bluuebunny/crossref_metadata_2025 huggingface dataset:
Subjective Assessment of Stress and its Relationship with Neuroendocrine Mechanisms of its Development in Obstetricians-Gynecologists against the Background of Professional Burnout
Authors: Kuzmin Mikhail , Tyumentseva Darya , Rashidova Maria , Sholokhov Leonid , Marianian Anait
Published: December 2021

The purpose of this сase-control study was to investigate the factors of subjective assessment of stress and their relationship with neuroendocrine mechanisms of its development in obstetricians-gynecologists against the background of professional burnout. Methods and Results: A total of 96 physicians and nurses from the different clinics specializing in both obstetrics and gynecology were surveyed. The Russian versions of MBI, BDI, SF-12, FFMQ, MAAS, and Coping strategies (the Ways of Coping Checklist) were applied. Blood serum/plasma was tested on the concentration of hormones (DHEA-C and TSH), melatonin, serotonin, and dopamine. Saliva cortisol was also estimated. In the present study, 43.75% of the physicians and nurses showed a high degree of burnout, which was comparable to that among physicians and nurses in other studies. Physicians and nurses with a high degree of burnout had more expressed coping strategies like Confrontive coping, Distancing, Self-controlling, Seeking social support and Escape-avoidance. Also, they have more expressed level of depressive manifestations. We found significant correlations between some factors of subjective assessment of stress (like coping and mindfulness) and neuroendocrine biomarkers. Adaptive coping like Planful problem-solving correlated negatively with the level of melatonin, and subscales of the mindfulness questionnaire were correlated negatively with levels of some biomarkers. Thus, we concluded that coping strategies and mindfulness could theoretically contribute to a decrease in the secretion of several hormones. Conclusion: Physicians and nurses with a low degree of burnout have a greater level of mindfulness and a lower level of some maladaptive coping strategies – Confrontive coping, Distancing, Escape-avoidance. Our results focus on the predictive role of these factors of subjective assessment of stress, in particular, Confrontive coping and mindfulness, in burnout syndrome. The present data confirm that there are some psychological and physiological aspects related to stress in the medical profession.
Mechanisms for Cardiac Troponin Increase in Arterial Hypertension
Authors: Chaulin Aleksey
Published: December 2021

Despite the fact that cardiac troponins (cTnI and cTnT) are cardiospecific, they can be elevated in many systemic and non-cardiac physiological and pathological conditions. The diagnostic value of cTnI and cTnT significantly depends on the method of their determination. Thus, previously used low- and moderate-sensitivity immunoassays detected only serious myocardial damage and did not determine troponins in patients suffering from certain chronic pathologies. High-sensitivity troponin assays can detect minor damage to cardiac muscle cells in many pathological conditions, and troponin levels have a high predictive value. Among the early pathological conditions requiring the attention of clinicians is arterial hypertension (AH), which is also accompanied by an increase in the levels of hsTn in serum and urine. Currently, mechanisms responsible for increased levels of cardiac troponins in the blood serum and urine in hypertension are not well covered in the scientific literature. This article discusses in detail the presumptive mechanisms that cause increased levels of cTnI and cTnT in AH.
How Digitization Lowers Oil & Gas Industry Break Even Cost
Authors: Dufour Sebastien , Sharma Rajesh D.
Published: December 2021

The Oil&Gas industry has experienced three price crises over the past twelve years. Swings in the key variables of politics, economy and technology affect supply and demand dynamics and consequently oil prices. The rise of unconventional sources brought the industry into a recurrent surplus of supply, putting pressure on prices and the combination of a supply shock, shortage of storage and an unprecedent demand drop brought prices to a 30-years low in April 2020.

Although volatile oil prices make it challenging for oil companies to manage their markets, the silver lining in low oil prices is that it forced the industry to focus on rendering their internal operations more efficient. O&G producers cut their costs dramatically to remain profitable. The industry embarked on an optimization path and consequently accelerated the adoption of digital transformation. The COVID-19 crisis along with increasing societal pressure has only been a catalyzer to this digital transformation, unlocking significant operational improvements and reducing carbon emissions.

According to the latest Rystad Energy analysis average breakeven price dropped 35% between 2014 and 2018, and an additional 10% over the last 2 years, to a $50 breakeven price per barrel.
Double Casing Exit for Side-Track to Commingle Two Borehole Sizes Based Sections in One Slim Shot to Well TD
Authors: Al-Khaldi Meshal , Al-Saadi Dhari , Al-Ajmi Mohammad , Dutta Abhijit , Elafify Ibrahim , Farhi Nadir , Nouh Walid
Published: December 2021

This project began when a 9-5/8" in 43.5 ppf production casing became inaccessible due to the existing cemented pipe inside, preventing further reservoir section exposure and necessitating a mechanical side-track meanwhile introducing the challenge of loosing one section and imposimg slim hole challenges. The size and weight of the double-casing made for challenging drilling, as did the eight very different formations, which were drilled. The side-track was accomplished in two steps, an 8½ in hole followed by a single long 6⅛ in section, rather than the three steps (16 in, 12¼ in, 8½ in) that are typically required.

The optimal kick off point carfully located across the dual casing by running electromagnetic diagnostics, the casing collar locator, and the cement bond log. The double casing mill was carefully tailored to successfully accomplish the exit in one run. Moreover, an extra 26 ft. MD rathole was drilled, which helped to eliminate the mud motor elongation run. A rotary steerable system was utilized directly in a directional BHA to drill an 8½ in open hole building section from vertical to a 30⁰ inclination. A 7.0 in liner was then set to isolate weak zones at the equivalent depth of the outer casing (13-3/8"). Subsequently, a single 6⅛ in section was drilled to the well TD through the lower eight formations.

Drilling a 6⅛ in section through eight formations came with a variety of challenges. These formations have different challenging behaviors relative to the wellbore pressure that typically leads to the drilling being done in two sections. Modeling the geo-mechanical characteristics of each formation allowed the determination of a mud weight range and rheology that would stabilize the wellbore through all eight formations. The slim, 6⅛ in, hole was stabilized with higher equivalent circulating density (ECD) values than is typically used in larger boreholes. Optimizing mud weight and drilling parameters, while managing differential sticking with close monitoring of real-time ECD, helped to stabilize the high-pressurized zones to deliver the well to the desired TD with a single borehole.

This project represents the first time in Kuwait that double casings in such large sizes have been cut and sidetracked. It is also the first time these eight formations have been cut across such a smaller hole size, slim hole (6⅛ in) in a single shot. Geo-mechanical modeling allowed us to stabilize the pressurized formations and to control the ECD. The well also deployed the longest production liner in the field commingling multiple reservoirs with differnt pore pressure ramps, with excellent cement quality providing optimal zonal isolation.
Mapping Trends and Hot-spots of Virtual Simulation Research in Nursing: A Bibliometric Analysis
Authors: Zhang Qian , Chen Jia , Liu Jing
Published: December 2021

Background: Virtual simulation has been widely used in nursing education and nursing training. This study aims to characterize the publications in terms of countries, institutions, journals, authors, collaboration relationships, and analyze the trends of virtual simulation in nursing research.Methods: Publications regarding virtual simulation in nursing were retrieved from Web of Science core collection. Microsoft Excel 2010, VOSviewer were used to characterize the contributions of the authors, journals, institutions, and countries. The trends, hot-spots and knowledge network were analyzed by Citespace and VOSviewer.Results: We identified 611 papers between 1999 and 2021. The number of publications grew slowly until 2019, after that, it got a sharp increase in 2020 and 2021. The USA, Canada and Australia were three key contributors to this field. Centennial College, University of Ottawa, and Ryerson University were three major institutions with a larger number of publications. Verkuyl M was the most productive and highest cited author. Clinical Simulation in Nursing, Nurse Education Today, Journal of Nursing Education were the three productive journals. "virtual patients," "nursing students," "clinical simulation," and "communication skills" were the frontier topics in recent years.Conclusion: Using the Virtual patients to train nursing students, developing more reliable and objective assessment methods to validate learning outcomes might be the recent and future hot-topics.
Comparison of Carotid Atherosclerotic Plaque Characteristics between Symptomatic Patients with Transient Ischemic Attack and Stroke using High-Resolution Magnetic Resonance Imaging
Authors: Lu Mingming , Zhang Lichen , Yuan Fei , Peng Peng , Zhang Hongtao , Liu Shitong , He Yao , Cai Jianming , Zhao Xihai
Published: December 2021

Background:This study aimed to compare the characteristics of carotid plaques between patients with transient ischemic attack (TIA) and ischemic stroke using magnetic resonance (MR) imaging.Methods：Patients with a recent ischemic stroke or TIA who exhibited atherosclerotic plaques of carotid arteries in the symptomatic sides determined by MR vessel wall imaging were recruited. The plaque morphology and compositions including intraplaque hemorrhage (IPH), lipid-rich necrotic-core (LRNC) and calcification were compared between TIA and stroke patients. Logistic regression was performed to relate the plaque characteristics to the types of ischemic events.Results:A total of 270 patients with TIA or ischemic stroke were recruited. Stroke patients had significantly higher prevalence of diabetes (42.2% vs. 28.2%, p=0.021), greater mean wall area (35.1 ± 10.1 mm2 vs. 32.0 ± 7.7 mm2, p = 0.004), mean wall thickness (1.3 ± 0.2 mm vs. 1.2 ± 0.2 mm, p=0.001), maximum normalized wall index (NWI)(63.9% ± 6.0% vs. 62.2% ± 5.9%, p=0.023) and %volume of LRNC (9.7%± 8.2% vs. 7.4% ±7.9%, p=0.025) in carotid arteries compared to those with TIA. After adjusted for clinical factors, above characteristics of carotid arteries were significantly associated with the type of ischemic events. After further adjusted for maximum NWI, this association remained statistically significant (OR, 1.41; CI, 1.01-1.96; p=0.041).Conclusions:Ischemic stroke patients had larger plaque burden and greater proportion of LRNC in carotid plaques compared to those with TIA. This study suggests that ischemic stroke patients had more vulnerable plaques compared to those with TIA.
Optimization of Hexagonal Boron-Doped Silicate Photonic Crystal Fiber To Obtain Near Zero Flattened Dispersion For Nonlinear Waves By Finite Difference Method
Authors: Dixit Achyutesh , Tiwari S. , Vyas Ajay Kumar , Kumar Rajesh , Pandey Atul
Published: December 2021

The B2O3-doped silicate photonic crystal fiber (PCF) containing small core and dielectric rods made of lead silicate SF57 has been most intensively investigated for different pump signals centered at 0.65 mm, communication band. This type of doping has been carried out to significantly diminish the upgraded refractive index of silica which enhances special capabilities that lead to an outstanding potential to PCF for the profoundly intense field in the optical Kerr effect. In this paper, the mode analysis has been done by solving a nonlinear wave equation for a Gaussian input beam using the finite difference method under analytical boundary conditions. Numerical results reveal that very minute doping of B2O3 is enough in giving prolonged confinement of beam with flattened dispersion due to ultra-low change in nonlinear behaviour.
Investigation of Target Sequencing of SARS-CoV-2 and Immunogenic Profiling in Host Cells of COVID-19 in Vietnam
Authors: Hoang Tham , Vu Giang , Tran Mai , Vo Nam , Le Quang , Tran Trang
Published: December 2021

Background: A global pandemic has been declared for coronavirus disease 2019 (COVID-19), which has serious impacts on human health and healthcare systems in the affected areas, including Vietnam. None of the previous studies have a framework to provide summary statistics of the virus variants and assess the severity associated with virus proteins and host cells in COVID-19 patients in Vietnam.
Method: In this paper, we comprehensively investigated SARS-CoV-2 variants and immune responses in COVID-19 patients in Vietnam. We provided summary statistics of a target sequence of SARS-CoV-2 for data scientists to use in downstream analysis for therapeutic targets. For host cells, we proposed a predictive model of the severity of COVID-19 based on public datasets of hospitalization status in Vietnam, incorporating a polygenic risk score. This score uses immunogenic SNP biomarkers as indicators of COVID-19 severity.
Result: We identified that the Delta variant of SARS-CoV-2 is most prevalent in southern areas of Vietnam and it is different from other areas in the world using various data sources. Our predictive models of COVID-19 severity had high accuracy (Random Forest AUC = 0.81, Elastic Net AUC = 0.7, and SVM AUC = 0.69) and showed that the use of polygenic risk scores increased the models’ predictive capabilities.
Conclusion: We provided a comprehensive analysis for COVID-19 severity in Vietnam. This investigation is not only helpful for COVID-19 treatment in therapeutic target studies, but also could influence further research on the disease progression and personalized clinical outcomes.
Intestinal Recruitment of CCR6-Expressing Th17 Cells By Suppressing miR-681 Alleviates Endotoxemia-Induced Intestinal Injury And Reduces Mortality
Authors: Gu Liwen , Jiang Jie , Liu Zhigang , Liu Qiangqiang , Liao Jinli , Zeng Qingli , Chen Chuanxi , Liu Zhihao
Published: December 2021

BackgroundSepsis or endotoxemia can induce intestinal dysfunction in the epithelial and immune barrier. Th17 cells, a distinct subset of CD4+ T-helper cells, act as “border patrol” in the intestine under pathological condition and in the previous studies, Th17 cells exhibited an ambiguous function in intestinal inflammation. Our study will explore a specific role of Th17 cells and its relevant mechanism in endotoxemia-induced intestinal injury.MethodsLipopolysaccharide was used to establish mouse model of endotoxemia. miR-681 was analyzed by RT-PCR and northern blot analysis and its regulation by HIF-1α was determined by chromatin immunoprecipitation and luciferase reporter assay. Intestinal Th17 cells isolated from endotoxemic mice were quantitatively evaluated by flow cytometry and its recruitment to the intestine controlled by miR-681/CCR6 pathway was assessed by using anti-miRNA treatment and CCR6 knockout mice. Intestinal histopathology, villus length, intestinal inflammation, intestinal permeability, bacterial translocation and survival were investigated, by histology and TUNEL analysis, ELISA, measurement of diamine oxidase, bacterial culture, with or without anti-miR-681 treatment in endotoxemic wild-type and (or) CCR6 knockout mice.ResultsIn this study, we found that miR-681 was significantly promoted in intestinal Th17 cells during endotoxemia, which was dependent on hypoxia-inducible factor-1α (HIF-1α). Interestingly, miR-681 could directly suppress CCR6, which was a critical modulator for Th17 cell recruitment to the intestines. In vivo, anti-miR-681 enhanced survival, increased number of intestinal Th17 cells, reduced crypt and villi apoptosis, decreased intestinal inflammation and bacterial translocation, resulting in protection against endotoxemia-induced intestinal injury in mice. However, CCR6 deficiency could neutralize the beneficial effect of anti-miR-681 on the intestine during endotoxemia, suggesting that the increment of intestinal Th17 cells caused by anti-miR-681 relies on CCR6 expression. ConclusionThe results of the study indicate that control of intestinal Th17 cells by regulating novel miR-681/CCR6 signaling attenuates endotoxemia-induced intestinal injury.
Impact of Ocular Residual Astigmatism On Anterior Corneal Astigmatism In Children With Low And Moderate Myopia
Authors: Lin Jian , An Dexiang , Lu Yun , Yan Dongmei
Published: December 2021

Background: To assess the influence of ocular residual astigmatism to anterior corneal astigmatism in children with low and moderate myopia.Methods: Refractive astigmatism was obtained by subjective manifest refraction. Anterior corneal astigmatism was obtained by IOL Master. Using Thibos vector analysis to calculate ocular residual astigmatism. Correlation analysis was used to assess the relationship between the magnitude of ocular residual astigmatism and anterior corneal astigmatism. The influence of ocular residual astigmatism to anterior corneal astigmatism was evaluated by Physical method.Results: The study analyzed 241 right eyes of 241 children aged 8 to 18 years old. In this study, the median magnitude of ocular residual astigmatism was 1.02 D, with interquartile range was 0.58 D. Against-the-rule ocular residual astigmatism was seen in 232 eyes (96.3%). There was a significant and moderate correlation between ocular residual astigmatism and anterior corneal astigmatism (r = 0.50, P < 0.001). The ocular residual astigmatism in 240 eyes (99.6%) had a compensatory effects on anterior corneal astigmatism. The mean compensation value was 1.00 ± 0.41 D (rang 0.02 D to 2.34 D). Based on this effect, 37 eyes had different axial classification of anterior corneal astigmatism and refractive astigmatism. By contrast, one eye (0.4%) had oblique ocular residual astigmatism and superimposed with-the-rule anterior corneal astigmatism.Conclusions: The magnitude of ocular residual astigmatism was relatively huge in myopia children and predominantly compensated anterior corneal astigmatism. The ocular residual astigmatism should be assessed first before fitting orthokeratology.
Prevalence and Risk Factors Analysis for Low Back Pain Among Occupational Groups in Key Industries of China
Authors: JIA Ning , ZHANG Meibian , Zhang Huadong , Ling Ruijie , Liu Yimin , Li Gang , YIN Yan , SHAO Hua , ZHANG Hengdong , QIU Bing , Li Dongxia , WANG Dayu , ZENG Qiang , WANG Rugang , CHEN Jianchao , ZHANG Danying , MEI Liangying , Fang Xinglin , LIU Yongquan , LIU Jixiang , ZHANG Chengyun , LI Tianlai , XU Qing , QU Ying , ZHANG Xueyan , SUN Xin , WANG Zhongxu
Published: December 2021

Background: With the acceleration of industrialization and the growth of population aging, LBP has become the main disease of life loss caused by disability, which brings huge economic burden to society and is a global public health problem that needs to be solved urgently. The purpose of this study is to carry out epidemiological investigation and research on a large sample of people in key industries in different regions of China, to find out the incidence and distribution characteristics of LBP in key industries in China, to explore the epidemic law, and to provide reference basis for alleviating the global public health problems caused by LBP.Methods: This study adopts the modified epidemiological cross-sectional survey method and the stratified cluster sampling method. From the representative enterprises in key industries in seven regions of North China, East China, central China, South China, southwest, northwest and Northeast China, all workers on duty and fulfill the criteria are taken as the research objects. The Chinese version of musculoskeletal disease questionnaire modified by a standardized Nordic Questionnaire was used to collect information, and a total of 57501 valid questionnaires were received. Descriptive statistics were used and multivariate logistic regression analysis (p < 0.05) was performed to explore the associations between musculoskeletal disorders and potential risk factors.Results: The annual incidence of LBP in key industries or workers in China is 16.4%. There was significant difference in the incidence of LBP among occupational groups in different industries (P < 0.05). The results of multivariate regression model show that always make the same movements with your trunk, working in the same positions at a high pace, trunk position, always turn round with your trunk, often work overtime, lift heavy loads (more than 20 kg), education level, staff shortage, working age (years), cigarette smoking, use vibration tools at work Body mass index (BMI), lift heavy loads (more than 5 kg) and age (years) were risk factors for LBP. Physical exercise, standing often at work and absolute resting time are protective factors.Conclusion: The incidence of LBP in key industries or workers in China is high. It is urgent to take relevant measures according to individual, occupational and psychosocial factors of LBP to reduce the adverse impact of LBP on workers' health.
Social and Regional Factors Predict the Likelihood of Admission to a Nursing Home After Acute Hospital Stay in Elderly People with Chronic Health Conditions: A Multilevel Analysis Using Routinely Collected Hospital and Census Data in Switzerland.
Authors: Bachmann Nicole , Zumbrunn Andrea , Bayer-Oglesby Lucy
Published: December 2021

Background: If hospitalisation becomes inevitable in the course of a chronic disease, discharge from acute hospital care in elderly individuals is often associated with temporary or persistent frailty, functional limitations and the need for help with daily activities. Thus, acute hospitalisation represents a particularly vulnerable phase of transient dependency on social support and health care. This study examines how social and regional inequality affect the decision for an institutionalisation after acute hospital discharge in Switzerland. Methods: The current analysis uses routinely collected inpatient data from all Swiss acute hospitals that was linked on the individual level with Swiss census data. The study sample included N=60,209 patients 75 years old and older living still at a private home and being hospitalised due to a chronic health condition in N=199 hospitals between 2010 and 2016. Random intercept multilevel logistic regression was used to assess the impact of social and regional factors on the odds of a nursing home admission after hospital discharge. Results: Results show that 7.8% of all patients were admitted directly to a nursing home after hospital discharge. We found significant effects of education level, insurance class, living alone and language regions on the odds of nursing home admission in a model adjusted for age, gender, nationality, health status, year of hospitalisation and hospital-level variance. The language regions moderated the effect of education and insurance class but not of living alone.Conclusion: Acute hospital discharge in elderly is a critical moment of transient dependency. Social and health care should work closely and coordinated together for a well-supported hospital discharge to avoid unnecessary institutionalisations of socially disadvantaged patients.
Foliar-Applied Selenium Nanoparticles Alleviate Cadmium Stress Through Changes in Physio-Biochemical Status and Essential Oil Profile of Coriander (Coriandrumsativum L.) Leaves
Authors: Babashpour-Asl Marzieh , Tabrizi Elnaz Farajzadeh Memari , Yousefpour-Dokhanieh Afsaneh
Published: December 2021

Since large areas of agricultural soils around the world are contaminated by Cd, a cost-effective and practical method is needed for the safe production of edible plants. The effective role of many nanomaterials to improve plant yield and alleviate environmental pollutions is addressed; however, selenium nanoparticles (Se-NPs) potential has not been well-known yet. The aim of this work was to investigate foliar application of Se-NPs on yield, water content, proline concentration, phenolic content, lipid peroxidation, and essential oil (EO) attributes of coriander (Coriandrum sativum L.) under Cd stress. This study consisted of Cd contamination (0, 4, and 8 mg L-1) and foliar application of Se-NPs (0, 20, 40, and 60 mg L-1) in a hydroponic system. The results showed enhanced Cd concentration of root and shoot of coriander under Cd stress; however, Se-NPs alleviate the uptake of Cd. There were observed the decreased shoot and root weight, chlorophyll (Chl) content and relative water content (RWC) by progressing Cd toxicity, but Se-NPs improved these attributes. Moderate Cd stress and 40 or 60 mg L-1 Se-NPs increased phenolic and flavonoid contents as well as EO yield. Proline concentration and malondialdehid (MDA) increased by enhancing Cd stress, but Se-NPs decreased MDA. The GC/MS analysis showed that the main EO constitutes were n-decanal (18.80-29.70%), 2E-dodecanal (14.23-19.87%), 2E-decanal (12.60-19.40%), and n-nonane (7.23-12.87%), representing different amounts under Cd pollution and Se-NPs. To sum up, 40-60 mg L-1 Se-NPs are effective in alleviating Cd stress.
Macrophage-derived microRNA-223 Promotes Intestinal Mucosal Barrier Dysfunction via Exosomal Pathways in Inflammatory Bowel Disease
Authors: CHang Xin , Song Yi-hang , He Zi-xuan , Zhao Sheng-bing , Wu Jia-yi , Gu Lun , Li Zhao-shen , Xu Can , Wang Shu-ling , Bai Yu
Published: December 2021

Background & Aim: Exosomes are effective mediators of cell-to-cell interactions and carry many regulatory molecules, including miRNAs, that can play crucial roles in diverse fundamental biological processes. However, to date, no study has reported macrophage exosomal involvement in the development of inflammatory bowel disease (IBD). This study investigated the specific miRNAs in macrophage-derived exosomes in IBD and the potential molecular mechanism. Methods: Dextran sulfate sodium (DSS) was used to generate IBD mice. The supernatants of murine bone marrow-derived macrophages (BMDMs) with or without lipopolysaccharide (LPS) were collected for exome isolation and miRNA sequencing. Lentiviruses were used to modify miRNA expression and further investigate the role of macrophage-derived exosomal miRNAs. In vitro, both mouse and human organoids were applied to a Transwell system in co-culture with BMDMs as a cellular IBD-related challenge.Results: Here, we show that LPS-induced macrophages can release exosomes containing various miRNAs, aggravating IBD. We analyzed miRNA sequencing of macrophage-derived exosomes, and miR-223 was selected for further study. In vivo, exosomes with high miR-223 expression contributed to the exacerbation of intestinal barrier dysfunction, which was further verified in both mouse and human colon organoids. Furthermore, time-dependent analysis of the mRNAs of DSS-induced colitis mouse tissue combined with miR-223 target gene prediction was performed to select the candidate gene, and the barrier-related factor TMIGD1 was identified.Conclusion: Collectively, these data indicated that macrophage-derived exosomal miR-223 played a novel role in intestinal barrier dysfunction by inhibiting TMIGD1 in the progression of DSS-induced colitis.
Optimal Surveillance of Intraductal Papillary Mucinous Neoplasms of the Pancreas Focusing on Remnant Pancreas Recurrence After Surgical Resection
Authors: FUJI Tomokazu , UMEDA Yuzo , TAKAGI Kosei , YOSHIDA Ryuichi , YOSHIDA Kazuhiro , YASUI Kazuya , MATSUMOTO Kazuyuki , KATO Hironari , YAGI Takahito , FUJIWARA Toshiyoshi
Published: December 2021

Background: The international consensus guidelines for intraductal papillary mucinous neoplasm of the pancreas (IPMN) presented clinical features as indications for surgery. Whereas surveillance for recurrence including de novo lesions is essential, optimal surveillance protocols have not been established.Aim and Methods: The aim of this study was to assess the clinical features of recurrence at the remnant pancreas (Rem-Panc) and extra-pancreas (Ex-Panc) after surgery for IPMN. Ninety-one cases of IPMN that underwent detailed preoperative assessment and pancreatectomy were retrospectively analyzed, focusing especially on the type of recurrence.Results: The IPMNs were finally diagnosed as low-grade dysplasia (LDA, n=42), high-grade dysplasia (HAD, n=19), and invasive carcinoma (IPMC, n=30). Recurrence was observed in 26 cases (28%), of which recurrence was seen at Rem-Panc in 19 cases and at Ex-Panc in 7 cases. The frequency of Rem-Panc recurrence was 10% in LDA, 21% in HDA, and 37% in IPMC. On the other hand, Ex-Panc recurrence was observed only in IPMC (23%). Ex-Panc recurrence showed shorter median recurrence-free survival (RFS) and overall survival (OS) than Rem-Panc recurrence (median RFS 8 months vs 35 months, p<0.001; median OS 25 months vs 72 months, p<0.001). Regarding treatment for Rem-Panc recurrence, repeat pancreatectomy resulted in better OS than no-pancreatectomy (MST 36 months vs 15.5 months, p=0.03). On multivariate analysis, main duct stenosis or disruption as a preoperative feature (hazard ratio [HR] 10.6, p=0.002) and positive surgical margin (HR 4.4, p=0.018) were identified as risk factors for Rem-Panc recurrence.Conclusions: The risk factors for Rem-Panc and Ex-Panc recurrence differ. Optimal surveillance based on these features is desirable to ensure that repeat pancreatectomy for Rem-Panc recurrence can be an appropriate surgical intervention.
The Feasibility and Utility of Hair Follicle Sampling To Measure FMRP and FMR1 mRNA in Children With or Without Fragile X Syndrome
Authors: Jalnapurkar Isha , Frazier Jean A. , Roth Mark , Cochran David M. , Foley Ann , Merk Taylor , Venuti Lauren , Ronco Lucienne , Raines Shane , Cadavid Diego
Published: December 2021

Background:

Fragile X syndrome (FXS) is the most common cause inherited cause of intellectual disability in males and the most common single gene cause of autism. This X-linked disorder is caused by an expansion of a trinucleotide CGG repeat (>200 base pairs) on the promotor region of the fragile X mental retardation 1 gene (FMR1). This leads to the deficiency or absence of the encoded protein, Fragile X mental retardation protein (FMRP). FMRP has a central role in the translation of mRNAs involved in synaptic connections and plasticity. Recent studies have demonstrated the benefit of therapeutics focused on reactivation of the FMR1 locus towards improving key clinical phenotypes via restoration of FMRP and ultimately disease modification. A key step in future studies directed towards this effort is the establishment of proof of concept (POC) for FMRP reactivation in individuals with FXS. For this it is key to determine the feasibility of repeated collection of tissues or fluids to measure FMR1 and FMRP.
Methods:

Individuals, ages 3 to 22 years of age, with FXS and those who were typically developing participated in this single-site pilot clinical biomarker study. The repeated collection of hair follicles was compared with the collection of blood and buccal swabs for detection of FMR1 mRNA and FMRP and related molecules.
Results:

There were n = 15 participants, of whom 10 had a diagnosis of FXS (7.0 ± 3.56 years) and 5 were typically developing (8.2 ± 2.77 years). Absolute levels of FMRP and FMR1 mRNA were substantially higher in healthy participants compared to full mutation and mosaic FXS participants, and lowest in the FXS boys. Measurement of FMR1 and FMRP levels by any method did not show any notable variation by collection location at home versus office across the various sample collection methodologies of hair follicle, blood sample, and buccal swab.
Conclusion:

Findings demonstrated that repeated sampling of hair follicles in individuals with FXS, in both, home and office settings, is feasible, repeatable, and can be used for measurement of FMR1 and FMRP in longitudinal studies.
Formation Control For Discrete-Time Multi-Agent System With Input and Output Delays Under Network Attacks
Authors: Jian Yuan , Hailin Liu , Wenxia Zhang
Published: December 2021

This paper addresses the mean square consensus-based formation control for multiple agent system (MAS) with input and output delays under network attacks, process noise, and measurement noise in MAS. Firstly, a time delay-free transformation approach for a multi-agent system with input and output delays is presented. The MAU system is transformed into a formal delay-free discrete-time system using the delay-free transformation method. Then a state observer based on Kalman filter is presented to estimate the states of agents. A distributed predictive consensus protocol based on the estimated states of each MAUS is proposed for the leader-following MAUS. The sufficient and necessary conditions of mean square consensus for MAUS under DoS attacks are derived. Finally, a numerical example of consensus-based formation control for Multi-agent systems is provided to verify the correctness and effectiveness of the proposed consensus control protocol.
The cross-scale correlations between individuals and nations in COVID-19 mortality
Authors: Zhang Lei , She Yu-Rong , She Guang-Hui , Li Rong , She Zhen-Su
Published: December 2021

It is challenging to quantitatively clarify the determining medical and social factors of COVID-19 mortality, which varied by 2-3 orders of magnitude across countries. Here, we present evidence that the whole-cycle patterns of mortality follow a logistic law for 52 countries. A universal linear law is found between the ICU time in the early stage and the most important quantity regarding the epidemic: its duration. Saturation mortality is found to have a power law relationship with median age and bed occupancy, which quantitatively explains the great variation in mortality based on the two key thresholds of median age (=38) and bed occupancy (=15%). We predict that deaths will be reduced by 36% when the number of beds is doubled for countries with older populations. Facing the next wave of the epidemic, this model can make early predictions on the epidemic duration and medical supply reservation.
Community Structure and Co-Occurrence Network Analysis of Bacteria and Fungi in Wheat Fields vs Fruit Orchards
Authors: Cui Xinyu , He Huan , Zhu Fengxiao , Liu Xiaobo , Ma You , Xie Wenming , Meng Han , Zhang Limin
Published: December 2021

Soil microorganisms play a vital role in biogeochemical processes and nutrient turnover in agricultural ecosystems. However, the information on how the structure and co-occurrence patterns of microbial communities respond to the change of planting methods is still limited. In this study, a total of 34 soil samples were collected from 17 different fields of two planting types (wheat and orchards) along the Taige Canal in Yangtze River Delta. The distribution and diversity of bacterial and fungal communities in soil were determined using amplicon sequencing targeting the 16S rRNA gene and ITS gene, respectively. The dominated bacteria were Proteobacteria, Acidobacteriota, Actinobacteriota, Chloroflexi, Bacteroidota, and Firmicutes. The relative abundance of Actinobacteriota and Firmicutes was higher in the orchards, while Chloroflexi and Nitrospirota were more abundant in wheat fields. Ascomycota, Mortierellomycota, and Basidiomycota were the predominant fungi in both types of soils. The diversity of bacterial and fungal communities was greater in the wheat fields than in the orchards. The statistical analyses showed that pH was the main factor shaping the community structure. Moreover, high co-occurrence patterns of bacteria and fungi were confirmed in both wheat fields and orchards. Network analyses showed that both the wheat fields and orchards occurred modular structure, which mainly contained nodes of Acidobacteriota, Chloroflexi, Gemmatimonadota, Nitrospirota and Ascomycota. In summary, our work showed the co-occurrence network and the convergence/divergence of microbial community structure in wheat fields and orchards, giving a comprehensive understanding of the microbe-microbe interaction during planting methods changes.
[68Ga]Ga-DOTA-FAPI-04 PET/CT in The Staging of Gastric Cancer: Improved Diagnostic Efficacy Confirmed By Postoperative Histopathology
Authors: Lin Rong , Lin Zefang , Chen Zhenying , Zheng Shan , Zhang Jiaying , Zang Jie , Miao Weibing
Published: December 2021

Purpose

This study aimed to compare the diagnostic performance of [68Ga]Ga-DOTA-FAPI-04 and [18F]-FDG PET/CT in the primary and metastatic lesions of gastric cancer.
Methods

Fifty-six patients with histologically proven gastric carcinomas were enrolled in this study. Each patient underwent both [18F]-FDG and [68Ga]Ga-FAPI-04 PET/CT within one week. Activity of tracer accumulation in lesions were assessed by maximum standardized uptake value (SUVmax) and TBR (lesions SUVmax/ ascending aorta SUVmean). Histological work-up including immunohistochemical staining for FAP served as a standard of reference.
Results

[68Ga]Ga-FAPI PET/CT is superior in detecting primary tumors both in patient-based (100% [45/45] vs. 97.8% [44/45]) and lesion-based analyses (97.8% [45/46] vs. 95.7% [44/46]), showing higher SUVmax (10.25 vs. 8.13, P = 0.004) and TBR (11.63 vs. 5.83, P < 0.001), compared with [18F]-FDG PET/CT. The specificity and positive predictive value of [68Ga]Ga-FAPI were significantly higher than that of [18F]-FDG (100.0% vs. 97.7%, P < 0.001; 100.0% vs. 57.1%, P = 0.001) in determining the lymph node (LN) metastases. [68Ga]Ga-FAPI PET/CT was superior to [18F]-FDG PET/CT in N-staging (47.1% [8/17] vs. 23.5% [4/17]), and in evaluation for LN, peritoneum and bone metastases. [68Ga]Ga-FAPI PET/CT detected positive recurrent lesions in all patients and showed more positive lesions and clearer tumor delineation. Two patients underwent follow-up [68Ga]Ga-FAPI PET/CT scans after chemotherapy, which both showed remission.
Conclusions

[68Ga]Ga-FAPI PET/CT can better detect primary gastric cancer and metastatic lesions in peritoneum, abdominal LNs and bone, showing high usefulness in guiding N staging. Furthermore, [68Ga]Ga-FAPI PET/CT provides more information for patients with recurrence detection and also has great potential in monitoring response to treatment.
Phacoemulsification Without Hydro-procedure: A Novel Technique to Deal with Posterior Polar Cataracts.
Authors: Bardoloi Narayan , Sarkar Sandip , Das Himanshu , Burgute Pankaj Suresh
Published: December 2021

Purpose: To describe a new phacoemulsification technique without hydro-procedures in patients of posterior polar cataract (PPC) and determine the posterior capsular rate (PCR) and postoperative outcomes.Methods: After capsulorhexis, we insert the phacoemulsification probe inside the eye and shave the cortex and epinucleus within the capsulorhexis area. Then the phaco probe is buried deep into the center, and an anteroposterior crack is fashioned. Then the probe is placed at 7’ o clock to chop away a triangular piece of the nucleus. A similar maneuver is done at a 4' o clock position to take out another piece. The phacoemulsification tip and the chopper are now positioned at the cracked site of the lower fragments. Using the 2 instruments, the fragments are now pushed away and easily emulsified.Results: We conducted a retrospective study with 115 eyes of 77 patients. The mean age of the study population was 51.87 + 14.19 years (range 22-87 years). Out of 77 patients, 39 (50.64%) patients had unilateral PPC, and 38 (49.35%) had bilateral PPC. PCR occurred in 9 eyes (7.82%). Two patients had fragment drop, and only 1 (0.87%) patient was left aphakic. Best-corrected visual acuity (BCVA) at postoperative day 30 was 20/20 or better in 102 (88.69%) eyes, 20/32-20/80 was in 11(9.56%) eyes, and BCVA 20/80-20/200 was in 2 (1.73%) eyes.Conclusion: Phacoemulsification without hydro-procedure is a novel technique that can be successfully implemented in PPC cases and expect an excellent visual outcome.
Clinical Characteristics and Prognosis of Patients With Antiphospholipid Antibodies Based on Cluster Analysis: An 8-Year Cohort Study
Authors: Qi Wanting , Zhao Jiuliang , Huang Can , Jiang Nan , Li Jing , Wu Chanyuan , Zhang Shangzhu , Hu Chaojun , Xu Dong , Wang Qian , Li Mengtao , Tian Xinping , Zhao Yan , Zeng Xiaofeng
Published: December 2021

Background: Antiphospholipid syndrome (APS) is an autoimmune disease characterized by persistent antiphospholipid antibodies (aPLs) positivity with a wide manifestation spectrum. A risk stratification is needed for management guidance and prognosis assessment. We aimed to identify phenotypes among aPL-positive patients and assess the prognosis of each phenotype.Methods: This was a single-center, prospective cohort study of aPL-positive patients presented to Peking Union Medical College Hospital from 2012 to 2020. Demographic characteristics, aPL-related manifestations, cardiovascular risk factors and antibodies profiles were recorded. The primary endpoint was defined as a combination of newly-onset thrombosis, major bleeding events, non-criteria manifestations and all-cause death. Hierarchical cluster analysis and Kaplan-Meier survival analysis were performed.Results: Four clusters among 383 patients (70.2% female; mean age 37.7 years) were identified. Cluster 1 (n=138): patients with systemic lupus erythematosus (SLE) and non-criteria manifestations; Cluster 2 (n=112): patients with multiple cardiovascular risk factors; Cluster 3 (n=83): female patients with obstetric morbidity; Cluster 4 (n=50): patients with isolated lupus anticoagulant (LA) positivity.Non-criteria manifestations were found aggregated with SLE from cluster analysis of variables. Cluster 3 showed the best outcome, while cluster 2 suffered highest frenquency of newly-onset arterial thrombosis.Conclusions: We identified 4 clinical phenotypes of aPL-positive patients. Non-criteria manifestations may indicate underlying SLE, for which immunosuppressive therapy besides anticoagulation may be necessary. Patients with isolated LA positivity suffered similar risks with secondary APS and patients with multiple cardiovascular risk factors. Attention should be paid to male patients, and the screening of cardiovascular risk factors should never be ignored.
Periodically kicked feedforward chains of simple excitable FitzHugh-Nagumo neurons
Authors: Ambrosio B. , Mintchev S.M.
Published: December 2021

This article communicates results on regular depolarization cascades in periodically-kicked feedforward chains of excitable two-dimensional FitzHugh-Nagumo systems driven by sufficiently strong excitatory forcing at the front node. The study documents a parameter exploration by way of changes to the forcing period, upon which the dynamics undergoes a transition from simple depolarization to more complex behavior, including the emergence of mixed-mode oscillations. Both rigorous studies and careful numerical observations are presented. In particular, we provide rigorous proofs for existence and stability of periodic traveling waves of depolarization, as well as the existence and propagation of a simple mixed-mode oscillation that features depolarization and refraction in alternating fashion. Detailed numerical investigation reveals a mechanism for the emergence of complex mixed-mode oscillations featuring a potentially high number of large amplitude voltage spikes interspersed by an occasional small amplitude reset that fails to cross threshold. Further careful numerical investigation provides insights into the propagation of this complex phenomenology in the downstream, where we see an effective filtration property of the network; the latter amounts to a successive reduction in the complexity of mixed-mode oscillations down the chain.
A Novel Variant of SMARCB1 in Rare Familial Schwannomatosis Identified by Whole-Exome Sequencing and Genotype-Phenotype Correlation Analysis.
Authors: Wang Conghui , Chai Yuqiong , Zhao Xuechao , Li Qianqian , Chen Chen , Kong Xiangdong
Published: December 2021

Background: Variants in the tumor suppressor gene SMARCB1 could cause different conditions. In some cases, germline and somatic variants in SMARCB1 are implemented in schwannomatosis. But the genotype and phenotype correlation for variants in SMARCB1 has not been determined.Methods: A Chinese schwannomatosis family with an autosomal dominant inheritance pattern was recruited. Whole-exome sequencing (WES) was performed to discover the causative variant, followed by Sanger sequencing. We evaluated the Human Gene Mutation Database (HGMD) regarding SMARCB1 variants and validated associated phenotype records to assess phenotype-genotype relationships. Results: A novel deletion variant c.885_896delGAAGCTGTGCTC p.(295_299del） in SMARCB1 was identified in the affected family members and cosegregated with phenotypes in the pedigree. About 51.1% of variants in SMARCB1 located in Snf5 subunit, 80.7% of variants were loss-of-function (LOF) variants, and more variants located in the Snf5 subunit of SMARCB1 in Rhabdoid tumour (67.8%) than that in schwannomatosis (25.7%).Conclusions: Our study expands the variant spectrum of SMARCB1 and the genetic background of schwannomatosis, confirms the clinical indications for genetic screening of the SMARCB1 gene, and has implications for genetic counseling in this disease.
A Novel Multi-Criteria Decision Analysis Technique Incorporating Demanding Essential Characteristics of Existing MCDA Techniques
Authors: Bandyopadhyay Susmita
Published: December 2021

This paper has proposed a novel Multi-Criteria Decision Analysis (MCDA) technique that considers relationships among the criteria, relationships among the alternatives, relationships among the criteria and the alternatives, the uncertainty or dilemma that the decision makers face in their decision-making, the entropy among the criteria. These characteristics seem to be the essential characteristics of various MCDA techniques as evident from the existing literature. The dilemma of the decision makers have been captured by the use of Hesitant Fuzzy Elements; the information content among the criteria have been captured by applying the concept of entropy through the application of a technique called IDOCRIW. Relationships have been determined by calculating the covariances among the criteria and among the alternatives. A kind of sensitivity analysis, rank reversal method has been performed to verify the effectiveness of the proposed technique. The proposed method has also been compared with four different types of already existing MCDA techniques, AHP, MAUT, MACBETH and MOORA. Both the sensitivity analysis and the comparison with other methods establish the effectiveness of the proposed technique.