bluuebunny/crossref_metadata_2025 huggingface dataset:
Oropharyngeal Cancer Patient Stratification Using Random Forest Based-learning Over High-dimensional Radiomic Features
Authors: Patel Harsh , Vock David , Marai Elisabeta , Fuller Clifton , Mohamed Abdallah , Canahuate Guadalupe
Published: January 2021

OBJECTIVE: To improve risk prediction for oropharyngeal cancer (OPC) patients using cluster analysis on the radiomic features extracted from pre-treatment Computed Tomography (CT) scans.MATERIALS AND METHODS: OPC Patients were classified into 2 or 3 risk groups by applying hierarchical clustering over the co-occurrence matrix obtained from a random survival forest (RSF) trained over 301 radiomic features. The cluster label was included together with other clinical data to train an ensemble model using five predictive models (Cox, random forest, RSF, logistic regression, and logistic-elastic net). Ensemble performance was evaluated over an independent test set for both recurrence free survival (RFS) and overall survival (OS). RESULTS: The Kaplan-Meier curves for OS stratified by cluster label show significant differences for both training (p-val<0.0001) and testing (p-val=0.005). Inclusion of the cluster label outperforms clinical data only improving AUC from .60 to .76 and from .63 to .75 for OS and RFS, respectively. CONCLUSION: The extraction of a single feature, namely a cluster label, to represent the high-dimensional radiomic feature space reduces the dimensionality and sparsity of the data. Moreover, inclusion of the cluster label improves model performance compared to clinical data only and compares to the raw radiomic features performance.
Non-uniform Model of Relationship Between Surface Strain and Rust Expansion Force of Reinforced Concrete
Authors: Chen Fanxiu , Zhong Yichen , Gao Xinya , Jin Zuquan , Wang Endong , Zhu Feipeng , Shao Xinxing , He Xiaoyuan
Published: January 2021

When operating within the environments rich with sodium chloride, steel bars of reinforced concrete structures are often subject to corrosion caused by surrounding erosive materials, and the associated rust expansion force due to corrosion takes a critical role in determining the durability of relevant reinforced concrete structures. By investigating the corrosion course of steel reinforcement with theory of elasticity, a numerical rust expansion model is established for the moment of concrete surface rupture based on non-uniform sin function. Cuboid reinforced concrete specimen with squared cross sections is tested to analyze the rust expansion when concrete cracks due to corrosive forces. The utility of the established expansion model is validated by numerical simulation with Abaqus through the comparison between the associated outcomes. The impacts of steel bar diameter and concrete cover thickness on the magnitude of rust expansion force are discussed.
The impact of COVID-19 pandemic on HIV care continuum in Jiangsu, China
Authors: Shi Lingen , Tang Weiming , Hu Haiyang , Qiu Tao , Marley Gifty , Liu Xiaoyan , Chen Yuheng , Chen Yunting , Fu Gengfeng
Published: January 2021

Background
The COVID-19 pandemic seriously threatens general public health services globally. This study aimed to evaluate the impact of the COVID-19 pandemic on HIV care continuum in Jiangsu province, China.
Methods
Data for analysis was retrieved from the web-based Comprehensive Response Information Management System (CRIMS) for HIV/AIDS in China. We used time series model of seasonal autoregressive integrated moving average (SARIMA) and Exponential smoothing to predict the amount of HIV care services during the COVID-19 measures, and Chi-square were performed to assess subgroup differences.
Results
Overall, the testing rated decreased 49.0% (919,938) decrease in the first three months during the COVID-19 measures, as compared with the estimated number. Although an estimated of 1555 confirmatory tests were expected in the first three months during the COVID-19 measures, only 48.7% (757) confirmed HIV/AIDS cases were actually recorded. In the actual data during the first period of COVID-19, 980 clients received confirmatory tests, only 71.4% (700) were reportedly linked to care. Only 49.5% (235) out of the expected 475 estimated number of clients received CD4 cell count test services. Meanwhile 91.23% (208) had initiated antiretroviral therapy (ART) which compared to 227 the estimated number of initiated ART. Compared with the same period during 2016 to 2019, PLWHIV who were less than 30, migrants were more likely to be influenced by the COVID-19 policies.
Conclusions
The COVID-19 pandemic had a negative impact on the HIV healthcare systems in Jiangsu, China. Further measures that can encounter the impact of the pandemic are needed, in order to maintain HIV care continuum.
A Rare Cause of Chronic Dysphagia: Pulmonary Inflammatory Myofibroblastic Tumor with Distal Esophagus Invasion
Authors: Gu Yi-Min , Chen Long-Qi
Published: January 2021

BackgroundInflammatory myofibroblastic tumor (IMT) is rare intermediate tumor, which happens mostly in children and young adults.Case presentationReported is the successful treatment of a 29-year-old man presented with progressively dysphagia and weight loss. No other abnormal symptoms were observed. The contrast enhanced computed tomography (CT) revealed a dumbbell-shaped lesion between lung and esophagus. Finally, it was pathologically diagnosed as pulmonary IMT invading to the distal esophagus after operation. The patient underwent en bloc esophagectomy and left lower lobectomy, and was discharged on 10th postoperative day.ConclusionIMT is a rare lesion that usually occurs in the lung, but pulmonary IMT with distal esophagus invasion has not been described previously. Discriminating untypical symptom, completed resection, pathological expertise and closed follow-up will reach the successful diagnosis and treatment.
A Critical Role for The COP9 Signalosome Subunit 3 as A Gatekeeper of Genome Integrity in 2-Cell Mouse Embryos
Authors: Israel Steffen , Drexler Hannes , Fuellen Georg , Boiani Michele
Published: January 2021

Investigations of genes required in early mammalian development are complicated by protein deposits of maternal products, which continue to operate after the gene locus has been disrupted. This leads to an underestimation of the number of genes known to be needed during the embryonic phase of cellular totipotency (up to the 4-cell stage). Here, we expose a critical role of the gene Cops3 by showing that it protects genome integrity during the 2-cell stage of mouse embryo development, in contrast to the previous functional assignment at postimplantation. This new role is mediated by a large, stable and hitherto overlooked deposit of maternal protein. Since protein abundance and stability defeat prospects of DNA- or RNA-based gene inactivation, we adopted a protein strategy of gene inactivation: antigen masking or TRIM21-mediated proteasomal degradation of COPS3. Both resulted in 2-cell embryo lethality, but the expected degradation remained outstanding, because the major fraction of the total COPS3 is secluded in a submembrane cortical rim that withstands extraction with detergent, thereby exposing a soluble vs. insoluble fraction of COPS3, which we ascribe with distinct functional properties. In mechanistic terms, transcriptomic and metabolic analyses reveal that soluble COPS3 is involved in several processes, which, however, converge on DNA endoreduplication and the accumulation of DNA strand breaks in the 2-cell nucleus, where the minor soluble fraction of COPS3 is placed. Thus, we have shown the critical role of maternal protein deposits in development, and we have also highlighted the distinction between the site of accumulation (cell cortex) and point of use (nucleus), which is a dimension of the protein-based strategies of gene inactivation not yet fully appreciated.
Clinical Impact of Serum Bilirubin Levels on Kidney Transplant Outcomes
Authors: Lee Juhan , Kim Eun Jin , Lee Jae Geun , Kim Beom Seok , Huh Kyu Ha , Kim Myoung Soo , Kim Soon Il , Kim Yu Seun , Joo Dong Jin
Published: January 2021

Serum bilirubin, a potent endogenous antioxidant, has been associated with decreased risks of cardiovascular disease, diabetes, and kidney disease. However, the effects of serum bilirubin on kidney transplant outcomes remain undetermined. We analyzed 1628 patients who underwent kidney transplantations between 2003 and 2017. Patients were grouped into sex-specific quartiles according to mean serum bilirubin levels, 3-12 months post-transplantation. Median bilirubin levels were 0.66 mg/dL in males and 0.60 mg/dL in females. The intra-individual variability of serum bilirubin levels was low (9%). Serum bilirubin levels were inversely associated with graft loss, death-censored graft failure, and all-cause mortality, independent of renal function, donor status, and transplant characteristics. Multivariable analysis revealed that the lowest serum bilirubin quartile was associated with increased risk of graft loss (HR 2.63, 95% CI 1.67-4.16, P < 0.001), death-censored graft failure (HR 2.96, 95% CI 1.62-5.40, P < 0.001), and all-cause mortality (HR 2.07, 95% CI 1.01-4.23, P = 0.046). Patients with lower serum bilirubin were also at greater risk of late-onset rejection and exhibited consistently lower glomerular filtration rates than those with higher serum bilirubin. Serum bilirubin levels were significantly associated with transplantation outcomes, suggesting that bilirubin could represent a therapeutic target for improving long-term transplant outcomes.
Rare Copy Number Variation Analysis in Chinese Children of Complete Atrioventricular Canal and Single Ventricle 
Authors: Zhang Xingyu , Wang Bo , You Guoling , Xiang Ying , Fu Qihua , Yu Yongguo , Zhang Xiaoqing
Published: January 2021

Background: Congenital heart disease (CHD) is the most common birth defects. Copy number variations (CNVs) have been proved to be important genetic factors that contribute to CHD. Here, we screened pathogenic CNVs in Chinese children with two rare types of CHD, complete atrioventricular canal (CAVC) and single ventricle (SV) .Methods：We screened CNVs in 262 sporadic CAVC cases and 259 sporadic SV cases respectively, using a customized SNP array. The detected CNVs were annotated and filtered using available databases.Results: Among 262 CAVC patients, we identified 44 rare CNVs in 43 individuals (16.4 %, 43/262), including 2 syndrome-related CNVs (7q11.23 and 8q24.3 deletion). Surprisingly, 88.6% rare CNVs (39/44) were duplications of 21q11.2-21q22.3, which were categorized as trisomy 21 (Down syndrome, DS). In CAVC with DS patients, the female to male ratio was 1.6:1 (24:15), and the rate of pulmonary hypertension (PH) was 41% (16/39). Additionally, 6 rare CNVs were identified in the SV patients (2.3%, 6/259), and none of them was trisomy 21.Conclusions: Our study identified 50 rare CNVs in 262 CAVC and 259 SV patients, representing the largest cohort of these two rare CHD types in Chinese population. The results provided strong correlation between CAVC and DS, which also showed sex difference and higher incidence of PH. The presence of rare CNVs suggests the etiology of complex CHD is incredibly diverse, and CHD candidate genes remain to be discovered.
Effect of Cutting Flute Offset and Surface Treatment on Self-tapping Bone Screw
Authors: Chen Changsheng , Ji Aimin , Zhao Zhonghang , Fu Lingjie
Published: January 2021

Background: Self-tapping bone screws hard to insert will brings many surgical risks such as damage the bone, screw failure. This study investigated the effect of different cutting flute offset and different surface treatment on the insertion torque and pullout strength for self-tapping bone screws.Methods: Titanium alloy screws with five types cutting flute offset and two types surface treatment, were tested for maximum insertion torque and pullout strength in a simulation cortical bone material. One group of each type surface treatment screws were tested for torsional properties. All tests were principally performed according to bone screws test standard. Results: For two types surface treatment, the insertion torque of design with 0.4mm offset was less than others cutting flute offset (p＜0.05), and the pullout strength of design with 0.2mm offset was bigger than others group (p＜0.05). Compared two surface treatment, the insertion torque of dark anodized screws was less than bead blasted, and the former pullout strength was bigger than the latter screws with the offset from 0mm to 0.4mm(p＜0.05).Conclusions: The study results show that different cutting flute offset design and surface treatment effect on the insertion torque, and the bigger cutting flute offset has the lower inserting resistance, and the comprehensive performance of dark anodized screws were better than bead blasted.
Clinical Characteristics and Nomogram for Adult Medullary Thyroid Carcinoma
Authors: Li Xiao , Lin Yu-jia , Wang Xian-zhi , Zeng Xiang-min , li Qiang , Zhang Xu-he
Published: January 2021

Objectives: The present study aimed to investigate the clinical characteristics and independent prognostic factors in adult patients with medullary thyroid carcinoma (MTC), followed by construction of nomogram-based prognostic prediction model for adult MTC.Methods: Relevant subjects were retrieved from Surveillance, Epidemiology, and End Results (SEER) program from January 1, 2004 through December 31, 2014. According to the multivariate analysis, the 3- and 5-year cancer-specific survival (CSS) in MTC patients was predicted by constructing a nomogram. Results: In total, 1279 patients diagnosed with primary MTC were extracted from the SEER database. The 3-, 5-and 10-year CSS rates were 91.11%, 88.32%, and 81.63%, respectively. The Cox proportional hazards model revealed that advanced AJCC stage and elderly age were independent unfavorable prognostic factors, and that surgery and radical lymph node dissection were protective prognostic factors (all P＜0.05). In addition, radiotherapy was independently related to the decreased survival. The C-index of nomogram was 0.902 (95% CI: 0.878–0.926) for the internal validations. Calibration plot revealed satisfactory agreement between the actual findings and predicted outcomes.Conclusion: The nomogram could individually and precisely predict the CSS of MTC patients, which could be used to facilitate in individualized prognostic assessment evaluation and clinical decision-making.
Genetic Dependency of Alzheimer’s Disease-associated Genes Across Cells and Tissue Types
Authors: Jaladanki Suraj K , Elmas Abdulkadir , Malave Gabriel Santos , Huang Kuan-lin
Published: January 2021

Background Multiple genes with genetic variants or expression changes associated with Alzheimer’s disease (AD) have been identified. Altering their expression and activity levels serve as potential therapeutic strategies, yet the cellular implications of such alterations remain largely unknown. Methods Cellular dependencies of 105 AD-associated genes, previously identified by genome-wide association studies (GWAS) and gene expression network studies, were evaluated in over 700 cell lines with CRISPR knockout/RNAi knockdown screen data. Expression-driven dependencies were examined within multiple tissue lineages. ResultsMultiple genes showed widespread cell dependencies across tissue lineages, suggesting their inhibition may yield off-target effects. SPI1, MEF2C, GAB2, and ABCC11 were identified as genes of interest since their genetic knockouts specifically affected high-expressing cells of the hematopoietic and lymphoid lineage related to microglia. Other genes exhibiting expression-driven dependencies include ACTG1 in autonomic ganglia and GLS in central nervous system lineages. Conclusions Analyses of genetic screen data identified AD-associated genes whose knockout or knockdown selectively affected cell lines of relevant tissue lineages, prioritizing targets for potential AD treatments.
How to Recognize and Manage Psychosomatic Pain in the Pediatric Emergency Department
Authors: Cozzi Giorgio , Lucarelli Annunziata , Borrometi Fabio , Corsini Ilaria , Passone Eva , Pusceddu Sara , Morabito Giuliana , Barbi Egidio , Benini Franca
Published: January 2021

Aim: Children and adolescents affected by somatization and somatic symptom disorder commonly refer to emergency services. Due to the absence of specific guidelines for the emergency setting and to a possible lack of knowledge, these patients are at risk of being unrecognized and mismanaged. This study aims at proposing a clinical practice to approach and manage these patients and their families in the emergency setting.Methods: This manuscript derived from the work of a research group of italian pediatric emergency physicians and anesthesiologists, with an expertise in pain management, members of the PIPER group. The research group reviewed the literature about psychosomatic pain and somatic symptom disorder and developed a clinical practice specific for the pediatric emergency setting. Results: The manuscript provides information about the main clinical features shared by patients with psychosomatic pain and about current diagnostic criteria and appropriate management in the emergency setting. Furthermore, it highlights the possible pitfalls in which the emergency physician may run into dealing with these patients.Conclusion: This clinical practice should be seen as a starting point toward a better understanding of patients with psychosomatic pain and a standardization of care in the pediatric emergency setting.
Sex Differences in Non-strangulated Postoperative Adhesive Small Bowel Obstruction: A Retrospective Cohort Study
Authors: Yamamoto Yuta , Miyagawa Yusuke , Kitazawa Masato , Tanaka Hirokazu , Kuroiwa Masatsugu , Hondo Nao , Koyama Makoto , Nakamura Satoshi , Tokumaru Shigeo , Muranaka Futoshi , Soejima Yuji
Published: January 2021

Background: Adhesive small bowel obstruction (ASBO) is one of the major causes of postoperative morbidity. Conservative treatment is generally applied to non-strangulated ASBO. Several factors have been reported to affect the response to conservative treatment in patients with ASBO. However, the association between sex differences and non-strangulated ASBO remains unclear. This study aimed to elucidate the effect of sex differences in non-strangulated postoperative ASBO.Methods: We divided 192 admissions of 99 patients with non-strangulated postoperative ASBO into two groups: the male group (n = 137) and female group (n = 55). Clinical features and prognosis were compared between the two groups.Results: Female patients had significantly poorer performance status (p < 0.001) and lower proportions of esophageal/gastric malignancies (p = 0.002), colorectal malignancies (p = 0.034), and history of ASBO (p = 0.028) than male patients. More female patients failed conservative treatment (p = 0.036) than male patients. Hospital length of stay (LOS) was longer (p = 0.002) in the female group than in the male group. Multiple logistic regression analysis showed that female sex was associated with increased odds of requiring elective surgery (odds ratio 2.381, p = 0.040). The Cox proportional hazards regression model revealed that female sex was an independent predictor of hospital discharge (hazard ratio 0.651, p = 0.015).Conclusion: Female sex adversely affected the response to conservative treatment and LOS in patients with non-strangulated postoperative ASBO.
Lack of autonomy in facility-based births makes women become absentees of maternity services in Somaliland fragile contexts - a qualitative study
Authors: Egal Jama Ali , Essa Amina , Yusuf Rahma , Osman Fadumo , Allvin Marie Klingberg- , Erlandsson Kerstin
Published: January 2021

ObjectiveSomaliland has high levels of both maternal and infant mortality. This has been attributed, in part, to the fact that nearly 80% of births in the country take place at home, with women assisted by Traditional Birth Attendants (TBA) who have limited medical knowledge when it comes to obstetric complications. In this study we aim to capture multipara women’s decision-making when choosing the place of birth, illuminated by their experiences of maternity services in SomalilandDesignAn explorative qualitative approach using individual interviews conducted in Somaliland with 25 multiparous women who had experience of both a home and facility-based birth within the last three years.FindingsThe main finding of this study was the description of how valuable autonomy and respectful care were for Somaliland women. Respectful care and the cost of maternity services were vital parts of women’s autonomous decision-making when choosing a place of birth. Disrespectful care in maternity services made low-risk pregnancy women chose homebirth instead of a health facility birth. Women who had previous high-risk pregnancies that suggested they should be returnees to facility-based antenatal care, were still planning for a homebirth as their first choice.Key conclusionThis qualitative study was conducted in the fragile context of Somaliland and suggest a need to transform maternal and child health clinics into midwifery-led birthing centers that promote natural birth. It is further important to create new roles and responsibilities for TBAs that link them to the formal health system assuring timely health care seeking during pregnancy and in relation to delivery. There is a need to conduct a country-wide study on the availability and distribution of healthcare providers and to construct a long-term sustainable plan to assure quality and equal access to maternal health care in the country.
Effect of Blastocyst Morphology and Developmental Speed on Transfer Strategy for Grade “C” Blastocyst in Vitrified-warmed Cycles
Authors: He yuxia , Chen shiping , Liu jianqiao , Kang xiangjin , Liu haiying
Published: January 2021

Background: High-quality single blastocyst transfer (SBT) is increasingly recommended to patients because of its acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared to double blastocyst transfer (DBT). However, there is no consensus on whether this transfer strategy is also suitable for poor-quality blastocysts. Moreover, the effect of the development speed of poor-quality blastocysts on pregnancy outcomes has been controversial. Therefore, this study aimed to explore the effects of blastocyst development speed and morphology on pregnancy and neonatal outcomes during the frozen embryo transfer (FET) cycle of poor-quality blastocysts and to ultimately provide references for clinical transfer strategies.Methods: A total of 2,038 FET cycles of poor-quality blastocysts were analyzed from January 2014 to December 2019 and divided based on the blastocyst development speed and number of embryos transferred: the D5-SBT (n=476), D5-DBT (n=365), D6-SBT (n=730), and D6-DBT (n=467) groups. The SBT group was further divided based on embryo morphology: D5-AC/BC (n=407), D5-CA/CB (n=69), D6-AC/BC (n=580), and D6-CA /CB (n=150).Results: When blastocysts reach the same development speed, the live birth and multiple pregnancy rates of DBT were significantly higher than those of SBT. Moreover, there was no statistical difference in the rates of early miscarriage and live birth between the AC/BC and CA/CB groups. When patients in the SBT group were stratified by blastocyst development speed, the rates of clinical pregnancy (42.44% vs. 20.82%) and live birth (32.35% vs. 14.25%) of D5-SBT group were significantly higher than those of D6-SBT group. Furthermore, for blastocysts in the same morphology group (AC/BC or CA/CA group), the rates of clinical pregnancy and live birth in the D5 group were also significantly higher than those of D6 group. Conclusion: For poor-quality D5 blastocysts, SBT can be recommended to patients because of acceptable pregnancy outcomes and significantly reduced multiple pregnancy rate compared with DBT. For poor-quality D6, the DBT strategy is recommended to patients to improve pregnancy outcomes. When blastocysts reach the same development speed, the transfer strategy of selecting blastocyst with inner cell mass “C” or blastocyst with trophectoderm “C” does not affect the pregnancy and neonatal outcomes.
Dynamic Handoff Policy for RAN Slicing by Exploiting Deep Reinforcement Learning
Authors: Wu Yuansheng , Zhao Guanqun , Ni Dadong , Du Junyi
Published: January 2021

It has been widely acknowledged that network slicing is a key architectural technology to accommodate diversified services for the next generation network (5G). By partitioning the underlying network into multiple dedicated logical networks, 5G can support a variety of extreme business service needs. As network slicing is implemented in radio access networks (RAN), user handoff becomes much more complicated than that in traditional mobile networks. As both physical resource constraints of base stations (BSs) and logical connection constraints of network slices should be considered in handoff decision, an intelligent handoff policy becomes imperative. In this paper, we model the handoff in RAN slicing as a Markov decision process (MDP) and resort to deep reinforcement learning to pursue long-term performance improvement in terms of user quality of Service (QoS) and network throughput. The effectiveness of our proposed handoff policy is validated via simulation experiments.
Combined Polar Codes and 2-12 QAM over AWGN and Rayleigh Fading Channels
Authors: Oliveira Flávia Camila Morais , Alcoforado Maria de Lourdes Melo Guedes , Markarian Garik , Júnior Valdemar Cardoso da Rocha
Published: January 2021

This article investigates a communication system using polar codes combined with a 2-12 QAM modulation scheme over channels disturbed by additive white Gaussian noise (AWGN) as well as over channels disturbed by Rayleigh fading in addition to AWGN. The 2-12 QAM modulation is compatible with legacy 16 QAM still widely used, and when combined with appropriate error correcting codes produces results that approach the Shannon limit.
Identification of A Key Major-Effect QTL Associated With Pre-Harvest Sprouting in Cucumber (Cucumis Sativus L.) Using the QTL-Seq Method
Authors: Cao Ming ming , Li Shu ju , Deng Qiang , Wang Hui zhe , Yang Rui huan
Published: January 2021

Background: Cucumber (Cucumis sativusL.) is cultivated worldwide, and it is essential to produce enough high-quality seeds to meet demand. Pre-harvest sprouting (PHS) in cucumber is a critical problem and causes serious damage to seed production and quality. Nevertheless, the genetic basis and molecular mechanisms underlying cucumber PHS remain unclear. QTL-seq is an efficient approach for rapid quantitative trait loci (QTL) identificationthat simultaneously takes advantage of bulked-segregant analysis (BSA) and whole-genome resequencing. In the present research, QTL-seq analysis was performed to identify QTLs associated with PHS in cucumber using an F2 segregating population.Results: Two QTLs that spanned 7.3 Mb on Chromosome 4 and 0.15 Mb on Chromosome 5 were identified by QTL-seq and named qPHS4.1and qPHS5.1, respectively. Subsequently, SNP and InDel markers selected fromthe candidate regions were used to refine the intervals using the extended F2populations grown in the 2016 and 2017 seasons. Finally, qPHS4.1 was narrowed to 0.53 Mb on chromosome 4 flanked by the markers SNP-16 and SNP-24 and was found to explain 19-22% of the phenotypic variation in cucumber PHS. These results reveal that qPHS4.1 is the key major-effect QTL associated with PHS in cucumber. Based on gene annotations and qRT-PCR expression analyses, Csa4G622760and Csa4G622800 were proposed as the candidate genes. Conclusions: These results provide novel insights into the genetic mechanism controlling PHS in cucumber and highlight the potential for marker-assisted selection of PHS resistance breeding.
Hydroxyapatite-Coated Compaction Short Stem Represents a Characteristic Pattern of Peri-Prosthetic Bone Remodelling After Total Hip Arthroplasty
Authors: Hayashi Shinya , Hashimoto Shingo , Kuroda Yuichi , Nakano Naoki , Matsumoto Tomoyuki , Kamenaga Tomoyuki , Niikura Takahiro , Kuroda Ryosuke
Published: January 2021

Purpose: We aimed to investigate the differences in peri-prosthetic bone remodelling between the full hydroxyapatite (HA)-collared compaction short stem and the short tapered-wedge stem.Methods: This retrospective cohort study enrolled 159 consecutive patients (159 joints) undergoing total hip arthroplasty (THA) using the full HA compaction short (n=64) and short tapered-wedge (n=95) stems. Body mass index (BMI), peri-prosthetic bone mineral density (BMD), and clinical factors, including the Japanese Orthopaedic Association score and the University of California Los Angeles (UCLA) activity score, were assessed and compared.Results: Both groups showed similar peri-prosthetic BMD changes. Peri-prosthetic BMD was almost maintained in the distal femur and Gruen zone 6 with both type of stems, but significant BMD loss was found in zones 1 and 7 in both groups and in zone 2 of the full HA compaction stem group. Significant positive correlations were found between the proximal femoral BMD changes and the UCLA score in the tapered-wedge stem group but not between BMD changes and clinical factors in the full HA compaction stem group. Femoral bone shape affected the peri-prosthetic BMD changes in the tapered-wedge stem but not in the full HA compaction group. The stem collar of the full HA compaction stem did not affect peri-prosthetic BMD, but unique bone remodelling in the calcar region was observed in 27.6% cases.Conclusion: Peri-prosthetic bone remodelling remained unaffected by clinical and radiographic factors after THA with the new short full HA compaction stem. Therefore, the new stem may be useful in a variety of cases.
Cognitive Capacity Genomewide Polygenic Scores Identify Individuals Resilient to Cognitive Decline in Aging 
Authors: Joo Yoonjung Yoonie , Cha Jiook , Freese Jeremy , Hayes M Geoffrey
Published: January 2021

The genetic underpinnings of cognitive resilience in aging remains unknown. Predicting an individual’s rate of cognitive decline—or cognitive resilience—using genetics will allow personalized intervention for cognitive enhancement and optimal selection of target samples in clinical trials. Here, using genome-wide polygenic scores(GPS) as the genomic indicators for variations of human intelligence, we examined the genetic liability of cognitive abilities in the behavioral/cognitive phenome to understand individual differences in cognitive capacity over time. Using the longitudinal sociogenomic data of 8,509 European-ancestry adults between the ages of mid-60s to 70s, we found that a higher cognitive GPS significantly correlated with a slower cognitive decline specifically in memory recall, but not in other cognitive domains. Linear mixed models with cognitive GPSs explained proportions of the variances in cognitive tests up to 60.4%. This study presents the novel genetic protective effects of cognitive ability on the decline of memory recall in aging population.
Exploring the impact of regional variation on outcome prioritisation in core outcome set development: a case study in the field of gastric cancer surgery
Authors: Alkhaffaf Bilal , Metryka Aleksandra , Blazeby Jane M , Glenny Anne-Marie , Williamson Paula R , Bruce Iain A
Published: January 2021

BackgroundInternational stakeholder participation is important in the development of core outcome sets (COS). Stakeholders, however, may value health outcomes differently when regional differences are considered. Here, we explore how region, health income and participant characteristics influence prioritisation of outcomes during development of a COS for gastric cancer surgery trials (the GASTROS study).Methods952 participants from 55 countries participating in a Delphi survey during COS development were eligible for inclusion. Recruits were grouped according to region (East or West), country income classification (high and low-to-middle income) and other characteristics (e.g. patients; age, sex, time since surgery, mode of treatment, surgical approach and healthcare professionals; clinical experience). Groups were compared with respect to how they categorised outcomes (‘consensus in’, ‘consensus out’, ‘no consensus’). Outcomes categorised as ‘consensus in’ or ‘consensus out’ by all 3 stakeholder groups would be automatically included in or excluded from the COS respectively.ResultsIn total, 13 outcomes were categorised ‘consensus in’, 13 ‘consensus out’ and 31 ‘no consensus’. There was little variation in prioritisation of outcomes by stakeholders from Eastern or Western countries and high or low-to-middle income countries. There was little variation in outcome prioritisation within either health professional or patient groups.ConclusionOur study suggests that there is little variation in opinion within stakeholder groups when participant region and other characteristics are considered. This finding may help COS developers when designing their Delphi surveys and recruitment strategies. Further work across other clinical fields is needed before broad recommendations can be made.
Methods for conducting international Delphi surveys to optimise global participation in Core Outcome Set development: a case study in gastric cancer informed by a comprehensive literature review.
Authors: Alkhaffaf Bilal , Blazeby Jane M , Metryka Aleksandra , Glenny Anne-Marie , Adeyeye Ademola , Costa Paulo Matos , Val Ismael Diez del , Gisbertz Suzanne , Guner Ali , Law Simon , Lee Hyuk-Joon , Li Ziyu , Nakada Koji , Nunez Rafael Mauricio Restrepo , Reim Daniel , Reynolds John V , Vorwald Peter , Zanotti Daniela , Allum William , Chaudry Asif , Griffiths Ewen , Williamson Paula , Bruce Iain
Published: January 2021

BackgroundCore outcome sets (COS) should be relevant to key stakeholders, and widely applicable and usable. Ideally, they are developed for international use to allow optimal data synthesis from trials. Electronic Delphi surveys are commonly used to facilitate global participation; however, this has limitations. It is common for these surveys to be conducted in a single language potentially excluding those not fluent in that tongue. The aim of this study is to summarise current approaches for optimising international participation in Delphi studies and make recommendations for future practice.MethodsA comprehensive literature review of current approaches to translating Delphi surveys for COS development was undertaken. A standardised methodology adapted from international guidance derived from 12 major sets of translation guidelines in the field of outcomes reporting was developed. As a case study this was applied to a COS project for surgical trials in gastric cancer to translate a Delphi survey into 7 target languages from regions active in gastric cancer research.Results332 abstracts were screened and four studies addressing COS development in rheumatoid and osteo-arthritis, vascular malformations and polypharmacy were eligible for inclusion. There was wide variation in methodological approaches to translation, including the number of forward translations, the inclusion of back translation, the employment of cognitive debriefing and how discrepancies and disagreements were handled. Important considerations were identified during the development of the gastric cancer survey including establishing translation groups, timelines, understanding financial implications, strategies to maximise recruitment and regulatory approvals. The methodological approach to translating the Delphi surveys were easily reproducible by local collaborators and resulted in an additional 637 participants to the 315 recruited to complete the source language survey. 99% of patients and 97% of healthcare professionals from non-English speaking regions used translated surveys.ConclusionConsideration of the issues described will improve planning by other COS developers and can be used to widen international participation from both patients and healthcare professionals.
Student Nurses’ Knowledge Acquisition on Oral Medication Administration: Comparison of Lecture Demonstration Vs. Video Demonstration
Authors: Sugathapala Ravilal Devananda Udeshika Priyadarshani , Chandrika Mattaka Gamage Ruwini
Published: January 2021

BackgroundOral Medication administration is one of the paramount nursing procedures, where nurses must pay their utmost commitment. The vital aims are to reduce medication errors and ensure patient safety. The objectives of this study were to evaluate whether the nursing students could learn and retain the basic guidelines for oral medication administration when they are taught using a video-assisted teaching method compared with the lecture-demonstration method and to assess the students' attitudes towards the two types of teaching methods.MethodsThis study was conducted as a quasi-experimental study with a pre and post-test design. Forty-five students in the first year of the bachelor's degree in nursing programme participated. All the participants completed a self- administered questionnaire, including socio demographic data and questions of oral medication administration. Subsequently, participants were randomly assigned to two groups. Oral medication administration procedure was taught using two different teaching methods. Finally, the post-test knowledge scores of both groups were assessed and analysed using the paired-sample t-test.ResultsThe results revealed that there was no significant difference in terms of age, gender and type of residence of students in the two groups. When comparing the pre-test mean score and post-test mean score using paired sample t-test, there was a statistically significant difference in both video demonstration group (t = -4.533, p < 0.001) and lecture-demonstration group (t = -4.208, p < 0.001). Almost all the students obtained good knowledge scores regardless of the method used in teaching oral medication administration. However, when comparing post-test scores of both groups using an independent sample t-test, it was identified that there was no significant difference between the two groups. Therefore, it was difficult to identify which method was effective than the other. According to the student feedback obtained at the end of the study, 67% of them preferred to have more video demonstrations in their skills classes.ConclusionThe results of this study suggested that oral medication administration can be effectively taught using lecture-demonstration and video-demonstration teaching methods.
Molecular and morphological clocks for estimating evolutionary divergence times
Authors: Barba-Montoya Jose , Tao Qiqing , Kumar Sudhir
Published: January 2021

Background: Matrices of morphological characters are frequently used for dating species divergence times in systematics. In some studies, morphological and molecular character data from living taxa are combined, whereas others use morphological characters from extinct taxa as well. We investigated whether morphological data produce time estimates that are concordant with molecular data. If true, it will justify the use of morphological characters alongside molecular data in divergence time inference.Results: We systematically analyzed three empirical datasets from different species groups to test the concordance of species divergence dates inferred using molecular and discrete morphological data from extant taxa as test cases. We found a high correlation between their divergence time estimates, despite a poor linear relationship between branch lengths for morphological and molecular data mapped onto the same phylogeny. This was because node-to-tip distances showed a much higher correlation than branch lengths due to an averaging effect over multiple branches. We found that nodes with a large number of taxa often benefit from such averaging. However, considerable discordance between time estimates from molecules and morphology may still occur because some deeper nodes show a large time differences between these two types of data.Conclusions: Our findings suggest that node- and tip-calibration approaches may be better suited for nodes with many taxa. Nevertheless, we highlight the importance of evaluating the concordance of time structure in morphological and molecular data before any dating analysis using combined datasets.
Prevalence, Distribution and Antimicrobial Susceptibility Pattern of Bacterial Isolates from a Tertiary Hospital in Malawi
Authors: Kumwenda Pizga , Adukwu Emmanuel C. , Tabe Ebot S. , Ujor Victor C , Kamudumuli Pocha S. , Ngwira Maono , Wu Joseph Tsung Shu , Chisale Master R.O.
Published: January 2021

Background Bacterial infections are a significant cause of sickness and death in sub-Saharan Africa. This study aimed at establishing the prevalence, distribution and antimicrobial susceptibility pattern of major bacterial isolates from patients accessing medical care at a tertiary hospital in Malawi. Methods We retrospectively reviewed bacteria culture and antimicrobial susceptibility records for 4,617 patients from 2002 to 2014 at Mzuzu Central Hospital (MCH). No inclusion and exclusion criteria were followed. Data was analysed using excel (Microsoft office, USA) and GraphPad prism 7 software programs. Results The most prevalent isolates were S. aureus (34.7%, n = 783), Klebsiella species (17.4%, n = 393) and Proteus species (11.4%, n = 256). Most microorganisms were isolated from adults (88.3%, n = 3889) and pus was the main source (69.3%, n = 1224). S. pneumoniae was predominantly isolated from cerebrospinal fluid (60.3%, n = 44) largely collected from children (88.2%, n = 64). Overall, most bacteria exhibited high resistance to all regularly used antimicrobials excluding ciprofloxacin. Conclusions Our report demonstrates an increase in bacterial infection burden in sites other than blood stream and subsequent increase in prevalence of antimicrobial resistance for all major isolates. Creating an epidemiological survey unit at MCH will be essential to help inform better treatment and management options for patients with bacterial infections.
Effect of socio-demographic and health factors on the association between multimorbidity and acute care service use: population-based survey linked to administrative data
Authors: Fisher Kathryn Ann , Griffith Lauren , Gruneir Andrea , Upshur Ross , Perez Richard , Favotto Lindsay , Nguyen Francis , Markle-Reid Maureen , Ploeg Jenny
Published: January 2021

Background: This study explores how socio-demographic and health factors shape the relationship between multimorbidity and one-year acute care service use (i.e., hospital, emergency department visits) in older adults in Ontario, Canada. Methods: We linked multiple cycles (2005-2006, 2007-2008, 2009-2010, 2011-2012) of the Canadian Community Health Survey (CCHS) to health administrative data to create a cohort of adults aged 65 and older. Administrative data were used to estimate one-year service use and to identify 12 chronic conditions used to measure multimorbidity. We examined the relationship between multimorbidity and service use stratified by a range of socio-demographic and health variables available from the CCHS. Logistic and Poisson regressions were used to explore the association between multimorbidity and service use and the role of socio-demographic factors in this relationship.Results: Of the 28,361 members of the study sample, 60% were between the ages of 65 and 74 years, 57% were female, 72% were non-immigrant, and over 75% lived in an urban area. Emergency department visits and hospitalizations consistently increased with the level of multimorbidity. This study did not find strong evidence of moderator or interaction effects across a range of socio-demographic factors. Stratified analyses revealed further patterns, with many being similar for both services – e.g., the odds ratios were higher at all levels of multimorbidity for men, older age groups, and those with lower household income. Rurality and immigrant status influenced emergency department use (higher in rural residents and non-immigrants) but not hospitalizations. Multimorbidity and the range of socio-demographic variables remained significant predictors of service use in the regressions. Conclusions: Strong evidence links multimorbidity with increased acute care service use. This study showed that a range of factors did not modify this relationship. Nevertheless, the factors were independently associated with acute care service use, pointing to modifiable risk factors that can be the focus of resource allocation and intervention design to reduce service in those with multimorbidity. The study’s results suggest that optimizing acute care service use in older adults requires attention to both multimorbidity and social determinants, with programs that are multifactorial and integrated across the health and social service sectors.
Relationship Between ABO Blood group Phenotypes and nCOVID-19 Susceptibility – A Retrospective Observational Study
Authors: Bhandari Sudhir , Shaktawat Ajeet Singh , Tak Amit , Patel Bhoopendra , Shukla Jyotsna , Gupta Jitendra , Kakkar Shivankan , Dube Amitabh , Dia Sunita , Dia Mahendra , Wehner Todd C
Published: January 2021

Background: Since the outbreak of coronavirus disease-19 research has been continued to explore multiple facets of the disease. The objective of the present study is to evaluate the relationship between blood group phenotypes and COVID-19 susceptibility.Methods: In this hospital based, retrospective observational study 132 COVID-19 patients were enrolled from SMS Medical Hospital in Jaipur, India after receiving approval from the institutional ethics committee. The ABO, Rh and Kell blood group phenotypes along with demographic data of the patients were recorded. The observed proportions of ‘A’ , ‘B’, ‘AB’, ‘O’, ‘Rh’, and ‘Kell’ blood groups in COVID-19 patients were compared against the expected proportions (the null hypothesis) of the general population using Pearson’s chi-squared test and partition analysis.Results: There were significant differences between observed and expected frequency for the ABO and Kell blood phenotypes. Further partition analysis of ABO phenotypes showed that the group ‘A’ phenotypes were more susceptible to COVID-19. The Kell negatives were also more susceptible. The blood groups ‘AB’, ‘B’, ‘O’, and ‘Rh’ showed no significant difference for susceptibility to COVID-19.Conclusion: The study shows a relationship between ABO, Rh, and Kell blood groups and COVID-19 susceptibility. The application of these relationships in clinics should be explored in future studies.