Published: August 2021

For close to a century, Lotka-Volterra (LV) models have been used to investigate interactions among populations of different species. For a few species, these investigations are straightforward. However, with the arrival of large and complex microbiomes, unprecedently rich data have become available and await analysis. In particular, these data require us to ask which microbial populations of a mixed community affect other populations, whether these influences are activating or inhibiting and how the interactions change over time. Here we present two new inference strategies for interaction parameters that are based on a new algebraic LV inference (ALVI) method. One strategy uses different survivor profiles of communities grown under similar conditions, while the other pertains to time series data. In addition, we address the question of whether observation data are compliant with the LV structure or require a richer modeling format.
Association between climate conditions and osteoarthritis: protocol for a systematic review and meta-analysis
Authors: Wang Lin , Xu Qinguang , Chen Yan , Xue Yan , Jiang Ding , Wang Xuezong , Wu Yun Yu , Zheng Yuxin , Cao Yuelong
Published: August 2021

Background

Osteoarthritis (OA) is the most common form of arthritis, causing by multiple factors. It has long been a belief that arthritis pain is influenced by the weather. However, scientific studies have documented inconsistent results. To date, neither systematic review nor meta-analysis of existing findings has comprehensively considered their relations. The present study will critically appraise and synthesize the existing evidence from observational studies that examined the relationship between certain climate conditions and OA.
Methods and design:

This protocol will be conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines. There are no restrictions on the study date or publication status for searches in the Cochrane Library, EMBASE, Web of Science, PubMed, and other relative databases. All eligible observational studies will be included, with weather conditions as effect factors and OA symptom or imaging abnormality as outcomes. Two reviewers will be responsible for data extraction and analysis. Risk of bias and quality appraisal will be performed for the included studies using Newcastle-Ottawa Scale (NOS). Meta-analysis will be conducted using Rev Man V.5.3 with the associations between weather conditions and OA presented by odds ratios (ORs), relative risks (RRs), hazard ratios (HRs) and the 95% confidence intervals (CIs).
Results

This systematic review and meta-analysis will present the overall association between weather conditions and OA. The association of climate factors influencing OA incidence or progression would be further illustrated in subgroup analysis depending on whether that has been extensively described in the literature.
Discussion

This study will provide the analysis evidence on the effect of meteorological factors on OA. In an approach of dealing with weather conditions, the results will benefit the daily management of OA.
Screening risk factors of intravenous thrombolysis for acute ischemic stroke : A multicenter retrospective cohort study
Authors: Wang Weiping , Liu Lu
Published: August 2021

Objective

To evaluate the risk factors associated with in-hospital unfavorable outcomes after IV thrombolytic therapy in AIS patients.
Materials and Methods

This two-center retrospective study included AIS patients admitted at the advanced stroke centers of two Grade A tertiary hospitals in China between January 2018 and January 2020. The unfavorable outcome was defined as National Institutes of Health Stroke Scale (NIHSS) score ≥ 16, indicating neurological functional deficit. Univariable and multivariable analyses were used to screen out the factors associated with an unfavorable outcome.
Results

A total of 878 AIS patients undergoing IV thrombolytic therapy were included in this study. After multivariable analysis, Age (odds ratio (OR) = 1.101, 95% confidence interval (95%CI) = 1.048–1.157, P < 0.001), NIHSS score immediately after thrombolysis (OR = 1.336, 95%CI = 1.235–1.444, P < 0.001), total cholesterol (OR = 2.51, 95%CI = 1.432-4.4, P = 0.001), electrocardiogram grade 2 (OR = 17.532, 95%CI = 1.765-174.178, P = 0.014), electrocardiogram grade 3 (OR = 25.213, 95%CI = 2.219-286.425, P = 0.009), computed tomography 24 h after thrombolysis (OR = 3.308, 95%CI = 1.325–8.26, P = 0.010), and lower extremity venous color Doppler ultrasound (OR = 5.685, 95%CI = 1.85-17.471, P = 0.002) were risk factors associated with the adverse outcome. Single antiplatelet (OR = 0.089, 95%CI = 0.033–0.237, P < 0.001), double antiplatelet (OR = 0.063, 95%CI = 0.014–0.289, P < 0.001), high-density lipoprotein cholesterol (OR = 0.047, 95%CI = 0.005–0.488, P = 0.010), and apoprotein A1 (OR = 0.034, 95%CI = 0.002–0.573, P = 0.019) were protecting factors for the outcome.
Conclusion

Electrocardiogram, cholesterol, NIHSS, computed tomography, and Doppler ultrasound could predict unfavorable neurological functional outcomes after thrombolysis for AIS. Antiplatelet therapy reduces the risk of unfavorable outcomes.
Longitudinal Analysis of Built Environment and Aerosol Contamination Associated with Isolated COVID-19 Positive Individuals
Authors: Horve Patrick , Dietz Leslie , Bowles Garis , MacCrone Georgia , Olsen-Martinez Andreas , Northcutt Dale , Moore Vincent , Barnatan Liliana , Parhizkar Hooman , Wymelenberg Kevin Van Den
Published: August 2021

The indoor environment is the primary location for the transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of coronavirus disease 2019 (COVID-19), largely driven by respiratory particle accumulation in the air and increased connectivity between the individuals occupying indoor spaces. In this study, we aimed to track a cohort of subjects as they occupied a COVID-19 isolation dormitory to better understand the impact of subject and environmental viral load over time, symptoms, and room ventilation on the detectable viral load within a single room. We find that subject samples demonstrate a decrease in overall viral load over time, symptoms significantly impact environmental viral load, and we provide the first real-world evidence for decreased aerosol SARS-CoV-2 load with increasing ventilation, both from mechanical and window sources. These results may guide environmental viral surveillance strategies and be used to better control the spread of SARS-CoV-2 within built environments and better protect those caring for individuals with COVID-19.
REVISITING THE DEMOCRATIC REPUBLIC OF THE CONGO STRATIFICATION MAP FOR THE YEAR 2000 USING CLOUD-BASED COMPOSITING AND OBJECT-BASED CLASSIFICATION ALGORITHMS
Authors:   Universityof Kisangani, Natural RenewableResources Management Faculty, BP. 2012, Kisangani, République Démocratique du Congo., Kombe Ibey Wilfred , Kibambe Lubamba Jean-Paul ,   University of Kinshasa, Agronomy Faculty, Dpt of Natural Resources Management.,   Wildlife Conservation Society, DRC.
Published: August 2021

National stratification maps are essential to improve forest management systems. For the Democratic Republic of the Congo, the existing maps derived from remote sensing techniques do not allow an optimal representation of the diverse land cover classes constituting the national stratification scheme. This situation is inherent to the cloud persistence, the seasonality effects and the spatial resolution of the input satellite imagery used that is not always adequate for the discrimination of certain land cover classes. This paper explores a cloud-based median luminance best pixel approach to obtain a cloud-free mosaic of optimal quality. The mosaic produced has necessitated nearly 2,500 Landsat scenes and a following object-based classification enabled the generation of a stratification map for the year 2000 according to the national stratification theme. A stratified random sampling approach that required 1,141 reference samples allowed estimating the map accuracy at 79.32%. Land cover classes areas computed using standard good practices recommendations to estimate land areas indicated that the dense moist forest area was about 158,810,975 Ã‚Â± 7,460,671 ha representing 68.40% Ã‚Â± 3.21% of the country area. Thanks to the free, user-friendly and cloud-based platforms for satellite images processing, the methodology implemented is easily replicable for other tropical countries.