bluuebunny/crossref_metadata_2025 huggingface dataset:
Cytoreductive Surgery (CRS) Plus Hyperthermic Intraperitoneal Chemotherapy (HIPEC) vs CRS Alone for Treatment of Endometrial Cancer with Peritoneal Metastases: A Multi-Institutional Study from PSOGI and BIG RENAPE Groups
Authors: DAVID Manuel GOMES , Bakrin N. , Salleron J. , Kaminsky M. C. , Bereder J. M. , Tuech J. J. , Lehmann K. , Mehta S. , Glehen O , Marchal F.
Published: August 2021

ObjectiveTo investigate the benefit of cytoreductive surgery (CRS) combined with hyperthermic intraperitoneal chemotherapy (HIPEC) for the treatment of endometrial peritoneal carcinomatosis compared to CRS alone.MethodsWe conducted a retrospective multicentre study of patients from experienced centres in treating peritoneal malignancies from 2002 to 2015. Patients who underwent surgery for peritoneal evolution of endometrial cancer (EC) where included. Two groups of 30 women were matched and compared: “CRS +HIPEC” which used HIPEC after CRS, and “CRS only” which did not used HIPEC. We analysed clinical, pathologic and treatment data for patients with peritoneal metastases from EC. The outcome measures were morbidity, overall survival (OS), and progression-free survival (PFS).ResultsIn “CRS plus HIPEC” group, 96,7% of women were treated for recurrence, while in “CRS only” 83,3 were treated for primary disease. There was no significant difference between Peritoneal Carcinomatosis Index at laparotomy or Completeness of Cytoreduction score. Grade III and IV complications rates did not significantly differ between “CRS plus HIPEC” group and “CRS only” group (20.7% vs 20.7%, p=0.739). Survival analysis showed no statistical difference between both groups. Median OS time was 19.2 months in “CRS plus HIPEC” group and 29.7 months in “CRS only” group (p=0.606). Median PFS survival time was 10.7 months in “CRS plus HIPEC” group and 13.1 months in “CRS only” group (p=0.511).ConclusionThe use of HIPEC combined to CRS appears to be as effective, well tolerated and feasible as CRS alone in patients with primary or recurrent peritoneal metastasis of endometrial cancer.
Prophylactic Effect of Memantine in Docetaxel Induced Neuropathy in Patients With Breast Cancer
Authors: Mohammadzadeh Pegah , Shaseb Elnaz , Sanaat Zohreh , Sarbakhsh Parvin , Gholami Nasrin , Boostani Farnaz , Akbari Farideh , Ghaffary Saba
Published: August 2021

Purpose

Peripheral neuropathy is a complication of taxane that in severe cases can limit the optimal treatment. The aim of this study was to evaluate the efficacy of memantine in prevention of docetaxel induced peripheral neuropathy in patients with breast cancer.
Methods

In this randomized clinical trial, 40 women between the ages of 18 and 64 years with non-metastatic breast cancer (stages I to III) were included (registry number: IRCT20160310026998N9 and registry date: 26 March 2019). All patients were treated with the AC-T regimen (with docetaxel). Patients in intervention group received memantine at a dose of 20 mg for 8 weeks at the beginning of the first cycle of docetaxel. Patients in control group did not take any medication for neuropathy prevention. To assess the neuropathy, DN4 and CTCAE questionnaires were used at baseline, one months, three months and six months after the intervention.
Results

The DN4 questionnaire score was remarkably less in memantine group in follow up one (p-value: 0.033) and three (p < 00.1). The CTCAE follow up score did not change during study. The Neuropathy duration and Neuropathy onset, were shown significant difference between the intervention and control groups, p = 0.050 and p = 0.001, respectively. From 40 patients, 8 (40%) in memantine group and 2 (10%) in control group, did not experience any kind of neuropathy.
Conclusion

Data showed that prophylactic administration of memantine 20 mg/day has been effective in prevention of severity and incidence of docetaxel induced neuropathy in patients with breast cancer.
Associations of FKBP5 Polymorphisms and Methylation and Parenting Style With Depressive Symptoms Among Chinese Adolescents
Authors: Guo Lan , Wang Wanxin , Guo Yangfeng , Du Xueying , Shi Guangduoji , Lu Ciyong
Published: August 2021

Background

Genetic factors may interplay with environmental stressors to contribute to risks of depressive symptoms. This study aimed to investigate the association of FKBP5 polymorphisms and DNA methylation with depressive symptoms among Chinese adolescents, considering the role of parenting style.
Methods

This study used a nested case-control study design based on a cohort study, and the case (n = 120) and control groups (n = 118) were matched with age. Depressive symptoms, parenting style, and other demographics were measured. Fourteen potential polymorphisms and one promoter region in the FKBP5 gene were selected for genotyping and methylation analysis.
Results

In the adjusted models, a significant association between FKBP5 rs7757037 and depressive symptoms was found in the codominant model (AG vs. GG; adjusted odds ratio [AOR] = 2.37, 95% CI = 1.07–5.28) and dominant model (AA + AG vs. GG; AOR = 2.22, 95% CI = 1.05–4.69); rs2817032 polymorphism was associated with depressive symptoms in the codominant model and dominant model. Significant interactions between rs7757037 and the father’s parenting style were found in the codominant model (P = 0.037) and dominant model (P = 0.038), but the gene-environment interactions were not significant after correcting for multiple testing. The main and interactive effects of FKBP5 methylation status on depressive symptoms were not observed, and no significant mediations were found in the association between FKBP5 polymorphisms and depressive symptoms through the methylation mechanism.
Conclusions

Further studies are required to confirm the effect of FKBP5 polymorphisms and methylation as well as their interactions with parenting styles in larger samples.
Effect of Energy Supplementation On Intake, Digestibility of Diets and Performance of Grazing Lambs During The Rainy Season
Authors: Silva Abias Santos , Pedreira Márcio dos Santos , Silva Herymá Giovane de Oliveira , Junior Antônio Amandio Pinto Garcia , Almeida Paulo José Presídio , Rocha Leone Campos , Diavão Jaciara
Published: August 2021

This study aimed to evaluate different energy sources in multiple supplements on performance, intake and digestibility of Santa Ines sheep grazing urochloa grass (Urochloa mosambicensis) during the rainy season. The experimental area was divided into seven paddocks of four-ha each, with an average of dry matter (DM) availability of 3213.45 kg/ha. A completely randomized design was carried out, in which there were four treatments, and each treatment was repeated six times. Twenty-four intact lambs (average: 32 kg of body weight) were supplemented with a mineral mixture, the control group (MM), mesquite pod meal (MPM), wheat bran (WB) or sorghum grain (SG) as energy sources. The digestibility of DM and crude protein (CP) in MPM, and WB is higher than in MM and SG groups. The DM digestibility was higher in the WB group; however, there was no difference between the other treatments. Neutral Detergent Fiber (NDF) digestibility was similar between supplemented lambs, and it was higher than the MM. The supplementation promoted higher weight gain than in the control group (0.125 vs. 0.61 g/day, respectively; P < 0.001). The supplementation increased the DM, and CP intake. The NDF intake only increased in the WB group. The CP digestibility was higher for the MPM and WB groups than for MM and SG ones (P < 0.001). Sheep supplementation in the rainy season increased the average daily gain (ADG). Any supplement tested in the present study can be used during the rainy season. The choice for the supplement will depend on the availability and costs of the supplement.
Factors Associated with Poor Viral Suppression Among Children and Adolescents Accessing Antiretroviral Therapy in Selected Health Facilities in Lagos, Nigeria
Authors: Egbonrelu Nneka , Awolola Adeola , Lawanson Teniola , Ogunsola Olabanjo , Odole-Akinyemi Oluwagbemisola , Olugbusi Janet , Akinmoladun Adebayo , Babalola Oluwatosin , Ogwara Chigozie , Akande Patrick , Olaitan Remi , Ogunyemi Kehinde Olawale , Okonkwo Prosper
Published: August 2021

IntroductionNigeria has the second largest HIV burden in Sub-Saharan Africa, with high burden amongst children and adolescents. In 2017, it was estimated that 160,000 children (0-9 years) and 230,000 adolescents (10-19 years) are living with HIV globally, with death in 21,000 children and 5400 adolescents resulting from AIDS-related illnesses. The main objective of the study was to determine the factors associated with poor viral suppression in children and adolescents accessing antiretroviral therapy in secondary health facilities in Lagos State.MethodsA descriptive retrospective study of children and adolescents living with HIV accessing care and support in 7 Global Fund supported ART treatment facilities in Lagos between January 2013 and June 2020. Data extraction was done between July 2020 and August 2020. The sociodemographic, clinical and laboratory data were extracted from patients’ folders. Binary logistic regression model was done to identify the determinants of viral non-suppression among children and adolescents age groups. ResultsThe study population consisted of 363 children (age 0-9 years) and 275 adolescents (age 10-19 years). The mean age of children was 5.8±2.2 years and that of adolescent was 13.21±2.8years. About 256(70 %) of children were virally unsuppressed and 118(43 %) had non-suppressed viral load status among adolescents. Binary logistic regression showed that children with WHO stage IV of HIV disease had greater odds (OR=7.984, 95% CI=1.042-61.163) of having suppressed viral load and children who live with their non-biological caregiver had greater odds of having a suppressed viral load compared to the biological caregiver group (OR=2.0421, 95% CI=1.083-10.965). Among adolescents, binary logistic regression showed location of abode and drug pick-up pattern as independent predictors of poor viral suppression. Adolescent patients living in rural setting had greater odds of being virally unsuppressed compared to those living in urban settlement (OR=1.755, 95% CI=1.001-3.083) while patients who have regular drug pick-up pattern from their ART health centres had lesser odds (OR=0.585, 95% CI=0.591-0.912) of viral non-suppression.CONCLUSIONThe findings highlight the need for a renewed focus on developing and strengthening HIV programmes in rural areas where children and adolescents living with HIV are more likely to be virally unsuppressed. More emphasis and resources should be channelled to Public health intervention such as health education, social support group programmes to improve drug pick up and adherence in adolescents living with HIV.
Differences In Awareness of Positive And Negative Age-Related Changes Account For Variability In Health Outcomes
Authors: Sabatini Serena , Ukoumunne Obioha , Brothers Allyson , Diehl Manfred , Wahl Hans-Werner , Ballard Clive , Collins Rachel , Corbett Anne , Brooker Helen , Clare Linda
Published: August 2021

Higher awareness of positive age-related changes (AARC gains) is related to better mental health, whereas higher awareness of negative age-related changes (AARC losses) is related to poorer mental and physical health. So far perceived gains and losses have been explored separately, but people report gains and losses concurrently in varying degrees, and different profiles of gains and losses may be differentially associated with health. We identified profiles of gains and losses and explored whether different profiles differed in physical, mental, and cognitive health. We used cross-sectional data from the PROTECT study (N= 6,192; mean(SD) age= 66.1(7.0)). Using latent profile analysis, a four-class solution showed the best model fit. We found that 45% of people perceived many gains and few losses (Class 1); 24% perceived moderate gains and few losses (Class 2); 24% perceived many gains and moderate losses (Class 3); 7% perceived many gains and many losses (Class 4). Analysis of variance and Chi-square tests showed that Class 1 had relatively better physical, mental, and cognitive health, followed by Classes 2, 3, and 4. Experiencing one’s ageing to a high degree as gain may be related to better health only when individuals interpret ageing as involving low levels of loss across several life domains. Risk in terms of poorer health emerged in those who perceived high losses. Considering gains and losses in parallel, rather than separately, may lead to a more fine-tuned understanding of relations with health.
Comparison of Objective and Subjective Sleep Time and Quality in Hospitalized Recipients of Hematopoietic Stem Cell Transplantation
Authors: Park Min kyoung , Suh Eunyoung E.
Published: August 2021

PurposeThis study investigated the sleep time and efficiency of recipients of hematopoietic stem cell transplantation (HSCT) throughout treatment and compared objective measurements with subjective self-reported data.MethodsSleep time and efficiency were measured using both objective and subjective methods throughout the treatment period in inpatients receiving HSCT. The participants were recruited among HSCT inpatients at a tertiary hospital in Seoul, South Korea, between August 2019 and August 2020. Actigraphy was used to measure objective sleep time and efficiency, and patients self-reported their sleep time during the same periods. Sleep quality was measured using the Insomnia Severity Index (ISI).ResultsMeasurement data from 40 patients were analyzed. The objective total sleep time was the lowest in the conditioning period, and there was a significant gap between treatment time points after accounting for the corresponding differences in measurement methods. There were no significant differences between subjective and objective results for sleep time (p=0.414), and the interaction between the two methods over time was not significant (p=0.345). However, meaningful differences were found among the groups in sleep efficiency throughout the treatment period (p= 0.001) and between objective and subjective methods (p<0.001), as well as a statistically significant interaction between the two methods over time (p= 0.002).Conclusion.Actigraphy misclassified patients’ low-energy state with little movement due to immune system impairment during treatment as sleep, resulting in high measured sleep efficiency, whereas their self-reported sleep efficiency was very low. Therefore, subjective measures might be more accurate for measuring sleep efficiency in HSCT patients.
An Evolutionary Trajectory Planning Algorithm for Multi-UAV-Assisted MEC System
Authors: Asim Muhammad , Khan Wali , Belhaouari Samir Brahim
Published: August 2021

This paper presents a multi-unmanned aerial vehicle (UAV)-assisted mobile edge computing (MEC) system, where multiple UAVs are used to serve mobile users (MUs). We aim to minimize the overall energy consumption of the system by planning the trajectories of UAVs. To plan the trajectories of UAVs, we need to consider the deployment of hovering points (HPs) of UAVs, their association with UAVs, and their order for each UAV. Therefore, the problem is very complicated, as it is non-convex, nonlinear, NP-hard, and mixed-integer. To solve the problem, this paper proposed an evolutionary trajectory planning algorithm (ETPA), which comprises three phases. In the first phase, variable-length GA is adopted to update the deployments of HPs for UAVs. Accordingly, redundant HPs are removed by the remove operator. Subsequently, differential evolution clustering is adopted to cluster HPs into different clusters without knowing the number of HPs in advance. Finally, a GA is proposed to construct the order of HPs for UAVs. The experimental results on a set of eight instances show that the proposed ETPA outperforms other compared algorithms in terms of the energy consumption of the system.This paper presents a multi-unmanned aerial vehicle (UAV)-assisted mobile edge computing (MEC) system, where multiple UAVs are used to serve mobile users (MUs). We aim to minimize the overall energy consumption of the system by planning the trajectories of UAVs. To plan the trajectories of UAVs, we need to consider the deployment of hovering points (HPs) of UAVs, their association with UAVs, and their order for each UAV. Therefore, the problem is very complicated, as it is non-convex, nonlinear, NP-hard, and mixed-integer. To solve the problem, this paper proposed an evolutionary trajectory planning algorithm (ETPA), which comprises three phases. In the first phase, variable-length GA is adopted to update the deployments of HPs for UAVs. Accordingly, redundant HPs are removed by the remove operator. Subsequently, differential evolution clustering is adopted to cluster HPs into different clusters without knowing the number of HPs in advance. Finally, a GA is proposed to construct the order of HPs for UAVs. The experimental results on a set of eight instances show that the proposed ETPA outperforms other compared algorithms in terms of the energy consumption of the system.
The Expected Length of Stay At Aged Care Facilities in Australia: Current and Future
Authors: Shi Yanlin , Zhang Jinhui
Published: August 2021

This paper analyzes the hazard functions of exiting from an aged care facility in Australia. Using a comprehensive dataset ranging over 2008--2018, we find that those functions are heterogeneous across the age, sex and year-of-leaving. The modelling results lead to in-sample estimated expected length of stay (LOS) for residents differed by age (in general, longer for older groups) and sex (longer for females). The estimated LOS declines gradually from 2008 to 2014 and then steadily increase afterwards for all heterogeneous age and sex groups. Out-of-sample predictions up to 2100 suggest that the longest LOS belongs to females aged 100 and older, with the estimated/predicted LOS increasing from 58.6 months in 2018 to 68.9 months in 2100. Relative uncertainty measures are also provided. Those results can be used to explore the nature of and aspects to improve service quality of Australian aged care facilities for policy makers.
A Nine-Immune-Related Gene Prognostic Signature for Predicting Outcomes in High-Grade Serous Ovarian Cancer
Authors: Jiang Yahui , Lyu Tianjiao , Zhou Tianyu , Shi Yiwen , Feng Weiwei
Published: August 2021

Background: Recently, immune system has been shown to be indispensable for ovarian cancer progression. The key immune-related genes (IRGs) related to the overall survival of ovarian cancer patients should be taken seriously. Here, we screened 9 survival-related IRGs in high-grade serous ovarian cancer (HGSOC) and build a prognostic signature to predict the outcome of HGSOC patients.Methods: We downloaded RNA-sequence profiles from The Cancer Genome Atlas (TCGA) and Genome Tissue Expression (GTEx) databases to identify differentially expressed genes between normal fallopian tube and HGSOC. Among these genes, IRGs were filtered based on the Immunology Database and Analysis Portal (ImmPort). Using univariate Cox regression, Lasso regression and multivariate Cox regression, we selected 9 survival-related IRGs and established a prognostic signature to compute the risk score. Patients were divided into a low-risk group and a high-risk group, and the immunological feature differences between them were analysed with the ESTIMATE R package, TIMER and GSEA software. Moreover, the prognostic signature was validated by data from Gene Expression Omnibus (GEO) datasets.Results: We obtained 1544 differentially expressed genes in HGSOC compared with normal fallopian tube, among which 99 genes were related to immunology. After univariate Cox regression, Lasso regression and multivariate Cox regression, nine IRGs (HLA-F, PSMC1, PI3, CXCL10, CXCL9, CXCL11, LRP1, STAT1 and OGN) were identified as optimal survival-related IRGs and used to establish a prognostic signature for calculating the risk scores of HGSOC patients. The prognostic signature showed its efficiency in predicting the overall survival of HGSOC patients in TCGA training cohort (p=1.018e-8) and GEO test cohort (p=2.632e-2). Age and risk scores were independent risk factors for overall survival. As the risk scores increased, the proportions of neutrophil, dendritic cells, CD8+ T cells, CD4+ T cells and B cells decreased (p values were 0.026, 1.909e-4, 9.165e-10, 0.003 and 2.658e-4, respectively). In addition, 21 out of 24 HLA-related genes were highly expressed in the low-risk group than in the high-risk group. The above might prompt a stronger immune response in the low-risk group.Conclusions: Our study constructed a nine-IRG-based prognostic signature that could effectively predict the overall survival of HGSOC patients and become a promising therapeutic target for HGSOC treatments.
Evaluation of Traffic Noise Pollution Around The Shrine of Imam Reza Using GIS And Descriptive Statistics Analysis (A Case Study of Mashhad, Iran)
Authors: Gheibi Mohammad , Karrabi Mohsen , Latifi Pooria , Fathollahi-Fard Amir Mohammad
Published: August 2021

The environmental consequences and the epidemiologic results of noise pollution have chronic effects and lead to widespread complications in the long run. Thus it might receive less attention by pollution monitoring and control systems when compared with other environmental pollutants. The city of Mashhad is Iran’s second largest metropolitan city and it is one of the biggest world religious cities in the world. Each year it becomes one of the main destinations for travel for tourists and pilgrims in Iran and abroad in the holidays of the beginning of the year and the summer. In this research study the distribution of sound pollutants in the streets and sidewalks leading to the Holy shrine of Imam Reza is investigated. Field measurements were carried out by noise level meters and on longitudinal and transverse points of the sidewalk of the streets leading to the Holy Shrine. All of the measurements and recordings were done during the peak of morning crowd (AM 10-12) and evening crowd (PM 4-6) and on both of the sidewalks of each street. The study showed that the pollution in all of the studied streets in the evening time span (PM 4-6) has the maximum level of noise. Among all of the studied streets, Tabarsi street has the most amount of noise pollution with a mean of 78 dB(A) for the mean intensity for each point and Imam Reza street has the minimum amount of pollution with a mean of 72.75 dB(A). The investigations showed that, from the temporal perspective, the noise pollution peaks in the evening, when weather conditions are most favorable for visiting the area. From the spatial perspective, the most intensive noise pollution was observed in the areas with residential and accommodation land use, which have the highest number of arterial routes towards the shrine.
Endocrinological Aspects of Pituitary Adenoma Surgery in Europe
Authors: Netuka David , Grotenhuis André , Foroglou Nicolas , Zenga Francesco , Froehlich Sebastien , Ringel Florian , Sampron Nicolas , Thomas Nick , Komarc Martin , Kosak Mikulas , Majovsky Martin
Published: August 2021

Purpose:Hormone-secreting adenomas are treated in many neurosurgical centers within Europe. The goal of the survey is to shed light on different endocrinological aspects of hormone-secreting adenomas surgery.Methods: A list of departments performing pituitary surgery was created. The survey consisted of 58 questions. This study focuses on neurosurgical care of hormone-secreting adenomas. For analysis, the departments were divided into four subgroups: academic/non-academic, high-volume/low-volume, “mainly endoscopic/mainly microscopic practice” and geographical regions. Results: Data from 254 departments from 34 countries were obtained. Most centers surgically treat 1-5 hormone-secreting adenomas per year. In prolactinomas this is the case in 194 centers, (76.4%), in GH-secreting adenomas: 133 centers, (52.4%), ACTH-secreting adenomas: 172 centers, (69.8%). Surgery as a primary treatment of prolactinomas is considered in 64 centers (25.2%). In 47 centers (18.8%), GH-secreting microadenomas are often treated pharmacologically first. Debulking surgery for an invasive GH-secreting adenoma in which hormonal remission is not a realistic goal of the surgery and the patient has no visual deficit surgery is always or mostly indicated in 156 centers (62.9%). Routine postoperative hydrocortisone replacement therapy is administered in 147 centers (58.6%). Conclusions:Our survey shows that in most centers, few hormone-secreting adenomas are treated per year. In about 25% of the centers, prolactinoma surgery may be regarded as first-line treatment; in about 20% of the centers, medical treatment is the first-line treatment for GH-secreting adenomas. Pretreatment for ACTH-secreting adenomas is routinely used in 21% of centers. This survey may serve as plea for neurosurgical care centralization of hormone-secreting adenomas.
Treatment of Comminuted Proximal Humeral Fractures with Fibular Autografts
Authors: Wang Binggang , Liu Na , Zhang Lifeng , Guan Pengfei
Published: August 2021

Background: For severe proximal humerus comminuted fractures, which are often accompanied by a large number of fracture defects, there are many cavities left at the fracture end after reconstruction, which is one of the important factors leading to the failure of internal fixation. At present, the appropriate treatment of these proximal humerus comminuted fractures has not been identified. The purpose of this study used locking plates combined with fibular autografts was increased fixed strength for the treatment of severe comminution fractures of the proximal humerus with bone defects. Methods: 10 cases of comminuted fracture of proximal humerus with bone defect were treated with open reduction and plate internal fixation combined with autologous fibular segment structural bone grafting. The postoperative follow-up was summarized and statistically analyzed by a paired sample t test.Results: There was a total of 10 cases, including 7 cases that had full follow up data. The constant Murley score of the shoulder joint was 88.57±4.28 points at 12 months after the operation. The preoperative HSS score of the knee joint was 90.14±4.95 points. The HSS score of the knee at 12 months after the operation was 90.5±5.47 points. The preoperative HSS score and the postoperative 12-month score had P=0.088 (>0.05). The shoulder function score at 12 months was defined as excellent in 2 cases, good in 5 case, and 100% of the patients had excellent or good scores.Conclusions: Locking plates combined with autogenous fibula segment transplantation may be an effective treatment for severe comminution fractures of the proximal humerus with bone defects.
Leucine Rich Alpha-2-Glycoprotein 1 Is A Novel Predictor Of Diastolic Dysfunction: A Cross-Sectional Study
Authors: Loch Alexander , Tan Kok Leng , Danaee Mahmoud , Idris Iskandar , Li Ng Mei
Published: August 2021

Background. Leucine-rich α2-glycoprotein (LRG1) mediates cardiac fibrocyte activation. It is upregulated in inflammatory conditions, atherosclerosis, and fibrosis. Diastolic dysfunction (DD) is due to myocardial fibrosis. This study examined the relationship between LRG1 and DD. Methods. Patients with symptoms of chronic coronary ischemia were recruited. Exclusion criteria: symptoms of overt heart failure, ejection fraction (EF) < 55%, impaired renal function, infection, recent trauma. Investigations: SYNergy between percutaneous coronary intervention with TAXus and cardiac surgery (SYNTAX) score, Echocardiographic assessment, and LRG1 levels. Binary stepwise logistic regression to evaluate the relationship between LRG1 and DD. ROC analysis with calculation of optimal cut-off values. Results. 94 patients were included; 47 had diastolic dysfunction. Serum LRG1 was significantly (U = 417.00, p<0.001) higher in the DD group (M=14) compared to the No-DD group (M=8) (U-Mann Whitney Test). There were higher SYNTAX scores in the DD group (M = 24.5) compared with No-DD (M=7). LRG1 had significant predictability of DD (OR =1.30 (95% CI:1.13-1.49)). The ROC for the adjusted model had an AUC=0.89 (95% CI: 0.82-0.95). The cut-off value of “9” LRG1 had a 78% sensitivity (95% CI: 65.3–87.7) and 72.3% specificity (95% CI: 57.4 – 84.4) for predicting DD. Conclusions. We identified LRG1 as a novel independent predictor of diastolic dysfunction. Further studies are warranted to validate the utility of LRG1 in predicting DD.
Protective Effects of Ulinastatin Combined With Thrombomodulin Against Lipopolysaccharide Induced Liver and Kidney Injury in Septic Rats
Authors: Zhang Xiong , Su Chenlin , Zhao Shuxin , Yang Jiaying , Anger Etienne Empweb , Li Xiaoxing , Feng Chen , Liao Qianwen , Li Ji , Yu Feng
Published: August 2021

Background: Sepsis, a systemic inflammatory disease that leads to life-threatening organ functions disorders, such as liver and kidney injury. Ulinastatin (UTI) and Thrombomodulin (TM) are active macromolecules isolated from human urine. UTI and TM have been found to have therapeutic effects on inflammatory diseases. In this study, we verified protective effect of UTI combined with TM on liver and kidney injury caused by sepsis, and further explored the mechanisms.Methods: The sepsis model was established by intravenous injection of LPS into the tail vein of rats. Blood, liver and kidney tissues were collected after injection of UTI or TM. ELISA was used to measure serum levels of pro-inflammatory cytokines. The characteristic functional indexes of liver and kidney in serum and multiple coagulation function indexes of rats were detected via corresponding kits. Histological changes of liver and kidney tissues were investigated by HE staining. Apoptosis in liver and kidney tissues were examined by TUNEL staining, and the expression levels of apoptosis-related proteins were also analyzed. HMGB1/TLR4/NF-κB pathway in liver and kidney tissues were examined by Western Blot. PCNA-positive cells were detected by immunohistochemistry. The survival rate of rats in each group was statistically analyzed.Results: UTI combined with TM reduced LPS-induced secretion of IL-6 and TNF-α in the serum. The drug combination reduced the liver and kidney functional indicators ALT, AST, BUN and Cr, and ameliorated liver and kidney pathology injury of rats. It inhibited apoptosis of liver and kidney cells via down-regulating the expression of apoptotic protein Bax, Cleaved caspase-3, up-regulating the expression of anti-apoptotic protein bcl-2, and promoted the proliferation of liver and kidney cells. The drug combination reversed the up-regulation of HMGB1, TLR4, and phosphorylated NF-κB protein mediated by LPS. Anticoagulation test indicated UTI does not affect the anticoagulant effect of TM when they are used in combination. Moreover, the drug combination significantly improved the survival rate of septic rats. Conclusions: These results indicate that UTI combined with TM plays a key role in protecting liver and kidney injury in septic rats, which will suggest a promising treatment for sepsis-induced organ injury.
Preoperative Lymphocyte to Monocyte Ratio as a Predictor of Prognosis for Patients Treated with Resection of Renal Cell Carcinoma with Venous Tumor Thrombus
Authors: Lv Zheng , Feng Hua-Yi , Wang Tao , Ma Xin , Zhang Xu
Published: August 2021

Objectives: To evaluate the prognostic value of preoperative lymphocyte to monocyte ratio (LMR) in patients with renal cell carcinoma and venous tumor thrombus (RCC-VTT) after surgery. Methods: We retrospectively reviewed the medical data of 144 consecutive patients with RCC and level I-IV VTT after surgery. Kaplan-Meier method was used to assess and compare survival. Univariable and multivariable Cox proportional hazard models were constructed to identify the independent prognostic factor for survival. The Harrell concordance index was used to assess the predictive accuracy. Results: Decreased preoperative LMR was significantly correlated with clinicopathologic features that are associated with tumor progression. Decreased preoperative LMR was an independently risk factor for decreased OS (P < 0.05) and PFS (P < 0.05). To evaluate PFS, integrating LMR to each model led to an increased predictive accuracy of 6.9% for TNM staging model (P = 0.014), 6.8% for UISS model (P = 0.006), 3.4% for SSIGN model (P = 0.017), respectively. Incorporating LMR into SSIGN model led to an increased predictive accuracy of 6.5% for OS (P < 0.001). Conclusions: Preoperative LMR is an independent prognostic factor for patients with RCC-VTT after surgery. Adding preoperative LMR to the prognostic models enhance their predictive accuracy.
A Novel Technique of Transpedicular Opening-wedge Osteotomy for Treatmtent of Rigid Kyphosis in Patients With Ankylosing Spondylitis
Authors: Zheng Guangbin , Hong Zhenghua , Wang zhangfu , Zheng Binbin
Published: August 2021

BackgroundTo investigate the effectiveness and feasibility of a novel vertebral osteotomy technique, transpedicular opening-wedge osteotomy (TOWO) for correcting rigid thoracolumbar kyphotic deformity in patients with ankylosing spondylitis (AS).Methods18 AS patients underwent TOWO for correcting rigid thoracolumbar kyphosis. Radiographic parameters were compared before surgery, 1 week after surgery and at last follow-up. SRS-22 questionnaire was assessed before surgery and at last follow-up to evaluate clinical improvement. The operating time, estimated blood loss and complications were analyzed. ResultsThe mean operating time and estimated blood loss were 236 minutes and 595 ml, respectively. Sagittal parameters improved significantly after surgery. The height of anterior column of osteotomized vertebrae was increased significantly at 1 week after surgery and last follow-up when compared to preoperative, but the height of middle column did not changed significantly. SRS-22 scores were improved significantly at last follow-up than preoperative. Solid fusion was achieved in all patients after 12 months follow-up, no screw loosening, screw pull out or rod breakage was noticed at last follow-up. ConclusionsTOWO could achieve a satisfactory kyphosis correction by opening anterior column instead of vertebral body decancellation and posterior column closing, which simplified the osteotomy procedure and improved the surgical efficacy.
Fire Performance of Automated Tall Car Park Structures
Authors: Ayva Burak , Selamet Serdar
Published: August 2021

Automated tall car park structures are modern alternatives to conventional parking structures to save space and volume in highly demanded parking regions in urban areas. -The design of such structures has significant knowledge gaps especially in regarding the effects of fire spread between passenger cars. The purpose of this study is to estimate the horizontal and vertical fire spread between passenger cars in automated tall car park structures and provide fire safety design to eliminate fire spread and possible structural collapse. The fire spread between cars is established by estimating irradiance heat flux of each car component. An 8-floor automated tall car park structure is designed in accordance with European standards. The results show that steel car pallets underneath cars reach to 1000 degree Celsius in early phases of fire, which could potentially cause a structural failure. Without any fire protection on the structure, the fire spreads to the neighboring cars in 25 minutes and to the cars above in 20 minutes. Significant fire protection is needed to eliminate fire spread between passenger cars. A more effective sprinkler system is also proposed to suppress the car fire.
Statins’ safety and impact on the clinical outcomes in COVID-19 critically ill patients: A Multicenter, Cohort Study
Authors: Sulaiman Khalid Al , Aljuhani Ohoud , Korayem Ghazwa B. , Altebainawi Ali F. , Harbi Shmeylan Al , Shaya Abdulrahman Al , Badreldin Hisham A. , Kensara Raed , Harthi Abdullah Al , Alghamdi Jahad , Alawad Ahad , Alotaibi Rand , Kharbosh Abdullah , Muqati Hessa Al , Alhuwahmel Abdulmohsen , Almusallam Mohammed , Sulaihim Ibrahim Al , Alanazi Bader , Al-Dosari Bodoor S. , Vishwakarma Ramesh , Alsaeedi Alawi S. , Ghamdi Ghassan Al , Al-Dorzi Hasan M
Published: August 2021

Purpose

The complications of Severe Corona Virus Disease 2019 (COVID-19) are attributed to the overproduction of early response proinflammatory cytokines, causing a systemic hyperinflammatory state. Statins are potentially a potent adjuvant therapy in COVID-19 infection due to their pleiotropic and anti-inflammatory effects, which are independent of their cholesterol-lowering activity. This study investigates the impact of statin use on the outcome of critically ill patients with COVID-19.
Methods

A multicenter, retrospective cohort study of all adult critically ill patients with confirmed COVID-19 admitted to Intensive Care Units (ICUs) between March 1, 2020, and March 31, 2021. Eligible patients were classified into two groups based on statin use during ICU stay and were matched with a propensity score which was based on patient’s age and admission APACHE II and SOFA scores. The primary endpoint was in-hospital mortality. Other outcomes were considered secondary...
Results

A total of 1049 patients were eligible; 502 patients were included after propensity score matching (1:1 ratio). The 30-day (hazard ratio 0.75 (95% CI 0.58, 0.98), P = 0.03) and in-hospital mortality (hazard ratio 0.69 (95% CI 0.54, 0.89), P = 0.004) were significantly lower in patients who received statin therapy on multivariable cox proportional hazards regression analysis. Moreover, patients who received statin have a lower risk of hospital-acquired pneumonia (OR 0.48(95% CI 0.32, 0.69), P = < 0.001), lower levels of markers of inflammation on follow up and no increased risk of liver injury.
Conclusion

The use of statin during ICU stay in COVID-19 critically ill patients may have a beneficial role and survival benefits with a good safety profile.
Role of a New Age-adjusted D-dimer Cutoff Value for Preoperative Deep Venous Thrombosis Exclusion in Elderly Patients With Hip Fractures
Authors: Zhang Kexin , Zhu Yanbin , Tian Yunxu , Tian Miao , Li Xiuting , Zhang Yingze
Published: August 2021

Objective: This study aimed to describe the characteristics of plasma D-dimer level with increasing age and establish a new age-adjusted D-dimer cutoff value for excluding preoperative lower limb deep vein thrombosis (DVT) in elderly patients with hip fractures.Methods: This was a retrospective study of elderly patients who presented with acute hip fracture in our institution between June 2014 and May 2020. All patients underwent D-dimer test and duplex ultrasound. Patients were divided into six 5-year-apart age groups. The optimal cutoff value for each group was calculated by using receiver operating characteristic (ROC) curves, whereby the new age-adjusted D-dimer cutoff value was determined. The sensitivity, specificity, positive predictive values (PPV) and negative predictive values (NPV) were calculated and compared when different D-dimer cutoff values were applied, i.e. conventional 0.5mg/L, previously well-established age-adjusted cutoff value (age*0.01 mg/L) and the new age-adjusted D-dimer cutoff value herein. Results: There were 2759 included, 887 males and 1872 females, with an average age of 77.8 years. 280 patients were diagnosed with preoperative DVT. The optimal cutoff values for the six age groups were 0.715 mg/L, 1.170 mg/L, 1.620 mg/L, 1.665 mg/L, 1.690 mg/L and 1.985 mg/L, respectively and the calculated age-adjusted coefficient was 0.02 mg/L. With this new coefficient applied, the specificity was 61.3%, clearly higher than those for conventional threshold (0.5mg/L, 36.9%) or previously established age-adjusted D-dimer threshold (age*0.01 mg/L, 22.2%). In contrast, the sensitivity was lower than that (58.9% vs 85.0% or 77.1%) when D-dimer threshold of 0.5 mg/L or age-adjusted cutoff value (age*0.01 mg/L) was used. The other indexes as PPV (14.7%, 11.0% and 12.1%) and NPV (93.0%, 92.9% and 93.5%) were comparable when three different D-dimer thresholds were applied. Conclusions: The use of the new age-adjusted D-dimer threshold increased the proportion of elderly hip fracture patients in whom preoperative lower limb deep vein thrombosis could be safely excluded.
Comparative Analyses of Volatile Metabolites Associated With Gene Expression From Non-climacteric and Climacteric Melon.
Authors: Los Kamila Karoline de Souza , Schemberger Michelle Orane , Reis Leticia , Stroka Marília Aparecida , Galvão Caroline Weigert , Etto Rafael Mazer , Forney Charles F. , Domingues Daniele Santos , de Almeida Mariana Celano Menezes , Ayub Ricardo Antonio
Published: August 2021

Melon (Cucumis melo L.) is an important species in the cucurbits family with a large economic importance in the world. Two melon cultivars commercially important in Brazil are the cultivars ‘Yellow’ and ‘Gaúcho’. In addition to the economic importance, these two cultivars display phenotypic differences in aroma, a major trait determining fruit quality. Volatile organic compounds (VOC) impart the different aroma found in these fruit and its biosynthesis is associated with fatty acid and amino acid metabolism. Using SPME-GC–MS and RT-qPCR techniques, volatile production and expression of seven genes (CmLOX9, CmLOX18, CmBCAT1, CmArAT1, CmPDC1, CmADH1 and CmAAT1) were determined during maturation and ripening. The climacteric melon ‘Gaúcho’ had a greater number and higher concentration of volatiles than that in the non-climacteric ‘Yellow’ melon. 2-Methylallyl acetate, 4-amino-1-butanol, 2-methylbutanol and ethyl 2-methylpropanoate were found in high concentrations in ripe climacteric ‘Gaúcho’ melons and were major contributors to its strong fruity aroma, but high concentrations of these volatiles were not found in non-climacteric ‘Yellow’ melons. The lipid pathway played a strong role in determining aroma composition in non-climacteric ‘Yellow’ melons. Most volatiles decreased during maturation and ripening explaining the non-aromatic characteristic of this cultivar. In climacteric ‘Gaúcho’ melons, the amino acid pathway was the main one related to the biosynthesis of esters, which contribute to the aroma of this cultivar. Volatile products of the branched chain amino acid pathway correlated with CmADH1 and CmAAT1 expression demonstrating their role in volatile synthesis of this climacteric melon cultivar. In addition, CmPDC1 contributes to the formation of aldehydes at the beginning of this pathway.
CD8+ T Cell Densities and Stromal PD-L1 but not Tumoral PD-L1 Associated with Favorable Prognosis in Schistosomal Colorectal Cancer
Authors: Wang Weixia , Jing Hongyan , Liu Jican , Bu Dacheng , Zhang Yingyi , Zhu Ting , Lu Kui , Xu Yanchao , Cheng Meihong , Liu Jing , Yao Junxia , Huang Sinian , Wang Limei
Published: August 2021

Backgroud: It was known that the expression of programmed cell death-ligand 1 (PD-L1) was correlated with CD8+ T cells, which could produce IFNγ. The effect of infection of Schistosoma japonicum on CD8+ T cells and then on PD-L1 expression was unknown and the utility of CD8+ TILs as a biomarker for schistosomal CRC (SCRC) has rarely been reported. Methods: A total of 338 patients with CRC were enrolled. Immunohistochemical analysis was conducted to evaluate the expression of PD-L1, infiltration by CD8+ T cells. Results: In the total cohort, results showed that CD8+ TIL density was positively correlated with tumoral and stromal PD-L1 expression (p＜0.05). But there were no correlation between schistosomiasis and CD8+ TILs and PD-L1. Furthermore, CD8+ TIL density, schistosomiasis, TNM stage, lymph nodes positive for CRC and gender were independent predictive factors for overall survival (OS) (p＜0.05). Stromal PD-L1(sPD-L1) but not tumoral PD-L1(tPD-L1) expression was correlated with OS but it was not an independent predictor (p=0.046). In patients without schistosomiasis, CD8+T cells and sPD-L1 were associated with better OS (p＜0.05). In patients with schistosomiasis, CD8+T cells were independent prognosis factor (p=0.05). Conclusions: The study showed that CD8+ TILs was an independent predictive factor for OS in CRC and SCRC patients. The expression of PD-L1 was positively associated with CD8+TILs density. There were no correlation between schistosomiasis and CD8+TILs and PD-L1. Stromal PD-L1 but not tPD-L1 was significantly associated with OS, whereas it was not an independent prognostic factor.
High SPAG5 Expression Is Associated With Oncological Features in Endometrial Carcinoma
Authors: Arora Mohit , Kumari Sarita , Singh Jay , Palanichamy Jayanth Kumar , Qamar Imteyaz , Chauhan Shyam S. , Chopra Anita
Published: August 2021

Sperm-associated Antigen 5 (SPAG5, also called astrin) is a mitotic spindle protein. SPAG5 has emerged as a promising biomarker and therapeutic target in a variety of cancers. However, its expression and role in endometrial cancer (EC) remain to be studied. Using multi-omic authoritative datasets from the TCGA and CPTAC studies, we characterized theexpression, regulation of SPAG5 and its association with clinicopathological and molecular features in EC. SPAG5 was observed to be overexpressed in tumor tissues compared to controls and receiver operating characteristic analysis suggested that its mRNA levels are an excellent predictor of tumor presence (AUC>0.98). SPAG5 overexpression was associated with serous histology and The Cancer Genome Atlas (TCGA) defined molecular subtypes. Analysis of DNA methylation levels at SPAG5 genomic regions exhibiting negative correlation to SPAG5 expression. Further, SPAG5 expression was associated with copy number gain in EC. Univariate and multivariate survival analysis revealed that higher SPAG5 expression was independently associated with poor patient outcomes in EC. Additionally, gene set enrichment analysis of SPAG5 correlated genes revealed its association with numerous oncological pathways which suggest its critical involvement in this malignancy.
An Emerging Application of Cholesterol-lowering Therapy in Inhibition of Rotavirus Infection
Authors: Ding Shihao , Yu Bingting , Vuuren Anneke van
Published: August 2021

The authors have requested that this preprint be removed from Research Square.
The Correlation Between Facet Joint Parameters and the Location of Lumbar Disc Herniation in the Young Population
Authors: Ke Song , Wang Naiguo , Yang Ming , Zhang Wentao , Sun Tianze , Li Zhonghai
Published: August 2021

Background: Facet joint parameters have been discussed as substantial factors in the development of LDH. However, the correlation between facet joint parameters and the location of LDH in the corresponding segment is still unclear. The objective of this study was to demonstrate a clearly relationship between facet orientation (FO), facet tropism (FT) and lumbar disc herniation (LDH) in young individuals.Methods: Between June 2017 and December 2019, 529 patients having single-level LDH (L4-5 or L5-S1) between 18 and 35 years old with a less than 2 years clinical history were included. Another 122 age-matched patients with no LDH were enrolled as the control group (N-LDH group). Based on the location of herniation, cases in LDH group were divided into three groups (LDHL, LDHR, and LDHM). We investigated the correlation between facet joint parameters and the location of LDH.Results: The FOA in L4-5 and L5-S1 level were significantly lower while FT were higher in LDH group than N-LDH group respectively. In terms of the correlation between the facet joint parameters and the location of LDH, the level of LDH, the FOL, FOR, and FT were significantly varied among the three groups. There is a significant association between the different location of LDH and different FO of bilateral facet joints in L4-5 while not in L5-S1 level.Conclusion: The facet joint parameters abnormality have an significant association with the development of LDH. Young individuals with higher FT and/or lower FO should be paid more attention to preventing the occurrence of LDH. There was more location of IVD herniated on the ipsilateral location with lower FO of facet joint when FT existed in L4-5 level.