bluuebunny/crossref_metadata_2025 huggingface dataset:
The Level of Care Needs of Patients With Cancer and the Time-dependent Burden on Their Family Caregivers in Home Palliative Care: A Cross-Sectional Study
Authors: Otsuki Naoko , Yamamoto Ryohei , Sakaguchi Yukihiro , Masukawa Kento , Morita Tatsuya , Kizawa Yoshiyuki , Tsuneto Satoru , Shima Yasuo , Fukui Sakiko , Miyashita Mitsunori
Published: May 2021

PurposeAlthough home care improves patients' quality of life (QOL), several studies have suggested that home care lowers the QOL and mortality of family caregivers. To alleviate the deleterious impact of home care on caregivers, the major burdens on caregivers and the clinical characteristics of the caregivers vulnerable to the major burden needs to be clarified. MethodA survey questionnaire was distributed to 710 family caregivers of patients with cancer in Japan, and 342 valid responses were obtained (valid response rate: 48.2%). The Burden Index of Caregivers was used to identify the major burden on caregivers. To assess the associations of the patients' care needs level and other clinically relevant factors with the major burden, a multivariable-adjusted logistic regression model was used. ResultsThe time-dependent burden was identified as a major burden. An adjusted model showed a non-linear association between the care needs level and the time-dependent burden, in which the caregivers of the patients who required moderate care needs level had the highest time-dependent burden [adjusted odds ratio of none, mild, moderate, and severe care needs levels: 0.50 (95% confidence interval 0.07–2.12), 1.08 (0.43–2.57), 1.87 (1.01–3.52), and 1.00 (reference), respectively]. Additionally, older patients and younger caregivers were significantly associated with a time-dependent burden. ConclusionThe time-dependent burden was highest in caregivers at the moderate care needs level and younger caregivers. An imbalance between the demand and supply of care services may be improved by considering the clinical characteristics of both patients and caregivers.
Combined Effects of Inoculating Serendipita Indica on Soybean Growth and Soil Health Under Cd Stress
Authors: Wang Xiaohui , Fan Xiaoxu , Wang Weidong , Song Fuqiang
Published: May 2021

Cadmium (Cd) pollution in the soil is a global environmental problem. Plants-microbial technology has been regarded as a potential technique for the remediation of Cd polluted soils. Here, we aimed to explore the combined effects of inoculating (Serendipita indica) S. indica on soybean growth and soil health under Cd stress. Therefore, a pot experiment was conducted to investigate the S. indica on soybean growth and the soil enzyme activities, pH and chemical forms of Cd in the soil under Cd 0, 10, 20, 30 mg/kg soil teatments. Results reflected that compared to non-inoculated ones, the application of S. indica can still enhance the dry weight (66.57%), shoot height (90.35%) and promote the net photosynthesis rate (72.18%), transpiration ratio (80.73%), and stomatal conductance (119.05%) photosynthesis of soybean under Cd 30 mg/kg soil. Furthermore, The pH, phosphatase (116.39%) and catalase (4.17%) activities in the S. indica treatments were increased under Cd 10 mg/kg soil. Meanwhile, inoculated S. indica treatments significantly shifted Cd from exchangeable fraction to other more stable fractions, primarily decreased Cd concentrations (23.66%) under Cd 20 mg/kg soil. The Cd pollution assessment in soil indicated that S. indica could effectively reduce Cd pollution in the Cd 10 mg/kg soil treatments. This work suggests that S. indica may be a potential method for not only promoting plant growth, but also relieving the phytotoxicity of Cd and remediating Cd contaminated soil.
Relevance of the Antenatal Corticosteroids-to-Delivery Interval in the Prevention of Neonatal Respiratory Distress Syndrome Through the Eyes of Causal Inference: A Review and Target Trial
Authors: Dehaene Isabelle , Roelens Kristien , Smets Koenraad , Decruyenaere Johan
Published: May 2021

Purpose - To critically analyse the literature on the antenatal corticosteroids (ACS)-to-birth interval from a causal point of view and to present a solution to the problem of bias caused by post-hoc analysis. Methods - Due to the post-hoc nature of the ACS-to-birth interval, a randomised controlled trial (RCT) of ACS versus placebo is not able to examine the importance of the interval. When an RCT is not feasible, for whatsoever reason, a target trial can be set up and an attempt can be made to answer the causal question of interest using observational data. An attempt was made to set up a target trial which could enable to examine the causal effect of the ACS-to-birth interval on neonatal outcomes. An analysis of current literature on the ACS-to-birth interval was done.Results - The majority of studies aimed to examine the causal effect of the interval, but their study design only permitted to find associations between the interval and neonatal outcomes. Barriers for setting up a target trial are highlighted.Conclusion - Evidence on the superiority of any ACS-to-birth interval is lacking and the question can only be addressed causally and become clinically relevant if baseline randomisation to ACS-to-birth intervals is made possible.
Nesting Algorithm for Optimization Part Placement in Additive Manufacturing
Authors: Calabrese Maurizio , Primo Teresa , Prete Antonio Del , Filitti Giuseppe
Published: May 2021

Significant savings in cost and time can be achieved in additive processes by manufacturing multiple parts in a single setup to obtain efficient machine volume utilization.In this paper the authors have developed a previsional model able to evaluate the potential performance of various printing technologies for the execution of a given job.This model aims to support technicians in choosing the best solution starting from a specific machine architecture and printing volume. In particular, the model is able to evaluate, from a qualitative and quantitative point of view, the performance of each technology in a transversal manner taking into consideration the aspects connected to printing: costs, time and technological parameters.Within the core of the previsional model there are multiple algorithms able to compute different Key Performance Indicator (nine KPIs). For the computation of some of them it was necessary to quantitatively evaluate aspects related to nesting operations, or to the arrangement of several components within the printing base depending on the dimensional characteristics of the component, the printing direction and its dimensional and geometric characteristics (rectangular or circular). Starting from this need, the developed nesting algorithm has given a specific answer.
Racial and Health Disparities among cirrhosis related hospitalizations in the US
Authors: Singal Ashwani K , Kuo Yong-Fang , Arab Juan P. , Bataller Ramon
Published: May 2021

Data are scanty on racial disparities in alcohol-associated liver disease (ALD) hospitalizations. National Inpatient Sample on 199,748 cirrhosis hospitalizations, 14,241 (2,893 AI/AN, 2,893 whites, 2,882 blacks, 2,879 Hispanics, and 2,694 Asian/other race) was matched 1:1 for demographics, insurance, and income quartile of residence zip code. After controlling for geographic location and hospital type, ALD etiology was higher by 1.6 folds in AI/AN vs. whites by 1.9 folds vs. blacks and Hispanic, and 2,2 folds vs. Asian/other race. Alcohol use disorder (AUD) was present in 38% of admissions in AI/AN vs. 24–30% in other races, P < 0.001. 5.9% admissions were associated with in-hospital mortality, with 34% reduced odds in AI/AN vs. blacks. Among cirrhosis related hospitalizations in the US, racial and ethnic disparities exist with alcohol as the commonest etiology in AI/AN, and highest in-hospital mortality in blacks. Public health policies are needed to reduce the health disparities individuals with ALD.
Concentration Assessment And Source Evaluation of Polycyclic Aromatic Hydrocarbons (PAHs) In Soil And Crops of The Agro-Industrial Tobacco Production Area of Igboho, Nigeria
Authors: Adedosu Taofik Adewale , Ajibade Okanlawon John , Omotayo Adeniyi Kayode , Adedosu Haleema Omolola , Mufutau Idris
Published: May 2021

The contribution of tobacco smoking and cigarette butts to global environmental pollution has been given significant attention. However, little is known about tobacco-related agricultural activities on environmental pollution by polycyclic aromatic hydrocarbons (PAHs). In this study, the spatial distributions, composition, source, and toxicity potential of polycyclic aromatic hydrocarbons (PAHs) in soil and food crops within the vicinity of the agro-industrial tobacco production area of Igboho, Nigeria was investigated. Soil and food crop (Zea mays, Dioscorea alata, and Manihot esculenta) samples collected from the tobacco curing site and the surrounded farmlands were analyzed for the PAHs concentrations. The identification and quantification of priority PAHs in the samples were carried out using a gas chromatograph equipped with a flame-ionization detector. The total concentration of the priority PAHs in the soil ranged between 136.70 ng.g-1 to 889.30 ng.g-1. The total concentration of carcinogenic PAHs ranged from 6.07 ng.g-1 to 321.04 ng.g-1, and the total concentration of toxic PAHs ranged from 6.27 ng.g-1 to 254.37 ng.g-1. The PAHs level was highest in crops from farmlands closest to the tobacco curing site. The distribution of PAHs ring size is in the order of 6-rings ˃ 4-rings ˃5-rings ˃ 3-rings ˃ 2, and the diagnostic indices showed that the sources of PAHs in the samples were mainly pyrogenic and associated with tobacco curing activities in the area.
Extremely wet summer events enhance permafrost thaw for multiple years in Siberian tundra
Authors: Magnússon Rúna , Hamm Alexandra , Karsanaev Sergey V. , Limpens Juul , Kleijn David , Frampton Andrew , Maximov Trofim C. , heijmans monique
Published: May 2021

Permafrost thaw can accelerate climate warming by releasing carbon from previously frozen soil in the form of greenhouse gases. Summer precipitation extremes have been proposed to increase permafrost thaw, but the magnitude and duration of this effect are poorly understood. Here we present empirical evidence showing that one extremely wet summer (+100mm; 120% increase relative to average summer precipitation) enhances thaw depth by up to 35% and prolonged the thaw period in a controlled irrigation experiment in an ice-rich Siberian tundra site. The effect persisted over two subsequent summers, demonstrating a carry-over effect of extremely wet summers. Using soil thermal hydrological modelling, we show that precipitation-induced increases in thaw are most pronounced during warm summers with mid-summer precipitation peaks. Our results suggest that, with summer precipitation and temperature both increasing in the Arctic, permafrost will likely degrade and disappear faster than is currently anticipated based on rising air temperatures alone.
Factors Associated With Hospital and Intensive Care Admission in Paediatric SARS-CoV-2 Infection: A Prospective Nationwide Observational Cohort Study
Authors: Uka Anita , Buettcher Michael , Bernhard-Stirnemann Sara , Fougère Yves , Moussaoui Dehlia , Kottanattu Lisa , Wagner Noémie , Zimmermann Petra , Ritz Nicole , (SPSU) Swiss Paediatric Surveillance Unit
Published: May 2021

Coronavirus disease 2019 (COVID-19) is usually less severe in children compared to adults. This study describes detailed clinical characteristics, treatment and outcomes of children with laboratory-confirmed COVID-19 in a non-hospitalised and hospitalised setting and quantifies factors associated with admission to hospital and intensive care unit in children with SARS-CoV-2 infection on a nationwide level. Data were collected through the Swiss Paediatric Surveillance Unit from children < 18 years with laboratory-confirmed SARS-CoV-2 infection. All 33 paediatric hospitals in Switzerland reported non-hospitalised and hospitalised cases from March 1 to October 31, 2020 during both pandemic peaks. In total, 678 children were included. The median age was 12.2 (IQR 5.0 – 14.6) years, 316 (47%) were female and 106 (16%) had comorbidities. Overall, 126 (18.6%) children were hospitalised of whom 16 (12.7%) required ICU admission. Comorbidities were the only factor associated with hospital admission in a multivariable regression analysis (odds ratio 3.23, 95%CI 1.89 to 5.50; p-value <0.01). Hospitalised children more often presented with fever (96 [76.2%] vs 209 [38.1%], p-value<0.01) and rash (16 [12.8%] vs 6 [1.1%], p-value<0.01). Anosmia/dysgeusia was more prevalent in non-hospitalised children (73 [13.3%] vs 3 [2.4%], p-value<0.01). In the hospitalised children, oxygen treatment was required in 34 (27.0%), inotropes in nine (7.3%) and mechanical ventilation in eight (6.3%). Complications were reported in 28 (4.1%) children with cardiovascular complications being most frequent (11 [1.6%]). Three deaths were recorded. Conclusion: This study confirms that COVID-19 is mostly a mild disease in children. Fever, rash, and comorbidities are associated with higher admission rates. Continuous observation is necessary to further understand paediatric COVID-19, guide therapy and evaluate the necessity for vaccination in children.
Early Life Stage Thyroid Hormone Disruption Causes Long-Term Impacts On Immune Cell Function And Transcriptional Responses To Pathogen In The Fathead Minnow (Pimephales Promelas)
Authors: Hampton Leah M. Thornton , Finch Miranda G. , Martyniuk Christopher J. , Venables Barney J. , Jeffries Marlo K. Sellin
Published: May 2021

Current evidence suggests thyroid hormones (THs) impact development of the immune system, but few studies have explored the connection between the thyroid and immune systems, especially in fish. This is important as some environmental contaminants disrupt TH homeostasis and may thus have negative impacts on the immune system. To determine the long-term consequences of early life stage (ELS) hypothyroidism on immune function, fathead minnows were exposed to the model thyroid hormone suppressant propylthiouracil (PTU) from <1 to 30 days post hatch. Fish were transferred to clean water and raised to adulthood at which time, several aspects of immune function were evaluated. Ex vivo assessment of immune cell function revealed significant decreases in the phagocytic cell activity of PTU-treated fish relative to the controls. Fish were also injected with Yersinia ruckeri to evaluate their in vivo immune responses across a suite of endpoints (i.e., transcriptomic analysis, leukocyte counts, spleen index, hematocrit, bacterial load and pathogen resistance). The transcriptomic response to infection was significantly different between control and PTU-treated fish, though no differences in bacterial load nor pathogen resistance were noted. Overall, these results suggest that early life stage thyroid hormone suppression causes long-term impacts on immune function at the molecular and cellular levels suggesting a key role for TH signaling in normal immune system development. This study lays the foundation for further exploration into thyroid-immune crosstalk in fish. This is noteworthy as disruption of the thyroid system during development may have lasting effects on immune function in adulthood.
Phase I Study of Rivoceranib, a Selective VEGFR-2 Angiogenesis Inhibitor, Administered Daily in Patients With Advanced Solid Tumors
Authors: Kang Yoon-Koo , Ryu Min-Hee , Hong Yong Sang , Choi Chang-Min , Kim Tae Won , Ryoo Baek-Yeol , Kim Jeong Eun , Kim Sang-We , Weis John R. , Gilcrease Glynn Weldon , Kingsford Rachel , Orgain Nicole , Kim Se Ra , Park Cheol Hee , Sachar Madhav , McGinn Arlo , Werner Theresa L , Sharam Sunil
Published: May 2021

Rivoceranib is a highly potent and selective inhibitor of VEGFR-2 and subsequent angiogenesis through this receptor signaling pathway. This phase I study was the first global study with rivoceranib outside of China in Korean and Caucasian patients and was designed to determine the safety profile (including maximum tolerated dose), pharmacokinetics, and efficacy in patients with advanced solid tumors. Thirty-one adult patients with advanced malignant solid tumors were enrolled to investigate 6 dose levels of rivoceranib. Twenty-five patients were initially enrolled to 5 dose levels of rivoceranib from 81 to 685 mg and an additional 6 patients were later enrolled in a supplemental study to evaluate the 805 mg dose level. Rivoceranib was very well tolerated. At the 805 mg dose level, 2 dose-limiting toxicities were observed but the 685 mg dose was well tolerated over multiple cycles of therapy. The maximum tolerated dose for rivoceranib was 685 mg (equivalent to 850 mg rivoceranib mesylate) and recommended for further study in patients with advanced solid tumors. The most common adverse events were hypertension (all grades %/≥G3%: 58/29), nausea (42/0), diarrhea (39/0), anorexia (32/3), and fatigue (29/6). Rivoceranib pharmacokinetics were proportional across all dose levels but interpatient variability was high. Of the 31 patients enrolled, 21 were evaluable for efficacy. In this evaluable group, partial response was recorded in 5 patients, stable disease in 10, and disease progression in 6. Results indicate the potential clinical benefit of daily rivoceranib in patients with advanced malignant solid tumors with a tolerable safety profile.Trial registration: NCT01497704 (ClinicalTrials.gov) registered on December 22, 2011 and NCT02711969 (ClinicalTrials.gov) registered on March 17, 2016.
TaBG1 Increases Seed Size and Alters Nutritional Characteristics of the Grain in Wheat But Does Lead to Increased Yields.
Authors: Milner Matthew J. , Bowden Sarah , Craze Melanie , Wallington Emma J.
Published: May 2021

Background: Grain size is thought to be a major component of yield in many plant species. Here we set out to understand if knowledge from other cereals such as rice could translate to increased yield gains in wheat and lead to increased nitrogen use efficiency. Previous findings that the overexpression of OsBG1 in rice increased yields while increasing seed size suggest translating gains from rice to other cereals may help to increase yields. Results: The orthologous genes of OsBG1 were identified in wheat. One homoeologous wheat gene was cloned and overexpressed in wheat to understand its role in controlling seed size. Potential alteration in the nutritional profile of the grains were also analyzed in wheat overexpressing TaBG1. It was found that increased TaBG1-A expression could indeed lead to larger seed size but was linked to a reduction in seed number per plant leading to no significant overall increase in yield. Other important components of yield such as biomass or tillering did not change significantly with increased TaBG1-A expression. The nutritional profile of the grain was altered, with a significant decrease in the Zn levels in the grain associated with increased seed size, but Fe and Mn concentrations were unchanged. Protein content of the wheat grain also fell under moderate N fertilization levels but not under deficient or adequate levels of N.Conclusions: TaBG1 does control seed size in wheat but increasing the seed size per se does not increase yield and may come at the cost of lower concentrations of essential elements as well as potentially lower protein content. Nevertheless, TaBG1 could be a useful target for further breeding efforts in combination with other genes for increased biomass.
Synergistic Effect of Anti-Thymocyte Globulin Combined with Post-Transplant Cyclophosphamide for Dual T Cell Modulation in Haploidentical Stem Cell Transplantation for Poor Prognosis Acute Leukemia.
Authors: Barkhordar Maryam , Mousavi Seied Asadollah , Kasaeian Amir , Tavakoli Sahar , Vaezi Mohammad , Fumani Hossein Kamranzadeh , Rad Soroush , Bahri Tanaz , Ghavamzadeh Ardeshir
Published: May 2021

Background: In the evolution of haploidentical stem cell transplantation (haplo-SCT), the implementation of anti-thymocyte globulin (ATG)-based and high-dose posttransplant cyclophosphamide (PTCy)-based regimens has improved patient outcomes. We hypothesized that the combination of ATG and PTCy in the correct sequence and with proper timing has a synergistic effect on immune tolerance. The purpose of the study was to discover whether the concomitant use of ATG and PTCy would be advantageous for haplo-SCT and which subgroup of patients would receive the most benefit.Methods: This cohort was conducted on 119 patients with poor prognosis acute myeloid leukemia (AML) or acute lymphoblastic leukemia (ALL) who underwent haplo-SCT with peripheral blood stem cell (PBSC) sources and myeloablative conditioning (MAC) regimens using a uniform protocol in our center from 2010 to 2019. The outcomes of patients who received a combination of rabbit ATG (2.5 mg/kg/d for three days) plus modified PTCy (40 mg/kg/d on days +3 and +4) (n=100) was compared with those of patients who received an ATG-only regimen (n=19). The median follow-up was 35.8 months. Both arms shared similar characteristics, except for the median donor age, the distribution of relationships, and the median time between diagnosis and transplantation.Results: The cumulative incidence of acute graft versus host disease (aGvHD) grade II-IV was significantly lower in the ATG-PTCy group (P < 0.0001), although the incidence of 30-day neutrophil engraftment was higher in the ATG group (P = 0.036). The overall outcome was not significantly different between the two arms. Subgroup analyses stratified by disease status separately for AML and ALL indicated 3-year leukemia-free survival rates of 72% and 24.6% for the first remission of intermediate-high risk AML and ALL; 34.4% and 34.5% for recurrent disease; and 46% and 33.3% for refractory disease.Conclusion: Our experience indicates that the combination of ATG +PTCy in the context of MAC and PBSC sources offers satisfactory outcomes for patients with intermediate-high risk AML receiving haplo-SCT during the first remission; however, some modifications are recommended to improve the results of other subgroups.
Factors Affecting Rehabilitation of Infants With Central Coordination Disorders During a Three-month-long Observation
Authors: Andrzejewska Malgorzata , Hap Katarzyna , Biernat Karolina , Sutkowska Edyta , Demczyszak Iwona , Marciniak Dominik , Kuciel Natalia
Published: May 2021

Background:Central coordination disorders (CCD) encompass various abnormalities observed in infants but early therapy may have an impact on their condition.The aim was to seek factors that may affect the early results of therapy of infants with CCD.Methods: In our retrospective study results of three-month therapy of infants, aged 1 to 6 months, with CCD were analysed regards to the effectiveness and the potential impact of different factors. Therapy and assessment of children were conducted with the use of the Vojta method, which was performed during the first (WW) and the follow-up visit (after 3 months- 1WK). The analysis of the influence of various factors on the effect of therapy included: mother's age at the time of delivery, duration of breastfeeding, child APGAR, gestational age in which the child was born, sex of the child, birth weight, age of the child at WW, type of delivery, craniosacral therapy as an additive treatment.Results:Based on the examination results from 66 medical records it was demonstrated that after 3 months of therapy, improvement was observed in 54 (81.81%) children. The sole factor impacting improvement after 3 months was the age of the child at WW, when the child started therapy. This factor significantly (p=0.002) increased the chance of achieving improvement - by 3.2 times. No statistical differences were shown for the other studied factors.ConclusionsThe age of the child at the beginning of the treatment had a significant impact on early (3 mo) improvement.
Fractalkine Deficiency Attenuates LPS-Induced Acute Kidney Injury and Podocytes Apoptosis by Targeting PI3K/Akt Signal Pathway
Authors: Gong Qiming , Ma Jingxue , Pan Xiuhong , Jiang Yan , Yang Fafen , You Yanwu
Published: May 2021

Podocytes injury is a major biomarker of primary glomerular disease that leads to massive proteinuria and kidney failure. The increased production of chemokine Fractalkine (FKN, CX3CL1) implicated as a hallmark in multiple inflammatory disease. However, the underlying mechanism of FKN on podocytes injury remains unknown. Here, we studied the effects of FKN in LPS-induced acute kidney injury (AKI) in wild type (WT) and FKN knockout (FKN-KO) mice. LPS stimulation resulted in kidney damage, increased expression of Bcl-2 family apoptosis protein while decreased the podocytes marker protein (nephrin and podocin) abundance compared with the control. LPS-induced FKN-KO mice exhibited reduced lethality and attenuated inflammatory cells infiltration, podocytes apoptosis and PI3K/Akt signal pathway inhibition compared with WT mice. Depletion of FKN served a protective effect in LPS-induced AKI by activating the PI3K/Akt signal pathway. In cultured podocytes, the interaction between FKN and PI3K/Akt signal pathway is well confirmed. FKN knockdown reduced podocytes apoptosis by regulating the Bcl-2 family, while this protective effect was reversed by co-administration of PI3K/Akt inhibitor (LY294002). These studies reveal a novel mechanistic property of FKN, PI3K/Akt signal and podocytes apoptosis.
Large-Scale Data Sorting Using Independent Equal-Length Subarrays
Authors: Moghaddam Shahriar Shirvani , Moghaddam Kiaksar Shirvani
Published: May 2021

Design an efficient data sorting algorithm that requires less time and space complexity is essential for large data sets in wireless networks, the Internet of things, data mining systems, computer science, and communications engineering. This paper proposes a low-complex data sorting algorithm that distinguishes the sorted/similar data, makes independent subarrays, and sorts the subarrays’ data using one of the popular sorting algorithms. It is proved that the mean-based pivot is as efficient as the median-based pivot for making equal-length subarrays. The numerical analyses indicate slight improvements in the elapsed time and the number of swaps of the proposed serial Merge-based and Quick-based algorithms compared to the conventional ones for low/high variance integer/non-integer uniform/Gaussian data, in different data lengths. However, using the gradual data extraction feature, the sorted parts can be extracted sequentially before ending the sorting process. Also, making independent subarrays proposes a general framework to parallel realization of sorting algorithms with separate parts. Simulation results indicate the effectiveness of the proposed parallel Merge-based and Quick-based algorithms to the conventional serial and multi-core parallel algorithms. Finally, the complexity of the proposed algorithm in both serial and parallel realizations is analyzed that shows an impressive improvement.
Can Only Fix Sternoclavicular Joint to Treat Bipolar Clavicle Injury?
Authors: Feng Dongxu , Liu Yong , Li Zijun , Huang Jie , Fan Mei , Kang Xiaomin , Zhang Jun
Published: May 2021

Background: Owing to the rarity of bipolar clavicle injury, treatment remains controversial. The purpose of this study is to report treatment of bipolar clavicle injury with internal plate fixation.Methods: We present our experience of clavicle hook plating for sternoclavicular joint dislocation and anatomical plating for distal clavicle fracture for the treatment of three consecutive bipolar clavicle injuries with different injury patterns. At follow up, radiographs were assessed for joint congruity, fracture union, and implant failure. Clinical evaluation included Disability of the Arm, Shoulder, and Hand (DASH), Constant and Murley Score, Visual Analog Scale (VAS), and complications.Results：All patients had a minimum follow-up of six months. Each fracture had solid union, and each dislocation showed no sign of recurrent dislocation, the mean shoulder forward flexion was 153.3°±10.4°, the mean DASH score was 13.9±9.2 points. The mean Constant and Murley score was 82.3±12.3 points, and, the mean VAS score was 2.2±2.0 point. No complications were encountered, and each patient was highly satisfied with their treatments.Conclusion: Our experience of using internal plating for bipolar clavicle injury is positive, as it allows early mobilization and resulted in good joint function. Also, only sternoclavicular joint fixation might be sufficient for some part of bipolar clavicle injury, acromioclavicular joint fixation is not necessary unless residual instability existence.
Catalytic Conversion of Lignin in an Isopropanol/formic Acid Medium With Nimo Catalyst Promoted by W Species
Authors: Lu Xinyu , Robin Hossain Mahmud , Guo Haoquan , Wang Dandan , Xiu Pengcheng , Chen Jiajia , Qin Yu , Xu Chaozhong , Gu Xiaoli
Published: May 2021

Background: Large amounts of enzymatic hydrolysis lignin (EHL) are generated with the production of cellulosic bioethanol. Efficient degradation and upgrading of EHL is significant for the sustainable and stable development of energy supply.Results: In this study, hydrodeoxygenation (HDO) of EHL to biofuels was carried out promoted by the in situ hydrogen donor produced from the decomposition of formic acid over NiMo catalysts. Results showed that active sites (derived from the support SiO2, W, and NiMo species) had remarkable effect on lignin conversion, and the highest oil yield (57.2 wt%) was gained over NiMo/W-SiO2 catalyst. Conclusions: The product evolution demonstrated that active metal sites (derived from NiMo species) favored hydrogenolysis and deoxygenation via leading in situ hydrogen to attack C-O-C bonds, while acid sites (derived from the support) adsorbed and activated chemical bonds in lignin, resulting in the linkage cleavage caused by the heating program. The obtained bio-oil was rich in alkyl guaiacols (6.7 wt%), containing stable chemical properties and high quality.
Characteristics and Related Factors of Length of Stay and Readmission Rates of Inpatients Under a DRG Based Payment System: a Cohort Study
Authors: Luo Ming-Wei , Xie Shi-Wei , Luo Ming-Yang , Cheng Xian-Qin , Yan Jing
Published: May 2021

ObjectivesPanzhihua has implemented the Diagnosis Related Groups (DRGs) since 2018, and the quality of medical under the DRG-Based Payment System is concerned. This study aimed to examine the characteristics of patients under the DRG payment system based on the related factors, length of stay, readmission of inpatients.MethodsWe conducted a retrospective cohort study using data from Hospital Information System (HIS) from 2019 . The study used logistic regression analysis to investigate the factors related to hospitalization time and readmission rate of patients under the DRG payment system.ResultsIn this study ,68210 inpatients were included in the study. Among these inpatients ,5.84% were readmitted within 30 days.The factors associated with the increased risk of readmission included age, DRG payment, admission, critical condition, and discharge (p <0.05). Surgical patients had the highest risk of readmission within 30 days (OR=1.04995% CI：0.982-1.122). Among the inpatients readmitted within 30 days, 79.65% of them were readmitted within 14 days. 11.49% of the inpatients were transferred to other hospitals.ConclusionThe study shows a significant correlation between readmission and age, DRG payment, admission, critical condition, and discharge. The results suggested that high risk groups need in-depth examination and evaluation when discharged and admitted to hospital.
The Effect of an on Body Personal Lift Assist Device (Jaipur Belt) on Trunk Muscle Fatiguability During a Repetitive Lifting Task in Manual Material Handlers – A Non-Randomized Single-Group Trial
Authors: Thomas Betty , K Shyam Krishnan , Prabhakar Ashish John , Nayak Megha M. , Eapen Charu
Published: May 2021

Background: An on body personal lift assist device (OBPLAD) is a non-motorized, passive device in which the elastic elements act as an external muscle power generator to assist lifting thereby offloading the trunk muscles. Though there is enough evidence for the use of OBPLAD generated through laboratory studies, we found a scarcity of evidence on the use of OBPLAD in real-life work settings, especially in the Indian population. This study investigates the effect of the Jaipur belt, an OBPLAD, on trunk muscle fatiguability while performing repetitive lifting task in manual material handlers. Methods:70 subjects engaged in manual material handling were recruited from industries in and around Mangalore, Karnataka in this non-randomized single group trial. Subjects were made to perform a repetitive lifting task over a period of 15 minutes with and without an OBPLAD. Electromyographic data were recorded from rectus abdominis, transverse abdominis, quadratus lumborum, and erector spinae from either side of the body, and the onset of fatigue was deduced from the changes in electromyographic parameters. Results: We found a delay in the onset of fatigue in all the muscle groups studied while the lift was performed wearing the Jaipur belt. However, the findings were statistically significant only for right erector spinae, right rectus abdominis, left transverse abdominis, and left quadratus lumborum. It was found also that number of repetitions as well as time for which a task would be sustained were both found to be significantly better wearing an OBPLAD.Conclusion: The findings of the study imply that the Jaipur belt could potentially delay the onset of fatigue in the trunk muscles while performing repetitive lifting task and hence, is proved to be useful in the prevention of fatigue-related musculoskeletal disorders of the lower back.CTRI Registration date: 10/02/2020 Trial registration number: CTRI/2020/02/023219
Systematic Elucidation of the Mechanism of Action of Curcumin Against Colorectal Cancer via Network Pharmacology Approach
Authors: Han Xinyue , Xu Yimin , Liu Xiaoqiang , Li Yuan , Guo Cui , Fu xiaoling
Published: May 2021

Background: Curcumin is a potential drug for the treatment of colorectal cancer (CRC). Its mechanism of action has not been elucidated.Aim: To investigate the mechanism of action of curcumin in the treatment of CRC via network pharmacology, molecular docking and experimental verification.Methods: The targets of curcumin and CRC were obtained from the public databases. The component-targets network of curcumin in the treatment of CRC was constructed by Cytoscape v3.7.2. Through protein-protein interaction (PPI), the Gene Ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG), important targets and signaling pathways related to CRC treatment were identified. Finally, the results were verified by molecular docking and in vitro experiments.Results: A total of 30 potential targets of curcumin for CRC treatment were collectedThe core targets included AKT1, EGFR and STAT3 were identified. GO function enrichment analysis showed 140 items, and KEGG pathway enrichment analysis showed 61 signaling pathways, that were related to the regulation of protein kinase activity, negative regulation of apoptosis process, cancer signaling pathway and PI3K-Akt signali-ng pathway. In vitro experimental verification showed that curcumin could promote the apoptosis of CRC cells, and the key proteins of these signaling pathways were differentially expressed.Conclusion: This study explored the targets and pathways of curcumin in the treatment of colorectal cancer. In vitro experiments showed that curcumin has a therapeutic effect against CRC by inhibiting PI3K-Akt signaling pathway. Our results will lay a foundation for subsequent clinical research and drug development.
Undertaking General Practice Quality Improvement to Improve Cancer Screening - A Thematic Analysis of Provider Experiences
Authors: TRANKLE STEVEN A , METUSELA CHRISTINE , REATH JENNIFER
Published: May 2021

Background: Cancer is a major cause of illness and death, and its incidence and mortality can be reduced through effective screening. In order to improve below target screening rates in one region of Australia, the local Primary Health Network supported local general practices to implement a range of quality improvement initiatives.Methods: We used a qualitative approach and interviewed 16 general practice staff and five Primary Health Network staff and contractors to understand their experiences with these quality improvement initiatives.Results: In a thematic analysis, we identified four key themes related to program set-up and implementation; patient and community education and promotion; engaging patients and communities in screening; and general practice enhancement. Program roles were clear and understood, and the program received strong oversight and support. Practice staff felt supported and motivated. Information Technology was a challenge for many practices often requiring tailored assistance. Education provided by practices facilitated patient empowerment but practice staff noted difficulties engaging patients in screening. Practices were enhanced though strong leadership and teamwork and practice learning activities.Conclusions: The tailored evidence-based quality improvement initiatives were considered effective in supporting general practices to increase their cancer screening. Key facilitators reported by participants included use of Plan-Do-Study-Act cycles, enhanced data entry and audit capacity, effective recall and reminder systems and maintaining staff motivation.
Gender disparities among medical students choosing to pursue careers in medical research: A cross-sectional cohort analysis
Authors: Snyder Austin , Xiang David , Smith Alison , Esswein Shannon , Toubat Omar , Capua John Di , Kwan Jennifer M , Daye Dania
Published: May 2021

Background: Though the proportion of women in medical schools has increased, gender disparities among those who pursue research careers still exists. In this study, we seek to better understand the main factors contributing to the existing gender disparities among medical students choosing to pursue careers in medical research.Methods: A cross-sectional cohort analysis was conducted using a 70-item survey that was sent to 16,418 medical students at 32 academic medical centers and was IRB approved at the University of Illinois at Chicago and the University of Pennsylvania. Data was collected from September 2012 to December 2014. Survey results were analyzed using chi-square tests to determine gender differences in demographic characteristics (training stage, race/ethnicity, marital status, parental status, financial support, and parental career background), career sector choice, career content choice, specialty choice, foreseeable career obstacles, and perceptions about medical research careers. Results: There were 4433 respondents (27% response rate). Female respondents were more likely to be enrolled in MD-only programs, while male respondents were more likely to be enrolled in MD/PhD programs. More male trainees selected academia as their first-choice career sector, while more female respondents selected hospitalist as their first-choice career sector. More female respondents identified patient care and opportunities for community service as their top career selection factors, while more male respondents identified research and teaching as their top career selection factors. Conclusions: There are many factors from a medical student’s perspective that contribute to the existing gender disparities in pursuing a career in medical research, including student loan burden, future compensation, work/life balance, and family/caretaker obligations. While much progress has been made in attracting nearly equal numbers of men and women to the field of medicine, active efforts to bridge the gap between men and women in medical research careers are needed.
Double Jeopardy: Persistently High Hepatitis C Rates in Haemodialysis Patients in Brazil: A Systematic Review and Meta-Analysis
Authors: Niquini Roberta , Mota Jurema Correa da , Bastos Leonardo Soares , Barbosa Diego da Costa Moreira , Falcão Juliane da Silva , Palmieri Paloma , Villar Livia Melo , Bastos Francisco Inácio
Published: May 2021

Background: We conducted a systematic review and meta-analysis of studies assessing HCV infection rates in haemodialysis patients in Brazil. Methods: A systematic review was carried out, followed by two independent meta-analyses. The 1 st included studies with data on HCV prevalence. The 2 nd included previous studies with a confirmatory PCR (i.e. active infection of hepatitis C). We used both Bayesian and classical statistical concepts and methods. A comprehensive set of different methods and procedures were used, including forest plots and respective statistics, polynomial regression, meta-regression, subgroup, influence, and trim and fill analysis. Results: 11,290 individuals were assessed in the pooled analyses. The average time patients were in haemodialysis varied from 23.5 to 56.3 months. Prevalence of HCV infection was highly heterogeneous, with a pronounced decrease from 1992 to 2001, followed by a plateau and a slight decrease in recent years. The summary measure for HCV prevalence was 34% (95%CI:26%-43%) for studies implemented before 2001. For studies launched after 2001, the corresponding summary measure was 11% (95%CI:8%-15%). Estimates for prevalence of active HCV infection were also highly heterogeneous. There was a marked decline from 1996 to 2001, followed by a plateau and a slight increase after 2010. The summary measure for active HCV infection was 19% (95% CI:15%-25%) in studies launched before 2001, with a high degree of heterogeneity. For studies implemented after 2001, the corresponding summary measure was 9% (95% CI: 6%-13%), again with high heterogeneity. The different analyses helped to identify the underlying sources of heterogeneity. Besides the year each study was conducted, the findings differed markedly between geographic regions and were heavily influenced by the size of the various studies and by publication biases.Conclusions: CKD should be targeted with specific interventions to prevent HCV infection, and if prevention fails, prompt diagnosis and treatment. Although the goal of HCV elimination by 2030 in Brazil appears elusive, it is possible and necessary to adopt measures to achieve micro-elimination and to launch initiatives towards targeted interventions to curb the spread of HCV among people with CKD, among other high-risk groups.
A Risk Scoring System Based on Tumor Microenvironment Cells to Predict Prognosis and Immune Activity in Triple-Negative Breast Cancer
Authors: Yang Anli , Wu Minqing , Ni Mengqian , Zhang Lijuan , Li Mingyue , Wei Peijun , Yang Yonggang , Xiao Weikai , An Xin
Published: May 2021

The tumor microenvironment (TME) interacting with the malignant cells plays a vital role in cancer development. Herein, we aim to establish and verify a scoring system based on the characteristics of TME cells for prognosis prediction and personalized treatment guidance in patients with triple-negative breast cancer (TNBC). 158 TNBC samples from The Cancer Genome Atlas (TCGA) were included as the training cohort, and Molecular Taxonomy of Breast Cancer International Consortium (METABRIC) (N = 297), as well as GSE58812 (N = 107), were included as the validation cohort. The enrichment scores of 64 immune and stromal cells were estimated by the xCell algorithm. In the training cohort, cells with prognostic significance were found out using univariate Cox regression analysis and further applied to the random survival forest (RSF) model. Basing on the scores of M2 macrophages, CD8+ T cells, and CD4+ memory T cells, a risk scoring system was constructed, which divided TNBC patients into 4 phenotypes (M2low, M2highCD8+ThighCD4+Thigh, M2highCD8+ThighCD4+Tlow, and M2highCD8+Tlow) and 2 groups. The low-risk group had superior survival outcomes than the high-risk one, which was further confirmed in the validation cohort. Moreover, in the low-risk group, immune-related pathways were significantly enriched, and a higher level of antitumoral immune cells and immune checkpoint molecules, including PD-L1, PD-1, and CTLA-4, could be observed. Additionally, consistent results were achieved in the SYSUCC cohort when the scoring system was applied. In summary, this novel scoring system might predict the survival and immune activity of patients and might serve as a potential index for immunotherapy.
Joint Association of Modifiable Lifestyle and Metabolic Health Status with Incidence of Cardiovascular Disease and All-Cause Mortality: A Perspective Cohort Study
Authors: Zuo Yingting , Li Haibin , Chen Shuohua , Tian Xue , Mo Dapeng , Wu Shouling , Wang Anxin
Published: May 2021

Purpose: We investigated the joint associations of modifiable lifestyle and metabolic factors with incident cardiovascular disease and all-cause mortality.Methods: This study included 94,831 participants (men, 79.76%; median age, 51.60 [43.47-58.87]) without a history of cardiovascular disease at baseline from Kailuan study during 2006 to 2007 and followed them until new-onset cardiovascular disease event, death or December 31, 2017. Baseline metabolic health status was assessed by Adult Treatment Panel-III criteria and five lifestyle factors was collected using a self-reported questionnaire. We performed Cox proportional hazards models to evaluate the joint associations. Results: During a median follow-up of 11.03 years, we observed 6,590 cardiovascular disease events and 9,218 all-cause mortality. Participants within more metabolic risk components and least healthy lifestyle had the highest cardiovascular disease risk (hazard ratio 2.06 [95% CI 1.77-2.39]) and mortality risk (hazard ratio 1.53 [95% CI 1.31-1.78]), as compared with the less metabolic risk components and most healthy lifestyle group. Compared with the most healthy lifestyle, the hazard ratio of cardiovascular disease for participants with least healthy lifestyle was 1.26 (95% CI 1.17–1.37) in the category with low metabolic risk, 1.16 (95% CI 1.03–1.31) and 1.07 (95% CI 0.90–1.27) for those with medium and high metabolic risk, respectively.Conclusions: We showed that healthy lifestyle was associated with a lower risk of cardiovascular disease and there was no significant interaction between metabolic risk and healthy lifestyle. Our results indicated that healthy lifestyle should be promoted even for people with high metabolic risk.
Effect of αvβ3 Blockade Against Acute Lung Injury Induced by Influenza A Virus and Its Mechanism
Authors: Yu Wendi , Zeng Maoseng , Liu Jinyuan , Wang Huixian , xu peiping
Published: May 2021

Integrin αvβ3 is a heterodimer formed by αv and β3 subunits that is expressed in pulmonary endothelial cells, alveolar epithelial cells, interstitial cells and macrophages. Integrin αvβ3 not only has a common role of integrin family molecules in inflammation and tissue fibrosis, but also mediates the adsorption and penetration of various viruses into susceptible cells. Nevertheless, there are few studies on the effect of αvβ3 on acute lung injury (ALI) induced by influenza virus and its mechanism. Here, the effects of αvβ3 blockade [Cyclo(RGDyK)] against ALI induced by influenza A virus (IAV) in vitro and in vivo and its possible mechanism were studied. A549 cells and mice were infected with influenza virus A/FM/1/47 to induce ALI in vitro and in vivo. The results showed that Cyclo(RGDyK) reduced the ALI induced by IAV, alleviated pulmonary edema, improved lung histopathological changes and alleviated the accumulation of inflammatory cells in the lung. Cyclo(RGDyK) had inhibitory effect on cells and mice infected by IAV. Cyclo(RGDyK) (150 µg/kg) showed effective antiviral activity in vivo. Cyclo(RGDyK) had 70% protective effect against IAV and effectively reduced virus titer and inflammation in lung tissue. Cyclo(RGDyK) exhibited significantly anti-inflammatory and anti-fibrotic effect on improving the pneumonia and degree of pulmonary fibrosis and reducing the levels of pulmonary fibrotic markers (LN, HA, PCIII, IV-C, TGF-β1, and α-SMA). Additionally, Cyclo(RGDyK) inhibited expression of αvβ3,TGF-β1, HIF-1α, NF-κB, and p38 MAPK in the cells and mice lung tissues. The results showed that Cyclo(RGDyK) had a protective effect on ALI in mice infected with IAV and inhibited the progress of lung inflammation and fibrosis, which may be concern with its regulation of αvβ3/TGF-β1/HIF-1α signaling pathway.