bluuebunny/crossref_metadata_2025 huggingface dataset:
Congenital Midureteral Stenosis in Children: A 13-year Retrospective Study based on Data from a Large Pediatric Medical Center
Authors: Meng Zhaoyi , Lin Defu , Wang Guannan , Qu Yanchao , Sun Ning
Published: September 2021

Background: Midureteral stenosis is very rare in children and can cause congenital hydronephrosis. We report our experience treating children with congenital midureteral stenosis at our center, focusing on the differences in preoperative diagnosis and treatment compared with other congenital obstructive uropathies.Methods: We retrospectively reviewed the medical records of 26 children diagnosed with congenital midureteral stenosis at our center between January 2007 and December 2020, including preoperative examination methods, intraoperative conditions, and postoperative follow-up results.Results: Of the 1625 children treated surgically for ureteral narrowing, only 26 (1.6%) were diagnosed with midureteral stenosis, including 15 infants and 11 children; 68% were boys; 48% were affected on the left side; and 88% had isolated ureteral stenosis. In all, 50% of the children presented with prenatal hydronephrosis, and 50% presented with abdominal pain or a mass. All children underwent urinary ultrasound and intravenous urography (IVU) preoperatively; the diagnostic rate of ultrasound was 92.3%. Only 7 (26.9%) children underwent pyelography. All children underwent surgery. The ureteral stenotic segment was less than 1 cm long in 96% of the children. The mean follow-up duration was 22 months (range: 6-50 months). One child developed anastomotic strictures. Urinary tract obstruction was relieved in the other children without long-term complications.Conclusions: Congenital midureteral stenosis is rare, accounting for 1.6% of all ureteral obstructions, and its diagnosis is very important. Urinary ultrasound has a high diagnostic rate and should be the first choice for midureteral stenosis. Retrograde pyelography can be used when diagnosis is difficult, but routine retrograde pyelography is not recommended. Congenital ureteral stenosis has a relatively short lesion range, largely within 1 cm. The treatment is mainly resection of the stenotic segment and end-to-end ureteral anastomosis, with a good prognosis.
The Association of Temperature Variability With Blood Pressure in Southern China: a Series of Cross-sectional Studies in Guangdong Province, China
Authors: Li Muyun , Meng Ruilin , Luo Jiali , Xu Xiaojun , Hu Jianxiong , He Guanhao , Li Xing , Zeng Weilin , Liu Tao , Xiao Jianpeng , Ma Wenjun
Published: September 2021

Background: Numerous studies have found a positive relationship between temperature variability and mortality, but few studies regarding the effects of temperature variability on blood pressure (BP) are available.Objective: To investigate the effects of temperature variability on BP in Guangdong province, southern China.Methods: Data on Meteorology and BP in Guangdong Province from 2004 to 2015 were collected from Guangdong Provincial Center for Disease Control and Prevention. There were 38088 participants aged 18 years and over. The generalized additive model (GAM) was used to estimate the relationship between temperature variability and BP after adjusting for confounding variables.Result: Our study found that there was a significant positively correlation between temperature variability and systolic blood pressure (SBP), and the estimate increase with the increment of exposure days in total population. The highest estimate was found at 7 days lag with increased 0.497 mmHg of SBP (95%CI: 0.335–0.660) for a 1 °C increase of TV0-7. There was insignificant association between temperature variability and diastolic blood pressure (DBP). The effects of temperature variability on BP among subpopulations with different hypertension statuses were various, and the estimates of Temperature variability with different exposure days on SBP were all higher in known hypertensives than that in normotensives.Conclusion: There was a significant association between temperature variability and SBP in Guangdong province with various effects for different populations. Our findings provide evidence that temperature variability is an independent risk factor for SBP changes, and temperature variability should be considered in hypertension clinic management and epidemiological survey.
Viscous Backpressure Forming And Feasibility Study of Hemispherical Aluminum Alloy Parts
Authors: Gao Tiejun , Zhang Jiabin , Wang Kaixuan
Published: September 2021

Hemispherical aluminum alloy parts are extensively used in modern aerospace and other manufacturing fields. However, wrinkling and cracking easily occur due to the large deformation of the parts, which leads to a complicated forming process. This research proposes a viscous backpressure forming method for hemispherical aluminum alloy parts. The forming limit diagram of LF2 sheet is established through the forming limit experiments. By the combination of finite element analysis and experimental verification, the forming process of the parts under different viscous backpressure and loading path conditions as well as the distribution law of stress-strain and wall thickness of the parts, are obtained. By comparing with the forming limit diagrams, technical feasibility of this forming process is discussed. The research results show that qualified parts can be formed using the viscous backpressure forming method under the conditions of viscous backpressure loading throughout the process with the backpressure at or above 12MPa. This provides a reference for the backpressure forming of hemispherical aluminum alloy parts.
The SGLT2 Inhibitor Empagliflozin Attenuates Atherosclerosis Progression by Inducing Autophagy
Authors: Xu Hualin , Fu Jie , Tu Qiang , Shuai Qinyun , Chen Yizhi , Wu Fuyun , Cao Zheng
Published: September 2021

Background: Cardiovascular disease due to atherosclerosis（AS）is one of the leading causes of death worldwide. Sodium-dependent glucose transporters 2 inhibitor (SGLT2i ) (SGLT2i), empagliflozin(EMPA), is a new type of hypoglycemic drug .Recent studies have shown that EMPA not only reduces increased glucose, but also has cardiovascular protective effects and that it slows the process of AS.However, the underlying mechanism has yet to be defined.Methods: Male apoE -/- mice were fed a western high-fat diet to establish an AS model. The area and size of atherosclerotic lesions in apoE -/- mice were then assessed by hematoxylin–eosin (HE) staining after EMPA treatment . After EMPA treatment of the RAW 246.7 macrophage cell line, human aortic smooth muscle cells (HASMCs) and human umbilical vein endothelial cells (HUVECs),western blotting was applied to measure the levels of autophagy-related proteins and proinflammatory cytokines,GFP-LC3 puncta were detected by confocal microscopy to confirme autophagosome formation. Oil red staining was performed to detect the foaming of macrophages and HASMCs, flow cytometry was used for cell cycle analysis. EdU, CCK-8 and scratch assays were also performed to examine the cell proliferation and migration of HASMCs. Results: EMPA suppressed the progression of atherosclerotic lesions in apoE -/- mice. EMPA also induced autophagy in RAW 246.7 cells, HASMCs and HUVECs, and it significantly increased the expression of Beclin1 and the LC3B-II/I ratio. In addition, EMPA decreased the expression of P62 and downregulated the protein levels of inflammatory cytokines, and it inhibited the foaming of RAW 246.7 cells and HASMCs as well as the expression of inflammatory factors via autophagy induction. Furthermore, the results of flow cytometry, EdU assays, CCK-8 cell viability assays and scratch assays indicated that EMPA blocked HASMC proliferation and migration.Conclusions: EMPA plays an important role in decelerating the progression of AS by inducing autophagy, providing a novel method for anti-AS treatment in the clinic.
A Multilevel Analysis Factors Associated With Diarrhea Among Under-five Children in Ethiopia Using 2016 EDHS Data: Individual and Community Level Factors.
Authors: Getnet Mekasha Demeke , Tesfahun Esubalew
Published: September 2021

Background: Despite numerous attempts, diarrhea remains one of the leading causes of death among children under the age of five around the world. Globally, diarrhea is the second prominent cause of death in children next to pneumonia. Every year, there are 1.7 billion children who develop diarrhea and at least 525,000 die from diarrhea. In low- and middle-income countries such as Ethiopia, diarrhea still remains one of the health problems due to its high morbidity and mortality. This study was conducted identify factors associated with diarrhea at community (cluster) level and individual level.Objectives: To assess individual and community level factors of childhood (0–59months) diarrhea in Ethiopia by using the 2016 Ethiopian Demography and Health surveys (EDHS) data, 2020. Methods: A cross-sectional secondary analysis of data pooled from 2016 Ethiopian Demographic and Health Surveys (EDHS) data was used. The analysis was done using Stata version 14.2. A multilevel logistic regression model was used to identify independent predictors of childhood diarrhea. Odds ratio with 95% CI was used in identifying the association between dependent and independent predictors Result: The prevalence of diarrhea in Ethiopia based on EDHS 2016 was 11.78%.The odds of diarrhea among children reside in rural area were 1.84 times more likely to develop diarrhea (AOR=1.82; 95% CI: 1.52-2.16) as compared to urban dwellers. Those children aged between 13 and 24 months were 2.2 times more likely to have diarrhea than (AOR=2.2, 2.15-2.98) their older counter parts (48-59 months). The measure of variation was also assessed by using ICC, MOR, and DIC with the result of 10.08, 1.56 and 316.18 respectively.Conclusion: Our findings identified that childhood diarrhea was affected by not only individual level factors but also community-level factors. At the individual level (age of the women, number of under five children in the households, age of the child, number of family members, maternal education, and the number of under-5 children) and the community-level, place of residence were significant factors associated with childhood diarrhea in Ethiopia.
Underweight Is A Major Risk Factor of Atrial Fibrillation In Asian People With Type 2 Diabetes Mellitus
Authors: Hsu Jung-Chi , Yang Yen-Yun , Chuang Shu-Lin , Chung Yi-Wei , Lin Lian-Yu
Published: September 2021

Background: Atrial fibrillation (AF) is prevalent in patients with type 2 diabetes mellitus (T2DM). Obesity commonly accompanies with T2DM and increases AF incidence. However, the dose-relationship of body mass index (BMI) and the risk of AF has seldom been studied in diabetes patients.Methods: This cohort study was conducted utilizing a database from National Taiwan University Hospital, a tertiary medical center in Taiwan. Between 2014 and 2019, a total of 64339 adult patients with T2DM were enrolled for analysis. The BMI was measured and categorized into several groups including underweight (BMI <18.5), normal range (18.5≤BMI <24), overweight (24≤BMI <27), obesity class 1 (27≤BMI <30), obesity class 2 (30≤BMI <35), and obesity class 3 (BMI≥35). Multivariate Cox regression models and spline regression model were employed to estimate the relationship between BMI and the risk of AF in patients with T2DM.Results: The incidence rate of AF was 1.97 per 1000 person-year during a median follow-up period of 70.7 months. In multivariate Cox regression model, by using normal BMI as reference group, individuals with underweight (HR 1.47, 95%CI 1.19-1.81, p<0.001) was significantly associated with increased risk of AF while overweight was significantly associated with reduced risk of AF (HR 0.83, 95%CI 0.76-0.91, p<0.001). The Kaplan-Meier analysis showed that the risk of AF was highest in the underweight group, followed by obesity class 3, while the overweight group had the least incidence of AF (log-rank test, p<0.001). Cubic restrictive spline model showed a “J-shaped” or “L-shape” relationship between BMI and the risk AF.Conclusions: We found that underweight carries the highest risk of AF in Asian patients with T2DM.
Dual Mutations Collaboration Mechanism with Elites Guiding and Inferiors Eliminating Techniques for Differential Evolution
Authors: Deng Libao , Li Chunlei , Sun Haili , Qiao Liyan , Miao Xiaodong
Published: September 2021

Differential Evolution (DE) is a powerful evolutionary algorithm for global optimization problems. Generally, appropriate mutation strategies and proper equilibrium between global exploration and local exploitation are significant to the performance of DE. From this consideration, in this paper, we present a novel DE variant, abbreviated to DMIE-DE, to further enhance the optimization capacity of DE by developing a dual mutations collaboration mechanism with elites guiding and inferiors eliminating techniques. More specifically, an explorative mutation strategy DE/current-to-embest with an elite individual serving as part of the difference vector and an exploitative mutation strategy DE/ebest-to-rand with selecting an elite individual as the base vector are employed simultaneously to achieve the balance between local and global performance of the whole population instead of only one mutation strategy in classical DE algorithm. The control parameters F and CR for above mutation strategies are updated adaptively to supplement the optimization ability of DMIE-DE based on a rational probability distribution model and the successful experience from the previous iterations. Moreover, an inferior solutions eliminating technique is embedded to enhance the convergence speed and compensate cost of the fitness evaluation times during the evaluation process. To evaluate the performance of DMIE-DE, experiments are conducted by comparing with five state-of-the-art DE variants on solving 29 test functions in CEC2017 benchmark set. The experimental results indicate that the performance of DMIE-DE is significantly better than, or at least comparable to the considered DE variants.
Construction of a Core Collection of Native Perilla Germplasm Collected From South Korea Based on SSR Markers and Morphological Characteristics
Authors: Sa Kyu Jin , Kim Dong Min , Oh Jun Seok , Park Hyeon , Hyun Do Yoon , Lee Sookyeong , Rhee Ju Hee , Lee Ju Kyong
Published: September 2021

The leaves and seed oil of Perilla crop (Perilla frutescens L.) have attracted interest as health foods in East Asia. This crop has been traditionally cultivated and used for a long time as a folk plant, especially in Korea. In our study, the 22 SSR markers and six morphological traits were used to assess the genetic diversity and population structure, to select a core collection of 400 Perilla accessions conserved in the RDA-Genebank of South Korea. A total of 173 alleles were detected and the number of alleles per locus ranged from 4 to 15 (average = 7.9). Gene diversity and polymorphic information content ranged from 0.138 to 0.868 (average = 0.567) and 0.134 to 0.853 (average = 0.522), respectively. The 400 accessions were not clearly distinguished geographically by STRUCTURE and UPGMA analyses. A core collection (44 accessions) was selected from the entire collection by using PowerCore. The core collection accounted for 11.0% of the entire Perilla collection, including 100% of the number of alleles maintained in the whole collection and with similar or greater Shannon-Weaver and Nei diversity indices than the whole collection. The core collection selected by SSR markers was evenly distributed in three clusters on a scatter plot by six morphological traits. The first core collection of Perilla accessions was constructed, and it maintained allelic richness. Further modiﬁcation of the core collection is expected with the continuous addition of new accessions of the two cultivated types of Perilla crop and their weedy types.
A new 3D geological modeling method based on remote sensing and its application in Ya'an Area sichuan Province
Authors: Ma zhaoyang , zhang lihai , wang yan , zhu guifan , liang yinping
Published: September 2021

Remote sensing technology provides a new way to explore the earth for geoscience applications. In the context of continuous deepening of geological research and the vigorous development of geospatial information science, 3D geological modeling technology has become a research hotspot in the intersection of earth science and information science. The traditional 3D geological modeling technology refers to underground 3D modeling using geological data. This modeling method can only display the underground scene in 3D visualization, but cannot display the surface in detail. In this study, remote sensing technology is adopted to improve the traditional 3D geological modeling method, so that geological modeling can be integrated with remote sensing image, and a new 3D geological modeling method based on remote sensing technology is developed. This method can perform integrated 3D visualization of underground and aboveground scenes, which provides a new way for disaster prevention and reduction, geological prospecting and tectonic interpretation. The new 3D geological modeling method is mainly applied in the geological field, and has made new progress in multi-source heterogeneous geological data fusion, large-scale high-precision modeling, geological grid subdivision, attribute modeling technology, remote sensing image fusion and other aspects. Taking the Ya'an area as an example, this paper makes use of the new generation of 3D geological modeling technology to carry out 3D geological modeling and visual display. The 3D visualization in Ya'an area verifies the feasibility and effectiveness of the new 3D geological modeling method based on remote sensing technology in the current data environment.
Robust Semi-Automatic Annotation of object Data Sets with Bounding Rectangles.
Authors: ZAIDI Abdelhamid
Published: September 2021

Object datasets used in the construction of object detectors are typically manually annotated with horizontal or rotated bounding rectangles. The optimality of an annotation is obtained by fulfilling two conditions (i) the rectangle covers the whole object (ii) the area of ​​the rectangle is minimal. Building a large-scale object dataset requires annotators with equal manual dexterity to carry out this tedious work. When an object is horizontal, it is easy for the annotator to reach the optimal bounding box within a reasonable time. However, if the object is rotated, the annotator needs additional time to decide whether the object will be annotated with a horizontal rectangle or a rotated rectangle. Moreover, in both cases, the final decision is not based on any objective argument, and the annotation is generally not optimal. In this study, we propose a new method of annotation by rectangles, called Robust Semi-Automatic Annotation, which combines speed and robustness. Our method has two phases. The first phase consists in inviting the annotator to click on the most relevant points located on the contour of the object. The outputs of the first phase are used by an algorithm to determine a rectangle enclosing these points. To carry out the second phase, we develop an algorithm called RANGE-MBR, which determines, from the selected points on the contour of the object, a rectangle enclosing these points in a linear time. The rectangle returned by RANGE-MBR always satisfies optimality condition (i). We prove that the optimality condition (ii) is always satisfied for objects with isotropic shapes. For objects with anisotropic shapes, we study the optimality condition (ii) by simulations. We show that the rectangle returned by RANGE-MBR is quasi-optimal for the condition (ii), and that its performance increases with dilated objects, which is the case for most of the objects appearing on images collected by aerial photography.
Development and Evaluation of the MAINTAIN Instrument, Selecting Patients Suitable for Secondary or Tertiary Preventive Manual Care – The Nordic Maintenance Care Program
Authors: Eklund Andreas , Palmgren Per , Jakobsson Ulf , Axén Iben
Published: September 2021

BackgroundChiropractic Maintenance Care (MC) has been found to be effective for patients classified as dysfunctional (high pain severity, marked interference with everyday life due to pain, high affective distress, low perception of life control, and low activity levels) by the Swedish equivalent of the West Haven-Yale Multidimensional Pain Inventory (MPI-S). Although displaying good psychometric properties such as validity and reliability, the instrument was not designed to be used in clinical practice to screen patients for stratified care pathways. To effectively be able to screen for individuals suitable for MC, the aim was to develop a clinical instrument with the intent of identifying dysfunctional patients with acceptable sensitivity, specificity, and discriminant ability.MethodsData from 249 patients with a complete MPI dataset from an RCT that investigated the effect and cost-effectiveness of MC with a 12-month follow-up was used in this cross-sectional analysis. The MPI’s data was used to develop a short screening instrument to identify dysfunctional patients, with a summary measure, based on the original instrument. Different cutoffs were considered with regards to sensitivity, specificity, and discriminant ability and compared to the original instrument’s classification of dysfunctional patients. The instrument was then tested in 3 other existing datasets to assess validity across populations.ResultsUsing an explorative approach, the MAINTAIN instrument with 10 questions (0-6 Likert responses) with 5 dimensions (pain severity, interference, life control, affective distress, and support) was developed, generating an algorithm-based score ranging from -12 to 48. Reporting a MAINTAIN score of 18 or higher, 146 out of the 249 patients were classified as dysfunctional with 95.8% sensitivity and 64.3% specificity. At a score of 22 or higher, 109/249 were classified as dysfunctional with 81.1% sensitivity and 79.2% specificity. Discriminant ability (area under the curve (AUC)) was estimated to 0.87 (95% CI: 0.83, 0.92; p <0.001) and Youden’s index was highest (0.70) at a score of 20. The discriminant ability is similar and acceptable across populations with minor differences in optimal thresholds for identifying dysfunctional individuals.ConclusionThe MAINTAIN instrument had an acceptable performance with regards to identifying dysfunctional patients and may be used as a decision aid in clinical practice. By using 2 thresholds, patients can be categorized into “low probability (-12 to 17)”, “moderate probability (18 to 21)”, and “high probability (22 to 48)” of having a good outcome from maintenance care for Low Back Pain (LBP).Trial registrationClinical trials.gov; NCT01539863; registered February 28, 2012; https://clinicaltrials.gov/ct2/show/NCT01539863
Rationale and Design of the Vasospastic Angina Treatment by Endothelin Receptor Antagonism (VERA) Trial
Authors: Feenstra Rutger G , Boekholdt Matthijs , Appelman Yolande , Damman Peter , Wittekoek Marianne E , de Winter Robbert J , de Hoef Tim P van , Piek Jan J , Beijk Marcel A
Published: September 2021

Background Pharmacological treatment of patients diagnosed with vasospastic angina (VSA) or microvascular angina (MVA) is challenging and often patients remain symptomatic. Endothelin (ET)-1 plays an important role in the regulation of the vascular tone and stimulation of ET-1 receptors can induce a potent and long-lasting vasoconstriction. Macitentan is a potent, inhibitor of the ETA receptor. Purpose This prospective, randomized, double-blind, placebo-controlled, sequential cross-over proof-of-concept trial is designed to investigate macitentan as a potential novel treatment for patients with VSA due to epicardial spasm or MVA due to microvascular spasm, together defined as coronary artery spasm (CAS).Methods and Results A total of 30 patients with CAS will receive treatment with either 10 mg of macitentan daily for 4 weeks followed by placebo for 4 weeks, or vice versa, in random order. The primary outcome is the reduction in angina, calculated as (1) the frequency of angina attacks * severity (on a VAS scale 1-10); and (2) the duration (in minutes) * severity (on a Visual Analogue Scale (VAS) pain scale 1-10) during medication use (macitentan or placebo) up to 2 weeks after discontinuation of the study medication. The primary analysis will assess the within-subject differences in the burden of anginal symptoms following treatment with macitentan versus placebo.Conclusions The VERA trial will be the first to evaluate the efficacy of the ETA receptor antagonist, macitentan, in the treatment of VSA due to epicardial spasm and MVA due to microvascular spasm.Trial Registration trialregister.nl, Identifier: NL7546. Registration date: 20 February 2019.
Copy Number Assessment of SMN1 Based on Real-Time PCR With High-Resolution Melting: Fast and Highly Reliable Testing
Authors: Xu Ying , Song Tingting , Wang Xiaozhou , Zheng Jiao , Li Yu , Guo Fenfen , Li Yuanfeng , Guo Zijian , Dou Yaling , Wang Yu , Zhao Ye , Yang Hong
Published: September 2021

Background: Spinal muscular atrophy (SMA) is a common neuromuscular disorder, caused by absence of both copies of the survival motor neuron 1 (SMN1) gene. Population-wide SMA screening to quantify copy number of SMN1 is recommended by multiple regions. SMN1 diagnostic assay with simplified procedure, high sensitivity and throughput is still needed.Methods: Real-Time PCR with High-Resolution Melting for the quantification of the SMN1 gene exon 7 copies and SMN1 gene exon 8 copies was established and confirmed by multiplex ligation-dependent probe amplification (MLPA). The diagnosis of 2563 individuals including SMA patients, suspected cases and the general population were analyzed by the real-time PCR. The results were compared with the gold standard test MPLA. Results: In this study, the homozygous deletions, heterozygous deletions were identified by Real-Time PCR with High-Resolution Melting method with an incidence of 10.18% and 2.42%, respectively. In addition, the R value distribution (P>0.05) among the 8 replicates and the coefficient of variation (CV<0.003) suggested that the qPCR screening test had high reproducibility. High concordance was obtained between Real-Time PCR with High-Resolution Melting and MPLA. Conclusions: The qPCR based on High-Resolution Melting provides a sensitive and high-throughput approach to large-scale SMA carrier screening with low cost and labor.
We-PAP, A novel, couples’ - based sleep health intervention for older adults with obstructive sleep apnea: Rationale and study protocol for a web-based randomized clinical pilot/feasibility trial of the We-PAP intervention compared to an educational control
Authors: BARON KELLY GLAZER , Gilles Allyson , Sundar Krishna M. , Baucom Brian R. W. , Duff Kevin , Troxel Wendy
Published: September 2021

BackgroundObstructive sleep apnea (OSA) is a serious health condition that affects approximately 30–50% of older adults and contributes to risk for cardiometabolic disorders and dementia. Despite the well-documented role of partners in treatment seeking and adherence to positive airway pressure (PAP), treatments for OSA have nearly exclusively focused on the patient and current treatments for OSA do not address co-existing sleep problems such as insomnia that are prevalent in both patients with OSA and their partners. Therefore, the goal of this study is to develop and test a novel couples-based sleep health intervention to promote adherence to PAP and improve sleep health of the couple.MethodsWe are conducting a two-arm, parallel group, single blind, randomized controlled pilot/feasibility trial to compare our novel couples-based sleep health intervention (We-PAP) to an information control group (IC). We-PAP is based on a transdiagnostic model and uses a dyadic approach including increasing effective partner support, communication skills, and couple-level goal-setting. We-PAP involves 3 sessions and is delivered via telehealth in weekly sessions. The IC includes standardized patient educational materials. Both groups receive the usual follow-up with their medical team. The study involves assessments at pre-treatment, post-intervention (approximately 1 month after starting PAP and completing We-PAP sessions or IC) and 3 months after starting PAP. Our main outcomes are feasibility and acceptability ratings. Secondary outcomes include comparing We-PAP to IC for PAP adherence, sleep quality (self-report and objective) and cognitive measures.DiscussionWe-PAP is the first couples-based transdiagnostic sleep health intervention for patients with OSA and their partners. Results of this study will be used to inform the design of a subsequent fully adequately-powered clinical trial. If successful, this intervention could significantly advance current clinical practice in the treatment of OSA and sleep health more comprehensively in older adults. Moreover, this intervention may be useful for improving sleep in other aging populations with multiple sleep and other health problems, including patients with chronic illnesses or those at risk for Alzheimer’s disease and their caregivers.Trial registrationNCT04759157
Levels of Pretreatment Blood Lipids are Prognostic Factors in Advanced NSCLC Patients Treated with Anlotinib
Authors: Tang Mengqiu , Song Chao , Zhang Yaowen , Wang Chen , Zhang Zhanchun , Chen Tian
Published: September 2021

Background: Anlotinib, a small molecule for multi-target tyrosine kinase inhibition, is the third or further line of defense for treatment of non-small cell lung cancer (NSCLC). Results from an ALTER0303 phase III trial revealed that this drug confers significant survival benefits in patients. Although numerous inflammatory biomarkers play a vital role in treatment, none of them has focused on blood lipids before treatment. Here, we explored the relationship between blood lipids and efficacy of anlotinib, with a view of generating insights to guide future development of convenient and individualized treatment therapies. Methods: We analyzed basal blood lipids, including triglyceride (TG), total cholesterol (TC), low density lipoprotein (LDL), and high density lipoprotein (HDL), among other variables before treatment, in 137 patients with advanced NSCLC who received anlotinib as third or further-line treatment at the Ningbo Medical Center Lihuili Hospital, between July 2018 and December 2020. We selected the best cut off value for predicting treatment response, generated survival curves using the Kaplan–Meier method, then applied univariate and multivariate Cox regression analyses to assess predictors of survival. Results: The entire study population recorded median progression-free survival (PFS) and overall survival (OS) of 4 (95% CI 3.142-4.858) and 8.3 (95% CI 6.843-9.757) months, respectively. We observed statistically significant differences across subgroup, between blood lipid indexes with different efficacies, except in the HDL subgroup. The low Disease control rate (DCR) was associated with significantly high TG, high TC and high LDL (P = 0.000). Results from multivariate analysis demonstrated that high TC and high LDL were independently associated with poor PFS or OS (P ≤ 0.003). We used these results to establish a prediction model, and set high TC or high LDL as risk factors, respectively. The outcomes significant difference between 0 and ≥1 scores in PFS (P = 0.000) and OS (P = 0.012).Conclusions: TC and LDL, before anlotinib therapy, were independent prognostic indicators for patients with advanced NSCLC who received this drug as a third or further-line of treatment. In addition, a risk score of 0 was attributed to a combination between low TC and low LDL, and these patients were exhibited excellent efficacy and survival rates.
Colonic Stent Placement May Reduce Mortality Rate and Length of Hospitalization in Obstructive Colorectal Cancer Cases: a Propensity Score-matched Analysis Using a Nationwide Database in Japan
Authors: Moroi Rintaro , Tarasawa Kunio , Shimoyama Yusuke , Kuroha Masatake , Shiga Hisashi , Kakuta Yoichi , Fushimi Kiyohide , Fujimori Kenji , Kinouchi Yoshitaka , Masamune Atsushi
Published: September 2021

Background and aims: Self-expandable metallic stent (SEMS) is widely used for obstructive colorectal cancer (OCC). Both SEMS and urgent surgery have several merits and demerits. This study aimed to clarify the efficacy of SEMS by comparing the mortality rate after the hospitalization between SEMS and urgent surgery for OCC.Methods: We collected OCC patients’ data using the Diagnosis Procedure Combination (DPC) database system. We divided eligible patients into the SEMS and urgent surgery groups using propensity score matching, and compared in-hospital death rates, length of hospitalization, and medical costs. We also conducted logistic regression analysis to identify clinical factors affecting in-hospital deaths.Results: We enrolled 17,140 cases after propensity score matching. SEMS reduced the in-hospital death rate compared to urgent surgery (2.0% vs. 3.6%, P < 0.0001). Length of hospitalization was shorter in the SEMS group than in the urgent surgery group (16 vs. 25 days, P < 0.0001). Medical costs were lower in the SEMS group than in the urgent surgery group (1,663,550 vs. 2,424,082 JPY, P < 0.0001). Multivariate analysis also showed that SEMS reduced in-hospital death (odds ratio = 0.58, 95% confidence interval: 0.50‒0.70, P < 0.0001).Conclusion: SEMS placement for OCC could reduce the mortality rate and shorten the length of hospitalization. These results facilitate considering SEMS with careful judgement for its indication when treating OCC patients.
RNA interference-mediated tolerance to whitefly (Bemisia tabaci) in genetically engineered tomato
Authors: Pizetta Carolina Senhorinho Ramalho , Ribeiro William Rafael , Ferreira Amanda Lopes , Moura Matheus da Costa , Bonfim Kenny , Pinheiro Patrícia Valle , Cabral Glaucia Barbosa , Aragão Francisco Lima
Published: September 2021

Whitefly (Bemisia tabaci) is a polyphagous insect that causes huge damage in several horticultural crops, including tomato, by sucking nutrients from the phloem and transmitting viruses. Whiteflies are particularly difficult to manage and the use of chemicals remains the common practice, which causes the development of insecticidal resistance. Thus, there is considerable interest in the introduction of whitefly resistance by classical and molecular breeding. Here, we explored the concept of using an RNA interference construct to silence a v-ATPase gene in whiteflies interacting with transgenic tomato plants that express siRNA molecules corresponding to a fragment from the B. tabaci vATPase. PCR analyses revealed the presence of both ΔATPase and nptII transgenes in all transgenic lines. siRNA expressing lines were challenged against whitefly and revealed a mortality rate of 57.1% in transgenic line 4.4.1, while in the control the mortality was 7.6%. Mortality of 2nd instar nymphs was higher on the transgenic plants and the development of 3rd instar nymphs was slightly longer than on the control plants. Although the attraction of insects was not significantly different between treatments, the number of eggs laid by the insects on the transgenic plants was significantly lower, compared to the controls. RT-qPCR revealed a decreased expression level of endogenous v-ATPase gene in whiteflies feeding on transgenic plants. No unexpected effect was observed on the non-target insects Myzus persicae or Tuta absoluta. Results presented here may form the foundation for the generation of elite tomato varieties resistant to whitefly, a devastating insect pest.
Computer-Aided Decision-Making System for Endometrial Atypical Hyperplasia based on Multimodal & Multi-Instance Deep Convolution Networks
Authors: Liao Xin , Li Qingli , Zheng Xin , He Jin
Published: September 2021

The pathological diagnosis is the gold standard for neoplasms and their precursors, which is highly relevant to the treatment planning and the prognostic analysis. Currently, deep learning networks have been used for the pathological computer-assisted diagnosis and treatment decision-makings. However, due to extremely large size of the whole slide images (WSIs) of pathological slides, the prevailing deep learning models are un-applicable directly in the WSIs analysis. Moreover, the precise exclusion of the blank regions and interfere regions, as well as the manual annotation of various lesioned and normal regions in super large WSIs are infeasible and unavailable in clinical practice. To address aforementioned problems, we develop an computer-aided decision-making system based on multimodal and multi-instance deep convolution networks (CNN) to assist in the diagnosis and treatment of endometrial atypical hyperplasia (AH)/ endometrial intraepithelial hyperplasia (EIH). Firstly, we set up the frame-work of computer-aided decision-making system based on the WSIs image patterns of AH/EIH, and then transfer the large-scale WSI analysis to the small-scale analysis of multiple suspected lesion regions which can be accomplished the major computer vision models, and eventually the results of prognostic analysis for multiple small-scale suspected lesion regions are summarized to obtain the prognostic results of WSIs by the decision supporting algorithm based on the cognition intelligence. We validate the method via experimental analysis of 102 endometrial atypical hyperplasia patients at the West China Second University Hospital of Sichuan University. The performance achieved for endometrial AH/EIH prognostic analysis includes accuracy (85.3%), precision (84.6%), recall (86.3%). Meanwhile, the method has superior performance to prognostic judgment of a single pathologist as well as approximates to analysis results determined by three pathologists according to the majority voting method.
A Non-Global Disturbance Targeted Adversarial Example Algorithm Combined with C&W and Grad-Cam
Authors: Zhu Yinghui , Jiang Yuzhen
Published: September 2021

Adversarial examples are artificially crafted to mislead deep learning systems into making wrong decisions. In the research of attack algorithms against multi-class image classifiers, an improved strategy of applying category explanation to the generation control of targeted adversarial example is proposed to reduce the perturbation noise and improve the adversarial robustness. On the basis of C&W adversarial attack algorithm, the method uses Grad-Cam, a category visualization explanation algorithm of CNN, to dynamically obtain the salient regions according to the signal features of source and target categories during the iterative generation process. The adversarial example of non-global perturbation is finally achieved by gradually shielding the non salient regions and fine-tuning the perturbation signals. Compared with other similar algorithms under the same conditions, the method enhances the effects of the original image category signal on the perturbation position. Experimental results show that, the improved adversarial examples have higher PSNR. In addition, in a variety of different defense processing tests, the examples can keep high adversarial performance and show strong attacking robustness.
Stress Recovery Algorithm for Reduced Order Models of Mechanical Systems in Nonlinear Dynamic Operative Conditions
Authors: BATTIATO GIUSEPPE , FIRRONE CHRISTIAN MARIA
Published: September 2021

Nonlinear forced response analyses of mechanical systems in the presence of contact interfaces are usually performed in built-in numerical codes on reduced order models (ROM). Most of the cases these derive from complex finite element (FE) models, because of the high accuracy the designers require in meshing the components in commercial FE software. In the technical literature several numerical methods are proposed for the identification of the nonlinear forced response in terms of kinematic quantity (i.e. displacement, velocity and acceleration) at the location where the master degrees-of-freedom are retained in the ROM. In fact, the displacement is the quantity usually adopted to monitor the nonlinear response, and to evaluate the effectiveness of a partially loose friction interface in damping vibrations with respect to a linear case where no friction interfaces exist and no energy dissipation can take place. However, when a ROM is used the engineering quantities directly involved in the mechanical design, i.e. the strains and stresses, cannot be retrieved without a further data processing. Moreover, in the case of a strong nonlinear behavior of the mechanical joints, the distributions of the nonlinear strains and stresses is likely different than the modal ones, meaning that the latter cannot be used to predict the safety margins of the structure working in real (nonlinear) operative conditions. This paper addresses this topic and presents a novel stress recovery algorithm for the identification of the strains and stresses resulting from a nonlinear forced response analysis on a ROM. The algorithm is applied to a bladed disk with friction contacts at the shroud joint, which make the behavior of the blades nonlinear and non-predictable by means of standard linear analyses in commercial FE software.
Melatonin pretreatment can improve the therapeutic effect of Adipose-derived Stem Cells on CCl4-induced liver fibrosis
Authors: Zhang Ziqiang , Sun Yingying , Wang Haojie , Yang Yuxiang , Dong Ruiqi , Xu Yaolu , Zhang Mengyu , Lv Qiongxia , Chen Xiaoguang , liu yumei
Published: September 2021

Background and PurposeIn this study, the therapeutic effect of Mel-incubated ADSCs on CCl4-induced hepatic fibrosis was investigated. MethodsThe experiment was arranged into ADSCS group, ADSCS + Mel group, Model group and Control group with 10 mice in each group. The other three groups of mice were intraperitoneally injected with 8% CCl4, and the control group was injected with the same dose of PBS twice a week for 4 weeks. From the fifth week, ADSCs group and ADSCs + Mel group mice were injected with 1×106 cells/1 ml PBS dose of ADSCs and 50 μM Mel pretreated ADSCs into tail vein, respectively, twice a week for 2 weeks, and mice in the control and model groups were injected with the same dose of PBS. Samples were tested after six weeks. ResultsIn model group, severe histomathological changes were observed in liver, including severe vacuolation, nuclear fragmentation and liver fibrosis, and these changes were ameliorated by Mel pretreated ADSCs. At the same time, RT-qPCR results showed that Mel-induced ADSCs significantly inhibited the expression of pro-apoptotic genes (Caspase-8, Bax and Caspase-3), and promoted the expression of anti-apoptotic gene (Bcl-2). Immunohistochemical results showed that a large number of MMP-9, TGF-β, MMP-2 yellow-stained positive cells were found in the liver tissues of the model group, while the expression of positive cells was blocked by Mel-induced ADSCs. Conclusion and ImplicationsADSCs pretreated with Mel significantly improved CCl4-induced liver fibrosis, which provides a reference for clinical treatment of liver injury with mesenchymal stem cells.
High divergence of human astrovirus genotypes circulating in pediatric patients hospitalized with acute gastroenteritis in Chiang Mai, Thailand, 2017 to 2020
Authors: Wei Hongyu , Khamrin Pattara , Kumthip Kattareeya , Yodmeeklin Arpaporn , Maneekarn Niwat
Published: September 2021

ABSTRCT
Human astrovirus (HAstV) is one of the common causes of acute gastroenteritis in children. The investigation of the molecular epidemiology of HAstV is essential for monitoring the emergence and/or re-emergence of new HAstV genotypes, as well as understanding the evolution of HAstV genotypes circulating in children suffering from acute gastroenteritis. The present study aimed to investigate the prevalence and distribution of HAstV genotypes circulating in children < 5 years of age hospitalized with acute gastroenteritis in Chiang Mai, Thailand during 2017 to 2020. A total of 1,500 fecal specimens collected from children diagnosed with acute gastroenteritis during 2017 to 2020 were screened for HAstV by RT-PCR and identified by nucleotide sequencing. The obtained sequences were compared with the reference sequences retrieved from GenBank database and analysed by MEGA X software to assign their genotypes. Of 1,500 fecal samples, 39 (2.6%) were positive for HAstV. Of these, both classic and novel HAstV genotypes, including classic HAstV1-HAstV5, novel HAstV-MLB1, MLB2, and novel HAstV-VA2, were detected in this study. The data in this study revealed a wide variety of HAstV genotypes circulating in pediatric patients admitted to the hospitals with acute gastroenteritis in Chiang Mai, Thailand during 2017 to 2020.
Development of a prognostic model for 1-year survival after fragile hip fracture in Chinese
Authors: FU Hairui , Liang Bin , Qin Wei , Qiao Xiaoxiong , Liu Qiang
Published: September 2021

BackgroundNo prognostic model for the survival of fragile hip fracture has been developed for Asians. The goal of this study was to develop a simple and practical prognostic model to predict survival within 1 year after fragile hip fracture in Asians.MethodsA single-center retrospective cohort study was designed. Under a multivariable Cox proportional hazards regression model, we used the preoperative characteristics of patients to predict survival within 1 year after hip fracture. We built a full model and then used the least absolute shrinkage and selection operator (LASSO) method to further shrink the model coefficients and achieved variable screening. Finally, we obtained a LASSO model. The model performance was evaluated with Nagelkerke’s R2 and the concordance (c) statistic. We assessed the internal validity with a bootstrapping procedure of 1 000 repetitions.ResultsA total of 735 eligible patients were admitted to our department for hip fracture from January 2015 to December 2020, but 11 (1.5%) patients were lost to follow-up. Among the remaining patients, 68 (9.3%) died within 1 year after hip fracture. We identified 12 candidate predictors from the preoperative characteristics of the patients. The last model contained 9 predictors: surgery, age, albumin, sex, serum creatinine, malignancy, hypertension, ability to live independently, and cardiovascular and cerebrovascular diseases. Among them, surgery, age and albumin are effective predictors of survival. The discrimination c statistic of the model is 0.814 (95% confidence interval 0.762–0.865); the corrected value through internal validation is 0.795.ConclusionsThis prognostic model can accurately predict a 1-year survival rate for patients with fragile hip fractures. This information can help clinicians develop a reasonable and personalized treatment plan.