bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Limitations Before and After Cancer Diagnosis and Contributing Factors: Longitudinal Findings from the China Health and Retirement Study
Authors: Yang Rumei , Liu Yin , Jiang Yun , Fleming Daniel J. M. , Fauth Elizabeth B.
Published: October 2021

Background: Although there is a general trend of functional decline with age, there lacks an understanding of how cancer diagnosis and other factors may contribute to this trend. This study aimed to examine functional limitation trajectories among adults with and without cancer, and before versus after the cancer diagnosis, and to explore potential contributing factors associated with functional trajectories among cancer survivors. Methods: The sample were middle-aged and older Chinese adults who participated in all 3 waves of the China Health and Retirement Longitudinal Study (CHARLS, 2011-2015). Ordinary and multiphase growth curve analyses were conducted to examine (1) differences in functional trajectories between participants with (n=139) and without cancer (n=7,313), (2) pre-and post-cancer diagnosis changes in functional limitations among those who reported a cancer diagnosis over the 4-year timeframe, and (3) contributing factors associated with functional trajectories among cancer survivors, guided by the Disablement Process Models, including psychological (depressive symptoms), physical (pain and falls), cognitive (self-reported memory problems), and environmental (social contact and available support) factors. Results: There was a trend of increased functional limitations among all participants over time (β=0.17, p<.0001). However, participants with cancer did not differ from non-cancer participants in neither the level (β=0.77, p=.08) nor the rate of functional decline (β=-0.43, p=.07). Functional limitation trajectories were different pre- versus post-cancer diagnosis, although not in expected directions (β=-0.48, p<.05). Cancer survivors with greater pain had higher levels of functional limitations which were sustained over time compared to those with less pain (β=0.93, p<.001).Conclusions: The study confirmed that Chinese middle-aged and older adults had overall decreased functional decline over time. A novel finding that cancer survivors experienced less rapidly functional decline after the cancer diagnosis suggested that cancer diagnosis might serve as an inflection point at which early intervention is promising to slow the functional decline. In addition, findings that within-person contributing factors, such as pain, can be influential in functional limitation trajectories suggested that more attention is needed to pay to patients with cancer-pain. These findings demonstrated the heterogeneity of functional limitation trajectories and needs for person-centered interventions among Chinese cancer survivors.
Reduction of the Uncertainties in the Hydrological Projections in Korean River Basins Using Dynamically Downscaled Climate Projections
Authors: Qiu Liying , Kim Joeng-Bae , Kim Seon-Ho , Choi Yeon-Woo , Im Eun-Soon , Bae Deg-Hyo
Published: October 2021

How the added value of dynamically downscaled climate variables can be transferable to the hydrological impact assessment has been a long standing issue. This study investigates the potential benefit of highresolution climate data locally tailored over South Korea in terms of the reduction of uncertainties in hydrological projections. For this purpose, a large ensemble consisting of three Global Climate Model (GCM) projections and their downscaling products with different resolutions (i.e., 20 and 5 km), and four bias correction (BC) methods is fed into a semi-distributed hydrological model (HM) customized over Korean river basins. The in-depth comparison among the 45-members hydrological simulations proves that the added value of RCM would not be erased by the application of BC. While this study acknowledges the necessity of BC to remove the systematic bias in climate simulations, it is found that the high-resolution dynamical downscaling can significantly narrow the spread brought with different BC methods, thus reducing the uncertainty in the projected hydrological change. The projected streamflow changes for both the mean of wet season and the high flows indicate that there will be an intensified runoff, especially for the extremes, over South Korea under the warming. Altogether, this study provides a valuable exploration of uncertainty reduction in hydrological projections from the perspective of resolution effect of dynamical downscaling, which is meaningful for hydroclimate studies and climate change impact assessment.
Plant production-community composition relationship associated with fungal guilds depends on grassland disturbance in surface and subsurface soils
Authors: Bai Huimin , Liu Zhiying , Li Huizhen , Wang Tianqi , Xu Hongbin , Zhang Tianyu , Baoyin Taogetao
Published: October 2021

Purpose

Soil fungal guilds have been proven to influence the plant community composition-production relationship, but not much is known about their effects on surface and subsurface soils under different disturbances.
Methods

Here, we assessed the functional characteristics of three fungal groups using the Ribosomal Database Project (RDP) classifier and data available in FUNGuild, and we characterized the community of saprotrophic, mycorrhizal, and potential plant pathogenic fungi in surface (0–10 cm) and subsurface soils (10–20 cm) of temperate grasslands under different management practices.
Results

We found that grassland disturbances decreased plant aboveground production and changed plant community composition. In surface soil, antagonistic interaction between potential plant pathogens and saprotrophic fungi drove the plant community composition-production relationship. In subsurface soil, this relationship was driven by antagonistic interaction between mycorrhizal fungi and potential plant pathogens.
Conclusion

These findings revealed that under grassland disturbances, the surface soil fungal communities were more strongly associated with plant community composition-production relationship than those from the subsurface soil were. Potential plant pathogens played an important role in plant community composition-production relationship. This knowledge is important for predicting the shifts in ecosystem functions as a consequence of changes in soil fungal groups during grassland management.
Potent Anti-Delta Effect By a Booster Third-Dose of UB-612, a Precision-Designed SARS-CoV-2 Multitope Protein-Peptide Vaccine
Authors: wang Chang Yi , Hwang Kao-Pin , Kuo Hui-Kai , Peng James , Shen Daphne , Kuo Besheng , Hou Kuo-Liang , Cheng Jennifer , Wang Min-Sheng , Yang Ya-Ting , Huang Juin-Hua , Chiu Han Chen , Jiang Ming-Han , Shih Hao-Yu , Shen Hsuan-Yu , Chang Po-Yen , Lan Yu-Rou , Chen Sky , Liu Hope , Ho Yu-Hsin , Lin Feng , Ding Shuang , Liu Zhi , Wu Huang-Ting , Lin Yi-Ling , Liang Jian-Jong , Liao Chun-Che , Chou Yu-Chi , Morris Mary Kate , Hanson Carl , Guirakhoo Farshad , Hellerstein Michael , Hu Mei Mei , Yu Hui-Jiing , King Chwan-Chuen King , Heppner Donald , Kemp Tracy , Monath Tom
Published: October 2021

SARS-CoV-2 breakthrough infection occurs due to waning immunity time-to-vaccine, to which the globally-dominant, highly-contagious Delta variant is behind the scene. In the primary 2-dose and booster series of clinical Phase-1 trial, UB-612 vaccine, which contains S1-RBD and synthetic Th/CTL peptide pool for activation of humoral and T-cell immunity, induces substantial, prolonged viral-neutralizing antibodies that goes parallel with a long-lasting T-cell immunity; and a booster (3rd ) dose can prompt recall of memory immunity to induce profound, striking antibodies with the highest level of 50% viral-neutralizing GMT titers against live Delta variant reported for any vaccine. The unique design of S1-RBD only plus multitope T-cell peptides may have underpinned UB-612’s potent anti-Delta effect, while the other full S protein-based vaccines are affected additionally by mutations in the N-terminal domain sequence which contains additional neutralizing epitopes. UB-612, safe and well-tolerated, could be effective for boosting other vaccine platforms that have shown modest homologous boosting. [Funded by United Biomedical Inc., Asia; ClinicalTrials.gov ID: NCT04967742 and NCT04545749]
Clinical Characteristics and Prognosis of Anti-Alpha- Amino-3-Hydroxy-5-Methyl-4-Isoxazolepropionic Acid Receptor Encephalitis
Authors: Zhang Zhe , Fan Siyuan , Ren Haitao , Zhou Lixin , Guan Hongzhi
Published: October 2021

Background
Encephalitis associated with antibodies against alpha-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor (AMPAR) is an extremely rare type of antibody-mediated encephalitis. This research aims to investigate the clinical characteristics and prognosis of anti-AMPAR encephalitis.
Methods
This retrospective study enrolled nine patients with anti-AMPAR encephalitis. Demographic information, clinical manifestations, laboratory and radiological findings, treatment and response were collected and analyzed. These patients were followed up with an average period of 72 weeks to gather prognostic information.
Results
Nine patients (7 females and 2 males) were enrolled with the mean age of disease onset as 59 years old. Three clinical syndromes, including limbic encephalitis (n=7; 78%), pure amnesia (n=1; 11%) and fulminant encephalitis (n=1; 11%) were identified. New symptoms of dysphagia and deafness were identified in the clinical spectrum of anti-AMPAR encephalitis. All patients had positive blood AMPAR antibodies, and six of them (67%) had paired positive antibodies in cerebrospinal fluid (CSF). Brain magnetic resonance imaging (MRI) were abnormal in 75% of the patients with no specific patterns recognized. Six patients (67%) had tumors, including lung cancers or thymomas. After immunotherapy and oncotherapy, partial improvement of neurological symptoms was observed among all 6 patients with available records during their hospitalization. During a mean follow-up of 72 weeks, 3 patients had marked improvement of modified Rankin Scale (mRS), one patient had unchanged mRS, 4 patients died and the other one was lost.
Conclusions
Anti-AMPAR encephalitis mainly presents as limbic encephalitis. Anti-AMPAR encephalitis is paraneoplastic in 67% cases and intensive screening for tumors is recommended for all anti-AMPAR patients. Although patients showed a good short-term therapeutic response, the overall prognosis was not satisfactory.
Polydrug use of Tobacco and Cannabis in a Cohort of Young People from Central Catalonia (2012-2020)
Authors: Codinach-Danés Eva , Obradors-Rial Nuria , González-Casals Helena , Cirera-Guàrdia Maria Rosa , Catalina Queralt Miro , Vidal-Alaball Josep , Espelt Albert
Published: October 2021

Background: The aim was to estimate the prevalence of tobacco and cannabis use and the relationship between these two substances in a cohort of young people from Central Catalonia in the period 2012-2020 according to sex and year of follow-up.Methods: Prospective longitudinal study with 828 students in 4th year of Compulsory Secondary Education (ESO) in Central Catalonia, who answered a survey on health behaviour in 2012 (828 young people), 2016 (342 young people) and in 2020 (271 young people). The dependent variables were traditional tobacco use, cannabis use in the last month and polydrug use of both substances. The independent variables were sex and year of follow-up. For the prevalence analysis, frequencies and percentages were analysed with their respective 95% confidence intervals. Chi-Square and Cochran's Q contrast were used to test the relationship between independent and paired qualitative variables. A significance level of 0.05 was set. Results: There are significant differences between the prevalence of smoking cannabis in the last month in boys and girls aged 19-20 years and 23-24 years. Girls who did not use traditional tobacco in 2012, 0.9% (0.1-6.5), 1.9% (0.4-7.5) and 7.5% (3.8-14.5) did use cannabis in 2012, 2016 and 2020 respectively, with a significant increase over the period analysed (p-value = 0.014). Boys who did not smoke traditional tobacco in 2012, 3.5% (1.1-10.6), 14.4% (8.3-23.9) and 14.3% (8.2-23.6) did smoke cannabis in 2012, 2016 and 2020 respectively, with a significant change between 2012 and 2020 (p-value = 0.006). Conclusions: There is a strong association between tobacco use and cannabis use, with those young people who smoke tobacco regularly having the highest prevalence of cannabis use. There is a significant percentage of young people where the gateway to smoked drugs is no longer tobacco but cannabis itself.
Epigenetic silencing and tumor suppressor gene of HAND2 by targeting ERK signaling in colorectal cancer
Authors: Yuan Zixu , Yu Xihu , Cai Jian , Chen Daici , Liu Xiaoxia , Wu Zhijie , Chen Wenle , Grady William M. , Wang Hui , Chen Chun
Published: October 2021

Background

The screening biomarkers for early detection of colorectal cancer (CRC) is lacking. The aim is to identify epigenetic silenced genes and clarify its roles and underlying mechanism in CRC. We conducted integrative analyses of epigenome-wide Human Methylation 450K arrays and transcriptome to screen out candidate epigenetic driver genes with transcription silencing. Methylated silencing HAND2 were identified and verified in large CRC cohort. The mechanism of HAND2 expression by promoter inhibition were clarified both in vitro and vivo assays. Cell biofunctional roles of HAND2 methylation was investigated in CRC cells. HAND2 reconstitution were constructed by lentivirus plasmid and tumor xenograft model of HAND2 were built subcutaneously. Genomic mRNA analysis by RNA-sequencing and subsequent GSEA analysis were performed to identify potential target of HAND2 and qPCR/WB was conducted to identify the results.
Results

We firstly reported high frequency of HAND2 methylation in promoter in CRC and hypermethylation was negatively correlated with expression silencing and leaded to poor survival in several CRC cohort patients. 5-Aza treatment to demethylated HAND2 could revert its expression in CRC cells. Functionally, HAND2 reconstitution can inhibit cell proliferation, invasion and migration in vitro. In tumor xenograft, HAND2 reconstruction significantly repressed tumor growth when compared to control vector. Thousands of aberrant expressed genes were observed in the heatmap of RNA-sequencing data. HAND2 reconstitution could bind to ERK and reduce its phosphorylation by CoIP assay. These above results showed HAND2 reconstitution perturbed the activation of MAPK/ERK signaling by reduction of ERK phosphorylation.
Conclusions

HAND2 is one tumor suppressor by targeting ERK signaling and one potential epigenetic driver gene in CRC.
The Effect of N-Acetyl Cysteine and Vitamin E on Oxidative Status and Hemoglobin Level in Transfusion-Dependent Thalassemia Patients: A Systematic Review and Meta-Analysis
Authors: Haghpanah Sezaneh , Hosseini-Bensenjan Mahnaz , Zekavat Omid Reza , Bordbar Mohammadreza , Karimi Mehran , Ramzi Mani , Asmarian Naeimehossadat
Published: October 2021

This meta-analysis was conducted to summarize the comparative effect of NAC and Vitamin E on oxidative status, including total antioxidant capacity (TAC), total oxidative stress (TOS), oxidative stress index (OSI), and hemoglobin (Hb) in patients with TDT.All methods were performed in accordance with the PRISMA checklist. We searched databases including Web of Science (ISI), Scopus, PubMed, and Embase. Meta-analysis was done using Stata statistical software version 16.0.Finally,four randomized-controlled trials (RCT)for NAC and four RCTs for Vitamin E were included.Our meta-analyses showed a significant increase in the weighted mean differences (WMD) of Hband a significant decrease in the WMD of OSI in the NAC group.In subgroup analysis based on age: in the NAC group, a significant increase in the WMD of TAC andHband a significant decrease in the WMD of TOS were detectedonly in children. In theVitamin E group, a significant increase in Hb and a significantdecrease in TOS and OSI were determined in the children subgroup as well.NAC can be used as an effective antioxidant supplementparticularlyin children with TDT. Also, Vitamin Eshowed a beneficial antioxidant effect in TDT children. So, more well-designed randomized, controlled trials for the effect of NAC in adult TDT andthe effect of vitamin E both in adults and children are recommended with more focus on theessential influencing factors on the oxidative status in TDT patients.
Clinical Characteristics of Choledochal Cysts With Intrahepatic Bile Duct Dilatations
Authors: Zhang Shuhao , Cai Duote , Zhang Yuebin , Chen Ken , Jin Yi , Luo Wenjuan , Huang Zongwei , Hu Di , Gao Zhigang
Published: October 2021

Background: Whether the dilated intrahepatic bile duct (IHBD) has any effect on prognosis of choledochal cyst (CC) remains controversy. In the study, we aim to summarize the clinical characteristics and prognosis of those patients.Methods: A total of 192 children (47 males, 145 females) diagnosed with CC were identified in our hospital, including 127 without IHBD dilatation (group A) and 65 with IHBD dilatation (group B). A retrospective analysis was performed to explore the clinical characteristics of group B based on clinical indices, symptoms, and complications. Results: Compared with group A, incidences of jaundice and fever were significantly increased in group B (p=0.01 and 0.033, respectively). Preoperative total bilirubin (TB), direct bilirubin (DB), and indirect bilirubin (IDB) were also higher in group B than in group A (p=0.0052, 0.0005, and 0.0136, respectively), as were preoperative levels of alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and total bile acid (TBA) (p=0.0057, 0.0250, 0.0002, and 0.0242, respectively). Early postoperative GGT levels in group B remained abnormal and were significantly higher than in group A (p=0.0003). The risk of liver fibrosis or cirrhosis was significantly increased for group B compared with group A (p=0.012) and also occurred earlier in group B (p<0.001), among them, dilated IHBDs recovered to normal in 89.23% (7/65) of patients. Meanwhile, the incidence of postoperative pancreatitis increased significantly in group B as well (p=0.003).Conclusion: CC with IHBD dilatation was associated with significantly increased preoperative bilirubin levels, abnormal liver function, and higher incidence of liver fibrosis or cirrhosis early in the disease course. Timely radical surgery is recommended for such patients and postoperative extinction of the IHBD dilatation occurs early in most of those patients.
MiR-132-3p suppresses cell proliferation and migration in gastric cancer by targeting KIF21B/Wnt/β-catenin signaling pathway
Authors: Liu Bingtian , Qiang Ling , Guan Bingxin , Ji Zhipeng
Published: October 2021

Background: Recently, kinesin family member 21B (KIF21B) has been reported to be an oncogene in non-small cell lung cancer and hepatocellular carcinoma. However, the functional role and related molecular mechanisms underlying gastric cancer (GC) pathogenesis remain largely uncovered. Methods: The expression of KIF21B was investigated by analysis of Oncomine microarray gene expression datasets and clinical specimens. The association between KIF21B and miR-132-3p was assessed by luciferase reporter assay. CCK-8 assay and transwell assay were performed to analyze the functional role of miR-132-3p/KIF21B in GC cells. Related protein expression levels were evaluated by immunohistochemistry and western blot analysis.Results: We first found that the expression of KIF21B was upregulated in GC tissues compared with adjunct normal tissues. Knockdown of KIF21B significantly suppressed the proliferation, migration and invasion in GC cell lines (AGS and SNU-5). KIF21B was confirmed as the target of miR-132-3p in GC cells. Moreover, miR-132-3p was down-regulated and inversely correlated with KIF21B expression in GC tissues. Further functional experiments demonstrated that overexpression of KIF21B remarkedly reversed the suppressive effects of miR-132-3p overexpression on GC cell proliferation, migration and invasion. Furthermore, miR-132-3p overexpression downregulated the protein levels of Wnt1, c-Myc, β-catenin, PCNA and N-cadherin, and upregulated E-cadherin expression in GC cells, which were all alleviated after KIF21B overexpression. Conclusions: In summary, our findings provide the first evidence that down-regulation of KIF21B by miR-132-3p suppresses cellular functions in GC via regulating Wnt/β-catenin signaling.
Role of Th17 Cytokines in Liver’s Immune Response during Fatal Yellow Fever:Triggering Cell Damage Mechanism
Authors: Carvalho Marcos Luiz Gaia , Sousa Jorge Rodrigues , Lopes Jeferson Costa , Mendes Caio Cesar Henriques , Olímpio Fábio Alves , Silva Carlos Augusto Moreira , Miranda Vanessa Cabral , Santos Lais Carneiro , Vilacoert Fellipe Souza Silva , Azevedo Raimunda do Socorro Silva , Cruz Ana Cecília Ribeiro , Falcão Luiz Fábio Magno , Galúcio Vanessa Costa Alves , Martins Lívia Caricio , Duarte Maria Irma Seixas , Filho Arnaldo Jorge Martins , Vasconcelos Pedro Fernando Costa , Quaresma Juarez Antônio Simões
Published: October 2021

Yellow fever (YF) is an infectious disease whoseevolution and outcome arerelated to the host immune response pattern. We investigated the Th17 cytokine profile in the liver of humans with fatal YF. Liver tissue samples were collected from 26 patients, including 21 YF-positive and five flavivirus-negative patients with preserved hepatic parenchyma architecture who died of other causes. Samples underwent histopathological and immunohistochemical analysis to detect the Th17 profile (ROR-γ, STAT3, IL-6, TGF-β, IL-17,and IL-23). Substantial differences were found in the expression of markers between fatal YF cases and control samples with a predominance of Th17 cytokine markers in the midzonal region of the YF cases, the most affected area in the liver acinus. Histopathological changes in the hepatic parenchyma revealed cellular damage characterised mainly by the presence of inflammatory infiltrate, Councilman bodies (apoptotic cells), micro/macrovesicular steatosis, and lytic and coagulative necrosis.Th17 cytokines play a pivotal role during YF and contribute significantly to triggering the mechanisms of cell damage in the fatal outcome of severe cases.
Impact of Tumor Progression on Survival during Neoadjuvant Chemotherapy in Breast Cancer: A Cohort Study
Authors: Nozawa Kazuki , Takatsuka Daiki , Endo Yuka , Horisawa Nanae , Ozaki Yuri , Kataoka Ayumi , Kotani Haruru , Yoshimura Akiyo , Hattori Masaya , Sawaki Masataka , Iwata Hiroji
Published: October 2021

Background: Although few patients with breast cancer experience tumor progression during neoadjuvant systemic therapy (NST), their extremely poor outcomes are similar to patients who fail to achieve pathological complete response (pCR). No reports have compared patients with pCR, non-pCR, and progression during NST to determine the survival outcomes.Methods: This retrospective chart review of patients with stage I–III breast cancer was conducted between January 2001 and December 2018. pCR was defined as no invasive cancer or in situ residuals in the breast and lymph nodes (ypT0 ypN0). Disease-free survival (DFS) and overall survival (OS) were estimated using Kaplan–Meier methods.Results: Of the 595 patients who received NST, 167 (29.2%) had pCR (pCR group), 404 (70.8%) responded to NST but did not have pCR (non-pCR group), and 24 (4.0%) experienced tumor progression during NST (PD group). The median DFS was 6.0 months, 154.0 months, and not reached in the PD, non-pCR, and pCR groups, respectively. The PD group had significantly shorter DFS than patients without tumor progression in the pCR and non-pCR groups [hazard ratios (HR) 13.0, 95% CI: 8.1–21.0, p < 0.01]. The median OS was 13.6 months (95% CI: 10.4–35.5) in the PD group and was not reached in the pCR and non-pCR (non-PD) groups. The OS was significantly poorer in the PD group than in the non-PD group (HR 15.8, 95% CI: 9.2–27.1, p < 0.01).Conclusion: The PD group had the poorest survival outcomes even after recurrence, thus warranting new treatment targets.
An Image-Guided Network for Depth Edge Enhancement
Authors: Lee Kuan-Ting , Liu En-Rwei , Yang Jar-Ferr , Hong Li
Published: October 2021

With the rapid development of 3D coding and display technologies, numerous applications are emerging to target human immersive entertainments. To achieve a prime 3D visual experience, high accuracy depth maps play a crucial role. However, depth maps retrieved from most devices still suffer inaccuracies at object boundaries. Therefore, a depth enhancement system is usually needed to correct the error. Recent developments by applying deep learning to deep enhancement have shown their promising improvement. In this paper, we propose a deep depth enhancement network system that effectively corrects the inaccurate depth using color images as a guide. The proposed network contains both depth and image branches, where we combine a new set of features from the image branch with those from the depth branch. Experimental results show that the proposed system achieves a better depth correction performance than state of the art advanced networks. The ablation study reveals that the proposed loss functions in use of image information can enhance depth map accuracy effectively.
Earlier Snowmelt May Lead to Late Season Declines in Plant Productivity and Carbon Sequestration in Arctic Tundra Ecosystems
Authors: Zona Donatella , Lafleur Peter , Hufkens Koen , Bailey Barbara , Gioli Beniamino , Burba George , Goodrich Jordan , Liljedahl Anna , Euskirchen Eugenie , Watts Jennifer , Farina Mary , Kimball John , Heimann Martin , Goeckede Mathias , Pallandt Martijn , Christensen Torben , Mastepanov Mikhail , Lopez-Blanco Efren , Jackowicz-Korczynski Marcin , Dolman Albertus J. , Marchesini Luca Belelli , Commane Roisin , Wofsy Steve , Miller Charles , Lipson David , Hashemi Josh , Arndt Kyle , Kutzbach Lars , Holl David , Boike Julia , Wille Christian , Sachs Torsten , Kalhori Aram , Song Xia , Xu Xiaofeng , Humphreys Elyn , Koven Charles , Sonnentag Oliver , Meyer Gesa , Gosselin Gabriel , Marsh Philip , Oechel Walter
Published: October 2021

Arctic warming is affecting snow cover and soil hydrology, with consequences for carbon sequestration in tundra ecosystems. The scarcity of observations in the Arctic has limited our understanding of the impact of covarying environmental drivers on the carbon balance of tundra ecosystems. In this study, we address some of these uncertainties through a novel record of 119 site-years of summer data from eddy covariance towers representing dominant tundra vegetation types located on continuous permafrost in the Arctic.Here we found that earlier snowmelt was associated with more net CO2 sequestration and higher gross primary productivity (GPP) only in June and July, but with lower net carbon sequestration and lower GPP in August. Although higher evapotranspiration (ET) can result in soil drying with the progression of the summer, we did not find significantly lower soil moisture with earlier snowmelt, nor evidence for a water stress that affected GPP in the peak and late growing season. Our results suggest that climate change and the associated increased length in the growing season might not benefit these northern tundra ecosystems if they are not able to continue sequestering CO2 later in the season.
General Practice Clinical Pharmacist Standards of Practice for Delivery of Polypharmacy and Chronic Disease Medication Reviews: A Consensus Study.
Authors: Earle-Payne Katie , Forsyth Paul , Johnson Chris F , Harrison Heather , Robertson Susan , Weidmann Anita E
Published: October 2021

BackgroundGeneral practice in the UK is experiencing a crisis. Greater multidisciplinary working is a potential solution. The new general practice contract in Scotland encourages this and includes a new pharmacotherapy service to be delivered by General Practice Clinical Pharmacists (GPCPs). Consensus is lacking for the standards of practice for delivery of pharmacotherapy medication reviews (which are polypharmacy and chronic medication reviews) as part of this service.AimTo identify and validate standards of practice for polypharmacy and chronic disease medication (pharmacotherapy level 3) reviews conducted by GPCPs. MethodA two-phased mixed-methods consensus methodology was used. Phase 1: An expert group of GPCPs (n=4) and clinical pharmacist managers (n=2) responsible for delivering the pharmacotherapy service used a Modified Nominal Group Technique to generate potential standards. Phase 2: Two-round Delphi survey involving GPCPs with ≥1 year of experience of working in general practice (n=159).ResultsThe expert group identified 44 potential standards of practice for polypharmacy and chronic disease reviews. Practicing GPCPs indicated during the Delphi phase that the 44 standards were applicable to practice. The standards of practice covered seven main categories: skills, environment, qualifications, qualities and behaviours, knowledge, process and experience.ConclusionPracticing GPCPs indicated that the standards identified by the expert group are acceptable and valid for current practice and the delivery of polypharmacy and chronic medication reviews. The application of these standards to practice may help GPCPs and general practices to ensure equitable delivery of patient care.
Increasing Buffering Capacity Enhances Rumen Fermentation Characteristics and Alters Rumen Microbiota Composition of High-Concentrate Fed Hanwoo Steers
Authors: Ramos Sonny C. , Kim Seon Ho , Jeong Chang Dae , Mamuad Lovelia L. , Son A-Rang , Kang Seung Ha , Cho Yong Il , Kim Tae Gyu , Lee Jin Sung , Cho Kwang Keun , Lee Sung Sill , Lee Sang Suk
Published: October 2021

This study determined the buffering capacity of buffer agents and its effect on in vitro and in vivo rumen fermentation characteristics and bacterial composition of a high-concentrate fed Hanwoo steers. Both BC0.9% and BC0.5% had significantly highest buffering capacity, pH, and ammonia-nitrogen (NH3-N) than BC0.3% and CON at 24 h incubation. Individual and total volatile fatty acids (VFA) were significantly lowest in CON. Phylum Bacteroidetes dominated all treatments but a higher abundance of Firmicutes in BC0.5% than others. Ruminoccocus bromii and Succiniclasticum ruminis were dominant in BC0.5% and Bacteroides massiliensis in BC0.3%. The normalized data of relative abundance of observed OTUs’ representative families have grouped the CON with BC0.3% in the same cluster, whereas BC0.5% and BC0.9% were clustered separately which indicates the effect of varying buffering capacity of buffer agents. Principal coordinate analysis (PCoA) on unweighted UniFrac distances revealed close similarity of bacterial community structures within and between treatments and control, in which BC0.9% and BC0.3% groups showed dispersed community distribution. Overall, the increasing buffering capacity enhances rumen fermentation parameters and affects rumen microbiome by altering bacterial community through distinct structure between high and low buffering capacity, thus an important factor to prevent ruminal acidosis during a high-concentrate diet.
Prevention of Postoperative Events Following Reversal With Sugammadex or Neostigmine (The P- PERSoN Trial) – Pilot Data Following Early Termination of a Prospective, Blinded, Randomised Trial.
Authors: Olesnicky Benjamin Luke , Doane Matthew , Farrell Clare , Knoblanche Greg , Delaney Anthony
Published: October 2021

Background: Residual paralysis following anaesthesia is common and can lead to postoperative morbidity. While sugammadex has been shown to be effective in minimising residual paralysis, uncertainty exists as to whether its use reduces any associated morbidity. We designed this trial to determine if the use of sugammadex for the reversal of intraoperative aminosteroid neuromuscular blockade results in improvements in postoperative pulmonary complications, complications in the recovery unit, postoperative nausea and vomiting, and patient satisfaction, when compared to reversal with neostigmine. Methods: A prospective, double-blind, randomised controlled trial in adult patients admitted for surgical operations at two Australian hospitals between December 2018 and March 2019 was performed comparing the reversal of neuromuscular paralysis using sugammadex 2mg/kg versus neostigmine 50mcg/kg. Statistical analysis of continuous data was performed using two tailed t-tests, with categorical and ordinal data was assessed by Chi-squared analysis. Results: The trial was terminated due to a combination of resource constraints and the 2019 novel coronavirus disease (COVID-19) pandemic. Of 51 patients screened, 33 were eligible for participation and 30 subsequently recruited and randomised. All patients received the intended treatment allocated. Data for the primary outcome was obtained in all patients. There was no difference in the rates of postoperative pulmonary complications between the sugammadex and neostigmine groups (0% (0/19) vs 9% (1/11) RR 5.0 (95%CI 0.22-113) p=0.37. There was no difference in any of the secondary outcomes between the groups. Conclusions: The P-PERSoN trial showed no difference in post operative pulmonary complications between sugammadex and neostigmine based reversal of aminosteroid neuromuscular block, but was underpowered to show any difference due to early trial termination. The randomisation and data collection was feasible. We support the need for an adequately resourced and funded randomised controlled trial to address this important clinical question. Trial Registration: The P-PERSoN trial is registered at the Australian and New Zealand Trial Registry (www.anzctr.org.au) # ACTRN12616000063415 and The U.S. National Library of Medicine (www.ClinicalTrials.gov) #NCT02825576
Analysis on factors behind sentinel lymph node metastasis in breast cancer by color ultrasonography, molybdenum target and pathological detection
Authors: Yiming Aibibai , Wubulikasimu Muhetaer , Yusuying Nuermaimaiti
Published: October 2021

Background
This study aimed to collect the factors underlying the metastasis of breast cancer and sentinel lymph node, and to screen and analyze the risk factors of sentinel lymph node metastasis, so as to provide reference and basis for clinical work.
Methods
A total of 100 patients with breast cancer were enrolled in the study. These patients received treatment in our hospital from May 2017 to May 2020. The general information, the characteristics of the color Doppler echocardiography, molybdenum, conventional pathology and molecular pathology of the patients were collected. The influencing factors of sentinel lymph node metastasis in breast cancer patients were retrospectively analyzed.
Results
In this study, age, tumor diameter and BI-RADS category, pathology type, expression profiles of CK5/6, EGFR, and CK19, and TP53 and BRAC1/2 mutations were independent risk factors for sentinel lymph node metastasis in breast cancer (P<0.05). The number and locations of tumors, the quadrant of tumors, the regularity of tumor margins, the presence of blood flow signals, the presence of posterior echo attenuation, the presence of calcification, histological grade, molecular typing, and mutations of BRAF, ATM and PALB2 were irrelevant factors (P>0.05).
Conclusions
In conclusion, age, tumor diameter, Bi-rads category, invasive type, expression of CK5/6, EGFR and CK19, and mutations of TP53 and BRAC1/2 were positively correlated with sentinel lymph node metastasis. They are independent risk factors that should be paid more attention in clinical studies, to strengthen the management and control of sentinel lymph node metastasis of high-risk breast cancer, and support early chemotherapy or targeted therapy.
Moderation Effect of Mammography Screening Among Women with Multiple Chronic Conditions
Authors: Hsieh Hui-Min , Shen Cheng-Ting , Chen Fang-Ming
Published: October 2021

Purpose: To investigate the moderation effects of mammography screening on early stage breast cancer and all-cause mortality among women aged 50-69 years with chronic conditions in Taiwan.Method: We used a matched cohort design with four nationwide population databases, and an exact matching approach to match groups with different chronic conditions. Women population aged 50-69 years in 2010 in Taiwan were studied. A generic Charlson comorbidity index (CCI) measure was used to identify chronic illness burden. The sample sizes of each paired matched group with CCI scores of 0, 1, 2, or 3+ were 170,979 using a 1-to-1 exact matching. Conditional logistic regressions with interaction terms were used to test moderation effect, and adjusted predicted probabilities and marginal effects to quantify average and incremental chronic conditions associated with outcome measures. Statistical analyses were conducted in 2020-2021. Results: Women with more chronic conditions were less likely to participate in mammography screening or to receive early breast cancer diagnoses, but were at greater risk of mortality. However, mammography participation increased the likelihood of early breast cancer diagnosis (OR=1.48, 95%CI=1.36-1.60) and decreased risk of all-cause mortality (OR=0.63, 95%CI=0.60-0.66). The interaction terms of CCI and mammography participation indicated significantly increased benefits of early breast cancer diagnosis and decreased risk of all-cause mortality as chronic illness increased. Conclusions: Mammography participation significantly moderated the link between comorbidity and outcome measures among women with chronic conditions. Hence, it is important for public health policy to promote mammography participation for women with multiple chronic conditions.
Morphometry of Cerebral Arterial Bifurcations Harbouring Aneurysms: A Case-Control Study On 253 Patients
Authors: Ćmiel-Smorzyk K. , Kawlewska E. , Wolański W. , Hebda A. , Ładziński P. , Kaspera Wojciech
Published: October 2021

Background

Conclusions from studies evaluating vessel dimensions and their deviations from the values resulting from the principle of minimum work (PMW) on the formation of intracranial aneurysms (IAs) are still inconclusive. The aim of our study was the morphometric analysis of cerebral arterial bifurcations harbouring aneurysms.
Methods

The study comprised 147 patients with basilar artery (BA) and middle cerebral artery (MCA) aneurysms, and 106 patients constituting the control group. The following morphometric parameters were evaluated: the radii of vessels forming the bifurcation, the junction exponent, the values of the bifurcation angles (Φ1 and Φ2 angles between the parent vessel trunk axis and the larger or smaller branches, respectively; α angle, total bifurcation angle) and the difference between the predicted optimal and observed branch angles.
Results

The analysed parameters for internal carotid artery (ICA) bifurcations were not significantly different among the groups. MCA and BA bifurcation angles and the radii of the parent MCA and BA vessels with aneurysms were significantly higher compared to the control group. The differences between the predicted optimal and observed branch angles were significantly higher for BA and MCA bifurcations with aneurysms compared to the control group. The mean junction exponent for bifurcations in the circle of Willis (i.e., ICA and BA bifurcations, respectively) and MCA bifurcations with aneurysms was significantly lower than the theoretical optimum and not significantly different among the groups. In a multilevel multivariate logistic regression analysis, the branch angles and the radius from the parent vessel were significant independent predictors of the presence of IAs. The ROC analysis indicated that the α angle was the best performer in discriminating between aneurysmal and non-aneurysmal bifurcations.
Conclusions

The dimensions of the arteries forming the circle of Willis do not follow the PMW. The deviation from optimum bifurcation geometry for bifurcations beyond the circle of Willis (particularly a wider radius of the parent artery and a wider total bifurcation angle) may lead to the formation of IAs. Further studies are warranted to investigate the significance of vessel dimensions and the bifurcation angle on the magnitude of the shear stress in the walls of arterial bifurcations.
Impact of Intraventricular Hemorrhage on Classification of Hematoma Expansion and Development of Radiomics Prediction Models
Authors: Wu Te-Chang , Liu Yan-Lin , Chen Jeon-Hor , Zhang Yang , Chen Tai-Yuan , Ko Ching-Chung , Su Min-Ying
Published: October 2021

Background: To investigate the impact of intraventricular hemorrhage (IVH) on the classification of hematoma expansion (HE), and the development of radiomics models using features extracted from the baseline hematoma to predict HE.Methods: Eighty-four patients with baseline and follow-up non-contrast CT within 4~24 hours were included. The intraparenchymal hemorrhage (IPH) and IVH were separately outlined by an experienced neuroradiologist. HE was defined as an absolute hematoma growth >6 mL or percentage growth >33%. HE was determined based on two criteria, using IPH alone (HEP) or IPH+IVH (HEP+V). The radiomics analysis was performed by using PyRadiomics to extract features, followed by random forest algorithm to select features, and lastly the decision tree to build classification models. Results: The classification of expansion showed 37 (44%) HEP and 47 (56%) non-HEP based on IPH alone, and similar results of 38 (45%) HEP+V and 46 (55%) non-HEP+V based on IPH+IVH. The majority, >94% of HE patients, had a poor outcome (death or mRS>3 at discharge). Three radiomics analysis (RA) models were built. The first model using baseline IPH to predict HEP (RAP-P) showed an accuracy of 80% but loss of correlation with the clinical outcome; the second model using IPH+IVH to predict HEP (RAPV-V) had a slightly higher accuracy of 81% and resumed the poor outcome association with HE; and the third model using IPH+IVH to predict HEP+V (RAPV-PV) had the highest accuracy of 86% with preserved clinical outcome correlation of HE. The sensitivity, specificity, and accuracy of three decision trees (RAP-P, RAPV-P, RAPV-PV) were 0.8/ 0.68/ 0.89; 0.81/ 0.92/ 0.72 and 0.86/ 0.82/ 0.89, respectively.Conclusions: The proposed radiomics approach with additional IVH information could be used to classify the expansion status highly associated with the clinical outcome and provide a robust tool for the enrollment of high-risk ICH cases in the anti-expansion trials.
Quasi-band structure of quantum-confined nanocrystals
Authors: Buerkle Marius , Lozac’h Mickäel , Mariotti Davide , Svrcek Vladimir
Published: October 2021

We discuss the electronic properties of quantum-confined nanocrystals. In particular, we show how, starting from the discrete molecular states of small nanocrystals, an approximate band structure (quasi-band structure) emerges with increasing particle size. Finite temperature is found to broaden the discrete states in energy space forming even for nanocrystals in the quantum-confinement regime quasi-continuous bands in k-space. This bands can be, to a certain extend, interpreted along the lines of standard band structure theory, while taking also finite size and surface effects into account. We discuss this on various prototypical nanocrystal systems.
Effect of a Toe-Walking Protocol in Plantar Heel Pain: A Proof of Concept
Authors: Huffer Dean , Hing Wayne , Charles John , Newton Richard , Clair Mike , Cannetti Elisa F.D.
Published: October 2021

Background: Plantar heel pain (PHP) is one of most common disorders of the foot treated in primary care. It affects athletic and sedentary populations, with patient reports of activity-limiting pain and reduced quality of life. Recently, atrophy of the forefoot plantar intrinsic musculature was identified in patients with PHP. Therefore, the purpose of this study was to assess whether loading the plantar fascia strengthens the intrinsic foot musculature (IFM) and decreases symptoms in subjects with PHP Methods: A within-subjects experimental design assessed foot function, foot pain, disability, and activity limitation in 12 subjects with PHP prior to and at the end of a six-week toe-walking program. The primary outcome measure was the Foot Function Index (FFI). IFM strength (both hallux flexion and lesser toe flexion) was measured as a secondary outcome. Results: After six weeks of treatment, the mean (SD) FFI score significantly decreased from 73.2 (32.4) to 43.3 (22.8) points (p = 0.010, ES=1.1). HHD measures: Both great toe flexion and lesser toes flexion strength measures demonstrated significant force increases from 21.8N to 29.6N (+7.8N) 95%CI [1.3, 14.4] (p=0.024, ES=1.0) and from 21.4N to 28.4N (+6.6N) 95%CI [1.8, 11.4] (p=0.010, ES=0.9), respectively. Conclusion: Results suggest that toe-walking may reduce PHP symptoms and increase IFM strength. There was no identified correlation between the IFM and FFI changes. Symptom reduction may be due to a reduction in cortical inhibition rather than IFM strength changes. Findings provide foundation for future larger and more controlled studies, to further validate the effectiveness of toe-walking in reducing symptoms of PHP patients. Trial registration: Bond University Ethics Committee (BUHREC Protocol No. 1908)
What if children with psychiatric problems disagree with their clinicians on the need for care? Factors explaining discordance and clinical directions.
Authors: Vijverberg Richard , Ferdinand Robert , Beekman Aartjan , Meijel Berno van
Published: October 2021

Background
Children and adolescents in mental healthcare often perceive their care needs and necessary treatment differently from their clinicians. As such discordance between young patients and clinicians may obstruct treatment adherence and compromise treatment outcomes, it is important to understand the factors associated with it. We therefore investigated the factors associated with patient-clinician discordance with regard to care needs in various areas of functioning.
Methods
A cross-sectional study involving 244 children/adolescents aged 6-18 participating with their clinicians in treatment at a specialized mental healthcare center. As a previous study conducted by our research group had found the greatest patient-clinician discordance in three CANSAS care needs – “mental health problems,” “information regarding diagnosis and/or treatment,” and “making and/or keeping friends” – we used univariable and multivariable statistics to investigate the factors associated with discordance regarding these three care needs.
Results
Patient-clinician discordance on the three CANSAS items was associated with child, parent, and family/social-context factors. Three variables were significant in each of the three final multivariable models: dangerous behavior towards self (child level); severity of psychiatric problems of the parent (parent level); and growing up in a single-parent household (family/social-context level).
Conclusions
To deliver treatment most effectively and to prevent drop-out, it is important during diagnostic assessment and treatment planning to address the patient’s care needs at all three levels: child, parent and family/social context.