bluuebunny/crossref_metadata_2025 huggingface dataset:
Incidence and cost of hemolytic uremic syndrome in urban China: a national population-based analysis
Authors: Feng Jingnan , Xu Ke , Shi Xinmiao , Xu Lu , Liu Lili , Wang Fang , Zhong Xuhui , Liu Guozhen , Wang Jinxi , Ding Jie , Wang Shengfeng , Gao Pei , Zhan Siyan
Published: January 2021

Background: HUS is a severe syndrome that imposes a substantial burden on patients and their families, furthermore, it’s the leading cause of acute kidney failure in children. However, data on the epidemiology and disease burden of HUS are limited in Asia, including in China. We aimed to estimate the incidence and cost of HUS in China.Methods: Data on HUS from 2012 to 2016 were extracted from the databases of the Urban Employee Basic Medical Insurance (UEBMI) and the Urban Resident Basic Medical Insurance (URBMI). All cases were identified by the ICD code and Chinese diagnostic terms. The national incidence rates in 2016 were estimated and stratified by sex, age and season; the associated medical costs were also calculated. Results: The crude incidence was 0.66 per 100,000 person-years (95% CI: 0.57 to 1.06), and the standardized incidence was 0.57 (0.19 to 1.18). The highest incidence was observed in patients younger than 1 year old (5.08,95% CI: 0.23 to24.87). Meanwhile, the incidence was 0.38 per 100,000 person-years (95% CI: 0.13 to 0.75) in patients younger than 5 years old, and 0.29 per 100,000 person-years (95% CI: 0.09 to 0.57) in patients younger than 18 years old. The season with the highest incidence was autumn, followed by winter. The average cost was 1.75 thousand US dollars per patient, which was higher than the national average cost for all inpatients in the same period. Conclusions: The incidence of HUS in our study was lower than those in the most developed countries, and with different age and season distribution in incidence, which may suggest that the cause of HUS in China may be different from that elsewhere. Due to insufficient knowledge of physicians and lacking laboratory facilities required for an accurate diagnosis, the incidence rate of HUS may be underestimated. In view of the healthcare economic burden of HUS, further analyses and supports are needed in the future.
Increased primary carnitine deficiency detection through second-tier newborn genetic screening
Authors: Lin Yiming , Zhang Weifeng , Huang Chenggang , Lin Chunmei , Lin Weihua , Peng Weilin , Fu Qingliu , Chen Dongmei
Published: January 2021

Background
Newborn screening for (NBS) for primary carnitine deficiency (PCD) is widely implemented worldwide, however, with poor sensitivity. This study aimed to evaluate the feasibility of improving the screening using second-tier genetic assay.
Methods
An Agena iPLEX assay was developed to identify 17 SLC22A5 mutations in the Chinese populations, then this assay was applied in NBS for second-tier mutation screening of newborns with low free carnitine (C0) levels.
Results
The Agena iPLEX assay was successfully established and performed in second-tier genetic screening. A total of316 (0.15%) residual NBS-positive specimens were subjected to second-tier genetic screening. Twenty screen-positive newborns harbored biallelic mutations in SLC22A5 gene, 99 screen-carriers with one mutation, and 197 screen-negative newborns with no mutation identified. Among 99 carriers, four newborns were found with a second disease-causing SLC22A5mutation by further genetic analysis. Four newborns were found with persistently low C0 levels among 197 screen-negatives, further genetic analysis revealed that one newborn with two novel SLC22A5 pathogenic variants. In total, 25 newborns were diagnosed with PCD, for a positive predictive value of 7.91% (25/316). The incidence of PCD in Quanzhou was estimated at 1:8191.
Conclusion
Data from this study revealed that 24% (6/25) of PCD cases would have been missed by conventional NBS. The high throughput iPLEX assay is a powerful tool for PCD genotyping. The incorporation of second-tier genetic screening into NBS program could increase PCD detection, however, further studies are needed to optimize the workflow of new screening algorithm.
Novel method of transpulmonary pressure measurement with an air-filled esophageal catheter
Authors: Massion Paul B , Berg J , Samalea N , Parzibut G , Lambermont B , Ledoux D , Massion Pierre P
Published: January 2021

Background

There is a strong rationale for proposing transpulmonary pressure-guided protective ventilation in acute respiratory distress syndrome (ARDS). The reference esophageal balloon catheter method requires complex in vivo calibration and dedicated ventilator with auxiliary pressure port. A simple, inexpensive, accurate and reproducible method of measuring esophageal pressure would greatly facilitate the measure of transpulmonary pressure to individualize protective ventilation in the intensive care unit.
Results

We propose an air-filled esophageal catheter method without balloon, using disposable catheter and transducer that allows reproducible esophageal pressure measurements, and that does not require any specific ventilator equipment. We use a 49 cm-long thin low compliance polyvinyl 10 Fr suction catheter, positioned in the lower third of the esophagus and connected to an air-filled disposable blood pressure transducer bound to the monitor. To guarantee air transmission, the transducer is pressurized by an air-filled infusion bag allowing its integrated flush device to deliver continuous air flow and to obtain a stable esophageal waveform. Calibration requires simple zeroing the transducer open to atmospheric pressure. Esophageal pressures recorded on the monitoring are expressed in mmHg and need to be converted in cmH2O. We tested our novel method in 10 consecutive intubated patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. We calculated the target transpulmonary pressures for protective lung and diaphragm ventilation, both in passive and spontaneously breathing conditions. Esophageal to airway pressure change ratio was close to one in both conditions (median [P25;P75] = 0.94 [0.92;1.00] and 0.98 [0.96;1.01]). We adjusted ventilator settings towards recommended pressure targets to limit atelectrauma, barotrauma, inspiratory effort and lung stress, by modifying positive end-expiratory pressure, tidal volume, or inspiratory pressure accordingly.
Conclusions

We propose a simple, inexpensive and reproducible method for esophageal pressure monitoring with an air-filled esophageal catheter without balloon. It holds the promise of widespread bedside use of transpulmonary pressure-guided protective ventilation in patients with ARDS.
HDM-induced Atg5 Mediates TSLP Expressing to Disrupt Epithelial Barrier
Authors: Yu Changhui , Zhou Zicong , Liang Shixiu , Zhou Zili , Liu Jieyi , Zou Fei , Cai Shaoxi
Published: January 2021

Background: Asthma is a complex and heterogeneous disease. Autophagy, process of self-protection in cells, is an intracellular process when cells are being attacked by certain stress. Our team focused upon the disruption of airways epithelial barrier in asthma, and we interested in whether autophagy played a key role in asthma. Methods: 400U HDM was used to treat HBECs and established asthmatic mice model. Western blotting, RT-PCR and immunofluorescence were mainly used to detect autophagy process in vivo and in vitro. One way ANOVA and Mann Whitney test were used for statistic. Results: After treated with HDM, expression of LC3ab increased in vivo and in vitro. Using Rapamycin, 3-MA and Chloroquine to treat HBECs, then we surprisingly found that HDM disrupts epithelial barrier through incomplete autophagy. To find out the connection between asthma and autophagy, we chose known autophagy related genes to determine the association between autophagy and disruption of airway epithelial barrier. Atg5 and atg12 were chosen because these two genes varied upon the time dependent manner. Knocked down the expression of atg5 or atg12 by siRNA, the expression of TSLP, which can induce the disruption of airway epithelial barrier, remarkably reduced. Conclusions: These results demonstrated that HDM induced inflammatory in airway epithelium through autophagy, and then knocked down autophagy related genes alleviated the inflammatory in HBECs.
Identification and Validation of A Hypoxia-Related Prognostic and Immune Microenvironment Signature in Bladder Cancer
Authors: Sun Xianchao , Zhang Ying , Wang Jinyou , Zhao Xiaofeng , Zhou Zhen , Jin Liang , Zhai Tingshuai , Liu Xiang , Zhang Jiaxin , Mei Wangli , Zhang Bihui , Luo Ming , Yao Xudong , Ye Lin
Published: January 2021

Bladder cancer is the main leading causes of cancer-related deaths and seriously affects population health. Hypoxia plays a key role in tumor development and immune escape, which contributes to malignant behaviors. In this study, we analyzed the RNA-seq and clinical information of bladder cancer patients from The Cancer Genome Atlas (TCGA) database. In order to investigate the hypoxia-related prognostic and immune microenvironment in bladder cancer, we constructed a hypoxia-related risk model for overall survival (OS). Moreover, the RNA-seq and clinical information of bladder cancer patients from Gene Expression Omnibus (GEO) database were used to verified. Our research revealed that the hypoxia risk signature significantly correlated with clinical outcome and independently predict the OS. Furthermore, the hypoxia risk signature could effectively reflect the level of immune cell type fraction and the expression of critical immune checkpoint genes were higher in the high-risk group compare to low-risk group. We also confirmed the expression level of the prognostic genes in bladder cancer and paracancerous tissue samples using qRT-PCR analysis. In summary, the present study identified 7 hypoxia-related genes (HRGs) signature that may be served as an independent clinical predictor and provide a potential mechanism in bladder cancer immunotherapy.
Special Hook Design for Hatch Cover Stocking Gantry Crane, Strength, Numerical Analysis under Static Loading
Authors: Şengül Ömer , Kam Menderes
Published: January 2021

In this study, Computer-Aided Design (CAM) of special crane hooks used to close the stack type hatch covers used for sea freight transport, which is of great importance in our world, has been made. In this design, bolt and pin connections were preferred in the connections of the hook with the crane, as well as the connection with the welding performed in other studies. Thanks to these fasteners, corrosion events caused by the place of use and environmental conditions will also be prevented, and the strength values and reliability of the material will be increased. Critical sections with high-stress values on this design were determined by the Finite Element Method (FEM) with ANSYS R3 analysis program. In this design, the necessary improvements and strength calculations of the hook were made. Numerical calculations performed by the FEM and strength calculation results were compared. Results overlap: This, in turn, has been associated with the fact that the design made for us provides an optimal level of efficiency. These calculations are based on the data of St-37 structural steel. According to the results of these strength calculations, improvements were made in the design. As a result of improvements in special design and strength values for hatch cover stocking gantry Crane hooks, the design is expected to be standardized.
Distorted chemosensory perception and female sex associate with persistent smell and/or taste loss in people with SARS-CoV-2 antibodies: A community based cohort study investigating clinical course and resolution of acute smell and/or taste loss in people with and without SARS-CoV-2 antibodies in London, UK
Authors: Makaronidis Janine , Firman Chloe , Magee Cormac , Mok Jessica , Balogun Nyaladzi , Lechner Matt , Carnemolla Alisia , Batterham Rachel
Published: January 2021

Background:Loss of smell and/or taste are cardinal symptoms of COVID-19. ‘Long-COVID’, persistence of symptoms, affects around one fifth of people. However, data regarding the clinical resolution of loss of smell and/or taste are lacking. We assessed COVID-19 symptoms in a community cohort in London 4-6 weeks after they initially reported acute loss of their sense of smell and/or taste, 78% of whom had SARS-CoV-2 IgG/IgM antibodies. In addition, to assess whether self-reported change in sense of smell was reliable, we compared subjective and objective smell assessments in a subset of participants. Methods:467 participants with acute loss of smell and/or taste who had undergone SARS-CoV-2 IgG/IgM antibody testing 4-6 weeks earlier completed a follow-up questionnaire about resolution of their symptoms. A subsample of 50 participants completed an objective olfactory test and results were compared to subjective smell evaluations.Results:People with SARS-CoV-2 antibodies with an acute loss of sense of smell and taste were significantly less likely to recover their sense of smell/taste than people who were seronegative (smell recovery: 57.7% vs. 72.1% , p=0.027. taste recovery 66.2% vs. 80.3%, p=0.017). In SARS-CoV-2 positive participants, a higher percentage of male participants reported full resolution of smell loss (72.8% vs. 51.4%; p<0.001) compared to female participants, who were almost 2.5-times more likely to have ongoing smell loss after 4-6 weeks (OR 2.46, 95%CI 1.47-4.13, p=0.001). Female participants with SARS-CoV-2 antibodies and unresolved smell loss and unresolved taste loss were significantly older (>40 years) than those who reported full resolution. Participants who experienced parosmia reported lower smell recovery rates and participants with distorted taste perception lower taste recovery rates. Parosmia had a significant association to unresolved smell loss (OR 2.47, 95%CI 1.54-4.00, p<0.001). Conclusion:Although smell and/or taste loss are often transient manifestations of COVID-19, 42% of participants had ongoing loss of smell, 34% loss of taste and 36% loss of smell and taste at 4-6 weeks follow-up, which constitute symptoms of ‘long-COVID’. Females (particularly >40 years) and people with a distorted perception of their sense of smell/taste are likely to benefit from prioritised early therapeutic interventions. Trials registration:ClinicalTrials.gov NCT04377815
Influence of white matter lesions on the prognosis of acute cardioembolic stroke without reperfusion therapy
Authors: Guo yikun , Zou Wenying , Chen Zhuoyou , Zhang Min , Wang Qian , Dong Guanzhong , Yao Tian
Published: January 2021

Background

Few studies have investigated the influence of white matter lesions (WMLs) on the prognosis of acute cardioembolic stroke (CES). We aimed to explore the role of WMLs in predicting 3-month prognosis of CES without reperfusion therapy.
Methods

A number of 251 acute CES patients without reperfusion therapy at a single center were retrospectively recruited. The severity of WMLs was evaluated by Fazekas scale and patients were divided into mild WMLs group (188 cases, Fazekas ≤ 2 points) and moderate to severe WMLs group (63 cases, Fazekas ≥ 3 points) accordingly. General data and clinical features of the two groups were compared. Functional outcomes of patients were followed up for 3 months using the modified Rankin scale (mRS) and patients were divided into poor outcome group (mRS ≥ 3) and favorable outcome group (mRS ≤ 2). The effect of WMLs on the prognosis was identified by binary logistic regression.
Results

Patients in moderate to severe WMLs group were older (P < 0.001). Also, they had higher baseline NIHSS score (P < 0.001) and elevated incidence of asymptomatic cerebral hemorrhage (P = 0.040) and stroke associated pneumonia (P = 0.001) than those in mild WMLs group. At 3 months, there were 100 cases in the poor outcome group. Patients in poor outcome group had higher baseline NIHSS score, increased proportion of moderate to severe WMLs, and elevated incidence of stroke associated pneumonia than those in favorable outcome group (P < 0.001). Binary logistic regression analysis showed that moderate to severe WMLs (odds ratio [OR] = 4.105, 95% confidence interval [CI] = 1.447–11.646), baseline NIHSS score (OR = 1.368, 95% CI = 1.240–1.511), and stroke-associated pneumonia (OR = 4.840, 95%CI = 1.889–12.400) were independent risk factors for poor outcome.
Conclusion

Moderate to severe WMLs is an independent risk factor for prognosis of CES patients without reperfusion therapy.
Aging-associated inflammation and fibrosis in arachnoid membrane
Authors: Suzuki Hime , Mikami Takeshi , Iwahara Naotoshi , Akiyama Yukinori , Wanibuchi Masahiko , Komatsu Katsuya , Yokoyama Rintaro , Hirano Tsukasa , Hosoda Ryusuke , Horio Yoshiyuki , Kuno Atsushi , Mikuni Nobuhiro
Published: January 2021

Background
The physiological and pathological significance of the arachnoid membrane (AM) is still unknown. In this study, we investigated various characteristics of the AM, focusing on the influence of inflammation and fibrosis.
Methods
Small pieces of AM sample were obtained during neurosurgical procedures from 74 cases. The clinical and pathological characteristics of the hyperplastic AM group (≥ 50 µm) and the non-hyperplastic AM group (< 50 µm) were compared. Then, potential correlations between AM thickness and clinical characteristics were analyzed. Moreover, VEGFα, TGFβ, and TGFα levels were quantitated by real time PCR. Then, the potential correlations between AM thickness and these inflammatory or anti-inflammatory markers, and the influence of the original disease were calculated.
Results
The median age of the patients in hyperplastic AM group was significantly older than that of the non-hyperplastic AM group. Moreover, the number of fibroblasts, CD68+ cells, CD86+ cells, and CD206+ cells in the hyperplastic AM group was significantly higher than that in the non-hyperplastic AM group. The AM thickness was significantly correlated to age and number of fibroblasts, CD68+ cells, CD86+ cells, and CD206+ cells. The thickness of the AM was significantly correlated to the messenger RNA expression levels of VEGFα (ρ = 0.337), and the VEGFα expression levels were significantly correlated with TGFβ, which in turn was significantly correlated with TNFα.
Conclusions
The AM hyperplasia was influenced by aging and could be a result of inflammation and fibrosis through cytokine secretion from the inflammatory cells and fibroblasts in the AM.
Analysis of Association between CT-assessed Body Composition and Survival Composition of Patients with Sepsis in EICU
Authors: Xu Tian Yun , Zhang He , Li Jie Zhi , Wang Nan
Published: January 2021

Background: The prevalence of sepsis among patients in the intensive care unit is high. Thus, the evaluation of prognosis in these patients is paramount. This study aimed to appraise the role of the abdominal composition quantified from computed tomography (CT) scan in predicting a 90-day mortality rate among patients with sepsis in the emergency intensive care unit (EICU).Method: Through Cox regression analysis, the skeletal muscle density (SMD, skeletal muscle area (SMA), and subcutaneous adipose tissue area (SAT) assessed by the CT abdomen were associated with the 90-day mortality rate, with adjustment to the acute physiology and chronic health assessment (APACHE II) score, sequential organ failure assessment (SOFA) score, and BMI. Linear regression was performed to analyze other clinical factors.Result: The Cox regression analyses showed that compared with the non-survival group at 90-day, patients with a higher SMD (HR per 10 HU = 0.619; 95% CI = 0.450 - 0.853; p = 0.003), SMA (HR per 10 cm2 = 0.870; 95% CI = 0.781 - 0.969; p = 0.011), and SAT (HR per 10 cm2 = 0.954; 95% CI = 0.912 - 0.999; P = 0.047) were significantly associated with a lower 90-day mortality rate. These significant correlations persisted after adjusting for the BMI, APACHE II, and SOFA scores. Further analysis revealed gender differences in the SMD and skeletal muscle index (SMI) between the survival and the non-survival group.Conclusion: The content of body composition assessed by an abdominal CT scan is highly associated with the 90-day mortality of patients with sepsis in the EICU, of which the SMD, SMA, and SAT represent valuable prognostic factors.
Double Blinded Clinical Study on D-Glyceric Acid, a Potential Novel Energy Metabolic Signaling Metabolite
Authors: Hirvonen Olli Petteri , Kyröläinen Heikki , Kainulainen Heikki
Published: January 2021

Based on earlier few studies natural metabolite D-glyceric acid does not seem to play any major role in cellular metabolism. Nevertheless, one study that concentrated on ethanol oxidation in the liver increased our curiosity. Therefore, research leading to the present 25 days lasting double blinded human study with placebo control was initiated. Main targets in the present study were: 1) to find out whether acute and long-term exogenous D-glyceric acid (DGA) regimen will cause activation related to energy metabolism in healthy 50-60-year old humans, and 2) to find out whether elevated levels of endogenous DGA can be found in the plasma after 30 min of a strenuous cycling exercise. Additional target was to find out whether certain effects of exogenous DGA regimen resemble the effects of physical exercises, and whether lowered halved dose of DGA regimen during a 14-day follow-up period continues to be effective. The main results revealed that: I) there was an acute effect on plasma glucose maintenance from DGA regimen, II) plasma metabolites and gene expressions related to aerobic energy production were strongly modulated, and subclinical inflammation was lowered already after the 4-day DGA regimen, and III) cycling with increasing load towards exhaustion increased endogenous levels of DGA in human plasma (p=0.013). Because the amounts of administered DGA were exceedingly small and cannot directly have caused observed substantial changes, we hypothesise that an increase in tissue DGA concentration causes an endogenous signal or a cascade of intracellular signals: “ more ATP is needed immediately ”. At the whole body level, the signal causes metabolic activation cascade that resembles initiation of physical exercises but without literally no signs of exhaustion. Tested exogenous DGA regimen possessed an effect even on circulating immune cells. Based on obtained results, the DGA regimen may facilitate in resolving energy metabolic challenges in main organs, like fatty liver, and simultaneously it seemed to lower systemic inflammation. The DGA regimen can possibly alleviate chronic diseases and disorders related to energy metabolism and/or elevated subclinical inflammation.Trial registration number (18th of Jan 2021), ClinicalTrials.gov Identifier: NCT04713319
Accelerated Osteoarthritis in Women with Polycystic Ovary Syndrome: a prospective nationwide registry-based cohort study.
Authors: Kluzek Stefan , Rubin Katrine Hass , Sanchez-Santos Maria , O'Hanlon Mary S , Andersen Marianne , Glintborg Dorte , Abrahamsen Bo
Published: January 2021

Background. Osteoarthritis (OA) is the most common form of arthritis with multiple risk factors implicated including female sex and obesity. Metabolic dysregulation associated with obesity leading to Metabolic Syndrome is a proposed component of that association. Polycystic ovary syndrome (PCOS) commonly affects women of reproductive age and these women are at higher risk of developing Metabolic Syndrome and thus likely to represent a high-risk group for early OA development. There are no published studies exploring the epidemiology of knee, hip and hand OA in women diagnosed with PCOS. Study aim. To assess the prevalence and incidence of knee, hip and hand osteoarthritis (OA) in women with Polycystic Ovary Syndrome (PCOS) when compared with age-matched controls. Methods. Prospective Danish national registry-based cohort study. The prevalence of OA in 2015 and incidence rates of OA over 11.1 years were calculated and compared in more than 75,000 Danish women with either a documented diagnosis of PCOS and/or hirsutism (during the period of 1995 to 2012) or age-matched females without those diagnoses randomly drawn from the same population register. Results. In 2015, the prevalence of hospital treated knee, hip and hand OA was 5.2% in women with PCOS diagnosis. It was 73% higher than that seen in age-matched controls. Significantly higher incidence rates were observed in the PCOS cohort compared with the age-matched controls during the follow-up period (up to 20 years), with the following hazard ratios (HR): 1.9 (95%CI: 1.7 to 2.1) for knee, 1.8 (95%CI: 1.3-2.4) for hand and 1.3 (95%CI: 1.1 to 1.6) for hip OA. After excluding women with obesity, similar associations were observed for knee and hand OA. However, risk of developing hip OA was no longer significant.Conclusions. In this large prospective study, women with PCOS diagnosis had higher prevalence and accelerated onset of OA of both weight and non-weight bearing joints, when compared with age-matched controls. Further studies are needed to understand the relative effect of metabolic and hormonal changes linked with PCOS and their role in promoting development of OA.
Degradation of Wetlands and Livelihood Dependence on Lake Abaya-Chamo Wetland, Southern Ethiopia.
Authors: Zekarias Tariku , Govindu Vanum , Kebede Yechale , Gelaw Abren
Published: January 2021

Back groundAbaya-Chamo and other wetlands of Ethiopia provide multiple ecosystem services, the wetlands are extremely affected by various anthropogenic factors. The unsustainable use of wetlands stems from the negligence of users about wetland degradation and limited policy attention by decision-makers. This study was aimed at analyzing the livelihood benefits of Abaya-chamo lake-wetland and the driving forces of its degradation. Data were gathered using a questionnaire survey of 384 households (selected via systematic random sampling), focus group discussion, and interview and ﬁeld observation. Percentage, regression, etc., was used for data analysis. ResultsIt was found that Abaya-chamo lake-wetland offers fish, lumber, firewood, fodder, irrigation water, farmland, rainfall, recreation, tourism, aesthetic, carbon sinks, air quality and climate regulation, etc., services to local people. Farm expansion, sedimentation, irrigation, invasive plants (e.g. emboch), open access and overuse of resources, lack of legal framework and rapid population growth were the main causes of the wetland degradation. Applying the lakes’ salty-water for irrigation is expected to lead to chemical land degradation in the next few decades. The invasive emboch-plant results in dwindling aquatic resources (e.g., fish), loss of economic and tour benefits, and change in local climate, thereby depleting the lake water, and the dissolved O2 and CO2 storage capacity of the lake-wetland rapidly. ConclusionsThe lakes’ salty-water based irrigation are expected to result in chemical land degradation to the extent of abandoning crop farming in the next few decades unless some actions are taken. Thus, the government should devise clear policy and legal framework about sustainable management of wetland resources.
Clinical Observation Research on the Application of Rapid Response System in General Wards
Authors: Wang Yan , Wu Haiyan , Liu Chang , Ran Suping , Wang Baoyu
Published: January 2021

Objective Observe and analyze the effect of the criticall rapid response system in general wards.Methods Analyze the data of CROT cases initiated in 2016-2019, and statistically analyze the reasons for the initiation, on-site treatment, the outcomes of patients, and the number of organ function support of patients transferred to ICU. Results A total of 312 cases were initiated in 43 months. The top three reasons for initiation were: unconsciousness (29.79%), respiratory distress (19.17%), and hypotension (18.60%). The effective call rate was 91.99%, and only 68.27% were transferred to ICU. Mechanical ventilation (89.67%), blood purification (85.92%), and vasoactive drugs (82.16%) were applied in ICU. Conclusions The critical rapid response system can guarantee the safety of inpatients in general wards, but the activatiaon characteristics are worthy of further discussion.
Timing of tracheostomy in acute traumatic spinal cord injury: a systematic review and meta-analysis
Authors: Foran Sarah , Taran Shaurya , Singh JM , Kutsogiannis Demetrios James , McCredie Victoria
Published: January 2021

Background Patients with acute traumatic cervical or high thoracic level spinal cord injury (SCI) typically require mechanical ventilation (MV) during their acute admission. Placement of a tracheostomy is preferred when prolonged weaning from MV is anticipated. However, the optimal timing of tracheostomy placement in patients with acute traumatic SCI remains uncertain. We systematically reviewed the literature to determine the effects of early versus late tracheostomy or prolonged intubation in patients with acute traumatic SCI on important clinical outcomes.Methods Six databases were searched from their inception to January 2020. Conference abstracts from relevant proceedings and the gray literature were searched to identify additional studies. Data was obtained by two independent reviewers to ensure accuracy and completeness. The quality of observational studies was evaluated using the Newcastle Ottawa Scale (NOS).Results Seventeen studies (2,804 patients) met selection criteria, 14 of which were published after 2009. Meta-analysis showed that early tracheostomy was not associated with decreased short-term mortality (risk ratio [RR] 0.84; 95% confidence interval [CI] 0.39 to 1.79; p = 0.65; n = 2,072), but was associated with a reduction in MV duration (mean difference [MD] 13.1 days; 95% CI -6.70 to -21.11; p = 0.0002; n = 855), intensive care unit (ICU) length of stay (MD -10.20 days; 95% CI -4.66 to -15.74; p = 0.0003; n = 855), and hospital length of stay (MD -7.39 days; 95% CI -3.74 to -11.03; p < 0.0001; n = 423). Early tracheostomy was also associated with a decreased incidence of ventilator-associated pneumonia (VAP) and tracheostomy-related complications (RR 0.86; 95% CI 0.75 to 0.98; p = 0.08; n = 2,043 and RR 0.08; 95% CI -0.01 to -0.15; p = 0.02; n = 812 respectively). The majority of studies ranked as good methodologic quality on the NOS. Conclusions Early tracheostomy in patients with acute traumatic SCI may reduce duration of mechanical ventilation, length of ICU stay, and length of hospital stay. Current studies highlight the lack of high-level evidence to guide the optimal timing of tracheostomy in acute traumatic SCI. Future research should seek to understand whether early tracheostomy improves patient comfort, decreases duration of sedation and improves long-term outcomes.PROSPERO registration number: CRD42020162488
Clinicopathological effects of Nigella sativa (kalonji) seeds in Escherichia coli infected Psittaculakrameri.
Authors: Waqar Muhammad , Khan Farhan Anwar , Ali Mehboob , Rehman Faiz ur , Ikram Muhammad Sohaib , Khan Muhammad Kashif , Saeed Muhammad , Nawaz Saqib
Published: January 2021

The clinicopathological effects of E. coli infected Psittaculakrameri (ring necked parrots) supplemented with N. sativa seeds in feed were evaluated. Faecal samples from “psittacine” species parrots were collected and E. coli was isolated for cultural, morphological, biochemical and in-vitro studies. A total of 27 parrots were selected and divided into 03 groups (A= control, B= no treatment and C= treatment+ infection) having 09 parrots in each and were fed with N. Sativa seeds @100mg/kg from 3rd day. The parrots of group B and C were challenged with 0.1ml pathogenic E. coli @106CFU/ml/bird subcutaneously on day 9th. Clinical signs, mortality and morbidity rates were observed during the trial. For haematology, histopathology and CRP in sera, three birds were slaughtered weekly from each group. Significant decreased in feed consumption, haematological values like red blood cells, haemoglobin and pack cell volume while significant increase in clinical signs, morbidity, mortality, liver, heart, kidneys weights and white blood cell were recorded in group B. C-Reactive protein values was significantly decreased in group C as compared to group B while degenerative changes were seen in liver, heart and kidneys of group B.
Exoskeleton-assisted walking improves pulmonary function and walking parameters among individuals with spinal cord injury: a randomized controlled pilot study
Authors: Xiang Xiao-na , Zong Hui-yan , Ou Yi , Yu Xi , Cheng Hong , Du Chun-ping , He Hong-chen
Published: January 2021

Background: Exoskeleton-assisted walking (EAW) is expected to improve the gait of spinal cord injury (SCI) individuals. However, few studies reported the changes of pulmonary function (PF) parameters after EAW trainings. Hence, we aimed to explore the effect of EAW on PF parameters, 6-minute walk test (6MWT) and lower extremity motor score (LEMS) in individuals with SCI and to compare those with conventional trainings.
Methods: In this prospective, single-center, single-blinded randomized controlled pilot study, 18 SCI participants were randomized into the EAW group (n=9) and conventional group (n=9) and received 16 sessions of 50-60min training (4 days/week, 4 weeks). PF parameters consisting of the forced vital capacity (FVC), forced expiratory volume in 1 sec (FEV1), forced expiratory flow (FEF), peak expiratory flow, and maximal voluntary ventilation, 6MWT with assisted devices and LEMS were reported pre- and post-training.
Results: Values of FVC (p=0.041), predicted FVC% (p=0.012) and FEV 1 (p=0.013) were significantly greater in EAW group (FVC: 3.8±1.1 L; FVC%pred=94.1±24.5%; FEV1: 3.5±1.0 L) compared to conventional group (FVC: 2.8±0.8 L; FVC%pred=65.4±17.6%; FEV1: 2.4±0.6 L) after training. Participants in EAW group completed 6MWT with median 17.3 meters while wearing the exoskeleton. There was no difference in LEMS and no adverse event.
Conclusions: The current results suggest that EAW has potential benefits to facilitate PF parameters among individuals with lower thoracic neurological level of SCI compared to conventional trainings. Additionally, robotic exoskeleton helped walking.
Trial registration: Registered on 22 May 2020 at Chinese Clinical Trial Registry (ChiCTR2000033166). http://www.chictr.org.cn/edit.aspx?pid=53920&htm=4
Keywords: Spinal Cord, Pulmonary, Exercise, Exoskeleton, 6MWT, Rehabilitation
Comparison of Psychiatric Disorders Between Levetiracetam Combined With Lacosamide and Perampanel
Authors: Matsunuma Satoru , Sunaga Shigeki , Hoshiai Akira , Arai Takao , Jimbo Hiroyuki , Yoshimoto Koichi
Published: January 2021

Background The number of patients with epilepsy receiving perampanel or lacosamide as an add-on treatment following levetiracetam treatment has increased. Although levetiracetam causes psychiatric disorders, it is unclear whether they occur with the combined use of these antiepileptic drugs.Objective To determine the frequency of psychiatric disorders in patients using lacosamide or perampanel as an add-on therapy to levetiracetam. Setting A single-center retrospective cohort study. Methods Patients who received levetiracetam, lacosamide, and perampanel between April 1, 2014 and April 30, 2019 in Hachioji Medical Center were selected. They were classified into the levetiracetam+lacosamide or levetiracetam+perampanel group. Medical records from the start of combination therapy contained patient background and the incidence of psychiatric disorders. Main outcome measure Onset of psychiatric disorders. Results Forty-four patients used levetiracetam+lacosamide and 50 used levetiracetam+perampanel. The incidence of psychiatric disorders was significantly lower (p = 0.000047) with levetiracetam+lacosamide (6.8%) than with levetiracetam+perampanel (46%). The time to the onset of psychiatric disorders was within 1 month of dose initiation or increase in one case (33.3%) with levetiracetam+lacosamide and 16 cases (76.2%) with levetiracetam+perampanel. The median time to onset was 56 and 6.5 days with levetiracetam+lacosamide and levetiracetam+perampanel, respectively. There was no significant difference in antiepileptic drug dosages owing to the presence or absence of psychiatric disorders. Conclusion As the frequency of psychiatric disorders was higher with levetiracetam+perampanel therapy, levetiracetam+lacosamide may be preferable. These disorders tended to develop within 1 month of therapy and were not dose-dependent. Antiepileptic drugs should be cautiously prescribed to avoid psychiatric disorders.
Photocatalytic decontamination of pharmaceutical effluent in a double tube reactor by ZnO catalyst. Physico chemical characterization and optimization. 
Authors: NAITALI F. , GHOUALEM H
Published: January 2021

This work focused on the study of the elimination of a non-steroidal anti-inflammatory drug (diclofenac) using heterogeneous photo catalysis as a treatment.The study investigated the effect of parameters (catalyst concentration, initial diclofenac concentration, ratio r r = . and volume flow) on the photocatalytic degradation of diclofenac. The analyses performed are pH, electrical conductivity, turbidity, surface tension, chemical oxygen demand, nitrite and diclofenac concentration.The study showed that: The heterogeneous photo catalytic degradation is influenced by :The concentration of the ZnO catalyst; The concentration of 1.5 g/L gives a better degradation in diclofenac with a percentage of elimination of 52%; The initial concentration of diclofenac; The concentration of 100 mg/L of diclofenac gives a better degradation with a percentage of elimination of 52%; The ratio r = ; The three ratios (1; 5; and 10%) give a total degradation after one hour of treatment; The volume flow rate of 25 mL/s gives a total degradation after one hour of treatment. Optimal conditions for heterogeneous photo-catalysis are : [ZnO] = 1.5 g/L, [diclofenac] = 100 mg/L, Volume flow rate = 25 mL/s For a volume flow rate of 20 mL/s, optimal conditions are met by adding H2O2.
Explaining corruption: How do firms respond to non-gravity trade in developing countries?
Authors: Hu Lin , Yan Wenshou
Published: January 2021

There has been limited effort to explore whether non-gravity trade, as not driven by standard variables entering an augmented gravity model, matters for firms’ corruption. To fill this gap, this paper explores the effect of non-gravity trade on firms’ corruption in 141 developing countries during the period 2006–2017. Our results show that non-gravity trade does matter for the firms’ corruption behavior. Specifically, we find that firms’ corruption decreases by 0.09–0.23% following a unit increase in non-gravity trade (e.g. 19.7 million dollars’ increase in real trade), and the effect is much larger during the world financial crisis period. The result is robust to exploiting conditional heteroskedasticity for identification, constructing a Bartik-type instrument variable, applying different econometric technics, and using alternative measures of firm corruption.
Assessment of Air Pollution status during COVID-19 Lockdown (Mar-May 2020) over Bangalore City in India
Authors: Gouda K C , Singh Priya , Nikhilasuma P , Benke Mahendra , Kumari Reshama , Agnihotri Geeta , H Kiran , Chandrika M , Kantharao B , Ramesh V , Himesh S
Published: January 2021

The Coronavirus disease 2019 (COVID-19), which became a global pandemic by March 2020 (WHO, 2020), forced almost all countries over the world to impose the lockdown as a measure of social distancing to control the spread of infection. India also strictly implemented a countrywide lockdown, starting from 24th March onwards. This measure resulted in the reduction of the sources of air pollution in general; industrial, commercial, and vehicular pollution in particular, with visible improvement in Ambient Air Quality. In this study, the impact of COVID-19 lockdown on the ambient concentration of air pollutants over the city of Bengaluru (India) is assessed using Continuous Ambient Air Quality Measurement (CAAQM) data from 10 monitoring stations spread across the city. The data was obtained from Central Pollution Control Board (CPCB) and Karnataka State Pollution Control Board (KSPCB). The analysis of the relative changes in the ambient concentration of six major air pollutants (NO, NO2, NOX, PM2.5, O3, and SO2) been carried out for two periods; March-May 2020 (COVID-19 lockdown) and the corresponding period of 2019 which was Non-COVID. The analysis revealed significant reduction in the concentration of ambient air pollutants at both daily and monthly intervals. This can be attributed to the reduction in sources of emission; vehicular traffic, industrial, and other activities. The average reduction in the concentration of NO, NO2, NOX, PM2.5, and O3 between 1st March to 12th May 2020 was found to be 63%, 48%, 48%, 18%, and 23% respectively when compared to the same period in 2019. Similarly, the comparative analysis of pollutant concentrations between pre-lockdown (March 01- March 23) and lockdown (Mar 24-May 12) period, shown a huge reduction in the ambient concentration of air pollutants; 47.3% (NO), 49% (NO2), 49% (NOX), 10% (SO2), 37.7% (PM2.5), and 15.6% (O3), resulting in improved air quality over Bangalore during the COVID-19 lockdown period. It is shown that the strict lockdown resulted in a significant reduction in the pollution levels. Such lockdowns may be useful as emergency intervention strategies to control air pollution in megacities when ambient air quality deteriorates dangerously.
A Multi-Layer Industrial-IoT Attack Taxonomy: Layers, Dimensions, Techniques and Application
Authors: Abbas Syed Ghazanfar , Hashmat Fabiha , Shah Ghalib A.
Published: January 2021

Industrial IoT (IIoT) is a specialized subset of IoT which involves the interconnection of industrial devices with ubiquitous control and intelligent processing services to improve industrial system’s productivity and operational capability. In essence, IIoT adapts a use-case specific architecture based on RFID sense network, BLE sense network or WSN, where heterogeneous industrial IoT devices can collaborate with each other to achieve a common goal. Nonetheless, most of the IIoT deployments are brownfield in nature which involves both new and legacy technologies (SCADA (Supervisory Control and Data Acquisition System)). The merger of these technologies causes high degree of cross-linking and decentralization which ultimately increases the complexity of IIoT systems and introduce new vulnerabilities. Hence, industrial organizations becomes not only vulnerable to conventional SCADA attacks but also to a multitude of IIoT specific threats. However, there is a lack of understanding of these attacks both with respect to the literature and empirical evaluation. As a consequence, it is infeasible for industrial organizations, researchers and developers to analyze attacks and derive a robust security mechanism for IIoT. In this paper, we developed a multi-layer taxonomy of IIoT attacks by considering both brownfield and greenfield architecture of IIoT. The taxonomy consists of 11 layers 94 dimensions and approximately 100 attack techniques which helps to provide a holistic overview of the incident attack pattern, attack characteristics and impact on industrial system. Subsequently, we have exhibited the practical relevance of developed taxonomy by applying it to a real-world use-case. This research will benefit researchers and developers to best utilize developed taxonomy for analyzing attack sequence and to envisage an efficient security platform for futuristic IIoT applications.
An Integrated Interval type 2 fuzzy AHP and COPRAS-G methodologies for supplier selection in the era of Industry 4.0
Authors: Kaya Sema Kayapinar , Aycin Ejder
Published: January 2021

Supply chain has a very extensive and dynamic structure that incorporates new business models, new customer expectations, market searches and technological developments. With the introduction of Industry 4.0 into supply chain, a rapid and intensive process of digitalization begin to transform every step of supply chain. Supply chain selection is one of the essential decisions in reducing the supply chain cost and improving overall quality of product and services. With the implication of digital technologies and Industry 4.0 on supply chain, the supplier selection process has been significantly changed during the recent years. Companies are willing to need new requirements for their own suppliers in accordance with Industry 4.0 implementations and technologies. This paper aims to identify key criteria to Industry 4.0 technologies and evaluate them to select the right suppliers selection in the era of Industry 4.0 Within the scope of this study attempts to develop an integrated Interval Type 2 Fuzzy AHP and GOPRAS-G methodology to select the appropriate supplier in the face of Industry 4.0 implementations. For this purpose, Interval Type 2 Fuzzy AHP was employed to weight the supplier evaluation criteria and then, Grey COPRAS method has been applied to prioritize suppliers. This paper is to provide practitioners and researchers with insight into how Industry 4.0 strategies influence on supplier selection.
Development of a predictive model of rock fragmentation for Nui Phao open-pit mine in Vietnam using multiple-output Neural Networks and Monte Carlo Dropout technique
Authors: Vu Trong , Bao Tran
Published: January 2021

Precise and reliable prediction of blast fragmentation is essential for the success of mining operations. Over the years, various machine learning models using artificial neural network have developed and proven to be efficient in predicting the blast fragmentation. In this research, we design multiple-output neural networks to forecast the cumulative distribution function (CDF) of blast fragmentation to improve this prediction. The model architecture contains multiple response variables in the output layer that correspond to the CDF curve’s percentiles. We apply Monte Carlo dropout procedure to estimate the uncertainty of the predictions. Data collected from a Nui Phao open-pit mine in Vietnam are used to train and validate the performance of the model. Results suggest that multiple-output neural network models provide better accuracy than single-output neural network models that predict each percentile on a CDF independently. Whereas, Monte Carlo dropout technique can give valuable and relative reliable information during decision making. Article highlights: • Precise and reliable prediction of blast fragmentation is essential for the success of mining operations. • A predictive model based on the multi-output neural network and Monte Carlo dropout technique was designed to predict the fragmentation CDF curve in the blasting operation of an open-pit mine. • The predictive model was proven reliable and provided better accuracy than models based on a single-output neural network.
For our world without sound. The opportunistic debitage in the Italian context: a methodological evaluation of the lithic assemblages of Pirro Nord, Cà Belvedere di Montepoggiolo, Ciota Ciara cave and Riparo Tagliente.
Authors: Carpentieri Mark , Arzarello Marta
Published: January 2021

The opportunistic debitage, originally adapted from Forestier’s S.S.D.A. definition, is characterized by a strong adaptability to local raw material morphology and its physical characteristics and it is oriented towards flake production. Its most ancient evidence is related to the first European peopling by Homo sp. during Lower Pleistocene starting from 1.6 Ma and gradually increasing around 1 Ma. In these sites a great heterogeneity of the reduction sequences and raw materials employed is highlighted, bringing to the identification of multiple technical behaviours. However, the scientific community does not always agree on associating the concepts of opportunism and method to describe these lithic complexes. The same methodological issues remain for the Middle Pleistocene where, simultaneously to an increase of the archaeological evidence and the persistence of the opportunistic debitage, the first bifacial complexes are attested. Further implications concerning the increasing complexity highlighted in core technology management are now at the centre of an important debate regarding the genesis of more specialized method (Levallois and Discoid) especially during MIS 12 and MIS 9. We suggest that the opportunistic debitage could be the starting point for this process, carrying within itself a great methodological and cultural potential.