bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and internal validation of an improved prognostic model with limited resources (Broaln-MEWS) for predicting 28-day mortality of critical illness: a retrospective cohort study
Authors: Zhang Xianming , yang Rui , Tan Yuanfei , Zhou Yaoliang , Lu Biyun , Ji Xiaoying , chen Hongda , Cai Jinwen
Published: April 2022

BackgroundPrognostic models in intensive care unit (ICU) were extensively applied in high-income countries, but were limited in lower income countries for lack of resource. A simple prognostic model for easy use in ICU was more attractive. The modified early warning score (MEWS), age, body mass index (BMI), red cell distribution width(RDW), neutrophil to lymphocyte ratio (NLR), lactate (lac) and osmolarity were easily accessible and objective indexes in resource limited settings to predict mortality of patients in ICU. However, using these indexes alone to predict mortality has the disadvantage of insufficient diagnostic efficiency. The usefulness of a combination of these indexes to predict 28-day mortality of critical illness was unclear.MethodsThis was a retrospective cohort study of patients admitted to ICU in MIMIC-III database. A total of 44103 patients older than 14 years were randomly assigned to a development (29402 patients) or validation cohort (14701 patients). Captured variables included demographic characteristics, clinical assessments, laboratory data, acute physiology and Chronic Health Evaluation (APACHE)-II, and MEWS. After identifying independent risk factors of 28-day mortality, we developed a 28-day mortality prediction model with multivariate logistic regression in development cohort. We compared the difference among Broaln-MEWS, APACHE-II, MEWS, RDW, NLR, lac and osmolarity by using area under the receiver operating characteristic curve (AUROC) to calculate discriminative ability, Hosmer-Lemeshow C-Statistic (H/L C-statistic) to assess calibration and Brier score to evaluate accuracy. Finally, the model was validated in the validation cohort and nomogram graph was offered to fast calculate predicted mortality risk.ResultsThe 28-day mortality of critical illness was 22.85% in the development cohort. Patients with increased age, MEWS, NLR, RDW, lac, osmolarity and decreased BMI at baseline exhibited higher risks of 28-day mortality. The mortality prediction model (Broaln-MEWS) that incorporated age, BMI, MEWS, RDW, NLR, lac and osmolarity had an AUROC of 0.741 for the developing data, which was higher than that of MEWS (0.669), NLR (0.634), RDW (0.591), lac (0.580), or osmolarity (0.592) alone(p < 0.000) and slightly lower than APACHE-II (0.747) (p = 0.060). The H/L C-statistic of Broaln-MEWS were equal to 9.641(p = 0.291) and Brier score was 0.103, respectively. Additionally, Broaln-MEWS model demonstrated good discriminative power in the validation group by AUROC that was 0.744 (p < 0.000)ConclusionThe Broaln-MEWS model had higher predictive value for 28-day prognosis in critically illness, which was used easily in resource limited settings.
Statistical modeling and optimization of biodiesel production from custard apple seed oil and characterization
Authors: Shumi Lema Deme , Waday Yasin Ahmed , Birru Meron Asteraye
Published: April 2022

The best condition for the biodiesel synthesis process from a non-edible and renewable source, custard apple seed oil, is presented in this paper, as well as its characterization. The seeds were harvested from Ethiopia's Jimma zone, and their average moisture, ash, fiber, protein, and oil contents are 5.7, 3.9, 2.1, 19.8, and 37.2 percent, respectively. Soxhlet and hexane as a solvent were used to extract the oil. Trans-esterification of oil with methanol and sodium hydroxide (NaOH) as a catalyst for biodiesel generation was investigated. The molar ratio of methanol to oil, temperature, catalyst, and reaction time all had a significant (p<0.05) impact on biodiesel yield. The optimum process parameters coupled to obtain the highest biodiesel output were reaction temperature of 72.426°C, catalyst 2.002wt %, methanol: oil molar ratio 12.334, and reaction time of 84.010min, according to the Experimental Design Response Surface Methodology (RSM) and ANOVA analysis. With a desirability of 1, the model anticipated a yield of 89.230±0.28 percent. Acid value, Saponification value, Kinematic viscosity, Density, Heating Value, Fire Point, and Flash Point are all physicochemical parameters of biodiesel made from custard apple seed oil (FP) 1.12 mg KOH/g, 16.75 mg KOH/g, 5.67mm2/s, 894.5kg/m3, 42.072kJ/kg 134oC and 179oC satisfied the ASTM criteria for biodiesel, respectively. In general, this research supports the manufacturing of biodiesel from Custard Apple seeds (Annona squamosa) oil as a means of replacing non-renewable energy with renewable energy and increasing the value of custard apple fruit.
Molecular Epidemiological Study of Germline APC Variant Associated with Hereditary Gastrointestinal Polyposis in Dogs: Current Prevalence in Jack Russell Terriers in Japan and Breed Distribution
Authors: Yoshizaki Kyoko , Hirata Akihiro , Matsushita Hiroyuki , Sakaguchi Masahiro , Yoneji Wakana , Owaki Keishi , Sakai Hiroki
Published: April 2022

Background: Cases of gastrointestinal (GI) neoplastic polyps in Jack Russell Terriers (JRTs) have increased in Japan since the late 2000s. We recently demonstrated that JRTs with GI polyps heterozygously harbor an identical germline variant in the adenomatous polyposis coli (APC) gene, c.[462_463delinsTT]; therefore, this is an autosomal dominant hereditary disease. We conducted a molecular epidemiological study to explore the current prevalence of germline APC variants in JRTs in Japan and the breed distribution of this disease.Results: Peripheral blood samples from 792 JRTs were collected at 93 veterinary hospitals in Japan in 2020. Using an established polymerase chain reaction-restriction fragment length polymorphism assay, the germline APC variant was detected in 15 JRTs, with an overall prevalence of 1.89%. The prevalence was not significantly different for sex, age, and coat type criteria. Notably, the variant carriers had a current or previous history of GI neoplastic polyps, providing further evidence of the association of the germline APC variant with GI polyposis. Pedigree analysis of carrier dogs revealed that the germline APC variant was no longer confined to a few specific bloodlines but was widely spread among JRTs in Japan. Furthermore, some ancestors of the carriers were from Australia or New Zealand, suggesting the possible presence of carriers in countries other than Japan. Next, we retrospectively investigated the germline APC variant status of dogs with GI epithelial tumors using genomic DNA samples extracted from archived pathological specimens, as well as those stored in a canine genome bank. In total, 67 purebred dogs of 24 breeds, including four JRTs, and four mixed-breed dogs were examined. While three variant carriers were found in JRTs, the germline APC variant was not detected in any of the other breeds. Conclusion: The current prevalence of the germline APC variant was approximately 2% in JRTs in Japan and the prevalence remained roughly flat during the last 15 years. In addition, hereditary GI polyposis associated with the variant was virtually specific to JRTs.
Housekeeping gene gyrA, a potential molecular marker for Bacillus ecology study
Authors: Xu Zhihui , Liu Yan , Štefanič Polonca , Miao Youzhi , Xue Yansheng , Xun Weibing , Shen Qirong , Zhang Ruifu , Mandic-Mulec Ines
Published: April 2022

Background: Bacillus is a ubiquitous microorganism and is one of the most commercially important species widely used in industry, agriculture and healthcare. Bacillus is relatively well understood at the single-cell level; however, molecular tools that determine diversity and ecology of Bacillus community are limited, which limits our understanding of how the Bacillus community works. Results: In this study, we investigated the potential of the housekeeping gene gyrA as a molecular marker for determining the diversity of Bacillus species, then designed a new primer pair that specifically target gyrA (gyrA3). The rate of variation of the gyrA gene was higher than 16S rRNA gene in inter- and intraspecific Bacillus. And the amplification efficiency for Bacillus species diversity could be greatly improved by primer design, the novel primer pair gyrA3 that can detect at least 92 Bacillus species and related species and showed its advantage in mock Bacillus community compared to 16S rRNA gene. For Bacillus amyloliquefaciens, Bacillus pumilus, and Bacillus megaterium, the high variability of the gyrA gene allows for more detailed clustering at the subspecies level that cannot be achieved by the 16S rRNA gene. Conclusion: Collectively, the gyrA gene provides better phylogenetic resolution than 16S rRNA gene and informs on the diversity of the Bacillus community, therefore gyrA gene may have broad application prospects in the study of Bacillus ecology.
Interval-valued Intuitionistic Fuzzy Multi-attribute Group Decision-making Method Considering Risk Preference of Decision-makers and Its Application
Authors: Fu Sha , Xiao Ye-zhi , Zhou Hang-jun
Published: April 2022

An improved interval-valued intuitionistic fuzzy multi-attribute group decision-making method considering the risk preference of decision-makers is proposed to solve the multi-attribute group decision-making problem with interval-valued intuitionistic fuzzy numbers and the condition that the attribute weight information is completely unknown. Firstly, the decision-maker weight of each attribute is determined by combining similarity and proximity. In order to consider the influence of the decision-maker's risk preference on the decision result and avoid the asymptotic behavior of interval-valued intuitionistic fuzzy matrix, the risk aversion coefficient of the decision-maker is introduced and combined with the determined decision-maker's weight aggregation to form a group decision matrix. Then, the information of group decision matrix is mined, and the interval-valued intuitionistic fuzzy entropy is used to determine the attribute weight and relative weight. Based on the interval-valued intuitionistic fuzzy distance measure formula and the TODIM method, the overall superiority of each scheme relative to other schemes is obtained by calculating the superiority between schemes, and the optimal scheme is determined by comparing and sequencing. Finally, the rationality and effectiveness of the proposed method are verified by an example of mechanical assembly supplier selection decision.
Correlation between the triglyceride-to-high-density lipoprotein cholesterol ratio and other unconventional lipid parameters with the risk of prediabetes and Type 2 diabetes in patients with coronary heart disease: a RCSCD-TCM study in China
Authors: Yu Chunquan , Yang Tong , Liu Yijia , Li Lin , Zheng Yanchao , Wang Yang , Su Jinyu , Luo Mingchi
Published: April 2022

Objective: Type 2 diabetes (T2DM) is often accompanied by undiagnosed dyslipidemia. Research on the association and predictive value of unconventional lipid markers for prediabetes (pre-DM) and T2DM simultaneously is limited in CHD patients.Methods: We collected patients who were diagnosed with CHD. Their lipid levels including triglycerides (TG), total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C) were measured and non-traditional lipid parameters were calculated. The diabetic status was defined as: normoglycemic (NG), Pre-DM, T2DM, multiple logistic regression was used to evaluate the relationship between the various lipid parameters with diabetic status. Pearson correlation analysis and linear regression analysis were used to test the correlation between TG/HDL-C and clinical factors of glucose metabolism, and ROC curve was used to test the predictive value of non-traditional lipid parameters for pre-DM and T2DM.Results: Multiple logistic regression results showed that in addition to traditional lipid parameters, the non-traditional lipid parameters including non-HDL-C, LDL-C/HDL-C, TC/HDL-C, TG/HDL-C were all correlated with the risk of pre-DM and T2DM, meanwhile TG/HDL-C showed the strongest correlation (OR: 1.21; 95% CI 1.6-1.25), (OR: 1.35; 95% CI 1.30-1.39). When dividing TG/HDL-C into tertiles, using T1(< 1.1) as a reference, T3(> 1.89) was observed to have the highest association with both pre-DM and T2DM (OR: 1.60; 95% CI 1.48-1.74), (OR: 2.79; 95% CI 2.60-3.00). The association of TG/HDL-C with T2DM and pre-DM is independent of gender, age and lifestyle. TG/HDL-C was significantly correlated with FBG and HbA1c (P < 0.001). It was the strongest predictor of pre-DM and T2DM in unconventional lipid parameters. The cut-off points were 1.46 and 1.50.Conclusion: Elevated non-traditional lipid parameters were significantly associated with pre-DM and T2DM in CHD patients, elevated TG/HDL-C was the risk factor with the strongest correlation with the risk of pre-DM and T2DM. It is also a valid predictor of T2DM occurrence.
A muscle synergy approach in evaluation of the gait recovery following surgical alignment
Authors: Nazifi Mohammad Moein , Lieberman Isador , Haddas Ram , Hur Pilwon
Published: April 2022

Background: Adult Degenerative Scoliosis (ADS) is a common musculoskeletal problem that commonly affects the elderly. ADS patients often suffer from low back pain and consequently have reduced mobility. Surgical alignment is one of the possible treatments in ADS patients. Due to the highly variant nature of the ADS, tracking and comparing the improvements following surgery can be challenging. Muscle synergy theory suggests that the central nervous system may use a few groups of coactive muscles (i.e., synergies) to achieve a motor task. Methods: In this study, we propose to use muscle synergy approach to determine the recovery from the ADS following surgery. More specifically, two metrics are proposed: i) the number of the required muscle synergies for a motor task and ii) an entropy-inspired measure (EnIM). Entropy is a measure of uncertainty in the data and has been shown to be sensitive to detect functional mobility enhancement. We hypothesize that the number of muscle synergies required for walking increases following surgery. We also hypothesize that EnIM associated with the muscle synergies decreases following surgery. Results: The results showed that the patients required a significantly higher number of walking muscle synergies following a surgery. Also, EnIM decreased significantly in ADS patients following surgical procedures, showing a more deterministic control. Conclusions: A muscle synergy approach in tracking the improvements in motor skills could be advantageous as it considers all of the involved muscles together, bypassing the potential subject-dependent differences. Trial registration: Western Institutional Review Board, #20151780. Participants were recruited from the ClinicalTrials.gov (registration no.: NCT02761265)
CTLA-4-Ig internalizes CD80 in fibroblast-like synoviocytes from chronic inflammatory arthritis mouse model
Authors: Miura Yoko , Isogai Shyuntaro , Maeda Shinji , Kanazawa Satoshi
Published: April 2022

Background
CD80 molecules interact with CD28 and cytotoxic T lymphocyte-associated antigen 4 (CTLA-4) on antigen-presenting cells, and function in the co-stimulatory signaling that regulates T cell activity. CTLA-4-Ig, a fusion of CTLA-4 and an immunoglobulin Fc fragment, is used to treat rheumatoid arthritis (RA) by blocking co-stimulatory signaling. We analyzed the therapeutic effect of CTLA-4-Ig in a mouse model of RA, in which CD80 was expressed in chondrocytes and synovial cells of joints.
Methods
Chronic inflammatory arthritis was induced in D1BC mice using low-dose arthritogenic antigens and treated with CTLA-4-Ig three times a week, from weeks 3 to 10 after the first induction. The progression of inflammatory arthritis was monitored using clinical scores. We performed histopathology of the joints and lymph nodes, serological examination for rheumatoid factors, and flow cytometric analysis of isolated synovial cells, including CD45- fibroblast-like synoviocytes (FLSs) and CD45+ synovial macrophages.
Results
CTLA-4-Ig treatment ameliorated the chronic inflammatory polyarthritis. There was a decrease in the number of infiltrating lymphoid cells in the joints as well as in the levels of RF-IgG associated with a decrease in the number of B cells in the lymph nodes; more than 15% of CD45− FLSs expressed CD80, and a small number of them expressed PD-L1, indicating the presence of PD-L1/CD80 cis-heterodimers in these cells. CTLA-4-Ig internalized CD80, but not PD-L1, in isolated synovial cells. Gene ontology analysis revealed that CTLA-4-Ig internalization did not significantly alter the expression of inflammation-related genes.
Conclusions
The therapeutic effect of CTLA-4-Ig appears to extend beyond the lymph nodes into the inflamed synovial compartment through the synergistic inactivation of T cells by the CD80 and PD-L1 axes.
Thermonuclear Reaction Rate of 3He(α;γ)7Be Process
Authors: Khoddam Maryam , Sadeghi Hossein , Nahidinezhad Shahla
Published: April 2022

The reaction rate of 3He - α radiation capture process has been calculated in astrophysical energies using the pionless Effective Field Theory (EFT) using the Faddeev equation approach up to Next-to Leading Order (NLO) while taking Coulomb interaction into account. The findings for the E1 and E2 transitions to the 7Be ground state have been normalized using NACRE 1999 experimental data and compared to certain theoretical and experimental data.
Metagenomic sequencing analysis of bacterial biodiversity in the treatment of surplus sludge and chicken manure mixtures by black soldier fly larvae (Hermetia illucens)
Authors: Zhang Lei , Zhao Qi , He Shuang , Zhang Luyan , Qiao Liang , Ding Cheng , Yuan Ye , Wang Feihong , Chen Tianming
Published: April 2022

The disposal of combined organic waste by black soldier fly larvae (Hermetia illucens) has drawn broad attention. However, changes of microflora during the treatment are lacking. In this study, livestock manure and surplus sludge were chosen as the target organic waste due to their wide produced in breeding industry and water treatment industry. Black solider fly (BSF) larvae were used to treat the mixture of chicken manure and surplus sludge for a week. Bacterial biodiversity of BSF larvae production residues were investigated with metagenomic sequencing technology to identify specific flora. The change trend of BSF larvae production residue derived from the mixture of chicken manure and surplus were closer to that resulting from chicken manure. Firmicutes, Actinobacteria, Proteobacteria and Bacteroidetes are the main bacteria in phylum level with the content of 75.39%,14.63%,5.69% and 2.42% in abundance. Bacilli were the major bacteria with 71.61% in class level. Pseudogracilibacillus(11.08%), Virgibacillus(9.86%) and Oceanobacillus(6.39%) were the key component in Bacilli. Erysipelotrichales as the probiotics of insect, also as pathogenic bacteria to poultry and human were found massive proliferation with the abundance of 2.71%. Overall, BSF has proved to be a sustainable management for organic waste by reducing its amount and whether the BSF larvae production residue can be used as organic fertilizer directly was controversial result from the bacterial biodiversity analysis.
Development of tubewell irrigation and its impact on farmer’s socio- economic condition of Dakshin Dinajpur district, West Bengal
Authors: Halder Manik , Roy Doli , Paul Ripom
Published: April 2022

Irrigation is a significant indicator to increase agricultural production. It also shapes the socio-economic status of farmers to some extent. Hence, Irrigated water has to use efficiently and judiciously. In this paper, an attempt has been made to show the spatial variation in the level of irrigation development of tube wells. Besides, an effort has been made to show the impact of tube well irrigation on farmers’ socio-economic status. To do so a cost-benefit analysis has been done. The present study is based on both primary and secondary sources of data. A positive relation has been found between tube well irrigated area and total irrigated area as changes in tube well irrigated area has influences on the overall irrigation system in the district. Hili block has the highest percentage of area under tube well irrigation. While Tapan block has the lowest percentage of tube well irrigated area. The key occupation of the study area is agriculture. The farmers of the study area are poorly represented in education as the majority of them have an education of upper primary level. A positive impact of tube well irrigation has been seen on farmers’ income through cost-benefit analysis.
Long-term variability of impulse Oscillometry and Spirometry in stable COPD and Asthma
Authors: Guo Jian , Xu Jianhua , Sun Xingxing , Zhu Hanqing , Cao Yuan , Pudasaini Bigyan , Yang Wenlan , Liu Jinming
Published: April 2022

Background: While optimizing spirometry is a challenge for all lung function labs, long-term variability is not known in stable COPD (chronic obstructive pulmonary disease) and chronic asthma. The forced oscillation technique is increasingly employed in routine lung function testing. Our aim in this study was to determine the variability in oscillometric parameters between clinic visits over weeks or months in two patient groups during a period of clinical stability (asthma patients and COPD patients). Moreover, the research assesses relationships between IOS (impulse oscillometry) parameter long-term variability and COPD severity.Methods: We used data from 73 patients with stable COPD and 119 patients with stable asthma at the Shanghai Pulmonary Hospital Affiliated to Tongji University. Patients were included if they had three or more clinic visits where spirometry and IOS were performed during a clinically stable period. Only data recorded from the first three visits were used. The standard deviation (SDbv), the coefficient of variation (COV), intraclass correlation coefficient (ICC) and the coefficient of repeatability (COR) were calculated, Wilcoxon Mann-Whitney test was used for data that did not conform to normality of distributions, Kruskal Wallis test was used to compare with multiple groups, post hoc comparison was analyzed by Bonferroni, Spearman correlation coefficients for non-parametric data, the multiple regression analyses to determine the relationship between long-term variability and airflow obstruction.Results: 1. the repeatability of IOS parameters were high (>0.80) ICC values in COPD and asthma, ICC values of IOS parameters were higher than for spirometry; 2. repeatability (ICC valve<0.8) of spirometry parameters was lower than IOS parameters (ICC valve>0.8) in different GOLD (the Global Initiative for Chronic Obstructive Lung Disease) stage, and the higher the stage, the worse the repeatability; 3. the severity of airflow obstruction was correlated with long-term variability of R5 (R at 5 Hz) (P<0.05) and R5-R20 (P<0.05), not with long-term variability of R20 (R at 20 Hz) (P>0.05).Conclusion: IOS parameters have good long-term repeatability in asthma and COPD. Additionally, variability is different between diseases and GOLD stages, repeatability of spirometry parameters is lower than that in IOS parameters in different GOLD stages. The greater the long-term variability seen in COPD is associated with airflow obstruction.
Ethnobotany of medicinal plants used by the Yao people in Gongcheng County, Guangxi, China
Authors: Lu Zhaocen , Chen Hailing , Lin Chunrui , Ou Gui , Li Junsheng , Xu Weibin
Published: April 2022

Background
Gongcheng Yao Autonomous County (Gongcheng) is typical for the Yao people in northeastern Guangxi, southern China. The Yao people have a long history of using medicinal plants. In this study, we used ethnobotanical methods to collect traditional knowledge regarding herbal medicines in Gongcheng. Our study provides fundamental data for developing and applying local ethnic medicines and their protection.
Methods
Ethnobotanical data were collected from 103 villages in nine townships from 2014 to 2018 in Gongcheng. A total of 352 informants (279 male and 73 female) were interviewed through semi-structured interviews, key informant interviews, and guided field walks. All the informants were local inhabitants aged between 28 and 101 years of age, of which 40 key informants were selected based on the recommendations of knowledgeable elders and local medical institutions. The informant consensus factor (ICF) was used to evaluate the degree and importance of differences in medicinal plant species and calculated the relative frequencies of citation (RFC) for the recorded medicinal plants.
Results
Data from 352 local healers were collected for the study. The Guanyin and Sanjiang townships had the highest distribution of per capita healers (Pch), while the Gongcheng, Lianhua, and Ping'an townships were relatively lower. Of the 352 local healers, more than half were older than 60 years of age, and therefore faced the problem of suitable successors and potential loss of traditional medicinal knowledge. There are 12 types of diseases treated by local healers in the study area, and most of the types had a high ICF value. The highest ICF (0.80) was reported for digestive system disease, followed by urinary system disease (0.78) and nervous system disease (0.77). Traumatic injury and orthopedics, digestive system, and rheumatic disease are the most common ailments. The RFC value calculated in 33 medicinal plant species (with an FC of more than 5) ranged from 0.024 to 0.056. The higher RFC values included Kadsura longipedunculata, Schefflera heptaphylla, Plantago asiatica, etc. The most commonly used medicinal method was decoction; plasters, creams, and some form of moxibustion and cupping skills were locally practiced, but only rarely. The local healers used 306 medicinal plant species (116 families and 255 genera). Herbal plants were most commonly used among these, with whole plants and roots being favored.
Conclusion
The Yao people are highly skilled at using medicinal plants to treat various diseases in Gongcheng. Their treatment methods are varied, convenient, and efficient. Due to the impact of urbanization and economic development, knowledge of traditional medicine is under threat, with declining numbers of local healers and a lack of suitable successors. In order to protect and inherit Yao's traditional medicinal knowledge, it is necessary to educate young healers, and to protect biodiversity.
Use of botulinum toxin type A associated with nonthermal microneedling for treating erythematoustelangiectatic rosacea: case report
Authors: Soares Andressa Dall’agnol , Antunes Flavia Tasmin Techera , Martins Marcia Gerhardt
Published: April 2022

Treatments for rosacea control the pathology for a short period of time, requiring daily maintenance with topical and oral cosmetics. This research aimed to report the result of treatment with microneedling associated with botulinum toxin type A in a 37-years old female affected by erythematoustelangiectatic rosacea. The procedure consisted in applying botulinum toxin type A (100 UI diluted in 4 ml of saline, via drug delivery), with the electric nonthermal microneedling device. It was performed in 2 sessions, with an interval of 15 days. The evaluation was done 45 days after the first session through the Evaluation Form facial, photographs, quality of life questionnaire – RosaQol, and evaluation by CEA (Clinician Erythema Assessment). As a result, improvements were observed in skin texture, in the flushing and in the participant's quality of life. It was concluded that the technique improved the appearance of rosacea flushing, as well as a decrease in telangiectasias. Still, more studies and practical research are needed to determine the number of sessions and on the adjusted amount of A botulinum toxin used in the therapeutic correlated to the rosacea severity.
Prostate cancer therapy personalization via multi-modal deep learning on randomized phase III clinical trials
Authors: Esteva Andre , Feng Jean , Wal Douwe van der , Huang Shih-Cheng , Simko Jeffry P , DeVries Sandy , Chen Emmalyn , Schaeffer Edward M , Morgan Todd M , Sun Yilun , Ghorbani Amirata , Naik Nikhil , Nathawani Dhruv , Socher Richard , Michalski Jeff M. , III Mack Roach , Pisansky Thomas M. , Monson Jedidiah M. , Naz Farah , Wallace James , Ferguson Michelle J. , Bahary Jean-Paul , Zou James , Lungren Matthew , Yeung Serena , Ross Ashley E. , Consortium NRG Prostate Cancer AI , Sandler Howard M. , Tran Phuoc T. , Spratt Daniel E. , Pugh Stephanie , Feng Felix Y. , Mohamad Osama
Published: April 2022

Prostate cancer is the most frequent cancer in men and a leading cause of cancer death. Determining a patient’s optimal therapy is a challenge, where oncologists must select a therapy with the highest likelihood of success and the lowest likelihood of toxicity. International standards for prognostication rely on non-specific and semi-quantitative tools, commonly leading to over- and under-treatment. Tissue-based molecular biomarkers have attempted to address this, but most have limited validation in prospective randomized trials and expensive processing costs, posing substantial barriers to widespread adoption. There remains a significant need for accurate and scalable tools to support therapy personalization. Here we demonstrate prostate cancer therapy personalization by predicting long-term, clinically relevant outcomes using a multimodal deep learning architecture and train models using clinical data and digital histopathology from prostate biopsies. We train and validate models using five phase III randomized trials conducted across hundreds of clinical centers. Histopathological data was available for 5,654 of 7,764 randomized patients (71%) with a median follow-up of 11.4 years. Compared to the most common risk stratification tool—risk groups developed by the National Cancer Center Network (NCCN)—our models have superior discriminatory performance across all endpoints, ranging from 9.2–14.6% relative improvement in a held-out validation set. This artificial intelligence-based tool improves prognostication over standard tools and allows oncologists to computationally predict the likeliest outcomes of specific patients to determine optimal treatment. Outfitted with digital scanners and internet access, any clinic could offer such capabilities, enabling global access to therapy personalization.
Developing Key Performance Indicators for Emergency Department of Teaching Hospitals: A Mixed Fuzzy Delphi and Nominal Group Technique Approach
Authors:   Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia, Rahman Nik Hisamuddin ,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia, Tuan Kamauzaman Tuan Hairulnizam ,   Department of Emergency Medicine, School of Medical Sciences, Universiti Sains Malaysia, Kelantan, Malaysia,   Hospital Universiti Sains Malaysia, Kelantan, Malaysia
Published: April 2022

Background: This article demonstrates combination of the fuzzy Delphi method (FDM) and the nominal group technique (NGT) to consolidate consensus agreement within a panel of experts regarding key performance indicators (KPIs) development for emergency department (ED). Methods: Twenty-four participants for NGT and 10 experts for FDM were randomly chosen from the emergency medicine (EM) department staff list obtained from the human resource department of study centres. A set of item constructs related to KPIs was developed from the NGT session and used for the FDM session in the second phase of the study. Results: We found that 16 out of 22 and 11 out of 15 items satisfied the first prerequisite ‘d’ value ≤ 0.2. Ten items (45%) from the service KPI domain and six items (40%) from the academic KPI domain had expert consensus of more than 75%. A total of 16 out of 22 (73%) and 14 out of 15 (93%) fit the criteria of an average fuzzy number (A value) of more than 0.5. Fifteen items that fulfilled the prerequisites were retained for the final KPI draft. Conclusion: The FDM and NGT analyses reached experts’ consensus on the suitability of the pre-selected items in the ED KPIs. The development of the KPI framework is expected to enhance future improvement of EM services and academic activities in all teaching hospitals in the country.
Nutritional Status of Orang Asli in Malaysia
Authors:   Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia, Tay Janice Ee Fang , Ulaganathan Vaidehi ,   Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia, Kua Goh Yoke Lian ,   Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia, Adan Mulki Abdullahi ,   Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia, Lim Sook Yee ,   Faculty of Applied Sciences, UCSI University, Kuala Lumpur, Malaysia
Published: April 2022

The national government policies and Jabatan Kemajuan Orang Asli (JAKOA) have to put more effort to improve the quality of life for Orang Asli communities. Over the years, under the government-sanctioned relocation programme, many Orang Asli groups were moved to a more developed and urban area. They were given proper facility, healthcare service to ensure the improvement of overall well-being. While undernutrition among the Orang Asli remains a major health issue, evidence has shown that overweight and obesity in this population are increasing. This observation might be attributed to an urbanised lifestyle that often leads to unhealthy dietary patterns, leading to an increased prevalence of obesity, chronic diseases, food insecurity and unhealthy diet intake. The nutritional transition should be capture for a better understanding of Orang Asli nutritional status. This review assessed the nutritional status and its related key factors among Orang Asli population in Malaysia.
Complexions and stoichiometry of the 60.8°//[100](011) symmetrical tilt grain boundary in Mg2SiO4 forsterite: A combined empirical potential and first-principles study
Authors: Furstoss Jean , Hirel Pierre , Carrez Philippe , Cordier Patrick
Published: April 2022

In this work we explore the low-energy complexions of the symmetrical tilt grain boundary (GB) 60.8°//[100](011) in forsterite through molecular dynamics and first principles calculations. Using a conservative sampling, we find six stoichiometric complexions with energies ranging from 0.66 to 1.25 J/m2. We investigate the segregation of MgO vacancy pairs, and find that in most cases it is more favorable for the vacancies to lie within the GBs than in the surrounding crystals, leading to new atomic structures. From these results we infer that at finite temperature when vacancies are present in the system, GBs are likely to absorb them and to be non-stoichiometric. We find many GB complexions containing a free oxygen ion, which may have profound implications for geological processes.
A new conceptualization of investor sophistication and its impact on herding and overconfidence bias
Authors: Yadav Ashutosh , Yadav Deepshikha , Kashyap Hazarika Ishan
Published: April 2022

Despite the success of behavioral finance, the question of whether behavioral biases persist in the face of expertise is an oft-expressed concern. It becomes pertinent to explore if investor sophistication is associated with behavioral biases, as traders gain sophistication with experience and knowledge. The current study explores this relationship by proposing a new conceptualization of investors’ sophistication via the processes of learning and competition. The study empirically explores if herding and overconfidence biases are related to learning and competition, and thus, with investors’ sophistication via these aspects. Using data from equity investors from India (n = 257), the study employs ANOVA and multiple regression analysis through indicator function to form dummy variables for different categories. The results of the study conclude that diversification is significantly related to both the biases using ANOVA (F(3,253) = 3.081; p < 0.05) as well as multiple regression (p < 0.05). The other variables considered are found to be non-significant (p > 0.05) for both the biases. The study controls for all the other observed variables of the conceptual model to find out the effect of the change in the observed variables on the level of investor sophistication, making this study a novel and a distinct attempt.
Genetic characterization and antimicrobial susceptibility of Escherichia coli isolated from household water sources in northern Ghana
Authors: Kichana Elvis , Addy Francis , Dufailu Osman Adamu
Published: April 2022

The microbial quality of household water is an important issue in developing countries, especially in Ghana, where many people still depend on unimproved sources of water. The present study investigated the prevalence, genetic characteristics, and antimicrobial resistance profile of Escherichia coli from surface water sources. Fifty-two water samples were analyzed by using a spread plate, a biochemical test, and multiplex polymerase chain reactions. E. coli was isolated from each of the 52 water samples. Of these isolates, 75% were noted to possess virulence genes. Approximately 54% of the isolates were characterized as follows: enterotoxigenic E. coli (ETEC, 10.26%), enteropathogenic E. coli (EPEC, 17.95%), verotoxigenic E. coli (VTEC, 23.07%), and enteroinvasive E. coli (EIEC, 2.57%). Eighteen of the fifty-two isolates could not be characterized due to heterogeneity in banding. The disc diffusion method was used to test for antimicrobial susceptibility. The isolates were most resistant to ceftazidime, augmentin, and cefuroxime. Multidrug resistance was recorded in 48.1% of the isolates. In contrast, the isolates were most susceptible to ciprofloxacin (86.5%), nitrofurantoin (84.6%), and ofloxacin (75%). These results revealed a high diversity and widespread of E. coli in northern Ghana. The study provides important data for public health nationwide surveillance of E. coli in surface water across the country.
Development and evaluation of a water quality index for groundwater quality assessment in parts of Jabalpur District, Madhya Pradesh, India
Authors: Ghoderao Sudesh Bhaskar , Meshram Sarita Gajbhiye , Meshram Chandrashekhar
Published: April 2022

Groundwater is an important source for drinking water supply in Jabalpur District, Madhya Pradesh, India. An attempt has been made in this work to understand the suitability of groundwater for human consumption. The parameters of pH, Electrical Conductivity (EC), Copper (Cu), Chromium (Cr), Sulphate (SO4), Iron (Fe), Nitrate (NO3), Chloride (Cl), Total Hardness (TH), Total Alkalinity (TA), and Sodium (Na) were analyzed to estimate the groundwater quality. The water quality index (WQI) has been applied to categorize the water quality, which is quite useful to infer the quality of water for the people and policy makers in the concerned area. The WQI in the study area ranges from 17.90 to 176.88. According to the WQI rating, sites 1, 3, and 4 are not appropriate for drinking water or have low water quality and site 2 has moderate drinking condition, whereas site 5 has excellent drinking condition. The current study suggests that the groundwater of the area with deteriorated water quality needs treatment before consumption.

HIGHLIGHTS WQI values in sites 1, 3 and 4 are 106.99, 176.88, 161.25, showing that the groundwater is not suitable for drinking purposes. WQI value in site 5 is 17.90, showing that water is fit for drinking purposes. Principal component analysis reveals that four parameters are responsible for the high values of WQI. The outcome of the study will be helpful in formulating effective drinking water management measures for residents in the Jabalpur region, India.
Mainstream short-cut N removal modelling: current status and perspectives
Authors: Kirim Gamze , McCullough Kester , Bressani-Ribeiro Thiago , Domingo-Félez Carlos , Duan Haoran , Al-Omari Ahmed , De Clippeleir Haydee , Jimenez Jose , Klaus Stephanie , Ladipo-Obasa Mojolaoluwa , Mehrani Mohamad-Javad , Regmi Pusker , Torfs Elena , Volcke Eveline I. P. , Vanrolleghem Peter A.
Published: April 2022

This work gives an overview of the state-of-the-art in modelling of short-cut processes for nitrogen removal in mainstream wastewater treatment and presents future perspectives for directing research efforts in line with the needs of practice. The modelling status for deammonification (i.e., anammox-based) and nitrite-shunt processes is presented with its challenges and limitations. The importance of mathematical models for considering N2O emissions in the design and operation of short-cut nitrogen removal processes is considered as well. Modelling goals and potential benefits are presented and the needs for new and more advanced approaches are identified. Overall, this contribution presents how existing and future mathematical models can accelerate successful full-scale mainstream short-cut nitrogen removal applications.
Prophylaxis for Venous Thromboembolic Events in Elective Total Hip and Total
Knee Arthroplasty
Authors: Karasavvidis Theofilos , Bouris Vasileios , Xiang William , Tzavellas Georgios , Charisis Nektarios , Palaiodimos Leonidas , Kigka Vassiliki , Bourantas Christos V. , Gkiatas Ioannis
Published: April 2022

Venous thromboembolism (VTE) is a serious complication after major orthopaedic operations, such
as a total hip (THA) and knee (TKA) arthroplasty. Therefore, perioperative VTE prophylaxis is recommended;
a multitude of modern options are available, including both pharmacologic (aspirin, unfractionated and lowmolecular-weight heparin, vitamin K antagonists, and novel oral anticoagulants) and/or mechanical interventions (early mobilization, graduated compression stockings, intermittent pneumatic compression devices, and
venous foot pumps). However, because of the abundance of these possibilities, it is crucial to understand the
benefits and drawbacks of each VTE prophylaxis option to ensure that the optimal treatment plan is developed
for each patient. The American College of Chest Physicians (AACP) and the American Academy of Orthopaedic Surgeons (AAOS) have both published individual guidelines on VTE prophylaxis regimens, alongside numerous studies evaluating the efficacy and outcomes of the different prophylaxis modalities. The purpose of
this review is to provide a summary of the evidence on VTE prophylaxis after elective total hip and knee arthroplasty based on current guidelines and highlight the major concerns and potential complications.
Interaction of Vitamin D and Corticosteroid Use in Hospitalized COVID-19
Patients: A Potential Explanation for Inconsistent Findings in the Literature
Authors: Efird Jimmy T. , Anderson Ethan J. , Jindal Charulata , Suzuki Ayako
Published: April 2022

Vitamin D is an important immune-modulator with anti-inflammatory properties. While this prohormone
has been studied extensively in the prevention and treatment of COVID-19, findings have been inconsistent
regarding its overall benefit in patients hospitalized with COVID-19. Most studies to date have been observational
in nature, not accounting for the use of corticosteroids. Furthermore, the few randomized clinical
trials designed to examine the effect of vitamin D supplementation on COVID-19 outcomes have been relatively
small and thus insufficiently powered to assure a balance of corticosteroid use between study arms. The current
perspective addresses the interaction of vitamin D and corticosteroids as a potential explanation for the divergent
results reported in the literature. Future research on vitamin D and COVID-19 will benefit by considering
this interaction, especially among hospitalized patients requiring oxygen and mechanical ventilation.
Impact of Drug Metabolism/Pharmacokinetics and its Relevance Considering Traditional
Medicine-based Anti-COVID-19 Drug Research
Authors: Hao Da-Cheng , Wang Fan , Xiao Pei-Gen
Published: April 2022

Background:

The representative anti-COVID-19 herbs, i.e., Poriacocos, Pogostemon, Prunus, and
Glycyrrhiza plants, are commonly used in the prevention and treatment of COVID-19, a pandemic caused by SARSCoV-
2. Diverse medicinal compounds with favorable anti-COVID-19 activities are abundant in these plants, and
their unique pharmacological/pharmacokinetic properties have been revealed. However, the current trends in drug
metabolism/pharmacokinetic (DMPK) investigations of anti-COVID-19 herbs have not been systematically summarized.

Methods:

In this study, the latest awareness, as well as the perception gaps regarding DMPK attributes, in the anti-
COVID-19 drug development and clinical usage was critically examined and discussed.

Results:

The extracts and compounds of P.cocos, Pogostemon, Prunus, and Glycyrrhiza plants show distinct and
diverse absorption, distribution, metabolism, excretion, and toxicity (ADME/T) properties. The complicated herbherb
interactions (HHIs) and herb-drug interactions (HDIs) of anti-COVID-19 Traditional Chinese Medicine (TCM)
herb pair/formula dramatically influence the PK/pharmacodynamic (PD) performance of compounds thereof, which
may inspire researchers to design innovative herbal/compound formulas for optimizing the therapeutic outcome of
COVID-19 and related epidemic diseases. The ADME/T of some abundant compounds in anti-COVID-19 plants
have been elucidated, but DMPK studies should be extended to more compounds of different medicinal parts, species,
and formulations and would be facilitated by various omics platforms and computational analyses.

Conclusion:

In the framework of pharmacology and pharmacophylogeny, the DMPK knowledge base would promote
the translation of bench findings into the clinical practice of anti-COVID-19 and speed up the anti-COVID-19
drug discovery and development.
Intracranial Imaging of Preterm Infants with Suspected Hypoxic Ischemic
Encephalopathy: Comparing MRI and Ultrasound
Authors: Ho Simon S. , Zhou Yujia , Rajderkar Dhanashree
Published: April 2022

Aims:

We correlate ultrasound, MRI, and clinical findings in neonates with suspected hypoxic ischemic injury.

Background:

Recent advances in neuroimaging have led to improved detection of subtle insults as-sociated with neurodevelopmental outcomes, beyond more historically described lesions such as large hemorrhages and hydrocephalus.

Objective::

In this study, we compare cranial ultrasound to MRI for the evaluation of suspected HIE in preterm infants.

Methods::

147 premature infant patients with paired ultrasound and MRI exams were retrospectively analyzed to compare imaging finding accuracy and clinical value.

Result::

We confirm that ultrasound is highly sensitive and specific for hydrocephalus, ventricular prominence, and gross structural abnormalities. Ultrasound is not a substitute for MRI in cases of small hemorrhages or white matter injury, however, certain US findings were associated with Apgar score and MRI sequelae of HIE.

Conclusion::

Choosing between ultrasound and MRI for preterm neonates at risk for intracranial ab-normalities based on their strengths can reduce cost and maximize clinical utility. MRI provides a highly sensitive identification of subtle brain injury, yet ultrasound is correlated with the peripartum clinical picture as measured by Apgar score.