bluuebunny/crossref_metadata_2025 huggingface dataset:
Intelligent Backpropagated Neural Networks for Numerical Computations for MHD Squeezing Fluid Suspended by Nanoparticles between Two Parallel Plates
Authors: Shoaib Muhammad , Raja Muhammad Asif Zahoor , Farhat Imrana , Shah Zahir , Kumam Poom
Published: January 2021

In the present research, artificial intelligence based backpropagated neural networks with Levenberg-Marquardt algorithm (BNN-LMA) are utilized to interpret the numerical computation for squeezing 2D magneto-hydrodynamic (MHD) nanofluid flow between two parallel plates. The non-linear system of ODEs represents the magneto-hydrodynamic, squeezing nanofluidic flow model (MHD-SNFM). A reference dataset for BNN-LMA is formulated by utilizing Adam numerical solver for different scenarios of MHD-SNFM by variation of squeezing number, Hartmann Number and heat source parameter. The validation, testing and training processes of BNN-LMA are exploited to analyze the approximate solution of MHD-SNFM for different scenarios and correctness of proposed BNN-LMA is verified by comparison of reference outcomes. The performance of BNN-LMA to solve the MHD-SNFM is validated through regression analysis, histogram studies and mean square error (MSE).
COVID-19 Pandemic in the Disguise of Multi System Inflammatory Syndrome in Children: A Case Series
Authors: Dashti Anahita Sanaei , Ebrahimi Kamyar , Shahriarirad Reza , Ghotbabadi Shabnam Hajiani , Aminnia Shiva
Published: January 2021

Although nearly a year has passed since the emerge of the SARS-CoV-2 virus, with it, a serious and novel pediatric condition called children's multisystem inflammatory syndrome (MIS-C) has subsequently emerged. In order to achieve a better understanding and management of the disease, documentation and reporting of atypical cases is justified, particularly with the growing number of children with inflammatory syndrome with clinical features simulating MIS during the ongoing COVID-19 pandemic. Based on similar reports from numerous countries with temporal relation to COVID-19 infection in the community, it is essential for general pediatricians to be on alert for such atypical presentations and early referral to tertiary care should be considered as appropriate. Here we four cases of Multisystem Inflammatory Syndrome (MIS) during the COVID-19 pandemic. Early diagnosis and treatment of patients meeting full or partial criteria for MIS are critical to preventing end-organ damage and other long-term complications, especially during times of public crisis and global health emergencies, such as the novel coronavirus pandemic.
Stroke Risk Factors, Subtypes and Outcome in Elderly Thai Patients
Authors: Samuthpongtorn Chatpol , Jereerat Tul , Suwanwela Nijasri
Published: January 2021

Background: Nowadays, the number of elderly has steadily increased annually. Elderly patients with ischemic stroke often have worse outcomes than younger patients. However, there has not been a study of ischemic stroke in the elderly in Thailand. A better knowledge of the risk factors, subtypes, and outcomes of strokes in the elderly may have significant practical implications for the aged society in the future. The objective of the study was to assess the risk factor, stroke subtypes, and outcome of stroke in the elderly compared to the younger patients.Method: All patients presented with acute ischemic stroke and transient ischemic attack (TIA) aged over 45 years who were admitted in the Stroke unit between November 1st, 2016 and December 31st, 2017 were retrospectively studied.Result: 542 patients were included. The average age was 68.78±12.03, 44.8% of them were male. 186 (34.3%) patients were 75 or older. Cardioembolism was found to be the most common cause of ischemic stroke in 156 patients (28.8%). Patients who were 75 or older had significantly worse outcomes in all categories including NIHSS at discharge, modified Rankin scale, length of stay and the number of deaths) compared to the younger group. Atrial fibrillation was the risk factors associated with older age with OR 3.861 (p value<0.001). Aged 75 years or older, atrial fibrillation, more NIHSS score on admission and history of the previous stroke were the risk factors associated with a patient's death.Conclusion: The elderly who are 75 years or older accounts for more than one-third of ischemic stroke in our study. Stroke in the elderly correlates with higher mortality and poorer outcome. Cardioembolism related to atrial fibrillation is the major cause of stroke in this population.
Obesity Drives an Oral Microbiota Signature of Female Patients With Periodontitis.
Authors: Thomas Charlotte , Minty Matthieu , Canceill Thibault , Loubieres Pascale , Azalbert Vincent , Terce Francois , Champion Camille , Burcelin Rémy , Barthet Pierre , Laurencin-Dalicieux Sara , Blasco-Baque Vincent
Published: January 2021

The aim of this study was to analyze the link between oral microbiota and obesity in humans. We conducted a pilot study including 19 subjects with periodontitis divided into two groups: normo-weighted subjects (NWS) with a body mass index (BMI) between 20 and 25 (n=9) and obese subjects (OS) with a BMI >30 (n=10). The abundance of the Capnocytophaga genus, found in oral microbiota by taxonomic analysis, was higher (2.47% ± 3.02 vs 0.27% ± 0.29, p=0.04) in OS compared to NWS. Decayed teeth (2.25 ± 2.21 vs 0, p=0.04) were significantly increased in obese females (OF) compared to obese males (OM) associated with a dysbiotic oral microbiota (39.45 ± 3.74 vs 26.41 ± 11.21, p=0.03 for the Chao 1 index). OF were characterized by an increase in the Streptococcus genus (34.12% ± 14.29 vs 10.55% ± 10.42, p=0.05) compared to OM where the Neisseria genus was increased (5.75% ± 5.03 vs 58.05% ± 30.64, p=0.008). These first data suggest that the sex gender is determinant in the link between oral dysbiotic microbiota and obesity. Our study proposes an adaption of therapeutic strategies for obese patients with periodontitis following the sex gender.
Skilful prediction of cod stocks in the North and Barents Sea a decade in advance
Authors: Koul Vimal , Sguotti Camilla , Årthun Marius , Brune Sebastian , Düsterhus André , Bogstad Bjarte , Ottersen Geir , Baehr Johanna , Schrum Corinna
Published: January 2021

Reliable information about the future state of the ocean and fish stocks is necessary for informed decision-making by fisheries scientists, managers and the industry. However, multiyear regional ocean climate and fish stock predictions have until now had low forecast skill. Here, we provide skillful forecasts of the biomass of cod stocks in the North and Barents Seas a decade in advance. We develop a unified dynamical-statistical prediction system wherein statistical models link future total stock biomass to dynamical predictions of sea surface temperature, while also considering different fishing mortalities. We evaluate non-linear effects of temperature and fishing on cod biomass, and provide evidence of climate-derived predictability in cod stocks. We forecast the continuation of unfavorable oceanic conditions for the North Sea cod for the coming decade which would inhibit its recovery at present fishing levels, and a decrease in Northeast Arctic cod stock compared to the recent high levels.
Improved Up-and-Down Procedure for Acute Toxicity Measurement With Reliable LD50 Verified by Typical Toxic Alkaloids and Modified Karber Method
Authors: Zhang Yan-Yu , Huang Yu-Feng , Liang Jie , Zhou Hua
Published: January 2021

Background: Up-and-down procedure (UDP) was recommended to replace traditional acute toxicity methods. However, it was limited due to the long experimental period (20 - 42 days). To improve UDP, an improved UDP method (iUDP) was developed by shortening observation time between sequence dosages. The aim of this study was to test the reliability of iUDP to provide a reliable method for the acute toxicity measurement of valuable or minor amount compounds. Methods: Oral median lethal dosage (LD50) of nicotine, sinomenine hydrochloride and berberine hydrochloride were measured both by iUDP and modified Karber method (mKM). Results: LD50 of the three alkaloids measured by iUDP with 23 mice were 32.71 ± 7.46, 453.54 ± 104.59, 2954.93 ± 794.88 mg/kg, respectively. LD50 of the three alkaloids measured by mKM with 240 mice were 22.99 ± 3.01, 456.56 ± 53.38, 2825.53 ± 1212.92 mg/kg, respectively. The average time consumed by the two methods were 22 days and 14 days respectively. Total grams of the alkaloids used by the two methods were 0.0082 and 0.0673 (nicotine), 0.114 and 1.24 (sinomenine hydrochloride), 1.9 and 12.7 (berberine hydrochloride). Conclusion: iUDP could replace mKM to detect acute toxicity of substances with comparable and reliable result. And it was suitable for valuable or minor amount substances.
Methylene Blue Adsorption from aqueous solution by low cost vine-wood biomass
Authors: Souidi Rachida , khane yasmina , Belarbi Lahcen , Bousalem Smain
Published: January 2021

In this work, the sawdust of vine wood (VW) was treated with sulfuric acid and used to adsorb methylene blue (MB) from aqueous solutions via a batch adsorption process. The characteristics of the adsorbent were determined by various analytical techniques such as Fourier-transform infrared (FT-IR) spectroscopy, X-ray diffraction (XRD) and scanning electron microscopy (SEM) and Brunauer−Emmett−Teller (BET) N2 adsorption−desorption isotherms. The effects of various experimental parameters including sulfuric acid concentration, particle size of the adsorbent, pH of the solution, contact time, initial concentration, adsorbent dosage and temperature on adsorption of MB by activating sawdust were systematically investigated. The experimental results showed that the adsorption efficiency was increased with contact time and adsorbent dosage. The maximum removal efficiency was found after 180 min of solid/liquid contact with adsorbent doses of 1 g/l for sawdust. The isotherm and kinetic experimental data for MB adsorption on VW sawdust were best-fitted by Langmuir models and Pseudo-second-order, respectively. The calculated values of the entropy (ΔS°), enthalpy (ΔH°) and Gibbs energy (ΔG°) indicated that the adsorption process was exothermic in nature. These results suggest that the activated sawdust can be employed as a low-cost and environmentally friendly adsorbent for the treatment of wastewaters containing dyes.
Assessment of Inter-Institutional Post-Operative Hypoparathyroidism Status Using A Common Data Model
Authors: Lee Joon-Hyop , Kim Suhyun , Kim Kwangsoo , Chai Young Jun , Yu Hyeong Won , Kim Su-Jin , Choi June Young , Chung Yoo Seung , Lee Kyu Eun , Yi Ka Hee
Published: January 2021

Post-thyroidectomy hypoparathyroidism may result in various transient or permanent symptoms, ranging from tingling sensation to severe breathing difficulties. Its incidence varies among surgeons and institutions, making it difficult to determine its actual incidence and associated factors. This study attempted to estimate the incidence of post-operative hypoparathyroidism in patients at two tertiary institutions that share a common data model, the Observational Health Data Sciences and Informatics. Of the 4848 eligible patients at the two institutions who underwent thyroidectomy, 1370 (28.26%) experienced transient hypoparathyroidism and 251 (5.18%) experienced persistent hypoparathyroidism. Univariate logistic regression analysis predicted that, relative to total bilateral thyroidectomy, radical tumor resection was associated with a 48% greater likelihood of transient hypothyroidism and a 102% greater likelihood of persistent hypothyroidism. Moreover, multivariate logistic analysis found that radical tumor resection was associated with a 50% greater likelihood of transient hypothyroidism and a 97% greater likelihood of persistent hypothyroidism than total bilateral thyroidectomy. In addition to estimating the incidence of and risk factors for post-operative hypoparathyroidism at two institutions, these findings, by integrating and analyzing two databases, suggest that this analysis could be expanded to include other large databases that share the same Observational Health Data Sciences and Informatics protocol.
Lockdown-associated Hunger May Be Affecting Breastfeeding: Findings From a Large SMS Survey in South Africa
Authors: Sayed Nazeeia , Burger Ronelle , Harper Abigail , Swart Elizabeth C (Rina)
Published: January 2021

There are growing concerns on the impact of COVID-19 on food security and child health in South Africa. A rapid SMS Maternal and Child Health survey was conducted in South Africa in June (n=3140) with a follow up in July (n=2287). Breastfeeding practices found in this survey confirmed findings from other studies: with high breastfeeding initiation rates and early introduction of other foods/mixed milk feeding. Logistic regression was conducted to explore the associations between breastfeeding, maternal depression and hunger in the household. The odds of hungry mothers breastfeeding were significantly lower (OR = 0.66; 95% CI: 0.44, 0.99). The prevalence of depression in this survey sample was 26.95%, but there was no association between breastfeeding behaviour and depression scores (OR = 0.89; 95% CI: 0.63, 1.27). A positive correlation was found between not breastfeeding and not going to the health clinic. Breastfeeding needs to be protected, promoted and supported; and mothers should be encouraged to continue to attend the health clinic. Further to communication to communities, supporting the breastfeeding mother to enable her to breastfeed and feel competent to do so is a critical gap that needs to be addressed. This support could include economic support to enable her to access a nutritious diet. Mothers also need reassurance on the quality of their breastmilk and their ability to breastfeed. Aside from the nutritional superiority, the safety and immune benefits of breastmilk may need to be asserted to counter concerns during the COVID-19 pandemic.
Interaction between Early in Ovo Stimulation of the Gut Microbiota and Chicken Host – Splenic Changes in Gene Expression and Methylation
Authors: Dunislawska Aleksandra , Slawinska Anna , Gryzinska Magdalena , Siwek Maria
Published: January 2021

Background: Epigenetic regulation of the gene expression results from interaction between the external environment and transcription of the genetic information encoded in DNA. Methylated CpG regions within the gene promoters lead to silencing of the gene expression. Factors contributing to epigenetic regulation include intestinal microbiota, which in chicken can be potently modified by in ovo stimulation. The main aim of this study was to determine global and specific methylation patterns for the spleen under the influence of host-microbiome interaction. Results: Incubating eggs were in ovo stimulated on day 12 of incubation in two chicken genotypes: Ross broilers and Green-legged Partridgelike. The injected compounds included: probiotic – Lactococcus lactis subsp. cremoris, prebiotic – galactooligosaccharides, and synbiotic – combination of both. Chickens were sacrificed on day 42 post-hatching. Spleen was collected, RNA and DNA were isolated and intended to gene expression, gene methylation and global methylation analysis. We have proved that negative regulation of gene expression after administration of bioactive substances in ovo might have epigenetic character. Epigenetic changes depend on the genotype and the substance administered in ovo. Conclusion: Epigenetic nature of microbial reprogramming in poultry and extension of issues related to host-microbiome interaction is a new direction of this research.
ATP Signaling in the Integrative Neural Center of Aplysia Californica
Authors: Györi János , Kohn Andrea , Romanova Daria , Moroz Leonid
Published: January 2021

ATP and its ionotropic P2X receptors are components of the most ancient signaling systems. However, little is known about the distribution and function of purinergic transmission in invertebrates. Here, we cloned, expressed, and pharmacologically characterized P2X receptors in the sea slug Aplysia californica – the prominent neuroscience model. acP2X receptors were successfully expressed in Xenopus oocytes and were displayed activation by ATP with two-phased kinetics and Na+-dependence. Pharmacologically, they were quite different from other P2X receptors. The ATP analog, Bz-ATP, was a less effective agonist than ATP, and PPADS was a more potent inhibitor of the acP2X receptors than the suramin. acP2X were uniquely expressed within the cerebral F-cluster, which contains multiple secretory peptides (e.g., insulins, interleukins, and potential toxins), ecdysone-type receptors, and a district subset of ion channels. We view F-cluster as the multifunctional integrative center, remarkably different from other neurosecretory cells. acP2X receptors were also found in the chemosensory structures and the early cleavage stages. Therefore, in molluscs, rapid ATP-dependent signaling can be implicated both in development and diverse homeostatic functions. Furthermore, this study illuminates novel cellular and systemic features of P2X-type ligand-gated ion channels for deciphering evolution of neurotransmitters.
The Prediction Factors of Anabolic-Androgenic Steroid Use among Bodybuilders: Application of Prototype Willingness Model
Authors: Manoochehri Zohreh , Barati Majid , Faradmal Javad , Manoochehri Sara
Published: January 2021

Background: One of the types of doping commonly used by bodybuilders is androgenic-anabolic steroids (AAS).The use of AAS in addition to violating sporting ethics, has serious consequences on physical and mental health. The purpose of this study was to determining the most important factors of AAS use among bodybuilders using prototype willingness model (PWM).Methods: In this analytical cross-sectional study, 280 male bodybuilders were selected using multistage sampling from the bodybuilding clubs in Hamadan city in 2016.A self-administered questionnaire consisting of demographic information and constructs of the PWM was used to collect data and random forest model was used to analyses the gathered data.Results: behavioral willingness, Attitude, previous AAS use were the most important factors in determining the behavioral intention. Subjective norms, attitude, BMI and prototypes were the factors that have the greatest impact on predicting of behavioral willingness of AAS use. Also behavioral intention was more important rather than behavioral willingness for predicting of AAS use.Discussion: The results based on PWM and random forest showed that the reasoned action path has a greater impact than social reaction path to predict AAS use among bodybuilders.
Keeping Children Healthy During and After COVID-19 Pandemic: Meeting Youth Physical Activity Needs
Authors: Pavlovic Andjelka , DeFina Laura F. , Natale Breanna L. , Thiele Shelby E. , Walker Timothy J. , Craig Derek W. , Vint Georgina R. , Leonard David , Haskell William L. , III Harold W. Kohl
Published: January 2021

Background: The purpose of this study was to: 1) examine the maintenance of Physical Education and physical activity during the distance learning time, 2) determine the resources educators are utilizing to deliver PE curricula, and 3) understand the challenges experienced by educators during distance learning.Methods: A survey was sent to a cohort of school-based fitness assessment software users. Respondents were largely school-based individuals including PE teachers (n= 1,789), school (n=62), and district administrators (n=64). nurses (n=3), and “other” (n =522). Results: Of 2,440 respondents, most were from a city or suburb (69.7%), elementary or middle school (72.3%), and had Title 1 status, an indicator of low socioeconomic status, (60.4%). Most campuses were closed during the COVID-19 pandemic (97.8%). Of the schools closed during the pandemic, only 2.8% had no prior PE requirements and that increased to 21% during the pandemic. In schools that remained open during the pandemic, 7.7% had no prior PE requirements and this increased to 60.5%. Importantly, 79% of respondents reported that students were either “significantly less” or “somewhat less” physically active during the closure. For closed schools, the most frequently cited challenges included “student access to online learning“, “teacher/student communication” and “teacher remote work arrangements”. For open schools, the most commonly reported challenges included “social distancing”, “access to gymnasium/equipment”, and “concern for personal health and wellbeing”.Conclusion: The COVID-19 pandemic has caused important reductions in PE requirements and time engaged in physical activity. Challenges experienced by teachers were identified for closed and open schools.
Watchful Waiting as a Strategy to Reduce Low-Value Spinal Imaging: Study Protocol for a Randomized Trial
Authors: Fenton Joshua , Jerant Anthony , Franks Peter , Gosdin Melissa , Fridman Ilona , Cipri Camille , Weinberg Gary , Hudnut Andrew , Tancredi Daniel J
Published: January 2021

• Background: Patients with acute low back pain frequently request diagnostic imaging, and clinicians feel pressure to acquiesce to such requests to sustain patient trust and satisfaction. Spinal imaging in patients with acute low back pain poses risks from diagnostic evaluation of false-positive findings, patient labeling and anxiety, and unnecessary treatment (including spinal surgery). Watchful waiting advice has been an effective strategy to reduce some low-value treatments, and some evidence suggests a watchful waiting approach would be acceptable to many patients requesting diagnostic tests. • Methods: We will use key informant interviews of clinicians and focus groups with primary care patients to refine a theory-informed standardized patient-based intervention designed to teach clinicians how to advise watchful waiting when patients request low-value spinal imaging for low back pain. We will test the effectiveness of the intervention in a cluster randomized clinical trial. We will recruit 8-10 primary care and urgent care clinics (~55 clinicians) in Sacramento, CA; clinicians will be randomized 1:1 to intervention and control groups. Over a 3 to 6 month period, clinicians in the intervention group will receive 3 visits with standardized patient instructors (SPIs) portraying patients with acute back pain; SPIs will instruct clinicians in a three-step model emphasizing establishing trust, empathic communication, and negotiation of a watchful waiting approach. Control physicians will receive no intervention. The primary outcome is the post-intervention rate of spinal imaging among actual patients with acute back pain seen by the clinicians adjusted for rate of imaging during a baseline period. Secondary outcomes are: use of targeted communication techniques during a follow-up visit with an SP; clinician self-reported use of watchful waiting with actual low back pain patients; post-intervention rates of diagnostic imaging for other musculoskeletal pain syndromes (to test for generalization of intervention effects beyond back pain); and patient trust and satisfaction with physicians. • Discussion: This trial will determine whether standardized patient instructors can help clinicians develop skill in negotiating a watchful waiting approach with patients with acute low back pain, thereby reducing rates of low-value spinal imaging. The trial will also examine the possibility that intervention effects generalize to other diagnostic tests. • Trial registration: NCT 04255199, ClinicalTrials.gov (January 20, 2020)
Analysis of Factors of Incompliance To Breastfeeding in Hepatitis B Virus-Infected Mothers Taking Nucleos(t)ide Analogs During Pregnancy for Prevention of Mother-To-Child Transmission
Authors: Xiao Li-xin , Mo Zhi-shuo , Gan Wei-qiang , Mei Yong-Yu , Lin Chao-Shuang
Published: January 2021

Background: We encourage Hepatitis B virus-infected mothers to breastfeed postpartum, even when continuing pregnancy category B nucleos(t)ide analogs treatment. However, a large proportion of the Hepatitis B virus-infected mothers were not compliance to the breastfeeding recommendation. This study aimed to investigate the causes and influencing factors of incompliance to breastfeeding recommendation in Hepatitis B virus-infected mothers receiving nucleos(t)ide analogs treatment during pregnancy for preventing mother-to-child transmission.Methods: A total of 155 mothers with chronic hepatitis B receiving nucleos(t)ide analogs treatment for preventing mother-to-child transmission during the late gestational period were included and divided into the exclusive breastfeeding (n=63), mixed feeding (n=34), and artificial feeding (n=58) groups according to the feeding types postpartum. Independent variables associated with feeding types were analyzed by logistic regression analysis.Results: Compared to the breastfeeding and mixed feeding groups, the artificial feeding group had significantly higher parity, later postpartum timing of stopping nucleos(t)ide analogs treatment, and lower proportion of having knowledge of nucleos(t)ide analogs medications (all P<0.05). In addition, multivariate logistic regression analysis confirmed that higher parity, later postpartum timing of stopping nucleos(t)ide analogs treatment, and lacking knowledge of medication were independent factors associated with incompliance to breastfeeding. Conclusion: Hepatitis B virus-infected mothers with later postpartum timing of stopping nucleos(t)ide analogs treatment and less knowledge of medication were more likely to incompliance to breastfeeding recommendation. Strengthening health education may be an important method to improve compliance to breastfeeding.
Reference Values For Intracranial Pressure And Lumbar Cerebrospinal Fluid Pressure: A Systematic Review
Authors: Norager Nicolas Hernandez , Olsen Markus Harboe , Pedersen Sarah Hornshoej , Riedel Casper Schwartz , Czosnyka Marek , Juhler Marianne
Published: January 2021

BackgroundAlthough widely used in the evaluation of the diseased, normal intracranial pressure and lumbar cerebrospinal fluid pressure remains sparsely documented. Intracranial pressure is different from lumbar cerebrospinal fluid pressure. In addition, intracranial pressure differs considerably according to body position of the patient. Despite this, the current reference interval are used indistinguishable for intracranial and lumbar cerebrospinal fluid pressure, and body position dependent reference intervals does not exist. In this study, we aim to establish these reference intervals.MethodA systematic search was conducted in MEDLINE, EMBASE, CENTRAL, and Web of Sciences. Methodological quality was assessed using an amended version of the Joanna Briggs Quality Appraisal Checklist. Intracranial pressure and lumbar cerebrospinal fluid pressure were independently evaluated and subdivided into body positions. Quantitative data were presented with mean ± SD, and 90% reference intervals.ResultsThirty-six studies were included. Nine studies reported values for intracranial pressure, while 27 reported values for the lumbar cerebrospinal fluid pressure. Reference values for intracranial pressure were -5.9 to 8.3 mmHg in the upright position and 0.9 to 16.3 mmHg in supine position. Reference values for lumbar cerebrospinal fluid pressure were 7.2 to 16.8 mmHg and 5.7 to 15.5 mmHg in the lateral recumbent position and supine position, respectively. ConclusionsThis systematic review is the first to provide position-dependent reference values for intracranial pressure and lumbar cerebrospinal fluid pressure. Clinically applicable reference values for normal lumbar cerebrospinal fluid pressure was established, and were in accordance with previously used reference values. For intracranial pressure, this study strongly emphasizes the scarse normal material, and highlights the need for further research on the matter.
Characteristics of Patients with Coronavirus Disease 2019 (COVID-19) and Seasonal Influenza at Time of Hospital Admission: a Single Center Comparative Study
Authors: Sieber Pablo , Flury Domenica , Güsewell Sabine , Albrich Werner , Boggian Katia , Gardiol Céline , Schegel Matthias , Sieber Robert , Vernazza Pietro , Kohler Philipp
Published: January 2021

BackgroundFor the winter season 2020/2021, co-circulation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and influenza viruses A/B is expected. From a clinical point of view, differentiation of these two acute respiratory illnesses is crucial for optimal patient management. We therefore aimed to detect clinical differences between Coronavirus Disease 2019 (COVID-19) and seasonal influenza patients at time of hospital admission.MethodsIn this single-center observational study, we included all consecutive patients hospitalized for COVID-19 or influenza between November 2019 and May 2020. Data were extracted from a nationwide surveillance program and from electronic health records. COVID-19 and influenza patients were compared in terms of baseline characteristics, clinical presentation and outcome. We used recursive partitioning to generate a classification tree to discriminate COVID-19 from influenza patients.ResultsWe included 96 COVID-19 and 96 influenza patients. Median age was 68 vs. 70 years (p=0.90), 72% vs. 56% (p=0.024) were males, and median Charlson Comorbidity Index (CCI) was 1 vs. 2 (p=0.027) in COVID-19 and influenza patients, respectively. Time from symptom onset to hospital admission was longer for COVID-19 (median 7 days, IQR 3-10) than for influenza patients (median 3 days, IQR 2-5, p<0.001). Other variables favoring a diagnosis of COVID-19 in the classification tree were higher systolic blood pressure, lack of productive sputum, and lack of headache. The tree classified 86/192 patients (45%) into two subsets with ≥80% of patients having influenza or COVID-19, respectively. In-hospital mortality was higher for COVID-19 patients (16% vs. 5%, p=0.018).ConclusionDiscriminating COVID-19 from influenza patients based on clinical presentation is challenging. Time from symptom onset to hospital admission is considerably longer in COVID-19 than in influenza patients and showed the strongest discriminatory power in our classification tree. Although they had fewer comorbidities, in-hospital mortality was higher for COVID-19 patients.
Sex differences in association between cognitive impairment and clinical correlates in Chinese patients with first-episode drug-naïve schizophrenia
Authors: Zhao Na , Wang Xiao Hong , Kang Chuan Yi , Zheng Yue , Yang Li Ying , Guan Tie Feng , Bai Yun Xia , Wei Ran , Hinman Hunter C , Zhang Xiangyang
Published: January 2021

Background
Schizophrenia is a complex mental illness with significant sex differences. Cognitive impairment is common in patients with schizophrenia, even in remission. This study was designed to examine the sex differences in the relationship between cognitive impairment and clinical correlations with first-episode drug-naïve (FEDN) schizophrenia.
Methods
93 FEDN patients (male/female = 45/48) and 160 controls (male/female = 74/86) were enrolled to compare the sex differences in cognitive functions measure by the MATRICS Consensus Cognitive Battery (MCCB). Positive and Negative Syndrome Scale (PANSS) and Hamilton Depression Scale (HAMD) were used to evaluated patients' clinical symptoms. We compared cognitive impairment with sociodemographic characteristics and measures of different genders, as well as group-by-sex interactions.
Results
Our results showed that the MCCB total and index score in FEDN were lower than in the control group, except for category fluency and social cognition. Male patients had significantly lower symbol coding, digital sequence, and verbal learning scores than female patients, and the controls showed a similar sex difference. Interestingly, we also found six indexes and MCCB total score that showed diagnosis-by-sex interactions, belonging to the speed of processing, attention, working memory, and verbal learning. The MCCB total score showed correlations with PANSS total score and education for both genders. In female patients, education showed significant positive correlations with MCCB total and all ten index scores. Multiple linear regression analysis confirmed that negative symptoms and general psychopathology of PANSS, HAMD total score, and education were independent contributors to MCCB total score. In male patients, only education was an independent contributor to MCCB total score.
Conclusions
These findings revealed significant sex differences in cognitive impairments and clinical symptoms in FEDN. These results should be considered, which will be worthy of a follow-up study of schizophrenia in the future.
High Expression of CDCA7 Predicts Poor Prognosis in Clear Cell Renal Cell Carcinoma and Its Associations With Immunity
Authors: Liu Shouyong , Wang Yi , Miao Chenkui , Xing Qianwei , Wang Zengjun
Published: January 2021

BackgroundCell division cycle-associated 7 (CDCA7), as a member of the cell division cycle associated family, was reported to be aberrantly expressed in both solid tumors and hematological tumors, suggesting its essential role in promoting tumorigenesis. Hence, we aimed to explore its comprehensive role of overall survival (OS) in clear cell renal cell carcinoma (ccRCC) and emphasis on immunity.MethodsThe RNA sequencing data and corresponding clinical information were downloaded from The Cancer Genome Atlas (TCGA) database. Gene set enrichment analysis (GSEA) was adopted to explore CDCA7 associated signaling pathways. Univariate and multivariate Cox regression analyses were carried out to assess independent prognostic factors. Furthermore, roles of CDCA7 in human immunity were also investigated.ResultsOur results suggested that CDCA7 was overexpressed in ccRCC and its elevated expression was related to shorter OS (P<0.01). Univariate and multivariate Cox regression analyses identified CDCA7 as an independent prognostic factor (both P<0.05). The prognostic nomogram integrating CDCA7 expression level and clinicopathologic variables was constructed to predict 1-, 3- and 5-year OS. GSEA indicated that high CDCA7 expression was related to the apoptosis pathway, cell cycle pathway, JAK-STAT pathway, NOD like receptor pathway, P53 pathway, T cell receptor pathway and toll like receptor pathway, etc. As for immunity, CDCA7 was significantly associated with tumor mutational burden (TMB), immune checkpoint molecules, tumor microenvironment and immune infiltration.ConclusionsCDCA7 could serve as an independent prognostic factor for ccRCC and it was closely related to immunity
Dynamic Predictive Scores for Cardiac Surgery-Associated Agitated Delirium: a single-center retrospective observational study
Authors: Tian Yu , Wang Yuefu , Zhao Wei , Ji Bingyang , Diao Xiaolin , Wang Chunrong , Wang Weiwei , Gao Yuchen , Wang Sudena , Zhou Chun , Zhang Qiaoni , Gao Sizhe , Xu Xinyi , Liu Jia
Published: January 2021

Background
Prevention, screening, and early treatment are the mainstays of postoperative delirium management. Score system is an objective and effective tool to stratify potential delirium risk for patients undergoing cardiac surgery
Methods
Patients undergoing cardiac surgery from January 1, 2012, to January 1, 2019, were enrolled in our retrospective study. The patients were divided into a derivation cohort (n = 45,744) and a validation cohort (n = 11,436). The agitated delirium (AD) predictive systems were formulated using multivariate logistic regression analysis at three time points: preoperation, ICU admittance, and 24 hours after ICU admittance.
Results
The prevalence of AD after cardiac surgery in the whole cohort was 3.6% (2,085/57,180). The dynamic scoring system included preoperative LVEF ≤ 45%, serum creatinine > 100 umol/L, emergency surgery, coronary artery disease, hemorrhage volume > 600 mL, intraoperative platelet or plasma use, and postoperative LVEF ≤ 45%. The area under the receiver operating characteristic curve (AUC) values for AD prediction of 0.68 (preoperative), 0.74 (on the day of ICU admission), and 0.75 (postoperative). The Hosmer-Lemeshow test indicated that the calibration of the preoperative prediction model was poor (P = 0.01), whereas that of the pre- and intraoperative prediction model (P = 0.49) and the pre-, intra- and postoperative prediction model (P = 0.35) was good.
Conclusions
Using perioperative data, we developed a dynamic scoring system for predicting the risk of AD following cardiac surgery. The dynamic scoring system may improve early recognition of and interventions for AD.
Predictive Value of Lactate Dehydrogenase to Albumin Ratio (LAR) in Patients With Coronavirus Disease 2019 (COVID-19)
Authors: Liu Mingqing , Zhang Luping , Zhang Yingli , Xu Xiaoming , Ma Tantan , Ni Fengming , Xu Hong , Zhang Nan
Published: January 2021

BackgroundCoronavirus Disease-2019 (COVID-19) is an emerging acute infectious disease that was first discovered in Wuhan, Hubei Province, China. Since then, it has quickly spread to over one hundred cities around the world. Therefore, it is crucial to identify the risk factors of in-hospital mortality and disease severity for COVID-19 patients. MethodsWe firstly proposed a biomarker ratio, lactate dehydrogenase(LDH) to albumin ratio (LAR) may be more reliable to assess the predictive value of LAR for in-hospital mortality and early identification of critical COVID-19 patients. A retrospective study was conducted including patients (≥18 years old) with laboratory-confirmed COVID-19 infection who had been discharged or had died from 1 February to 29 February, 2020. ResultsThe study included 321 patients with COVID-19. The median age of the 321 patients was 63.0 (IQR 51.0-70.0), ranging from 19 to 95 years old and 180 (56.1%) patients were male. 142 (44.2%) patients had 1 or more coexisting comorbidity. The most common symptoms on admission were fever(289[90%]) and cough(258[80.4%]). In multivariable logistic regression, only older age (OR, 1.11; 95% CI, 1.05-1.16), WBC count (OR, 1.26; 95% CI, 1.11-1.44), lymphocyte count (OR, 0.78; 95% CI, 0.62-0.99) and LAR (OR, 1.29; 95% CI, 1.18-1.40) were found to be significantly associated with in-hospital death. ROC analysis showed that LAR had a higher AUC (0.917) and the highest specificity(84.0%) and sensitivity(84.6%). Furthermore, the results showed that LAR had a higher AUC (0.931) to differentiate critical from mild patients and had a sensitivity of 87.7% and a specificity of 82.1%. Besides, LAR had an AUC (0.861) to differentiate critical from severe patients and had a sensitivity of 86.0% and a specificity of 73.8% and the role of LAR to distinguish severe from mild patients was the worst. ConclusionsTo the best of our knowledge, this study is the first for us to explore the predictive value of LAR for in-hospital mortality and disease severity. A high LAR appears to predict higher odds of mortality and differentiate critical patients from mild or severe COVID-19 patients.
Sexualized Drug Use Among Female Sex Workers From Eight Cities in China: a Cross-sectional Study
Authors: Ong Jason , Xiong Mingzhou , Tucker Joseph D. , Wang Yajie , Smith M. Kumi , Tang Weiming , Fu Hongyun , Zheng Heping , Yang Bin , Wang Cheng
Published: January 2021

Background There is rich literature on sexualized drug use (i.e. drug use before or during sex) for men who have sex with men but less data from female sex workers (FSW) particularly from low- and middle-income countries. We describe the sexual and reproductive health outcomes in FSW reporting sexualized drug use.Methods We conducted a cross-sectional study in eight cities from seven provinces in China (2019). We recruited FSW through community organizations working with sex workers, and included those who were age 18 years or above; exchanged sex at least once for money or goods in the past three months. Multivariable logistic regression models were used.Results In total, 1287 women participated: average age was 35.1 years (SD 10.3), 52.4% reported a monthly income over 5000 RMB ($USD 707), and 17.4% completed high school or above. Among participants, 284 (22.1%, 95%CI:19.8-24.4) reported a history of sexualized drug use. Compared to FSW who never reported a history of sexualized drug use, FSW who reported a history of sexualized drug use had greater odds of: reporting inconsistent condom use for vaginal sex (AOR 2.67, 95%CI:1.93-3.69), inconsistent condom use for oral sex (AOR 2.33, 95%CI:1.25-4.37), ever had an unintended pregnancy (AOR 1.43, 95%CI:1.04-1.96), and ever diagnosed with STIs (AOR 5.39, 95%CI:3.92-7.40).Conclusion We recommend routinely asking FSW about sexualized drug use as nearly one in five FSW reported a history of sexualized drug use and these women had an elevated risk profile compared with those who reported no sexualized drug use.
FFT-Based Numerical Method for Non-Linear Elastic Contact
Authors: Guo Fei , Wu Fan , Li Xinyong , Huang Yijie , Wang Zhuo
Published: January 2021

Based on FFT, a numerical method suitable for elastoplastic and hyperelastic frictionless contact is proposed in this paper, which can be used to solve 2D and 3D contact problems. The non-linear elastic contact problem is transformed to linear elastic contact considering residual deformation (or equivalent residual deformation). Numerical simulations for elastic, elastoplastic and hyperelastic contact between hemisphere and rigid plane are compared with the results of finite element method (FEM) to verify the accuracy of the numerical method. Compared with the existing elastoplastic contact numerical methods, the calculation efficiency is improved while ensuring a certain calculation accuracy (pressure error does not exceed 15% while calculation time does not exceed 10 minutes in a 64×64 grid). For hyperelastic contact, the proposed method reduces the dependence of the approximation result on load as in linear elastic approximation. Despite a certain error, the simplified numerical method shows a better approximation result than linear elastic contact approximation, which can be used for the fast solution in engineering applications. Finally, taking the sealing application as an example, the contact and leakage rate between 3D complicated rough surfaces are calculated.
Performance of Cell-Free DNA Sequencing-Based Non-invasive Prenatal Testing: Our Experience on 36456 both Singleton and Multiple Pregnancies.
Authors: Verde Marco La , De Falco Luigia , Torella Annalaura , Savarese Giovanni , Saverese Pasquale , Ruggiero Raffaella , Conte Anna , Fico Vera , Torella Marco , Fico Antonio
Published: January 2021

Background: To describe the clinical practice and performance of cell-free DNA sequencing-based noninvasive prenatal testing as a screening method for detecting trisomy 21, 18, and 13 (T21, T18, and T13, respectively), as well as sex chromosome aneuploidy (SCA), in a general Italian pregnancy population.Methods: The AMES-accredited laboratory offers noninvasive prenatal testing in maternal blood as a clinical screening test for foetal T21, T18, T13 and SCA. Samples were sequenced on a NextSeq 550 (Illumina) using the VeriSeq NIPT Solution v1 assay.Results: A retrospective analysis was performed on a cohort of 36456 consecutive maternal blood samples, including 35650 singleton pregnancies, 800 twin pregnancies, and 6 triplet pregnancies, which were tested between April 2017 and September 2019. The cohort included 46% elevated-risk and 54% low-risk patients. Genetic and/or clinical outcomes were available in 36000 cases (98.7%). In the overall cohort, 356 (1%) results were indicative of classic trisomy: 254 T21, 69 T18, and 33 T13. In addition, 145 results (0.4%) were indicative of SCA. Of the combined 501 screen-positive cases, 484 had confirmatory diagnostic testing results available: 99.2% (247/249) of T21 cases, 91.2% (62/68) of T18 cases, 84.4% (27/32) of T13 cases, and 86.7% (117/135) of SCA cases were confirmed. Follow-up data were available for 98.8% of the 35955 cases reported as unaffected by trisomy or SCA. No false negative cases were reported. The sensitivity of NIPT was 100.00% for T21 (95% Cl 98.47-100.0), T18 (95% Cl 94.17-100.0), T13 (95% Cl 87.54-100.0) and SCA (95% Cl 96.62-100.0). The specificities were 99.99% (95% Cl 99.98-100.0), 99.98% (95% Cl 99.96-100.0), 99.99% (95% Cl 99.97-100.0), and 99.95% (95% Cl 99.92-99.97) for T21, T18, T13, and SCA, respectively.Conclusion: This retrospective analysis of a large cohort of consecutive patients who had whole-genome sequencing-based NIPT for classic trisomies and SCA showed excellent detection rates and low false positive rates.
An Ultrasonic Osteotomy Device Enhanced Post-osteotomy Bone Healing Beyond That With a Conventional Rotary Device in a Rat Calvarial Model
Authors: Danjo Atsushi , Aijima Reona , U.Yoshimoto Reiko , Tanaka Shin-Ichi , Katsuki Takeshi , A.Kido Mizuho , Yamashita Yoshio
Published: January 2021

Ultrasonic osteotomy devices (UODs) have many clinical benefits; for example, they cause little damage to adjacent tissues in oral surgery. However, few reports have focused on bone healing with UODs. This study aimed to compare bone healing after osteotomy with UODs versus rotary osteotomy devices (RODs) in a rat calvarial defect model. Calvarial bone defects were made with a UOD on the right side and an ROD on the left side. Micro-CT analysis revealed that the bone volume was greater with a UOD than with an ROD at 2-3 weeks. In HE-stained sections and micro-CT images, the bone wound gap was closed earlier on the UOD side than on the ROD side. Bone thickness, the quantity of newly formed bone, and the number of osteocytes were greater on the UOD side than on the ROD side. Scanning electron microscopy (SEM) showed that UOD cuts had smoother surfaces than ROD cuts. Osteoblast-like cells harvested from bone chips cut by the UOD had greater proliferative activity than those harvested from ROD-cut bone chips. The use of a UOD may assist bone regeneration, presumably because of osteoblast activation by ultrasonic microvibration and UODs cause less damage to the bone than RODs.
Efficacy of Interceptor® G2, a Long-Lasting Insecticide Mixture Net Treated with Chlorfenapyr and Alpha-Cypermethrin Against Anopheles Funestus: Experimental Hut Trials in North-Eastern Tanzania
Authors: Tungu Patrick , Michael Elisante , Sudi Wema , Kisinza William , Rowland Mark
Published: January 2021

BackgroundThe effectiveness of long-lasting insecticidal nets (LLINs), the primary method for preventing malaria in Africa, is compromised by evolution and spread of pyrethroid resistance. Further gains require new insecticides with novel modes of action. Chlorfenapyr is a pyrrole insecticide that disrupts mitochrondrial function and confers no cross-resistance to neurotoxic insecticides. Interceptor® G2 LN (IG2) is an insecticide-mixture LLIN which combines wash-resistant formulations of chlorfenapyr and the pyrethroid alpha-cypermethrin. Our objective was to determine IG2 efficacy under controlled household-like conditions for personal protection and control of wild, pyrethroid-resistant Anopheline funestus mosquitoes. MethodsExperimental hut trials tested IG2 efficacy against two positive controls - a chlorfenapyr-treated net and a standard alpha-cypermethrin LLIN, Interceptor LN (IG1) - consistent with World Health Organisation (WHO) evaluation guidelines. Mosquito mortality, blood-feeding inhibition, personal protection, repellency and insecticide-induced exiting were recorded after zero and 20 washing cycles. The trial was repeated twice and analysed using multivariate and meta-analysis. ResultsIn the two trials held in NE Tanzania, A. funestus mortality was 2.27 (risk ratio 95% CI 1.13-4.56) times greater with unwashed Interceptor G2 than with unwashed Interceptor LN (p=0.012). There was no significant loss in mortality with IG2 between 0 and 20 washes (1.04, 95% CI 0.83-1.30, p=0.73). Comparison with chlorfenapyr treated net indicated that most mortality was induced by the chlorfenapyr component of IG2 (0.96, CI 0.74-1.23), while comparison with Interceptor LN indicated blood-feeding was inhibited by the pyrethroid component of IG2 (IG2: 0.70, CI 0.44-1.11 vs IG1: 0.61, CI 0.39-0.97). Both insecticide components contributed to exiting from the huts but the contributions were heterogeneous between trials (heterogeneity Q=36, P=0.02). WHO susceptibility tests with pyrethroid papers recorded 44% survival in A. funestus. ConclusionsThe high mortality recorded by IG2 against pyrethroid-resistant A. funestus provides first field evidence of high efficacy against this primary, anthropophilic, malaria vector.