bluuebunny/crossref_metadata_2025 huggingface dataset:
Prediction of Building Orientation Effects Through Machine Learning Process of Additively Manufactured Triply Periodic Minimal Surface Scaffolds
Authors: Assis Matheus Mendes da Silva de , Conte Erik Gustavo del
Published: March 2021

Triply periodic minimal surfaces (TPMS) are porous structures which can be used to create multifunctional materials for various technological applications. TPMS have a complex geometry, therefore, additive manufacturing is shown as the ideal method for their manufacturing, due to the flexibility of such method. Thus, this work aims to predict the building orientation effects through machine learning process of additively manufactured triply periodic minimal surface scaffolds. DOE (Design of experiments) was used to determine the effect of the 30°, 60° and 90° angles of the X, Y and Z axes of the TPMS and ANOVA (Analysis of variance) to determine the relevant statistical interactions. Subsequently, the Multi-Layer Perceptron, Random Tree and Multiple Linear Regression machine learning algorithms were used through WEKA software to predict the cost and support material consumption for each TPMS. The results showed that the cost of TPMS can vary between about 12 and 15% according to the most expensive to the most economical building orientation. The Multiple Linear Regression algorithm obtained the best result for the cost prediction and in the support material consumption prediction the Multi-Layer Perceptron algorithm got the best.
Factors associated with practicing evidence-based medicine among medical interns in Amhara regional state teaching hospitals, Northwest Ethiopia, 2020
Authors: Emwodew Delelegn , Melese Tesfahun , Takele Adamu , Mesfine Nebiyu
Published: March 2021

Background

Evidence-based medicine (EBM) is an essential component of modern medical practice and crucial for patient safety and high-quality healthcare services. The purpose of this study is to assess the factors associated with practicing EBM among medical interns in Amhara regional state teaching hospitals, Northwest Ethiopia.
Methods

An institution based cross-sectional survey was conducted from March to April, 2020. Simple random sampling with proportional allocation was used. A total of 403 medical interns were included in the study. The data were collected using a structured self-administered questionnaire. Data were coded and entered in to Epi info 8.1 then exported to and analyzed by using SPSS 20.1. Multivariable logistic regression analysis method was used to identify the factors associated with the practice of EBM.
Results

From the total of 403 medical interns, 48.4% had good practices towards EBM. EBM knowledge, attitude towards EBM, ability to critically appraise evidence and having sufficient time to search for evidence were the factors significantly associated with EBM practice.
Conclusion

Medical interns have limited practice of integrating scientific evidence in to clinical practice. There is a need to setup EBM journal club, which helps to increase awareness and use of evidence, as well as assist medical interns and other clinical staffs to ensure the correct application of EBM in to clinical practice.
A novel design of CTZS/Si tandem solar cell: A numerical approach
Authors: Bibi Baseerat , Farhadi Bita , Rahman Waseem ur , Liu Aimin
Published: March 2021

Multijunction or tandem solar cells can split the solar spectrum over several subcells with different bandgaps to transform the sunlight into electricity more effectively than single-junction solar cells. The monolithic tandem design of third generation silicon solar energy materials is auspicious for photovoltaics. In this paper, the Simulation-based studies of copper zinc tin sulfide/Silicon (CZTS/Si) tandem cells based on CZTS as an upper subcell and silicon as a lower subcell absorber layer have been performed using SCAPS-1D. This study aims to evaluate the CZTS tandem cells' performance based on the fact that both subcells are simulated to produce the best efficiency recorded at its bandgap. The Simulation and optimization of the single junction CZTS and Si solar cells were initially performed to fit the state-of-art records efficiency of 11.65% and 18.7%, respectively. Further, both the upper and lower cell has evaluated at different thicknesses for tandem configuration after validation. Also, to obtain the current matching condition for tandem structure, the upper subcell's performance is investigated at different thickness ranges from 0.1 µm -1 µm while keeping the lower subcell thickness at 80µm. Thus, at optimized upper absorber thickness of 0.191 µm and lower subcell 80 µm at transmitted spectrum the current matching condition obtained and gave an efficiency of 10.6% and 11.9%, respectively. The maximum efficiency of ~ 23 is obtained for tandem design with enhancing open circuit voltage 1.4 V.
Evaluation of the quality of groundwater in the municipality of Ji-Paraná, Rondônia, in the Brazilian Amazon region
Authors: Ramos Caryne Ferreira , Laureano Josilena de Jesus , Rosa Ana Lúcia Denardin da , Gomes Beatriz Machado , Gomes João Paulo de Oliveira , Oliveira Gislayne Alves de , Mendonça Andreza Pereira , Bastos Wanderley Rodrigues , Nascimento Elisabete Lourdes do
Published: March 2021

Groundwater quality can be affected by many factors. The objective of this study was to assess the quality of groundwater and map the flow direction, to identify possible sources of contamination in the districts of Nova Londrina and Nova Colina (Ji-Paraná, Rondônia). Water samples were collected in September 2015 and February 2016 in 20 wells in Nova Londrina and in December 2016 and April 2017 in 15 wells in Nova Colina. The turbidity, pH and electrical conductivity (EC) were measured in loco. The microbiological parameters were determined by the membrane filtration method in a chromogenic medium, and the total dissolved solids (TDS) were measured by the gravimetric method. The nutrients ammonia, nitrite, nitrate, dissolved phosphorus and total phosphorus were ascertained by the spectrophotometric method and the underground flow was obtained by applying the Surfer 8.0 software. Through principal component analysis (PCA) it was possible to detect that the TDS, total coliforms, pH and EC had important contributions to formation of the groundwater axes in Nova Londrina, while the variables EC, nitrate and well and cesspit depths contributed in Nova Colina. The groundwater flow did not differ among the months studied, and was mainly in the northwest-southeast direction in Nova Londrina and from the southeast to other regions in Nova Colina.
Epidemiology of chemical poisoning among adults in Qassim region: An eight years study
Authors: Alnasser Sulaiman
Published: March 2021

Background

Chemical poisoning is considered a common medico-social problem that, in addition to causing extensive morbidity and mortality, dominates the valuable health care service resources.
Objective

This study was conducted to explore the extent and frequency of chemical poisoning events among adults in Qassim region as well as the most common poisoning agents involved.
Methods

This is a retrospective study employing medical record review for chemical poisoning cases that occurred in Qassim region during the 8-year period from January 2008 to December 2015. Data was collected using a standardized, validated data collection sheet.
Results

There is no steady trend (either decreasing or increasing) of the number of poisoning cases through time. There is statistically significant association between the type of poisoning agent and gender (χ2 = 14.3104, P < 0.05). Also, there is statistically significant association between the type of poisoning agent and period in years (χ2 = 19.7565, P < 0.05).
Conclusions

Most cases of poisoning affected female, with no pattern through time. Educational programs are needed to raise public awareness about poisoning, especially among women.
Asymptomatic and Sub-microscopic Plasmodium Falciparum Infection in Children in the Mount Cameroon Area: a Cross-sectional Study on Altitudinal Influence, Haematological Parameters and Risk Factors
Authors: sumbele Irene Ule Ngole , Teh Rene Ning , Nkeudem Gillian Asoba , Sandie Sorelle Mekachie , Moyeh Marcel Nyuylam , Shey Robert Adamou , Shintouo Cabirou Mounchili , Ghogomu Stephen Mbigha , Batiha Gaber El-Saber , Alsharif Khalaf F , Kimbi Helen Kuokuo
Published: March 2021

Background: The Mount Cameroon area has experienced a 57.2% decline in confirmed malaria cases between 2006 and 2013 with the implementation of different control measures but, the disease is still of public health concern. The objective of the study was to assess the burden of asymptomatic and sub-microscopic Plasmodium infection, altitudinal influence on it, their effect on haematological parameters as well as identify the risk factors of infection.Methodology: A cross-sectional community-based survey involving 1319 children of both sexes aged 6 months to 14 years was conducted between July 2017 and May 2018. Asymptomatic malaria parasitaemia was confirmed by Giemsa-stained microscopy, sub-microscopic Plasmodium infection by 18S mRNA using nested PCR and full blood count analysis was done using an auto haematology analyser. Results: Malaria parasite, asymptomatic and sub-microscopic Plasmodium infection and anaemia were prevalent in 36.4%, 34.0%, 43.8% and 62.3% of the children, respectively. The risk of having sub-microscopic Plasmodium infection was highest in children 5‒9 (OR = 3.13, P < 0.001) and 10‒14 years of age (OR = 8.18, P < 0.001), non-insecticide treated net users (OR = 1.69, P < 0.04) and those anaemic (OR = 9.01, P < 0.001). Children with sub-microscopic infection had a significantly lower mean haemoglobin (9.86 ± 1.7 g/dL, P < 0.001), red blood cell counts (4.48 ± 1.1 x 1012/L, P < 0.001), haematocrit (31.92%, P < 0.001), mean corpuscular haemoglobin concentration (313.25 ± 47.36, P = 0.035) and platelet counts (280.83 ± 112.62, P < 0.001) than their negative counterparts. Children <5 years old (73.8%), having asymptomatic (69.8%) and sub-microscopic Plasmodium infection (78.3%) as well as resident in the middle belt (72.7%) had a higher prevalence of anaemia than their peers. Conclusion: The significant heterogeneity in the burden of asymptomatic and sub-microscopic Plasmodium infection in addition to its corollary on haematological variables among children in the different attitudinal sites of the Mount Cameroon Region accentuate the need for strategic context specific planning of malaria control and preventative measures.
Laboratory and Field Performance of Five Cheap Commercial Light Traps for Capturing Mosquitoes In China
Authors: Huang Run , Song Hongyun , Fang Qian , Qian Junping , Zhang Yaodan , Jiang Hong
Published: March 2021

BackgroundMosquito light traps for household use are popular because they are small, cheap, user friendly, and environmentally friendly. At present, there are many variations and specifications of mosquito traps intended for household use on the market. Their labels claim they are powerful, but research and evaluation of their claims is lacking.MethodsThis article tested the key parameters, the laboratory capture rates, and the field capture rate of 5 popular mosquito traps intended for household use. ResultsThe study found that in the laboratory experiment, the capture rate of the mosquito traps selected was between 34.7%-65.0%. The analysis showed that the fan speed, and design of the air guide of the traps are important factors that affect the mosquito catch rate. Field tests in the greenhouse found that the 5 mosquito traps had high catch rates for Culex quinquefasciatus. The average percentage of Cx. quinquefasciatus, Aedes albopictus, Anopheles sinensis, and other flying insects captured every night was 51.76%, 25.29%, 14.12%, and 8.82%, respectively. There was no significant difference in the capture rate of Ae. Albopictus and An. sinensis by the 5 mosquito traps in the greenhouse, but a significant difference in the catch rate of Cx. Quinquefasciatu. ConclusionsThe ultraviolet wavelength (395-400nm) involved in the selected mosquito traps is not the main reason that affects the mosquito catching effect, but the fan speed and the air guide may be the reason for the difference in the catching effect among the five mosquito traps. Therefore, the mosquito traps intended for household use can be improved by adjusting the fan speed and optimizing the air guide.
Impact of DNA Double-Strand Breaks on Pancreaticobiliary Maljunction Carcinogenesis
Authors: Kuraishi Yasuhiro , Uehara Takeshi , Muraki Takashi , Iwaya Mai , Kinugawa Yasuhiro , Nakajima Tomoyuki , Watanabe Takayuki , Umemura Takeji
Published: March 2021

Background: Pancreaticobiliary maljunction (PBM) is a condition characterized by chronic inflammation due to refluxed pancreatic juice into the biliary tract that is associated with an elevated risk of biliary tract cancer. DNA double-strand breaks (DSBs) are considered the most serious form of DNA damage. DSBs are provoked by inflammatory cell damage and are recognized as an important oncogenic event in several cancers. This study used γ-H2AX, an established marker of DSB formation, to evaluate the impact of DNA damage on carcinogenesis in PBM. Methods: We investigated γ-H2AX expression immunohistochemically in gallbladder epithelium samples obtained from 71 PBM cases and 19 control cases. Results: Fourteen PBM cases with gallbladder adenocarcinoma were evaluated at non-neoplastic regions. A wide range of nuclear γ-H2AX staining was detected in all PBM and control specimens. γ-H2AX expression was significantly higher in PBM cases versus controls (median γ-H2AX-positive proportion: 14.4% vs. 4.4%, p = 0.001). Among the PBM cases, γ-H2AX expression was significantly higher in patients with carcinoma than in those without (median γ-H2AX-positive proportion: 21.4% vs. 11.0%, p = 0.031). Conclusion: DSBs occurred significantly more abundantly in the PBM gallbladder mucosa, especially in the context of cancer, indicating an involvement in PBM-related carcinogenesis.
Hyperuricemia May Affect the Healing of Anastomosis in Dixon Surgery for Rectal Cancer: A Retrospective Study
Authors: Zheng Xue-Cong , Su Jin-Bo
Published: March 2021

Background：The impact of Hyperuricemia (HUA) on Dixon surgery is rarely reported. Anastomotic leakage (AL) is the main serious complication in Dixon surgery. We discussed the relationship between HUA and AL. Our aim was to identify these factors to provide intervention measures for clinical practice.Methods：The clinical data of 1147 patients who underwent Dixon operation for rectal cancer in the Second Affiliated Hospital of Fujian Medical University from January 2009 to December 2018 were retrospectively analyzed. Rank sum test was used for measurement data, and χ2 test was used for counting data. In univariate analysis, significant variables (P < 0.05) were used for multivariate analysis, and multivariable logistic regression was used to examine their independent roles. All tests were 2-sided, P<0.05 was considered statistically significant.Results：A total of 1147 patients with rectal cancer undergoing Dixon operation were included in the study, including 153 patients with HUA and 994 patients with normal uric acid (UA). The AL was 148 cases (14.9%) in UA group and 37 cases (24.2%) in HUA group. There was significant difference in AL (P = 0.006). The influence of HUA (P = 0.006), Tumor distance from the anal margin (TD) (P = 0.024) and preoperative chemoradiotherapy (PCT) (P = 0.040) on AL were significantly different. Logistic analysis showed that HUA (P = 0.021) and TD (P = 0.014) had significant effects on AL. In rectal cancer group with HUA, there were significant differences in the effects of male (P = 0.035), body mass index (BMI) (P = 0.017) and PCT (P = 0.013) on AL. Logistic analysis showed that there were significant differences between male (P = 0.001) and PCT (P = 0.004) on AL.Conclusions：HUA is an independent risk factor of AL in Dixon operation for rectal cancer. In patients with HUA undergoing Dixon operation, gender, BMI and PCT have significant difference on AL. Male and PCT are independent risk factors of AL.
The impact of medical student research as a discussion topic during the residency interview process
Authors: Daus Kelly , McEchron Matthew
Published: March 2021

Background

Students with a greater number of research experiences are more successful in the National Residency Match Program (NRMP.) As a result, approximately two-thirds of allopathic medical schools have implemented a scholarly research project (SP) as a part of their curriculum. While inclusion of a SP in the medical school curriculum increases research productivity, literature to date has not investigated its ability to provide students with a means to communicate their scholarly strengths to residency programs during interview discussions.
Methods

123 students from the graduating class of 2019 and 2020 at the University of Arizona College of Medicine Phoenix (UACOMP) completed a 17-question survey examining the student’s SP and whether they completed additional research.
Survey participants were asked to
quantify how many residency interviewers asked about their SP or
additional research during the interview process.
Results

27% of interviewers (SD 27.0) asked students about their SP and 41% of interviewers (SD 32.0) asked students about additional non-SP research. 40% of interviewers asked about research overall to include SP and/or non-SP research. A greater percentage of interviewers (50%, SD 26.2) asked students about their SP if they had undertaken additional research compared to interviewers of students who did not undertake additional research (29%, SD 28.4, p = 0.0237). A greater percentage of interviewers at academic institutions (31%, SD 27.9) asked students about their SP, compared with a smaller percentage of interviewers at predominantly non-academic programs (22%, SD 25.5, p = 0.0054). There were no significant differences in the proportion of interviewers asking about the SP based on the type of specialty, competitiveness of specialty, topic relatedness of project, and publication/presentation status of project.
Conclusion

Student research experiences may serve as a meaningful discussion topic during the residency interview. Approximately one-third of interviewers ask about the SP regardless of specialty, research topic, and publication/presentation status of the project. Students with additional research experiences beyond their SP may experience a higher percentage of interviewers asking about their SP. Also, students applying to predominantly academic programs may experience a higher proportion of interview questions about research compared to peers interviewing at non-academic programs.
Early combined rehabilitation intervention to improve the prognosis of premature infants
Authors: Liu Yang , Li Zheng-feng , Zhong Yun-huan , Zhao Zhi-hui , Deng Wen-xin , Chen Ling-ling , Liu Bei-bei , Du Tao-jun , Zhang Yong
Published: March 2021

Background: To explore the clinical effect of early combined rehabilitation intervention on premature infants in the neonatal intensive care unit (NICU) Methods: Premature infants with gestational ages less than 32 weeks or birth weights less than 1500 g were included in the present study.The participants were divided into the intervention group and control group. All infants received the current routine treatment based on the clinical guidelines, and the intervention group was additionally treated by visual and auditory stimulation, oral motor function, respiratory function and neurodevelopmental training. The following clinical outcomes were compared: durations of oxygen supplementation and indwelling gastric tube use; incidences of retinopathy of prematurity (ROP) and neonatal necrotizing enterocolitis (NEC); Sliverman scores; incidences of bronchopulmonary dysplasia (BPD) and intraventricular haemorrhage; days of hospitalization; and neurodevelopmental outcomes. Datas were analysed using the following statistical tests: the chi-square test, the independent samples or paired t test, repeated measures ANOVA, and the Wilcoxon rank sum test.Results: Compared with those in the control group, premature infants in the intervention group had shorter durations of oxygen supplementation and indwelling gastric tube use, fewer hospitalization days and lower incidences of ROP, BPD, and NEC.The intervention group had lower Sliverman scores and higher Ballard neuromuscular scores than the control group.Conclusion Early combined rehabilitation intervention can improve the short-term clinical outcomes of premature infants.
Changes in ocular astigmatism after superotemporal versus temporal clear corneal incision cataract surgery
Authors: Fan Qi , Qian Dongjin , Zhao Zhennan , Jiang Yongxiang , Lu Yi
Published: March 2021

Background

The incision site to choose to manage postoperative astigmatism during cataract surgery is still debated. This study investigated corneal and internal astigmatism changes after superotemporal versus temporal clear corneal incision cataract surgery.
Methods

Patients included were diagnosed between December 2019 and January 2020 with age-related cataract with corneal astigmatism < 1.5 diopters (D) and were divided into two groups: Right Eye Group (R Group, superotemporal incision) and Left Eye Group (L Group, temporal incision). Uncorrected visual acuity, manifest refraction, corneal topography, anterior segment optical coherence tomography were performed pre- and 6 months postoperatively. Total ocular astigmatism, corneal astigmatism, surgically induced corneal astigmatism (SICA), non-corneal ocular residual astigmatism (N-CORA), postoperative intraocular lens (IOL) decentration, and tilt were analysed.
Results

Thirty-eight subjects were included: 21, R Group; 17, L Group. After surgery, the N-CORA decreased significantly from 1.17 ± 0.72D to 0.73 ± 0.47D in all patients (P = 0.001), 1.03 ± 0.52D to 0.70 ± 0.40D in the R Group (P = 0.005), and 1.35 ± 0.90D to 0.78 ± 0.55D in the L Group (P = 0.033). Significant differences between the R and L groups were found in the postoperative meridian of anterior corneal astigmatism (75.95 ± 52.50 vs 116.79 ± 47.29; P = 0.017), total corneal astigmatism (51.65 ± 42.75 vs 95.20 ± 57.32; P = 0.011), J45 change vector of SICA in the anterior cornea (-0.10 ± 0.18 vs 0.00 ± 0.11; P = 0.048), and total cornea surface (-0.14 ± 0.17 vs 0.03 ± 0.12; P = 0.001). IOL decentration, tilt, and the meridian of IOL tilt were not significantly correlated with N-CORA.
Conclusions

The N-CORA significantly decreased after cataract surgery. Superotemporal and temporal incisions can cause differences in the meridian components of oblique astigmatism but will not have a significant effect on the magnitude of corneal astigmatism.
Prominent role of sulfate reduction in robust sulfur retention in subtropical soil
Authors: Yu Qian , Mulder Jan , Si Gaoyue , Yu Longfei , Kang Ronghua , Liu Kaiyi , Hao Jiming , Duan Lei
Published: March 2021

Sulfur budgets in catchments indicated that about 80% of the deposited sulfur was retained in the subtropical soil, it alleviates the historical acidification caused by elevated deposition. The strong sulfur retention was attributed to the reversible sulfate adsorption in previous studies. Here we report that sulfate reduction is a prominent yet thus far overlooked mechanism for sulfur retention, based upon the comprehensive evidence of soil sulfur storage and multi-isotope within entire soil profile along a hydrological continuum in a typical subtropical catchment of China. Using a dual isotopic mass balance model, we determined that annual flux of reduction accounted for approximately 38% of sulfur retention, which was close to the proportion of reduced species in soil. Consequently, the release of sulfur legacy would be less serious with the decreasing sulfur deposition in China, compared to the projections only considering adsorption.
Harnessing Interpretable and Unsupervised Machine Learning to Address Big Data from Modern X-ray Diffraction
Authors: Kim Eun-Ah , Venderley Jordan , Matty Michael , Mallayya Krishnanand , Krogstad Matthew , Ruff Jacob , Pleiss Geoff , Kishore Varsha , Mandrus David , Phelan Daniel , Poudel Lekh , Wilson Andrew , Weinberger Kilian , Upreti Puspa , Norman Michael , Rosenkranz Stephan , Osborn Raymond
Published: March 2021

The information content of crystalline materials becomes astronomical when collective electronic behavior and their fluctuations are taken into account. In the past decade, improvements in source brightness and detector technology at modern x-ray facilities have allowed a dramatically increased fraction of this information to be captured. Now, the primary challenge is to understand and discover scientific principles from big data sets when a comprehensive analysis is beyond human reach. We report the development of a novel unsupervised machine learning approach, XRD Temperature Clustering (X-TEC), that can automatically extract charge density wave (CDW) order parameters and detect intra-unit cell (IUC) ordering and its fluctuations from a series of high-volume X-ray diffraction (XRD) measurements taken at multiple temperatures. We apply X-TEC to XRD data on a quasi-skutterudite family of materials, (CaxSr1-x)3Rh4Sn13, where a quantum critical point arising from charge order is observed as a function of Ca concentration. We further apply X-TEC to XRD data on the pyrochlore metal, Cd2Re2O7, to investigate its two much debated structural phase transitions and uncover the Goldstone mode accompanying them. We demonstrate how unprecedented atomic scale knowledge can be gained when human researchers connect the X-TEC results to physical principles. Specifically, we extract from the X-TEC-revealed selection rule that the Cd and Re displacements are approximately equal in amplitude, but out of phase. This discovery reveals a previously unknown involvement of 5d2 34 Re, supporting the idea of an electronic origin to the structural order. Our approach can radically transform XRD experiments by allowing in-operando data analysis and enabling researchers to refine experiments by discovering interesting regions of phase space on-the- y.
A Comparison of Laparoscopic Enucleation with Preoperative Selective Arterial Embolization (SAE) and Non-SAE for Renal Angiomyolipoma: A Meta-Analysis
Authors: Kang Jiaqi , Song Yuxuan , Wang Shangren , Tian Jia , Liu Li , Liu Xiaoqiang
Published: March 2021

Background: To compare the outcomes of laparoscopic enucleation with preoperative selective arterial embolization (SAE) and non-SAE for renal angiomyolipoma (RAML), we performed this systematic review and meta-analysis. Methods: We searched Web of Science, PubMed, EMBASE, the Cochrane Library, the Web of Science Core Collection, ClinicalTrials.gov, and China National Knowledge Infrastructure up to May 2019. Pooled relative ratio (RR) and standardized mean difference (SMD) with their 95% confidence intervals (CIs) were used to estimate the perioperative outcomes assessing the effectiveness and safety of laparoscopic enucleation with SAE and non-SAE.Results: A total of 4 studies were incorporated. The results showed that SAE group had a shorter operative time (SMD -2.15, 95% CI: -2.85 to -1.46, P < 0.001) , less blood loss (SMD -1.77, 95% CI: -2.06 to -1.47, P < 0.001), shorter warm ischemia time (SMD -2.57, 95% CI: -3.04 to -2.10, P < 0.001), and lower postoperative complication rate (RR 0.29, 95% CI: 0.08 to 0.98, P = 0.047), compared with the Non-SAE group. However, there was no significant difference in length of stay after operation (SMD -0.82, 95% CI: -3.26 to 1.63, P = 0.512), postoperative serum creatinine (SMD -0.59, 95% CI: -1.35 to 0.18, P =0.133), and GFR (SMD 0.59, 95% CI: -0.15 to 1.32, P =0.116) between the two groups. Sensitivity analysis showed that the results of our meta-analysis were robust, and deleting anyone study had no significant effect on the pooled results.Conclusions: Laparoscopic enucleation with preoperative SAE can shorten the operation time and warm ischemia time, decrease blood loss, preserve the renal function, and reduce the incidence of complications, which is a good option for the treatment of large RAMLs.
Iranian Primary Healthcare System's Response to Pandemic Covid- 19 Using Healthcare Incident Command System
Authors: Yari Arezoo , Yousefi-Khoshsabeghe Homa , Zarezadeh Yadolah , Amraei Majid , Boubakran Mohsen Soufi , Motlagh Mohamad Esmaeil
Published: March 2021

Background: The healthcare incident command system (HICS) is a potent disaster management tool in healthcare systems. The present study aimed to evaluate the effects of HICS on the district health networks (DHNs) covered by provincial Medical Universities (PMU) in terms of the management and commanding of the corona crisis in Iran. Methods: This cross-sectional research was performed in June 2020 in Iran. Data were collected using the HICS assessment tool by trained crisis management experts in the DHNs. In addition, we investigated the effects of the HICS use on the management and commanding of the corona crisis. Furthermore, the effects of the HICS use were evaluated on two groups of DHNs with active HICS and DHNs with inactive or no HICS. Results: The total mean score of the corona incident command and management was 78.79±11.90 (range: 20-100) in all the DHNs. The DHNs had the highest scores in the dimensions of organizational support and coordination and the lowest score in the dimension of support and planning. Significant differences were observed between the DHNs with active HICS and DHNs with inactive or no HICS in terms of the mean scores of incident management and command and its dimensions.Conclusions: According to the results, the HICS use had a positive impact on the improvement of incident management and command and all of its dimensions. Therefore, the HICS could be used in primary healthcare for the systematic and proper management of infectious disease crises and increasing their efficiency in response to these phenomena.
Dirac Redux - Dirac’s Equation in Physical Spacetime without Internal Degrees of Freedom
Authors: Andoni S.
Published: March 2021

The Dirac equation (DE) is one of the cornerstones of quantum physics. We prove in the present contribution that the notion of internal degrees of freedom of the electron represented by Dirac’s matrices1,2 is superfluous. One can write down a coordinate-free manifestly covariant vector equation by direct quantization of the 4-momentum vector with modulus m: Pψ=mψ (no slash!), the spinor ψ taking care of the different vector grades at the two sides of the equation. Electron spin and all the standard DE properties emerge from this equation. In coordinate representation, the four orthonormal time-space frame vectors Xµ appear instead of Dirac’s Yµ-matrices, the two sets obeying to the same Clifford algebra. The present formalism expands Hestenes’ spacetime algebra (STA) by adding a reflector vector x5 that is defining for the C (particle-antiparticle) symmetry and the CPT symmetry of DE, as well as for left- and right-handed rotors and spinors. In 3D it transforms a parity-odd vector x into a parity-even vector σ=x5x and vice versa. STA augmented by the reflector will be referred to as STAR, which operates on a real vector space of same dimension as the equivalent real dimension of Dirac’s complex 4×4 matrices. There are no matrices in STAR and the complex character springs from the signature and dimension of spacetime-reflection. This appears most clearly by first showing that STAR comprises two isomorphic subspaces, one for generators of polar vectors and boosts and the other for generators of axial vectors and rotors, including Pauli spin vectors. These then help to discuss the symmetries, probability current, transformation properties and nonrelativistic approximation of STAR DE. We prove here that the information from γ-matrices is contained in spacetime-reflection, which makes the matrices redundant. Therefore, it becomes relevant to reexamine those areas of quantum physics that take the γ-matrices and their generalizations as fundamental.
Weighted Gene Co-expression Network Analysis Identifies TBC1D10C as A New Prognostic Biomarker for Breast Cancer
Authors: Qiao Huiying , Lv Rong , Pang Yongkui , Yao Zhibing , Zhou Xi , Zhu Wei , zhou wenqing
Published: March 2021

Background: Immune checkpoint inhibitors are a promising therapeutic strategy for breast cancer (BRCA) patients. The tumor microenvironment (TME) can downregulate the immune response to cancer therapy. Our study aimed to find a TME-related biomarker to identify patients who might respond to immunotherapy. Method: We downloaded raw data from several databases including TCGA and MDACC to identify TME hub genes associated with overall survival (OS) and the progression-free interval (PFI) by WGCNA. Correlations between hub genes and either tumor-infiltrating immune cells or immune checkpoints were conducted by ssGSEA.Result: TME-related green and black modules were selected by WGCNA to further screen hub genes. Random forest, univariate and multivariate Cox regressions were applied to screen hub genes (MYO1G, TBC1D10C, SELPLG, and LRRC15) and construct a nomogram to predict survival of BRCA patients. The C-index for the nomogram was 0.713. A DCA of the predictive model revealed that the net benefit of nomogram was significantly higher than others and the calibration curve demonstrated a good performance by the nomogram. Only TBC1D10C was correlated with both OS and the PFI (both p-values<0.05). TBC1D10C also had a high positive association with tumor-infiltrating immune cells and common immune checkpoints (PD-1, CTLA-4, and TIGIT).Conclusion: We constructed a TME-related gene signature model to predict the survival probability of BRCA patients. We also identified a hub gene, TBC1D10C, which was correlated with both OS and the PFI and had a high positive association with tumor-infiltrating immune cells and common immune checkpoints. TBC1D10C may be a new biomarker to select patients who may benefit from immunotherapy.
Smart Traffic Management and Control system Based on IoT
Authors: Abuga Dominic , Raghava Nallanthighal
Published: March 2021

Over the last two decades, there has been an exponential increase in population in many cities globally, posing a challenge in managing and controlling traffic. According to the National Transport and Safety Authority of Kenya, in the year 2020, 134,000 crashes led to 3600 fatalities. During peak hours of traffic, Kenya's average city resident wastes two litres of fuel in traffic daily. Traffic jams result in wastage of time with an average motorist using almost an hour daily. They cause fuel wastage and environmental pollution as a result of the emission of greenhouse gases that cause global warming. Pollution has a devastating effect on human beings, animals, and plants around us. IoT technology is best suited for tackling the problem of traffic management and control in the city. This paper will focus on the design and development of IoT based real-time monitoring framework for the city that also incorporates the use of remote sensing technology. The proposed system has an advantage over other existing methods because it is easy to design, develop and implement; it will reduce the amount of time spent in traffic, will lower the consumption of fuel and the number of fatalities and accidents on the roads.
The Relationship Between ABO Blood Groups and Retinal Venous Occlusion
Authors: Kaya Pinar , Uzel Mehmet Murat , Kayıkçıoğlu Ömer Can , Güler Cenap
Published: March 2021

Purpose The aim of this study is to investigate the relationship between retinal vein occlusions (RVO) and blood groups.Methods Detailed ophthalmological examinations, systemic diseases and blood groups of patients who applied to Balıkesir University Faculty of Medicine, Ophthalmology Outpatient Clinic between February 2019 and May 2020 with retinal vein occlusion were retrospectively analyzed. The blood groups of the patients were divided into 2 groups as O and non-O. The results were compared with a normal group matched in terms of age and gender. Regression analysis was performed to determine the relationship between blood group types and vein occlusions.Results A total of 116 people were included in the study. The mean age of 38 patients with vein occlusion was 61.8 ± 11.3, while the mean age of 78 patients without vein occlusion was 62.6 ± 11.1 (p=0.696). In the RVO patients group, 14 (36.8%) were female, 30 (78.9%) had non-O blood group, 20 (52.6%) had hypertension (HT), 19 (50%) had diabetes mellitus (DM). According to the results of simple logistic regression analysis, non-O blood group and HT have statistically significant effects on RVO formation (Simple Regression Analysis results: OR 2.47, 95% CI 1.00-6.09, p=0.049; OR 2.22, 95% CI 1.00-4.90, p=0.048 ; respectively). Non-O blood group and HT significance remained limited as a result of multiple regression analysis (OR 2.47,95% CI 0.97-6.06, p=0.057; OR 2.18, 95% CI 0.97-4.88, p=0.057, respectively).Conclusion Non-0 blood type can be considered as a risk factor for retinal vein occlusion.
Feasibility and Outcomes of Cytoreductive Surgery & HIPEC for Peritoneal Surface Malignancies in Low and Middle Income Countries: A Single centre Experience of 232 Cases
Authors: Deo Suryanarayana , Ray Mukurdipi , Bansal Babul , Bhoriwal Sandeep , Bhatnagar Sushma , Garg Rakesh , Gupta Nishkarsh , Sharma Atul , Kumar Lalit , Thulkar Sanjay , Dhamija Ekta , Mathur Sandeep , Das Prasenjit
Published: March 2021

Background: Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) has recently emerged as a viable management option for peritoneal surface malignancy (PSM). CRS and HIPEC is a complex, multidisciplinary and resource intensive surgical option with a steep learning curve and significant morbidity and mortality. Most of experience is limited to few dedicated high volume centres from developed countries. We present a single institutional experience of 155 cases of CRS and HIPEC performed at a tertiary care cancer centre in a low & middle-income country (LMIC).Methods: A multidisciplinary PSM program was initiated in 2015 at a high volume tertiary care cancer centre in north India catering largely to patients belonging to low and middle income groups. Perioperative protocols applicable to practice setting were developed and a prospective structured PSM data base was created for capturing the data. All patients undergoing CRS & HIPEC between January 2015 to December 2020 were identified and the data was analysed for clinical spectrum, surgical details, peri-operative morbidity and mortality.Results: A total of 232 cases of PSM underwent CRS and HIPEC during the study period. Epithelial ovarian carcinoma (56.5%) was the most common clinical entity treated, followed by pseudomyxoma peritonei (18.5%), colorectal carcinoma (13.4%) and malignant mesothelioma (5.6%). Optimal CRS could be achieved in 94.4% of patients. Cisplatin and mitomycin were the most common drugs used for HIPEC. A total of 28.0% of patients had morbidity including deep vein thrombosis, sub-acute intestinal obstruction, sepsis, burst abdomen, lymphocele, ureteric injury, acute renal failure, entero-cutaneous fistula. The overall treatment related mortality was 3.5%.Conclusions: Results of the current study indicate that it is feasible to establish a successful CRS and HIPEC program for PSM in LMIC facing resource constraints. The most common indication for CRS and HIPEC were carcinoma ovary followed by pseudomyxoma peritonei and colorectal carcinoma. Overall morbidity and mortality of the current series are comparable to global rates reported from high income countries. A protocol based multidisciplinary team approach, optimal patient selection and surgical expertise plays a crucial role for optimal outcomes.
Continuous effectiveness and safety after a hospital-wide switch to adalimumab biosimilar: an observational study in rheumatoid arthritis patients
Authors: Brouwer Rianne , Klooster Peter M. ten , Masselink Joost B. , Vonkeman Harald E.
Published: March 2021

Objectives

Only few observational studies have investigated the actual effectiveness of switching to biosimilars in daily clinical practice in unselected patients. The objective of this study was to examine the maintenance of effect and safety after a hospital-wide switch for economic reasons from adalimumab originator Humira® to biosimilar Amgevita® in real-world rheumatoid arthritis (RA) patients and patient satisfaction with the switch.
Methods

A single centre retrospective observational study of RA patients on the course of their disease activity (DAS28, ESR and CRP), health-related quality of life (SF-36) and functional disability (HAQ-DI) before and up to one year after the switch, supplemented with a cross-sectional survey on satisfaction and experienced side effects approximately 18 months after the switch. Treatment outcomes were analysed with linear mixed modelling and generalized estimation equations.
Results

On November 1st 2018, 239 rheumatology patients switched to the adalimumab biosimilar. Of 52 RA patients who met the inclusion criteria sufficient data were available. Disease activity levels, the proportion of patients in remission (DAS28 < 2.6), and SF-36 and HAQ-DI scores did not significantly change from before the switch. 38 of the 52 analysed patients returned the questionnaire. Overall, patients were satisfied with the switch. Three patients (7.9%) stopped the biosimilar due to side effects.
Conclusion

Switching to the adalimumab biosimilar did not result in increased disease activity or worse patient-reported outcomes over an observation period of 9 to 12 months. Also, there was no apparent evidence of increased side effects. Patients themselves were mostly satisfied with the switching experience.
Atypical benign partial epilepsy and a new variant of SLC35A3 gene plus 2p25.1 duplication. Phenotypic-Genotypic correlation?
Authors: Parano Enrico , Pavone Piero , Pappalardo Xena Giada , Caraballo Roberto , Praticò Andrea Domenico , Falsaperla Raffaele
Published: March 2021

Background Atypical Benign Partial Epilepsy (ABPE), recognized also as pseudo-Lennox syndrome, is an uncommon form of epilepsy characterized by generalized minor seizures such as atonic, absences, or myoclonic seizures, and electroencephalographic pattern of focal or multifocal sharp waves with activation of epileptiform discharges during sleep. ABPE is indicated as a variant of ESES (ILAE classification 2017). ESES is a clinical entity that is characterized by encephalopathy with cognitive/ behavioral regression and EEG pattern of electrical status epilepticus during slow sleep. Fine and gross motor, language and social/behavioral impairment are associated symptoms, which may have reversible or persistent course. ABPE has been ascribed to the group of the “epilepsy aphasia spectrum” disorders, which includes also Rolandic Epilepsy, Landau-Kleffner syndrome, and electrical status epilepticus during sleep/continuous spike-wave during sleep. We report a young boy with a previous mild motor and language delay, who at 2-year-old presented with recurrent atonic seizures and an EEG pattern consisting of continuous spike and waves during sleep. Methods Next Generation Sequencing and microarray technology were used to investigate the molecular background of the proband, and the findings were then analyzed and integrated with clinical data. Results The child has been followed up to 7 years of age showing a progressive, complete EEG resolution and a normalization of the previous motor and cognitive impairment in association to the levetiracetam treatment. Genetic diagnosis displayed a novel heterozygous mutation c.310G>A of the SLC35A3 gene and a partial duplication of the short arm of chromosome 2, which might have pathogenic correlation with the neurological signs presented by the child. Conclusions Data generated by a genomic approach disclose a more comprehensive view of the genotype-phenotype correlation analysis for the novel pathogenic variant and ABPE. The relationship between the phenotypic manifestations of the child and genetic data is discussed.
Higher risk for poor handwriting in Taiwanese children born late preterm
Authors: Hwang Yea-Shwu , Chen Chih-Cheng , Shih Hui-Ning , Tsai Wen-Hui
Published: March 2021

BackgroundLate preterm and early term births constitute a significant proportion of live births. However, handwriting skills of these two populations remain unclear. We aimed to investigate their risk for poor Chinese handwriting in grade two.MethodsA total of 185 second graders born late preterm (34+ 0-36+ 6 weeks gestation, n = 54), early term (37+ 0-38+ 6 weeks gestation, n = 56), and full term (39+ 0-41+ 6 weeks gestation, n = 75) without any intervention or diagnosis related to developmental delays were included. Their handwriting performance was rated by teachers using the Chinese Handwriting Evaluation Form (CHEF), which is a standardized handwriting scale including five handwriting dimensions (construction, accuracy, directionality, speed, and pencil grasp).ResultsAfter controlling for demographic risk factors, the late preterm born group had a greater risk of having worse performance in the full form (adjusted odds ratio < OR > = 3.93; p = .038) and construction dimension (adjusted OR = 4.77; p = .009) of the CHEF than peers born at full term; whereas the risks were comparable for the early and full term born groups.ConclusionsLate preterm but not early term born children were found to be at higher risk for poor Chinese handwriting in grade two. They particularly have difficulty with spatial construction including size, spacing, and alignment of Chinese characters and components that may influence handwriting legibility.
Randomised Clinical Trial to Evaluate Safety and Efficacy of Convalescent Plasma Use Among Hospitalized Patients with COVID-19 (PERUCONPLASMA): A Structured Summary af a Study Protocol for a Randomised Controlled Trial.
Authors: Soto Alonso , Krapp Fiorella , Vargas Alex , Cabrejos Lucía , Argumanis Enrique , García Patricia L , Altamirano Karina , Montes Martín , Chacón-Uscamaita Pamela R , García Patricia J.
Published: March 2021

Objectives The general objective of this study is to test the hypothesis that administration of convalescent plasma from donors with previous diagnosis of severe COVID-19 pneumonia is safe and associated with a decrease in all-cause in-hospital mortality among hospitalized patients with COVID-19 at 30 days in comparison with standard treatment alone. The secondary objectives are: 1) to assess the efficacy of convalescent plasma to reduce the length of hospitalization; 2) to assess the efficacy of convalescent plasma to reduce the length of ICU stay; and 3) to assess the efficacy of convalescent plasma on reducing the requirement of invasive mechanical ventilation or ICU stay. Trial design PERUCONPLASMA is a IIb phase open label, randomised, superiority clinical trial with 1:1 allocation taking place in real life routine clinical practice at public hospitals in Lima, Peru. Participants will be randomised to receive convalescent plasma along with local standard treatment or local standard treatment alone. After allocation all participants will be followed for a total of 30 days or until hospital discharge, whichever occurs first.