bluuebunny/crossref_metadata_2025 huggingface dataset:
The Dutch Microbiome Project defines factors that shape the healthy gut microbiome
Authors: Weersma Rinse , Gacesa Ranko , Kurilshikov Alexander , Vila Arnau Vich , Sinha Trishla , Klaassen Marjolein , Bolte Laura , Andreu-Sanchez Sergio , Chen Lianmin , Collij Valerie , Hu Shixian , Dekens Jackie , Lenters Virissa , Björk Johannes , Swarte J. Casper , Swertz Morris , Jansen B. H. , Gelderloos-Arends Jody , Hofker Marten , Vermeuelen Roel , Sanna Serena , Harmsen Hermie , Wijmenga Cisca , Fu Jingyuan , Zhernakova Alexandra
Published: December 2020

The gut microbiome is associated with diverse diseases, but the universal signature of an (un)healthy microbiome remains elusive and there is a need to understand how genetics, exposome, lifestyle and diet shape the microbiome in health and disease. To fill this gap, we profiled bacterial composition, function, antibiotic resistance and virulence factors in the gut microbiomes of 8,208 Dutch individuals from a three-generational cohort comprising 2,756 families. We then correlated this to 241 host and environmental factors, including physical and mental health, medication use, diet, socioeconomic factors and childhood and current exposome. We identify that the microbiome is primarily shaped by environment and cohousing. Only ~13% of taxa are heritable, which are enriched with highly prevalent and health-associated bacteria. By identifying 2,856 associations between microbiome and health, we find that seemingly unrelated diseases share a common signature that is independent of comorbidities. Furthermore, we identify 7,519 associations between microbiome features and diet, socioeconomics and early life and current exposome, of which numerous early-life and current factors are particularly linked to the microbiome. Overall, this study provides a comprehensive overview of gut microbiome and the underlying impact of heritability and exposures that will facilitate future development of microbiome-targeted therapies.
A randomised controlled trial to examine the effects of cinacalcet on bone, cardiovascular parameters and mortality in haemodialysis patients with secondary hyperparathyroidism
Authors: Eddington Helen , Chinnadurai Rajkumar , Alderson Helen , Ibrahim Sara , Chrysochou Constantina , Green Darren , Erekosima Ibi , Hutchison Alastair , Bubtana Abdalla , Hegarty Janet , Kalra Philip
Published: December 2020

Background Secondary hyperparathyroidism may lead to increased cardiovascular risk. The use of cinacalcet may improve bone and cardiovascular health with improved parathormone (PTH) and phosphate control. Methods This is an open-label prospective randomised controlled trial to compare progression of cardiovascular and chronic kidney disease mineral and bone disorder (CKD-MBD) parameters. Patients were randomised to receive cinacalcet alongside standard therapy or standard therapy alone. 36 haemodialysis patients who had >90 days on dialysis, iPTH >300pg/mL, calcium >2.1mmol/L and age 18-75 years were included. Following randomization, all 36 patients underwent an intensive 12-week period of bone disease management aiming for iPTH 150-300pg/mL. The primary outcome was change in vascular calcification using CT agatston score. Secondary outcomes included pulse wave velocity (PWV), left ventricular mass index (LVMI), carotid intima-media thickness (CIMT), augmentation index (Aix) and bone measurements. The above measurements were obtained at baseline and 12 months. The difference in mortality between the groups was compared during long-term follow-up. Results There was no evidence of a group difference in the progression of calcification (median change (IQR) cinacalcet: 488 (0 to1539); standard therapy: 563 (50 to 1214)). In a post hoc analysis combining groups there was a mean (SD) phosphate reduction of 0.3mmol/L (0.7) and median (IQR) iPTH reduction of 380pg/mL (-754, 120). Regression of LVMI and CIMT was seen (P=0.03 and P=0.001) and was significantly associated with change of phosphate on multi-factorial analyses. Over a median follow-up of 32 months, there was no significant difference in the mortality between the two groups.Conclusions No significant benefit in bone and cardiovascular markers was seen with the addition of cinacalcet to standard therapy over one year. Tight control of hyperphosphataemia and secondary hyperparathyroidism may lead to a reduction in LVMI and CIMT but this needs further investigation. Although the sample size was small, meticulous trial supervision resulted in very few protocol deviations with therapy.
Fatty acids in rumen and meat of lambs fed with different condensed and hydrolysable tannin extracts
Authors: Valenti Bernardo , Campidonico Luca , Natalello Antonio , Lanza Massimiliano , Salami Saheed , Priolo Alessandro , Serra Andrea , Pauselli Mariano , Luciano Giuseppe
Published: December 2020

Five groups of lambs (n = 9 each) were used to test the effect of plant extracts rich in hydrolysable (HT) or condensed tannin (CT) on animal performance, fatty acid composition of rumen content and meat. The control group (CO) received a concentrate-based diet without tannins supplementation. The other groups received the same diet as the control lambs plus 4% chestnut (CH) and tara (TA) extracts as a source of HT and mimosa (MI) and gambier (GA) extracts as a source of CT. Dietary CH negatively affected animal performance. The rumen content of the different groups showed comparable levels of 18:3 c9c12c15, 18:2 c9c12, 18:2 c9t11, 18:1 t11 and 18:0, whereas 18:1 t10 was greater in CO. Also, 18:1 t10 tended to be lower in the rumen of HT than CT-fed lambs. These data were partially confirmed in meat, where CO showed a greater percentage of individual trans 18:1 fatty acids in comparison with tannins-fed groups. Our findings challenge some accepted generalizations on the use of tannins in ruminant diets as they were ineffective to favour the accumulation of dietary PUFA or healthy fatty acids of biohydrogenation origin in the rumen content and lamb meat, but suggest a general action of tannins on the whole biohydrogenation process.
Occupational Burnout and Job Satisfaction Among Physicians in Times of COVID-19 Crisis: A Convergent Parallel Mixed-Method Study
Authors: Alrawashdeh Hamzeh Mohammad , Al-Tammemi Ala'a B. , Alzawahreh Mohammad Kh. , Al-Tamimi Ashraf , Elkholy Mohamed , Sarireh Fawaz Al , Abusamak Mohammad , Elehamer Nafisa Mhna , Malkawi Ahmad , Al-Dolat Wedad , Abu-Ismail Luai , Al-Far Ali , Ghoul Imene
Published: December 2020

Background Healthcare professionals including physicians were subjected to an increased workload during the COVID-19 crisis, leaving them exposed to significant physical and psychological distress. Therefore, our present study aimed to (i) assess the prevalence of burnout and level of job satisfaction among physicians in Jordan, and (ii) explore physicians’ opinions, experiences, and perceptions during the pandemic crisis.Methods This was a mixed-method study that utilized a structured web-based questionnaire and semi-structured individual interviews. The 10-Item Burnout Measure, Short version (BMS), and the 5-Item Short Index of Job Satisfaction (SIJS) were adopted to assess occupational burnout and job satisfaction, respectively. Semi-structured interviews were conducted, based on a conceptual framework that was developed from Herzberg's Two-Factor Theory of Motivation and Job Demands-Resources Model. Descriptive statistics and regression models as well as inductive thematic analysis were used to analyze quantitative and qualitative data, respectively.Results A total of 973 survey responses and 11 interviews were included in our analysis. The prevalence of burnout among physicians was (57.7%). Several significant factors were positively associated with burnout, including female gender, working at highly loaded hospitals, working for long hours, doing night shifts, lack of sufficient access to personal protective equipment, and being positively tested for SARS-CoV-2. Regarding job satisfaction, regression analysis revealed that age was positively associated with higher levels of job satisfaction. On contrary, being a general practitioner or specialist, working at highly loaded hospitals, low salaries, and suffering from burnout have predicted lower levels of job satisfaction.Besides, four themes have emerged from the thematic analysis: (i)Work-induced psychological distress during the pandemic, (ii)Decision-driven satisfactory and dissatisfactory experiences, (iii)Impact of the pandemic on doctor-patient communication and professional skills, and (iv)Economic impacts of the pandemic crisis and lockdown.Conclusion A significant physical and psychological burden was associated with the COVID-19 pandemic. Reliable efforts should be implemented aiming at protecting physicians’ physical and mental wellbeing, enhancing their working conditions, and raising awareness about burnout. Evidence-based decisions and proper utilization of financial and human resources at institutional and national levels are believed to be crucial for the sustainability of the health workforce, especially in crises.
New Systematic Solution for Nonlinear Dynamic Systematic Problems in Modern Science
Authors: Cha Deok soo , Jun Hee jong
Published: December 2020

The reason why modern science is stagnated the development of physical science is unable to solve nonlinear systematic problem; moreover, the physical science’s development reached to saturation. However, modern science has no perfect systematical solution for the nonlinear dynamic systematic problem. This study presents a new solution, which has completed by coordination with physics and engineering such as an interdisciplinary study. Therefore, physicist can be solved the nonlinear dynamics using both solution logical solution and systematic solution but it has no problem. Although, physicists cannot deny the validity of new solution itself but they cannot understand the other science such as control theory; hence, they do not welcome it and reject it. However, there is no problem because all scientists wait for a time until physicists master the control theory if physicists agree with its condition, the new solution discloses first and verify after. It will be contributed and development of physics.
Reduced burden from major diseases due to an increase in vegetable intake in Japan: projections of disability-adjusted life years, 2017-2040
Authors: Tanaka Shiori , Yoneoka Daisuke , Ishizuka Aya , Ueda Peter , Nakamura Keiji , Uneyama Hisayuki , Hayashi Naoki , Shibuya Kenji , Nomura Shuhei
Published: December 2020

Background: Low vegetable intake is one of the key dietary risk factors known to be associated with a range of health problems, including cardiovascular diseases (CVDs), cancer, and diabetes and kidney diseases (DKDs). Using data from Japan's National Health and Nutrition Surveys and the Global Burden of Diseases study in 2017, this study aimed to forecast the impact of change in vegetable intake on disability-adjusted life years (DALYs) between 2017 and 2040 for three diseases. Methods: We generated a three-component model of cause-specific DALYs, including changes in major behavioural and metabolic risk predictors, the socio-demographic index and an autoregressive integrated moving average model to project future DALY rates for 2017-2040 using the data between 1990 and 2016. Data on Vegetable consumption and risk predictors, and DALY rate were obtained from Japan’s National Health and Nutrition Surveys and the Global Burden of Diseases Study in 2017. We also modelled three scenarios of better, moderate and worse cases to evaluate the impact of change in vegetable consumption on the DALY rates for three diseases (CVDs, cancer, and DKDs). Results: Projected mean vegetable intake in the total population showed a decreasing trend through 2040 to 237.7g/day. A significant difference between the reference scenario and the better case scenario was observed with un-overlapped 95% prediction intervals of DALY rates in females aged 20-49 years (-8.0%) for CVDs, the total population for cancer (-5.6%), and in males (-8.2%) and females (-13.7%) for DKDs. Conclusions: Our analysis indicates that increased vegetable consumption would have a significant reduction in the burdens of CVDs, cancer and DKDs in Japan. By estimating the disease burden attributable to low vegetable intake under different scenarios of future vegetable consumption, our study can inform the design of targeted interventions for public health challenges.
H2-CO2 polymer electrolyte fuel cell that generates power while evolving CH4 at the Pt0.8Ru0.2/C cathode
Authors: Matsuda Shofu , Niitsuma Yuuki , Yoshida Yuta , Umeda Minoru
Published: December 2020

Generating electric power using CO2 as a reactant is challenging because the electroreduction of CO2 usually requires a large overpotential. Herein, we report the design and development of a polymer electrolyte fuel cell driven by feeding H2 and CO2 to the anode (Pt/C) and cathode (Pt0.8Ru0.2/C), respectively, based on their theoretical electrode potentials. Pt-Ru/C is a promising electrocatalysts for CO2 reduction at a low overpotential; consequently, CH4 is continuously produced through CO2 reduction with an enhanced faradaic efficiency (18.2%) and without an overpotential (at 0.20 V vs. RHE) was achieved when dilute CO2 is fed at a cell temperature of 40 °C. Significantly, the cell generated electric power (0.14 mW·cm− 2) while simultaneously yielding CH4 at 86.3 µmol·g− 1·min− 1. These results show that a H2-CO2 fuel cell is a promising technology for promoting the carbon capture and utilization (CCU) strategy.
Development of a Pre-hospital Emergencies Protocol for the Management of Suicidal Patients in Iran
Authors: shirzad Fatemeh , Gholamzad Shakiba , Shafiee Maisam , Shariat Seyed Vahid
Published: December 2020

Background: Suicide is a painful consequence of many psychiatric disorders and one of the most frequent psychiatric emergencies. Generally, pre-hospital technician is the first person in treatment chain who attends the situation; hence, his/her sound clinical judgment and professional behavior can play an important role in preventing or stopping the suicide process. We tried to develop a concise, evidence-based, and step-by-step guide for dealing with a suicidal patient, which could be quickly reviewed by technicians before confronting a suicide situation. Method: We reviewed the literature for suicide management plans and protocols, to extract the evidence-based interventions and instructions for dealing with a suicide situation. Then, we discussed the extracted material in an expert panel, and developed the initial version of the protocol considering the local socio-cultural issues and available facilities. Subsequently, we reviewed the protocol in a meeting with pre-hospital technicians and emergency physicians, to receive their feedback and address any possible executive problems. Finally, we revised the protocol to its final version considering the feedbacks. Results: The basic principles of dealing with a suicidal patient are similar to other psychiatric emergencies and include: Patient Safety; Patient evaluation and diagnosis; and Patient (behavioral and pharmacological) management. However, specific considerations should be taken into account and special arrangements are necessary for suicidal patients. Whether the patient has attempted suicide or not, would guide the management to one of the two major paths. In addition, the needs of the family should be considered. Conclusion: A locally adapted protocol considering existing facilities in the emergency system and cultural issues in Iranian society is provided for pre-hospital emergency technicians.
Discovery of Potent Sialic Acid Inhibitors Against the Hemagglutinin of Influenza A Virus
Authors: Chang Yu-Jen , Yeh Cheng-Yun , Cheng Ju-Chien , Huang Yu-Qi , Hsu Kai-Cheng , Lin Yu-Feng , Lu Chih-Hao
Published: December 2020

Influenza A virus (IAV) is hard to eradicate due to its genetic drift and reassortment ability. Neuraminidase (NA), frequently the target protein, cleaves the sialic acid (SA) and discharges virions to complete the infectious cycle. However, the increasing use of NA inhibitors aroused drug resistance in recent years. Hemagglutinin (HA), on the opposite, initiates the infectious cycle and sticks virions to cells by connecting to the host SA so that HA might be a tempting target. In this study, HA was chosen for SA-binding site model preparation to screen more than 200,000 compounds by molecular docking method in silico. According to the post-screening analysis by iGemdock and SiMMap, nine of the top twenty compounds based on the ranking score were purchased and evaluated. NSC85561 was initially identified from the compounds through the bioassays. Next, the twelve derivatives of NSC85561 were selected to consolidate the primary results. NSC85561 and two of its derivatives were finally identified as potent HA inhibitors by cell proliferation, plaque reduction, and hemagglutination inhibition assays in vitro. These results suggested that virtual screening may be a powerful tool to concise the compounds from the massive database and reduce the complicated bioassays.
Cardiometabolic Risks of SARS-CoV-2 Hospitalization Using Mendelian Randomization
Authors: Lorincz-Comi Noah , Zhu Xiaofeng
Published: December 2020

IntroMany cardiometabolic conditions have demonstrated associative evidence with COVID-19 hospitalization risk. However, the observational designs of the studies in which these associations are observed preclude causal inferences of hospitalization risk. Mendelian Randomization (MR) is an alternative risk estimation method more robust to these limitations that allows for causal inferences.Methods & materialsWe applied four MR methods (MRMix, IMRP, IVW, MREgger) to publicly available GWAS summary statistics from European (COVID-19 GWAS n=2,956) and multi-ethnic populations (COVID-19 GWAS n=10,808) to better understand extant causal associations between Type II Diabetes (GWAS n=659,316), BMI (n=681,275), diastolic and systolic blood pressure, and pulse pressure (n=757,601 for each) and COVID-19 hospitalization risk across populations. ResultsAlthough no significant causal effect evidence was observed, our data suggested a trend of increasing hospitalization risk for Type II diabetes (IMRP OR, 95% CI: 1.67, 0.96-2.92) and pulse pressure (OR, 95% CI: 1.27, 0.97-1.66) in the multi-ethnic sample. ConclusionsType II diabetes and Pulse pressure demonstrates a potential causal association with COVID-19 hospitalization risk, the proper treatment of which may work to reduce the risk of a severe COVID-19 illness requiring hospitalization. However, GWAS of COVID-19 with large sample size is warranted to confirm the causality.
Differences in Lipoprotein Profiles Between Palestinian and Israeli Adults
Authors: Halloun Rana , Ighbariya Ahmad , Hanna Suhair , Sinnreich Ronit , Weiss Ram
Published: December 2020

Background: Palestinians exhibit a substantially greater prevalence of type 2 diabetes mellitus, cardiovascular disease (CVD) incidence and CVD mortality in comparison to Israelis. In view of Palestinians' increased insulin resistance, known to be associated with an adverse lipoprotein profile, we aimed at showing lipoprotein variations between Palestinian and Israelis residing in Jerusalem. Methods: The study included, 968 Palestinians and 707 Israelis, ages 25-74 years, who underwent fasting and 2h post oral challenge plasma glucose determinations. We evaluated metabolic risk by measuring sub-populations of VLDL, LDL and HDL particles, using nuclear magnetic resonance spectroscopic analysis. Results: Palestinians exhibit higher levels of very large VLDL including chylomicrons, in comparison to their Israeli counterparts, whereas levels of medium and small VLDL were similar between the two populations. Small oxidized LDL levels were higher among Palestinians while intermediate and large LDL were similar between the two groups. Levels of large HDL were higher among Israelis while levels of medium and small HDL were similar between the two populations. Small oxidized LDL levels were higher among Palestinians in comparison to Israeli participants. Levels of large HDL were higher among Israelis in comparison to Palestinians. Limiting the analysis to young participants with normal glucose tolerance, showed greater levels of large VLDL including chylomicrons, medium and small VLDL and oxidized LDL in Palestinians. Conclusions: Palestinians, including healthy young participants, exhibit an adverse pro-atherogenic lipid profile compared to Israelis. These findings may explain the increased CVD morbidity and mortality observed in Palestinians.
Long-Term Outcomes of Mitral Valve Replacement in Patients Weighing Less Than 10 Kg
Authors: Yuan Haoyong , Wu Zhongshi , Lu Ting , Tang Yilun , Chen Jinlan , Yang Yifeng , Huang Can
Published: December 2020

Background: The outcomes of mitral valve replacement (MVR) in pediatrics especially in the patients weighing less than 10kg are not always favorable. This study aimed to measure long-term outcomes of MVR in our institution.Methods: Nine young children weighing less than 10 kg underwent MVR with mechanical prostheses from November 2006 to April 2019 were enrolled in this retrospectively study. Kaplan–Meier survival analysis was used for the prediction of freedom from death and adverse events. Chi-square test was performed to compare outcomes for patients based on the ratio of mechanical prosthesis and weight. 14 related literatures were also reviewed to support our study.Results: All patients received bileaflet mechanical prostheses. The surgical technique varied among the patients with prostheses implanted in the intra-annular (n = 5), supra-annular (n=1), or with a Dacron conduit segment in the supra-annular position(n = 3). The valve size/weight ratio ranged from 2.11 to 5.00. After a mean follow-up period of 80.67 ± 63.37 months, the survival rate was 66.67%. One (11.1%) patient underwent an immediate revision MVR after initial MVR for the periprosthetic leak. No patients required surgical reintervention for the development of left ventricular outflow tract obstruction or permanent pacemaker placement during long-term follow-up.Conclusions: The tailored surgical strategy utilized for MVR in infants resulted in reliable valve function and excellent survival. Although revision is inevitable due to somatic growth, the bileaflet mechanical prostheses displayed appropriate durability.
Testing the Contextual Interaction Theory in a UHC Pilot District in South Africa
Authors: Michel Janet , Mohlakoana Nthabiseng , Bärnighausen Till , Tediosi Fabrizio , Evans David , McIntyre Di , Bressers Hans T.A , Tanner Marcel
Published: December 2020

Background: World-wide, there is growing universal health coverage (UHC) enthusiasm. The South African government began piloting policies aimed at achieving UHC in 2012. These UHC policies have been and are being rolled out in the ten selected pilot districts. Our study explored policy implementation experiences of 71 actors involved in UHC policy implementation, in one South African pilot district using the Contextual Interaction Theory (CIT) lens.Method: Our study applied a two-actor deductive theory of implementation, Contextual Interaction Theory (CIT) to analyse 71 key informant interviews from one National Health Insurance (NHI) pilot district in South Africa. The theory uses motivation, information, power, resources and the interaction of these to explain implementation experiences and outcomes. The research question centred on the utility of CIT tenets in explaining the observed implementation experiences of actors and outcomes particularly policy- practice gaps.Results: All CIT central tenets (information, motivation, power, resources and interactions) were alluded to by actors in their policy implementation experiences, a lack or presence of these tenets were explained as either a facilitator or barrier to policy implementation. This theory was found as very useful in explaining policy implementation experiences of both policy makers and facilitators. Conclusion: A central tenet that was present in this context but not fully captured by CIT was leadership. Leadership interactions were revealed as critical for policy implementation, hence we propose the inclusion of leadership interactions to the current CIT central tenets, to become motivation, information, power, resources, leadership and interactions of all these.
Serum Syndecan-1 Reflects Organ Dysfunction in Critically Ill Patients
Authors: Suzuki Keiko , Okada Hideshi , Sumi Kazuyuki , Tomita Hiroyuki , Kobayashi Ryo , Ishihara Takuma , Kakino Yoshinori , Suzuki Kodai , Yoshiyama Naomasa , Yasuda Ryu , Kitagawa Yuichiro , Fukuta Tetsuya , Miyake Takahito , Okamoto Haruka , Doi Tomoaki , Yoshida Takahiro , Yoshida Shozo , Ogura Shinji , Suzuki Akio
Published: December 2020

Syndecan-1 (SDC-1) is found in the endothelial glycocalyx and shed into the blood during systemic inflammatory conditions. We examined organ dysfunction associated with changing serum SDC-1 levels in critically ill patients. A single-center, retrospective, observational study was conducted at Gifu University Hospital. Patients admitted to the intensive care unit from March 2019 to February 2020 were enrolled. To evaluate the effect of SDC-1 on laboratory parameters measured the day after SDC-1 measurement with consideration for repeated measures, linear mixed effects models were constructed with each parameter as an outcome variable. A total of 94 patients were enrolled, and 831 samples were obtained. Analysis using mixed effects models for repeated measures with adjustment for age and sex showed that serum SDC-1 levels measured the day before significantly affected several outcomes, including aspartate aminotransferase (AST), alanine transaminase (ALT), creatinine (CRE), blood urea nitrogen (BUN), antithrombin III, fibrin degradation products, and D-dimer. Moreover, serum SDC-1 levels from the day before significantly modified the effect between time and several outcomes, including AST, ALT, CRE, and BUN. Serum SDC-1 may be a useful biomarker for daily monitoring of critically ill patients with kidney, liver and coagulation system injuries.
Syntheses of Dinor-cis/iso-12-oxo-phytodienoic acid (dn-cis/iso-OPDAs), Ancestral Jasmonate Phytohormones of the Bryophyte Marchantia Polymorpha L., and their Catabolites
Authors: Ueda Minoru , Kato Nobuki , Wang Jianxin , Sakurai Haruka , Kaji Takuya
Published: December 2020

Dinor-cis-12-oxo-phytodienoic acid (dn-cis-OPDA, 4) and dn-iso-OPDA (5) are ancestral plant hormones of the bryophyte Marchantia polymorpha L. We succeeded in the first practical synthetic supply of these hormones as well as their possible catabolites.
Intramuscular Coherence of the Lower Flexor Muscles During Robotic Ankle-assisted Gait
Authors: Nakagawa Kei , Kadono Naoto , Mitsuhara Takafumi , Tanaka Eiichiro , Yuge Louis
Published: December 2020

Background: A close-fitting assisted walking device (RE-Gait) designed to assist ankle movements might be a novel approach for acquiring the forefoot rocker function in the gait cycle. The purpose of the present study was to investigate the effects of using RE-Gait by evaluating the intramuscular coherence (IMC) of the two parts of the tibialis anterior muscles (TA) in the initial, mid, and terminal swing phase, which could indicate whether the common synaptic drive of motor neurons was populated.Methods: Seventeen healthy volunteers walked on a treadmill at a comfortable speed before, during, and immediately after 15-minute RE-Gait intervention (pre / RG / post). RE-Gait supported plantar flexion at toe lift-off in the terminal stance phase and dorsiflexion in the initial swing phase. Electromyograms of the right lower leg and gait parameters were analyzed for each session.Results: After RE-Gait intervention, the step length was significantly increased. IMC of the two parts of the TA muscles in the beta frequency band in the initial swing phase was significantly enhanced during RE-Gait intervention compared with pre session. In addition, IMCs in the beta and low-gamma frequency bands were significantly correlated with the enhancement ratio of the step length.Conclusions: These results suggest that robotic ankle planter flexion and dorsiflexion assistance in the pre- and initial swing phase would be effective for learning adaptively modified walking by activating corticospinal tracts. RE-Gait will be a useful tool for re-learning of gait with smooth switching with appropriate forefoot rocker function.
Intra and Inter-observer Concordance of a New Classification System for Myopic Maculopathy
Authors: Zhang Rong-rong , Yu Yan , Hou Yin-fen , Wu Chang-fan
Published: December 2020

Background: Myopic maculopathy (MM) is one of the major causes of visual impairment and irreversible blindness in eyes with PM. However, the classification of each type of lesion associated with MM has not been determined. Recently, a new MM classification system was proposed, known as the ATN grading and classification system, which was based on the fundus photographs and OCT images, including three variable components: atrophy (A), traction (T), and neovascularization (N). Hence, this study aimed to perform an independent interobserver and intraobserver agreement evaluation of the recently developed ATN grading system for MM. Methods: This was a retrospective study. Fundus photographs and the optical coherence tomography (OCT) images of 125 patients (226 eyes) with various of MM were evaluated and classified using the ATN grading of the new MM classification system by four evaluators (2 attending ophthalmologists and 2 ophthalmic residents). All cases were repeatedly evaluated by the same evaluators after an interval of 6 weeks. The Kappa coefficient (κ) and 95% confidence interval (CI) were used to determine the interobserver and intraobserver agreement.Results: The interobserver reliability was substantial when considering the maculopathy type (A, T, and N). The weighted Fleiss κ values for each MM type (A, T, and N) were 0.651 (95% CI: 0.602–0.700), 0.734 (95% CI: 0.689–0.779), and 0.702 (95% CI: 0.649–0.755), respectively. The interobserver agreement when considering the sub-types was good or excellent, except for stages A1, A2, and N1 which weighted κ value was less than 0.6, with a moderate agreement. The intraobserver reproducibility of types or sub-types was excellent, with κ>0.8. No significant differences were observed between attending ophthalmologists and residents in the interobserver reliability and intraobserver reproducibility.Conclusions: The ATN classification allows an adequate agreement among ophthalmologists with different qualifications and by the same observer on separate occasions. Future prospective studies should further evaluate whether this classification can be better implemented at clinical decision-making and disease progression assessment.
Bioinformatics Analysis to Screen and Identify Key Biomarkers of Papillary Renal Cell Carcinoma
Authors: Xu Yingying , Zou Chunbo
Published: December 2020

Background: Papillary renal cell carcinoma (PRCC) is the second most common type of renal cell carcinoma after clear cell renal cell carcinoma(ccRCC). Its pathological classification is controversial and its molecular mechanism is poorly understood. Therefore, the identification of key genes and their biological pathways is of great significance to elucidate the molecular mechanisms of PRCC occurrence and progression. Methods: Downloaded PRCC-related datasets GSE7023, GSE48352 and GSE15641 from the Gene Expression Omnibus (GEO) database. Differential expression genes (DEG) were identified and gene ontology (GO) term enrichment analysis and Kyoto Encyclopedia of Genes and Genomics (KEGG) pathway analysis were performed. Cytoscape and STRING are used to construct the Protein-Protein Interaction Network (PPI) and module analysis to find hub genes and key pathways. Hierarchical clustering of hub genes was constructed using UCSC. Overall survival and relapse-free survival of Hub genes were analyzed using Kaplan-Meier plotter. UALCAN was applied to analyze genes expression in primary organizations, different stages ,different subtypes and races. Results: A total of 214 DEG genes were identified, including 205 down-regulated genes and 9 up-regulated genes. DEG is mainly concentrated in angiogenesis, kidney development, oxidation-reduction process, metabolic pathways, etc. 17 hub gene enrichment mainly in angiogenesis, cell adhesion, platelet degranulation, Leukocyte transendothelial migration biological processes, etc. 17 hub genes were screened out, which were mainly enriched in the biological processes of angiogenesis, cell adhesion, platelet degranulation, and leukocyte transendothelial migration. Survival analysis showed that EGF, KDR, CXCL12, REN, PECAM1, CDH5, THY1, WT1, PLAU and DCN may be related to the carcinogenesis, metastasis or recurrence of PRCC. Conclusions: DEG and hub genes identified in present study provide clues to the specific molecular mechanisms of PRCC occurrence and development, and may be potential molecular markers and therapeutic targets for accurate classification and efficient diagnosis and treatment of PRCC.
Impact and Cost-benefit Analysis: A Unifying Approach
Authors: Scandizzo Pasquale Lucio
Published: December 2020

This paper presents a methodology to integrate cost benefit analysis and SAM-CGE based impact evaluation. While the two types of analysis have developed in parallel and without a clear connection, there is growing consensus that the two approaches should be integrated for complex investment projects, since their economic evaluation cannot rely solely on the partial equilibrium assumptions of cost benefit (CB) analysis. Unlike CB analysis, impact evaluation looks at the economy as a complete system of interdependent components (industries, households, investors, government, importers, exporters). By integrating project accounting into a SAM-CGE framework, the methodology developed presents several properties that make it fit to the purpose of providing a reliable assessment of project contribution to the economy.JEL Codes: D57, D58, D62, E17, F35, O22
Nitric Oxide Could Allay Arsenic Phytotoxicity in Tomato (Solanum lycopersicum L.) by Modulating Photosynthetic Pigments, Phytochelatin Metabolism, Molecular Redox Status and Arsenic Sequestration
Authors: Ghorbani Abazar , Pishkar Leila , Roudbari Nasim , Pehlivan Necla , Wu Chu
Published: December 2020

Background: Plants do not always have the genetic capacity to tolerate high quantities of (As) which does not only arrest the plant growth, but commit potential health risks by dietary bioaccumulation. However, the interplay between the tomato plants and As-NO driven molecular cell dynamics are obscure. Hence, seedlings were treated with As (10 mg/L) alone or in combination with 100 µM sodium nitroprusside (SNP, NO donor) and 200 µM 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (cPTIO, NO scavenger).Results: SNP immobilized the As in the roots and reduced the shoot translocation by up-regulating the transcriptional expression of the PCS, GSH1, MT2 and ABC1. SNP further restored the growth retardation by modulating the chlorophyll and proline metabolism, increasing NO accumulation and stomatal conductance along with a clear crosstalk between the activity of antioxidants as well as glyoxalase I and II leading endogenous H2O2 and MG decrease.Conclusion: Higher PCs and glutathione accumulation helped to protect photosynthetic apparatus, however, cPTIO reversed the protective effects of SNP, authenticating the role of NO in the As toxicity alleviation.
Biofeedback Posture Training for Adolescents with Mild Scoliosis
Authors: Cheung Mei-chun , Yip Joanne , Lai Janelle S.K.
Published: December 2020

Asymmetry in paraspinal myoelectric activities is a prominent risk factor for curve progression in adolescent idiopathic scoliosis. This study aimed to evaluate the effectiveness of a surface electromyography (sEMG) biofeedback posture training program for adolescents with mild scoliosis (Cobb’s angle < 30°), with the ultimate goal of controlling the curve progression. Seven female adolescents (age, 12–14 years) with mild scoliosis (Cobb’s angle < 30°) were recruited. The participants received 30 tailor-made sessions of sEMG biofeedback posture training at a rate of one to two sessions per week for approximately 6 months. The activities of the paraspinal muscles (the trapezius, latissimi dorsi, thoracic erector spinae, and lumbar erector spinae), as measured by sEMG during habitual sitting postures, and spinal deformity, as evaluated by ultrasound imaging, were compared before and after training to evaluate its effectiveness. The mean values of the root-mean-square sEMG ratio, an index of symmetry in paraspinal muscle activity between the concave and convex of the spinal curve, revealed significant asymmetry over the trapezius and lumbar erector spinae before the training. After the training, all seven adolescents achieved significantly more symmetrical muscle activity over these two muscle pairs. In two adolescents, the spinal curvature decreased by more than 5°, whereas the remaining adolescents showed a minimal curve progression with changes in the spinal curvature controlled under 5°. sEMG biofeedback posture training is effective in adolescents with mild scoliosis, and can be implemented as an early intervention to improve their posture and mitigate curve progression.
The Effect of Turbulence Modelling on the Assessment of Platelet Activation
Authors: Bozzi Silvia , Dominissini Davide , Redaelli Alberto , Passoni Giuseppe
Published: December 2020

Pathological platelet activation induced by abnormal shear stresses is regarded as a main clinical complication in recipients of cardiovascular biomedical implantable devices and prostheses. In order to improve their performance computational fluid dynamics (CFD) has been used to evaluate flow fields and related shear stresses. More recently CFD models have been equipped with mathematical models that describe the relation between fluid dynamics variables, and in particular shear stresses, and the platelet activation state (PAS). These mathematical models typically use a Lagrangian approach to extract the shear stresses along possible platelet trajectories. However, in the case of turbulent flow, the choice of the proper turbulence closure model is still debated for both concerning its effect on Lagrangian statistics and shear stress calculation. In our study five numerical simulations of the flow through a mechanical heart valve were performed and then compared in terms of Eulerian and Lagrangian quantities: a direct numerical simulation (DNS), a large eddy simulation (LES), two Reynolds-averaged Navier-Stokes (RANS) simulations (SST k-ω and RSM) and a “Laminar” (no turbulence modelling on a Taylor microscale-based grid) simulation. Results exhibit a large variability in the PAS assessment depending on the turbulence model adopted. “Laminar” and RSM estimates of platelet activation are about 60% below DNS, while LES is 16% less. Surprisingly, PAS estimated from the SST k-ω velocity field is only 8% less than from DNS data. This appears more artificial than physical as can be inferred after comparing frequency distributions of PAS and of the different Lagrangian variables of the mechano-biological model of platelet activation. Our study indicates that turbulence closures can lead to a severe underestimation of platelet activation and suggests that turbulence should be fully resolved by DNS when assessing blood damage in blood contacting devices.
Entrepreneurial Networks, Entrepreneurial Orientation, and Performance of Small and Medium Enterprises: Are Dynamic Capabilities the Missing Link?
Authors: Abu-Rumman Ayman , Al-Shra'ah Ata E. M. , Al-Madi Faisal , Alfalah Tasneem
Published: December 2020

Performance of small and medium enterprises (SMEs) has been addressed widely in the literature. Developed and developing both the countries are highly concerned about the growth and performance of small and medium enterprises. The literature over the performance is abundant, however, has certain controversies. To identify the reasons behind those controversies, this study has been conducted. the aim of the study was to identify the mediating role of dynamic capabilities which are developed by the entrepreneurial networks and entrepreneurial orientation. The study collected the data from those small and medium enterprises which were connected through a closed network and were the part of groups. The data was collected with the help of adopted questionnaire. 100 small and medium enterprises were contacted for the collection of data. The sample firms were chosen on purposive sampling basis. Structural equation modelling was applied to identify the direct impacts and the mediating impact. The findings identified that among the chosen firms, entrepreneurial networking has an insignificant impact, however, entrepreneurial orientation has shown a significant positive impact. Furthermore, the mediating role of dynamic capabilities was significant in both the relationships. The findings suggested that the sector should develop strong networks and should consider strategic alliances to gain competitive edge. Future researchers are guided to implement the same framework along with the dimensions of the variable.
Quantitative Bone Single Photon Emission Computed Tomography Imaging for Uninfected Nonunion: Comparison of Hypertrophic Nonunion and Non-Hypertrophic Nonunion
Authors: Oe Keisuke , Zeng Feibi , Fukui Tomoaki , Nogami Munenobu , Murakami Takamichi , Matsumoto Tomoyuki , Kuroda Ryosuke , Niikura Takahiro
Published: December 2020

BackgroundRecently, a standardized uptake value (SUV) has been used to evaluate bone single photon emission computed tomography (SPECT). The aim of this study was to investigate quantitative SPECT imaging of uninfected nonunion to compare hypertrophic nonunion and non-hypertrophic nonunion using volume-based parameters.MethodsWe evaluated 23 patients with uninfected nonunion who underwent SPECT acquisition 3 h after an injection of 99mTc-hydroxymethylene diphosphonate or 99mTc-methylene diphosphonate from April 2014 to November 2019. We reconstructed the acquired data and performed voxel-based quantitative analysis using GI-BONE software. Quantitative parameters, maximum SUV (SUVmax), peak SUV (SUVpeak), and mean SUV (SUVmean) in the high and low uptake areas of nonunion were compared between hypertrophic nonunion and non-hypertrophic nonunion. The contralateral limb was used as a control, and the ratios of the quantitative parameters were calculated. ResultsThe values for the quantitative parameters (high uptake area/low uptake area, respectively), SUVmax control ratio (12.13 ± 4.95/6.44 ± 4.71), SUVpeak control ratio (11.65 ± 4.58/6.45 ± 4.64), and SUVmean control ratio (11.94 ± 5.03/6.28 ± 4.95) for hypertrophic nonunion were higher than those for non-hypertrophic nonunion (7.82 ± 4.76/3.41 ± 2.09 (p = 0.065/0.12), 7.56 ± 4.51/3.61 ± 2.23 (p = 0.065/0.22), and 7.59 ± 5.18/3.05 ± 1.91 (p = 0.076/0.23). ConclusionsSUVmax, peak, mean control ratios obtained from bone SPECT images can quantitatively evaluate the biological activity of nonunions and may be an effective evaluation method for treatment decisions, especially the necessity of autologous bone grafting.
Effect of Denosumab in Preventing Joint Destruction in Rheumatoid Arthritis With Anti-Cyclic Citrullinated Peptide Antibodies
Authors: Mori Yu , Izumiyama Takuya , Kurishima Hiroaki , Kamimura Masayuki , Baba Kazuyoshi , Mori Naoko , Itoi Eiji
Published: December 2020

Introduction: This study aimed to determine the effects of denosumab treatment on the joint destruction of Japanese females with rheumatoid arthritis (RA) and anti-cyclic citrullinated peptide (CCP) antibodies. Materials and Methods: This retrospective longitudinal study included 56 patients treated with denosumab and 50 patients treated with bisphosphonate. All participants were positive for anti-CCP antibodies. All patients also had a history of osteoporosis treatment with bisphosphonate, which was either continued or switched to 60 mg of subcutaneous denosumab injection every 6 months. To assess the progression of joint destruction, hand and foot radiographs were taken, and changes in modified total Sharp score (mTSS), erosion score (ERO) and joint space narrowing score (JSN) were evaluated at 12 months and 24 months. The changes in BMD of the lumbar spine and hip were also assessed at 12 months. Results: At 12 months, there were significant differences in the change of ERO (p = 0.015) and mTSS (p = 0.01). Similarly, there were significant differences in the change of ERO (p = 0.013) and mTSS (p = 0.003) at 24 months. In contrast, no significant difference was observed in the changes of JSN and clinical parameters. There were significant differences in the changes in BMD in the femoral neck (p = 0.011) and total hip (p = 0.012).Conclusion: Denosumab treatment was effective for the inhibition of bone erosion progression, and it contributes to the treatment of osteoporosis and prevention of destructive arthritis in patients with RA.
Surgical Treatment for Patients With Hemophilic Pseudotumor-Related Femoral Fracture: A Retrospective Study
Authors: Chen Keyu , Jiang Guiyong , Xu Yaowen , Yang Yunping , Mao Zexiong , Lv Jiaxin , Liu Fei , Chen Bin
Published: December 2020

Purpose: Hemophilic pseudotumor (HPT)-related fracture is a rare but severe complication in patients with HPTs. These fractures often occur in femurs. There is no consensus on the standard surgical protocol for HPT-related femoral fracture. The aim of this retrospective study is to evaluate the outcome of these patients treated with surgical interventions.Methods: Ten patients with HPT-related femoral fractures who were treated with 12 surgical procedures in our hospital from Jan 2014 to April 2020 were retrospectively evaluated. Demographic data, fracture location, complications after operation and follow-up outcomes were recorded and analyzed with a mean follow-up period of 39.7 months.Results: Bone union was observed in five patients, an adequate callus was visible in two patients, and three patients underwent amputation. Both of 2 patients with closed reduction external fixation (CREF) had pin infection. Nonunion combined with external fixation (EF) failure occurred in one of whom, and the plate was broken after open reduction internal fixation. Three patients underwent autogenous or allogeneic cortical strut grafting. Three patients had HPT recurrence.Conclusion: It is necessary to perform surgery in patients with HPT-related femoral fractures. Surgical treatments must take both fracture stabilization and HPT resection into account. Internal fixation is preferable and EF should be dismissed unless for the purpose of temporary fixation. If the HPT erodes more than one-third of the bone diameter, struct grafts are necessary for mechanical stability. Amputation is a proper curative method in certain situations.