bluuebunny/crossref_metadata_2025 huggingface dataset:
Optimized Zirconia 3D Printing Using Digital Light Processing with Continuous Film Supply and a Recyclable Slurry System
Authors: Sarwar Waqas Ahmed , Kang Jin-Ho , Yoon Hyung-In
Published: June 2021

Additive manufacturing (AM) processes, including stereolithography (SL), can fabricate complex ceramic parts layer by layer using computer-aided design (CAD) models. A ceramic slurry with high solid loading is usually used in SL to fabricate the desired shape, which is further sintered to produce the final part. The traditional SL system utilizes a tank filled with printable material, known as a vat, which for ceramic slurry contributes several limitations and operational difficulties, and further renders it non-recyclable mainly due to its high viscosity and the fragility of the green state. In this study, we utilized a continuous film supply (CFS) printer integrated with a tape casting system using in-house-designed ceramic slurry to print standard prototype specimens. Various printing parameters, including viscosity, layer thickness control, and slurry recycling efficiency, were studied. In addition, post-processing optimizations of the prototype, characterizations, and the microhardness of sintered samples were studied to determine their properties and compare them with traditional methods. The effectiveness of slurry reusability was demonstrated by printing with original and recycled slurry to produce consistent densification of final parts. Post-processing was optimized to achieve a relative sinter density of 99.02% and microhardness of 12.59 GPa. This method provides new opportunities to realize dense complex ceramic features with final properties comparable to those produced by subtractive machining and traditional SL. Furthermore, slurry recycling helps to reduce the overall cost and material consumption.
Factors Affecting Tolerance to Low Night Temperature Differ by Fruit Types and Sizes in Tomato
Authors: Yang Eun Young , Rajaemtov Sherzod Nigmatullaevich , Cho Myeong Cheoul , Jeong Hyo Bong , Chae Won Byoung
Published: June 2021

Low night temperature (LNT) can be a practical and economical target in tomato breeding programs in terms of energy saving in greenhouses. This study was conducted to investigate the physiological responses to LNT using four tomato accessions of cherry and large fruit types with LNT tolerance and sensitivity grown in two greenhouses with night temperature set-points of 10 and 15°C for heating. LNT significantly reduced plant height regardless of fruit types and LNT tolerance. The number of flowers were significantly reduced in 10°C in cherry but not in large fruit types. Fruit set in 10°C was significantly lower in LNT sensitive accessions than tolerant ones regardless of fruit types, which was due to abnormal flower morphology in 10°C. Proline accumulation patterns between 10 and 15°C significantly differed between fruit types as well as between LNT tolerant and sensitive accessions. Chlorophyll content in 10 °C was significantly higher at later growth stages in LNT tolerant accessions than sensitive ones in both fruit types. No clear difference in photosynthetic parameters was observed between fruit types or tolerance and sensitive accessions except for photosynthetic rate, which was significantly lower in tolerant than sensitive accessions during early growing period. These results suggest that different tomato fruit types may have different mechanisms for LNT tolerance.
Comparison of Indexes to Measure Comorbidity Burden and Predict All-Cause Mortality in Rheumatoid Arthritis
Authors: Huang Yun Ju , Chen Jung Sheng , Luo Shue Fen , Kuo Chang Fu
Published: June 2021

Objectives To examine the comorbidity burden in patients with rheumatoid arthritis (RA) patients using a nationwide population-based cohort by assessing the Charlson Comorbidity Index (CCI), Elixhauser Comorbidity Index (ECI), Multimorbidity Index (MMI), and Rheumatic Disease Comorbidity Index (RDCI) scores and to investigate their predictive ability for all-cause mortality. Methods We identified 24,767 RA patients diagnosed between 1998–2008 in Taiwan and followed up until December 31, 2013. The incidence of comorbidities was estimated in three periods (before, during, and after the diagnostic period). The incidence rate ratios were calculated by comparing during vs. before and after vs. before the diagnostic period. One- and 5-year mortality rates were calculated and discriminated by low and high-score groups and modified models for each index. Results The mean score at diagnosis is 0.8 in CCI, 2.8 in ECI, 0.7 in MMI, and 1.3 in RDCI, and annual percentage changes are 11.0%, 11.3%, 9.7%, and 6.8%, respectively. The incidence of any increase in the comorbidity index is significantly higher in the periods of ‘during’ and ‘after’ the RA diagnosis (incidence rate ratios for different indexes: 1.33-2.77). The mortality rate significantly differs between the high and low-score groups measured by each index (adjusted hazard ratios: 2.5-4.3 for different indexes). CCI is slightly better in the prediction of 1- and 5-year mortality rates. Conclusion Comorbidities are common before and after RA diagnosis, and the rate of accumulation accelerates after RA diagnosis. All four comorbidity indexes are useful to measure the temporal changes and to predict mortality.
REALIZING THE PURPOSE OF ISLAMIC EDUCATION THROUGH BOARDING SCHOOL MANAGEMENT
Authors: Nur Asih Istiqomah  , Farid Setiawan
Published: June 2021

This research aims to determine the implementation of boarding school management to realize Islamic education purpose in one of the boarding schools, namely Muhammadiyah Boarding School Yogyakarta. The research method used is field research with a qualitative type based on data collection techniques in interviews, observation, and documentation. The results showed a substantial relationship between boarding school management and national education goals in general and the goals of Islamic education in particular. There are efforts to achieve the four dimensions of Islamic education goals. First, Physical education discusses Fiqh and ushul fiqh lessons. Second, spiritual education with Islamic practices such as fasting Monday Thursday. Third, through religious studies, academic education is based on arguments and history of mujtahid priests such as Imam Maliki, Imam Shafi'i, Imam Hanafi, and Imam Hambali. Fourth, social education through joint activities both in dormitories at schools and in the community. Providing soft skills that help develop children's intellectuals with activities that include tahfidz (memorizing the Koran), language areas (mandatory English and Arabic language environments), speech, and others. Likewise, hard skills provisioning in the form of extracurricular activities for Tapak Suci and Hizbul Wathan. With the implementation of boarding school management, it's hoped that the school can achieve Islamic education purpose.
THE CLINICAL COMPREHENSIVE PRACTICE EVALUATION SYSTEM OF PHYSIOTHERAPY STUDENTS DIPLOMA-IV BINAWAN UNIVERSITY
Authors: Arsyad Noraeni
Published: June 2021

This study aims to describe the problems of the clinical practice assessment system are not in accordance with standards which has an impact on the results of Binawan University Diploma IV physiotherapy graduate. Some items in measuring devices to assess the clinical performance of physiotherapy students have low responsive level. To solve this problem, this study uses descriptive qualitative methods with case study approach that uses various sources of information in gathering data to provide conclusions or detailed descriptions. Data is collected through in-depth interviews with student, clinical instructors and document observations. Data analysis through reduction techniques, presenting data and giving conclusions through triangulation of sources, data and methods by connecting the suitability of relevant theories with the data obtained. The results of the study are generally illustrated the assessment system has been running more focused on case reports, general competency and group comprehensive test assessments. It was found that lack of an independent clinical performance assessment to see individual competencies related to learning outcome from implementation of comprehensive practice physiotherapy clinic. Thus the findings are expected to improve and evaluate the implementation of clinical  comprehensive practice evaluation system of physiotherapy students Diploma IV Binawan University
DIAGNOSTIC TEST INSTRUMENTS FOR THE BASIS OF REMEDIAL LEARNING
Authors: Iriyadi Deni
Published: June 2021

his research is a type of development research that is focused on developing a diagnostic test instrument to see students' conceptions. The research was conducted at SMA Negeri 1 Watampoen in class X. This research regulates the stage of developing an instrument consisting of 6 steps: (1) determining the specifications of the instrument, (2) determining the domain of the instrument, (3) determining whether the format is open-ended or closed ones to be used, (4) determining the test / instrument format, (5) determining whether the instrument is used for groups or individuals, (6) determining the length of the instrument. From this study, one third of the diagnostic tests were obtained which consisted of testing, examination format, and error checking. Giving remedials to students should not be done just like that without taking into account the knowledge that students have. By using a diagnostic test, students' understanding can be identified including what material they do not understand. This can be used as a reference for providing improvements to students
Alternatives for large crater repairs using Rapid Set Concrete Mix®
Authors: Edwards Lulu , Bell Haley , Opperman Marcus
Published: June 2021

Research was conducted at the U.S. Army Engineer Research and Development Center (ERDC) in Vicksburg, MS, to identify alternative repair methods and materials for large crater repairs using Rapid Set Concrete Mix®. This report presents the technical evaluation of the field performance of full-depth slab replacement methods conducted using Rapid Set Concrete Mix® over varying strength foundations. The performance of each large crater repair was determined by using a load cart representing one-half of the full gear of a C-17 aircraft. Results indicate that using rapid-setting concrete is a viable material for large crater repairs, and the performance is dependent on surface thickness and base strength.
The Stratigraphy Machine
Authors: Miall Andrew D. , Holbrook John M. , Bhattacharya Janok P.
Published: June 2021

There is a significant difference between the average sedimentation rate of a lengthy stratigraphic section spanning many millions of years, and the rate that can be calculated from any short segment within such a section, such segments typically yielding rates several orders of magnitude more rapid than the overall rate. Stratigraphic successions contain numerous surfaces of nondeposition and erosion representing time spans from minutes to many millions of years, which collectively may account for as much as 90% of the total elapsed time that the succession represents. The stratigraphic record is constructed by a range of geological processes that operate over all time scales from seconds to billions of years, and at rates that vary by ten orders of magnitude. The generation of the stratigraphic record can be conceptualized in the form of a mechanical device, which we term the “Stratigraphy Machine.”
Characteristics and Geological Significance of the Hydrocarbon Source Rocks of the Qum Formation in Outcrop of the Northern Garmsar Area, Iran
Authors: Li Xiaojun , Tian Jingchun , Wang Miao , Chen Yong
Published: June 2021

The carbonate rocks were collected from the Qum Formation in outcrop of the northern Garmsar Area, Iran. In order to evaluating the hydrocarbon generation prospects of these source rocks, we analyzed their geochemical characteristics, including the abundance, type, and maturity of organic matter, and investigated their formation conditions by analyzing the characteristics of soluble organic matter and sedimentary environment. The results show that the organic matter abundance of the source rocks in the Qum Formation in the Garmsar Area is low in the north and west. The organic matter type is mainly II1-II2, locally showing type I and III, and in general, it is conducive to hydrocarbon generation. The maturity of organic matter is low, showing the Tmax between 416°C and 439°C, vitrinite reflectance (Ro) from 0.49% to 0.83%, which indicate it is at the stage of low to moderate maturity. The soluble organic matter characteristics indicated that the organic matter evolution of the source rocks in the Qum Formation is low. Through comparison between the study area and other areas, and different places within the working area, the abundance, type, and maturity of organic matter of the source rocks in the Qum Formation are different, caused by the basin facie zones, sedimentary environment, and history of sedimentation of the source rocks. Overall, the source rock in the Qum Formation in Garmsar Area has good prospects of hydrocarbon generation. This study has important significance for further exploration in the Garmsar Area.
Incorporation of Physics into Machine Learning for Production Prediction from Unconventional Reservoirs: A Brief Review of the Gray-Box Approach
Authors: Liu Hui-Hai , Zhang Jilin , Liang Feng , Temizel Cenk , Basri Mustafa A. , Mesdour Rabah
Published: June 2021

Prediction of well production from unconventional reservoirs is often a complex problem with an incomplete understanding of physics and a considerable amount of data. The most effective way for dealing with it is to use the gray-box approach that combines the strengths of physics-based models and machine learning (ML) used for dealing with certain components of the prediction where physical understanding is poor or difficult. However, the development of methodologies for the incorporation of physics into ML is still in its infancy, not only in the oil and gas industry, but also in other scientific and engineering communities, including the physics community. To set the stage for further advancing the use of combining physics-based models with ML for predicting well production, in this paper we present a brief review of the current developments in this area in the industry, including ML representation of numerical simulation results, determination of parameters for decline curve analysis (DCA) models with ML, physics-informed ML (PIML) that provides an efficient and gridless method for solving differential equations and for discovering governing equations from observations, and physics-constrained ML (PCML) that directly embeds a physics-based model into a neural network. The advantages and potential limitations of the methods are discussed. The future research directions in this area include, but are not limited to, further developing and refining methodologies, including algorithm development, to directly embed physics-based models into ML; exploring the usefulness of PIML for reservoir simulations; and adapting the new developments of how the physics and ML are incorporated in other communities to the well-production prediction. Finally, the methodologies we discuss in the paper can be generally applied to conventional reservoirs as well, although the focus here is on unconventional reservoirs.
Loneliness and Depression in College Students During the COVID-19 Pandemic: The Role of Boredom and Repetitive Negative Thinking
Authors: Hager Nathan M. , Judah Matt R. , Milam Alicia L.
Published: June 2021

The COVID-19 pandemic triggered increased rates of depression, especially among college students. Due to social distancing guidelines, loneliness has been suspected as a prominent factor in depression during the pandemic. Research is needed to identify possible mechanisms through which loneliness conveys risk for pandemic-era depression. Two potential mechanisms are boredom and repetitive negative thinking (RNT). This study examined cross-sectional associations between depression, loneliness, boredom, and RNT in a sample of college students (N =199) in April 2020 immediately following campus closure. Results showed a serial indirect effect of loneliness on depression through boredom then RNT. Moreover, specific indirect effects of loneliness on depression were found through boredom and RNT, individually. Though limited by the cross-sectional design, these data align with cognitive-behavioral theory and identify boredom and RNT as possible mechanisms of the association between loneliness and depression in college students during the COVID-19 pandemic.
A novel cell type negatively associated with secondary autoimmunity in alemtuzumab-treated patients is revealed through single-cell longitudinal analysis of clinical trial samples
Authors: Savova Virginia , Hanamsagar Richa , Chamberlain Mathew , Shankara Srinivas , Marcus Robert , Baker Darren , Klinger Katherine , Havari Evis , Nestle Frank , de Rinaldis Emanuele
Published: June 2021

Alemtuzumab, a humanized anti-CD52 monoclonal antibody, is an approved treatment for relapsing forms of multiple sclerosis (RMS). While its efficacy has been demonstrated in clinical studies, its use is associated with unpredictable non-MS autoimmunity manifesting months or years after treatment. Approximately 40% of treated patients present with autoimmune thyroid events, 2% with platelet deficiency (immune thrombocytopenia; ITP)1, and 0.34% with autoimmune nephropathies2. The lack of predictive biomarkers necessitates careful monitoring in clinical practice with a Risk Management Plan or Risk Evaluation and Mitigation Strategy (RMP/REMS) in place for early detection of these autoimmune events. We carried out a longitudinal single-cell analysis of PBMCs in a small subset of alemtuzumab-treated patients from the phase 3 CARE-MS I (CAMMS323) study3 and identified a novel platelet lineage cell negatively associated with thyroid autoimmunity. This discovery raises the possibility that a shared underlying mechanism may contribute to the incidence of thyroid autoimmunity and ITP in alemtuzumab-treated patients.
Multivariate Analysis to Assess the Quality of Irrigation Water in a Semi-Arid Region of North West of Algeria : Case of Ghrib Dam
Authors: HALLOUZ FAIZA , Meddi Mohamed , Rahmani Salaheddine Ali
Published: June 2021

Dams are critical to agriculture, industry, and the needs of humans and wildlife. This study evaluates the water quality of the Ghrib dam in north west of Algeria, using Irrigation Water Quality Index (IWQI), sodium absorption rates (SAR) and multivariate statistical methods (Clustering and principal component analysis). The study concerns the analysis of physical and chemical parameters (pH, EC, O2, TUR, Ca, Mg, HCO3, Na, K, BOD, DCO, Cl−, PO4, SO3. NH4 et NO3) which were measured at twelve selected points along the dam over 8 periods (dry and wet periods) using standard methods. Irrigation Water Quality Index values in the dam were found to be between 41 and 59, according to classifications for different water uses, values below 60 indicate that water is of poor quality for irrigation and treatment is recommended to make dam water more suitable for irrigation. The results of water analysis in our study area reveal the presence of acute pollution which is certainly caused by direct releases of either industrial or domestic origin, and we note that this pollution remains variable depending on the collection periods. Also, Chloride-calcium and sulfate facies are the most dominant in sampling periods for dam water, resulting in poor water quality for irrigation. In addition, water is, therefore, highly mineralized and is likely to be suitable for irrigation of certain species (cucumbers...) that are well tolerant to salt and on well-drained and leached soils.
Does higher health literacy lead to higher trust in public hospitals?
Authors: Bertram Maja , Brandt Urs Steiner , Hansen Rikke Klitten , Svendsen Gert Tinggaard
Published: June 2021

Background:

Does higher health literacy lead to higher trust in public hospitals? Existing literature suggests that this is the case since a positive association between the level of health literacy and the level of trust in physicians and the health care system has been shown. This study aims to challenge this assumption.
Methods:

Based on theoretical arguments from game theory and analysis of empirical data, we argue that the association is better described as an inversely u-shaped curve, suggesting that low and high levels of health literacy lead to a lower level of trust than a medium level of health literacy does. The empirical analysis is based on a study of the Danes’ relationship to the overall health care system. More than 6,000 Danes have been asked about their overall expectations of the health service, their concrete experiences and their attitudes to a number of change initiatives.
Results:

Game theory analysis show that the combined perceived cooperation and benefit effects can explain an inversely u-shaped relationship between social groups and trust in the health care system. Based on quantitative, binary regression analyses of empirical data, the lowest degree of trust is found among patients from the lowest and highest social groups, while the highest degree of trust is found in the middle group. The main driver for this result is that while patients having low health literacy perceive that the health care system is not cooperative, patients with a high level of health literacy have high expectations about the quality, which the health care system might not be able to provide. This reduces the perceived benefit from their encounter with the health care system.
Conclusion:

It is important that health care professionals understand that some patient groups have a higher chance of cooperation (e.g., agreeing on the choice of treatment) or defection (e.g. passing a complaint) than others. In perspective, future research should undertake further qualitative examinations of possible patient types and their demands in relation to different health care sectors, focusing specifically on the opportunities to improve the handling of different patient types.
Laser-triggered combined chemotherapy and photodynamic therapy enabled by iron sulfide-doxorubicin@bovine lactoferrin nanozymes for breast cancer therapy
Authors: Ning Shipeng , Zheng Yang , Qiao Kun , Li Guozheng , Xu Shouping , Bai Qian
Published: June 2021

BackgroundThe use of magnetic nanozymes with the ability to synchronize gas therapy through photodynamic and chemotherapy in the treatment of breast cancer has received much attention. ResultsHence, in this study, we designed a bovine lactoferrin-coated iron sulfide nanozymes containing doxorubicin (FeS-Dox@bLf NZs) by wet chemical synthesis that can respond to tumor acidity. Then, the physicochemical properties of synthesized NZs were investigated by TEM, SEM, DLS and spectroscopic methods. Likewise, the level of Fe2+ release, H2S and Dox from FeS-Dox@Lf NZs under acidic conditions was evaluated. It was observed that Fe2+ and S2- caused significant OH and H2S release through the Fenton reaction. Also, the toxic effects of FeS-Dox@Lf NZs on 4T1 cancerous cells were investigated by MTT and flow cytometry assays. After intravenous injections of NZs and laser irradiation, significant effects of FeS-Dox@Lf NZs on mice weight and tumor status were observed. Afterwards, not only the distribution of Dox in the body was examined by fluorescent, but also the time of Fe clearance and the amount of Dox and Fe retention in vital tissues were determined. The findings confirm that FeS-Dox@Lf NZs, in addition to targeted drug distribution in tumor tissue, resulted in superior therapeutic performance compared to free Dox due to reduced Dox side effects in vital tissues, and increased level of free radicals in 4T1 cells. ConclusionOverall, FeS-Dox@Lf nanozymes with the ability to synchronize chemotherapy and gas therapy raised hopes for more effective treatment of breast cancer.
Spatial-Temporal Heterogeneity of Rock Samples’ Deformation and Damage: Experimental Study and Digital Image Correlation Analysis
Authors: Yan Fayuan , Qi Chengzhi , Shan Renliang
Published: June 2021

In-situ observations and laboratory experiments showed that slow deformation waves widely exist in geomedia under loading conditions. Slow deformation waves’ behavior exhibits some similarities in media ranging from the scale as large as the Earth's crust to the scale as small as the laboratory test samples. However, the mechanism underlying their generation has not been clarified yet. In this research an experimental study was performed on small-scale red sandstone samples subjected to uniaxial compression at the displacement rates of 0.1, 0.5, and 1 mm/min. Slow deformation waves under different loading rates were analyzed by speckle photography for microscopic characterization combined with the digital image correlation (DIC) technique. The Luders deformation bands were predominantly observed in the flow channels formed at the stage of macro-elastic deformation. The spatial-temporal heterogeneity of the rock sample surface was quantified, and the deformation waves' propagation velocities under different loading rates were obtained. The linear relationship between the propagation velocities of slow deformation waves and the loading rates was determined. The research findings shed some new lights on the evolutionary characteristics of the slow deformation waves.
On the Quest of Small Molecules that Can Mimic Psalmotoxin-1, a Powerful Peptidic Modulator of the Acid Sensing Channel ASIC1a
Authors: Pietra Francesco
Published: June 2021

Acid-sensing ion channels (ASICs) are thought to play a key role in a number of pathologies, from neuronal injury to pain sensation, while no drug has yet been approved as their modulator. This work was devised to asses roughly, yet from first principles, the relative energies of binding in the most important acidic pocket of cASIC1a, thereby paving the way to find small molecules that can mimic Pctx1, the most powerful peptidic modulator of cASIC1a. To this end, MD simulations for the overall conformation, and QM-MM simulations specifically for the location of hydrogen atoms, allowed disentangling the relative weight of the various non-bonded interactions between PcTx1 and cASIC1a. Main weight could be attributed to deeply buried salt bridges formed by the guanidinium end chains of residues Arg26 and Arg27 on PcTx1 and carboxylate end chain of distant residues Asp and Glu on cASIC1a. Rewardingly, in a preliminary attempt at exploiting these observations toward a small-molecule modulator, a Arg26-Arg27 stretch, excised from the PcTx1-cASIC1a complex and slightly simplified, on automated rigid docking on ligand-free receptor was observed to form most of the above salt bridges.
Implementation and Evaluation of Urban Green Space Supply for Debre Berhan Town, Ethiopia
Authors: Dejen Awlachew Dejen , Yitagesu Ayele Behaylu , Aysassa Dodge Getachew
Published: June 2021

Urban green space (UGS) is part of urban land covered with vegetation which has an immense benefit for sustainable urban development. The main objective of this study was urban green space supply analysis and evaluation for Debre Berhan town, Ethiopia. To realize this objective, we generated UGSs information by using normalized difference vegetation index (NDVI) which was calculated from Sentinel 2 satellite image. Then, the result of NDVI calculation was classified as small vegetation and high vegetation with over all accuracy of 87.29% and kappa value of 0.808. According to the result, there are 15.85% and 1.55% supply of urban green space for small and high vegetation respectively. In addition, the UGS supply in inner and outer part of the town for each land use was quantified. The result showed that in the inner part of the town, service, green area, and vacant land uses have 30.12%, 30.06%, and 13.32% of UGS supply respectively. Conversely, recreation, commercial, and administration land uses are least supplied with 0.11%, 0.26%, and 0.40% share of UGS. Furthermore, the UGS supply was evaluated against the new urban planning strategy of Ethiopia (30% coverage) and World Health Organization standard (9m2 per person). The coverage of small vegetation and high vegetation was 15.85% and 1.55% respectively. The UGS per capita for small vegetation was about 75.16m2 while the value for high vegetation was 7.33m2. The results of our analysis can be used as an input for urban planning and master plan revision.
Comparative Proteomic Analysis of Erythropoiesis Tissue Head Kidney Among three Antarctic Fish Species
Authors: Jia Ruonan , Huang Shaojun , Zhai Wanying , Jiang Shouwen , Li Wenhao , Wang Faxiang , Xu Qianghua
Published: June 2021

Antarctic icefish is the only known vertebrate species that lacks oxygen-carrying hemoglobin and functional erythrocytes. To reveal the unique hematopoietic process of icefish, we used an integrated approach including tandem mass tag (TMT) labeling and liquid chromatography-tandem mass spectrometry (LC-MS/MS) to quantify the dynamic changes in the head kidney whole proteome of a white-blooded icefish, Chionodraco hamatus, compared to those in two other red-blooded Antarctic fish, Trematomus bernacchii and Notothenia coriiceps. Of the 4,672 identified proteins, in the Antarctic ice fish head kidney, 123 proteins were significantly up-regulated and 95 proteins were down-regulated. The functional grouping of differentially expressed proteins based on KEGG pathway analysis shows that white blood fish and red blood fish have significant differences in erythropoiesis, heme biogenesis, leucocyte and platelet cell development. The proteins involved in the hematopoietic process in icefish showed a clear trend of downregulation of erythroid lineage marker proteins and upregulation of lymphoid and megakaryocytic lineage marker proteins, including CD9, ITGB2, and MTOR, which suggests a shift in hematopoiesis in the icefish head kidney due to the loss of erythrocytes. The results of the present study not only provide basic datasets for the head kidney proteins of Antarctic fishes, but also provide important references for studies on immunity and hematopoiesis in various species.
Psychiatric complications (depression, anxiety disorders, post-traumatic stress disorder) of ARDS: a systematic review
Authors: Klimcik Nela , Nguyen Maxime , D'Athis Philippe , Forestier Nathalie , Guinot Pierre-grégoire , Gelinier Jean Christophe Chauvet , Bouhemad Belaid
Published: June 2021

Background: ARSDS requires extensive resuscitation and has major physical sequelae. We evaluated the psychiatric sequelae by conducting a systematic review to determine prevalence of symptoms of depression, anxiety disorders and post-traumatic stress disorder (PTSD) following ARDS, as well as their risk factors.Methods: We conducted a search on Pubmed by including all studies meeting our primary endpoint (prevalence of symptoms of depression, anxiety disorders and PTSD following ARDS) and secondary endpoint (associated risk factors). Results: Included studies found prevalence ranging from 16 to 46% for symptoms of depression, 23 to 62% for symptoms of anxiety disorders and 16 to 47% for symptoms of PTSD. The data were too heterogeneous to conduct a meta-analysis. Among the risk factors associated with a risk factor of depression, anxiety disorders or PTSD after ARDS were; factors related to patient (as an history of mental illness) risk factors related to ICU management (as use opioids and benzodiazepine). Effect of severity of ARDS is not known.Conclusion: This systematic review shows that depression, anxiety disorders and PTSD following ARDS are frequent, long-lasting, disabling and have severe psychiatric consequences. Associated risk factors can be identified and among us use of opioids.
The Views of Public Service Managers on the Implementation of National Health Insurance in Primary Care
Authors: Murphy Shane Darren , Moosa Shabir Ahmed
Published: June 2021

Background The South African government is implementing National Health Insurance as a monopsony health care financing mechanism to drive the country towards Universal Health Coverage. Strategic purchasing, with separation of funder, purchaser and provider, underpins this initiative. The NHI plans contracting units for primary healthcare services to function as independent sub-district purchasers and District Health Management Offices to support and monitor these contracting units. This decentralised governance model to the operational unit of primary healthcare, the heartbeat of any universal healthcare system, is critical to programme success. The views of district-level managers, who are at the centre of the planned phased rollout will shed light on current policy implementation.ObjectivesThis is a qualitative study to explore district and sub-district managerial views on National Health Insurance and its implementation. Methods Purposive sampling was used to identify key respondents from a major urban district in Gauteng, South Africa, for participation in exploratory in-depth interviews. This study employed framework analysis within MaxQDA software for robust thematic analysis. Results Managers viewed National Health Insurance as a social and moral imperative but lacked clarity and insight into the National Health Insurance Bill and relevant implementation strategies. The majority of respondents had not received any engagement or had the opportunity to engage in policy formulation. District managers highlighted several pitfalls in current organisational operations. National and provincial government continue to function in a detached and rigid top-down hierarchy. The voices of coalface managers and workers, who live the reality of South African healthcare service provision, go unheard and unengaged. The findings of this study dishearteningly echo lessons already learned around established pillars of universal healthcare implementation such as human resources, multi-lateral stakeholder engagement and collaboration, devolution of governance with empowerment and capacitation of district managers. These findings imply that the South African Government has failed to anticipate and address these challenges and raises questions around reflective and experiential practices of the South African government. Conclusion It appears that strategic purchasing is not being operationalised in PHC. NHI policy implementation appears trapped in a rigid top-down hierarchy. District managers need to be engaged and capacitated to operationalise the planned decentralised purchasing-provision function of NHI.
An Effective Hybrid and Adaptive Caching Network Framework Approach In Time-to–Live (TTL) Based Data Item for Peripatetic Computing Environment
Authors: P Srimanchari , G Anandharaj
Published: June 2021

Caching is a well established technique to improve the efficiency of data access. This research paper introduces a Hybrid and Adaptive Caching (HAC) approach to cache the data item based on the varying size, and, Time-to-Live (TTL) based invalidation of the data item in a mobile computing environment. Mobile nodes establish single-hop communication with the base station and ad-hoc peer to peer communication with other neighbor nodes in the network to access data items. The proposed work adjusts the caching functionality level based on the size of the data item and stores the cached data item in two different storage systems. The cache of each node is separated into Temporary Buffer (TB) and Permanent Buffer (PB) to improve the data access efficiency. This approach is based on the fact that the smaller size data (e.g. stocks) are updated for shorter Time-to-Live (TTL) whereas the larger size data (e.g. video) are updated only for longer TTL. This proposed work also suggests an adaptive cache replacement and cache invalidation technique to resolve the issues regarding bandwidth utilization and data availability. In cache replacement technique, the cached data item is effectively replaced based on the size of the data item and TTL value. A timestamp-based cache invalidation strategy where the cached data is validated according to the update history of the data items has also been introduced in this paper. The threshold values have greater impact on the system performance. Therefore, the threshold values are fine tuned such that they do not affect the system performance. The proposed approaches significantly improve the query latency, cache hit ratio and efficiently utilize the broadcast bandwidth. The simulation result proves that the proposed work outperforms the existing caching techniques.
Reproducibility of Choroidal Thickness Measurements in Hemodialysis Patients. A Spectral Domain Optical Coherence Tomography Study
Authors: Eroğul Özgür , Uzel Mehmet Murat , Eroğul Leyla Eryiğit , Uzel Ayşe Güzin Taşlıpınar , Gobeka Hamidu Hamısı , İbiş Avşin
Published: June 2021

PurposeTo investigate the effects of hemodialysis (HD) on the reproducibility of subfoveal choroidal thickness (SFCT) as measured by spectral domain-optical coherence tomography (SD-OCT)MethodsIn this study, 26 HD (26 eyes) patients had their pre- and post-HD SFCT measured, and the results were compared for reproducibility. Following a thorough ophthalmic examination, SD-OCT was performed three times in a row during a single session. The same physician measured SFCT after automatically identifying choroid with a software caliper. The reproducibility parameters, including intra-class correlation coefficients (ICCs), coefficients of variation (COV), and test-retest variability (TRTV) were then calculated.ResultsMales made up 53.85% of the 26 HD patients. There was a significant IOP difference between pre-HD (16.42±3.14 mmHg) and post-HD (14.21±2.78 mmHg) (P<0.001). SFCT decreased significantly from pre-HD 243.50±10.23 μm to post-HD 234.29±9.41 μm (P<0.001). ICC value increased significantly after HD, rising from 0.948 to 0.989 (P<0.001, for all). Pre- and post-HD COV values were 1.6% and 0.65%, respectively. Also, pre- and post-HD TRTV values were 7.864±1.996 μm and 3.074±1.536 μm, respectively.ConclusionThe reproducibility of SFCT as measured by OCT was lower during pre-HD compared to post-HD. Post-HD SD-OCT assessment appears to improve the reliability of clinical outcomes in the diagnosis and monitoring of HD patients.
Prevalence of Mycobacterium Tuberculosis and Rifampicin-Resistant Tuberculosis Among Tuberculosis Presumptive Adults in Northern Ethiopia, 2016-2019
Authors: Dejene Tsehaye Asmelash , Hailu Genet Gebrehiwet , Wasihun Araya Gebreyesus
Published: June 2021

Background: Tuberculosis (TB) is the second leading cause of mortality from an infectious disease worldwide. Multidrug-resistant tuberculosis (MDR-TB), where rifampicin-resistant TB is the most contributor, remains a global health threat. There is scant data on MTB and rifampicin resistance (RR-MTB) using Gene Xpert MTB/RIF assay in Ethiopia, particularly in the study area. This study aimed at determining the prevalence of MTB and RR-MTB among presumptive TB patients in Tigray, Northern Ethiopia.Methods: A multi-center retrospective cross-sectional study was conducted from October 2019 to December 2019 among presumptive MTB patients from four governmental hospitals in Tigray regional state. Records of sputum sample results of presumptive MTB patients with Gene Xpert MTB/RIF assay from January 2016 to December 2019 were investigated. Data-extraction tool was used to collect data from registration books and analyzed using SPSS ver.21 statistical software. Statistically significant was set at P-value ≤ 0.05. Results: Out of the total 17,329 presumptive adult MTB patients who had submitted sputum samples for TB diagnosis, 16,437 (94.9%) had complete data and were included in the study. More than half (60.2%) of them were males and the age of the patients ranged from 18-98 years, with a mean age of 44.2 (±16.4 SD) years. The majority, 15,047(91.5%) and 11,750 (71.5%) of the participants were new cases and with unknown HIV status, respectively. Prevalence of MTB was 9.7% (95% CI: 9.2-10.2%) of these, rifampicin resistant-MTB was 8.7% (95% CI: 7.32-10.09%). Age (being greater than 29 years) [p < 0.001] and new cases [AOR= 0.46; 95%CI = 0.39, 0.53, p < 0.001] were associated with low TB infection. Whereas age groups of 18-29 years were associated with higher RR-MTB [AOR= 3.08; 95% CI= 1.07, 8.72, p = 0.036]. Gender (being male) [AOR= 0.68; 95 % CI= 0.47, 0.96, p= 0.032] and having no history of previous treatment [AOR= 0.29; 95 % CI= 0.202, 0.44, p < 0.001] were associated with lower RR-MTB. Conclusion: Nearly one-tenth of the presumptive tuberculosis patients tested positive for MTB; out of those, 8.7% were positive rifampicin-resistant-MTB. The high prevalence of TB and RR-MTB at a young age and previously treated cases calls for a concerted effort to improve and monitor TB treatment to reduce the problem.
Interferon-alpha 2b: An Effective Treatment for Hepatic Epithelioid Hemangioendothelioma
Authors: Liu Xiaolei , Yang Zhiying
Published: June 2021

Background: Hepatic epithelioid hemangioendothelioma (HEH) is a rare tumor and no standard treatment has been established. This study was aimed to prospectively investigate the effect of interferon-alpha 2b (IFN-a 2b) for HEH patients.Methods: Since March 2014, a total of 62 pathologically diagnosed HEH patients were followed up regularly. IFN-a 2b was suggested to HEH patients with progressed disease. Safety was assessed each month and tumor assessment scan was performed every 3 months. The primary end point was objective response rate (ORR) and disease control rate (DCR). Results: A total of 42 HEH patients were finally included in this study. Median patient age was 35.5 years (range 18-65 years old). No severe (grade ≥3) adverse event (AE) of IFN-a 2b was reported in the whole group. The most common treatment-related AEs were fever (50.0%) and fatigue (21.4%). Two patients had grade 2 level hypothyroidism and 1 patient had grade 2 level of leukopenia and thrombocytopenia. Partial response and complete response were achieved in 20 (47.6%) and 2 (4.8%) patients, respectively, and the ORR was 52.4%. Stable disease was observed in 12 (28.6%) patients and the DCR was 81.0%. Progressive disease was observed in 8 (19.0%) patients. The 1, 3 and 5-year progression free rate were 81.0%, 69.2% and 62.3%, respectively. Only 1 patient died due to the progression of disease during the study. The1, 3 and 5-year overall survival rate were 100%, 97.2% and 97.2%, respectively.Conclusion: IFN-a 2b is a safe and effective treatment for HEH patients.
C-Reactive Protein or Procalcitonin Combined with Rhinorrhea for Discrimination of Viral from Bacterial Infection in Hospitalized Adults of Non-Intensive Care Medical with Lower Respiratory Tract Infection
Authors: Shengchen DUAN , Gu Xiaoying , Fan Guohui , Zhou Fei , Zhu Guangfa , Cao Bin
Published: June 2021

Background: Whether procalcitonin (PCT) or C-reactive protein (CRP) combined with some clinical characteristics can better distinguish viral from bacterial infection is not clear. The aim was to assess the ability of PCT or CRP combined with clinical characteristics to distinguish between viral and bacterial infections in hospitalized non-intensive care unit (ICU) adults with lower respiratory tract infection (LRTI).Methods: This was a post-hoc analysis of a randomized clinical trial previously conducted among LRTI patients. The ability of PCT, CRP, and PCT or CRP combined with clinical characteristics to discriminate between viral and bacterial infection were estimated by portraying receiver operating characteristic (ROC) curves among patients with only vial or typical bacterial infection .Results: In total, 209 patients (virus 69%, bacteria 31%) were included in this study. When using CRP or PCT to discriminate between viral and bacterial LRTI, the optimal cut-off point were 22mg/L and 0.18ng/ml, respectively. When the optimal cut-off for CRP (≤22ml/L) or PCT (≤0.18ng/ml) combined with rhinorrhea was used to discriminate viral from bacterial LRTI, the AUCs were 0.81 (95% CI, 0.75–0.87) and 0.80 (95% CI, 0.74–0.86), respectively. When CRP≤22ml/L, PCT≤0.18ng/ml and rhinorrhea were combined, the AUC was 0.86 (95% CI, 0.80–0.91), which was statistically significant higher than that when CRP(≤22mg/L) or PCT (≤0.18ng/mL) was combined with rhinorrhea (p=0.0107 and p=0.0205).Conclusions: Either CRP≤22mg/L or PCT≤0.18ng/mL combined with rhinorrhea could help distinguish viral from bacterial infection in hospitalized non-ICU adults with LRTI. When rhinorrhea was combined together, discrimination ability can be further improved.
Freely Dissolved Organochlorine Pesticides (OCPs) and Polychlorinated Biphenyls (PCBs) along the Indus River Pakistan: Spatial pattern, Air-water Exchange and Risk Assessment
Authors: Sohail Muhammad , Eqani Syed Ali Musstjab Akber Shah , Bokhari Habib , Hashmi Muhammad Zaffar , Ali Nadeem , Alamdar Ambreen , Podgorski Joel E , Adelman Dave , Lohmann Rainer
Published: June 2021

Freely dissolved OCPs and PCBs were measured by using polyethylene passive samplers, at 15 sites during 2014 throughout the stretch of Indus River to investigate spatial pattern, air−water exchange gradients and risk assessment. Concentrations (pg/L) of dissolved ∑OCPs and ∑PCBs ranged from 34–1600 and 3–230. Among the detected OCPs, dissolved DDTs (p,p′-DDE, followed by p,p′-DDT) predominated with levels of 0.48 to 220 pg/L. The order of occurrence for other studied OCPs was as follows; HCB, Endosulfans, Chlordanes, and HCHs. Spatially, dissolved (pg/L) ∑OCPs varied (p < 0.05) as: surface water of Alluvial Riverine Zone (ARZ) showed highest levels (114) followed by Frozen Mountain Zone (FMZ) (52.9), Low Lying Zone (LLZ) (28.73) and Wet Mountain Zone (WMZ) (14.43) respectively. However, our zone wise PCBs data did not exhibit significant differences (p > 0.05). The PCA/MLR results showed that pesticides usage in crop/orchard fields and health sector, electric & electronic materials, and widespread industrial activities as the main source of OCPs and PCBs along Indus River. Air-water exchange of OCPs at FMZ, o,p′-DDE, p,p′-DDE and o,p′-DDD exhibited net volatilization while p,p′-DDD/o,p′-DDT showed net deposition, while all other studied zones (i.e., WMZ, ARZ and LLZ) showed net deposition of DDTs. Nevertheless, air-water exchange of PCBs showed that, there was net volatilization at the FMZ, WMZ and ARZ and net deposition at LLZ. Our results showed that OCPs and PCBs contaminated water intake, played an important role towards the considerable cancer/non-cancer risk (HI and CR values) along the Indus River Flood-Plain.
Association of Blood Lead Level and Breast Cancer Risk in US Women: A Cross-Sectional Study(NHANES 2003-2014)
Authors: Xu Qin , Gao Shan , Yi Qinchuan
Published: June 2021

Background: Environmental chemical exposures may play a important role in breast cancer etiology.Higher levels of exposure to environmental chemicals, such as heavy metals, may be associated with a high risk of patients with breast cancer, but the evidence is limited and inconsistent. Thus, In the current study, we used National Health and Nutrition Examination Survey (NHANES) data to to assess the influence of blood lead on risk of patients with breast cancer.Methods:This cross-section study was conducted by extracting data from NHANES database(2003-2014). Logistic regression was applied to explore the association between the blood lead and the incidence of breast cancer. Cox proportional hazards regression models were used to estimate the odds ratio (OR) and 95% confifidence interval (CI) of association between blood lead and the risk of breast cancer adjusted for confounder factors.Results: A total of 10153 participants were included. Elevated blood levels of lead was associated with higher risks of breast cancer ( OR 1.16; 95% CI, 1.09–1.22)in the unadjusted analysis.But after adjustment for established risk factors, we did not observe significant association between blood levels and breast cancer risk ( OR 1.00; 95% CI, 0.95–1.15).Conclusion: We found no significant association between elevated blood lead levels and high risk of breast cancer in our cross-section study.