bluuebunny/crossref_metadata_2025 huggingface dataset:
“…we were like tourists in the theatre, the interns assisted almost all procedures…” Challenges facing the Assistant Medical Officers training for the performance of Caesarean section delivery in Tanzania
Authors: Sirili Nathanael , Anaeli Amani , Mselle Lilian , Nyongole Obadia Venance , Massawe Siriel
Published: January 2021

Background: Training of mid-level providers is a task-sharing strategy that has gained popularity in the recent past for addressing the critical shortage of the health workforce. In Tanzania, training of mid-level providers has existed for over five decades; however, concerns exist regarding the quality of mid-level cadres amidst the growing number of medical universities. This study sought to explore the challenges facing the Assistant Medical Officers training for the performance of Caesarean section delivery in Tanzania. Methods: An exploratory qualitative case study was carried out in four regions to include one rural district in each of the selected regions and two AMO training colleges in Tanzania. A semi-structured interview guide was used to interview 29 key informants from the district hospitals, district management, regional management, AMO training college, and one retired AMO. Also, four focus group discussions were conducted with 35 AMO trainees.Results: Training of AMOs in Tanzania faces many challenges. The challenges include: use of outdated and static curriculum, inadequate tutors (lack of teaching skills and experience of teaching adults), inadequate teaching infrastructure in the existence of many other trainees, including interns, and limited or lack of scholarships and sponsorship for the AMO trainees. Conclusions: The findings of this study underscore that the challenges facing AMO training for the performance of Caesarean section delivery have the potential to negatively impact the quality of Caesarean sections performed by this cadre. A holistic approach is needed in addressing these challenges. The solutions should focus on reviewing the curriculum, deploying qualified tutors, and improving the competencies of the available tutors through continuing medical education programmes. Furthermore, the government in collaboration with other stakeholders should work together to address the challenges in teaching infrastructure and providing financial support to this cadre that has continued to be the backbone of primary healthcare in Tanzania. Long-term solutions should consider deploying medical officers at the primary facilities and phasing out the performance of Caesarean section by AMOs.
Volcanoes and ENSO: a re-appraisal with the Last Millennium Reanalysis
Authors: Zhu Feng , Emile-Geay Julien , Anchukaitis Kevin , Hakim Gregory , Wittenberg Andrew , Morales Mariano , King Jonathan
Published: January 2021

The potential for explosive volcanism to affect the state of the El Niño-Southern Oscillation (ENSO) has been debated since the1980s. Several observational studies, largely based on tree rings, have since found support for a positive ENSO phase in the year following large eruptions. Models of different complexities also simulate such a response, detectable above the backdrop of internal variability – though they disagree on the underlying mechanisms. In contrast, recent coral data from the heart of the tropical Pacific suggest no uniform ENSO response to all eruptions over the last millennium. Here we leverage paleoclimate data assimilation to integrate the latest paleoclimate evidence into a consistent dynamical framework and re-appraise this relationship. Our analysis finds only a weak statistical association between volcanism and ENSO, suggestive of either no causal association, or of an insufficient number of large volcanic events over the past millennium to obtain reliable statistics. While currently available observations do not support the model-based inference that tropical eruptions promote an ENSO response, there are hints of a response to hemispherically asymmetric forcing, consistent with the "ITCZ shift" mechanism. We discuss the difficulties of conclusively establishing a volcanic influence on ENSO given the many degrees of freedom affecting the response, including eruption season, spatial characteristics of the forcing, and ENSO phase preconditioning.
Domain-Specific Self-Perceptions of Aging are Associated with Different Gait Patterns in Older Adults: A Cross-Sectional Latent Profile Analysis
Authors: Blawert Anne , Krumpoch Sebastian , Freiberger Ellen , Wurm Susanne
Published: January 2021

Background: Previous studies have pointed to the impact of self-perceptions of aging (SPA) on self-reported physical function in later life. However, less is known about the role of SPA for objectively measured physical function, especially gait. Research that examined other psychological variables and objectively measured gait has focused on single gait parameters such as gait speed, which seems to fall short for the complexity of this movement. Some approaches have proposed ways to identify gait patterns in specific patient groups (such as patients with hemiplegia), but not in community samples. Our goal was a) to identify gait patterns based on a combination of important gait parameters in a community sample, and b) to investigate differential associations of gain- and loss-related SPA with these gait patterns.Methods: The study used an electronic walkway to assess gait parameters of 150 community dwelling adults aged 71-93 years (61.0% women) at their usual and maximum gait speed. SPA were assessed with a questionnaire. We used latent profile analysis (LPA) to identify groups exhibiting distinct gait patterns and binary logistic regression to investigate associations of SPA with these groups, controlling for personality traits, number of illnesses, age, gender, and education. To compare overall function between groups, a t-test for scores in the Short Physical Performance Battery was used.Results: LPA revealed two distinct groups in both gait speed conditions. The fit group exhibited a stable, well-coordinated and faster gait pattern while the functionally limited group’s gait pattern was less stable, less coordinated and slower. The odds of belonging to the functionally limited group were increased by loss-related SPA at usual gait speed, while the odds of belonging to the fit group were increased by gain-related SPA at individual maximum speed. Conclusions: The findings a) suggest LPA as a useful approach to investigate complex gait patterns considering several gait parameters simultaneously, and b) provide first evidence for the differential role of gain- and loss-related SPA for gait patterns at usual and maximum gait speed. Intervention studies addressing gait in older adults should additionally address gain-related views on aging.Trial registration: NA
Observation of anti-damping spin-orbit torques generated by in-plane and out-of-plane spin polarizations in MnPd3
Authors: DC Mahendra , Shao Ding-Fu , Hou Vincent , Quarterman Patrick , Habiboglu Ali , Venuti Brooks , Miura Masashi , Kirby Brian , Vailionis Arturas , Bi Chong , Li Xiang , Xue Fen , Huang Yen-Lin , Deng Yong , Lin Shy-Jay , Tsai Wilman , Eley Serena , Wang Weigang , Borchers Julie , Tsymbal Evgeny , Wang Shan
Published: January 2021

High spin-orbit torques (SOTs) generated by topological materials and heavy metals interfaced with a ferromagnetic layer show promise for next generation magnetic memory and logic devices. SOTs generated from the in-plane spin polarization along y-axis originated by the spin Hall and Edelstein effects can switch magnetization collinear with the spin polarization in the absence of external magnetic fields. However, an external magnetic field is required to switch the magnetization along x and z-axes via SOT generated by y-spin polarization. Here, we present that the above limitation can be circumvented by unconventional SOT in magnetron-sputtered thin film MnPd3. In addition to the conventional in-plane anti-damping-like torque due to the y-spin polarization, out-of-plane and in-plane anti-damping-like torques originating from z-spin and x-spin polarizations, respectively have been observed at room temperature. The spin torque efficiency (θ_y) corresponding to the y-spin polarization from MnPd3 thin films grown on thermally oxidized silicon substrate and post annealed at 400 ℃ is 0.34 - 0.44 while the spin conductivity (σ_zx^y) is ~ 5.70 – 7.30× 105 ℏ⁄2e Ω-1m-1. Remarkably, we have demonstrated complete external magnetic field-free switching of perpendicular Co layer via unconventional out-of-plane anti-damping-like torque from z-spin polarization. Based on the density functional theory calculations, we determine that the observed x- and z- spin polarizations with the in-plane charge current are due to the low symmetry of the (114) oriented MnPd3 thin films. Taken together, the new material reported here provides a path to realize a practical spin channel in ultrafast magnetic memory and logic devices.
2108 Cases of Thyroid Cancer: Cervical Lymph Node Dissection or Not
Authors: Han Lin , Wu Zhen , Li Wenlei , Li Yingxue , Ma Jinglin , Wu Xinxin , Wen Wenjuan , Li Rui , Yao Yumin , Wang Yongkun
Published: January 2021

Based thyroid cancer data from patients treated in Liaocheng People’s Hospital from 2015 to 2018, with Chinese national and regional characteristics, in this study we addressed the controversy of which initial thyroid surgical mode, lobectomy or total thyroidectomy, is most effective. Clinical and pathological data from 2108 patients with thyroid cancer, who were initially diagnosed and treated surgically, were collected from the Department of Thyroid Surgery. The overall metastasis rate of all patients was 57.23%.With the increase of tumor diameter, the metastasis of cervical lymph nodes ranged from 22.54–73.33%, which showed positive correlation.49.32% of patients had lymph node metastasis in the lateral cervical region.When the diameter of the tumor reached T1c level, the metastasis of the cervical lymph nodes was 56.91%, and the number of metastatic cases above T1c level accounted for 69.96% of the total metastatic cases. It is recommended that initial treatment should comprise at least total thyroidectomy + central lymph node dissection in China, to avoid the risks associated with secondary surgery and effects on patient quality of life.When the tumor diameter exceeds 1 cm, the risk of cervical lymph node metastasis is high, we recommended the lateral lymph node dissection.
Human endemic coronavirus emergence in the context of past and recent zoonotic outbreaks
Authors: Forni Diego , Cagliani Rachele , Arrigoni Federica , Benvenuti Martino , Pontremoli Chiara , Pozzoli Uberto , Clerici Mario , Gioia Luca De , Sironi Manuela
Published: January 2021

Understanding the evolutionary dynamics of the four human endemic coronaviruses might provide insight into the future trajectories of SARS-CoV-2 evolution. We re-assessed the timing of endemic coronavirus emergence and we show that all viruses entered human populations in a time-frame ranging from ~500 to 55 years ago. Because the three highly pathogenic coronaviruses (SARS-CoV, MERS-CoV, and SARS-CoV-2) spilled-over in tight temporal succession, the pattern of coronavirus emergence, in analogy to that of influenza pandemics, is highly irregular. To contextualize this observation in a wider perspective of viral diseases emergence since 1945, we mined epidemiology database information. After controlling for reporting bias, we find that, contrary to widespread beliefs, the occurrence of viral diseases (either zoonotic or not) has not increased over the last decades. Analysis of the recent and ongoing evolution of HCoV-229E and HCoV-OC43 indicated that positive selection most likely contributed to fine-tune the interaction with the human interferon/inflammatory response. Conversely, integration of evolutionary inference and molecular dating provided evidence that these viruses are not undergoing antigenic drift and the temporal emergence of spike protein variants is best explained by optimization of receptor binding affinity. These data provide a fresh look on viral disease emergence and on coronavirus evolution.
The Prevalence of Drug-Resistant-epilepsy and its Associated Factors in Patients with Epilepsy
Authors: Mohammadzadeh Parisa , Nazarbaghi Surena
Published: January 2021

Background: Drug-resistant-epilepsy (DRE) is a major challenge in adult patients with epilepsy. The majority of previous studies evaluating the risk factors of DRE have been conducted in children. Therefore, this study aimed to investigate the prevalence of DRE and its associated factors in adults. Methods: All patients aged over 12 years with an established diagnosis of epilepsy since at least one year before the admission who were admitted with seizure to the neurology ward of a tertiary care hospital were consecutively included from 20th March 2014 to 19th March 2020. Patients were classified into two groups of DRE and non-DRE groups. The archived-files of the patients were retrospectively reviewed and the data were extracted and recorded in a pre-prepared checklist. Results: A total of 436 patients were investigated. The most common causes of epilepsy were idiopathic (53.9%), vascular (22.5%), and CP/developmental disorders (8.3%). There was no significant difference between DRE and non-DRE patients in terms of age, sex, seizure type (generalized/partial). Vascular causes were more prevalent in the non-DRE group, and idiopathic, post-traumatic/surgery, MS/degenerative, poor compliance, CP/developmental disorders, and space-occupying lesions were more prevalent in the DRE group. In multivariate regression analysis only the presence of CP/developmental disorders was independently associated with a higher probability of DRE (adjusted OR= 2.170, 95% CI = 1.017 to 4.633, p = 0.045).Conclusion: The prevalence of DRE is still considerably high. Therefore, considering its serious consequences, more investigations should be carried out to determine proper strategies for reducing its incidence. We found the history of CP/developmental disorders to be independently associated with DRE. Therefore, perinatal care to reduce the incidence of CP/developmental disorders and encouraging these patients to use their medications accurately may be helpful.
Acute Symptomatic Vitreous Floaters Assessed With Ultra-Wide Field Scanning Laser Ophthalmoscopy and Spectral Domain Optical Coherence Tomography
Authors: Son Gisung , Sohn Joon Hong , Kong Mingui
Published: January 2021

Purpose: To describe the eyes with vitreous floaters and to analyze the development of acute symptomatic posterior vitreous detachment (PVD). Methods: A retrospective review of medical records was performed on patients with the vitreous floater developed for the first time of their life. Peripapillary vitreous opacity (pVO) was searched in Ultra-wide field (UWF) scanning laser ophthalmoscopy and PVD stage was assessed through spectral-domain optical coherence tomography (SD-OCT). Results: 196 patients (55 males and 141 females), who were 58.4(±9.1) on years old, visited a retinal clinic 9.4 (±9.1) days after they experienced vitreous floaters. (pVO) was noticed in 62.2% at UWF and PVD was initiated more than 94.3%. Symptomatic eyes had more prevalence of peripapillary vitreous opacity (63.2% vs 18.4%, p=0.040) and more advance staged PVD (p<0.001) than symptom free eyes. Eyes with floaters were more myopic (-0.7±2.2D vs -0.5±1.9D, p=0.02), and had lower IOP (14.7±3.2mmHg vs 15.2±3.0mmHg, p=0.02) than the other symptom free eyes. Conclusion: In patients with first floater symptoms, PVD was in progress in most of the eyes not only the symptomatic eyes but also on the contralateral symptom free eyes. Eyes with vitreous floaters were more myopic and had lower IOP than the opposite symptom free eyes.
Gentlefile Versus Protaper in the Shaping Ability in Simulated J-shaped Root Canals
Authors: Chen Xixiong , Ge Jiuyu
Published: January 2021

Background: The aim of this study was to compare the shaping ability of Gentlefile (GF), a unique stainless-steel (SS) rotary system, and ProTaper (PT), a popular mechanical nickel-titanium (NiTi) system, in J-shaped simulated canals. Methods: Thirty-three resin blocks with a J-shaped canal were selected and randomly divided into 3 groups according to tip diameters: GF red (#23); PT F2(#25); GF blue (#26). They were prepared in one training model which imitated human dentition. Specimens were photographed by a dental operating microscope before and after preparation. The images were processed and measured using professional software. Centering ability and canal transportation were calculated, canal aberration and instrument separation were also recorded. Results: The GF system was significantly less transported than PT F2 in the apical and middle section. What’s more, better centering ability of GF was shown in all sections, including the coronal level. However, there was no difference between GF red and GF blue based on above criteria. Two cases of instrument separation of GF were noted.Conclusion: Under the conditions of this study, the two GF files showed better shaping ability, but were more easily separated than PT F2. As a novel SS rotary system, Gentlefile is more flexible to prepare narrow and curved root canals by scraping dentin with high-speed rotation, which might help remove smear layer much thoroughly and cause less dentin microcracks.
A Versatile Microfluidic Tool for the 3D Culture of HepaRG Cells Seeded at Various Stages of Differentiation
Authors: Boul Manon , Benzoubir Nassima , Messina Antonietta , Ghasemi Rasta , Mosbah Ismail Ben , Duclos-Vallée Jean-Charles , Dubart-Kupperschmitt Anne , Pioufle Bruno le
Published: January 2021

The development of livers-on-a-chip aims to provide pharmaceutical companies with reliable systems to perform drug screening and toxicological studies. To that end, microfluidic systems are engineered to mimic the functions and architecture of this organ. In this context we have designed a device that reproduces series of liver microarchitectures, each permitting the 3D culture of hepatocytes by confining them to a chamber that is separated from the medium conveying channel by very thin slits. We modified the structure to ensure its compatibility with the culture of hepatocytes from different sources. Our device was adapted to the migratory and adhesion properties of HepaRG cells at various stages of differentiation. To prevent hepatoblast-like cells from migrating out of the chambers, the slit height was decreased and the medium flow rate increased. Maintaining already differentiated and less adherent cells within the chambers required desensitisation of the system to pressure variations. Using this device, it was possible to keep the cells alive for more than 14 days, during which they achieved a 3D organisation and acquired or maintained their differentiation into hepatocytes. With its multiple micro-chambers for hepatocyte culture, this microfluidic device architecture offers a promising opportunity to provide new tools for drug screening applications.
Midterm Outcomes of Penetrating Keratoplasty Following Allogeneic Cultivated Limbal Epithelial Transplantation in Patients with Bilateral Limbal Stem Cell Deficiency
Authors: Xue Junfa , Li Dongfang , Wang Yani , Chen Chen , Yang Rufei , Zhou Qingjun , Liu Ting , Xie Lixin , Dong Yanling
Published: January 2021

To evaluate the midterm outcomes of penetrating keratoplasty (PK) following allogeneic cultivated limbal epithelial transplantation (CLET) for bilateral total limbal stem cell deficiency (LSCD)，ten patients (10 eyes) with bilateral LSCD were enrolled in this prospective noncomparative case series study. Each participant received a PK approximately 6 months after a CLET. Topical tacrolimus, topical and systemic steroids, and oral ciclosporin were given postoperatively. Best-corrected visual acuity (BCVA), intraocular pressure (IOP), ocular surface grading scores (OSS), corneal graft epithelial rehabilitation, persistent epithelial defect (PED), immunological rejection, and graft survival rate were assessed. The time interval between PK and allogeneic CLET was 6.90 ± 1.29 (6-10) months. BCVA developed from 2.46±0.32 LogMAR preoperatively to 0.77±0.55 LogMAR post-PK (P<0.001). Kaplan-Meier mean graft survival was 100% at 12, 24 months, 80.0% at 36 months. PEDs appeared in 5 eyes at different periods post-PK, while graft rejection post-PK occurred in 4 eyes. Total OSS dropped from 12.4±4.4 before allogeneic CLET to 1.4±1.5 after PK. The sequential therapy of PK following allogeneic CLET can maintain a stable ocular surface with improved BCVA despite a relatively high graft rejection rate. Topical tacrolimus is effective in promoting PK survival post-CLET compared with previous reports.
Forecasting Daily Arrivals and Peak Occupancy in a Combined Emergency Department
Authors: Tuominen Jalmari , Roine Antti , Saviauk Taavi , Seppo Anssi , Pihlaja Miika , Ovaska Jani , Pauniaho Satu-Liisa , Oksala Niku
Published: January 2021

Objective Emergency department (ED) crowding is a global problem associated with negative patient outcomes such as mortality and prolonged length of stay. Forecasting overcrowding would enable pre-emptive strategical maneuvers and is a subject of constant academic interest. However, most studies focus on forecasting arrivals in United States ED setting. We propose a novel and intuitive crowding metric called daily peak occupancy and assess forecasting ED crowding in a Nordic Combined ED using both established and novel predictive algorithms.Methods All episodes of care in Tampere University Hospital ED were acquired from December 1, 2014 to June 19, 2019, amounting to 488 167 individual events. Predictability of two target variables was investigated: total daily arrivals (TDA) and daily peak occupancy (DPO) with forecast horizon of one day. Three models were investigated: Seasonal Autoregressive Moving Average (SARIMA), Facebook’s Prophet algorithm, and General Linear Model (GLM). Calendar variables were used as independent variables.Results SARIMA outperformed other models in predicting both total daily arrivals and daily peak occupancy with mean absolute percentage errors of 6.6% (±5.3) and 12.4% (±10.7) respectively. Next day overcrowding can be predicted using SARIMA with an AUC of 0.74 and accuracy of 79 %.Conclusion Predictive models can be utilized in a Nordic emergency medicine setting with similar or better accuracy as previously reported. Predicting future occupancy is possible but more challenging than predicting arrivals. Predicting peaks in demand remains a significant challenge. Future work should focus on investigating the value of exogenous variables in increasing model sensitivity.
Changes in Serum 25 Hydroxyvitamin D Concentrations in Male University Long-Distance Runners Following Vitamin D3 Supplementation During Winter: A Randomized Controlled Trial
Authors: Mami Toraishi , Mayumi Kasai , Takayuki Nakano , Jun Sasahara
Published: January 2021

BackgroundVitamin D insufficiency and deficiency remain a global problem, even among athletes. In this study, we evaluated the serum 25 hydroxyvitamin D [25 (OH) D] concentrations of male long-distance runners during winter and the effect of short-term vitamin D3 supplementation to elucidate their dietary vitamin D requirements. MethodsUsing double-blind randomization, 34 athletes on the “Ekiden” (long-distance road race) team at University A were divided into a vitamin D group (n = 17, 25 μg/day of vitamin D3 intake) and a placebo group (n = 17, placebo tablet intake). Both groups ate normal meals with either the supplement or placebo included, and all subjects underwent a 31-day dietary survey. The pre- and post-intervention body composition and blood test were measured and compared.ResultsPrior to intervention, the vitamin D intake amount was 16.7 ± 7.2 μg/day, but the serum 25 (OH) D concentration was 28.9 ± 5.7 ng/mL, and 22 (65%) of the 34 subjects had insufficient vitamin D (<30 ng/mL). During the intervention period, the mean amount of vitamin D intake was 40.0 ± 5.5 μg/day in the vitamin D group and 13.4 ± 7.7 μg/day in the placebo group. Serum 25 (OH) D concentrations increased from 30.7 ± 6.7 ng/mL to 35.4 ± 6.6 ng/mL in the vitamin D group and from 27.1 ± 3.9 ng/mL to 28.5 ± 4.4 ng/mL in the placebo group, respectively (p < 0.001, p < 0.01). After intervention, the serum 25 (OH) D concentration in the vitamin D group was significantly higher (p < 0.001). Additionally, the rate of vitamin D sufficiency was 82% in the vitamin D group and 43% in the placebo group, indicating a significant difference (p < 0.01). Conclusions﻿Our results demonstrate that post-intervention serum 25 (OH) D concentration was related to both mean vitamin D intake amount during the intervention period and pre-intervention serum 25 (OH) D concentration. However, to better quantify the required amount of vitamin D, further study of the effect of vitamin D supplementation on bone health is needed.
NADPH Oxidase 4 Signaling in a Ventilator-induced Lung Injury Mouse Model
Authors: Lee Sang Hoon , Shin Mi Hwa , Leem Ah Young , Lee Su Hwan , Chung Kyung Soo , Kim Young Sam , Park Moo Suk
Published: January 2021

For patients with acute respiratory distress syndrome, a ventilator is essential to supply oxygen to tissues, but it may also cause lung damage. We investigated the role of NOX4 in a ventilator-induced lung injury (VILI) model.Wild-type (WT) male C57BL/6J mice and NOX4 knockout (KO) male mice were divided into five groups: (1) control group; (2) high tidal ventilation (HTV) group: WT mice + HTV; (3) NOX4 KO group; (4) NOX4 KO with HTV group; (5) NOX4 inhibitor group: WT mice + HTV + NOX4 inhibitor. In addition, the relationship between EphA2 (which is related to lung injury) and NOX4 was investigated using EphA2 KO mice, and NOX4 levels in the bronchoalveolar lavage fluid (BALF) of 38 patients with pneumonia were examined.In the NOX4 inhibitor group, cell counts and protein concentrations from BALF were significantly lower than those in the HTV group (both, p<0.001). In the NOX4 KO group and the NOX4 inhibitor group, EphA2 levels were significantly lower than those in the HTV group (p<0.001). NOX4 levels were significantly higher in patients with pneumonia and patients who received ventilator treatment in the ICU.In the VILI model, it may be possible to block VILI using NOX4 antibodies.
Response of a Hydrothermal System to Escalating Phreatic Unrest the Case of Turrialba and Irazú in Costa Rica (2007-2012)
Authors: Rouwet Dmitri , Mora-Amador Raul , Ramirez Carlos , González-Ilama Gino , Baldoni Eleonora , Pecoraino Giovannella , Inguaggiato Salvatore , Capaccioni Bruno , Lucchi Federico , Tranne Claudio Antonio
Published: January 2021

This study presents the first hydrogeochemical model of the hydrothermal systems of Turrialba and Irazú volcanoes in central Costa Rica, manifested as thermal springs, summit crater lakes, and fumarolic degassing at both volcanoes. Our period of observations (2007-2012) coincides with the pre- and early syn-phreatic eruption stages of Turrialba volcano that resumed volcanic unrest since 2004, after almost 140 years of quiescence. Peculiarly, the generally stable Irazú crater lake dropped its level during this reawakening of Turrialba. The isotopic composition of discharged fluids reveals the Caribbean meteoric origin; a contribution of “andesitic water” for Turrialba fumaroles up to ~50% is suggested. Four groups of thermal springs drain the northern flanks of Turrialba and Irazú volcanoes into two main rivers. Río Sucio (i.e. “dirty river”) is a major rock remover on the North flank of Irazú, mainly fed by the San Cayetano spring group. Instead, one group of thermal springs discharges towards the south of Irazú. All thermal spring waters are of SO4-type (i.e. steam heated waters), although none of the springs has a common hydrothermal end-member. A water mass budget for thermal springs results in an estimated total output flux of 187 ± 37 L/s, with 100 ± 20 L/s accounted for by the San Cayetano springs. Thermal energy release is estimated at 110 ± 22 MW (83.9 ± 16.8 MW by San Cayetano), whereas the total rock mass removal rate by chemical leaching is ~3,000 m3/y (~2,400 m3/y by San Cayetano-Río Sucio). Despite Irazú being the currently less active volcano, it is a highly efficient rock remover, which, on the long term can have effects on the stability of the volcanic edifice with potentially hazardous consequences (e.g. flank collapse, phreatic eruptions). Moreover, the vapor output flux from the Turrialba fumaroles after the onset of phreatic eruptions on 5 January 2010 showed an increase of at least ~260 L/s above pre-eruptive background fumarolic vapor fluxes. This extra vapor loss implies that the drying of the summit hydrothermal system of Turrialba could tap deeper than previously thought, and could explain the coincidental disappearance of Irazú’s crater lake in April 2010.
Localnet: A Simple Recurrent Neural Network Model for Protein Secondary Structure Prediction Using Local Amino Acid Sequences Only
Authors: Yang Shutong , Wang Yuhong , Cruz-Gutierrez Kennie , Wu Fangling , Ding Chuan-Fan
Published: January 2021

BackgroundProtein secondary structure prediction (PSSP) is important for protein structure modeling and design. Over the past a few years, deep learning models have shown promising results for PSSP. However, the current good performers for PSSP often require evolutionary information such as multiple sequence alignments and even real protein structures (templates), entire protein sequences, and amino acid property profiles. ResultsIn this study, we used a fixed-size window of adjacent residues and only amino acid sequences, without any evolutionary information, as inputs, and developed a very simple, yet accurate RNN model: LocalNet. The accuracy for three states of secondary structures is as high as 85.15%, indicating that the local amino acid sequence itself contains enough information for PSSP, a well-known classical view. By comparing to other predictors, we also achieve an state-of-art accuracy on dataset of CASP11, CASP12 and CASP13.ConclusionThe well-trained models are expected to have good applications in protein structure modeling and protein design. This model can be downloaded from https://github.com/lake-chao/protein-secondary-structure-prediction.
Noninvasive Temperature Estimation Based on Texture Features of Ultrasound Images for RFA
Authors: Chen Ming , Zhao Xingqun , Yao Linfang
Published: January 2021

BackgroundHyperthermia is one of the most common therapy for tumor， in which temperature monitoring is essential. Invasive temperature monitoring is mostly used in clinic at present, which leads to limited points under monitoring and extra hurt to patients. Therefore, noninvasive temperature estimation is a key and tough problem in hyperthermia. In this paper, a noninvasive temperature estimation method for hyperthermia based on B-mode ultrasonic image with wavelet transform and texture analysis is proposed.MethodsAnimal tissue both in vitro and in vivo(pig kidneys in vitro and rabbit kidney in vivo) were taken as experimental materials. Ultrasound images and temperature data were collected from radio frequency ablation experiment under approved protocol. Image subtraction and wavelet transform were performed on the ultrasound images to enhance the change during ablation, after which texture features were extracted to analyze the relationship with temperature.ResultsTexture features hybrid entropy and energy extracted from gray-level gradient co-occurrence matrix of ultrasound images processed had higher linear correlation with temperature than traditional gray value method. From in vitro and in vivo experiments, the linear correlation coefficients obtained between hybrid entropy and temperature were 0.979±0.028 and -0.935±0.037, respectively, and those between energy and temperature were 0.932±0.056 and -0.915±0.034, respectively. In addition, the slopes of linear model obtained in vitro were relatively consistent, while those under in vivo condition had certain individual differences.ConclusionsThe results demonstrated that texture features hybrid entropy and energy of ultrasound image processed with the method proposed in this paper can be used for temperature estimation with a smaller error because of high linear correlation with temperature both in vitro and in vivo. Compared with most previous research which only based on biomaterial in vitro, the in vivo experiment conducted in this paper verified the feasibility of the noninvasive temperature estimation method proposed in practice.
Canons and Sparrows II*: The Enhanced Bernoulli Exact Method for Determining Statistical Significance and Effect Size in the Meta-Analysis of k 2 x 2 Tables
Authors: Paul Lawrence Marc
Published: January 2021

BackgroundThe use of meta-analysis to aggregate the results of multiple studies has increased dramatically over the last 40 years. For homogeneous meta-analysis, the Mantel-Haenszel technique has typically been utilized. In such meta-analyses, the effect size across the contributing studies of the meta-analysis differ only by statistical error. If homogeneity cannot be assumed or established, the most popular technique developed to date is the inverse-variance DerSimonian & Laird (DL) technique [1]. However, both of these techniques are based on large sample, asymptotic assumptions. At best, they are approximations especially when the number of cases observed in any cell of the corresponding contingency tables is small.ResultsThis research develops an exact, non-parametric test for evaluating statistical significance and a related method for estimating effect size in the meta-analysis of k 2 x 2 tables for any level of heterogeneity as an alternative to the asymptotic techniques. Monte Carlo simulations show that even for large values of heterogeneity, the Enhanced Bernoulli Technique (EBT) is far superior at maintaining the pre-specified level of Type I Error than the DL technique. A fully tested implementation in the R statistical language is freely available from the author. In addition, a second related exact test for estimating the Effect Size was developed and is also freely available.Conclusions﻿This research has developed two exact tests for the meta-analysis of dichotomous, categorical data. The EBT technique was strongly superior to the DL technique in maintaining a pre-specified level of Type I Error even at extremely high levels of heterogeneity. As shown, the DL technique demonstrated many large violations of this level. Given the various biases towards finding statistical significance prevalent in epidemiology today, a strong focus on maintaining a pre-specified level of Type I Error would seem critical.
Quantifying the Pattern of Retinal Vascular Orientation in Diabetic Retinopathy Using Optical Coherence Tomography Angiography
Authors: Ma Yanhui , Ohr Matthew , Roberts Cynthia
Published: January 2021

Quantitative imaging using optical coherence tomography angiography (OCTA) could provide objective tools for the detection and characterization of diabetic retinopathy (DR). In this study, we developed a novel quantitative approach using OCTA images to delineate the vessel orientation pattern of a specific region of interest, which is an orientation distribution curve depicting the probability of vessels at each angle from 0 to 360 degrees. Three quantitative metrics including vessel preferred orientation, vessel anisotropy and vessel mass were extracted from the orientation pattern and analyzed in each of eight 45° sectors at the macula. Differential retinal microvascular orientation patterns were observed between three healthy subjects and three subjects with DR. Greater variability of vessel preferred orientation (p<0.001) and vessel mass (p<0.001) was exhibited among subjects with DR than healthy in eight sectors. In the nasal-superior sector, there was a significant difference between healthy and DR subjects in preferred orientation and vessel anisotropy. The vessel mass characterized from the vascular orientation pattern was shown to be strongly correlated with the traditionally reported vessel density (p<0.00001). These preliminary results suggest the feasibility and advantage of our vessel orientation-based quantitative approach using OCTA to characterize DR-associated changes in retinal microvasculature.
A Localized Study on Reducing Total Dissolved Solids Present in Southern California Tap Water
Authors: Wang Bill
Published: January 2021

This study, based in San Bernardino County, Southern California, explores the feasibility of adopting non-industrial equipment and methods to reduce water hardness in local tap water. We have utilized water boiling, activated carbon and sodium bicarbonate additives, as well as electrolysis methods to investigate how water quality could be improved. The results of this study show that when water is heated to a temperature around 50 °C (122°F), there is a maximum decrease in water hardness as well as its TDS levels. When water is left to boil for more than 10 minutes, there is a significant increase in TDS, making the water unfavorable for drinking. Activated carbon is unable to lower TDS, because it is unable to bind to any impurities present in the water. However, adding less than 4 mg/L of sodium bicarbonate will further eliminate water hardness by reacting with magnesium ions and improve taste, while increasing the pH. Electrolysis is the one of the methods that are successful in eliminating TDS, resulting in a direct proportion from an increasing electrical current and duration of time lowering the amount of TDS. These results will help residents determine safer and more effective ways to lower their water hardness and control mineral levels for their health and nutritional benefits.
Genetic Diversity and Population Structure of the Parental lines of Hybrid Japonica Rice in Northern China Revealed by 8K SNP-Chips
Authors: Gao Hong , Ma Zuobin , Wang Yuanzheng , Wang Changhua , Tang Zhiqiang , Zhang Liying , Fu Liang , He Na , Wang Hui , Bai Yuanjun , Sui Guomin , Zheng Wenjing
Published: January 2021

BackgroundThe hybrid rice varieties have made a significant contribution to food security. Although there has been rapid development of hybrid indica rice variety, the development of hybrid japonica rice has been relatively slow. This study aimed to understand the genetic background of representative parental lines of hybrid japonica rice in northern China that were beneficial for increasing efficiency to find a superior breeding combination using a restorer line and a sterile line. ResultsWe selected 137 parental lines of hybrid japonica rice, including 90 restorer lines, 47 sterile lines, which broadly represented the recent rice breeding trends in China. These lines were genotyped using 8K SNP-Chips (China Golden Marker Biotechnology Co. Ltd.) to understand the genetic diversity, population structure, phylogenetic evolution, and indica blood content. The genetic diversity of total parental lines averaged 0.264, with values for the restorer line and sterility line as 0.287 and 0.148, respectively. Based on the model-based population structure analysis and distance-based clustering, these 137 lines were divided into 14 groups, including seven independent restorer lines groups and seven mixture groups. There were 70% restorer lines in the above-mentioned seven independent restorer lines groups, and the indica blood content was 0.348, while 30% restorer lines were genetically similar to the sterile lines and constituted the other seven mixture groups, where the indica blood content in the restorer lines and the sterility lines was 0.142 and 0.121, respectively. The results of distance-based clustering revealed that the restorer lines, Group 1 and Group 2 (containing only restorer lines), had longer genetic distances with groups containing mainly sterile lines (the genetic distance ranged from 0.672 to 0.788), which served as a potential heterotic for hybrid rice breeding. This observation was consistent with the breeding strategy of high yield hybrid japonica rice.ConclusionsThe typical japonica sterile lines were crossed with the restorer lines containing high indica components indicating a strong heterosis pattern was a feasible scheme for heterosis utilization of indica-japonica subspecies. Thus, the effective ways to further improve the rice quality of hybrid japonica rice in northern China included maintaining moderate genetic distance and indica components between the parental lines along with the excellent quality of both the parental lines.
Alteration in the Immune Microenvironment Based on APC Status in MSS/pMMR Colon Cancer Data Retrieved from TCGA
Authors: Lin Haishan , Ma Nina , Zhen Hongchao , Shang Kun , Ma Xiaoting , Cao Bangwei
Published: January 2021

BackgroundImmunotherapy is currently the most advanced anti-tumor treatment approach. The efficacy of anti-tumor immunotherapy is closely related to the tumor immune microenvironment, including immune cells, infiltration of immune factors, and expression of immune checkpoints. At present, the biomarkers for predicting the efficacy of colon cancer immunotherapy do not cover all colon cancer patients suitable for immunotherapy. In this study, TCGA database was used to identify tumor genotypes suitable for anti-tumor immunotherapy. MethodsWe downloaded 390 samples with RNA-sequencing data and somatic mutation status data from TCGA. We applied the ESTIMATE, Package limma, the CIBERSORT and some other algorithms to analyze the cellular immune microenvironment. And validated with immunohistochemistry in tumor tissues of colon cancer patients. ResultsWe found that some of the MSS/pMMR populations, that were initially considered unsuitable for immunotherapy, might actually be suitable. In APC-wt/MSS colon cancer, the expression of PD-1, PD-L1, CTLA4 and CYT（GZMA and PRF1）were increased. Based on calculations done by ESTIMATE and CIBERSORT algorithms, the ImmunoScore and the proportion of CT8+ T cell infiltration is increased in these patients. Enrichment analysis was done to screen signaling pathways involved in immune response, extracellular matrix, and cell adhesion. Tumors from 42 colon cancer patients, including 22 APC-mt/MSS and 20 APC-wt/MSS, were immunohistochemically evaluated for expression of CD8 and PD-L1. And APC-wt/MSS tumors showed significantly higher expression of CD8 and PD-L1 than APC-mt/MSS tumor. ConclusionsBased on the results, we found that some colon cancers of APC-wt/MSS are classified by Tumor Immune Microenvironment types (TIMTs) TMIT I. So that we speculate that APC-wt/MSS colon cancer patients could benefit from anti-tumor immunotherapy.
Combination of Palbociclib and Erlotinib Exhibits Synergistic Antitumor Effect in Colorectal Cancer Patient-Derived Xenograft (PDX) Models
Authors: Zhou Xiaohui , Gong Yeqing , Liu Xiaorong , Mao Jiaqi , Chen Zhen , Zhou Tingting , Chen Chao , Hua Yunfen , Shi Xin , Yang Liu , Lin Fan
Published: January 2021

Background: The heterogenetic nature of colorectal cancer (CRC) constitutes a major challenge for drug development. Simultaneous targeting multiple molecules by combination therapy provides a promising strategy, but it requires identification of more potentially useful targeted agents. Palbociclib, a selective CDK4/6 inhibitor approved for the treatment of HR/ER-positive and HER2-negative breast cancer, exhibited anti-cancer versatility in several types of cancer. In this study, we evaluated its usefulness in the treatment of CRC either by single-agent or combined with a small molecule EGFR inhibitor erlotinib. Methods: The impacts of palbociclib, erlotinib, and their combination on cell proliferation, colony formation, cell cycle, apoptosis, senescence, and ROS accumulation in CRC cells were assessed. Their efficacies were evaluated in CRC patient-derived organoids (PDO) and xenograft (PDX) models.Results: Single-agent palbociclib efficiently inhibited proliferation, suppressed the RB phosphorylation, and caused G1-phase arrest in KRAS/BRAF mutated CRC cell lines. IC50 of all cell lines were below 1 µM. Moreover, it induced ROS accumulation and consequently caused apoptosis and senescence of CRC cells. The addition of erlotinib further aggravated palbociclib-induced anti-proliferation, cell cycle arrest, ROS accumulation, apoptosis, and senescence via blocking multiple critical effectors on RB/PI3K/RAS pathways and such interaction between two agents are synergistic. Finally, both palbociclib and erlotinib demonstrated anti-CRC activities, but only their combination caused statistically meaningful inhibition of tumor growth and prolonged survival with tolerable toxicity in KRAS wildtype/mutated PDX models. Conclusion: Our work demonstrated that the palbociclib and erlotinib combination treatment is a promising therapy for CRC and worthy of further clinical evaluation.
Analysis of Acupoint Selection and Combinations in Acupuncture Treatment of Asthma Based on Data Mining
Authors: Shang Pan-Pan , Chen Cai-Tao , Cheng Mi , Shi Yang-Lin , Yang Yong-Qing , Xu Yu-Dong
Published: January 2021

Background: Asthma is a highly prevalent respiratory disease that remains difficult to control. Acupuncture, as an important alternative therapeutic modality in preventing and treating asthma, is widely used in the world due to its promising efficacy and safety. Although acupoint selection and combinations are critical to therapeutic effects of acupuncture, its fundamental rules for asthma have not been fully understood. Thus, using data mining, the present study aimed to discover the most effective acupoints and combinations in the acupuncture treatment of asthma..Methods: Controlled clinical trials (CCTs) of acupuncture treatment for asthma were searched and retrieved from databases including Chinese National Knowledge Infrastructure (CNKI), Wanfang, and PubMed. Data regarding the main acupoints prescribed in these clinical trials was collected and quantified. A network analysis was performed to uncover the interconnections between the acupoints. Additionally, hierarchical clustering analysis and association rule mining were conducted to discover the potential acupoint combinations. Results: A total of 183 CCTs were retrieved. Feishu (BL13), Dingchuan (EX-B1), Dazhui (GV14), Shengshu (BL23), Pishu (BL20), and Fengmen (BL12) appeared to be the most frequently used acupoints for asthma. While the Bladder Meridian of Foot Taiyang, the Governor Vessel, and the Conception Vessel, compared to other meridians, were found to be the more commonly selected meridians. In the acupoint interconnection network, Feishu (BL13), Fengmen (BL12), Dingchuan (EX-B1), and Dazhui (GV14) were defined as key node acupoints. Moreover, acupoint clustering analysis revealed the treatment principle of “facilitating the flow of the lung Qi, tonifying spleen and kidney, and treating both the symptoms and root causes”. Association rule mining analysis demonstrated that the combination of Pishu, Shenshu, Feishu, and Dingchuan, as well as that of Feishu, Dazhui, and Fengmen were potential acupoint combinations that should be selected with priority in asthma treatment.Conclusion: Based on a data mining analysis of published CCTs, this study provides valuable information regarding the selection of the most effective acupoints and combinations for clinical acupuncture practice and experimental study aimed at the prevention and treatment of asthma.