bluuebunny/crossref_metadata_2025 huggingface dataset:
Abdominal Obesity and Short-term Mortality in Critically Ill Patients with Sepsis: A Retrospective Cohort Study Based on the MIMIC-IV Database
Authors: Lv Zhou , Gu Minglu , Zhou Miao , Mao Yanfei , Jiang Lai
Published: November 2021

Purpose: Multiple studies have demonstrated an obesity paradox such that obese septic patients have a lower mortality rate and a relatively favorable prognosis. However, less is known on the association between abdominal obesity and short-term mortality in patients with sepsis. We conducted this study to determine whether the obesity-related survival benefit remains among abdominal obese patients.Methods: A retrospective cohort study was conducted using data derived from the Medical Information Mart for Intensive Care IV database. Septic patients (≥18 years) with or without abdominal obesity of first intensive care units (ICU) admission in the database were enrolled. The primary outcome was mortality within 28 days of ICU admission and multivariable logistic regression analyses were employed to assess any association between abdominal obesity and the outcome variable.Results: A total of 21534 patients were enrolled finally, the crude 28-day mortality benefit after ICU admission was not observed in patients with abdominal obesity (15.8% vs. 15.3%, p=0.32). In the extended multivariable logistic models, the odds ratio (OR) of abdominal obesity was significantly inversed after incorporating metabolic variables into the logistic model (OR range 1.094-2.872, p = 0.02). The subgroup analysis showed interaction effects in impaired fasting blood glucose/diabetes and metabolic syndrome subgroups (P = 0.001 and <0.001, respectively). In the subgroups of blood pressure, high-density lipoprotein cholesterol, and triglyceride level, no interaction was detected in the association between abdominal obesity and mortality. After propensity score matching, 6523 pairs of patients were selected. The mortality significantly higher in the abdominal obesity group (17.0% vs. 14.8%, p = 0.015). Notably, the non-abdominal obese patients were weaned off vasopressors and mechanical ventilation more quickly than those in the abdominal obesity group (vasopressor‑free days on day 28 of 27.0 vs. 26.8, p < 0.001; ventilation-free days on day 28 of 26.7 vs. 25.6, p < 0.001).Conclusion: Abdominal obesity was associated with increased risk of adjusted sepsis-related mortality within 28 days after ICU admission and was partially mediated through metabolic syndrome components.
Allium Sativum Leaf Agglutinin (ASAL) Endowed Enhanced Resistance Against Myzus Persicae under Both Constitutive and Phloem Specific Promoters
Authors: Umer Noroza , Naqvi Rubab Zahra , Rauf Imran , Anjum Naveed , Siddiqui Hamid Anees , Najeebullah Syed , Asad Shaheen , Asif Muhammad
Published: November 2021

Globally, aphid, Myzus persicae is an economically significant, polyphagous crop pest that feeds on more than 400 plant species and transmits more than 100 plant viruses. Aphid infestation is mostly managed by insecticides that cause heavy environmental contamination and insect resistance. Cloning of plant derived insecticidal genes to develop transgenic plants under suitable promoter is a promising technology. In the present study, ASAL (MN820725) was isolated from native garlic and cloned in plant transformation vector, pGA482 through Agrobacterium mediated tobacco transformation. PCR of genomic DNA of transgenic tobacco plants using gene specific primers confirmed the presence of asal gene of 546 bp. To detect the integration of gene Southern blot analysis was conducted that revealed stable integration of asal gene while, gene expression was analyzed through qRT-PCR that showed variable expression of asal gene in transgenic tobacco plants. Efficacy of asal gene was evaluated through aphid bioassay. Aphid bioassay revealed that transgenic tobacco lines LS-17, LS-20, LR-1, and LR-7 exhibited 100% aphid mortality and significantly reduced the aphid population. These findings suggested the potential of ASAL against aphids that can be further used against other notorious sap sucking pests.
Weaving Words For Textile Museums: The Development of The Linked SILKNOW Thesaurus
Authors: Alba Ester , Gaitán Mar , León Arabella , Mladenic Dunia , Branek Janez
Published: November 2021

The cultural heritage domain in general and silk textiles, in particular, are characterized by large, rich and heterogeneous data sets. Silk heritage vocabulary comes from multiple sources that have been mixed up across time and space. This has led to the use of different terminology in specialized organizations in order to describe their artefacts. This makes data interoperability between independent catalogues very difficult. To address these issues, SILKNOW created a multilingual thesaurus related to silk textiles. It was carried out by experts in textile terminology and art historians and computationally implemented by experts in text mining, multi-/cross-linguality and semantic extraction from text. This paper presents the rationale behind the realization of this thesaurus.
Epigenetic And Transcriptomic Alterations in Offspring Born To Women With Type 1 Diabetes (The EPICOM Study)
Authors: Knorr Sine , Skakkebæk Anne , Just Jesper , Trolle Christian , Vang Søren , Lohse Zuzana , Bytoft Birgitte , Damm Peter , Højlund Kurt , Jensen Dorte , Gravholt Claus
Published: November 2021

Background: Offspring born to women with pregestational type 1 diabetes (T1DM) are exposed to an intrauterine hyperglycemic milieu and has an increased risk of metabolic disease in later in life. In this present study we hypothesize that in utero exposure to T1DM alters offspring DNA methylation and gene expression, thereby altering their risk of future disease. Design: Follow-up study using data from the Epigenetic, Genetic and Environmental Effects on Growth, Metabolism and Cognitive Functions in Offspring of Women with Type 1 Diabetes (EPICOM) collected between 2012-2013.Setting: Exploratory sub study using data from the nationwide EPICOM study.Participants: Adolescent offspring born to women with T1DM (n=20) and controls (n=20) matched on age, sex and postal code. Main outcome measures: This study investigates DNA methylation using the 450K-Illumina Infinium assay® and RNA expression (RNA sequencing) of leucocytes from peripheral blood samples. Results: We identified 9 hypermethylated and 5 hypomethylated positions (p < 0.005, |DM-value| > 1). RNA expression profiling identified 38 up- and 1 down-regulated genes (p < 0.005, log2FC ≥ 0.3.). Functional enrichment analysis revealed enrichment in ontologies related to diabetes, carbohydrate and glucose metabolism, pathways including MAPK1/MAPK3 and MAPK family signaling and genes related to T1DM, obesity and atherosclerosis. Lastly, by integrating the DNA methylation and RNA expression data, we identified six genes where relevant methylation changes corresponded with RNA expression (CIITA, TPM1, PXN, ST8SIA1, LIPA, DAXX). Conclusions: Findings suggest the possibility for intrauterine hyperglycemia to impact later life methylation and gene expression, a profile that may be linked to the increased risk of metabolic disease.
Artificial Stem Cells Mediated Inflammation-Tropic Delivery of Antiviral Drugs for Pneumonia Treatment
Authors: Qin Aiping , Chen Sheng , Li Songpei , Huang Xiaotao , Lin Yinshan , Shen Ao , Xiang Andy Peng , Zhang Lingmin
Published: November 2021

Background: Cytomegalovirus (CMV) pneumonia is a major cause of morbidity and mortality in immunodeficiency individuals including transplant recipients and Acquired Immune Deficiency Syndrome patients. Currently, antiviral drugs ganciclovir (GCV) and phosphonoformate (PFA) are first-line agents for pneumonia caused by herpesvirus infection. However, the therapy suffers from various limitations such as low efficiency, drug resistance, toxicity, and lack of specificity.Methods: The antiviral drugs GCV and PFA were loaded into the pH-responsive nanoparticles fabricated by poly(lactic-co-glycolic acid) (PLGA) and 1,2-dioleoyl-3-trimethylammonium-propane (DOTAP), and further coated with cell membranes derived from bone marrow mesenchymal stem cells to form artificial stem cells, namely MPDGP. We evaluated the viral suppression effects of MPDGP in vitro and in vivo.Results: MPDGP showed significant inflammation tropism and efficient suppression of both viral replication and virus infection-associated inflammation in the CMV-induced pneumonia model. The synergistic effects by combination of viral DNA elongation inhibitor GCV and viral DNA polymerase inhibitor PFA on suppressing the inflammation efficiently. Conclusion: The present study develops a novel therapeutic intervention using artificial stem cells to deliver antiviral drugs at inflammatory sites, which shows great potential for the targeted treatment of pneumonia. To our best knowledge, we are the first to fabricate this kind of artificial stem cells to deliver the antiviral drugs for pneumonia treatment.
Biomarker Levels in Patients with Atrial Fibrillation Before and After Electrical Cardioversion
Authors: Meyre Pascal B , Aeschbacher Stefanie , Blum Steffen , Voellmin Gian , Kastner Peter M , Hennings Elisa , Kaufmann Beat A , Kühne Michael , Osswald Stefan , Conen David
Published: November 2021

Background

Biomarkers may help to improve our knowledge about the complex pathophysiology of atrial fibrillation (AF), the most common sustained cardiac arrhythmia. We aimed to identify significant changes in biomarkers and clinical measures in patients with and without AF recurrence after electrical cardioversion.
Methods

Patients with persistent AF undergoing elective electrical cardioversion were enrolled. We measured 21 conventional and new biomarkers before and 30 days after electrical cardioversion and assessed the associations of changes in biomarker levels with rhythm status at follow-up using multivariable logistic regression models.
Results

Of the 100 patients included (mean [SD] age 66 (10) years, 25% women), 28 (28%) had an AF recurrence. Of the 21 biomarkers assessed, 4 reached the predefined between group significance of p<0.01. The most significant ones were bone morphogenetic protein 10 (BMP10), N-terminal pro-B-type natriuretic peptide (NT-proBNP) and total bilirubin. Their respective changes were -10.4%, -62.0% and -25.6% in patients with sinus rhythm, and 3.1%, 1.1% and -9.4% in patients with recurrent AF, for a between group difference of -13.5% (95% confidence interval [CI], -19.3% to -7.6%; P<0.001), -63.1% (95% CI, -76.6% to -49.6%; P<0.001) and -16.3 (95% CI, -27.9% to -4.7%; P=0.007). In age and sex adjusted models, reductions of BMP10 and NT-proBNP were significantly associated with rhythm status at follow-up (β coefficient per 1-SD decrease, -2.03; 95% CI, -3.06 to -1.00; P<0.001 and -3.98; 95% CI, -5.75 to -2.22; P<0.001, respectively). After additional adjustment for demographic characteristics, risk factors for AF, and changes in clinical measures, the β coefficients per 1-SD were -3.85 (95% CI, -6.34 to -1.35; P=0.003) for BMP10 and -5.84 (95% CI, -10.22 to -1.47; P=0.009) for NT-proBNP.
Conclusions

Changes in BMP10 und NT-proBNP levels were strongly associated with rhythm status after electrical cardioversion, suggesting that these markers may be dependent on the actual heart rhythm.
Differences and similarities of biophysical and biological characteristics between GBM and astrocyte cells
Authors: Özdil Berrin , Calik-Kocaturk Duygu , Altunayar-Unsalan Cisem , Acikgoz Eda , Oltulu Fatih , Gorgulu Volkan , Uysal Aysegul , Oktem Gulperi , Unsalan Ozan , Aktug Huseyin
Published: November 2021

The current cancer studies focus on the molecular-targeting diagnostics and their interaction with surrounding microenvironment, however, there are some missing points on the characterization of the cells with their topological differences and elemental composition. Glioblastoma multiforme (GBM) which is an astrocytic aggressive brain tumour with short survival time. GBM and astrocyte cells may differ at molecular level and the elemental and topological evaluation of these cells are vital for a definition of new potential targets for cancer research. Here, we report the topology and chemistry of cancer (GBM) and healthy (astrocyte) cells by atomic force microscopy (AFM), scanning electron microscopy (SEM) supported with energy dispersive X-ray spectroscopy (EDS) and X-ray photoelectron spectroscopy (XPS), for the first time. Additionally, F-actin Immunofluorescence staining and Real-Time Polymerase chain reaction (RT-PCR) techniques were performed. Actin related genes were similar in level of gene expression; however, F-actin protein intensities were different. The gene expressions related to the invasion were elevated in GBM cells. Morphologically, GBM cells were found to be longer and narrower while astrocytes were shorter and more disseminated based on AFM. Furthermore, roughness values of these cells were relatively close to each other. SEM-EDS analysis demonstrated that elongated GBM cells exhibited several filopodial protrusions whereas the astrocyte surfaces were rougher in lamellipodial area. Our investigation provides considerable further insight into rapid cancer cell characterization field in terms of its combinatorial spectroscopic and microscopic approach.
Continuous Venovenous Hemodiafiltration Versus Standard Medical Therapy for the Prevention of Rhabdomyolysis-Induced Acute Kidney Injury: A Retrospective Cohort Study
Authors: Meng Yan , Zhou Ming-xue , Wu Chun-bo , Wang De-hua , Shi Dong-yin , Zhao Jian-rong
Published: November 2021

Aim: To determine whether continuous venovenous hemodiafiltration (CVVHDF) plus standard medical therapy (SMT) vs. SMT alone prevents rhabdomyolysis (RM)-induced acute kidney injury (AKI) and to analyze the related health economics.Methods: This retrospective cohort study involved patients with RM without AKI, coronary heart disease, or chronic kidney disease treated with CVVHDF plus SMT (treatment group, n = 9). Matched patients with RM without AKI treated with SMT only served as controls (1:1 ratio). Baseline characteristics, biochemical indexes, renal survival data, and health economic data were compared between groups. In the treatment group, some biochemical data were compared at different time points.Results: At 2 and 7 days after admission, serum biochemical indices (e.g., myoglobin, creatine kinase, creatinine, and blood urea nitrogen) did not differ between the two groups. Total (P = 0.011) and daily hospitalization costs (P = 0.002) were higher in the treatment group than in the control group. After 53 months of follow-up, no patient developed increased serum creatinine, except for 1 treatment-group patient who died of acute myocardial infarction. In the treatment group, myoglobin levels significantly differed before and after the first CVVHDF treatment (P = 0.008), and serum myoglobin, serum creatinine, and blood urea nitrogen decreased significantly at different time points after CVVHDF.Conclusions: Although CVVHDF facilitated myoglobin elimination, its addition to SMT did not improve serum myoglobin or other biochemical indices or the long-term renal prognosis. Despite similar hospitalization durations, both total and daily hospitalization costs were higher in the treatment group.
Asprosin, a Novel Therapeutic Candidate for Painful Neuropathy: An Experimental Study in Mice
Authors: Ozcan Sibel , Kelestemur Muhammed Mirac , Hekim Munevver Gizem , Bulmus Ozgur , Bulut Ferah , Bilgin Batuhan , Canpolat Sinan , Ozcan Mete
Published: November 2021

Neuropathic pain is primarily caused by nervous system lesions or dysfunction. Evidence strongly suggests that obesity, diabetes and cancer are common in chronic pain conditions, and pain complaints are common in these individuals. Recent studies indicate presence of a strong link between adipokines and neuropathic pain. However, the effects of asprosin, a novel adipokine, on neuropathic pain have not been studied in animal modelsMouse models were employed to investigate the antinociceptive effectiveness of asprosin in the treatment of three types of neuropathic pain, with metabolic (streptozocin/STZ), toxic (oxaliplatin/OXA), and traumatic (sciatic nerve ligation/CCI [chronic constriction nerve injury]) etiologies, respectively. Changes in nociceptive behaviors were assessed relative to controls using thermal (the hot plate and cold plate tests, at 50 °C and 4 °C respectively) and mechanical pain (Von Frey test) tests at baseline and 30, 60, 120 and 180 minutes after asprosin administration. Serum level of asprosin was quantified by ELISA. In all three neuropathic pain models (STZ, OXA and CCI), asprosin administration significantly reduced both mechanical and thermal hypersensitivity, indicating that it exhibits a clear-cut antihypersensitivity effect in the analyzed neuropathic pain models. Asprosin levels were significantly lower in three types of neuropathic pain compare to controls (p < 0.05). The results yielded by the present study suggest that asprosin exhibits an analgesic effect in the neuropathic pain models and may have clinical utility in alleviating chronic pain associated with disease and injury originating from peripheral structures.
Unsupervised Clustering Identifies Sub-Phenotypes and Reveals Pre-Dialysis Hyperlactatemia as a Novel Outcome Predictor in Dialysis-Requiring Sepsis-Associated Acute Kidney Injury
Authors: Lai Chun-Fu , Wu Vin-Cent , Liu Jung-Hua , Lin Shuei-Liong , Chen Yung-Ming
Published: November 2021

BackgroundHeterogeneity exists in sepsis-associated acute kidney injury (SA-AKI). This prospective observational cohort study aimed to perform consensus cluster analysis and investigate the clinical relevance of identified sub-phenotypes of critically ill patients with dialysis-requiring SA-AKI.MethodsAll septic patients with dialysis-requiring SA-AKI, defined by the Sepsis-3 and Kidney Disease: Improving Global Outcomes AKI criteria, admitted to an intensive care unit in Taiwan between 2002 and 2018 were included. We employed unsupervised consensus clustering based on 22 clinical variables upon initialising renal replacement therapy. They were observed until death or 90 days after hospital discharge. The outcomes were mortality and being free of dialysis.ResultsIn total, 1,397 patients were enrolled (mean age of 63.8 ± 16.38 years and 69.7% were men). After a median follow-up period of 31 (interquartile range 8-123) days, all-cause mortality occurred in 911 patients (65.12%). Moreover, 133 (9.51%) survivors were dialysis dependent, where 355 (25.38%) survivors were free of dialysis. Unsupervised consensus clustering identified three sub-phenotypes associated with significantly different risks of mortality and being free of dialysis. This strategy led us to reveal that the pre-dialysis hyperlactatemia of ≥ 3.1 mmol/L was an independent predictor of mortality and being free of dialysis according to the competing risk modeling. Our results were validated in an independent multi-center AKI cohort.ConclusionsBy the data-driven clustering analysis, we identified sub-phenotypes in septic patients with dialysis-requiring SA-AKI and revealed pre-dialysis hyperlactatemia as a novel outcome predictor. This result represents a step towards precision medicine for septic patients.
Electron Energization Dynamics in Interaction of Self-Generated Magnetic Vortices in Upstream of Collisionless Electron/Ion Shocks
Authors: Naseri N. , Bochkarev S. G. , Bychenkov V. Y. , Khudik V. , Shvets G.
Published: November 2021

Relativistic collisionless shocks are considered responsible for particle energization mechanisms leading to particle acceleration. While electron energization in shock front region of electron/ion collisionless shocks are the most commonly studied, the mechanism of electron energization in interaction with self-generated magnetic vortices (MVs) in upstream region is still unclear. We investigate electron energization mechanism in upstream region of electron/ion relativistic collisionless shocks, using two dimensional particle-in-cell (PIC) simulations. We discuss mechanism of electron energization which takes place in upstream region of the shock, where the counter stream particles interact with incoming flow. The energy gain of electrons happens during their interaction with evolving fields of self-generated magnetic vortices in this region. Three Fermi-like electron energization scenarios are discussed. Stochastic acceleration of electrons in interaction with fields of MV leads to anisotropic heating of fast electrons due to diffusion in the momentum space of electrons and, finally, synergetic effect of evolving fields of MVs leads to the formation of a power-law tail of supra-thermal particles.
Central Line Access is Predictive of Diagnostic Blood Loss and Transfusion in the Surgical Intensive Care Unit
Authors: Adkins Brian D , Deanda Abe , Trieu Judy A , Polineni Srinivas , Okorodudu Anthony O , Yates Sean G
Published: November 2021

Background: Diagnostic laboratory testing (DLT) is a source of blood loss in critically ill patients. Approximately half of patients admitted to the intensive care unit (ICU) present with anemia, with the remainder developing a multifactorial anemia with etiologies including central venous catheter (CVC) placement. Consequently, about a third of ICU patients require red blood cell (RBC) transfusion, a practice associated with poorer clinical outcomes. Our objectives were to characterize DLT blood loss in the surgical intensive care unit (SICU), and its relationship with anemia, RBC transfusion, and CVC placement.Methods: An observational study was performed by retrospective chart review of patients admitted to a SICU over 1-year. The number of DLT blood draws, average volume of blood drawn, and estimated discard volume were recorded along with clinical and laboratory findings. Results: A cohort of 292 patients (mean age 62.2 years, male to female ratio 1.5) underwent 299 hospitalizations with an average daily DLT blood loss of 14.3 mL (229.5 mL per admission). Among admissions, 51.2% presented with anemia and 95.3% were anemic at discharge, with 32% of patients receiving an RBC transfusion. Patients with greater DLT-associated blood loss had lower discharge hemoglobin (p=<0.001). Admissions requiring CVC (49.8%), demonstrated a significantly greater number of DLT blood draws, increased DLT-associated blood loss, higher rates of RBC transfusion, and an increased length of stay.Conclusions: Findings from this study suggest that DLT blood loss contributes to anemia in the SICU and the presence and duration of CVC leads to increased testing, blood loss, anemia, and is predictive of RBC transfusion.
Development of a Machine Learning Model for the Prediction of the Real Time Mortality in Patients in the Intensive Care Unit
Authors: Yang Jaeyoung , Lim Hong-Gook , Park Wonhyeong , Kim Dongseok , Yoon Jin Sun , Lee Sang-Min , Kim Kwangsoo
Published: November 2021

BackgroundPrediction of mortality in intensive care units is very important. Thus, various mortality prediction models have been developed for this purpose. However, they do not accurately reflect the changing condition of the patient in real time. The aim of this study was to develop and evaluate a machine learning model that predicts short-term mortality in the intensive care unit using four easy-to-collect vital signs.MethodsTwo independent retrospective observational cohorts were included in this study. The primary training cohort included the data of 1968 patients admitted to the intensive care unit at the Veterans Health Service Medical Center, Seoul, South Korea, from January 2018 to March 2019. The external validation cohort comprised the records of 409 patients admitted to the medical intensive care unit at Seoul National University Hospital, Seoul, South Korea, from January 2019 to December 2019. Datasets of four vital signs (heart rate, systolic blood pressure, diastolic blood pressure, and peripheral capillary oxygen saturation [SpO2]) measured every hour for 10 h were used for the development of the machine learning model. The performances of mortality prediction models generated using five machine learning algorithms, Random Forest (RF), XGboost, perceptron, convolutional neural network, and Long Short-Term Memory, were calculated and compared using area under the receiver operating characteristic curve (AUROC) values and an external validation dataset.ResultsThe machine learning model generated using the RF algorithm showed the best performance. Its AUROC was 0.922, which is much better than the 0.8408 of the Acute Physiology and Chronic Health Evaluation II. Thus, to investigate the importance of variables that influence the performance of the machine learning model, machine learning models were generated for each observation time or vital sign using the RF algorithm. The machine learning model developed using SpO2 showed the best performance (AUROC, 0.89). ConclusionsThe mortality prediction model developed in this study using data from only four types of commonly recorded vital signs is simpler than any existing mortality prediction model. This simple yet powerful new mortality prediction model could be useful for early detection of probable mortality and appropriate medical intervention, especially in rapidly deteriorating patients.
Models To Predict The Short-Term Survival of Acute-On-Chronic Liver Failure Patients Following Liver Transplantation
Authors: Yang Min , Peng Bo , Zhuang Quan , Li Junhui , Liu Hong , Cheng Ke , Ming Yingzi
Published: November 2021

Background: Acute-on-chronic liver failure (ACLF) is featured with rapid deterioration of chronic liver disease and poor short-term prognosis. Liver transplantation (LT) is recognized as the curative option for ACLF. However, there is no standard in the prediction of the short-term survival among ACLF patients following LT.Method: Preoperative data of 132 ACLF patients receiving LT at our center were investigated retrospectively. Cox regression was performed to determine the risk factors for short-term survival among ACLF patients following LT. Five conventional score systems (the MELD score, ABIC, CLIF-C OFs, CLIF-SOFAs and CLIF-C ACLFs) in forecasting short-term survival were estimated through the receiver operating characteristic (ROC). Four machine-learning (ML) models, including support vector machine (SVM), logistic regression (LR), multi-layer perceptron (MLP) and random forest (RF), were also established for short-term survival prediction.Results: Cox regression analysis demonstrated that creatinine (Cr) and international normalized ratio (INR) were the two independent predictors for short-term survival among ACLF patients following LT. The ROC curves showed that the area under the curve (AUC) ML models was much larger than that of conventional models in predicting short-term survival. Among conventional models the model for end stage liver disease (MELD) score had the highest AUC (0.704), while among ML models the RF model yielded the largest AUC (0.940). Conclusion:Compared with the traditional methods, the ML models showed good performance in the prediction of short-term prognosis among ACLF patients following LT and the RF model perform the best. It is promising to optimize organ allocation and promote transplant survival based on the prediction of ML models.
A Unilateral Robotic Knee Exoskeleton to Assess the Role of Natural Gait Assistance in Hemiparetic Patients
Authors: Lora-Millan Julio Salvador , Sanchez-Cuesta Francisco José , Romero Juan Pablo , Moreno Juan C. , Rocon Eduardo
Published: November 2021

Background: Hemiparetic gait is characterized by strong asymmetries that could severely affect the quality of life of stroke survivors. This asymmetry is due to motor deficits in the paretic leg and the resulting compensations in the non-paretic limb. In this study, we aim to evaluate the effect of actively promoting gait symmetry in hemiparetic patients by assessing the behavior of both paretic and non-paretic lower limbs. This paper introduces the design and validation of the REFLEX prototype, a unilateral active Knee-Ankle-Foot Orthosis able to naturally assist the paretic limb of hemiparetic patients during gait.Methods: REFLEX uses an Adaptive Frequency Oscillator to estimate the continuous gait phase of the non-paretic limb. Based on this estimation, the device synchronically assists the paretic leg following two different control strategies: (1) Replicating the movement of the sound leg or (2) Inducing a healthy gait pattern on the paretic leg. Technical validation of the system was implemented on three healthy subjects, while the effect of the generated assistance was assessed in three stroke patients. Results: Preliminary results proved the feasibility of the REFLEX prototype to assist gait by reinforcing symmetry. They also pointed out that the assistance of the paretic leg resulted in a decrease of the compensatory strategies developed by the non-paretic limb to achieve a functional gait. Notably, better results were attained when the assistance was provided according to a standard healthy pattern, which initially might suppose a lower symmetry but enabled a healthier evolution of the motion of the non-paretic limb.Conclusions: This work presents the preliminary validation of the REFLEX prototype, a unilateral knee exoskeleton for gait assistance in hemiparetic patients. The experimental results indicate that assisting the paretic leg of hemiparetic patients based on the movement of their non-paretic one is a valuable strategy for reducing the compensatory mechanisms developed by their sound limb.
p53 Missense Mutation is Associated with Immune Cell PD-L1 Expression in Triple-negative Breast Cancer
Authors: Wang Bin , Wang Kun , Yu Jian , Liu Long , Liang Ke , Xing Ai-yan
Published: November 2021

BackgroundImmunotherapy is an important treatment for triple-negative breast cancer (TNBC). The programmed death ligand 1 (PD-L1) is a pivotal biomarker in TNBC, and its expression is closely related to immunotherapy response. Therefore, the association of p53 expression and mutation and PD-L1 expression was explored. Methods and Results PD-L1 expression and p53 mutation and expression were evaluated by immunohistochemistry. PD-L1 expression and expression levels between p53 mutation (missense and nonsense) and wild type; no-expression/loss vs. expression; and missense vs. nonsense groups were compared. PD-L1 expression was found mainly in tumor-infiltrating immune cells (ICs) in TNBC. Positive PD-L1 expression was associated with a high Ki67 index. There was a significant association between p53 mutation, especially missense mutation and higher histological grade, and PD-L1 expression in ICs. Compared with p53 nonsense mutation, cases with missense mutations tended to display more PD-L1 positive ICs. However, PD-L1 expression in ICs was not significantly different between the p53 mutation and expression groups. Conclusionsp53 missense mutation is partially involved in the regulatory expression of PD-L1. Both p53 missense mutation and PD-L1 expression may be potential targets for improving immunotherapy response in TNBC.
Establishment of a 5 DNA Methylation Site Prognostic Signature Associated with N6-Methyladenosine in Lung Adenocarcinoma
Authors: Yuan Liqiang , Jiang Wei , Xu Zhanyu , Deng Kung , Sun Yu , Qin Junqi , Huang Liuliu , Zheng Tiaozhan , Zheng Zhiwen , Qin Fanglu , Li Shikang
Published: November 2021

Background: There is a high incidence of lung adenocarcinoma (LUAD). Even with surgery, targeted therapy and immunotherapy, the survival rate of LUAD patients is still low. N6-methyladenosine (m6A) and DNA methylation markers can help with the diagnosis and treatment of LUAD patients. Therefore, it is necessary to identify a novel m6A-related DNA methylation sites signature to predict the survival of patients with LUAD. Methods: In this study, we screened 15 m6A-related genes and their 217 methylation sites. RNA sequencing data of 15 genes and the clinicopathological parameters of TCGA-LUAD were obtained from the TCGA database (http://cancergenome.nih.gov/). The LUAD-DNA CpG site information was obtained from the Illumina Human Methylation 450 BeadChip (Illumina, San Diego, CA, United States). The methylation sites related to prognosis were screened using univariate COX analysis, and the independent predictors of LUAD patients were identified using multivariate COX analysis of least absolute shrinkage and selection operator (LASSO) Cox regression analysis. Finally, a model with 5 methylation sites as the main body to predict the prognosis of OS in patients with LUAD was obtained. According to the risk grouping of the prediction model, Kaplan-Meier curve and the receiver operating characteristic (ROC) curve were performed in the test and training sets to assess the predicted capacity of the model. In addition, a nomogram constructed by combining the risk score of methylation group and other related clinicopathological factors to verify the reliability of our model.Results: We constructed a m6A-related 5-DNA methylation site model to predict OS in LUAD patients. According to the results of the Kaplan-Meier curve, both the test set and the training set, the high-risk group showed a worse prognosis. The AUCs of the 5 DNA methylation signature at 1, 5 and 10 years in test datasets were 0.730, 0.649 and 0.726, respectively, and 0.679, 0.656 and 0.732 in training datasets. Finally, we constructed a nomogram to further verify the reliability of the model.Conclusion: In this study, we analyzed the methylation sites of m6A-related genes and established a m6A-related 5-DNA methylation site model to predict OS in LUAD patients.
Spinal obstruction-related versus craniocervical junction related syringomyelia: a comparative study of spinal cord injury
Authors: chenghua yuan , guan jian , du yueqi , fang zeyu , wang xinyu , yao qingyu , zhang can , jia shanhang , liu zhenlei , wang kai , duan wanru , wang xingwen , wang zuowei , wu hao , chen zan , jian fengzeng
Published: November 2021

Background

No prior reports have focused on spinal cord injury (SCI) characteristics or inflammation after destruction of the blood-spinal cord barrier by syringomyelia. To compare the difference of syringomyelia-related central SCI between craniocervical junction (CCJ) and post-traumatic syringomyelia (PTS) before and after decompression.
Methods

Between 2015 and 2019, 106 CCJ, 26 CCJ revision and 15 PTS patients (mean history of symptoms 71.5 ± 94.3, 88.9 ± 85.5 and 32.3 ± 48.9 months). The symptom courses were analysed with the ASIA, Klekamp and Samii scoring systems and Kaplan-Meier statistics for neurological changes. The mean follow-up was 20.7 ± 6.2, 21.7 ± 8.8 and 34.8 ± 19.4 months.
Results

Compared with the other group, the interval time after PTS was longer, but the natural history of syringomyelia was shorter (P=0.0004, 0.0173, respectively). The initial symptoms were usually paraesthesia (P=0.258), and the symptoms were mainly hypoesthesia (P=0.006), abnormal muscle strength (P=0.004), gait (P<0.0001) and abnormal urination (P<0.0001). SCI associated with PTS was more severe than that CCJ related (P=0.003). The cavities in the PTS group were primarily located at the thoracolumbar level, which was different from those in the cervical-thoracic segment at the CCJ. The rate of syrinx/cord was more than 75% (P=0.009), and the intradural adhesions tended to be more severe (P<0.0001). However, there were no significant differences in peripheral blood inflammation markers (PBIM) or long-term clinical efficacy except for the RBC (P=0.042).
Conclusion

The natural history of PTS tends to progress faster and is more severe than CCJ related. PBIM had no distinguishing effect on the difference in inflammation of syringomyelia except for the RBC. The predictive value of NLR for syringomyelia-related inflammation except in the acute phase was negative.
Two New Teleomorphic Talaromyces Species Discovered From The Estuary Soil In China
Authors: Han Pei-Jie , Sun Jian-Qiu , Wang Long
Published: November 2021

Two new species producing ascospores of Talaromyces sect.Talaromyces are proposed, namely, T. haitouensi (ex-type AS3.160101 T) and T. zhenhaiensis (ex-type AS3.16102 T). Morphologically, T. haitouensis is featured by moderate growth, green-yellow gymnothecia, orange-brown mycelium, and echinulate ellipsoidal ascospores. T. zhenhaiensis is characterized by fast growth, absent sporulation, cream yellow to naphthalene yellow gymnothecia and mycelium, smooth-walled ellipsoidal ascospores with one equatorial ridge. The proposal of the two new taxa is well supported by individual phylogenetic analyses based on individual sequences of BenA, CaM, Rpb2 and ITS1-5.8S-ITS2, and the concatenated BenA-CaM-Rpb2 sequence.
The viability of utilising phone-based text messages in data capture and reporting of morbidities due to Lymphatic Filariasis by Community Health Workers: A qualitative study in Kilwa district, Tanzania
Authors: Kalinga Akili , Munga Michael , Ngenya Abdallah , John Winfrida , Kisoka William , Oriyo Ndekya , Mutalemwa Prince , Mandara Wilfred , Masagati Leonard , Ogondiek John , Korir Patricia , Klarmann-Schulz Ute , Horn Sacha , Kroidl Inge , Debrah Alex , Hoerauf Achim , Mwingira Upendo
Published: November 2021

Background

Globally, there is recognition of the value of using mobile phones among health providers in improving health systems performance. However, in many Low- and Middle-income countries where there is shortage of health providers, Community Health Workers have assumed some responsibilities especially relating to identifying and reporting on health problems within their communities. Despite the known benefits of using mobile phone technology to deliver health services, there is limited information on the extent to which Community Health Workers are able to effectively use the technology in data collection and reporting. The aim of this study was to determine the feasibility of utilizing phone-based text messages on Lymphatic Filariasis morbidity surveillance by Community Health Workers
Methods

This was a cross sectional study whose data was collected through key informant interviews and focused group discussions among community health workers, health providers and staff of neglected tropical diseases control program. Collected transcripts were analysed through Thematic content analysis as it allowed for the identification of data codes through inductive reasoning.
Results

The use of mobile phone-based text messages in data collection and reporting lymphatic filariasis morbidity cases by Community Health Workers was perceived by study participants to be a relevant tool and feasible due to the ease of use of the technology. The tool was reported by end-users to significantly increase their performance and efficiency was gained in terms of reduced paper work, increased the number of patients accessing health care services and the ability to report in real-time. All respondents were confident that Community Health Workers were the right persons to interact with communities in tracking and reporting morbidity cases using mobile technology.
Conclusion

Mobile phone-based text messages have proven to be effective in routine workflows such as, data collection and reporting on Lymphatic Filariasis morbidity cases, patient to provider communication, decision making and supportive supervision. Mobile phones have also improved efficiency and general performance of end users in terms of increased number of cases identified and efficiency gained in terms of reduced paper work and the ability to collect and report in real-time.
Patient Satisfaction with Healthcare at a Tertiary Hospital in Northern Malawi: Results from a Triangulated Cross-sectional Survey
Authors: Sinyiza Frank Watson , Kaseka Paul Uchizi , Chisale Master Rodgers , Chimbatata Chikondi Sharon , Mbakaya Balwani Chingatichifwe , Kamudumuli Pocha Samuel , Wu Tsung-Shu Joseph , Kayira Alfred Bornwell
Published: November 2021

BackgroundIn 2016 the Malawi government embarked on several interrelated health sector reforms aimed at improving the quality of health services at all levels of care and attain Universal Health Coverage by 2030. Patient satisfaction with services is an important proxy measure of quality. We assessed patient satisfaction at a tertiary hospital in Northern Malawi to understand the current state in the country. MethodsWe conducted exit interviews with patients aged18 years and above using a 28 statement interviewer administered questionnaire. Patients were asked to express their level of agreement to the statements on a five-point Likert scale – strongly disagree to strongly agree, corresponding to scores of 1 to 5. Overall patient satisfaction was calculated by summing up the scores and diving the sum by the number of statements. Scores >3 constituted satisfaction while scores ≤3 constituted dissatisfaction. Patient self-rated satisfaction was determined from a single statement that asked patients to rate their satisfaction with services on a five-point Likert scale. We also solicited inputs from patients on aspects of hospital care that needed improvement. Responses were reviewed and grouped into themes. Recurring themes are presented according to frequencies.ResultsOverall patient satisfaction was 8.4% (95% CI: 5.2% - 12.9%). Patient self-rated satisfaction was 8.9% (95% CI: 5.5% - 13.4%). Patients raised six major issues that dampened their healthcare seeking experience including health workers reporting late to work, doctors not listening to patients concerns and neither examining them properly nor explaining the diagnosis, shortage of medicines, diagnostics and medical equipment, unprofessional conduct of health workers, poor sanitation and cleanliness, and health workers behaviour of favouring or priotising their relatives and friends over other patients.ConclusionWe found very low levels of patient satisfaction, suggesting that quality of services in the public health sector is still low. It is therefore critical to accelerate and innovate the Ministry of Health’s quality improvement initiatives to attain Malawi’s health goals.
Soft Computing and Multi-Scal Model Technics to Predict the Early Age Compression Strength of Cement Paste as a Function of Polymer Contents, Water-to-Cement-Ratio, and Curing Ages
Authors: Mohammed Ahmed , Ghafor Kawan , Mahmood Wael , Sarwar Warzer , Burhan Lajan
Published: November 2021

In this study, the effect of two water reducer polymers with smooth and rough surfaces on the compression strength of Ordinary Portland cement (OPC) was investigated. Three different initial ratios between water and cement (w/c) 0.5, 0.6, and 1 were used in this study. The amount of polymer contents varied from 0 to 0.06 % (%wt) for the cement paste with initial w/c of 0.5 and the polymer contents ranged between 0 to 0.16% (%wt) for the cement paste with initial w/c of 0.6 and 1 were investigated. SEM test was conducted to identify the impact of polymers on the behavior of cement paste. The compression strength of OPC cement was increased significantly with increasing the polymer contents. Because of a fiber net (netting) around cement paste particle was developed when the polymers were added to the cement paste which leads to decrease the void between the particles, binding the cement particles, therefore, increased the viscosity and compression strength of the cement rapidly. In this analysis, the hardness of cement paste with polymer contents has been evaluated and modeled using four different model technics. More environmentally sustainable construction, and lower cost than conventional building materials and early age strengths of the cement. To overcome the mentioned matter, this study aims to establish systematic multiscale models to predict the compression strength of cement paste containing polymers and to be used by the construction industry with no theoretical restrictions. For that purpose, a wide data a total of 280 tested cement paste modified with polymers, has been conducted, analyzed, and modeled. Linear, Nonlinear regression, M5P-tree, and Artificial Neural Network (ANN) technical approaches were used for the qualifications. In the modeling process, the most relevant parameters affecting the strength of cement paste, i.e. polymer incorporation ratio (0-0.16% of cement's mass), water-to-cement ratio (0.5-1), and curing ages (1 to 28 days). According to the correlation coefficient (R), mean absolute error and the root means a square error, the compression strength of cement paste can be well predicted in terms of w/c, polymer content, and curing time using four various simulation techniques. Among the used approaches and based on the training data set, the model made based on the Non-linear regression, ANN, and M5P-tree models seem to be the most reliable models. The sensitivity investigation concludes that the polymer content is the most dominating parameter for the prediction of the compression strength of cement paste with this data set.
Uniting The Sun’s Hale Magnetic Cycle and ‘Extended Solar Cycle’ Paradigms
Authors: McIntosh Scott W. , Scherrer Phillip H. , Svalgaard Lief , Leamon Robert J.
Published: November 2021

Through meticulous daily observation of the Sun’s large-scale magnetic field the Wilcox Solar Observatory has catalogued two magnetic (Hale) cycles of solar activity. Those two (∼22-year long) Hale cycles have yielded four (∼11-year long) sunspot cycles-21 through 24. Recent research has highlighted the persistence of the “Extended Solar Cycle” (ESC) and its connection to the fundamental Hale Cycle-albeit through a host of proxies resulting from image analysis of the solar photosphere, chromosphere and corona. This Letter presents, for the first time, a direct mapping between the ESC, the Sun’s toroidal magnetic field evolution of the Hale Cycle. As Sunspot Cycle 25 begins to accelerate its growth, interest in mapping the Hale and Extended cycles could not be higher given potential predictive capability that synoptic scale observations can provide.
The Corporate Innovation in Europe
Authors: Costantiello Alberto , Laureti Lucio , Angelo Leogrande
Published: November 2021

In this article we investigate the political and industrial determinants of firm investment in Research and Development. We use data from the European Innovation Scoreboard of the European Commission for 36 countries in the period 2000-2019. We found that firm investments in Research and Development are positively associated with “Linkages”, “Innovation Index”, “International Co-publications”, “Medium and high-tech product exports”, “Non-R&D innovation expenditure”, “Turnover share large enterprises”, “Human Resources”, “Intellectual Assets”. Firm investments in Research and Development are negatively associated to “Foreign doctorate students”, “Knowledge-intensive services exports”, “Private co-funding of public R&D expenditures”, “Basic-school entrepreneurial education and training (SD)”, “New doctorate graduates”, “Trademark applications”, “Tertiary education” “Design applications”, “Lifelong Learning”, “Foreign-controlled enterprises – share of value added (SD)”, “Total Entrepreneurial Activity (TEA) (SD)”.
The SMEs Innovation in Europe
Authors: Costantiello Alberto , Lucio Laureti , Angelo Leogrande
Published: November 2021

In this article we investigate the determinants of SMEs Innovation in Europe. We use data from the European Innovation Scoreboard of the European Commission in the period 2000-2019 for 36 countries. Data are analyzed through Panel Data with Fixed Effects, Random Effects, Dynamic Panel at 1 Stage and WLS. Results show that the presence of Innovators is positively associated with “Enterprise births”, “Government Procurement of Advanced Technology Products”, “Firm Investments”, “Intellectual Assets”, “Sales Impacts”, “Share High and Medium High-Tech Manufacturing” and negatively associated to “FDI Net Inflows” and “Population Density”.