bluuebunny/crossref_metadata_2025 huggingface dataset:
Conformity assessment of a computer vision-based clinical decision support system for the detection of postural spinal deformity
Authors: Sohn Moon-Jun , Kim Kwang Hyeon
Published: February 2022

Background: This study evaluates the conformity of using a computer vision-based posture analysis system as a screening assessment for postural deformity detection in spine that is easily applicable to clinical practice.Methods: One hundred forty participants were enrolled for screening of the postural deformation. Factors that determine the presence or absence of spinal deformation, such as shoulder height difference (SHD), pelvic height difference (PHD), and leg length mismatch (LLD), were used as parameters for the clinical decision support system (CDSS) using a commercial computer vision-based posture analysis system. For conformity analysis, the probability of postural deformation provided by CDSS, the Cobb angle, the PHD, and the SHD were compared and analyzed between the system and radiographic parameters. A principal component analysis (PCA) of the CDSS and correlation analysis were conducted.Results: The Cobb angles of the 140 participants ranged from 0° to 61°, with an average of 6.16° ± 8.50°. The postural deformation of CDSS showed 94% conformity correlated with radiographic assessment. The participants of postural deformation with normal (0-9°) and mild (10-25°) range of scoliosis were more accurate in conformity assessment result (98.57%). The referenced SHD and the SHD of the CDSS showed statistical significance (p < 0.001) on a paired t-test. SHD and PHD for PCA were the predominant factors (PC1 SHD for 79.97%, PC2 PHD for 19.86%).Conclusion: The CDSS showed 94% conformity for the screening of postural spinal deformity. The main factors determining diagnostic suitability were analyzed as two main variables: SHD and PHD. In conclusion, a computer vision-based posture analysis system can be utilized as a safe, efficient and convenient CDSS for early diagnosis of spinal posture deformation, including scoliosis.
Artificial intelligence based on automated breast volume scanner (ABVS) in breast nodules:A deep learning model for diagnosis
Authors: Jiang Wei , Yang Yi , Zhu Ting , Deng Xiaoji , Fang Jing
Published: February 2022

Objectives We aimed to explore the use of artificial intelligence (AI) in differential diagnosis of benign and malignant breast nodules with automated breast volume scanner (ABVS). Methods The AI model used in this study is based on the VNet, trained with a collection of breast nodules. Another collection of breast nodules were used to test the diagnostic accuracy among AI model, radiologists with different experiences, and AI-assisted junior radiologist. Sensitivity, specificity, accuracy, positive predictive value, negative predictive value and area under the curve (AUC) were used as indices to evaluate the efficiency on distinguishing between benign and malignant breast nodules of four different diagnostic groups. Results The training cohort includes 100 breast nodules, the validation cohort includes 47 breast nodules. Among these 147 cases, 92 cases were benign (62.6%), 55 cases were malignant (37.4%). The AUC values of AI diagnosis, independent diagnosis by senior radiologist, independent diagnosis by junior radiologist, and AI-assisted diagnosis by junior radiologist were 0.839(95%CI, 0.703-0.930), 0.956(95%CI, 0.853-0.994), 0.814(95%CI, 0.674-0.912), and 0.963(95%CI, 0.863-0.996), respectively. The diagnostic efficiency of junior radiologist improved with the assistance of AI (AUC = 0.814 vs 0.963, Z=2.772, p <0.01). No significant difference in diagnostic ability was found between the AI-assisted junior radiologist and the senior radiologists (AUC = 0.963 vs 0.956, Z=0.158, p > 0.05). Conclusions The AI model could distinguish between benign and malignant breast nodules with ABVS. AI model is the fastest diagnosis method with equivalent diagnosis efficiency with experienced radiologists, and could improve the diagnostic ability of junior radiologist.
NET Rounding: A Novel Approach to Efficient and Effective Rounds for the Modern Clinical Learning Environment
Authors: Chan Shirley J. , Archibald Hannah L. , Conner Stephanie M.
Published: February 2022

Background: Rounds are a foundational practice in patient care and education in the inpatient healthcare environment, but increased demands on inpatient teams have led to dissatisfaction with inefficient, ineffective rounds. In this study, we describe the design, implementation, and evaluation of a novel rounding framework (“NET Rounding”) that provides behaviorally-based strategies to inpatient teams to achieve efficient rounds while preserving patient safety and education.Methods: NET Rounding consists of nine recommendations divided into three categories: Novel rounding strategies, shared Expectations, and Time management. This framework was introduced as a bundled intervention at a single-site, quaternary-care, academic hospital from March-May 2021. 83 residents and 64 attendings rotated on the inpatient teaching service during the intervention period. Participants were surveyed before, during, and after their rotation about rounding’s contribution to educational value, patient safety, resident duty hour violations and rotation experience. Additionally, rounding duration was recorded daily by team attendings.Results: 32 residents (38.5%) and 45 attendings (79%) completed post-intervention surveys. Rounding duration was recorded on 529/626 rounding days (80.6%) and resulted in achieving efficient rounds on 412/529 days (77.9%). Residents reported improvement in perceived patient safety (54% to 84%, p=0.0131) and educational value of rounds (38% to 69%, p=0.0213) due to NET Rounding; no change was observed amongst attendings in these areas (79% to 84% and 70% to 80%, p=0.7083 and 0.4237, respectively). Overall, 29/32 residents (91%) and 33/45 attendings (73%) reported a positive impact on rotation experience.Conclusions: NET Rounding enabled inpatient teaching teams to complete rounds more efficiently while preserving patient safety and education.
Impact of a Patient-centered Medical Home on Healthcare Utilization for Patients With Complex Needs in Singapore: a Matched Cohort Study
Authors: Sim Silvia Yu Hui , Chay Junxing , Ho Soon Hoe , Ginting Mimaika Luluina , Lim Zoe Zon Be , Sum Grace , Yoong Joanne , Wong Chek Hooi
Published: February 2022

Background: Patients with complex needs require greater biopsychosocial support. Fragmented services often result in gaps, duplication or incompatibility in treatments, leading to poorer health outcomes and higher utilization of costly hospital-based healthcare services. Patient-Centred Medical Home (PCMH) is a primary care model reform advocated as more appropriate for patients with complex needs. This analysis assessed the impact of a PCMH demonstration on healthcare utilization for patients with complex needs in Singapore. Methods: This study assessed the Community for Successful Ageing (ComSA)-PCMH in Singapore that was launched in Nov’2016. ComSA-PCMH serves adults aged 40 and above with complex needs, delivering care integrated between its primary care clinic, home-based care management, an acute hospital and other community-based services. This was a matched cohort analysis that used a difference-in-difference approach to compare quarterly healthcare utilization of PCMH study participants and controls. 165 PCMH study participants enrolled between Oct’2017 and Apr’2019 were compared against 5,385 controls selected using Coarsened Exact Matching from a neighbouring geographical precinct. Healthcare utilization data spanning Oct’2014 to Mar’2020 were extracted from a public regional health system, including primary care, specialist outpatient clinic and emergency department utilization, and inpatient admissions. Two-part models were fitted, with controls for socio-demographics, Charlson Comorbidity Index, secular trends including effect of COVID-19, and between-group differences. Statistical inferences were based on cluster-robust standard errors at the individual level.Results: At ≥4 four quarters post-enrolment, PCMH study participants had sustained reductions of 1.08 polyclinic visits (p<0.001), 0.37 SOC visits (p=0.047), 0.04 ED visits (p=0.013) and 0.02 inpatient admissions (p=0.093) per person-quarter, compared to the quarter before enrolment and controls.Conclusions: ComSA-PCMH study participants reduced healthcare utilization after enrolment into the programme, adding to a growing global body of evidence supporting the benefits of PCMH for patients with complex needs and pointing to its potential in Asia.Trial registration: This analysis is part of the ComSA Patient-Centered Care (COPACC) study, retrospectively registered with ClinicalTrials.gov in October 2020 (Protocol ID: NCT04594967; https://clinicaltrials.gov/ct2/show/NCT04594967).
C2 Fracture Operative and Non-Operative Management Outcomes in Large Database Review
Authors: Foote Christopher , Doan Xuan-Lan , Vanier Cheryl , Betancourt Alejandro , Palacio Carlos
Published: February 2022

Background:Odontoid fractures are common and projected to increase. Comorbidities compound risk of surgery and balancing the risk of non-operative management is controversial. Stable fractures are managed based on patient comorbidity with suspected clinical prognosis. Type I and III fractures are typically managed safely with cervical orthoses. Management decisions of type II fractures however, come under frequent debate. This paper evaluates overall morbidity and mortality, and outcomes of operative and non-operative management. Methods:We performed national database review of C2 fractures from January 2014 to December 2019. Patients were divided into categories based on Glasgow Coma Scale (GCS) and Injury Severity Score (ISS). Outcomes data considered hospital admission, Intensive Care Unit (ICU) admission, hospital length of stay (LOS), ICU LOS, and mortality. Logistic regression was used for mortality, hospital admission, and ICU admission. Odds ratios (OR) and 95% confidence intervals (CI) were calculated from the logistic regression models. The Kruskal-Wallis test was used to compare the hospital and ICU LOS based on surgery overall, and by GCS and ISS.Results:42,003 patients were identified, 9,187 had surgery with overall mortality rate of 0.7%. There was a younger operative median age (67) and interquartile range (IQR: 47, 78) than non-operative group (73, IQR: 56, 83). Both had the same median ISS score (10). Surgery was associated with lower rates of mortality, from 0.1% to 0.9% mortality for non-operative. Mild or moderate GCS mortality improved operative (0.07%) to non-operative (0.23%). Severe GCS patients with surgery had significantly improved mortality rates patients without (0.29% vs 7.69%, respectively). Surgery increased ICU admissions for every ISS category. Severe GCS had higher chances of ICU admission, but no interaction with surgery. Operative patients had longer hospital and ICU stays. For all GCS and ISS categories, hospital and ICU LOS was longer for operative patients.Conclusions:This review demonstrates significant improvement in mortality with operative management. Standard non-operative management of type I and III C2 fractures is appropriate. Surgeons should consider operating on type II odontoid fractures unless patient cannot undertake the surgical risks of induction with general anesthesia.Level of evidence: Level IV
Diethylcarbamazine, TRP channels and Ca2+ signaling in cells of the Ascaris intestine
Authors: Williams Paul D. E. , Kashyap Sudhanva S. , McHugh Mark A. , Robertson Alan P. , Martin Richard J.
Published: February 2022

The nematode parasite intestine absorbs nutrients, is involved in innate immunity, can metabolize xenobiotics and as we show here, is also a site of action of the anthelmintic, diethylcarbamazine. Diethylcarbamazine (DEC) is used to treat lymphatic filariasis and activates TRP-2, GON-2 & CED-11 TRP channels in Brugia malayi muscle cells producing spastic paralysis. DEC also has effects on ascarid nematode parasites. Using PCR techniques, we detected, in A. suum intestine, message for: Asu-trp-2, Asu-gon-2, Asu-ced-11, Asu-ocr-1, Asu-osm-9 and Asu-trpa-1. Comparison of amino-acid sequences of the TRP channels of B. malayi, and A. suum revealed noteworthy similarity, suggesting that the intestine of Ascaris will also be sensitive to DEC. We used Fluo-3AM as a Ca2+ indicator and observed characteristic unsteady time-dependent increases in the Ca2+ signal in the intestine in response to DEC. Application of the TRP channel inhibitor, 2APB, prevented DEC mediated increases in intracellular Ca2+. These observations are important because they emphasize that the nematode intestine, in addition of muscle, is a site of action of DEC as well as other anthelmintics. DEC may also enhance the Ca2+ toxicity effects of other anthelmintics acting on the intestine or, increase the effects of other anthelmintics that are metabolized and excreted by the nematode intestine.
Young Children with A Minor Traumatic Head Injury: Clinical Observation or CT Scan?
Authors: Niele Nicky , Plötz Frans B. , Tromp Ellen , Boersma Bart , Biezeveld Maarten , Douma Matthijs , Heitink Katja , Tusscher Gavin ten , Goudoever Hans B. van , Houten Marlies A. van
Published: February 2022

Purpose: In young children with minor traumatic head injuries (MTHI) classified as intermediate risk (IR) either clinical observation or computed tomography (CT) scan is recommended. In this study we describe clinicians’ choice and which factors contribute to this decision. Methods: This was a planned sub-study of a prospective multicentre observational study that enrolled 1,006 children younger than 18 years with MTHI who presented to six emergency departments in The Netherlands. Results: Of those, 280 children classified as IR group fulfilling one or more minor criteria, leaving the clinician with the choice between clinical observation or a CT scan. In our cohort 228/280 (81,4%) children were admitted for clinical observation, 15/280 (5,4%) received a CT scan, 6/280 (2,1%) received a CT scan and were admitted for observation, and 31/280 (11,1%) children were discharged from the emergency department without any intervention. Three objective factors were found in favour for a CT scan; namely age above two years, the presence of any loss of consciousness (LOC) and presentation on weekend days. Conclusion: In children with MTHI in an IR group, clinicians prefer clinical observation above performing a CT scan.
Lignin ammoxidation: Synthesis of nitrogen releasing soil conditioning products from waste pulp liquor and their pot trial evaluation
Authors: Tyhoda Luvuyo , Ngiba Qiniso , Görgens Johann F.
Published: February 2022

Purpose This study investigated the ammoxidation of three industrial lignins of which two were respectively precipitated from kraft and soda liquors, and the third one, a filtered sodium lignosulfonate for the synthesis of soil conditioning materials.Method The industrial lignins were characterized for structural properties and ammoxidized in a 1 L Parr reactor at 80 oC, 10 barg, for 4 hours, with 7 wt. % ammonia and 10 wt. % lignin in the reaction mixture. A plant trial assessment of the products was conducted over four weeks.Results N-lignins with C/N ratios of 12.30, 15.81, and 14.64 were obtained from kraft, soda and sodium lignosulfonate against a standard requirement of a C/N < 20. However, soda lignin and sodium lignosulfonate could not meet the criteria for N-lignins (C/N < 20) under standard reaction conditions, requiring an additional pre-oxidation with 5% hydrogen peroxide prior to ammoxidation. In the plant trial, N-modified kraft (3.50 t/ha) and soda lignin (3.21 t/ha) recorded crop yields that were 71% and 57% higher than the control (2.04 t/ha), respectively. The sodium lignosphonate, while it met the requirements for use as a soil fertilizing material in terms of nitrogen content, resulted in complete crop failure. Further characterization showed that due to its high pH (8.81 pH) and a high salt index (63.62%) due to the pulping technique used in its isolation, was unsuitable as a raw material for soil fertilizing materials.Conclusion Kraft and soda lignins could be successfully ammoxidized to synthesize N-lignins that are suitable for use as soil conditioning materials.
Non-invasive Measurement of Hemoglobin for Rural India using Artificial Intelligence
Authors: Mude Shoban
Published: February 2022

The body sensor networks includes the nodes of ECG and PPG sensors, with the aim to investigate a novel technique for cuffless Blood Pressure estimation with better exactness. The sensor networks performance in the BSN, correlates various PTTs determined from ECG and PPG, with the reference BP recorded at various postures. The outcome shows that SBP and DBP have better connection with PTTs determined ECG to PPG sensors. The interesting thing is values of PTT acquired from ECG to PPG sensor at fingertip are better when compared with regular methods. Later this circuit is embedded with Bluetooth module and monitors fully automatic and continuous measurement Blood Pressure, SpO2 and Hemoglobin.
Global Mapping of Optometry Workforce
Authors: Naidoo Kovin , Govender-Poonsamy Pirindhavellie , Morjaria Priya , Block Sandra S , Chan Ving Fai , Yong Ai Chee , Bilotto Luigi
Published: February 2022

BACKGROUND:The growing global burden of vision impairment makes it imperative that there are appropriately trained human resources. Optometrists play a critical role in alleviating this burden, but the low number of optometrists available or the numbers in different countries has always been a challenge for eye care planning. Despite this, there have been limited studies conducted to quantify the deficits in the number of optometrists globally. Methods:A standardised English language questionnaire was used in this cross-sectional study to determine the number and distribution of optometrists globally between February 2017 and May 2020. The survey was translated where necessary and completed by key informants. Using the World Council of Optometry’s scope of practice guidelines, optometrists were defined at levels 2 to 4. Optometrist-to-population ratios were calculated for all countries and regions and compared to targets of 1:50 000 (in developing contexts) or 1:10 000 (in developed contexts).Results:An overall response rate of 80.9% was achieved with responses from 123 of the 152 countries invited. Most (40.7%) key informants were academics. The total number of optometrists across 21 Global Burden of Disease (GBD) regions was 331,781 as of 2019. Sixty-six (53.7%) of 123 countries met the 1:50,000 Optometrist-to-population ratio. A strong (r=0.7) direct positive relationship existed between age-standardised prevalences of blindness and mild- and severe-vision impairment and optometrist-to-population ratios. Strong inverse relationships were observed between country GDP and optometrist-to-population ratio.Conclusion:High-income countries met the target for optometrist-to-patient ratios, while low-to-, middle-income countries and low-income countries did not meet the targets. Low optometrist-to-patient ratios were strongly associated with a higher magnitude of blindness and vision impairment.
Asterarcys quadricellulare (Chlorophyceae) protects H9c2 cardio-myoblasts from H2O2-induced oxidative stress
Authors: Saadaoui Imen , Bounnit Touria , Mraiche Fatima , Joseph Jensa M. , Cherif Maroua , Jabri Hareb Al
Published: February 2022

Oxidative stress is recently identified as an important mediator of cardiovascular diseases. The need to find efficient antioxidant molecules is essential in the disease’s prevention. Therefore, the present study aimed to evaluate the potential of microalgae bioactive in protecting H9c2 cardiomyo-blasts from H2O2-induced oxidative stress. Four microalgal species were investigated for their antiox-idant capacity. A qualitative assessment of oxidative stress in H9c2 cardiomyoblasts stained with DCFH-DA, treated with the highly active microalgae extracts, was performed. The protein expression of total caspase-3 was also examined to investigate whether extract protects H9c2 cardimyoblasts from H2O2-induced apoptosis. High antioxidant activity was observed for the hexanoic extracts after 10 days of cultivation. Asterarcys quadricellulare exhibited the highest antioxidant capacity of 110.59 ± 1.75 mg TE g−1 dry weight and was tested against H9c2 cardiomyoblasts, which were initially subjected to H2O2-induced oxidative stress. This hexanoic extract protected against H2O2 induced oxida-tive stress with a similar scavenging capacity as N-Acetylcysteine. Furthermore, total caspase-3, was increased following treatment with the hexanoic extract, suggesting that A. quadricellulare also had anti-apoptotic properties. The outcome of our study highlighted the possible use of the local A. quadricellulare strain QUCCCM10 as a natural, safe, and efficient antioxidant to prevent cardiovascular diseases.
Production and Partial Purification of Pectinases Produced by Three Novel Cladosporium Species Isolated from Egypt
Authors: Moharram Ahmed Mohamed , Zohri Abdel-Naser Ahmed , Hesham Abd El-Latif , Maher Mohamed Al-Amin , Al-Bedak Osama Abdel-Hafeez
Published: February 2022

Based on phenotypic characters and sequencing of the internal transcribed spacers (ITS), 28S Large Subunit (LSU) and partial actin (ACT), three novel species of Cladosporium were described in this study as C. parasphaerospermum, C. chlamydosporum, and C. compactisporum. Activities of pectinases produced by the three strains were 5700, 3720, and 3480 U mg− 1 enzymes, at the optimum pH (6.0, 7.0, and 8.0) and temperature (35, 30, and 35 ºC), respectively. The ions potassium and manganese had a strong activating impact on the activity of C. compactisporum pectinase (124.4 and 172%, respectively). When tested under optimal conditions, EDTA and the other metal ions inhibited the activity of the pectinases in varied degrees. The strongest inhibitory effects of C. parasphaerospermum, C. chlamydosporum, and C. compactisporum pectinases were with Ni+ 2, Zn+ 2, and EDTA, respectively. Cladosporium species have a long history of biotechnological uses, and here we add another: pectinase makers. We offer three unique suppliers of low-temperature active fungal pectinases for biotechnological applications such as the management of Pectinacious wastes in the juice industry.
International registry of congenital porto-systemic shunts A multi-centre, retrospective and prospective registry of neonates, children and adults with congenital porto-systemic shunts
Authors: KORFF Simona , Mostaguir Khaled , Beghetti Maurice , D’Antiga Lorenzo , Debray Dominique , Franchi-Abella Stéphanie , Gonzales Emmanuel , Guerin Florent , Hachulla Anne-Lise , Lambert Virginie , Makrythanasis Periklis , Roduit Nicolas , Savale Laurent , Senat Marie-Victoire , Spaltenstein Joël , Steenbeek Frank van , Wildhaber Barbara E. , Zwahlen Marcel , McLin Valérie A.
Published: February 2022

Background: Congenital portosystemic shunts (CPSS) are rare vascular malformations associated with the risk of life-threatening systemic conditions, which remain underdiagnosed and often are identified after considerable diagnostic delay. CPSS are characterized by multiple signs and symptoms, often masquerading as other conditions, progressing over time if the shunt remains patent. Which patients will benefit from shunt closure remains to be clarified, as does the timing and method of closure. In addition, the etiology and pathophysiology of CPSS are both unknowns. This rare disorder needs the strength of numbers to answer these questions, which is the purpose of the international registry of CPSS (IRCPSS). Method: A retrospective and prospective registry was designed using secuTrial® by the ISO certified Clinical Research Unit. Given that a significant number of cases entered in the registry are retrospective, participants have the opportunity to use a semi-structured minimal or complete data set to facilitate data entry. In addition, the design allows subjects to be entered into the IRCPSS according to clinically relevant events. Emphasis is on longitudinal follow-up of signs and symptoms, which is paramount to garner clinically relevant information to eventually orient patient management. The IRCPSS includes also three specific forms to capture essential radiological, surgical, and cardiopulmonary data as many times as relevant, which are completed by the specialists themselves. Finally, connecting the clinical data registry with a safe image repository, using state-of-the-art pseudonymization software, was another major focus of development. Data quality and stewardship is ensured by a steering committee. All centers participating in the IRCPSS have signed a memorandum of understanding and obtained their own ethical approval. Conclusion: Through state-of-the-art management of data and imaging, we have developed a practical, user-friendly, international registry to study CPSS in neonates, children, and adults. Via this multicenter and international effort, we will be ready to answer meaningful and urgent questions regarding the management of patients with CPSS, a condition often ridden with significant diagnostic delay contributing to a severe clinical course. We look forward to working with an ever expanding network of collaborators.
When saliency goes off on a tangent: Interpreting Deep Neural Networks with nonlinear saliency maps
Authors: Rosenzweig Jan , Cvetkovic Zoran , Rosenzweig Ivana
Published: February 2022

A fundamental bottleneck in utilising complex machine learning systems for critical applications has been not knowing why they do and what they do, thus preventing the development of any crucial safety protocols. To date, no method exist that can provide full insight into the granularity of the neural network’s decision process. In past, saliency maps were an early attempt at resolving this problem through sensitivity calculations, whereby dimensions of a data point are selected based on how sensitive the output of the system is to them. However, the success of saliency maps has been at best limited, mainly due to the fact that they interpret the underlying learning system through a linear approximation.We present a novel class of methods for generating nonlinear saliency maps which fully account for the nonlinearity of the underlying learning system. While agreeing with linear saliency maps on simple problems where linear saliency maps are correct, they clearly identify more specific drivers of classification on complex examples where nonlinearities are more pronounced.
This new class of methods significantly aids interpretability of deep neural networks and related machine learning systems. Crucially, they provide a starting point for their more broad use in serious applications, where 'why' is equally important as 'what'.
Small RNA Sequencing and Bioinformatics Analysis of RAW264.7-Derived Exosomes after Mycobacterium Bovis Bacillus Calmette-Guérin Infection
Authors: Zhan Xuehua , Yuan Wenqi , Zhou Yueyong , Ma Rong , Ge Zhaohui
Published: February 2022

Background: The mechanisms through which Mycobacterium tuberculosis evades immune surveillance during tuberculosis (TB) infection remain complex. Previous studies have found that Mycobacteria can manipulate the miRNAs of host cells to promote their survival during host-pathogen interactions, and most of these effects occur at the cellular miRNA level. We at-tempted to investigate the possible related mechanisms at the exosomal miRNA level. Results: High-throughput sequencing revealed that Bacillus Calmette-Guérin (BCG) infection could alter the composition of the macrophage exosome content, and the expression levels of miRNAs in exosomes derived from the cell culture media of macrophages showed significant differences be-tween the BCG-infected and noninfected groups. Compared with the non-infection group, 20 exosomal miRNAs were up-regulated and 7 exosomal miRNAs were down-regulated in the infection group (p<0.05), of which mmu-miR-27b-3p, mmu-miR-93-5p, mmu-miR-25-3p, mmu-miR-1198-5p, mmu-let-7c-5p and let-7a-5p were significantly up-regulated. A bioinformatic analysis indicated that these differentially expressed exosomal miRNAs were involved in multiple biological processes and pathways. The target genes of top six miRNAs in up-regulated groups were positively correlated with the regulation of apoptosis.Conclusions: Our study provides relatively strong evidence for unravelling the complex pathophysiological processes of TB and the mechanisms of mycobacterial immune escape based on differential exosomal miRNA expression in host macrophages. Additionally, these exosomal miRNAs may serve as potential immunotherapy targets for the effective control of TB infection, but this probability requires further study.
Preparation of Gamma Poly-Glutamic Acid/Hydroxyapatite/Collagen Composite as the 3D-Printing Scaffold for Bone Tissue Engineering
Authors: Nguyen Thu-Trang , Hu Chih-Chien , Sakthivel Rajalakshmi , Nabilla Sasza Chyntara , Huang Yu-Wen , Yu Jiashing , Cheng Nai-Chen , Kuo Yi-Jie , Chung Ren-Jei
Published: February 2022

Background
Movement activities involving the role of articular cartilage and bones. The presence of cartilage enables bones to move over one another smoothly. However, repetitive microtrauma and ischemia as well as genetic effects can cause an osteochondral lesion. Numerous treatment methods such as microfracture, autograft, and allograft have been used, however, it possesses treatment challenges including extensive recovery time after surgery and financial burden on patients. Nowadays, tissue engineering approaches have been developed to repair bone and osteochondral defects using biomaterial implants to induce the regeneration of stem cells.
Methods
In this study, a collagen/γ-polyglutamate acid (PGA)/hydroxyapatite composite scaffold was fabricated using a 3D printing technique. A collagen/γ-PGA/hydroxyapatite 2D membrane was also fabricated for comparison. The scaffolds (4 layers) were designed with the size of 8 mm in diameter and 1.2 mm in thickness. The first layer was hydroxyapatite/γ-PGA and the second to fourth layers were collagen/γ-PGA. In addition, a 2D membrane was constructed from hydroxyapatite/γ-PGA and collagen/γ-PGA with a ratio of 1:3. The biocompatibility property and degradation activity were investigated for both scaffold and membrane samples. The rat bone marrow mesenchymal stem cells (rBMSCs) and human adipose stem cells (hADSCs) were cultured on the samples and were tested in-vitro to evaluate cell attachment, proliferation, and differentiation. The in-vivo experiments were performed in the rat and nude mice models.
Results
Finally, the in-vitro and in-vivo results show that the developed scaffold is of well biodegradation and biocompatible properties; the Col-HA scaffold enhances the mechanical properties for osteochondrogenesis in both in-vitro and animal trials.
Conclusions
It would be a great biomaterial application for bone and osteochondral regeneration.
Feasibility of Quantitative Sensory Testing in Juvenile Idiopathic Arthritis.
Authors: Mensink Maarten , Eijkelkamp Niels , Veldhuijzen Judy S. , Wulffraat Nico
Published: February 2022

Background Juvenile Idiopathic Arthritis (JIA) is a childhood-rheumatic disease with pain as a major complaint. Very few data exist on sensory thresholds changes at the knee in JIA, a location in which inflammation often manifest. We determined whether JIA is associated with sensory threshold changes at the knee by using Quantitative Sensory Testing (QST) and established reference values at the knee of children.Methods 16 JIA patients aged 9-18 years with one affected knee and a patient-reported pain (VAS)>10 on a 0-100 scale, and 16 healthy controls completed the study and were included for the analysis. QST was assessed in compliance with the DFNS standard. Disease severity was determined using JADAS. Perceived pain was assessed with a visual analogue scale(0-100). Feasibility of QST was tested in patients aged 5-9.Results JIA patients reported an average VAS pain score of 54.3. QST identified a significant reduction in PPT and increase in CDT compared to healthy controls. Under the age of 9, QST testing showed not to be feasible.Conclusion Sensory threshold changes at the knee are restricted to pressure pain and cold detection thresholds in JIA patients. This study shows that in a Dutch population, the extensive QST protocol is only feasible in the age group from 9 years and older, and a reduced set of QST tests containing at least pressure pain thresholds and cold detection thresholds could prove to be better suited to the pediatric setting with arthritis.
Chronic Recurrent Multifocal Osteomyelitis with an uncommon presentation and disabling features: A case report
Authors: Shahin Sarvenaz , Asnaashari Kosar , Zarei Mohammad , Faraji-Goodarzi Mojgan , Ziaee Vahid
Published: February 2022

Background: Chronic recurrent multifocal osteomyelitis (CRMO) is one of the auto-inflammatory bone disorders with yet to be determined etiology. Due to overlapping signs and symptoms with other bone involvements, the diagnosis of this disease might take a long period of time and the patients may develop deformities in long-term. Thus, increasing awareness about different presentations of the disease seems beneficial.Case presentation: A 12-year-old boy was referred to our center with severe back pain in his thoracic vertebrae from 18 months before referral. He had previously undergone two vertebroplasty surgeries due to his kyphosis and had received several courses of antibiotics, which resulted in no improvement in his disabling pain. His physical examination was unremarkable, except for severe thoracic vertebrae tenderness and a mild dextroscoliosis. MRI showed diffuse multiple hypo-signal lesions in thoracic vertebral bodies with slight enhancement, causing compression fractures of T8, T11 and T12 bodies. Bone scan revealed increased activity in thoracic region (T7-T8-T9-T12 vertebral bodies) and left clavicle. Other differentials were ruled out by bone marrow aspiration, bone biopsy and laboratory tests. His disease showed a favorable response to treatment with Pamidronate, Methotrexate and Indomethacin and he had no relapse in three years of follow-up.Conclusions: Uncommon presentations of CRMO can be misleading to the specialists and might result in prolonged diagnosis process. Increased awareness among different specialists about such presentations can potentially lead to earlier diagnosis, and timelier and more effective treatment of the CRMO patients.
Health System Barriers to the Variation of Caesarean Section Rates in Palestinian Governmental Hospitals
Authors: Shalash Aisha , Wahdan Yasmeen , Alsalman Hasan , Shehab Ala' , Afifi Tayseer , Nabaa’ Hendia , Sarsour Iman , Jarour Naheel , Hamed Ala'a , Abu-Rmeileh Niveen
Published: February 2022

Background
Globally, the increased use of cesarean sections has become prevalent in high-income and low and middle-income countries. In Palestine, the rate had risen from 20.3% in 2014 to 25.1% in 2018. The difference is that we have rates as high as 35.8 % in some public hospitals and some as low as 15%. This study aimed to understand better why there is a variation in cesarean rates in public hospitals that use the same protocol.
Methods
A qualitative approach was used. In-depth interviews with 27 specialists, obstetrics and gynecologists, and midwives in five government hospitals were performed. The hospitals were selected based on the 2017 Annual Health Report reported cesarean section rates. The interview guide was created with the support of specialists and researchers and was piloted. Questions focused mainly on adherence to the obstetric guidelines and barriers to the use, sources of information, training for healthcare providers, the hospital system, and the factors that affect decision making.
Results
The results indicated that each public hospital at the system level had a different policy on cesarean sections. One specialist decided for a cesarean section at high-rate hospitals, while low-rate hospitals used collective decision-making with empowered midwives. At the professional level, all hospitals urged for the importance of a continuous training program to refresh the medical team knowledge, in-house training of new members joining the hospital, and to discuss cases that are subjective to obstetrician-gynecologists interpretations.
Conclusion
We recommend strengthening the implementation of support for staff to meet the standards in the national obstetric protocol. Encourage collective decision-making between obstetrician-gynecologists and midwives and use a second opinion. The Robson classification implementation in hospitals will allow medical teams to evaluate delivery management processes and provide a standardized method for reporting and comparison between hospitals, regions, and countries.
What is the impact of COVID-19 pandemic years on Deliveries and Home Based New Born Care in India? A cross-sectional comparative research study, Jan 2018-2021Dec
Authors: Kumar Piyush
Published: February 2022

The COVID-19 pandemic caused by SARS-CoV-2 has led to disruption of health services globally. I assessed the effect of the ongoing pandemic on the Deliveries and Home Based New Born Care (HBNC) in India. The author is curious and suspects a rise in maternal and neonatal mortality due to possible negative effects of COVID-19 on maternal institutional delivery and HBNC. Hence author decided to find out answer to the research question mentioned as title above. I conducted a retrospective cross-sectional comparative study among total numbers of women and newborn who have received delivery and HBNC care at different health facilities in 36 states and union territories across India during the pandemic years with pre-pandemic years (comparing 2020 and 2021(forecasted up to December 2021 with available data from January2021 to May 2021) with previous two years of pre-pandemic era i.e. 2018–2019). The data for the research study is extracted from electronic records of HMIS (health management information system) of MoHFW (ministry of health and family welfare), Govt. of India and analysed with stata and Microsoft office. The mean number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)] during the pandemic year 2021 with total number of observation of 5 months of 2021(January to May) forecasted up to December 2021 across India was 13370.27938, for years 2020, 2019, 2018 it was 16429.25, 19006.58, 21317.83 respectively with total number of observation of 12 months across India for these three years. This research study revealed that pandemic years have negative impact on number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)]. This research study revealed that pandemic years have negative impact on number of home deliveries attended by SBA [(Skill Birth Attendant) (Doctor/Nurse/ANM/ Midwife)]. There is a (projected) decrease of 37.28% in mean number of home deliveries attended by SBA in 2021 as compared to 2018. This novel research study revealed that during pandemic years 2020 and 2021 all the variables reduced quantitatively except Number of PW given Tablet Misoprostol during HD which increased in 2020 (first pandemic year).The ongoing COVID-19 pandemic has had negative effects on Deliveries and Home Based New Born Care (HBNC) in India. More research is required to investigate the direct and indirect consequence of the pandemic on birth and provision of HBNC as well as the health facility type which are not performing well in providing respectful maternity care and newborn services during pandemic period. The facility based research analysis is under process by the author which will be available in next version of this article.
Relating SARS-CoV-2 Variants Using Cellular Automata Imaging
Authors: de Souza Luryane Ferreira , Filho Tarcísio Marciano da Rocha , Moret Marcelo Albano
Published: February 2022

We classify the main variants of the SARS-CoV-2 virus representing a given biological sequence represented as a symbolic sequence of digital codes and its evolution by a cellular automata with a properly chosen rule.The spike protein, common to all variants of the SARS-CoV-2 virus, is then represented by an image of the cellular automaton evolution which represents in a more visible way important features of the protein. We use information theory Hamming distance between different stages of the evolution of the cellular automaton representing seven variants with respect to the original Wuhan/China virus. We show that our approach allows to classify together variants with common ancestors and same mutations. Although being a much simpler method, it can be used as an alternative for building phylogenetic trees.
The effect of different bands of LED exposure on vitreous metabolites and retinal architecture.
Authors: TN Nagarajan , Joshi Manjunath B , Valiathan Manna , Rao Shonraj BG , Bhat Shailaja , Surendran Sudarshan
Published: February 2022

The accumulating experimental evidence indicates that exposure to blue and white LED light leads to damage in the visual system against short-term exposure. Chronic exposure, adaptive responses to light and self-protective mechanisms against LED light exposures need to be explored and would be essential to know the repercussions of LED radiations on vitreous metabolites. A total of 24 male Wistar rats were used in our study, which was divided into four groups (n = 6 in each group). Three groups were exposed to either blue, white, or yellow LED light for 90 days (12:12 light-dark cycle routine) with uniform illumination (450–500 lux). Control rats were maintained under standard laboratory conditions. Post-exposure the vitreous was removed for mass spectrometry and retinal tissues for immunofluorescence and H&E staining. The thickness of the retina decreased in blue and white light exposure animals compared with controls, whereas the yellow light exposure group showed an increase in thickness (p < 0.001). The number of apoptotic cells was significantly lower in controls compared to light-exposed groups (p < 0.001) and (p < 0.001). Altered metabolites were observed in light exposure groups particularly in D-alanine, taurine, D-serin (p < 0.05 and lysine (p < 0.001). The self-protective or reworking system in the chronic light exposure could be dazed and drop the ability to compensate for the defending mechanism. This might fail to maintain the metabolomic structural integrity of the vitreous and retina.
Surface Plasmon Resonance Based Refractive Index Biosensor: A External Sensing Approach
Authors: Mitu Sumaiya Akhtar , Aktar Mst. Nargis , Ibrahim Sobhy Mohamed , Ahmed Kawsar
Published: February 2022

A surface plasmon resonance (SPR) based sensor founded on Photonic crystal fiber (PCF) is suggested and numerically analyzed in the manuscript. The refractive index (RI) detecting SPR based sensor has the ability to identify the analyte range from 1.33 to 1.4. Pure silica is used as a base material and it has high RI value than the analyte RI. Furthermore, an analyte layer and chemically stable gold (Au) layer are also placed at the sensor design. The simulations are done based on the Finite Element Method (FEM). Here, the scaled-down approach has the necessity to increase phase matching point within the core mode and surface plasmon polariton (SPP) mode which tends to the sensor to reach high sensitivity response. At the intersect point of core and SPP mode, the loss curve shows a maximum peak value. The suggested sensor shows the highest wavelength sensitivity (WS) response of 35,943.22 nm/RIU, amplitude sensitivity (AS) response of 2321.36 RIU−1, sensor resolution of 9.04×10−6 RIU, and Figure of merit (FOM) value of 600. It is noted that all the optical parameters show better performance analysis. Furthermore, an external sensing approach provides more fabrication feasibility which marks the offered sensor more suitable for practical experimentation. Besides, the investigated sensor provides the maximum and rapid sensing performance that will be helpful for microfluidic analyte detection, detection of biomolecules, medical diagnostics, virus detection, security, and bio-imaging.
Necroptosis-related Prognostic Gene Signature to Aid Therapy in Lung Adenocarcinoma
Authors: Song Yuqi , Zhang Jinming , Fang Linan , Liu Wei
Published: February 2022

Lung adenocarcinoma (LUAD) is the most common type of non-small cell lung cancer (NSCLC), which is also the most important cause of cancer-related deaths. Necroptosis is a phenomenon of cellular necrosis resulting from cell membrane rupture by the corresponding activation of Receptor Interacting Protein Kinase 3 (RIPK3) and Mixed Lineage Kinase domain-Like protein (MLKL) under programmed regulation. It is reported that necroptosis is closely related to the development of tumor, but the prognostic role and biological functions of necroptosis in LUAD are still obscure. In this study, we constructed a prognostic Necroptosis-related gene (NRG) signature based on the RNA transcription data of LUAD patients from The Cancer Genome Atlas (TCGA) and Gene Expression Omnibus (GEO) databases as well as the corresponding clinical characteristics information. Next, Kaplan-Meier analysis, receiver operating characteristic (ROC), univariate Cox and multivariate Cox regression were made to validate and evaluate the model. We also accurately and quantitatively predicted the prognosis of LUAD patients using our nomogram, which includes age, gender, stage and risk score. To improve patients’ prognosis and achieve personalized precision medicine, we analyzed the immune landscape in LUAD and predicted the sensitivity of LUAD patients with different risk scores to immunotherapeutic regimens and chemotherapeutic regimens. In conclusion, our study provides a reference for in-depth mechanistic exploration of necroptosis in LUAD.
Hamilton-Jacobi and Lagrange formulation of relativistic quantum mechanics wave equations with solutions with only-positive and only-negative kinetic energies
Authors: de Peralta Luis Grave , Ruiz-Columbie Arquimedes
Published: February 2022

Using the Hamilton-Jacobi and the Lagrange formalisms, a pair of relativistic quantum mechanics equations are obtained. These equations, in contrast with the Klein-Gordon and other relativistic quantum mechanics equations, have no solutions with both positive and negative kinetic energies. The equation with solutions with only positive kinetic energy values describes a spin-0 particle of mass m, which is moving at relativistic speeds in a scalar potential. The wavefunctions and the energies corresponding to the associated antiparticle can be obtained by solving the other equation, which only has solutions with negative kinetic energy values.