bluuebunny/crossref_metadata_2025 huggingface dataset:
Psychological Distress, Somatic Complaints and Their Relation to Negative Psychosocial Factors in a Sample of Swedish High School Students
Authors: Kerekes Nóra , Zouini Btissame , Tingberg Sofia , Erlandsson Soly
Published: January 2021

Background Adolescence is a period in a life characterized by major neurobiological, physiological, and psychological changes. Those changes may give rise to worsened mental health and an increased prevalence of somatic complaints combined with a negative psychosocial environment. Rapid changes in society, which may also affect young people in several ways, call for a renewed screening of today's adolescents' mental and somatic well-being.Aim The present study's primary aim was to measure the level of self-rated psychological distress and the prevalence of somatic complaints in a sample of Swedish high school students. As a secondary aim, it identifies gender-specific patterns and examines mental and somatic health in relation to negative psychosocial factors (such as parental alcohol use problems or the experience of physical or psychological abuse).Method 287 Swedish high school students completed a survey including the Brief Symptom Inventory (BSI) and a questionnaire about the presence of defined somatic complaints. In order to examine the relationship between negative psychosocial factors and mental and somatic health, three groups were formed: those reporting (1) parental substance use problems, (2) previous experience of abuse, (3) none of these problems.Results The majority of the Swedish high-school students (> 80%) reported no or only a few problems with psychological distress and no or only one somatic complaint. Female students disclosed a significantly higher psychological distress level captured by each BSI domain. The number of somatic complaints was similarly distributed between the genders. The students rarely reported parental substance use problems, but almost 40% of the male and 50% of the female students indicated the experience of physical and/or psychological abuse. Such negative psychosocial circumstances were related to an increased level of anxiety in the male and an increased general level of psychological distress in female students.Conclusions The study confirmed female students’ higher psychological distress level, while no gender differences in the number, but the type, of physical complaints were detected. The experience of physical and/or psychological abuse was found to worsen psychological distress in students of both genders significantly.
Polymerized hybrid perovskites with enhanced stability, flexibility and lattice rigidity
Authors: Chen Wenjing , Shi Yongliang , Chen Jia , Ma Pingchuan , Fang Zhibin , Ye Dan , Lu Yiyang , Yuan Yongbo , Zhao Jin , Xiao Zhengguo
Published: January 2021

The intrinsic soft lattice nature of organometal halide perovskites (OHPs) makes them very tolerant to defects and ideal candidates for solution-processed optoelectronic devices. However, the soft lattice results in low stability towards external stresses such as heating and humidity, and induces high density of phonons, causing strong electron-phonon coupling. Here, we report solid-state polymerization of OHPs using unsaturated 4-vinylbenzylammonium as organoammonium cations without damaging perovskite structure and its tolerance to defects. The polymerized perovskites show enhanced stability and flexibility. Furthermore, the polymerized 4-vinylbenzylammonium group improves perovskite lattice rigidity substantially, resulting in reduced electron-phonon coupling and non-radiative recombination rate, and enhanced carrier mobility because of suppressed phonon scattering. We finally demonstrate efficient polymerized perovskite based light-emitting diodes with an external quantum efficiency of 23.2% and enhanced operation stability.
Correlative Multi-scale Cryo-imaging Unveils SARS-CoV-2 Assembly and Egress
Authors: Zhang Peijun , Mendonca Luiza , Howe Andrew , Gilchrist James , Sun Dapeng , Knight Michael , Zanetti-Domingues Laura , Bateman Benji , Krebs Anna-Sophia , Chen Long , Radecke Julika , Sheng Yuewen , Li Vivian , Ni Tao , Kounatidis Ilias , Koronfel Mohamed , Szynkiewicz Marta , Harkiolaki Maria , Martin-Fernandez Marisa , James William
Published: January 2021

Since the outbreak of the SARS-CoV-2 pandemic, there have been intense structural studies on purified recombinant viral components and inactivated viruses. However, structural and ultrastructural evidence on how the SARS-CoV-2 infection progresses in the frozen-hydrated native cellular context is scarce, and there is a lack of comprehensive knowledge on the SARS-CoV-2 replicative cycle. To correlate the cytopathic events induced by SARS-CoV-2 with virus replication process under the frozen-hydrated condition, here we established a unique multi-modal, multi-scale cryo-correlative platform to image SARS-CoV-2 infection in Vero cells. This platform combines serial cryoFIB/SEM volume imaging and soft X-ray cryo-tomography with cell lamellae-based cryo-electron tomography (cryoET) and subtomogram averaging. The results place critical SARS-CoV-2 structural events – e.g. viral RNA transport portals on double membrane vesicles, virus assembly and budding intermediates, virus egress pathways, and native virus spike structures from intracellular assembled and extracellular released virus - in the context of whole-cell images. The latter revealed numerous heterogeneous cytoplasmic vesicles, the formation of membrane tunnels through which viruses exit, and the drastic cytoplasm invasion into the nucleus. This integrated approach allows a holistic view of SARS-CoV-2 infection, from the whole cell to individual molecules.
The Development of An Effective Synthetic Route of Rilpivirine
Authors: Zhang Tao , Yang Jiapei , Zhou Zhongxia , Fu Zhipeng , Cherukupalli Srinivasulu , Kang Dongwei , Zhan Peng , Liu Xinyong
Published: January 2021

Background: Rilpivirine (RPV) is a potent and selective non-nucleoside reverse transcriptase inhibitor (NNRTI) of the diarylpyrimidine family with unique antiviral activity, low toxicity and high specificity. It is approved by the U.S. FDA (Food and Drug Administration) in 2011 to treat individuals infected with human immunodeficiency virus 1 (HIV-1). Significantly, rilpivirine is 3-fold more potent than etravirine. Once-daily, it is used with a low oral dose (25mg/tablet), decreasing the drug administration and bringing the better choice to the patients. However, there are many shortcomings in the existing synthesis route of RPV, such as the high cost, prolonged reaction time and low yield (18.5%).Results: This article describes our efforts to develop an efficient and practical microwave-promoted method to synthesize rilpivirine using less toxic organic reagents and low boiling solvents. The last step's reaction time decreased from 69 h to 90 min through this optimized synthetic procedure, and the overall yield improved from 18.5% to 21%. In addition, the yield of intermediate 3 increased from 52% to 62% compared to the original patent.Conclusion: Overall, through a series of process optimization, we have developed a practical synthesis method of rilpivirine, which is easy to scale with higher yield and shorter reaction time.
Six Genes Involved in Prognosis of Hepatocellular Carcinoma Identified by Cox Hazard Regression
Authors: Dai Qinghong , Liu Tao , Gao Yongchao , Zhou Honghao , Li Xiong , Zhang Wei
Published: January 2021

Background: Hepatocellular carcinoma (HCC), derived from hepatocytes, is the main histological subtype of primary liver cancer and poses a serious threat to human health due to the high incidence and poor prognosis. This study aimed to establish a multigene prognostic model to predict the prognosis of patients with HCC. Results: Gene expression datasets (GSE121248, GSE40873, GSE62232) were used to identify differentially expressed genes (DEGs) between tumor and adjacent or normal tissues, and then hub genes were screened by protein–protein interaction (PPI) network and Cytoscap software. Seventeen genes among hub genes were significantly associated with prognosis and used to construct a prognostic model through COX hazard regression analysis. The predictive performance of this model was evaluated with TCGA data and was further validated with independent dataset GSE14520. Six genes (CDKN3, ZWINT, KIF20A, NUSAP1, HMMR, DLGAP5) were involved in the prognostic model, which separated HCC patients from TCGA dataset into high- and low-risk groups. Kaplan-Meier (KM) survival analysis and risk score analysis demonstrated that low-risk group represented a survival advantage. Univariate and multivariate regression analysis showed risk score could be an independent prognostic factor. The receiver operating characteristic (ROC) curve showed there was a better predictive power of the risk score than that of other clinical indicators. At last, the results from GSE14520 demonstrated the reliability of this prognostic model in some extent. Conclusion: This prognostic model represented significance for prognosis of HCC, and the risk score according to this model may be a better prognostic factor than other traditional clinical indicators.
Controllable Synthesis of Conjugated Microporous Polymer Films for Ultra-sensitive Detection of Chemical Warfare Agents
Authors: Mo Wanqi , Chen Yu , Liu Huaqian , Cheng Zhiyong , Ma Hongwei , Li Xiaobai , Li Bin
Published: January 2021

Nerve agents, one of the most toxic chemical warfare agents, seriously threaten human life and public security. The development of highly sensitive nerve-agent sensors has become an imperative and challenging topic. Reported here are two fluorescent conjugated microporous polymer (CMP) films, which show superior sensitivity for DCP (nerve-agent simulant). The limit of detection of TCzP-CMP can be determined as 13.2 ppt, which is the best report. This is due to the synergy of the susceptible "on-off" effect of hybridization and de-hybridization of hybrid local and charge transfer (HLCT) materials and the microporous structure of CMP films facilitating the inward diffusion of DCP vapor, and the “molecular wire effect”. This strategy provides a new idea for the future development of gas sensors. In addition, a portable sensor is successfully integrated based on TCzP-CMP films that enables wireless, remote, ultrasensitive, and real-time detection of DCP vapors.
Imaging current distribution in a topological insulator Bi2Se3 in the presence of competing surface and bulk contributions to conductivity
Authors: Jash Amit , Kumar Ankit , Ghosh Sayantan , Bharathi A. , Banerjee S.
Published: January 2021

Two-dimensional (2D) topological surface states in a three-dimensional topological insulator (TI) should produce uniform 2D surface current distribution. However, our transport current imaging studies on Bi2Se3 thin film reveal non-uniform current sheet flow at 15 K with strong edge current flow. This is consistent with other imaging studies on thin films of Bi2Se3. In contrast to strong edge current flow in thin films, in single crystal of Bi2Se3 at 15 K our current imaging studies show the presence of 3.6 nm thick uniform 2D sheet current flow. Above 70 K, this uniform 2D sheet current sheet begins to disintegrate into a spatially non-uniform flow. The flow becomes patchy with regions having high and low current density. The area fraction of the patches with high current density rapidly decreases at temperatures above 70 K, with a temperature dependence of the form 1/|T-70| 0.35. The temperature scale of 70 K coincides with the onset of bulk conductivity in the crystal due to electron doping by selenium vacancy clusters in Bi2Se3. Thus our results show a temperature dependent competition between surface and bulk conductivity produces a temperature dependent variation in uniformity of current flow in the topological insulator.
Axial Compression Capacity of Concrete Columns Reinforced With Corrosion-Resistant Metallic Reinforcement
Authors: Wright John , Pantelides Chris
Published: January 2021

Axial compression performance of concrete columns reinforced with 2304 duplex stainless bars and spirals, carbon steel bars and spirals, and 316L stainless steel clad bars, in varying combinations is examined when the columns are exposed to corrosion. Two groups of columns were investigated: a control group, and a group submerged in a 5.0% by weight chloride solution subjected to accelerated corrosion. A relatively high corrosion rate of 8.5 μA/mm2 was used. After 60 days of corrosion the columns were tested to failure under axial compression. In terms of mass loss per unit of corrosion energy, columns reinforced with stainless steel spirals and either solid stainless or stainless clad vertical bars were 197% more corrosion resistant than carbon steel. Bars made with 2304 stainless steel and 316L stainless clad materials developed localized pitting corrosion that led to degradation of the concrete cover and a larger drop in axial compression than carbon steel reinforced columns. However, the all-carbon steel reinforced columns reached lower failure displacements and a corroded carbon steel reinforced column was the only column to experience sudden failure prior to reaching its theoretical maximum axial compression capacity. Axial compression capacity of the columns in both the control and corroded conditions was modeled using concrete confinement models that produced very good agreement with the experimental results.
Curriculum Initiatives to Enhance Research Skills Acquisition by Medical Students: A Scoping Review of the Literature
Authors: Carberry Crea , McCombe Geoff , Tobin Helen , Stokes Diarmuid , Last Jason , Bury Gerard , Cullen Walter
Published: January 2021

Background: Although it is accepted that providing medical students with opportunities to engage in research activity is beneficial, little data has been collated on how medical degree curricula may address this issue. This review aims to address this knowledge gap by conducting a scoping review examining curriculum initiatives that seek to enhance research experience for medical students.Methods: This review looks to specifically look at ’doing research’ as defined by the MEDINE 2 consensus rather than ‘using research’ for the bachelor component of the Bologna Cycle. The five-stage framework developed by Arksey & O’Malley was utilised.Results: Ultimately, 120 articles were included in this scoping review; 26 related to intercalated degree options and 94 to non-intercalated degree options. Research initiatives from the United States were most featured (53/120 articles). For non-intercalated research options, mandatory and elective research projects predominated. The included studies were heterogeneous in their methodology. The main outcomes reported were student research output, description of the curriculum initiative(s) and self-reported research skills acquisition. For the intercalated degree options, the three main findings were descriptions of more ‘novel’ intercalated degree options than the traditional BSc, student perspectives on intercalating and the effect of intercalating on medical student performance and careers. Conclusion: There are a number of options available to faculty involved in planning medical degree programmes but further research is needed to determine whether research activity should be optional or mandatory. For now, flexibility is probably appropriate depending on a medical school’s resources, curriculum, educational culture and population needs.
Crossing Knowledge Boundaries: Health Care Providers’ Perceptions and Experiences of What is Important to Achieve More Person-Centered Patient Pathways For Older People
Authors: Olsen Cecilie , Bergland Astrid , Bye Asta , Debesay Jonas , Langaas Anne
Published: January 2021

Background: Improving the transitional care of older people, especially hospital-to-home transitions, is a salient concern worldwide. Older people’s patient pathways may be unpredictable and complex, posing significant challenges for health care providers (HCPs). In particular, appropriate follow-up in primary care after discharge is key. Current research in the field endorses person-centered care as crucial to improving the patient pathways of older people. The aim of this study was to explore HCPs’ perceptions and experiences of what is important to achieve more person-centered patient pathways for older people.Methods: This was a qualitative study. We performed individual semistructured interviews with 20 HCPs and three key persons who participated in a Norwegian quality improvement collaborative. In addition, participant observation of 22 meetings in the quality improvement collaborative was performed. Results: A thematic analysis resulted in five themes: 1) Finding common ground through the mapping of the patient journey; 2) the importance of understanding the whole patient pathway; 3) the significance of getting to know the older patient; 4) the key role of home care providers in the patient pathways of older people; and 5) ambiguity toward checklists and practice implementation. Conclusion: To understand the findings, it proved useful to see them in light of knowledge sharing and boundary crossing, which are central concepts in the literature on transitional care. HCPs in the collaborative shared and coproduced new knowledge of the patient pathways of older people based on a patient journey perspective. Mapping the patient journey and asking, “What matters to you?” facilitated the crossing of knowledge boundaries between the HCPs; hence, a new and more holistic view of the patient pathways of older people in the current context emerged. The centrality of getting to know the patient and the special role of providers working in home care services was a central finding. The study adds to existing knowledge by suggesting that the achievement of person-centered patient pathways for older people does not only depend on the crossing of knowledge boundaries among HCPs, but also between HCPs and older persons.
Althaea officinalis extracts heal skin wounds in second- and third-degree burns in mice
Authors: Ranjbar Ali Mohammad , Sojaeemehr Arefeh , Zabihi Mohsen , Shishehbor Fatemeh , Ramezani Vahid
Published: January 2021

Background and Purpose: Burns are one of the most common injuries. There are few medications to repair skin in burns. Although antibacterial drugs such as topical silver sulfadiazine may prevent wound infections, they usually can’t attenuate skin healing. Marshmallow is used in Iranian traditional medicine to improve skin burns. We aimed to evaluate the effect of hydroalcoholic and aqueous extract of Althaea officinalis on the histopathologic parameters of second- and third-degree burns in mice. Experimental approach: The mice were randomly divided into 9 groups (n=6) including control and treatment groups. Experimental second- and third-degree burns were induced on dorsal skin of the mice by a metal plate (2 cm in diameter) under general anesthesia. Control and treatment groups were treated twice daily for 21 days topically. Normal saline was used for control group and hydroalcoholic and aqueous extracts of Althaea officinalis in three concentrations (1%, 2% and 4%) were used for the treatment groups. All of the preparations were made in hydrogel base. Finally, the histopathological parameters of the burned skin including polymorphonuclear (PMN) migration, epithelialization, angiogenesis and collagenization were scored and total score of wound healing was calculated. Key Results: The findings showed that topical application of both hydroalcoholic and aqueous extracts of Althaea officinalis attenuates the wound healing process. they reduce PMN migration, collagenization, epithelialization and angiogenesis scores compared to control group. Conclusions & Implications: Althaea officinalis can be used as an adjunct medication to attenuate wound healing in skin burns.
Integrating the Complexity of Healthcare Improvement with Implementation Science: A Longitudinal Qualitative Case Study
Authors: Melder Angela , Robinson Tracy , Mcloughlin Ian , Iedema Rick , Teede Helena
Published: January 2021

BackgroundImplementation science seeks to enable change, underpinned by theories and frameworks such as the Consolidated Framework for Implementation Research (CFIR). Yet academia and frontline healthcare improvement remain largely siloed, with limited integration of implementation science methods into frontline improvement where the drivers include pragmatic, rapid change. We aimed to explore how pragmatic and complex healthcare improvement and implementation science, through the CIFR lens, can be integrated. MethodsOur research involved the investigation of a case study that was undertaking the implementation of an improvement initiative at a large public health service. This research involved qualitative data collection methods of semi-structured interviews and non-participant observations of the implementation team delivering the initiative. Thematic analysis identified key themes from the qualitative data. We examined our themes through the lens of CFIR to gain in-depth understanding of how the CFIR components operated in a ‘real-world’ context.ResultsThe key themes emerging from our research outlined that leadership, context and process are the key components that dominate and affect improvement work. Leadership which cultivates connections with front line clinicians, fosters engagement and trust. Navigating context was facilitated by ‘bottom-up’ governance. Multi-disciplinary, cross-sector capability, responded to a changing complex environment, adjusting pragmatically, and responsively. Process reflected the theoretically-informed, and iterative approach. Mapping CFIR domains and constructs, with these themes demonstrated close alignment with the CFIR. The findings bring further depth to CFIR and demonstrates that leadership that focuses on patient need as a key motivator to engage clinicians, and that applied and ensured iterative processes, which leveraged contextual factors achieved successful, sustained implementation and healthcare improvement. ConclusionsThis longitudinal study highlights profound insights that strengthen alignment between implementation science and pragmatic frontline healthcare improvement. We identify opportunities to enhance the relevance of CFIR in the ‘real-world’ setting through the interconnected nature of our themes. Our study demonstrates actionable knowledge to enhance the integration of implementation science in healthcare improvement.
Microbial Predation Accelerates Granulation and Modulates Microbial Community Composition
Authors: Chan Siew Herng , Ismail Muhammad Hafiz , Tan Chuan Hao , Rice Scott A. , McDougald Diane
Published: January 2021

BackgroundBacterial communities are responsible for biological nutrient removal and flocculation in engineered systems such as activated floccular sludge. Predators such as bacteriophage and protozoa exert significant predation pressure and cause bacterial mortality within these communities. However, the roles of bacteriophage and protozoan predation in impacting granulation process remain limited. Recent studies hypothesised that protozoa, particularly sessile ciliates, could have an important role in granulation as these ciliates were often observed in high abundance on surfaces of granules. Bacteriophages were hypothesized to contribute to granular stability through bacteriophage-mediated extracellular DNA release by lysing bacterial cells. This current study investigated the bacteriophage and protozoan communities throughout the granulation process. In addition, the importance of protozoan predation during granulation was also determined through chemical killing of protozoa in the floccular sludge.ResultsFour independent bioreactors seeded with activated floccular sludge were operated for aerobic granulation for 11 weeks. Changes in the phage, protozoa and bacterial communities were characterized throughout the granulation process. The filamentous phage, Inoviridae, increased in abundance at the initiation phase of granulation. However, the abundance shifted towards lytic phages during the maturation phase. In contrast, the abundance and diversity of protozoa decreased initially, possibly due to the reduction in settling time and subsequent washout. Upon the formation of granules, ciliated protozoa from the class Oligohymenophorea were the dominant group of protozoa based on metacommunity analysis. These protozoa had a strong, positive-correlation with the initial formation of compact aggregates prior to granule development. Furthermore, chemical inhibition of these ciliates in the floccular sludge delayed the initiation of granule formation. Analysis of the bacterial communities in the thiram treated sludge demonstrated that the recovery of ‘Candidatus Accmulibacter’ was positively correlated with the formation of compact aggregates and granules.ConclusionPredation by bacteriophage and protozoa were positively correlated with the formation of aerobic granules. Increases in Inoviridae abundance suggested that filamentous phages may promote the structural formation of granules. Initiation of granules formation was delayed due to an absence of protozoa after chemical treatment. The presence of Candidatus Accumulibacter was necessary for the formation of granules in the absence of protozoa.
ARID1A Upregulation Predicts Poor Survival in Patients With Liver Cancer 
Authors: Jiang Feng , Wei Ke , Wang Ming , Wu Chuyan
Published: January 2021

Objective: ARID1A has been identified as a possible biomarker for certain cancers. There is, however, some debate regarding its function in liver cancer. Methods: Associations between clinical variables and ARID1A were evaluated. Cox and Kaplan – Meier analysis were used to examine clinical pathological factors linked to overall survival of patients with liver cancer. Gene set enrichment analysis (GSEA) was conducted using the dataset of the cancer genome atlas(TCGA). Results: High expression of ARID1A was correlated with the gender and tumor topography (T) diagnosis of liver cancer. Patients with elevated ARID1A expression had poorer prognosis than those with low ARID1A expression. The study also showed that ARID1A was an independent risk factor for overall survival. GSEA established pathways involved in ERBB signaling, cancer, insulin signaling, mTOR signaling, MAPK signaling, VEGF signaling, Ubiquitin signaling, and Wnt signaling as differentially enriched in ARID1A-high expression liver cancer. Conclusion: ARID1A has been shown to be expressed at high rates of liver cancer and to represent a possible independent molecular marker for diagnosis and prognosis of liver cancer.
Identification of significant genes with invasive promotion in non-functional pituitary adenoma via bioinformatical analysis
Authors: Wang An Shuo , Xu Hao , Zeng Ming Hui , Wang Fei
Published: January 2021

Background

Non-functional pituitary adenoma (NFPA) is a disease with a high incidence, which accounts for a large part of pituitary tumors and plays a pivotal role. While invasive NFPAs which have not any endocrinology manifestations and space-occupying symptoms at early stages account for about 30 percent of NFPAs. The purpose of the present academic work was to identify significant genes with invasive promotion and their underlying mechanisms.
Methods

Gene expression profiles of GSE51618 was available from GEO database. There are 4 non-invasive NFPA tissues, 3 invasive NFPA tissues and 3 normal tissues in the profile datasets. Differentially expressed genes (DEGs) between non-invasive NFPA tissues and invasive NFPA tissues were picked out by GEO2R online tool. There were total of 226 up-regulated genes and 298 down-regulated genes. Next, we made use of the Database for Annotation, Visualization and Integrated Discovery (DAVID) to analyze Kyoto Encyclopedia of Gene and Genome (KEGG) pathway, gene ontology (GO) and Kaplan Meier Plotter. Then protein-protein interaction (PPI) of these DEGs was visualized by Cytoscape with Search Tool for the Retrieval of Interacting Genes (STRING). There were total of 141 up-regulated genes and 171 down-regulated genes. Of PPI network analyzed by Molecular Complex Detection (MCODE) plug-in, all 141 up-regulated genes were selected.
Results

After reanalysis of GO, five genes (ATP2B3, ADCYAP1R1, PTGER2, FSHβ, HTR4) were found to significantly enrich in the cAMP signaling pathway, Neuroactive ligand-receptor interaction and Renin secretion via reanalysis of DAVID.
Conclusions

We have identified five significant up-regulated DEGs with invasive promotion in invasive NFPAs on the basis of integrated bioinformatical methods, which could be potential therapeutic targets for invasive NFPAs patients.
Conventional Suture with Prolonged Timing of Drainage Is As Good As Quilting Suture In Preventing Seroma Formation at Pectoral Area After Mastectomy
Authors: Huang Juan , Wang Shouman , Wu Yuhui , Hai Jian , Mao Jie , Dong Xue , Xiao Z
Published: January 2021

BackgroundThe aim of this study was to compare conventional suture with prolonged timing of drainage with quilting suture on the formation of seroma at pectoral area after mastectomy (ME) with sentinel lymph nodes biopsy (SLN) or axillary lymph nodes dissection (ALND) for breast cancer.Methods388 consecutive breast cancer patients were retrospectively analyzed and categorized into three group. Patients in group 1 were with quilting suture, group 2 with conventional suture and 13-15 days drainage in situ, and group 3 with conventional suture and 20-22 days drainage. The primary outcome was the incidence of Grade 2 and 3 seroma at anterior pectoral area within one month postoperatively. Cox regression was used for analysis.ResultsThe incidence of Grade 2 and 3 seroma was comparable among groups (9.5% vs. 7.9% vs. 5.3%, p = 0.437), as well as late Grade 2 and 3 seroma among groups (4.3% vs. 2.9% vs. 1.5%, p = 0.412). Old age, high body mass index and hypertension were independently risk factors for Grade 2 and 3 seroma.ConclusionsProlonged timing of drainage to 13-15 days in conventional suture was long enough to decrease the incidence of Grade 2 and 3 seroma as lower as that in quilting suture group at pectoral area within one month after mastectomy.
Retroperitoneal Leiomyosarcoma with Left Hip Pain as its Clinical Manifestation: A Case Report and Literature Review
Authors: Shi Yunfu , Zhang Bing , Zhang Mingxia , Yang Wenjuan , Qi Yiming , Hong Xiufang
Published: January 2021

Background: Leiomyosarcoma is a malignant tumor that originates from smooth muscle tissue, and can occur in multiple organs and tissues of the abdominal cavity, and most often in the retroperitoneum. It can occur at any age, usually 40 to 70 years old, and it is more common in women. The main clinical manifestations were abdominal discomfort, abdominal mass, abdominal pain, weight loss, nausea, vomiting or edema of the lower limbs. It is easy to invasion, recurrence and metastasis, and its prognosis is poor. Surgical resection is the preferred treatment method. Case presentation: A 55-year-old woman had pain in the left hip more than 6 years. Abdominal enhanced CT and MR showed that the tumor was located on the left side of psoas major muscle. She underwent surgical treatment, and the postoperative pathology was leiomyosarcoma. No other treatment was performed after the operation. The patient has been followed up for 78 months and no tumor recurrence. Conclusions: Retroperitoneal leiomyosarcoma is a rare type of malignant tumor with no specific clinical manifestation. Because of its atypical clinical manifestations, particular attention should be paid to avoid misdiagnosis and missed diagnosis.
Cognitive Impairment At 3, 6 and 12 Month After the First-Ever Stroke Among Lebanese Survivors: Incidence and Risk Factors
Authors: Boutros Celina , Khazaal Walaa , Taliani Maram , Salameh Pascale , Hosseini Hassan , Sadier Najwane Said
Published: January 2021

Cognitive impairment is a prevalent outcome of stroke, affecting the quality of life and increasing the disability. Its risk factors are unknown in Lebanon. Therefore, the aims of this study were to evaluate the cognitive impairment incidence among Lebanese stroke survivors at 3, 6 and 12 month post stroke, and to identify the associated factors. A multicenter longitudinal prospective study was conducted in 10 hospitals of Beirut and Mount Lebanon among 150 subjects aged ≥ 18 years old between February 2018 until May 2019. The Mini-Mental State Examination assessed the cognitive function. Univariate and Multivariable analyses were performed to identify the predictors of the post stroke cognitive impairment. A p-value <0.05 was considered statistically significant. At 3 month post stroke, 74.8% were cognitively impaired versus 46.7% and 37.6% at 6 and 12 month post stroke respectively. Older age, past smoking, presence of a caregiver, sedentary ≥ 12 hours, aphasia at the time of stroke occurrence, the length of hospital stay, severe stroke, high disability degree, post stroke anxiety and depression, epileptic seizures and physical disorders were the risk factors inducing cognitive decline. Whereas, the high education level, the employment and the history of diabetes mellitus played a protective role for the cognitive function. Findings reveal levels of cognitive impairment post-stroke that are concerning. Thus, primary and secondary prevention is essential to reduce its incidence and to cope with its burden.
Thixotropy of A Transparent Clay Manufactured by Carbopol Simulate Marine Soil
Authors: SUN Zhiwen , KONG Gangqiang , ZHOU Yang , SHEN Yang , XIAO Hanyu
Published: January 2021

A transparent clay manufactured by Carbopol® UltrezTM 10 (simplified as U10) was introduced, and its manufacture processes were briefly described. Both relative transparency (RT) and modulation transfer function (MTF) methods were used to quantify the optical character variation via soil thickness. The transparency of this new transparent clay was comparative analyzed with traditional four previous transparent materials. The results show that this new transparent clay has relative higher optical transparency than majority of previous materials. The thixotropic properties of this synthetic transparent clay were measured in detail through laboratory vane test. Exponential function was used to describe the thixotropy and sensitivity of clay. The good fitting results shown similar development trend of thixotropy for synthetic transparent clay and natural one. Furthermore, sensitivity of transparent clay belongs to low to medium sensitivity, which can simulate marine soil. With the test results, Carbopol® UltrezTM 10 shows a great potential as a substitute for natural clay and is expected to be widely used in model tests.
Clinical Outcomes of Micropulse Transscleral Cyclophotocoagulation in Refractory Glaucoma
Authors: Seo Duri , Lee Taek June , Kim Joo Yeon , Choi Wungrak , Lee Sang Yeop , Seong Gong Je , Kim Chan Yun , Bae Hyoung Won
Published: January 2021

This study evaluated the clinical outcomes of first-time micropulse transscleral cyclophotocoagulation (MP-TSCPC) performed in cases of refractory glaucoma. This retrospective study analysed the patients with refractory glaucoma who underwent MP-TSCPC rom February 2018 to February 2020 at Yonsei University Severance Hospital. A total of 45 eyes of 43 Asian patients (aged 55.71±16.84 years) who underwent MP-TSCPC for the first time, were included in this study. The mean baseline intraocular pressure (IOP) was 25.96±9.27 mmHg. The most common diagnosis was secondary glaucoma (44.4%) with a mean logarithm of the minimum angle of resolution (logMAR) visual acuity of 1.19±1.02. There was a significant reduction (P<0.05) in IOP on 1 day 1,to 18.03±5.99 mmHg;, at 1 week, to 13.29±5.24 mmHg;, at 1 month, to 14.98±4.55 mmHg;, at 3 months, to 17.05±5.52 mmHg;, 6 months to 17.78±6.37 mmHg; and 12 months, to 16.56±5.96 mmHg. There was also a reduction (P<0.05) in the number of topical anti-glaucoma medications required to control IOP from baseline (3.69±0.63) at 1, 3, and 6 months. MP-TSCPC is an effective procedure that offers good results in reducing IOP and decreases the use of anti-glaucoma medications in patients with refractory glaucoma.
COVseq is a cost-effective workflow for mass-scale
SARS-CoV-2 genomic surveillance
Authors: Simonetti Michele , Zhang Ning , Harbers Luuk , Milia Maria Grazia , Nguyen Thi , Brossa Silvia , Bienko Magda , Sapino Anna , Sottile Antonino , Ghisetti Valeria , Crosetto Nicola
Published: January 2021

Genomic surveillance of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is critical to monitor the spread and evolution of the virus across different populations, geographical regions and species. Here, we present a streamlined workflow—COVseq—based on the CUTseq method that we previously described, which can be used to generate highly multiplexed sequencing libraries compatible with Illumina platforms, from hundreds of SARS-CoV-2 samples in parallel, in a rapid and cost-effective manner. We validated COVseq on RNA extracted from the supernatant of a SARS-CoV-2 culture as well as from 85 RNA samples from nasopharyngeal swabs, demonstrating the ability of COVseq to achieve near complete genome coverage, including the S region encoding the spike protein. A cost analysis showed that COVseq could be used to sequence thousands of samples per week at less than 10 USD per sample, including library preparation and sequencing costs. COVseq is a versatile and scalable method that can be readily applied for genomic surveillance of the ongoing pandemic and easily adapted to other pathogens such as influenza viruses.
Arthroscopic reconstruction of anterior cruciate ligaments with allograft: Single-tunnel double-bundle versus single-tunnel single-bundle
Authors: Zhu Weimin , Zheng Yizi , Lu Wei , Xiong Jianyi , Wang Daping , Deng Zhenhan
Published: January 2021

Background: Arthroscopic reconstruction of anterior cruciate ligament (ACL) commonly adopted single-tunnel single-bundle (STSB) or double-tunnel double-bundle (DTDB) methods. Though single-tunnel double-bundle (STDB) has been used in clinical practice, the efficacy remains unclear. The objective of this study is to compare the clinical results of ACL reconstruction using the STDB and STSB techniques.Methods: Between March 2010 to June 2013, 78 patients with ACL rupture underwent arthroscopic STDB reconstruction (42 cases) or STSB reconstruction (36 cases) using anterior tibialis tendon allografts in our department. IKDC, Lysholm and Tegner scores were used to evaluate the subjective function of the knee joint during the postoperative follow-up. In addition, the Lachman test and pivot shift test were used to objectively assess the stability of the knee.Results: The average follow-up time is 24.2±5.7 months in the STDB group, and 24.8±6.6 months in the STSB group. Patients in both groups recovered to preoperative sports level with few complications. The postoperative Lysholm, IKDC, Tegner scores, and knee joint stability were significantly improved compared to preoperative status in both groups (P<0.05). However, no statistically significant difference was observed between the two groups at the final follow-up (P>0.05), except for the improvement of pivot shift test positive rate in the STDB group compared with STSB group (P<0.05).Conclusion: Both techniques can be used to restore the stability and function of the knee joint with satisfactory short-term efficacy, and STDB showed better rotational stability than STSB technique, indicating the STDB technique may also considered a reliable method for ACL reconstruction.
Comorbidities of COVID-19 Patients With Low Cycle Threshold (Ct) Value of Nucleocapsid (N) Gene: An Application to Cluster-Based Logistic Model.
Authors: RUDRA SUJAN , DAS SHUVA , HOQUE MD. EHSANUL , KALAM ABUL , RAHMAN MOHAMMAD ARIFUR , SHIZUKA SWAGATA NANDY , RAHMAN TAZRINA
Published: January 2021

Background: Coronavirus disease 2019 (COVID-19) is a health crisis throughout the world. The widely used Real-time Reverse Transcriptase Polymerase Chain Reaction (rRT-PCR) method is most capable to demonstrate the patient’s condition. Comorbidities can make patients more critical.Materials and methods: In this study, we shed light on the low cycle threshold (Ct) value of the N gene in the rRT-PCR test of the COVID-19 patients who had comorbidities and their cure rate as well as the needfulness of ICU (Intensive Care Unit) management. We conducted the research in the Molecular Biology Laboratory of Chittagong Medical College between May and August 2020, then took the telephone interview with 300 positive patients who fulfilled the study criteria. We applied cluster-based logistic regression to analyze the data.Results: Low Ct value of the N gene was found 1.324 times more in Type 2 DM patients and 1.871 times higher in hypertensive patients. Hospitalized patients are 2.480 times more vulnerable to shift in ICU in case of low Ct value of the N gene. Conclusion: While infection with Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) frequently causes severe diseases, suspected cases with comorbid conditions should go through the rRT-PCR as early as possible.
Real Time Viral Sub-Strains Discovery in Emerging Infectious Disease Situation – The African Perspective
Authors: Ekpenyong Moses Effiong , Uzoka Faith-Michael , Edoho Mercy , Inyang Udoinyang G. , Udo Ifiok J , Uto Nseobong P. , Ekaidem Itemobong S. , Moses Anietie E. , Anwana Enoabasi D. , Tatfeng Youchou M. , Joseph Geoffery , Dan Emmanuel A.
Published: January 2021

Background: The increased number of accessible genomes has prompted large-scale comparative studies for decerning evolutionary knowledge of infectious diseases, but challenges such as non-availability of close reference sequence(s), incompletely assembled or large number of genomes, preclude real time multiple sequence alignment and sub-strain(s) discovery. This paper introduces a cooperatively inspired open-source framework, for intelligent mining of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) genomes. We situate this study within the African context, to drive advancement on state-of-the-art, towards intelligent infectious disease characterization and prediction. The outcome is an enriched Knowledge Base, sufficient to provide deep understanding of the viral sub-strains’ identification problem. We also open investigation by gender, which to the best of our knowledge has been ignored in related research. Data for the study came from the Global Initiative on Sharing All Influenza Data database (https://gisaid.org) and processed for precise discovery of viral sub-strains transmission between and within African countries. To localize the transmission route(s) of each isolate excavated and provide appropriate links to similar isolate strain(s), a cognitive solution was imposed on the genome expression patterns discovered by unsupervised self-organizing map (SOM) component planes visualization. The Freidman-Nemenyi’s test was finally performed to validate our claim. Results: Evidence of inter- and intra-genome diversity was noticed. While some isolates (or genomes) clustered differently, implying different evolutionary source (or high-diversity), others clustered closely together, indicating similar evolutionary source (or less-diversity). SOM component planes analysis revealed multiple sub-strains patterns, strongly suggesting local- or intra-community and country to country transmissions. Cognitive maps of both male and female isolates revealed multiple transmission routes. Freidman’s test results showed highly significant difference (p<0.01) among the various isolate groups. Nemenyi’s test revealed groups that differed in their isolates.Conclusion: The proposed framework offers explanations to SARS-CoV-2 diversity and provides real time identification to disease transmission routes, as well as rapid decision support for facilitating inter- and intra-country contact tracing of infected case(s). Intermediate data produced in this paper are helpful to enrich the genome datasets for intelligent characterization and prediction of COVID-19 and related pandemics, as well as the construction of intelligent device for accurate infectious disease monitoring.
Characterizing and tailoring climate change adaptation practices into a diversified agroecosystem 
Authors: Adego Tsega
Published: January 2021

Smallholder farmers require viable adaptation strategies for climate change. Adaptation project might be mal-practiced unless it considers the local diversity. This paper argued that the challenge of agriculture in developing countries in general and Ethiopia, in particular, is much diversified and thus interventions require a systematic shift to specific agro-ecosystems. In light of this, we used agro-ecosystem analysis to design locally appropriate adaptation strategies specific to Rib watershed in Ethiopia. The agro-ecosystem uses three inputs of agro-climatic zoning, soil type and terrain analysis, and farming systems. We used primary data collected from 383 randomly selected farm-households. The survey data was supplemented by key-informant interviews, focus group discussions and secondary data. We characterized and mapped the study area in two distinct groups of agro-ecosystems: Fogera plain and Libo-Farta highlands. The finding portrayed that across these agro-ecosystems, there was considerable difference in the: potentials, constraints, crop type, income distribution, and soil type. We found blanket application of the same strategies irrespective of these heterogeneities. The income distribution shows that the poorest 20 percent of the population share about 5 percent of the income. Relatively the plain has less income inequality with 38.3 as compared to the highlands Gini coefficient of 42.8. Looking only at the average distribution of income does not reveal the inequality. It is important to disaggregate into the specific agroecosystems. The study identified that drainage projects, fruit trees, and fishing are among the prioritized adaptation strategies for the plain while conservation structures, irrigation, agroforestry are tailored to the highland areas. It is important to consider diversities before intervention.
Assessment of Microscopic detection of Malaria with Nested Polymerase Chain Reaction in War-torn Federally Administered Tribal Areas of Pakistan
Authors: Nadeem Muhammad Faisal , Khattak Aamer Ali , Yaqoob Adnan , Awan Usman Ayub , Zeeshan Nadia
Published: January 2021

Background: Diagnostic accuracy of malaria is critical for early treatment, control, and elimination of malaria, especially in war-affected malaria endemic areas. Microscopic detection of Plasmodium species has been the gold standard in remote malaria-endemic regions. However, the diagnostic accuracy is still questioned, especially in discriminating mixed and submicroscopic parasitic levels. This study was designed to evaluate the diagnostic performance of microscopic examination against nested PCR analysis in war-torn malaria-endemic Federally Administered Tribal Areas (FATA) of Pakistan. Methods: Venous blood samples were collected from symptomatic patients for microscopic examination and nested PCR analysis from January 2016 - December 2016 from five Agencies (Bajaur, Mohmand, Khyber, Orakzai and Kurram Agency) and four Frontier Regions (Peshawar, Kohat, Bannu, and Dera Ismail Khan Frontier Region) of FATA. Malaria-positive isolates were confirmed by nested PCR (targeting Plasmodium small subunit ribosomal ribonucleic acid (ssrRNA) genes) for speciation. Results: Among enrolled participants, 762 were found positive for malaria parasite on microscopic examination of the blood film. P. vivax was found in 623, P. falciparum in 132 and 7 were diagnosed with mixed infection (P. vivax and P. falciparum coinfection). Nested PCR detected Plasmodium infection in 679 samples (523 P. vivax, 121 P. falciparum, and 35 mixed infections). Compared with microscopy, the sensitivity of nested PCR was 98.94%, and specificity was 98.27%, while the sensitivity and specificity of slide microscopy 89.34% and 87.99% respectively. Conclusion: The conventional microscopy method has low sensitivity to detect mixed infection as compared to nested PCR. High sensitivity and specificity observed in nested PCR makes this molecular tool a useful technique for monitoring, controlling, and eliminating malaria-endemic regions.