bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficient perioperative time-management methods for operating theatres: a systematic review showing how to reduce overall patient waiting times for elective surgery
Authors: Rathnayake Dimuthu
Published: May 2021

Introduction: The effects on long waiting times for elective surgeries from lower operating theatre (OT) performance have been reported in many studies. The timeliness of perioperative processes and adherence to scheduled times is crucial for efficient performance in OT but the perioperative workflow includes multiple tasks assigned to different work teams. Each of these needs to be completed in a timely manner. This systematic review investigates the effects of efficient preoperative systems on the timeliness of upstream and downstream processes in surgical care pathways in order to reduce overall patient waiting times for elective surgery. Methods: We searched PubMed, EMBASE, SCOPUS, Web of Science and Cochrane Library databases during December 2019 and January 2020, for articles published after 1 January 2014. All studies pertaining to perioperative time-management methods, which had an intention to reduce waiting times for elective surgery were eligible for this review. Eligibility criteria included major elective surgery lists of adult patients, excluding cancer and cancer-related surgeries. Both randomized trials and non-randomized controlled studies were considered and the quality of studies was assessed using ROBINS-I and CASP tools. The review findings are presented as a narrative synthesis due to the heterogeneity of included studies. The PROSPERO registration is CRD42019158455. Results: The electronic search yielded 7543 records and 20 articles were eligible after deduplication and full article screening. There were two experimental studies, five quasi-experimental studies and 13 observational studies. The studies varied widely in design, scope, reported outcomes and overall quality. The first-case-start-time and patient change-over-time at OT were the main time related measures considered as affecting timeliness in many studies. Conclusion: This review suggests that a significant amount of time could be saved with efficient scheduling and planning perioperative processes, which could reduce overall patient waiting time for elective surgeries. Managing perioperative time in isolation could be an enabling factor for an overall increase in both theatre utilisation and theatre efficiency. However, only a small number of good quality studies were available and further evaluation with higher quality study designs and rigour is recommended in order for firm conclusions to be reached.
Preparation, Physicochemical Properties, Invitro And In Vivo Release Evaluation of Chitosan Decorated Curcumin Loaded Niosome
Authors: Salehi Sahar , Nourbakhsh Mohammad Sadegh , Yousefpour Mardali , Rajabzadeh Ghadir , Sahab-negah Sajad
Published: May 2021

Purpose: Based on several pharmacological activities of curcumin (Cn), it has been introduced as an ideal candidate for different neurological disorders. But poor solubility, rapid clearance and low stability have limited its clinical application. Development of curcumin loaded smart niosome for crossing blood brain barrier could be and interesting option to overcome these limitations.Object: The aim of this study is preparation and characterization of chitosan decorated curcumin loaded niosome(CH-CLN) and evaluation of invitro release and in vivo bioavailability and bio stability of curcumin in the brain tissue.Methods: Niosomal formulations were prepared by modified heating method by using 3-factor and 3 level mixture design. The formulations were characterized using DLS, zeta potential, Fourier transform infrared (FTIR) spectroscopy, high performance liquid chromatography (HPLC) and transmission electron microscopy(TEM). The entrapment efficiency and invitro release were also evaluated. Wistar rats were subjected to intraperitoneal injection (i. p.) of formulations, and curcumin 15 minutes before perfusion. Cn concentration in different parts of the central nervous system, liver, and plasma was analyzed for in vivo analysis.Results: Encapsulation efficiency was obtained 75% for optimized formulation and presented sustain release, followed by the Hixon-Crowell model. The particle size was about 100nm with polydispersity index (PDI) of 0.2. Chitosan decorated niosomal formulation increased Cn concentration in central nervous system.Conclusion: We can conclude the chitosan decorated curcumin loaded niosome improved bioavailability of curcumin in brain tissue and cold be a promising tool for crossing blood-brain barrier
P- and S-wave Velocity Structures and the Influence of Volcanic Activities in the East Java Area from Seismic Tomography
Authors: Ridha Syawaldin , Maryanto Sukir , Martha Agustya A. , Syahra Vanisa , Anshori Muhajir , Supendi Pepen , Widiyantoro Sri
Published: May 2021

Indonesia is one of the most interesting targets for seismic tomographic studies due to its tectonic complexity. The subduction zone was formed when the Indian oceanic plate was subducted beneath the Eurasian continental plate. This activity caused the formation of volcanoes along the Sunda Arc, including the area of East Java. In this study, we aim to identify the influence of volcanic activities which extends from the west to the east of East Java. We used the data of 1,383 earthquakes, recorded by the 22 stations of the Indonesia Tsunami Early Warning System (InaTEWS) seismic network. We relocated the earthquakes and conducted a tomographic study using SIMULPS12. We then explored the anomalies of P- and S-wave velocities and Vp/Vs ratio. The low-velocity zone was observed in the volcanic area related to the partial melting zone or magma chamber with high Vp/Vs. This zone is observed at the depth range from 27 to 155 km and is correlated with the slab of Java subduction zone. We assume that the plumbing system of volcanoes is interlinked. If it is true, this can be helpful to carry out further detailed studies regarding the continuity of the plumbing system and the volcanic arc.
Affordances of Audience Response Systems: Effects of Instant and Regular Feedback
Authors: Osorio Ricardo Tamayo , Sánchez-Mora Johanna , Corredor-Aristizábal Javier
Published: May 2021

Audience Response Systems (ARS), also known as clickers, are wireless devices commonly used in instruction. The present study explored the effects of ARS on students’ performance in an introductory psychology course. The study also described the trajectories of students during the course. Participants in the experimental group used ARS to solve ten true/false questions throughout a three-hour lecture, held once a week. They received feedback immediately after providing an answer. The control group was exposed to the same questions in a paper-and-pencil format at the beginning of each lecture. They received feedback after seven days. The key dependent variable was quantitative performance on course quizzes and exams. Results show that students in the experimental group had statistically significant superior performance compared to the control group. Additionally, analysis of learning trajectories of students in both groups showed that the ARS group gradually progressed to higher performance, whereas the paper-and-pencil group maintained similar performance through the study. These results are discussed within the context of previous findings related to the effects of ARS on instruction. Particularly, we revisit research related to environmental affordances, learning monitoring, motivational factors, feedback density, and ecological validity. .
Prospective Observational Study on Pazopanib in Patients Treated for Advanced or Metastatic Renal Cell Carcinoma in Countries in Asia Pacific, North Africa, and Middle East regions: PARACHUTE Study
Authors: Erman Mustafa , Biswas Bivas , Danchaivijitr Pongwut , Chen Lingwu , Wong Yoke Fui , Hashem Tarek , Lim Chun Sen , Karabulut Bulent , Chung Hsiao-Jen , Chikatapu Chandra , Ingles Sara , Slimane Khemaies , Kanesvaran Ravindran
Published: May 2021

Background: Clinical effectiveness and safety data of pazopanib in patients with advanced or mRCC in real-world setting from Asia Pacific, North Africa, and Middle East countries are lacking.Methods: PARACHUTE is a phase IV, prospective, non-interventional, observational study. Primary endpoint was the proportion of patients remaining progression free at 12 months. Secondary endpoints were ORR, PFS, safety and tolerability, and relative dose intensity (RDI).Results: Overall, 190 patients with a median age of 61 years (range: 22.0-96.0) were included. Most patients were Asian (70%), clear-cell type RCC was the most common (81%), with a favourable (9%), intermediate (47%), poor (10%), and unknown (34%) MSKCC risk score. At the end of the observational period, 78 patients completed the observational period and 112 discontinued the study; 60% of patients had the starting dose at 800 mg. Median RDI was 82%, with 52% of patients receiving <85%. Of the 145 evaluable patients, 56 (39%) remained progression free at 12 months, and the median PFS was 10 months (95% CI: 8.48-11.83). 19% of patients (21/109) were long-term responders (on pazopanib for ≥18 months). The best response per RECIST 1.1 was CR/PR in 24%, stable disease in 44%, and PD in 31%. Most frequent (>10%) TEAEs related to pazopanib included diarrhoea (30%), palmar-plantar erythrodysesthesia syndrome (15%), and hypertension (14%).Conclusions: Results of the PARACHUTE study support the use of pazopanib in patients with advanced or mRCC who are naive to VEGF-TKI therapy. The safety profile is consistent with that previously reported by pivotal and real-world evidence studies.
Evaluation the performance of conventional water-based mud characteristics by applying Zinc Oxide and Silica Dioxide Nanoparticles materials for a selected well in The Kurdistan/ Iraq
Authors: AlBajalan Ahmed Rafiq , Haias Huner
Published: May 2021

Nanomaterials have gained a wide interest in the oil and gas industry due to its immense applicability. Nanomaterial is being used for formulating a new generation of drilling mud which is known as Nano- mud. Where it has the ability to improve mud properties and eliminate bore hole problems. Using nanoparticles as an additive agent in conventional drilling mud can lead to a more efficient drilling process in troublesome formations. In this experimental study, several conventional water-based muds from a selected well drilled in the Kurdistan / Iraq oil field have been prepared. Then nano-drilling muds were formulated by dispersing SiO2 and ZnO nanoparticles in concentrations ranging from (0.25 to 1 wt.%) to conventional water-based mud (WBM). The objective of this experimental study is evaluating and comparing the performance of conventional water-based muds after adding SiO2 and ZnO nanoparticles. This comparison was performed by carrying out a series of laboratory experiments to determine the rheological and mud filtrate properties. The results demonstrated that adding SiO2 and ZnO NPs to conventional water-based mud improved the rheological behavior and provided better filtration control compared to conventional drilling muds. However, there was little or no impact of nanomaterials on the mud density for all mud systems.
Combined small cell lung carcinoma with pulmonary adenocarcinoma
Authors: shen cheng , Guowei Che
Published: May 2021

Background

Combined SCLC is defined as SCLC combined with an additional component that consists of any of the histological types of non-SCLC, usually squamous cell carcinoma or large cell carcinoma. CSCLC contains adenocarcinoma is extremely rare and has been reported to account for less than 1–3% of CSCLC.
Case presentation:

We report a case with a rare and surgically treated CSCLC with adenocarcinoma in an elderly and concerned with the clinical features of this disease. The patient has remained well for over 2 weeks after the treatment without any signs of disease recurrence.
Conclusion

Combined small cell carcinoma is uncommon, but is nevertheless a well-described diagnostic category in lung cancers. To facilitate the preoperative diagnosis and avoid the misdiagnosis of such rare disease, more cases will need to be reported.
Experimental Investigation on Map-Environment Disparity to the Performance of Image-Retrieval-Based Localization
Authors: Takahashi Junji , Shimmra Kohei , Yu Yong , Shibata Akihiro , Sakamoto Toshiaki
Published: May 2021

This paper deals with a problem of map-based localization. When a robot has a pre-constructed map of an environment and explores there with sensing, the localization problem boils down to the problem of finding the closest data pattern to the sensing data from the map. Although, the map quality as well as the sensing data quality greatly affects to the localization performance, however it has been rarely discussed up to this point. To study the influence of the map quality to the localization performance, we propose a simulational experiment using an architectural 3D CAD models. We prepared a precisive 3D CAD model imitating a corridor of elementary school and generated a 3D wireframe map and virtual sensing images from the CAD model. The precisive 3D CAD model is regarded as the ground-truth data through the whole experiments. Then, we prepared several levels of broken maps with randomly shifted joinery parts such as, doors and windows. For localization process, our previously developed image-retrieval based localization method is used. Totally 3,500 number of localization experiments are conducted with various broken map setting. We show the influence of map-environment disparity to the localization performance by comparing these experimental results and discuss the requirements of map quality.
Different Montages of Transcranial Direct Current Stimulation on Dual-Task Walking and Cortical Activity in Chronic Stroke: Double-Blinded Randomized Controlled Trial
Authors: Wong Pei-Ling , Yang Yea-Ru , Tang Shun-Chang , Huang Shi-Fong , Wang Ray-Yau
Published: May 2021

Background: Transcranial direct current stimulation (tDCS) is a noninvasive brain stimulation to modulate cortical activity for improving motor function. However, the different tDCS applications for modulating cortical activity and dual task gait performance in chronic stroke have not yet been investigated. This study investigated the effects of different tDCS applications on dual task gait performance and contralesional M1 activation in chronic stroke.Methods: Forty-eight participants were randomized to anodal, bilateral, cathodal, and sham tDCS groups. Each group received 20 mins of tDCS stimulation, except the sham group. Gait performance was measured by GaitRite system during cognitive dual task (CDT) walking, motor dual task (MDT) walking, and single walking (SW). Contralesional M1 activity of unaffected tibialis anterior (TA) was measured using transcranial magnetic stimulation (TMS). Intragroup difference was analyzed by Wilconxon sign ranks test with Bonferroni correction, and Kruskal-Wallis one-way analysis of variance by ranks was used for intergroup comparisons, followed by post-hoc Mann-Whitney U tests with Bonferroni correction.Results: The bilateral tDCS (p=0.017) and cathodal tDCS (p=0.010) improved the CDT walking speed more than sham group. The bilateral tDCS (p=0.048) and cathodal tDCS(p=0.048) also improved the MDT walking speed more than sham group. Furthermore, bilateral tDCS (p=0.012) and cathodal tDCS (p=0.040) increased the silent period (SP) more than the anodal and sham group. Thus, one-session of bilateral and cathodal tDCS improved dual task walking performance paralleled with increasing contralesional corticomotor inhibition in chronic stroke.Conclusions: Our results indicate that one-session of bilateral and cathodal tDCS increased contralesional corticomotor inhibition and improved dual task gait performance in chronic stroke. Trial registration: Thai Clinical Trials Registry (TCTR20180116001). Registered on 16th Jan, 2018.
­­­­GMP-conform production of [ 68Ga ]Ga-NeoB for positron emission tomography imaging of patients with gastrointestinal stromal tumor
Authors: Pretze Marc , Reffert Laura , Diehl Steffen , Schönberg Stefan O. , Wängler Carmen , Hohenberger Peter , Wängler Björn
Published: May 2021

Background: [68Ga]Ga-NeoB is a novel DOTA-coupled Gastrin Releasing Peptide Receptor (GRPR) antagonist with high affinity for GRPR and good in vivo stability. This study aimed at (1) the translation of preclinical results to the clinics and establish the preparation of [68Ga]Ga-NeoB using a GMP conform kit approach and a licensed 68Ge/68Ga generator and (2) to explore the application of [68Ga]Ga-NeoB in patients with gastrointestinal stromal tumors (GIST) before and/or after interventional treatment (selective internal radiotherapy, irreversible electroporation, microwave ablation).Results: Validation of the production and quality control of [68Ga]Ga-NeoB for patient use had to be performed before starting the GMP production. Six independent batches of [68Ga]Ga-NeoB were produced, all met the quality and sterility criteria and yielded 712 ± 73 MBq of the radiotracer in a radiochemical yield of >50%, a radiochemical purity of >95% and a molar activity of 14.2 ± 1.5 GBq/µmol within 20 min synthesis time and additional 20 min quality control. Three patients (2 females, 1 male, 51–77 yrs of age) with progressive gastrointestinal stromal tumor metastases in the liver or peritoneum not responsive to standard tyrosine kinase inhibitor therapy underwent both [68Ga]Ga-NeoB scans prior and after interventional therapy. Radiosynthesis of 68Ga-NeoB was performed using a kit approach under GMP conditions. No specific patient preparation such as fasting or hydration was required for [68Ga]Ga-NeoB PET/CT imaging. Contrast-enhanced PET/CT studies were performed. A delayed, second abdominal image was acquired at 120 minutes p.i. of admistration of the first dose of [68Ga]Ga-NeoB.Conclusions: A fully GMP compliant kit preparation of [68Ga]Ga-NeoB enabling the routine production of the tracer under GMP conditions was established for clinical routine PET/CT imaging of patients with metastatic GIST and proved to adequately visualize tumor deposits in the abdomen expressing GRPR. Patients could benefit from additional information derived by [68Ga]Ga-NeoB diagnosis to assess the presence of GRPR in the tumor tissue and monitor antitumor treatment.
Radiolabeling of Iranian Androctonus crassicauda Scorpion Venom with Technetium-99m for Biological Studies
Authors: Yekany Leila Valipour , Mofrad Farshid Babapour , Shirmardi Seyed pezhman , Erfani Mostafa , Mirakabadi Abbas Zare
Published: May 2021

Background: Androctonus crassicauda has a neurotoxin venom that can affect most of the vital organs of the body and result in death. In this study 99mTc-labeling and biological evaluation of Androctonus crassicauda scorpion venom are described.Method: In this research, Toxic fraction of this venom was labelled with 99mTc. Radiochemical purity of the labelled toxic fraction was obtained by using chromatographic system. Animal biodistribution studies were performed after injection of labelled compound into normal rats.Results: Radiochemical purity was obtained more than 90%. Biodistribution studies in normal rats showed moderate clearance of blood circulation system. The results of the study indicated that scorpion venom labeling with 99mTc can be a useful tool for the biodistribution and kinetic studies of the venoms for clinical use.
Long-term outcome of postpartum psychosis: a prospective clinical cohort study in 106 women
Authors: Rommel Anna-Sophie , Molenaar Nina Maren , Gilden Janneke , Kushner Steven A. , Westerbeek Nicola J. , Kamperman Astrid M. , Bergink Veerle
Published: May 2021

Objective: We aimed to investigate the outcome of postpartum psychosis over a four-year follow-up, and to identify potential clinical markers of mood/psychotic episodes outside of the postpartum period. Methods: One hundred and six women with a diagnosis of first-onset mania or psychosis during the postpartum period were included in this prospective longitudinal study. Women were categorized into either 1) recurrence of non-postpartum mood/psychotic episodes or 2) mania/psychosis limited to the postpartum period. We summarize the longitudinal course of the illness per group. We used a logistic regression model to identify clinical predictors of recurrence of mood/psychotic episodes outside of the postpartum period. Results: Over two thirds of the women included in this study did not have major psychiatric episodes outside of the postpartum period during follow-up. The overall recurrence rate of mood/psychotic episodes outside the postpartum period was ~33%. Of these women, most transitioned to a bipolar disorder diagnosis. None of the women fulfilled diagnostic criteria for schizophrenia or schizophreniform disorder. No clinical markers significantly predicted recurrence outside of the postpartum period. Conclusions: For the majority of women with first-onset postpartum psychosis, the risk of illness was limited to the period after childbirth. For the remaining women, postpartum psychosis was part of a mood/psychotic disorder with severe non-postpartum recurrence, mainly in the bipolar spectrum. No clinical predictors for risk of severe episodes outside the postpartum period emerged. Our findings add to previous evidence suggesting a fundamental link between postpartum psychosis and bipolar disorder, which may represent two distinct diagnoses within the same spectrum.
REBOARREST, resuscitative endovascular balloon occlusion of the aorta in non-traumatic out-of-hospital cardiac arrest: a study protocol for a randomised, parallel group, clinical multicentre trial
Authors: Brede Jostein Rødseth , Skulberg Arne Kristian , Rehn Marius , Thorsen Kjetil , Klepstad Pål , Tylleskär Ida , Farbu Bjørn , Dale Jostein , Nordseth Trond , Wiseth Rune , Krüger Andreas Jørstad
Published: May 2021

Background Survival after out-of-hospital cardiac arrest (OHCA) is poor and dependent on high-quality cardiopulmonary resuscitation. Resuscitative endovascular balloon occlusion of the aorta (REBOA) may be advantageous in non-traumatic OHCA due to the potential benefit of redistributing the cardiac output to organs proximal to the aortic occlusion. This theory is supported by data from both preclinical studies and human case reports. Methods This multicentre trial will enrol 200 adult patients, who will be randomised in a 1:1 ratio to either a control group that receives advanced cardiovascular life support (ACLS) or an intervention group that receives ACLS and REBOA. The primary endpoint will be the proportion of patients who achieve return of spontaneous circulation with a duration of at least 20 minutes. The secondary objectives of this trial are to measure 30-day survival with good neurological status, to describe the haemodynamic physiology of aortic occlusion during ACLS, and to document adverse events. Discussion Results from this study will assess the efficacy and safety of REBOA as an adjunctive treatment for non-traumatic OHCA. This novel use of REBOA may contribute to improve treatment for this patient cohort. Trial registration The trial is approved by the Regional Committee for Medical and Health Research Ethics in Norway (reference 152504) and is registered at ClinicalTrials.gov (reference NCT04596514) and as Universal Trial Number WHO: U1111-1253-0322.
Highly Hydrophilic Ultrafiltration Membranes Synthesized From Acrylic Acid Grafted Polyethersulfone For Downstream Processing Of Therapeutic Insulin And Cobalamin
Authors: Nandala Shiva Prasad , Nimmagadda Lakshmi Gayatri , Bala Naga Sandhya , Swayampakula Kalyani , Sundergopal Sridhar
Published: May 2021

The significance of the present study is to purify small therapeutic biomolecules such as urea, cobalamin, and insulin of molecular weights below 10 kDa through surface grafted polyethersulfone (PES) ultrafiltration (UF) membranes. The membranes were synthesized by adding an additive of 6 kDa polyethylene glycol (PEG) and grafted with acrylic acid (AA) by varying the concentrations from 2 to 6 wt. % under UV-induce phtocataltic reaction. These membranes were characterized by various tools such as Scanning electron microscope ((SEM), Fourier transforms infrared spectra (FTIR), thermogravimetric analysis (TGA), and contact angle for membrane morphological, structural, thermal stability, and hydrophilicity, respectively. The degree of grafting and their MWCOs of the indigenous membranes were analyzed using various molecular weight solutions of PEG. After PEG doping, the PWF of the membrane was enhanced to 41.50 L m− 2 h− 1 for PES [6+] [0], and a similar trend was also observed for the PEG doped PES grafted membranes. From the experimental results, the synthesized membranes of additive loaded with 5 and 6 wt. % AA grafted PES reject 90 % of the insulin and cobalamin. The results are found to be in correlation with the MWCO values of these membranes ranging from 1 to 10 kDa. From the overall characterization and experimental observations, it can be confirmed that these indigenously synthesized flat sheet grafted membranes showed excellent permeabilities and higher % rejection towards the therapeutic biomolecules.
Effect of Monotherapy Weifuchun Tablets on Chronic Atropic Gastritis: A Randomized Controlled Trial
Authors: He Jiamin , Shen Weiyi , Zhang Yawen , Hu Mengjia , Fang Yanfei , Deng Yanyong , Chen Shujie , Wang Lan , Mo Jianling
Published: May 2021

Background and Aim:

Chronic atrophic gastritis is a common gastric disease which shows a positive correlation with the occurrence of gastric cancer. Traditional chinese medicines have been used in the treatment of chronic atrophic gastritis. There is no solid evidence for the curative effects of traditional chinese medicines. This study aimed to investigate the clinical efficacy of Weifuchun tablets on patients with chronic atrophic gastritis.
Methods

97 patients of chronic atrophic gastritis without current H. pylori infection were divided into two groups: an experiment group treated with Weifuchun and a control group treated with teprenone and folic acid for six months. Pathological examination of gastric biopsies and clinical symptoms assessment were performed for all patients before and after treatments. Primary outcome was the pathological response rate in each group evaluated by changes of histological scores.Secondary outcome was the clinical symptom scores.
Results

Twenty four patients in the Weifuchun group and twenty eight patients in the control group completed the study. The pathological response rates for atrophy and intestinal metaplasia were 66.7% and 45.8% in the Weifuchun group and 66.7% and 42.9% in the folic acid group, respectively, without statistical significance between groups.Clinical symptoms failed to improve after treatments in either group.
Conclusions

Weifuchun is effective to improve pathological changes of chronic atrophic gastritis in patients without current H. pylori infection. Monotherapy of Weifuchun had a similar efficacy to the combined therapy by teprenone and folic acid in the treatment of chronic atrophic gastritis.
Trial registration:

Evaluation of Weifuchun Pills on chronic atrophic gastritis, ChiCTR-IPR-17013939, Registered 15 December 2017, http://www.chictr.org.cn/ showproj.aspx?proj = 23910.
Identical Shapes Results in a Failed Memory Formation of Location of Dark Surroundings in Planarians
Authors: Huang Kaiyuan
Published: May 2021

Planarians, the first kind of animal to have evolved a brain structure yet has not evolved vision, were demonstrated to have a capability of spatial learning in the last several decades, but what does the navigation of planarians depends on is still unknown. Here, we provide an objective, strictly variable-controlled planarian training method using 3D printing techniques fabricated mazes. Then we use modifications of the mazes to first demonstrate a learning paradigm that worms can memorize the location of a darkened surrounding through training. However, a memory formation failure was found that in the situation of providing identical shapes in a maze, planarians cannot memorize the location of the darkened surrounding. Thus, this result shows the planarians associated darkness with the crude shape of the objects they’ve crawled, which is a kind of spatial learning. This finding not only provides a key insight into spatial learning information that planarians are processing, but also an interpretation of the origin of memory formation where higher grades of memory formation might originate from.
Clinical characteristics of late recurrence in granulosa cell tumor of ovary
Authors: Zheng Yawen , Gu Ying , Zhang Wenjin , Yang Xingsheng , Dong Ruiying
Published: May 2021

Objective: To explore the clinical features and treatment of 22 patients with recurrent ovarian granulosa cell tumor (GCT). Methods: The clinical data of 22 females with recurrent ovarian GCT and received treatments in Qilu hospital were retrospectively analyzed. Results: During the recurrence interval, late recurrence (≥5 years) appeared in 14 patients, early recurrence (<5 years) were in 8 patients. Among the 22 recurrent patients, 8 cases had second relapses during the time of follow-up. Of the 14 late recurrent cases, 10 cases had FIGO stage Ⅰ cancers, 4 had stage Ⅲ cancers. Among the 8 early recurrent GCT cases, 5 had FIGO stage Ⅰ cancers. FIGO stage and whether performed fertility-sparing surgery or not had significant impacts on the recurrence type (P =0.035 and 0.016, respectively). Conclusions: The intervals of GCT recurrence are usually long after the initial diagnosis. Continuous long-term follow-up is absolutely required, especially for those with early stage and complete surgery.
Use of a Feedback Device in Simulated Cardiopulmonary Arrest can improve cardiopulmonary resuscitation better than training
Authors: Zeng Rong , Liu Daoquan , Ma Haoli , Lin Lian , Zhou Xianlong , Zhao Yan , Jin Xiaoqing
Published: May 2021

Background:High-quality cardiopulmonary resuscitation (CPR) is the basis of successful cardiac arrest resuscitation, but the bystanders often perform inadequate compressions.Objective:To determine whether the use of an audiovisual feedback (AVF) device during cardiopulmonary resuscitation(CPR) training or a simulated cardiopulmonary arrest (CPA) scenario is more conducive to improving the quality of chest compression (CC).Methods:A total of 160 participants from Wuhan University and senior clinical medicine undergraduates who had not participated in any CPR training before and had no actual CPR experience were recruited.They were randomly divided into the following 4 groups.First,all participants practiced on the Resusci Anne QCPR manikin during CPR training. All participants practiced at least 3 cycles of CC each time (Group C and Group D received the AVF device) until they passed the assessment. Finally, they took part in a 2-minute continuous CC during simulated CPA (Group B and Group D received the AVF device)Results:CC quality was improved with the AVF device during simulated CPA. With the AVF device compared with no AVF device improved depth compliance during simulated CPA by 22.8% (P<0.001) and rate compliance by 11.3% (P=0.003). The use of the AVF device during CPR training resulted in a –2.6% (P =0.61) change in appropriate CC depth compliance compared with no AVF device. At the same time, there was a –1.3% (P = 0.724) change in compliance with rate guidelinesConclusion:Use of a feedback device in simulated cardiopulmonary arrest can improve cardiopulmonary resuscitation better than training.
Identification of a novel epithelial-mesenchymal transition-related gene signature for the prognosis prediction of endometrial carcinoma
Authors: Ruan Tianyuan , Wan Jing , Liu Li , Song Qian , Chen Peigen , Li Xiaomao
Published: May 2021

Background Endometrial cancer (EC) is the most prevalent gynecological malignant tumor worldwide. The prognosis of EC patients with distant metastasis is poor. Epithelial‐mesenchymal transition (EMT) plays a crucial role in tumor invasiveness and metastasis. the expression profile of EMT-related gene and their prognostic value and therapy target potential have not been systematically explored in endometrial cancer.MethodThe RNA-Seq expression profile and corresponding clinical data of EC patients were downloaded from The Cancer Genome Atlas database and the Gene Expression Omnibus (GEO) databases. A 9 EMT-related genes (EPHB2, TUFT1, CDKN2A, ONECUT2, RBP2, KLF8, E2F1, SIX1, ERBB2) prognosis risk model of EC was built by combining a machine learning algorism and multivariate Cox regression. Estimation of STromal and Immune cells in MAlignant Tumor tissues using Expression data (ESTIMATE) and Cibersort was applied to acquire for tumor purity and immune cell infiltration of high and low risk group. Also, response to immune checkpoint blockades (ICB) therapy and drug sensitivity were separately evaluated in TIDE and GDSC database for the EC patients.ResultA 9 prognostic EMT-related genes (ERGs) signature was constructed according to TCGA-UCEC and then verified in the GEO dataset. EC Patients were assigned to high- and low-risk group according to the signature, and significant survival difference were discovered between the two groups. Furthermore, ERGs signature was identified as an independent prognostic factor in the multivariate Cox regression and the ROC curve revealed a high sensitivity and specificity to the model (0.78 at 2 years and 0.83 at 5 years). Furthermore, quantitative prognostic nomogram was constructed to predict survival time in EC patients. This ERGs signature was also significantly correlated with tumor purity and immune cell infiltration, which in compliance to the prediction that clinical response to ICB therapy were better in the high-risk group base on TIDE database. In addition, 8 chemical components which the high-risk group may be more sensitive to were screened out and analyzed.Conclusions We identified a novel EMT‐related gene signature for predicting prognosis of EC patients and molecular understanding of EMT and immune microenvironment of EC. This may facilitate the decision-making during EC treatment.
Comprehensive Analysis of Eph-Ephrin as Novel DLBC Biomarkers for Molecular Subtyping and the Predictability in Prognosis and Drug Response
Authors: Li Xiaoxi , Zhang Chenxiao , Deng Minyao , Qian Hui
Published: May 2021

Background: Receptor tyrosine kinases (RTKs) are key signal molecules for sustaining proliferative signaling and abnormal of RTKs appears in many cancers, including Lymphoid Neoplasm Diffuse Large B-cell Lymphoma (DLBC).Methods: Cluster analysis based on RNA-seq and RPPA data were calculated to establish novel signature for molecular subtyping of DLBC. Principal component analysis (PCA) was used to evaluation relationship of selected genes.Results: EPHB4, EPHB6, EFNA3, EFNA4, EFNB1 are 5 specific genes in DLBC and their expression level are significantly relevant to poor prognosis. Integration analysis of DLBC Expr-Ab signature discovered five DLBC related Eph-Ephrin genes may be involved in epigenetic regulation in DLBC progress. Four novel clusters based on Expr-Ab are generated and we first link five Eph-Ephrin to well-defined oncogenes as following: EPHB4-BCL6; EFNA3/EFNA4-MYC; EPHB6-EZH2; EFNB1-Epigenetic modulators. Drug response data involving 13 traditional and targeting drugsConclusions: Expr-Ab signature we established in this study indicates the power of both RNA-seq and RPPA data in developing and evaluating precision regimens. We also highlight Eph-Ephrin, as surface proteins, are powerful potentially biomarkers. Our finding underlines Eph-Ephrin as biomarkers for predicting prognosis and precision regimen for patients with lymphoma.
Identification of Multi-omics Biomarkers and Construction of the Novel Prognostic Model for Hepatocellular Carcinoma
Authors: Yan Xiaokai , Xiao Chiying , Yue Kunyan , Chen Min , Zhou Hang
Published: May 2021

Background: Change in the genome plays a crucial role in cancerogenesis and many biomarkers can be used as effective prognostic indicators in diverse tumors. Currently, although many studies have constructed some predictive models for hepatocellular carcinoma (HCC) based on molecular signatures, the performance of which is unsatisfactory. To fill this shortcoming, we hope to construct a novel and accurate prognostic model with multi-omics data to guide prognostic assessments of HCC. Methods: The TCGA training set was used to identify crucial biomarkers and construct single-omic prognostic models through difference analysis, univariate Cox, and LASSO/stepwise Cox analysis. Then the performances of single-omic models were evaluated and validated through survival analysis, Harrell’s concordance index (C-index), and receiver operating characteristic (ROC) curve, in the TCGA test set and external cohorts. Besides, a comprehensive model based on multi-omics data was constructed via multiple Cox analysis, and the performance of which was evaluated in the TCGA training set and TCGA test set. Results: We identified 16 key mRNAs, 20 key lncRNAs, 5 key miRNAs, 5 key CNV genes, and 7 key SNPs which were significantly associated with the prognosis of HCC, and constructed 5 single-omic models which showed relatively good performance in prognostic prediction with c-index ranged from 0.63 to 0.75 in the TCGA training set and test set. Besides, we validated the mRNA model and the SNP model in two independent external datasets respectively, and good discriminating abilities were observed through survival analysis (P < 0.05). Moreover, the multi-omics model based on mRNA, lncRNA, miRNA, CNV, and SNP information presented a quite strong predictive ability with c-index over 0.80 and all AUC values at 1,3,5-years more than 0.84.Conclusion: In this study, we identified many biomarkers that may help study underlying carcinogenesis mechanisms in HCC, and constructed five single-omic models and an integrated multi-omics model that may provide effective and reliable guides for prognosis assessment and treatment decision-making.
Reducing exposure to COVID-19 by improving access to fever clinics: An empirical research of the Shenzhen area of China
Authors: Yong Qing , Liu Dinglong , Li Guoqi , Wu Wanshan , Sun Wenjie , Liu Sijing
Published: May 2021

Background:The current 2019 coronavirus disease (COVID-19) pandemic is hitting citizen's life and health like never before, with its significant loss to human life and a huge economic toll. In this case, the fever clinics (FCs) were still preserved as one of the most effective control measures in China, but this work is based on experience and lacks scientific and effective guidance. Here, we use travel time to link facilities and populations at risk of COVID-19 and identify the dynamic allocation of patients’ medical needs, and then propose the optimized allocation scheme of FCs。Methods:We selected Shenzhen, China, to collect geospatial resources of epidemic communities (ECs) and FCs to determine the ECs' cumulative opportunities of visiting FCs, as well as evaluate the rationality of medical resources in current ECs. Also, we use the Location Set Covering Problem (LSCP) model to optimize the allocation of FCs and evaluate efficiency. Results:Firstly, we divide the current ECs into 3 groups based on travel time and cumulative opportunities of visiting FCs within 30 minutes: Low-satisfied communities (22.06%), medium- satisfied communities (59.8%), and high-satisfied communities (18.14%) with 0,1-2 and no less than 3 opportunities of visiting FCs. Besides, our work proposes two allocation schemes of fever clinics through the LSCP model. Among which, selecting secondary and above hospitals as an alternative in scheme 1, will increase the coverage rate of hospitals in high-satisfied and medium-satisfied communities from 59.8 percent to 80.88 percent. In scheme 2, selecting primary and above hospitals as an alternative will increase the coverage rate of hospitals in medium-satisfied and large-satisfied communities to 85.29 percent, with the average travel time reducing from 22.42 minutes to 17.94 minutes.Conclusions: The optimized allocation scheme can achieve two objectives: a. equal access to medical services for different types of communities has improved while reducing the overutilization of high-quality medical resources. b. the travel time for medical treatment in the community has reduced, thus improving medical accessibility. On this basis, during the early screening in prevention and control of the outbreak, the specific suggestions for implementation in developing and less developed countries are made.
Application of CD54 in Diagnosing Bone Marrow Involvement by using Flow Cytometry in Patients with Diffuse Large B-cell Lymphoma
Authors: Wang Wei , Li Yan , Rivera Xavier Rivera , Zhao Linjun , Mei Di , Hu Wenqing , Bin Jiang
Published: May 2021

BackgroundFlow cytometry plays a key role in detecting bone marrow (BM) involvement in patients with diffuse large B-cell lymphoma (DLBCL). To improve its detection sensitivity, we need to explore novel markers. In this study, we detected the expression CD54 on lymphoma cells in BM specimens from DLBCL patients and clarified its diagnostic significance in BM involvement by DLBCL.MethodsWe collected BM specimens from 76 patients with DLBCL (germinal center B-cell (GCB) = 25, non-GCB = 51) and 10 control patients without lymphoma. We detected and compared the expression of CD54 on lymphoma cells and normal mature B cells by using 10-color panels. ResultsNormal plasma cells expressed a higher level of CD54 as compared with hematogones (p < 0.05) and normal mature B cells (p < 0.05). Lymphoma B cells expressed a higher level of CD54 compared to normal mature B cells (p < 0.05). Additionally, lymphoma cells of the non-GCB subtype frequently expressed a higher level of CD54 in comparison to the GCB subtype (p < 0.05). And the high expression of CD54 was not related to plasmacytoid differentiation. ConclusionAberrant expression of CD54 on lymphoma cells is frequently seen in patients’ BM specimens involved by DLBCL, especially in the non-GCB subtype. CD54 could be used as a new marker to gate on lymphoma cells and improve the detection sensitivity of BM involvement in patients with DLBCL.
Increased glucosylceramide production leads to decreased cell energy metabolism and lowered tumor marker expression in non-cancerous liver cells
Authors: Wegner Marthe-Susanna , Schömel Nina , Olzomer Ellen M , Trautmann Sandra , Olesch Catherine , Byrne Frances L , Brüne Bernhard , Gurke Robert , Ferreirós Nerea , Weigert Andreas , Geisslinger Gerd , Hoehn Kyle L
Published: May 2021

Hepatocellular carcinoma (HCC) is one of the most difficult cancer types to treat. Liver cancer is often diagnosed at late stages and therapeutic treatment is frequently accompanied by development of multidrug resistance. This leads to poor outcomes for cancer patients. Understanding the fundamental molecular mechanisms leading to liver cancer development is crucial for developing new therapeutic approaches, which are more efficient in treating cancer. Mice with a liver specific UDP-glucose ceramide glucosyltransferase (UGCG) knockout (KO) show delayed diethylnitrosamine (DEN)-induced liver tumor growth. Accordingly, the rationale for our study was to determine whether UGCG overexpression is sufficient to drive cancer phenotypes in liver cells. We investigated the effect of UGCG overexpression (OE) on normal murine liver (NMuLi) cells. Increased UGCG expression results in decreased mitochondrial respiration and glycolysis, which is reversible by treatment with EtDO-P4, an UGCG inhibitor. Furthermore, tumor markers such as FGF21 and EPCAM are lowered following UGCG OE, which could be related to glucosylceramide (GlcCer) and lactosylceramide (LacCer) accumulation in glycosphingolipid-enriched microdomains (GEMs) and subsequently altered signaling protein phosphorylation. These cellular processes lead to decreased proliferation in NMuLi/UGCG OE cells. Our data show that increased UGCG expression itself does not induce pro-cancerous processes in normal liver cells, which indicates that increased GlcCer expression leads to different outcomes in different cancer types.
Effects of changes of osteocyte shape on fluid flow and fluid shear stress of loaded bone
Authors: Yu WeiLun , Huo Xuyang , Li Hongliang , Yang Fengjian , Qi Qiuju , Wu Xiaogang , Chen Weiyi
Published: May 2021

Background: Load-induced pressure gradients (PG) result in interstitial fluid flow in bone tissue, which is not only provides sufficient nutrient supply and metabolic pathway for the bone cells, but also enables bone cells to accept external mechanical signals. Methods: We calculate the number and distribution of bone canaliculus around the osteocyte based on the varying shape of osteocyte, and then use these calculated parameters and other microstructure data of bone tissue to estimate the anisotropy permeability of the lacunar–canalicular. Finally, according to the calculated parameters, the poroelastic finite element models of the osteon are established, and the influence of the osteocyte shape on the fluid flow properties of osteon under the axial displacement load is analyzed. Two kinds of boundary conditions are considered on the cement line of osteon, elastic restrained (BC1) and displacement confined (BC2). Results: In the range of parameters we studied, the changes of osteocyte shape (Case1-Case6) make the maximum value of PG, pore pressure (PP), fluid velocity (FV) and fluid shear stress (FSS) 33.36%, 67.67%, 8.6% and 26.6% larger than the Reference model in BC1, respectively. And the maximum value of PG, PP, FV and FSS are 65.39%, 67.67%, 8.4% and 29% larger than reference model in BC2. The maximum PG, PP, FV and FSS in BC2 are 96.72%, 95.51%, 97.87% and 97.13% larger than that in BC1, respectively. The permeability of elongated osteocyte model (Case 3, Case 4 and Case 6) have a difference of one magnitude order in X and Y direction. Conclusion: The changes of osteocyte shape has a significant impact on the degrees of anisotropy for fluid flow and porous media of osteon. This model can facilitate better accurately quantifying the fluid flow in lacuna-canalicular system.
Design of logic configuration platform for large power grid security and stability simulation based on object-oriented
Authors: Xuetao Yang , Dunwen Song , Shiying Ma
Published: May 2021

In response to the multi-state simulation business process requirements of large power grids in actual engineering, this paper designs a set of logic configuration platform for large power grid security and stability simulation. In order to improve the application adaptability of the existing configuration software, firstly, the overall architecture and visual operation interface design of the large power grid security and stability simulation logic configuration platform were proposed. Secondly, the key technology of realization of generalized large-scale power grid simulation logic configuration platform was discussed in depth from the aspects of logic compilation and engine implementation. Based on the configuration platform, the innovative application of the intelligent large-scale grid operation arrangement system is realized. System development replaces the engineering customization mode of conventional manual software coding with visual logic configuration mode, which greatly improves the engineering adaptability of multi-state large power grid simulation business requirements.