bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical characteristics and risk factors of hepatitis B virus-related cirrhosis in Chinese adults aged 40 years or younger: a retrospective study
Authors: Li Jing , Wen Jun , Feng Yongmei , Wang Chunyan , Jia Li , Zhu Yujin
Published: June 2022

Background: In China,the incidence of cirrhosis in young patients is not low, and some patients initially present with serious life-threatening decompensated liver cirrhosis. So we retrospectively analyze the clinical characteristics and risk factors of young (age ≤ 40 years) patients with hepatitis B virus-related cirrhosis. Methods: 163 patients with hepatitis B virus-related cirrhosis admitted to Tianjin Second People's Hospital from June 2019 to August 2020 were enrolled, and they were divided into age ≤ 40 years old group (n = 102) and age > 40 years old group (n=61). All patients were initially diagnosed as hepatitis B virus-related cirrhosis and did not receive antiviral therapy. All patients performed liver function, HBV serum markers, HBV DNA, abdominal ultrasonography,elastography,abdominal CT, and gastroscopy detections at the same period. The differences in clinical indicators between the two groups were compared, and the independent risk factors for hepatitis B cirrhosis of age ≤40 years old were further explored. Results: Compared with patients aged > 40 years, the proportion of male with hepatitis B cirrhosis in the age ≤ 40 years group was higher (P<0.05), the proportion of patients with family history of liver disease was lower (P<0.05), the levels of ALT, GGT, ALB, CHE are higher (P<0.05), the level of TBIL is lower (P<0.05), the level of HBV DNA is higher (P<0.05); and the proportion of patients with compensatory cirrhosis is higher (P<0.001). Multivariate logistic regression analysis showed that elevated GGT levels(P=0.010,OR=1.007,95%CI:1.002-1.013), and higher HBV DNA levels(P=0.025,OR=1.353,95%CI: 1.039-1.760)are independent risk factors for hepatitis B virus-related cirrhosis in patients aged ≤40 years. Conclusions: Hepatitis B virus-related cirrhosis in Chinese adults aged ≤40 years have more obvious liver inflammation, better liver synthesis, and reserve function, more active replication of hepatitis B virus, and a higher proportion of patients at the compensatory stage of cirrhosis. Elevated GGT and HBV DNA level are risk factors of cirrohosis. For these patients, reinforced follow-ups are required,and liver biopsy should be actively performed, use of antiviral drugs may be considered if necessary.
Research on imbalance machine learning methods for MRT1WI soft tissue sarcoma data
Authors: Liu Xuanxuan , Guo Li , Wang Hexiang , Guo Jia , Yang Shifeng , Duan Lisha
Published: June 2022

Background: Soft tissue sarcoma is a rare and highly heterogeneous tumor in clinical practice. Pathological grading of the soft tissue sarcoma is a key factor in patient prognosis and treatment planning while the clinical data of soft tissue sarcoma are imbalanced. In this paper, we propose an effective solution to find the optimal imbalance machine learning model for predicting the classification of soft tissue sarcomas data. Methods: In this paper, a large number of features are first obtained based on T1WI images using the radiomics methods. Then, we explore the combinations of different sampling techniques, feature selection methods, and classification algorithms, and get nine imbalance machine learning models based on the above features. The receiver operating characteristic curve model is used to evaluate the performance of these nine methods on predicting the pathological grade of soft tissue sarcoma. Results: The experimental results show that the combination of extremely randomized trees classification algorithm using random oversampling examples (ROSE) and the recursive feature elimination technique performs best compared to other combination methods. The receiver operating characteristic area under the curve, accuracy, sensitivity, specificity and G-mean of this method for predicting high-grade versus low-grade soft tissue sarcoma are 0.9457, 94.61%, 93.55%, 95.59% and 0.9456, respectively. Conclusion: Preoperative predicting pathological grade of soft tissue sarcomas in an accurate and noninvasive manner is essential. Our proposed machine learning method can make a positive contribution to solving the imbalanced data classification problem, which can favorably support the development of personalized treatment plans for soft tissue sarcoma patients.
Knowledge, attitude and practices of HIV/AIDS prevention among trainee nurses in north-eastern corridor, Ghana: A cross-sectional survey
Authors: Mutaru Abdul-Manaf , Ibrahim Aminu , Wumpini Abdul-Nuru Osman , Agana Timothy Atanga , Alhassan Ahmad Sukerazu
Published: June 2022

Background: HIV/AIDS remains a modern-day global burden, killing almost 39 million people with over 36 million living with the disease, and two million new cases annually. The risk of infection in clinical practice among health workers has been noted to be high, compared to the general population. The study therefore seeks to determine the knowledge, attitude, and practice of HIV/AIDS prevention among nursing students along the north-eastern corridor of Ghana.Methods: A cross-sectional descriptive design with a quantitative approach was employed. Multistage stratified random sampling technique was used to select 373 trainee nurses. A Pearson’s chi-square analysis was performed at 0.20 precision level. Determinants of knowledge, attitude, and practice was established with a multivariate logistic regression at 95% confidence level.Results: Majority of participants had satisfactory knowledge (88.0%), good attitude (87.9%), and good practices (57.6%) towards HIV/AIDS prevention. Students in their final year of the study were 2.3 times more likely to demonstrate good attitudes towards HIV/AIDS prevention than first years (aOR: 2.28; CI: 1.10 – 4.72). Those with sufficient knowledge on HIV/AIDS were 3.5 times more likely to have good attitudes towards its prevention than those with insufficient knowledge levels (aOR: 3.46; 1.76 – 6.77). Conclusion: There are satisfactory knowledge, attitude, and practices among trainee nurses regarding HIV/AIDS prevention in the study setting. Increase access to knowledge regarding HIV/AIDS can improve attitudes towards its prevention. However, there is a need for appraisal of the clinical placement programs of trainee nurses to ensure improved practice. Further studies are needed to ascertain the role of knowledge and attitudes in enhancing practices on HIV/AIDS prevention.
Quantification and Molecular Characterization of Extended Spectrum Beta-Lactamase Producing Enterobacteriaceae From Agropastoral Communities of Mbarara District, South Western Uganda
Authors: Muhwezi Ivan , Bazira Joel , Zamarano Henry , Byarugaba Frederick , Sabiiti Wilber , Holden Mathew , Asiimwe Benon B.
Published: June 2022

Background: Bacterial infections are the commonest in both community and healthcare settings. Emergency of Extended Spectrum Beta-Lactamase producing Enterobacteriaceae has contributed to poor clinical outcomes. More efforts regarding antibiotic resistance have been dedicated to clinical settings and we do not know the extent of the catastrophe in community settings. We aimed at determining the burden, antimicrobial susceptibility patterns and molecular characteristics of Extended Spectrum Beta-Lactamase producing Enterobacteriaceae in agro-pastoral communities of Mbarara district, South western Uganda.Methods: A laboratory based descriptive cross-sectional study was carried out among Enterobacteriaceae isolated from outpatients presenting with signs and symptoms of Urinary Tract Infections. Urine samples were delivered to Microbiology Laboratory of Mbarara University of Science and Technology for culture, identification, testing for ESBL production and Antibiotic Susceptibility Testing. Molecular characterization of ESBL producing Enterobacteriaceae was carried out at Medical and Molecular Laboratories Limited of Makerere University.Results: A total of 88 Enterobacteriaceae fulfilling the inclusion criteria were considered into the study. Escherichia coli 70.45% and Klebsiella pneumoniae 13.64% were the most isolated followed by Klebsiella oxytoca, Proteus mirabilis and Enterobacter aerogenes at 10.23%, 3.41% and 2.27% respectively. The production of ESBL was observed at 23.86%. Generally, high resistance rates were observed against Ampicillin 100%, Cefepime 100%, Aztreonam 95.24%, Nalidixic acid 90.48%, Ciprofloxacin 85.71% and Amoxicillin/clavulanate 80.95%. High rates of sensitivity were observed to Meropenem 95.24%, Imipenem 95.24%, Amikacin 95.24%, Gentamycin 90.48%, Cefoxitin 76.19% Piperacillin/tazobactam 80.95% and Nitrofurantoin 66. 67%. MDR was observed at 85.71%. The most prevalent genes in ESBL producing Enterobacteriaceae were CTX-MU 46.7%, TEM 30.00% and SHV 23.3%.Conclusion: We demonstrated high prevalence, antibiotic resistance rates among Extended Spectrum Beta-Lactamase producing Enterobacteriaceae in the community. We recommend more community ESBL related studies and a One Health Approach to guide public health interventions.
Autologous myocutaneous flap implantation for chronic refractory chest wall sinus with infection:a case report
Authors: Wang Lei , Liu Zhijun , He Zhongliang , Zhang Chun
Published: June 2022

Background Chest wall sinus with infection is a refractory disease caused by a variety of susceptible factors, and the treatment is still challenging.For clinically complex cases, although there are various surgical methods to choose from, it is still very difficult to achieve clinical cure,especially for patients with older age and many underlying diseases.Complete resection of chest wall sinus and application of repair and reconstruction technology may bring hope to refractory cases. Case presentation Herein,We report a case of a 67-year-old woman who had undergone breast cancer surgery and a history of multiple cycles of radiotherapy and chemotherapy.One year ago, she had a fistula in the left chest wall with yellow purulent fluid.After admission to our hospital, chest computed tomography (CT) showed the formation of the left chest wall sinus, accompanied by high-density images of the left clavicle, part of the ribs and part of the sternu.According to the patient's symptoms, signs and imaging examination, we preliminarily diagnosed the patient as chest wall sinus with infection and chronic osteomyelitis.Therefore, in the first-stage operation,the patient underwent left chest wall sinus resection, left partial rib resection, left partial clavicular resection and left partial sternal resection,After surgery, the wound surface was changed with gauze dressing with sensitive antibiotic solution every day until the wound surface was clean and new granulation was formed.In the second-stage operation, the wound surface was appropriately expanded, and the pedicled latissimus dorsi myocutaneous flap was transferred to the chest wall defect. Finally, the skin paddle was sutured without tension to the normal skin around the chest, and two drainage tubes were placed.Anti-infection, anti-spasm, anti-coagulation and other treatments were given after operation, and the survival of myocutaneous flap, wound healing and sinus disappearance were observed. Conclusions The application of pedicled latissimus dorsi myocutaneous flap in the treatment of intractable chronic chest wall sinus is an effective method. It does not change the shape of the thorax. The clinical effect is satisfactory in the near and medium term, which is worthy of clinical promotion.
The impact of obesity on the accuracy of DXA BMD for DXA-equivalent BMD estimation.
Authors: LEE DongHa
Published: June 2022

Introduction: As the radiomics technique using texture features in CT is adopted for accessing DXA-equivalent bone mineral density (BMD), this study aims to compare BMD by DXA and predicted BMD to investigate the impact of obesity and central obesity in general patients.Materials and Methods: A total of 710 cases (621 patients) obtained from May 6, 2012, to June 30, 2021, were used in the study. We focused both their abdomen & pelvis CT’s first lumbar vertebrae axial cuts to predict DXA-equivalent BMD and bone mineral content (BMC). In each patient’s CT, we extracted the largest trabecular region of the L1 vertebral body as a region of interest (ROI) using the gray-level co-occurrence matrices (GLCM) technique, and linear regression was applied to predict the indices. Cases were divided by central obesity/overall obesity and normal group by body mass index (BMI), waist circumference (WC), or index of central obesity (ICO) standard. Results: The coefficients were all above 0.73, respectively. P-values from ICO were over 0.05 when the measures were Hip BMD and Hip BMC. In contrast, those from ICO were 0.0131 and 0.0351 when the measures were L1 BMD and L1 BMC, respectively, which show a difference between the two groups. Conclusions: The CT HU texture analysis method was an effective and economical method for measuring DXA-equivalent BMD and BMC and evaluating the impact of obesity. We found that central obesity especially exerted an effect on the disturbance of the DXA-based measurements since groups were significantly different under the ICO standard.
Drosophila Keap1 xenobiotic response factor regulates nuclear architecture through interacting with B-type lamin
Authors: Carlson Jennifer , Neidviecky Emma , Cook Isabel , Deng Huai
Published: June 2022

The Keap1-Nrf2 pathway is a central regulator that mediates transcriptional response to xenobiotic and oxidative stimuli. Recent studies revealed that Keap1 and Nrf2 can regulate transcription other than antioxidant and detoxifying genes, and the underlying mechanisms remain unclear. We have found that Drosophila Keap1 (dKeap1) and Nrf2 (CncC) proteins can control high-order chromatin structure including heterochromatin. Here, we describe evidence supporting that dKeap1 regulates heterochromatin through the interaction with lamin, the intermediate filament proteins that form nuclear lamina and organize chromatin architecture. dKeap1 forms complex with the Drosophila B-type lamin, lamin Dm0, in the nucleus. Ectopic expression of dKeap1 relocated lamin to the intra-nuclear area and caused a spreading of the heterochromatin marker H3K9me2 to euchromatin regions. Mis-regulated dKeap1 also disrupted the nuclear lamina morphology. Knock down of dKeap1 partially rescued the lethality induced by lamin overexpression, suggesting that dKeap1 and lamin function in the same pathway during development. Taken together, these results support a model where dKeap1 regulates chromatin structure and transcription through interaction with lamin protein. This study reveals a novel epigenetic function of the Keap1 oxidative/xenobiotic response factor.
Prevalence, socio-demographic determinants, and self-reported reasons for hysterectomy and choice of hospitalization in India
Authors: Kumari Priyanka , Kundu Jhumki
Published: June 2022

Background
There is limited evidence of hysterectomy in India because of a lack of data in large-scale, nationally representative health surveys. The fifth National Family Health Survey collected direct data on hysterectomy and self-reported reasons for the treatment among women of reproductive age in 2019–21 using the NFHS-5 dataset. This study evaluates the prevalence, determinants, and choice of hospitalization (Public vs. Private) for conducting hysterectomy in India among women aged 15–49 years in 29 states and seven union territories (UTs).
Methods
Cross-tabulations and percentage distributions were utilized to analyse the prevalence of hysterectomy and the choice of hospitalization (public vs. private) across different socioeconomic backgrounds and reasons for undergoing hysterectomy. A multivariate binary logistic regression model was also used to find statistically significant determinants of hysterectomy.
Results
In India as a whole, 3% of women aged 15–49 years had undergone a hysterectomy. The percentage of women who had undergone the procedure was found to vary considerably across the states and the UTs. A noticeable fact that emerged was that the majority of the hysterectomies were performed in the private sector in India. Age, place of residence, religion, caste, level of education, geographic region, wealth quintiles, parity, age at first cohabitation of women were found to be the socio-demographic determinants statistically associated with hysterectomy in India. The reasons frequently reported for hysterectomy were excessive menstrual bleeding/pain, followed by fibroids/cysts.
Conclusion
The percentage and likelihood of undergoing hysterectomy were relatively high among women, those who reside in rural areas, those without schooling, those who belonged to the richest wealth quintile, those with an early age at first cohabitation and those who reside in the eastern and southern parts of India. These findings have policy implications in that reproductive health programme managers should assure regular screening and treatment of issues that lead to hysterectomy.
Innovation of NURBS feedrate direct interpolator in five-axis for CNC high-precision and high-efficiency machining
Authors: Cao Libo , Wang Taiyong , Jia Songhui , Dong Jingchuan , Tian Chong , Tian Ying , Zheng Mingliang
Published: June 2022

The high-precision machining is restricted by truncation error and computational burden of second-order derivative in the second-order Taylor expansion (STE) interpolator which is usually used by scholars due to its advantages of high-precision and G3 continuity or higher. In conventional methods, the improved accuracy of interpolation parameter in the Taylor expansion interpolator will lead to a great increase in the computational burden of higher-order derivatives or compensation methods, resulting in degraded real-time performance. To tackle the bottlenecks, Non-uniform rational B-Splines (NURBS) feedrate direct interpolator (FDI) is proposed in the paper. The FDI for NURBS is divided into three parts, S-shaped acceleration/deceleration algorithm, feedrate scheduling, and the proposed FDI. In feedrate scheduling, four typical scheduling patterns are established to reduce the complexity of feedrate scheduling based on S-shaped flexible acceleration/deceleration and are used to obtained the maximum starting feedrate with feedrate constraint. The round method of feedrate duration must be adopted due to the non-integer multiple between interpolation period Ts and the generated duration time based on S-shaped acceleration/deceleration in conventional methods, while the proposed FDI completely follows the original feedrate produced by the feedrate scheduling. FDI is an equation in the continuous time domain rather than an inequality like STE, which can ensure the accuracy of interpolation parameter in theory. Furthermore, Computerized Numerical Control (CNC) system are inherently discrete-time systems, not continuous-time systems. Based on discrete features, the FDI equation is discretized to follow the precision of original feedrate duration which is the exact mapping of NURBS curve. The consistent precision greatly ensures the accuracy of the interpolation parameter in theory. Only with the original feedrate, can FDI directly obtain theoretically accurate interpolation parameter without any round and compensation method. With the proposed FDI, feedrate synchronous interpolator (FSI) method is proposed for dual-NURBS in five-axis machining. Only the tool tip interpolation parameter needs to be calculated by FDI and the interpolation parameter of tool orientation can be obtained by FSI directly with optimal tool attitude and high real-time performance. The FSI can make the tool orientation vector closer to the surface normal direction, which is more conducive to improving the cutting quality. Experiments were carried out on the machine tool to demonstrate the advantage of the proposed method in improving machining efficiency and the accuracy of interpolation parameter, simultaneously.
Outcome of Patients with Soft Tissue Sarcomas of the Extremities and Trunk Treated by (Neo)adjuvant Intensity Modulated Radiation Therapy in Curative Intention
Authors: Dapper Hendrik , Hoyer Annika , Diehl Christian , Knebel Carolin , Mogler Carolin , Borm Kai , Görner Martin , Dobiasch Sophie , Combs Stephanie E. , Peeken Jan C.
Published: June 2022

BACKGROUND Soft tissue sarcomas (STS) are a relatively rare group of malignant tumors. Currently, there is very little published clinical data, especially in the context of curative multimodal therapy with image-guided, conformal, intensity-modulated radiotherapy.METHODSPatients who received preoperative or postoperative intensity-modulated radiotherapy for STS of the extremities or trunk with curative intent were included in this single centre retrospective analysis. A Kaplan-Meier analysis was performed to evaluate survival endpoints. Multivariable proportional hazard models were used to investigate the association between survival endpoints and tumour-, patient-, and treatment-specific characteristics. RESULTS86 patients were included in the analysis. The most common histological subtypes were undifferentiated pleomorphic high-grade sarcoma (UPS) (27) and liposarcoma (22). More than two third of the patients received preoperative radiation therapy (72%). During the follow-up period, 39 patients (45%) suffered from some type of relapse, mainly remote (31%). The two-years overall survival rate was 88%. The median DFS was 48 months and the median DMFS was 51 months. Male gender (HR 0.460 (0.217; 0.973)) and histology of liposarcomas compared to UPS proved to be significantly more favorable in terms of DFS (HR 0.327 (0.126; 0.852)).CONCLUSIONConformal, intensity-modulated radiotherapy is an effective treatment modality in the preoperative or postoperative management of STS. Especially for the prevention of distant metastases, the establishment of modern systemic therapies or multimodal therapy approaches is necessary.
Rapid and unplanned urbanization in the least developed districts of Bangladesh: A case study from Jamalpur
Authors: Mamun SM Abdullah Al , Islam Md. Mozahidul , Okely Anthony D , Hossain Mohammad Sorowar
Published: June 2022

Urbanization monitoring is critical for planners, governments and non-governmental organizations, and scientists to design policies that maximize the use of natural resources and accommodate development while reducing environmental effects. The purpose of this research is to analyze how land use/land cover (LULC) has changed since 2001 in the largely unknown least developed districts of Bangladesh using multispectral satellite imagery. Utilizing object-based image classification and on-field validation for seven LULC classes, it was found that built-up area expanded by 622.65% during the past two decades depleting agricultural lands, water bodies, and vegetation. This study will act as a baseline for future studies and will be insightful to urban planners and policymakers in developing countries regarding urban sustainability and minimizing urban risks and hazards.
Blood DNA methylation signatures of lifestyle exposures: Tobacco and alcohol consumption
Authors: Chamberlain Jonviea D , Nusslé Sébastien , Chapatte Laurence , Kinnaer Cassandre , Petrovic Dusan , Pradervand Sylvain , Bochud Murielle , Harris Sarah E , Corley Janie , Cox Simon R , Nusslé Semira Gonseth
Published: June 2022

BackgroundSmoking and alcohol consumption may compromise health by way of epigenetic modifications. Epigenetic signatures of alcohol and tobacco consumption could provide insights into the reversibility of phenotypic changes incurred with differing levels of lifestyle exposures. This study describes and validates two novel epigenetic signatures of tobacco (EpiTob) and alcohol (EpiAlc) consumption and investigates their association with disease outcomes.MethodsThe epigenetic signatures, EpiTob and EpiAlc, were developed using data from the the Swiss Kidney Project on Genes in Hypertension (SKIPOGH) (N=730). Epigenetic and phenotypic data available from the 1921 (N=569) and 1936 (N=1091) Lothian Birth Cohort (LBC) studies, and two publicly available datasets on GEO Accession (GSE50660, N=464; and GSE110043, N=94) were used to validate the signatures. A multivariable logistic regression model, adjusting for age and sex, was used to assess the association between self-reported tobacco or alcohol consumption and the respective epigenetic signature, as well as to estimate the association between CVD and the epigenetic signatures. A Cox proportional hazard model was used to estimate the risk of mortality in association with the EpiTob and EpiAlc signatures. ResultsThe EpiTob signature was positively associated with self-reported tobacco consumption for current or never smokers with explained variance ranging from 0.49 (LBC1921) to 0.72 (LBC1936) (pseudo-R2). In the SKIPOGH, LBC1921 and LBC1936 cohorts, the epigenetic signature for alcohol consumption explained limited variance in association with self-reported alcohol status [i.e., non-drinker, moderate drinker, and heavy drinker] (pseudo-R2=0.05, 0.03 and 0.03, respectively), although this improved considerably when measuring self-reported alcohol consumption with standardized units consumed per week (SKIPOGH R2=0.21; LBC1921 R2=0.31; LBC1936 R2=0.41). Both signatures were associated with history of CVD in SKIPOGH and LBC1936, but not in LBC1921. The EpiTob signature was associated with increased risk of all-cause and lung-cancer specific mortality in the 1936 and 1921 LBC cohorts.ConclusionsThis study found the EpiTob and EpiAlc signatures to be well-correlated with self-reported exposure status and associated with long-term health outcomes. Epigenetic signatures of lifestyle exposures may reduce measurement issues and biases and could aid in risk stratification for informing early-stage targeted interventions.
Pessary With Perineal Suture for Treatment of Pelvic Organ Prolapse: Description and Benefit of the Technique
Authors: Febles Marta Pérez , Manso Sonia De Miguel , García Elena García , Pais Maria López , Gonzalez Maria Cuaresma , Nieto Marta Ibañez
Published: June 2022

Introduction and Hypothesis:Vaginal pessaries are used as a conservative treatment for POP in women who do not want or are not candidates for surgery, or as a preliminary step to surgery. Our goals are:· Evaluate the evolution of patients with advanced POP and repeated expulsion of the pessary, who underwent perineal suture to try to maintain the device.· Describe the epidemiological characteristics of patients treated with pessaries in our environment, with or without perineal closure.Methods:Observational, descriptive and prospective study (October 2016-March 2021) that includes 352 women with advanced-stage POP treated with a pessary, of which 55, after repeated expulsion of the pessary, were treated with a pessary and perineal suture.Results:After pessary insertion associated with perineal closure, 26 patients (47.2%) expelled the pessary and underwent surgery, and 29 (52.8%) kept the device, avoiding surgery.Regarding the women who required perineal suture:The mean age was higher than in the group of patients who did not need this intervention (75.3 vs. 68.3 years), 94.5% had POP ≥ grade III and 100% had a perineal width >2.5cm. Conclusions:· Treatment with pessary and perineal closure avoids surgery in women with advanced age and repeated expulsion.· Although age should not be an independent factor that limits surgical treatment or the type of intervention, it would be useful to have scales to quantify the frailty of patients, being able to standardize perineal closure in elderly and/or frail women, and in those who do not want or have contraindications for surgery.
Synthesis and Antitumor Activity Evaluation in Vitro of Novel 5-cyano-6-phenyl-2,4-Disubstituted Pyrimidine Derivatives
Authors: Si Xiaojie , Gao Chao , Chi Lingling , Wang Hao , Zhang Yutong , Dai Honglin , Liu Limin , Wang Zhangjie , Zheng Jiaxin , Ke Yu , Liu Hongmin , Zhang Qiurong
Published: June 2022

In order to search for new antitumor drugs with high efficiency, a series of novel 5-cyano-6phenyl-2,4-disubstituted pyrimidine derivatives were designed, synthesized and evaluated for antiproliferative activity against four human cancer cell lines (MGC-803, PC-3, A549 and H1975) using MTT assay in vitro. Among them, compound N-(3-chloro-4-fluorophenyl)-2-((5-cyano-4phenyl-6-(pyrimidin-2-ylthio) pyrimidin-2-yl) thio) acetamide (15n) showed good anti-tumor proliferation activity against four tested cancer cell lines, with IC50 values of 1.86±0.27μM to PC-3 cell. The antitumor activity was significantly better than that of the positive control 5-Fluorouracil. Further mechanism studies showed that compound (15n) inhibited the clonal formation and migration of PC-3 cells in a concentration dependent manner, and induced PC-3 cell cycle arrest in G0/G1 phase, thereby inhibiting the proliferation of PC-3 cells. At the same time, compound (15n) induced PC-3 cell apoptosis in a concentration dependent and time-dependent manner. When the concentration of compound (15n) is 4 μM, the proportion of apoptotic cells was 66.13%. And compound (15n) promoted the accumulation of reactive oxygen species in PC-3 cells in a concentration dependent manner.
An important tool in lymphedema management: validation of turkish version of the gynecologic cancer lymphedema questionnaire
Authors: abakay hanife , abdulrezzak ümmühan , akbayrak türkan
Published: June 2022

Backround: The aim of this study was to research the reliability and validity of the Turkish version of the Gynecologic Cancer Lymphedema Questionnaire (GCLQ) for individuals with gynecologic cancer.Materials and Method: The study included 60 patients who underwent gynecologic cancer surgery with lower limb lymphedema (LLLE) in the lymphedema group (LE) and 30 who underwent gynecologic cancer surgery without LLLE in the non-LE group. The Turkish adaptation of the GCLQ was completed by considering the cultural adaptation process. For the evaluation of lymphedema, circumference measurement, skin layer thickness and lymphoscintigraphy assessments were performed. The intraclass correlation (ICC) coefficient was calculated for GCLQ test-retest reliability, the Cronbach alpha was calculated for internal consistency reliability and the criteria validity method was used for survey validity.Results: The symptom subsections and total score of the GCLQ, the ICC values for test-retest points were 0.780, 0.968, 0.695, 0.945, 0.896, 0.945, and 0.947. The Cronbach 𝛼 values for internal consistency were 0.928, 0.824, 0.656, 0.429, 0.923 and 0.948 for the subsections. Criteria validity was used for the validity analysis and statistically significant (p<0.05) positive correlations were determined between skin fold thickness measurements and total points on the scale in the LE group for values at the midpoint of the right and left tibial shaft (r=0.336, r=0.284).Conclusion: The GCLQ was determined to be a reliable and valid scale to differentiate patients with LLLE from those without LLLE in a Turkish female population.
Maternity protection for female non-standard workers in South Africa: the case of domestic workers
Authors: Pereira-Kotze Catherine , Doherty Tanya , Faber Mieke
Published: June 2022

Background
Many women work in positions of non-standard employment, with limited legal and social protection. Access to comprehensive maternity protection for all working could ensure that all women and children can access health and social protection. This study aimed to describe the maternity protection benefits available to women in positions of non-standard employment in South Africa, using domestic workers as a case study.
Methods
A qualitative descriptive study design was used. National policy documents containing provisions on maternity protection were identified and analysed. Interviews were conducted with purposively selected key informants. Data extracted from published policy documents and information obtained from interviews were triangulated. A thematic analysis approach was used for evaluation of policy content and analysis of the interviews.
Results
Twenty-nine policy and legislative documents were identified that contain provisions on maternity protection relevant to non-standard workers. These documents together with three key informant interviews and two media releases are used to describe availability and accessibility of maternity protection benefits for non-standard workers in South Africa, using domestic workers as a case study. Maternity protection is available in South Africa for some non-standard workers. However, the components of maternity protection are dispersed through many policy documents and there is weak alignment within government on maternity protection. Implementation, monitoring, and enforcement of existing maternity protection policy is inadequate. It is difficult for non-standard workers in South Africa to access maternity protection benefits, particularly cash benefits. Some non-standard workers in South Africa have unique challenges in accessing maternity protection, for example domestic workers whose place of work is a private household and therefore difficult to monitor.
Conclusion
The heterogeneity of non-standard employment makes it challenging for many women to access maternity protection entitlements. There are policy amendments that could be made and improvements to policy implementation that would improve non-standard workers’ access to maternity protection. Potential long-term benefits to women and children’s health and development could come from making comprehensive maternity protection available and accessible to all women.
A new approach to fixed point methodologies for cyclic contraction mappings in C*-algebra-valued b-metric spaces
Authors: Rashwan Rashwan A. , Omran Saleh , Hammad Hasanen A. , Gamal Mohamed
Published: June 2022

In this manuscript, we focused our attention on extracting some fixed point results for cyclic contraction mappings under a new contractive condition in the context of C*-algebra. These results are considered a generalization and extension of some results in the literature such as the results of Banach, Kannan and Chatterjea in the setting of C*-algebra valued b-metric space (shortly C*-algebra Vb − MS). We present some new definitions and nontrivial examples to support our main results.Mathematics Subject Classification: 47H10, 46L07.
COVID-19 vaccination acceptance in underserved urban areas of Islamabad and Rawalpindi: Results from a cross-sectional survey
Authors: Kazmi Twangar , Khan Adnan Ahmad , Abdullah Mujahid , Safdar Rana Muhammad , Afzal Sabeen , Khan Ayesha
Published: June 2022

Background:
Urban slums are home to a significant number of marginalized individuals and are often excluded from public services. This study explores the determinants of willingness and uptake of COVID-19 vaccines in urban slums in Pakistan.
Methods:
The study is a cross-sectional survey of 1760 individuals from five urban slums in Rawalpindi and Islamabad. The survey was conducted between June 16 and 26, 2021 to ask about the experience of COVID-19 infection, willingness and registrations to receive, and actual vaccinations.
Results:
A prior experience of COVID-19 infection was uncommon in any locality in that only 2–17% had encountered the infection themselves or by a family member. Willingness to receive vaccination and uptake correlated with increasing age, education, employment, prior infection in the family (but not self), family vaccination, and knowing of and living close to a vaccination center. Both willingness and vaccination were the lowest in the two informal settlements that are the furthest from public facilities.
Conclusions:
We found low lived experience with COVID-19 infection in urban slums, which was associated with moderate willingness and low vaccination rates. Interventions that seek to vaccinate individuals against COVID-19 must account for urban poor settlement populations and overcome structural barriers such as distance from vaccination services, perhaps by bringing such services to these communities.
Improved Delivery of Mcl-1 and survivin siRNA combination in breast cancer cells with additive siRNA complexes
Authors: Santadkha Tinnabhop , Skolpap Wanwisa , K.C. Remant , Ansari Aysha , Kucharski Cezary , Uludağ Hasan
Published: June 2022

This study aimed at investigating the influence of commercial transfection reagents (Prime-Fect, Leu-Fect A, and Leu-Fect C) complexed with different siRNAs (CDC20, HSP90, Mcl-1 and Survivin) in MDA-MB-436 breast cancer cells and the impact of incorporating an anionic additive, Trans-Booster, for improving in vitro gene silencing and delivery efficiency. Gene silencing was quantitatively analyzed by real-time RT-PCR while cell proliferation and siRNA uptake were evaluated by the MTT assay and flow cytometry, respectively. Amongst the investigated siRNAs and transfection reagents, Mcl-1/Prime-Fect complexes showed the highest inhibition of cell viability and most effective siRNA delivery. The effect of various formulations on transfection efficiency showed that a anionic additive with 1:1 ratio with siRNA was optimal achieving the lowest cell viability compared to untreated cells and negative control siRNA treatment (p<0.05). Furthermore, the combination of Mcl-1 and survivin siRNA suppressed the growth of MDA-MB-436 cells more effectively than treatment with the single siRNAs and resulted in a cell viability as low as ~20% (vs. non-treated cells). This aligned well with the induction of apoptosis as analyzed by flow cytometry, which revealed higher apoptotic cells with the combination treatment group. We conclude that commercial transfection reagents formulated with Mcl-1/Survivin siRNA combination could serve as a potent anti-proliferation agent in treatment of breast cancers.
Changes in plasma fatty acids profile in hyperketonemic ewes during early lactation revealed by gas chromatography (GC) technique
Authors: Lisuzzo Anastasia , Fiore Filippo , Harvatine Kevin , Mazzotta Elisa , Berlanda Michele , Spissu Nicoletta , Badon Tamara , Contiero Barbara , Moscati Livia , Fiore Enrico
Published: June 2022

The transition from late pregnancy to early lactation is characterized by marked changes in energy balance of dairy ruminants. The mobilization of adipose tissue led to an increase in plasma non-esterified fatty acids (NEFA) and β-hydroxybutyrate (BHB). The aim of this study was to analyze the total plasma fatty acids of healthy and hyperketonemic dairy ewes in early lactation through gas chromatography (GC) to evaluate metabolic alterations. An observational study was used with a cross-sectional experimental design. Forty-six Sarda dairy ewes were enrolled in the immediate post-partum (7±3 days in milk) and divided into two groups according to serum BHB concentration: non-hyperketonemic group (n=28; BHB<0.86 mmol/L) and hyperketonemic group (n=18; BHB≥0.86 mmol/L). A two-way ANOVA included the effect of group and parity was used to evaluate differences in fatty acids concentrations. A total of 34 plasma fatty acids was assessed using GC. Among them, twelve fatty acids were significant and three tended to significance. Only NEFA concentration and stearic acid were influenced by parity. The study revealed relationships with lipid metabolism, inflammatory and immune responses. In conclusion, GC represents a useful tool in the study of hyperketonemia and primiparous dairy ewes might show a greater risk to develop this disease.
Public Engagement in Micro-Hydro Technology in Central Java, Indonesia
Authors: Pradheksa Pratama Yudha , Arimbi Putri Cahya
Published: June 2022

* Indonesia's abundance of rivers and waterfalls boosted the potential for micro-hydro in remote areas.* Public engagement in micro-hydro is important to Indonesia's decarbonization targets.* The engagement has been driven mostly by social and economic concerns, as well as environmental ones.* Micro-hydro development requires equitable engagement between local stakeholders and credential experts, supported by decentralized regulations.
The faunal Ponto-Caspianization of European waterways
Authors: Soto Ismael , Cuthbert Ross N. , Ricciardi Anthony , Ahmed Danish A. , Altermatt Florian , Archambaud-Suard Gaït , Bonada Núria , Cañedo-Argüelles Miguel , Csabai Zoltan , Datry Thibault , Dick Jaimie T. A. , Floury Mathieu , Forio Marie Anne Eurie , Forcellini Maxence , Fruget Jean-François , Gallardo Belinda , Goethals Peter , Haase Peter , Hudgins Emma J. , Jones J. Iwan , Kouba Antonín , Leitner Patrick , Lizée Marie-Helène , Maire Anthony , Murphy John F. , Ozolins Davis , Rasmussen Jes Jessen , Schäfer Ralf , Schmidt-Kloiber Astrid , Skuja Agnija , Stubbington Rachel , Lee Gea H. Van der , Vannevel Rudy , Várbíró Gábor , Verdonschot Ralf C. M. , Welti Ellen A.R. , Wiberg-Larsen Peter , Haubrock Phillip J. , Briski Elizabeta
Published: June 2022

As alien invasive species are a key driver of biodiversity loss, understanding patterns of rapidly changing global species compositions depends upon knowledge of biological invasion dynamics and trends. The Ponto-Caspian region is among the most notable donor regions for aquatic invasive species in Europe. Using macroinvertebrate time series collected over 52 years (1968–2020) at 265 sites across 11 European countries, we examined the occurrences, invasion rates and interspecific interactions of freshwater Ponto-Caspian fauna, as well as biotic homogenization trends in European waterways. According to our data, Ponto-Caspian macroinvertebrates increased from two species in 1972 to 29 species in 2012 and we found a greater richness of invading Ponto-Caspian macroinvertebrates in datasets collected closer to the source region. This may reflect dispersal lag times, indicating that more distant sites will be increasingly invaded in the future. The pioneering Ponto-Caspian species that arrived first were often bivalves (46.5% of cases), particularly Dreissena polymorpha, followed secondarily by amphipods (83.8%; primarily Chelicorophium curvispinum and Dikerogammarus villosus). With increasing invasions, the time between consecutively-appearing invaders decreased six-fold, indicating potential facilitations that improved invasion success of subsequent taxa. We detected a negative relationship between the abundance trends of the first and second Ponto-Caspian macroinvertebrate species, suggesting that interactions between these species are asymmetrical, with the initial invader facilitating the subsequent invader at the potential cost of its own population growth rate. Lastly, we found that macroinvertebrate communities became increasingly similar over time. European invasion rates from the Ponto-Caspian region suggest a high potential for future invasions from this region, with more hotspots and donor regions likely emerging.
Mullerian adenosarcoma: clinicopathologic and molecular characterization highlighting recurrent BAP1 loss and distinctive features of high-grade tumors
Authors: Boroujeni Amir Momeni , Kertowidjojo Elizabeth , Wu Xinyu , Soslow Robert , Chiang Sarah , Silva Edaise da , Weigelt Britta , Chui M. Herman
Published: June 2022

Mullerian adenosarcoma is an uncommon mesenchymal tumor of the gynecologic tract, usually of uterine origin. Tumors are generally low-grade and associated with good prognosis, whereas high-grade adenosarcomas are rare and less well studied. Herein, we sought to characterize the molecular features of 27 adenosarcomas (primary uterine, n = 19, cervical, n = 3, ovarian, n = 4, peritoneal, n = 1), enriched for high-grade tumors (n = 17) subjected to targeted panel sequencing. Recurrent genetic alterations in adenosarcomas included TP53 mutations (n = 4, 15%), restricted to high-grade cases, BAP1 homozygous deletions (n = 4, 15%), DICER1 mutations (n = 4, 15%), ARID1A mutations (n = 3), TERT promoter mutations (n = 2) and amplification (n = 1), ATRX frameshift mutation/homozygous deletions (n = 3), MDM2 (n = 2), CDK4 (n = 2) and CCNE1 (n = 2) amplifications, as well as alterations involving members of the PI3K (PTEN, n = 3; PIK3CA, n = 4; AKT1, n = 2) and MAPK (KRAS, n = 4, BRAF, n = 2) signaling pathways. One tumor harbored an ESR1-NCOA3 fusion and another had an MLH1 homozygous deletion, associated with loss of MLH1 and PMS2 protein expression. The fraction of genome altered was significantly higher in high-grade compared to low-grade adenosarcomas (P = 0.001). Somatic ATRX frameshift mutations were found in two patients with low-grade adenosarcoma with high-grade recurrences and one case of high-grade adenosarcoma with an adjacent low-grade component. Immunohistochemical analysis for BAP1 revealed loss of nuclear expression in 6/24 (25%) cases, including all 4 tumors with BAP1 deletions. Notably, out of 196 mesenchymal neoplasms of gynecologic origin, BAP1 homozygous deletion was only found in adenosarcomas (4/27,15% adenosarcomas vs 0/169, 0% other mesenchymal neoplasms, P = 0.0003). This study demonstrates that high-grade adenosarcomas are heterogeneous at the molecular level and are characterized by genomic instability and TP53 mutations; ATRX loss may be involved in high-grade transformation of low-grade adenosarcoma; and BAP1 inactivation appears to be a specific pathogenic driver in a subset of adenosarcomas.
A feasibility study on Plantago psyllium L. seed gum electrospinnability: The effect of sonication and gelatin as an auxiliary polymer
Authors: Mohajeri Parisa , Sourki Abdollah Hematian , Nikoo Alireza Mehregan , Gholamhosseinpour Aliakbar , Dalvi-Isfahan Mohsen
Published: June 2022

The authors have requested that this preprint be removed from Research Square.
Sex Differences in Students’ Performance in VR-based Learning of Gross Anatomical Education
Authors: Wang Chao-Ying , Yin Ti , Ma Kuo-Hsing , Shyu Jia-Fwu , Cheng Chia-Pi , Huang Yun-Ling , Chiang Ming-Hsien
Published: June 2022

Background: Studying anatomy has always challenged medical students. The coronavirus disease 2019 pandemic has transformed medical education worldwide, and virtual reality (VR) has recently emerged as a useful learning tool to promote memorization through understanding and visualization. With a remarkable rise in the use of remote learning methods during the pandemic, more schools are adopting distance learning through VR for anatomy. However, scholars have yet to explore the potential sex differences among students who use VR-based anatomical learning. Thus, we investigated the effects of teaching strategies on learners’ experiences with and performance in an anatomy course using VR-based learning. Method: Fifty first-year medical students enrolled in a human anatomy course were provided with VR devices for anatomical learning. They received a questionnaire comprising four determinants of experience: demographic background, discomfort symptoms, satisfaction levels, and opinions about the VR-based learning experience after their final examination. Student performance was then compared to previous performances over three-semester years when traditional teaching methods were used. A three-way mixed-model ANOVA was used to test the effects of sex, examination, and teaching methods on the examination scores. Results: VR-based learning resulted in better exam scores when compared to the traditional learning method. Female students experienced significantly higher disorientation symptoms compared with male students, and male students showed significant improvement in laboratory examination performance. Results showed that VR-based teaching can facilitate gross anatomical learning among first-year medical students and improve the laboratory performance of male students. Conclusion: Medical schools can use VR to teach anatomy effectively; however, faculty should be prepared to support inexperienced users when learning to use a VR system. Future research should further explore sex differences for reliability.