bluuebunny/crossref_metadata_2025 huggingface dataset:
Development and Validation of a Prognostic Nomogram for Predicting the Overall Survival of Patients with Metastatic Gastric Cancer who Undergo Surgery
Authors: Guan Jiayun , Sun Dan , Pan Xixin , Liu Feiye , Rong Xiaoxiang , Ou Yanhua
Published: March 2022

Background
The benefits of surgery in patients with metastatic gastric cancer remain unclear. A nomogram may predict overall survival (OS) time of patients with metastatic gastric cancer who undergo surgery.
Methods
The development set consisted of 1300 patients from the Surveillance, Epidemiology, and End Results Program who were diagnosed with metastatic gastric cancer and underwent surgery in 2004–2015, whereas the validation set consisted of 555 patients diagnosed in 2004–2015. Variables were incorporated into a Cox proportional hazards model to identify independent risk factors for survival. Nomograms predicting 1-, 2-, and 3-year OS probabilities were designed using the development dataset. Receiver operating characteristic (ROC) curves and calibration curves were plotted to determine the accuracy of the nomograms. The net benefit of prediction models was evaluated using decision curve analysis (DCA).
Results
Age, primary tumor site, T stage, and N stage were risk factors for OS, whereas chemotherapy and radiotherapy were protective factors of OS. A nomogram including all of these variables had areas under the ROC curves (AUC) predicting 1-, 2-, and 3-year OS of 0.684, 0.676, and 0.685, respectively, for the development dataset and 0.689, 0.642, and 0.665, respectively, for the validation dataset. A calibration curve showed that the OS probability predicted by the nomogram was in good agreement with the actual OS probability. The DCA curves suggested that the nomogram provides a superior net benefit.
Conclusions
This nomogram can help predict the OS of patients with metastatic gastric cancer who underwent surgery. This nomogram can help clinicians make correct clinical decisions to prolong the OS of these patients.
Predictors of central line-associated bloodstream infections in cancer patients undergoing chemotherapy through implanted venous access ports: a cross-sectional, observational study
Authors: Chen Hao , Yamane Takamasa , Kazahari Hiroki , Ishihara Masashi , Sakamoto Takahiko , Tanzawa Shigeru , Honda Takeshi , Ichikawa Yasuko , Watanabe Kiyotaka , Seki Nobuhiko
Published: March 2022

Background: Central vascular catheters (CVCs) are superior to peripheral vascular access in chemotherapy. Central line-associated bloodstream infections (CLABSIs) are an important complication of CVCs in chemotherapy.Methods: A cross-sectional, observational study was conducted to investigate patients with implanted venous access ports (PORTs) from July 2010 to June 2021 in a teaching hospital. General conditions of the PORTs, backgrounds, and characteristics of patients were compared between CLABSI and uninfected patients to identify predictors of CLABSI.Results: A total of 566 patients with PORTs who underwent chemotherapy were enrolled in this study, with CLABSI identified in 41 patients, for a total of 436,597 catheter-days. The median duration of PORT use was 26 days vs 494 days (p < 0.001) in the CLABSI and uninfected groups, respectively. There were no significant differences in tumor classification, staging, white blood cell (WBC) count, neutrophil proportion, lymphocyte proportion, albumin, C-reactive protein (CRP), and performance status between the CLABSI and uninfected groups. Multivariable analysis showed that total protein, antibiotic usage before one week, and immediate use of PORT were independently associated with CLABSI, and their odds ratios (ORs) were 1.84 (95% confidence interval (CI) 1.08, 3.13), 3.34 (95%CI 1.20, 9.32), and 2.37 (95%CI 1.01, 5.54), respectively.Conclusions: PORT implantation should be avoided in patients who have received antibiotic treatment or had antibiotic treatment episodes within one week, especially for those with low serum total protein levels.
Diversity and Richness of the Herbaceous Assemblage on Urbanized and Non-urbanized Dunes on the Brazilian Amazonian Coast
Authors: Amorim Ingrid Fabiana Fonseca , Lima Patrícia Barbosa , Santos-Filho Francisco Soares , Almeida Eduardo Bezerra
Published: March 2022

The urbanization is a factor that directly affects the structure of vegetation, which makes it essential studies aimed at conserving the biodiversity of these environments. This study aimed to describe the structure of the vegetation and identify the predominant species in order to record the herbaceous composition in non-urbanized and urbanized dune areas, analyzing the diversity of and richness of the dunes of Maranhão Island. The study was conducted in six dunes in which were allocated 150 plots in non-urbanized and 150 plots in urbanized dunes. We counted all the herbs in each plot (1 m2), recording data on richness, diversity and vegetation cover. To evaluate the difference in the composition of the areas, the following tests were used: Shapiro-Wilk W test (data distribution), Student t test (species richness) and Hutcheson t test (diversity comparison). NMDS showed that the urbanized and non-urbanized dunes presented distinct species compositions and densities; ANOSIM and the INDVAL test revealed a significant correlation between dunes and plots. We recorded 3,643 individuals: of this total, 2,075 individuals in urbanized dunes and 1,568 individuals in non-urbanized dunes; we found 91 species, 59 genera and 27 families. Richness was higher in urbanized areas; however, non-urbanized areas showed greater diversity and uniformity. The floristic composition of the areas differed, according to the species indicator, showing 19 typical urbanized dune species and 9 non-urbanized dune species. The diversity of the herbaceous vegetation provide important data that can be used to guide research on conservation and management of dune areas.
Estimation of chlorophyll and nitrogen in double-cropping rice based on machine learning
Authors: Zhu Haijun , Zhang Ting , He Xiao-E , Shi Ai-Long , Wen Tian , Tan Wei-Jian , Xue Hua-Liang , Yi Zhen-Xie , Wang Xue-Hua
Published: March 2022

It can solve the disadvantages of traditional crop biochemical parameters measurement methods on combining hyperspectral technology with machine learning technology to retrieve crop growth index. Four nitrogen application levels were set by taking rice varieties Zhuliangyou 819 and Zhuliangyou 39 as materials. Through the rice test in 2020, the spectral data of rice leaves at different growth stages and their corresponding SPAD values and nitrogen contents were collected. Savitzky-Golay Smoothing (SG), Standard Normal Variable (SNV), Principal Component Analysis (PCA) and Multiplicative Scattering Correction (MSC) were used to preprocess spectral reflectance. Three classifiers, Support Vector Machine (SVM), Partial Least Squares Regression (PLSR) and Random Forest (RF) were used to build the model. The results showed that SG-PLSR combination had the highest accuracy in predicting chlorophyll and nitrogen in double-cropping rice. The test results provide a good reference for other indexes of rice.
Left atrial appendage closure in nonvalvular atrial fibrillation patients with percutaneous coronary intervention
Authors: Yu Yunan , Xu Jing , Wang Liang , Ye Zi , Chen Zhisong , Chen Fadong
Published: March 2022

Objectives: Nonvalvular atrial fibrillation (NVAF) concomitant with coronary artery disease (CAD) may increase the risk of thromboembolism. Antithrombotic therapy for NVAF patients with percutaneous coronary intervention (PCI) remains contradictory and challenging. This study aimed to assess the safety and efficacy of left atrial appendage closure (LAAC) in a cohort of patients with NVAF and PCI.Methods: 109 patients undergoing LAAC procedures between March 2017 and December 2020 were categorized into 2 groups, 36 patients with PCI (Group I) and 73 without (Group II). Peri-procedural and long-term complications as well as ischemia and bleeding events were retrospectively analyzed. Results: Group I had more diabetes mellitus (55.6% vs. 26.0%; p=0.003), a higher CHA2DS2-VASc scores (5.44±1.85 vs. 4.22±1.64; p=0.002) and HAS-BLED scores (3.39±0.93 vs. 2.74±1.05; p=0.003) compared to Group II. Procedure-related complications within 7 days were similar in both groups (8.3% vs 8.2%; P= 1.000). Over a median follow-up period of 20 months, there were no significant differences between two subgroups with regard to cardiovascular death (2.8% vs. 0%, p=0.330), stroke/transient ischemic attack (2.8% vs. 5.5%, p=1.000), major bleeding (0% vs. 2.7%, p=1.000) and device related thrombus (8.3% vs. 1.4%, p=0.104). The observed annualised thromboembolic and major bleeding events by Kaplan–Meier analysis was decreased by 82.4% and 100% in group I, 55.9% and 75.8% in group II, respectively.Conclusions: LAAC is a safe and effective option for stroke prevention in NVAF patients with PCI.
The Prevalence and Characterization of Comorbid Medical Conditions in Adult Patients Having Elective Surgery
Authors: Aronson Solomon , Williams David , Crittenden Timothy , Murray Sutton , Fuller Matt
Published: March 2022

Background: Identifying pre-surgery medical conditions has important implications for patient care, research, and policy. We hypothesized that modifiable medical conditions before surgery are common and under-recognized. Methods: Adult patients scheduled for elective surgery in a single site academic tertiary hospital from January 2019 through December 2020 were screened for modifiable medical and lifestyle conditions by history and chart review and an electronic medical record (EMR) screening tool. The presence of a modifiable medical conditions was quantified and characterized by surgical site of service, ASA status, age, gender, race, visit type and surgical service. Patients screened for transplant, eye surgery, obstetric care, GI, or other “endoscopy” procedures, were excluded. If more than one surgery was performed, then only the first procedure was included. A logistic regression analysis was performed to evaluate the association of patient characteristics with odds of having any modifiable condition. P value less than 0.05 was considered significant. Agreement between history - chart review versus the EMR screening tool was compared using Cohen’s kappa coefficient. Patient characteristics associated with the presence of modifiable medical conditions were assessed using chi-squared tests. Results: 19, 838 (63%) of 31,291 qualified patients evaluated had at least one modifiable medical condition or qualified for lifestyle modification. 76.5% of Inpatients had a modifiable condition versus 56.4% of outpatients. Older patients were more likely to have at least one modifiable medical condition (p<0.001) compared to younger patients and Black or African American patients were more likely to have at least one modifiable medical condition compared to Caucasian patients [OR 1.34 (1.26-1.44), (p<0.001). Site of service, age, gender, race, visit type and surgical service were independent predictors of a medical condition at the time of surgery. The likelihood of discovery of a medical condition was significantly greater with use of the EMR screening tool compared to a designation of a medical conditions based on chart review reliance alone (p<0.0001).Conclusion: The prevalence of co-existing and potentially modifiable co-morbid medical conditions among adult patients scheduled to undergo elective surgery is high regardless of surgery site of service with noteworthy differences among patient populations.
Research On Visual Question Answering Based On Dynamic Memory Network Model Of Multiple Attention Mechanisms
Authors: Yalin Miao , Shuyun He , Wenfang Cheng , Guodong Li , Meng Tong
Published: March 2022

Since the existing visual question answering model lacks long-term memory modules for answering complex questions, it is easy to cause the loss of effective information. In order to further improve the accuracy of the visual question answering model, this paper applies the multiple attention mechanism combining channel attention and spatial attention to memory networks for the first time and proposes a dynamic memory network model (DMN-MA) based on the multiple attention mechanism. The model uses the multiple attention mechanism in the situational memory module to obtain the most relevant visual vectors for answering questions based on continuous memory updating, storage and iterative inference of the questions, and effectively uses contextual information for answer inference. The experimental results show that the accuracy of the model in this paper reaches 64.57% and 67.18% on the large-scale public datasets COCO-QA and VQA2.0, respectively.
An analytical relationship for calculating the surface evaporation rate of the AL2O3 and TiO2 nanofluids using numerical and RSM methods
Authors: Bayati Morteza , Sarvestani Mohsen Tahmasebi
Published: March 2022

The surface evaporation rate of water as a base fluid and Al2O3 and TiO2 nanofluids have been investigated numerically and analytically. The numerical analysis was performed through a 3D-CFD code. The analytical study was formed by the response surface method (RSM) to optimize the old analytical relationships for pure water, including various effects affecting the evaporation rate and applying them to nanoparticles. The obtained results were validated with experimental and correlation results in the literature. The optimization process was done to obtain an algebraic expression to predict the surface evaporation rate that includes the factors affecting evaporation. Then, the RSM method got the maximum and minimum values of the evaporation rate. It was found that the presence of the nanoparticles in the base fluid leads to a change in the saturation vapor pressure and subsequently changes the surface evaporation rate of the base fluid. In this research a correlation for surface evaporation rate in terms of input parameters such as air velocity, the saturation vapor pressure of the nanofluid, relative humidity, nanofluid, air temperature, nanoparticle size, and concentration of the nanoparticle was obtained.
Association of Maternal Psychological Distress and Use of Childcare Facilities with Children's Behavior Problems: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study
Authors: Takahashi Ippei , Murakami Keiko , Kobayashi Mika , Kikuchi Saya , Igarashi Ayaka , Obara Taku , Ishikuro Mami , Ueno Fumihiko , Noda Aoi , Onuma Tomomi , Matsuzaki Fumiko , Kobayashi Natsuko , Hamada Hirotaka , Iwama Noriyuki , Saito Masatoshi , Sugawara Junichi , Tomita Hiroaki , Yaegashi Nobuo , Kure Shigeo , Kuriyama Shinichi
Published: March 2022

Background
Childcare facilities have been reported as a factor in lowering the association of postnatal psychiatric symptoms with children's behavior problems; however, no studies have considered prenatal psychiatric symptoms. This study aimed to examine whether the use of childcare facilities moderates the association of maternal psychological distress in the prenatal and postnatal periods with behavior problems in children.
Methods
The present study was based on the data from 23,130 mother-child pairs participating in the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study. We used the K6 to assess and divide maternal psychological distress in early pregnancy and two years postpartum into four categories: none in both prenatal and postnatal periods (none), only the prenatal period (prenatal only); only the postnatal period (postnatal only); both prenatal and postnatal periods (both). The children's behavior problems were assessed using the Child Behavior Checklist for Ages 1½-5 (CBCL) at four years of age. The clinical range of the externalizing, internalizing, and total problem scales of the CBCL was defined as having behavior problems. To examine whether the use of childcare facilities moderates the association between maternal psychological distress and children's behavior problems, we conducted a stratified analysis based on the use of childcare facilities or not at two years old. In addition, the interaction term between maternal psychological distress and the use of childcare facilities was included as a covariate in the multivariate logistic regression analysis to confirm the p-value for interaction.
Results
The prevalence of the clinical ranges of externalizing problems, internalizing problems, and clinical range of total problems were 13.7%, 15.4%, and 5.8%, respectively. The association of maternal psychological distress with a high risk of children's behavior problems was significant, except a significant association was not identified between prenatal only psychological distress and externalizing problems in the group that did not use childcare facilities. In addition, interactions between the use of childcare facilities and maternal psychological distress on behavioral problems in children were not significant.
Conclusions
The use of childcare facilities did not moderate the association of maternal psychological distress in prenatal and postnatal periods with behavior problems in children.
Cascade Comparison with GHG Emissions Soil Fern Plant Samples for Prevention of Weed Development
Authors: Ubani Solomon
Published: March 2022

Cascades were basically tray used to incubate in a botanical garden. This was on a much smaller scale than Green House Gas Emissions [1]. Properties such as moisture content, UV rays differ between the two for growing of plants. These researches compared reap of a controlled to environment harsh but larger scope of farming and growing of plants [2]. The root failure as a result of weed development is researched in this study [3].
Liquid-Crystalline Assembly of Sphere-Shaped Cellulose Nanocrystals
Authors: Cheng Li , Liu Bingrui , Hu Jian , Zhou Lijuan , Zong Lu , Duan Yongxin , Zhang Jianming , Yuan Yuan
Published: March 2022

Rod-like cellulose nanocrystals (that is cellulose nanorods, CNRs) can self-organize into chiral nematic liquid crystals owing to their anisotropy character. Unexpected, sphere-like cellulose nanocrystals (cellulose nanospheres, CNSs) have been observed to form a chiral liquid crystalline phase also. Herein, to understand how the similar assembly take places as the particle dimension changes, the organization features of the CNSs were investigated. It reveals that CNSs organize into a liquid-crystal phase constituted by periodically parallel-aligned layer-structure above a critical concentration in suspension, the structure of which retains after drying. Compared with CNRs, the CNSs alignment shows short layer distance, low order degree, and weak long-range orientation. Considering the lower surface charge and the spherical appearance, a “knot-like” model which was captured by “freezing” the CNSs suspension in intermediate aggregation state, is proposed in the early stage of tactoid formation. Such structure acts as the fundamental unit to achieve the liquid-crystal assembly further.
Ultrasound-based radiomics technology in fetal lung texture analysis prediction of neonatal respiratory morbidity
Authors: Zhou JianQiao , Du Yanran , Jiao Jing , Ji Chao , Li Man , Guo Yi , Wang Yuanyuan , Ren Yunyun
Published: March 2022

Objectives To develop a novel method for predicting neonatal respiratory morbidity (NRM) by ultrasound-based radiomics technology.Methods In this retrospective study, 430 high-throughput features per fetal-lung image were extracted from 295 fetal lung ultrasound images (four-chamber view) in 295 single pregnancies. Images had been obtained between 28+3 and 37+6 weeks of gestation within 72 hours before delivery. A machine-learning model was created using 20 radiomics features extracted from the images and 2 clinical features (gestational age and pregnancy complications) to predict the possibility of NRM.Results Of the 295 standard fetal lung ultrasound images included, 210 in the training set and 85 in the testing set. The overall performance of the neonatal respiratory morbidity prediction model achieved AUC of 0.88 in the training set and 0.81 in the testing set, sensitivity of 84.32% in the training set and 77.78% in the testing set, specificity of 81.13% in the training set and 82.09% in the testing set, and accuracy of 81.90 in the training set and 81.18% in the testing set. Conclusions Ultrasound-based radiomics technology can be used to predict NRM. The results of this study may provide a novel method for non-invasive approaches for the prenatal prediction of NRM.
Changes in the Characteristics of Patients Treated for Brain Metastases with Repeat Stereotactic radiotherapy (SRT): A Retrospective Study of 184 Patients
Authors: Kuntz L. , Fèvre C. Le , Jarnet D. , Keller A. , Meyer P. , Thiery Alicia , Cebula H. , Noel Georges , Antoni D.
Published: March 2022

Purpose
Brain metastases (BMs) are the leading cause of intracranial malignant neoplasms in adults. WHO, Karnofsky performance status (KPS), age, number of BMs, extracerebral progression (ECP), recursive partitioning analysis (RPA), diagnosis-specific graded prognostic assessment (Ds-GPA) are validated prognostic tools to help clinicians decide on treatment. No consensus exists for repeat stereotactic radiotherapy (SRT) for BMs. The aim of this study was to review the changes in patient characteristics treated with repeated SRTs.
Methods and Materials
The data of patients treated between 2010 and 2020 with at least two courses of SRT without previous whole brain radiotherapy (WBRT) were reviewed. Age, WHO, KPS, ECP, type of systemic treatment, number of BMs were recorded. RPA, Ds-GPA and brain metastasis velocity (BMV) were calculated.
Results
184 patients were treated for 915 BMs and received two to six SRTs for local or distant brain recurrence. The median number of BMs treated per SRT was 1 (range:1–6), for a median of 4 BMs treated during all sessions (range:2–19). WHO, Ds-GPA and RPA were stable between each session of SRT, whereas KPS was significantly better in SRT1 than in the following SRT. The number of BMs was not significantly different between each SRT, but there was a tendency for more BM at SRT1 (p = 0.06). At SRT1, patients had largest BM and undergo more surgery than during the following SRT (p < 0.001). 6.5%, 37.5% and 56% of patients were classified as high, intermediate, and low BMV, respectively, at the last SRT session. There was almost perfect concordance between the BMV-grade calculated at the last SRT session and at SRT2 (r = 0.89; p < 0.001).
Conclusion
Repeated SRT doesn't lead to a marked alteration in the general condition, KPS was maintained at over 70% for more than 95% of patients during all SRTs. Long survival can be expected, especially in low-grade BMV patients. WBRT shouldn't be aborted, especially for patients developing more than twelve BMs annually.
What Makes A Perinatal Woman Suicidal? A Grounded Theory Study
Authors: Reid Holly E. , Pratt Daniel , Edge Dawn , Wittkowski Anja
Published: March 2022

Background: Suicide is a leading cause of maternal death during pregnancy and up to a year after birth. Psychological and psychosocial risk factors for maternal suicide ideation and behaviour have been identified but do not account for why mothers begin to experience suicidal thoughts. Qualitative research offers a way of identifying what might drive mothers to initially consider suicide and then go on to act on such thoughts; crucial for the development of assessments to identify, and interventions to target, maternal suicide ideation and behaviour. We aimed to develop a grounded theory outlining what makes women think about suicide and/or engage in suicidal behaviour during pregnancy and the first 12 months following birth?Method: Semi-structured interviews were conducted with 12 mothers in the UK who had suicidal thoughts during pregnancy and/or the first year following birth. A constructivist approach to grounded theory was adopted which guided the data collection and analysis processes. Results: We developed a model outlining the theorised process of psychological factors that culminates in mothers experiencing suicidal thoughts and then making a suicide attempt during the perinatal period. The process was initiated when mothers felt attacked by motherhood which led to feeling like a failure, self-identifying as a “bad mother” and subsequent appraisals of entrapment and/or defeat. When nothing resolved the distress and as mothers collated reasons for why they perceived they needed to die, suicidal behaviour became a viable and appealing option. We theorised that mothers might make a suicide attempt when they entered a state of intense “darkness” brought on by a trigger, followed by a temporary lapse in the conflict between the desire to live and desire to die and an opportunity to attempt.Conclusions: Participants stressed the rapid onset of suicidal thoughts. We suggest that healthcare professionals enquire about the mother’s feelings towards the baby and of isolation, how she views herself as a mother, feelings of entrapment and defeat during routine contacts to aid identification and prevention of suicidal ideation/behaviour. Suggested interventions to prevent suicidal thoughts and behaviour include helping women manage their expectations for pregnancy and the postpartum period.
Multi‑Strategy Equilibrium Optimizer: An Improved Meta-Heuristic Tested On Numerical Optimization And Engineering Problems
Authors: Li Yu , Liang Xiao , Liu Jingsen , Zhou Huan
Published: March 2022

In order to solve complex numerical optimization problems and engineering problems more effectively, an Improved Equilibrium Optimizer (IEO) based on multi-strategy optimization is proposed. Firstly, Tent mapping is used to initialize the algorithm instead of randomly generating initial population in basic Equilibrium Optimizer. The diversified initial population lays a good foundation for global search of the algorithm. Moreover, nonlinear time parameter is used to update the position equation, which dynamically balances the exploration and exploitation phases of IEO. Finally, Lens Opposition‑based Learning (LOBL) is introduced, which can avoid local optimization by improving the population diversity of the algorithm. Simulation experiments are carried out on 23 classical functions, IEEE CEC2017 problems and IEEE CEC2019 problems, and the stability of the algorithm is further analyzed by Friedman statistical test and box plots. Experimental results show that IEO has good solution accuracy and robustness. In addition, six engineering design problems are solved, and the results show that IEO not only has high optimization efficiency, but also can achieve cost minimization.
The association between early onset of alcohol, smokeless tobacco and marijuana use with adult binge drinking in United States
Authors: Dai Zheng , Wang Kesheng
Published: March 2022

1) BackgroundBinge drinking remains significant public health problems in United States. To date, less is known how the early onset of substance use and other factors impacted the severity of adult binge drinking. 2) MethodThe 2018 National Survey on Drug Use and Health data was used to identify binge drinking (binary and in number of days in the past month). Age at onset was categorized four groups as 1–12, 13–14, 15–17, or beyond 18. Weighted multivariate logistic regression and Poisson regression analyses were performed to examine the association between early onset of alcohol, smokeless tobacco, and marijuana use with binge drinking. 3) ResultsThe severity of binge drinking was statistically significantly associated with substance use (2.66 days in a month), early (before age 15) onset of alcohol, smokeless tobacco, and marijuana use (3.20–4.93 days, all p-values < 0.0001), after accounting for the covariates. Past year substance use disorder is strongly associated with binge drinking. 4) ConclusionsThe severity of adult binge drinking is significantly associated with early onset of substance use including alcohol, smokeless tobacco, and marijuana. Continued efforts are warranted to improve substance use prevention and treatment tailored for adolescents and youth to prevent development of adult binge drinking.
Zinc Status is Related To Dialysis Adequacy In Peritoneal Dialysis Patients: A Cross-Sectional Study In Central China
Authors: Zhang Danfeng , Li Dandan , Zhao Xinyu , Chen Mengpin , Zhu Yuyu , Wang Deguang , Liu Guiling
Published: March 2022

Background: Zinc displays an essential role in regulation of inflammation and redox oxidative stress and patients on peritoneal dialysis (PD) are prone to develop zinc deficiency due to decreased dietary intake and losses via PD effluent and urinate. This study was aimed to evaluate the prevalence rate of zinc level in Chinese patients on PD and the relationship between zinc level and total Kt/V (tKt/V) on PD; Methods: A cross-sectional study of a cohort of 116 patients with end-stage kidney disease (ESKD) receiving PD was conducted. Peritoneal dialysis Kt/V were identified and patients were grouped as high tKt/V (＞1.7) ( n=78) group and low tKt/V（＜1.7）(n=38) group. The zinc level in whole blood were measured using atomic absorption spectroscopy（AAS）; Results: The zinc level in whole blood showed significantly higher values in patients with high tKt/V than those with low tKt/V (5.47±0.47 and 5.02±0.35, p=0.031, respectively). Age, zinc, albumin and cholesterol level were identified as independent predictors of Kt/V in PD patients by multivariate analysis. The prognostic value of zinc of high tKt/V was revealed as an area under the curve (AUC) of 0.799 (95% CI :0.717-0.881, p＜0.001) with a sensitivity of 80.8% and specificity of 73.7%. Compared with albumin and cholesterol, Delong’test was empolyed and the results showed that zinc in whole can predict the better adequacy of PD significantly (p＜0.05); Conclusions: Zinc level in whole blood are low in patient undergoing peritoneal dialysis. Low zinc concentration is associated with low tKt/V in PD patients, suggesting that zinc level in whole blood may serve as an independent factor of dialysis quality of PD patients.
The Effect of Acceptance and Commitment Therapy on Youth with Body Dysmorphic Disorders Symptoms: A Randomized Clinical Trial
Authors: Torkian Akram , Zanjani Zahra , Pourkmali Zahra , Omidi Abdollah
Published: March 2022

Background
Body dysmorphic disorder (BDD) is the most distressing body image disorders. The aim of this study was to evaluate the efficacy of acceptance and commitment therapy (ACT) in improving psychological problems in individuals with BDD symptoms.
Methods
This was a randomized clinical trial study with 34 eligible patients with BDD symptoms were recruited from Kashan city in 2021. These individuals were randomly assigned to either an intervention group (n = 17) with 8 weekly ACT sessions or a placebo group (n = 17). Used assessments included Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder (Y-BOCS-BDD), Depression Anxiety Stress Scales 21-item version (DASS-21), Cognitive Fusion Questionnaire (CFQ), and Body-Image Acceptance and Action Questionnaire (BI-AAQ). Data were analyzed by using SPSS 26.
Results
The results revealed that there was no significant difference in demographic variables of either age or gender. On the other hand, statistical analyze showed that two groups had the significant difference in term of body symptoms severity (F = 4.89), cognitive fusion (F = 9.18), emotional symptoms (depression F = 4.03, anxiety F = 4.02, and stress F = 4.87) in the post-test.
Conclusion
It can be said ACT has a positive effect on body image flexibility, cognitive fusion, and emotional symptoms of young people with body dysmorphic disorders and it can improve their symptoms.
Intraoperative frozen section can reduce unnecessary second operation in breast cancer patients that failed to be diagnosed by previous core needle biopsy: a retrospective analysis of Chinese clinical practice
Authors: Xue Jialei , Li Jianwei , Gong Yue , Cui Qiuxia , Dai Li , Guo Tianwei , Liu Zhebin , Liu Guangyu
Published: March 2022

Objective: The value of frozen section in the intraoperative diagnosis of breast cancer that failed to be diagnosed by previous core needle biopsy (CNB) is indeterminate. To evaluate and improve the clinical utility of frozen section on this kind of breast cancer, we conducted a retrospective data analysis and constructed a prediction model.Method: We reviewed data of breast cancer patients that failed to be diagnosed by previous CNB (CNB-undiagnosable) in Fudan University Shanghai Cancer Center (FUSCC) from May 1, 2006 to December 31, 2019. Clinical characteristics of patients were collected. the correlation between clinical features and false negative rate (FNR) of frozen sections was explored with logistic regression analysis, after which a nomogram was constructed to predict the probability of false negative.Result: The diagnostic sensitivity of frozen section on CNB-undiagnosable breast cancer was 67.18%, and the FNR was 32.82%. In multivariate analysis, papillary lesion (OR, 4.251; 95% CI, 2.804-6.492; P<0.0001) and sclerosing adenosis (OR, 3.727; 95% CI, 1.897-7.376; P= 0.0001) on CNB were risk factors of false negative, while clustered microcalcifications on mammography (OR, 0.345; 95% CI, 0.216-0.543; P < 0.0001) and ultrasonic BI-RADS category 4C-5 (OR, 0.250; 95% CI, 0.081-0.777; P = 0.0157) were favorable factors of true positive. The false negative rate of frozen section could be controlled at about 11% or less by the prediction of nomogram. Conclusion: Frozen sections are valuable in the intraoperative diagnoses of CNB-undiagnosable breast cancers. It is recommended to implement the intraoperative frozen sections for high-risk breast lesions with a low probability of false negative indicated by prediction, so as to minimize the occurrence of unnecessary second operation.
Forest Ecosystems and Evolution of Cattle Husbandry Practices of the Earliest Central European Farming Societies
Authors: Gillis Rosalind , Kendall Iain , Roffet-Salque Mélanie , Zanon Marco , Anders Alexandra , Arbogast Rose-Marie , Bogucki Peter , Brychova Veronika , Casanova Emmanuelle , Claßen Erich , Csengeri Piroska , Czerniak Lech , Domboróczki László , Fiorillo Denis , Gronenborn Detlef , Hachem Lamys , Jakucs János , Ilet Micheal , Lyublyanovics Kyra , Lenneis Eva , Marciniak Arkadiusz  , Marton Tibor , Oross Krisztián , Pavúk Juraj , Pechtl Joachim , Pyzel Joanna , Stadler Peter , Stäuble Harald , Vostrovská Ivana , Wijk Ivo van , Vigne  , Balasse Marie , Evershed Richard
Published: March 2022

Stable isotope signatures of domesticates found on archaeology sites provide information about past human behaviour, such as the evolution and adaptation of husbandry strategies. A dynamic phase in cattle husbandry evolution is during the 6th millennium BCE, where the first cattle herders of central Europe spread rapidly through diverse forested ecological niches, where little is known about pasturing strategies. Here we investigate cattle pasturing and foddering practices using a multi-regional dataset of stable isotope values (δ13C and δ18O; compound-specific stable isotopic analysis δ15N-amino acids and δ13C-dairy fats) measured from cattle bone and teeth, and pottery residues from early farming contexts, and palaeoenvironmental information. Our analysis reveals that farmers practiced different pasturing strategies with the intensive use of forested ecosystems in some areas for both graze and seasonal forage. We propose that the diversity of strategies is related to the adaptation of herding to new environments, which had a positive impact on cattle breeding and milk availability for human consumption.
The occurrence of the strongylid nematodes, Kalicephalus viparae viparae (Nematoda: Diaphanocephalidae), in viper Snake, Macrovipera lebetina (Reptilia: Viperidae), Southwestern Iran
Authors: Larki Sara , Alborzi Alireza , Bahramnejad Kia , Asadi Zeinab
Published: March 2022

An ancylostomatid Kalicephalus spp. is the common parasitic intestinal nematode of reptiles. West-Asian blunt-nosed viper, a venomous snake found in extensive areas of Iran. Between June - September 2017, two dead viper snakes were referred to the parasitology laboratory and examined for intestinal parasites. Several white elongated roundworms were collected and fixed to identify under light and scanning electron microscopes (SEM) based on morphological and molecular characteristics. For the molecular survey, some parts of identified worms were extracted and the ITS of nuclear ribosomal DNA (rDNA) amplified by PCR reaction. All collected hookworms were taxonomically identified as Kalicephalus viperae viperae and exposited in an individual branch far from of Ancylostomatidae species and close to A. braziliense with 88% discrepancies in the phylogenetic tree. The morphological characteristics and a large part of K. viperea viperea rDNA nucleotide sequence was reported in viper snakes for the first time in the world and Iran.
Inequality in energy transitions: Air pollution disparities amidst national decarbonization strategies
Authors: Goforth Teagan , Nock Destenie
Published: March 2022

Energy transitions and decarbonization require rapid changes to a nation's electricity generation mix. There are many feasible decarbonization pathways for the electricity sector, yet there is vast uncertainty about how these pathways will advance or derail the nation's energy equality goals. We present a framework for investigating how decarbonization pathways, driven by a least-cost paradigm, will impact air pollution inequality across different vulnerability groups in the US (e.g., low-income, high poverty or minority communities). We find that using least-cost optimization capacity expansion models without strict carbon or renewable energy technology mandates will fall short of achieving national energy equality. We find that Black or poor communities have higher co-pollutant concentrations during the energy transition, until a national mandate requires full deployment of renewable or low-carbon technologies. Thus, decisions regarding national decarbonization pathways must have strict mandates for equality outcomes or be driven by an equality-focused paradigm throughout the energy transition.
Clinical Analysis of the Etiological Spectrum of Bilateral Adrenal Lesions: a Large Retrospective, Single-center Study
Authors: Yan Fangfang , Zeng Jinyang , Chen Yulong , Cheng Yu , Pei Yu , Zang Li , Chen Kang , Gu Weijun , Du Jin , Guo Qinghua , Wang Xianling , Ba Jianming , Lyu Zhaohui , Dou Jingtao , Yang Guoqing , Mu Yiming
Published: March 2022

Purpose: To investigate the clinical characteristics, endocrinological function, and etiologies of patients with bilateral adrenal lesions.Methods: A retrospective study of 777 patients with bilateral adrenal lesions was conducted at the Chinese General Hospital of the People’s Liberation Army between January 2013 and January 2018. Patient demographic features, hormonal profiles, imaging findings, and histopathological findings were reviewed from the database records. Results: Of the 777 patients with bilateral adrenal lesions, 495 were men, and the mean age at diagnosis was 52.0±13.0 years. A total of 511 (65.8%) cases were benign, followed by adrenal metastases (n=224, 28.8%), pheochromocytoma (n=26, 3.3%), adrenal lymphoma (n=9, 1.2%), and adrenal corticocarcinoma (ACC) (n=7, 0.9%). Hormonal evaluation revealed that 34.3% of bilateral adrenal lesions were functional. The primary etiologies of functional lesions were primary aldosteronism (16.6%, 129/777) , and PBMAH (8.8%, 68/777). Patients with lymphoma and metastases were significantly older than those with benign nonfunctional lesions (60.4±11.0 years vs. 54.5±10.4 years and 57.9±10.8 years vs. 54.5±10.4 years, respectively; P<0.001). Lesions in adrenal lymphoma, ACC, pheochromocytoma, metastases, CAH, tuberculosis, and Cushing’s syndrome were significantly larger than benign nonfunctional lesions (all P<0.001). Conclusion: Benign adrenal lesions and metastases to the lungs are the most common causes of bilateral adrenal lesions, and primary aldosteronism and BMAH are the most prevalent functional lesions. In addition, our findings suggest that patients with lymphoma or metastases are older and possess larger masses.
Design and analysis of a plasmonic refractive index sensor with symmetrical cavities and rings.
Authors: HamidAbbasi
Published: March 2022

This paper analyzes and designs the structure of a sensor, the performance of which is evaluated by changing the refractive index. The structure of this sensor consists of two waveguides, eighteen cavities and nine rings. For better and more accurate results, we only change the refractive index of the middle ring and the refractive index of the other amplifiers remains constant. The results show that with increasing and changing the refractive index, the resonance wavelength will shift. This means that this method can be used to understand the refractive index and resonance wavelength. By changing the wavelength and refractive index and calculating the resonance amplitude curve (FWHM), three characteristics of sensitivity coefficient, figure of merit (FOM) and quality factor Q can be examined. These three characteristics, especially the sensitivity coefficient, tell us whether this sensor has a good performance or notIn this structure, the sensor sensitivity has reached 6591 nm / RIU. This means that the performance of the proposed sensor is better and more powerful than similar sensors and can achieve a more flexible amplitude of the wavelength. Also, the maximum figure of merit (FOM) is 43.73 nm / RIU and the highest quality factor Q is equal to 60.01. In the end, we come to the conclusion that this method has tremendous potential for use in various fields of measurement, such as biochemical, medical and military analysis. Also, all the diagrams obtained in this research have been drawn using MATLAB program.
Characterization of Resistome in Lactobacillus Genomic Sequences From the Human Gut
Authors: Moradi Jale , Fathollahi Matin , Halimi Shahnaz , Alvandi Amirhooshang , Abiri Ramin , Vaziri Siavash , Rezaei Akram
Published: March 2022

The gut is a complex environment inhabited by a wide range of bacterial species. Lactobacillus species constitute a significant proportion of this environment, and, due to their mobile genetic elements such as plasmids and transposons, are more likely to acquire and transfer antibiotic resistance genes through horizontal gene transfer (HGT). The current study obtained and analyzed 321 genome assemblies to determine the prevalence of intrinsic and acquired antibiotic resistance genes (ARGs) among Lactobacillus species colonizing the human gastrointestinal tract. A total of four high-frequency resistance genes were identified, including dfra42 (42%), poxtA (17.4%), lmrB (12%), and BJP-1 (7.7%), aside from dfra42, which is an intrinsic resistance gene, the other genes are acquired resistance genes. PoxtA was found in several different species, mainly in L. paracasei, whereas BJP-1 and lmrB were only found in one species, L. rhamnosus. IS5-like elements family transposase flanked 11% and 8% of detected lmrB and BJP-1, respectively, while, a variety of insertion sequences surrounded 22% of identified poxtA. Furthermore, to the best of our knowledge, this is the first report of BJP-1 in lactobacilli that would suggest it has transferred from soil microbiota to humans. According to the “One Health” perspective, early detection of a new reservoir would control the global spread of the antibiotic-resistant bacterial species between the three environments, which include humans, the environment, and animals. Finally, the study's findings may then highlight the possibility of lactobacilli acquiring or transmitting resistance to other species within or outside the human intestine.
Application Of 3D Printing Customized Bone Cement Molds In Reconstructing The Defect Of The Proximal Humerus And Distal Radius After Oncologic Resection: A Case Series Report
Authors: Ke Song , Ran Tianfei , Wang Chao , Zheng Lingling , He Yongqin , Wang Min
Published: March 2022

Background: Reconstructing the defect of the proximal humerus and distal radius after en bloc resection of tumors is challenging for surgeons. We present a defect reconstruction technique using bone cement prosthesis shaped by 3D printing customized molds in a case series as well as the oncologic and functional outcomes of these cases. Methods: A total of thirteen bone tumor cases (eight cases in the proximal humerus and five cases in the distal radius) of patients who experienced this reconstructive method from 2014-2019 were retrospectively reviewed. Local recurrence, metastases, complications, musculoskeletal tumor society score (MSTS score), and visual analogue scale (VAS) were used to evaluate the outcomes.Results: The average follow-up period was 46.5 months (range, 27-76 months). At the end of the follow-up, neither metastasis nor recurrence was found in all cases, and no patients demonstrated complications of fracture, infection, or implant loosening (only one patient who underwent proximal humerus resection and reconstruction complained of weakness in lifting the arms). The average MSTS score was 23.2 (77.2%, range, 66.7%-80%), and the average postoperative VAS was 1.31 ± 0.48 (range, 1-2).Conclusion: Bone cement prosthesis molded by 3D printing can be an effective and inexpensive option for reconstructing the proximal humerus and distal radius after en bloc resection of bone tumors. We recommend this method especially for elderly patients who need to undergo this procedure and do not require much function of the upper extremity.Level of evidence Ⅳ, a retrospective study.
18F-AIFNOTA-FAPI-04 Accumulation in Left Ventricular Myocardium in a Patient with Hypertensive Heart Disease
Authors: Xu Yi , Tang Yonjin , Wang Lu , Guo Jun , Ling Xueying , Wu Shaorong , Li Zicheng
Published: March 2022

A 62-year-old man with a history of hypertension for 20 years was admitted to our hospital. Echocardiogram showed thickened septum and decreased left ventricular diastolic function, indicating hypertensive heart disease. He underwent 18F-AIFNOTA-FAPI-04 PET/CT for suspected gastric cancer. Instead of aberrant tracer uptake in his stomach, uptake was observed unexpectedly in inferolateral wall of his left ventricle. This case suggests the possible role of 18F-AIFNOTA-FAPI-04 PET/CT in evaluation of hypertensive cardiac fibrosis/remodeling.
Area-level and individual-socioeconomic variation in use of GP and specialist services. A multilevel analysis using linked data
Authors: Butler Danielle C. , Jorm Louisa R. , Larkins Sarah , Korda Rosemary J.
Published: March 2022

BackgroundTimely access to primary healthcare and supporting specialist care relative to need is essential for health equity. However, use of services can vary according to an individuals' socioeconomic circumstances or where they live. This study aimed to quantify individual socioeconomic variation in GP and specialist use in New South Wales (NSW), accounting for area-level variation in use.MethodsBaseline data (2006–2009) from the 45 and Up Study, involving 267,112 adults in NSW, Australia, were linked to Medicare Benefits Schedule (MBS) and death data (to December 2012). Multilevel logistic regression was used to estimate median odds ratios (MORs) to quantify small-area variation in need-adjusted GP use and quality-of-care and specialist use, and odds ratios (ORs) to quantify associations with individual socioeconomic position (SEP), separately by remoteness.ResultsGP (MOR=1.32-1.35) and specialist use (1.16-1.18) varied between areas, accounting for individual characteristics. For a given level of need and accounting for area-variation, low-SEP individuals were more likely to be frequent users of GP services (no school certificate vs university, OR=1.63-1.91, depending on remoteness category) and have continuity of care (OR=1.14-1.24), but were less likely to see a specialist (OR=0.85-0.95).ConclusionGP and specialist use varied across small-areas in NSW, independent of individual characteristics. Specialist but not GP care was inequitable. Failure to address inequitable specialist use may undermine equity gains within the PHC system. Policies should also focus on local variation.