bluuebunny/crossref_metadata_2025 huggingface dataset:
Determination of CLINDAMYCIN HCl in Capsules by New, Validated, Simple and Green Kinetic Spectrometric Method
Authors: Affas Shaza , Sakur Amir Alhaj
Published: February 2021

Background: simple, sensitive, free of organic solvents, kinetic spectrophotometric method has been developed for the determination of Clindamycin Hydrochloride, both in pure form and Capsules. Method used is based on reaction of Clindamycin with potassium iodide and potassium iodate in aqueous medium at (25 ±2 °c) to produce yellow colored tri iodide ions (I3-). the reaction is followed spectrophotometrically by measuring the absorbance at 350 nm wavelength during 40 minutes. Results: the effects of analytical parameters on reported kinetic methods were investigated. Under the optimized conditions, the initial rate and fixed time (at 10 min) methods were used for constructing the calibration graphs. The graphs were linear in concentration ranges 1-20 μg.ml-1 with limit of detection of 0.12 and 0.22 μg ml-1for the initial rate and fixed time methods, respectively. The results were satisfactory and the analytical performance for both methods was validated. Conclusion: The proposed methods have been applied to determine the components in capsules with an average recovery of 98.25% to 102.00% and the results are in good agreement with those found by the reference method.
Reporting Violations of European Charter of Patients’ Rights: Analysis of Patient Complaints in Croatia
Authors: Karačić Jasna , Viđak Marin , Marušić Ana
Published: February 2021

Background

The European Charter of Patients' Rights (ECPR) presents basic patients' rights in health care. We analysed the characteristics of patients' complaints about their rights through the official system and non-governmental organizations in Croatia.
Methods

The official system for patients ’complaints in Croatia does not have a common protocol but there are different modes for addressing patient complaints. In this cross-sectional study, we analysed the reports about patients’ complaints from the regional committees sent to the Ministry of Health and mapped the complaints received by the Croatian Association for the Protection of Patient’s Rights (CAPR) to ECPR.
Results

The official data from the Ministry of Health in 2017 and 2018 included only 289 individual complaints from 10 out of 21 counties. Complaints were most frequently related to secondary and tertiary healthcare institutions and details were not provided. CAPR had 301 complaints about violations of patients ’rights. The most common complaint was the Right of Access to health care (35.3%) followed by the Right to Information (29.9%) and the Right to Safety (21.7%). The fewest complaints were about the Right to Complain (1.9%), Right to Innovation (1.4%), Right to Compensation (1.4%), and Right to Preventive Measures (1.0%).
Conclusions

Reporting and dealing with patients’ complaints about violations of their patients’ rights is not effective in systems with parallel but uncoordinated complaints pathways. Mapping patient's complaints to the ECPR is a useful tool to assess the perception of patients’ rights and to plan actions to improve the complaints system for effective health care.
Multilocus sequence based systematics of Pseudomonas sp. from supraglacial site of Sikkim Himalaya and their adaptational strategies
Authors: Mukhia Srijana , Kumar Anil , Kumari Poonam , Kumar Rakshak , Kumar Sanjay
Published: February 2021

Background Being one of the most complex and diverse genera, deciphering the correct taxonomy of Pseudomonas species has always been challenging. This study investigates and resolves the taxonomic ambiguity of 11 strains of Pseudomonas obtained from the supraglacial site of East Rathong glacier. Since the supraglacial region represents an extreme, stressful environment, the inhabitant microorganisms must have evolved multiple adaptive traits that define their origin. Hence, for adaptation study, we examined the survivability of the 11 strains in physical conditions of freezing and ultraviolet radiation, and their ability to produce extracellular cold-active enzymes. Results Multilocus sequence analysis (MLSA) using five housekeeping genes (1140 polymorphic sites) supported the taxonomic assignment of these strains to Pseudomonas antarctica, further supported by their lesser mean genetic distances with P. antarctica (0.73%) as compared to P. fluorescens (3.65 %). The studied strains displayed significant tolerance to freezing for 96 hours as compared to the mesophilic control strain, while except 4 strains, all strains exhibited substantial tolerance to UV-C radiations, and all strains produced cold active enzymes as well. Conclusion MLSA successfully resolved the taxonomy of these significant group of bacteria from physical extremes of temperature and radiation. The isolates ERGC3:01 and ERGC3:05, owing to their polyadaptational attributes, may be considered promising for exploitation in various industries.
Trans-obturator Cable Fixation for Disrupted Pubic Symphysis: A Reasonable Option Compared to Plating?
Authors: Jordan Martin C. , Jaeckle Veronika , Scheidt Sebastian , Gilbert Fabian , Hoelscher-Doht Stefanie , Ergün Süleyman , Meffert Rainer H. , Heintel Timo M.
Published: February 2021

Operative treatment of ruptured pubic symphysis by plating is often accompanied by complications. Trans-obturator cable fixation might be a more reliable technique; however, have not yet been tested for stabilization of ruptured pubic symphysis. This study compares symphyseal trans-obturator cable fixation versus plating through biomechanical testing and evaluates safety in a cadaver experiment. APC type II injuries were generated in synthetic pelvic models and subsequently separated into three different groups. The anterior pelvic ring was fixed using a four-hole steel plate in Group A, a stainless steel cable in Group B, and a titan band in Group C. Biomechanical testing was conducted by a single-leg-stance model using a material testing machine under physiological load levels. A cadaver study was carried out to analyze the trans-obturator surgical approach. Peak-to-peak displacement, total displacement, plastic deformation and stiffness revealed a tendency for higher stability for trans-obturator cable/band fixation but no statistical difference to plating was detected. The cadaver study revealed a safe zone for cable passage with sufficient distance to the obturator canal. Trans-obturator cable fixation has the potential to become an alternative for symphyseal fixation with less complications.
Proteasome Inhibitor or Immunomodulators Which is The Optimal Maintenance For Newly Diagnosed Multiple Myeloma: A 7-Year Real-World Data in China.
Authors: Han Xiaoyan , Jin Chunxiang , Zheng Gaofeng , He Donghua , Zhao Yi , Li Yi , Wu Wenjun , Zheng Weiyan , Wei Guoqing , Zhang Enfan , He Huang , He Jingsong , Cai Zhen
Published: February 2021

Background: According to different patients’ subgroups choose optimal maintenance therapy. Methods: 226 Newly Diagnosed Multiple Myeloma (NDMM) patients in our center were included, the patients’ characteristics, survival, response, subgroup analysis, adverse reactions were compared between the patients with or without maintenance, proteasome inhibitor (PI) or immunomodulators (IMiDs) maintenance. And the survival of different maintenance duration of bortezomib-based regimens was also analyzed.Results: The maintenance therapy not only upgraded more patients’ response (34.3 vs. 13.3%, p= 0.006), but also significantly prolonged the patients’ PFS (median PFS: 41.1 vs. 10.5 months, p < 0.001) and OS (median OS: not reached vs. 38.6 months, p < 0.001). Compared with IMiDs, the PFS (median PFS: 43.7 vs. 38.5 months, p = 0.034) and OS (median OS: not reached vs. 78.5 months, p = 0.041) can both benefit from bortezomib-based maintenance. The patients younger than 65 years old with bortezomib-based maintenance significantly prolonged the OS (p= 0.032). Patients achieving the only partial response (PR) after induction and consolidation therapy experienced a significantly longer PFS and OS with bortezomib-based maintenance compared to IMiDs (p= 0.007, 0.002). Besides, the high-risk patients (ISS 2-3, DS 2-3 and RISS 2-3) with bortezomib-based maintenance can benefit PFS (p= 0.002, 0.02, 0.06, respectively) and OS (p=0.059, 0.047, 0.044, respectively) compared with IMiDs. The OS was significantly prolonged in the patients who received ≥12 months of bortezomib-based maintenance than those with maintenance < 12 months (p< 0.001), but no difference was observed in OS between the patients who received the 12-24 or ≥ 24months of bortezomib-based maintenance (p= 0.292).Conclusion: Maintenance therapy can significantly improve the survival of NDMM patients. Bortezomib-based regimens maintenance was more superior to IMiDs in overall PFS and OS. The beneficial effect is most evident in patients achieving the only PR after induction and consolidation therapy, and the high-risk patients. Moreover, younger patients also could benefit from bortezomib-based maintenance in OS. The bortezomib-based maintenance duration lasting 12-24 months after induction and consolidation therapy can reach a satisfactory OS.
Gender-specific association between unidirectional variation of cholesterol and cognitive decline: a longitudinal study of middle-aged and elderly adults
Authors: Liu Huamin , Zhou Rui , Zheng Jiazhen , Zhang Minyi , Wu Keyi , Huang Zhiwei , Yuan Zelin , Wu Xianbo
Published: February 2021

Background

Higher fluctuation of cholesterol has been shown associated with cognitive decline. But the association between unidirectional variation of cholesterol and cognition remains unclear. In the present study, we examined the association between variation of cholesterol from normal to high level or from high to normal level and cognition.
Methods

A total of 4,915 participants (mean age, 57.7 years; 49.2% female) with normal cognition in baseline (2011) from the China Health and Retirement Longitudinal Study (CHARLS) were included. Plasma total cholesterol (TC), non-high-density lipoprotein cholesterol (NHDL-C), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were divided into two clusters according to cutoff in 2011 and 2015, respectively. Participants were divided into four groups: normal-normal, normal-high, high-normal and high-high. Cognitive functions were assessed by episodic memory and mental intactness. The binary logistic regression was used to analyze the association of cholesterol variation with cognitive decline.
Results

Participants with increased cholesterol were more likely had lower incidence of cognitive decline. The fluctuations of cholesterol were more likely occurred in females. The odds ratio (OR) and 95% confidence interval (CI) of global cognitive decline in normal-high compared with normal-normal group of TC was 0.61 (0.36–1.03), and significant only in females [OR and 95% CI: 0.50 (0.26–0.97)]; the risk of memory function decline in high-normal group compared with high-high group was increased both in males [OR and 95% CI: 1.98 (1.02–4.05)] and females [OR and 95% CI: 1.61 (1.01–2.74)]. The similarly results were shown in NHDL-C groups [OR and 95% CI of global cognitive decline in normal-high group: 0.50 (0.26–0.95) for overall; 0.38 (0.17–0.85) for females]; but the risk of memory function decline in high-normal group only increased in females [OR and 95% CI: 1.64 (1.02–2.25)]. The risk of mental intactness decline in males significantly decreased in high-normal group of LDL-C compared with high-high group [OR and 95% CI: 0.30 (0.13–0.67)] and increased in high-high compared with normal-normal group [OR and 95% CI: 2.27 (1.18–2.98)].
Conclusions

Longitudinal decreasing of TC or NHDL-C is detrimental to cognitive function, especially in females. But LDL-C is still a risk factor of cognitive decline in males.
Modeling and Optimization of Reactive Cotton Dyeing Using Response Surface Methodology Combined with Artificial Neural Network
Authors: Rosa Jorge Marcos , Guerhardt Flavio , Júnior Silvestre Eduardo Rocha Rocha Ribeiro , Belan Peterson Adriano , Lima Gustavo Araujo , Santana José Carlos Curvelo , Berssaneti Fernando Tobal , Tambourgi Elias Basile , Vanale Rosangela Maria , Araújo Sidnei Alves de
Published: February 2021

This work explores the modeling and optimization of the conditions to obtain a set of blue pigments for dyeing reactive cotton, by means of an approach that combines the techniques response surface methodology (RSM) and artificial neural network (ANN). By means of RSM technique the interactions and the effects of the main process variables (factors) on the behavior of coloristic intensity (K.S-1) were investigated. For this, a 26 central composite rotational design (CCRD) was carried out considering the factors temperature, NaCl, Na2CO3, NaOH, processing time and RB5 concentration. The results obtained show that all investigated factors have considerable effect on the behavior of K.S-1. The data produced in the dyeing experiments were used to build and train a Multilayer Perceptron ANN (MLP-ANN) to predict K.S-1, being the input layer of the MLP-ANN designed according to the results achieved by the RSM. The non-linear behavior of dyeing with RB5 was successfully modeled by a three-layer MLP-ANN comprising 6 input neurons, 15 hidden neuros, and 1 output neuron to indicate the value of K.S-1. The results achieved in the performed simulations confirmed the ANN effectiveness to predict K.S-1 values in RB5 the dyeing process, with high coefficient of determination (R2=0.942). The developed approach allowed the composition of a table containing optimized conditions to obtain a set of colors of the blue palette using RB5 dye, varying from sky blue to oxford blue, which will facilitate the assembly of the dyes. Finally, the experiments conducted in this work allowed the development of a computational tool to support the dyeing process, saving chemical inputs and time in cotton dyeing with specific dyestuff.
Liquid Biopsy in Cholestatic Liver Disease Using Hepatocyte-Specific Methylation Markers
Authors: Punia Sohan , Juran Brian D. , Ali Ahmad H. , Schlicht Erik M. , Moore Raymond M. , Sun Zhifu , Lazaridis Konstantinos N.
Published: February 2021

Background: Quantification of circulating organ-specific cell-free DNA (cfDNA) provides a sensitive measure of ongoing cell death that could benefit evaluation of the cholestatic liver diseases primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), which lack reliable non-invasive biomarkers. Our goal in this pilot study was to determine whether liver-specific cfDNA levels are increased in PBC and PSC patients relative to controls and in advanced versus early disease, to evaluate their potential as novel disease biomarkers.Methods: Peripheral blood derived bisulfite-treated DNA was PCR amplified from patients with PBC (n=48), PSC (n=48) and controls (n=96) to evaluate methylation status at 16 CpG sites reported to be specifically unmethylated in liver tissue near the genes IGF2R, ITIH4 and VTN. Amplicons were used to prepare paired end libraries which were sequenced on a MiSeq sequencer. Trimmed reads were aligned and used to determine unmethylation ratios and to calculate concentration of liver-specific cfDNA. Comparisons between groups were performed using the two-tailed Mann-Whitney Test and relationships between variables were evaluated using Pearson’s Correlation. Results: Levels of liver-specific cfDNA, as measured at the 3 genetic loci, were increased in PBC and PSC patients relative to controls and in late-stage relative to early-stage patients. As well, cfDNA levels were correlated with levels of alkaline phosphatase, a commonly used biochemical test to evaluate disease severity in liver disease, in patients, but not in controls. Conclusions: cfDNA offers promise as a non-invasive liquid-biopsy to evaluate liver-specific cell-death in patients with cholestatic liver diseases.
Predicting Stroke Risk in Patients with Atrial Fibrillation Using Machine Learning
Authors: Jung Seonwoo , Lee Eunjoo , Lee Minji , Bae Sejin , Kim Yeon-Yong , Lee Doheon , Song Min-Keun , Yoo Sunyong
Published: February 2021

Atrial fibrillation (AF) is a well-known risk factor for stroke. Predicting the risk is important to prevent the first attack and re-attack of cerebrovascular diseases by determining the medication. Although several statistical methods have been developed to assess the stroke risk in AF patients, considerable improvement is needed in predictive performance. We propose a machine learning-based approach based on the massive and complex Korean National Health Insurance (KNHIS) data. We extracted 72-dimensional features, including demographics, health examination, and medical history information, of 754,949 patients with AF from KNHIS. Logistic regression was used to determine whether the extracted features had a statistically significant association with stroke occurrence. Then, we constructed the stroke risk prediction model based on a deep neural network. The extracted features were used as input, and the occurrence of stroke after the diagnosis of AF was the output used to train the model. When the proposed deep learning model was applied to 150,989 AF patients, it was confirmed that stroke risk was predicted with high accuracy, sensitivity, and specificity. As part of preventive medicine, this study could help AF patients prepare for stroke prevention based on predicted stoke associated feature and risk scores.
NAP-CNB: Bioinformatic Pipeline to Predict MHC-I-Restricted T Cell Epitopes in Mice
Authors: Sánchez-García Rubén , Macías José R , Sanz-Pamplona Rebeca , Méndez-Pérez Almudena , Alemany Ramon , Veiga Esteban , Sorzano Carlos Óscar Sánchez , Muñoz-Barrutia Arrate , Wert-Carvajal Carlos
Published: February 2021

Lack of a dedicated integrated pipeline for neoantigen discovery in mice hinders cancer immunotherapy research. Novel sequential approaches through recurrent neural networks can improve the accuracy of T-cell epitope immunogenicity predictions in mice, and a simplified variant selection process can reduce operational requirements. We have developed a web server tool (NAP-CNB) for a full and automatic pipeline based on recurrent neural networks, to predict putative neoantigens from tumoral RNA sequencing reads. The developed software can estimate H-2 peptide ligands, with an AUC of 0.95, directly from tumor samples. As a proof-of-concept, we used the B16 melanoma model to test the system’s predictive capabilities, and we report its putative neoantigens. NAP-CNB web server is freely available at http://biocomp.cnb.csic.es/NeoantigensApp/ with scripts and datasets accessible through the download section.
Assessing the Role of Initial Conditions in the Local Structural Identifiability of Large Dynamic Models
Authors: Joubert Dominique , Stigter J.D. , Molenaar Jaap
Published: February 2021

Structural identifiability is a binary property that determines whether or not unique parameter values can, in principle, be estimated from error-free input-output data. The many papers that have been written on this topic collectively stress theimportance of this a priori analysis in the model development process. The story however, often ends with a structurallyunidentifiable model. This may leave a model developer with no plan of action on how to address this potential issue. We continue this model exploration journey by identifying one of the possible sources of a model’s unidentifiability: problematic initial conditions. It is well-known that certain initial values may result in the loss of local structural identifiability. Nevertheless, literature on this topic has been limited to the analysis of small toy models. Here, we present a systematic approach to detect problematic initial conditions of real-world systems biology models, that are usually not small. A model’s identifiability can often be reinstated by changing the value of such problematic initial conditions. This provides modellers an option to resolve the “unidentifiablemodel” problem. Additionally, a good understanding of which initial values should rather be avoided can be very useful during experimental design. We show how our approach works in practice by applying it to five models. First, two small benchmark models are studied toget the reader acquainted with the method. The first one shows the effect of a zero-valued problematic initial condition. The second one illustrates that the approach also yields correct results in the presence of input signals and that problematic initial conditions need not be zero-values. For the remaining three examples, we set out to identify key initial values which may result in the structural unidentifiability. The third and fourth examples involve a systems biology Epo receptor model and a JAK/STAT model, respectively. In the final Pharmacokinetics model, of which its global structural identifiability has only recently been confirmed, we indicate that there are still sets of initial values for which this property does not hold.
Spatial distribution of potentially toxic element and the potential ecological risk of wolfberry-soil system in genuine producing area of Ningxia，China
Authors: Zhou Tongning , Qin Jiaqi , Wang Yan , Zhang Yahong , Ma Caihong , Yang Jianjun , Zhu Meilin
Published: February 2021

The potentially toxic element (PTE) content and physical and chemical properties of 37 wolfberry and root soil samples obtained from Zhongning county and Shapotou district (Ningxia Hui Autonomous Region) were analyzed, and a potential ecological risk assessment was performed. In addition, multiple linear regression and geostatistical methods were used to predict and analyze the PTE concentrations and potential ecological risks of both soil and wolfberries. The PTE content in the soil was within the standard limits, and only one wolfberry sample contained Cd exceeding the standard limit (by 2.7%). The other potentially toxic elements (PTEs) did not exceed the standard limits. In the regression fitting, the models obtained for Cu, Zn, Pb, and Ni contents in the fruits showed a good correlation (p < 0.05), the PTE content of the soil showed an overall trend of high concentrations in the central part of the studied region. The ecological risk of Hg in the soil is rated as high, whereas the risks of the remaining PTEs were mostly medium or low. Further, the predicted PTE content of the wolfberries was generally high in the western region and low in the eastern region, although there were slight variations for different PTEs in some areas.
Predictor Analysis of Middle and Low Achieving Students in Cell Biology Online Course in Health Nutrition Undergraduate Program
Authors: Susilowati Rina , Fachiroh Jajah , Purnomosari Dewajani , Paramita Dewi Kartikawati , Sumiwi Yustina Andwi Ari , Septyaningtrias Dian Eurike
Published: February 2021

Background

Lack of direct contact with the students in online courses can result in lower lecturer’s awareness of their engagement and progress. Examination scores generally have the highest proportion in determining students’ grades. Predicting examination scores from the earliest point of the course may be useful in designing timely and appropriate interventions.
Aim

To analyze the predictors of midterm and final examination scores in an online cell biology course of health nutrition in the undergraduate program at the Faculty of Medicine, Public Health and Nursing Universitas Gadjah Mada, Yogyakarta Indonesia.
Methods

The learning materials including texts, PowerPoints, videos and miniquizzes were uploaded in a course management system before conducting online meetings. In total, 10 different topics were delivered. Pretest and posttest, both not used for grading, were given at the first and last online meeting. Components of the final score were classroom assessments, group assignments, midterm and final examinations. Students (n = 154) were divided into three groups based on their final examination scores, i.e., low, middle and high score. Each component of the final score was reported as mean ± standard deviation and the mean difference between groups was analyzed. Linear regression analysis was performed to reveal the main predictors of the midterm and final exam scores. Two-step cluster analysis determined by the earliest-obtained scores was performed to identify low achieving students.
Results

Students with higher final examination scores had significantly higher scores for pretest, posttest, pre and post-midterm class assessments, midterm exam and group assignments (p < 0.05). Premidterm class assessment was the main predictor of the midterm exam score. Midterm exam score was the strongest predictor of final exam score and clustering using midterm-premidterm scores identified 75% of low achieving students. To assist students with low and middle achievement, several modifications were considered such as providing longer and multiple access to the learning and formative test materials, facilitating a communication platform with fellow students and sending personal encouraging messages.
Conclusion

Scores obtained in various activities during the course potentially predict student grades. The activities should be optimized to improve students’ achievement especially for the less privileged students.
Forecast and Uncertainty Analysis of Extreme Precipitation in China from Ensemble of Multiple Climate Models
Authors: Deng Peng , Zhu Jianting
Published: February 2021

Global climate change is expected to have major impact on the hydrological cycle. Understanding potential changes in future extreme precipitation is important to the planning of industrial and agricultural water use, flood control and ecological environment protection. In this paper, we study the statistical distribution of extreme precipitation based on historical observation and various Global Climate Models (GCMs), and predict the expected change and the associated uncertainty. The empirical frequency, Generalized Extreme Value (GEV) distribution and L-moment estimator algorithms are used to establish the statistical distribution relationships and the multi-model ensemble predictions are established by the Bayesian Model Averaging (BMA) method. This ensemble forecast takes advantage of multi-model synthesis, which is an effective measure to reduce the uncertainty of model selection in extreme precipitation forecasting. We have analyzed the relationships among extreme precipitation, return period and precipitation durations for 6 representative cities in China. More significantly, the approach allows for establishing the uncertainty of extreme precipitation predictions. The empirical frequency from the historical data is all within the 90% confidence interval of the BMA ensemble. For the future predictions, the extreme precipitation intensities of various durations tend to become larger compared to the historic results. The extreme precipitation under the RCP8.5 scenario is greater than that under the RCP2.6 scenario. The developed approach not only effectively gives the extreme precipitation predictions, but also can be used to any other extreme hydrological events in future climate.
Human Performance in Three-hands Tasks
Authors: Noccaro A. , Eden J. , Pino G. , Formica D. , Burdet E.
Published: February 2021

The successful completion of complex tasks like hanging a picture or laparoscopic surgery requires coordinated motion of morethan two limbs. User-controlled supernumerary robotic limbs (SL) have been proposed to bypass the need for coordination witha partner in such tasks. However, neither the capability to control multiple limbs alone relative to collaborative control with partners, nor how that capability varies across different tasks, is well understood. In this work, we present an investigation of tasks requiring three-hands where the foot was used as an additional source of motor commands. We considered: i) how does simultaneous control of three hands compare to a cooperating dyad; ii) how this relative performance was altered by the existence of constraints emanating from real or virtual physical connections (mechanical constraints) or from cognitive limits (cognitive constraints). It was found that a cooperating dyad outperformed a single user in all scenarios in terms of tasks core, path efficiency and motion smoothness. However, while the participants were able to reach more targets with increasing mechanical constraints/decreasing number of simultaneous goals, the relative difference in performance between a dyad and a participant performing trimanual activities decreased, suggesting further potential for SLs in this class of scenario.
Promoter Methylation Changes in the Placental DIO3 and CRH Genes Are Involved in the Second Trimester Maternal Depression Induced Preterm Birth and Small for Gestational Age Birth
Authors: Yang Jianhui , Zhang Yumin , Deng Jiahui , Lin Xuemei , Xie Lili , Deng Xiaochun , Liu Honglin , Chen Peishan , Huang Yuejun
Published: February 2021

Background

Recent studies suggest that the incidence of preterm birth and SGA birth related to maternal depression, but the mechanism is unclear. The aim of this study was to explore the placental epigenetic changes involved in maternal depression induced preterm birth and small for gestational age birth.
Methods

Three hundred forty-five pregnant women were enrolled in this cohort study. Maternal depression in the second and third trimesters was assessed using a self-rating depression scale (SDS). We selected placental samples from pregnant women with depression and an equivalent number for samples from pregnant women without depression. Methylation of the promoter regions of the placental DIO3 and CRH genes was determined using next generation sequencing based on bisulfite sequencing PCR (NGS-BSP).
Results

There were 97 (28.1%) and 95 (27.5%) pregnant women who had depression in the second trimester and third trimester, respectively. The risk factors of preterm birth were older maternal age (RR = 1.43, 95%CI = 1.01–2.03), uterine infection (RR = 129.31, 95%CI = 2.16-7725.55), and maternal depression in the second trimester (RR = 79.97, 95%CI = 3.57-1792.56). The risk factors of SGA birth were low maternal BMI (RR = 0.71, 95%CI = 0.54ཞ0.92), hypertensive disorder complicating pregnancy (HDCP, RR = 4.7, 95%CI = 1.18ཞ18.72), and maternal depression in the second trimester (RR = 3.71, 95%CI = 1.31ཞ12.16). Pregnant women with depression had higher placental methylation of CRH and DIO3 genes, and there was a correlation between placental methylation of CRH and DIO3 genes.
Conclusion

Our study suggested that the changes in the promoter region of the placental DIO3 and CRH genes were involved in maternal depression in the second trimester induced preterm birth and small for gestational age birth.
Identification of a 9-gene signature related to stemness for prognosis in hepatocellular carcinoma basing on weighted gene coexpression network analysis
Authors: Yao Xinghong , Lu Chengquan , Pang Qidi , Zeng Ye
Published: February 2021

Background

Cancer stem cells (CSCs) are heterogeneous with self-renewal and differentiation ability. The mRNA expression-based stemness index (mRNAsi) described the similarity between tumor cells and CSCs, which is positively associated with the poor prognosis of cancer patients. However, the key prognostic genes related to mRNAsi in hepatocellular carcinoma (HCC) remains unclear.
Methods

In this study, RNA sequencing (RNA-seq) data of 374 liver HCC (LIHC) and 50 normal liver tissue samples were downloaded from The Cancer Genome Atlas (TCGA) database, with the corresponding clinical phenotypes. Differential expression of genes between tumor and normal tissues were analyzed. Modules correlated to mRNAsi and hub genes were identified using the weighted gene coexpression network analysis (WGCNA) package. Then, the prognostic genes associated with mRNAsi were identified. The expressions of the prognostic genes in HCC tissues were achieved by the human protein atlas (HPA) database. Gene Ontology (GO), and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis of the prognostic genes were performed. Finally, the correlations between hub genes and clinical characteristics, immune subtypes, and tumor microenvironment were analyzed.
Results

A total of 1146 downregulated genes and 5593 upregulated genes were identified in LIHC, compared with normal tissues. A 9-gene signature related to mRNAsi and HCC prognosis including PSMG3, SNRPD1, DTYMK, PIGU, NME1, TXNL4A, IPO4, PES1, and REXO4 was obtained and their expressions were confirmed by the HPA database. High expression of this signature indicates poor prognosis of HCC. Among them, DTYMK and NME1 enriched in pyrimidine metabolism, SNRPD1 and TXNL4A enriched in spliceosome and PIGU enriched in glycosyl phosphatidylinositol (GPI)-anchor biosynthesis pathways. PIGU was an independent prognostic factor of HCC, which was significantly associated with clinical characteristics. High expression of the 9-gene signature was negatively correlated with the stromal cell infiltration, and positively correlated with specific immune subtypes-related to angiogenesis, M1/M2 macrophage polarization, and M2 response.
Conclusion

A 9-gene signature related to mRNAsi and poor prognosis in HCC were identified, which can be used as biomarkers for the diagnosis of HCC and functional mechanism exploration of CSCs in HCC.
The Psychometric Properties of the Bangla Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): A Large-scale Validation Study
Authors: Islam Md. Saiful , Ferdous Most. Zannatul , Sujan Md. Safaet Hossain , Tasnim Rafia , Masud Jakir Hossain Bhuiyan , Kundu Sourav , Mosa Abu Syed Md. , Choudhuri M. Shahabuddin K. , Kira Ibrahim A. , Gozal David
Published: February 2021

Background: The Posttraumatic Stress Disorder Checklist (PCL-5) is the most widely used screening tool in assessing posttraumatic stress disorder symptoms, based on the Diagnostic and Statistical Manual of Mental disorders (DSM-5) criteria. This study aimed to evaluate the psychometric properties of the newly translated Bangla PCL-5. Methods: A cross-sectional survey was carried out among 10,605 individuals (61.0% male; mean age: 23.6±5.5 [13-71 years]) during May and June 2020, several months after the onset of the COVID-19 outbreak in Bangladesh. The survey included Bangla PCL-5 and PHQ-9 depression scale. We used confirmatory factor analysis to test the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor Hybrid model. Results: Bangla PCL-5 displayed adequate internal consistency (Cronbach’s alpha = 0.90). The Bangla PCL-5 score was significantly correlated with scores of the PHQ-9 depression scale. Confirmatory factor analyses indicated the models had a good fit to the data, including the four-factor DSM-5 model, the six-factor Anhedonia model, and the seven-factor Hybrid model.Conclusions: The Bangla PCL-5 appears to be a valid and reliable psychometric screening tool that may be employed in the prospective evaluation of posttraumatic stress disorder in Bangladesh.
Nonclassical Atomic System Dynamics Time-dependently Interacts With Finite Entangled Pair Coherent Parametric Converter Cavity Fields
Authors: mohamed A.B. , Khalil E. M. , Abd-Rabbou M. Y.
Published: February 2021

We consider a time-dependent model that describes a qubit time-dependently interacts with a cavity containing finite entangled pair coherent parametric converter fields. The dynamics of some quantum phenomena, as: phase space information, quantum entanglement and squeezing, are explored by atomic Husimi function, atomic Wehrl entropy, variance, and entropy squeezing.

The influences of the unitary qubit-cavity interaction, the difference between the two-mode photon numbers, the initial atomic coherence, and the time-dependent qubit location are investigated. It is found that the regularity, the amplitudes and the frequency of the quantum phenomena can be controlled by the physical parameters. For the initial atomic pure state, the qubit-cavity entanglement, the qubit phase space information, and atomic squeezing can be generated strongly compared to those of the initial atomic mixed state.

The time-dependent location parameters enhance the generated quantum phenomena, and its effect can be enhanced by the parameters of the two-mode photon numbers and the initial atomic coherence.
Assessment and referral in suspected COVID-19: a community based observational study
Authors: Finnikin Samuel , Haroon Shamil , Cooper Jennifer , Anand Astha , Pakiyaraja Abijan , Duncombe Ben , Lasserson Daniel
Published: February 2021

Background

The COVID-19 pandemic presented new diagnostic and management challenges to primary care alongside rapid changes in service delivery. The purpose of this study was to describe the characteristics of patients with symptoms of COVID-19 in primary care, explore which characteristics were associated with a clinical diagnosis of COVID-19 and referrals to secondary care, and to describe secondary care referral decisions with reference to national guidance.
Methods

An observational study using routinely collected data from the Birmingham Out-of-hours Research Database. The study uses consultation data from the Birmingham and Solihull COVID Referral Centre (CRC) between 21st April and 24th July. All CRC consultations were examined to extract patient demographics, free text consultations, prescriptions, observation and onward referrals. The National Early Warning Score (NEWS2) was calculated and the clinical diagnosis of COVID-19 was established. The population was described and univariate logistic regression was used to identify characteristics associated with clinical diagnosis of COVID-19 and referral decisions.
Results

681 patients were seen at the CRC and 56.3% were identified to have a clinical diagnosis of COVID-19. 14.0% of all patients were referred to secondary care, but 59% of patients classified as most severe according to national criteria were not referred. Referral was associated with increasing age, shortness of breath, tachycardia, tachypnoea and hypoxia but patients with a clinical COVID-19 diagnosis were less likely to be referred than those with other diagnoses.
Conclusion

Just over half of patients seen in the CRC were clinically diagnosed with COVID-19 and most patients were managed in the community. Guidelines developed in the absence of service delivery data for the management of COVID-19 were inconsistent with community urgent care delivery.
Effect of Altitude on Covid-19 Mortality in Ecuador: an Ecological Study
Authors: CAMPOS ADRIANA , SCHEVECK BRIDGET , PARIKH JEEGAN , HERNANDEZ-BOJORGE SANTIAGO , TERAN ENRIQUE , IZURIETA RICARDO
Published: February 2021

BackgroundThe SARS-CoV-2/COVID-19 pandemic has claimed nearly 900,000 lives worldwide and infected more than 27 million people. Researchers worldwide are studying ways to decrease SARS-CoV-2 transmission and COVID-19 related deaths. Several studies found altitude having a negative association with both COVID-19 incidence and deaths. Ecuadorian data was used to explore the relationship between altitude and COVID-19. MethodsThis is an ecological study examining province-level data. To explore a relationship between altitude and COVID-19, this study utilized publicly available COVID-19 data and population statistics. ANOVA, correlation statistics, and a multivariate linear model explored the relationship between different Ecuadorian altitudes against incidence, mortality, and case-fatality rates. Populations statistics attributed to COVID-19 were included in the linear model to control for confounding factors. ResultsRegional differences were observed for incidence, mortality, and case fatality rate suggesting an association between altitude and SARS-CoV-2 transmission and COVID-19 disease severity. In both the correlation analysis and linear model altitude showed a statistically significant negative correlation between altitude and COVID-19 mortality. ConclusionAltitude may have an effect on COVID-19 mortality rates. More research is needed to understand why altitude may have a protective effect against COVID-19 mortality and how this may be applicable in a clinical setting.
Feature-Tracking Left Ventricular Global Longitudinal Strain Improves 6 Months After Kidney Transplantation Associated With Reverse Remodeling, Not Myocardial Tissue Characteristics
Authors: Barbosa Maurício Fregonesi , Contti Mariana Moraes , Andrade Luis Gustavo Modelli de , Mauricio Alejandra del Carmen Villanueva , Ribeiro Sergio Marrone , Szarf Gilberto
Published: February 2021

PurposeTo determine whether left ventricular (LV) global longitudinal strain (GLS) measured by feature-tracking (FT) cardiac magnetic resonance (CMR) improves after kidney transplantation (KT) and to analyze associations between LV GLS, reverse remodeling, and myocardial tissue characteristics.MethodsThis is a prospective single-center cohort study of kidney transplant recipients who underwent two CMR examinations in a 3T scanner, including cines, tagging, T1 and T2 mapping. The baseline exam was done until 10 days after transplantation and the follow-up after 6 months. Age and sex-matched healthy controls were also studied for comparison. ResultsA total of 44 patients (mean age 50 ± 11 years-old, 27 (61.4%) male) completed the two CMR exams. LV GLS improved from -13.4% +/- 3.0 at baseline to -15.2% +/- 2.7 at follow-up (p < 0.001), but remained impaired when compared with controls (-17.7% +/- 1.5, p = 0.007). We observed significant correlation between improvement in LV GLS with reductions of left ventricular mass index (r = 0.356, p= 0.018). Improvement in LV GLS paralleled improvements in LV stroke volume index (r = -0.429, p = 0.004), ejection fraction (r = -0.408, p = 0.006), global circumferential strain (r = 0.420, p = 0.004) and global radial strain (r = -0.530, p = 0.002). There were no significant correlations between LV GLS, native T1 or T2 measurements (p > 0.05). Conclusion﻿In this study, we demonstrated that LV GLS measured by FT-CMR improves 6 months after KT in association with reverse remodeling, but not native T1 or T2 measurements.
Title: Preoperative Endoleak Type in Patients of Aneurysmal Sac Expansion After Endovascular Aneurysm Repair and Intraoperative Blood Loss in Aneurysmorrhaphy: Analysis of a Case Series of 18 Patients
Authors: Oshida Kazuma , Ikeda Kohei , Shibuya Yuka , Hara Masayuki , Uezono Shoichi
Published: February 2021

Purpose

EVAR (endovascular aneurysm repair) has become a possible treatment option of abdominal aortic aneurysms, and endoleak is the most common complication after EVAR. The purpose of this study was to determine the difference of intraoperative blood loss in aneurysmorraphy for aneurysmal sac expansion after EVAR according to type of endoleak.
Methods

Perioperative data of 18 patients underwent aneurysmorrhaphy for aneurysmal sac expansion after EVAR from July 2010 to November 2017 at the Jikei University Hospital are collected. Patients were divided in two group, endoleak type II or type V (endotension) according to preoperative imaging. Patient demographic and quantitative data, including intraoperative blood loss and intraoperative red blood cell transfusion volume, were collected from electronic medical and anesthetic records. Intraoperative blood loss in aneurysmorrhaphy were compared between the two groups.
Results

In 18 patients, 13 patients were diagnosed type II endoleak, and 5 patients were diagnosed endotension. There were statistically differences in intraoperative blood loss and red cell transfusion volume between type II endoleak and endotension groups (P = 0.0016 and P = 0.018, respectively).
Conclusion

These results suggest that the type of endoleak after EVAR may be associated with intraoperative blood loss in aneurysmorrhaphy. Pre-operative estimation of intraoperative blood loss depending on endoleak type may be helpful for the decision making of anesthetic management in aneurysmorrhaphy.
Marital Status and Prostate Cancer Incidence: A Pooled Analysis of 12 Case-Control Studies From the PRACTICAL Consortium
Authors: Salmon Charlotte , Song Lixin , Muir Kenneth R , Pashayan Nora , Dunning Alison M , Batra Jyostsna , Chambers Suzanne , Stanford Janet L , ostrander Elaine A , Park Jong Y , Lin Hui-Yi , Cussenot Olivier , Cancel-Tassin Geraldine , Menegaux Florence , Cordina-Duverger Emilie , Kogevinas Manolis , Llorca Javier , Kaneva Radka , Razack Azad , Lim Jasmine , Gago-Dominguez Manueal , Castelao Jose E , Kote-Jarai Zsofia , Parent Marie-Elise , Eeles Rosalind
Published: February 2021

While being in a committed relationship is associated with a better prostate cancer prognosis, little is known about how marital status relates to its incidence. Social support provided by marriage/relationship could promote a healthy lifestyle and an increased healthcare seeking behavior.We investigated the association between marital status and prostate cancer risk using data from the PRACTICAL Consortium. Pooled analyses were conducted combining 12 case-control studies based on histologically-confirmed incident prostate cancers and controls with information on marital status prior to diagnosis/interview. Marital status was categorized as married/partner, separated/divorced, single, or widowed. Tumours with Gleason scores ≥8 defined high-grade cancers, and low-grade otherwise. NCI-SEER’s summary stages (local, regional, distant) indicated the extent of the cancer. Logistic regression was used to derive odds ratios (ORs) and 95% confidence intervals (CI) for the association between marital status and prostate cancer risk, adjusting for potential confounders. Overall, 14,760 cases and 12,019 controls contributed to analyses. Compared to men who were married/with a partner, widowed men had an OR of 1.19 (95%CI 1.03-1.35) of prostate cancer, with little difference between low- and high-grade tumours. Risk estimates among widowers were 1.14 (95%CI 0.97-1.34) for local, 1.53 (95%CI 1.22-1.92) for regional, and 1.56 (95%CI 1.05-2.32) for distant stage tumours. Single men had elevated risks of high-grade cancers. Our findings highlight elevated risks of incident prostate cancer among widowers, more often characterized by tumours that had spread beyond the prostate at the time of diagnosis. Social support interventions and closer medical follow-up in this sub-population are warranted.