bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case on Queue-Systems Analytical and Simulation Solutions By SAN Formalism
Authors: Besharati Mohammad Reza , Izadi Mohammad
Published: March 2021

There is a case about a system comprising two queues of M/M(a)/1/K with a due date with FCFS service policy in each queue. Using the methods of simulation and mathematical analysis, the solution diagrams were illustrated for the fixed due date Ɵ=1 second at the phase of due date up to the commencement of the service, limited capacity K1=5 and K2=4, for both scenarios of different service management rate resulted. For the analytical solution, first, a SAN model from the system was created in the Mobius tool. For simulation, a java discrete systems simulation code was used. Adjustment of the initial values, selection of the scenarios for service rate, the number of the consumers in the simulation, etc. were all carried out in the simulation code.
An Integrated Simulation Approach for Wellbore Blockage Considering Precipitation, Aggregation, and Deposition of Asphaltene Particles
Authors: Qi Minhui , Moghanloo Rouzbeh Ghanbarnezhad , Su Xin , Li Mingzhong
Published: March 2021

Asphaltene deposition triggers serious flow assurance issues and can significantly restrict the production capacity. Because of the complexity associated with asphaltene deposition that includes several mechanisms acting simultaneously, an accurate prediction of asphaltene blockage along the wellbore requires integration of asphaltene precipitation, aggregation, and deposition. In this work, an integrated simulation approach is proposed to predict the asphaltene deposition profile along the wellbore. The proposed approach is novel because it integrates various deposition patterns of particulate flow (which depends on hydrodynamics) with aggregation processes to investigate how the distribution of asphaltene particle size varies (governed by molecular dynamics) after being precipitated out of the oil phase (controlled by thermodynamics).

To improve the predictability capability of simulations, a direct input from the wellbore flow simulator is used to update the velocity profile after the wellbore radius changes beyond a certain predefined threshold. The fraction of asphaltene precipitation is determined using the asphaltene solubility model and combined with aggregation models to feed into deposition calculations.

Wellbore blockage was examined for two cases with and without the aggregation mechanism included. A sensitivity analysis was carried out to study parameters that affect the severity of blockage, such as range of pressure-temperature along the wellbore, flow velocity, and radial distribution of asphaltene particles. The simulation approach proposed in this paper provides an in-depth understanding of the wellbore flow assurance issues caused by asphaltene deposition and thus provides useful insights for improving the predictions of production performance.
Intentional Fallers with Complex Pelvic and Acetabular Fractures Do Not have Worse Radiological and Functional Outcomes than Accidental Fallers
Authors: Yu Yi-Hsun , Chou Ying-Chao , Hsu Yung-Heng , Chen I-Jung , Wei Lien-Chung
Published: March 2021

Background: Individuals who fell from heights of >6 m accidentally or intentionally can suffer from complex pelvic and acetabular fractures. The extent to which an intentional fall correlates with prognosis and outcome after osteosynthesis is unclear. We aimed to investigate the clinical outcomes of fallers with pelvic and acetabular fractures after osteosynthesis and to compare the radiological and functional outcomes between intentional and accidental fallers.Methods: Between 2014 and 2017, individuals who fell from heights of >6 m, developed pelvic and acetabular fractures, survived after resuscitation, and completed surgical treatments were enrolled. The fallers were divided into the intentional and accidental fallers, and their clinical parameters were statistically evaluated and compared.Results: Forty-nine fallers who underwent osteosynthesis for pelvic and acetabular fractures were included. Sixteen patients were intentional fallers, whereas the rest of the patients fell accidentally. All patients who fell intentionally had pre-existing mental disorders, and the major diagnosis was adjustment disorder. The group with intentional fallers had female sex predominance, higher injury and new injury severity scores, and longer hospital stay. However, the early loss of fixation (less than three month) and functional outcomes (6- and 12-month follow-up) did not significantly differ between the intentional and accidental fallers. Conclusions: The intentional fallers with pelvic and acetabular fractures might be accompanied by more severe injuries compared to accidental fallers. However, the radiological and functional outcomes of the intentional fallers after osteosynthesis were not inferior to those of the accidental fallers.
Virulence factors and molecular characteristics of Shigella flexneri isolated from calves with diarrhea
Authors: Zhu Zhen , Wang Weiwei , Cao Mingze , Liu Guanhui , Zhou Xuzheng , Li Bing , Shi Yuxiang , Zhang Jiyu
Published: March 2021

Background: The natural hosts of Shigella are conventionally humans and other primates; however, the host range of Shigella has been shown to expand to many animals. Although Shigella is becoming a huge threat to animals, there is limited information on the genetic background of local strains. The purpose of this study was to assess the presence of virulence factors and the molecular characteristics of S. flexneri isolated from calves with diarrhea.Methods: From 2014 to 2016, 54 S. flexneri isolates were collected from diarrhea, and their biochemical characteristics were determined according to API20E and virulence factors via PCR. The molecular characteristics of the isolates were studied by MLST, MLVA and PFGE.Results: Fifty-four S. flexneri isolates possessed four typical biochemical characteristics of Shigella. The prevalences of ipaH, virA, ipaBCD, ial, sen, set1A, and set1B were 100%, 100%, 77.78%, 79.63%, 48.15% and 48.15%, respectively. None of the studied strains possessed the stx gene. Regarding the differences in virulence factor distributions, the 54 S. flexneri isolates fell into seven gene profile types. Among these VTs, VT4 and VT6 were the most common, accounting for 74.07% of all VTs. MLVA based on 8 VNTR loci discriminated the isolates into 39 different MTs, PFGE based on NotI digestion divided the 54 isolates into 31 PTs, and MLST based on 15 housekeeping genes differentiated the isolates into 7 STs, with 1 ST (ST227) being novel.Conclusion: Our findings provide baseline information on the distribution of virulence genes in and the molecular characteristics of S. flexneri collected from diarrheal calves, which is a potential threat to public safety. These data will be important for addressing clinical and epidemiological issues regarding Shigellosis.
Imaging the communicating structures on oocyte through high-resolution spinning-disc microscope
Authors: Zhang Yan , Wang Ye , Zhang Hua
Published: March 2021

The communications between oocyte and granulosa cells are essential for ovarian folliculogenesis in mammals, and the communicating structures in the ZP had been widely reported. However, there was lack of direct approach to visualize these structures in a 3D model with a high-resolution. Here, we present a protocol to image the structures which derived from oocytes by combining endogenous fluorescent mouse models with a high-resolution spinning disc-confocal system in details
Bedside Diffuse Optical Tomography of Disrupted Brain Connectivity During Acute Stroke
Authors: Burke Broc , Bergonzi Karla , Sherafati Arefeh , Fishell Andrew , Burns-Yocum Tracy , Ferradal Silvina , Palanca Ben , Dhar Rajat , Kumar Gyanendra , Lee Jin-Moo , Culver Joseph , Eggebrecht Adam
Published: March 2021

Neurological instability during the first days following ischemic stroke reflects the potential to salvage brain tissue at risk for infarct growth, hemorrhagic transformation, or malignant edema. However, current clinical care provides intermittent assessments on the order of at least an hour apart potentially missing the early detection of neurological deterioration. Optical imaging offers a continuous, portable alternative to the current combination of physical exams and radiological imaging. However, optical imaging technology has heretofore lacked the crucial combination of portability, resolution, and coverage required for assessing distributed brain function. Here, we present a portable high-density diffuse optical tomography (HD-DOT) system that overcomes these limitations to assess neurological disruption at the bedside. We imaged patients within 72 hours after ischemic stroke onset and demonstrate that HD-DOT is sensitive to both the presence of stoke (Cohen’s d = 1.5, p = 1.2 × 10− 3) as well as the degree of neurological disruption measured by NIH Stroke Scale (R2 = 0.69, p = 4.7 × 10− 4).
Community-Clinical Partnership: Engaging health navigators to support refugees and non-refugee immigrants amidst the COVID-19 pandemic
Authors: Harris Megan A , Lupone Christina D , Asiago-Reddy Elizabeth , Anderson Kathryn B , Cronkright Peter , Blatt Steven D , Turbide Sophia , Kambhampaty Abby , Sous Waseem , Goodman Alexandra , Lichtenstein Daniel A , Mozo Nicole , Blatt Mia , Castricone Felicia , Shaw Andrea V
Published: March 2021

Background: The COVID-19 pandemic has exacerbated health inequities in vulnerable populations. Linguistic and sociocultural barriers, misinformation, and mistrust of Western medicine hinder public health outreach to diverse refugee and non-refugee immigrant communities. SUNY Upstate Medical University partnered with local resettlement agencies and health navigators to expand outreach and screening to this hard-to-reach population. Methods: Health navigators engaged participants for enrollment and screening. SARS-CoV2 status was assessed via RT-PCR of saliva swabs. Surveys captured COVID-19-related psychosocial behavioral insights.Results: Over 9 weekly sessions, 603 individuals in 195 refugee/immigrant households from 27 countries of origin were screened. COVID-19 positivity rate was 2% for households and 0.2% amongst individuals. Surveys provided insight into households’ concerns and health behaviors, and a space to reinforce protective behaviors and address misinformation and stigma. Conclusions: During these unprecedented times, our interdisciplinary community-clinical partnership successfully implemented COVID-19 screening, outreach, and support to local refugees and non-refugee immigrants through trusted networks of culturally, socially, linguistically congruent health navigators.
p16 Expression Represses DNA Damage Repair via a Novel Ubiquitin-Dependent Signaling Cascade.
Authors: Molkentine David , Molkentine Jessica M. , Bridges Kathleen A. , Sheth Aakash , Valdecanas David R , Bahri Rishi , Hefner Andrew J. , Kumar Manish , Yang Liang , Abdelhakiem Mohamed , Pifer Phillip M. , Sandulache Vlad C. , Beadle Beth M. , Thames Howard D. , Mason Kathryn A. , Pickering Curtis R. , Meyn Raymond E. , Skinner Heath D.
Published: March 2021

Human papillomavirus (HPV) drives the development of squamous cell carcinoma at several sites, including the oropharynx. Generally, the presence of HPV renders a tumor more sensitive to DNA-damaging therapies such as radiation; however, the mechanism behind this phenomenon is elusive. Previous studies have shown that p16, the clinically utilized surrogate for HPV tumor positivity, can render cells more sensitive to radiation. In the current manuscript, using a combination of immunoprecipitation mass spectrometry (IP/MS), in vivo and in vitro modulation and clinical tumor profiling, we identify a novel ubiquitin-dependent signaling pathway linking p16 to increased activity of the transcription factor SP1 leading to increased HUWE1 transcription and degradation of ubiquitin-specific protease 7 (USP7). This pathway is activated in HPV-positive tumor cells, leading to an absence of TRIP12, decreased DNA damage repair and increased mitotic death following radiation. As USP7 inhibitors are currently in clinical trials, this pathway provides a novel means by which radioresistant tumors may be targeted to increase response and improve outcome.
Person-centred practice and technology - a complex intervention study in two Norwegian nursing homes
Authors: Grøndahl Vigdis Abrahamsen , Anker-Hansen Camilla , Fagerli Liv Berit , Helgesen Ann Karin , Rummelhoff Guri , Halvorsrud Liv , Bååth Carina
Published: March 2021

Objective: The overall objective is to explore how the implementation of person-centred practice and use of technology affects patients’ and relatives’ perceptions of care quality and healthcare personnel’s job satisfaction, as well as shed light on nursing students’ experiences when performing person-centred interventions. In this paper, the interventions used to assure implementation of person-centredness and use of technology in relation to patients are described to facilitate an increased understanding of the study’s future results. Results: A person-centred practice framework was introduced and facilitated in three phases. These included: 1) Establishing a project group consisting of ward leaders and researchers. Workshops and meetings were held with the healthcare personnel to inform and discuss the concept of person-centred practice, use of technology and the interventions: “one-to-one-contact”, collection of life stories, advanced care planning, and point prevalence of wounds, including pressure ulcers, incontinence associated dermatitis and developing a skin care bundle. 2) A twelve months’ intervention period including facilitated innovation groups for personnel and leaders and conducting the four interventions. 3) Discussion of results with personnel. Inhibitors and promoters for the continuation of interventions will be highlighted. Strategies will ensure the further development of person-centred practice and use of technology in nursing homes.
The Association Between Vitamin D and Acute Rejection in Human Kidney Transplantation: A Systematic Review and Meta-analysis Study
Authors: Mirzakhani Mohammad , Mohammadkhani Sheyda , Hekmatirad Shirin , Aghapour Soudabeh , Gorjizadeh Negar , Shahbazi Mehdi , Mohammadnia-Afrouzi Mousa
Published: March 2021

Background: Vitamin D (VitD) deficiency is associated with several diseases such as multiple sclerosis, rheumatoid arthritis, respiratory infection, and so forth. In the field of transplantation (kidney transplantation), some studies reported that patients with VitD deficiency are of increased chance of acute rejection, but other studies did not show such a chance. On the other hand, since VitD is a modulatory factor and can reduce the inflammatory response, understanding the exact role of it in transplantation may contribute to tolerance condition in these patients.Methods: The electronic databases, including PubMed, Scopus, Embase, ProQuest, Web of Science, and Google Scholar, were searched for eligible studies. In general, 14 studies with a total of 4,770 patients were included in this meta-analysis. Regarding the methodological heterogeneity, we selected a random-effects combination model. Moreover, OR was chosen as an effect size for this study.Results: After the combination of 14 studies, we showed that patients in the VitD-deficient group had an 82% increased chance of acute rejection compared with patients in the VitD-sufficient group, and this effect was significant (OR 1.82; 95% confidence interval [CI] [1.29, 2.56]; I2 = 52.3%). This result was significant, and, regarding the narrow CI, it can be a conclusive result. Study quality and gender variables were the main sources of inconsistent results in the primary studies. Moreover, using meta-regression, we showed that VitD deficiency (independent from the estimated glomerular filtration rate (eGFR) of patients) increased the chance of acute rejection.Conclusion: The normal VitD status of patients a few days before and after transplantation can reduce the risk of acute rejection, as it has definite modulatory effects on immune cells.
Association between respiratory and heart rate fluctuations and death occurrence in dying cancer patients: Continuous measurement with a non-wearable monitor
Authors: Fukui Sakiko , Ikuta Kasumi , Maeda Isseki , Hattori Satoshi , Hatano Yutaka , Yamakawa Miyae , Utsumi Momoe , Higami Yoko , Tanaka Haruka , Higuchi Akari
Published: March 2021

Background
The present study aimed to explore the association between impending death and continual changes in respiratory and heart rates measured by a non-wearable monitor every minute for the final 2 weeks of dying cancer patients.
Methods
In this longitudinal study, we enrolled patients in a palliative-care-unit and continuously measured their respiratory/heart rates by a monitor, capturing their other vital signs and clinical status from medical records.
Result
A dataset was created with 240 patient-days from every minute data to death (345,600 data) among 24 patients for 3–14 days to death. We analyzed this 240 patient-day data. After confirming the associations between the value of death day (n = 24) or other days (2–14 days before death, n = 216) and the mean, maximum, minimum, and variance of respiratory and heart rates every 24 hours by univariate analyses, we conducted a repeated measures logistic regression analysis using a generalized estimating equation. Finally, the maximum respiratory rate and mean heart rate were significantly associated with death at 24, 48, and 72 hours later, other than the respiratory rate of the last 24 hours.
Conclusion
The maximum respiratory rate and mean heart rate measured every minute by a monitor can warn imminent death during the last days of life among dying patients. Our findings can help for family caregivers and care staff to aware imminent death among dying patients at home or in facilities, in collaboration with palliative care professionals.
A pivotal restructuring of modelling the control of COVID-19 during and after massive vaccination for the next few years
Authors: Cruz Jose B , Ronquillo Tirso A , Sangalang Ralph G B , Amante Albertson D , Ronquillo Divina G D , Peralta Janice F , Chua Antonette V , Jose Oliver L J A , Inojosa Raynell A
Published: March 2021

This paper presents a new mathematical feedback model to demonstrate how direct observations of the epidemiological compartments of population could be mapped to inputs, such that the social spread of the disease is asymptotically subdued. Details of the stabilization and robustness are included. This is a pivotal restructuring of modelling the control of corona virus from the current models in use world-wide which do not utilize feedback of functions of epidemiological compartments of population to construct the inputs. Although several vaccines have received Emergency Use Authorization (EUA) massive vaccination would take several years to reach herd immunity in most countries. Furthermore, the period of efficacy of the vaccination may be approximately one year only resulting in an unending vaccination. Even during the vaccination, there would be an urgent need to control the spread of the virus. When herd immunity is reached and vaccination is discontinued, there would be new surges of the disease. These surges of disease are not possible in appropriately designed stable feedback models. However, extensive testing, contact tracing, and medical treatment of those found infected, must be maintained.
Hypoxia-Related Gene FUT11 Promoted Pancreatic Cancer Progression Via Maintaining The Stabilization of PDK1
Authors: Cao Wenpeng , Zeng Zhirui , Pan Runsang , He Zhiwei , Wu Hao , Zhang Xiangyan , Chen Hui , Nie Yingjie , Lei Shan , Yu Zijiang
Published: March 2021

Background: Hypoxia participated in the occurrence and development of pancreatic cancer (PC). However, genes associated with hypoxia respond and their regulated mechanism in PC cells were unclear. The current research was aimed to illuminate the role and hypoxia regulated mechanism of fucosyltransferase 11 (FUT11) in the progression of PC.Methods: After predicting FUT11 as a key hypoxia associated gene in PC using bioinformatics analysis. The expression of FUT11 in PC using quantitative real-time fluorescent PCR, western blot and immunohistochemistry. The effects of FUT11 on PC cells proliferation, migration and invasion under normoxia and hypoxia were detected using Cell Counting Kit 8, 5-ethynyl-2’-deoxyuridine assay, colony formation assay and transwell assay. Spleen capsule injected liver metastasis and subcutaneously injected model were performed to confirm the effects of FUT11 in vivo. Furthermore, western blot, luciferase assay and immunoprecipitation were performed to explore the regulated relationship among FUT11, hypoxia-inducible factor 1α (HIF1α) and pyruvate dehydrogenase kinase 1 (PDK1) in PC.Results: FUT11 was markedly increased of PC cells in hypoxia, up-regulated in the PC clinical tissues, and predicted a poor outcome. Inhibition of FUT11 reduced PC cell growth and mobility of PC cells under normoxia and hypoxia conditions in vitro, and growth and mobility in vivo. FUT11 bind with PDK1 and regulated the expression PDK1 under normoxia and hypoxia. FUT11 knockdown significantly increased the degradation rate of PDK1 under hypoxia, while treatment with MG132 can relieve the degradation of PDK1 induced by FUT11 knockdown. Overexpression of PDK1 in PC cells under hypoxia conditions reversed the suppressiv impacts of FUT11 knockdown on PC cell growth and mobility. In addition, HIF1α bound to the enhancer of FUT11 and increased its expression, as well as co-expressing with FUT11 in PC tissues. Furthermore, overexpress of FUT11 partially rescued the suppressiv effects of HIF1α knockdown on PC cell growth and mobility in hypoxia conditions.Conclusion: Our data further implicate that hypoxia-induced FUT11 in PC contributes to proliferation and metastasis by maintaining the stability of PDK1, and suggest FUT11 maybe a novel and effective target for treatment of pancreatic cancer.
Transmission frequency of covid-19 through pre-symptomatic and asymptomatic patients in AJK: A report of 201 cases
Authors: Mahmood Majid , Ilyas Noor-ul-ain , Khan Muhammad Faraz , Hasrat Muhammad Naseem
Published: March 2021

Background: Corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2, declared as “once-in-a-century” pandemic, has affected about entire human population. Till now, the most promising control strategy is to block the transmission which will never be effective without completely knowing the transmission patterns.Methods: This was a retrospective case to case study aiming to estimate and calculate the transmission rate of COVID-19 through pre-symptomatic and asymptomatic patients. Contact history of included positive cases during the period of 24 hours before appearance of symptoms and infection confirmation for symptomatic and asymptomatic cases respectively was traced for disease transmission. Results: Overall, a total of 201 cases had contacted with 7168 people in last 24 hours with an average of 35.66 contacts per patient ranging from a minimum of 4 to maximum of 87 contacts (Meetings). Out of 7168 meeting persons, the infection was traced in 64 (0.89%) persons. For 155 symptomatic patients, a total of 5611 contacting persons were traced before appearance of symptoms (pre-symptomatic) in last 24 hours with an average of 36.20 meetings per patient. The infection was transmitted in 63 (1.12%) people and remaining 5548 (98.88%) were remained uninfected. Out of the 63 transmissions, 62 (98.4%) were traced within last 6 hours before the onset of symptoms while only 1 was traced from 6-12 hours before symptoms. A total of 1557 persons were traced having meeting/contacts with asymptomatic cases in last 24 hours before their infection confirmation. Out of these 1557 persons, only 1 was found to be infected and the infection rate was calculated to be 0.06%. Conclusion: The study concludes that the risk of pre-symptomatic transmission of infection is low (1.12%) and it becomes very rare in contacts made longer than 6 hours before onset of symptoms. The infection transmission is traced as long as about 9 hours before the appearance of clear symptoms in the patients but the incidence was as low as about 0.02% of the total contacts in that period. Transmission frequency by asymptomatic patients is also rare (0.06%) in the studied population.
Elevated Liver Enzymes and Incident Type Two Diabetes Mellitus Risk in Yemeni Patients     
Authors: Dahman Lotfi S. Bin , Humam Mariam A. , Musiaan Nabil S. , Daakik Ahmed M. , Balfas Mohammed A.
Published: March 2021

This case-control study was aimed to assess the association between liver enzymes and incident T2D in Yemeni patients. The present study comprising 142 T2D patients and 142 healthy control subjects were recruited from the diabetic outpatient clinic of Ibn-Sina Hospital in Mukalla during the period from 1st January to 30th May 2020. Serum fasting blood glucose (FBG), total cholesterol, triglyceride, high-density lipoprotein cholesterol (HDL-C), alanine aminotransferase (ALT), aspartate aminotransferase (AST), and gamma-glutamyl transferase (GGT) were analyzed using the Cobas Integra Plus 400 autoanalyzer. Anthropometric and blood pressure measurements were taken from each participant. T2D patients had significantly higher FBG (P= <0.0001), total cholesterol (P= <0.0001), LDL-C (P= <0.0001), and GGT (P= <0.0001) while, HDL-C was significantly lower in T2D patients (P= 0.021). Serum ALT and GGT levels were significantly associated with increased incident T2D risk (P= 0.006 for ALT and 0.022 for GGT), and the odds ratios at 95% CI comparing the highest versus lower tertiles of ALT and GGT were 2.75(2.01-3.48) and 1.17(1.83-6.42) respectively. In conclusion, higher levels of ALT and GGT are positively associated with increased blood glucose levels and are used as predictive biomarkers for developing a higher risk of diabetes. Thus, routine screening of ALT and GGT in T2D patients is recommended for the early detection of liver disorders.
Ocular related emergencies in Spain during the COVID-19 pandemic, a multicenter study.
Authors: Puzo Martin , Sanchez-Monroy Jorge , Plana Carmen Alejandra Porcar , Bartol-Puyal Francisco de Asís , Dotti-Boada Marina , Peña-Urbina Pilar , Izquierdo-Serra Jordi , López-Montero Ana , Pérez-García Pilar , Bordonaba-Bosque Daniel , Pablo-Julvez Luis Emilio , Calvo-Perez Pilar
Published: March 2021

Purpose: To evaluate ophthalmological emergencies (OE) during the COVID-19 pandemic comparing them with the same period of the previous year. Methods: Retrospective observational study of all OE visits in four tertiary hospitals in Spain comparing data from March 16th to April 30th, 2020 (COVID-19 period) and the same period of 2019 (pre-COVID-19 period). Severity of the conditions was assessed following Channa et al. publication. Data on demographics, diagnosis and treatments were collected from Electronic Medical Records. Results: During lockdown, OE significantly declined by 75.18%, from 7,730 registered in the pre-COVID-19 period to 1,928 attended during the COVID-19 period (p<0.001). In 2019, 23.86% of visits were classified as emergent, 59.50% as non-emergent, and 16.65% could not be determined. In 2020, the percentage of emergent visits increased up to 29.77%, non-emergent visits significantly decreased to 52.92% (p<0.001), and 17.31% of the visits were classified as “could not determine”. During the pandemic, people aged between 45 and 65 years old represented the largest attending group (37.89%), compared to 2019, where patients over 65 years were the majority (39.80%). In 2019, most frequent diagnosis was unspecified acute conjunctivitis (11.59%), followed by vitreous degeneration (6.47%), and punctate keratitis (5.86%). During the COVID-19 period, vitreous degeneration was the first cause for consultation (9.28%), followed by unspecified acute conjunctivitis (5.63%) and punctate keratitis (5.85%). Conclusions: OE visits dropped significantly during the pandemic in Spain (75.18%), although more than half were classified as non-urgent conditions, indicating a lack of understanding of the really emergent ocular pathologies among population.
Minimally Invasive Open Reduction by a Modified Suture Bridge with Anchors for Avulsion-type Greater Tuberosity Fracture of the Humerus
Authors: Kong Lingpeng , Yang Juanjuan , Yang Yongliang , Wang Fu
Published: March 2021

Background: This study aims to describe a new procedure of minimally invasive open reduction by a modified suture bridge with anchors for avulsion-type greater tuberosity fracture of the humerus and to evaluate its clinical effectiveness.Methods: From January 2015 to January 2018, 16 patients who were diagnosed with an avulsion-type greater tuberosity fracture of the proximal humerus and treated with minimally invasive open reduction by modified suture bridges with anchors were retrospectively studied. Endpoints were assessed preoperatively and postoperatively and included the visual analog scale (VAS), the University of California Los Angeles (UCLA) shoulders score, the American Shoulder and Elbow Surgeons score (ASES), and the range of motion (ROM) for shoulders.Results: There were 7 males and 9 females with an average age of 44.94 years. Six fractures involved the left shoulder, and 10 involved the right shoulder. The time between injury and operation ranged from 1 to 5 days, with an average of 2.32 days. The average length of stay was 6.5 ± 0.85 days; the mean operation time was 103.1 ± 7.23 minutes; and the mean amount of operative blood loss was 51.88 ± 6.40 ml. All patients achieved bone union within 3 months after surgery. The VAS score significantly decreased at 3 weeks postoperatively (p = 0.002), as did the average degree of forward elevation (p = 0.047). The mean degree of abduction increased at 6 weeks after the operation (p = 0.035), and the average degree of external rotation and internal rotation improved at 3 months postoperatively (p = 0.012; p = 0.007). The ASES score and the UCLA score improved at the 6-week follow-up (p = 0.092; p = 0.029). No procedure-related death or incision-related superficial or deep tissue infection was identified in any case. No iatrogenic neurovascular injuries or fractures were found in this study.Conclusion: The fracture block was fixed firmly by minimally invasive open reduction with a modified suture bridge with anchors. Patients were allowed to move their shoulder early after surgery and recovered quickly. It is an efficient method for the treatment of avulsion-type greater tuberosity fractures of the humerus.
Renin-Angiotensin System Blockade Influences ACE2 in Human Type II Pneumocytes
Authors: Silva Mauro G , Falcoff Nora L , Corradi Gerardo C , Alfie José , Seguel Rolando F. , Tabaj Gabriela , Iglesias Laura , Nuñez Myriam , Guman Gabriela R. , Gironacci Mariela M.
Published: March 2021

Rationale—Angiotensin converting enzyme (ACE) 2 and the transmembrane protease serine 2 (TMPRSS2) are key for cellular entry of the type 2 coronavirus that causes severe acute respiratory syndrome (SARS-CoV2), the etiological agent of coronavirus-19 disease (COVID-19). There has been a growing concern that renin-angiotensin system (RAS) blockade with ACE inhibitors (ACEIs) or type 1 angiotensin (Ang II) receptor blockers (ARBs) increases ACE2 expression and then elevate patient susceptibility to SARS-CoV-2. However, evidence about RAS blockade and ACE2 in human lung are lacking.Objective– To investigate RAS blockade on ACE2 and TMPRSS2 in type II pneumocytes of human lung parenchymal of untreated and ACEI/ARB-treated hypertensive subjects.Methods and Results– ACE2 and TMPRSS2 protein expression were measured by immunohistochemistry. We found that smoking and RAS blockade influence on the percentage of human ACE2-expressing type II pneumocytes (p= 0.026). Smokers subjects under RAS blockade treatment exhibited higher percentage of ACE2-expressing type II pneumocytes than normotensive ones. Within the ACEI/ARB-treated group, the percentage of ACE2-expressing type II pneumocytes was higher in smokers than never smokers. A significant association between ACE2 immunostaining intensity and smoking on subjects over 60 years old was found (p= 0.05): older smokers exhibited higher ACE2 protein levels compared to youngers. The percentage of TMPRSS2-expressing type II pneumocytes was greater in men than women (p= 0.026) and in subjects under 60 years old (p= 0.040) and trend to be higher in ACEI/ARB-treated subjects than normotensives (p= 0.060). A significant association between TMPRSS2 immunostaining intensity with smoking and age or with RAS blockade and age or with RAS blockade and smoking was observed. Older or smokers subjects under ACEI/ARB treatment exhibited higher TMPRSS2 protein levels than youngers or never smokers.Conclusions—ACE2 and TMPRSS2 are influenced by smoking and ACEI/ARB treatment. These findings help explain the increased susceptibility to COVID-19 in subjects with treated cardiovascular-related pathologies.
Estimation of effective dilution rate to inhibit cyanobacterial blooms based on a novel competitive growth model -Case study in Lake Tega, Japan
Authors: Li Jingnan , Chujo Masato , Amano Yoshimasa , Machida Motoi
Published: March 2021

Although water transfer as a functional method to improve water quality and control cyanobacterial blooms in lakes has been used for several decades, there was few studies examining effective dilution rate depending on various water qualities in lakes. It would be due to the scarcity of water transfer execution in fields. Therefore, in order to clarify the optimum dilution rate to suppress cyanobacterial blooms, the competitive growth model based on the Droop model and the Lotka-Volterra model developed for eutrophic conditions was used. First, to verify the wide applicability of the simulation model, a competitive culture experiment between Microcystis sp. and Cyclotella meneghiniana under limited phosphorus and sufficient nitrogen concentration was conducted, then the cell densities of the two species were predicted by using the simulation model. Results of the competitive experiment revealed that there was no significant discrepancy in the growth of Microcystis sp. cell among different dilution groups (p＞0.05), while that of Cyclotella meneghiniana had significant discrepancy between groups (p＜0.05), and the accuracy of the simulation model under limited phosphorus concentration was verified. Based on these results, an exact effective dilution rate for the inhibition of Microcystis blooms in Lake Tega, Japan, was suggested by this novel simulation model. When the dilution rate reaches 13.3%, the Microcystis blooms will hard to occur. The predicted data were also compared with the actual data collected over years in Lake Tega, and its effectiveness has been confirmed.
Determinants of timely access to Specialized Mental Health Services and maintenance of a link with Primary Care: A cross-sectional study.
Authors: Treichel Carlos Alberto dos Santos , Bakolis Ioannis , Onocko-Campos Rosana Teresa
Published: March 2021

Background: Although it is known that several factors may influence the access to specialized care, the factors related to the maintenance of a link with Primary Care by patients who accessed Specialized Mental Health Services (SMHS) remain unknown. The aim of this study was to evaluate the determinants of timely access to SMHS and maintenance of a link with Primary Care. Methods: This is a cross-sectional study, conducted with 341 users of SMHS at outpatient and community level in a medium-sized city in Brazil. Associations between the outcomes and the other variables were explored with the use of Poisson regression models with robust variance estimators. Results: Among the factors associated with the study outcomes, those related to the organization of services and the movement between them were noteworthy. Patients referred by Primary Care were less likely to access specialized services in a timely manner (RR: 0.61; 95% CI: 0.40, 0.93). However, the referral of cases by Primary Care (RR: 1.38; 95% CI: 1.06, 1.79) and follow-up with visits by Community Health Agents (RR: 1.26; 95% CI: 1.04, 1.53) appeared to favor maintenance of the patient-Primary Care link. Conclusion: This study reinforces the idea that integration between Primary Care and SMHS should be strengthened, both to reduce waiting times for between-service referrals and benefit continuity of care.
Outcome of Pituitary Hormone Deficits After Surgical Treatment of Non-functioning Pituitary Macroadenomas (NFPMA)
Authors: Alexopoulou Orsalia , Everard Valérie , Etoa Martine , Fomekong Edward , Gaillard Stéphane , Parker Fabrice , Raftopoulos Christian , Chanson Philippe , Maiter Dominique
Published: March 2021

Objectives: Non-functionning pituitary macroadenomas (NFPMA) are benin tumors that cause symptoms of mass effects including hypopituitarism. Their primary treatment is trans-sphenoidal surgery. We aimed to determine the outcome of pituitary hormone deficits after surgical treatment of NFPMA and to identify factors predicting hormonal recovery.Design: We retrospectively included 246 patients with NFPMA diagnosed and operated in one of the two participating centers. All hormonal axes were evaluated except growth hormone (GH). Postoperative improvement of pituitary endocrine function was considered if at least one hormonal deficit had recovered and a lower total number of deficits was observed one year after surgery.Results: 80% (n=197) of patients had one or more pituitary deficits and 28% had complete anterior hypopituitarism. Besides GH, the gonadotropic and thyrotropic axes were the most commonly affected (68% and 62%, respectively). The number of hypopituitary patients dropped significantly to 61% at one year (p<0.001) and a significant improvement was observed for all hormonal axes, except central diabetes insipidus. Among patients with preoperative hypopituitarism, 88/175 (50%) showed improved pituitary function at one year. Both hyperprolactinemia at diagnosis and a lower tumor diameter independently predicted favourable endocrine outcome.Conclusions: Hypopituitarism is present in 80% of patients with NFPMA and nearly half of them will benefit from sustained improvement after surgery. Hyperprolactinae-mia at diagnosis and lower tumor dimensions are associated with favourable endocrine prognosis. This supports the option of early surgery in NFPMA patients with pituitary deficits independent of the presence of visual disturbances.
Ischemic Index and Distribution of Retinal Capillary Non-perfusion in Neovascular Glaucoma: a Retrospective Study
Authors: DeBoer Charles , Wong Brandon J. , Ameri Hossein
Published: March 2021

Purpose: To evaluate the pattern of retinal ischemia in newly diagnosed neovascular glaucoma (NVG).Methods: This is a retrospective single-center cross-sectional study of patients seen at LAC+USC Medical Center from January 2015 to April 2020. Patients with newly diagnosed NVG and ultra-widefield fluorescein angiography (UWFA) without prior panretinal photocoagulation were included. A total of 11 eyes from 10 patients met inclusion criteria. Three zones centered on the fovea were defined: posterior pole (within 2 disc-fovea lengths), mid periphery (between 2 and 3 disc-fovea lengths), and far periphery (>3 disc-fovea lengths). Ischemic index was calculated in these zones using ImageJ software.Results: The etiology of NVG was from proliferative diabetic retinopathy (n=9) and central retinal vein occlusion (n=2). Patients were aged between 48-74 years old. Ischemic index was found to be 91% in the far periphery, 77% in the mid periphery, and 42% at the posterior pole. The total average ischemic index was 76%. There was a statistically significant difference between the far periphery and posterior pole and mid periphery and posterior pole.Conclusions: High levels of retinal ischemia were found with newly diagnosed NVG. The pattern of ischemia was more pronounced in the far periphery than posterior pole.
An Image Quality Comparison Study Between Homemade and Commercial Dental Cone-beam CT Systems
Authors: Tran Trang Thi Ngoc , Jin David Shih-Chun , Shih Kun-Long , Hsu Ming-Lun , Chen Jyh-Cheng
Published: March 2021

Purpose: Cone-beam computed tomography (CBCT) has been widely applied in dental and maxillofacial imaging. Several dental CBCT systems have been recently developed in order to improve the performance. This study aimed to evaluate the image quality of our prototype (YMU-DENT-P001) and compare with another commercial CBCT system made in Taipei, Taiwan (system A). Methods: The Micro-CT-Contrast Scale, Micro-CT Water and Micro-CT HA phantoms were utilized to evaluate the contrast to noise ratio (CNR), signal to noise ratio (SNR), uniformity, distortion, and the linear relation between image intensity and calcium hydroxyapatite concentrations. Another customized thin-wire phantom was used to evaluate the FWHM spatial resolution. These phantoms were scanned by the two CBCT systems using the same exposure protocol. Acquired data were evaluated using the image analysis platform designed by our lab, which followed ISO standard. Results: The SNR of our prototype YMU-DENT-P001 is nearly five times higher (prototype: 159.85 ± 3.88; A: 35.42 ± 0.61; p<0.05) while CNR is three times higher than system A (prototype: 329.39 ± 5.55; A: 100.29 ± 2.31; p < 0.05). The spatial resolutions recorded are 0.2446 mm in the prototype DENT and 0.5179 mm in the commercial system A. Image produced by the prototype is also better in terms of distortion level (0.03 mm in prototype, compared to 0.294 mm in A, p < 0.05). The linear relationship between bone mineral density (BMD) and image intensity of both systems were similarly performed.Conclusion: Within the limitation of this study, our prototype DENT-P001 has potential to produce better image quality than system A in terms of spatial resolution, SNR, CNR, uniformity, and distortion.
Transparent water quality model induction in a reservoir affected by the rainfall-runoff process using a grammar-based genetic programming
Authors: Ham JongHwa , Hong Timothy Yoon-Seok
Published: March 2021

Building a reliable water quality prediction model in the catchment is of importance both for understanding the process of these natural systems and providing a basis for water quality management decisions. Due to a rapid change of river flow during a Typhoon season in South Korea, water quality parameters in reservoirs are affected significantly within a short-time period by a rainfall-runoff process. Integrated conceptual hydrological and water quality models seem to be complicated to produce a good model calibration and prediction with reasonable generalizations under these dynamic condition of heavy rainfall events. As an alternative, this paper proposes an evolutionary model induction system based on grammar-based genetic programming (GBGP) to derive the transparent mathematical model for estimating the dynamic change of water quality parameters within a short-time period in an agricultural reservoir affected by the rainfall-runoff process during a typical Typhoon summer period. Results showed that the GBGP system performed to evolve accurate water quality models, expressed in the form of explicit mathematical formulae which could predict the concentration and load of COD, SS, T-N, and T-P during the heavy rainfall event as a function of easily measurable rainfall, cumulative rainfall, and flow rate. The performance of the water quality models evolved by the GBGP was superior to ANN and optimized pollutant rating curve (PRC) model, showing that it has the lowest RMSE value. The transparent nature of water quality models evolved by the GBGP may allow inferences about underlying processes to be made. This work demonstrates that complex dynamic water quality change affected by the rainfall-runoff process in natural catchments can be successfully modelled through the use of GBGP system without costly or time-consuming tasks required in the conceptual modeling approach.
The short and long-term implications of warming and increased sea water pCO2 on the physiological response of a temperate neogastropod species
Authors: Mardones Maria Loreto , Thatje Sven , Fenberg Phillip , Hauton Chris
Published: March 2021

Global average temperatures and sea water pCO2 have rapidly increased due to the oceanic uptake of atmospheric carbon dioxide producing severe consequences for a broad range of species. The impacts on marine ectotherms have been largely reported at short-term scales (i.e. from days to weeks); however, the prolonged effects on long-term processes such as reproduction have received little attention. The gastropod Ocenebra erinaceus is a key predator structuring communities on rocky shores of the French and UK coasts. Even though rocky shore species are regarded as being very tolerant to changes in temperature and pH, many of them are living near their upper tolerance limits, making them susceptible to rapid environmental changes. Here, we report that future mean sea water conditions (RCP8.5, + 3°C and ~ 900 µatm CO2) do not significantly affect the physiology and molecular response of O. erinaceus adults after 132 days. During the first fifty-days, there was a slight impact on oxygen consumption rates and body weight; however, after ninety-five days of exposure, gastropods relied on food resources to fully acclimate to the experimental condition. Despite this, it was after long-term exposure (~ 10 months) reproduction ceased in females exposed to these future sea water conditions. Therefore, in the short-term O. erinaceus appear to be capable of full compensation; however, in the long-term, they fail to invest in reproduction. Future research should take into account the combined results from both, short- and long-term effects to improve our projections of the ecological consequences of climate change.
Newton's Third Law in the Framework of Special Relativity for Charged Bodies
Authors: Yahalom Asher , Rajput Shailendra
Published: March 2021

Newton's third law states that any action is countered by a reaction of equal magnitude but opposite direction. The total force in a system not affected by external forces is thus zero. However, according to the principles of relativity, a signal cannot propagate at speeds exceeding the speed of light. Hence the action and reaction cannot be generated at the same time due to the relativity of simultaneity. Thus, the total force cannot be null at a given time.
In a previous paper \cite{MTAY1}, we have shown that Newt\-on'n third law cannot strictly
hold in a distributed system, where the different parts are at a finite distance from each other. This is due to the finite speed of signal propagation, which cannot exceed the speed of light in the vacuum. A specific example of two current loops with time dependent currents demonstrated that the summing of the total force in the system does not add up to zero. This analysis led to the suggestion of a relativistic engine \cite{MTAY3,AY1}. As the system is affected by a total force for a finite period, the system acquires mechanical momentum and energy. Now the question then arises how can we accommodate the law of momentum and energy conservation. The subject of momentum conversation was discussed in \cite{MTAY4}, while preliminary results regarding energy conservation were discussed in \cite{AY2,RY,RY2}. Previous analysis relied on the fact that the bodies were macroscopically natural, which means that the number of electrons and ions is equal in every volume element. Here we relax this assumption and study charged bodies, thus analyzing the consequences on a possible electric relativistic engine.