bluuebunny/crossref_metadata_2025 huggingface dataset:
Economic Evaluation of Remote Patient Monitoring System in Patients With Type 2 Diabetes
Authors: Salehi Sahar , Olyaeemanesh Alireza , Mobinizadeh Mohammad Reza , Esfahani Ensieh Nasli , Riazi Hossein , Hezaveh Alireza Mahdavi , Azadbakht Mahdi , pour Elahe Bavand , Jamali Maryam
Published: January 2021

Introduction: Nowadays, an alternative model for evolution of health care is required to reduce the chronic illness burden notably diabetes; to this end, using the remote patient monitoring system is recommended. This system virtually eliminates distance barriers and constantly monitors the patients' information on urban and rural areas. Moreover, in case of trouble, patients are immediately supported and quick warnings are sent to the health care provider and the patient, if necessary. This study aimed to investigate the economic evaluation of the remote type 2 diabetes monitoring for controlling the blood glucose (glycosylated hemoglobin) compared to routine type 2 diabetes care.Methods: Economic evaluation was carried out using the finished cost of the remote type 2 diabetes monitoring technology and the routine treatment, incremental cost-effectiveness ratio as well as one-way and multiple sensitivity analysis using the key variables such as population, cost items, the minimum, maximum and average population size. In this study, the remote type 2 diabetes monitoring technology was compared with the routine treatment.Results: The results showed that, considering the incremental cost-effectiveness ratio in the base model, the remote type 2 diabetes monitoring system in comparison with routine treatment of type 2 diabetes was placed in the second quarter (more effective and affordable technology) of the graph as the most dominant alternative. The results of the two-way sensitivity analysis revealed that the research findings are consistent in terms of cost and population variables and in all cases were included in the second quarter (more effective and affordable technology) in the incremental cost-effectiveness ratio graph and were dominant compared to the routine treatment.Conclusion: Remote patient monitoring is a dominant alternative compared to routine treatment. Further evidence on long-term remote patient monitoring experience is needed for future studies. Results indicated that remote type 2 diabetes monitoring interventions play an effective role in reducing HbA1c that may be considered the rationale for policy makers on domestication of this technology.
Emergent constraints on climate—carbon cycle feedbacks from tropical atmospheric aridity
Authors: Barkhordarian Armineh , Bowman Kevin , Cressie Noel , Jewell Jeffrey , Liu Junjie
Published: January 2021

The vulnerability of the terrestrial tropical carbon cycle to changes in climate, especially temperature and moisture, remains one of the largest sources of uncertainty in future climate projections. Harnessing new satellite-driven global carbon reanalysis, we show here that tropical atmospheric aridity, which is directly related to the atmospheric vapor pressure deficit (VPD), is a causal driver of the interannual variability of the tropical net carbon balance and consequently the CO2 growth rate with observed present-day sensitivities of -3.2 ± 0.62 GtC mb-1 yr-1. Our results provide evidence that a large part of tropical net biome exchange variability is indirectly driven by land-atmospheric coupling via VPD variations that cannot be explained by tropical temperatures alone. Furthermore, we find that there is an emergent relationship between the sensitivity of the tropical carbon balance to VPD and the long-term response of tropical-land carbon storage to increase in VPD across an ensemble of Earth System Models used in the Climate Model Intercomparison Project 6 (CMIP6). Employing a hierarchical emergent constraint, the global carbon—climate feedback from aridity is -22±11 GtC mb-1 which represents a substantial reduction in uncertainty relative to the CMIP6 ensemble. Our findings show that atmospheric aridity is an important proxy for the combined effects of both water and temperature on the terrestrial carbon balance and a key predictor of carbon—climate feedbacks.
Fast and Accurate Automated Recognition of the Dominant Cells From Fecal Images Based on Faster R-CNN
Authors: Zhang Jin , DU XIAOHUI , XU FAN , WANG XIANGZHOU , NI GUANGMING , LIU JUANXIU , HAO RUQIAO , LIU LIN , LIU YONG
Published: January 2021

Fecal samples can easily be collected and are representative of a person’s current health state; therefore, the demand for routine fecal examination has increased sharply. However, manual operation may pollute the samples, and low efficiency limits the general examination speed; therefore, automatic analysis is needed. Nevertheless, recognition exhaust time and accuracy remain major challenges in automatic testing. Here, we introduce a fast and efficient cell detection algorithm based on the Faster-R-CNN technique and is the Resnet-152 convolutional neural network architecture. Additionally, a region proposal network and a network combined with principal component analysis were proposed for cell location and recognition in microscopic images. Our algorithm achieved a mean average precision of 84% and a 723 ms detection time per sample for 40560 fecal images. Thus, this approach may provide a solid theoretical basis for real-time detection in routine clinical examinations while accelerating the process to satisfy increasing demand.
Insights Into the Mechanism of Rhizosphere Microorganisms Effecting on Quality Formation of Authentic Angelica Sinensis Under Different Soil Microenvironments
Authors: Zhu Lei , Yan Hui , Zhou GuiSheng , Jiang ChunHao , Liu Pei , Yu Guang , Guo Sheng , Wu QiNan , Duan JinAo
Published: January 2021

Background: Angelica sinensis (Oliv.) Diels (A. sinensis), the commonly used famous-region Chinese herbs, grew in different geographical locations which were crucial to active components accumulation in medicinal plants. Rhizosphere microbiome played a critical role in plant performance, including nutrient acquisition, growth and development and plant diseases resistance etc., there were still few studies on how microbiome effecting on accumulation of active components of A. sinensis. This study aim to illustrate whether the variations of rhizosphere microbial communities and metabolites profilings of A. sinensis were dependant on soil microenvironments. Soils from the two main A. sinensis producing areas, Gansu and Yunnan Province, were selected for a pot experiment, and then divided into two parts, one part was sterilized and the other did not, planting with Gansu danggui 90-01, allowed to grow for 180 days. After the trial radix A. sinensis were collected for analysis of growth targets and chemical compositions, rhizosphere soils for microbial analyses. Results: The metabolic profiles and rhizosphere microbial communities of A. sinensis grown under different soil microenvironments showed similar variation. The GN (Gansu non-sterilized), YN (Yunnan non-sterilized), GS (Gansu sterilized), and YS (Yunnan sterilized) group were significantly separated. Specifically, compared with Yunnan soil, antagonistic bacteria such as Sphingomonas, Pseudomonas, Lysobacter, Pseudoxanthomonas, etc. were significantly (p <0.05) enriched in Gansu soil. The characteristic constituents of senkyunolide I and ligustilide dimers enriched in GS group has an extremely positive correlation with Pseudomonas parafulva; organic acids (including chlorogenic acid, dicaffeoylquinic acid and 5-feruloylquinic acid) and their ester coniferyl ferulate enriched in YS Group were significantly positively relevant with Gemmatimonadetes bacterium WY71 and Mucilaginibater sp., respectively. Conclusions: Given that soil microenvironments may contribute to growth and active components accumulation of A. sinensis. Further study aimes at exploring the functional characteristics of quality-related bacterias, and finding the main response genes and the interactions between genes and the environments, to elucidate the main mechanism of genuine A. sinensis quality formation.
Application of Quantile Regression to Examine Changes in the Distribution of Stunting of Indian Children Aged 0-36 Months Using Four Rounds of NFHS Data.
Authors: Mokalla Thirupathi , MENDU VISHNU VARDHANA
Published: January 2021

Background: In India, it has been observed that the prevalence of stunting among under-five children decreased, but the prevalence is still alarmingly high. In previous studies, traditional (linear and logistic) regression analyses were used, and these analyses were limited to encapsulated cross-distribution variations. Our study's objective was to examine how the different determinants are heterogenous in various percentiles. Methods: This article examined the change in the stunting distribution of children and examined the relationships between the key covariate's trends and patterns in stunting among children aged <3 years over a period of 24 years. Four successive rounds of the National Family Health Survey data 1992-93, 1998-99, 2005-06, and 2015-16 were used for analysis. The final study included 206579 children aged <3 years (N= 106136 male, 100443 female). To explain and analyze differences in the stunting distribution, the lambda-mu-sigma (LMS) method was used. Trends in stunting distribution over time were analysed using separate sex-stratified quantile regression (QR). The selected socioeconomic, demographic and other predictors considered for this analysis. Results: The quantile regressions have clearly indicated that mothers who have higher than primary level education were beneficial to decrease child malnutrition at the lower end of the distribution. The age, birth order, mother's body-mass-index (BMI) and wealth, among others, were some more determining factors for HAZ. Results of selected quantile regression estimated at 5th, 10th, 25th, 50th, 75th, 90th, and 95th quantiles. The wealth index was a highly negative association with lower quantiles compared to upper quantiles in stunting However, in the age classification, as the age increases, there was a negative association in the upper quantiles of stunting. Small size at birth was having a negative association in all the quantiles of stunting. Conclusions: The outcome of various covariates working differently across the stunting distribution was suggested by quantile regression. The major discrepancies in different aspects were underlined by socioeconomic and demographic aspects of India. The heterogeneity of this effect was shown using quantile regression.
Modeling of the Weekly Variation of the Reported COVID-19 Cases as A Potential Indicator of the Surveillance System Accuracy
Authors: Zamaninasab Zahra , Sharifi Hamid , Mostafavi Ehsan , Mounesan Leila , Haghdoost Ali Akbar
Published: January 2021

Periodical daily variation in the number of reported COVID-19 cases within weeks is a common observation in global and national statistics. This variation may imply that the day of week has a significant role in the number of reported cases. We compared the pattern in some countries with an acceptable surveillance system. Data of 18 European and North American countries between 6 Mar and 8 Nov 2020 were extracts. Harmonic regression models were used to quantify the peak day, the absolute intensity and the average of coefficient of variation within weeks (ACVW) classified by country. In eight countries, the within week variation was statistically significant, the maximum and minimum number reported cases were in Saturday and Monday respectively, however, this pattern varied among countries. The maximum of ACVW was observed in Belgium and France, while it was minimum in Russia. The level of intensity of infection had a positive association with the ACVW (r = 0.54, p-value = 0.021). The observed variation and its pattern may show that the coverage or the tidiness of COVID-19 surveillance system fluctuates in different days of week. In addition, we suggest that the level of this fluctuation might be used as an accuracy indicator of the surveillance system.
Women’s Intention to Abort a Fetus Diagnosed with a Genetic Disease: Results from Israel, Cyprus and Germany
Authors: Kivity Sara , Barnoy Sivia
Published: January 2021

Background: Developments in genetics‏, have now enabled early detection of fetus genetic abnormalities in utero. In parallel, a woman's right to her body has led to legal changes, which permit abortions under certain conditions. The decision whether to undergo an abortion following the discovery of a fetal abnormality is affected by culture, legal regulations, and attitudes. The aim of the study was to assess the cultural influence on women’s intention to undergo an abortion in case her fetus is diagnosed with a genetic disease. Research Design: A scenario based study conducted in Israel, Germany and Cyprus. A questionnaire presented six scenarios in which a woman is pregnant and her fetus is diagnosed with a mild, moderate or severe genetic disease. For each scenario, the women were asked to rate their perceived severity about having a child with the disease, sense of control over performing an abortion and their intention to undergo an abortion. For analyzing the differences between the countries, one-way analysis of variance (ANOVA) was used with Tukey’s-b post hoc tests. Multiple linear regressions were used to detect variables associated with the intention to terminate the pregnancy. Results: A total of 358 women participated in the study 141 Israeli, 121 German and 96 from Cyprus. The results revealed that for all diseases, Israeli women were more inclined to perform an abortion than German and Cypriot women. In all cases Israeli women reported a higher sense of control over performing an abortion and Cypriot women expressed the highest perceived severity. Sense of control, severity perception, being Israeli, and increased age predicted the intention to abort.Conclusions: The intention to abort following the diagnosis of a fetus with a genetic disease is influenced by culture. There is a greater intention to abort when women feel more control, and have a higher perceived severity, regardless of the severity of the disease.
Effects of Delayed Suprapubic Port Removal on Post-laparoscopic Shoulder Pain: A Randomized Controlled Trial
Authors: Chalermchockcharoenkit Amphan , Hengrasmee Pattaya , Sophontanarak Paiboon , Sirimai Korakot , Sutchritpongsa Pavit , Srichai Pisutt
Published: January 2021

Background: One of the major drawbacks of gynecologic laparoscopy is post-laparoscopic shoulder pain (PLSP) that is believed to result from intra-abdominal CO2 retention leading to peritoneal and diaphragmatic stretching and causing referred pain in C4 dermatome. Several interventions have been applied to prevent and reduce its incidence and severity, with contradictory results. Only pulmonary recruitment maneuver, extended assisted ventilation and active intra-abdominal gas aspiration have been mentioned to be effective interventions for CO2 evacuation. However, in our experience, an alternative technique of delayed suprapubic port removal (DSPR) was found to be an effective method in CO2 expulsion. Therefore, we conducted this randomized trial to determine the effectiveness of the DSPR technique in reducing the incidence and severity of PLSP. The trial was conducted at a single, tertiary hospital between May 2015 and May 2016. Having complied with the criteria, 220 patients scheduled for elective gynecological laparoscopy were randomly allocated into 2 groups after giving informed consent. Laparoscopic procedures were performed through 10-mm umbilical port and at least 2 ancillary, including suprapubic, ports. In conventional group, ancillary ports were removed at the end of surgery leaving only opened umbilical cannula for pneumoperitoneum deflation. Abdominal compression from periphery towards umbilicus was performed to further expel CO2 before removing the umbilical cannula. In DSPR group, both umbilical and suprapubic cannulas were retained. Two-step abdominal compression was undertaken, primarily towards umbilicus and secondarily towards pelvic cavity, before sequentially removing the umbilical and the suprapubic cannulas. Postoperatively, each patient was asked to rate PLSP level on 100–mm VAS during 0-6, 6-12, 12-24, and 24-48 hours respectively. Statistical analysis was performed to determine both incidence and severity of PLSP during 24- and 48-hours post-laparoscopy.Results: Patients in DSPR group demonstrated significantly lower incidence of PLSP within 24 hours (43.8% vs 59.0%; p=0.027) and 48 hours (43.8% vs 60.0%; p=0.019), and expressed apparently lower pain scores (0(0-0) vs 0(0-8); p=0.020) during 24-48 hours post-surgery.Conclusion: DSPR is an effective CO2 expulsion technique, resulting in significant reduction of both incidence and severity of PLSP within 24-48 hours post-laparoscopy.Trial registration: Thai Clinical Trials Registry; TCTR20160208003; Registered 8 February 2016 - Retrospectively registered; http://www.clinicaltrials.in.th/index.php?tp=regtrials&menu=trialsearch&smenu=fulltext&task=search&task2=view1&id=1715
Effects of Urban Topography and Traffic Emissions of Ultrafine Particulate Matter, Reactive Nitrogen Species, and Ozone in Greater Los Angeles Area
Authors: Bhatia Agam Mohan Singh
Published: January 2021

Traffic-related air pollution (TRAP) is a major source of pollutant exposure in urban areas. Particulate species concentrations have drastically increased over the past decade and little has been done to understand them further. This study aims to further research in atmospheric and environmental sciences and influence decisions made regarding urban climate policy by furthering the understanding of UFP size and concentrations. It will lead to a better understanding of dangerous particles and act as a basis for future studies that aim to further understand or mitigate anthropogenic ultrafine particle emissions. This can help policymakers design and implement better, more effective policies that aim to reduce traffic-related air pollution exposure in urban areas.
Trends of Maternal Health Service Coverage in the Democratic Republic of the Congo: A Pooled Cross-Sectional Study of MICS 2010 to 2018
Authors: Guo Fuyu , Qi Xinran , Xiong Huayi , He Qiwei , Zhang Tingkai , Zou Siyu , Wang Hanyu , Takesue Rie , Tang Kun
Published: January 2021

Background Maternal health service is essential for reducing maternal and newborn mortality. However, maternal health service status in the Democratic Republic of the Congo (DRC) remains poorly understood. This study aims to explore the trends of antenatal care (ANC) and skilled birth attendance coverage in the past decade in the DRC.Methods The 13,313 participants were from two rounds of Multiple Indicators Cluster Survey (MICS) conducted by the National Institute of Statistics of the Ministry of Planning of the DRC, in collaboration with the United Nations Children’s Fund (UNICEF), in 2010 and 2017-2018. A regression-based method was adopted to calculate the adjusted coverages of ANC and skilled birth attendance. Subgroup analysis based on different socioeconomic status (SES) was conducted to explore the impact of domestic conflicts.Results From 2010 to 2018, the overall weighted ANC coverage declined from 87.3% (95% CI 84.1% to 86.0%) to 82.4% (95% CI 81.1% to 84.0%), while the overall weighted skilled birth attendance coverage increased from 74.2% (95% CI 72.5% to 76.0%) to 85.2% (95% CI 84.1% to 86.0%) in the DRC. The adjusted ANC coverage and adjusted skilled birth attendance coverage both declined in the Kasai Oriental, but both increased in the Nord Kivu and Sud Kivu. In the Kasai region, the largest decline for the adjusted coverages of ANC and skilled birth attendance was found among the poorest women. Nevertheless, in the Kivu region, both the adjusted coverages of ANC and the skilled birth attendance increased for the poorest women. Conclusions With lasting domestic conflicts, there was a systemic deterioration of maternal healthcare coverage in some regions, particularly among people with low SES. While in some other regions, maternal healthcare service was not severely disrupted due possibly to the substantial international health assistance.
Kugel ball as an interesting application of designing the hydrosphere
Authors: Elescandarany Ahmad Waguih
Published: January 2021

Analytical solutions are not available for the partial hemispherical hydrosphere which called as the Kugel ball fountain or the Kugel ball. However, this study offers a comprehensive idea about this phenomenon presenting a design map that gives a panoramic sight enabling the designers to easily choose whatever specifications needed for their fountain. Through simplifying the author previous formulae for this type of bearings, this paper removes the mystery of the Kugel ball phenomenon and shows that no complicated mathematic or physics are needed, as believed, to be grasped for producing such fountains. A new simple design technique is used and the most two famous fountains (at the House of Science in Patras, Greece and the largest at the Science Museum of Virginia, Richmond, USA.) are checked as an application of this design. One of the most important side results of this study is finding the equilibrium point, discovered in the author previous papers, which was considered as the equilibrium point between the forces of centripetal inertia, viscosity and friction due to the surface roughness. It becomes clear that this point is a natural characteristic of this type of bearings.
Association between first birth cesarean delivery and adverse maternal-fetal outcomes in the second pregnancy: a registry-based study in Northern Tanzania
Authors: Gaffur Raziya , Maro Eusebious , Mchome Bariki , Mahande Micheal , Ndaninginan Lyasimana , Asubiojo Benjamin
Published: January 2021

Background: Cesarean delivery is the commonest obstetric surgery and surgical intervention to save lives of the mother and/or the new-borns. It has been accepted as safe procedure, yet it has increased risk of adverse maternal and fetal outcomes. The rise in rate of cesarean delivery has been a major public health concern worldwide. Previous caesarean section has been associated with repeated cesarean delivery, causing potential adverse maternal-fetal outcomes in the subsequent pregnancy. We aimed to examine the relationship between first birth cesarean delivery and adverse maternal-fetal outcomes in the subsequent pregnancy among women who delivered at Kilimanjaro Christian Medical Centre in Northern Tanzania. Methods: A retrospective cohort study was conducted using maternally-linked data from Kilimanjaro Christian Medical Centre. All women who had singleton second delivery between the years 2011 to 2015 were studied. A total of 5,984 women with singleton second delivery were analysed. Multivariable log-binomial regression was used to determine the association between first cesarean delivery and maternal-fetal outcome in subsequent pregnancy. Results: Cesarean delivery in the first birth was associated with an increased risk of adverse maternal and fetal outcomes in the subsequent pregnancy. These included repeated cesarean delivery (ARR 1.19; 95% CI: 1.05-1.34), pre/eclampsia (ARR 1.38; 95% CI: 1.06-1.78), gestational diabetes Mellitus (ARR 2.80; 95% CI: 1.07-7.36), uterine rupture (ARR 1.56; CI: 1.05-2.32), peri-partum hysterectomy (ARR 2.28; CI: 1.04-5.02) and preterm birth (ARR 1.21; CI: 1.05-1.38). Conclusion: Women with CD in their first pregnancy had an increased risk of repeated CD and other adverse maternal-fetal outcomes. Findings from a present study highlight the importance of devising regional specific measures to mitigate unnecessary primary caesarean delivery. Additionally, this information may serve as a basis to guide mode of delivery counselling prior to Trial of labour after caesarean delivery.
Aggrecan - a new biomarker for acute type A aortic dissection
Authors: König Karl , Lahm Harald , Dreßen Martina , Doppler Stefanie , Eichhorn Stefan , Beck Nicole , Krähschütz Kathrin , Holdenrieder Stefan , Kastrati Adnan , Lange Rüdiger , Krane Markus , Doll Sophia
Published: January 2021

Acute type A aortic dissection (ATAAD) constitutes a life-threatening aortic pathology with significant morbidity and mortality. Without surgical intervention the usual mortality rate averages between 1-2 % per hour. Thus, an early diagnosis of ATAAD is of pivotal importance to direct the affected patients to the appropriate treatment. As a consequence, we investigated whether aggrecan (ACAN) is a potential biomarker for diagnosing ATAAD. Our investigation showed that ACAN mRNA expression is highest in aortic tissue from ATAAD patients. Mean ACAN protein concentration showed a significantly higher plasma concentration in ATAAD patients (38.59 ng/mL) compared to plasma of patients with thoracic aortic aneurysms (4.45 ng/mL), patients with ST-elevation myocardial infarction (11.77 ng/mL) and healthy volunteers (8.05 ng/mL). Cardiac enzymes like creatine kinase MB and cardiac troponin T showed no correlation with ACAN levels in ATAAD patients. Receiver-operator characteristics (ROC) curve analysis for ATAAD patients versus control subjects revealed an area under the curve of 0.947 and an optimum discrimination limit of ACAN plasma levels at 14.3 ng/mL with a corresponding sensitivity of 97 % and specificity of 81 %. According to our findings ACAN is a reliable potential biomarker in plasma samples to detect ATAAD with high sensitivity and specificity.
Quantitative Measurement of Toxic Metals and Assessment of Health Risk in Plant-based Food from Markazi Province of Iran
Authors: Karimi Fereshteh , Shariatifar Nabi , Rezaei Mohammad , Alikord Mahsa , Arabameri Majid
Published: January 2021

The aim of current study is to measurement and investigate the toxic metals levels in plant-based food collected in Markazi province and human health risk by using inductively coupled plasma - optical emission spectrometry (ICP-OES). The levels of arsenic (As) and cadmium (Cd) in all samples were lower than LOD, while level of Cd in potato samples were lower than permitted limit of European commission (EC). The highest mean of toxic metals were observed for lead (Pb) in legume samples (562.17 µg kg− 1). Mercury (Hg) and Pb levels in all samples were higher than LOD, while Pb level in wheat samples were lower than of EC. The rank order of Hg and Pb levels in all samples based on target hazard quotient (THQ) value was wheat > potato > legume. The 95% THQ index of Hg and Pb for adults in wheat samples were 2.59E + 00 and 7.19E-01, in potato samples were 2.07E-01 and 1.64E-01; in legume samples were1.41E-01 and 6.61E-02respectively, while in the case of children, the 95% THQ index of Hg and Pb in wheat samples were 8.90E + 00 and 2.44E + 00; in potato samples were 1.17E + 00 and 5.81E-01; in legume samples were4.77E-01 and 2.20E-01 respectively. The high hazard index values were estimated, indicating a high health risk from consumption of wheat and potato.
Designing Magnetic Field Sensor Based on Tapered Photonic Crystal Fibre Assisted by A Ferrofluid
Authors: Taghizadeh Mostafa , Bozorgzadeh Forough
Published: January 2021

A novel magnetic field sensor is proposed based on the combination of in-line tapered photonic crystal fibre (PCF) Mach-Zehnder interferometer (MZI) and magnetic nanoparticles. The sensor was theoretically investigated and experimentally realized. The effect of the mechanical strain and the magnetic field on the sensitivity of the sensor is studied. It is found that the proposed sensor shows a strain sensitivity of 1pm/µε. In order to evaluate the magnetic nanoparticles effect on the intensity of output light, the sensitivity response of the device has been measured under different magnetic field strengths for three length scales. The experimental results show refractive index changes of the magnetic nanoparticles-infiltrated PCF - acting as a fibre cladding - under applied magnetic field leads to variations of the interferometric output. The sensitivity of magnetic field measurement could reach up to 0.003 dB/mT. The results show a very good linear response that is an essential requirement for the practical sensors. The proposed magnetic field sensor finds applications in various areas, such as optical sensing, military, power industry, and tunable photonic devices.
The Anatomical Variations of the Posterolateral Tubercle of Talus in Patients with Posterior Ankle Impingement Syndrome
Authors: Kalbouneh Heba , Alsalem Mohammad , Hani Maysoon Bani , Alhusamiah Hamzeh , Momani Yazan , Massad Talal , Barakat Tamer , Alajoulin Omar
Published: January 2021

Background: The most important anatomical variations of the posterolateral talar tubercle that can predispose patients to development of posterior ankle impingement syndrome (PAIS) are an os trigonum and Stieda process. The aim of this study was to elucidate the prevalence of different anatomical variants of posterolateral talar tubercle on CT imaging, their prevalence in patients with PAIS, and to evaluate the risk posed by these anatomical variants to PAIS. Methods: 1478 ankle CT scans were retrospectively reviewed for the different anatomical variants of the lateral talar tubercle, the type and size of os trigonum. In addition, these anatomical differences were assessed in a subgroup of patients with PAIS. Results: Normal sized lateral tubercle was found in 46.1%, Stieda’s process in 26.1%, os trigonum in 20.5% and almost absent tubercle in 7.3%. A statistically higher prevalence of Stieda’s process was found in males while os trigonum was higher in females (p<0.05). In patients with PAIS, the most common variant was os trigonum (48.8%), followed by Stieda process (34.1%). Patients with Stieda process were 1.5 times more likely to have PAIS, and patients with os trigonum were 4.4 times more likely to have PAIS. PAIS was observed in 20.8% of patients with os trigonum. Fused forms of os trigonum (by cartilage) and sizes larger than 1cm were associated with a higher risk of occurrence of PAIS (OR 2.10 and OR 1.96 respectively)(p<0.05). Conclusion: Patients with os trigonum, followed by Stieda process were more likely to have PAIS compared to other anatomical variants of lateral talar tubercle.
Clustering of social disadvantage with attention-deficit/hyperactivity disorder in young adults: a register-based study in Sweden
Authors: Virtanen Marianna , Lallukka Tea , Alexanderson Kristina , Helgesson Magnus , Heikkilä Katriina , Ervasti Jenni , Pentti Jaana , Vahtera Jussi , Kivimäki Mika , Mittendorfer-Rutz Ellenor
Published: January 2021

Background

Whether clustering of social disadvantage in young adulthood is associated with attention-deficit/hyperactivity disorder (ADHD) is poorly understood. We examined clustering of ADHD with low educational attainment and unemployment in young adulthood; whether such clustering is stronger when unemployment was prolonged; and whether further clustering of disability pensioning, low education and unemployment occurs among those with ADHD.
Methods

Data were obtained from Swedish health, demographic and social security registers from which 8990 individuals with recorded ADHD diagnoses at the age of 10 to 35 and their 44387 matched references without mental disorders. Social disadvantage was measured using data on educational attainment, unemployment and disability pension from the diagnosis year or age 19 if diagnosed at younger age. Clustering was examined by comparing observed and expected occurrence (O/E ratio) of all possible combinations of ADHD, low education and unemployment, and, among those with ADHD, additional combinations with new-onset disability pension.
Results

The likelihood of having neither ADHD, low education nor unemployment was increased (O/E ratio = 1.20, 95% confidence interval 1.19–1.20 at baseline; 1.18, 1.17–1.18 at follow-up), as well as having all three characteristics (O/E ratio = 3.99, 3.89–4.10 at baseline; 5.68, 5.47–5.89 at follow-up). This clustering was stronger among women than men and when unemployment was prolonged. Among individuals with ADHD, clustering of low education with disability pension and unemployment was observed.
Conclusions

Low education and unemployment appear to cluster remarkably with ADHD among young adults, more so among women and when unemployment is prolonged.
Genome-Wide SNPs Redefines Species Boundaries and Conservation Units in the Freshwater Mussel Genus Cyprogenia of North America
Authors: Roe Kevin , Kim Kyung Seok
Published: January 2021

Detailed information on species delineation and population genetic structure is a prerequisite for designing effective restoration and conservation strategies for imperiled organisms. Phylogenomic and population genomic analyses based on genome-wide ddRAD-Seq data has identified three allopatric lineages in the North American freshwater mussel genus Cyprogenia. Cyprogenia stegaria is restricted to the Eastern Highlands and displays little genetic structuring within this region. However, two allopatric clusters of C. aberti in the Ozark and Ouachita highlands exhibit substantial levels (mean FST = 0.120) of genetic differentiation and each warrants recognition as a distinct evolutionary lineage. Lineages of Cyprogenia in the Ouachita and Ozark highlands are further subdivided reflecting structuring at the level of river systems. Species tree inference and species delimitation in a Bayesian framework using SNP data supported results from phylogenetic analyses, which favors recognizing three species of Cyprogenia over the currently recognized two species.A comparison of SNPs generated from both destructively and non-destructively collected samples revealed no significant difference in the SNP error rate, quality and amount of ddRAD sequence reads, indicating that nondestructive or trace samples can be effectively utilized to generate SNP data for organisms for which destructive sampling is not permitted.
A Novel Prognostic Nomogram Based on Metastasis-Related Genes Signature for Predicting the Progression-free Interval in Patients With Papillary Thyroid Carcinoma
Authors: Liu Rui , Wu Mengwei , Cao Zhen , Li Xiaobin , Yuan Hongwei , Liu Ziwen
Published: January 2021

Background: The recurrence rate for papillary thyroid carcinoma (PTC) after surgery is high, which is a significant issue for patients regarding with low-grade malignancy. We built a novel predictive model with metastasis-related genes (MTGs) and relevant clinical parameters for predicting progression-free interval (PFI) after surgery for PTC.Methods: We performed a bioinformatic analysis of integrated PTC datasets with the MTGs to identify differentially expressed MTGs (DE-MTGs). Then we generated PFI-related DE-MTGs and established a 14-gene signature using Lasso-Penalty regression. Finally, we established a signature and clinical parameters-based nomogram for predicting the PFI of PTC . We then validated the efficacy of the signature in marking off high risk patients; the nomogram's performance in predicting PFI was also evaluated with receiver operating characteristic (ROC) curve and Harrell's concordance index (C-index).Results: We identified 155 DE-MTGs related to PFI in PTC. The functional enrichment analysis showed that the DE-MTGs were associated with important oncogenic process. Consequently, we found a novel 14-gene signature. The 14-gene signature could distinguish patients with poorer prognosis and predicted PFI accurately. The signature was a significant independent prognostic factor in PTC. Finally, we built a nomogram by including the signature and relevant clinical factors. Validation analysis showed that the nomogram’s efficacy was superior to the current clinical risk evaluating system in predicting the recurrence of PTC. Conclusions: The 14-gene signature and nomogram were closely associated with PTC prognosis and may help clinicians improve the individualized prediction of PFI, especially for high-risk patients after surgery.
A Comparison of Five Epidemiological Models for Transmission of SARS-CoV-2 in India
Authors: Purkayastha Soumik , Bhattacharyya Rupam , Bhaduri Ritwik , Kundu Ritoban , Gu Xuelin , Salvatore Maxwell , Mishra Swapnil , Mukherjee Bhramar
Published: January 2021

BackgroundMany popular disease transmission models have helped nations respond to the COVID-19 pandemic by informing decisions about pandemic planning, resource allocation, implementation of social distancing measures and other non-pharmaceutical interventions. We study how five epidemiological models forecast and assess the course of the pandemic in India: a baseline model, an extended SIR (eSIR) model, two extended SEIR (SAPHIRE and SEIR-fansy) models, and a semi-mechanistic Bayesian hierarchical model (ICM). MethodsUsing COVID-19 data for India from March 15 to June 18 to train the models, we generate predictions from each of the five models from June 19 to July 18. To compare prediction accuracy with respect to reported cumulative and active case counts and cumulative death counts, we compute the symmetric mean absolute prediction error (SMAPE) for each of the five models. ResultsFor active case counts, SMAPE values are 0.72 (SEIR-fansy) and 33.83 (eSIR). For cumulative case counts, SMAPE values are 1.76 (baseline) 23. (eSIR), 2.07 (SAPHIRE) and 3.20 (SEIR-fansy). For cumulative death counts, the SMAPE values are 7.13 (SEIR-fansy) and 26.30 (eSIR). For cumulative cases and deaths, we compute Pearson’s and Lin’s correlation coefficients to investigate how well the projected and observed reported COVID-counts agree. Three models (SAPHIRE, SEIR-fansy and ICM) return total (sum of reported and unreported) counts as well. We compute underreporting factors as of June 30 and note that the SEIR-fansy model reports the highest underreporting factor for active cases (6.10) and cumulative deaths (3.62), while the SAPHIRE model reports the highest underreporting factor for cumulative cases (27.79).ConclusionsIn this comparative paper we describe five different models used to study full disease transmission of the SARS-Cov-2 disease transmission in India. While simulation studies are the only gold standard way to compare the accuracy of the models, here we were uniquely poised to compare the projected case-counts against observed data on a test period. Prediction of daily active number of cases does show appreciable variation across models. The largest variability across models is observed in predicting the “total” number of infections including reported and unreported cases. The degree of under-reporting has been a major concern in India.
Stroke During Extracorporeal Membrane Oxygenation: Timing, Risk Factors and Clinical Outcomes
Authors: Kim Harim , Yang Jeong Hoon , Chung Chi Ryang , Jeon Kyeongman , Suh Gee Young , Chung Suryeun , Sung Kiick , Cho Yang Hyun
Published: January 2021

Background Among various complications of extracorporeal membrane oxygenation (ECMO), stroke continues to be a major factor that worsens the clinical outcome because it is associated with mortality and adverse neurologic outcomes. Appropriate risk evaluation, screening, and management of neurologic injury under ECMO support has not yet been established and requires further investigation. Thus, this study analyzes the stroke related risk factors and outcomes in order to determine the appropriate intervention to minimize neurologic sequalae while on ECMO. Method Total 1039 patients who underwent ECMO from January 2012 to September 2019 at the Samsung Medical Center were reviewed and 759 subjects were selected for the analysis. The exclusion criteria were age < 18y, failure of successful ECMO initiation, multiple ECMO runs, underlying severe brain injury, and incomplete medical records. Multivariate analysis was performed to identify the risk factors of strokes on ECMO support using cox proportional hazard regression. In order to analyze the timing of stroke after ECMO initiation, the Mann–Whitney U test and Kruskal–Wallis rank sum test were performed.Results Among The overall incidence of stroke was 5.1% (n = 39) without a significant difference between venoarterial (VA) and venovenous(VV) ECMO (5.3% and 4.8%, respectively, p = 0.480). Independent risk factors for stroke were intraaortic balloon pump (IABP, p = 0.0008) and a history of stroke (p = 0.0354). Most hypoxic brain injuries were found in the VA ECMO (93.3%), and 54.5% of intracranial hemorrhage were in the VV ECMO. Most patients with strokes (61.5%) were diagnosed within 72hours after ECMO initiation. The time taken for stroke event from the time of ECMO insertion was shorter in the VA ECMO than in the VV ECMO (median 1.5 vs. 3 days). The stroke group had a higher mortality rate than the non-stroke group (64.1% and 44.7%, respectively, p = 0.014). Conclusion Concurrent ECMO and IABP use may increase the incidence of stroke during ECMO support. Evaluation for stroke that includes CT within 72 hours of ECMO insertion may enable early diagnosis, allowing timely intervention.
Proteomic Comparison of Aged and OPTN E50K Retina in the Development of Normal Tension Glaucoma
Authors: Liu Xinna , Wang Qi , Shao Zhengbo , Zhang Shiqi , Hou Mingying , Jiang Menglu , Du Mengxian , Li Jing , Yuan Huiping
Published: January 2021

Background: Progressive degeneration of retinal ganglion cells (RGCs) is a major characteristic of glaucoma, whose underlying mechanisms are still largely unknown. An E50K mutation in the Optineurin (OPTN) gene is a leading cause of normal tension glaucoma (NTG), directly affecting RGCs without high intraocular pressure and causing severe glaucomatous symptoms in clinical settings. A systematic analysis of the NTG mouse model is crucial for better understanding of the underlying pathological mechanisms for glaucoma.Methods: To elucidate proteomic and biochemical pathway alterations during NTG development, we established an OPTN E50K mutant mouse model through CRISPR/Cas9. Retinal proteins from resulting mice exhibiting glaucomatous phenotypes were subject to tandem mass tag-labelled quantitative proteomics. Retinal proteomes were analyzed through bioinformatics methods to characterize the molecular and functional signatures of NTG. Results: We identified 6364 quantitative proteins in our proteomic analysis. Bioinformatics analysis revealed that OPTN E50K mice experienced protein synthesis dysregulation, age-dependent energy defects and autophagy-lysosome pathway dysfunction. Certain biological features, including amyloid deposition, RNA splicing, microglia activation and reduction of crystallin production, were similar to Alzheimer’s Disease (AD). Conclusions: Our study is the first to describe proteomic and biochemical pathway alterations in NTG pathogenesis during disease advancement. Several proteomic signatures overlapped with retinal changes found in the AD mice model, suggesting the presence of common mechanisms between age-related degenerative disorders, as well as prospective new targets for diagnostic and therapeutic strategies.
Healthcare Utilization of Below Poverty Line Population under Government-Funded Health Protection Scheme in One Sub-district in Bangladesh: A Cross-Sectional Study
Authors: Hasan Md. Zahid , Ahmed Mohammed Wahid , Mehdi Gazi Golam , Khan Jahangir A. M. , Islam Ziaul , Chowdhury Mahabub Elahi , Ahmed Sayem
Published: January 2021

Background The below poverty line (BPL) population in rural Bangladesh have low access to hospital inpatient-care (IPC) services. The Government of Bangladesh (GoB) launched pilot Shasthyo Suroksha Karmasuchi (SSK) at Kalihati Upazila of Tangail district in 2016 aiming to improve IPC access of the BPL population and financial protection for healthcare. The GoB funded scheme provides IPC for 78 diseases and outpatient consultation through an existing health facility. In this study, we aimed to assess the level of healthcare utilization among the scheme beneficiaries and identify the associated factors with utilization. MethodsThis was an exploratory study with a cross-sectional household survey conducted from July to September 2018 among 806 sampled households using a structured questionnaire. Data on illness and healthcare utilization was collected from the selected households for the last 90 days of the interview date. A logistic regression model was applied to determine the factors associated with healthcare utilization from SSK facility. ResultsOverall, 8% of the ill patients in the last 90 days prior to survey sought healthcare from SSK facilities (n=639; total patients who sought care), 28% from medically trained providers (MTPs), and 64% from non-MTPs. Of the 23 (3.6%) patients who sought inpatient care (IPC), less than half (10 patients) of them utilized IPC under SSK. Individuals with accident/injury, unemployed, having knowledge about SSK, non-BPL status, were more likely to utilize healthcare from SSK facility. Individuals reside more than 15 km away from facility, had 4-5 family members, and above secondary level education were less likely to utilize care from SSK facility. Conclusions It is evident that healthcare utilization of beneficiaries from the SSK scheme was very low. Effective strategies for enhancing knowledge on SSK benefits and precise BPL households targeting can be instrumental in increasing utilization of the scheme. The scheme also has a potential to bring the individuals under its coverage who utilize healthcare from other MTP and non-MTP.
Youth Sport Participation and Physical Activity in Rural Communities: A Case Study
Authors: Kellstedt Debra K. , Schenkelberg Michaela A. , Essay Ann M. , Von Seggern Mary , Rosenkranz Richard R. , Welk Gregory J. , High Robin , Dzewaltowski David A.
Published: January 2021

BackgroundPhysical activity, a high-frequency health behavior, varies by where youth live, learn, and play. Youth accumulate physical activity in adult-led in-school and out-of-school settings. Youth sport is a potential setting for physical activity, but there are differences in youth sport participation based on age, gender, and socioeconomic status. There is a gap in understanding demographic influences on youth sport participation and how these factors interact to influence physical activity. This case study examines influences of grade, gender, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity of youth in rural communities.MethodsYouth (n=418 3rd–6th graders) living in two rural communities completed the online Youth Activity Profile as part of Wellscapes, a type 3 hybrid implementation-effectiveness community randomized trial. Mixed models with community as a random effect examined main effects and interactions of grade, gender, and family income on youth sport participation and these factors and youth sport participation on moderate-to-vigorous physical activity. ResultsAbout 80% of youth engaged in youth sport, and full pay lunch students were almost four times more likely to have youth sport participation than students with free/reduced lunch (OR = 3.91, 95% CI = 1.95, 7.8). Females and 6th graders (p <0.05) had lower physical activity than comparison groups. Males with higher family income had greater physical activity; females with higher family income had less physical activity. For 6th graders, high family income had less effect on physical activity than similar 3rd-5th graders (p<0.01). ConclusionsWhile a fairly high percentage of youth participate in youth sports, there are disparities in rural communities on youth sport participation and physical activity outcomes based on age, gender, and family income.
Invasive Mole Lead to Uterine Rupture, a Case Report
Authors: Wu Anshan , Zhu Qiong , Tan Chang , Chen Long , Tao Yin
Published: January 2021

Uterine rupture common in scar uterus. In invasive mole lead to uterine rupture are rarely seen. A 31-year-old woman, in a clinic was abortioned. After abortion, the patient abdomen paind and litter vaginal bleeding fivty-three days ago. Then, the Human Chorionic Gonadotrophin(HCG) was rised and MR imaging showed a mass in myometrium. Suddenly, the uterine ruptured and shock. The patient was operated on for a hysterectomy of Gynaecologist. The pathological result is invasive mole.