bluuebunny/crossref_metadata_2025 huggingface dataset:
Non-smooth Dynamics Emerging from Predator-driven Discontinuous Prey Dispersal
Authors: Bhattacharyya Joydeb , Chattopadhyay Joydev
Published: May 2021

In ecology, the refuge protection of the prey plays a significant role in the dynamics of the interactions between prey and predator. In this paper, we investigate the dynamics of a non-smooth prey-predator mathematical model characterized by density-dependent intermittent refuge protection of the prey. The model assumes the population density of the predator as an index for the prey to decide on when to avail or discontinue refuge protection, representing the level of apprehension of the prey by the predators. We apply Filippov's regularization approach to study the model and obtain the sliding segment of the system. We obtain the criterion for the existence of the regular or virtual equilibria, boundary equilibrium, tangent points, and pseudo-equilibria of the Filippov system. The conditions for the visibility (or invisibility) of the tangent points are derived. We investigate the regular or virtual equilibrium bifurcation, boundary-node bifurcation and pseudo-saddle-node bifurcation. Further, we examine the effects of dispersal delay on the Filippov system associated with prey vigilance in identifying the predator population density. We observe that the hysteresis in the Filippov system produces stable limit cycles around the predator population density threshold in some bounded region in the phase plane. Moreover, we find that the level of apprehension and vigilance of the prey play a significant role in their refuge-dispersion dynamics.
Symmetry Collapse due to the Presence of Worm-Aromaticity in Ge244-
Authors: Xu Hong-Lei , Tkachenko Nikolay , Muñoz-Castro Alvaro , Boldyrev Alexander , Sun Zhong-Ming
Published: May 2021

In this work, we synthesized and isolated a continuous 24-atom cluster Ge244−, which was characterized by X-ray diffraction analysis and Energy-dispersive X-ray spectroscopy, showing an elongated worm-like structural characteristic. Theoretical analysis reveals that electron delocalization plays a vital role in the formation and stabilization of the prolate cluster. In contrast with carbon atoms, 4s orbitals of Ge-atoms do not easily hybridize with 4p orbitals and s-type lone-pairs could be localized with high occupancy. Thus, there are not enough electrons to form a stable symmetrical fullerene-like structure such as C24 fullerene. Three aromatic units with two [Ge9] and one [Ge6] species, connected by classical 2c-2e Ge-Ge σ-bonds, have been aligned together forming three independent shielding cones (worm-aromaticity) and eventually caused a collapse of the global symmetry of the prolate cluster.
Externalizing Your Eating Disorder: A Qualitative Interview Study
Authors: Voswinkel Marthe Marie-Hélène , Rijkers Cleo , Delden Johannes J.M. van , Elburg Annemarie A. van
Published: May 2021

Background: Anorexia nervosa (AN) is a psychiatric disorder with an ego-syntonic nature, causing many patients to perceive their AN as part of their personal identity. Therefore, an important part of treatment is the externalization of the eating disorder, in order to help patients to perceive AN as an external influence. Studies on patient experiences of externalization in treatment for AN are sadly missing. The aims of this study were to investigate, first, patients’ perspectives on the relation between identity and anorexia nervosa (AN) and second, their experiences of an externalizing approach during treatment. Method:, A qualitative interview study was conducted including fourteen patients with AN in either Family Based Treatment, the Maudsley Model for Anorexia Nervosa Treatment for Adults, Specialist Supportive Clinical Management-Severe Enduring or Cognitive Behavioural Therapy-Enhanced. Results: There are important differences in participants’ perceptions on how AN is related to identity. AN was perceived as part of identity, as alien or as a different side of the self. Patients’ experiences towards an externalizing approach were ambivalent. Externalization was considered helpful, whilst also evoking a negative response. Participants reported feeling as if all their behaviour was referred to as part of AN, which elicited feelings of not being taken seriously or being wrongfully accused of being dishonest. Conclusions: First, there is considerable variation in the perceived relation between AN and identity. Second, an externalizing approach within treatment may lead to so called epistemic injustice. Awareness of these two facts is of importance for clinicians and the therapeutic relationship because that will help them to refrain from actions that can be perceived as epistemic injustice.
A Preliminary Study of Left Atrial Function and Left Atrial Stiffness in Type 2 Diabetic Patients with Normotensive Patients Without Symptomatic Cardiovascular Disease
Authors: Huang Liping , Zhu Xiangming , Hu Guobing , Zhang Xia , Li Guojie , Pang Bo
Published: May 2021

Background: The purpose of this study was to investigate the relationship between left atrial function and left atrial stiffness in type 2 diabetic patients.Methods: A total of 41 healthy subjects (controls) and 39 patients with type 2 diabetes mellitus (DM2 patients) were enrolled in this study. The left atrial volume index was measured by biplanar Simpson method. The early and late diastolic velocities (e'and a') were measured by tissue Doppler in lateral and septal boeder of the mitral annulus. Lateral and septal myocardial velocities were averaged. E/eʹ ratio was computed.The peak atrial longitudinal strain (PALS) was analyzed by tow-dimensional speckle tracking imaging (2D-STI) technique.The ratio of E/e ' to PALS was used as an indicator of LASI.Results:The maximum volume (LAVImax), minimum volume (LAVImin) and pre-contraction volume (LAVIpre) of the left atrium in DM2 patients were significantly higher than those in the control groups, and the differences were statistically significant (P<0.05). The difference between PALS decrease and LASI increase was statistically significant (P<0.05).PALS and LASI were statistically correlated with three phase volume index of left atrial and E/e'ratio. LASI was superior to PALS and left atrial volume index in diagnosing diabetic normotensive patients without symptomatic cardiovascular disease.Conclusion: Compared with the controls, PALS decreased and LASI increased in DM2. PALS and LASI were significantly correlated with left atrial volume and E/e’. LASI showed the highest diagnostic efficacy in the diagnosis of diabetes. PALS and LASI can be used as indicators for early evaluation of left atrial function in patients with DM2.Trial registration number:+86-17856931224;date of registration:May 3,2021
Characterization Of Age-Related Immune Features After Autologous NK Cell Infusion
Authors: Tang Xiaofeng , Deng Biaolong , Zang Aiping , He Xiaowen , Zhou Ye , Wang Daimeng , Li Dan , Zhang Xuhua , Liu Ye , Xu Yonghua , Chen Jingjing , Zheng Weijie , Zhang Luding , Gao Constance , Yang Huanfeng , Li Bin , Wang Xueqi
Published: May 2021

Objective: To analyze the characterization of age-related immune features after autologous NK cell infusion.Background: Aging is a progressive loss of physiological function, accompanied with a functional decline of immune system, especially in T cell responses, which consequently leads to the increase of infections and cancers. However, understanding of immune ageing on body health is currently lacking. Methods: In this study, we originally checked whether the administration of autologous NK cells would affect T cell senescence and exhaustion in healthy human beings with middle ages. Also, we detected whether NK cells infusion would affect senescence associated secretory phenotype (SASP)-related factors level. Results: Results showed that senescent T cells including CD28-, CD57+, CD28-CD57+ and CD28-KLRG1+ subsets decreased significantly in both CD4+ and CD8+ T cells following once infusion of autologous NK cells. In addition, PD-1+ and TIM-3+ population within CD4+ and CD8+ T cells also dramatically declined after the infusion. Changes were continuously observed in senescent and exhausted T cell in 4 weeks after the intervention. Meanwhile, we found out that several key senescence associated secretory phenotype (SASP)-related factors including IL-6, IL-8, IL-1α, IL-17, MIP-1α, ΜΙP-1β, MMP1 were significantly decreased after NK cell infusion. Moreover, gender did not influence the effects reducing extent caused by NK cell infusion, and whether the cells were frozen or fresh influenced several immune indexes. Conclusion: Our findings imply that immune aging is a reversible process in healthy human beings and autologous NK cell administration can be introduced to alleviate the aging.
Coverage, Determinants of Use and Repurposing of Long-Lasting Insecticidal Nets Two Years After a Mass Distribution in Lihir Islands, Papua New Guinea: A Cross-Sectional Study
Authors: Martínez Pere Millat , Gabong Rebecca , Balanza Núria , Luana Sakaia , Sanz Sergi , Raulo Silvia , Elizah Arthur , Wali Chilaka , Paivu Benjamin , Dalmas Julian , Tabie Samson , Karl Stephan , Laman Moses , Pomat William , Mitjà Oriol , Baro Bàrbara , Bassat Quique
Published: May 2021

Background: Universal coverage with long-lasting insecticidal treated nets (LLINs) is an essential component of malaria control programs. Three-yearly mass distribution of LLINs in Papua New Guinea (PNG) has been successful in reducing infection transmission since 2009, but malaria prevalence ramped up from 2015 onwards. Although LLIN universal coverage is mostly achieved during these campaigns, it may not be related with net use over time. We evaluated coverage, uses given to LLINs and non-compliance of this strategy.Methods: A knowledge, attitude and practice (KAP) cross-sectional study was conducted in Lihir Islands, PNG, 2 to 2.5 years after the last LLIN mass distribution campaign. Data on bed net ownership, use and maintenance behaviour was collected using a household questionnaire administered by trained community volunteers. Logistic regression models were used to identify factors associated with owning at least one LLIN and sleeping under a LLIN the previous night. Results: Among 2,694 households surveyed, 27.4% (95% CI: 25.8-29.2) owned at least one LLIN and 8.7% (95% CI: 7.6-9.8) had an adequate LLIN coverage (at least one LLIN for every two people). Out of 13,595 individuals in the surveyed households, 13.6% (95% CI: 13.0-14.2) reported having slept under a LLIN the preceding night. Determinants for sleeping under LLIN included living in a household with adequate LLIN coverage [adjusted OR (aOR) = 5.82 (95% CI: 3.23-10.49)], household heads knowledge about LLINs [aOR = 16.44 (95% CI: 8.29-32.58)], and female gender [aOR = 1.92 (95% CI: 1.53-2.40)] (all p-values <0.001). LLIN use decreased with older age [aOR = 0.29 (95% CI: 0.21-0.40) for ≥15 year-olds, aOR = 0.38 (95% CI: 0.27-0.55) for 5-14 year-olds] compared to <5 year-olds (p-value <0.001). Knowledge on the use of LLIN was good in 37.0% of the household heads. Repurposed nets were reported serving as fishing nets (30.4%), fruits and seedlings protection (26.6%), covering up food (19.0%) and bedlinen (11.5%). Conclusions: Two years after mass distribution, LLIN coverage and use in Lihir Islands is extremely low. Three yearly distribution campaigns may not suffice to maintain an acceptable LLIN coverage unless knowledge on maintenance and use is promoted trough educational campaigns.
Dietary Approach to Stop Hypertension (DASH) and Obesity Among Iranian Adults: Yazd Health Study-TAMYZ and Shahedieh Cohort Study
Authors: khorasani sahar sarkhosh , Mozaffari-Khosravi Hassan , Mirzaei Masoud , Nadjarzadeh Azadeh , Hosseinzadeh Mahdieh
Published: May 2021

Objectives: Established data revealed a relationship between obesity and increasing the risk of mortality and morbidity of chronic diseases. There are conflicting data regarding the association between adherence of Dietary Approach to Stop Hypertension (DASH) and obesity. Therefore, this study intends to investigate this relationship among a large sample of Iranian adults.Methods: This cross-sectional study was carried out on the data collected by two prospective studies executed in urban and suburb parts; in the urban population: TAghzieh Mardom-e-Yazd (Yazd Nutrition Study) (TAMYZ), which was conducted on Yazd Health Study participants, and in the suburb region: Shahedieh cohort study. Final analysis was performed by 10693 individuals; Shahedieh (n=3943) and YaHS (n=6750). Dietary intake was evaluated by using a validated Food Frequency Questionnaire (FFQ). In all participants, anthropometric indices including body mass index were measured. The DASH score was considered utilizing gender-specific quintiles of DASH items. To evaluate the relationship of DASH diet and obesity, multivariate logistic regression analysis was used.Results: By adjusting confounders, participants in highest quintiles of DASH dietary patterns compared to the lowest have lower odds of obesity in suburb area (OR: 0.78; 95% CI: 0.63, 0.96), in urban (OR: 0.71; 95% CI: 0.52, 0.99), and in whole population of both studies (OR: 0.75; 95% CI: 0.63, 0.90). Besides, more compliance of women to this diet in urban (OR: 0.64; 95% CI: 0.48, 0.85) and population of both studies (OR: 0.77; 95% CI: 0.62, 0.96) were associated with reduced odds of central obesity. However, in suburb study, no significant relationship was observed between adherence to DASH diet and odds of central obesity.Conclusions: DASH dietary pattern could decrease odds of obesity in both urban and suburb area, and central obesity in urban area only. Further prospective studies are needed for causal conclusion.
Adaptation is cost-effective to offset rising river flood risk in Europe
Authors: Dottori Francesco , Mentaschi Lorenzo , Bianchi Alessandra , Alfieri Lorenzo , Feyen Luc
Published: May 2021

River flooding in Europe could rise to unprecedented levels due to global warming and continued development in flood-prone areas. Here we appraise the potential of four key adaptation strategies to mitigate flood risk across Europe based on detailed flood risk modelling and cost-benefit analysis. We find that reducing flood peaks using retention areas is economically the most attractive option. In a scenario without climate mitigation, they can lower projected flood losses in Europe by the end of the century from 42 to 7.5 €billion/year and population exposed by 81%, or achieve a risk level comparable to today. This would require an investment of 2.9 €billion/year over 2020-2100, with a return of 4€ for each 1€ invested. The risk-reduction potential of economically-optimised strengthening of dykes is somewhat lower with 71% for a comparable annual investment. These measures avoid floods to happen and their cost-effectiveness increases with the level of global warming. Implementing building-based flood proofing measures and relocating people and assets are less cost-effective but can reduce impacts in localized areas.
The Spectrum of Epstein-Barr Virus Infections of the Central Nervous System After Organ Transplantation
Authors: Ridha Mohamed , Jones Dylan G. , Lerner David P. , Vytopil Michal , Voetsch Barbara , Burns Joseph D. , Ramineni Anil , Raibagkar Pooja
Published: May 2021

BackgroundEpstein-Barr virus (EBV)-related neurologic complications have a diverse presentation in transplant recipients, creating diagnostic and therapeutic challenges for clinicians. In this case series, we report unique manifestations of EBV related neurologic complications following solid organ transplant and highlight pitfalls in management. Case Presentations:A retrospective search of the electronic medical record of all patients from January 2015 and December 2020 who underwent solid organ transplantation and had central nervous system complications as determined by ICD-10 codes were included. Three patients with unique manifestation of EBV-related neurologic complications after liver transplantation were identified. The first was a 52-year-old man with a live-donor liver transplant 11 years prior for Budd-Chiari syndrome presented with several weeks of headache and found to have several lesion on brain MRI who was diagnosed with primary central nervous system post-transplant lymphoproliferative disorder. The second patient was a 63-year-old man with a deceased-donor liver transplant 16 years prior for alpha-1-antitrypsin deficiency who was found to have a stroke and was diagnosed with EBV encephalitis with vasculitis. The final patient was a 75-year-old woman with a deceased-donor liver transplant six years prior for primary biliary cirrhosis who presented with four months of gait instability and was diagnosed with EBV myelitis. A review of the literature was performed to supplement description of the different diseases. ConclusionsEBV-related central nervous infection in post-transplant patients can manifest in a variety of neurologic syndromes, which can be challenging to diagnose. Careful correlation of clinical, pathologic, and radiologic findings and a high index of suspicion are crucial in identification and appropriate management.
Molecular Epidemiology and clinical Features Analysis of Respiratory Human Adenovirus Infections in Hospitalized Children: A Retrospective Study in Zhejiang
Authors: Wang Caiyun , Liu Juanjuan , Mi Yumei , Chen Jing , Bi Jing , Chen Yinghu
Published: May 2021

Background: HAdV is one of the common pathogens in hospitalized children with respiratory infection (RI). we aim to describe the epidemiological characteristics, clinical features, and genotype of inpatients with HAdV positive with RI.Methods: Respiratory samples were gathered from inpatients diagnosed RI in Children’s Hospital, Zhejiang University School of Medicine and were detected by using Direct Immunofluorescence Assay (DFA) from 2018 to 2019. PCR amplification and sequencing of the hypervariable zone of hexon gene were used for genotyping. The clinical and laboratory features, and typing of HAdV, and epidemiological characteristic analysis were retrospectively performed. Results: Of 7072 samples collected, 488 cases were identified as HAdV-positive RI. The overall detection rate was 6.9%. The peaked detection rate was 14.1% in January 2019. HAdV-positive cases with RI mainly appeared in winter and summer. The detection rate was highest among children between 6 months and 2 years (8.7%, 123/1408). Clinical diagnosis included pneumonia (70.3%, 343/488), bronchitis (7.0%, 34/488) and acute upper respiratory tract infection (22.7%, 111/488). The common clinical manifestations were fever (93.4%, 456/488), cough (94.7%, 462/488), wheezing (26.2%,128/48), and shortness of breath (14.8%, 72/488). 213 (43.6%) cases had co-infection and 138 (28.3%) cases had extrapulmonary symptoms. 96(19.7%) cases had intrapulmonary and intrathoracic complications.78 (16.0%) had an underlying condition, the most of them were congenital heart diseases (20.5%,17/78). The proportions of hyperpyrexia, duration of fever more than 10 days, severe pneumonia, and proportion of wheezing in the co-infection group were remarkably higher than those in HAdV single-infection group (p<0.05). 4 HAdV species were successfully identified in 155 cases and represented by 8 genotypes. HAdV-B3 (56.1%,87/155) and HAdV -B7 (31.0%,48/155) were the most predominant detected types and occurred commonly in different severity groups (p=0.000), while, HAdV-B55 was detected only in the severe group. HAdV-B7’s detection rate in the severe group was significantly higher than the non-severe infected group. Conclusion: HAdV detection rate is related to age and season. Bronchopneumonia accounts for about 70% HAdV -positive inpatients. The common manifestations include hyperpyrexia, cough, wheezing, and shortness of breath. HAdV-B3 and HAdV-B7 are the most common types in children diagnosed with RI.
Influence of Vitamin D3 Supplementation on Infliximab Efficacy in Chinese Patients With Crohn’s Disease: A Retrospective Cohort Study
Authors: Xia Sheng-long , Min Quan-jia , Shao Xiao-xiao , Lin Dao-po , Ma Guo-long , Hu Ding-yuan , Cao Shu-guang , Jiang Yi
Published: May 2021

Background: It remains uncertain whether vitD3 supplementation is beneficial for remission of Crohn’s disease (CD). The influence of vitD3 supplementation on Infliximab (IFX) efficacy was retrospectively analyzed in Chinese CD patients.Methods: Patients with moderate-to-severe CD, who were bio-naïve and prescribed with IFX treatment for at least 54 weeks were recorded. VitD3 supplementation was defined as patients additionally took oral vitD3 (125 IU/d) within 3 days after the first infusion and persisted in the whole follow-up period. Disease activity was assessed using Harvey-Bradshaw Index (HBI). Serum cytokine profiles were quantitatively analyzed in a subset of all patients at baseline and 54-week after intervention.Results: Among 73 enrolled patients, 37 took vitD3 regularly (D3-patients), the others (non-D3-patients) did not. At 54-week, the mean 25-hydroxyvitaminD level increased in D3-patients (P<0.001). The clinical remission rate was higher in D3-patients compared to non-D3-patients (P=0.030). The decrease of HBI from baseline to 54-week was more in D3-patients than non-D3-patients (P=0.023). Furthermore, vitD3 supplementation was independently related to the increase of remission rate at 54-week in D3-patients (P=0.015). The benefit of vitD3 supplementation was significant only in patients with deficient vitD3, but not in non-deficient vitD3. In non-D3-patients, the decreases of IL-6 and TNF-α at 54-week were more obvious than at baseline (both P<0.05). In D3-patients, however, only IL-10 increased at 54-week compared with its baseline value (P=0.037).Conclusions: VitD3 supplementation could not only improve IFX efficacy, especially for patients with vitD3 deficiency, but also affected the cytokine profiles in CD patients. (Clinical Trials. Gov NCT04606017)
Efficacy of Gelatin Sponge Impregnated with Ropivacaine on Postoperative Pain After Transforaminal Lumbar Interbody Fusion: A Comparative Study
Authors: Wang Shanxi , Wang Bo , Yu Xiaojun , Ma Tian , Yan Jiyuan , Ding Qing , Zhang Ruizhuo , Wu Hua , Liu Chaoxu
Published: May 2021

Background The purpose of this study was to investigated the efficacy of gelatin sponge impregnated with ropivacaine on postoperative pain after transforaminal lumbar interbody fusion (TLIF) in patients with lumbar degenerative diseases.Methods A total of 127 patients were evaluated in this retrospective study. All patients underwent transforaminal lumbar interbody fusion. Based on whether they were administered by gelatin sponge impregnated with ropivacaine or saline during operation, patients were divided into ropivacaine group or saline group. The two groups were compared in reference to bedridden period, hospital stay, postoperative complications, visual analog scale (VAS) scores and functional score. The consumption of postoperative diclofenac sodium suppository use was also recorded. The Oswestry Disability Index (ODI) scores and and Japanese Orthopaedic Association (JOA) scores were used for functional evaluation at 1 year postoperatively. Results The mean bedridden period and hospital day in the ropivacaine group were significantly lower than saline group. The VAS score was significantly lower in patients receiving gelatin sponge impregnated with ropivacaine as compared with patients in saline group on postoperative day 1, 2, 3 and 4. The number of patients who need the administration of diclofenac sodium suppositor and the mean consumption of postoperative diclofenac sodium suppository was significantly lower in the ropivacaine group as compared with saline group.Conclusion The application of gelatin sponge impregnated with ropivacaine around the nerve root in patients undergoing TLIF is a safe and effective method, which can effectively control the postoperative pain and promote the functional recovery of patients.
Reference Genes for Quantitative Real-time Polymerase Chain Reaction (qPCR)) Analyses in Freshly Isolated Monocytes of Septic Patients
Authors: Gritte Raquel Bragante , Souza-Siqueira Talita , Masi Laureane Nunes , Germano Juliana Freitas , Murata Gilson Masahiro , Machado Marcel Cerqueira César , Azevedo Ricardo Bentes , Pithon-Curi Tania Cristina , Curi Rui , Soriano Francisco Garcia
Published: May 2021

Background: Sepsis is a life-threatening organ dysfunction associated with unregulated host response to infection. About 20 million people develop sepsis annually, and up to 50% die. Monocytes and macrophages play a key role in the innate and adaptive immune responses but the fully role of these cells in patients with sepsis still remains to be investigated. One of the limitations for the studies of gene expression in monocytes/macrophages in sepsis is the choice of the reference genes. We determined herein the most stable internal gene (s) to investigate gene expressions in monocytes/macrophages of septic patients.Methods: The expression stability of fifteen commonly used reference genes was analyzed by determining the comparative threshold cycle (Ct) values, using the BestKeeper, GeNorm, and NormFinder algorithms.Results: BestKeeper analysis revealed that the syntaxin 5 (STX5A) and hypoxanthine phosphoribosyltransferase 1 (HPRT1) genes are highly stable. GeNorm pointed out STX5A and phosphoglycerate kinase 1 (PGK1) as the most suitable combination, whereas through NormFinder glyceraldehyde 3-phosphate dehydrogenase (GAPDH) and 14-3-3 zeta/delta protein (YWHAZ) was the most stable combination. All program analyses discarded the use of heterogeneous nuclear ribonucleoprotein A/B (HNRNPAB). GeNorm and NormFinder indicated actin-beta (ACTB) as the minor stable gene.Conclusions: The combined data indicated that STX5A, PGK1, GAPDH, and HPRT1 are highly suitable reference genes for qPCR analysis of septic patient monocytes. In choosing one reference gene, the results point out STX5A (first place by GeNorm and BestKeeper and third place by NormFinder). This study is the first report on reference genes in freshly obtained monocytes/macrophages from septic patients.
Predicting the response of neoadjuvant chemotherapy in hormone receptor- positive and HER2-negative breast cancer with axillary lymph node metastasis by a multigene assay (GenesWell™ BCT)
Authors: Lee Jun-Hee , Ryu Jai Min , Ahn Jee Hyun , Cho Soo Youn , Lee Se Kyung , Yu Jonghan , Chae Byung Joo , Nam Seok Jin , Han Jinil , Lee Jeong Eon , Kim Seok Won
Published: May 2021

The GenesWell™ BCT (BCT score) is a recently developed multigene assay that predicts the risk of distant recurrence in patients with hormone receptor-positive (HR+) and HER2 negative (HER2-) early breast cancer (BC). The ability of the assay to predict the response to neoadjuvant chemotherapy (NACT) has not been established to date. Biopsy specimens of HR+/HER2- BC patients with axillary lymph node (LN) metastasis who underwent NACT were analyzed using the BCT score. The modified breast cancer test (BCT) score was developed and classified into high-and low-response groups. A total of 88 patients were available for the BCT score among 108 eligible patients. The median follow-up duration was 35.9 (7.8-128.5) months. Among these, 61 (65.1%) had cN1 and 53 (60.2%) had cT1 or T2. The BCT score was low in 25 (28.4%) patients and high in 63 (71.6%) patients. Among 50 patients with pathologic complete response or partial response, 41 (82.0%) were in the high-response group, and 9 (18.0%) were in the low-response group. Among 38 patients with stable disease or progressive disease, 22 (57.9%) patients were in the high-response group, and 16 (42.1%) were in the low-response group (p = 0.025). Ki-67 before NACT was a significant factor for predicting tumor response (p = 0.006; 3.81 [1.50-10.16]). The BCT score showed a significant response to NACT (p = 0.016; 4.18 [1.34–14.28]). A significant difference was found in distant metastasis-free survival between the high and low response groups (p = 0.004). We demonstrated that the BCT score predicts NACT responsiveness of HR+/HER2- BC with LN metastasis and might help determine whether to undergo NACT or not. Further studies are warranted to validate these findings.
Long Non-Coding RNA RP5-821D11.7 Promotes Proliferation, Migration, and Epithelial-Mesenchymal Transition in Glioma and Glioma Stem-Like Cells
Authors: Younis Muhammad , Shaikh Sana , Shahzad Khawar Ali , Sial Nuzhat
Published: May 2021

Long noncoding RNA (lncRNA) has been recently revealed as a main regulatory molecule, which implicates many cellular functions. Studies showed that lncRNA abnormally expressed and involved in the progression and tumorigenesis of glioma. Present study identified a novel lncRNA associated with glioma, glioma stem-like cells (GSCs), and then revealed their potential functions. During the screening of lncRNAs, we found out lncRNA RP5-821D11.7 (lncRNA-RP5) overexpress in GSCs compared to glioma cells. Lentivirus-mediated shRNA for lncRNA-RP5 was constructed and transfected into glioma cells. Transfected stable glioma cells were transplanted into nude mice and tumor growth was determined. Knockdown of lncRNA-RP5 significantly inhibits proliferation, colony formation, migration and reduces epithelial-mesenchymal transition (EMT) by activating the Wnt/β-catenin pathway. Additionally, the results showed that lncRNA RP5 knockdown enhances cell apoptosis through endoplasmic reticulum stress. Therefore, this study may provide a better understanding and demonstrates that lncRNA-RP5 may be a potential therapeutic target in glioma.
Hippo/YAP Signaling Choreographs The Tumor Immune Microenvironment to Promote Triple Negative Breast Cancer Progression Via TAZ/IL-34 Axis
Authors: Wang Zheng , Wang Fan , Ding Xin-Yuan , Li Tian-En , Wang Hao-Yu , Gao Yu-Hao , Wang Wen-Juan , Liu Yan-Feng , Chen Xiao-Song , Shen Kun-Wei
Published: May 2021

Background: Growing evidence suggests that the bidirectional interactions between cancer cells and their surrounding environment namely the tumor microenvironment (TME), contributes to cancer progression, metastasis, and resistance to treatment. Intense investigation of Hippo pathway, which controls multiple central cellular function to tumorigenesis, was focused on cancer cells. However, the role of Hippo pathway in modulating tumor–stromal interactions in triple negative breast cancer remains largely unknow. This study therefore focused on revealing effects of Hippo-YAP/TAZ signaling to immune microenvironment.Methods: The correlation between Hippo/YAP signaling and the abundance of immune cells were estimated by Immune Cell Abundance Identifier. Clinical TNBC samples from 120 patients were analyzed to assess the correlation between TAZ expression and disease prognosis as well as tumor-infiltrating immune cells. Inflammatory immune profiles, bioinformatics analysis and chromatin immunoprecipitation were performed to identify the expression of immune-related genes that were regulated by TAZ. An in vitro co-culture system was applied to investigate the crosstalk between TNBC cells and tumor-associated macrophages (TAMs) modulated by the TAZ/interleukin 34 (IL-34) axis. In vivo tumor growth and metastasis models were used to evaluate the pro-tumor functions of TAZ, IL-34, and TAMs as well as the antitumor efficacy of anti-PD-L1 and IL-34/colony-stimulating factor 1 receptor (CSF-1R) blockade.Results: In TNBC patients, high activity of Hippo pathway was correlated with decreased number of T cells, upregulated TAM infiltration, and poor prognosis. TAZ could directly regulate IL-34 and PD-L1 expression and promote IL-34 secretion in TNBC cells, leading to increased TAM infiltration and distant metastasis. TAM-derived transforming growth factor beta 1 (TGF-β1) could also induce TAZ expression in TNBC cells, thus forming a positive feedback loop between TNBC cells and TAMs. Furthermore, targeting the TAZ/IL-34 axis through its CSF-1R inhibitor could dramatically decrease TAM infiltration and significantly improve anti-PD-L1 efficacy in inhibiting metastasis in TNBC.Conclusions: Activity of Hippo pathway was associated with worse disease outcomes in TNBC and could increase TAM infiltration through the TAZ/IL-34 axis, leading to an immunosuppressive microenvironment and impairing the treatment efficacy of anti-PD-L1. Thus, the TAZ/IL-34 axis can serve as a novel target for TNBC patients.
Design and Analysis of Three-Dimensional Printing of A Porous Titanium Scaffold
Authors: Yang Chunxi , Yang Jiajie , Shi Xiaojian , Shen Meihua , Shi Kaibing , Shen Lingjie
Published: May 2021

Objective To develop suitable structural designs for the three-dimensional (3-D) printing of a porous titanium scaffold to fill bone defects in knee joints. Pore diameter and mechanic strength are key factors for the 3-D printing of porous titanium scaffolds. Methods Fifteen different pore unit structural models of titanium scaffolds were designed with 3-D printing computer software; five different scaffold shapes were designed: imitation diamond-60°, imitation diamond-90°, imitation diamond-120°, regular tetrahedron and regular hexahedron. Each structural shape was evaluated with three pore diameters 400μm, 600μm and 800μm, and fifteen types of cylindrical models(diameter: 20mm; height: 20mm). Autodesk Inventor software was used determine the strength and safety of the models by simulating simple strength acting on the knee joints. We analyzed the data and found suitable models for 3-D printing of porous titanium scaffolds. Results Fifteen different types of pore unit structural models were evaluated under positive pressure; the compressive strength was lower when the pore diameter(400μm, 600μm and 800μm) was larger, except for the regular tetrahedron structure. Under lateral pressure, the compressive strength was also lower when the pore diameter(400μm, 600μm and 800μm) was larger. Under torsional pressure, the strength of the imitation diamond structure was similar when the pore diameter(400μm, 600μm and 800μm) was larger, and the strengths of the regular tetrahedron and regular hexahedron structures were lower when the pore diameter(400μm, 600μm and 800μm) was larger. In each case, the compressive strength of the regular hexahedron structure was highest, that of the regular tetrahedron was second highest, and that of the imitation diamond structure was relatively low. Fifteen types of cylindrical models under a set force were evaluated, and the sequence of comprehensive compressive strength, from strong to weak was: regular hexahedron> regular tetrahedron> imitation diamond-120°> imitation diamond-90°> imitation diamond-60°. The compressive strength of cylinder models was higher when the pore diameter was smaller. Conclusion The compressive strength differed among titanium scaffolds with different pore structures. The pore diameter and shapes of the pore structure were important factors influencing the compressive strength. The models of regular hexahedron, regular tetrahedron and imitation diamond-120°appeared to meet the conditions of large pore diameters and high compressive strength. The strength of each structure was lower when the pore diameter(400μm, 600μm and 800μm) was larger.
Extremely low-frequency pulses of faint magnetic field, weaker than the geomagnetic field, induce mitophagy to rejuvenate mitochondria
Authors: Toda Takuro , Ito Mikako , Takeda Jun-ichi , Masuda Alkio , Hattori Nobutaka , Mohri Kaneo , Ohno Kinji
Published: May 2021

Humans are frequently exposed to time-varying and static weak magnetic fields (WMF). However, the effects of faint magnetic fields, weaker than the geomagnetic field, have not been reported. We found that extremely low-frequency (ELF)-WMF, comprised of serial pulses of 10 µT intensity at 1–8 Hz, which was three or more times weaker than the geomagnetic field, reduced mitochondrial mass to 70% and the mitochondrial electron transport chain (ETC) complex II activity to 88%. Chemical inhibition of electron flux through the mitochondrial ETC complex II nullified the effect of ELF-WMF. Suppression of ETC complex II subsequently induced mitophagy by translocating parkin and PINK1 to the mitochondria and by recruiting LC3-II. Thereafter, mitophagy induced PGC-1α-mediated mitochondrial biogenesis to rejuvenate mitochondria. The lack of PINK1 negated the effect of ELF-WMF. Thus, ELF-WMF may be applicable for the treatment of human diseases that exhibit compromised mitochondrial homeostasis, such as Parkinson’s disease.
Hemoglobin Life-threatening Value (1.9 g/dl) in Good General Condition: a Pediatric Case-report.
Authors: Parodi Emilia , Riboldi Lorenzo , Ramenghi Ugo
Published: May 2021

Background: we report a pediatric patient presenting in good general condition despite an hemoglobin value of 1,9 g/dL, which is normally regarded as life-threatening. Case presentation: an African 5 years-old girl presented to our Emergency Department (ED) for worsening asthenia, within a clinical picture of good general condition. The hemoglobin value at admission was 1,9 g/dL. The subsequent diagnostic-therapeutic pathway highlighted the presence of two different causes, both well known to be responsible for chronic anemia (with slow reduction of hemoglobin values): iron deficiency anemia (IDA) due to a very low dietary intake of iron-rich foods, and homozygous sickle cell disease (HbSS). She received transfusions of packed red blood cells (overall 15 ml/kg) and subsequently intravenous iron preparations (total amount 200 mg) followed by oral iron supplements. The Hb value at discharge, 10 days after the admission, was 9.8 g/dL.Conclusions: when approaching a picture of severe anemia, we suggest pediatricians to take into consideration clinical conditions rather than laboratory values and to take advantage of detailed anamnestic data in order to make the diagnosis.
How Unexpected Is Out-of-hospital Sudden Cardiac Arrest? A Retrospective Cohort Study
Authors: Heymes Hana Katharina , Schröder Hanna , Follmann Andreas , Sommer Anja , Lapp Nils , Rossaint Rolf , Beckers Stefan Kurt , Felzen Marc
Published: May 2021

BackgroundApproximately 100,000 patients suffer from sudden cardiac arrest (CA) annually in Germany. The causes for CA are cardiac in 75% of these cases. The present study aims to investigate the medical prehistory of patients who suffered from out-of-hospital cardiac arrest (OHCA) in a town with 250,000 inhabitants during 5 years and how many of these patients had already been previously treated at the local cardiac arrest center (CAC).Case presentationAll resuscitations due to OHAC were retrospectively analyzed for the cause of OHCA, preexisting cardiac conditions and treatment, lay resuscitation, and outcome from January 1, 2012, to December 31, 2016, in Aachen, Germany. Data analysis was based on the resuscitation protocols and data from the CAC clinical information system. More than 50% of the patients with CA from cardiovascular origin were already known at the receiving respective CAC. Almost 60% of all patients already had cardiac preexisting conditions. Nevertheless, lay resuscitation occurred in only 34.1% of all cases. It was not performed in more than 60% although the probability of discharge can be significantly increased by lay resuscitation.ConclusionThe rate of lay resuscitation is relatively low although many patients suffering from CA have cardiac preexisting conditions. These findings show the importance of better priming their relatives for emergencies to improve lay resuscitation and improve the chances for a better outcome.
The Impact of an Online Intervention on the Medical, Dental and Health Sciences Students About Interprofessional Education; A Quasi-experimental Study
Authors: Guraya Salman Yousuf , David Leena R. , Hashir Shermin , Mousa Noha A. , Bayatti Saad Wahbi Al , Hasswan Ahmed Abd Alrazzak , Kaouas Mujtaba
Published: May 2021

BackgroundInterprofessional education (IPE) encompasses integration, communication, mutual trust and shared decision-making with a common goal of improved patient care and safety. Despite its crucial role, IPE has not gained its anticipated popularity. This study aims to determine the impact of an online educational intervention about IPE on medical, dental and health sciences students in the University of Sharjah (UoS). MethodsThis quasi-experimental research was conducted in three phases; a pre-intervention phase where the Readiness for Interprofessional Learning Scale (RIPLS) inventory was administered online to the medical, dental and health sciences students of UoS; an intervention phase where an online workshop was organized via Microsoft Teams®; and a post-intervention phase where RIPLS was used to gather the students’ attitudes towards IPE. The independent t test was used to compare the responses between genders and junior and senior students. A paired sample t test was used to determine the impact of the intervention on the students’ understandings and attitudes about IPE. ResultsOut of 800 invited students, 530 students responded to the pre-intervention RIPLS survey. A comparison of the pre-post intervention for the RIPLS subscales of teamwork and collaboration, professional identification, and professional roles showed a significant improvement of the students’ attitudes with p-values 0.03, 0.00 and 0.00, respectively. All workshop moderators scored a median of 4 or 5 to the essential elements of IPE during intervention except for a median of 3 for group dynamics.ConclusionIn this study, the present data derived from the application of a brief online educational intervention underpins the readiness and positive attitudes of undergraduate medical students towards IPE. The positive impact of our intervention necessitates the development of a structured and unified IPE curriculum to enhance the receptiveness and application of IPE in the medical field.
Identification of Genes Associated With Laryngeal Squamous Cell Carcinoma by Weighted Gene Co-Expression Network Analysis
Authors: Huang Chao , He Jun , Dong Yi , Chen Yichao , Peng Anquan , Huang Hao
Published: May 2021

Background: Laryngeal squamous cell carcinoma (LSCC) is one of the leading malignant cancers of the head and neck. Patients with LSCC infiltration and metastasis have a poor prognosis. There is an urgent need to identify more potential targets for drugs and biomarkers for early diagnosis.Methods: RNA sequence data from LSCC and patient clinic traits were obtained from the Gene Expression Omnibus (GEO) (GSE142083) and The Cancer Genome Atlas (TCGA) database. Differentially expressed genes (DEGs) analysis and weighted gene co-expression network analysis (WGCNA) were performed to identify the hub genes. Gene ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) analysis, prognostic values analysis and the tumor-infiltrating immune cell (TIC) abundance profiles estimation were performed.Results: In present study, a total of 432 DEGs, including 199 up-regulated genes and 233 down-regulated genes were screened in GSE142083 dataset. After intersecting with DEGs in TCGA, 211 common DEGs were screened. Using WGCNA, five modules were identified to be closely related to LSCC. After compared with common DEGs and performed with univariate Cox regression analysis, only eight genes, including CEACAM6, FSCN1, INHBA, MYO1B, PLAU, SERPINH1, TJP3 and TNFRSF12A, were screened out to be significantly related to the prognosis of patients diagnosed with LSCC.Conclusions: The results in present study shows that CEACAM6, FSCN1, INHBA, MYO1B, PLAU, SERPINH1, TJP3 and TNFRSF12A have the potential to become new therapeutic targets and biomarkers for LSCC.
Fine Mapping of Qph9, A Major Quantitative Trait Locus, Responsible for Plant Height In Foxtail Millet [Setaria Italica (L.) P. Beauv.]
Authors: Du Xiaofen , Wang Zhilan , Han Kangni , Lian Shichao , Li Yuxin , Zhang Linyi , Guo Erhu , Wang Jun
Published: May 2021

Plant height is vital for crop yield by influencing plant architecture and resistance to lodging. Although lots of quantitative trait loci (QTLs) controlling plant height had been mapped in foxtail millet, their contributions to phenotypic variation were generally small and mapping regions were relatively large, indicating the difficult application in molecular breeding using marker-assisted selection. In the present paper, a total of 23 QTLs involving in 15 traits were identified via a high-density Bin map containing 3024 Bin markers with an average distance of 0.48 cM from an F2 population. Among them, qPH9 with a large phenotypic variation explained (51.6%) related to plant height, was one of the major QTLs. Furthermore, qPH9 was repeatedly detected in multi-environments under field conditions using two new F2 population from the same F1 plant, and was narrowed down to a smaller interval of 281 kb using 1024 recessive individuals of F2 population. Finally, we found that there was an extremely significant correlation between marker MRI1016 and plant height, and speculated that Seita.9G088900 and Seita.9G089700 could be key candidates of qPH9. This study laid an important foundation for the cloning of qPH9 and molecular breeding of dwarf varieties via marker-assisted selection.
Localized Cystic Disease of the Kidney in Pediatric Patients: Clinical and Imaging Findings With Long Term Follow Up
Authors: Yoon Haesung , Kim Myung-Joon , Shin Hyun Joo , Lee Mi-Jung
Published: May 2021

Background: This study aimed to describe the clinical and imaging findings, including ultrasonography (US) findings, and long-term follow-up results in pediatric patients with localized cystic disease of the kidney (LCDK).Methods: From January 2002 to August 2020, pediatric patients diagnosed with LCDK based on imaging findings showing multiple localized renal cysts with intervening normal renal parenchyma were retrospectively reviewed. Clinical presentations and US features of the affected and contralateral kidneys were reviewed and compared with computed tomography or magnetic resonance imaging findings, if available. Results: A total of 18 patients (male:female = 11:7; median age, 8 years) were included. Initial clinical presentations were incidental findings (n = 5), abdominal pain (n = 5), or hematuria (n = 5). Of the seven (7/18, 39%) patients who showed multiple hyperechoic foci with ring-down artifacts within the cystic lesions on US, six patients showed focal calcification of the cysts on CT. Two (2/18, 11%) patients had tiny cysts in the contralateral kidney. During follow-up (range, 2–122 months), there was an increase in lesion size, with ipsilateral renal growth in four (4/18, 22%) patients. There was no renal function impairment at the initial presentation or during follow-up in all patients.Conclusions: LCDK can present with tiny calcifications (39%), contralateral tiny renal cysts (11%), and mild size increase during renal growth (22%) in children without renal function impairment. Follow-up US is recommended without surgical intervention in these typical cases.
Deep Learning with Diverse Objectives Improves ARDS Prediction
Authors: Lam Carson , Thapa Rahul , Maharjan Jenish , Rahmani Keyvan , Tso Chak Foon , Calvert Jacob , Mao Qingqing , Das Ritankar
Published: May 2021

When training neural networks (NNs) on time-series inpatient data, as the number of outcomes predicted diversifies, the NN both generalizes better on external validation and reaches higher performance in similar numbers of training epochs. We demonstrated this in the context of predicting decompensation in Acute Respiratory Distress Syndrome (ARDS). The NN outperformed gradient boosted trees, achieving an area under the receiver operating characteristic of 0.86 on an external hold out test set of hospitals not included in the training set. We estimated real world benefit by comparing mortality rates between similarly at risk patients when diagnosed before or after the time of algorithm evaluation. We showed that, among similarly at risk patients, earlier diagnosis of ARDS nearly doubles the rate of in-hospital survival. Using cluster analysis of the algorithm’s internal representations, we identified distinct ARDS sub-groups, some of which had similar mortality rates but different clinical presentations.