bluuebunny/crossref_metadata_2025 huggingface dataset:
Clinical and imaging analysis to evaluate the response of patients with anti-DPPX encephalitis to immunotherapy
Authors: Xiao Jun , Fu Pei-cai , Li Zhi-jun
Published: March 2021

Background: To report the main spectrum, new clinical and imaging characteristics of dipeptidyl-peptidase-like protein 6 (DPPX) antibody-associated encephalitis, and evaluate the effect of immunotherapy.Methods: A retrospective analysis of nine patients reported describing the clinical and immunological features was performed, and all previously reported cases were reviewed. A cell-based indirect immunofluorescence assay with human embryonic kidney 293 cells transfected with DPPX was used. Results: Nine patients were identified (median age, 51 years; range, 14–65 years) with prodromal fever, diarrhea, or weight loss, followed by a rapidly progressive encephalopathy characterized by cognitive disorder. One patient who received methylprednisolone therapy and a trail of tacrolimus showed substantial improvement and had no relapse in the six-month follow-up. Our comprehensive literature review demonstrated that a total of 53 cases were reported, of which more than half had prodromal weight loss (52.8%), and gastrointestinal disorders (58.5%). Cognitive (74.6%) and brainstem/spinal cord disorders (75.5%) were the most common major symptoms. Our study is the first to report three patients with anti-DPPX encephalitis who had sleep disorder of rapid eye movement sleep behavior disorder (RBD), limb paralysis (two), severe pleocytosis and elevated protein levels (two) in the cerebrospinal fluid, and increased T2/FLAIR signal abnormalities in the bilateral hippocampus, temporal lobe, amygdala, basal ganglia, thalamus, centrum semiovale, and frontal and parietal lobes in seven cases (77.8%).Conclusion: Our study expanded the clinical and imaging phenotype of anti-DPPX- encephalitis. We also reported the use of tacrolimus for long-term immunosuppressant therapy in anti-DPPX encephalitis, with substantial improvement and no relapse during a follow-up period of 6 months. Further studies elucidating the entire clinical spectrum of anti-DPPX encephalitis, pathogenic roles, and prognosis under long-term immunosuppressive therapy are warranted.
Business Intelligence Applied to The Consumption of Iodinated Contrast Agents in Computed Tomography Scans
Authors: ANDRADE JOSE RODRIGO , Blomberg Luciano
Published: March 2021

Background: The management of the use of iodinated contrast agents (ICA) in the computed tomography (CT) has clinical and financial impacts; however, the approaches in the current research setting have limitations with regard to their exploration of the theme. This work describes the application of the stages of a process of business intelligence (BI), from the formulation of business questions, the building of a research database, and the adaptation of a multidimensional model, to the creation of dashboards to give support to the decision-making process in a hospital. This research aims to apply and document a BI process that provides support to the decision making of managers, so the use of ICA can be better managed, allowing for the identification of situations in which the material was wasted using a study applied to the hospital field.Methods: An applied exploratory research with a quantitative approach in a database made up by 24 variables and 35,388 records extracted from the RIS (Radiology Information System) that is used by the General Hospital of Porto Alegre - HCPA. The software used, supplied by AGFA Healthcare, were the Qdoc system (version 6.2.0) and the Impax BI (Version 11.1.1) for, respectively, data entry and data exploration. At the end of the process, a total of 48 variables was considered.Results: The BI process applied allowed for the identification of situations in which ICA was being wasted during the operationalization of the volume/mass ratio of the agent injected in the patient. It also offered the necessary substantiation for the managers to formulate plans, actions, and controls associated to the use of the material. This work made it possible to diminish in 15.65% the total consumption of ICA injected in the patients who underwent the CTAB1 exam (full CT scan of the abdomen), with a projected economy of US$ 10,039.95, for the performance of this exam from 2020 on. The measuring of the impact and the relevance of the process was 99.6% positive, according to the evaluation of the managers. Conclusions: This research generated clinical and financial benefits for the HCPA, a positive evaluation by the managers and the generation of new knowledge, which can be shared with other public or private health organizations.
Influence of Abrasive Water Jet parameters on the surface integrity of Inconel 718
Authors: Salinas Lorena Cano , Moussaoui Kamel , Hejjaji Akshay , Salem Mehdi , Hor Anis , Zitoune Redouane
Published: March 2021

Inconel 718 (IN718) is a precipitation hardened nickel-base super-alloy exhibiting high strength and good corrosion resistance at elevated temperatures and on the downside it is characterized by poor machinability. Abrasive Water Jet (AWJ) process, offers a potential method to machining difficult-to-cut materials such as IN718. The present work investigates the influence of Abrasive Water Jet parameters on surface roughness, topography, depth of cut and residual stress when milling IN718. Surface characterization was conducted through 3D optical microscopy and SEM techniques. Residual stresses were measured in longitudinal and transverse directions with respect to the machining path using X-ray diffraction (XRD) technique. The obtained results showed that milled surfaces have a homogeneous texture with embedded abrasive particles and high surface roughness. AWJ process introduced high compressive residual stresses with similar order of level in both directions (X and Y). In addition, it was observed that jet pressure is the most influencing parameter on roughness and depth of cut, whilst traverse speed and step-over distance had a significant effect on the residual stress. Based on the experimental analysis, an empirical model to predict the depth of cut was proposed. The validation of the proposed model, has shown around 5% error in the predicted and actual pocket depth.
Hydrogeochemistry of intermittent alluvial aquifers controlling arsenic and fluoride contamination for corresponding influencing health risk assessment
Authors: Sathe Sandip Sampatrao , Mahanta Chandan , Subbiah Senthilmurugan
Published: March 2021

Identification and management of safe groundwater supply in a high As and F− contaminated region is a major concern facing most of the developing countries worldwide. This study provides a comprehensive hydrogeochemistry result for a complex hydro-stratigraphy soil aquifer, which is bound between the Shillong plateau and Himalayan ranges in the North-Eastern region of India. In this study, distinct contaminated regions of As and F− were identified in rainy (n = 94) and winter (n = 50) seasons groundwater samples. The maximum dissolved concentration of As was measured as 71 µg L− 1 in rainy and 211 µg L− 1 in winter season groundwater samples, whereas maximum F− concentration was measured as 7 mg L− 1 in rainy and 6 mg L− 1 in winter season groundwater samples. Identified minerals saturation condition, weathering, and dissolution results of hydrogeochemistry were well corroborated with the Bivariate plot, Gibbs and Pourbaix diagrams. Results of health risk assessment showed that population of age below 18 years old are prone to carcinogenic diseases and symptoms of non-carcinogenic health risk due to daily consumption of As contaminated groundwater. Children of age below 18 years old, in total 39% (i.e. 6834) and 64% (i.e. 13937) were found more susceptible to arsenic ingestion effect. The male population was found prone to As cancer risk than the female population. Overall, this study provides a critical result about the cause of high As and F− concentration in groundwater and health risk assessment, it provides a prime concern matter for the young generation which is at higher risk of As cancer.
CD248(TEM1/CD164L1/Endosialin): A new molecular target for anti-angiogenic therapy in Pancreatic ductal adenocarcinoma
Authors: Zhang Huan , Dai Zhujiang , Liao Yiqun , Yan Cheng , Zhao Bin , Liu Tian , Zhang Jie , Xing Juan , Zhang Wenjie , Zhang Jingqiu , Wang Daorong , Tang Dong
Published: March 2021

Background: Pancreatic ductal adenocarcinoma (PDCA) is one of the malignant tumors with the worst prognosis with a 5-year survival rate of <1%, which is known as the "king of cancers". At present, there is a lack of effective early diagnosis and treatment plan for pancreatic cancer. Therefore, there is an urgent need to understand the molecular mechanisms of pancreatic cancer to generate innovative approaches for the development of effective early diagnosis and treatment strategies.Methods: In this study, we performed single gene pan-cancer analysis, gene co-expression analysis and gene regulatory correlation analysis to understand the molecular mechanism of CD248 in pancreatic cancer using bioinformatics tools. Additionally, we provided potential molecular targets for pancreatic cancer treatment by constructing the lncRNA-miRNA-gene network axis.Results: The results showed that CD248 is differentially expressed in normal and tumor tissues, and abnormally high expression predicts poor prognosis, is a proto-oncogene in pancreatic cancer. Besides, CD248 is associated with angiogenesis of tumors. We obtained three new lncRNA-miRNA-gene network axes, namely AC008040.1-hsa-miR-200c-3p-CD248 axis, AC055822.1-hsa-miR-200c-3p-CD248 axis, RRN3P2-hsa-miR-200c-3p-CD248 axis that provide promising molecular targets for anti-angiogenic therapy and diagnostic biomarkers for pancreatic cancer.Conclusion: In conclusion, this study shows that over-expression of CD248 (TEM1/CD164L1/Endosialin) is always present in breast cancer and predicts a poor prognosis, associated with tumor angiogenesis, suggesting it as an attractive therapeutic target for pancreatic cancer.
Evaluation of groundwater quality in central Saudi Arabia using hydrogeochemical characteristics and pollution indices
Authors: Alharbi Talal , El-Sorogy Abdelbaset Sabry , Qaysi Saleh , Alshehri Fahad
Published: March 2021

The groundwater quality and heavy metal contamination were evaluated in thirty palm farms, central Saudi Arabia using pollution indices, irrigation quality parameters, and multivariate statistical analyses. The results showed that the average values of TDS, Ca + , Na + , K + , Cl − , SO 4 2− , and F − were greater than the permissible limits of the WHO standards for drinking water. The groundwater facies types were Ca–Na–SO 4 –Cl (23 samples), Ca–Cl–SO 4 , (4 samples), and Ca–SO 4 –Cl type (3 samples). The groundwater quality index indicated that 15 groundwater samples were of good quality and 15 were of poor quality, whereas the metal index and heavy metal pollution index indicated that all samples were categorized as slightly affected and with low pollution, respectively. The variation is attributed to the increasing average values of some ions and decreasing HMs. The dissolution/precipitation of silicates, gypsum, and carbonates, and soil leaching were the natural factors affecting groundwater chemistry, whereas higher PO 4 3− , NO 3 − , F − , Pb, and Zn values in some samples may be attributed to human activities from the extensive use of fertilizers and pesticides on the investigated farms.
Study of pain level control targets after arthroscopic surgery
Authors: Wang Xin , Liu Congying , Zhang Xiaole , Wang Hong , Xu Yan , Li Baohua , Wang Jianquan
Published: March 2021

Objective: To explore the goal of pain control in patients after arthroscopic surgery.Design: Investigation. Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated.Setting: Department of Sports Medicine,Peking University 3rd Hospital,Beijing, P.R.ChinaSubjects: 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. The patient inclusion criteria were an age of at least 18 years, a lack of significant personality disorders, stable social and psychological factors, the ability to clearly express his or her pain and an agreement to voluntarily cooperate with the investigators. The exclusion criteria were patients who had been using painkillers long-term and those with other acute and chronic pain disorders.Methods: Postoperative pain, pain control satisfaction and the effect of pain on daily activities were investigated and evaluated by administering a homemade questionnaire to 514 patients selected by convenience sampling from patients hospitalized in a level A hospital in Beijing from 2020.06-2020.11. Pain was assessed using a digital pain numerical rating scale (NRS) (0-10), and a digital score ranging from 0 to 10 was used for satisfaction with pain control and the impact of pain on aspects of daily living.Results: The pain level was most severe in patients 6-24 hours after arthroscopic surgery, during which pain control satisfaction was at its worst. The pain score was significantly related to the effects of pain on aspects of daily life, and the degree of these effects changed significantly for pain scores greater than 2 points.Conclusion: Pain control 6 to 24 hours after surgery is not satisfactory. It is recommended that a pain score of 2 points is used as the goal for pain control after arthroscopic surgery to guide both doctors and patients to effectively control postoperative pain.
Radiation-induced Hounsfield unit change correlates with dynamic CT perfusion better than 4DCT-based ventilation measures in a novel-swine model
Authors: Wuschner Antonia E. , Wallat Eric M. , Flakus Mattison J. , Shanmuganayagam Dhanansayan , Meudt Jennifer , Christensen Gary E. , Reinhardt Joseph M. , Miller Jessica R. , Lawless Michael J. , Baschnagel Andrew M. , Bayouth John E.
Published: March 2021

Purpose: To analyze radiation induced changes in Hounsfield units and determine their correlation with changes in perfusion and ventilation. Additionally, to compare the post-RT changes in human subjects to those measured in a swine model used to quantify perfusion changes, and validate their use as a preclinical model. Methods: A cohort of 5 Wisconsin Miniature Swine (WMS™) were studied. Additionally, 19 human subjects were recruited as part of an IRB approved clinical trial studying functional avoidance radiation therapy for lung cancer and were treated with SBRT. Imaging (a contrast enhanced dynamic perfusion CT in the swine and 4DCT in the humans) was performed prior to and post-RT. Jacobian elasticity maps were calculated on all 4DCT images. Contours were created from the isodose lines to discretize analysis into 10 Gy dose bins. B-spline deformable image registration allowed for voxel-by-voxel comparative analysis in these contours between timepoints. The WMS™ underwent a research course of 60 Gy in 5 fractions delivered locally to a target in the lung using an MRI-LINAC system. In the WMS™ subjects, the dose-bin contours were copied onto the contralateral lung, which received < 5 Gy for comparison. Changes in HU and changes in Jacobian were analyzed in these contours.Results: Statistically significant (p < 0.05) changes in the mean HU value post-RT compared to pre-RT were observed in both the human and WMS™ groups at all timepoints analyzed. The HU increased linearly with dose for both groups. Strong linear correlation was observed between the changes seen in the swine and humans (Pearson coefficient > 0.97, p< 0.05) at all timepoints. Changes seen in the swine closely modeled the changes seen in the humans at 12 months post RT (slope=0.95). Jacobian analysis showed between 30-60% of voxels were damaged post-RT. Perfusion analysis in the swine showed a statistically significant (p < 0.05) reduction in contrast inside the vasculature 3 months post-RT compared to pre-RT. The increases in contrast outside the vasculature was strongly correlated (Pearson Correlation 0.88) with the reduction in HU inside the vasculature but were not correlated with the changes in Jacobians. Conclusions: Radiation induces changes in pulmonary anatomy at 3 months post-RT, with a strong linear correlation with dose. The change in HU seen in the non-vessel lung parenchyma suggests this metric is a potential biomarker for change in perfusion. Finally, this work suggests that the WMS™ swine model is a promising pre-clinical model for analyzing radiation-induced changes in humans and poses several benefits over conventional swine models.
Online training in evidence-based medicine and research methods for GP Registrars: a mixed-methods evaluation of engagement and impact
Authors: Rahimi-Ardabili Hania , Spooner Catherine Spooner , Harris Mark F , Magin Parker , Tam Chun Wah Michael , Liaw Teng , Zwar Nicholas
Published: March 2021

Background

Evidence-based medicine (EBM) is a core skillset for enhancing the quality and safety of patients’ care. Online EBM education could improve clinicians’ skills in EBM, particularly when it is conducted during vocational training. There are limited studies on the impact of online EBM training on clinical practice among GP registrars (trainees in specialist general practice). We aimed to explore GP registrars’ experience with an online interactive course that was a compulsory component of their vocational training. The course was developed by content-matter experts with educational designers to encompass effective teaching methods (e.g. it was interactive and used multiple teaching methods).
Methods

Mixed-method data collection was conducted after individual registrars’ completion of the course. The course comprised six modules that aimed to increase knowledge of research methods and application of EBM skills to everyday practice. GP registrars who completed the online course during 2016–2020 were invited to complete an online survey asking about their experience and satisfaction with the course. Those who completed the course within the six months prior to data collection were invited to participate in semi-structured phone interviews. A thematic analysis approach was used to analyse the data from qualitative interviews.
Results

The data showed the registrars were generally positive towards the course and the concept of EBM. They stated that the course improved their confidence, knowledge, and skills and consequently impacted their practice. The students perceived the course increased their understanding of EBM with a Cohen’s d of 1.6. Registrars identified factors that influenced the impact of the course. Of those, some were GP-related including their perception of EBM, and being comfortable with what they already learnt; some were work-place related such as time, the influence of supervisors, access to resources; and one was related to patient preferences.
Conclusions

This study showed that an online education program was able to improve GP registrars’ knowledge, confidence, skill and practice of EBM over the period of three months. It also highlights the supervisor’s role on GP registrars’ ability in translating the EBM skills learnt in to practice and suggests exploring the effect of EBM training for supervisors.
Identification of source information for sudden hazardous chemical leakage accidents in surface water on the basis of particle swarm optimisation, differential evolution and Metropolis–Hastings sampling
Authors: Yang Haidong , Li Jinjin , Liu Biyu , Chen Luying
Published: March 2021

A quick and accurate identification of source information on sudden hazardous chemical leakage accident is crucial for early accident warning and emergency response. This study firstly regards source identification problem of sudden hazardous chemical leakage accidents as an inverse problem and constructs a source identification model based on the Bayesian framework. Secondly, a new identification method is designed on the basis of particle swarm optimisation (PSO), differential evolution (DE) and the Metropolis–Hastings (M-H) sampling method. Lastly, the designed method, i.e. PSO-DE-MH, is verified by an outdoor experiment analyses in a section of the South–North Water Transfer Project. Results show that the number of iterations, the average absolute error, the average relative error and the average standard deviations of the identification results obtained by PSO-DE-MH are less than those of PSO-DE and DE-MH. Moreover, the relative error and the sampling relative error of the identification results under five different measurement errors (MEs) (σ = 0.01, 0.05, 0.1, 0.15, 0.2) are less than 9.5% and 0.2%, respectively. The designed method is effective even when the standard deviation of the ME increases to 0.2. Therefore, the designed method can effectively and accurately obtain the source information of sudden hazardous chemical leakage accidents. This study provides a new idea and method to solve the difficult problems of emergency management.
Determınıng the Covıd-19 Exıstence in Perıtoneal Fluıd
Authors: Ilgen Orkun , Ozgozen Eyuphan , Appak Ozgur , Ertan Begum , Dogan Erbil , Posaci Cemal
Published: March 2021

Purpose: To determine the SARS-CoV-2 existence in the peritoneal fluid for preventing healthcare workers from surgical smoke and aerosolization of Covid-19 during laparoscopyMethods: All the data of the 6 Covid-19 positive patients included in this study were collected prospectively between the 31st August 2020 and 31st November 2020. Clinicopathologic data of the patients including age, symptoms, radiological and laboratory findings, antiviral treatment before the operation, operation, and peritoneal fluid Covid-19 existence were recorded. Covid-19 status of the patients was diagnosed with a nasal swab test. Covid-19 existence in the peritoneal fluid was determined by the RT-PCR test.Results: All the 6 Covid-19 positive patients were pregnant. Therefore, all the operations were ceserean section operation. Only one patient had high fever. The Covid-19 specific radiological finding was detected only in one patient. In laboratory findings: 4 of 6 cases had lymphopenia and all cases had D-dimer positivity. Antiviral drugs were not used in any of the cases in this study. There was no detected Covid-19 virus in the peritoneal fluid examples of any cases. Conclusion: Aerosolization of Covid-19 from the peritoneal cavity by laparoscopy or electrocautery is not a big concern under the condition of applying cautions according to the guidelines.
Effect of root interaction on nodulation characteristics and isoflavonoid mechanism of alfalfa in the simulated alfalfa/oat in pots
Authors: Zhao Yajiao , Liu﹡ Xiaojing , Wu Yong , Tong Changchun
Published: March 2021

Rational intercropping is capable of promoting nodulation and facilitating the fixation and utilization of nitrogen (N) of legumes. Isoflavonoid is critical to form root nodules of legumes, whereas the regulation of isoflavonoid over nodulation and N fixation in legume/cereal intercropping remains unclear. In the present study, nutrient solution of different root partitions (e.g., no barrier (A-O), nylon mesh barrier (NA-O), plastic barrier (PA-O) and sole alfalfa (SA)) and nitrogen levels (e.g., 21 and 210 mg L-1 N) were used to delve into the variations of nodulation, N fixation, isoflavonoid content, isoflavonoid synthase (IFS) and nodulation-signaling pathway (NOD) genes in alfalfa. As suggested from the results, the parameters of nodulation and N fixation ability with A-O were all evidently higher than those with PA-O and SA. Formononetin and genistein with A-O had noticeably higher contents than those with PAT and SA. Daidzein and luteolin with A-O had remarkably higher contents than those with NA-O in the root. IFR 1, IFR 4, NOD 1 and NOD 2 with A-O and NA-O had noticeably higher relative expressions than those with SA and PA-O. IFR 2 and IFR 3 with AT and NA-T had significantly lower relative expressions than those with PA-O and SA. The nodulation and isoflavonoids met significant positive associations. IFR and NOD genes and TNN and ENN followed significant positive associations. NOD genes and formononetin exhibited extremely significant positive associations. The conclusion was drawn that the closer root interaction between alfalfa and oat, the more effective the nodulation, N fixation ability and isoflavoids content of alfalfa will be. Isoflavonoids primarily affected nodulation and N fixation. The mechanism of isoflavonoids on nodulation and N fixation in alfalfa/oat intercropping was explained that root interaction results in the reduction of environmental N, thereby regulating the relative expressions of IFR genes, elevating the isoflavonoids contents, and up-regulating the relative expressions of NOD genes; as a result, the nodulation and N fixation ability in alfalfa are facilitated.
Towards a Flood Vulnerability Assessment of Watershed Using Integration of Decision Making Trial and Evaluation Laboratory, Analytical Network Process, and Fuzzy Theories
Authors: Hosseini Farzaneh Sajedi , Sigaroodi Shahram Khalighi , Salajegheh Ali , Moghaddamnia Alireza , Choubin Bahram
Published: March 2021

Among natural disasters, flood is increasingly recognized as a serious worldwide concern that causes the most damages in parts of agriculture, fishery, housing, and infrastructure, and strongly affects economic and social activities. Universally, there is a requirement to increase our conception of flood vulnerability and to outstretch methods and tools to assess it. Spatial analysis of flood vulnerability is part of non-structural measures to prevent and reduce flood destructive effects. Hence, the current study proposes a methodology for assessing the flood vulnerability in the area of watershed in a severely flooded area of Iran (i.e., Kashkan Watershed). First interdependency analysis among criteria (including population density, PD; livestock density, LD; percentage of farmers and ranchers, PFR; distance to industrial and mining areas, DTIM; distance to tourist and cultural heritage areas, DTTCH; land use; distance to residential areas, DTRe; distance to road, DTR; and distance to stream, DTS) was conducted using the decision-making trial and evaluation laboratory (DEMATEL) method. Hence, the cause and effect factors and their interaction levels in the whole network were investigated. Then, using the interdependency relationships among criteria, a network structure from flood vulnerability factors to determine their importance of factors was constructed and the analytical network process (ANP) was applied. Finally, with aim of overcome ambiguity, reduce uncertainty, and keep the data availability, an appropriate Fuzzy membership function was applied to each layer by analyzing the relationship of each layer with flood vulnerability. Importance analysis indicated that the variables of land use (0.197), DTS (0.181), PD (0.180), DTRe (0.140), and DTR (0.138) were the most important variables. The flood vulnerability map produced by the integrated method of DEMATEL-ANP-FUZZY showed that about 19.2% of the region has a high to very high flood vulnerability.
The impact of Nordic walking on bone properties in postmenopausal women with pre-diabetes and non-alcohol fatty liver disease: a randomized controlled trial
Authors: Du Xiaming , Zhang Chao , Zhang Xiangqi , Qi Zhen , Cheng Sulin , Le Shenglong
Published: March 2021

Background: How bone properties would change after exercise intervention in patients with comorbidities are largely unknown. This study investigated the impact of Nordic walking on bone properties in postmenopausal women with pre-diabetes and non-alcohol fatty liver disease (NAFLD).Methods: The study is a part of a large randomized controlled trial. Of the eligible participants, 63 postmenopausal women (aged 50-65 years) with prediabetes and NAFLD participated in either a progressive supervised Nordic walking training (60-75% VO2max intensity), 2-3 times/week, 30-60 min/sessions for 8.6-month (AEx, n=33), or maintained their daily lifestyle during intervention (Con, n=30). Bone mineral content (BMC) and density (BMD) of the whole body (WB), total femur (TF), femoral neck (FN) and lumbar spine (L2-4) were assessed by a dual-energy X-ray absorptiometry. Venous blood samples were analyzed for serum osteocalcin, pentosidine and receptor activator of nuclear factor kappa-B ligand (RANKL) levels by ELISA assay. Results: After 8.6-month intervention, the AEx group maintained their BMCTF, BMDTF, BMCL2-4 and BMDL2-4, and increased their BMCFN (p<0.016), while the Con group decreased their BMCTF (p<0.008), BMDTF (p<0.001)) and BMDL2-4 (p<0.002). However, no significant group × time interaction was observed, except for BMDL2-4 (p=0.013). Decreased pentosidine was correlated with increased BMCWB (=-0.352, p=0.019). The intervention has no significant effect on osteocalcin and RANKL. Conclusions: Our results suggest that Nordic walking is effective in preventing bone loss among postmenopausal women with pre-diabetes and NAFLD. Changing of bone mass is associated with changing of pentosidine. However, this effect is not associated with osteocalcin and RANKL.Trial registration: ISRCTN registry, ISRCTN 42622771, registered 23 April 2013, https://www.isrctn.com/
Characteristics of Patients Meeting the New Definition of Pre-capillary Pulmonary Hypertension (Nice 2018) in a Single Japanese Pulmonary Hypertension Center
Authors: Yamamoto Keiko , Tanabe Nobuhiro , Takahashi Yukiko , Naito Akira , Sekine Ayumi , Suda Rika , Sanada Takayuki Jujo , Sugiura Toshihiko , Shigeta Ayako , Sakao Seiichiro , Tatsumi Koichiro
Published: March 2021

Background: The 6th World Symposium on Pulmonary Hypertension (Nice 2018) proposed a new definition of pre-capillary pulmonary hypertension (PH) as a condition with mean pulmonary artery pressure (mPAP) > 20 mmHg, pulmonary artery wedge pressure (PAWP) ≤ 15 mmHg, and pulmonary vascular resistance (PVR) ≥ 3 Wood units (WU). The characteristics and prognosis of patients with pre-capillary PH, according to this new definition, is unclear. Therefore, we determined the characteristics of patients with pre-capillary PH who had pulmonary vascular disease with slight elevation in mPAP.Methods: We retrospectively enrolled 683 patients who underwent their first right heart catheterization (RHC) at Chiba University, Japan. Among them, 489 patients met the pre-capillary PH requirement with mPAP ≥ 25 mmHg (conventional pre-capillary PH group), while 22 patients met the borderline pre-capillary PH criteria (borderline pre-capillary PH group). Results: The borderline pre-capillary PH group comprised 4.3% of the total pre-capillary PH patients, and the majority was in Group 3 (40.9%) or 4 (45.5%). The survival of the borderline pre-capillary PH group tended to be better than that of the conventional pre-capillary PH group. Conclusions: Pre-capillary PH patients, according to the Nice 2018 definition, comprised 4.3 % of the population with total pre-capillary PH and had better survival than the conventional PH pre-capillary group; moreover, the majority of the pre-capillary PH cases were either Group 3 and 4.
Investigation of Copper-supported Ceria Nanofibers for Catalytic Oxidation of Diesel Soot
Authors: Pal Dan Bahadur , Mishra Anupama
Published: March 2021

In the present research, CeO2 and CuO/CeO2 nanofibers were synthesized by electrospinning at 12 kV DC by maintaining a tip to collector distance of 10 cm. The morphology of the as-synthesized nanofibers was determined by scanning electron microscopy, and their elemental composition was verified by X-ray photoelectron spectroscopy. The activity of the prepared samples for diesel soot oxidation was determined in a bench-scale fixed bed tubular reactor, and effluent gases were analyzed by online gas chromatography. The variations of working parameters (air flow rate, catalyst-soot ratio, catalyst-soot contact type) were evaluated in a range to optimized reaction conditions for diesel soot oxidation. The catalyst with 40% CuO/CeO2 had the highest surface area, the smallest crystallite size, and the best activity for diesel soot oxidation (tight contact) at Tf = 318oC.
Mechanical Strength and Water Absorption Analysis of Silane Treated Kenaf Natural Composites With Silicon Nanoparticles
Authors: N Parthipan , C Ramesh , C Mohanraj , S Padmavathy , Ang Chun Kit
Published: March 2021

This research is mainly focused on the analysis of tensile and flexural strength, water absorption angle measurement of untreated and silane treatment of natural kenaf fiber composites reinforced with silicon nanoparticles. The percentages of nano silicon were 0.5 wt%, 1.5 wt% and 2.5 wt%. Before reinforcement, the kenaf fiber was treated with silane solution ( 90 vol% of water and 10 vol% of pure silane) to enhance the bonding strength. The composites samples were prepared using Epoxy, Kenaf and Silicon nanoparticle (EKS) by the compression moulding process. The tensile and flexural strength were measured about automobile interior application. Moreover, the samples were immersed in water for 24 hours with different environmental conditions. The results indicated that the tensile strength of epoxy improved from 8-9% when increasing the nanoparticles. Also, it was found that 3-5% of strength enhancement in silane treated samples than untreated composites. Similarly, the flexural strength of silane treated samples were found higher about 4% than untreated samples. And, lower water absorption was noted with silane treated than untreated kenaf hybrid composites, which tends to improve the bonding. It causes improvements in mechanical strength with silane treated kenaf hybrid composites.
On the Stability of Periodic Motions of a Two-Body SystemWith Flexible Connection in an Elliptical Orbit
Authors: Zhong Xue , Zhao Jie , Yu Kaiping , Xu Minqiang
Published: March 2021

This paper deals with periodic motions and their stability of a flexible connected two-body system with respect to its center of mass in a central Newtonian gravitational field on an elliptical orbit. Equations of motion are derived in a Hamiltonian form and two periodic solutions as well as the necessary conditions for their existence are acquired. By analyzing linearized equations of perturbed motions, Lyapunov instability domains and domains of stability in the first approximation are obtained. In addition, the third and fourth order resonances are investigated in linear stability domains. A constructive algorithm based on a symplectic map is used to calculate the coeffcients of the normalized Hamiltonian. Then a nonlinear stability analysis for two periodic solutions is performed in the third and fourth order resonance cases as well as in the nonresonance case.
On the dielectric constant of titanium dioxide
Authors: Bonkerud Julie , Zimmermann Christian , Weiser Philip Michael , Vines Lasse , Monakhov Eduard V.
Published: March 2021

Conductive rutile TiO2 has received considerable attention recently due to a number of applications. However, the static dielectric constant in conductive, reduced or doped TiO2 appears to cause controversy with reported values in the range 100-10000. In this work, we propose a method for measurements of the dielectric constant in conductive, n-type TiO2 that involves: (i) hydrogen implantation to form a donor profile at a known depth, and (ii) capacitance-voltage measurements for donor profiling. We can not confirm the claims stating an extremely high dielectric constant. On the contrary, the dielectric constant of conductive, reduced rutile TiO2 is similar to that of insulating rutile TiO2 established previously, with a Curie-Weiss type temperature dependence and the values in the range 160-240 along the c-axis.
Performance, Combustion and Emission evaluation of Direct Injection diesel engine fueled with ZnO dispersed waste cooking oil biodiesel
Authors: M Dhanarasu , A Rameshkumar K , P Maadeswaran
Published: March 2021

In present scenario, the fast depletion of fossil fuels and energy crises motivated the researchers towards finding an alternative sources for energy. In this work, the performance, combustion and emission of hydrothermally synthesized ZnO nanoparticles dispersed waste cooking oil biodiesel in single cylinder, four stroke, Direct Injection- Diesel Engine with eddy current dynamometer was investigated. The synthesized ZnO nano particles were characterized by XRD, FTIR, SEM and EDX to find crystallinity, functional groups and surface morphology. Waste cooking oil biodiesel was produced via conventional one step alkali catalyst Trans-esterification process. Test fuels were prepared with dispersion of ZnO nanoparticles in the concentration of 10ppm, 20ppm and 30ppm with B20 (20% waste cooking oil biodiesel and 80% diesel) with the aid of magnetic stirrer and ultra-sonication. The test results exposed that the addition of ZnO nanoparticles with B20 gave better Performance in terms of BTE and BSFC compared to B20. The addition of ZnO nano particles with 30ppm concentration was identified as better fuel among all tested fuels in this work. 30ppm addition of ZnO nano particles with B20 records 1.78 % increase in BTE and 10.34% decrease in BSFC. The emission like CO, HC and smoke were 20%, 15.4% and 17.39% lower than diesel. On the other hand NOx was slightly higher than diesel but lower than B20.
Camrelizumab-related lethal arrhythmias and myasthenic crisis in a patient with metastatic thymoma: a case report
Authors: Zhang Bo , Gyawali Laxman , Liu Zengzhang , Du Huaan , Yin Yuehui
Published: March 2021

Immune checkpoint inhibitors (ICIs) have emerged in recent years as a promising treatment option for several malignant tumors. However, ICI therapy has also been associated with various immune-related adverse events (irAEs), especially with pre-existing autoimmune status, which sometimes can be life-threatening. A 68-year-old woman diagnosed with metastatic thymoma was treated with camrelizumab as her initial anti-tumor protocol at a nearby hospital. On 11 days after the first dose of camrelizumab, the patient was admitted to our hospital with symptoms of dyspnea, fatigue, and poor appetite. Workup on admission indicated dramatically elevated transaminase, troponin I, creatine kinase, and creatine kinase MB and a new-onset conduction abnormality on electrocardiography. She had no other underlying disease prior to ICI treatment; therefore, ICI-related myocarditis, myositis and hepatitis were diagnosed, and intravenous methylprednisolone (80mg/day) and other supporting treatments were administered sequentially. Coronary angiography was performed on day 3 of hospitalization, but no abnormality was detected. On the same day, she lapsed into a coma with respiratory muscle failure, which was highly suspected of myasthenic crisis. Therefore, mechanical ventilation and higher dose of methylprednisolone (1 g/day) plus intravenous immunoglobulin (20g/day) were applied immediately. The third artrioventricular block occurred abruptly and an urgent temporary pacemaker was placed. Repeated ventricular tachycardia (VT) occurred, and even multiple antiarrhythmic drugs used in combination failed to alleviate the VT storm. On day 5 of hospitalization, she suffered from ventricular fibrillation and die of cardiac arrest. In conclusion, close follow-up should be conducted after ICI treatment, especially for patients already with or at high risk for autoimmune disorders. Once diagnosed with severe irAEs, prompt high dose of glucocorticoid alone or in combination with other immunomodulators if necessary should be administered. A multidisciplinary team approach is of importance for better management of patients with multiple organs involvement.
Primary suprasellar germinoma: A retrospective study of 15 cases
Authors: Xue Kai , Han Guoqing , Wang Zheng , Zhang Xuebin , Wang Jiwei
Published: March 2021

The authors have requested that this preprint be removed from Research Square.
Effects of Pomegranate Juice (Punica Granatum) on Inflammatory Biomarkers and Complete Blood Count in Patients with COVID-19: A Structured Summary of a Study Protocol for a Randomized Clinical Trial
Authors: Yousefi Mojtaba , Sadriirani Mohammadreza , Pourmahmoodi Azizollah , Mahmoodi Sara , Samimi Bahar , Hosseinikia Mahboobe , Saeedinezhad Zaker , Panahande SeyedBahman
Published: March 2021

ObjectivesThis study is conducted to investigate efficacy of pomegranate juice on inflammatory biomarkers, C-reactive protein (CRP), interleukin 6(IL-6), erythrocyte sedimentation rate (ESR) and complete blood count (CBC) in hospitalized patients with mild to moderate coronavirus disease 2019 (COVID- 19).Trial DesignThis is a randomized, placebo-controlled, double-blind, parallel 2-arm (1:1 ratio) clinical trial.
Role of the apparent diffusion coefficient as a predictive factor for tumor recurrence in patients with intracranial epidermoid tumor
Authors: Oh Hyeong-Cheol , Hong Chang-Ki , Yoo Jihwan , Lee Kyu-Sung , Cha Yoon-Jin , Ahn Sung-Jun , Suh Sang-Hyun , Park Hun Ho
Published: March 2021

Purpose.

Intracranial epidermoid tumors are slowly growing benign tumors, but due to adjacent critical neurovascular structures, surgical resection is challenging, with the risk of recurrence. The apparent diffusion coefficient (ADC) has been used to evaluate the characteristics of brain tumors, but its utility for intracranial epidermoid tumors has not been specifically explored. This study analyzed the utility of preoperative ADC values in predicting tumor recurrence for patients with intracranial epidermoid tumors.
Methods.

Between 2008 and 2019, 23 patients underwent surgery for intracranial epidermoid tumor, and their preoperative ADC data were analyzed. The patients were divided into two groups: the recurrence group, defined by regrowth of the remnant tumor or newly developed mass after gross total resection on magnetic resonance imaging (MRI); and the stable group, defined by the absence of growth or evidence of tumor on MRI. Receiver operating characteristic (ROC) analysis was used to obtain the ADC cutoff values for predicting tumor recurrence. The prognostic value of the ADC was assessed using Kaplan-Meier curves.
Results.

The minimum ADC values were significantly lower in the recurrence group than in the stable tumor group (P = 0.046). ROC analysis showed that a minimum ADC value lower than 804.5×10− 6 mm2/s could be used to predict higher recurrence risk of intracranial epidermoid tumors. Subtotal resection, younger age, and mean and minimum ADC values lower than the respective cutoffs were negative predictors of recurrence-free survival.
Conclusions.

Minimum ADC values could be useful in predicting the recurrence of intracranial epidermoid tumors.
Diversity, Utilization and Dependency on NTFPs – A case study of a National Park in Indian sub-Himalayan Region
Authors: Lepcha Lakpa Doma , Shukla Gopal , Vineeta  , Chakravarty Sumit
Published: March 2021

Background: Non timber forest products (NTFPs) greatly contribute to livelihood, development, and poverty alleviation of indigenous and rural communities across the tropics. We also assumed that the fringe communities inhabiting Jaldapara National Park (JNP) of Indian eastern sub-Himalayan region largely rely on the NTFPs for their livelihood due to its remote and isolated location with no physical infrastructure and facilities. Methodology: Multistage sampling technique was used for the study. The sample size was 205 households selected randomly from a sample frame of 10 villages. Descriptive statistics was employed to analyze and summarize the data. Results: A total of 146 NTFP species was documented. The communities in our study area also relied on their NTFP collection/harvest for food, medicine, firewood, animal fodder, and other socio-cultural items for household use and cash income. Income from NTFPs contributed on an average 45 % of the total annual household income of the sampled households.Conclusion: NTFPs provided a natural insurance to households especially during the periods of scarcity. Focused interventions with technical and financial support are recommended to uplift the livelihood of the forest fringe indigenous communities in JNP.
The Assessment of Structural and Functional Test Results for Early Detection of Hydroxychloroquine Macular Toxicity
Authors: Sonalcan Vildan , Koklu Burcin , Aksoy Nilgün , Gündoğdu Kübra , Çelik Erkan , Alagöz Gürsoy
Published: March 2021

PurposeTo assess structural (optical coherence tomography, fundus autofluorescence) and functional (contrast sensitivity and visual field) test results used for detecting early retinal changes in patients who were using oral hydroxychloroquine.METHODSPatients who were taking oral hydroxychloroquine for at least one year were divided into two groups in accordance with the duration of drug use. Group 1 and 2 comprised patients with drug use exceeding 5 years and 1–5 years, respectively. Besides, drug-free control group was composed. Upon full ophthalmic examination, the mean retinal nerve layer thickness (RNFL), central macular thickness (CMT), ganglion cell-inner plexiform layer thickness (GC-IPL), static 10 − 2 visual field, fundus autofluorescence (FAF) imaging, and contrast sensitivity tests were performed and statistically compared between groups.RESULTSRNFL thickness was found to be statistically significantly lower in the median and temporal quadrant than in the control group. No significant difference was found between the groups in the other quadrants. The GC-IPL sectoral and mean thickness were found to be statistically lower in all quadrants as compared to the control group in the patient groups. CMT was also found to be similar in all three groups. There was no significant difference between the groups in visual field parameters. While macular FAF images were significantly higher in the drug users than in the control group, no significant difference was found between the three groups in foveal FAF images. Contrast sensitivity measurements were significantly lower in the patient groups than in the control group at all spatial frequencies except 6 and 18 cycles / degree.CONCLUSIONSThe combined use of structural and functional tests in patients using hydroxychloroquine provides useful information in detecting early retinal changes.
Identification of Lipid Metabolism-Related Genes as Prognostic Indicators in Papillary Thyroid Cancer
Authors: Wen Shi-Shuai , Luo Yi , Wu Wei-Li , Zhang Ting , Yang Yi-Chen , Ji Qing-Hai , Wu Yi-Jun , Shi Rong-Liang , Ma Ben , Xu Midie , Qu Ning
Published: March 2021

Purpose
Lipid metabolism plays important roles not only in the structural basis and energy supply of healthy cells but also in the oncogenesis and progression of cancer. In this study, we investigate the prognostic value of lipid metabolism related genes in papillary thyroid cancer (PTC).
Methods
The in time to recurrence predictive gene signature was developed, internally and externally validated based on PTC datasets including The Cancer Genome Atlas (TCGA) and GSE33630 datasets. Univariate, LASSO and multivariate Cox regression analysis were applied to assess prognostic genes and build the prognostic gene signature. The expression profiles of prognostic genes were further determined by immunohistochemistry by using in-house cohorts which enrolled 97 patients. Kaplan-Meier curve, time-dependent receiver operating characteristic curve, nomogram and decision curve analysis were used to assess the performance of the gene signature.
Results
We identified four recurrence-related genes, PDZK1IP1, TMC3, LRP2 and KCNJ13, and established a 4-gene signature recurrence risk model. The expression profile of the 4 genes in the TCGA and in-house cohort indicated that stage T1/T2 PTC and locally advanced PTC exhibited notable associations not only with clinicopathological parameters but also with recurrence. Calibration analysis plots indicated the excellent predictive performance of the prognostic nomogram constructed based on the gene signature. GSEA showed that high-risk cases exhibited changes in several important tumorigenesis-related pathways, such as the intestinal immune network and the p53 and Hedgehog signalling pathways.
Conclusion
Our findings indicate that lipid metabolism-related gene profiling represents a potential marker for prognosis and treatment decisions for PTC patients.