bluuebunny/crossref_metadata_2025 huggingface dataset:
Diagnostic accuracy of symptoms as a diagnostic tool for SARS-CoV 2 infection: a cross-sectional study in a cohort of 2,173 patients 
Authors: Romero-Gameros Carlos Alfonso , Colin-Martínez Tania , Waizel-Haiat Salomón , Vargas-Ortega Guadalupe , Ferat-Osorio Eduardo , Guerrero-Paz José Alberto , Intriago-Alor Marielle , López-Moreno Mayra Alejandra , Cuevas-García Carlos Fredy , Zubieta Victoria Mendoza , Martínez-Ordaz Jose Luis , González-Virla Baldomero
Published: February 2021

Background: The SARS-CoV-2 pandemic continues to be a priority health problem; According to the World Health Organization data from October 13, 2020, 37,704,153 confirmed COVID-19 cases have been reported, including 1,079,029 deaths, since the outbreak. The identification of potential symptoms has been reported to be a useful tool for clinical decision-making in emergency departments to avoid overload and improve the quality of care. The aim of this study was to evaluate the performances of symptoms as a diagnostic tool for SARS -CoV-2 infection.Methods: An observational, cross-sectional, prospective and analytical study was carried out, during the period of time from April 14 to July 21, 2020. Data (demographic variables, medical history, respiratory and non-respiratory symptoms) were collected by emergency physicians. The diagnosis of COVID-19 was made using SARS-CoV-2 RT-PCR. The diagnostic accuracy of these characteristics for COVID-19 was evaluated by calculating the positive and negative likelihood ratios. A Mantel-Haenszel and multivariate logistic regression analysis was performed to assess the association of symptoms with COVID-19.Results: A prevalence of 53.72% of SARS-CoV-2 infection was observed. The symptom with the highest sensitivity was cough 71%, and a specificity of 52.68%. The symptomatological scale, constructed from 6 symptoms, obtained a sensitivity of 83.45% and a specificity of 32.86%, taking ≥ 2 symptoms as a cut-off point. The symptoms with the greatest association with SARS-CoV-2 were: anosmia odds ratio (OR) 3.2 (95% CI; 2.52-4.17), fever OR 2.98 (95% CI; 2.47-3.58), dyspnea OR 2.9 (95% CI; 2.39-3.51]) and cough OR 2.73 (95% CI: 2.27-3.28).Conclusion: The combination of ≥ 2 symptoms / signs (fever, cough, anosmia, dyspnea and oxygen saturation <93%, and headache) results in a highly sensitivity model for a quick and accurate diagnosis of COVID-19, and should be used in the absence of ancillary diagnostic studies. Symptomatology, alone and in combination, may be an appropriate strategy to use in the emergency department to guide the behaviors to respond to the disease.Trial registration: Institutional registration R-2020-3601-145, Federal Commission for the Protection against Sanitary Risks 17 CI-09-015-034, National Bioethics Commission: 09 CEI-023-2017082.
Urine Specimen Collection For Diagnosing a Urinary Tract Infection-Patient Experience and Preference For Urine Specimen Collection: A Qualitative Study
Authors: Collins Linda , Khasriya Rajvinder , Malone-Lee James
Published: February 2021

Background A urinary tract infection (UTI) is very common and patients frequently present to their General Practitioner and emergency department with symptoms. Diagnosis of the infection is made by examining fresh urine with microscopy, to detect white cells and epithelial cells shed from the bladder or by submitting the urine for microbial culture. Patients are often requested to provide a urine specimen, but very little is known about the patient experiences of carrying out the task or their preference of specimen collection method. The aim of this study was to explore patient experiences and preferences between four different urine specimen collection methods for diagnosing the presence of a UTI.Materials Semi-structured interviews were conducted and explored patient experiences of four different urine specimen collection methods (midstream urine specimen (MSU), catheter specimen (CSU), Peezy MSU™ and Natural void). The interviews consisted of four open-ended questions and all data were collated and organised using NVivo to establish themes that emerged from the data.Results The natural void without technique was repeatedly referred to and was regarded as being the most straightforward of all of the sampling methods. Pain symptoms were described only in the catheter method and not in the MSU, Peezy MSU™ or natural void method. The catheter was regarded as the urine collection method that produced the best specimen for diagnostic testing by the patients’. Conclusion A majority of the participants expressed the desire for straightforward urine sampling methods and preferred the natural void as a standard method in clinical practice.
Perfluorooctanoic Acid Exposure in Early Pregnancy Induces Oxidative Stress in The Uterus and Liver in Mice
Authors: Zhang Yan , Zhang Linchao , Bao JiaLu , Liu LianTao , Wang Xiaodan
Published: February 2021

To investigate the mechanism perfluorooctanoic acid (PFOA)’s toxicity on the uterus and liver of the mice during early pregnancy, pregnant mice were given 0, 1, 5, 10, 20, 40 mg/kg PFOA daily by gavage from gestational day (GD) 1-7, and sacrificed on GD 9. Uterus and liver weight were recorded, liver and uterine indexes were calculated, histopathological changes of the liver and uterus were examined, and levels of malondialdehyde (MDA), superoxide dismutase (SOD), and glutathione peroxidase (GSH-PX) in liver were detected by spectrophotometric method. Expression of FAS, FASL, Bax, Bcl-2, and Caspase-3 in decidual cells were detected by immunohistochemistry and the TUNEL method was used to detect apoptotic uterine cells. Results showed that liver weight increased, and the uterus index was significantly reduced at 40 mg/kg compared with the control group. With increasing doses of PFOA, levels of SOD and GSH-PX were significantly decreased, and MDA significantly increased in liver tissue. 20 mg/kg and 40 mg/kg of PFOA caused greater harm to the uterus and congestion and resorption may occur. Expression of FAS, FASL, Bax, and Caspase-3 in decidual cells of the uterus in PFOA treatment groups significantly increased in a dose-dependent manner. The expression of Bcl-2 was down-regulated, which decreased the ratio of Bcl-2/Bax. It is therefore proposed that oxidative damage may be one of the mechanisms by which PFOA induces liver toxicity, and a subsequent increase in uterine cell apoptosis may induce embryo loss or damage.
Forced Swimming and Crocin Supplementation Protects Rat Cardiomyocytes From H2O2‐Induced Apoptosis
Authors: Akbari Mina , Shahidi Fereshteh , Rajabi Hamid , Kashef Majid
Published: February 2021

Introduction: Oxidative stress and hypoxia/reperfusion can damage cells and lead to apoptosis in cardiomyocytes. Physical activities and antioxidants supplementations have shown to have potent anti-apoptotic properties. This study aimed to determine the interactive effect of forced swimming and Crocin supplementation on apoptotic and anti-apoptotic cardiomyocytes gene expression in male rats infected with H2O2.Methods: Thirty-six male Wistar rats were divided randomly into six groups of sham, control, H2O2, H2O2+forced swimming, H2O2+ Crocin, H2O2+ forced swimming, and H2O2+ forced swimming+ Crocin. The forced swimming protocol was two stages. Crocin injected a dose of 12.5 mg/kg through the intraperitoneal route. Real-time PCR was used to reveal the expression of Bcl2, Bax, and Caspas3 genes. Also, apoptosis was evaluated by TUNEL staining.Results: H2O2 exposure was associated with a significant increase in the apoptotic gene expression of BAX and caspase3 and a decrease in anti-apoptotic BCL-2 gene expression. Administration of Crocin and six weeks of forced swimming resulted in a significant decrease in the expression of BAX. Also, treatment accompanied by forced swimming and Crocin significantly reduced the expression of caspase3 and increased BCL-2 expression as compared to the H2O2 group.Conclusion: Our results reveal that regular forced swimming and Crocin consumption led to a significant reduction in gene expression of BAX and caspase3 and the significant increase in anti-apoptotic gene expression of BCL-2 in rats' cardiomyocytes.
FMRI Functional Connectivity Evaluation in Alzheimer’s Stages: Linear and Non-Linear Approaches
Authors: Ahmadi Hessam , Fatemizadeh Emad , Nasrabadi Ali Motie
Published: February 2021

Neuroimaging data analysis reveals the underlying interactions in the brain. It is essential, yet controversial, to choose a proper tool to manifest brain functional connectivity. In this regard, researchers have not reached a definitive conclusion between the linear and non-linear approaches, as both have pros and cons. In this study, to evaluate this concern, the functional Magnetic Resonance Imaging (fMRI) data of different stages of Alzheimer’s disease are investigated. In the linear approach, the Pearson Correlation Coefficient (PCC) is employed as a common technique to generate brain functional graphs. On the other hand, for non-linear approaches, two methods including Distance Correlation (DC) and the kernel trick are utilized. By the use of the three mentioned routines and graph theory, functional brain networks of all stages of Alzheimer’s disease (AD) are constructed and then sparsed. Afterwards, graph global measures are calculated over the networks and a non-parametric permutation test is conducted. Results reveal that the non-linear approaches have more potential to discriminate groups in all stages of AD. Moreover, the kernel trick method is more powerful in comparison to the DC technique. Nevertheless, AD degenerates the brain functional graphs more at the beginning stages of the disease. At the first phase, both functional integration and segregation of the brain degrades, and as AD progressed brain functional segregation further declines. The most distinguishable feature in all stages is the clustering coefficient that reflects brain functional segregation.
Prognostic Value of Neutrophil To Lymphocyte Ratio In Acute Ischemic Stroke Patients Treated With Intravenous Thrombolysis: A Meta-Analysis
Authors: Wang Chengbing , Zhang Qian , Ji Mingwei , Mang Jing , Xu Zhongxin
Published: February 2021

Background: The neutrophil to lymphocyte ratio (NLR) has been shown to be an important independent inflammatory indicator in stroke. The relationship between NLR and poor prognostics in acute ischemic stroke (AIS) patients who received intravenous thrombolysis (IVT) still unclear. The purpose of this meta-analysis was to evaluate the association between NLR and poor prognosis after IVT. Furthermore, we aim to concluded whether admission NLR or post-IVT NLR play a role in AIS.Methods: Pubmed, Embase, Wed of Science and China National Knowledge Infrastructure were searched for relevant articles until October 7, 2020. Cohort and case-control studies were included if related to NLR in AIS patients treated with IVT. Odds ratios (ORs) and 95% confidence intervals (95% CIs) were pooled to estimate the relationship between NLR and poor prognosis after IVT. A random effects model was used to calculate the pooled data.Results: Twelve studies, including 3641 patients met the predefined inclusion criteria. Higher NLR levels were associated with an increased risk of hemorrhagic transformation (HT) (OR=1.33,95%CI=1.14-1.56, P<0.001) and 3-month poor functional outcome (OR=1.64,95%CI=1.38-1.94, P<0.001) in AIS patients receiving IVT. Subgroup analysis of HT suggested that admission NLR levels rather than post-IVT NLR levels was associated with higher risk of HT (OR=1.33,95%CI=1.01-1.75, P=0.039). But There had no statistically significant difference between higher NLR levels and 3-month mortality (OR=1.14, 95%CI=0.97-1.35, P=0.120).Conclusions: High NLR can predict HT and 3-month poor functional outcome in AIS patients received IVT. Admission NLR rather than post-IVT NLR was independent risk factor of increased risk of HT.
The Comparison Between Certainty Factor Method and Index of Entropy Method For Landslide Hazard Assessment: South Western Chamba District, Himachal Pradesh, India
Authors: Pandey Desh Deepak , Banshtu Rajeshwar Singh , Mahajan Ambrish Kumar , Versain Laxmi Devi
Published: February 2021

The present study reflects the contributions of geo-environmental factors that were analyzed for the development of landslide hazard zonation map using certainty factor method and index of entropy method. Heavy rainfall, unscientific excavation of slopes during road construction, expansion of infrastructure, and unplanned growth in urban population were the major factors for unstable slopes in the Lesser Himalayan region. Historical database, interpretation of satellite and Google earth images were used to identification of 248 landslides. The data collected using remote sensing images have been verified by conducting ground truth surveys undertaken from January 2018 to October 2020 in preparing the landslide inventory of the study area. Inventory thus generated was divided into 70% training and 30% validation datasets. Relationships between slope failure and its causative factors (relief, slope, aspect, curvature, lithology, soil, weathering, land use, lineament density, rainfall, and density of drainage networks) were analyzed by using certainty factor (CF) and index of entropy (IOE) methods. The analysis of all causative factors and assigning relative weightage values by using the index of entropy and certainty factor models leads to the generation of Landslide hazard zonation maps of the region. Finally, the landslide prediction accuracy of hazard zonation maps was calculated by drawing Successive Rate Curve (SRC) curves for both training and validation datasets. The outcomes of this study will be useful to government agencies, planners, decision-makers, researchers, and general land-use planners for sustainable development of the study area.
Litter-Fall Production, Decomposition and Elemental (Ca, K, Mn, Fe, Zn and Co) Cycling in Deciduous Sal (Shorea Robusta) Forest in Bangladesh
Authors: Sultana Razia , Saifullah ASM , Khan Rahat Khan , Diganta Mir Talas Mahammad
Published: February 2021

The litters in the forest floor are the principal contributor for regulating the cycling of necessary elements, primary productivity and maintain soil fertility within the forest ecosystems. Therefore, this study was conducted in a deciduous forest of Bangladesh to ascertain the leaf-litter production and decomposition along with elemental dynamics (K, Ca, Mn, Fe, Co and Zn). Leaf-litter samples from five deciduous plant species and soil samples were collected from the Madhupur Sal Forest for about six months (July-December) in 2018. Production of leaf-litter during the dry season (December) was found in an order of Shorea robusta>Dipterocarpus indicus>Terminalia bellirica>Tectona grandis>Grewia microcos. The decomposition rates were higher for the long sampling period (90 days) followed by the intermediate (60 days)> short(30 days) sampling period. The nutrient release pattern from the leaf-litter was similar (Ca>K>Mn>Fe>Zn>Co) for all plant species except for Terminalia bellirica and Tectona grandis. The Pearson correlation coefficients showed a significant relationship between K and Fe (r=0.54; p<0.05), Ca and Co (r=0.59; p<0.01), Fe and Co (r=0.97; p<0.05) in leaf-litters. Analysis of variance (ANOVA) revealed significant variation in the litter production, decomposition and nutrient content (except Zn; p>0.05) among the different plant species (p<0.05). There revealed a significant dynamic of necessary elements from soil to trees and vice-versa.
Molecular Investigation of Brain Tumors Progressing During Pregnancy or Postpartum Period: The Association Between Tumor Type, Their Receptors, and the Timing of Presentation
Authors: Ichimura Saeko , Ohara Kentaro , Kono Maya , Mizutani Katsuhiro , Kitamura Yohei , Saga Isako , Kanai Ryuichi , Akiyama Takenori , Toda Masahiro , Kohno Michihiro , Yoshida Kazunari , Sasaki Hikaru
Published: February 2021

Brain tumors are frequently present during pregnancy; however, the mechanism has not been well elucidated. Purpose of this study is to investigate the influence of molecular genetic factors on the progression of brain tumors during pregnancy or the postpartum period. Twelve cases of brain tumors that presented during pregnancy or postpartum period were included: five gliomas, three meningiomas, two vestibular schwannomas, and two chordomas. Tumor samples were investigated by metaphase comparative genomic hybridization and immunohistochemistry, for chromosomal copy number aberration (CNA) and receptor expression of sex hormones and growth factors. The results were correlated with the timing of tumor presentation in relation to the stage of pregnancy. EGFR, VEGFR-1/2, AR, and c-Myc were expressed in gliomas, PgR, ER, HER-2, VEGFR-1, EGF and VEGFR2 in meningiomas, VEGFR-1 in vestibular schwannomas, and EGFR, VEGFR-1/2, and c-Myc in chordomas. The CNAs of the tumors varied. Four of the five gliomas presented in the 2nd trimester, all three meningiomas in the 3rd trimester or postpartum period, and both of the two schwannomas in the late 2nd trimester. Expression of VEGFR-1/2 and EGFR was observed regardless of the timing of tumor presentation, whereas female hormone receptors and HER-2 were exclusively found in meningiomas. Interestingly, one anaplastic astrocytoma (IDH mut, non-codeleted) that progressed from precedent grade 2 tumor harbored amplification of the MYC locus. Progression of brain tumors during pregnancy is associated with various growth factors as well as sex hormones. The timing of presentation is likely dependent on molecular　receptors specific to each tumor type.
Long-Term Effects of Perfluorooctanoic Acid (PFOA) and Perfluorooctane Sulfonic Acid (PFOS) on Soil Microbial Community
Authors: Tao Wan , Xu Rui , Lin Hanzhi , Huang Duanyi , Su Pingzhou , Gao Pin , Sun Xiaoxu , Yang Zhaohui , Sun Weimin
Published: February 2021

The extensive application of perfluoroalkyl and polyfluoroalkyl substances (PFASs) causes their frequent detection in various environments. Nevertheless, the effects of PFASs exposure on environmental microorganisms still remain unknown. In current work, two typical PFASs, perfluorooctanoic acid (PFOA) and perfluorooctanesulfonic acid (PFOS), are selected to investigate their long-term effects on soil microbes. Microbial community structure and diversity were investigated by high-throughput sequencing and multiple statistical methods. Under 90-days of exposure, PFAS treatments increased the alpha-diversity of soil microbial communities with PFOS treatment, followed by PFOA treatment. The long-term exposure of PFASs substantially changed the compositions of soil microbial communities. The most abundant phylum Proteobacteria decreased from 82.9% (without amended PFASs) to 62.1% (with PFOA treatment) and 77.8% (with PFOS treatment). As a comparison, the relative abundance of Bacteroidetes, Chloroflexi, Acidobacteria, and Ignavibacteriae increased in the PFOA or PFOS groups. Comparative co-occurrence networks were constructed to investigate the biotic interactions in the two treatments. It was found that most taxonomy nodes in the PFOA and PFOS networks were associated with the genus Hydrogenophaga and Pseudoxanthomonas, respectively. The LEfSe analysis identified a set of core taxonomies (e.g., Azospirillum, Methyloversatilis, Ancylobacter, Hydrogenophaga, and Methylomonas) in the soil microbial communities and suggested their different preferences to PFAS exposures. Functional gene prediction suggested that the microbial metabolism processes, such as nucleotide transport and metabolism, cell motility, carbohydrate transport and metabolism, energy production and conversion, and secondary metabolites biosynthesis transport and catabolism, might be significantly inhibited under PFAS exposure, which may further affect soil ecological services.
Treatment Patterns of Newly Diagnosed Asthma Patients in an Urban Setting in China: A Retrospective Longitudinal Real World Evidence Study
Authors: Hu Zhizhen , Xuan Jianwei , Zhao Haijin , Dong Hangming , Yu Changhui , Gao Yue , Li Liran , Hu Xiaohan , xi Cai Shao
Published: February 2021

Background: Asthma is prevalent but largely undiagnosed and undertreated in China. Despite readily available effective therapies, the outcomes still leave much to be desired. There is a scarcity of data describing the treatment patterns of patients with newly diagnosed asthma in real world settings. The main goal of this study was to investigate treatment patterns of newly diagnosed asthma patients with up to 1 year follow-up to gain a better understanding of gaps of optimal asthma management in China.Methods: We conducted a large-scale of retrospective cohort analysis of asthma treatment for newly diagnosed patients using an electronic medical record database (SuValue). Eligible patients were at least 14 years old at the diagnosis from 2001 to March 2019. We categorized anti-asthmatic medication use by its classes and documented their use by the underlying disease severity. To examine the use of controlled medications over follow-ups, we summarized their utilization over consecutive 3-month time windows from the initial diagnosis to the end of follow-up. Results: A total of 26,301 patients from tertiary (25.24%), secondary (71.83%) and primary (2.92%) hospitals were included in the study; 54.01% received one or more controller medications during the study period and 30.4% had 12 months of follow-up visits. Initial prescriptions were inhaled corticosteroid (ICS)-containing controller treatment (13.9%), other controller treatment (31.59%), anti-asthmatic relivers (23.76%), symptomatic medications (14.54%) and no medication (16.2%). Patients mostly discontinued their controller prescriptions within 6 months after the initial diagnosis. Of the 45.98% patients not receiving any controller medication, 70.16% used relivers or symptomatic medications during follow-up visits. In patients who had 12-month follow-up visits, 76.86%, 17.25%, 5.88% were deemed to have mild, moderate, and severe asthma, respectively, during the 1st 3 months. Percentages of severe and moderate asthma patients were halved by the 2nd 3-month landmark and remained stable over the remaining follow-up visits. There were significant differences in asthma treatment between tertiary and secondary hospitals.Conclusion: In newly diagnosed asthma patients, controller medications were significantly underused while symptom-relief drugs, on the other hand, appeared to be overused. Poor adherence to current guidelines were common and more noticeable in lower tiered hospitals. These findings call for needs of more aggressive asthma management and more educational efforts in China.
Extracellular CIRP Activates the IL-6Rα/STAT3/Cdk5 Pathway in Neurons
Authors: Sharma Archna , Brenner Max , Jacob Asha , Marambaud Philippe , Wang Ping
Published: February 2021

Extracellular cold-inducible RNA-binding protein (eCIRP) stimulates microglial inflammation causing neuronal damage during ischemic stroke and is a critical mediator of alcohol-induced cognitive impairment. However, the precise role of eCIRP in mediating neuroinflammation remains unknown. In this study, we report that eCIRP activates neurotoxic cyclin-dependent kinase-5 (Cdk5)/p25 through the induction of IL-6Rα/STAT3 pathway in neurons. Amyloid b (Aβ)-mediated neuronal stress, which is associated with Alzheimer’s disease, increased levels of eCIRP released from BV2 microglial cells. The released eCIRP levels from BV2 cells increased 3.2-fold upon stimulation with conditioned medium from Neuro-2a (N2a) cells containing Aβ compared to control N2a supernatant in a time-dependent manner. Stimulation of N2a cells and primary neurons with eCIRP upregulated the neuronal Cdk5 activator p25 expression in a dose- and time-dependent manner. eCIRP directly induced neuronal STAT3 phosphorylation and p25 increase via its novel receptor IL-6Rα. Next, we showed using surface plasmon resonance that eCIRP-derived peptide C23 inhibited the binding of eCIRP to IL-6Rα at 25 mM, with a 40-fold increase in equilibrium dissociation constant (Kd) value (from 8.08 x 10-8 M to 3.43 x 10-6 M), and completely abrogated the binding at 50 mM. Finally, C23 reversed the eCIRP-induced increase in neuronal STAT3 phosphorylation and p25 levels. In conclusion, the current study demonstrates that upregulation of neuronal IL-6Rα/STAT3/Cdk5 pathway is a key mechanism of eCIRP’s role in neuroinflammation and that C23 as a potent inhibitor of this pathway, has translational potential in neurodegenerative pathologies controlled by eCIRP.
The Protective Effects of Endogenous PACAP in Oxygen-induced Retinopathy 
Authors: Kvarik Timea , Werling Dora , Vaczy Alexandra , Kovari Petra , Szabo Edina , Kovacs Krisztina , Reglodi Dora , Hashimoto Hitoshi , Ertl Tibor , Gyarmati Judit , Atlasz Tamas
Published: February 2021

Purpose: Pituitary adenylate cyclase-activating polypeptide (PACAP) is a neuropeptide having trophic and protective functions in neural tissues including the retina. Previously we have shown that intravitreal PACAP administration can maintain retinal structure in the animal model of retinopathy of prematurity (ROP). The purpose of this study is to examine the development of ROP in PACAP-deficient and wild-type mice to reveal the function of endogenous PACAP. Methods: Wild-type and PACAP-KO mouse pups at postnatal day (PD) 7 were maintained at 80% oxygen for 5 consecutive days then returned to room air on PD12 to develop oxygen-induced retinopathy (OIR). On PD15 animals underwent electroretinography (ERG) to assess visual function. On PD16 eyes were harvested for either immunohistochemistry to determine the percentage of central avascular retinal area and neovascular tuft formation or molecular analysis to assess angiogenesis proteins by array kit and antiapoptotic protein kinase B (Akt) change by western blot. Results: The retina of PACAP deficient OIR mice showed greater central avascular area than that of the wild types. ERG revealed significantly decreased b-wave amplitude in PACAP KO compared to their controls. Several angiogenic proteins were upregulated as a results of OIR and 11 further proteins markedly increased in PACAP deficient mice. Conclusion: This is the first study to examine the endogenous effect of PACAP in OIR model. Previously we have shown the beneficial effect of exogenous local PACAP treatment in the rat OIR model. Together with the present findings we suppose that PACAP could be a novel retinoprotective agent in ROP.
Myocardial Area at Risk and Salvage in reperfused acute MI Measured by Texture Analysis of Cardiac T2 Mapping and Its Prediction Value of Functional Recovery in the Convalescent Stage
Authors: Fan Zi-yang , Wu Chong-wen , An Dong-Aolei , Chen Bing-hua , Wesemann Luke , Yue Ting , He Jie , Hu Jia-ni , Bu Jun , Xu Jian-rong , Wu Lian-Ming
Published: February 2021

To assess the ability of distinguishing the area at risk (AAR) and evaluating the prognostic abilities of T2-mapping texture analysis (TA) in reperfused acute MI, 106 patients who were diagnosed with AMI and treated with percutaneous coronary intervention (PCI) underwent acute (less than five days) enhanced cardiac magnetic resonance imaging. Of these patients, 45 of them had a subsequent CMR scan following recovery (after at least three months). Cine imaging, T2-Mapping, T2-weighted STIR imaging, and LGE imaging were performed. In the TA, regions of interest (infarcted, salvageable, and remote) were drawn by two blinded, independent readers based on LGE and T2-weighted imaging. Seven independent texture features on T2-Mapping were selected: Perc.50%, S(2,2)InvDfMom, S(2.-2)AngScMom, S(4,0)Entropy, 45dgrLngREmph, 45dgr_Fraction and 135dr_GLevNonU. Among them, 45dgr_LngREmph, 45dgr_Fraction and 135dr_GLevNonU showed more promise. The average value of 135dr_GLevNonU in the infarct zone, AAR zone, and the remote zone was: 61.96 ± 26.03, 31.811 ± 18.933 and 99.839 ± 26.231, respectively. Additionally, 135dr_GLevNonU provided the highest 0.855(± 0.083) area under the curve (AUC) from the receiver operating characteristic curve (ROC curve) for distinguishing AAR from the infarct zone. The AUC for differentiating AAR from the remote zone is 0.942 ± 0.041. Texture features are not associated with convalescent decreased strain or ejection fraction (EF) (p > 0.05) in the standard regression analysis; and cannot predict left ventricle remodeling (LVR) in the logistic regression analysis (p > 0.05). T2-mapping TA in reperfused AMI can distinguish AAR from both the infarct zone and the remote myocardial zone without LGE imaging. However, these features cannot predict patients’ functional recovery in the convalescent stage.
Computing the Bond Strength of 3D Printed Polylactic Acid Scaffolds in Mode I and II Using Experimental tests, Finite Element Method and Cohesive Zone Modeling
Authors: Nazemzadeh Nogol , Soufivand Anahita Ahmadi , Abolfathi Nabiollah
Published: February 2021

The advent of the Three-Dimensional (3D) printing technique, as an Additive Manufacturing (AM) technology, made the manufacture of complex porous scaffolds plausible in the tissue engineering field. In Fused Deposition Modeling (FDM) based 3D printing, layer upon layer deposition of filaments produces voids and gaps, leading to a crack generation and loose bonding. Cohesive Zone Model (CZM), a fracture mechanics concept, is a promising theory to study the layers bond behavior. In this paper, a combination of experimental and computational investigations was proposed to obtain bond parameters and evaluate the effect of porosity and microstructure on these parameters. First, we considered two different designs for scaffolds beside a non-porous Bulk design. Then, we performed Double Cantilever Beam (DCB) and Singe Lap Shear (SLS) tests on the 3D printed samples for Modes I and II, respectively. Afterward, we developed the numerical simulations of these tests using the Finite Element Method (FEM) to obtain CZM bond parameters. Results demonstrate that the initial stiffness and cohesive strength were pretty similar for all designs in Mode I. However, the cohesive energy for the Bulk sample was approximately four times of porous samples. Furthermore, for Mode II, the initial stiffness and cohesive energy of the Bulk model were five and four times of porous designs while their cohesive strengths were almost the same. Also, using cohesive parameters was significantly enhanced the accuracy of FEM predictions in comparison with fully bonded assumption. It can be concluded that for the numerical analysis of 3D printed parts mechanical behavior, it is necessary to obtain and suppose the cohesive parameters. The present work illustrates the effectiveness of CZM and FEM combination to obtain the layer adhesive parameters of the 3D printed scaffold.
Impacts of the COVID-19 Pandemic on Ambient Air Quality in China: Atox Quasi-difference-in-difference Approach
Authors: ZHANG Tuo , Tang Maogang
Published: February 2021

The novel coronavirus pandemic (COVID-19) outbreak has provided a distinct opportunity to explore the mechanisms by which human activities affect air quality and pollution emissions. We conduct a quasi-difference-in-differences (DID) analysis of the impacts of lockdown measures on air pollution during the first wave of COVID-19 pandemic in China. Our study covers 367 cities from the beginning of the lockdown on January 23, 2020 until April 22, two weeks after the lockdown in epicenter was lifted. Static and dynamic analysis of the average treatment effects of treated effects is conducted for the air quality index (AQI) and six criteria pollutants. The results indicate that, first, on average, the AQI decreased by about 7%. However, it was still over the threshold of the World Health Organization (WHO). Second, we detect heterogeneous changes in the level of different pollutants, which suggests heterogeneous impacts of the lockdown on human activities: carbon monoxide (CO) had the biggest drop of about 30% and nitrogen dioxide (NO2) had the second-biggest drop of 20%. In contrast, ozone (O3) increased by 3.74% due to the improvement of visibility. We project that it would reduce the premature deaths related to air pollution by 150 thousand nationwide during the research period, which is much larger than the death due to COVID-19 infections. Third, air pollution rebounded immediately after the number of infections dropped, which indicates a swift recovery of human activities. This study provides insights for the implementation of environmental policies in China and other developing countries.JEL codes: Q51, Q52, Q53
Impact of ARDS Etiology on the Failure of Noninvasive Ventilation and 28-Day Mortality: A Multicenter Prospective Observational Study
Authors: Shu Weiwei , Guo Shuliang , Yang Fuxun , Liu Bicui , Zhang Zhongxing , Liu Xiaoyi , Chen Baixu , Huang Tao , Li Liucun , Wang Ke , He Dehua , Chen Qimin , Wei Bilin , Chen Lijuan , Tang Manyun , Yuan Guodan , Mao Min , Tang ZhiJun , Ding Fei , Ge Wenpin , Han Xiaoli , Zhang Rui , Jiang Lei , Bai Linfu , Duan Jun
Published: February 2021

Background: The failure rate of noninvasive ventilation (NIV) remains high in patients with acute respiratory distress syndrome (ARDS). The etiology of ARDS may play an important role in NIV failure.Methods: A multicenter prospective observational study was performed in 17 ICUs in China from September 2017 to December 2019. ARDS patients who used NIV as a first-line therapy were enrolled. The etiology of ARDS was recorded at study entry. Results: A total of 306 patients were enrolled. Of the patients, 146 were classified as having pulmonary ARDS (ARDSp) and 160 were classified as having extrapulmonary ARDS (ARDSexp). NIV improved PaO2/FiO2 from initiation to 24 h of NIV in both groups. However, it improved more slowly in patients with ARDSp than in those with ARDSexp (interaction effect: p < 0.01). ARDSp patients experienced more NIV failure (55% vs. 28%; p < 0.01) and higher 28-day mortality (47% vs. 14%; p < 0.01). The multivariate Cox regression also showed that ARDSp was independently associated with NIV failure (hazard ratio [HR] = 2.81, 95% confidence interval [CI]: 1.89-4.18) and 28-day mortality (HR = 7.49, 95% CI: 4.32-13.01). After propensity matching, 62 patients remained in each group. The baseline data were comparable between the two groups. ARDSp was still independently associated with NIV failure and 28-day mortality (HR = 2.62, 95%CI: 1.49-4.61; and 5.70, 2.59-12.55, respectively). Sensitivity analysis also confirmed these results. Conclusions: Among ARDS patients who used NIV as a first-line therapy, ARDSp was associated with slower improvement in oxygenation, more NIV failure, and higher 28-day mortality than ARDSexp.
Structural, Mechanical and Electrical Properties of Sputter Coated Copper Thin Films on Poly Ethylene Terephthalate 
Authors: Atta A. , Abdeltwab E. , Bek Alpan
Published: February 2021

Copper (Cu) thin films are deposited on polyethyleneterephthalate (PET) substrate using ion-beam-sputtering technique. The formation of Cu thin films is successful confirmed as investigated by X-ray diffraction (XRD). Surface morphology of Cu/PET is studied by atomic force microscopy (AFM). The AFM results show that Cu film dewets PET surface and the surface roughness increased from 22.6 nm for PET to 45.3 nm after 40min of deposited Cu/PET. The sheet resistance decreases from 5.16x104Ω to 1.3x104Ω and resistivity decreases from 2.3x10-2Ω.cm to 1.77x10-2Ω.cm, as the Cu deposition time increases from 20min to 60min. The Young’s modulus increases from 2.82GPa to 2.96GPa and the adhesion force enhanced from 14.7nN to 29.90nN after 40min of Cu deposition. The DC electrical conductivity at 300V is improved from 1.75x10-8 S.cm-1 to 3.57x10-8 S.cm-1 after 60min of Cu deposition. The results show that ion beam deposition of Cu on flexible PET platform clearly exhibits improvement over pristine PET in the mechanical and electrical properties which renders it useful for electronics applications.
Valuation of Ecosystem Services: Insight From Lake Malombe, Malawi
Authors: MAKWINJA RODGERS , Mengistou Seyoum , Kaunda Emmanuel , Alemiew Tena , Njaya Friday
Published: February 2021

Lake Malombe is endowed with a variety of ecosystem services (ES) that have a considerable economic value. This study used, a combination of market-based and value transfer techniques to evaluate the lake ES. The results showed that the annual economic value of Lake Malombe ES is estimated at US$ 40.68million, equivalent to US$635.63/hh/yr. The ecosystem provisioning service (EPS) is ranked the highest (87.45%) in terms of contribution, followed by biodiversity (8.64%), flood regulation (3.70%) then carbon sequestration, culture, and aesthetic services. The ES quality index ranks culture and aesthetic services as the lowest suggesting that investment in the tourism industry in Lake Malombe is not much advanced. Although this study did not take into account all ES components such as non-use values and other regulatory services, the estimated total annual ES value of US$ 40.68million derived from Lake Malombe provides a strong basis for a need to design an economic incentive model to encourage the local communities to take responsibility for managing the lake. Any decline in the supply of ES can eventually worsen poverty and push the local population to desperately over depend on EPS and degrade even the areas deemed to be conserved for future generations thereby creating a vicious circle of poverty and ecosystem disservices. This study provides a significant insight into the trade-offs between ES and diverse stakeholders. Balancing the interest of local communities given the importance of EPS in sustaining their livelihoods and that of global communities is required to effectively manage the lake.
Consequences of Long-term Exposure to Increased Salinity on the Amphibian Skin Bacterium Erwinia Toletana
Authors: Gabriel Antonieta , Costa Sara , Henriques Isabel , Lopes Isabel
Published: February 2021

Amphibian’s skin bacterial community may help them to cope with several types of environmental perturbations, including osmotic stress caused by increased salinity. This work aimed at assessing if an amphibian skin bacterium could increase its tolerance to NaCl after a long-term exposure to this salt. A strain of Erwinia toletana, isolated from the skin of Pelophylax perezi, was exposed to two salinity scenarios (of 18g/L of NaCl): (i) long-term exposure (for 46 days; Et-NaCl) and (ii) long-term exposure followed by a recovery period, (exposure for 30 days to NaCl and then to LB medium for 16 days; Et-R). After exposure, the sensitivity of E. toletana clonal populations to NaCl was assessed by testing 6 NaCl concentrations (LB medium spiked with NaCl) plus a control (LB medium). Genotypic alterations were assessed by PCR-based molecular typing method (BOX-PCR). Results shown that tolerance of E. toletana to NaCl slightly increased after the long-term exposure, EC50 for growth were: 22.5g/L (8.64-36.4) for Et-LB; 30.3g/L (23.2-37.4) for Et-NaCl, and 26.1g/L (19.3-32.9) for Et-R. Differences in metabolic activity were observed between Et-LB and Et-R and Et-NaCl and Et-R suggesting the use of different substrates by this bacterium when exposed to salinized environments. NaCl-induced genotypic alterations were not detected. This work suggests that E. toletana exposed to low levels of salinity, activate different metabolic pathways to cope with osmotic stress. Which may be further explored to be used in bioaugmentation procedures in natural populations of amphibians exposed to salinization.
Informed Consent in the U.S. Indigenous Peoples Context: A Systematic Literature Review 
Authors: Gross Tasha , Lefthand-Begay Clarita
Published: February 2021

BACKGROUND: Tribal communities in the United States (U.S.) have a long history of subjection to unethical and exploitive medical and research practices. Today, many Tribal nations are establishing procedures in order to protect themselves from further harm and to advance culturally informed research practices. These procedures are also meant to ensure that their communities benefit from research conducted within their communities. Informed consent is a key element in protecting human subjects, but it may not be sufficient in the tribal context, as its conception is rooted in Western understandings of protection. Specifically, the informed consent emphasizes the individual, rather than the community as a whole, which is just as important in the context of conducting research with Native communities.METHODS: We conduct a systematic literature review to answer two related questions: How is informed consent being conceived of by U.S. tribes? And how is informed consent being required by U.S. tribes? Our inclusion criteria include articles focusing on informed consent within the U.S. tribal context, written in English in 2010-2020. Articles that did not fit our inclusion criteria were excluded. Two reviewers independently reviewed and coded 30 peer-reviewed articles by using content analysis and, in an iterative process, agreed on emerging codes and themes. RESULTS: A number of themes arise in the selected literature, including the conception of informed consent as a process, its operation at various levels (individual, collective, and government-to-government), possible alternatives to informed consent, and the need for specificity about ownership of samples and data, benefits and/or risks, and the methods and procedures that researchers use in the course of study.CONCLUSIONS: Our key results point to a need for clear and transparent information for prospective research participants and for consent forms and processes to include the collective, as well as the individual. This will better align with the cultural values and political standing of sovereign tribes in the U.S.
Serum Lactate Dehydrogenase Level As a Predictor Of Survival For Patients With Acute Exacerbation of Idiopathic Interstitial Pneumonias Undergoing Polymyxin B-Immobilized Fiber Column-Direct Hemoperfusion
Authors: Kato Motoyasu , Nakazawa Shun , Akimoto Takashi , Soma Soichiro , Eri Hayakawa , Arai Yuta , Tateyama Misa , Motomura Hiroaki , Yamada Tomoko , Ochi Yusuke , Sumiyoshi Issei , Watanabe Junko , Ihara Hiroaki , Togo Shinsaku , Sasaki Shinichi , Azuma Arata , Takahashi Kazuhisa
Published: February 2021

BackgroundAcute exacerbation of chronic fibrosing idiopathic interstitial pneumonias (AE-IIPs) is known to be associated with a poor prognosis. In Japan, polymyxin B-immobilized fiber column-direct hemoperfusion (PMX-DHP) therapy is often used along with corticosteroids for the treatment of patients with AE-IIPs. However, the serum marker that predicts treatment response to PMX-DHP is still unknown. Our aim was to evaluate the serum marker that predicts the outcome in patients with AE-IIPs undergoing PMX-DHP therapy.MethodsWe retrospectively collected the medical records of 104 patients who developed AE-IIPs for the first time and visited Juntendo University Hospital between April 2009 and July 2020. Among these patients, 33 patients who received PMX-DHP were identified. Among the patients who received PMX-DHP, 18 patients who survived for over 30 days since the initiation of PMX-DHP therapy were classified into the “survival group,” and 15 patients who succumbed to the condition in less than 30 days were categorized into the “non-survival group.” We evaluated data on the patients’ background, survival, and differences in the serum markers associated with AE-IIPs and in oxygenation markers between the groups.ResultsAmong patient characteristics, median forced vital capacity was significantly higher in the survival group than in the non-survival group. Among serum markers, 7 days after the initiation of PMX-DHP therapy, serum lactate dehydrogenase (LDH) levels, white blood cell counts, and D-dimer levels were significantly higher and serum lymphocyte count was significantly lower in the non-survival group than in the survival group. PaO2/FiO2 ratio (P/F ratio) and alveolar-arterial oxygen difference (Aa-DO2) were significantly different between the two groups. The changes in LDH level (ΔLDH), P/F ratio, and Aa-DO2 were significantly different from day 1 to 7 days after the initiation of PMX-DHP between the two groups. Multivariate analysis revealed that ΔLDH was the only risk factor associated with poor prognosis. The cut-off value of ΔLDH was calculated as −8. The median survival time (MST) was significantly longer in patients with low ΔLDH values (<−8) than in those with high ΔLDH values (>−8).ConclusionsChanges in serum LDH levels are reasonable markers for evaluating the prognosis of PMX-DHP therapy.
Risk Factors for Postpartum Hemorrhage After Elective Cesarean Delivery for Twin Pregnancy
Authors: wan xiao jie , Zhao Wei , Zhao Li , Wen Hong
Published: February 2021

Objective: To identify the high risk factors associated with postpartum hemorrhage (PPH) after selective cesarean delivery of twins. Methods: This retrospective cohort study included all women with twin gestations who choosed an elective cesarean delivery after 28 weeks of gestation at Women's Hospital of Zhejiang University School of m from September 2014 to April 2019. The Women with an intrauterine fetal demise one or both of twins were excluded.A total of 532 wemen were analysed,they were classified as PPH group(n=70) and No PPH group(n=462). Estimated blood loss greater than or equal to 1000 ml was defined as Postpartum hemorrhage(PPH).Univariate and multivariate logistic regression analysis were performed to assess the independent risk factors.Results: Of the 532 twin pregnant women, PPH occurred in 13.2% (n=70). There were statistically signifcant diferences in preeclampsia (P=0.005), premature rupture of membranes(P<0.001), placental adhesion (P<0.001), placenta previa (P<0.001), hemoglobin (Hb)< 100 g/L（P=0.003)）, hematocrit (HCT)< 0.39（P=0.004）.However, the indepedent risk factors for PPH after selective cesarean delivery for twin pregnancy were preeclampsia (OR3.538, p < 0.05), premature rupture of membranes (OR17.9, P < 0.05), placental adhesion (OR5.71, p < 0.05) and placenta previa (OR10, p < 0.05). Conclusions: preeclampsia , premature rupture of membranes , placental adhesion and placenta previa were risk factors for postpartum hemorrhage after elective cesarean section for twin pregnancy. Risk factor identification and prevention should be a priority.