bluuebunny/crossref_metadata_2025 huggingface dataset:
Acute Respiratory Distress Syndrome Caused By Human Adenovirus In Adults: A Prospective Observational Study In Guangdong, 2019–2020
Authors: Wu Zhan , Zhang Rong , Liu Dongdong , Liu Xuesong , Zhang Jierong , Zhang Zhihui , Chen Sibei , He Weiqun , Li Yimin , Xu Yonghao , Liu Xiaoqing
Published: August 2021

Background: Viral causes of acute respiratory distress syndrome (ARDS) are mostly limited to influenza. However, adenovirus has been emerging as a cause of ARDS with a high mortality rate and described in adults are rare.Methods: We conducted a prospective, single-center observational study of viral pneumonia with ARDS and confirmed adenovirus-associated ARDS in adults at our quaternary referral institution between March 2019 and June 2020. We prospectively analyzed clinical characteristics, laboratory test results, radiological characteristics, viral load from nasopharyngeal swabs and endotracheal aspirates, treatments, and outcomes for the study participants.Results: The study enrolled 143 ARDS patients, including 47 patients with viral pneumonia-related ARDS, among which there were 14 adenovirus-associated ARDS patients, which accounted for 29.79% of the viral pneumonia-related ARDS cases. Among the adenovirus-associated ARDS patients, 78.57% were men with a mean age of 54.93 ± 19.04 years. Adenovirus-associated ARDS patients had no specific clinical characteristics, but they presented with shortness of breath and fever, and their initial chest radiographic findings were multifocal or showed diffuse opacity. The viral load and the positivity rate in the lower respiratory tract were higher than that of the upper respiratory tract in the patients with adenovirus-associated ARDS, and 85.71% of the patients had a significant decrease in the number of CD3+CD4+ T cells during the early stage. All patients required invasive mechanical ventilation treatment. The average time from shortness of breath to the application of invasive ventilation was 24 hours. The median duration of invasive mechanical ventilation was 22 days (14–75 days). Six patients (42.86%) required renal replacement therapy, and three patients (21.43%) required extracorporeal membrane oxygenation support. Additionally, 85.71% of the 14 adenovirus-associated ARDS patients survived.Conclusion: Adenovirus infection is an important cause of virus-related ARDS. The positivity rate of adenovirus infection in lower respiratory tract secretions was higher than that in upper respiratory tract secretions in these patients. Most of the patients had a significant decrease in the number of CD3+CD4+ T cells during the early stage. Early identification and intervention to prevent disease progression are essential for reducing the mortality rate in these patients.Trial registration: ChiCTR1900022822. Registered 27 April 2019, https://www.chictr.org.cn/showproj.aspx?proj=38064
Support Vector Machine for Stock Movement Direction Prediction with Sparsity for Feature Selection
Authors: Miao Maoxuan , Wu Jinran , Cai Fengjing , Fu Liya , Wang You-Gan
Published: August 2021

In the stock market, accurate prediction of stock price movement direction can effectively increase the profits for investors. However, the stock price is an extremely complex dynamic system with strong fluctuation, proper selection of technical indicators can potentially improve the accuracy of the direction prediction. We propose a novel sparse least squares support vector machine (LSSVM) by combining recursive feature elimination (RFE) and Relief via a weight parameter. Specially, the benefit if this hybrid is three fold: (1) accounting for any intrinsic correlations among the features, (2) more effective prediction due to the sparse framework capable of removing some “noise” features completely; and (3) simultaneously select technical indicators according to the feature ranking and accounts for possible interactions and possible non-linear effects among the features. Three stock datasets from the liquor and spirits concept are analyzed to demonstrate the superiority of our proposed new framework providing sparse solutions resulting in more accurate predictions and higher returns among all seven considered classifiers.
Overview of National Health Reporting in the EU and Quality Criteria for Public Health Reports – Results of the Joint Action InfAct
Authors: Thissen Martin , Seeling Stefanie , Achterberg Peter , Fehr Angela , Palmieri Luigi , Tijhuis Mariken J. , Unim Brigid , Ziese Thomas
Published: August 2021

Background: Health reporting shall provide up-to-date health-related data to inform policy-makers, researchers and the public. To this end, health reporting formats should be tailored to the needs and competencies of the target groups and provide comparable and high-quality information. Within the Joint Action on Health Information ‘InfAct’, we aimed at gaining an overview of health reporting practices in the EU Member States and associated countries, and developed quality criteria for the preparation of public health reports. The results are intended to facilitate making health information adequately available while reducing inequalities in health reporting across the EU.Methods: A web-based desk research was conducted among EU Member States and associated countries to generate an overview of different formats of national health reporting and their respective target groups. To identify possible quality criteria for public health reports, an exploratory literature review was performed and earlier projects were analysed. The final set of criteria was developed in exchange with experts from the InfAct consortium. Results: The web-based desk research showed that public health reports are the most frequently used format across countries (94%), most often addressed to scientists and researchers (51%), politicians and decision-makers (41%). However, across all reporting formats, the general public is the most frequently addressed target group. With regards to quality criteria for public health reports, the literature review has yielded few results. Therefore, two earlier projects served as main sources: the ‘Evaluation of National and Regional Public Health Reports’ and the guideline ‘Good Practice in Health Reporting‘ from Germany. In collaboration with experts, quality criteria were identified and grouped into eight categories, ranging from topic selection to presentation of results, and compiled in a checklist for easy reference.Conclusion: Health reporting practices in the EU are heterogeneous across Member States. The assembled quality criteria are intended to facilitate the preparation, dissemination and access to better comparable high-quality public health reports as a basis for evidence-based decision-making. A comprehensive conceptual and integrative approach that incorporates the policy perspective would be useful to investigate which dissemination strategies are the most suitable for specific requirements of the targeted groups.
Tracking Excess of Maternal Deaths Directly and Indirectly Associated With COVID-19 in Brazil: A Nationwide Database Analysis
Authors: Guimarães Raphael Mendonça , Reis Lenice Gnocchi Costa , Gomes Maria Auxiliadora Souza Mendes , Magluta Cynthia , de Freitas Carlos Machado , Portela Margareth Chrisostomo
Published: August 2021

Background
The COVID-19 pandemic brought a new challenge to maternal mortality in Brazil. Throughout 2020, Brazil registered 549 maternal deaths, mainly concentrated in second and third-trimester pregnant women. The objective of this study was to verify the excess of maternal deaths that occurred in Brazil caused directly and indirectly by Covid-19 in the year 2020. In addition, we sought to identify clinical social and health care factors associated with these maternal deaths, when they were directly caused by Covid-19.
Methods
We performed nationwide analyses, based on data from the Mortality Information System (SIM), for general deaths and maternal deaths, and the Influenza Epidemiological Surveillance System (SIVEP-Influenza), for estimates of female and maternal deaths due to COVID-19. The methodological approach adopted two distinct techniques. First, we estimated the excess maternal mortality and the breakdown of the excess between total and COVID-19 deaths. Then, we estimated the odds ratios of occurrence of symptoms, comorbidities, social determination proxies, and hospital care aspects between COVID-19 maternal and childbearing age female deaths. We chose women of childbearing age (15 to 49 years) as a reference because sex and age introduce differentials in the risk of COVID-19 death.
Results
Most of maternal deaths occurred during pregnancy in all months of 2020 (µ = 59.8%, SD = 14.3%, range 50%-100%). Even considering the excess mortality due to COVID-19 for the childbearing age female population, maternal mortality was more penalized. Clinical variables suggest that the chances of occurrence of symptoms among maternal deaths were like those observed in the deaths of women of childbearing age. On the other hand, the odds of being a black woman, living in a rural area and being hospitalized out of the residence municipality among maternal deaths were 44%, 61%, and 28% higher than control group. Odds of hospitalization, ICU admission, and invasive ventilatory support use among maternal deaths were, respectively, 4.37, 1.73, and 1.64 times as control group.
Conclusions
Differences between the two groups of deaths are significantly associated with social determination and (in)adequate obstetric care. Year 2021 has been more severe for maternal mortality. We need to increase immunization and monitoring among pregnant women immediately.
Integration of Satellite Observation and Dust Trajectory Modeling for Dust Transport and Dispersion Monitoring
Authors: Alizadeh Faezeh , Falahatkar Samereh , Afzali Afsaneh
Published: August 2021

Land use/cover change was distinguished as one of the most local environmental consequences and has an important role in increasing dust due to land degradation. The aim of study was to identify the local dust storm sources in Khuzestan province (southwestern Iran) due to land use/cover change and their dispersion and transport modeling from these sources by Lagrangian particle HYSPLIT model. In the first part of study, Landsat images for 1984, 1992, 2002, and 2017 were used in order to produce the land use/cover maps and post classification comparison was applied for land use/cover change detection from 1984 to 2017. The results of change detection showed that wetland areas (Horolazim wetland and Shadegan international wetland) experienced sever changes and converted to probable dust storm centers. Subsequently, HYSPLIT model was performed in dust trajectory modeling from the detected dust storm centers for 365 days of 2016 in three elevation level. Aerosol optical depth (AOD) product of MODIS and air quality monitoring(AQM) data were used for HYSPLIT performance assessment. The findings of modeling showed that storms originated from detected dust storm centers can be transferred to the transboundary of Khuzestan province, especially in hot season. Therefore, focusing on national programs could be as valuable as international cooperation for mitigation and controlling dust storms in southwestern Iran.
Burden of Liver Cancer Attributable to Five Risk Factors by Specific Etiologies in 204 Countries and Territories
Authors: Li Yizhen , Wei Bajin , Deng Yujiao , Liu Yuanxing , Deng Xinyue , Xiang Dong , Hu Jingjing , Zheng Yi , Xu Peng , Yao Jia , Zhai Zhen , Zhou Linghui , Yang Si , Wu Ying , Zheng Shusen , Dai Zhijun
Published: August 2021

Background Liver cancer has caused a serious disease burden worldwide wherein prognostic risk factors may have had a significant role. However, previous studies have focused on liver cancer distributions and trend variations without analyzing the role of risk factors. Methods We assessed liver cancer burden attributable to five recognized risk factors as well as temporal trends from 1990 to 2019 based on the 2019 Global Burden of Disease Study. The risk exposure levels and their contributed burden were estimated by cause, sex, age, and location. Furthermore, the relationship between the risks and social-demographic index (SDI) was investigated. Results The total liver cancer burden attributable to risk factors is still increasing year by year in terms of death and disability-adjusted life years. However, the burden attributable to alcohol use and smoking has shown a downward trend in recent years. Risk-related burden in males was more than three times as that in females, the burden among the middle-aged and elderly was the most serious, and Central Asia, high-income Asia Pacific and East Asia exhibited the highest burden worldwide. The exposure levels of the five recognized risk factors were generally positively correlated with SDI value. However, the risk-related liver cancer burden first increased and then decreased with the SDI value. Conclusion These findings could help in understanding the role of prognostic risk factors in liver cancer burden, in promoting the development of relevant studies, and in proposing better prevention and control policies tailored to local conditions.
CERTAIN Program: Logic Model for System Level Planning and Evaluation of Innovative Education Delivery and Dissemination
Authors: Sun Yuqiang , Li Heyi , Tekin Aysun , Bogojevic Marija , Flurin Laure , Heise Katherine , Kashyap Rahul , Finch Alexander , Niven Alexander , Gajic Ognjen , Dong Yue
Published: August 2021

Background

CERTAIN (Checklist for Early Recognition and Treatment of Acute Illness and iNjury) has been shown to improve critical care process and patient outcomes in international ICUs with variable resources.
Methods

CERTAIN education program derived from this approach is designed, promoted, and implemented following the Logic model. Through the roadmap of the Logic model, we presented a dynamic, longitudinal implementation framework that had sufficient rigor yet offers flexibility to reach the need of the existing and emerging diversified medical education projects.
Results

Using the Logic model, the delivery of the CERTAIN education program is optimized to deliver relevant education content in various environments. During the COVID-19 outbreak, the implementational framework demonstrated that it could serve as an excellent template for effective response to global pandemics.
Conclusions

The Logical model is useful as a facilitation tool for planning and evaluating innovative education delivery and dissemination. The CERTAIN program provided an example for other continuous professional education projects.
Socio-Economic Productive Capacities and Energy Efficiency: Global Evidence by Income Level and Resource Dependence
Authors: Demiral Mehmet , Demiral Özge
Published: August 2021

This study tests the effects of productive capacities in socio-economic factors (human capital, transport, information-communication technology, institutions, private sector, and structural change) on energy efficiency in a sample of 125 countries. Energy efficiency is assessed by energy productivity (gross domestic product per unit of total primary energy supply) and energy intensity (total primary energy supply per capita). The world sample is divided into four income groups and an income-heterogeneous control group of non-renewable resource-dependent economies. The study utilizes cross-sectionally dependent and stationary panel data over the period 2000-2018. The analysis of variance shows that higher income groups monotonically have higher productive capacities and energy intensity. The regression results from appropriate fixed-effects and random-effects modeling reveal varied driver and barrier influences of the socio-economic factors on energy efficiency improvements (higher energy productivity and lower energy intensity). In some cases, predictors scale up both energy productivity and energy intensity indicating the issue of the rebound effect. Higher human capital capacity stimulates energy efficiency except for middle-income groups. Higher transport capacity reduces energy productivity, except for upper-middle-income economies, and tends to increase energy intensity for low-income and middle-income groups. The deployment of information-communication technologies is positively associated with energy productivity, except for low-income economies. Energy productivity performance of resource-dependent economies is improved by higher productive capacities in institutions and private sectors but impaired by structural change, whereas structural change drives energy efficiency in low-income economies. Additionally, the growth of gross national income per capita worsens energy efficiency for resource-dependent economies. Bidirectional feedback causalities are established between energy efficiency and its predictors in most cases. The heterogeneous findings are discussed for providing research and policy implications.
Assessment of Genetic Diversity Among Chinese High-Oleic Peanut Genotypes Using Miniature Inverted-Repeat Transposable Element Markers
Authors: Wang Chuan Tang , Song Guo Sheng , Wang Zhi Wei , Li Hong Ju , Han Hong Wei , Wang Xiu Zhen , Sun Xiu Shan
Published: August 2021

As compared with normal-oleic peanut, high-oleic peanut proved to be heart-healthier, and had prolonged shelf life and extended seed longevity. However, there have concerns about the genetic diversity of present-day high-oleic peanut cultivars, which relied heavily on high-oleic donors with F435 type FAD2 mutations. In the study, a total of 104 high-oleic peanut cultivars/lines/mutants from main breeding teams in China were used to assess their genetic diversity with AhMITE markers. Of all the 31 cultivars tested, those from CTW team had the highest genetic variability. Again, of all the 73 lines studied, those from CTW team ranked first in genetic diversity. As compared with cultivars from CTW and C&Y teams, greater genetic diversity was detected in new lines of both teams, indicating that recent breeding efforts had resulted in improved genetic diversity in high-oleic peanut.
On the Use of Self-Organizing Maps in Detecting Teleconnections. Part I: Spatial Aspects
Authors: Stryhal Jan , Beranová Romana , Huth Radan
Published: August 2021

Self-organizing maps (SOMs) represent a popular classification tool, output of which has been used to link typical synoptic-scale circulation patterns to large-scale teleconnections, or modes of low-frequency circulation variability. However, recently there have been attempts to interpret SOM output directly as a continuum of teleconnections. In the present paper, we provide a theoretical study dealing with how predefined idealized modes of variability project onto SOM arrays. Three orthogonal modes are defined and their various linear combinations used to generate datasets of known structure. Multiple variants of SOMs that differ in their initialization are generated for SOMs of various shapes and sizes. The results show that how a mode projects on a SOM array is sensitive not only to data structure, but also to various SOM parameters. The leading mode of variability projects rather strongly on SOMs if its explained variance is markedly higher than that of the second-order mode; the remaining modes project considerably more weakly, and all modes tend to blend when their explained variance is close to each other, which leads to underrepresentation of some phases of modes and/or combinations of modes among the SOM patterns. Furthermore, non-linear features appear in SOM arrays even if the underlying modes of variability are strictly linear. The findings point to limitations in the applicability of SOMs in the research of teleconnections.
Blood Transfusion Had No Influence on the 5-year Biochemical Recurrence After Robot-assisted Radical Prostatectomy: A Retrospective Study
Authors: Han Jiwon , Jeon Young-Tae , Ryu Jung-Hee , Oh Ah-Young , Kim Hwanik , Bae Yu Kyung , Koo Chang-Hoon
Published: August 2021

BackgroundAlthough red blood cells (RBC) transfusion is known to be significantly associated with biochemical recurrence in patients undergoing open prostatectomy, its influence on biochemical recurrence after robot-assisted laparoscopic radical prostatectomy remains unclear. Therefore, this study aimed to validate the effect of RBC transfusion on the 5-year biochemical recurrence in patients undergoing robot-assisted laparoscopic radical prostatectomy. MethodsThis study retrospectively analyzed the medical records of patients who underwent robot-assisted laparoscopic radical prostatectomy at single tertiary academic hospital between October 2007 and December 2014. Univariate and multivariate Cox proportional hazard regression analysis was performed to identify any potential variables associated with 5-year biochemical recurrence. ResultsA total of 1311 patients were included in the final analysis. Of these, 30 patients (2.3%) were transfused with RBC either during robot-assisted laparoscopic radical prostatectomy or during their hospital stay, which corresponded to 5-year biochemical recurrence of 15.7%. Multivariate Cox proportional hazard regression analysis showed that RBC transfusion had no influence on the 5-year biochemical recurrence. Variables including pathologic T stage (Hazard ratio [HR] 3.5, 95% confidence interval [CI] 2.4-5.1 p < 0.001), N stage (HR 2.3, 95% CI 1.5-3.7, p < 0.001), Gleason score (HR 2.4, 95% CI 1.8-3.2, p < 0.001), and surgical margin (HR 2.0, 95% CI 1.5-2.8, p < 0.001) were independently associated with the 5-year biochemical recurrence.ConclusionsRBC transfusion had no significant influence on the 5-year biochemical recurrence in patients undergoing robot-assisted laparoscopic radical prostatectomy.
Advantages and Disadvantages of Different Coupling Methods of Plasma Antennas
Authors: Hadaegh Mostafa , Mohajeri Farzad
Published: August 2021

One of the important challenges in plasma antennas, is the coupling of RF signal to the plasma column. RF signal coupling has a significant effect on antenna efficiency, antenna implementation cost, structure implementation complexity, antenna pattern shape, and final structure weight and volume. In this article, firstly the various methods of coupling were introduced. Then capacitive coupling, direct coupling and sleeve coupling were presented and their advantages and disadvantages were mentioned. As a sample, a plasma folded monopole antenna with sleeve coupling was fabricated and measured. By comparison of the different coupling methods and as a result, one can conclude that the sleeve coupling method is the most suitable method. This method has the least sensitivity to change the dimensions. It is also easy and cheap to implement. In this type of coupling, the efficiency of the Nesta antenna is suitable and the coupling structure adds small weight and volume to the antenna structure.
Improving the patient-reported outcome sections of clinical trial protocols: a mixed methods evaluation of educational workshops
Authors: King Madeleine , Tait Margaret-Ann , Campbell Rachel , Müller Fabiola , Rutherford Claudia , Beckmore Corinna , Chima Sophie , Langbecker Danette , Shaw Joanne , Mercieca-Bebber Rebecca
Published: August 2021

IntroductionFailure to incorporate key patient-reported outcome (PRO) content in trial protocols affects the quality and interpretability of the collected data, contributing to research waste. Our group developed evidence-based training specifically addressing PRO components of protocols. We aimed to assess whether 2-day educational workshops improved the PRO completeness of protocols against consensus-based minimum standards provided in the SPIRIT-PRO Extension in 2018.MethodAnnual workshops were conducted 2011–2017. Participants were investigators/ trialists from cancer clinical trials groups. Although developed pre-2018, workshops covered 15/16 SPIRIT-PRO items. Participant feedback immediately post-workshop and, retrospectively, in November 2017 was summarised descriptively. Protocols were evaluated against SPIRIT-PRO by two independent raters for workshop protocols (developed post-workshop by participants) and control protocols (contemporaneous non-workshop protocols). SPIRIT-PRO items were assessed for completeness (0 = not addressed, 10 = fully addressed). Mann-Whitney U-tests assessed whether workshop protocols scored higher than controls by item and overall.ResultsParticipants (n = 107) evaluated the workshop positively. In 2017, 16/41 survey responders (39%) reported never applying in practice; barriers included role restrictions (14/41, 34%) and lack of time (5/41, 12%). SPIRIT-PRO overall scores did not differ between workshop (n = 16, mean = 3.84 (standard deviation = 1.86)) and control protocols (n = 6, 2.46 (1.35)), (p = 0.09). Workshop protocols scored higher than controls on two items: ‘specify PRO concepts/domains’ (p = 0.035); ‘specify analysis methods’ (p = 0.011).ConclusionAlthough participants were highly satisfied with these workshops, the completeness of PRO protocol content improved only slightly. Additional knowledge translation efforts are needed to assist protocol writers address SPIRIT-PRO guidance and avoid research waste that may eventuate from sub-optimal PRO protocol content.
Genetic Characterisation of Spring Viraemia of Carp Virus Strains in Russia
Authors: Perchun Aleksey , Pavlov Dmitry , Melnikov Vladimir , Antonychev Aleksey , Zinyakov Nikolay , Korennoy Fedor , Moroz Natalya , Chvala Ilya , Metlin Artem
Published: August 2021

The paper presents genetic characteristics of two strains of the spring viraemia of carp virus strains Kirov/08 and Orenburg/14 isolated in the Kirov and Orenburg Oblasts of the Russian Federation, respectively. The nucleotide sequence analysis of the 516-bp fragment of Kirov/08 and Orenburg/14 G gene showed 9.5% difference. The phylogenetic analysis demonstrated a high level of homology of these strains to SVC viruses, isolated earlier in Russia, Ukraine and the Republic of Moldova.
Beauveria Bassiana as Fungal Endophyte for the Potential Control of the Potato Tuber Moth Phthorimaea Operculella on Potatoes
Authors: Zhang Mengdi , Yan Junjie , Reitz Stuart , Wu Shengyong , Gao Yulin
Published: August 2021

The potato tuber moth, Phthorimaea operculella, is the most damaging potato pest in the world and is difficult to control as the larvae are internal feeders in the foliage or tubers. Entomopathogenic fungi (EPF) which colonize plants as endophytes, have lethal and sublethal pathological effects on insect pests. Experiments showed that Beauveria bassiana colonized the aerial parts of potato plants endophytically after inoculation through soil drenching. The colonization rate reached 100% for both upper and lower foliage parts one day after inoculation, and endophytic B. bassiana remained present for more than 21-day post inoculation. Mortality experiments indicated that B. bassiana and B. bassiana-inoculated potato plants were pathogenic against 2nd instar larvae of P. operculella. Development experiments showed that the weight of P. operculella pupae reared on B. bassiana-colonized potato leaves (4.25 mg) was significantly lighter than of those reared on uninoculated control plants (8.89 mg). Sublethal experiments indicated that B. bassiana negatively affected the growth, development and reproduction of P. operculella. Compared to newly eclosed larvae fed on control plants, those fed on B. bassiana-inoculated plants had significantly lower survival, with only 17.8% developing to the adult stage. Oviposition of P. operculella females reared on B. bassiana endophytically-colonized plants was significantly lower (35 eggs/per female) than of those reared on uninoculated plants (115 eggs/per female). This study demonstrates that endophytic B. bassiana can be a potential biological agent for the control and management of P. operculella.
Diagnostic Utility of Next-Generation Sequencing-Based Panel Testing in 543 Patients with Suspected Skeletal Dysplasia
Authors: Scocchia Alicia , Kangas-Kontio Tiia , Irving Melita , Hero Matti , Saarinen Inka , Pelttari Liisa , Gall Kimberly , Valo Satu , Huusko Johanna M. , Tallila Jonna , Sistonen Johanna , Koskenvuo Juha , Alastalo Tero-Pekka
Published: August 2021

Background: Skeletal dysplasia is typically diagnosed using a combination of radiographic imaging, clinical examinations, and molecular testing. Identifying a molecular diagnosis for an individual with a skeletal dysplasia can lead to improved clinical care, guide future medical management and treatment, and inform assessment of risk for familial recurrence. The molecular diagnostic utility of multi-gene panel testing using next-generation sequencing (NGS) has not yet been characterized for an unselected population of individuals with suspected skeletal dysplasia. In this study, we retrospectively reviewed patient reports to assess the diagnostic yield, reported variant characteristics, impact of copy number variation, and performance in prenatal diagnostics of panel tests for variants in genes associated with skeletal dysplasia and growth disorders. Results: Clinical reports of consecutive patients with a clinical indication of suspected skeletal dysplasia who underwent panel testing were examined. The 543 patients included in the study submitted samples for diagnostic genetic testing with an indication of suspected skeletal dysplasia or growth disorder and received one of three nested panel tests. A molecular diagnosis was established in 42.0% of patients (n=228/543). Diagnostic variants were identified in 71 genes, nearly half of which (n=35, 49.3%) contributed uniquely to a molecular diagnosis for a single patient in this cohort. Diagnostic yield was significantly higher among fetal samples (58.0%, n=51/88) than postnatal samples (38.9%, n=177/455; z=3.32, p<0.0009). Diagnostic variants in fetal cases were identified across 18 genes. Thirteen diagnostic CNVs were reported, representing 5.7% of diagnostic findings and ranging in size from 241-bp to whole chromosome aneuploidy. Additionally, 11.4% (36/315) of non-diagnostic patient reports had suspicious variants of unknown significance (VUS), in which additional family studies that provide segregation data and/or functional characterization may result in reclassification to likely pathogenic. Conclusions: These findings demonstrate the utility of panel testing for individuals with a suspected skeletal dysplasia or growth disorder, with a particularly high diagnostic yield seen in prenatal cases. Pursuing comprehensive panel testing with high-resolution CNV analysis can provide a diagnostic benefit, given the considerable phenotype overlap amongst skeletal dysplasia conditions.
Prognostic Role of Ultrasound Imaging in Desmoplastic Small Round Cell Tumor: A Retrospective Study and Literature Review
Authors: Zhang Jing , Cheng Xueqing , Liu Juxian , Liu Jiakai , Lu Qiang , Yan Feng , Xu Jinshun , Peng Yulan
Published: August 2021

Background: Desmoplastic small round cell tumor (DSRCT) mostly arose in the abdominopelvic cavity is an aggressive sarcoma with poor prognosis. The purpose of this study is to analyze ultrasonographic performance in prediction of prognosis of DSRCT.Method: Between March 1999 and October 2019, a total of 27 patients with pathologically confirmed DSRCT in our hospital were conducted. Clinical and ultrasonographic characterizations, including age, sex, symptoms, tumor size, number, location, shape, margin, echogenicity, homogeneity, vascularity, and metastases were recorded and analyzed with overall survival (OS) by using univariate analysis.Result: Ultrasonographic performance of DSRCT were irregular (74%), posterior echo enhancement (63%), calcification (51.9%), and liquefaction (55.6%) in tumors companied with ascites (63%), hydronephrosis (59%) and metastases (63%). The median OS was 22 months (range 7–36 months) and 5-year OS rate was 19.6%. Using univariate analysis, a higher hazard ratio (HR) of mortality was associated with liquefaction (HR: 3.09, 95% CI:1.23-7.76, p=0.016) and bone metastasis (HR: 2.95, 95%CI: 1.16-7.49, p=0.023). According to a risk staging system developed by selected predictors (low = neither liquefaction nor bone involvement; moderate = either liquefaction or bone involvement; high = both liquefaction and bone involvement), 40%, 10%, and 0 of 3-year survival were found in the low, moderate, and high risk patients, respectively.Conclusion: Ultrasound imaging is effective to evaluate prognosis of DSRCT. Findings of liquefaction and bone involvement in the ultrasonography may predict a poor prognosis of DSRCT patients.
Building a Cancer Coalition: A co-design framework for evaluating regionalism in the South Pacific
Authors: Hyatt Amelia , Chan Belinda , Moodie Rob , Varlow Megan , Bates Chris , Folaki Sunia , Palafox Neal , Burich Shelley , Aranda Sanchia
Published: August 2021

Background

Cancer is a significant problem for the South Pacific region due to a range of complex and unique health challenges caused by shared social, environmental and economic factors. Currently gaps in diagnosis, treatment and palliative care are significant, and while governmental commitment is strong, economic constrains limit health system strengthening. Collaboration, alliances and partnerships in cancer control have been successful in resource constrained settings. A regional approach has therefore been recommended as an effective solution to addressing many of the challenges for cancer control in the South Pacific. However, comprehensive and appropriate information detailing how to effectively scope and establish a multi-national or regional coalition is scarce. This study therefore aimed to 1) create a Coalition Development Framework, and 2) use the Framework to co-design a South Pacific Cancer Control Coalition through consultation with key cancer control stakeholders working within Fiji, New Caledonia, Papua New Guinea, Samoa and Tonga.
Results

Analysis of the consultations with key cancer control stakeholders identified overwhelming appetite and support for a South Pacific Cancer Control Coalition. This paper details the following six coalition development outputs: coalition design and purpose, strategic imperatives, structure, South Pacific foundations, barriers and facilitators to coalition establishment and ongoing operations, priorities for action. Concurrent evaluation of the Coalition Development Framework using theory of change revealed the framework to be an effective mechanism to drive engagement, discovery, unification and action in alliance-building.
Conclusions

A regional Coalition to drive cancer control in the South Pacific has significant support among key Pacific stakeholders. Likewise, design and scope of the Coalition has been synthesised and mapped to guide feasible and appropriate establishment. Importantly our results also describe the effective implementation of a Coalition Development Framework in an applied setting, to guide future use. If momentum is continued, and a regional South Pacific Coalition established, the benefits in reducing the burden of cancer within the region will be substantial.
Is waist-to-height ratio the best predictive indicator of cardiovascular disease incidence in hypertensive adults? A cohort study
Authors: Sun Yingxian , Zhang Shu , Fu Xin , Du Zhi , Guo Xiaofan , Sun Guozhe , Li Zhao , Zhou Ying , Yang Hongmei , Yu Shasha , Zheng Liqiang
Published: August 2021

Background

Cardiovascular disease (CVD) brings high mortality and economic burden to patients, especially in rural areas. Simple, low-cost abdominal adiposity measures may help identify individuals with increased CVD risk. It is unclear that which obesity indice is the best to predict CVD in hypertensive people.
Methods

NCRCHS is a prospective cohort study in a general population in Northeast China. The study examined the cardiovascular health from 2013–2015, and follow-up captured the CVD incidence in 2018. Baseline waist-to-height ratio (WHtR), body mass index (BMI),waist-to-hip(WHR)and waist circumference (WC) were calculated and analyzed in relation to the CVD incidence.
Results

A total of 4244 hypertensive adults without pre-existing CVD at baseline were included in this analysis (age 35–92 years; 2108 men). Over a median follow-up of 4.66 years, a total of 290 CVD cases (6.83%) were documented during the follow-up. Baseline WHtR showed a significant positive association with CVD incidence, even after adjusting for age, sex, diabetes, drinking, smoking, SBP, DBP, Triglyceride, HDL-C, LDL-C, and TC (Hazard Ratios per SD of WHtR ranging from 1.03 to 1.31, p = 0.017). Reclassification and discrimination analyses indicated WHtR addition could improve the conventional model for predicting adverse outcomes within 4 years. Moreover, WHtR predicted the CVD incidence better than other obesity indices (BMI, WC, WHR).
Conclusion

These findings support a positive association between WHtR and CVD incidence in CVD-free hypertensive adults. WHtR may be useful in predicting CVD incidence in hypertensive adults.
A secondary data analysis of qualitative study of individualized treatment regimen for North Indians living with human immunodeficiency virus-1
Authors: Barik Sushanta Kumar , Bansal Avi Kumar , Yadav Ashwini , Tripathy Srikanth Prasad , Singh Tej Pal , Jena Srikanta , Patil Shripad A , Mohanty Keshar Kunja
Published: August 2021

Background
A correlation between the CD4 counts and viral loads of HIV-1 infected North Indian patients with first line ART was reported. The follow up of fifty-seven patients were conducted after a confirmation genotypic test. The secondary data analysis was done on the data available to observe the correlation between the CD4 counts and viral loads (markers of clinical outcome) of HIV-1 Subtype C infected North Indian patients.
Methods
After analysis of the drug resistance mutations in individual patients through the drug resistance database, Stanford University, the data of resistance associated drugs, CD4 counts, viral load of individuals were compiled and analysed using Microsoft Excel 2016 and SPSS Version 22. Normality of data was checked by Shapiro-Wilk test (p < 0.05).
Results
Starting and study end point data on CD4 count, viral load and drug resistance pattern associated with multiple first line ART was available for 24 North Indian patients. Starting and study end point data on CD4 count and drug resistance pattern associated with multiple first line ART was available for 33 North Indian patients.
Conclusion
Our findings are categorically indicative that policy recommendation to provide tailor-made individualized regimen based on molecular drug resistance testing to HIV patients under AIDS control program requires robust evidence before implementation.
Natural Glycoside Salidroside Ameliorates Orthopedic Surgery-Induced Cognitive Dysfunction Through Activating Adenosine 5‘-Monophosphate-Activated Protein Kinase Signaling in Mice
Authors: Pan Cai-Long , Dai Guo-Liang , Zhang Hui-Wen , Zhang Chen-Yang , Meng Qing-Hai , Xu Lu , Xu Ning , Liu Xue , Zhang Zhiren , Zhang Yong , Tan Qi-Lian , Wang Xiao-Liang , Zhang Zhi-Yuan
Published: August 2021

Background: Perioperative neurocognitive disorders (PND) are the most common postoperative complications with few therapeutic options. Salidroside, a plant-derived compound, has gained increased attention as treatment for various neurological diseases and particularly modifier of microglia-mediated neuroinflammation. However, the effect of salidroside on orthopedic surgery-induced cognitive dysfunction and the underlying mechanisms are largely unknown.Methods: The Morris water maze test was used to investigate potential effects of salidroside in the animal model of tibia fracturing with intramedullary fixation. Therapeutic mechanism and related signaling pathways of salidroside in PND were further investigated with animal tissues and microglial cultures in vitro by molecular biology tests.Results: Here we found that salidroside greatly attenuated cognitive impairment in mice after orthopedic surgery. Neuroinflammation in mouse hippocampus were also attenuated by salidroside. Meanwhile, salidroside treatment induced a switch in microglia polarization to the anti-inflammatory phenotype. In vitro, salidroside suppressed the expression of pro-inflammatory cytokines and induced a switch in microglial phenotype to the anti-inflammatory phenotype. Mechanically, molecular docking studies revealed potential AMPK activation activity of salidroside. And salidroside did up-regulated the AMPK pathway proteins. Moreover, AMPK antagonist abolished the effects of salidroside in vivo and in vitro.Conclusions: Taken together, our results demonstrated that salidroside effectively suppressed PND by suppressing microglia-mediated neuroinflammation through activating AMPK pathway, and it might be a novel therapeutic approach for PND.
Association Between the Triglyceride Glucose Index and Alanine Aminotransferase Levels: a Cross-sectional Study
Authors: Hua Yu , Yu Haiyue , Chen Shuang , Zhang Xueyao , Zhang Xingang , Sun Yingxian
Published: August 2021

Background: The triglyceride glucose index (TyG) has been proposed as a marker of insulin resistance or type 2 diabetes mellitus (T2DM). Risk of serum alanine aminotransferase (ALT) levels is increased in T2DM patients. We aimed to evaluate the association between TyG index and elevated ALT. Methods: A multicenter, cross-sectional study was conducted in China from Northeast China Rural Cardiovascular Health Study (NCRCHS), and 11,573 adults with complete data were included in our final analysis.Results: TyG index was positively associated with the prevalence of elevated ALT. Frequency of elevated ALT increased from the lowest to the top quartile of TyG in both sexes (p for trend <0.001). Compared with the participants in the lowest quartile of TyG, the adjusted odds ratio and 95% CIs for elevated ALT were 1.71 (1.32-2.21) and 2.46 (1.90-3.19) for those in the third and the fourth quartile of TyG (p<0.001). Compared with the first quartile of TyG, participants in the top quartile of TyG had more than 2 times risk for elevated ALT (2.38-times for men and 2.22-times for women, respectively, p<0.001). According to the ROC analysis, the optimal cut-off point of TyG for elevated ALT was 8.69 and 8.96 for men and women, respectively. Conclusions: TyG index is effective to identify individuals at risk for elevated ALT. TyG thresholds of 8.69 for men and 8.96 for women was highly sensitive for detecting elevated ALT subjects. Findings from this study underscore that TyG index may be suitable as a surrogate marker for abnormal liver enzymes in Chinese adults.
Overexpression of Calreticulin Promotes Cardiac Fibroblasts Activation Via Regulating IRE1 Pathway
Authors: zhiyue liu , Liu Zhiyue , Zhang Wen , Li Junli , Xiao Lei , Huang He
Published: August 2021

Calreticulin (CRT) is an endoplasmic reticulum (ER) chaperone involved in cardiac fibroblasts (CFs) activation. It has been reported that the expression of CRT increased in the process of CFs activation. However, the role of CRT in CFs activation and the mechanism is not yet fully elucidated. Therefore, we aimed to verify whether CRT was involved in CFs activation and the possible mechanism underlying this process. We found that CRT protein level was elevated in AngⅡ-induced CFs activation. Knocking down CRT by its siRNA could decrease the protein expression of connective tissue growth factor (CTGF), α-smooth muscle actin (α-SMA), and transforming growth factor-β (TGF-β), and meanwhile attenuate proliferation and migration ratio of CFs. Moreover, the proliferation and migration rates of CFs were promoted and the expression of CTGF, α-SMA and TGF-β were increased when transfection with high-titer adenovirus of CRT. In AngⅡ-induced CFs, inositol-requiring enzyme 1(IRE-1), one of the main ER pathways, was inhibited through CRT silence and activated through CRT overexpression. Overall, this study demonstrates that CRT overexpression could promote AngⅡ induced-CFs activation by activating IRE1 pathway, which could be a potential target for CFs activation.
Femur-tibia Angle and Patella-tibia Angle: New Indicators for Diagnosing Anterior Cruciate Ligament Tears in Magnetic Resonance Imaging
Authors: Li Zeng , Li Mengyuan , Du Yan , Jiang Hai , Ma Yuanchen , Zheng Qiujian
Published: August 2021

Background: Torn anterior cruciate ligament (ACL) contributes to internal rotation of tibia. However, there is no indicator in MRI to reflect the rotation of knee joint. So the purpose of this study is to introduce two new measurements in MRI, femur-tibia angle (FTA) and patella-tibia angle (PTA), which reflect the rotation of knee joint and assess their role in diagnosing ACL tears.Methods: Present study retrospectively reviewed the cases of primary arthroscopic knee surgery from January 2018 to December 2019 from the Arthroscopy Database at Guangdong Provincial People's Hospital. Firstly, comparisons of different measurements were conducted between the ACL tears group and isolated meniscus injury group. Then, the measurements were tested in diagnosing complete or partial ACL tears. Diagnostic performance of different measurements was assessed by area under the curve (AUC) of receiver operating characteristic (ROC) curve and cutoff values were determined by Youden index. Results: FTA and PTA in ACL tears group had 4.79 and 7.36 degrees more than that of control group (p = 0.022 and < 0.001, respectively). Besides, ACL angle and distance of anterior tibial subluxation (D) also showed significant differences (p<0.05). In distinguishing complete ACL tear with intact ACL, the ROC curves indicated that ACL angle had the highest AUC of 0.906 (95% CI: 0.833-0.978) while AUC of PTA was 0.849 (95% CI: 0.763-0.936) and AUC of FTA was 0.809 (95% CI: 0.710-0.908). In distinguishing partial ACL tear with intact ACL, the ROC curves showed that FTA and PTA had the highest AUCs of 0.847 and 0.813 with 95% CI of 0.737-0.957 and 0.680-0.947, respectively. In contrast, the AUCs of ACL angle and D were only 0.519 and 0.387 with 95% CI of 0.292-0.745 and 0.227-0.546.Conclusion: Present study introduced two new quantitative parameters, FTA and PTA, to assess the rotation of knee joint. FTA and PTA increased when ACL tears and they might be valuable in diagnosing ACL tears, especially in distinguishing partial ACL tear with intact ACL which was poorly diagnosed in MRI.
A Pilot Study on Hepatitis E Virus (HEV) Epidemiology in Animal Reservoirs in Bulgaria
Authors: Palombieri Andrea , Tsachev Ilia , Sarchese Vittorio , Fruci Paola , Profio Federica Di , Pepovich Roman , Baymakova Magdalena , Marsilio Fulvio , Martella Vito , Martino Barbara Di
Published: August 2021

Information on hepatitis E virus (HEV) epidemiology in animal reservoirs in Bulgaria is still lacking. Herein, by screening HEV seropositive sera obtained from Bulgarian swine and wild boars, viral RNA was detected at high prevalence rate (28.2%) in industrial pigs. Sequence analysis of the partial polymerase (RdRp) region revealed the highest genetic correlation with HEVs of genotype (Gt) 3 identified in French and Dutch patients. For three such strains a 700-bp fragment of the ORF 2 gene was generated. On phylogenetic analysis, the Bulgarian strains clustered tightly (93.8-98.3% nt) with human and animal HEVs classified within the Gt3 subtype c.