bluuebunny/crossref_metadata_2025 huggingface dataset:
Morphology of large-scale debris avalanche deposits in Cianjur Plains, West Java, Indonesia
Authors: Setiawan A. , Syafri I. , Yuningsih E.T. , Sudradjat A. , Burhanudinnur M.
Published: October 2021

Large-scale debris avalanche deposit (DAD) processes rarely occur, but the impact is catastrophic. Large-scale flank collapse from ancestral Gede volcano resulted in the deposition of debris avalanche deposits that manifested as prominent hummocky hill landforms covering 192 km2 of the Cianjur Plains, West Java, Indonesia. Although the deposit covers large areas and shows unique volcanic landscape morphology, studies on debris avalanche deposits are limited. Here, we show the results of field reconnaissance, satellite photography and digital elevation model analysis to understand the morphology of large-scale debris avalanche deposits, including their distribution and morphological characteristics. The interpreted thickness of the deposit ranges from 200-500 m, although the hummocky hill with a well-rounded texture is only 50-100 m high due to intense erosion in the tropical region with the remaining portion of the megaclast blocks buried. The distribution of hummocky hills indicates that the flow was constrained by the pre-existing basin configuration. The debris avalanche deposit shows fan-like morphology that characterizes block facies located near the fan mouth, while the matrix facies has matrix-supported smaller blocks in the distal part. The mouth of the debris avalanche deposit is located just south of Cianjur township, with the highest concentration of megaclast block as block facies, which is interpreted as the main depositional axis. The block facies apparently stopped by lineament of the SW-NE-oriented Cimandiri valley to the southeast and NNE-SSW-oriented Cisokan River lineament to the east, which was interpreted as a buried normal fault that was considered a barrier to confine the flow of block facies deposition.
Material Scarcity and Unethical Economic Behavior: A Systematic Review and Meta-Analysis
Authors: Elbaek Christian , Mitkidis Panagiotis , Aarøe Lene , Otterbring Tobias
Published: October 2021

Individuals around the globe experience different forms of material resource scarcity in terms of aspects such as hunger, thirst, or financial strains. As experiences of material scarcity have been found to make individuals more risk-taking, impulsive, and focused on regaining resources in the short-term, a growing body of research has investigated how such scarcity affects moral economic behavior. Yet, findings remain mixed and at times contradictory, thus calling for a systematic meta-analytical review on this overarching topic. In this pre-registered systematic review and meta-analysis, we evaluate qualitatively and quantitatively how material resource scarcity affects moral economic behavior. We analyze a comprehensive dataset including 44 published and unpublished studies comprising a total of 6,921 respondents across four distinct types of material scarcity: financial scarcity, physiological scarcity, scarcity reminders, and lower social class. Our findings show that acute scarcity significantly increases the propensity to engage in unethical economic behavior (gfinancial = .24, gphysiological = .39, greminders = .32). Importantly, we find no evidence that chronic experiences of scarcity in the form of low social class affect unethical economic behavior (gsocial class = .02). These results appear robust to the influence of publication bias and contextual sensitivity. We discuss how these findings advance our understanding of the psychological and moral consequences of scarcity and elaborate on implications for public policy.
Transfer Learning Based Multiclass Classification For Covid-19 Detection Using Chest X-Rays
Authors: Monga Japman Singh , Champawat Yuvraj Singh , Kharb Seema
Published: October 2021

In the year 2020 world came to a halt due to spread of Covid-19 or SARS-CoV2 which was first identified in Wuhan, China. Since then, it has caused plethora of problems around the globe such as loss of millions of lives, economic instability etc. Less effectiveness of detection through Reverse Transcription Polymerase Chain Reaction and also prolonged time needed for detection through the same calls for a substitute for Covid-19 detection. Hence, in this study, we aim to develop a transfer learning based multi-class classifier using Chest X-Ray images which will classify the X-Ray images in 3 classes (Covid-19, Pneumonia, Normal). Further, the proposed model has been trained with deep learning classifiers namely: DenseNet201, Xception, ResNet50V2, VGG16, VGG-19, InceptionResNetV2 .These are evaluated on the basis of accuracy, precision and recall as performance parameters. It has been observed that DenseNet201 is the best deep learning model with 82.2% accuracy.
Optical Multi-Imaging-Casting Accelerator for Fully Parallel Universal Convolution Computing
Authors: Zhou Changhe , Ma Guoqing , Zhu Rongwei , Yu Junjie
Published: October 2021

Over the last few years, optical computing has become a potential solution to computationally heavy convolution, aimed at accelerating various artificial intelligence applications. However, past schemes have never efficiently realized fully parallel optical convolution. Here, we propose a new paradigm for a universal convolution accelerator with truly massive parallelism and high precision based on optical multi-imaging-casting architecture. Specifically, a two-dimensional Dammann grating is adopted for the generation of multiple displaced images of the kernel, which is the core process for kernel sliding on the convolved matrix. Our experimental results indicate that the computing accuracy is typically close to 8-bit, and this accuracy can be improved further by using hybrid analog–digital coding method. In addition, a convolutional neural network for the standard MNIST dataset is demonstrated, and the recognition accuracy for inference is up to 97.3%. The paradigm reported here will open new opportunities for high-throughput universal convolution accelerators for real-time or quasi-real-time AI applications.
Prognostic Signature based on Transcriptome Characteristics of the C-C Motif Chemokine Receptor Genes in Hepatocellular Carcinoma and Validation
Authors: Zhou Xin , Nong Ju-sen , Li Tian-man , Wei Zhong-liu , Lan Chen-lu , Fu Tian-hao , Liao Xi-wen , Ye Xin-ping , Peng Tao
Published: October 2021

Object: This investigation aimed to assess the clinical significance of C-C motif chemokine receptor (CCR) genes in HCC and construct the prognostic signature based on transcriptome characteristics of the CCRs. Methods: Clinical significance of CCRs were evaluated in TCGA database and GSE14520 dataset, and prognostic CCRs (CCR1,5,7) were screened out for validation and further analysis. The relationships between CCR1,5,7 and prognosis were then evaluated in the Guangxi cohort. Based on the expression levels of CCR1,5,7 and clinicopathological characteristics, the nomograms and prognostic signatures were respectively constructed in GSE14520 dataset and Guangxi cohort. Results: CCR1,5,7 were associated with overall survival of the HCC patients in GSE14520 database, TCGA database or Guangxi cohort. In the prognostic signature, the accuracy of prognosis risk assessment based on CCR1,5,7 expression was satisfactory. The nomogram constructed in terms of the expression levels of CCR1,5,7 and clinicopathological characteristics provided a convenient tool for clinician to assess the prognostic risk of each patient. GSEA results suggested that CCRs were mainly related to B cell receptor signal pathway, chemokine signaling pathway, T cell receptor signal pathway, etc. In addition, we also found that CCR1,5,7 were significantly positively correlated with the degree of immune infiltration of B cells, T cells, and macrophagesConclusion: CCR1,5,7 might serve as prognostic biomarkers in HCC; CCR1,5,7 might regulate the progression of HCC by impacting immune cells infiltration.
Reduced CXCR4 expression in associated with extramedullary and predicts poor survival in newly diagnosed multiple myeloma
Authors: Chen Dangui , Chen Ying , Zhan Yang , Yan Hong , Liang Hong , yao fusheng
Published: October 2021

Multiple myeloma (MM), a bone marrow-resident hematological malignancy of plasma cells, has remained largely incurable despite the advancement of novel therapies in recent years. Because of the heterogeneity of myeloma cells, risk stratification of MM is important for making therapeutic regimens. Nevertheless, no immunohistochemical (IHC) predictive and prognostic marker of MM has been constructed yet. Herein, the prognostic value of C-X-C motif chemokine receptor 4 (CXCR4) expression in 48 newly diagnosed MM patients was explored using IHC. Correlations between CXCR4 expression and clinical features of MM were analyzed. CXCR4-positive patients significantly outperformed CXCR4- negative patients in both 3-year estimated overall survival (93.8% vs 45.8%) and progression-free survival (57.1% vs 40.9%). The incidence of extramedullary lesions in CXCR4-negative patients increased significantly compared with CXCR4-positive patients. Plasma cells that reduce CXCR4 expression have poor prognosis and increase the incidence of extramedullary lesions.
Intestinal Gluconeogenesis Shapes Gut Microbiota, Fecal and Urine Metabolome in Mice with Gastric Bypass Surgery
Authors: Vily-Petit Justine , Barataud Aude , Zitoun Carine , Gautier-Stein Amandine , Serino Matteo , Mithieux Gilles
Published: October 2021

Background&Aims: Intestinal gluconeogenesis (IGN), gastric bypass (GBP) and gut microbiota positively regulate glucose homeostasis and diet-induced dysmetabolism. GBP modulates gut microbiota but whether IGN intensity could shape it has not been investigated. Methods: To this aim, we studied gut microbiota and microbiome in wild-type and IGN-deficient mice which underwent GBP and were fed on either a normal chow (NC) or a high-fat/high-sucrose (HFHS) diet. We also studied fecal and urine metabolome in NC-fed mice. Results: IGN and GBP had a peculiar effect on both gut microbiota and microbiome, on NC and HFHS diet. IGN inactivation induced Deltaproteobacteria on NC and higher Proteobacteria such as Helicobacter on HFHS diet. GBP induced higher Firmicutes and Proteobacteria on NC-fed WT mice and Firmicutes, Bacteroidetes and Proteobacteria on HFHS-fed WT mice. The combined effect of IGN inactivation and GBP induced higher Actinobacteria on NC and higher Enterococcaceae and Enterobacteriaceae on HFHS diet. A reduction was observed in short-chain fatty acids in fecal (by GBP) and in both fecal and urine (by IGN inactivation) metabolome. Conclusions: IGN and GBP, alone and in combination, shape gut microbiota and microbiome on NC- and HFHS-fed mice, together with a change in fecal and urine metabolome.
Longitudinal Study on the Progression of Muscle Status Among Community-Dwelling Ambulatory Older Multiethnic Asians With Type 2 Diabetes Mellitus
Authors: Tan Ngiap Chuan , Sankari Usha , Ng Chiat Eng , Ling Eileen Koh Yi
Published: October 2021

Background:Muscle health decline with age, but its deterioration in older persons with type-2 diabetes mellitus (T2DM) over time is not well-established. This study aimed to determine the change in muscle mass, grip strength and gait speed over a period of observation among community-dwelling ambulatory older multi-ethnic Asian patients with T2DM and their associated factors.Methods:Among 387 eligible patients aged 60-89 years who were recruited at baseline, 348 (89.9%) were reviewed at a public primary care clinic in Singapore in the subsequent 9 to 34 months. The change in their clinical and functional status, levels of physical activity and muscle status (mass, grip strength and gait speed based on the Asian Working Group for Sarcopenia criteria) were recorded and compared. Their physical activity levels were assessed using the Physical Activity Scale for the Elderly (PASE) and International Physical Activity Questionnaire (IPAQ). Their quality of life was evaluated based on the World Health Organization Quality of Life (WHOQOL) domains. Linear regression analysis was used to identify the factors associated with muscle health change.Results:The study population comprised men (52.9%), Chinese (69.3%), Malay (15.5%), Indian (8.6%), mean age of 68.4±SD5.6 years and had at least secondary education (76.4%). Overall, their mean muscle mass significantly decreased by 0.7±SD1.2kg/m2, mean grip strength by 1.0±SD4.6kg and negligible change in gait speed. Their mean weight significantly decreased by 0.5±SD3.9kg, waist and hip circumferences by 2.5±SD6cm and 3.2±SD5.1cm respectively, with no change in BMI. Linear regression shows significant associations between muscle mass and education level (β=0.29, p=0.040, 95%CI=0.01-0.56), BMI (β=0.10, p=0.001, 95%CI=0.04-0.16) and review interval (β=-0.003, p<0.001, 95%CI=-0.004--0.002); gait speed is associated with singlehood (β=-0.12, p=0.035, 95%CI=-0.23--0.01) and WHOQOL physical health (β=0.01, p=0.028, 95%CI=0.00-0.02) domain. No factor is associated with hand grip strength change.Conclusions:The study population showed significant decline in their mean weight, waist and hip circumferences, mean muscle mass and mean grip strength but gait speed was unaffected. Muscle mass change was associated with education level, BMI and length of review interval. Grip strength was not correlated with any significant factor. Gait speed was associated with singlehood and physical health.
Clinically Significant Prostate Cancer Detection with Various Prostate Sampling Schemes Based on Different csPCa Definitions
Authors: Wang Fei , Chen Tong , Wang Meng , Chen Hanbing , Wang Caishan , Liu Peiqing , Liu Songtao , Luo Jing , Ma Qi , Xu Lijun
Published: October 2021

Background Combining targeted biopsy (TB) with systematic biopsy (SB) is currently recommended as the first-line biopsy method by the European Association of Urology (EAU) guidelines in patients diagnosed with prostate cancer (PCa) with an abnormal magnetic resonance imaging (MRI). The combined SB and TB indeed detected an additional number of patients with clinically significant prostate cancer (csPCa); however, it did so at the expense of a concomitant increase in biopsy cores. Our study aimed to evaluate if ipsilateral SB (ipsi-SB) + TB or contralateral SB (contra-SB) + TB could achieve almost equal csPCa detection rates as SB + TB using fewer cores based on a different csPCa definition.Methods Patients with at least one positive prostate lesion were prospectively diagnosed by MRI. The combination of TB and SB was conducted in all patients. We compared the csPCa detection rates of the following four hypothetical biopsy sampling schemes with those of SB + TB: SB, TB, ipsi-SB + TB, and contra-SB + TB. Results The study enrolled 279 men. The median core of SB, TB, ipsi-SB + TB, and contra-SB + TB was 10, 2, 7 and 7, respectively; they all differed significantly from SB + TB (P < 0.001). ipsi-SB + TB detected significantly more patients with csPCa than contra-SB + TB based on the EAU guidelines (P = 0.042). ipsi-SB + TB and contra-SB + TB detected almost equal number of csPCa on the basis of the Epstein criteria (P = 1.000). Compared with SB + TB, each remaining method detected significantly fewer patients with csPCa regardless of the definition (P < 0.001) except ipsi-SB + TB, which achieved an almost equivalent csPCa detection rate to that of SB + TB on the grounds of D1 (P = 0.066).Conclusions ipsi-SB + TB could detect significantly more patients with csPCa than contra-SB + TB and acquire an almost equivalent csPCa detection rate to that of SB + TB using significantly fewer cores when csPCa was defined as International Society for Urological Pathology (ISUP) 2 or higher.
The Feasibility and Effects in Full Staging Surgery of Endometrial Cancer by Combination of Transumbilical Single-port Laparoscopy and ERAS
Authors: Cai Zhifu , Chen Mengjie , Wang He , Li Li
Published: October 2021

BackgroundsTo study the safety, feasibility and aesthetics of transumbilical single port laparoscopic technology combined with accelerated rehabilitation surgery in stage I endometrial cancer staging surgery, and whether the laparoscopic surgery is a factor affecting the prognosis of endometrial cancer. MethodsA total of 93 patients with type I endometrial cancer stage I were enrolled in this study, including 31 cases and 62 cases in the single port and multi-port laparoscopic groups, respectively. Both groups received ERAS technology to compare the intraoperative and postoperative conditions. Subsequently, the medical records of 62 patients who had undergone open surgery were collected, and the survival, recurrence and death of the single port laparoscopic group, the multi-port laparoscopic group and the open surgery group were compared through survival analysis. ResultsThe time of surgery, intraoperative blood loss and fluid infusion volume in the single port group and the multi-port group were significantly less than those of the multi-port group (P<0.05). The single-hole group was better than the open group in terms of rapid postoperative recovery, hospitalization days, incision abdominal incision cometic effect, physical function, physical pain, vitality, and mental health (P<0.05). And there is no significant differences of mortality and recurrence among single port, multi-port and open surgery (P>0.05). Laparoscopic surgery is not a risk factor affecting OS and DFS in patients with endometrial cancer. ConclusionsTransumbilical single port laparoscopy combined with ERAS was safe and feasible for the treatment of stage I endometrial cancer with good cosmetic results and more advantages than multi-port laparoscopy.
Attitudes Toward Aging And Happiness In Chinese Old Adults：A Mediating Effect of Spirituality
Authors: Li Jie
Published: October 2021

Background: Attitudes toward aging in old adults are critical for their adjustment, health-promoting behavior, quality of life and life satisfaction. However, fairly little is known about the inner mechanism between attitudes toward aging and happiness in Chinse old adults. This study examined the relationship between attitudes toward aging and happiness in old adults by introducing the mediator of spirituality in a Chinese context. Methods: A descriptive cross-sectional study among persons aged 50 to 100 years old was carried out in 16 selected cities of 9 provinces (municipality) in Western,Central,and Eastern China. Trained research assistants collected data by face to face interview with the aid of online questionnaire. The Attitude to Aging Questionnaire (AAQ),Howden’ Spirituality Assessment (SA),and Memorial University of Newfoundland Scale of Happiness (MUNSH) were used to measure participants’ attitudes toward aging,spirituality and happiness. Data were analyzed using SPSS 25 and AMOS 24.Results: The mean scores of AAQ and its three domains of psychosocial loss, physical change and psychological growth,spirituality and happiness were 81.85(+10.39), 26.46(+4.97), 28.34(+4.69), 27.01(+4.02),101.06 (+12.88),and 31.72 (+9.87), respectively. Three domains, spirituality and happiness were positively correlated with each other. The spirituality acted as a full mediator on the positive relationship between the two domains of physical change and psychological growth and happiness.Conclusions: First, Chinese old adults’ attitudes toward aging was positive and positively related to spirituality and happiness; second, Chinese old adults’ spirituality was high and positively related to happiness; third, Chinese old adults’ happiness was fair and the significantly positive association between old adults’ attitude toward aging (i.e. physical change and psychological growth) and happiness was entirely due to the growth of spirituality.
Biocompatible Iron Sulphide Nanoparticles Against Neuroinflammation for Intracerebral Haemorrhage and Long-term Neurological Functional Recovery
Authors: Zhang Song , Xiong Tianqing , Yuan Yuan , Zhuang Wenwen , Xu Yijun , Zhang Jingwen , Tao Chunhua , Liang Jingyan , Xu Zhuobin
Published: October 2021

BackgroundMass effects of haematoma, neuroinflammation, oxidative stress, and neuronal apoptosis are the major causes of poor prognosis of intracerebral haemorrhage (ICH). Our previous study suggests that biocompatible iron sulphide nanoparticles possess peroxidase-like activity and can release hydrogen polysulfanes, which may inhibit brain injury. The purpose of this study was to investigate the neuroprotective efficacy of diallyl disulfide (DADS)-nFeS in mice after ICH and preliminarily illustrate the potential mechanism. MethodsAdult male C57BL/6 mice (n = 176) were injected with bacterial collagenase in the striatum. In the first part, DADS-nFeS at different doses (25, 50, or 100 mg/kg) was intragastrically administered 2 h, 26 h, and 50 h before ICH. In the second and third parts, DADS-nFeS (50 mg/kg) was administered 2 h, 26 h, and 50 h before and after the induction of ICH in the pre-treatment group and post-treatment group, respectively. H&E staining was performed to detect drug toxicity. Haematoma volume measurement, Fluoro-Jade C (F-JC) staining, Nissl staining, immunofluorescence staining, western blotting, terminal deoxynucleotidyl transferase dUTP nick end labelling (TUNEL) staining, malondialdehyde (MDA) and superoxide dismutase (SOD) assays, and neurobehavioural tests were performed. ResultsAll three doses of DADS-nFeS had neuroprotective effects, and 50 mg/kg resulted in the best outcome. DADS-nFeS reduced the haematoma volume and MDA content, inhibited the activation of microglia and astrocytes, progressive neuronal degeneration, and apoptosis, increased SOD activity and neuronal survival, and improved both short-term and long-term neurological functions in perihaematomal areas after ICH. Moreover, DADS-nFeS was associated with the downregulation of Iba-1, GFAP, TNF-α, IL-1β, 4-hydroxynonenal (4-HNE), and Bax/Bcl-2 levels in perihaematomal areas after ICH. Finally, post-treatment with DADS-nFeS had a better effect than pre-treatment with DADS-nFeS. ConclusionsOur study indicated that gavage administration of DADS-nFeS decreased the haematoma volume, suppressed neuroinflammation, oxidative stress, and neuronal apoptosis, and improved short- and long-term neurological functions, which was, at least in part, realized by inhibiting the activation of microglia and astrocytes, enhancing local SOD activity, and decreasing the recruitment of reactive oxygen species. Therefore, DADS-nFeS may serve as a potential therapeutic strategy via the diet against central nervous system diseases.
Evaluation of the Societal Burden of Rare Diseases in the United States
Authors: Cioffi Gina , Andreu Pedro , Karam Jenny , Child Caroline , Chiesi Giacomo
Published: October 2021

BackgroundMost patients with rare diseases have no effective treatment or cure available to them. However, scarcity of data and disease complexity mean the full extent of the patient, family and social burden of rare diseases remains undocumented. Understanding the cost drivers and the economic impact that a lack of treatment poses is critical for highlighting the unmet need to inform future investments and policymaking.MethodsWe selected five priority therapeutic areas (TAs; metabolic, neurological, congenital, hematological and immunological) encompassing 227 well documented rare diseases. Discussions with patients and physicians identified the 24 most relevant (highest unmet need) diseases within the five TAs. We assessed direct (costs associated with medical care), indirect (costs related to productivity losses) and mortality (costs associated with loss of life) costs. We also assessed these costs for 24 chronic mass-market (MM) diseases. Based on the overall cost burden per patient per year (PPPY) for the rare diseases, a scenario analysis was conducted to assess the average cost if treatments were not available. Lastly, the findings from the initial 24 rare diseases were extrapolated to 227 rare diseases in the five TAs. ResultsThe average cost burden of the 24 diseases analyzed ranged from $121 000 to $334 000 PPPY compared with $26 000 PPPY for MM diseases. Averaging across selected rare diseases, lack of treatment was associated with a 21.2% increase in total costs, from $198 000 to $240 000 PPPY. When these results were extrapolated to 227 rare diseases belonging to the five TAs, similar results were obtained: the average cost of rare diseases was approximately 10 times higher ($266 000 PPPY vs $26 000 PPPY) than for the MM diseases. ConclusionsOur findings demonstrate that rare diseases impose substantial economic burden, which remains high even when treatments are available. However, the cost composition shifts towards medical care and away from other types of burden. To the extent that new treatments provide clinical benefit for patients and their families, these shifts in burden are likely productive. Accelerated progress in the development of diagnostic methods, treatments and updated regulatory frameworks for rare diseases are recommended.
Dual Guidance Structure for Evaluation of Patients with Unclear Diagnosis in Centers for Rare Diseases (ZSE-DUO): Study Protocol for a Controlled Multi-center Cohort Study
Authors: Hebestreit Helge , Zeigler Cornalia , Schippers Christopher , de Zwaan Martina , Deckert Jürgen , Heuschmann Peter , Krauth Christian , Bullinger Monika , Berger Alexandra , Berneburg Mark , Brandstetter Lilly , Deibele Anna , Dieris-Hirche Jan , Graeßner Holm , Gündel Harald , Herpertz Stephan , Heuft Gereon , Lapstich Anne-Marie , Lücke Thomas , Maisch Tim , Mundlos Christine , Petermann-Meyer Andrea , Müller Susanne , Ott Stephan , Pfister Lisa , Quitmann Julia , Romanos Marcel , Rutsch Frank , Schaubert Kristina , Schubert Katharina , Schulz Jörg B. , Schweiger Susann , Tüscher Oliver , Ungethüm Kathrin , Wagner Thomas O. F. , Haas Kirsten
Published: October 2021

Background In individuals suffering from a rare disease the diagnostic process and the confirmation of a final diagnosis often extends over many years. Factors contributing to delayed diagnosis include health care professionals' limited knowledge of rare diseases and frequent (co-)occurrence of mental disorders that may complicate and delay the diagnostic process. The ZSE-DUO study aims to assess the benefits of a combination of a physician focusing on somatic aspects with a mental health expert working side by side as a tandem in the diagnostic process.Study design This multi-center, prospective controlled study has a two-phase cohort design. Methods Two cohorts of 682 patients each are sequentially recruited from 11 university-based German Centers for Rare Diseases (CRD): the standard care cohort (control, somatic expertise only) and the innovative care cohort (experimental, combined somatic and mental health expertise). Individuals aged 12 years and older presenting with symptoms and signs which are not explained by current diagnoses will be included. Data will be collected prior to (T0) and at the first visit (T1) to the CRD’s outpatient clinic and 12 months thereafter (T2). Outcomes Primary outcome is the percentage of patients with one or more confirmed diagnoses covering the symptomatic spectrum presented. Sample size is calculated to detect a 10 percent increase from 30% in standard care to 40% in the innovative dual expert cohort. Secondary outcomes are a) time to diagnosis/diagnoses explaining the symptomatology; b) proportion of patients successfully referred from CRD to standard care; c) costs of diagnosis including incremental cost effectiveness ratios; d) predictive value of screening instruments administered at T0 to identify patients with mental disorders ; e) patients’ quality of life and evaluation of care; and f) physicians’ satisfaction with the innovative care approach. Conclusions This is the first multi-center study to investigate the effects of a mental health specialist working in tandem with a somatic expert physician in CRDs. If this innovative approach proves successful, it will be made available on a larger scale nationally and promoted internationally. In the best case, ZSE-DUO can significantly shorten the time to diagnosis for a suspected rare disease.
Spatial Distribution and Growth Potential of Economically Important Rattan Species in Cameroon Seen Through the Lens of Indigenous Populations
Authors: Nfornkah Barnabas Neba , Kevin Enongene , Rene Kaam , Djomo Chimi Cedric , Forje Gadinga Walter , Awazi Nyong Princely , Delanor Tanougong Armand
Published: October 2021

Background: Rattan is an important Non-Timber Forest Product (NTFP) with huge potentials to boost socio-economic development in indigenous communities of Cameroon in particular and the entire country in general. Exploitation is from the wild, with no implication of stakeholders in renewing the resource, thus leading to resources scarcity. Insufficient knowledge on rattan’s growth potentials in Cameroon jeopardize resource regeneration and renewal. It was in this context that this study was initiated to (i) determine economically important rattan species distribution; (ii) identify their habitats and conservation status; (iii) examine harvester’s perceptions/observations on annual growth rate and age to maturity. Results: It was found that Eremospatha macrocarpa exist in all AEZs, Calamus deerratus was found in AEZ 2 & 5, Laccosperma Secundiflorum, L. Robustum, was found in AEZ 3, 4 and 5 and Eremospatha wendlandiana was found only in AEZ4. They grow in diverse habitat/environments with some habitats/environments specifically suitable for some rattan species. The current conservation status of commercial rattan species identified shows Least Concern (LC); but resource scarcity in high. Most harvesters observed that rattan takes either 2 – 3 years (51%) or 4 – 5 years (35%) to attain maturity. The harvesters’ observation on annual growth rate of economic rattan species varied in relation to the species and AEZs, nevertheless, globally 25% and 23% of the respondents observed a growth rate of 2-3 m and 3-4 m respectively. Kruskal-Wallis test shows a significant variation in harvesters’ perception in the different AEZs for all growth and maturity parameters of different rattan species (p<0.05) except for the number of years it takes for rattan to attain maturity (p>0.05)”.Conclusions: All five economically important rattan species are highly distributed in the Southern zone of Cameroon. The availability of E. macrocarpa in all zones indicates its great adaption. Renewing (plantations) rattan resource implies appropriate planting in the Southern and Coastal regions of Cameroon, since the all the species inhabit and grow rapidly. This is important to policymakers and development planners for policy reformulation towards the sustainable development of rattan in Cameroon.
Novel interferon-gamma-related 2-gene signature predicts outcome and responsiveness to immune checkpoint blockade in glioma
Authors: Li Yongzhe , Ji Hang
Published: October 2021

Background

Glioma represents the most common and aggressive brain malignancy. Interferon-gamma (IFNG)-related gene signatures have been shown of clinical significance in multiple cancers, while its role in glioma remains less addressed.
Methods

A total of 2933 glioma samples ranging from WHO grade II to IV with corresponding demographics were included. Multiple bioinformatics and machine learning algorithms were employed to establish an IFNG-related biomarker to classify survival differences and to elucidate the potential of glioma to respond to immune checkpoint blockade (ICB) therapy.
Results

The ssGSEA score of IFNGR1 and IFNGR2 was defined as the IFNGR score, which well-characterized the IFNG response in the glioma microenvironment. Increased IFNGR score was associated with clinicopathological parameters characterizing glioma malignancy, including WHO grade IV, mesenchymal subtype, and molecular biomarkers, including IDH1 wildtype, 1p19q non-codeletion, and unmethylated MGMT promoter. Consequently, K-M and Cox regression analysis found that the IFNGR score was a robust prognostic biomarker that was associated with tumor relapse for patients in certain subgroups. Moreover, the IFNGR-based group had the potential to predict ICB responsiveness, as effectively as previously validated IFNG-related gene signatures.
Conclusion

Together, we have developed a concise biomarker of clinical significance that may improve the current diagnosis and treatment of glioma.
Optimizing Stand Spatial Structure by Using Neighborhood-Based Quantitative Indicators: A Case of Boreal Forests
Authors: Dong Lingbo , Bettinger Pete , Liu Zhaogang
Published: October 2021

Background: Over the past fifty years, societies have placed increasing demands on forests, and their use has shifted gradually from wood production to the diversified benefits and functions of ecosystem services. The effects of neighborhood-based structural characteristics on regulating growth and promoting sustainability have therefore drawn much attention. However, direction for managing natural mixed forests using neighborhood-based indicators are still not clear.Methods: In this study, a tree-level harvest planning tool that considers four neighborhood-based structural parameters (species mingling, diametric differentiation, horizontal spatial pattern and crowdedness of trees) while concurrently recognizing other operational constraints, was developed using simulated annealing algorithm. The approach was applied to four 1-ha mapped stands in northeast China, namely a natural larch forest (NLF), a natural birch forest (NBF), a natural secondary forest (SEF), and a Korean pine broad-leaved forest (KBF). Results: The tree-level harvest optimization improved the objective function values by approximately 78.33% of NLF, and 134.96% of NBF, and 156.70% of SEF and 252.95%, respectively. The optimal harvest intensities for partial cutting activities varied from 22.16% (SEF) to 26.07% (NBF) of the standing volume. In evaluating the four neighborhood-based structural parameters, both species mingling and crowdedness have the highest priority to be used in structure-based forest management.Conclusions: Our results demonstrated that that the commonly used neighborhood-based structural parameters could be used to control the spatial layout of potential harvest trees, in turn may be conducive to regulate the growth and stability of forests.
Development and Validation of a Nomogram for the Early Prediction of Iga Nephropathy in Primary Glomerulonephritis
Authors: Luo Hou-Long , Cui Lixia , Li Mingyang , Huang Chencui , Liu Wei , Xia Yong , Ji Ling
Published: October 2021

Background: To make early prediction of immunoglobulin A nephropathy (IgAN) before renal biopsy, we developed and validated a new non-invasive nomogram for the early prediction of IgAN in primary glomerulonephritis (GN) in south China. Methods: A total of 431 patients were included in this study and additional 113 patients were included as the independent test cohorts to validate our results. A stepwise regression model was used for features selection. Multivariate logistic regression analysis with 5-fold cross validation was used to validate the result of the stepwise selection. Performance of the logistic regression model was assessed with respect to its calibration, discrimination, and clinical usefulness. Independent test was assessed. Results: We developed a model incorporating age of patients and four clinical chemistry signatures, including serum IgA, serum albumin (ALB), serum phosphorus (P) and 24-hour urinary protein (24hUpro) and presented with a nomogram. The area under the receiver operating characteristic (ROC) curve (AUC) reached 0.89 (95% CI: 0.86–0.92) and 0.88 (95%: 0.85-0.92) in the training set and validation set, respectively. The model also had good performance in independent test cohorts (AUC of 0.82, 95% CI: 0.75–0.90). The DCA and calibration plot of the model also shows good performance. Conclusions: The logistic regression model presented in this study incorporates age of patients, IgA, ALB, P and 24hUpro and can be conveniently used to facilitate the individualized prediction of IgAN.
Functional Orderly Topography of Brain Networks Associated with Gene Expression Heterogeneity
Authors: Liu Wei , Zeng Lingli , Shen Hui , Zhou Zongtan , hu dewen
Published: October 2021

The human cerebral cortex expanded much more relative to non-human primates and rodent in evolution, leading to a functional orderly topography of the brain networks. Here, we show that functional topography may be associated with gene expression heterogeneity in various brain structures. The neocortex exhibits greater gene expression heterogeneity, with lower housekeeping gene proportion, a longer mean path length, less clusters, and a lower degree of ordering of networks, compared to archicortical and subcortical area in human, rhesus macaque, and mouse brains consistently. In particular, the cerebellar cortex displays greater gene expression heterogeneity than cerebellar deep nuclei in the human brain, but not in the mouse brain, corresponding to the emergence of novel functions in the human cerebellar cortex. Moreover, the cortical areas with greater gene expression heterogeneity, primarily located in multimodal association cortex, tend to express genes with higher evolutionary rates and exhibit higher functional connectivity degree measured by resting-state fMRI, implying that such spatial pattern of cortical gene expression may be shaped by evolution and favorable for the specialization of higher cognitive functions. Together, the cross-species imaging genetic findings may provide convergent evidence to support the association between the orderly topography of brain function networks and gene expression.
BNIP3 attenuates hepatocellular carcinoma by promoting lipid droplet turnover at the lysosome.
Authors: Berardi Damian , Bock-Hughes Althea , Drake Lauren , Terry Alexander , Bozek Grazyna , Macleod Kay
Published: October 2021

Hepatic steatosis is a major etiological factor in hepatocellular carcinoma (HCC). Work reported here identifies BNIP3 as a suppressor of HCC that mitigates against lipid accumulation.
Loss of BNIP3 decreased tumor latency and increased tumor burden in a mouse model of HCC. This was associated with increased lipid accumulation and elevated HCC tumor cell growth. Conversely, exogenous BNIP3 decreased lipid levels and reduced HCC tumor cell growth. Mutant BNIP3W18A that is unable to promote mitophagy did not decrease HCC cell growth and was defective at reducing lipid levels. Growth suppression by BNIP3 was not mediated by effects on fatty acid oxidation (FAO) or de novo lipogenesis (DNL). Rather, BNIP3 suppressed HCC cell growth by promoting lipid droplet turnover at the lysosome through a process we have termed “mitolipophagy” in which lipid droplets and mitochondria are turned over together at the lysosome. Low BNIP3 expression in human HCC also correlated with increased lipid content and worse prognosis than HCC expressing high levels of BNIP3. This work reveals a role for BNIP3 and lipid droplet turnover at the lysosome in attenuating HCC.
The Association between Homocysteinemia and Mortality in Pre-dialysis CKD patients: A Propensity-Score Matched Analysis Using NHANES-National Death Index Link
Authors: Song Je Hun , Huh Hyuk , Bae Eunjin , Lee Jeonghwan , Lee Jung Pyo , Lee Jong Soo , Yoo Kyung Don , Kim Gwang Sil
Published: October 2021

Background: Hyperhomocysteinemia (HHcy) is considered a risk factor for cardiovascular disease (CVD) including chronic kidney disease (CKD). In this study, we investigated the association between serum homocysteine (Hcy) level and mortality according to the presence of CKD.Methods: Our study included data of 9,895 participants from the 1996–2016 National Health and Nutrition Examination Surveys (NHANES). Moreover, linked mortality data were included and classified into four groups according to the Hcy level. Multivariable-adjusted Cox proportional hazards models using propensity-score were used to examine dose-response associations between Hcy level and mortality.Results: Of 9,895 participants, 1032 (21.2%) participants were diagnosed with CKD. In a multivariate Cox regression analysis including all participants, Hcy level was associated with all-cause mortality, compared with the 1st quartile in Model 3 (2nd quartile: hazard ratio (HR) 1.751, 95% confidence interval (CI) 1.348-2.274, p<0.001; 3rd quartile: HR 2.220, 95% CI 1.726-2.855, p<0.001; 4th quartile: HR 3.776, 95% CI 2.952-4.830, p<0.001). In the non-CKD group, there was a significant association with all-cause mortality; however, this finding was not observed in the CKD group. The observed pattern was similar after propensity score matching. In the non-CKD group, overall mortality increased in proportion to Hcy concentration (2nd quartile: HR 2.195, 95% CI 1.299-3.709, p = 0.003; 3rd quartile: HR 2.607, 95% CI 1.570-4.332, p<0.001; 4th quartile: HR 3.720, 95% CI 2.254-6.139, p<0.001). However, the risk of all-cause mortality according to the quartile of Hcy level did not increase in the CKD groupConclusion: This study found a correlation between the Hcy level and mortality rate only in the non-CKD group. This altered risk factor patterns may be attributed to protein-energy wasting or chronic inflammation status that is accompanied by CKD.
Automated Pancreas Segmentation And Volumetry Using Deep Neural Network On Computed Tomography
Authors: Lim Sang-Heon , Kim Young Jae , Park Yeon-Ho , Kim Doojin , Kim Kwang Gi , Lee Doo-Ho
Published: October 2021

Pancreas segmentation is necessary for observing lesions, analyzing anatomical structures, and predicting patient prognosis. Therefore, various studies have designed segmentation models based on convolutional neural networks for pancreas segmentation. However, the deep learning approach is limited by a lack of data, and studies conducted on a large computed tomography dataset are scarce. Therefore, this study aims to perform deep-learning-based semantic segmentation on 1,006 participants and evaluate the automatic segmentation performance of the pancreas via four individual three-dimensional segmentation networks. In this study, we performed internal validation with 1,006 patients and external validation using the Cancer Imaging Archive (TCIA) pancreas dataset. We obtained mean precision, recall, and dice similarity coefficients of 0.869, 0.842, and 0.842, respectively, for internal validation via a relevant approach among the four deep learning networks. Using the external dataset, the deep learning network achieved mean precision, recall, and dice similarity coefficients of 0.779, 0.749, and 0.735, respectively. We expect that generalized deep-learning-based systems can assist clinical decisions by providing accurate pancreatic segmentation and quantitative information of the pancreas for abdominal computed tomography.
Happi Kneecaps! A Double-Blind, Randomised, Parallel Group Superiority Trial Investigating the Effects of Shoe Inserts for Adolescents with Patellofemoral Pain: Phase II Feasibility Study
Authors: O'Sullivan Isobel C , Crossley Kay M , Kamper Steven J , Middelkoop Marienke van , Vicenzino Bill , Smith Melinda M Franettovich , Menz Hylton B , Smith Anne J , Tucker Kylie , O'Leary Karina T , Costa Nathalia Cordeiro da , Collins Natalie J
Published: October 2021

Background: Patellofemoral pain (PFP) affects one-third of adolescents and can persist into adulthood, negatively impacting health and quality of life. Foot orthoses are a recommended treatment for adults with PFP, but have not been evaluated in adolescents. The primary objective was to determine the feasibility of conducting a full-scale randomised controlled trial (RCT) evaluating effects of contoured, prefabricated foot orthoses on knee pain severity and patient-perceived global change, compared to flat insoles. The secondary objective was to describe outcomes on a range of patient-reported outcome measures. Methods: We recruited adolescents aged 12-18 years with PFP of ³2 months duration into a double-blind, randomised, parallel-group feasibility trial. Participants were randomised to receive prefabricated contoured foot orthoses or flat shoe insoles, and followed for 3 months. Participants and outcome assessors were blinded to group allocation. Primary outcomes were feasibility of a full-scale RCT (number of eligible/enrolled volunteers; recruitment rate; adherence with the intervention and logbook completion; adverse effects; success of blinding; drop-out rate), and credibility and expectancy of interventions. Secondary outcomes were patient-reported measures of pain, symptoms, function, quality of life, global rating of change, patient acceptable symptom state, and use of co-interventions.Results: 36 out of 279 (12.9%) volunteers (27 female, mean (SD) age 15 (2) years, body mass 60 (13) kg) were eligible and enrolled, at a recruitment rate of 1.2 participants/week. 17 participants were randomised to receive foot orthoses, and 19 to flat insoles. 15 participants returned logbooks; 7/15 (47%) adhered to the intervention. No serious adverse events were reported. 28% (10/36, 4 pandemic-related) of participants dropped out before 3 months. Blinding was successful. Both groups found the inserts to be credible. Conclusions: Based on a priori criteria for feasibility, findings suggest that a full-scale RCT comparing contoured foot orthoses to flat insoles in adolescents with PFP would not be feasible using the current protocol. Prior to conducting a full-scale RCT, further feasibility studies are needed, with protocol modifications to facilitate participant retention, logbook completion and shoe insert wear. Trial registration: Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000957190. Date registered: 8/07/2019.
Mitigation of the Impact of the Covid 19 Pandemic on Poverty and Income Distribution: A Case Study in Wonogiri Regency
Authors: Rahayu Endang Siti , Astirin Okid Parama , Suryanto Suryanto
Published: October 2021

The Covid pandemic had a significant impact on the economy because almost all sectors are affected. Food and Agriculture Organization (FAO) warned countries to be alert to the potential food crisis due to the COVID-19 pandemic. The research objectives are to (1) identify the income of the people affected by Covid 19, (2) analyze the changes in income, (3) formulate a mitigation model. The research method used is a survey with 240 respondents from rural communities affected by Covid 19, especially farmers and Micro, Small and Medium Enterprises (MSMEs). The analytical method used is cost and income analysis, SWOT analysis, poverty analysis and income distribution with the Gini Index approach. Covid 19 has impacted decreasing income and increasing poverty by 48.44% and the GI value of 0.604. The income distribution is increasingly widening and low/poor. Based on the SWOT analysis, the people affected by Covid 19 are in quadrant II, the point of growth and development. Mitigation model to prevent poverty and increase equity level with intensive strategy and integrative strategy. The strategy is to maintain product quality and continuity and optimization and development of marketing by utilizing government support and institutional strengthening.