bluuebunny/crossref_metadata_2025 huggingface dataset:
Gene Expression and Alternative Splicing Dynamics Are Perturbed in Head Transcriptomes of Heterospecifically Mated Females
Authors: Diaz Fernando , Allan Carson , Markow Therese , Bono Jeremy , Matzkin Luciano
Published: January 2021

Background

Despite the growing interest in the female side of copulatory interactions, the roles played by alternative splicing mechanisms of pre-RNA and the epistatic effects of these interactions on tissues outside of the reproductive tract have remained largely unknown. Here we addressed these questions in the context of con- vs heterospecific matings between Drosophila mojavensis and its sister species, D. arizonae. We analyzed transcriptional responses in female heads using an integrated investigation of genome-wide patterns of gene expression, including differential expression (DE), alternative splicing (AS) and intron retention (IR).
Results

Our results indicated that early transcriptional responses were largely congruent between con- and heterospecific matings but are substantially perturbed over time. Conspecific matings induced functional pathways related to amino acid balance previously associated with the brain’s physiology and female postmating behavior. Heterospecific matings often fail to activate regulation of some of these genes and induce expression of additional genes when compared with those of conspecifically-mated females. These results are consistent for all transcriptional mechanisms with some distinctions: DE genes were mostly linked to pathways of proteolysis and nutrient homeostasis, while AS genes are more related to photoreception and muscle assembly pathways.
Conclusions

IR seem to be an important mechanism of DE regulation during the female postmating response. While AS genes evolve at slower evolutionary rates than the genome background, DE genes evolve at much higher rates, similar or even higher than those of seminal fluid proteins, which unveil their potential role for reproductive barriers and the extent of sexual conflict.
Proxies for COVID-19 Diagnosis for Adults in Resource Limited Settings: A Case Series Study in Zambia. 
Authors: Mutengo Katongo H , Kachimba John S , Mupeta Francis
Published: January 2021

The novel coronavirus disease of 2019 (COVID-19); caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has presented a unique range of clinical manifestations. Thought to be primarily a respiratory disorder during its early outbreak in China in early December of 2019, it has now emerged from various scientific studies that the clinical manifestation of COVID-19 is indeed protean. This paper is aimed at exploring various proxies that can be used to increase the index of suspicion for COVID-19 in resource-limited settings like Zambia by reviewing four cases that presented to our health facilities. We hope this will help reduce healthcare costs through instituting early and more targeted treatment approaches.
Atomic Engineering Bifunctional Niobium (V)-based Heterostructure Nanosheet for High Efficiency Lean-Electrolyte Lithium-Sulfur Full Batteries
Authors: Shi Haodong , Qin Jieqiong , Lu Pengfei , Dong Cong , Das Pratteek , Wang Jiemin , Zhang Liangzhu , Wu Zhong-Shuai
Published: January 2021

High-efficiency lithium-sulfur (Li-S) batteries depend on advanced electrode structure that can attain high sulfur utilization at lean-electrolyte and limited lithium. Herein, a twinborn holey Nb4N5-Nb2O5 heterostructure is designed as a dual-functional host for both redox-kinetics-accelerated sulfur cathode and dendrite-inhibited Li anode simultaneously for long-cycling and lean-electrolyte Li-S full batteries. Benefiting from the accelerative polysulfides anchoring-diffusion converting efficiency and electronic-conducting properties of Nb4N5-Nb2O5, polysulfide-shutting is significantly alleviated. Meanwhile, the lithiophilic nature of holey Nb4N5-Nb2O5 is applied as ion-redistributor for homogeneous Li-ion deposition. Taking advantage of these merits, the Li-S full batteries present the excellent electrochemical properties, including a minimum capacity decay of 0.025% per cycle, and a high areal-capacity of 5.0 mAh cm− 2 at sulfur loading of 6.9 mg cm− 2, corresponding to negative to positive capacity ratio (2.4:1) and electrolyte to sulfur ratio (5.1 µl mg− 1). Therefore, this work opens a new avenue for boosting high-performances Li-S batteries towards practical applications.
Determining Future Aflatoxin Contamination Risk Scenarios for Corn in Southern Georgia, USA using Spatio-temporal Modelling and Future Climate Simulations
Authors: Kerry Ruth , Ingram Ben , Garcia-Cela Esther , Magan Naresh , Ortiz Brenda V. , Scully Brian
Published: January 2021

Mycotoxins are toxins produced by fungi which are harmful to humans and animals and can contaminate staple crops. Aflatoxins are particularly toxic and can cause liver cancer so the permitted levels in foodstuffs are legislated. Batches of grain where average aflatoxin concentrations are higher than legislative thresholds are rejected or sold at a lesser price for a more limited range of use. High maximum temperatures and low rainfall have been shown to increase contamination. For corn grown in Southern Georgia, USA, June weather is particularly important as this coincides with the sensitive mid-silk growth stage. An AFs survey and weather data have been used to show the association between AFs and June weather [1]. The risk factors were June maximum temperatures >33˚C and June rainfall <50mm, the 30-year normals for the region. Future climate data were estimated for each year (2000-2100) and county in southern GA using the RCP 4.5 and RCP 8.5 emissions scenarios and weather risk factors were calculated. The number of counties with June maximum temperatures >33˚C and rainfall <50mm increased significantly between 30-year time periods. The percentage of years that counties exceeded thresholds was greater for the RCP 8.5 than the RCP 4.5 scenario. A change in the spatial distribution of high-risk counties was seen over time. The results suggest the need for changes in the where crops are grown or the employment of adaptation strategies such as planting more resistant varieties, improving irrigation and planting earlier to avoid increasingly frequent rejection of grain batches. There were significantly more counties with June maximum temperatures >33˚C and June rainfall <50mm in 2010-2040 compared to 2000-2030. This suggests that adaptation strategies should be employed as soon as possible.
The Implication of Autoantibodies in Early Diagnosis and Monitoring of Plasmonic Photothermal Therapy in the Treatment of Feline Mammary Carcinoma
Authors: El-Rasikh Asmaa M. , Farghali Haithem A. M. , AbdelRahman Hisham A. , Elgaffary Mostafa , Abdelmalek Shaymaa , Emam Ibrahim A. , Ghoneim Magdy A. , Selim Salah A.
Published: January 2021

BackgroundLast year’s plasmonic photothermal therapy (PPTT) achieved great success in the treatment of feline mammary carcinoma and there is a demand for developing an easy, cheap, rapid, sensitive, and specific tool for early diagnosis and monitoring of treatment response.MethodsA panel of four autoantibodies (P53, PCNA, MUC-1, and C-MYC) was evaluated in serum of 11 normal cats and 34 cats diagnosed with mammary tumors before, during, and after the treatment using Enzyme-Linked Immunosorbent Assay (ELISA) assay. Out of the 34 cats, 15 did not receive any treatment, ten cats were treated with PPTT, three cats were treated by mastectomy, and six cats were treated with a combination of PPTT and surgery. ResultsThe panel showed high specificity and sensitivity to mammary tumors. The panel also was efficient in the evaluation of PPTT treatment response as their values decreased significantly after three months from the end of treatment. During the PPTT treatment course, the panel values increased within a month before the appearance of secondary tumors and/or metastasis but this increase was not statistically significant. As a result of the short follow-up period in this study, the studied panel was not valid in early diagnosis of primary and/or recurrent tumors nor the evaluation of treatment response of surgery alone or combination therapy. Cats treated with PPTT monotherapy showed the highest survival rate followed by cats treated with combination therapy then cats treated with mastectomy.ConclusionThe studied autoantibodies panel can be used to evaluate PPTT treatment response after three months of the end of treatment and may be efficient in early diagnosis of primary tumors, secondary tumors, recurrence, or metastasis.Trial registrationAll animals were handled in accordance with the Association for Assessment and Accreditation of Laboratory Animal Care and Office of Laboratory Animal Welfare guidelines. All animal experiments were approved by the Institutional Animal Care and Use Committee (CU-IACUC) Cairo University (code: CU II F 9 16). The animal experiments were carried out after the owner's permission. Written informed consent was provided by each cat owner for the treatments.
Comparison of Polishing Methods Used in Extrinsic Discolouration of Primary Teeth in Terms of Surface Roughiness 
Authors: Duman Burcu , Doğan Salih
Published: January 2021

BackgroundSurface roughness is one of the main factors affecting bacterial adhesion, biofilm growth, plaque formation and coloration on the tooth surface. Improper polishing may increase roughness or not contribute to a reduction in roughness while removing biofilms on tooth surfaces. The aim of this study is to examine the effects of different polishing pastes applied to the enamel of primary teeth on the surface roughness through AFM, which enables a more detailed examination of the measurements, and to evaluate the roughness changes created by the paste on the surface. MethodsIn the present study, in order to compare polishing made using Septodent Détartrine, Kerr Cleanic, Shofu Mersaage Regular under the recommendations of the companies in addition to the application of pumice with a rubber brush, a total of 88 samples with 22 samples in each group were created using 88 primary molar teeth. Before and after polishing, roughness measurements and visualizations were performed with atomic force microscopy (AFM). After polishing, Ra (average roughness) values, which express the surface roughness of the re-scanned samples, were calculated so that the samples were the same as the first scanning. For statistical analysis, Shapiro-Wilk normality test and generalized linear models tests were applied and p <0.05 was considered as statistically significantResultsIn the groups; while there was no significant difference in terms of roughness values ​​(Ra) within the group (p> 0.05), a statistically significant reduction in roughness (Ra) was observed on the sample surfaces after polishing in all groups compared to the baseline (p <0.05). According to the data obtained; all polishing methods used in the treatment of primary tooth discoloration can reduce the plaque formation and thus the amount of recoloring by reducing the surface roughness at a similar level.ConclusionAccordingly, it has been observed that the current polishing pastes do not provide a significant advantage over the traditional polishing method (polishing brush with pumice) in terms of surface roughness in removing discoloration in primary teeth.
Exergetic Evaluation of Steel Coaxial Heat Exchangers
Authors: Blanke Tobias , Hagenkamp Markus , Döring Bernd , Göttsche Joachim , Reger Vitali , Kuhnhenne Markus
Published: January 2021

Background: A proven option to found buildings are geothermally activated steel pipes. Statics determine their dimensions. Energy improvement research focuses on the radius of inner pipe of such coaxial geothermal probes. Mass flow rate is often constant when optimizing inner pipe dimensions. In contrast, in this study flow conditions in outer pipe are constant (constant Reynolds number) to ensure that they not change during optimization. Aim is to maximize net exergy difference for the desired flow type by changing inner pipe radius (after deduction of hydraulic effort). System technology can be selected based on this optimal design and its associated boundary conditions for mass flow and temperatures.Methods: Thermal calculations based on Hellström are carried out to quantify an influence of changing inner pipe radius on thermal yield. A hydraulic optimization of inner pipe radius is performed. Increasing inner pipe radius results in decreasing hydraulic losses in inner pipe but increases hydraulic losses in outer circular ring. Net exergy difference is a key performance indicator to combine thermal and hydraulic effects. Optimization of net exergy difference is carried out for selected scenarios. All calculations are based on various, but fixed Reynolds numbers in the circular ring (Re = [4e3; 1e4; 1e5]), instead of fixed mass flow rates. This ensures fixed flow conditions and no unnecessary high mass flow rate.Results: Optimal inner radius is approximately as large as outer radius considering thermal results. Reynolds numbers are always bigger in inner pipe, due to the constant Reynolds number in circular ring. Both indicate that from a thermal point of view, a high mass flow rate and a high degree of turbulence are particularly important. Hydraulic optimal inner pipe radius is 54% of outer pipe radius for laminar flow scenarios and 60% for turbulent flow scenarios. Exergetic optimization shows a predominant influence of hydraulic losses, especially for small temperature gains.Conclusions: Design of coaxial geothermal probes should focus on the hydraulic optimum and take energetic optimum as a secondary criterion to maximize net exergy difference.
A novel ferroptosis-related 12-gene signature predicts clinical prognosis and reveals immune relevancy in clear cell renal cell carcinoma
Authors: Hong Yingkai , Lin Mingen , Ou Dehua , Huang Zhuangkai , Shen Peilin
Published: January 2021

Background

Clear cell renal cell carcinoma (ccRCC) is still highly aggressive and lethal even with various therapeutic approaches. As kidney is an iron-metabolism-related organ, exploring and assessing the clinical value of ferroptosis, an iron-dependent regulated cell death, is practical and significant.

Methods

Prognostic ferroptosis-related differentially expressed genes (DEGs) were identified from KIRC cohort in TCGA database, from which a prognostic signature was established using the Lasso-penalized Cox regression analysis. Each patient in the KIRC cohort and the E-MTAB-1980 cohort (from the ArrayExpress database) was assigned with a calculated signature-correlated risk score and categorized to be either in high- or low-risk group divided by the median risk score in the KIRC cohort. Then, the independent prognostic value of the signature was further assessed by Kaplan-Meier (K-M) survival, time-dependent receiver operating characteristic (ROC) and Cox regression analyses base on overall survival (OS) in both cohorts. Lastly, risk-related DEGs were identified in both cohorts and applied with the enrichment analyses for Gene Ontology (GO), Kyoto Encyclopedia of Genes and Genomes (KEGG) and immune infiltration.

Results

Within 60 ferroptosis-related genes, 32 prognostic DEGs were identified, from which we constructed a prognostic 12-gene signature including CARS1, HMGCR, CHAC1, GOT1, CD44, STEAP3, AKR1C1, CBS, DPP4, FANCD2, SLC1A5 and NCOA4. Patients in both cohorts were divided into high- and low-risk group which were visually distributed in two sets and with positive-risk-related mortality. The K-M survival and the ROC curves validated the signature as prognostic valuable with P <0.05 and area under the curve >0.7 in both cohorts, respectively. Multivariate Cox regression further confirmed the risk score as an independent prognostic predictor for OS. Commonly enriched term in GO and KEGG not only shown a highly iron correlation, but also, interesting, an immunity relevancy of 3 immune cells (macrophages, mast cells and regulatory T cell) and 1 immune-related function (antigen processing cell co-stimulation).

Conclusion

We established a novel 12 ferroptosis-related-gene signature which was proved as an independent prognostic predictor for OS and inferred as relating to tumor immunity in ccRCC, however, the underlying mechanism is still poorly characterized and needed further exploration.
Expression of Coiled-Coil Domain Containing Family mRNA and prognostic value in hepatocellular carcinoma
Authors: Zhang Sina , Jin Chen , Yang Yan , Li Haoqi , Ma Jun , Chen Gang , Wang Yi
Published: January 2021

Background: The CCDC family plays a significant role in the development and progression of malignant tumors. However, the relationship between CCDC family members and HCC progression is incompletely known. This study used bioinformatics analysis to investigate the expression as well as clinical prognostic value of CCDC family members in HCC and to predict the role of CCDCs family in the development and progression of HCC. Methods: This study utilized the data from two platforms databases to explore the diagnostic value and prognostic significance of CCDC family members by Cox proportional hazards regression analysis, Kaplan-Meier curve and log-rank test, ROC and nomogram diagnostic and prognostic analysis methods. GSEA and tumor microenvironment analysis were employed to investigate the underlying mechanisms and cell-cell interactions of CCDCs family in the development and progression of HCC. The relationship between mutational signatures and CCDCs family were evaluated in HCC patients with somatic mutation. Results: Five CCDC family members (CCDC34, CCDC137, CCDC77, CCDC93 and CCDC21) mRNA expression showed significantly higher in HCC tissues than in normal tissues and high expression levels of these genes predicted poor prognosis in HCC patients. The combined effect analysis of five CCDCs family prognostic markers suggests that the prognosis difference for CCDC family members combination was more significant than that for any individual CCDC family genes. We then developed a risk score model that could predict the prognosis of HCC, and nomogram gene expression was visualized with the probability of predicting the prognosis of HCC by clinical factors. GSEA revealed that, while five CCDCs family combined high expression was associated with increased cell cycle progression and low expression was associated with complement activation pathway. Mutation analysis showed that the combined high expression group had a higher TP53 mutation rate than the combined low expression group, and the high expression group showed higher TMB, which was associated with a better prognosis than high TMB. Conclusions: Our data suggest that the expression of CCDC34, CCDC137, CCDC77, CCDC93 and CCDC21 may be potential prognostic markers in HCC and in combination have a strong interaction and better predictive value for HCC prognosis.
Portal Modulation Effects of Terlipressin on Liver Regeneration and Survival in a Porcine Model Subjected to 90% Hepatectomy
Authors: Jo Hye-sung , Park Hyun-Jin , Choi Yoon Young , Seok Jin-I , Han Jae-Hyun , Yoon Young-In , Kim Dong-Sik
Published: January 2021

BackgroundExcessive postoperative portal pressure is associated with post-hepatectomy liver failure and small-for-size syndrome after partial liver transplantation. This study aimed to identify the portal modulation effects of terlipressin on liver regeneration and survival in a porcine model subjected to 90% hepatectomy.MethodsTwenty pigs undergoing 90% hepatectomy were divided into control (n=10) and terlipressin (n=10) groups. Terlipressin 0.5 mg was injected subcutaneously three times a day, from immediately before hepatectomy to 7 days after surgery, for surviving pigs in the terlipressin group. Portal pressure measurement, biochemical analysis, assessment of molecular markers for liver regeneration, and immunohistochemistry were performed in both groups. ResultsThe 7-day survival rate was significantly higher in the terlipressin group than in the control group. Portal pressure in the terlipressin group was lower than that in the control group at 30 min and 1 h after hepatectomy. Total bilirubin level was lower in the terlipressin group than in the control group at 1 h and 6 h after hepatectomy. Proliferating cell nuclear antigen expression was higher in the control group than in the terlipressin group at 6 h after hepatectomy, while the proportion of Ki-67-positive cells was higher in the terlipressin group than in the control group at 7 days after hepatectomy. Endothelin-1 levels reflecting liver injury were lower in the terlipressin group than in the control group at 1 h and 6 h after hepatectomy.Conclusion﻿Terlipressin could optimize liver regeneration and improve survival through rapid and effective portal modulation after extensive hepatectomy.
Six-gene Signature Based on Metabolism Is Closely Related to the Prognosis and Immune Infiltration of Patients With Sepsis
Authors: Feng Huaguo , Pan Qingbo , Wang Yanqin , Zhang Wenfeng , Gong Jianping , Qin Fanbo
Published: January 2021

Background Sepsis is a leading cause of mortality and morbidity in the intensive care unit. Current studies indicated that metabolism associated genes (MAGs) have critical roles in sepsis T his study aim s to construct a gene signature for sepsis and explore its possible mechanism ss. Methods: Differentially expressed metabolism associated genes (DEMAGs) were identified in sepsis patients based on the Gene Expression Omnibus (GEO) database. Univariate and multivariate Cox regression analyses were performed to identify and construct the prognostic gene signature. Quantitative real time PCR was applied to examine the mRNA level of sig nature genes in the sepsis mice model established by cecalligation and puncture (CLP). Next, Gene S et Enrichment Analysis (GSEA) was performed to further understand the underlying molecular mechanisms of gene signature We then assessed the abundance of infiltrating immune cell s in each sample to explore the immune microenvironment of sepsis patient s Finally, the Tumor Immune Dysfunction and Exclusion (TIDE ) and SubMap algorithms were used to explore the immunotherapy response of sepsis patients .Results: A novel six gene signature (including ELANE , NQO2 , TLR2 , PTGDS , SMAD3 , CD3E ) was established for sepsis prognosis prediction , which could accurately predict the overall survival ( of sepsis patients. In the sepsis mice model, except PTGDS, the mRNA expression of the other five genes was consistent with that of sepsis patients. T he result s of GSEA analysis indicate that the prognostic signature w as closely related to immunity function Besides , we found that the risk score was strikingly negatively correlated with the tumor microenvironment (TME) immunecells infiltration and expression of critical immune checkpoints The patients in the low risk group were more likely to benefit from immune therapy through the TIDE and SubMap analysis Conclusion : In conclusion, our signature can predict the OS of sepsis patients and provide potential guidance for exploring patients who may benefit from immunotherapy.
Metabolic Adaptation is Associated With Less Weight and Fat Mass Loss in Response to Low-Energy Diets
Authors: Martins Catia , Roekenes Jessica , Gower Barbara , Hunter Gary
Published: January 2021

Background: The practical relevance of metabolic adaptation remains a controversial issue. To the best of our knowledge, no study has properly evaluated the role of metabolic adaptation in modulating weight loss outcomes. Therefore, the aim of this study was to determine the association between metabolic adaptation, at the level of resting metabolic rate (RMR), and weight and fat mass (FM) loss after low-energy diets (LED), after adjusting for dietary adherence and other confounders. Methods: 71 individuals with obesity (BMI: 34.6±3.4 kg/m2; age: 45.4±8.2 years; 33 males) were randomized to one of three 1000 kcal/day diets for 8 weeks. Body weight, FM and fat-free mass (FFM) (air displacement plethysmography), RMR (indirect calorimetry) and physical activity level (PAL) (armbands) were measured at baseline and at week 9. Metabolic adaptation at week 9 was defined as measured – predicted RMR (using own regression model). Dietary adherence was calculated from RMR, PAL and body composition changes. Linear regression was used to assess the potential role of metabolic adaptation in predicting weight and FM loss after adjusting for dietary adherence, average PAL, sex, baseline FM and FFM and randomization group.Results: Participants lost on average 14±4 kg (13±3%) and presented with metabolic adaptation (-92±110 kcal/day, P<0.001). Metabolic adaptation was a significant predictor of both weight and FM loss (β=-0.01, P<0.001 for both), even after adjusting for confounders (R2=0.88, 0.93, respectively, P<0.001 for both). On average, an increase in metabolic adaptation of 50 kcal/day was associated with a 0.5 kg lower weight and FM loss in response to the LED. Conclusion: In individuals with obesity, metabolic adaptation at the level of RMR is associated with less weight and FM loss in response to LED. Trial registration ID: NCT02944253
Metabolic Adaptation Delays Time to Reach Weight Loss Goals
Authors: Martins Catia , Gower Barbara , Hunter Gary
Published: January 2021

BackgroundThe clinical relevance of metabolic adaptation remains to be fully determined, but its role as a driver of weight regain has been dismissed. It could be hypothesized that metabolic adaptation increases the length of time needed to reach weight loss goals. The aim of this study was, therefore, to determine if metabolic adaptation, at the level of resting metabolic rate (RMR), is associated with time to reach weight loss goals, after adjusting for confounders. Methods65 premenopausal women with overweight (BMI: 28.6±1.5 kg/m2; age: 36.4±5.9 years; 36 Whites and 29 Blacks) followed an 800 kcal/day diet until body mass index ≤25 kg/m2. Body weight and composition (4 compartment model (4CM) and dual x-ray absorptiometry (DXA)) and RMR (indirect calorimetry) were measured at baseline and after weight loss (after a 4-week weight stabilization period). Dietary adherence was calculated from total energy expenditure (TEE) determined by double labeled water measures and DXA body composition changes. Metabolic adaptation was defined as a significantly lower measured vs predicted RMR (from own regression model using 4CM data). A regression model to predict time to reach weight loss goals was developed including baseline body weight, baseline TEE, dietary adherence and metabolic adaptation as predictors. ResultsParticipants lost on average 12.5±3.1 kg (16.1±3.4%) over 155.1±49.2 days. Average dietary adherence was 63.6±31.0%. There was significant metabolic adaptation after weight loss (-46±113 kcal/day, P=0.002) and this variable was a significant predictor of time to reach weight loss goal (β=-0.1, P=0.033), even after adjusting for confounders (R2 adjusted = 0.59, P<0.001). ConclusionIn premenopausal women with overweight, metabolic adaptation after a 16% weight loss increases the length of time necessary to achieve weight loss goals. Trial registration ID (JULIET study)﻿NCT00067873
Successful Treatment of Necrotizing Fasciitis of the Upper Extremity Caused by Vibrio vulnificus: Two Case Reports and Literature Review
Authors: Guo Pengchao , Li Nan , Zhao Quangfeng , Hu Xueqing
Published: January 2021

Background: Vibrio vulnificus infection patients are more common in China's coastal areas and military activities, but there have been very rare reports successful treatment and limb salvage patients. Case presentation: We present two cases of patients with the successful treatment of necrotizing fasciitis caused by V. vulnificus and review the pathogenetic mechanism, epidemiology, clinical characteristics, and treatment of this infection.Conclusion: When Vibrio vulnificus patients develop bacteraemia and necrotizing fasciitis symptoms,emergency surgical debridement combined with anti-infection therapy should be considered.
A Long-Term Control Study of the Treatment of Cervical Radiculopathy by Percutaneous Endoscopic Posterior Cervical Discectomy and Anterior Cervical Decompression, Bone Graft Fusion and Internal Fixation
Authors: Huang Xiaodong , Wang Weiheng , Meng Qingxi , Yu Jiangming , Ye Xiaojian
Published: January 2021

Background: Cervical spondylotic radiculopathy (CSR) is very common all over the world. However, there are only a few reports about the efficacy of percutaneous endoscopic posterior cervical discectomy (PEPCD) in the treatment of CSR. Anterior cervical decompression and fusion (ACDF) and PEPCD which is a better way to treat CSR need further study.Methods：From January 2015 to December 2016. A retrospective study of 70 patients undergoing surgery for CSR (33 using PEPCD and 37 using ACDF). The intra-operative parameters, neck disability index (NDI), neck and arm visual analog scale (VAS) score were used to assessed clinical outcome. Radiological outcomes were assessed by measuring cervical 2-7 (C2-7) lordosis, disc height index (DHI), and degree of degenerative changes at the corresponding level.Results: The mean follow-up period was 48.5 month (36 –66 months). Two groups can significantly improve the clinical symptoms. There was no significant difference between the two groups in clinical results (VAS, NDI). Compared with preoperative, the lordosis of C2-7 increased significantly at the last follow-up. At the last follow-up, C2-7 lordosis in the ACDF group was significantly higher than that in the PEPCD group. In PEPCD, compared with preoperative, there was no significant difference in the DHI, but the degree of disc degeneration was significantly increased at the last follow-up.Conclusion: For patients with CSR, PEPCD had similar clinical early and intermediate outcomes when compared with ACDF, with the advantages of minimally invasive. PEPCD is a sufficient and safe supplement and alternative to conventional surgery.
Efficient Performance of Chiral Boron Nitride Nanotubes as Suitable Selector for Separation of Ibuprofen Enantiomers Using DFT-D3 Calculations and Molecular Dynamics Simulation
Authors: Rasoolidanesh Melahatsadat , Ganji Masoud Darvish
Published: January 2021

The authors have requested that this preprint be removed from Research Square.
Native Metals in Far Eastern Brown Coal (Russian Federation) 
Authors: Lavrik Nataliya Analolievna , Rasskazova Anna Vadimovna , Lavrik Alexandra Viktorovna , Burdonov Alexandr Evgenievich
Published: January 2021

Metal-bearing brown coal and coal ash can have a practical importance as the alternate sources of metals. Brown coal of Sutarsk and Ushumunsk deposits, as well as other coal deposits of the Far East, contain rare and rare-earth, precious and ferrous metals. At a comprehensive approach they can be sequentially extracted from ashes of coals in a production string. The possibility of metal extraction heavily depends on mode of their occurrence and grain size. In coals and coal ash of the researched deposits metals are localized in various mineral phases: oxides, sulfides, carbonates, phosphates, in a native mode of occurrence and as a part of intermetallic compounds. Particles are usually fine (1-30 microns). Gold, silver, copper, bismuth, iron, titanium, tungsten, zinc, barium, alloy of rare earths (cerium - lanthanum - neodymium) are found in native mode of occurrence. The interesting fact is that mode of occurrence of metals typical both for the reduction and oxidizing conditions are observed in one sample. It is necessary to account for the processing and extraction of metals from coal ashes that the most mineral particles are small and characterized by various morphology and composition.
Spinosin Attenuates Osteoclastogenesis Through Suppressing NF-κB by the Activation of Nrf2/HO-1 Signaling in Osteoporosis
Authors: Liu Bo , Zhang Yuna
Published: January 2021

ObjectiveOsteoporosis is a prevalent metabolic skeletal disorder featured by microarchitecture bone injury and excessive osteoclastic activity.Here, we aimed to explore the effect of Spinosin on osteoclastogenesis of osteoporosis.DesignThe receptor activator of nuclear factor-kappaB ligand (RANKL)-induced osteoclastogenesis model was established in bone marrow macrophages (BMMs) in vitro. The ovariectomy (OVX)-induced bone loss mouse model was constructed in vivo, followed by micro-CT analysis, Histomorphometric analysis, Hematoxylin and Eosin (H&E) and TRAP staining.ResultsOur data showed that the treatment of Spinosin significantly inhibited the TRAP positive osteoclast and bone resorption induced by RANKL in the BMMs. Spinosin significantly reduced the expression of osteoclast-specific factors, including osteoclast stimulatory transmembrane protein (OC-STAMP), dendritic cell-specific transmembrane protein (DC-STAMP), cathepsin K (CTSK), TRAP, c-Fos and nuclear factor of activated T cells cytoplasm 1 (NFATc1)， in the RANKL-treated BMMs. Mechanically, Spinosin was able to inactivate NF-κB by stimulating Nrf2/HO-1 signaling in BMMs. The trabecular space (Tb.Sp), trabecular number (Tb.N), trabecular thickness (Tb.Th), and bone volume to total volume (BV/TV) were inhibited by OVX treatment, and Spinosin could reverse the effect in the bone resorption mouse model. The OVX-induced serum levels of tumor necrosis factor-α (TNF-α) and tartrate-resistant acid phosphatase 5 B (TRAcp5B) were blocked by Spinosin in the mice. Moreover, Spinosin was able to alleviate OVX-induced loss of femur bone and osteoclasts in vivo.ConclusionsIn conclusion, Spinosin attenuates osteoclastogenesis of osteoporosis through inhibiting NF-κB by activating Nrf2/HO-1 expression. Spinosin may serve as the potential candidate for the treatment of osteoporosis.
Metabolic Effects of PCSK9 Inhibitors in a Tertiary Care Center – Real World Data
Authors: Fischer Laurenz T , Hochfellner Daniel A , Knoll Lisa , Pöttler Tina , Mader Julia K , Aberer Felix
Published: January 2021

BackgroundThe lipid-lowering and positive cardiovascular effect of proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors was shown in several studies, hence, they are more widely used in the lipid-lowering management of patients with high cardiovascular risk. As real-world data are still scarce, the aim of this retrospective analysis was to investigate the efficacy of PCSK9 inhibitors in lowering low-density lipoprotein cholesterol (LDL-C) in an outpatient clinic of a tertiary care center in routine care.MethodsA retrospective analysis of data extracted from the electronic patient record was performed. Patients who were routinely prescribed with PCSK9 inhibitor therapy (Alirocumab or Evolocumab) during the years 2016 and 2019 were included in the analysis. Characteristics of the patient population, the effects on LDL-C and HbA1c levels were assessed over the course of treatment.ResultsWe identified 237 patients treated with PCSK9 inhibitors between January 2016 and September 2019. Almost all patients (97.5%) received PCSK9 inhibitors for secondary prevention. Comorbidities at baseline included: arterial hypertension (68.8%), diabetes mellitus (25.3%), smoking (5.9%). Vascular disease at baseline was present as follows: coronary heart disease (74.7%), history of stroke or transient ischemic attack (13.5%), carotid artery disease (30.8%), peripheral artery disease (18.1%), chronic kidney disease (9.7%), history of percutaneous coronary intervention (46.4%), history of coronary artery bypass surgery (16.0%).Intolerance to statins (83.1%), ezetimibe (44.7%), and both agents was reported frequently (42.6%).Six to nine months after initiation of PCSK9 inhibitor therapy, 61.7% of the patients achieved LDL-C levels ≤70 mg/dl, and 44.3% achieved LDL-C levels ≤55 mg/dl. The median LDL-C was lowered from 141 (IQR 117 - 188) mg/dl at baseline, to 60 (43 - 91) mg/dl (6 to 9 months) and 67 (44 - 89) mg/dl (12 to 18 months) indicating a reduction of LDL-C as follows: -54.9% (interquartile range (IQR) 44.4 – 57.3) after 6 to 9 months, -53.2% (IQR 42.6 – 67.1) after 12 to 18 months from baseline. ConclusionsSignificant reductions in LDL-C and a high percentage of patients achieving recommended treatment targets were observed. Still some patients did not achieve LDL-C levels recommended in current guidelines. Special attention to the characteristics of these patients is required in the future to enable achievement of treatment goals and avoid adverse cardiovascular outcomes.
Combination of the pedicled penile skin flap with the penile advancement flap as a coverage technique for repair of urethrocutaneous fistulas secondary to urethroplasty
Authors: Jin chongrui , Sa Yinglong , Xu Yuemin , Fu Qiang
Published: January 2021

Background: The urethrocutaneous fistula is a common complication secondary to urethroplasty. The management is complex and not standard yet. We report our experience and techique with combined pedicled skin flap and local skin advancement flap for urethrocutaneous fistulas secondary to urethroplasty. Methods: We retrospectively analysed data of 36 cases of urethrocutaneous fistulas secondary to different urethroplasties treated from January 2014 to January 2019. All patients underwent treatment with the combination of a pedicled penile skin flap and local skin advancement flap as a coverage technique. The fistula size, fistula location, number of fistulas, and surgical outcomes of fistula repair were recorded. Postoperative evaluation included voiding cystourethrography, uroflowmetry. All patients underwent postoperative follow-up for 6 to 12 months. Results: Fistula repair was successfully performed in all 36 patients. The overall success rate of urethrocutaneous fistula repair was 30/36 (83.3%). Three patients were cured after a second surgery, one was cured after wound dressing, and two were lost to follow-up after failure of the second surgery. Among all patients, the treatment success rate for urethrocutaneous fistulas in the coronal sulcus, penis, penoscrotal junction, and perineum was 2/2 (100%), 21/26 (80.8%), 5/6 (83.3%), and 2/2 (100%), respectively. The treatment success rate for small- and large-diameter urethrocutaneous fistulas was 23/27 (85.2%) and 7/9 (77.8%), respectively. The treatment success rate for single and double urethrocutaneous fistulas was 28/33 (84.8%) and 2/3 (66.7%), respectively. During the 6- to 12-month follow-up, one patient developed a urethral stricture at the urethral fistula repair site and was cured by urethral dilation Conclusions: The repair of urethrocutaneous fistula secondary urethroplasty induces minimal trauma but is quite challenging for surgeons and has a high failure rate. The combined pedicled skin flap and local skin advancement flap for coverage the urethrocutaneous fistulas secondary to urethroplasty can improve the success rate.
Functional and Clinical Outcome With Modified Lateral Approach Total Hip Arthroplasty in Stiff Hips With Ankylosing Spondylitis 
Authors: JACOB MATHEW KIRAN , VJ CHANDY , TD HARIHARAN , SHANKAR ARUN , POONNOOSE PRADEEP MATHEW , OOMMEN ANIL THOMAS
Published: January 2021

Background Ankylosing spondylitis at THA have significant hip stiffness with flexion deformity and restricted function. ROM (range of movement) improvement with good functional outcome is seen following THA with modified lateral approach in these hips.Methods 69hips who underwent THA with a modified Hardinge approach in 40patients were evaluated at a mean follow up of 38.33 months (0 to 83 months). Modified Harris hip score, ROM (range of movement), and SF 36 scores were used to assess clinical and functional improvement at review. Results 69 hips with significant decrease in ROM preoperatively with 32 clinically fused hips showed significant improvement in the range of flexion. The mean flexion in 69 hips improved from 29.35 (SD 31.38) to 102.17 degrees (SD10.48). The mean difference of 72.82 with p Value <0.0001 was found to be significant. 45 /69 hips had fixed flexion deformity with 13 hips having a deformity above 30 degrees. The flexion at review was below 90 degrees in 3 hips. Eleven hips had flexion of 90 degrees at review while the remaining 55 hips had flexion above 100 degrees. Modified HHS improved from 17.03(SD 6.02) to 90.66 (SD7.23). SF 36 at review indicated health status in 40 patients as excellent in 11, very good in 20, fair in 3 and poor in 1. Mean mental health score was 84.10(SD11.58)Conclusion Our study suggests that modified lateral approach THA in AS with stiff hips achieves significant improvement in ROM, HHS and quality of life indicated by SF12 and SF36 scores. Modified lateral approach is useful especially in fused AS hips with flexion deformity.
Indicators for measuring health promotion practice among healthcare workers in the Nelson Mandela Bay Municipality, South Africa: A cross sectional study
Authors: Melariri Herbert Ikechukwu , Chimbari Moses J. , Kalinda Chester
Published: January 2021

Background: Measuring indicators for health promotion (HP) practice among healthcare workers is essential if health goals and objectives must be achieved. Such indicators provide connections between health policies and health outcomes; and ultimately add value to healthcare. This study identified indicators of health promotion among healthcare workers and compared them across levels of healthcare facilities in Nelson Mandela Bay Municipality, South Africa. Method: A cross sectional study involving 495 healthcare workers randomly sampled from 23 hospitals including primary, secondary, and tertiary level hospitals was conducted. Questionnaires were distributed to medical doctors, nurses, and allied health workers (AHW) such as social workers, physiotherapists, occupational therapists, and speech therapist. Questions (hereto referred to as dimensions) in the questionnaires were categorized to address Facility Related Indicators (FRI), Health worker related indicators (HRI) and Outcome related indicators (ORI). Descriptive and bivariate analysis were used to identify the indicators of HP among the three HCW groups from the three levels of health care. Indicators observed to be significant in the bivariate analysis were subjected to a multivariate analysis using the multinomial regression model. (p–value < 0.05).Results: Emerging Indicators were grouped into three categories: facility related indicators (FRI), healthcare workers’ related indicators (HRI), and outcome related indicators (ORI). Four FRI dimensions were observed to be predictors of HP among doctors. Two dimensions were positively associated with HP practices while two others were negatively associated with HP practices among medical doctors and AHWs. On the other hand, seven HRI dimensions were significantly associated with HP among medical doctors and AHW. Furthermore, 5 outcome related indicator (ORI) dimensions were significant predictors of HP among medical doctors while only two dimensions were predictors of HP among AHW. The generalized Hosmer–Lemeshow Chi-square test showed that the models for the different HP indicators fit the data.Conclusions:We identified indicators for measuring HP that can be applied at primary, secondary and tertiary hospitals in Nelson Mandela Bay Municipality, South Africa. These indicators which healthcare workers and health systems’ managers in the study area should be aware of may be adapted for use in other areas.
Adjuvant Chemotherapy Guidance for pT1-3N0-1 Breast Cancer Patients with HR+, HER2- subtype: a study based on SEER database
Authors: Qiu juanjuan , Xu Li , Wang Yu , Zhang Jia , Yang Jiqiao , Lv Qing , Du Zhenggui
Published: January 2021

Background

Although the results of gene testing can guide early breast cancer patients with HR+, HER2- to decide whether they need chemotherapy, there are still many patients worldwide whose problems cannot be solved well by genetic testing.
Methods

144 735 patients with HR+, HER2-, pT1-3N0-1 breast cancer from the Surveillance, Epidemiology, and End Results database were included from 2010 to 2015. They were divided into chemotherapy (n = 38 392) and no chemotherapy (n = 106 343) group, and after propensity score matching, 23 297 pairs of patients were left. Overall survival (OS) and breast cancer-specific survival (BCSS) were tested by Kaplan–Meier plot and log-rank test and Cox proportional hazards regression model was used to identify independent prognostic factors. A nomogram was constructed and validated by C-index and calibrate curves. Patients were divided into high- or low-risk group according to their nomogram score using X-tile.
Results

Patients receiving chemotherapy had better OS before and after matching (p < 0.05) but BCSS was not significantly different between patients with and without chemotherapy after matching: hazard ratio (HR) 1.005 (95%CI 0.897, 1.126). Independent prognostic factors were included to construct the nomogram to predict BCSS of patients without chemotherapy. Patients in the high-risk group (score > 238) can get better OS HR 0.583 (0.507, 0.671) and BCSS HR 0.791 (0.663, 0.944) from chemotherapy but the low-risk group (score ≤ 238) cannot.
Conclusion

The well-validated nomogram and a risk stratification model was built. Patients in the high-risk group should receive chemotherapy while patients in low-risk group may be exempt from chemotherapy.
Implementing evidence-based task-strengthening strategies for hypertension control within Ghana’s Community-based Health Planning Services: a concept mapping analysis
Authors: Nyame Solomon , Iwelunmor Juliet , Asante Kwaku Poku , Gyamfi Joyce , Adjei Kwame , Apusiga Kingsley , Onakomaiya Deborah , Adjei Kezia Gladys Amaning , Aifah Angela , Plange-Rhule Jacob , Ogedegbe Gbenga
Published: January 2021

Background

As efforts are made to systematically implement an evidence-based task-strengthening strategy for hypertension control (TASSH) in Ghana, understanding their content can help national, regional and district health stakeholders within Ghana’s Health Services (GHS) identify strategies for enhancing intervention uptake and sustainability in their local context. This study sought to describe national, regional and district health stakeholders’ perspectives and characterize the array of strategies needed to enhance the uptake of evidence-based TASSH within Ghana’s Community-based Health and Planning Services (CHPS) zones.
Methods

This qualitative study was conducted among national, regional and district health stakeholders within GHS serving patients who utilize CHPS zones. The CHPS initiative is Ghana’s flagship strategy for achieving universal health coverage. Semi-structured interviews were conducted with 22 national, regional and district health stakeholders identified via purposive sampling. Interviews were conducted in 2018. Data analysis was conducted between July 2019 and December 2019. Data was analyzed using group concept mapping systems to identify major themes and subthemes.
Results

About 68 % of participants were male with mean age of 40 years and mean years of experience providing hypertension-related care within GHS of 9 years. A conceptual map emerged, consisting of 46 strategies needed for implementing evidence-based TASSH, organized into 6 clusters: 1) Referral Systems; 2) Availability of Equipment; 3) Protocols and Guidelines; 4) Capacity Building/Training; 5) Policy Reform, and 6) Technical Support and Supervision. Availability of equipment was rated as the most important strategy (mean 4.80 out of 5) needed to implement evidence-based TASSH, while Capacity Building/Training was rated as the most feasible strategy (mean 4.20 out of 5) to address. Although important (mean 4.40 out of 5), Policy reform was rated as the least important and feasible strategy to address.
Conclusions

These findings demonstrate strategies that can help inform future interventions focused on the adoption and sustainability of evidence-based TASSH within Ghana’s CHPS zones. Also, national, regional and district health stakeholders can support healthcare workers by facilitating access to equipment and strategies for enhancing capacity and training with implementing evidence-based task-shifting hypertension interventions in Ghana.