bluuebunny/crossref_metadata_2025 huggingface dataset:
Time Series Modeling of Road Traffic Accidents in Amhara Region
Authors: Alemtsega Kidane
Published: March 2021

Road traffic accidents are commonly encountered incidents that can cause injuries, death, and property damage to members of society. Ethiopia is one of the highest incident rates of road traffic accidents. Report of Transport and Communication from 2012–2014, shows an increment in the number of traffic accidents in Ethiopia. Amhara region accounted for 27.3% of the total road traffic accident-related deaths in Ethiopia during the year 2008/9, which is the highest share among all regions. The current research aims to model the trend of injury, fatal and total road traffic accidents in the Amhara region from September 2013 to May 2017. Monthly reported traffic accidents were obtained from traffic police offices and other concerned governmental organizations at the zonal and regional levels. The most universal class of models for forecasting time series data called Auto-regressive Integrated Moving Averages models are applied to model the trends and patterns of road traffic accident cases in the Amhara region. The average number of observed injury RTA, fatal RTA, and total RTA were 27.2, 14, and 78.2 per month respectively. It was observed that a relatively large number of RTA’S are reported on Tuesday, Thursday, and Saturday relative to other days of the week. The data also reveals that more than 60% of accidents involve drivers between the ages of 18–30 years. ARIMA (2,0,0) (1,0,0) ARIMA (2,0,0) and ARIMA (2,0,0) (1,1,0) were fitted as the best model for total injury accidents, fatal RTA and total RTA data respectively. A 48 months forecast was made based on the fitted models and it can be concluded that road traffic accident cases would continue at the non-decreasing rate in the Amhara region for the predicted periods. Therefore, the findings of this study draw attention to the importance of implementing improved better policies and close monitoring of road trafficking to change the existing trend of road traffic accidents in the region.
Persistent postoperative limitation of range of motion after total knee arthroplasty - Are there predictors?
Authors: Oberberg Stella , Dammers Jessica , Nottenkämper Jan , Krapp Jan , Willburger Roland Ernst
Published: March 2021

BackgroundImplantation of total knee arthroplasty (TKA) is one of the most common operations in orthopedics. However, about 20% of all patients are not satisfied with the result after TKA. Thus, persistent postoperative limitation of range of motion, for instance in the context of arthrofibrosis is with approximately 10% one of the most frequent complications after TKA and, thus, one of the most reasons for an operative revision or a worse postoperative outcome. Some potential therapeutic strategies are described in recent literature including patient-related risk factors and models for the pathogenesis of arthrofibrosis. The weighting of individual risk factors is currently not fully understood. MethodsIn the present study, a retrospective analysis of patient data was performed using a literature-based questionnaire in 72 patients following mobilization under anesthesia due to persistent limitation of range of motion (ROM) after TKA. An existing internal data set of 72 patients without restriction of ROM after TKA was used as a control-population. The study-group was invited to a follow-up examination to assess long-term outcome by several scores “Knee osteoarthritis outcome score” (KOOS) and “Knee society score” (KSS). In addition, patient expectation and satisfaction were evaluated according to the New KSS. ResultsIn total, 144 patients were included in the retrospective analysis. Person-related risk factors described in the literature, such as gender or secondary diseases (diabetes mellitus, rheumatoid arthritis, or psychiatric diseases) could not be confirmed as risk factors in our population. There was a statistically significant difference in pre- and postoperative range of motion. The study-group showed a essentially higher preoperative flexion deficit and developed a lower postoperative range of motion in both extension and flexion deficits. Significant differences were found with respect to previous surgeries and duration of surgery. The study-population showed an increased number of previous operations, especially arthroscopic surgeries of the knee joint, as well as a prolonged operation time exceeding 90 minutes. Preoperative patient expectations were not fulfilled on average, despite this, patient satisfaction was still high in the long term examination. ConclusionsWe determined risk factors for our population. For example, the preoperative range of motion, previous operations, and the duration of surgery were relevant factors that were closely related to the postoperative outcome of our study-population. However, due to the retrospective study design, these results are limited. In order to perform an exact evaluation of the risk factors mentioned above, we would recommend to supplement a prospective investigation with regard to these aspects. In the follow-up examination, we furthermore could confirm the significant impact of patient expectation on outcome after TKA as described in the literature.
Adjusting spatial dependence of climate model outputs with Cycle-Consistent Adversarial Networks
Authors: François Bastien , Thao Soulivanh , Vrac Mathieu
Published: March 2021

Climate model outputs are commonly corrected using statistical univariate bias correction methods. Most of the time, those 1d-corrections do not modify the ranks of the time series to be corrected. This implies that biases in the spatial or inter-variable dependences of the simulated variables are not adjusted. Hence, over the last few years, some multivariate bias correction (MBC) methods have been developed to account for inter-variable structures, inter-site ones, or both. As proof-of-concept, we propose to adapt a computer vision technique used for Image-to-Image translation tasks (CycleGAN) for the adjustment of spatial dependence structures of climate model projections. The proposed algorithm, named MBC-CycleGAN, aims to transfer simulated maps (seen as images) with inappropriate spatial dependence structure from climate model outputs to more realistic images with spatial properties similar to the observed ones. For evaluation purposes, the method is applied to adjust maps of temperature and precipitation from climate simulations through two cross-validation approaches. The first one is designed to assess two different post-processing schemes (Perfect Prognosis and Model Output Statistics). The second one assesses the influence of nonstationary properties of climate simulations on the performance of MBC-CycleGAN to adjust spatial dependences. Results are compared against a popular univariate bias correction method, a ``quantile-mapping'' method, which ignores inter-site dependencies in the correction procedure, and two state-of-the-art multivariate bias correction algorithms aiming to adjust spatial correlation structure. In comparison with these alternatives, the MBC-CycleGAN algorithm reasonably corrects spatial correlations of climate simulations for both temperature and precipitation, encouraging further research on the improvement of this approach for multivariate bias correction of climate model projections.
Additive Manufacturing of AISI 420 Stainless Steel: processes validation, defects analysis and mechanical characterization in different process and post-process conditions.
Authors: Liverani Erica , Fortunato Alessandro
Published: March 2021

Stainless steel (SS) alloys produced by Laser-based Powder Bed Fusion (LPBF) process offers comparable and sometime improved mechanical properties respect to conventionally processed materials. Some of these steels have been extensively studied in the last decade, however additively manufactured martensitic SS, as AISI 420, need further research in characterizing their post built quality and mechanical behaviour. This lack of information on martensitic SS is not consistent with their growing demand in the automotive, medical and aerospace industries due to their good corrosion resistance, high hardness and good tensile properties. Selection of the appropriate process parameters and post treatments plays a fundamental role in determining final properties. For this reason, the effect of LPBF process parameters and different heat treatments on density, defects characteristics and location, roughness and mechanical properties of AISI 420 were investigated in this paper. A first experimental campaign was carried out to establish different set of suitable process parameters for industrial applications. Starting from this result, the detected defects properties was investigated by Computed Tomography (CT) scans. Dimensions, sphericity and distributions of defects inside the volume were analysed and compared between samples manufactured with different parameters. In the second part of the paper, the influence of process and post process conditions on mechanical properties was investigated. The final presented results establish a correlation between the involved production cycle and the resulting properties of LPBF AISI 420 specimens.
Public Trust, Information Sources and Vaccine Willingness Related to the COVID-19 Pandemic in a Caribbean Country
Authors: Freitas Loren De , Basdeo Damion , Wang Han-i
Published: March 2021

BackgroundEvaluating public trust and vaccine willingness may contribute to the effectiveness of pandemic response policies and plans. This is particularly important in developing countries, such as those in the Caribbean region. This study aimed to evaluate public trust in information sources, confidence in institutions and COVID-19 vaccine willingness in Trinidad and Tobago. MethodsA cross-sectional online survey was conducted amongst the general population in Trinidad and Tobago from November 10th to December 7th 2020. The survey instrument was a validated questionnaire developed by the World Health Organisation (WHO) and adapted to the local setting. Descriptive statistics and regression analyses were used to analyse the data. ResultsOf the 623 responses analysed, 46.2% thought they were likely to contract COVID-19 while 37.7% considered themselves at high risk of contracting the illness. The most trusted sources of information included health workers (53.9%) and the ministry of health (42.4%). Each one unit increase in trust in the medical sector lowered the odds of believing misinformation and conspiracy theories. Overall, 62.6% of respondents said they would take the COVID-19 vaccine if available and recommended. Regression analyses showed those who agreed that everyone should adhere to the national immunization schedule and those who would take the flu vaccine, were 2.92 (p<0.001) and 3.68 times (p<0.001) as likely to take the vaccine, respectively.ConclusionOur study found that increasing trust in health sources, confidence in medical sector, adherence to the national immunisation schedule and acceptance of the flu vaccine may increase COVID-19 vaccine willingness rates. These results may guide public health response activities and identify areas for prioritisation and improvement.
Left atrial strain in the assessment of diastolic function: providing new insights into primary myocardial dysfunction in Marfan syndrome
Authors: García-Izquierdo Eusebio , Moñivas-Palomero Vanessa , Forteza Alberto , Martín-López Carlos , Torres-Sanabria Mario , Cia-Mendioroz Xabier , Olivo-Rodríguez Consuelo , Navarro-Rico Sara , Sánchez-Gómez Andrés , Mirelis Jesús G. , Cavero Miguel A. , Mingo-Santos Susana
Published: March 2021

Previous studies using conventional echocardiographic measurements have reported subclinical left ventricular (LV) diastolic abnormalities in patients with Marfan syndrome (MFS). Left atrial (LA) strain allows an accurate categorization of LV diastolic dysfunction. We aimed to characterize LV myocardial performance in a cohort of MFS patients using STE-derived measurements (LV and LA strain) along with conventional echocardiographic parameters. We studied 127 adult patients with MFS (no prior cardiac surgery or significant valvular regurgitation) and 38 healthy controls. We performed detailed echocardiograms and selected left atrial reservoir strain (LASr) as a surrogate of impaired relaxation. Additionally, we searched for possible determinants of LASr in patients with MFS, with a special focus on the elastic properties of the aorta. In spite of lower E-wave, septal and lateral e’ velocities and average E/e’ ratio in MFS patients, all participants had normal diastolic function according to current guidelines. MFS patients exhibited reduced LV global longitudinal strain (19.3 ± 2.6 vs 21.6 ± 2.1%, p < 0,001) and reduced LASr (32.9 ± 8.5 vs 43.3 ± 7.8%, p < 0.001) compared to controls. In the MFS cohort, we found weak significant (p < 0.05) correlations between LASr and certain parameters: E/A ratio (R = 0.258), E wave (R = 0.226), aortic distensibility (R = 0.222), stiffness index (R=-0.216), LV ejection fraction (R = 0.214), lateral e’ (R = 0.210), LV end-systolic volume index (R=-0.210), LV global longitudinal strain (R = 0.201), septal e’ (R = 0.185). After multivariate analysis, only LV end-systolic volume index and E/A ratio maintained a weak independent association with LASr (R=-0,220; p = 0,017 and R = 0,199; p = 0,046, respectively). In conclusion, LASr is reduced in patients with MFS, which may represent an early stage of LV diastolic dysfunction. LASr is not determined by the elastic properties of the aorta, suggesting that impaired myocardial relaxation is a primary condition in MFS.
Spatial-Temporal Population Dynamics of Male and Female Aedes Albopictus at a Local Scale in Medellín, Colombia
Authors: Camargo Carolina , Alfonso-Parra Catalina , Díaz Sebastián , Rincón Diego F. , Ramírez-Sánchez Luis Felipe , Agudelo Juliana , Barrientos Luisa M. , Arias Sara Villa , Avila Frank William
Published: March 2021

Background: Diseases transmitted by invasive Aedes aegypti and Aedes albopictus mosquitoes are major public health issues in the tropics and subtropics. Understanding the ecology of mosquito vectors is essential for the development of effective disease mitigation programs and will allow for accurate predictions of vector occurrence and abundance. Studies that examine mosquito population dynamics are typically focused on female presence or total adult captures without discriminating the temporal and spatial distribution of both sexes. Methods: We collected immature and adult mosquitoes twice monthly during a two-year period (2018 – 2019) in the Medellín Botanical Garden (Medellín, Colombia) and assessed: 1) the relationship between climatic variables/vegetation coverage and adult captures, 2) the temporal and spatial distribution of Ae. aegypti and Ae. albopictus during the study period, 3) the temporal and spatial distribution of Ae. albopictus males and females, and 4) the correlation of male and female size in relation to climatic variables and vegetation coverage. Results: We show that Ae. albopictus was the predominant species in the park during the study period. Adult captures were positively correlated with precipitation and relative humidity, and inversely correlated with temperature and wind speed. Spatial analysis showed that Ae. aegypti and Ae. albopictus were distributed at different locations within the surveilled area. Moreover, we observed a spatial misalignment of Ae. albopictus males and females—the majority of males were located in the high vegetation coverage sites and the females in the medium vegetation coverage sites. Conclusions: Our work elucidates the differential dynamics of Ae. albopictus males and females, which is pivotal to develop accurate surveillance and the successful establishment of vector control programs based on the disruption of insect reproduction.
A new approach to find gouge free tool positions for a toroidal cutter for Bezier surfaces in Five axis machining
Authors: Sing Mukhmeet , Qu Jerry , Duvedi Ravinder Kumar , Bedi Sanjeev , Mann Stephen
Published: March 2021

We implement and test a multi-point machining tool positioning technique that positions the tool using only a variation on gouge checking. The result is a method that is roughly twice as fast as an earlier method that performed a numerical search to find a tool position with multiple points of contact with the design surface. A GPU implementation provides an additional factor of ten speedup. Verification of the method was done via simulation and machining and measuring physical parts.
Decomposition of Carbon Adsorbed on Iron (III)-Treated Clays and Their Effect on the Stability of Soil Organic Carbon and External Carbon Inputs
Authors: You Mengyang , Zhu-Barker Xia , Doane Timothy A. , Horwath William R.
Published: March 2021

The interaction of organic carbon (OC) with clay and metals stabilizes soil carbon (C), but the influence of specific clay-metal-OC assemblages (flocs) needs further evaluation. Clay-metal-OC assemblages representing OC-mineral soil fractions were synthesized using dissolved organic C (DOC) combined with kaolinite (1:1 layer structure) or montmorillonite (2:1 layer structure) clays in the absence or presence of two levels of Fe (III). Flocs were mixed with soil and incubated for 30 days. Total C mineralization from flocs was approximately 70% lower than non-flocced DOC. The flocs made with montmorillonite had 16–43% lower C mineralization rate than those made with kaolinite with no Fe or low Fe. However, when flocs were made with high Fe, clay mineralogy did not significantly affect total C mineralization. A positive priming effect (PE) of flocs on native soil OC was observed in all treatments, with a stronger PE found in lower Fe treatments. The high-Fe clay flocs inhibited ryegrass decomposition, while the flocs made without clay had no impact on it. Interestingly, flocs significantly decreased the PE of ryegrass on native soil OC decomposition. These results indicate that the adsorption of DOC onto clay minerals in the presence of Fe (III) stabilizes it against decomposition processes and its stability increases as Fe in flocs increases. Flocs also protect soil OC from the PE of external degradable plant C input. This study showed that Fe level and clay mineralogy play an important role in controlling soil C stability.
Combined Amino Acid Pet-Mri for Differentiating Recurrence from Radiation Necrosis in Gliomas- Together We Grow
Authors: Jabeen Shumyla , Arbind Arpana , Kumar Dinesh , Singh Pardeep kumar , Saini Jitender , Sadashiva Nishanth , Arimappamagan Arivazhagan , Santosh Vani , Nagaraj Chandana
Published: March 2021

PURPOSE: To compare the diagnostic accuracy of amino acid PET, MR perfusion and diffusion as stand-alone modalities and in combination in differentiating recurrence from radiation necrosis in post-treatment gliomas and to qualitatively assess spatial concordance between the three modalities using simultaneous PET-MR acquisition.METHODS: A retrospective review of 48 cases of post-treatment gliomas who underwent simultaneous PET-MRI using C11 Methionine as radiotracer was performed. MR perfusion and diffusion sequences were acquired during the PET study. The following parameters were obtained: TBRmax, TBRmean, SUVmax and SUVmean from the PET images, rCBV from perfusion, ADCmean and ADCratio from the diffusion images. The final diagnosis was based on clinical/imaging follow-up and histopathology when available. ROC curve analysis in combination with logistic regression analysis was used to compare the diagnostic performance. Spatial concordance between modalities was graded as 0,1 and 2 representing discordance, <50% and >50% concordance respectively.RESULTS: There were 35 cases of recurrence and 13 cases of radiation necrosis. The highest area under curve(AUC) was obtained for TBRmax followed by rCBV and ADCratio. The AUC increased significantly with a combination of rCBV and TBRmax. Amino acid PET showed the highest diagnostic accuracy and maximum agreement with the final diagnosis. There was discordance between ADC and PET in 22.9%, between rCBV and PET in 16.7% and between PET and contrast enhancement in 14.6% cases.CONCLUSIONAmino acid PET had the highest diagnostic accuracy in differentiating radiation necrosis from recurrence. Combination of PET with MRI further increased the AUC thus improving the diagnostic performance.
Time Course of Outcome in Poor Grade Subarachnoid Hemorrhage Patients: A longitudinal retrospective study
Authors: Bogossian Elisa Gouvea , Diaferia Daniela , Minini Andrea , Djangang Narcisse Ndieugnou , Menozzi Marco , Peluso Lorenzo , Annoni Filippo , Creteur Jacques , Schuind Sophie , Dewitte Olivier , Taccone Fabio Silvio
Published: March 2021

Background

Neurological outcome and mortality of patients suffering from poor grade subarachnoid hemorrhage (SAH) may have changed over time. Several factors, including patients’ characteristics, the presence of hydrocephalus and intraparenchymal hematoma, might also contribute to this effect. The aim of this study was to assess the temporal changes in mortality and neurologic outcome in SAH patients and identify their predictors.
Methods

We performed a single center retrospective cohort study from 2004 until 2018. All non-traumatic SAH patients with poor grade on admission (WFNS score of 4 or 5) who remained at least 24 hours in the hospital were included. Time course was analyzed into four groups according to the years of admission (2004–2007; 2008–2011; 2012–2015 and 2016–2018).
Results

A total of 353 patients were included in this study: 202 patients died (57%) and 260 (74%) had unfavorable neurological outcome (UO) at 3 months. Mortality tended to decrease in in 2008–2011 and 2016–2018 periods (HR 0.55 [0.34–0.89] and HR 0.33 [0.20–0.53], respectively, when compared to 2004–2007). The proportion of patients with UO remained high and did not vary significantly over time. Patients with WFNS 5 had higher mortality (68% vs 34%, p = 0.001) and more frequent UO (83% vs 54%, p = 0.001) than those with WFNS 4. In the multivariable analysis, WFNS 5 was independently associated with mortality (HR 2.12 [1.43–3.14]) and UO (OR 3.23 [1.67–6.25]). The presence of hydrocephalus was associated with a lower risk of mortality (HR 0.60 [0.43–0.84]).
Conclusions

Both hospital mortality and UO remained high in poor grade SAH patients. Patients with WFNS 5 on admission had worse prognosis than others; this should be taken into consideration for future clinical studies.
Successful Treatment of Pulmonary Mucormycosis Caused by Rhizopus Microsporus With Posaconazole
Authors: Yuan Fan , Chen Jun , Liu Fang , Dang Yongchao , Kong Qingtao , Sang Hong
Published: March 2021

Background: Mucormycosis is a rare fungal infection occurring chiefly in the lung or the rhino-orbital-cerebral compartment, particularly in patients with immunodeficiency or diabetes mellitus. Among Mucorales fungi, Rhizopus spp. are the most common cause of mucormycosis. Case presentation: We report the case of pulmonary mucormycosis caused by Rhizopus microsporus in a young patient with diabetes but no other apparent risk factors. The diagnosis has mainly relied on clinical manifestation, positive pulmonary tissue biopsy, and fungal culture. The patient was successfully treated with posaconazole oral suspension and remains asymptomatic at one-year follow-up.Conclusions: Pulmonary mucormycosis is a life-threatening condition and based on direct microscopy, histopathology, and culture for the diagnosis.
Application of Renewable Kenaf Cellulose Nanofiber as a Temephos Nanocarrier for Control of Aedes Aegypti (Diptera: Culicidae) Larvae
Authors: Pengiran Hazirah binti , Kamaldin Jahangir , Fen Leo Bey , Ahmad Hamdan
Published: March 2021

Larviciding is an effective control method in managing mosquito-borne diseases. However, current carrier materials used in larvicides formulation raised environmental concerns due to its non-renewable origin. Herein, our study aimed to evaluate the application of the renewable source kenaf cellulose nanofiber (KCNF) impregnated with temephos for the control of Aedes aegypti mosquito larvae. The morphology of KCNF+T was examined using field emission scanning electron microscope (FESEM) and transmission electron microscopy (TEM) while the quantity of temephos impregnated, released, and retained on the fibers upon dispersion in water were determined using high performance liquid chromatography (HPLC). Subsequently, the bioefficacy of the KCNF+T was evaluated against Ae. aegypti larvae. The FESEM and TEM micrograph verified the presence of temephos on the KCNF after the impregnation. HPLC analysis showed the amount of temephos impregnated on KCNF was 97 % of the 0.1 mg temephos. Upon dispersion in water, KCNF+T released 53% temephos and the retention of temephos on KCNF+T gradually decreased to 30, 17 and 7 % on the first, third and fifth month, respectively. The exposure of Ae. aegypti larvae to KCNF+T at concentration 0.006 to 0.01 mg/L was effective at 17 - 25 folds in killing Ae. aegypti larvae compared to temephos without KCNF. Microscopy examination revealed accumulation of the KCNF on the larval appendages. Overall, our study demonstrated that KCNF made from renewable source is an effective nanocarrier of temephos for the control of Ae. aegypti mosquito larvae.
Neutralizing Antibody Response and Associated Factors in Coronavirus-19 Disease (COVID-19) up to One Month: A Case-Series of 129 Hospitalized Patients
Authors: Bastug Aliye , Bodur Hurrem , Safak Urartu Ozgur , Filazi Nazlican , Aydos Omer , Kehribar Ebru Sahin , Hanifehnezhad Alireza , Kazancioglu Sümeyye , Ahan Recep Erdem , Aslan Volkan , Cakir Banu , Sertcelik Ahmet , Ozkul Aykut
Published: March 2021

Purpose Little is known about the characteristics of neutralizing antibody(NAb) response in patients recovered COVID - 19. We aimed to elucidate the factors affecting presence and titers of in an early phase of infection up to 30 days.Methods A total of 129 laboratory-confirmed COVID-19 patients in a tertiary-care hospital were enrolled. Clinical and laboratory data were obtained retrospectively. SARS-CoV-2 specific NAb, IgM, and IgG antibody responses were analyzed. NAb-positive and negative patients were compared, to examine potential associations between clinical, demographical, and laboratory characteristics and the presence/titers of NAb.Results SARS-CoV-2 specific NAb, IgM and IgG were detected at the time of hospital discharge in 60.5%, 30.2%, and 51.9% of the patients, respectively. The presence of antibodies was 42.4%(NAb), 20.3%(IgM) and 44.1%(IgG) among patients within 5-9 days since onset; increased to 79.5%(NAb), 34.1%(IgM) and 47.7%(IgG) by 10-14 days; and detected in 66.7%(NAb), 50%(IgM), 83.3%(IgG) at/after day-15, following symptom onset. The median titer of neutralizing antibody(SN 50) was significantly higher in severe patients(25 versus 7.5, p= 0.009). Of the 23 severe patients, 52.2%(n=12) had higher NAb titers (i.e., SN 50 ≥ 1:25) when compared to that in non-severe patients(p= 0.021; OR = 2.89; 95%CI= 1.15 – 7.28), yet, potential effect of follow-up time on NAb status and titers could not be ruled out.Conclusion Presence and higher titers of NAb were detected more in severe patients compared to their non-severe counterparts. Survival analysis suggested that this difference could at least be partially explained by the length of follow-up after symptoms’ onset.
Endothelial Glycocalyx Degradation Is Associated With Early Organ Impairment in Multiple Trauma Patients
Authors: Qi Feng , Zhou Hao , Gu Peng , Tang Zhi-He , Zhu Bao-Feng , Chen Jian-Rong , Zhang Jin-Song , Li Feng
Published: March 2021

BackgroundEndothelial glycocalyx (EG) abnormal degradation were widely found in critical illness. However, data of EG degradation in multiple traumas is limited. We performed a study to assess the EG degradation and the correlation between the degradation and organ functions in multiple trauma patients. MethodsA prospective observational study was conducted to enroll health participants (control group) and multiple traumas patients (trauma group) at a University affiliated hospital between Feb 2020 and Oct 2020. Syndecan1 (SDC1) and heparin sulfate (HS) were detected in serum sample of both groups. In trauma group, injury severity scores (ISS) and sequential organ failure assessments (SOFA) were calculated. Occurrences of acute kidney injury (AKI), trauma-induced coagulopathy (TIC) within 48 hours and 28-day all-cause mortality in trauma group were recorded. Serum SDC1 and HS levels were compared between two groups. Correlations between SDC1/HS and the indicators of organ systems in the trauma group were analyzed. ROC analyses were performed to assess the predictive value of SDC1 and HS for AKI, TIC within 48 hours, and 28-day mortality in trauma group. ResultsThere were 45 multiple trauma patients and 15 healthy participants were collected, totally. SDC1 and HS were significantly higher in trauma group than in control group (69.39 [54.18–130.80] vs. 24.15 [13.89–32.36], 38.92 [30.47–67.96] vs. 15.55 [11.89–23.24], P<0.001, respectively). SDC1 and HS were both positively correlated with prothrombin time, activated partial thromboplastin time, EVLW, N-terminal pro-B-type natriuretic peptide, myoglobin, creatinine, lactic acid, interleukin-6, and tumor necrosis factor-α (P<0.05, respectively). SDC1 and HS were both negatively correlated with Ca2+, anti-thrombin-III, PaO2/FiO2 ratio, pH and albumin (P<0.05, respectively). Trauma group was divided into high degradation group and low degradation group according to SDC1 median. High degradation group had more severe ISS, SOFA scores, worse organ functions (respiratory, kidney, coagulation and metabolic system), and higher incidence of hypothermia, acidosis and shock. ROC curve analyses demonstrated SDC1 can predict the occurrence risk of AKI, TIC within 48h, and 28-day mortality. ﻿ConclusionsEG degradation was elevated significantly in multiple trauma patients, and the degradation was correlated with impaired respiratory, kidney, coagulation and metabolic systems. Serum SDC1 is a valuable predictive indicator of early TIC, AKI risk, and 28-day mortality in multiple trauma patients.
Exosomes derived from adipose-derived stem cells overexpressing Glyoxalase-1 protect endothelial cells and enhance angiogenesis in type 2 diabetic mice with limb ischemia
Authors: Zhang Xing , Jiang Yihong , Huang Qun , Wu Zhaoyu , Pu Hongji , Xu Zhijue , Li Bo , Lu Xinwu , Yang Xinrui , Qin Jinbao , Peng Zhiyou
Published: March 2021

Background: Diabetic limb ischemia is a clinical syndrome and refractory to therapy. Our previous study demonstrated that adipose-derived stem cells (ADSCs) overexpressing glyoxalase-1 (GLO-1) promoted the regeneration of ischemic lower limbs in diabetic mice, but low survival rate, difficulty in differentiation, and tumorigenicity of the transplanted cells restricted its application. Recent studies have found that exosomes secreted by the ADSCs have the advantages of containing parental beneficial factors and exhibiting non-immunogenic, non-tumorigenic, and strong stable characteristics.Methods: ADSCs overexpressing GLO-1 (G-ADSCs) were established using lentivirus transfection, and exosomes secreted ADSCs (G-ADSC-Exos) were isolated and characterized to co-culture with human umbilical vein endothelial cells (HUVECs). Proliferation, apoptosis, migration, and tube formation of the HUVECs were detected under high glucose conditions. The G-ADSC-Exos were injected into ischemic hindlimb muscles of type 2 diabetes mellitus (T2DM) mice, and the laser Doppler perfusion index, Masson’s staining, immunofluorescence and immunohistochemistry assays were adopted to assess the treatment efficiency. Moreover, the underlying regulatory mechanisms of the G-ADSC-Exos on the proliferation, migration, angiogenesis, and apoptosis of the HUVECs were explored.Results: The G-ADSC-Exos enhanced the proliferation, migration, tube formation, and anti-apoptosis of the HUVECs in vitro under high glucose conditions. After in vivo transplantation, the G-ADSC-Exo group showed significantly higher laser Doppler perfusion index, better muscle structural integrity, and higher microvessel’s density than the ADSC-Exo and control groups by Masson’s staining, and immunofluorescence assays. The underlying mechanisms by which the G-ADSC-Exos protected endothelial cells both in vitro and in vivo might be via the activation of eNOS/AKT/ERK/P-38 signaling pathways, inhibition of AP-1/ROS/NLRP3/ASC/Caspase-1/IL-1β, as well as the increased secretion of VEGF, IGF-1, and FGF.Conclusion: Exosomes derived from adipose-derived stem cells overexpressing GLO-1 protected the endothelial cells and promoted the angiogenesis in type 2 diabetic mice with limb ischemia, which will be a promising clinical treatment in diabetic lower limb ischemia.
Regorafenib pharmacokinetics and its association with real-world treatment outcomes
Authors: Fukudo Masahide , Asai Keiko , Tani Chikayoshi , Miyamoto Masashi , Ando Katsuyoshi , Ueno Nobuhiro
Published: March 2021

Purpose Despite the established activity of regorafenib in metastatic colorectal cancer (CRC), gastrointestinal stromal tumor (GIST), and hepatocellular carcinoma (HCC), its toxicity profile has limited clinical use. We aimed to evaluate the pharmacokinetics of regorafenib and its active metabolites M-2/M-5, and to clarify the relationships between total drug-related exposure and clinical outcomes in real-world practice.Methods Blood samples were obtained at steady state in Cycle 1 in patients treated with regorafenib. Plasma concentrations of regorafenib and its metabolites were measured by liquid chromatography–tandem mass spectrometry. The efficacy and safety endpoints were progression-free survival (PFS) and dose-limiting toxicities (DLTs), respectively. The exposure–response relationships were assessed.Results Thirty-four Japanese patients with advanced cancers were enrolled (CRC, n = 26; GIST and HCC, each n = 4). Nine patients started regorafenib treatment at the recommended dose of 160 mg once daily (3 weeks on / 1 week off), while the other patients received a reduced starting dose to minimize toxicities. The median PFS was significantly longer in patients achieving total trough concentrations (Ctrough) of regorafenib and M-2/M-5 ≥2.9 µg/mL than those who did not (112 vs. 57 days; p = 0.044). Furthermore, the cumulative incidence of DLTs during the first 2 cycles was significantly higher in patients with summed Ctrough levels ≥4.3 µg/mL than in others (p = 0.0003).Conclusions Dose titration of regorafenib to achieve drug-related Ctrough levels in Cycle 1 between 2.9 and 4.3 µg/mL may improve the efficacy and safety, warranting further investigation in a larger patient population.
Characterization of the Gut Microbiome in Wild Rocky Mountainsnails (Oreohelix strigosa)
Authors: Chalifour Bridget , Li Jingchun
Published: March 2021

BackgroundThe Rocky Mountainsnail (Oreohelix strigosa) is a terrestrial gastropod of ecological importance in the Rocky Mountains of western United States and Canada. Across the animal kingdom, including in gastropods, gut microbiomes have profound effects on the health of the host. Current knowledge regarding snail gut microbiomes, particularly throughout various life history stages, is limited. Understanding snail gut microbiome composition and dynamics can provide an initial step toward better conservation and management of this species. ResultsIn this study, we employed 16S rRNA gene amplicon sequencing to examine gut bacteria communities in wild-caught O. strigosa populations from the Front Range of Colorado. These included three treatment groups: (1) adult and (2) fetal snails, as well as (3) sub-populations of adult snails that were starved prior to ethanol fixation. Overall, O. strigosa harbors a high diversity of bacteria. We sequenced the V4 region of the 16S rRNA gene on an Illumina MiSeq, and obtained 2,714,330 total reads. We identified a total of 7,056 unique operational taxonomic units (OTUs) belonging to 36 phyla. The core gut microbiome of four unique OTUs accounts for roughly half of all sequencing reads returned and may aid the snails’ digestive processes. Significant differences in microbial composition, as well as richness, evenness, and Shannon Indices were found across the three treatment groups.ConclusionsComparisons of gut microbiomes in O. strigosa adult, fetal, and starved samples provide evidence that the host internal environments influence bacterial community compositions, and that bacteria may be transmitted vertically from parent to offspring. This work provides the first comprehensive report on the structure and membership of bacterial populations in the gastropod family Oreohelicidae and reveals similarities and differences across varying life history metrics. Strong differentiation between these life history metrics demonstrates the need for wider sampling for studies of dynamics of the snail gut microbiome.
Reduced Order Model for Nonlinear Multi-Field-Coupled Spinning Shaft During Transient Operation Based on Coupled Modes Extracted by POD
Authors: Bani-Khaled Mohammad A. , Georgiou Ioannis
Published: March 2021

The authors have requested that this preprint be removed from Research Square.
Geographic Variation of Mercury in Breeding Tidal Marsh Sparrows of the Northeastern United States
Authors: Sayers Christopher J. , Roeder Mackenzie R. , Forrette Lindsay , Roche Daniel , Dupont Gaetan L.B. , Apgar Sam E. , Kocek Alison R. , Cook Alexandra M. , Shriver W. Gregory , Elphick Chris S. , Olsen Brian , Bonter David N.
Published: March 2021

Saltmarsh sparrows ( Ammospiza caudacuta ) and seaside sparrows ( A. maritima ) are species of conservation concern primarily due to global sea-level rise and habitat degradation. Environmental mercury (Hg) contamination may present additional threats to their reproductive success and survival. To assess site-specific total mercury (THg) exposure and identify environmental correlates of THg detection across a large portion of the breeding range where these species co-occur, we sampled blood from adult male saltmarsh and seaside sparrows at 27 marsh sites from Maine to Virginia, USA. The mean THg concentration (±1 SD) throughout the entire sampling range was 0.531 ± 0.287 µg/g wet weight (ww) for saltmarsh sparrows and 0.442 ± 0.316 µg/g ww for seaside sparrows. Individual THg concentrations ranged from 0.135–1.420 µg/g ww for saltmarsh sparrows and 0.153–1.530 µg/g ww for seaside sparrows. Model averaging from a suite of linear mixed models supported species-based differences in blood THg. On average, saltmarsh sparrows had 20.1% higher blood THg concentrations than seaside sparrows. We hypothesize that species-specific THg concentrations are influenced by differences in diet or foraging preferences between these species. We did not detect any correlations between sparrow THg concentrations and land cover characteristics surrounding sampled marshes or cumulative average annual precipitation.
DblurDoseNet: A Deep Residual Learning Network for Voxel Radionuclide Dosimetry Compensating for SPECT Imaging Resolution
Authors: Li Zongyu , Fessler Jeffrey A. , Mikell Justin K. , Wilderman Scott J. , Dewaraja Yuni K.
Published: March 2021

PurposeCurrent methods for patient specific voxel-level dosimetry in radionuclide therapy suffer from a trade-off between accuracy and computational efficiency. Monte Carlo (MC) radiation transport is considered as the gold standard but is computationally expensive, while faster dose voxel kernel (DVK) convolution can be sub-optimal in the presence of tissue heterogeneities. Furthermore, the accuracies of both these methods are limited by the spatial resolution of the reconstructed emission image. To overcome these limitations, this paper takes a novel approach of constructing a single deep convolutional neural network (CNN) named as DblurDoseNet that learns to produce dose-rate maps while compensating for the limited resolution of SPECT images.MethodsTo mitigate the effects of poor SPECT resolution and reconstruction artifacts on dosimetry, we trained our CNN using MC-generated dose-rate maps that directly corresponded to the true activity maps in virtual patient phantoms. We applied residual learning such that our CNN only learned the difference between the true dose-rate map and DVK dose-rate map with density scaling. The network consists of a depth feature extractor and a 2D U-Net, where the input was 11 slices (3.3 cm) of Lu-177 SPECT/CT images and the output was the dose-rate map corresponding to the center slice. In addition to phantoms, 42 SPECT/CT scans of patients who underwent Lu-177 DOTATATE therapy were also used for testing.ResultsIn test phantoms, the lesion/organ mean dose-rate error and the normalized root mean square error (NRMSE) relative to ground-truth for the CNN method was consistently lower than DVK and MC. In particular, for CNN compared to DVK/MC, the average improvement in mean dose error was 55%/53% and 66%/56%; and in NRMSE was 18%/17% and 10%/11% for lesion and kidney, respectively. Line profiles and dose-volume histograms demonstrated compensation for SPECT resolution effects in the CNN generated dose-rate maps. Noise, determined from multiple Poisson realizations, showed an average improvement of 21%/27% compared to DVK/MC. In patients, a high concordance was observed between CNN and MC in joint histogram analysis. The trained residual CNN took ~ 30 seconds on GPU to generate a (\(512\times 512\times 130\)) dose-rate map for a patient.ConclusionThe proposed CNN is well-suited for real-time patient-specific dosimetry for clinical treatment planning due to its demonstrated improvement in accuracy, resolution, noise and speed over the current gold-standard.
The Airway Microbiota Signatures of Infection and Rejection in Lung Transplant Recipients
Authors: Su Jin , Li Chun-xi , Liu Hai-yue , Chen Ao , You Zhi-xuan , Lian Qiao-yan , Li Kun , Cai Yu-hang , Lin Yan-xia , Pan Jian-bing , Zhang Guo-xia , He Jian-xing , Ju Chun-rong , You Chang-xuan
Published: March 2021

BackgroundInfection and rejection are the two most common complications after lung transplantation (LT) and are associated with increased morbidity and mortality. The differential diagnosis of infection and rejection is sometimes difficult due to similar clinical manifestations. However, few studies have investigated the airway microbiota between lung transplant recipients (LTRs) with infection and rejection. ResultsA total of 181 sputum samples (event-free, n=47; infection, n=103; rejection, n=31) were collected from 59 LTRs. A distinct airway microbiota was observed among clinically stable (or event-free) recipients and those with infection or acute rejection after LT. Alpha and beta diversity were significantly different between event-free and rejection recipients and between infection and rejection recipients. Ten differential genera were identified by linear discriminant analysis effect size (LEfSe), with Corynebacterium, unclassified Enterococcaceae and unclassified Lactobacillales enriched in recipients with infection, and Rothia, Granulicatella, Neisseria, Actinomyces, Leptotrichia, Lactobacillus and unclassified Aerococcaceae more abundant in LTRs with acute rejection. Random forest analyses indicated that the combination of the 10 microbiota constituents and procalcitonin (PCT) and T-lymphocyte levels showed AUCs of 0.894, 0.955 and 0.913 to differentiate between event-free and infection, event-free and rejection, and infection and rejection recipients, respectively. ConclusionsOur study is the first to compare the airway microbiota between LTRs with infection and acute rejection. The airway microbiota, especially combined with PCT and T-lymphocyte levels, showed satisfactory predictive efficiency in discriminating among clinically stable recipients and those with infection and acute rejection, suggesting that the airway microbiota was an indicator to differentiate between infection and acute rejection after LT.
Long-term outcomes of grade I/II skull base chondrosarcoma: an insight into the role of surgery and upfront radiotherapy
Authors: Hasegawa Hirotaka , Vakharia Kunal , Graffeo Christopher S , Carlson Matthew L , Pollock Bruce E , Brown Paul D , Perry Avital , Gompel Jamie J Van , Driscoll Colin L. W. , Link Michael J
Published: March 2021

PurposeTo clarify the need for post-operative radiation treatment in skull base chondrosarcomas (SBCs).MethodsA retrospective analysis of patients with grade I or II SBC. Patients were divided according to post-surgical treatment strategies: (A) planned upfront radiotherapy and (B) watchful waiting. Tumor control and survival were compared between the treatment groups. The median follow-up after resection was 105 months (range, 9-376).ResultsThirty-two patients (Grade 1, n = 16; Grade 2, n = 16) were included. The most frequent location was petroclival (21, 64%). A gross total resection (GTR) was achieved in 11 patients (34%). Fourteen (44%) underwent upfront radiotherapy (group A) whereas 18 (56%) were followed with serial MRI alone (group B). The tumor control rate for the entire group was 77% and 69% at 10- and 15-year, respectively. Upfront radiotherapy (P = 0.25), extent of resection (P = 0.11) or tumor grade (P = 0.83) did not affect tumor control. The majority of Group B patients with recurrent tumors (5/7) obtained tumor control with repeat resection (n = 2), salvage radiotherapy (n = 2), or a combination of both (n = 1). The 10-year disease-specific survival was 95% with no difference between the group A and B (P = 0.50). ConclusionFor patients with grade I/II SBC, a reasonable strategy is deferral of radiotherapy after maximum safe resection until tumor progression or recurrence. At that time, most patients can be successfully managed with salvage radiotherapy or surgery. Late recurrences may occur, and life-long follow-up is advisable.
A Simple Method of Simultaneously Endowing Paper or Fluff Pulp With Both High Softness or Appropriate Fluffing Properties and Antimicrobial Properties
Authors: Xu Yongjian , Shi Yun , Chen Xuyong , Liu Fenfen , Zhao Wei
Published: March 2021

As the living standard improve, disposable sanitary and living paper requires not only softness or easy to fluff in a dry state, but also good antibacterial property. In this study, a series of alkyl quaternary ammonium salts (AQAS), a kinds of antibacterial-debonding agents, were synthesized by using a two-step process. The SN2 nucleophilic substitution reaction was designed between triethanolamine and sulfoxide chloride, and followed subsequent quaternization by tertiaryamines with different long alkyl chains. The obtained products can be used as an antibacterial and softening/debonding agent for improving the performance of paper or fluff pulp. The results showed that these new compounds can endow antibacterial function and high softness to paper or control appropriate burst strength to fluff pulp board. These AQAS products can be not only used in daily disposable sanitary products, but also have potential applications in other products such as glass spacer paper, advanced household paper, or antibacterial tissue products to prevent microbial contamination.