bluuebunny/crossref_metadata_2025 huggingface dataset:
Comprehensive Molecular Characterization and Identification of Prognostic Signature in Stomach Adenocarcinoma on The Basis of Energy-Metabolism-Related Genes
Authors: Chang Jinjia , Wang Xiaoyu , Li Wenhua , Tan Cong , Sheng Weiqi , Xu Midie
Published: January 2021

Background: Stomach adenocarcinoma (STAD) is a leading cause of cancer deaths, but its molecular and prognostic characteristics has never been fully illustrated. Methods: We describe a comprehensive molecular evaluation of primary STAD based on comprehensive analysis of energy-metabolism-related gene (EMRG) expression profiles. Results: On the basis of 86 EMRGs that were significantly associated to patients’ progression-free survival (PFS), we propose a molecular classification dividing gastric cancer into two subtypes: Cluster 1, most of which are young patients and display more immune and stromal cell components in tumor microenvironment (TME) and lower tumor priority; and Cluster 2, which show early stages and better PFS. Moreover, we construct a 6-gene signature that can classify the prognostic risk of patients after a three-phase training, test and validation process. Compared with patients with low-risk score, patients with high risk score had shorter overall survival. Furthermore, calibration and DCA analysis plots indicate the excellent predictive performance of the 6-gene signature, and which present higher robustness and clinical usability compared with three previous reported prognostic gene signatures. According to gene set enrichment analysis (GSEA), gene sets related to the high-risk group were participated in the ECM receptor interaction and hedgehog signaling pathway.Conclusions: Identification of the EMRG-based molecular subtypes and prognostic gene model provides a roadmap for patient stratification and trials of targeted therapies.
The Risk Prediction Model for Healthcare-Associated Infections among Elderly Patients Underwent Pancreaticoduodenectomy
Authors: Feng Yuejing , Yao Hongwu , Li Jie , Du Mingmei , Gao Xibao , Liu Yunxi , Zhou Chengchao
Published: January 2021

Background: The elderly are a high-risk group of healthcare-associated infections (HAIs) after pancreaticoduodenectomy (PD), and the effective prediction model may be beneficial to HAIs control. Methods: The data were obtained from Hospital Infection Surveillance System. The BP-ANN model was conducted according to univariate analysis. The receiver operating characteristic curve (ROC), the prediction accuracy, sensitivity and specificity were used to estimate the predicted performance. The final weight coefficients were calculated to illustrate the relative importance of indicators. Results: Of 688 elderly patients underwent PD, 83 (12.06%) were diagnosed with HAIs. 9 significant factors (P<0.05) including weight, fever, continuous fever for more than three days, blood routine abnormal percentage, ever livered in intensive care unit (ICU), antibacterial combination, postoperative antibacterial use days, ventilator use and urinary catheter use days were included into prediction model. The prediction accuracy in testing sets was 93.79%, and the sensitivity and specificity were 0.67 and 0.97. The contribution level of 9 significant factors were 10.65%, 8.54%, 10.17%, 9.64%, 9.26%, 10.02%, 12.53%, 11.90% and 17.29%, respectively. Conclusions: The 9-9-1 BP-ANN prediction model underpinned by complex factors in this study has relatively excellent performance for HAIs prediction among elderly patients after PD. Urinary catheter use days, postoperative antibacterial use days, ventilator use, weight and continuous fever for more than three days are the top five contribution indicators for HAIs prediction, which should be fully taken into consideration when developing HAIs prediction for the PD patients.
Plastic and low-cost zero thermal expansion alloy by a natural dual-phase composite
Authors: Yu Chengyi , Lin Kun , Jiang Suihe , Cao Yili , Li Wenjie , Wang Yilin , Chen Yan , An Ke , You Li , Kato Kenichi , Li Qiang , Deng Jinxia , Xing Xianran
Published: January 2021

Zero thermal expansion (ZTE) alloys are not only of great scientific significance, but also of great application value due to their unique dimensional stability, high thermal and electrical conductivities. However, the practical application and further development of ZTE alloys are limited by their inherent brittleness because ZTE and plasticity are generally incompatible in a single material. Besides, ZTE alloy is highly sensitive to composition, so conventional methods such as alloying or the design of multiphase to improve its mechanical properties are inapplicable. In this study, we report a one-step eutectic reaction method to overcome this contradiction: by melting 4 atom% holmium with pure iron to form a natural dual-phase composite. The composite shows unprecedented comprehensive advantages such as moderate plasticity and strength, axial zero thermal expansion, good thermal stability and low cost, making it the first plastic ZTE alloy other than Invar. Through the joint study of synchronous X-ray diffraction, in-situ neutron diffraction and microscopy, the critical role of dual-phase synergy mechanism on both thermal expansion regulation and mechanical property enhancement is revealed. These results indicate that eutectic reaction is likely to be a general and effective method for the design of high-performance intermetallic compound-based ZTE alloys.
Moisture-induced autonomous surface potential oscillations for energy harvesting
Authors: Long Yu , He Peisheng , Shao Zhichun , Kim Han , Yao Archie , Peng Yande , Xu Renxiao , Lee Seung-Wuk , Zhong Junwen , Lin Liwei
Published: January 2021

A variety of autonomous oscillations in nature such as heartbeats and biochemical reactions have been widely studied and utilized for applications in the fields of bioscience and energy technology, etc. Here, we report a unique phenomenon of moisture-induced electrical potential oscillations on P(MEDSAH-co-AA) polymers during the diffusion of water molecules. Using the moisture in the ambient environment as the activation source, this self-excited chemoelectrical reaction could have broad influences and usages in surface-reaction based devices and systems. As a proof-of-concept demonstration, an energy harvester is constructed to demonstrate the continuous energy production for more than 15000 seconds with an energy density of 16.8 mJ/cm2. A 2-Volts output voltage has been produced to power a liquid crystal display (LCD) with five energy harvesters connected in series toward practical applications.
Non-invasive in vivo optical monitoring of human placental oxygenation
Authors: Wang Lin , Cochran Jeffrey , Ko Tiffany , Baker Wesley , Abramson Kenneth , He Lian , Busch David , Kavuri Venki , Linn Rebecca , Parry Samuel , Yodh Arjun , Schwartz Nadav
Published: January 2021

Direct assessment of human placental blood oxygenation can provide valuable information about placental function and, potentially, detect dysfunction. Currently however, no bedside tools exist for non-invasive monitoring of placental oxygenation. Here we report a continuous, non-invasive in vivo method to probe placental oxygen hemodynamics using deep penetrating Frequency Domain Diffuse Optical Spectroscopy (FD-DOS) with concurrent ultrasound (US) imaging. This multi-modal instrument facilitates assessment of placental oxygenation properties from image reconstruction algorithms that integrate anatomical US information about layer morphology with information from optics about functional hemodynamics. Tissue phantom experiments, simulations, and human subject studies validate the approach and demonstrate sensitivity to placental tissue located £ 5 cm below the surface. In a pilot study (n=24), human placental oxygen hemodynamics are measured non-invasively during maternal hyperoxia. Initial results suggest placental response to maternal hyperoxia may serve as a tool to detect placenta-related adverse pregnancy outcome and maternal vascular malperfusion of placenta, weeks before delivery.
Effects of Clavien-Dindo classification on long-term survival of patients with advanced gastric cancer after radical resection:A propensity score-matched study
Authors: Yan Wenwu , Du Jun , Li Qingyi , Yao Changsheng , Zhu Mengxiang , Wang Jinguo
Published: January 2021

Background The impact of postoperative complications (POCs) classified by the Clavien-Dindo (C-D) system on long-term survival after radical resection in patients with advanced gastric cancer (AGC) is not yet clear.Methods This study analyzed 531 patients with AGC who underwent radical resection in an institution between January 2015 and December 2017. Patients were divided into two groups according to the occurrence of POCs and recorded according to C-D classifications.The long-term survival outcomes of the entire cohort after propensity score matching (PSM) were compared.Results After PSM, there was no significant difference in baseline data between the complications (C) group (n = 92) and the non-complications (NC) group (n = 92). Survival analysis showed that the 5-year overall survival (OS) and relapse-free survival (RFS) were lower in the C group (48.9% vs. 62.0%, p = 0.040; 38.5% vs. 54.9%, p = 0.005; respectively). Subgroup analysis showed that severe complications (C-D grade > II) were associated with a decrease in 5-year OS and RFS compared with the matched NC group (40.0% vs. 62.0%, p = 0.008; 29.4% vs. 54.9%, p = 0.001; respectively). Multivariate analysis confirmed adjuvant chemotherapy, tumor size, and complications were independent risk factors for poor survival outcomes. Further multivariate analysis showed that older age, combined excision, and comorbidities were independent risk factors for POCs.Conclusions Severe complications reduced the survival outcome of patients.Older age, combined excision, and comorbidities were independent risk factors for POCs. More attention should be paid to perioperative management of patients with high risk factors for complications.
Effects of Sevoflurane Exposure on Apoptosis and Cell Cycle of Peripheral Blood Lymphocytes, and Immunologic Function
Authors: ji zhimin , Wu Wanjun , zhou Fan , Hu Junfang , Xu Qiuping , Yang Weibin , Peng Xueyong , Wang XInguo , Zhang Cheng , Li Li
Published: January 2021

Background: Waste anesthetic gases (WAGS) leaked from new-type halogenated inhalational anesthetics such as sevoflurane were reported to pose a risk for the health of operation room personnel. The effects of WAGS on peripheral blood lymphocytes remain yet controversial. Purpose: The present study was undertaken to examine whether occupational exposure to sevoflurane has detrimental effects on the peripheral blood lymphocytes of exposed medical personnel in vivo. Methods: A cohort of 56 medical residents were divided into exposed group (n=28) and control group (non-exposed group) (n=28). Gas chromatograph was used to measure the concentration of sevoflurane in the medical resident’s breathing zone during surgeries under inhalation anesthesia in exposure group. The collection time lasted for one hour. Peripheral blood lymphocytes were isolated from venous blood and then apoptosis and cell cycle were analyzed by flow cytometry. EDTA-anticoagulated whole blood was harvested to analyze the lymphocyte subsets by flow cytometry. Immunoglobulins (IgA, IgM, IgG) were quantified by immunoturbidimetry.Results: The average concentration of sevoflurane in exposed group was 1.03 ppm with a range from 0.03 ppm to 2.24 ppm. Sevoflurane had no significant effect on the apoptosis and cell cycle of peripheral blood lymphocytes in the exposed group relative to the control group (P>0.05). Similarly, there was no significant difference in the lymphocyte subsets and the levels of immunoglobulins (IgA, IgM, IgG) between the two groups (P>0.05).Conclusion: Occupational exposure to low-level sevoflurane has no significant effect on the peripheral blood lymphocytes of operating room staff, but this conclusion needs to be confirmed by multicenter and long-term follow-up studies with large samples.Trial registration number and date of registration：ChiCTR2000040772, December 9, 2020 (Retrospective registration)
How Are We Evaluating the Cost-Effectiveness of Companion Biomarkers for Targeted Cancer Therapies? A Systematic Review
Authors: Seo Mikyung Kelly , Cairns John
Published: January 2021

Background Despite the increasing economic assessment of biomarker-guided therapies, no clear agreement exists whether existing methods are sufficient or whether different methods might produce different cost-effectiveness results. This study aims to examine current practices of modeling companion biomarkers when assessing the cost-effectiveness of targeted cancer therapies. It highlights the challenges in methods and data requirements faced in the evaluation of biomarker tests which do not necessarily arise with the evaluation of pharmaceutical drugs.Methods A literature search was performed using Medline, Embase, EconLit, Cochrane library. Articles published from 2014 to 2018 were searched. Economic evaluations on biomarker-guided therapies with companion diagnostics in cancer were searched. Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines followed. Studies were selected by pre-specified eligibility criteria using PICO framework. To make studies more comparable, data were synthesized under ten categories of key areas of methods where consensus deemed lacking.Results Eighteen papers were included in this review. Three out of eighteen studies found to be of good quality regarding incorporating the characteristics of companion biomarkers in economic evaluations. However, many evaluations focused on a pre-selected patient group with a specific biomarker status instead of including all patients with a disease regardless of their biomarker status. Companion biomarker characteristics captured in evaluations were often limited to the cost or the accuracy of the test. Often, only the costs of biomarker testing were modelled. Clinical outcomes or utilities were often difficult to include due to the limited data generated by clinical trials. We found that no consistency and consensus existed to the methods of existing economic evaluations of companion cancer biomarkers for targeted therapies. It was also shown that conflicting cost-effectiveness results were likely depending on what comparator arm was chosen and what comparison structure was designed in the model.Conclusion We found that there was no consistent approach applied in assessing the value of biomarkers and including the characteristics of biomarkers in an economic evaluation of targeted oncology therapies. Currently, many EEs fail to capture the full value of companion biomarkers beyond sensitivity/specificity and cost related to biomarker testing.
Construction of a High-density Genetic Map and Identification of Candidate Genes for Resistance to Fusarium Wilt based on the Resequencing of Recombinant Inbred Line Population in Gossypium Barbadense
Authors: Han Wanli , Zhao Jieyin , Deng Xiaojuan , Gu Aixing , Li Duolu , Wang Yuxiang , Lu Xiaoshuang , Zu Qianli , Chen Qin , Chen Quanjia , Qu Yanying
Published: January 2021

Background: Resistance to Fusarium wilt (FW) is of great significance for increasing the yield of Gossypium barbadense. Most published genetic studies on G. barbadense focus on yield and fiber quality traits, while there are few reports on resistance to FW. Results: To understand the genetic basis of cotton resistance to FW, this study used 110 recombinant inbred lines (RILs) of G. barbadense obtained from the parental materials Xinhai 14 and 06-146, and Nannong was used to construct a high-density genetic linkage map. The high-density genetic map was based on the resequencing of 933,845 single-nucleotide polymorphism (SNP) markers, and 3627 bins covering 2483.17 cM were finally obtained. The collinearity matched the physical map. A total of 9 QTLs for FW resistance were identified, each QTL explained 4.27-14.92% of the observed phenotypic variation, and qFW-Dt3-1 was identified in at least two environments. According to gene annotation information from multiple databases, promoter homeopathic elements and transcriptome data, 10 candidate genes were screened in a stable QTL interval. qRT-PCR analysis showed that the GOBAR_DD06292 gene was differentially expressed in the roots of the two parents under FW stress and exhibited the same expression trend in the G. barbadense resource materials.Conclusions: These results indicate the importance of the GOBAR_DD06292 gene in FW resistance in G. barbadense and lay a molecular foundation for the analysis of the molecular mechanism of FW in G. barbadense.
Assessment of an Electronic Patient Record System on Discharge Prescribing Errors in a Tertiary University Hospital
Authors: O'Shea Michael , Kennedy Cormac , Relihan Eileen , Harkin Kieran , Hennessy Martina , Barry Michael
Published: January 2021

BackgroundPrescribing error represent a significant source of preventable harm to patients. Prescribing error at discharge, including omission of pre-admission medications (PAM), are particularly harmful as they frequently propagate following discharge. This study assesses the impact of an educational intervention and introduction of an Electronic Patient Record (EPR) in the same centre on omission of PAM at discharge using a pragmatic design. A survey of newly qualified doctors is used to contextualise findings.Methods Discharge prescriptions and discharge summaries were reviewed at discharge, and compared to admission medicine reconciliation, using a paper-based chart system. Discrepancies were noted, using Health Information and Quality Authority guidelines for discharge prescribing. An educational intervention was conducted. Further review of discharge prescriptions and discharge summaries took place. Hospital-wide introduction of an EPR took place. Subsequently, review of discharge summaries and discharge prescriptions was repeated. A survey was administered to qualified doctors, and analysed using descriptive statistics and thematic analysis. Results Omission of PAM as prescribed or discontinued items at discharge occurs frequently. An educational intervention did not significantly change prescribing error rates. EPR introduction did significantly reduce omission of PAM on discharge prescribing, however there was also a reduction in the rate of deliberate discontinuation of PAM at discharge. Survey results demonstrated that multiple sources are required to develop a discharge prescription. Time pressure, access to documentation and lack of admission medicine reconciliation are frequently cited causes of discharge prescribing error.ConclusionThis study verified passive educational interventions alone do not improve discharge prescribing. Introduction of EPR improved discharge prescribing, but negatively impacted deliberate discontinuation of PAM at discharge. This is attributable to reduced access to key sources of information used in formulating discharge prescriptions, and separation of the discontinuation function from the prescribing function on the EPR discharge application.
Softer but tougher: The impact of alloying on defect-free nanoparticles
Authors: Bisht Anuj , koju Raj , Qi Yuanshen , Hickman James , Mishin Yuri , Rabkin Eugen
Published: January 2021

The classic paradigm of physical metallurgy is that the addition of alloying elements to metals increases their strength. It is less known if the solution-hardening can occur in nano-scale objects, and it is totally unknown how alloying can impact the strength of defect-free faceted nanoparticles. Purely metallic defect-free nanoparticles exhibit an ultra-high strength approaching the theoretical limit. Tested in compression, they deform elastically until the nucleation of the first dislocation, after which they collapse into a pancake shape. Here, we show by experiments and atomistic simulations that the alloying of Ni nanoparticles with Co reduces their ultimate strength. This counter-intuitive solution-softening effect is explained by solute-induced local spatial variations of the resolved shear stress, causing premature dislocation nucleation. At the same time, the subsequent deformation of the particle requires more work, making it tougher. The emerging compromise between strength and toughness can make alloy nanoparticles promising candidates for applications.
Adequate Animal Protein Intake Maintains Normal Thyroid Antibody Levels in Pregnant Women With Mild Iodine Deficiency
Authors: Wang Zhengyuan , Shen Jiaying , Song Qi , Cui Xueying , Shi Zehuan , Guo Changyi , Su Jin , Zang Jiajie
Published: January 2021

Background: Both of the iodine and animal protein may affect thyroid function. We explored the association between animal protein intake and thyroid antibody status in pregnant women after universal salt iodization.Method: Pregnant women were enrolled by using a multistage, stratified random sampling method. 4,646 eligible participants were interviewed in person with questionnaires physical examination and thyroid antibody test. Results: Only thyrotropin receptor antibodies (TR-Ab) positive rates were different among different animal protein intake groups. The median of urinary iodine concentration (UIC) in thyroid peroxidase antibodies (TPO-Ab) positive groups was higher than the negative group. The median of total protein intake, animal protein intake and UIC in TR-Ab positive group was higher than the negative group. The medians of total protein intake and UIC in TPO-Ab/TG-Ab/TR-Ab positive group were higher than the negative group. The above differences were statistically significant (P < 0.05). The multivariable logistic regression results showed that insufficient iodine had a negative correlation with TPO-Ab positive and TR-Ab positive (P < 0.05). The middle third and top third animal protein intakes served as protective factors for TR-Ab (coefficient = 0.559, 95% CI = 0.415–0.752; coefficient = 0.0.406, 95% CI = 0.266–0.621) and positive TPO-Ab/TR-Ab/TG-Ab (coefficient = 0.817, 95% CI = 0.687–0.971; coefficient = 0.805, 95% CI= 0.672–0.964). Conclusions: Adequate animal protein intake protects against elevated anti-thyroid antibody levels in pregnant women with mild iodine deficiency.
The Dutch Version of the Oxford Knee Score – Activity and Participation Questionnaire: A Validation Study
Authors: Molder Malou te , Vriezekolk Johanna , Bénard Menno , Heesterbeek Petra
Published: January 2021

Background: Patients undergoing total knee arthroplasty (TKA) tend to be younger and tend to receive TKA at an earlier stage compared to 20 years ago. The Oxford Knee Score – Activity and Participation (OKS-APQ) questionnaire evaluates higher levels of activity and participation, reflecting activity patterns of younger or more active people. The purpose of this study was to translate a Dutch-language version of the OKS-APQ questionnaire, and to validate it in pre- an postoperative TKA patients. Methods: We evaluated the Dutch translation of the OKS-APQ for reliability and validity. Internal consistency, test-retest reliability, factor analysis, construct validity and, floor and ceiling effects were evaluated using quality criteria. The OKS-APQ, the Oxford Knee Score (OKS), the Short Form-36 (SF-36), a Visual Analogue Scale (VAS) for pain and the Forgotten Joint Score (FJS) were assessed in 131 patients, and the OKS-APQ was administered twice in 50 patients after an interval of minimal 2 weeks.Results: Internal consistency (Cronbach α‘s from 0.81 to 0.95) and test-retest reliability (Intraclass Correlation Coefficients (ICCs) from 0.63 – 0.88) were satisfactory to good. The standard Error of Measurements (SEMs) ranged from 8.5 – 12.2 and the Smallest Detectable Changes in individuals (SDCind) ranged from 23.5 – 34.0 (on a scale from 0 to 100). Confirmatory factor analyses (CFA) indices indicated a satisfactory fit of a 1-factor model (Comparative Fit Index (CFI): 0.97, Tucker-Lewis Index (TLI): 0.96, Root Mean Square Error of Approximation (RMSEA): 0.1, Standardized Root Mean Square Residual (SRMSR): 0.03). Construct validity was supported as >75% of the hypotheses were confirmed and floor effects were observed in preoperative patients. Conclusions: The Dutch translation of the OKS-APQ showed good reliability and validity in the Dutch population, and can be used alongside the OKS in clinical research and clinical practice to discriminate among levels of activity and participation in postoperative patients.
Serum ROBO4 and CLEC14A: Preliminary Evaluation as Diagnostic and Progression Biomarkers in Colorectal Cancer Patients
Authors: Pietrzyk Łukasz , Torres Kamil
Published: January 2021

Colorectal cancer (CRC) is an important global burden, and the discovery of biomarkers for screening and monitoring is a current challenge. The present study aimed to determine the serum concentration of ROBO4 and CLEC14A in CRC patients and assess the clinical value of these diagnostic and progression biomarkers in CRC. The ROBO4 and CLEC14A levels were measured using ELISA tests. Blood sera were tested in 32 CRC patients and 16 controls at two time points (before and after surgery). The serum concentrations of ROBO4 and CLEC14A were significantly higher in CRC patients than non-cancer controls; the concentrations were already higher in TNM stage I+II CRC patients. The sensitivitiy and specificity of ROBO4 and CLEC14A in distiguishing cancer patients form controls ranged from 71.9% to 100% and from 84.5% to 100%, respectively. The serum ROBO4 concentration was associated with the TNM stage, depth of invasion, and lymph node and distant metastases. No significant relationship was observed between the CLEC14A concentration and the tumor site or the N and M stages. The level of ROBO4 was statistically lower 3 months after the surgery, compared to the level noted prior to the operation. The concentration of CLEC14A decreased in the postoperative period, compared to preoperative one; however, the decline was not statistically significant. Our preliminary study has provided evidence that ROOB4 and CLEC14A seem to be suitable biomarkers for clinical diagnostic purposes. However, ROOB4 appears to be more appropriate for assessment of CRC progression.
Effects of Long-term Nonylphenol Exposure on Myocardial Fibrosis and Cardiac Function in Rats
Authors: Liu Chao , Ni Chengyu , Liu Weichu , Yang Xiaolian , Zhang Renyi , Zhang Jianling , Luo Man , Xu Jie , Yu Jie
Published: January 2021

Background: Myocardial fibrosis is a critical pathological basis for the poor prognosis of cardiovascular diseases. Studies have found that myocardial fibrosis is closely associated with exposure to environmental estrogens such as nonylphenol (NP), as a representative of environmental estrogens. The aim of this study was to examine the effects of NP chronic exposure on myocardial fibrosis as well as cardiac structure and function. Forty Sprague Dawley rats were randomly divided into four groups (n = 10): control group (C), low NP dose (0.4 mg/kg, L), medium NP dose (4 mg/kg, M), and high NP dose (40 mg/kg, H) groups. The NP dose groups were gavaged with NP for 180 days. Results: The NP level in the heart of the NP groups was significantly higher than those in the control group (F = 43.658, P < 0.001). Serum aspartate aminotransferase (AST), creatine kinase (CK), creatine kinase isozyme (CK-MB), lactate dehydrogenase (LDH) and α-hydroxybutyrate dehydrogenase (α-HBDH) significantly increased in the NP groups compared with the control group (). Histopathological examination of the heart biopsy illustrates that in the medium and high NP groups, the fibrous connective tissue had a disordered and loose gridding shape, muscle fibers had fractured, and muscle fibers were loose with a widened gap. Extensive inflammatory cell infiltration and fibroblast proliferation in the myocardial interstitium were also found. With increasing NP dose, the degree of muscle fiber loosing and disorder became more significant in the NP treatment groups, and the collagen volume fraction (CVF) was higher than that in the control group (P < 0.01). Compared with the control group, the expression of collagen I and collagen III increased significantly in the medium and high NP groups (P < 0.05). The values of the systolic thickness of the left ventricular anterior wall (LVAWs), the diastolic thickness of the left ventricular posterior wall (LVPWd), the systolic thickness of the left ventricular posterior wall (LVPWs), and the left ventricular anterior wall (LVAWd) in the NP groups are were slightly lower than those in of the control group. The values of left ventricular end systolic dimensions (LVIDs) in the NP groups increased compared with the control group. Conclusions: Long-term NP exposure could lead to fibrosis in the rat myocardium, which is characterized by increased expressions of myocardial collagen I and collagen III, as well as elevated cardiac enzymes. In addition, the cardiac structure was affected and changes were observed in the thinner ventricular wall and as an enlarged ventricular cavity.
Acceptance and Image Quality of High-Resolution Peripheral Quantitative Computed Tomography of the Metacarpophalangeal Joints in Rheumatoid Arthritis.
Authors: Jensen Rasmus Klose , Keller Kresten Krarup , Langdahl Bente , Hauge Ellen-Margrethe
Published: January 2021

Objective: To investigate the acceptance of the high-resolution peripheral quantitative computed tomography (HR-pQCT) in rheumatoid arthritis (RA). The second objective was to investigate the motion artefacts of the metacarpophalangeal (MCP) joints with two different custom-made positioning devices. Methods: Fifty patients with established RA had their MCP joints scanned by HR-pQCT with two different custom-made positioning devices and examined by conventional X-ray. Afterwards, the patients answered a questionnaire of imaging experience. The comparability of the erosion measures was investigated between the two different custom-made positioning devices by Bland-Altman plot, and intrareader repeatability by intraclass correlation coefficient. The motion artefacts were graded for each acquisition, and intrareader repeatability was investigated by Cohen's kappa coefficient.Results: Forty percent of the patients preferred HR-pQCT imaging, only 6% preferred conventional X-ray. Seventy-four percent found it difficult to keep their fingers steady during the scan. Fifty percent of the patients reported the inflatable immobilization device helped to keep their fingers steady while only 6% reported that it impaired their ability to do so. However, this difference was not reflected in the visual grading, as motion artefacts were sparse, and no clinically relevant difference could be observed. The intrareader repeatability and comparability for the erosion measures were excellent.Conclusion: The high acceptance among patients adds to the feasibility of HR-pQCT imaging of MCP joints in patients with RA. The inflatable immobilization device did not reduce motion-induced image degradation, as the overall visual grading for motion artefacts was low for imaging of the MCP joints in both acquisitions.
Association of Women’s Empowerment With Water, Sanitation, and Hygiene (Wash) Services in Ethiopia: A Cross-sectional Analysis
Authors: Bogale Daniel
Published: January 2021

Background: Access to safe drinking water, sanitation, and hygiene (WASH) services is vital for human health and well-being. In Ethiopia, lack of improved WASH services has existed as a health problem for many years. Empowering women is among the most important factors for improving WASH services, but research-based evidence is lacking in this regard. The present study was designed to analyse the association between women’s empowerment and WASH services in Ethiopia.Methods: This analysis is based on the 2016 Ethiopian Demographic and Health Survey (EDHS). The survey-based Women’s emPowERment (SWPER) index approach is used to develop women’s empowerment indices. The three empowerment domains used by the SWPER authors include attitude to violence, social independence, and decision-making. Multilevel logistic regression was used to assess the association between these domains of women’s empowerment and WASH services. Estimates were presented as odds ratio (OR) and expressed per one standard deviation (SD) with significance levels set at the 5% level. Results: Overall, 90.9%, 78.4%, and 50.3% of the households included in this analysis had no basic handwashing facility, improved sanitation facility, and improved water source, respectively. A one SD increase in the social independence domain was associated with 16% higher odds of having basic handwashing facility (AOR: 1.16; 95%CI: 1.02, 1.33). As women’s attitude to violence increased by one SD, the odds of having improved sanitation facility is increased by 22% (AOR: 1.22; 95%CI: 1.05, 1.42). Also, a SD increase in social independence domain was associated with 18% higher odds of having improved sanitation facility (AOR: 1.18; 95% CI: 1.04, 1.34). There was no statistically significant association between domains of women’s empowerment and source of water.Conclusions: This study has shown that most of the households in Ethiopia had no access to improved WASH services. Multiple regression analyses revealed that empowering women had association with having basic handwashing and improved sanitation facility. The findings of this study have suggestive evidence that empowering women could improve WASH cervices.
Developing an Interventional and Educational Program Based on Social Marketing Approach to Increase Regular Physical Activity in Girl Students: A Qualitative Study
Authors: Moeini Babak , Rezapur-Shahkolai Forouzan , Heidarimoghadam Rashid , Tapak Leili , Geravandi Azam
Published: January 2021

Background : Physical activity is one of the key factors in children and teenagers’ health. The present paper follows a qualitative approach to identify subjects’ viewpoints about regular physical activity and determine approaches to promote it based on social marketing mix. Methods: The study was carried out as a qualitative content analysis study in 2020 in Kermanshah city, Iran . Totally, 23 students as the main participants along with five parents and four physical trainers were selected through purposive sampling. After data analysis and extraction of primary codes, four categories emerged based on the elements of social marketing mix (product, price, place, and promotion) along with subcategories.Results: The majority of participants emphasized on the advantages namely prevention of chronic diseases, physical fitness, increased concentration, better learning performance, and a decrease in depression. They noted that they preferred a happy and friendly environment for doing physical activity. The teenagers listed fitness clubs, the media, and social media as preferred places to receive educational messages. Conclusion: The results showed that physical activity in teenagers was affected by personal, environmental, and social obstacles. The results gave an insight and a deeper knowledge about values and motivations in teenagers that affect their decision to do regular physical activity.
A Comparison of Modelling the Spatio-temporal Pattern of Disease: A Case Study of Schistosomiasis in Anhui Province, China
Authors: Su Qing , Bergquist Robert , Ke Yongwen , Dai Jianjun , He Zonggui , Gao Fenghua , Zhang Zhijie , Hu Yi
Published: January 2021

Background: Various methods have been proposed in modelling spatio-temporal pattern of diseases in recent years. The construction of the spatio-temporal models can be either descriptive methods or dynamic. While the former mainly explores correlations by functions, the latter also depicts the process of transmission quantitatively. In this study, we aim to evaluate the differences in model fitting between a descriptive, spatio-temporal model and dynamic spatio-temporal model of schistosomiasis transmission in Guichi, Anhui Province, China. Methods: The parasitological and environmental data at the village level from 1991 to 2014 were obtained by cross-sectional survey. The space-time changes of schistosomiasis risk were explored by two different spatio-temporal models, the Fixed Rank Kriging (FRK) model and the Integral-Difference Equation (IDE) model, and the performance of the two models in fitting schistosomiasis risk were compared.Results: In both models, the average daily precipitation and the normalized difference vegetation index (NDVI) are significantly positively associated with schistosomiasis prevalence while distance to water bodies, the hours of daylight and day land surface temperature (LSTday) are significantly negatively associated. The overall root mean squared prediction error (MSPE) of the Integral-Difference Equation (IDE) and the FRK model were 0.35e-02 and 0.63e-02, respectively, and the correlation between the predicted and observed values of the IDE model (0.71) (p <0.01) was larger than the FRK one (0.51) (p=0.02). Our results also showed that the prediction error of the IDE model is lower than that of FRK model.Conclusions: In capturing schistosomiasis risk combined with environment factors, the IDE model fits better than the descriptive FRK one. As a dynamic spatio-temporal method, the IDE approach models the process of disease transmission quantitatively and therefore provides more accurate predictions, which is of great importance with reference to schistosomiasis and other diseases.
The significance of routine biochemical markers in patients With Sepsis
Authors: Meng Yan , Wang Yue , Qiao Wenbin , LIU Yumei , Wang Liang , Fan Jiahui , Tian Fengming , Wang Xuanzheng , Zhang Tao , Ma Xiumin
Published: January 2021

Background

Sepsis is a highly complex and fatal syndrome. It is the main cause of death in the intensive care unit. Early diagnosis is beneficial to reduce the mortality of sepsis and improve the prognosis of patients. Therefore, we look forward to finding cheap and fast diagnostic criteria to quickly assess the patient's condition.
Methods

Our study enrolled 499 patients in the First Affiliated Hospital of Xinjiang Medical University from January 1, 2018 to June 22, 2020, and 96 healthy cases in the same period. Using the diagnostic criteria of bacterial infection, SIRS criteria and Sepsis-2 consensus criteria, 499 patients and 96 healthy cases were divided into 4 groups: sepsis group (n = 300), SIRS group (n = 151), infection group (n = 48), the control group (n = 96). We collected the results of routine laboratory tests, inflammation indicators and blood culture results of these patients.
Results

The sepsis group compared with the control group, MCV, NE, WBC, PLT, HB, D-Dimer, PT, CRP, PCT, IL-6, ALB, TBIL, Cr, LAC, CysC and BNP were statistically significant. D-dimer, CRP and PCT have higher diagnostic efficiency. Compared with the difference between the infection group and the SIRS group, PLT and IL-6 are statistically significant, and have a certain diagnostic value. Sepsis group VS infection group, WBC, IL-6, NE and TBIL showed statistical differences in the comparison. The AUC of NE was 67.6, which was the largest among the three. The specificity (95.8%) was the highest, but the sensitivity (49%) was low.
Conclusions

This retrospective study shows that NE, WBC, and D-dimer can help in the early diagnosis of sepsis. D-dimer performs best. WBC and NE may have a differential diagnosis significance between the sepsis group and the infection group. This result can provide a timely and convenient assessment tool for early diagnosis of sepsis.
Economic Valuation of the Provisioning Services Provided by the Sundarban in Bangladesh
Authors: Sarker A. H. M. Raihan , Nobi Mohammad Nur , Nath Biswajit , Røskaft Eivin , Kvinta Paul , Suza Ma , Chivers David J. , Misbahuzzaman Khaled
Published: January 2021

The Sundarban provides various types of resources for an estimated four million people living in and around this mangrove forest in its Bangladesh parts. This study was carried out to quantify the value of forest income in these communities with the aim of understanding the contribution and importance of forest resources to the livelihoods of the poor, and their possible role in poverty alleviation. Eight key different resources such as fish, shrimp fry, crab, fuel-wood, wood for the construction of house and boat, thatching materials, honey and wax were identified in this study and their economic value estimated at US$145.2 million/year. It was also revealed that the households depended on mangrove resources for their livelihoods, with the lower and the middle-income households being heavily dependent. The households belonging to the lowest income group had neither land nor agricultural or livestock resources for generating income, therefore, a greater proportion of their income came from the forest, making them highly dependent on forest resources for survival. Given a population of about 4 million people residing in 17 upazilas (sub-districts) close to the Sundarban Reserve Forest, and their higher dependence on forest resources, sustainable management of the common pool resources provided by the forest is essential for alleviating extreme poverty. Management regimes for the Sundarban Reserve Forest need to be ensured continued access of the local residents to forest resources, especially of those who are the poorest, for sustaining livelihoods. In this regard, co-management of resources could be a pro-poor strategy if it does not compromise the livelihoods of the poorest living in and around the Sundarban.
Preoperative Neutrophil-Lymphocyte Ratio for Predicting Surgery-Related Acute Kidney Injury in Non-cardiac Surgery Patients under General Anaesthesia: A Retrospective Cohort Study
Authors: Tang Yongzhong , Chen Linchong , Li Bo , Yang Lin , Ouyang Wen , Li Dan
Published: January 2021

Background This study was conducted to investigate the relationship between the Neutrophil-Lymphocyte Ratio (NLR) and the incidence of surgery-related acute kidney injury (AKI) in non-cardiac surgery patients under general anaesthesia. Methods In this retrospective study, 5057 patients from Third Xiangya hospital from January 2012 to December 2016 and 1686 patients from Second Xiangya hospital from January 2016 to December 2016 for non-cardiac surgery under general anesthesia were included. According to receiver operating characteristic (ROC) curve constructed by NLR for postoperative AKI，the cut-off point was obtained as the basis for grouping low or high NLR. The baseline characteristics of two sets were compared with each other. A multi-factor model was constructed by Least absolute shrinkage and selection operator (LASSO) method with the training set, and verified by outside validation set. Results 243 patients (3.604 %) developed postoperative AKI. The ROC curve showed that the AUC of the NLR for predicting postoperative AKI in non-cardiac surgery was 0.743 (95 % CI, 0.717-0.769), and the cut-off value was 3.555 (sensitivity, 86.4 %; specificity 51.9 %). There was no significant difference in the baseline characteristics of training set and validation set. The AUC in the training set was 0.817 (95 % CI, 0.784-0.850), and the AUC in the validation set was 0.804 (95 % CI, 0.749-0.858), the AUC deviation was 0.012 (P > 0.05) from validation set, and the likelihood ratio test showed P < 0.05. Conclusion This study showed that preoperative high NLR (NLR≥3.555) was an independent risk factor associated with postoperative AKI (OR, 2.410; 95 % CI, 1.371-4.335) in patients for non-cardiac surgery under general anesthesia.
Growth and Autolysis of Kluyveromyces Marxianus Stimulated with Lactate Provides Insights into Symbiosis
Authors: Lo Shou-Chen , Yang Chia-Yin , Mathew Dony , Huang Chieh-Chen
Published: January 2021

Kluyveromyces marxianus is a yeast that was identified from kefir and can use a broad range of substrates, such as glucose and lactate, as carbon sources. The lactate produced in kefir culture can be a substrate for K. marxianus. However, the complexity of the kefir microbiota makes the traits of K. marxianus difficult to study. In this research, we focused on K. marxianus cultured with lactate as the sole carbon source. The optimal growth and released protein in lactate culture were determined under different pH conditions, and the LC-MS/MS-identified proteins were associated with the tricarboxylic acid cycle, glycolysis pathway, and cellular stress responses in cells, indicating that autolysis of K. marxianus had occurred under the culture conditions. The abundant glyceraldehyde-3-phosphate dehydrogenase (GAP1) was crystallized in the cell-free fraction, and the low transcription level of the GAP1 gene indicated that the protein abundance under autolysis conditions was dependent on protein stability. These results suggest that lactate produced by lactic acid bacteria stimulates the growth and autolysis of K. marxianus, releasing proteins and peptides. These findings can be fundamental for K. marxianus probiotic and kefir studies in the future.
Development of Novel Deep Multimodal Representation Learning-based Model for the Differentiation of Liver Tumors on B-Mode Ultrasound Images
Authors: Sato Masaya , Kobayashi Tamaki , Soroida Yoko , Tanaka Takashi , Nakatsuka Takuma , Nakagawa Hayato , Nakamura Ayaka , Kurihara Makoko , Endo Momoe , Hikita Hiromi , Sato Mamiko , Gotoh Hiroaki , Iwai Tomomi , Tateishi Ryosuke , Koike Kazuhiko , Yatomi Yutaka
Published: January 2021

Recently, multimodal representation learning for images and other information such as numbers or language has gained much attention due to the possibility of combining latent features using a single distribution. The aim of the current study was to analyze the diagnostic performance of deep multimodal representation model-based integration of tumor image, patient background, and blood biomarkers for the differentiation of liver tumors observed using B-mode ultrasonography (US). First, we applied supervised learning with a convolutional neural network (CNN) to 972 liver nodules in the training and development sets (479 benign and 493 malignant nodules), to develop a predictive model using segmented B-mode tumor images. Additionally, we also applied a deep multimodal representation model to integrate information about patient background or blood biomarkers to B-mode images. We then investigated the performance of the models in an independent test set of 108 liver nodules, including 53 benign and 55 malignant tumors. Using only the segmented B-mode images, the diagnostic accuracy and area under the curve (AUC) values were 68.52% and 0.721, respectively. As the information about patient background such as age or sex and blood biomarkers was integrated, the diagnostic performance increased in a stepwise manner. The diagnostic accuracy and AUC value of the multimodal DL model (which integrated B-mode tumor image, patient age, sex, AST, ALT, platelet count, and albumin data) reached 96.30% and 0.994, respectively. Integration of patient background and blood biomarkers in addition to US image using multimodal representation learning outperformed the CNN model using US images. We expect that the deep multimodal representation model could be a feasible and acceptable tool that can effectively support the definitive diagnosis of liver tumors using B-mode US in daily clinical practice.