bluuebunny/crossref_metadata_2025 huggingface dataset:
Continuous Deterioration of Glucose Metabolism in Treatment-Naive Male Patients with Human Immunodeficiency Virus and Treated with Tenofovir Plus Lamivudine Plus Efavirenz for 156 Weeks
Authors: Liu Dafeng , Zhang Xinyi , Zhou Ruifeng , Cai Lin , Yan Dongmei , Lan Lijuan , He Shenghua , Tang Hong
Published: November 2021

Introduction: The dynamic characteristics of glucose metabolism and its risk factors in people living with human immunodeficiency virus (PLWH) accepted primary treatment with the efavirenz (EFV) plus lamivudine (3TC) plus tenofovir (TDF) (EFV+3TC+TDF) regimen are unclear and warrant investigation.Methods: This study was designed using follow-up study. Sixty-one male treatment-naive PLWH were treated with EFV+3TC+TDF regimen for 156 weeks. The glucose metabolism dynamic characteristics, the main risk factors and the differences among the three CD4+ count groups were analyzed.Result: In treatment-naive male PLWH who accepted treatment with the EFV+3TC+TDF regimen for 156 weeks, a continuous increase in the fasting plasma glucose (FPG) level, the rate of impaired fasting glucose (IFG) and the glycosylated hemoglobin (HbA1c) level were found. These changes were not due to insulin resistance but rather to significantly reduced islet β cell function, according to the homeostasis model assessment of β cell function (HOMA-β). Moreover, the lower the baseline CD4+ T cell count was, the higher the FPG level and the lower the HOMA-β value. Furthermore the main risk factors for the FPG levels were the CD3+CD8+ cell count and viral load (VL), and the factors contributing to the HOMA-β values were the alanine aminotransferase (ALT) level, VL and CD3+CD8+ cell count.Conclusions: These findings provide guidance to clinicians who are monitoring FPG levels closely and are concerned about IFG and decreased islet β cell function during ART with the EFV+3TC+TDF regimen for long-term application.
Texture and Digestion Properties of Cooked Rice and Rice Noodles
Authors: Hu Liqin , Xiao Zhengwu , Chen Jiana , Cao Jialin , Iqbal Anas , Abou-Elwafa Salah F. , Huang Min
Published: November 2021

Rice varieties high in amylose content have low glycemic and insulin responses. Rice noodles are processed by extrusion from high amylose content rice, which may also have low glycemic and insulin responses. In this study, cooked rice and rice noodles processed from two high amylose content cultivars, Guangluai4 (GL4) and Zhenguiai (ZGA), were chosen for in vitro starch digestion evaluation. Apparent amylose content of cultivars (i.e., GL4-28.4% and ZGA-26.8%) and pasting properties except final viscosity were significantly different between the cultivars. In vitro starch digestion results showed that the glucose production rate in rice noodles was significantly slower than that in cooked rice by 65.7% and 42.0% in GL4 and ZGA, respectively. The main reason for low glucose production in rice noodles was active digestion duration longer in rice noodles than in cooked rice, which reflects the slow release of glucose during starch digestion. The texture of rice noodles in the GL4 and ZGA cultivars is 3 and 2.3 times harder than that of cooked rice, respectively. Thus digestive enzymes can hardly enter the interior of rice noodles for amylolysis. As a result, the digestion time of rice noodles is longer, and the release of glucose during digestion is slower than that of cooked rice. The slower release of glucose during rice noodle digestion may be beneficial for prolonging satiety and reducing food intake. Consequently, eating rice noodles may help in improving or preventing diabetes and obesity over time.
ECMO For Pediatric Cardiac Arrest Caused by Bronchial Rupture and Severe Lung Injury: a Case Report About a Life-threatening Rescue at an Adult ECMO Center
Authors: Chu Xiaoqiong , Chen Weibiao , Wang Yafei , Zhu Luqi , Zhang Mengqin , Zhang Sheng
Published: November 2021

BackgroundBronchial rupture in children is a rare but dangerous complication after chest trauma that has been associated with increased mortality. Veno-venous (V-V) extracorporeal membrane oxygenation (ECMO) is reported as one of the treatments for this life-threatening complication.Case presentationA 4-year-old boy who suffered from bronchial rupture and traumatic wet lung complicated by cardiac arrest after chest trauma was admitted to an adult ECMO center. He had two cardiac arrests-one before and one during the operation. The total duration of cardiac arrest was 30 minutes. V-V ECMO was initiated because of severe hypoxia and carbon dioxide retention during the operation. ECMO was performed for 6 days, and mechanical ventilation lasted 11 days. On the 31st day after the operation, he recovered completely and discharged without neurological deficit.ConclusionV-V ECMO can be considered for support in children with severe acute respiratory failure after bronchial rupture. In an emergency, V-V ECMO can be carried out effectively in a qualified and experienced adult ECMO center. But the application of ECMO in children is different from that in adults and requires more refined management.
Hemodynamic And Morphological Changes of The Central Retinal Artery In Myopic Eyes
Authors: Zhao Mei , Lam Andrew Kwok-Cheung , Ying Michael Tin-Cheung , Cheong Allen Ming-Yan
Published: November 2021

Due to excessive elongation of the eyeball, myopia-related vascular abnormalities are frequently observed in the central retinal artery (CRA) and its intraretinal branches. In addition to inconsistency in previously reported findings, hemodynamic (reduced flow velocity, increased vascular resistance) and morphological changes (narrower vessel diameter) were usually studied separately. This cross-sectional study evaluated the hemodynamic and morphological characteristics concurrently in a large sample of healthy myopes, by using the color Doppler ultrasound and adaptive optics retinal camera. Results showed that the retrobulbar segment of CRA had a tendency of slightly reduced flow velocity in eyeballs with longer axial length, but the correlation was not significant after adjusting for the multiple correlations. Vascular resistance was not affected by the axial elongation. With respect to the intraretinal branches, no significant changes in longer eyes of total diameter or lumen diameter were observed , while both the wall thickness and the wall cross-sectional area were significantly increased, but only a marginally increase in the wall to lumen ratio was found with increasing axial length. This implies some potential small artery remodeling in the intraretinal CRA branches. Overall, blood supply of the inner retina in healthy young myopes is likely to be maintained. Additionally, morphological parameters of vascular microstructure could be potential biomarkers to monitor myopia progression and understand myopia-related vascular abnormalities in future studies.
IL4 Reduces Epileptogenesis Susceptibility Acutely After TBI: The Role of Macrophage/Microglia Polarization
Authors: Radpour Mozhdeh , Khoshkroodian Bahar , Asgari Tara , Pourbadie Hamid Gholami , Sayyah Mohammad
Published: November 2021

Traumatic brain injury (TBI) is responsible for 5% of all epilepsy cases, which are known as post-traumatic epilepsy. Macrophage/microglia are key players in TBI pathogenesis. They are activated after TBI, transform to inflammatory phenotype (M1) and trigger neuroinflammation, which provokes epileptogenesis. Interleukin-4 (IL-4) is a well-known polarizer of macrophage/microglia to the anti-inflammatory phenotype (M2). We tested the effect of IL-4 on the rate of epileptogenesis, brain expression of inflammatory and anti-inflammatory cytokines, and the lesion size in traumatic rats. Trauma was exerted to temporo-parietal cortex of rats by Controlled Cortical Impact. Thereafter, rats received a single dose (100ng/rat) of IL-4 through intracerebroventricular injection. After 24h, pentylenetetrazole (PTZ) kindling started and development of generalized seizures was recorded. Level of TNF-α, TGF-β, IL-10, and arginase-1 (Arg-1) was measured in the brain by immunoblotting at 6h, 12h, 24h, 48h, and 5 days after TBI. The lesion size and cell survival were determined by staining. Traumatic rats were kindled by 5±1 PTZ injections (significantly less than 11±2 injections of control and sham-operated rats, p<0.001). IL-4 did not change kindling rate in sham-operated rats but inhibited acceleration of kindling rate in traumatic rats (13±1 PTZ injections, p<0.001). IL-4 decreased post-TBI overexpression of TNF-α (6h, p<0.001) whereas upregulated post-TBI expression of TGF-β (48h, p<0.001), IL-10 (24h, p<0.05; 48h, p<0.01), and Arg-1 (24h, p<0.001). IL-4 decreased lesion volume and number of dead neurons. IL-4 suppresses TBI-induced acceleration of epileptogenesis in rats by directing macrophage/microglia to the anti-inflammatory M2 phenotype and inhibition of neuronal death.
Wnt/β-catenin Signaling Pathway Promotes Transdifferentiation from Fetal Skin Fibroblasts to Keratinocyte-like Cells
Authors: Zhao Hongqing , Liu Xinzhu , Sun Jiachen , Niu Yuezeng , Zhang Kun , Li Zhisheng , Ma Jinglong , Yang Jianqiu , Shen chuanan
Published: November 2021

Background: Wound healing is a dynamic, sequential,and complex physiological process, including a variety of cellular events, such as proliferation, adhesion, chemotaxis, and apoptosis. Skin fibroblasts and keratinocytes are the two most important cells involved in wound repair, and Relying on the proliferation and differentiation of keratinocytes to form epithelium to completely cover the wound is the most ideal result for wound repair, so expanding the source of keratinocytes is a huge challenge. In this study, we examined the phenomenon that fetal skin fibroblasts spontaneously transdifferentiated into keratinocyte-like cells in conventional culture, and evaluated the characteristics of KLCs and the potential mechanisms of the transdifferentiation process.Methods: HFF-1 were routinely cultured in ordinary DMEM medium for more than 40 days,and observed the cell morphology. The cytological properties of KLCs at the cellular and molecular levels were detected by RT-PCR, Western-blot, immunofluorescence, Transwell, and cell scratch experiments.The functionality and safety of KLCs were determined through wound healing and tumorigenicity experiments. And high-throughput transcriptome sequencing (RNA-seq) was performed to explore the mechanism underlying HFF-1 transdifferentiation.Results: The transdifferentiation process started on the 25th day and was completed by the 40th day. KLCs and KCs had similar expressions at the molecular and protein levels, both functioned similarly in wound healing and were non-tumorigenic.RNA-seq revealed that the transdifferentiation process was regulated by the activation of the classical Wnt/β-catenin signaling pathway, which could shorten the process to 10 days.Conclusion: This study demonstrates that HFF-1 can spontaneously transdifferentiate into KLCs with conventional culture conditions, and the Wnt/β-catenin signaling pathway regulates the transdifferentiation process.
Time to Switching to Second-line Antiretroviral Therapy and Its Predictors Among HIV/AIDS Infected Children at General Hospitals, Northern Ethiopia: A Survival Analysis
Authors: Sibhat Migbar , Mulugeta Tewodros , Aklilu Dawit
Published: November 2021

BackgroundWith expanding access to pediatric antiretroviral therapy, a growing amount of patients in the developing world has switched to second-line therapy, and some requiring third-line medications. A delay in switch increases mortality and risk of developing opportunistic infections. There remain limited and often conflicting estimates on the use of second-line ART in children. Thus, this study intended to determine the incidence and predictors of switching to second-line antiretroviral therapy among children.MethodsRetrospective follow up study was conducted by reviewing all charts. Data were collected by extraction tool; entered using Epi-data; cleaned and analyzed by STATA V-14. Kaplan-Meier curve, log-rank test, and life table were used for data description and adjusted hazard ratios and p-value for analysis by Cox proportional hazard regression. Any variable at P≤0.25 in the bi-variable analysis was taken to multivariate analysis and significance was declared at P≤0.05. Data were presented using texts, tables, and figures.Results and conclusionAnalysis was conducted on 424 charts with total person-time observation of 11686.1 child-months and incidence switch rate of 5.6 (95% CI 4.36-7.09) per 1000 child-month-observations. Being orphaned [AHR=2.36; 95%CI: 1.10-5.07], suboptimal ART adherence [AHR= 2.10; 95% CI: 1.12-3.92], drug toxicity [AHR= 7.05; 95% CI: 3.61-13.75], advanced recent WHO stage [AHR=2.75; 95%CI: 1.05-7.15], and initiating ART with TB co-infection [AHR=3.08; 95%CI: 1.26-7.51] were significantly associated with switch to second-line ART regimen. Moreover, long duration of ART follow up [AHR=0.75; 95% CI: 0.71-0.81] was found to be protective against switching. Hence, it is better to give priority for strengthening the focused evaluation of tuberculosis co-infection and treatment failure with continuous adherence monitoring. Further research is also needed to evaluate the effect of drug resistance.
Epistatic Interaction Effect Between Chromosome 1BL (Yr29) and A Novel Locus on 2AL Facilitating Resistance to Stripe Rust in Chinese Wheat Changwu 357-9
Authors: Huang Shuo , Zhang Yibo , Ren Hui , Li Xiang , Zhang Xin , Zhang Zeyuan , Zhang Chuanliang , Liu Shengjie , Wang Xiaoting , Zeng Qingdong , Wang Qilin , Singh Ravi P. , Bhavani Sridhar , Wu Jianhui , Han Dejun , Kang Zhensheng
Published: November 2021

Stripe rust (yellow rust) is a serious disease of bread wheat ( Triticum aestivum L.) worldwide. Genetic resistance is considered the most economical, effective and environmentally friendly method to control the disease. The current study focused on characterizing the components of stripe rust resistance and understanding the interactions in Changwu 357-9 (CW357-9)/Avocet S RIL population. A genetic linkage map constructed using a new GenoBaits Wheat 16K Panel and the 660K SNP array had 5,104 polymorphic SNP markers spanning 3,533.11 cM. Four stable QTL were detected on chromosome arms 1BL, 2AL, 3DS, and 6BS across all environments in Chngwu357-9. The most effective QTL Q YrCW357-1BL was Yr29 and the 6BS QTL was identified as Yr78 . The novel QTL on 2AL with moderate effect showed significant epistatic interaction with Yr29 . The QTL on 3DL should be same as QYrsn.nwafu-3DL and enriches the overall stripe rust resistance gene pool for breeding. Polymorphisms of flanking AQP markers AX-110020417 (for QYrCW357-1BL ), AX-110020417 (for QYrCW357 -2AL ), AX-109466386 (for QYrCW357 -3DL ), and AX-109995005 (for QYrCW357 -6BS ), were evaluated in a diversity panel including 225 wheat cultivars and breeding lines. The results suggested that these high-throughput markers could be used to introduce QYrCW357-1BL ( Yr29 ), QYrCW357-2AL , QYrCW357 -3DL , and QYrCW357 -6BS into commercial wheat cultivars. Combinations of these genes with other APR QTL should lead to higher levels of stripe rust resistance along with the beneficial effects of multi-disease resistance gene Yr29 on improving resistance to other diseases.
Effect of Nutrition Education Intervention on Anaemia Among Children aged 6 to 59 Months in Pastoralist and Agro-Pastoralist Community of Somali Region, Eastern Ethiopia: Community Based Case Control Study
Authors: Guled Rashid Abdi , Mamat Nik Mazlan , Abubakar WanAzdie Mohd , Belachew Tefera , Assefa Nega
Published: November 2021

Background: Anaemia is one of the major public health problems. It affects over 1.6 billion individuals of all age groups globally. About 273.2 million children below five years of age were affected by anaemia, of which around two-thirds (62.3%) occur in Sub-Saharan Africa. The overall global anaemia prevalence rate reported was 24.8%, of which almost half (47.4%) of it occurs in preschool children. Ethiopia is one of the seriously affected countries. The Ethiopia Demographic and Health Survey (EDHS), 2016 report showed, 56% and 82.6% of preschool children in Ethiopia and the Somali region, respectively, were affected by some degree of anaemia. Hence, this study aims to assess the effect of nutrition education intervention (NEI) on anaemia prevalence in preschool children in the Pastoralist and Agro-pastoralist communities of the Somali Region, Eastern Ethiopia. Methods: A community based case control study was conducted among 404 paired children 6 – 59 months to mothers/caregivers in two phases. Adadle district was used as an NEI group and Gode district as a control group. A face-to-face interview for mothers/caregivers using a semi-structured questionnaire and haemoglobin measurement of the children was done. The same procedure was repeated after eight months of NEI. The blood haemoglobin (Hb) level of the children was measured using Hemocue 301. SPSS version 20 was used, a chi-square test for categorical and t-test (independent and repeated paired) for continuous variables were performed. Results: the overall anaemia prevalence was decreased from 72% at baseline and 51% at post-intervention. The majority of this change had occurred in the intervention group (79.3 - 44.8%). The mean Hb level score difference of the difference (DOD) was significantly improved (-1.163, p<0.001) after NEI. While, the intervention group showed a significantly higher increment of Hb level (9.4g/dl – 10.6g/dl, p<0.001). Conclusion: The NEI has been shown effective and significant improvement in the mean haemoglobin level and decreased the anaemia prevalence in the intervention group. Therefore, behaviour change communication, using religious leaders and other potential people. Advocating the use of locally available, accessible, and affordable nutritious foods, with proper infant and young child feeding and basic health services, are highly effective to tackle the children’s anaemia status.
The Bidirectional Temporal Relationship Between Headache and Affective Disorders: Longitudinal Data from the HUNT Studies
Authors: Hagen Knut , Giri Samita , Tronvik Erling Andreas
Published: November 2021

Background Few prospective population-based studies have evaluated the bidirectional relationship between headache and affective disorder. The aim of this large-scale population-based follow-up study was to investigate whether tension-type headache (TTH) and migraine had increased risk of developing anxiety and depression after 11 years, and vice-versa. Methods Data from the Trøndelag Health Study (HUNT) conducted in 2006-2008 (baseline) and 2017-2019 (follow-up) were used to evaluate the bidirectional relationship between migraine and TTH and anxiety and depression measured by Hospital Anxiety and depression Scale (HADS). The population at risk at baseline consisted of respectively 18,380 persons with HADS score ≤ 7 and 13,893 without headache, and the prospective data was analyzed by Poisson regression. Results In the multi-adjusted model, individuals with HADS anxiety (HADS-A) and depression scores (HADS-D) of ≥8 at baseline nearly doubled the risk of migraine (Risk rations (RR) between 1.8 and 2.2) at follow-up whereas a 40% increased risk (RR 1.4) was found for TTH. Vice versa, the risk of having HADS-A and HADS-D scores of ≥8 at follow-up were increased for TTH (RR 1.3) and migraine (RR 1.3-1.6) at baseline. Migraine with aura was associated with 81% (RR 1.81, 95% 1.52-2.14) increased risk of HADS-A score of ≥8. Conclusions In this large-scale population-based follow-up study we found a bidirectional relationship between anxiety and depression and migraine and TTH. For anxiety, this bidirectional association was slightly more evident for migraine than TTH.
Surgeons’ Attitudes About Use of Preoperative Risk Assessment Tools
Authors: Pradhan Nisha , Dyas Adam R. , Bronsert Michael R. , Lambert-Kerzner Anne , Henderson William G. , Qiu Howe , Colborn Kathryn L. , Mason Nicholas J. , Meguid Robert A.
Published: November 2021

Background: Formal surgical risk assessment tools have been developed to predict risk of adverse postoperative patient outcomes. Such tools accurately predict common postoperative complications, inform patients and providers of likely perioperative outcomes, guide decision making, and improve patient care. However, these are underutilized. We studied the attitudes towards and techniques of how surgeons preoperatively assess risk.Methods: 108 surgical faculty, 95 surgical residents, and 58 affiliate surgeons at a large academic tertiary referral hospital and affiliate community hospitals were emailed a 16-question survey between 8/2019-6/2020. Surveys were analyzed using descriptive statistics (frequency distributions and percentages for categorical variables, means, and standard deviations for continuous variables), and Fisher’s exact test and unpaired t-tests comparing responses by surgical attendings vs. residents.Results: Overall response rates were 50.0% for faculty surgeons, 47.4% for residents, and 36.2% for affiliate surgeons. Only 20.8% of surgeons used risk calculators most or all of the time. Attending surgeons were more likely to use prior experience and current literature while residents used risk calculators more frequently. Risk assessment tools were more likely to be used when predicting major complications and death in older patients with significant risk factors. Greatest barriers for use of risk assessment tools included time, inaccessibility, and trust in accuracy.Conclusions: Even though risk assessment tools are available, few surgeons use them as part of their routine practices. Developers of the tools need to design the tools to better promote the positive features and to avoid the burdens commonly reported by users.
Safety and Effectiveness of Mepolizumab Therapy in Remission Induction Therapy for Eosinophilic Granulomatosis with Polyangiitis: A Retrospective Study
Authors: Ueno Masanobu , Miyagawa Ippei , Aritomi Takafumi , Kimura Koichi , Iwata Shigeru , Hanami Kentaro , Fukuyo Shunsuke , Kubo Satoshi , Miyazaki Yusuke , Nakayamada Shingo , Tanaka Yoshiya
Published: November 2021

Objectives: To investigate the safety and effectiveness of mepolizumab (MPZ), an anti-interleukin-5 antibody, as remission induction therapy for severe eosinophilic granulomatosis with polyangiitis (EGPA).Methods: The clinical courses of patients with severe EGPA over 6 months were retrospectively investigated and compared between patients treated with high-dose corticosteroid (CS) plus MPZ therapy (MPZ group, n=7) and those treated with high-dose CS plus intravenous cyclophosphamide (IVCY) pulse therapy (IVCY group, n=13). The primary endpoints were the MPZ retention rate and the IVCY completion rate. The secondary endpoints were adverse events and changes in the Birmingham Vasculitis Activity Score (BVAS), Vascular Damage Index (VDI), eosinophil counts, and concomitant CS doses, and the extent and rates of these changes were compared between the MPZ and IVCY groups.Results: Regarding the primary endpoints, the MPZ retention rate was 100%, and the IVCY completion rate was 61.5%. Regarding the secondary endpoints, adverse events were detected in 2/7 patients (28.6%) in the MPZ group and 7/13 patients (53.8%) in the IVCY group. BVAS and eosinophil counts significantly decreased in both groups at and after month 1, but there was no significant difference in the magnitude of changes between the two groups. VDI scores did not significantly increase in either group, and the degree of changes did not significantly differ between the two groups. Although concomitant CS doses significantly decreased at and after month 1 in both groups, the rates of decrease in CS doses at and after month 3 were significantly higher in the MPZ group.Conclusions: This study suggested that the use of MPZ as remission induction therapy for severe EGPA might be safe and effective for controlling disease activity and reducing CS doses.
On The Dynamics of Interstate Diffusion of Firearm Violence and Impact of Firearm Regulations
Authors: Sen Swagatam , Sen Anindya , Liu Ye , Sen Bisakha
Published: November 2021

Objectives – Our purpose was to test the impact of firearm regulations on the firearm violence flow across US state borders. Further we assessed the spatial variations in these impacts across different regions with the goal of identifying state-groups that are especially vulnerable to cross-border firearm violence.Methods – Incidence of firearm violence (2000-2017) has been modelled as an inhomogeneous diffusion process whose parameters depend on state firearm regulations. Firearm regulations measurement for a state accounted for all 14 law categories across 54 states since 1991 as per State Firearm Law Database. The effects of regulations and other covariates were estimated across all states. Results – Six clusters of states were identified based on the variations of effects within and across those clusters. For 3 of these clusters the diffusive flow parameters were statistically significant. In all of these clusters the deterring effect of regulations on incidence and flow of crime was statistically significant.Conclusion – The clusters can be assigned to 5 descriptive categories based on their roles in the flow of firearm violence – Source states, Transitive states, Destination states, Isolated issue states and Stable states. It was found that flow of firearm violence indeed does follow a diffusive process for most categories of states. It has also been recommended that while in-state regulations are important to curb firearm violence flowing into Destination states, they are not adequate unless regulatory stringency is also applied to neighboring Source and Transitive States.
WITHDRAWN: Establishment of a Finite Element Model and Biomechanical Analysis of Different Fixation Methods for Total Talar Prosthesis Replacement
Authors: yang qian dong , Le Chang , Wan Chen , Xuting Bian , Lin Ma , Xu Tao , Kanglai Tang
Published: November 2021

Background: As a new technology, three-dimensional (3D)-printed personalized talar prostheses are associated with different fixation methods for implanted prostheses, including fixing the subtalar joint and talus-navicular joint with screws and fixing the subtalar joint with screws only and fixation without screws. No biomechanical study has been conducted yet. we aimed to build a 3D finite element model to compare the biomechanical effects of different fixation methods.Methods: With 3D CT and MRI data of a volunteer's foot, Mimics research 19.0 and Geomagic wrap 2017 software were used to complete the geometric reconstruction of bone and cartilage, which was then input to NX12.0 software to build finite element models with different fixation methods. Finally, the models were imported into Abaqus 6.14 software for meshing and assigning material properties and the different biomechanical effects in three gait phases (heel-strike, midstance and push-off) were simulated. The pressure changes in the articular surface around the talus or the prosthesis, the micromotion of the talus and the prosthesis and ankle motion were measured.Results: The 3D finite element model created in this study has been verified to be consistent with previous studies.Finite element analysis of the biomechanical mechanism showed that screw fixation of the prosthesis in different gait phases mainly increased the pressure on the tibia-talus articular surface and decreased the pressure on the fused articular surface and joint micromotion, which hindered ankle motion. The indicator values were nearly the same in the models of fixation without screws and the healthy state.Conclusions: The biomechanical mechanism varies by fixation method according to the finite element analysis. Fixation of the prosthesis without screws yields values most similar to healthy values.Trial registrationThis study was approved by the institutional review board ethics committee of the Southwest Hospital Affiliated with the Army Medical University (No. ECFAH2006051)
Impact of Early Palliative Care on End of Life in Advanced Biliary Tract Cancer Patients
Authors: Miralles Margaux , Borg Christophe , Manfredi Sylvain , Minello Anne , Bouché Olivier , Tambou Marlène , Mutter Didier , Chiappa Pascale , Kurtz Jean-Emmanuel , Luc Amandine , Baumann Cedric , Lopez Anthony
Published: November 2021

Background: Majority of biliary tract cancer (BTC) patients have not access to surgery. They receive chemotherapy and/or palliative care (PC). We studied if early palliative care referral could influence overall survival (OS) and the aggressiveness of end-of-life care. Participants and Design: We conducted a retrospective cohort study in patients with non-curative BTC, diagnosed between 2013 and 2019 in 6 hospitals of Eastern France. PC was defined a specialist-delivered palliative care encounter.Results: 200 patients with BTC were included in our study, with 188 deaths. 87 (44%) had no PC, 30 (15%) had a very early PC (<3 months after diagnosis), 20 (10%) had an early PC (3-6 months), and 63 (32%) a late PC (>6 months). The median time between referral and death was 0.9 to 1.3 months (depending on groups). OS were 12.4 months (no PC), 3.0 months (PC<3 m), 6.4 months (PC 3-6 m), 16 months (PC>6 m). We had no evidence for survival improvement with early PC. PC seemed to reduce chemotherapy near death (37% without PC, 30% with PC<3m, 11% with PC 3-6m, 10% with PC>6m), visits in emergency department (ED) during final month (respectively: 36%, 20 %, 15%, and 7%), intensive care unit hospitalizations (ICU) near death (13%, 0%, 0%, 2%). Place of death seemed to be positively impacted by PC (conventional acute unit, respectively: 73%, 21%, 21%, 25% and ICU or ED: 8%, 0%, 5%, 2%).Conclusion: Referral to PC seems too late for changing disease course. Our practice should evolve, with the objective that each advanced BTC patient has early-PCR after diagnosis, for improving management of end-of-life, symptoms, and family needs. Trial registration number: 2019PI274 , 05/28/2020.
Profiling of microRNAs Targeting Survivin in the Iranian Patients with Colorectal Cancer
Authors: Chavoshi Hadi , Bornehdeli Soghra , Asadi Milad , Dolatkhah Roya , Shanehbandi Dariush , Raeisi Mortaza
Published: November 2021

Background: Survivin is involved in the apoptosis of cells. Impaired levels of survivin have been associated with increased survival of tumor cells. In this study, we intended to profile the microRNAs (miRNAs) targeting survivin in the tumoral and marginal tissues obtained from Iranian patients with colorectal cancer (CRC). Methods and Materials: Fifty CRC patients with Iranian Azari ethnicity were recruited. The RNA content of the tumoral and marginal tissues was isolated and the transcript levels of miR-34a, miR-16, miR-150, and miR-203a and survivin were determined through quantitative Real-time PCR. Results: The mRNA expression of survivin was significantly increased (fold change= 3.21, P= 0.0029) in the tumoral tissues in comparison to the marginal tissues. There was significant downregulation of miR-16 (fold change= 0.28, P= 0.003) and miR-203a (fold change= 0.36, P= 0.014) in the tumoral samples in comparison to marginal samples. There was an inverse significant correlation (rho= -0.81; P< 0.001) between expression of miR-203a and mRNA expression of survivin in the tumoral tissues from CRC patients. The mRNA expression of survivin was higher significantly in the tumoral tissues from CRC patients with lymph node metastasis in comparison to those without lymph node metastasis (P= 0.020). In addition, there was significantly higher miR-203 expression level in the tumoral tissues from CRC patients with lymph node metastasis in comparison to those without lymph node metastasis (P=0.011).Conclusion: It is suggested that miR-203 play an oncogenic role in CRC cancer by regulating survivin and lymph node metastasis.
Efficacy and Safety of Deep Acupuncture at Qugu Point (CV2) for Benign Prostatic Hyperplasia: Study Protocol for a Randomized Controlled Trial
Authors: Tang Han , Lu Yonghui , Ren Hua , Fu Jianhua , Meng Yulian , Li Baoying , Lu Fang , Song Xinzi
Published: November 2021

Background: Benign prostatic hyperplasia (BPH) is one of the most common urological disease and often associated with lower urinary tract symptoms (LUTS) in elderly men. Chinese acupuncturists found that deep acupuncture at Qugu point (CV2) can effectively relieve urination difficulties and improve quality of life of patients with troublesome BPH/LUTS. However, there are currently insufficient scientific evidence and well-designed trials to support its effect as well as safety in the treatment of BPH/LUTS. Therefore, this study protocol is designed to evaluate the effectiveness and safety of deep acupuncture at CV2 for men with BPH/LUTS.Methods: A single-center, randomized, subject-and assessor-blinded, placebo-controlled trial will be conducted in an outpatient acupuncture department in Beijing, China. A total of 120 subjects (50-80 yr) will be randomized to one of three balanced groups: deep acupuncture group 1 (deep acupuncture at CV2 with needle tip reaching the prostate capsule), deep acupuncture group 2 (deep acupuncture at CV2 with needle tip 10mm away from the prostate capsule), and sham acupuncture group (sham acupuncture with non-penetrating needle) in a ratio of 1:1:1. The study period for each subject will be 4 months, including 4 weeks baseline observation period, 4 weeks intervention period, and 8 weeks follow-up period. All subjects will receive 10 treatments during the intervention period. Subjects in deep acupuncture groups will be measured the needle depth and angle by computerized tomography (CT) in their first treatment. The primary outcome is the change in International Prostate Symptom Score. Secondary outcomes include quality of life, maximum urinary flow rate, and post-void residual.Discussion: The objectives of this study include: 1) to assess the efficacy of deep acupuncture at CV2 in the treatment of BPH; 2) to evaluate the safety of acupuncture at CV2 by measure the needle depth and angle under CT. This study will provide an evidence-based recommendation for acupuncture at CV2 in the treatment of BPH.Trial registration: Registered on 18 January 2020. Chinese Clinical Trials Register, ChiCTR2000029203.
Study on the Emission Characteristics and Mechanism of Sulfur-Containing Gas During Sludge Pyrolysis at Low Temperatures
Authors: Shang Shuo , Fan Haihong , Li Binbin , Li Lin , Li Zhou
Published: November 2021

In order to explore the influence of the release of sulfur-containing gases in the process of sludge pyrolysis, temperature, time and calcium-based conditioner were selected to conduct low-temperature sludge pyrolysis experiment on sludge, and effective measures to control the release of sulfur-containing gases such as CS2, H2S and SO2 were proposed. The experimental results show that when the temperature is below 200℃, the release of H2S gas is less than 50 µg/g. The release amounts of C2S and H2S within 3min were 20.84µg/g and 339.42µg/g, respectively. Combined with the release characteristics of the three gases, it was concluded that the drying temperature of the sludge was controlled below 250℃ and the drying time was controlled within 1 min. The concentration of sulfur-containing gas is 59.81 mg/m3, 94% lower than that of dry pure sludge gas when the addition of calcium base powder is 20% of the original sludge mass fraction. After absorption of calcium base powder, there are almost no organic compounds containing sulfur and sulfur gas. The research results provide a direction for the selection of pyrolysis sludge treatment process, which is beneficial to control the discharge of harmful gases.
Impact of A Simulation-Based Training on Self Assessed Nursing Performance in Anaphylactic Shock Management: A Pre-Post Educational Intervention Study
Authors: Ren Qi , Chen Fang , Zhang Huijuan , Tu Juanhua , Xu Xiaowei , Liu Caixia
Published: November 2021

Background

The New Nurses who lack the ability to recognize and manage anaphylactic shock can endanger the patients. In this study, we explored the effect of a simulated scenario designed to improve nurses’ understanding of their roles and responsibilities during the rescue of a patient with anaphylactic shock.
Methods

The program of a simulation-based training was designed to teach learners to recognize the signs and symptoms of anaphylactic shock, place the patient in the correct position, stop ongoing intravenous infusion of the antibiotic which trigger the anaphylactic shock, restart an intravenous infusion on a new infusion apparatus, give 100% oxygen via a nasal cannula or mask, preserve airway patency, call the rapid response team (RRT), and correctly administer the medications prescribed by the clinician. Instructors evaluated each learner’s skills and behaviors by using a clinical competency questionnaire. All learners then completed the Chinese version of the Simulation Design Scale (SDS) and participated in semi-structured interviews with their instructors after the training.
Results

All learners showed significant improvements in the 6 competencies assessed by the clinical competency questionnaire after the simulation-based training (all P<0.001). Scores on the SDS revealed that the learners were highly satisfied with all aspects of the simulation-based training (the 20 satisfaction rates were all above 90.00%). During the semi-structured interviews, new graduated nurses reported that simulation-based training in the management of anaphylactic shock was extremely important and would guide them in clinical practice.
Conclusions

The simulation-based training in anaphylactic shock is a potentially viable and effective method to teach new registered nurses to manage clinical incidents.
Hemodynamic Characteristics of Dilated Ascending Aorta in Patients with Bicuspid Aortic Valve
Authors: Zheng Tie , Lu Shijie , Zhu Shuai , Ou Jiafu , Zhu Jun-Ming
Published: November 2021

Objective: Aim of this study is to investigate the influence of aortic diameter on hemodynamic environment characteristics in patient with the bicuspid aortic valve (BAV) and dilated ascending aorta (AAo) .Methods: In this study, an MRI of one BAV patient with 4.5 cm AAo was collected and numerical model was constructed. Based on the images，the other three numerical models were constructed with different ascending aortic size with 4.0cm, 5.0cm and 5.5cm respectively while the size and the geometry of other parts were fixed. Then hemodynamics in these four models was simulated numerically and the flow patterns and loading distributions were investigated.Results: Hemodynamics environments in the AAo were simulated with different aortic size. As the aortic diameter increases, we find: 1. the blood flow becomes more disturbing;2.the wall pressure at ascending aortic is higher; 3. the wall shear stress at the ascending aortic decreases; 4.oscillatory shear index of the outer part on the proximal AAo increases;5. all these hemodynamic parameters described above are asymmetrically distributed in dilated AAo and more parts of aorta would be affected as the AAo dilatation progresses.Conclusions: The study revealed that the diameter of ascending aortic can significantly influence the magnitude and distribution of the dynamics. There are altered flow patterns, pressure difference, WSS and OSI distribution features in bicuspid aortic valve patients with vascular dilatation. As the extent of aortic dilatation increases especially exceed 5.5cm,this study support the recent guideline that aortic replacement should be considered .
Valorization of The By-Products of Poultry Industry (Bones) By Enzymatic Hydrolysis and Glycation to Obtain Antioxidants Compounds
Authors: Zapata Luisa María Londoño , Cardona Sara Franco , Manotas Sandra Patricia Restrepo , Narváez Fáver Gómez , Restrepo Lina Marcela Suárez , Andrade Helena Nuñez , Araya Pedro Valencia , Simpson Ricardo , Castro Óscar Vega
Published: November 2021

Currently, one of the fastest growing industries in the world is the poultry industry; however, the increase in demand has generated the production of various byproducts, such as bones, and these byproducts have a negative impact on the environment. The aim of the present work was to evaluate the effect of glycation on the increase in antioxidant compounds and the formation of indicators of advanced glycation end products (AGE) in chicken bone hydrolysates; it also aimed to maximize the protein content, degree of hydrolysis and antioxidant content. Through analysis of variance (ANOVA), the content of AGE products (HMF and furfural) formed in the glycation process was analyzed. The chicken bone hydrolysate (CBH) had a protein content of 1.42 g/l, a degree of hydrolysis of 17.2% and an antioxidant capacity of 8334 and 10343 μmol ETrolox/l according to ABTS and ORAC evaluations, respectively. The glycation process increased the ORAC by 6.57%. The presence of hydroxymethylfurfural and furfural was determined in the glycated samples and detected at values between 0.05 and 0.22 and 0 and 0.26 ppm, respectively. In conclusion, hydrolysis and glycation are suitable alternatives that enable the use of chicken bones in producing food ingredients with higher added value.
Phosphorous Containing poly(amidoamine-organosilicon) (P@PAMAMOS) Flame Retardants: Synthesis and Sol-gel Application on Cotton Fabrics
Authors: Zhang Zhen , Li Jin lan , Zhou Chang nian , Sun Jie
Published: November 2021

A novel hyperbranched phosphorous containing poly(amidoamine-organosilicon) (P@PAMAMOS) was successfully synthesized and the structure was characterized using Fourier transform infrared spectra (FT-IR), 1H NMR and 31P NMR. The cotton fabrics was grafted with P@PAMAMOS by sol-gel methods. The results of P@PAMAMOS modified cotton fabrics were proved by FT-IR and scanning electron microscopy (SEM). The thermal degradation of blank cotton fabrics and P@PAMAMOS modified cotton fabrics were probed by thermogravimetric (TG) analysis, the phenomenon showed that modified cotton fabrics has exquisite thermal stability, when the temperature reached 700℃，the char residues of A10 treated cotton, B10 treated cotton, C10 treated cotton were 29.5%, 34.5%, 28.8%, respectively. The combustion properties of cotton fabrics were tested by limiting oxygen index (LOI) and vertical burning test. The untreated cotton fabrics was completely burned and the LOI value reached 18.0%, however the char diameter of 20wt% P@PAMAMOS modified cotton fabrics was reduced 3.2 cm and LOI value increase to 31.2%, this means that P@PAMAMOS modification shows desirable flame retardancy.
Effects of Immune Response and Time Delays in Models of Acute Myeloid Leukaemia
Authors: Sun Weigang , Yang Lei , Luo Min
Published: November 2021

In this paper, we propose a general acute myeloid leukaemia (AML) model and introduce an immune response and time delays into this model to investigate their effects on the dynamics. Based on the existence, stability and local bifurcation of three types of equilibria, we show that the immune response is a best strategy for the control of the AML on the condition that the rates of proliferation and differentiation of the hematopoietic lineage exceed a threshold. In particular, a powerful immune response leads to bi-stability of the steady states, and a stronger response wipes out all the leukaemia cells. In addition, we further reveal that the time delays existing in the feedback regulation and immune response process induce a series of oscillations around the steady state, which shows that the leukaemia cells can hardly be eliminated. Our work in this paper aims to investigate the complex dynamics of this AML model with the immune response and time delays on the basis of mathematical models and numerical simulations, which may provide a theoretical guidance for the treatments of the AML.
Down-regulation of Risa Improves Podocyte Injury by Enhancing Autophagy in Diabetic Nephropathy
Authors: Su Peipei , Liu Dongwei , Zhou Sijie , Chen Hang , Wu Xianming , Liu Zhangsuo
Published: November 2021

BackgroundLncRNA AK044604 (Risa), Sirt1 and GSK3β are autophagy related genes that can play important roles in diabetic nephropathy (DN). In this study, we sought to explore the effect of Risa on Sirt1/GSK3β-induced podocyte injury.MethodsTransgenic db/db mice were fed and injected with Risa inhibition of adeno-associated virus by tail vein injection, as well as intraperitoneally injected with LiCl. Blood, urine, kidney tissue samples, and clinical data were collected at different time points. Immortalized mouse podocyte cells (MPCs) were cultured and treated with Risa inhibition of lentivirus, EX-527, and LiCl. MPCs were collected under different stimulations. The effects of Risa on podocyte autophagy were examined by qRT-PCR, Western blot analysis, transmission electron microscope, PAS staining, and immunofluorescence staining. ResultsRisa and activated GSK3β were overexpressed, but Sirt1 decreased in Renal tissues of DN mice and high-glucose-treated MPCs and correlated with poor prognosis. Risa overexpression attenuated Sirt1-mediated downstream autophagy levels and aggravated the injury of podocytes by inhibiting the expression of Sirt1. In contrast, Risa inhibition enhanced Sirt1-induced autophagy and attenuated podocyte injury, but this effect could be abrogated by EX-527, suggesting that Risa overexpression aggravated podocyte injury by decreasing autophagy. ConclusionsRisa inhibits autophagy by regulating the Sirt1/GSK3β axis and thereby aggravates podocyte injury in DN. Risa may serve as a therapeutic target for the treatment of DN.
Enhanced Spring Warming in a Mediterranean Mountain:In Quest for Multi Causalities
Authors: Rambal Serge , Bruley Enora , Mouillot Florent , Lauvaux Thomas
Published: November 2021

We analyzed trends of air temperature across the Cévennes National Park in Southern France, a mid-altitude coastal mountain experiencing a rapid spread of forests at the expense of rangelands and submitted to Mediterranean Sea influences and so, impacted by local and regional processes of climate change. Since 1980, April to June warming trend reached a maximum temperature increase of +0.124°C year−1 and uniform whatever the altitude. Minimum temperature increased by +0.058°C year−1 at 500 m altitude and +0.089°C year−1 at 1500 m. Concomitantly, forest cover is increasing by +0.51% year−1. Using an intrinsic biophysical mechanism model, we demonstrated that, at monthly scale, the forest surface is 1.7–3.1°C cooler than that of nearby grasslands. As a result, the decrease in albedo corresponding to the conversion from grasslands to dense forests, translates into a cooling of maximum air temperatures of 0.023°C year−1 which contributes to slow down the warming rate enhancement. Spring warming trends co-varied with negative WeMO phases associated with a low in the Gulf of Cádiz and an anticyclone in Central Europe. An east to west pressure gradient increases atmospheric humidity leading to a strong water vapor feedback, enhancing the forcing of thermal long wave radiations and hence the rise in temperature.