bluuebunny/crossref_metadata_2025 huggingface dataset:
Complex Impedance, Dielectric Properties and Electrical Conduction Mechanism of LaBa0.5Ag0.5FeMnO6 Double Perovskite Oxides
Authors: Nassar Kais Iben , Rammeh Nizar , Teixeira Sílvia Soreto , Graça Manuel Pedro F.
Published: February 2021

The double perovskite oxide with formula LaBa0.5Ag0.5FeMnO6 was prepared by the sol-gel method. The structural analysis at room temperature indicated that this sample is single phase and crystallize in the cubic system with the Pm-3m space group. The complex impedance spectroscopy has been measured in the range of temperature, 200–340 K, and frequency, 100 Hz–1MHz, respectively. Dielectric measurements by analysis of the impedance function, Z" as a function of Z' versus frequency curves, were mounted to an equivalent circuit consisting of series of combinations of resistor, capacity and constant phase elements. The study of ac conductivity as a function of frequency has been interpreted using the Joncher's law and determines the activation energy. The modulus analysis was also performed indicating the presence of a relaxation process accompanied by a conduction phenomenon.
Using Probabilistic Genotypes in Linkage Analysis of polyploids
Authors: Liao Yanlin , Voorrips Roeland E. , Bourke Peter M. , Tumino Giorgio , Arens Paul , Visser Richard G.F. , Smulders Marinus J.M. , Maliepaard Chris
Published: February 2021

Marker genotypes are generally called as discrete values: homozygous versus heterozygous in the case of diploids, or an integer allele dosage in the case of polyploids. Software for linkage map construction and/or QTL analysis usually relies on such discrete genotypes. However, it may not always be possible, or desirable, to assign definite values to genotype observations in the presence of uncertainty in the genotype calling. Here, we present an approach that uses probabilistic marker dosages for linkage map construction in polyploids. We compare our method to an approach based on discrete dosages, using simulated SNP array and sequence reads data with varying levels of data quality. We validate our approach using experimental data from a potato (Solanum tuberosum L.) SNP array applied to an F1 mapping population. In comparison to the approach based on discrete dosages, we mapped an additional 562 markers. All but three of these were mapped to the expected chromosome and marker position. For the remaining three markers, no physical position was known. The use of dosage probabilities is of particular relevance for map construction in polyploids using sequencing data, as these often result in a higher level of uncertainty regarding allele dosage.
Pathways to Pain and Disability: the Impact of Early Social Deprivation and Educational Attainment in Newly Diagnosed Osteoarthritis Patients
Authors: Kouraki Afroditi , Bast Tobias , Ferguson Eamonn , Valdes Ana M.
Published: February 2021

BackgroundLinks between pain and cognitive function on one hand and pain and anxiety on the other have already been shown in other studies and there is biological evidence linking osteoarthritis to educational attainment. However, the inter-play of these factors and the role of key social (social deprivation) factors at the early disease stages are not understood. Therefore, we tested how social deprivation, education and anxiety, before diagnosis, affects the cognition, pain and independence (activities of daily living) relationship longitudinally after diagnosis of osteoarthritis. MethodsUsing data from waves 4, 5, 6 and 7 of the Survey of Health, Ageing and Retirement in Europe (SHARE) (n = 1,240), we examined the impact of social deprivation, education and anxiety on the dynamic relationship between cognitive function, pain and instrumental activities of daily living (IADL) in a subsample of respondents reporting a diagnosis of osteoarthritis at wave 6, with cross-lagged panel models.ResultsSocial deprivation before diagnosis predicted poorer cognitive function and higher pain levels after diagnosis, and further predicted impairments in IALD at wave 7 through its negative effect on cognitive function at wave 6. Education before diagnosis was protective against impairments in daily living after diagnosis via better cognitive function and lower anxiety at wave 5.ConclusionWe show for the first time that social deprivation, before osteoarthritis diagnosis, predicts functional impairment in daily living, after diagnosis with this effect partly mediated by impaired cognitive function. We also show for the first time that, education before diagnosis was protective against impairments in daily living after diagnosis via better cognitive function and lower anxiety before diagnosis. Therefore, improving cognitive function and managing anxiety may dampen the impact of social deprivation and low educational attainment on poor health and help to promote independence in patients with osteoarthritis.
Atena: A Public Primary Healthcare Environment Supported by an Implementation Science Approach
Authors: Dantas Mario Antonio Ribeiro , Campos Fernanda Alves , Mendonças Fabricio M , David José Maria N , Ströele Victor , Medeiros Alvaro A.M. , Nascimento Mateus G , Iorio Gabriel , Thomé Thiago Goldoni
Published: February 2021

Public primary healthcare environments are facing grand challenges related to digital transformations. This is reported from many studies, in several countries, and observed from diverse areas. The present war against the Covid-19 pandemic has shown the required utilization of combined information and communications technology approaches. In this paper we present the Atena research work, which is a proposal development that focus on a public primary healthcare system digital transformation. The approach of implementation science is observed through our scientific studies of methods to gather the digital data, and recommendation strategies to facilitate healthcare personal, and using the evidence-based practice from the Atena. Study scenarios provide interesting view of several elements which can help to enhance a wider discussion about technologies and their scientific implementation. We considered wearable devices used by different groups of voluntaries. Vital digital signals from these voluntaries were gathered to afterwards be evaluated by professionals inside the healthcare premises. To provide a better understanding of these people´s behaviors, a recommendation system (RS) is being conceived as a support tool, utilizing their digital vital signals. Another element from the proposal is a simulator-based architecture. This component highlights people´s movement and predictable scenarios of contamination. A common daily monitoring scenario can be enhanced from these simulations’ experiences. After our initial results, it is possible to affirm that the Antena proposal provides a valuable approach to face several efforts in digital transformation in public primary healthcare structures. This transformation can be verified in the present pandemic scenario. Experiences from this research indicates that the adoption of some computational technologies requires major changes on the present behavior from governments and citizens.
Electrospun synthesis of silver/poly (vinyl alcohol) nano-fibers: investigation antibacterial activity and flame retardant property
Authors: Azarakhsh Sara , Bahiraei Hamed , Haidari Gholamhosain , Ghanbar Davood
Published: February 2021

Polyvinyl alcohol (PVA) and Ag nanoparticles-embedded polyvinyl alcohol (Ag/PVA) nano-fibers have been synthesized successfully via the electro-spinning technique at room temperature. XRD patterns confirmed the presence of Ag nanoparticles in the electro-spinning PVA nano-fibers. FE-SEM images displayed that silver nanoparticles with an average particle size of 32 nm are uniformly dispersed in PVA nano-fibers. Also, the average diameter of Ag/PVA nano-fibers was estimated to be 142 nm. The EDX analysis of Ag/PVA nano-fiber determined the aggregation of Ag nanoparticles in the range of polymer nano-fibers. The antibacterial property of Ag/PVA nano-fiber for inhibition of Escherichia coli (E-coli) growth was approved. Since polyvinyl alcohol is a biocompatible and water-soluble polymer, it can be considered as unique candidate for the preparation of wound dressing nano-fibers. It is also found that the nontoxic nanostructures can appropriately enhance both flame retardant and thermal stability properties of the Ag/PVA matrix. These results show that the Ag/PVA nano-fibers may find practical applications as self-reinforced medical devices and tissue-engineering scaffolds.
Clinicopathological characteristics and outcomes of 23 patients with secretory carcinoma of major salivary glands
Authors: Sun Jingjing , Liu Sirui , Fu Kun , Gao Ning , Li Rui , He Wei , Gao Zhenjie
Published: February 2021

Background
Secretory carcinoma of salivary glands (SCSGs) are generally low-grade salivary gland carcinomas, and are characterized by morphological resemblance to mammary analogue secretory carcinoma and ETV6–NTRK3 gene fusion. Several reports on histopathological features of SCSG have recently been published; however, little is known about the clinical characteristics of this new tumor, including its outcomes. The research is to investigate the clinicopathological characteristics of secretory carcinoma of major salivary glands and to analyze outcomes of these carcinomas as a reference for standardizing their diagnosis and treatment.
Methods
The cohort of this retrospective study comprised 23 patients treated for histopathologically-confirmed SCSG between January 2010 and December 2020. Their clinical characteristics and outcomes were retrieved from patient files.
Results
The 23 patients comprised 13 male and 10 female patients (male:female ratio 1.3:1). They were aged 10–69 years (median 45 years) and the average duration of disease was 2.44 years (0.25–20 years). Twenty-one patients (91.3%) had SCSGs in the parotid gland and two (8.7%) in the submandibular gland. All 23 patients had single nodules with diameters of 0.8–4.8 cm (average 2.6 cm). Five patients had lymph node metastases and two had distant metastases. All tumors were pathologically diagnosed as SCSGs. Immunohistochemical staining was strongly positive for S-100, mammaglobin, CK7, and Gata3, and negative for Dog1, P63 and calponin. Ki-67 positivity ranged from 1–50%. Fluorescence in situ hybridization data were available for 15 patients, in all of whom ETV6 gene rearrangement was confirmed. All patients had undergone oncological resections. Four had radioactive particles implanted postoperatively, one received chemotherapy, and seven underwent chemoradiotherapy. Six patients had regional recurrences, two distant metastases, and one had died at the time of last follow-up.
Conclusions
SCSGs are typically indolent with a low rate of locoregional recurrence and excellent survival. Their prognosis is correlated with clinical stage, pathological grade, and surgical procedures performed.
Tofacitinib as a Steroid-Sparing Therapy in Pulmonary Sarcoidosis, An Open-Label Prospective Proof-of-Concept Study
Authors: Friedman Marcia Alwina , Le Brian , Stevens Janelle , Desmarais Julianna , Seifer Daniel , Ogle Kimberly , Choi Dongseok , Harrington Christina , Jackson Peter , Rosenbaum James T
Published: February 2021

This is a prospective, open-label, proof-of-concept study of tofacitinib, a Janus kinase inhibitor, as a steroid sparing therapy in corticosteroid-dependent pulmonary sarcoidosis. 5 patients with corticosteroid-dependent pulmonary sarcoidosis were treated with tofacitinib 5 mg twice daily. The primary endpoint was a ≥50% reduction in corticosteroids at week 16 with no worsening in pulmonary function or respiratory symptoms. 60% of patients (3/5) met the primary endpoint. One patient was lost to follow up prior to steroid taper, and another was withdrawn due to worsening of known neurosarcoidosis. The three patients who met the primary endpoint each tapered to ≤5 mg/day prednisone, respiratory symptoms improved, and spirometry remained stable. In this proof-of-concept study, the addition of a JAK-inhibitor allowed 60% of patients with pulmonary sarcoidosis to successfully taper corticosteroids. JAK-inhibitors are a promising therapy for pulmonary sarcoidosis, which require further investigation in randomized trials.Trial Registration: clinicaltrials.gov NCT03793439; registered Jan 4, 2019
Empirical and numerical investigation on the thermal efficiency of a tripartite transparent covered hexagonal composite salt-gradient solar pond with East-West side reflector
Authors: D Sathish , S Jegadheeswaran
Published: February 2021

The authors have requested that this preprint be removed from Research Square.
Extracellular Vesicle-associated miRNAs Are an Adaptive Response to Gestational Diabetes Mellitus
Authors: Nair Soumyalekshmi , Guanzon Dominic , Jayabalan Nanthini , Lai Andrew , Scholz-Romero Katherin , Croft Priyakshi Kalita-de , Ormazabal Valeska , Palma Carlos , Diaz Emilio , McCarthy Elizabeth A , Shub Alexis , Miranda Jezid , Gratacos Eduard , Crispi Fatima , Duncombe Gregory , Lappas Martha , McIntyre H David , Rice Gregory E , Salomon Carlos
Published: February 2021

Background: Gestational diabetes mellitus (GDM) is a serious public health issue affecting 9-15% of all pregnancies worldwide. Recently, it has been suggested that extracellular vesicles (EVs) play a role throughout gestation, including mediating a placental response to hyperglycaemia. Here, we investigated the EV-associated miRNA profile across gestation in GDM, assessed their utility in developing accurate, multivariate classification models, and determined the signaling pathways in skeletal muscle proteome associated with the changes in the EV miRNA profile.Methods: Discovery: A retrospective, case-control study design was used to identify EV-associated miRNAs that vary across pregnancy and clinical status (i.e. GDM or Normal Glucose Tolerance, NGT). EVs were isolated from maternal plasma obtained at early, mid and late gestation (n=29) and small RNA sequencing was performed. Validation: A longitudinal study design was used to quantify expression of selected miRNAs. EV miRNAs were quantified by real-time PCR (cases=8, control=14, samples at three times during pregnancy) and their individual and combined classification efficiencies were evaluated. Quantitative, data-independent acquisition mass spectrometry was use to establish the protein profile in skeletal muscle biopsies from normal and GDM.Results: A total of 2822 miRNAs were analyzed using a small RNA library, and a total of 563 miRNAs that significantly changed (p<0.05) across gestation and 101 miRNAs were significantly changed between NGT and GDM. Analysis of the miRNA changes in NGT and GDM separately identified a total of 256 (NGT-group), and 302 (GDM-group) miRNAs that change across gestation. A multivariate classification model was developed, based on the quantitative expression of EV-associated miRNAs, and the accuracy to correctly assign samples was >90%. We identified a set of proteins in skeletal muscle biopsies from women with GDM associated with JAK-STAT signaling which could be targeted by the miRNA-92a-3p within circulating EVs. Interestingly, overexpression of miRNA-92a-3p in primary skeletal muscle cells increase insulin-stimulated glucose uptake.Conclusions: During early pregnancy, differently-expressed, EV-associated miRNAs may be of clinical utility in identifying presymptomatic women who will subsequently develop GDM later in gestation. We suggest that miRNA-92a-3p within EVs might be a protected mechanism to increase skeletal muscle insulin sensitivity in GDM.
Is X-ray Exposure Related to Dentist Remuneration?
Authors: Kalmus Olivier , Chalkley Martin , Listl Stefan
Published: February 2021

Background: In many market settings individuals are encouraged to switch health care providers as a means of ensuring more competition. Switching may have a potentially undesirable side effect of increasing unnecessary treatment. Focusing on the most common source of medical radiation (dental X-rays), the purpose of this study was to assess whether, upon switching dentist, X-ray exposure increases depending on the type of provider payment. Methods: The analysis used longitudinal data from 2005 to 2016 covering a 5% random sample of the Scottish adult population covered by the National Health Service (NHS). Multiple fixed-effects panel regression analyses were employed to determine the correlation of provider remuneration with patients' likelihood of receiving an X-ray upon switching to a new dentist other things equal. A broad set of covariates including a patient’s copayment status was controlled for. Results: Upon switching to a dentist who was paid fee-for-service, patients had a by 9.6 %-points (95% CI: 7.4%-11.8%) higher probability of receiving an X-ray, compared to switching to a salaried dentist. Results were robust when accounting for patient exemption status, as well as unobserved patient and dentist characteristics. Conclusions: In comparison to staying with the same dentist, patients may be exposed to substantially more X-rays upon switching to a dentist who is paid fee-for-service. There may need to be better guidance and regulation to protect the health of those who have to switch provider due to moving and greater caution in advocating voluntary switching.
Diagnostic Performance of Oncuria™, a Urinalysis Test for Bladder Cancer
Authors: Hirasawa Yosuke , Pagano Ian , Chen Runpu , Sun Yijun , Dai Yunfeng , Gupta Amit , Tikhonenkov Sergei , Rosser Charles , Furuya Hideki
Published: February 2021

Background: Due to insufficient accuracy, urine-based assays currently have a limited role in the management of patients with bladder cancer. The identification of multiplex molecular signatures associated with disease has the potential to address this deficiency and to assist with accurate, non-invasive diagnosis and monitoring. Methods: To evaluate the performance of Oncuria™, a multiplex immunoassay for bladder detection in voided urine samples. The test was evaluated in a multi-institutional cohort of 362 prospectively collected subjects presenting for bladder cancer evaluation. The parallel measurement of 10 biomarkers (A1AT, APOE, ANG, CA9, IL8, MMP9, MMP10, PAI1, SDC1 and VEGFA) was performed in an independent clinical laboratory. The ability of the test to identify patients harboring bladder cancer was assessed. Bladder cancer status was confirmed by cystoscopy and tissue biopsy. The association of biomarkers and demographic factors was evaluated using linear discriminant analysis (LDA) and predictive models were derived using supervised learning and cross-validation analyses. Diagnostic performance was assessed using ROC curves.Results: The combination of the 10 biomarkers provided an AUROC 0.93 [95% CI: 0.87 – 0.98], outperforming any single biomarker. The addition of demographic data (age, sex, and race) into a hybrid signature improved the diagnostic performance AUROC 0.95 [95% CI: 0.90 – 1.00]. The hybrid signature achieved an overall sensitivity of 0.93, specificity of 0.93, PPV of 0.65 and NPV of 0.99 for bladder cancer classification. Sensitivity values of the diagnostic panel for high-grade bladder cancer, low-grade bladder cancer, MIBC and NMIBC were 0.94, 0.89, 0.97 and 0.93, respectively. Conclusions: Urinary levels of a biomarker panel enabled the accurate discrimination of bladder cancer patients and controls. The multiplex Oncuria™ test can achieve the efficient and accurate detection and monitoring of bladder cancer in a non-invasive patient setting.
Use of Palliative Radiotherapy Among Patients With Metastatic Non-small-cell Lung Cancer in Puerto Rico
Authors: Quinones-Avila Valerie , Ortiz-Ortiz Karen J. , Ríos-Motta Ruth , Marín-Centeno Heriberto , Tortolero-Luna Guillermo
Published: February 2021

Background: Palliative radiotherapy (RT) represents an important treatment opportunity for improving the quality of life in metastatic non-small cell lung cancer (NSCLC) patients through the management of symptoms within the course of the illness. This study examines the patient and clinical factors associated with palliative RT use among metastatic NSCLC patients in Puerto Rico. Methods: A retrospective cohort study was performed using secondary data analysis from 2009-2015 from the Puerto Rico Central Cancer Registry–Health Insurance Linkage Database (PRCCR-HILD). A logistic regression model was used to examine factors associated with palliative RT. Results: Among the 929 patients identified with metastatic NSCLC, 33.80% received palliative RT within the first year after diagnosis. After adjusting for other covariates, receipt of chemotherapy (ORAdj = 3.90; 95% CI = 2.91-5.45; P < 0.001) and presence of symptoms (ORAdj =1.41; 95% CI =1.00-1.98; P = 0.045) were associated with increased odds of palliative RT use. Although marginally significant, patients with private health insurance had increased odds of palliative RT use (ORAdj = 1.50; 95% CI = 0.98-2.29; P = 0.061) when compared to beneficiaries of Medicaid, after adjusting by other covariates. Conclusions: The results of this study reveal concerning underuse of palliative RT among patients with metastatic NSCLC in Puerto Rico. Additional research is necessary to further understand the barriers to using palliative RT on the island.
A Tree Based Approach for Multi-class Classification of Surgical Procedures Using Structured and Unstructured Data
Authors: Khaleghi Tannaz , Murat َAlper , Arslanturk Suzan
Published: February 2021

Background: In surgical department, CPT code assignment has been a complicated manual human effort, that entails significant related knowledge and experience. While there are several studies using CPTs to make predictions in surgical services, literature on predicting CPTs in surgical and other services using text features is very sparse. This study improves the prediction of CPTs by the means of informative features and novel re-prioritization algorithm. Methods: The input data used in this study is composed of both structured and unstructured data. The ground truth labels (CPTs) are obtained from medical coding databases using relative value units which indicates the major operational procedures in each surgery case. In the modeling process, we first utilize Random Forest multi-class classification model to predict the CPT codes. Second, we extract the key information such as label probabilities, feature importance measures, and medical term frequency. Then, the indicated factors are used in a novel algorithm to rearrange the alternative CPT codes in the list of potential candidates based on the calculated weights. Results: To evaluate the performance of both phases, prediction and complementary improvement, we report the accuracy scores of multi-class CPT prediction tasks for datasets of 5 key surgery case specialities. The Random Forest model performs the classification task with 74% to 76% when predicting the primary CPT versus the CPT set with respect to the two filtering conditions on CPT codes. The complementary algorithm improves the results from initial step by 8% on average. Furthermore, the incorporated text features enhanced the quality of the output by 20-35%. Conclusions: We have established a robust framework based on a decision tree predictive model. We predict the surgical codes more accurately and robust compared to the state-of-the-art deep neural structures which can help immensely in both surgery billing and scheduling purposes in such units.
Association Between Nonalcoholic Fatty Liver Disease and Incident Diabetes Mellitus among Japanese: A Retrospective Cohort Study Using Propensity-Score Matching
Authors: Zheng Xiaodan , Cao Changchun , He Yongcheng , Wang Xinyu , Wu Jun , Hu Haofei
Published: February 2021

Background: Previous studies demonstrated nonalcoholic fatty liver disease (NAFLD) was a significant risk factor of diabetes mellitus (DM). However, these studies could not fully reflect the association between NAFLD and DM due to unbalanced confounding factors. We aimed to use propensity score matching (PSM) analysis to explore the actual association between NAFLD and DM in a large Japanese population cohort. Methods: This was a retrospective PSM cohort study. A total of 14,271 Japanese participants without DM at baseline from Murakami Memorial Hospital were eventually enrolled in our study between 2004 and 2015. The baseline NAFLD and incidence of DM during follow-up were selected as the independent variable and outcome measure. To balance the confounding factors between 1,711 participants with NAFLD and 1,711 participants with non-NAFLD, we performed a non-parsimonious multivariable logistic regression for 1:1 PSM. Our study used the doubly robust estimation method to verify the correlation between NAFLD and DM. Result: After PSM, the approximate incidence of DM in NAFLD participants and non-NAFLD participants were 907.082/100,000 person-years and 458.980/100,000 person-years, respectively. The risk of developing DM in participants with NAFLD increased by 92% in the PSM cohort (HR=1.92, 95% confidence interval (CI): 1.35-2.74, P=0.0003). The participants with NAFLD were 2.15-fold more likely to develop diabetes than non-NAFLD participants in the PSM cohort after adjusting for the demographic and laboratory biochemical variables (HR=2.15, 95%CI: 1.48-3.11, P<0.0001). In the PSM cohort, the participants with NAFLD had an 89% increased risk of diabetes after adjustment of the propensity score (HR=1.89, 95%CI: 1.33-2.69, P=0.0004). In the subgroup analysis, most potential confounding variables did not influence the association between NAFLD and DM risk after PSM, except for body mass index (P for interaction=0.0140) and visceral fat obesity (P for interaction=0.0157). In the sensitivity analysis, participants with NAFLD had an 82% increase in the risk of DM in the original cohort (HR=1.82，95%CI: 1.33-2.48, P=0.0001) and a 70% increase in the weighted cohort (HR=1.70，95%CI: 1.40-2.06, P <0.00001), respectively.Conclusion: In the PSM cohort, the risk of developing DM in the participants with NAFLD increased by 92%. In the sensitivity analysis, the risk of developing DM in the participants with NAFLD increased by 70% in the weighted cohort. Additionally, subgroup analysis showed that obese participants with NAFLD should be more concerned about the risk of diabetes.
Standardization of calibration scheme in NB Chirp ABR Hearing Assessment: A Preliminary Study Based on Normal Hearing Soldiers
Authors: Li Zhicheng , Lai Xiaofen , Lai Jinmei , Qi Min , Yuan Lianxiong , Zeng Xiangli , Ji Fei
Published: February 2021

Background: Optimal medical intervention for veterans suffering from military noise-induced hearing impairment is a major concern of the specialists in military medicine, otology, and audiology sectors. Thus, it is important to objectively and accurately reflect the hearing level of the subject in the intervention to aid hearing and improve the existing hearing disability evaluation program. Purpose: The present study intends to identify the optimal correction scheme by comparing the accuracy and range of deviation of narrow-band chirps evoked auditory brainstem responses (NB Chirp ABR) corrected by different schemes in estimating the hearing level of people with normal hearing. Methods: A total of 66 individuals could hear sounds of a frequency <25dB hearing level (HL) in the pure tone audiometry were randomly divided into a model group (26 subjects), test group 1 (with 20 subjects), and test group 2 (with 20 subjects). The mean threshold difference and the regression equation at each frequency were obtained through the model group, and the correction results of the “mean threshold difference scheme (S1)” and the “regression equation scheme (S2)” were compared in the test groups 1 and 2. All data were analyzed using SPSS 24.0. Results: 1) The accuracy of the estimated hearing level (eHL) of non-corrected NB Chirp ABR was significantly higher than that of NB Chirp ABR corrected by S1 or S2; 2) The range of deviation of the eHL of non-corrected NB Chirp ABR from the pure tone audiometry threshold was greater than that of NB Chirp ABR corrected by S1 or S2 from the pure tone audiometry threshold at 500 and 1000 Hz, while at 2000 and 4000 Hz, the values were similar. Conclusion: Among people with normal hearing, it was necessary to correct NB Chirp ABR at 500 and 1000 Hz for higher accuracy of the eHL, but the strengths of different correction schemes were not defined. For clinical convenience, the “mean threshold difference scheme,” with the correction values of 7 and 4 dB, was recommended for correction. At 2000 and 4000 Hz, it was not necessary to correct NB Chirp ABR. Thus, additional subjects with different HLs should be included in future studies to discuss the differences between the two schemes.
Signatures of selection and genomic diversity of Muskellunge (Esox masquinongy) from two populations in North America.
Authors: Chinchilla-Vargas Josue , Rothschild Max F. , Bertolini Francesca
Published: February 2021

Background
Muskellunge (Esox masquinongy) is the largest and most prized game fish for anglers in North America. However, little is known about Muskellunge genetic diversity in Iowa’s propagation program. We used whole genome sequence from 12 brooding individuals from Iowa and publicly available RAD-seq of 625 individuals from Saint-Lawrence river in Canada to study the genetic differences between populations, analyze signatures of selection that might shed light on environmental adaptations, and evaluate the levels of genetic diversity in both populations. Given that there is no reference genome available for Muskellunge, reads were aligned to the genome of Pike (Esox lucius), a closely-related species.
Results
Variant calling produced 7,886,471 biallelic variants for the Iowa population and 16,867 high quality SNPs that overlap with the Canadian samples. The Ti/Tv values were 1.09 and 1.29 for samples from Iowa and Canada, respectively. PCA and Admixture analyses showed a large genetic difference between Canadian and Iowan populations. Moreover, PCA showed a clustering by sex in the Iowan population although widow-based Fst did not find outlier regions. Window based pooled heterozygosity found 6 highly heterozygous windows containing 244 genes in the Iowa population and Fst comparing the Iowa and Canadian populations found 14 windows with Fst values larger than 0.9 containing 641 genes. One enriched GO term (sensory perception of pain) was found through pooled heterozygosity analyzes. Although not significant, several enriched GO terms associated to growth and development were found through Fst analyses.
Inbreeding calculated as Froh was 0.03 on average for the Iowa population and 0.32 on average for the Canadian samples. The inbreeding rate appears is presumably due to isolation of subpopulations.
Conclusions
This study is the first of its kind in Muskellunge from Iowa in which captured brood stock showed marked genetic differences with the Canadian population. Additionally, despite genetic differentiation based on sex has been observed, no major locus has been detected . Inbreeding does not seem to be an immediate concern for Muskellunge in Iowa, isolation of subpopulations has caused levels of homozygosity to increase in the Canadian Muskellunge population.
These results prove the validity of using genomes of closely related species to perform genomic analyses when no reference genome assembly is available.
Laser-assisted selection of immotile spermatozoa has no effect on obstetric and neonatal outcomes of TESA-ICSI pregnancies
Authors: Chen Huanhua , Wang Caizhu , Zhou Hong , Shu Jinhui , Gan Xianyou , Xu Kongrong , Wu Zhulian , Deng Xihe , Huang Guiting , Lin Ruoyun
Published: February 2021

Background

Azoospermic patients have benefited from both epididymal and testicular spermatozoa intracytoplasmic sperm injection (ICSI) treatment and lasers have been used to identify viable but immotile spermatozoa before the procedure. However, there are limited studies on the safety of laser-assisted selection of immotile spermatozoa. The aim of this study was to investigate the impact of laser-assisted selection of immotile spermatozoa on the obstetric and neonatal outcomes after ICSI.
Methods

A retrospective comparative study was conducted on patients who underwent ICSI treatment with testicular spermatozoa in our Reproductive Medicine Unit from June 2014 to June 2018. The 132 cycles were divided into two groups according to whether laser-assisted selection of spermatozoa was used.
Results

Compared with control group, no significant differences were found in the pregnancy, implantation, miscarriage and live birth rates in the laser group in either fresh or frozen transfer cycles. The cumulative live birth rate in the laser group was 69.70%, which was slightly higher than in the control group (60.61%), but this was not statistically different. There were no differences in the average gestational age, premature birth rate, neonatal birth weight and the malformation rate between the laser and control groups (P > 0.05). In addition, the obstetric outcome between the two groups were not different (P > 0.05).
Conclusions

No negative effect on perinatal and neonatal outcomes was seen by using laser-assisted selection of immotile spermatozoa for TESA-ICSI. This study endorses the use of laser-assisted selection of viable spermatozoa for ICSI cycles.
The New Role of Cytomorphology from Ultrasound-Guided Fine Needle Aspiration Cytology in Evaluating the Status of Prognostic Factors Including Estrogen Receptor, Progesterone Receptor and HER2 in Breast Cancer
Authors: Li Yunzhu , Li Jiayu , Jia Shijun , Yao Yuqi , Zhou Yehan , Liu Yang
Published: February 2021

Purpose It is well established that estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (HER2) have therapeutic implications cand could be regarded as prognostic factors in breast cancer. Ultrasound-guided fine needle aspiration cytology (FNAC) has revolutionized the management of cancers, providing less invasive and quick diagnostic method. There are hardly studies on the correlation between cytomorphology and three prognostic markers. Methods We retrospectively analyzed the immunohistochemistry and fluorescence in situ hybridization of axillary lymph node specimen from 252 patients, who have been diagnosed as breast cancer at Sichuan Cancer Hospital. Morphologic features of cytology sections were scored. The relationship between cytological features and three markers were analyzed. Based on this, we developed a new system to predict the status of markers.Results The results indicated that some cytological parameters, especially the features of nucleoli, were distinctively related to the makers’ expression. In the new scoring system, a cutoff of 12.5 provided a statistical discrimination for cytological grading. Meanwhile, it was associated with higher sensitivity for evaluating the ER and PR status (94% and 86%, respectively), but a lower sensitivity for HER2 status (76%). Conclusions We concluded that cytomorphological features are associated with three prognostic factors. The HR+ tumors showed scattered micro-nucleoli, while HER2-amplication tumors demonstrated centered macro-nucleoli. Based on this, we summarized six parameters to form a new scoring system to predict the status of three factors. This may help us to broaden the application of breast cancer cytology.
Does an Innovative Paper-Based Health Information System (PHISICC) Improve Data Quality and use in Primary Health Care? Protocol of a Multi-Country, Cluster Randomised Controlled trial in Sub-Saharan African Rural Settings.
Authors: Bosch-Capblanch Xavier , Oyo-Ita Angela , Muloliwa Artur Manuel , Yapi Richard B , Auer Christian , Samba Mamadou , Gajewski Suzanne , Ross Amanda , Krause L Kendall , Ekpenyong Nnette , Nwankwo Ogonna , Njepuome Anthonia Ngozi , Lee Sofia Mandjate , Sacarlal Jahit , Madede Tavares , Berté Salimata , Matsinhe Graça , Garba Abdullahi Bulama , Brown David
Published: February 2021

BackgroundFrontline health workers in remote, rural health facilities are the first contact of the formal health sector and are confronted with the need to make life-saving clinical and public health decisions. Appropriate health information systems (HIS) provide data to support the collection and use of data, thus facilitating decision-making. However, HIS focus on reporting and are unfit to support critical decisions at the peripheral level. Since data tools are paper-based in most primary health care settings, we have produced an innovative paper-based HIS (PHISICC), embracing all health care areas in primary health care, using a Human Centred Design, co-creation approach. The PHISICC tools aid decision-making, include recording and reporting and substitute the regular HIS tools. We are carrying out a cluster-randomised controlled trial in three African countries to assess the effects of PHISICC compared with the current systems, on data use and quality, quality of health care and health worker perceptions, in remote, rural settings.MethodsWe have selected study areas in rural zones of Côte d’Ivoire, Mozambique and Nigeria. Seventy health facilities in each country have been randomly allocated to using PHISICC tools or to continuing to use the regular HIS tools (35 per arm). We have selected three villages in the catchment area of each health facility to carry out surveys in 10 households each. Outcomes of interest include data quality and use, coverage of health services, health workers perceptions and other process and explanatory variables. DiscussionWe strive to contribute to producing robust evidence on health systems interventions, affecting people in remote, rural settings where the most vulnerable live. The PHISICC tools focus on decision-making rather than data and are meant to support health workers decisions as well as reporting to the higher levels of the system. Robust evidence on HIS can better find its way to high quality systematic reviews and guidance development to inform policy and practice.Trial registration: Pan African Clinical Trials Registry - PACTR201904664660639. Registered 01/04/2019, https://pactr.samrc.ac.za/Search.aspx.
Simulation of Heat Loss in CZTSSe Thin Film Solar Cells: A Coupled Optical-Electrical-Thermal Modeling
Authors: Zandi Soma , Seresht Mohsen Jamshidi , Gorji NIMA E.
Published: February 2021

A coupled optical-electrical-thermal modeling has been developed to investigate the heat generation in CZTSSe solar cells via Thermalization, Joule heat, Peltier heat, Surface Recombination heat, and non-radiative recombination heat and also the heat dissipation via convective and radiative cooling. These were calculated and displayed in 2D and 3D maps either at zero bias or open-circuit voltage (V oc) conditions. At V=0, the heat is generated mainly at the junction of CZTSSe/CdS where the thermalization and Joule heats are dominantly higher compared to non-radiative (SRH and Auger) recombination heat. However, at V=V oc , the nan-radiative recombination heat becomes comparatively higher than the Joule heating whereas the thermalization remains highest as before. Apart from the bulk heating factors, we also studied the surface recombination and Peltier heat generation. The surface recombination heat is higher at V=V oc compared to at V=0 while the Peltier heat is zero at V=V oc which can be explained by looking at the energy band diagrams at these voltages. The total heat generation does not change much across the cell thickness (<5×10 9 W/m 3) as the cell is quite thin. Nevertheless, the individual impact of every heat generation factor on power-density and current-voltage characteristics of the cell reveals that the thermalization, Joule, and non-radiative recombination heats reduce the open-circuit voltage of the cell from 0.54 V to 0.49 V (∆V = 0.047 V) while the Peltier and surface recombination heat is less effective. The temperature of the cell shows a small distribution across the cell (0.01 K). However, the temperature of the initial study at 293 K increases to 315-320 K for the coupled study. At this increased temperature, the short current-density doesn’t change but the fill factor decreases from 73.8% to 71.8% and, therefore, the energy conversion efficiency of the cell falls by 11.11% (from initial 12.78% to 11.36%). All the total heat dissipation, convective, and radiation cooling follow a similar trend to the total heat generation but convective cooling is the dominant component of dissipation.
A comparison of thrombosis in total knee arthroplasty with and without a tourniquet: A meta-analysis of randomized controlled trials
Authors: Xie Jia , Yu Hao , Wang Fangyuan , Jing Juehua , Li Jun
Published: February 2021

Background

Tourniquets are widely used in total knee arthroplasty (TKA), but the issue of their safety remains controversial. Previous studies have focused on TKA blood loss, duration of surgery, and hemostatic drugs. The purpose of this meta-analysis was to analyze the effect of tourniquet use on postoperative deep venous thrombosis (DVT).
Methods

PubMed, SCOPUS, Web of Science, Embase, and the Cochrane Library were searched for randomized clinical trials published before April 17, 2020 that compared the effect of tourniquet use on postoperative DVT, knee circumference, D-dimers, and pain measured using the visual analogue scale (VAS).
Results

Fourteen clinical trials that included 1321 unique participants were included in the meta-analysis. Among the total, 721 and 600 participants were randomized to the tourniquet and non-tourniquet groups, respectively. The incidence of postoperative thrombosis in the tourniquet group was significantly higher than in the non-tourniquet group (RR 2.30, 95% CI: 1.51–3.49, P < 0.0001, I2 = 0%). On the 1st, 3rd, and 5th to 21st days, and 3 to 6 weeks after surgery, the knee circumference difference of the tourniquet group was significantly larger than that of the non-tourniquet group (P < 0.05). However, 4 to 6 months after the surgery, no significant difference in knee circumference was found between the two groups (MD 0.14, 95% CI: -0.02-0.31, P = 0.09, I2 = 0%). The VAS score of the tourniquet group was higher than the non-tourniquet group on the 3rd and 5th days after surgery (P < 0.05). However, this difference was not significant (MD 0.31, 95% CI: -0.05-0.66, P = 0.09, I2 = 89%).
Conclusion

Results of this meta-analysis indicate that tourniquet application could increase the incidence of postoperative DVT and aggravate postoperative pain and swelling in the short term. Level of evidence III.
Investigating the Antecedents of User Acceptance of Clinical Decision Support Systems: a Case from Saudi Arabia
Authors: Albahly Mohammed Suliman , Seliaman Mohammed Elhassan
Published: February 2021

Background
The purpose of this paper is to develop an integrated research model to identify the technological and non-technological factors that influence user acceptance of the CDSS. This model is empirically tested using a data sample collected from selected healthcare facilities in Saudi Arabia.
Methods
The research study uses the quantitative approach to evaluate the currently implemented CDSS as a part of Hospital Information System BESTCare 2.0 in Saudi Ministry of National Guard Health Affairs. A survey questionnaire is conducted at all Ministry of National Guard Health Affairs hospitals for data collection. Then, the survey data is analyzed using Structural Equation Modeling (SEM) and AMOS 21.0. This analysis includes: measurement instrument reliability, discriminant validity, convergent validity, and hypothesis testing. Moreover, a CDSS usage data sample is extracted from the data warehouse to be analyzed as an additional data source.
Results
The results of the hypotheses testing show that usability, availability, and medical history accessibility are the important factors influencing user acceptance of CDSS.
Conclusions
This study provides prudence pertaining to healthcare facilities and their higher management to adopt CDSS.
Improving patient safety through identifying barriers to reporting medication errors among nurses: an integrative review
Authors: Afaya Agani , Konlan Kennedy Diema , Do Hyunok Kim
Published: February 2021

Background: The aim of the third WHO challenge released in 2017 was to attain a global commitment to lessen the severity and to prevent medication-related harm by 50% within the next five years. To achieve this goal, comprehensive identification of barriers to reporting medication errors is imperative.Objective: This review aimed to identify studies that investigated barriers to reporting medication administration errors among nurses, systematically summarize the findings to make recommendations for improving error reporting, and for future investigation.Design: An integrative review Review methods: PubMed, Web of Science, EMBASE and the Cumulative Index to Nursing and Allied Health Literature (CINAHL) including Google scholar were searched to identify published studies on barriers to medication error reporting from January 2016 to December 2020. The reviewers independently assessed the quality of all the included studies using the Mixed Methods Appraisal Tool (MMAT) version 2018.Results: Of the 10937 articles reviewed, 14 studies were included. The main themes and subthemes identified after the integration of results from qualitative and quantitative studies were; organizational barriers (inadequate reporting systems, management behavior, and unclear definition of medication error), and professional and individual barriers (fear of management/colleagues/lawsuit, individual reasons and inadequate knowledge of errors).Conclusion: It is not expected that nurses will freely report medication errors in a fearful, punitive, and blaming culture. Providing an enabling environment void of punitive measures and blame culture is imperative for nurses to report medication errors. To minimize the burden on nurses reporting medication errors, an effective, non-time consuming, and uncomplicated anonymous system is required. An open feedback system for motivating or rewarding nurses for reporting medication errors is imperative and will therefore increase the rate of error reporting. Policymakers, managers, and nurses should agree on a uniform definition of what constitutes medication error to enhance nurses' ability to report.
The neural mechanism by which fatigue sensation suppresses physical performance: a magnetoencephalography study
Authors: Matsuo Takashi , Ishii Akira , Minami Takayuki , Nanjo Hitoshi , Yoshikawa Takahiro
Published: February 2021

The right dorsolateral prefrontal cortex (DLPFC) has been proposed to be the brain region regulating performance through fatigue sensation in fatigue, but direct evidence has been lacking for right DLPFC activation when physical performance is suppressed in the presence of fatigue sensation. We examined whether the right DLPFC is activated when physical performance is suppressed by re-experiencing a fatigue sensation. Eighteen healthy male volunteers participated. They performed a rest session followed by a handgrip session to induce physical fatigue sensation. Then, they were instructed to re-experience the state of the right hand with (i.e., the target condition) and without (i.e., the control condition) fatigue sensation as experienced in the handgrip and rest sessions, respectively, while performing motor imagery of maximum handgrip of the right hand. Neural activity during both conditions was recorded using magnetoencephalography. The level of fatigue sensation was higher in the target condition than in the control condition. Decreases of handgrip strength and beta band power in the right Brodmann’s area 46 were observed in the target condition, suggesting that the right DLPFC is involved in the regulation of physical performance through fatigue sensation. These findings may help elucidate the neural mechanisms regulating performance under fatigue conditions.