bluuebunny/crossref_metadata_2025 huggingface dataset:
Estimating Age-Specific Mean Sojourn Time of Breast Cancer and Sensitivity of Mammographic Screening by Breast Density among Korean Women
Authors: Choi Eunji , Suh Mina , Jung So-Youn , Jung Kyu-Won , Park Sohee , Jun Jae Kwan , Choi Kui Son
Published: February 2021

Background: High breast cancer incidence among women in forties are specific to Asian, implicating dense breast. This study examined the natural history of breast cancer progression among Korean women according to the levels of breast density.Methods: We applied a three-state Markov model to fit the natural history of breast cancer to data in the Korean National Cancer Screening Program. Diagnosis of breast cancer was ascertained by linkage to the Korean Central Cancer Registry. Disease progression rates (i.e., transition rates from healthy to preclinical state, and from preclinical to clinical state) were estimated across levels of breast density determined by the Breast Imaging, Reporting and Data System (BI-RADS). Preclinical incidence of breast cancer, mean sojourn time (MST) and mammographic screening sensitivity were simultaneously generated in the model.Results: Overall prevalence of dense breast among Korean women was 53.9%, which declined with age. Transition rate from healthy to preclinical state, indicating the preclinical incidence of breast cancer, was estimated to be higher among women aged 40-49 years (0.0019, 95% CI; 0.0017-0.0021) and women aged 50-59 years (0.0020, 95% CI; 0.0017-0.0022), than older women aged 60-69 years (0.0014, 95% CI; 0.0012-0.0017). Transition rate from preclinical to clinical state was also fastest among younger age groups, which directly translated to the shortest MSTs, estimated as 1.98 (95% CI; 1.67-2.33), 2.49 (95% CI; 1.92-3.22) and 3.07 (95% CI; 2.11-4.46) years for women in forties, fifties and sixties, respectively. The sensitivity of the mammographic screening was higher among older women (0.70, 95% CI; 0.62-0.77) than women in fifties (0.65, 95% CI; 0.62-0.77) and women in forties (0.61, 95% CI; 0.54-0.61). Having dense breasts increased the likelihood of the preclinical cancer risk (1.96 to 2.35 times) and decreased the duration of MST (1.53 to 2.02 times).Conclusions: Korean women showed 1.5 to 2 times higher prevalence of dense breast tissues, compared to Western women. This study estimated Korean-specific parameters for the natural history of breast cancer that would be utilized for establishing optimal screening strategies in countries with higher dense breast prevalence.
Efficacy of Mesenchymal Stromal Cells in Preclinical Models of Necrotizing Enterocolitis: a Systematic Review Protocol
Authors: Maltais-Bilodeau Camille , Henckel Ewa , Cobey Kelly D. , Ahmadzai Nadera , Skidmore Becky , Ferretti Emanuela , Thébaud Bernard
Published: February 2021

BackgroundNecrotizing enterocolitis is an acute inflammatory disease of the intestine that can lead to necrosis and bowel perforation. It is a severe complication of preterm birth with a prevalence of 7% in infants with a birth weight less than 1500 grams. It’s mortality rate is up to 30% and survival after necrotizing enterocolitis leads to long-term gastrointestinal and neurocognitive consequences. The current treatment is supportive and includes bowel rest and decompression and antibiotics. Thus, new treatments are necessary to reduce mortality and morbidity. Mesenchymal stromal cells are known to have anti-inflammatory properties and might be a promising option for treatment. Here we present a protocol for a systematic review with the aim to explore the efficacy of cell therapies with mesenchymal stromal cells in animal models of necrotizing enterocolitis. The primary outcome is histological signs of necrotizing enterocolitis. Additional outcomes include survival, bowel perforation, gut permeability, gut motility, levels of inflammatory markers, cytokine levels and adverse events.MethodsWe will conduct a systematic search of MEDLINE, Embase, and Web of Science databases. The retrieved records will be screened individually by two investigators. We will include all preclinical in vivo animal models of experimentally induced NEC that evaluate the efficacy of mesenchymal stromal cells or other cell therapy treatments. Outcome data will be extracted from each article and risk of bias assessment performed. Funnel plots and SYRCLE’s risk of bias tool for animal studies will be used. Data will be reported as ratios, divided in predefined subgroups where relevant. DiscussionThis systematic review aims to examine the efficacy of mesenchymal stromal cells in preclinical models of necrotizing enterocolitis and whether there is sufficient evidence to support a clinical trial of efficacy and safety of the treatment with mesenchymal stromal cells in infants with necrotizing enterocolitis.Systematic review registrationThis protocol has been registered on Open Science framework: osf.io/5rc6t
A Multifunctional Biodegradable Prussian blue Analogue for Synergetic Photothermal/Photodynamic/Chemodynamic therapy and Intrinsic Tumor Metastasis Inhibition
Authors: Hao Yuting , Mao Lianzhi , Zhang Rongjun , Liao Xiaoshan , Yuan Miaomiao , Liao Wenzhen
Published: February 2021

Background

To date, various Prussian blue analogues (PBA) have been prepared for biomedical applications due to their unique structural advantages. However, the safety and effectiveness of tumor treatment still need further exploration.
Results

This contribution reports a facile synthesis of novel PBA with superior tumor synergetic therapy effects and a detailed mechanistic evaluation of their intrinsic tumor metastasis inhibition activity. The as-synthesized PBA have a uniform cube structure with a diameter of approximately 220 nm and showed high near infrared light (NIR) photoreactivity, photothermal conversion efficiency (41.44%) and photodynamic effect. Additionally, PBA could lead to chemodynamic effect which caused by Fenton reaction and ferroptosis. The combined therapy strategy of PBA exhibit notable tumor ablation properties due to photothermal therapy (PTT)/photodynamic therapy (PDT)/ chemodynamic therapy (CDT) effect without obvious toxicity in vivo. The PBA also demonstrate potential as a contrast agent for magnetic resonance imaging (MRI) and photoacoustic (PA) imaging. More importantly, careful investigations reveal that PBA displays excellent biodegradation and anti-metastasis properties. Further exploration of this PBA implies that its underlying mechanism of intrinsic tumor metastasis inhibition activity can be attributed to modulation of epithelial mesenchymal transition (EMT) expression.
Conclusions

The considerable potential exhibits by as-synthesized PBA make it an ideal candidate as a synergetic therapeutic agent for tumor treatment.
Nerve Transfer Surgery in Spinal Cord Injury: Online Information Sharing
Authors: Moltaji Syena , Novak Christine B , Dengler Jana
Published: February 2021

BackgroundNerve transfer to improve upper extremity function in persons with cervical spinal cord injury (SCI) is a new reconstructive option, and has led to more people seeking and sharing surgical information and experiences. This study evaluated the role of social media in information-sharing on nerve transfer surgery within the SCI community.MethodsData were collected from Facebook, which is the favored information-sharing platform among individuals seeking medical information. Searched terms included ‘spinal cord injury’ and ‘SCI’ and excluded groups with: less than two members (n = 7); closed groups (n = 2); not pertaining to SCI (n = 13); restricted access (n = 36); and non-English (n = 2). Within public and private accessed groups, searches were conducted for ‘nerve’, ‘transfer’, ‘nerve transfer’, and ‘nerve surgery’. Each post about nerve transfer, responses to posts, and comments about nerve transfer in response to unrelated posts were tabulated. Thematic content analyses were performed and data were categorized as seeking information, sharing information, sharing support, and sharing appreciation.ResultsThe search yielded 99 groups; 35 met the inclusion criteria (average size = 2,007, largest = 12,277). Nerve transfer was discussed in nine groups, with 577 total mentions. In the seeking information axis, posts were related to personal experience (54%), objective information (31%), surgeon/center performing the procedure (9%), and second opinion (4%). At least 13% of posts were from individuals learning about nerve transfers for the first time. In the sharing information axis, the posts: shared personal experience (52%); shared objective information (13%); described alternative treatment (3%); tagged someone to share information (11%); linked to outside resources (12%); and recommended a specific surgeon/center (9%).ConclusionSocial media is an important source of information and support for people with SCI. There is a paucity of information on nerve transfers. These study findings will inform implementation of future education strategies.
Rain Drop Size Distribution Analysis at a Tropical Location Near Land-sea Boundary
Authors: Saha Pallabi , Majumder Souvik , Maitra Animesh
Published: February 2021

Rain events can be characterized by rain drop size distribution (DSD) that denotes the number of drops as a function of diameter per unit size interval and per unit volume of space. DSD describes the microstructure of precipitation during different phases of rain varying both spatially and temporally. DSD can be influenced by the nature and origin of rain. The present study investigates the role of continental and maritime airflow in influencing the precipitation features near the land-sea boundary. Rain DSD data used in the present analysis are collected from a ground based disdrometer located at Kolkata, India during the year of 2011-2017. The dataset is divided into two categories namely, maritime and continental rainfall, based on the airflow trajectories associated with rainfall, respectively, from Bay of Bengal and from land surface in the west of Kolkata, as derived from TRAJSTAT software. Variations of the DSD parameters using Gamma model is presented showing the abundance of smaller drops during maritime rain events whereas dominance of larger raindrops in the case of the continental rain events. The Z-R relations are also found to be significantly different for these two types of rain. The present study reveals the microstructures of rain at a location where the influences of both land and sea climatic features prevail.
A Retrospective Study of Nine Patients with Progressive Pseudorheumatoid Dysplasia: To Explore Early Diagnosis and Further Treatment
Authors: Yin Lei , Mao Youying , Zhou Yunfang , shen Yongnian , Chen Huijin , Zhou Wei , Jin Yanliang , Huang Hua , Yu Yongguo , Wang Jian
Published: February 2021

Background: Most patients with progressive pseudorheumatoid dysplasia (PPRD) are initially misdiagnosed because of disease rarity and lack of awareness by most clinicians. The purpose of this present study was to provide further early diagnostic options and potential treatment to patients with PPRD. Methods: This was a retrospective study. Clinical manifestations, laboratory test results, radiographic features, Sanger Sequencing to determine CCN6 gene variants, treatment and follow-up records were collected in the patients with PPRD. Time to diagnosis, phenotype and genotype correlation were analyzed. Results: Nine PPRD children were included. There were 3 pairs of siblings and one patient had parental consanguinity. Five patients were misdiagnosed as juvenile idiopathic arthritis (JIA). The onset of disease in 8 patients was between 3 to 6 years of age. The interval from onset of symptoms to obtaining the diagnosis for 8 of the patients varied from 3.6 years to 20 years. The onset of symptoms included enlarged and stiff interphalangeal joints of the fingers, gait disturbance or joint pain. Laboratory tests revealed normal range of inflammatory parameters. Serum levels of 25-hydroxyvitamin D3 in six patients were below the normal range. Radiographic findings included different degree of abnormal vertebral bodies, epiphyseal enlargement of the interphalangeal joints with juxta-articular osteopenia, or cyst-like structures femoral head. All the patients harbored CCN6 variants, and a total of 7 variants were identified. After the treatment of calcitriol in 5 patients with low level of 25-hydroxyvitamin D3 for 1.25 years to 1.75 years, two of them kept stable, while 3 of them improved gradually. Conclusions: Combining the patient’s family history, clinical features presenting with abnormal gait or enlarged and stiff interphalangeal joints of the fingers, normal inflammatory markers, and the characteristic radiographic findings, we can obtain the clinical diagnosis of PPRD for the patients at a very early stage of the disease. Anterior blunt of the vertebral bodies could be an early radiological sign in the patient even without obvious clinical symptoms and characteristics yet. The patients with PPRD having c.624dupA variant in CCN6 may have delayed onset. Underlying vitamin D deficiency should be sought and corrected in patients with PPRD. Keywords: progressive pseudorheumatoid dysplasia; noninflammatory; articular cartilage; CCN6 gene variant; vitamin D deficiency
Huashan Perioperative Nursing Program for Stroke Patients Undergoing Contralateral Seventh Cervical Nerve Transfer
Authors: Su Fan , Wang Xiaoqian , Xu Ye , Zhou Yiqun , Xu Wendong , Zhang Jinyao , Liu Ying
Published: February 2021

Background: The previous investigation regarding contralateral seventh cervical nerve transfer (CC7) revealed a novel and effective approach to improve arm function in patients with chronic spastic paralysis. The patients who underwent both CC7 and standard rehabilitation showed greater functional improvements and spasticity reductions than did the control group who underwent rehabilitation only. Additional efforts are needed to maximize the benefits in patients and establishing a supporting nursing program is a promising way of achieving this goal.Methods: The present Huashan nursing program was established in consideration of the following elements, that were the routine perioperative care, ensuring surgical safety and improving patient cooperation. Before surgery, psychiatric nursing, health education and risk control were stressed. After surgery, in addition to routine nursing and positioning, special attention was needed for the targeted nursing of postoperative adverse events. In addition, we performed descriptive statistical analysis on the clinical data of patients receiving the Huashan nursing program, focusing on postoperative adverse events. Totally 85 patients were included in the study, and postoperative adverse events occurred in 10 patients, including severe pain (5, 5.88%), neck hematoma (2, 2.35%), dyspnea (2, 2.35%) and hoarseness (1, 1.18%). The above adverse events were alleviated under the targeted nursing guided by the Huashan program.Discussion: This article introduces the Huashan nursing program, which is based on preoperative evaluations, educational sessions, postoperative monitoring and targeted nursing, for patients undergoing CC7. The present nursing program helped the promotion and provided the opportunity to maximize the benefits of CC7.
Malignant Hyperthermia When Dantrolene Is Not Readily Available
Authors: Gong Xiaodan
Published: February 2021

Background: Malignant hyperthermia is a rare but life-threatening pharmacogenetic muscle disorder characterized by abnormal hypermetabolic reactions and commonly triggered in susceptible individuals by volatile anesthetics or succinylcholine, or both. Unfortunately, the specific medicine dantrolene is not readily available in many countries including China. The aim of this study was to find the characteristics of malignant hyperthermia under the situation that dantrolene is not readily available. Methods: The cases of malignant hyperthermia reported on the most commonly used databases in China from 1985 to 2020 were analyzed. The inclusion criteria were the MH episodes only related to anesthesia. The exclusion criteria were dubious MH episodes only caused by Ketamine administration or MH episodes irrelevant to anesthesia. Independent samples t-test and Pearson’s chi-squared test were applied to assess the difference between the survived and death cases.Results: Ninety-two cases of malignant hyperthermia reported on the most commonly used databases in China from 1985 to 2020 were analyzed. Median (IQR [range]) age was 18.5 (11.8-37.0 [0-70.0 ]) years. Compared with the survived cases, the death cases had higher maximum end-tidal partial pressure of CO2 (P=0.033), the maximum arterial partial pressure of CO2 (P=0.006), temperature first measured when the patient was first discovered abnormal (P=0.012), and maximum temperature (P<0.001). Besides, the death cases had less minimum pH (P<0.001) and higher potassium (P<0.001) and were more likely to have coagulation disorders (p=0.018). Concerning treatment, cases used furosemide (P=0.024), mannitol (P=0.029), blood purification treatment (P=0.017) had the advantage on the outcome. Creatine phosphokinase, myoglobin, and MB isoenzyme of creatine phosphokinase differed greatly among cases during the first week. 43 (46.7%) cases had congenital diseases. 12 (13.0%) cases were reported with abnormal laboratory test results or abnormal signs that are possibly relevant before anesthesia. Conclusions: In countries that dantrolene is not readily available, early warning, diagnosis, and prompt effective therapies are crucial for MH patients to survive.
Stage-dependent Plasticity in Biomass Allocation and Allometry of Abutilon Theophrasti in Response to Population Density 
Authors: Wang Shu , Zhou Dao-Wei
Published: February 2021

How plants respond to density via modular plasticity is obscure, probably because relevant studies using covariance and allometry analyses rarely focus on multiple stages of plant growth, and also the two approaches are seldom used simultaneously in a same study. To address this issue, a field experiment was conducted by subjecting plants of Abutilon theophrasti to low, medium and high densities and measuring the mass of various plant modules, before covariance and allometry analyses at three stages of plant growth. Results showed inconsistent responses in allocation traits and allometric relationships at each growth stage. At 30 d, high density increased root:stem, root:leaf and stem:leaf ratios, but did not affect any allometric relationships. At 50 d, density altered most allocation traits, but not for allometric exponents. At 70 d, density altered allometric relationships, with no effects on allocation traits. The stage-dependent allometric relationships and inconsistent results of allometric and covariance analyses suggested one-stage allometric plasticity might be apparent plasticity. In response to the increase of density, plants first altered the strategy of biomass partitioning, then growth rate or developmental stage, indicating density effects intensified over time. For plasticity in a modular trait, size effects can be regarded as a component of (indirect) environmental effects, with the left variation after removal of size effects being the other component of plant (direct) active response. The insights into apparent plasticity of allometry and two components of plasticity should be of essential importance to investigating phenotypic plasticity and its implications in plants.
Rapid, risk-based levee design framework for greater risk reduction at lower cost than standards-based design
Authors: Johnson David , Wang Jingya , Geldner Nathan , Zehr Andrew
Published: February 2021

Standards-based levee design aims to protect against events with specific probabilities, for example eliminating overtopping from a “1-in-100-year” storm surge. This allows levee segments to be analyzed independently but ignores interior dynamics and overall risk. We present and implement a framework for calculating optimal risk-informed design heights. Using this design paradigm and multi-objective evolutionary algorithms, we identify levee and floodwall design heights that minimize the total system cost and expected flood losses over 50 years. With our model, decision makers may feasibly evaluate hundreds or thousands of alternative designs. Comparing to the existing design elevations of the Larose to Golden Meadow Hurricane Protection Project in coastal Louisiana, over multiple climate change scenarios, we identify system configurations of similar cost that reduce the expected value of discounted residual risk of 26–73% ($8–85 million). We also achieve the same residual risk at 90–97% of the cost of the existing system (saving $19–73 million).
Voices of a generation
Authors: Eide Elisabeth , Kunelius Risto
Published: February 2021

In this article, we look at the most recent high tide of the climate crisis attention from the perspective of the school strikers’ movement. It is based on interviews with 31 young climate activists from 23 countries around the world, made possible by the work of several colleagues in MediaClimate –network (mediaclimate.net), a group of researchers who have studied global climate media coverage/debates since 2008. The interviews followed a semi-structured guideline, prompting respondents to discuss how their activism started, their role in the local movement, the nature of movement organization and their relations to other institutions and actors (NGOs, media, politicians). This diverse sample of dialogues with activists in a wide variety of global political and cultural contexts cultures, languages and local conditions collectively produced a vast discursive material. In our analysis, we first look at the specific way science and interaction with scientists is part of the youths’ action horizon, combining this to the ways in which they relate their life experiences to climate science. Second, we will situate this specific science-activism analysis to a brief overview of the nature (or inner logic) of the school movement and the identity of the activists. Through these two empirical excursions, we harvest some lessons about communicating climate science suggested by the youth movement.
Spinal Mobility in Radiographic Axial Spondyloarthritis: Criterion Concurrent Validity of Classic and Novel Measurements
Authors: Snow John Charles , Simpson Kyle , Rahman Proton , Howarth Samuel , Carvalho Diana De
Published: February 2021

Background: Limitations in spinal mobility are a characteristic feature of Axial Spondyloarthritis. Current clinical measurements of spinal mobility have shown low criterion-concurrent validity. This study sought to evaluate criterion-concurrent validity for a clinically feasible measurement method of measuring spine mobility using tri-axial accelerometers.Methods: 15 radiographic-Spondyloarthritis patients were recruited for this study. Two postural reference radiographs, followed by three trials in forward, left and right lateral bending were taken. For all trials, three measurements were collected: tape (Original Schober’s, Modified Schober’s, Modified-Modified Schober’s, Lateral Spinal Flexion Test and Domjan Test), followed immediately by synchronized radiograph and accelerometer measurements at end range of forward and bilateral lateral flexion. The criterion-concurrent validity of all measurement methods were compared to the radiographic measures using Pearson’s correlation coefficients. A Bland-Altman analysis was conducted to assess agreement.Results: In forward bending, the accelerometer method (r=0.590, p=0.010) had a stronger correlation to the radiographic measures than all tape measures. In lateral bending, the Lateral Spinal Flexion tape measure (r=0.743, p=0.001) correlated stronger than the accelerometer method (r=0.556, p=0.016). The Domjan test of bilateral bending (r=0.708, p=0.002) had a stronger correlation to the radiographic measure than the accelerometer method. Conclusions: Accelerometer measures demonstrated superior criterion-concurrent validity compared to current tape measures of spinal mobility in forward bending. While a moderate correlation exists between accelerometer and radiographs in lateral bending, the Lateral Spinal Flexion Test and Domjan Test were found to have the best criterion-concurrent validity of all tests examined in this study.
A Comparative Multicenter Study on the Epidemiology of Traumatic Fractures During the COVID-19 Early Emergency Response Period in Yogyakarta Special Region, Indonesia
Authors: Hidayat Luthfi , Rahayu Bernadeta Fuad Paramita , Khadafi Rosyad Nur , Purwanta Acep Eko Budi , Saputra Marda Ade , Sumardiyono Eko , Triangga Aditya Fuad Robby
Published: February 2021

Background: The changes of lifestyle and mobility during the Coronavirus Disease 2019 (COVID-19) pandemic may influence the epidemiology of traumatic fractures. This study aimed to investigate the epidemiology of traumatic fractures in Yogyakarta Special Region (Daerah Istimewa Yogyakarta/DIY) during the COVID-19 emergency response period and compare the data with the similar period in the previous year.Methods: This was a retrospective study involving five secondary referral hospitals and one tertiary referral hospital. We included all patients who presented to the emergency departments or orthopedic clinics who were then diagnosed with new onset fractures. We compared the data during the emergency response period (COVID group) with a similar period in 2019 (control group).Results: There were 1,249 patients with 1,428 fractures included in this study. There was almost half reduction of patients during the emergency response period. There was no significant difference in proportion of gender and mean of age between patients in the control group and the COVID group. During the emergency response period, there was significant increases in the proportions of patients experiencing low energy injuries (38.0% vs. 30.8%), injuries occurring at home (34.0% vs. 23.8%), and surgically treated closed fractures (51.8% vs. 45.3%), along with decrease of patients’ referrals (1.6% vs. 4.1%). The difference in proportions of fracture type, osteoporotic fractures, and multiple trauma was not significant across the groups. Conclusions: During the COVID-19 emergency response period in DIY, there were nearly half reduction (47.68%) of patients with fractures, increased proportion of patients injured at home, reduced proportion of patients referred to another hospital, and increased proportion of surgically treated closed fractures. The knowledge about this epidemiological trend may help in developing preventive programs and treatment policy for fractures and other injuries during the current pandemic.
Thromboelastography Performs Well for the Diagnosis of Periprosthetic Joint Infection.
Authors: Yuan Tao , Wang Yi , Sun Shui
Published: February 2021

Background: Coagulation-related biomarkers are drawing new attention in diagnosing periprosthetic joint infection (PJI). Thromboelastography (TEG) analysis provides a comprehensive assessment of coagulation and therefore could be a promising test for PJI. This study aims to assess the value of TEG in diagnosing PJI and to determine the clinical significance of TEG in analyzing reimplantation timing for the second-stage revision.Methods: From October 2017 to September 2020, 62 patients who underwent revision arthroplasty were prospectively included, PJI was defined by 2011 Musculoskeletal Infection Society (MSIS) criteria. Twenty-three patients were diagnosed with PJI (Group A) and the other 39 patients were included as aseptic loosen (Group B). Seventeen patients in Group A finished two-stage revision in our center. C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), D-dimer and TEG parameters (K (clotting time), Angle (α-angle), MA (maximum amplitude), A30 (amplitude at 30 min), TPI (thrombodynamic potential index)) were measured preoperatively in all included patients. Receiver operating characteristic curves were applied to evaluate the diagnostic value of these biomarkers.Results: ESR (AUC 0.953, sensitivity 81.82, specificity 94.87) performed best in PJI diagnosis, followed by MA (AUC 0.895, sensitivity 82.61, specificity 97.44) and CRP (AUC 0.893, sensitivity 82.61, specificity 94.74). When these biomarkers combined in pairs, the diagnosis value improved compared with any individual biomarker. The overall success rate of the two-stage revision was 100%. ESR and MA showed valuable in determining the time of reimplantation, with their values all decreased below cut-off values before reimplantation.Conclusion: TEG could be a promising test in assisting PJI diagnosis, and a useful tool in judging the proper timing of reimplantation.
SARS-COV-2 Spike Glycoprotein as Inhibitory Target for Insilico Screening of Natural Compounds
Authors: Omoboyowa Damilola Alex , A Balogun Toheeb , Chukwudozie Onyeka S. , Nweze Victor N. , Saibu Oluwatosin A. , Abdulahi Alausa
Published: February 2021

Coronavirius disease 2019 (Covid-19) pandemic caused by SARS-Cov-2 has raised global health concern without approved drug for management of this lie threatening disease. The aim of this study was to predict the inhibitory potential of quercetin-3-o-rutinoside against SARS-Cov-2 spike glycoprotein. Targeting the SARS-Cov-2 spike protein from angiotensin converting enzyme 2 complex (pdb: 6lzg) is gaining importance. In this study, in silico computational relationship between plant-derived natural drug and spike glycoprotein was predicted. The results were evaluated based on glide (Schrodinger) dock score. Among the five (5) screened compounds, quercetin-3-o-rutinoside has the best docking score (-9.296) with the target. Molecular dynamic (MD) simulation study was performed for 1000ps to confirm the stability behavior of the spike protein and quercetin-3-o-rutinoside complex. The MD simulation study validated the stability of quercetin-3-o-rutinoside in the spike protein binding pocket as potent inhibitor.
Public Health Implications of Vaping in The US: The Smoking and Vaping Simulation Model
Authors: Levy David T , Tam Jamie , Sanchez-Romero Luz Maria , Li Yameng , Yuan Zhe , Jeon Jihyoun , Meza Rafael
Published: February 2021

Background: Nicotine vaping products (NVPs) are increasingly popular worldwide. They may provide public health benefits if used as a substitute for smoking, but may create public health harms if used as a gateway to smoking or to discourage smoking cessation. This paper presents the Smoking and Vaping Model (SAVM), a user-friendly model which estimates the public health implications of NVPs in the US. Methods: SAVM adopts a cohort-approach. We derive public health implications by comparing smoking- and NVP-attributable deaths and life-year lost under a No-NVP and an NVP Scenario. The No-NVP Scenario projects current, former and never smoking rates via smoking initiation and cessation rates, with their respective mortality rates. The NVP Scenario allows for smoking- and NVP-specific mortality rates, switching from cigarette to NVP use, separate NVP and smoking initiation rates, and separate NVP and smoking cessation rates. After validating the model against recent US survey data, we present the base model with extensive sensitivity analyses.Results: The SAVM projects that under current patterns of US NVP use and substitution, NVP use will translate into 1.8 million premature smoking- and vaping-attributable deaths avoided and 38.9 million life-years gained between 2013 and 2060. When the NVP relative risk is set to 5%, the results are sensitive to the level of switching and smoking cessation rates and to a lesser extent smoking initiation rates. When the NVP relative risk is raised to 40%, the public health gains in terms of averted deaths and LYL are reduced by 42% in the base case, and the results become much more sensitive to variations in the base case parameters.Discussion: Policymakers, researchers and other public health stakeholders can apply the SAVM to estimate the potential public health impact of NVPs in their country or region using their own data sources. In developing new simulation models involving NVPs, it will be important to conduct extensive sensitivity analysis and continually update and validate with new data. Conclusion: The SAVM indicates potential benefits of NVP use. However, given the uncertainty surrounding model parameters, extensive sensitivity analysis becomes particularly important.
Pediatric Triage Variations Among Nurses, Pediatric and Emergency Residents Using the Canadian Triage and Acuity Scale
Authors: Alshaibi Saleh , AlBassri Tala , AlQeuflie Suliman , Philip Winnie , Alharthy Nesrin
Published: February 2021

BackgroundEmergency care continues to be a challenge, since patients’ arrival is unscheduled and could occur at the same time which may fill the Emergency Department with non-urgent patients. Triaging is an integral part of every busy ED. The Canadian Triage and Acuity Scale (CTAS) is considered to accurate tool to be used outside Canada. This study aims to identify the chosen triage level and compare the variation between registered nurses, pediatric and adult emergency residents by using CTAS cases.MethodThis study was conducted at King Abdulaziz Medical City, Saudi Arabia. A cross-sectional self-administered questionnaire was used, and which contains 15 case scenarios with different triage levels. All cases were adopted from a Canadian triage course after receiving permission. Each case provides the patient’s symptoms, clinical signs and mode of arrival to the ED. The participants were instructed to assign a triage level using the following scale: 1=resuscitation, 2=emergent, 3=urgent, 4=less urgent, and 5=non-urgent. A non-random sampling technique was used for this study.ResultA total of 151 participants completed the study questionnaire. 73 (48.34%) were nurses and 78 (51.66%) were residents (42 pediatric residents and 36 emergency residents).Each participant was given a score based on the correct answer for the case scenario. A mean score was compared among the nurses, pediatric residents and emergency residents. Since our data were not normally distributed, we used the Kruskal-Wallis test to observe statistical differences between the groups. The Kruskal Wallis Post-Hoc test was performed to see which groups were statistically significant, and it was found that there was a significant difference between nurses and pediatrics residents (P value < 0.001). Moreover, there were no significant differences found between nurses and ER residents (P value > 0.05).ConclusionThe triaging system was found to be a very important tool to prioritize patients based on their complaints. The results showed that nurses had the greatest experience in implementing patients on the right triage level. On the other hand, ER and pediatric residents demonstrated a need to develop more knowledge about CTAS and become exposed more to the triaging system during their training.
Green Transformations In The Healthcare System: The Covid-19 Impact
Authors: Us Yana , Pimonenko Tetyana , Tambovceva Tatjana , Segers Jean-Pierre
Published: February 2021

This paper summarizes the arguments and counterarguments within the scientific discussion on the healthcare systems’ transformations towards sustainability, considering COVID-19 pandemic. The paper aims to forecast changes in the healthcare sector’s greenhouse gas emissions of the EU countries. For gaining that purpose, the authors carried out the study in the following logical sequence. Firstly, the bibliometric analysis was conducted based on 2313 publications indexed by Scopus database. The study sample consists of 1995 publications indexed by the keywords such as healthcare, green, carbon and sustainable; and 318 publications – green, carbon-free, covid, pandemic, coronavirus and health. The fields for search are titles, keywords and abstracts. The search was limited to the subject areas such as Social science; Environmental sciences; Business, Management and Accounting; Economics, Econometrics and Finance. The time framework is 2000-2020. The scientific background analysis stated the strong relationship between implementing green innovation in the healthcare system towards gaining sustainable development goals. The obtained results indicated that the COVID-19 requires the decisive green transformation in the economy. Thus, the forecast of greenhouse gas volume from the healthcare activity (human health and social work activities; human health activities; manufacture of basic pharmaceutical products and pharmaceutical preparations) until 2030 was conducted. The methodological tool of this research based on the Autoregressive Integrated Moving Average (ARIMA) model. The software EViews 11 was used to provide empirical calculation. This study involved data of the EU countries such as Hungary, Slovakia, Malta, Denmark and Portugal from 1995 to 2019. The base of data is the EU statistical service Eurostat. Based on the obtained results, the authors concluded that there are still disparities in the healthcare sectors of the EU-countries towards sustainability. Therefore, the authors highlighted the necessity to improve the EU countries’ cohesion policy, which would allow decisively and quickly cooperate to find effective solutions towards developing resilience in the healthcare sector due to implementing green strategies. The authors emphasized that this study’s obtained results could be the base for future investigations devoted to effective green solutions to minimize greenhouse gas emissions from the healthcare activity.
The Correction of the Dimensionless Equation for the Mass Transfer Coefficient Estimation during the Membrane Modules Regeneration
Authors: Huliienko S.V. , Korniienko Y.M. , Metlina M.S. , Tereshenko I.Y. , Kaminskyi V.S.
Published: February 2021

The cleaning or regeneration of fouled membrane modules is an essential procedure in the membrane equipment operation. Despite the development of some successful cleaning techniques, the predictions of the membrane separation process operation parameters after regeneration is still an unsolved problem. In our previous works, the attempt to develop the methodology of estimating the membrane productivity after the regeneration of the fouled spiral wound membrane modules by cleaning the subatmospheric pressure has been made. However, this methodology requires some improvement, including the correction of the dimensionless equation to calculate the mass transfer coefficient. In this work, a set of additional experiments was carried out, and the corrections of the mass transfer correlation were done using both new and previously obtained experimental data. As a result, the improved dimensionless equation was contained as Sh = 0.00045Re0.8Sc0.33(de/l). This equation is valid in the range of Reynolds number variation of 0.4–60.0 for the case of the regeneration of spiral wound modules and can be used for the prediction of the permeate flux after the regeneration procedure.
Simulation of Energy Consumption Processes at the Metallurgical Enterprises in the Energy-Saving Projects Implementation
Authors: Kiyko S.G. , Druzhinin E.A. , Prokhorov O.V. , Haidabrus B.V.
Published: February 2021

The features of improving energy efficiency at a metallurgical enterprise based on portfolio management of energy-saving projects are considered. A simulation model of energy consumption at the metallurgical enterprise, which covers the entire metal products manufacture process, has been developed. The parameters, conduct, and visualization of simulation models of the main equipment such as an electric arc furnace and a ladle furnaces are described. With this software package’s help, a comparison of the permissible values and the adjusting of the predicted consumption of active power by a metallurgical enterprise for each fixed point in time are carried out. The system calculates the operating mode regulation range of electric arc furnaces to ensure the continuity of steel casting during melting of a particular steel grade along the appropriate technological routes. The model likewise includes algorithms for transport equipment management that minimize disruptions in continuous casting machines’ operation and simulate emergencies. The analysis of the results of energy consumption processes simulation at the metallurgical enterprise is carried out. As a result of modeling, it was possible to increase the productivity of a group of electric arc furnaces and ladle furnaces and reduce the maximum consumption of active power by the metallurgical enterprise. Experimental studies of energy consumption planning methods have been carried out based on real data on the metal products manufacture and electrical energy consumption by the production units of PJSC “Electrometallurgical plant “Dniprospetsstal”. The use of the electrical energy consumption model allows in an integrated manner and responds to the dynamics of production processes to carry out further calculations of economic feasibility studies, analysis, and selection of options for the project’s implementation of an energy-saving portfolio at the metallurgical enterprise.
Incidental Gallbladder Carcinoma in Gallbladder Polyps: Challenges of Gallbladder Malignancy for an Endemic Population
Authors: Gautam Abhishek , Pandey Anshuman , Masood Shakeel , Chauhan Smita , Choudhary Dinesh , Kumar Suneed , Madhawa Shibumon , Jha Sneha , Saini Vijay
Published: February 2021

Background: Gallbladder polyps are considered pre-malignant lesions of gallbladder carcinoma. This study aims to highlight the role of early cholecystectomy in the management of gallbladder polyps in an endemic population.
Methods: A retrospective analysis of 2,076 lap cholecystectomy procedures performed at the Department of Surgical Gastroenterology at a tertiary referral centre in Northern India was conducted and incidental malignancy in gallbladder polyps analysed. The 8th edition of the American Joint Committee on Cancer for tumour-node-metastasis (TNM) staging of gallbladder carcinoma was used.
Results: Of 54 patients with gallbladder polyps, 53 had benign histology and one had malignant cells in the lamina propria suggestive of T1a adenocarcinoma. The patient with the malignant polyp was older (57 years old) than the patients in the non-cancer group, which had a mean age of 45 (P = 0.039). The size of the malignant polyp was approximately 4 mm, significantly smaller than the average 7.9 mm size of the benign polys (P = 0.031).
Conclusion: Cholecystectomy needs to be considered early in the management of small- sized gallbladder polyps, particularly in areas endemic for gallbladder carcinoma.
Comparison of Non-Operative Mesotherapy and Surgery in the Management of Superficial Lipomas
Authors: Kataria Kamal , Venkatesh Meghna , Chumber Sunil , Rathore Yashwant , Srivastava Anurag , Dhar Anita , Ranjan Piyush , Yadav Rajni , Vyas Surabhi , Naranje Priyanka
Published: February 2021

Background: Lipomas are benign adipocytic tumours. Surgical excision is the gold standard for treating such lipomas, but it results in unaesthetic scarring.
Methods: A total of 126 patients were randomised into two groups. The patients in Group A underwent mesotherapy (n = 66) and those in Group B underwent surgery (n = 60). The patients in Group A group received six sessions of mesotherapy treatment at 2-week intervals. Both groups were followed up for 12 weeks, during which they were assessed for complications arising from treatment, reduction of the size of the lipoma and cosmetic outcomes.
Results: The overall mean age of the patients was 32.93 (± 10.1) years old and the mean volume of the lipomas was 2.29 (± 3.8) mL. A 55.86% (P = 0.0032) mean reduction in the volume of lipomas was noted in the patients who received mesotherapy, while one patient showed a gain of 16% by volume. The patients in Group A (cosmetic score ≥ 4: 63%) were happier with the treatment than those in Group B (cosmetic score ≥ 4: 21%).
Conclusion: Our findings indicate that mesotherapy modestly reduces the volume of lipomas with very few and minor complications and excellent cosmetic outcomes.
Short-Term Versus Long-Term Systemic Corticosteroid Use in the Acute Exacerbation of Chronic Obstructive Pulmonary Disease Patients
Authors: Alshehri Samah , Alalawi Mai , Makeen Abdulrahman , Jad Ammar , Alhuwaysi Ahmed , Alageeli Mohammed , Alshibani Mohannad
Published: February 2021

Background: The administration of systemic corticosteroids in chronic obstructive pulmonary disease (COPD) exacerbation is the first line of management. The duration of this administration, however, is not well established in clinical practice. The objective of this study is to compare the clinical outcomes between short-term and long-term corticosteroid use in the acute exacerbation of COPD patients.
Methods: A single-centre, retrospective cohort study was conducted. From 2014 to 2018, all patients over 40 years old with COPD who were admitted to the hospital with a case of COPD exacerbation and received systemic corticosteroids at presentation were included. The subjects were divided into two groups according to the duration of systemic corticosteroid therapy. The primary outcome was hospital re-admission within 180 days. The secondary outcomes were 30 days mortality and length of hospitalisation. The two groups were compared using an independent sample t-test, a Chi-square test, and a Mann-Whitney U test, according to the data type.
Results: Eighty patients met the inclusion criteria. A total of 52 (65%) patients completed long-term therapy, while 28 (35%) patients were on short-term treatment. A total of 15 (28.8%) patients reached the primary endpoint in the long-term treatment group versus 19 (67.9%) in the short-term treatment group (P = 0.001). The 30-day mortality was 4 (7.7%) and 0 (0%), respectively, and the median length of hospitalisation was 6.5 and 7.5 days in the long-term group and short-term group, respectively (P = 0.32, P = 0.88).
Conclusion: Long-term corticosteroid use in the management of acute COPD exacerbation was significantly associated with fewer 180 days re-admission. The duration of corticosteroid use remains controversial, and further studies are recommended to assess the relationship between patient profile and adherence to therapy post-discharge with re-exacerbation.