bluuebunny/crossref_metadata_2025 huggingface dataset:
Retrospective analysis of safety and efficacy of enhanced recovery pathways in stage II–III colorectal cancer patients submitted to surgery and adjuvant therapy
Authors: Wang Baoxin , Wu Zhenming , Zhang Rui , Chen Yue , Dong Jiuxing , Qi Xiuheng
Published: April 2021

Background

The American Society of Colon and Rectal Surgeons is suggesting laparoscopic surgeries for colorectal cancer. Conventional perioperative procedures like long preoperative fasting and bowel procedures are not useful and harmful to patients undergoing surgeries for colorectal cancer. The objectives of the study were to compare surgery outcomes, hospital stays, and survival of patients who received fast-track (laparoscopy/open) surgical procedure followed by chemotherapy against those who received conventional (laparoscopy/open) surgical procedure followed by chemotherapy for colorectal cancer.

Methods

The study analyzes the outcomes of a total of 542 colorectal cancer (preoperative biopsies stage II or III) patients submitted to surgery and adjuvant chemotherapy. The study cohort is retrospectively subdivided in 4 groups submitted to open or laparoscopic resection with or without fast-track protocol appliance and two different chemotherapy regimens. Patients who ended up being TNM stage I have not received the adjuvant chemotherapy.

Results

The fast-track surgical procedure had shorter total hospital stays and postoperative hospital stays than the conventional surgical procedures. Flatus resumption time, the time until first defecation, and intraoperative blood loss were shorter for the fast-track surgical procedures than the conventional surgical procedures. Those surgery outcomes were also shorter for the fast-track laparoscopy than the open fast-track. Resumption of a fluid diet and ambulation onset time were shorter for the fast-track surgical procedures than the conventional surgical procedures. The surgical checkpoints that were compliance by patient of fast-track surgeries were significantly fewer than those of the conventional surgeries. Clinically significant difference for QLQ-C30/CR38 score after chemotherapy was reported between patients who received open conventional surgeries and those patients who received fast-track laparoscopy (59.63 ± 2.26 score/patient vs. 71.67 ± 5.19 score/patient). There were no significant differences for the number of patients with any grade adverse effects (p= 0.431) or with grade 3–4 adverse effects (p= 0.858), and the disease-free and overall survival among cohorts.

Conclusions

The fast-track surgical procedure is effective and safe even in a multidisciplinary scenario as colorectal cancer treatment in which surgery is only a part of management.

Level of evidence: III

Technical efficacy stage: 4.
A scoping review of international policy responses to mental health recovery during the COVID-19 pandemic
Authors: McCartan Claire , Adell Tomas , Cameron Julie , Davidson Gavin , Knifton Lee , McDaid Shari , Mulholland Ciaran
Published: April 2021

The COVID-19 pandemic has affected people’s physical and mental health. Quarantine and other lockdown measures have altered people’s daily lives; levels of anxiety, depression, substance use, self-harm and suicide ideation have increased. This commentary assesses how international governments, agencies and organisations are responding to the challenge of the mental health impact of COVID-19 with the aim of informing the ongoing policy and service responses needed in the immediate and longer term. It identifies some of the key themes emerging from the literature, recognises at-risk populations and highlights opportunities for innovation within mental health services, focusing on the published academic literature, international health ministry websites and other relevant international organisations beyond the United Kingdom and Ireland. COVID-19 has challenged, and may have permanently changed, mental health services. It has highlighted and exacerbated pre-existing pressures and inequities. Many decision-makers consider this an opportunity to transform mental health care, and tackling the social determinants of mental health and engaging in prevention will be a necessary part of such transformation. Better data collection, modelling and sharing will enhance policy and service development. The crisis provides opportunities to build on positive innovations: the adaptability and flexibility of community-based care; drawing on lived experience in the design, development and monitoring of services; interagency collaboration; accelerating digital healthcare; and connecting physical and mental health.
The effect of on-shelf sugar labeling on beverage sales in the supermarket: a comparative interrupted time series analysis of a natural experiment
Authors: Hoenink J. C. , Stuber J. M. , Lakerveld J. , Waterlander W. , Beulens J. W. J. , Mackenbach J. D.
Published: April 2021

Background

Nutrition labels show potential in increasing healthy food and beverage purchases, but their effectiveness seems to depend on the type of label, the targeted food category and the setting, and evidence on their impact in real-world settings is limited. The aim of this study was to evaluate the effectiveness of an industry-designed on-shelf sugar label on the sales of beverages with no, low, medium and high sugar content implemented within a real-world supermarket.

Methods

In week 17 of 2019, on-shelf sugar labels were implemented by a Dutch supermarket chain. Non-alcoholic beverages were classified using a traffic-light labeling system and included the beverage categories “green” for sugar free (< 1.25 g/250 ml), “blue” for low sugar (1.25–6.24 g/250 ml), “yellow” for medium sugar (6.25–13.5 g/250 ml) and “amber” for high sugar (> 13.5 g/250 ml). Store-level data on beverage sales and revenue from 41 randomly selected supermarkets for 13 weeks pre-implementation and 21 weeks post-implementation were used for analysis. In total, 30 stores implemented the on-shelf sugar labels by week 17, and the 11 stores that had not were used as comparisons. Outcome measures were differences in the number of beverages sold in the four label categories and the total revenue from beverage sales in implementation stores relative to comparison stores. Analyses were conducted using a multiple-group Interrupted Time Series Approach. Results of individual store data were combined using random effect meta-analyses.

Results

At the end of the intervention period, the changes in sales of beverages with green (B 3.4, 95%CI -0.3; 7.0), blue (B 0.0, 95%CI -0.6; 0.7), yellow (B 1.3, 95%CI -0.9; 3.5), and amber (B 0.9, 95%CI -5.5; 7.3) labels were not significantly different between intervention and comparison stores. The changes in total revenues for beverages at the end of the intervention period were also not significantly different between intervention and comparison stores.

Conclusion

The implementation of an on-shelf sugar labeling system did not significantly decrease unhealthy beverage sales or significantly increase healthier beverage sales. Nutrition labeling initiatives combined with complementary strategies, such as pricing strategies or other healthy food nudging approaches, should be considered to promote healthier beverage purchases.
The CD200R1 microglial inhibitory receptor as a therapeutic target in the MPTP model of Parkinson’s disease
Authors: Rabaneda-Lombarte Neus , Serratosa Joan , Bové Jordi , Vila Miquel , Saura Josep , Solà Carme
Published: April 2021

Background

It is suggested that neuroinflammation, in which activated microglial cells play a relevant role, contributes to the development of Parkinson’s disease (PD). Consequently, the modulation of microglial activation is a potential therapeutic target to be taken into account to act against the dopaminergic neurodegeneration occurring in this neurological disorder. Several soluble and membrane-associated inhibitory mechanisms contribute to maintaining microglial cells in a quiescent/surveillant phenotype in physiological conditions. However, the presence of activated microglial cells in the brain in PD patients suggests that these mechanisms have been somehow overloaded. We focused our interest on one of the membrane-associated mechanisms, the CD200-CD200R1 ligand-receptor pair.

Methods

The acute MPTP experimental mouse model of PD was used to study the temporal pattern of mRNA expression of CD200 and CD200R1 in the context of MPTP-induced dopaminergic neurodegeneration and neuroinflammation. Dopaminergic damage was assessed by tyrosine hydroxylase (TH) immunoreactivity, and neuroinflammation was evaluated by the mRNA expression of inflammatory markers and IBA1 and GFAP immunohistochemistry. The effect of the modulation of the CD200-CD200R1 system on MPTP-induced damage was determined by using a CD200R1 agonist or CD200 KO mice.

Results

MPTP administration resulted in a progressive decrease in TH-positive fibres in the striatum and TH-positive neurons in the substantia nigra pars compacta, which were accompanied by transient astrogliosis, microgliosis and expression of pro- and anti-inflammatory markers. CD200 mRNA levels rapidly decreased in the ventral midbrain after MPTP treatment, while a transient decrease of CD200R1 mRNA expression was repeatedly observed in this brain area at earlier and later phases. By contrast, a transient increase in CD200R1 expression was observed in striatum. The administration of a CD200R1 agonist resulted in the inhibition of MPTP-induced dopaminergic neurodegeneration, while microglial cells showed signs of earlier activation in CD200-deficient mice.

Conclusions

Collectively, these findings provide evidence for a correlation between CD200-CD200R1 alterations, glial activation and neuronal loss. CD200R1 stimulation reduces MPTP-induced loss of dopaminergic neurons, and CD200 deficiency results in earlier microglial activation, suggesting that the potentiation of CD200R1 signalling is a possible approach to controlling neuroinflammation and neuronal death in PD.
Epigenetics in blood–brain barrier disruption
Authors: Ihezie Stephanie A. , Mathew Iny Elizebeth , McBride Devin W. , Dienel Ari , Blackburn Spiros L. , Thankamani Pandit Peeyush Kumar
Published: April 2021

The vessels of the central nervous system (CNS) have unique barrier properties. The endothelial cells (ECs) which comprise the CNS vessels contribute to the barrier via strong tight junctions, specific transporters, and limited endocytosis which combine to protect the brain from toxins and maintains brain homeostasis. Blood–brain barrier (BBB) leakage is a serious secondary injury in various CNS disorders like stroke, brain tumors, and neurodegenerative disorders. Currently, there are no drugs or therapeutics available to treat specifically BBB damage after a brain injury. Growing knowledge in the field of epigenetics can enhance the understanding of gene level of the BBB and has great potential for the development of novel therapeutic strategies or targets to repair a disrupted BBB. In this brief review, we summarize the epigenetic mechanisms or regulators that have a protective or disruptive role for components of BBB, along with the promising approaches to regain the integrity of BBB.
Impact of the COVID-19 pandemic on psychological well-being of students in an Italian university: a web-based cross-sectional survey
Authors: Villani Leonardo , Pastorino Roberta , Molinari Enrico , Anelli Franco , Ricciardi Walter , Graffigna Guendalina , Boccia Stefania
Published: April 2021

Background

Italy was the first European country to implement a national lockdown because of the COVID-19 pandemic. Worldwide, this pandemic had a huge impact on the mental health of people in many countries causing similar reaction in terms of emotions and concerns at the population level. Our study investigated the impact of the COVID-19 pandemic on psychological well-being in a cohort of Italian university students.

Methods

We conducted a cross-sectional survey in the period immediately after the first lockdown through the administration of a questionnaire on the personal websites of students attending their undergraduate courses at the Università Cattolica del Sacro Cuore. We used the Patient-Health-Engagement-Scale, Self-Rating-Anxiety-Scale, and Self-Rating-Depression-Scale to assess engagement, anxiety symptoms, and depression symptoms of our sample.

Results

The sample size was 501 subjects, of which 35.33% were classified as anxious and 72.93% as depressed. Over 90% of respondents had good understanding of the preventive measures despite over 70% suffered from the impossibility of physically seeing friends and partners. Around 55% of students would have been willing to contribute much more to face the pandemic. An increase in the occurrences of anxiety was associated with being female, being student of the Rome campus, suffering from the impossibility of attending university, being distant from colleagues, and being unable of physically seeing one’s partner. Performing physical activity reduced this likelihood.

Conclusion

University students are at risk of psychological distress in the case of traumatic events. The evolution of the pandemic is uncertain and may have long-term effects on mental health. Therefore, it is crucial to study the most effective interventions to identify vulnerable subgroups and to plan for acute and long-term psychological services to control and reduce the burden of psychological problems.
Traditional food plants of the upper Aswa River catchment of northern Uganda—a cultural crossroads
Authors: Masters Eliot T.
Published: April 2021

Background

In the parkland agroforestry system of northern Uganda, smallholder farming households rely on a diversity of plant species to fulfil their nutritional requirements, many of which also serve a range of medicinal, cultural, and livelihood functions. The purpose of the study was to assemble an inventory of indigenous plant species used as food in four districts within the Aswa River catchment of northern Uganda, and to document their utilization and management by rural communities.

Methods

From July 1999 to August 2000, a series of 61 community-based focus group discussions on the utilization of plant biodiversity were conducted in the vernacular language at 34 sites in four districts of northern Uganda, with participation by key informants self-selected on basis of their technical knowledge and personal interest. Of these, 232 respondents subsequently contributed to a collection of herbarium specimens, which were submitted to the Makerere University Herbarium for identification. On receipt of each specimen collected, a structured interview was conducted to document the botanical, ecological, seasonal, and alimentary attributes of each identified taxon, and details of its processing and utilization by the community from which it was obtained. The data analysis was undertaken during 2019 and 2020, including statistical tests to assess the relative importance of the cited taxa using the Relative Importance Index (RI), and to determine the similarity of edible plant use between the four cultures using the Jaccard Index of similarity (JI).

Results

Key informant interviews yielded 1347 use reports (URs) for 360 identified specimens of 88 indigenous edible plant species. The data describes patterns of use of indigenous edible plants of four cultures of the Aswa River catchment of northern Uganda. RI scores ranged from 0.93 to 0.11, with fruit trees occupying the top 25 taxa (RI 0.45 and above). Jaccard similarity scores ranged from 25.8% between Lango and Acholi, to 15.8% between Acholi and Ethur, indicating that cultural factors appear to be more significant than shared ancestry as determinants of cultural similarity of plant use.

Conclusions

The data constitute an inventory of on-farm plant species, including cultivated, semi-cultivated, and wild plants, integrated into a parkland agroforestry system in which useful trees and other plant species are sustained and managed under cultivation. Agricultural and on-farm plant biodiversity may be seen as a food security resource, and a nutritional buffer against increasing risks and stressors on low-input smallholder agriculture. Further studies should assess the intra-species biodiversity of these resources, with respect to farmer-valued traits and vernacular (folk) classification systems.
Isolated medial patellofemoral ligament reconstruction for recurrent patellofemoral instability: analysis of outcomes and risk factors
Authors: Migliorini Filippo , Oliva Francesco , Maffulli Gayle D. , Eschweiler Jörg , Knobe Matthias , Tingart Markus , Maffulli Nicola
Published: April 2021

Background

The medial patellofemoral ligament (MPFL) is always damaged after patellar dislocation. In selected patients, MPFL reconstruction is necessary to restore a correct patellar tracking. Despite the large number of different techniques reported to reconstruct the MPFL, there is no consensus concerning the optimal procedure, and debates is still ongoing. The present study analysed the results after isolated MPFL reconstruction in patients with patellofemoral instability. Furthermore, a subgroup analysis of patients presenting pathoanatomical risk factors was made.

Methods

In November 2020, the main electronic databases were accessed. All articles reporting the results of primary isolated MPFL reconstruction for recurrent patellofemoral instability were considered for inclusion. Only articles reporting a minimum 12-month follow-up were eligible.

Results

Data from a total of 1777 knees were collected. The mean age of the patients involved was 22.8 ± 3.4 years. The mean follow-up was 40.7 ± 25.8 months. Overall, the range of motion (+ 27.74; P < 0.0001) and all the other scores of interests improved at last follow-up: Kujala (+ 12.76; P = 0.0003), Lysholm (+ 15.69; P < 0.0001), Tegner score (+ 2.86; P = 0.006). Seventy-three of 1780 patients (4.1%) showed a positive apprehension test. Thirty of 1765 patients (1.7%) experienced re-dislocations, while 56 of 1778 patients (3.2%) showed persisting joint instability. Twenty-five of 1786 patients (1.4%) underwent revision surgeries.

Conclusion

Isolated MPFL reconstruction for recurrent patellofemoral instability provides reliable surgical outcomes. Patients with pathoanatomical predisposing factors reported worse surgical outcomes.
Risk factors of unintended return to the operating room in adult spinal deformity
Authors: Chan Lung , Li Yue , Hai Yong , Liu Yuzeng , Zhang Yangpu
Published: April 2021

Background

To evaluate the incidence and risk factors associated with unintended return to the operating room in adult spinal deformity after spinal deformity corrective surgery.

Methods

Retrospect of 141 adult spinal deformity patients in a single institution between January 2017 and December 2019. Inclusion criteria enrolled 18 to 80 years old patients who diagnosed with congenital/idiopathic/syndromic/acquired spinal deformity underwent posterior corrective spinal surgery. The surgical details and complications were recorded. The rate of unintended return to the operating room (UIROR) during hospitalization was examined, and the risk factors of unintended return to the operating room were investigated via multivariate analysis.

Results

This is a retrospective study. One hundred and forty-one patients who underwent spinal deformity surgery with a mean age of 31.8 years (range 18-69 years) were studied. The rate of unintended return to the operating room was 10.64% (15/141). Two of 15 patients had twice unintended surgery during hospitalization (13.33%). The most principal complication was neurologic deficit (73.3%); six of 15 postoperative present implants deviation causes severe lower limbs radiating pain (40%). The multivariate analysis shows higher apical vertebral rotation (AVR>grade II, odds ratio [OR] = 9.362; 95% CI= 1.930-45.420; P= .006), obesity (OR = 11.448; 95% CI= 1.320-99.263; P= .027), and previous neurological symptom (OR = 7.358; 95% CI= 1.798-30.108; P= .006) were independent predictors of unintended return to the operating room.

Conclusion

Postoperative neurologic deficit and short-term implant malposition are essential causes of unintended return to the operating room in adult spinal deformity patients. Preoperative factors such as higher AVR (> grade II), obesity, and previous neurological symptom may significantly increase the risk of morbidity in UIROR. Spine surgeons should be alert to these risk factors and require adequate preoperative evaluations to reduce the incidence of unintended return to the operating room.
Urinary phthalate exposures and risk of breast cancer: the Multiethnic Cohort study
Authors: Wu Anna H. , Franke Adrian A. , Wilkens Lynne R. , Tseng Chiuchen , Conroy Shannon M. , Li Yuqing , Polfus Linda M. , De Rouen Mindy , Caberto Christian , Haiman Christopher , Stram Daniel O. , Le Marchand Loïc , Cheng Iona
Published: April 2021

Background

The epidemiologic evidence from observational studies on breast cancer risk and phthalates, endocrine disrupting chemicals, has been inconsistent. In the only previous study based on pre-diagnostic urinary phthalates and risk of breast cancer, results were null in mostly white women.

Methods

We examined the association between pre-diagnostic urinary phthalates and breast cancer in a nested case-control study within the Multiethnic Cohort (MEC) study, presenting the first data from five major racial/ethnic groups in the USA. We measured 10 phthalate metabolites and phthalic acid, using a sensitive liquid chromatography mass spectrometry assay on 1032 women with breast cancer (48 African Americans, 77 Latinos, 155 Native Hawaiians, 478 Japanese Americans, and 274 Whites) and 1030 matched controls. Conditional logistic regression was used to examine risk with individual metabolites and ratios of primary (MEHP, mono-2-ethylhexyl-phthalate) to secondary (MEHHP, mono(2-ethyl-5-hydroxyhexyl); MEOHP, mono(2-ethyl-5-oxohexy)) metabolites of di-2-ethylhexyl phthalate (DEHP), a widely used plasticizer. In addition, we investigated risk associations with high (∑HMWP) and low molecular weight (∑LMWP) phthalates, as well as total phthalates which included high and low molecular weight phthalates with phthalic acid (∑LMHMPA) or without phthalic acid in molar ratios (∑LMHMmolar) and adjusted for creatinine and potential confounders.

Results

Among all women, breast cancer risk was higher for those in tertile 2 and tertile 3 of primary to secondary metabolites of DEHP (MEHP/(MEHHP + MEOHP)) in comparison to those in tertile 1; the respective odds ratios were 1.32 (95% CI 1.04–1.68) and 1.26 (95% CI 0.96–1.66) (Ptrend = 0.05). Risk among Native Hawaiian women increased with exposures to eight of ten individual phthalates and total phthalates (∑LMHMPA ORT3 vs T1 = 2.66, 95% CI 1.39–5.12, Ptrend = 0.001). In analysis by hormone receptor (HR) status, exposure above the median of ∑LMWP was associated with an increased risk of HR-positive breast cancer (OR = 1.30, 95% CI 1.05–1.60) while above the median exposure to phthalic acid was associated with an increased risk of HR-negative breast cancer (ORabove vs below median = 1.59, 95% CI 1.01–2.48).

Conclusions

Further investigations of suggestive associations of elevated breast cancer risk with higher ratios of primary to secondary metabolites of DEHP, and differences in risk patterns by race/ethnicity and HR status are warranted.
Interactive effects of biological, human and environmental factors on tick loads in Boran cattle in tropical drylands
Authors: Chepkwony Richard , van Bommel Severine , van Langevelde Frank
Published: April 2021

Background

Tick-borne diseases (TBDs) are a serious threat to humans, wildlife and livestock, and cause severe economic losses in many tropical drylands. The effective control of TBDs has been constrained by limited understanding of what determines tick loads in animals. We tested interactive effects of several biological factors (sex, age and body condition), one environmental factor (rainfall) and one human factor (management type) on tick loads in animals.

Methods

We collected ticks on animals at four sampling sites in the semi-arid savanna area of Laikipia County, Kenya, of which two are commercial ranches and the other two are open pastoral grazing areas. From 2017 to 2019, we collected a total of 2038 ticks from 619 domestic animals from various cattle and camel herds and from 79 tranquilised wild animals.

Results

Generally, wild herbivores (zebras, rhinos and elephants) had higher tick loads than domestic animals. As 83% of the tick samples were taken from Boran cattle, we analysed tick load in these cattle in more detail. Boran cattle had high tick loads in the wet season, especially those animals in poor condition. No differences were found between female and male cattle, regardless of season. The calves had high tick loads during both the wet and dry seasons, whereas the sub-adult and adult cattle had less ticks during the dry season. Cattle on the intensively managed ranches had lower tick load than those in the transhumant management system.

Conclusion

These findings highlight the importance of establishing effective control of ticks on domestic animals in transhumant management systems as tick loads were high on these animals in both the wet and dry season.

Graphic abstract
Vaccination against the brown stomach worm, Teladorsagia circumcincta, followed by parasite challenge, induces inconsistent modifications in gut microbiota composition of lambs
Authors: Rooney James , Cortés Alba , Scotti Riccardo , Price Daniel R. G. , Bartley Yvonne , Fairlie-Clarke Karen , McNeilly Tom N. , Nisbet Alasdair J. , Cantacessi Cinzia
Published: April 2021

Background

Growing evidence points towards a role of gastrointestinal (GI) helminth parasites of ruminants in modifying the composition of the host gut flora, with likely repercussions on the pathophysiology of worm infection and disease, and on animal growth and productivity. However, a thorough understanding of the mechanisms governing helminth-microbiota interactions and of their impact on host health and welfare relies on reproducibility and replicability of findings. To this aim, in this study, we analysed quantitative and qualitative fluctuations in the faecal microbiota composition of lambs vaccinated against, and experimentally infected with, the parasitic GI nematodeTeladorsagia circumcinctaover the course of two separate trials performed over two consecutive years.

Methods

Two trials were conducted under similar experimental conditions in 2017 and 2018, respectively. In each trial, lambs were randomly assigned to one of the following experimental groups: (i) vaccinated/infected, (ii) unvaccinated/infected and (iii) unvaccinated/uninfected. Faecal samples collected from individual animals were subjected to DNA extraction followed by high-throughput sequencing of the V3-V4 region of the bacterial 16S rRNA gene and bioinformatics and biostatistical analyses of sequence data.

Results

Substantial differences in the populations of bacteria affected by immunisation against and infection byT. circumcinctawere detected when comparing data from the two trials. Nevertheless, the abundance ofPrevotellaspp. was significantly linked to helminth infection in both trials.

Conclusions

Despite the largely conflicting findings between the two trials, our data revealed that selected gut microbial populations are consistently affected byT. circumcinctainfection and/or vaccination. Nevertheless, our study calls for caution when interpreting data generated fromin vivohelminth-microbiome interaction studies that may be influenced by several intrinsic and extrinsic host-, parasite- and environment-related factors.

Graphical Abstract
Sparse signal recovery from modulo observations
Authors: Shah Viraj , Hegde Chinmay
Published: April 2021

We consider the problem of reconstructing a signal from under-determined modulo observations (or measurements). This observation model is inspired by a relatively new imaging mechanism called modulo imaging, which can be used to extend the dynamic range of imaging systems; variations of this model have also been studied under the category of phase unwrapping. Signal reconstruction in the under-determined regime with modulo observations is a challenging ill-posed problem, and existing reconstruction methods cannot be used directly. In this paper, we propose a novel approach to solving the signal recovery problem under sparsity constraints for the special case to modulo folding limited to two periods. We show that given a sufficient number of measurements, our algorithm perfectly recovers the underlying signal. We also provide experiments validating our approach on toy signal and image data and demonstrate its promising performance.
Optimization strategy of wireless charger node deployment based on improved cuckoo search algorithm
Authors: Wang Yang , Wang Feifan , Zhu Yujun , Liu Yiyang , Zhao Chuanxin
Published: April 2021

In wireless rechargeable sensor network, the deployment of charger node directly affects the overall charging utility of sensor network. Aiming at this problem, this paper abstracts the charger deployment problem as a multi-objective optimization problem that maximizes the received power of sensor nodes and minimizes the number of charger nodes. First, a network model that maximizes the sensor node received power and minimizes the number of charger nodes is constructed. Second, an improved cuckoo search (ICS) algorithm is proposed. This algorithm is based on the traditional cuckoo search algorithm (CS) to redefine its step factor, and then use the mutation factor to change the nesting position of the host bird to update the bird’s nest position, and then use ICS to find the ones that maximize the received power of the sensor node and minimize the number of charger nodes optimal solution. Compared with the traditional cuckoo search algorithm and multi-objective particle swarm optimization algorithm, the simulation results show that the algorithm can effectively increase the receiving power of sensor nodes, reduce the number of charger nodes and find the optimal solution to meet the conditions, so as to maximize the network charging utility.
A multi-objective model-based vertical handoff algorithm for heterogeneous wireless networks
Authors: Wang Shumin , Deng Honggui , Xiong Rujing , Liu Gang , Liu Yang , Liu Hongmei
Published: April 2021

The emergence of 5G communication systems will not replace existing radio access networks but will gradually merge to form ultra-dense heterogeneous networks. In heterogeneous networks, the design of efficient vertical handoff (VHO) algorithms for 5G infrastructures is necessary to improve quality of service (QoS) and system resource utilization. In this paper, an optimized algorithm based on a multi-objective optimization model is proposed to solve the lack of a comprehensive consideration of user and network impacts during the handoff process in existing VHO algorithms. The Markov chain model of each base station (BS) is built to calculate a more accurate value of the network state that reflects the network performance. Then, a multi-objective optimization model is derived to maximize the value of the network state and the user data receiving rate. The multi-objective genetic algorithm NSGA-II is finally employed to turn the model into a final VHO strategy. The results of the simulation for the throughput and blocking rate of networks demonstrate that our algorithm significantly increases the system throughput and reduces the blocking rate compared to the existing VHO strategies.
Note on constructing a family of solvable sine-type difference equations
Authors: Ahmed Ahmed El-Sayed , Iričanin Bratislav , Kosmala Witold , Stević Stevo , Šmarda Zdeněk
Published: April 2021

We obtain a family of first order sine-type difference equations solvable in closed form in a constructive way, and we present a general solution to each of the equations.
Association between visceral adiposity and DDX11 as a predictor of aggressiveness of small clear-cell renal-cell carcinoma: a prospective clinical trial
Authors: Park Jee Soo , Jang Won Sik , Kim Jongchan , Lee Seung Hwan , Rha Koon Ho , Ham Won Sik
Published: April 2021

Background

Visceral fat produces several hormones and cytokines associated with carcinogenesis and tumor progression. Herein, we investigated the association between visceral adiposity and target-gene mRNA expression in patients with localized small clear-cell renal-cell carcinoma (ccRCC).

Methods

We included 200 patients with localized clinical T1a stage ccRCC who had undergone nephrectomy from November 2018 to November 2020 in a prospective clinical trial (NCT03694912). Visceral, subcutaneous, and total adipose tissue in these patients was measured via preoperative computerized tomography of the mid-third lumbar vertebra region. We then examined the association between adiposity and the mRNA levels of PBRM1, BAP1, SETD2, KDM5C, FOXC2, CLIP4, AQP1, DDX11, BAIAP2L1, and TMEM38B in matched frozen tumor tissues and plasma samples.

Results

Upon the stratification of patients into quartiles according to their relative visceral adiposity, high visceral adiposity was found to be significantly associated with low ISUP grade (P = 0.004). Multivariate logistic regression analysis revealed a significant association between frozen tissue DDX11 expression and high visceral adiposity (OR 0.676, 95% CI 0.587–0.779, P < 0.001). Moreover, frozen tissue DDX11 expression was significantly associated with high ISUP grade (OR 1.556, 95% CI 1.223–1.981, P < 0.001). The frozen tissue mRNA expression of DDX11 was identified as a biomarker for visceral adiposity and cancer aggressiveness.

Conclusions

The results obtained herein will aid in inferring the aggressiveness of small ccRCCs, represented by ISUP nuclear grade, in clinical practice. Our findings indicated that DDX11 and visceral fat play active roles in small ccRCC. These roles should be examined in future studies for the possible use of DDX11 and visceral fat as prognostic biomarkers in the treatment of patients with ccRCC.

Trial registration

ClinicalTrials.gov, NCT03694912, Registered 3 October 2018.
Point-of-care detection of lactate in cerebrospinal fluid
Authors: Stephani C. , Choi A. H. K. , Moerer O.
Published: April 2021

Purpose

Measurements of cerebrospinal fluid (CSF) lactate can aid in detecting infections of the central nervous system and surrounding structures. Neurosurgical patients with temporary lumbar or ventricular CSF drainage harbor an increased risk for developing infections of the central nervous system, which require immediate therapeutic responses. Since blood gas analyzers enable rapid blood-lactate measurements, we were interested in finding out if we can reliably measure CSF-lactate by this point-of-care technique.

Methods

Neurosurgical patients on our intensive care unit (ICU) with either lumbar or external ventricular drainage due to a variety of reasons were included in this prospective observational study. Standard of care included measurements of leucocyte counts, total protein and lactate measurements in CSF by the neurochemical laboratory of our University Medical Center twice a week. With respect to this study, we additionally performed nearly daily measurements of cerebrospinal fluid by blood gas analyzers to determine the reliability of CSF-lactate measured by blood gas analyzers as compared to the standard measurements with a certified device.

Results

62 patients were included in this study. We performed 514 CSF-lactate measurements with blood gas analyzers and compared 180 of these to the in-house standard CSF-lactate measurements. Both techniques correlated highly significantly (Pearson correlation index 0.94) even though lacking full concordance in a Bland–Altman plotting. Of particular importance, regular measurements enabled immediate detection of central infection in three patients who had developed meningitis during the course of their treatment.

Conclusion

Blood gas analyzers measure CSF-lactate with sufficient reliability and can help in the timely detection of a developing meningitis. In addition to and triggering established CSF diagnostics, CSF-lactate measurements by blood gas analyzers may improve surveillance of patients with CSF drainage.

This study was retrospectively registered on April 20th 2020 in the German trial register. The trial registration number is DRKS00021466.
Could contact lens dryness discomfort symptoms sometimes have a neuropathic basis?
Authors: McMonnies Charles W.
Published: April 2021

Symptoms of dryness discomfort in soft contact lens wearers frequently lead to discontinuation from wear. The negative influence of pre-fitting tear dysfunctions appears likely to be exacerbated by the challenges to tear homeostasis caused by contact lenses. The corneal mechanisms for symptoms in contact lens wearers are different to those for dry eye disease because the cornea is insulated by the lens from ambient conditions as well as from lid wiper friction during blinking. Symptoms of dryness discomfort might be the consequence of increased lid wiper friction during blinking when the lens front surface becomes soiled and dry and exhibits very rapid tear break up. It is possible that some cases of contact lens intolerance and discontinuation could be a function of lid wiper neuropathy. In relation to the possibility of corneal neuropathy, a stagnant post-lens tear pool with the possibility of increased concentrations of metabolic by-products, cellular debris, and bacterial exotoxins, might have the potential to disturb the corneal epithelial and sub-basal nerves. Contributions by contact lens-induced inflammation to any neuropathic changes may partly depend on the degree to which inflammatory mediators are concentrated in a stagnant post-lens tear pool. It does not appear to be known if corneal neuropathic changes could develop under these conditions. The chances of neuropathic involvement may be greater if discomfort develops after a significant period of successful wear and there is a history of comorbid pain conditions. Esthesiometry and in vivo confocal microscopy in discontinued contact lens wearers may support a diagnosis of contact lens-related corneal neuralgia.
Analysing spatial interdependence among the 2011 Thailand flood-affected small and medium enterprises for reduction of disaster recovery time period
Authors: Pathak Shubham , Olmo Jorge Chica
Published: April 2021

Natural disasters have been a significant hurdle in the economic growth of middle-income developing countries. Thailand has also been suffering from recurring flood disasters and was most which are severely affected during the 2011 floods. This paper aims to identify the various factors that impact the speed of disaster recovery among the Small and Medium Enterprises (SMEs) severely affected by the floods in Pathumthani province in central Thailand, and how it is related to its speed decision of neighbours SMEs. The methodology adopts a spatial econometric model, to analysis and understand each of the chosen factors’ impact. The findings include the impact of disaster resilience, mitigation and planning at the SME level as well as the government level. The absence of accurate perception of actual risk, flood insurance and disaster management planning before the 2011 floods had contributed to the severity of the impacts during the 2011 floods.
Atypical respiratory distress in eastern Democratic Republic of the Congo prior to the COVID-19 pandemic. A case report
Authors: Mateso Guy-Quesney , Baguma Marius , Mwene-Batu Pacifique , Balemba Ghislain Maheshe , Nzabara Fabrice , Makali Samuel , Bedha Aline , Furaha Bonheur , Minani Jimmy , Muhindo Christian Tshongo , Malembaka Espoir Bwenge , Masimango Mannix Imani , Shindano Tony Akilimali , Cikomola Justin Cirhuza , Mubagwa Kanigula
Published: April 2021

Background

Predictions have been made that Africa would be the most vulnerable continent to the novel Coronavirus disease 2019 (COVID-19). Interestingly, the spread of the disease in Africa seems to have been delayed and initially slower than in many parts of the world. Here we report on two cases of respiratory distress in our region before the official declaration of the disease in December 2019, cases which in the present times would be suspect of COVID-19.

Case presentation

These two cases (one 55-year-old man and one 25-year-old woman) of acute respiratory distress secondary to atypical pneumonia were seen in Bukavu, in Eastern Democratic Republic of the Congo (DRC), between September and December 2019. One patient had returned from China and the other had close contacts with travellers from China in the 2 weeks prior to the onset of symptoms. In either case, the aetiology could not be accurately determined. However, the two cases presented a clinical picture (progressive dyspnoea, preceded by dry cough and fever) and laboratory changes (procalcitonin within the normal range, slight inflammation, and lymphopenia) compatible with a viral infection. The chest X-ray series of the first patient showed lesions (reticulations, ground glass, and nodules ≤6 mm) similar to those currently found in COVID-19 patients. In addition, unlike the 25-year-old female patient who had no comorbidity, the 55-year-old male patient who had hypertension as comorbidity, developed a more severe acute respiratory distress which progressed to death.

Conclusion

These cases bring to the attention the fact that COVID-19-like syndromes may have already been present in the region months before the official beginning of the pandemic. This also brings to question whether a prior presence of the disease or infections with related virus may account for the delayed and less extensive development of the pandemic in the region.
Human nasal septal chondrocytes (NSCs) preconditioned on NSC-derived matrix improve their chondrogenic potential
Authors: Noh Yong Kwan , Kim Sung Won , Kim Ik-Hwan , Park Kwideok
Published: April 2021

Background

Extracellular matrix (ECM) has a profound effect on cell behaviors. In this study, we prepare a decellularized human nasal septal chondrocyte (NSC)-derived ECM (CHDM), as a natural (N-CHDM) or soluble form (S-CHDM), and investigate their impact on NSCs differentiation.

Methods

N-CHDM, S-CHDM were obtained from NSC. To evaluate function of NSC cultured on each substrate, gene expression using chondrogenic marker, and chondrogenic protein expression were tested. Preconditioned NSCs-loaded scaffolds were transplanted in nude mice for 3 weeks and analyzed.

Results

When cultivated on each substrate, NSCs exhibited similar cell spread area but showed distinct morphology on N-CHDM with significantly lower cell circularity. They were highly proliferative on N-CHDM than S-CHDM and tissue culture plastic (TCP), and showed more improved cell differentiation, as assessed via chondrogenic marker (Col2, Sox9, and Aggrecan) expression and immunofluorescence of COL II. We also investigated the effect of NSCs preconditioning on three different 2D substrates while NSCs were isolated from those substrates, subsequently transferred to 3D mesh scaffold, then cultivated them
in vitro
or transplanted
in vivo
. The number of cells in the scaffolds was similar to each other at 5 days but cell differentiation was notably better with NSCs preconditioned on N-CHDM, as assessed via real-time q-PCR, Western blot, and immunofluorescence. Moreover, when those NSCs-loaded polymer scaffolds were transplanted subcutaneously in nude mice for 3 weeks and analyzed, the NSCs preconditioned on the N-CHDM showed significantly advanced cell retention in the scaffold, more cells with a chondrocyte lacunae structure, and larger production of cartilage ECM (COL II, glycosaminoglycan).

Conclusions

Taken together, a natural form of decellularized ECM, N-CHDM would present an advanced chondrogenic potential over a reformulated ECM (S-CHDM) or TCP substrate, suggesting that N-CHDM may hold more diverse signaling cues, not just limited to ECM component.
Transient dynamical-thermal-optical system modeling and simulation
Authors: Hahn Luzia , Eberhard Peter
Published: April 2021

In modern high resolution optical systems like astronomical telescopes or lithographic objectives, performance degradations can be caused by various disturbances. Holistic optical system simulation is required to predict the performance or the high precision systems. In this paper a method for transient dynamical-thermal-optical system modeling and simulation is introduced. Thereby, elastic deformation, rigid body motion, and mechanical stresses due to dynamical excitation are calculated using elastic multibody system simulation and temperature changes are determined using thermal finite element analysis. The deformation, the motion, and the mechanically and thermally induced stress index changes are then considered in a gradient-index ray tracing. Finally, the presented method is applied in a dynamical-thermal single lens system.
Karyomegalic interstitial nephritis: diagnosed only when suspected
Authors: Sivakumar Monica , Gaspar Balan Louis , Narasimhan Balakrishnan
Published: April 2021

Background

Karyomegalic interstitial nephritis (KIN) is an uncommon cause of chronic interstitial nephritis that eventually progresses to end-stage renal disease. Overall less than 50 cases have been reported in the literature.

Case presentation

We describe an asymptomatic 25-year-old gentleman with a family history of chronic interstitial nephritis who came to check the status of his kidney functions. On evaluation, he was found to have chronic interstitial nephritis which could not be attributed to a specific etiology. Renal biopsy confirmed the diagnosis of KIN.

Conclusion

KIN remains underdiagnosed. It is important to recognize this entity because of the familial nature, a wide range of differential diagnoses, and prognostic implications. A high index of clinical suspicion is necessary to perform renal biopsy which remains the gold standard for the diagnosis of KIN.
Assessing the risks of SARS-CoV-2 in wildlife
Authors: Delahay R. J. , de la Fuente J. , Smith G. C. , Sharun K. , Snary E. L. , Flores Girón L. , Nziza J. , Fooks A. R. , Brookes S. M. , Lean F. Z. X. , Breed A. C. , Gortazar C.
Published: April 2021

The novel coronavirus SARS-CoV-2 likely emerged from a wildlife source with transmission to humans followed by rapid geographic spread throughout the globe and severe impacts on both human health and the global economy. Since the onset of the pandemic, there have been many instances of human-to-animal transmission involving companion, farmed and zoo animals, and limited evidence for spread into free-living wildlife. The establishment of reservoirs of infection in wild animals would create significant challenges to infection control in humans and could pose a threat to the welfare and conservation status of wildlife. We discuss the potential for exposure, onward transmission and persistence of SARS-CoV-2 in an initial selection of wild mammals (bats, canids, felids, mustelids, great apes, rodents and cervids). Dynamic risk assessment and targeted surveillance are important tools for the early detection of infection in wildlife, and here we describe a framework for collating and synthesising emerging information to inform targeted surveillance for SARS-CoV-2 in wildlife. Surveillance efforts should be integrated with information from public and veterinary health initiatives to provide insights into the potential role of wild mammals in the epidemiology of SARS-CoV-2.