bluuebunny/crossref_metadata_2025 huggingface dataset:
Residual Level, Profile and Potential Ecological Risk of Organochlorine Pesticides in Subsurface Sediments from Lakeshore Backfill Site and Lakebed of an Abandoned Oxidation Pond After Desilting for 15 Years
Authors: Wang Ya-Fen , Liu Tao , Tang JinCan , Xiong ZhiWei , Song LiangChu , Ma Teng
Published: June 2021

The occurrence and distribution of 19 organochlorine pesticides (OCPs), together with microbial ester-linked fatty acid methyl ester (EL-FAME) profiles were investigated in sediments from an abandoned oxidation pond of Ya-Er lake, China, which had been heavily polluted by hexachlorocyclohexanes (HCHs) and chlorobenzenes in 1980s. Subsurface sediment samples were taken from five sediment cores along the transect running from lakeshore to lakebed. The concentration of total OCPs ranged from 29.8 to 941.8 ng g-1 dw, with a mean value of 193.3 ng g-1 dw. Hexachlorobenzene (HCB), HCHs and dichlorodiphenyl-trichloroethanes (DDTs) were the three dominant OCP classes, accounting for 26.5%-97.4%, 1.8%-51.5%, and 0.4%-15.5% of the total, respectively. Hot spots of HCB, HCHs and DDTs were detected in 0.9-2.7 m deep layers of the lakeshore, where was one of the dredged sediment backfill sites for in-situ remediation of the oxidation pond in 2002-2004. High potential risks of HCHs and HCB were still indicated. Historical industrial input (27.2%), recent agricultural input (14.7%), and persistent residuals (14.3%) were the three major identified sources of OCPs, using Absolute Principal Component Scores-Multiple Linear Regression (APCS-MLR). Redundancy analysis of microbial EL-FAME profiles and nine dominant OCPs revealed that the spatial variation in microbial community structure was significantly corresponded with the OCP composition. This is the first study highlighted the concern on historical industrial inputs of OCPs in subsurface sediments of the lakeshore disposal zone. The findings could help to distinguish the artificial backfill sediments from natural polluted sediments for optimization of further desilting plans.
The Analysis of lncRNA-miRNA-mRNA Competitive Endogenous RNA Network to Identify 4-lncRNA Signature Related to the Prognosis of Bladder Cancer
Authors: Zhu Huili , Song Zhijuan , Jia Xiaocan , Wang Yuping , Yang Yongli , Shi Xuezhong
Published: June 2021

BackgroundBladder cancer (BLCA) is one of the leading causes of cancer deaths in the world, and the molecular mechanism of its pathogenesis is very complicated. Long non-coding RNA (lncRNA) can interact with microRNA (miRNA) through the mechanism of competitive endogenous RNA (ceRNA), and affect the expression of Messenger RNA (mRNA), and affect the pathogenesis of bladder cancer. This study aims to construct the ceRNA-regulated bladder cancer network related to lncRNA and identify a novel lncRNA signature related to the survival prognosis of patients with bladder cancer. It was validated in GEPIA's online bioinformatics network server assists. MethodsThe RNA sequencing data of normal and adjacent bladder cancer tissues are from the Cancer Genome Atlas (TCGA). We identify differentially expressed (DE) genes by comparing gene expression between normal tissues and tumors in the TCGA dataset. Construct a ceRNA network and explore potential biological markers. Based on the ceRNA network, univariate regression analysis and multivariate regression analysis were used to screen out the lncRNA related to the overall survival (OS) of bladder cancer. It was validated in GEPIA's online bioinformatics network server assists. Receiver operating characteristic curve (ROC) analysis was used to evaluate the prognostic value of the risk score.ResultsWe screened out 666 lncRNAs, 160 microRNAs (miRNAs), and 1,820 Messenger RNAs (mRNAs) by comparing normal bladder cancer tissues and adjacent tissues (P<0.05). Then, we constructed a ceRNA regulatory network containing 44 DElncRNA, 22 DEmiRNA, and 52 DEmRNA. The survival analysis of differential genes in the ceRNA network identified 9 lncRNAs, 8 miRNAs, and 12 mRNAs that are associated with the prognosis of BLCA. Cox regression analysis of 9 LncRNAs related to the prognosis of bladder cancer showed that 4 lncRNAs (AC078778.1, ADAMTS9-AS1, ADAMTS9-AS2, and NAV2-AS2) can be independently used as prognostic markers of bladder cancer.ConclusionsBased on the construction of the bladder cancer ceRNA network, a new prognostic signature of four lncRNA-based has been discovered. It will help to better understand the mechanism of bladder cancer occurrence, development and metastasis, and provide direction for future research.
Distance and Direction of Retained Root Migration After Lower Third Molar Coronectomy
Authors: Niyomthai Prattana , Vorakulpipat Chakorn , Manosuthi Pattamawan , Waikakul Aurasa
Published: June 2021

Background: The present study evaluated the pattern of root migration following coronectomy of the mandibular third molar in terms of distance, degree of direction, and relevant factors related to root migration. Methods: This retrospective study included 50 coronectomies in 44 patients with at least 1-year follow-up. Panoramic radiographs were taken pre-operatively, within 2 weeks after surgery, and at 3, 6, and 12 months post-operatively. Multiple factors are possibly related to root migration, so we analyzed sex, age, tooth, figure of root, residual bone height, and also as Winter’s and Pell& Gregory classification with respect to angulation, class, and position of tooth. Results: Over the first three months after the coronectomies, all retained roots moved and/or changed their root axis. The respective mean distance of retained root migration in the horizontal (C1), coronal (C2), and oblique (C3) direction during the first year post-operatively was 3.14 ± 1.86 mm, 2.42 ± 1.61 mm, and 3.45 ±1.76 mm. The mean (±SD) root axis change was 11.26 ± 5.55 degrees. The significant influencing factors related to root migration were sex, age, and in particular tooth angulation (GEE: P<0.05). The mesio- and horizontal angulation (M, H) group migrated significantly further horizontally forward (C1) over time than the vertical (V) and distoangulation (D) group. The V, D group showed significantly greater coronal migration (C2) (P=0.05) than the M, H group. The V, D group had only mesial rotation. Conclusion: These findings could contribute to evaluation and/or planning for root removal.
The Impact Of Sleep, Physical Activity And Sedentary Behaviour On Symptoms of Depression And Anxiety Before And During The COVID-19 Pandemic
Authors: Lewis Raphaella , Roden Laura C. , Scheuermaier Karine , Gomez-Olive Francesc X. , Rae Dale E. , Iacovides S , Bentley Alison , Davy Jonathan P. , Christie Candice J. , Zschernack Swantje , Roche Johanna , Lipinska Gosia
Published: June 2021

During lockdowns associated with the COVID-19 pandemic, individuals have experienced changes in sleep and lifestyle behaviours, and heightened depression and anxiety. However, the inter-relationship and relative strength of those behaviours on mental health outcomes is still unknown. Using structural equation modelling, we investigated how insomnia symptoms, sleep regularity, exercise intensity/frequency and sitting/screen-use (sedentary screen-use) interacted to predict depressive and anxiety-related symptoms before and during lockdown in 1048 South African adults (median age: 27y; n = 767 female; n = 473 students). We also controlled for the effects of sex and student status. Irrespective of lockdown, (a) more severe symptoms of insomnia and greater sedentary screen-use predicted greater symptoms of depression and anxiety and (b) the effects of sedentary screen-use on mental health outcomes were mediated by insomnia. The effects of physical activity on mental health outcomes, however, were only significant during lockdown. Low physical activity was associated with greater insomnia symptom severity, which in turn was associated with increased depressive and anxiety-related symptoms. Overall, relationships between the study variables and mental health outcomes were amplified during lockdown. The findings highlight the importance of maintaining physical activity and reducing sedentary screen-use to promote better sleep and mental health.
Carriage and Antibiogram of Methicillin Resistant Staphylococcus Aureus among Admitted Patients of a Surgical Ward in A Tertiary Hospital, South Western Uganda
Authors: Benson Musinguzi , Mugimba Pross , Baguma Andrew , Itabangi Herbert , Bazira Joel
Published: June 2021

Background: Methicillin Resistant Staphylococcus aureus (MRSA) is one of the most common nosocomial infections affecting post-surgery patients. Antimicrobial resistance prolongs the duration of hospitalization. We sought to determine the MRSA carriage among patients admitted to surgical ward in a tertiary hospital in South Western Uganda. Methods: Total of 46 participants were included in the study, swabbed at four different sites: nares, hands, perineum and surgical wound site. Identification of Staphylococcus aureus was done by standard conventional microbiological methods. Antibiotic susceptibility testing was done using disk diffusion method, except for Vancomycin were MIC was used as per CLSI guidelines. Using these results, prevalence of MRSA was determined. The on admission were followed up for 7days to determine the incidence of MRSA. Site carriage rate of MRSA was determined using drug susceptibility test (DST) test results. Questionnaire was used to collect data on factors associated with MRSA. Results: The prevalence of MRSA carriage at admission was 18/46 (39.1%). Among patients who were MRSA negative at admission, the incidence of MRSA carriage during hospitalization was13/26 (50%). Of the 122 S. aureus isolates, resistance to Oxacillin was 55(45.1%), Ciprofloxacin 50(41.0%), Ceftriaxone 46(37.7%), Methicillin 44(36.1%), Levofloxacin 39(32.0), Imipenem 13(10.7%) and Vancomycin 3(2.5%). The site with the highest carriage rate was the Nares 16/77 (20.8%), Hands 14/77(18.2%), Perineum 15/77(19.5%), surgical wound site 9/77(11.7%). 80% of the isolates were MDR. The factors measured were not statistically associated to MRSA carriage outcome. Conclusion: There was high MRSA carriage among patients on surgical ward. Resistance to commonly used antibiotics was high, 80% of the isolates were MDR. Therefore, there is the need for continuous surveillance to monitor aetiology and antimicrobial susceptibility patterns in order to guide the empirical use of antimicrobials. Sex was the only factor associated with MRSA carriage. Further studies should be done to fully assess factors associated to MRSA.
Landslide Susceptibility Mapping using Bivariate Statistical Models and GIS in Chattagram District, Bangladesh
Authors: Chowdhury Md. Sharafat , Hafsa Bibi
Published: June 2021

This study attempts to produce Landslide Susceptibility Map for Chattagram District of Bangladesh by using five GIS based bivariate statistical models, namely the Frequency Ratio (FR), Shanon’s Entropy (SE), Weight of Evidence (WofE), Information Value (IV) and Certainty Factor (CF). A secondary landslide inventory database was used to correlate the previous landslides with the landslide conditioning factors. Sixteen landslide conditioning factors of Slope Aspect, Slope Angle, Geology, Elevation, Plan Curvature, Profile Curvature, General Curvature, Topographic Wetness Index, Stream Power Index, Sediment Transport Index, Topographic Roughness Index, Distance to Stream, Distance to Anticline, Distance to Fault, Distance to Road and NDVI were used. The Area Under Curve (AUC) was used for validation of the LSMs. The predictive rate of AUC for FR, SE, WofE, IV and CF were 76.11%, 70.11%, 78.93%, 76.57% and 80.43% respectively. CF model indicates 15.04% of areas are highly susceptible to landslide. All the models showed that the high elevated areas are more susceptible to landslide where the low-lying river basin areas have a low probability of landslide occurrence. The findings of this research will contribute to land use planning, management and hazard mitigation of the CHT region.
A Novel 3d Printed Curved Monopole Microstrip Antenna Design for Biomedical Applications
Authors: Biçer Mustafa Berkan , Aydın Emine Avşar
Published: June 2021

This paper proposes a novel and compact monopole microstrip antenna (MA) design with a three-dimensional (3D) printed curved substrate for biomedical applications. A curved substrate was formed by inserting a semi-cylinder structure in the middle of the planar substrate consisting of polylactic acid (PLA). The antenna was fed with a microstrip line, and a partial ground plane was formed at the bottom side of the substrate. The copper plane with two triangular slots is arranged on the curved semi-cylinder structure of the substrate. The physical dimensions of the radiating plane and ground plane were optimally determined with the use of the sparrow search algorithm (SpaSA) to provide a wide -10 dB bandwidth between 3 GHz and 12 GHz. A total of six microstrip antennas having different parameters related to physical dimensions were designed and simulated to compare the performance of the proposed antenna with the help of full-wave electromagnetic simulation software called CST Microwave Studio. The proposed curved antenna was fabricated, and a PNA network analyzer was used to measure the S11 of the proposed antenna. It was demonstrated that the measured S11 covers the desired frequency range.
Grazing Intensity Changed The Activities of Nitrogen Assimilation Related Enzymes In Desert Steppe Plants
Authors: Zhu Aimin , Han Guodong , Liu Haili , Wang Yuehua
Published: June 2021

Background: The study on nitrogen assimilation mechanism of grazing grassland plants is of great significance to reveal the law of nutrient absorption and utilization of grassland vegetation. Methods: This study took Stipa breviflora desert steppe which was grazed for 17 years as the research object, and sampled the root system, leaf and rhizosphere soil of constructive species Stipa breviflora under the treatments of no grazing, light grazing, moderate grazing and heavy grazing during the peak growing season. The activities of enzymes related to nitrogen assimilation in roots and leaves were measured, and the related factors affecting nitrogen content were analyzed. Results: The results showed that heavy grazing significantly increased the total nitrogen content in the root system of Stipa breviflora, but decreased the total nitrogen content in the leaves, and the performance of grazing prohibition was consistent with that of heavy grazing; The activities of Nitrate reductase (NR), glutamine synthetase (GS), glutamic oxaloacetic transaminase (GOT) and glutamic pyruvate transaminase (GPT) were stronger under light or moderate grazing. Under grazing prohibition and heavy grazing, the content of proline in roots and leaves of Stipa breviflora increased significantly, especially in leaves; NR, GS, GOT and GPT were significantly correlated with total nitrogen content in roots and leaves of Stipa breviflora. Conclusions: Grazing prohibition and heavy grazing were not conducive to the nitrogen absorption and utilization of Stipa breviflora, which was closely related to the reduction of nitrate and ammonium nitrogen contents in the rhizosphere soil of Stipa breviflora by grazing. Grazing prohibition and heavy grazing affected the nitrogen content of Stipa breviflora by affecting the activities of related enzymes in the process of nitrogen assimilation of roots and leaves.
Ghrelin Treatment Induces Rapid and Delayed Increments of Food Intake: A Heuristic Model to Explain Ghrelin’s Orexigenic Effects
Authors: Cornejo Maria Paula , Denis Raphael , Romero Guadalupe Garcia , Fernandez Gimena , Reynaldo Mirta , Luquet Serge , Perello Mario
Published: June 2021

Ghrelin is a stomach-derived peptide hormone with salient roles in the regulation of energy balance and metabolism. Notably, ghrelin is recognized as the most powerful known circulating orexigenic hormone. Here, we systematically investigated the effects of ghrelin on energy homeostasis and found that ghrelin primarily induces a biphasic effect on food intake that has indirect consequences on energy expenditure and nutrient partitioning. We also found that ghrelin-induced biphasic effect on food intake requires the integrity of Agouti-related peptide/neuropeptide Y-producing neurons of the hypothalamic arcuate nucleus (ARH), which seem to display a long-lasting activation after a single systemic injection of ghrelin. Finally, we found that different autonomic, hormonal and metabolic satiation signals transiently counteract ghrelin-induced food intake. Based on our observations, we propose a heuristic model to describe how the orexigenic effect of ghrelin and the anorectic food intake-induced rebound sculpt a timely constrain feeding response to ghrelin.
Comparison of the BOPPPS Model and Traditional Instructional Approaches in Thoracic Surgery Teaching
Authors: Hu Kang , Ma Rui-Jie , Ma Chao , Zheng Qing-Kang , Sun Zhi-Gang
Published: June 2021

IntroductionBOPPPS (bridge-in, learning objective, pretest, participatory learning, posttest, and summary) is a student-centered modular teaching model that improves classroom teaching effectiveness. This study's primary aim was to explore whether the BOPPPS model has advantages over traditional instructional approaches in teaching lung cancer courses to clinical medical interns.MethodsA total of 88 students majoring in clinical medicine of Shandong First Medical University and Shandong University, who had clinical practice in thoracic surgery from January 2018 to December 2019, were divided into two groups, receiving the same lung cancer teaching content. The experimental group (n=44) utilized the BOPPPS model, while the control group (n=44) used the traditional instructional approach. A questionnaire was used to attain the students’ satisfaction and self-evaluation of the course, and a post-study examination was used to assess end-of-course performance. ResultsThe experimental group's theoretical examination scores with the BOPPPS teaching model were significantly higher than those in the control group. Students can recognize the BOPPPS model more than the traditional instructional approach in course satisfaction, student-teacher interaction, learning initiative, analytical ability, clinical thinking ability, and self-study ability (p<0.05). ConclusionsCompared with the traditional instructional approach. The BOPPPS model can better inspire clinical medical students' enthusiasm for thoracic surgery and enhance the students' comprehensive ability. In a word, the BOPPPS model has better teaching effectiveness in the clinical teaching practice of thoracic surgery, which is worthy of reference and popularization.
Feasibility of Duodenal Covered Self-Expandable Metal Stent Fixation: A Pilot Study (With Video)
Authors: Hori Yasuki , Hayashi Kazuki , Naitoh Itaru , Miyabe Katsuyuki , Natsume Makoto , Yoshida Michihiro , Kataoka Hiromi
Published: June 2021

Migration of duodenal covered self-expandable metal stents (C-SEMSs) is the main cause of stent dysfunction in patients with malignant gastric outlet obstruction (mGOO). Because endoscopic SEMS placement is frequently selected in patients with poor performance status, we concurrently focused on the safety of the treatment. This pilot study included 15 consecutive patients with mGOO who underwent duodenal C-SEMS placement with fixation using an over-the-scope-clip (OTSC). Technical feasibility, clinical success for oral intake estimated by the Gastric Outlet Obstruction Scoring System (GOOSS) score, and adverse events including stent migration were assessed. All procedures were successful, and clinical success was achieved in 86.7% (13/15). Mean GOOSS scores were improved from 0.07 to 2.53 after the procedure (P < 0.001). Stent migration occurred in one case (6.7%) with no other adverse events. For fixation using an OTSC, additional time required for the procedure was 8.9 ± 4.1 minutes. Poor performance status was associated with clinical success (P = 0.03), but we could provide the treatment safely and reduce mGOO symptoms even in patients with poor performance status. In conclusion, duodenal C-SEMS fixation using an OTSC is feasible for preventing stent migration in patients with mGOO including those with poor performance status.
Radiographic Outcomes of Treatment of Complex Femoral Shaft Fractures by Intramedullary Nailing: A Retrospective Analysis of Different Techniques
Authors: Chen Yu-Hung , Lin Shang Ming , Chang Chih-Hung , Lan Tsung-Yu
Published: June 2021

BackgroundThis study aimed to determine whether the outcomes of femoral diaphyseal fractures (AO/OTA/32-C) were dependent on the treatment technique (closed vs. open reduction and internal ﬁxation with an interlocking nail).This retrospective study was conducted at a level III trauma center. A total of 47 consecutive patients with femoral diaphyseal fractures (AO/OTA/32-C) were included. All patients underwent reduction and fixation and were divided into two groups according to the surgical techniques used: closed reduction and open reduction groups. The radiographic union score of the femur, mean union time, re-operation rate, and complication rate were assessed.ResultsAt 12 postoperative months, the union rate was 80.76% in the open reduction group and 82.35% in the closed reduction group; however, the difference was not significant (p=0.787). The rate of anatomical-to-small gaps was 96.15% and 47.05% in the open and closed reduction groups, respectively (p=0.01). The radiographic union score of the femur at 6 postoperative months (9.30 vs. 7.76, p=0.02) and postoperative months (9.94 vs. 10.80, p=0.03) was significantly higher in the open reduction group. Further, the required time to union in the open reduction group was significantly shorter (7.39 vs. 9.18 months, p=0.025). The difference in the need for revision surgery was not significant between the two groups (19.23% vs. 23.52%, p=0.964). ConclusionsCompared to closed reduction, intramedullary nailing of severe comminuted femoral shaft fractures with open reduction has similar outcomes and carries no increased risk of complications. Surgeons should consider open reduction if the outcomes of closed reduction are not satisfactory. This will aid in restoring anatomical reduction, enable primary bone grafting, and result in an optimal union rate, better strength of union, and shorter time to union.
Subcutaneously Delivered Nano-Insulin Drug as Label Free Nanotheranostic
Authors: Say Rıdvan , Şenat Almila , Ünlüer Özlem Biçen , Akyüz Fahrettin , Ersöz Arzu
Published: June 2021

In this study, it has aimed to understand the relationship between purified insulin and insulin receptor, also nanoinsulin and insulin receptors. The insulin receptor has separated from rat liver using a cryogel column material that is photosensitively insulin cross-linked in the Fast Protein Liquid Chromatography (FPLC) system based on the affinity between insulin and insulin receptor. In the second step, an isolated insulin receptor has used to synthesize insulin receptor cross-linked cryogels for purifying insulin from rats. Subcutaneously delivered nano-insulin drug has prepared from the purified insulin using AmiNoAcid (monomer) Decorated and Light Underpinning Conjugation Approach (ANADOLUCA) method. Lastly, Reflectometric Interference Spectroscopy (RIfS) study has performed to understand the interaction between purified insulin receptor and purified insulin, commercial insulin analog, and nano insulin. These studies have demonstrated that nano-insulin drugs can be effectively used as a theranostic platform to monitor affinity and blocking interactions of nanoprotein drug and its receptor.
Does Psychological Distress Interact With Patients’ Illness and Treatment Perceptions to Predict Adherence to Dietary Recommendation Among Persons With T2DM in Ghana? A Facility Based Cross Sectional Survey
Authors: Doglikuu Be-Ikuu , Abubakari Abdulai , Yaseri Mehdi , Shakibazadeh Elham , Djazayery Abolghassem , Mirzaei Khadijeh
Published: June 2021

Background: Psychological distress is a pervasive condition that interacts with other factors to influence adherence to treatment regimens, yet information-gap exists on how psychological-distress interact with Type-2-Diabetes Mellitus (T2DM) patients’ perceptions about their disease state and treatment benefits for adherence to dietary-recommendation. This study therefore investigates how T2DM patients’ psychological-distress interacts with perception about disease state and treatment benefits for adherence to dietary-recommendation. Methods: Facility-based cross-sectional-study was conducted among 530 T2DM patients at six health-facilities in Ghana. Structured-questionnaires were used to collect socio-demographics data, and Health Belief Model (HBM) questionnaires used to assess perceived-beliefs. Perceived-Dietary-Adherence-Questionnaire (PDAQ) for T2DM patients was used to assess adherence to dietary-recommendation. SPSS version-22 was used in data analysis.Results: Weight, diabetes-duration, total-cholesterol, HbA1c and fasting-blood-sugar were statistically significant for adherence to dietary-recommendation (P-value <0.05). Perceived-Susceptibility, Perceived-Benefit and Perceived-Cue to action were statistically significant for adherence to dietary-recommendations (P-value <0.05). After adjusting for confounders, interaction between low-psychological-distress and moderately-perceive-susceptibility[Adjusted Odd ratio(Adj.OR: 0.21, 95% confidence interval CI:1.18, 9.83); interaction between high-psychological-distress and moderately-perceived-susceptibility (Adj.OR: 4.49, 95% CI: 1.41, 14.28); interaction between low-psychological distress and highly-perceived-benefit (Adj.OR: 3.20, 95% CI: 1.30, 6.62); interaction between low-psychological-distress and moderately-perceived-barriers (Adj. OR: 4.79, 95% CI: 1.82, 12.60) and interaction between moderate-psychological-distress and highly-perceived-cue to action (Adj. OR 1.93, 95% CI: 1.36, 4.50) were statistically significant for adherence to dietary-recommendations. Conclusion: Psychological-distress can interact with patients’ perceptions for adherence to dietary recommendation. Therefore, health care workers globally should be mindful of this and offer professional care.
An Integrated Model of Pathological Complete Response and Postoperative CEA Predicts Survival and Benefit of Adjuvant Chemotherapy for Locally Advanced Rectal Cancer
Authors: Ye Shu-Biao , Chen Dong-Wen , Li Pei-Si , Lin Zhen-Sen , Long Jia-Hui , Cheng Yi-Kan , Lan Ping
Published: June 2021

Background:

Pathological complete response (pCR) and postoperative carcinoembryonic antigen (CEA) respectively represent pathological and biological response to treatment and prognostic indictors for locally advanced rectal cancer. However, the prognostic significance of integrated pCR and postoperative CEA model is rarely investigated.
Methods:

This big-data intelligence platform-based cohort biomarker study extracted clinicopathological characteristics and postoperative CEA of 919 locally advanced (clinical stage II-III) rectal cancer patients receiving neoadjuvant treatment from 6125 cases between April 2011 through September 2018 at Sun Yat-sen University, the Sixth Affiliated Hospital. An integrated model was constructed using pCR combined with the cut-off value of postoperative CEA generated from the receiver operating characteristic (ROC) curve. The model stratified locally advanced rectal cancer patients into four groups.
Results:

Both pathological response-pCR and biological response-postoperative CEA were independent prognostic indicators. In all patients, the 3-year distant metastasis-free survival (DMFS) (70.0%) and disease-free survival (DFS) (64.8%) rates were significantly lower in patients without pCR and postoperative CEA > 2.78 ng/ml (all p values < 0.05). Among patients treated with < 3 months of postoperative adjuvant chemotherapy (ACT), all others had higher 3-year DMFS and DFS rates. Among patients receiving ≥ 3 months of ACT, those without pCR had similar 3-year DMFS rates regardless of postoperative CEA level.
Conclusions:

The response integrated model with pCR and postoperative CEA not just effectively predict DMFS and DFS in locally advanced rectal cancer patients, but also was a predictive tool to potentially modify the optimal duration of ACT for locally advanced rectal cancer patients.
Aortic Hypoplasia in Young Adult Patients With Sudden Intrinsic Cardiopulmonary Arrest: An Observational Study
Authors: Bando Misaki , Yoshioka Yuki , Akagawa Yoko
Published: June 2021

Background: The leading cause of sudden cardiac death in adults over 40 is ischemic heart disease due to vascular atherosclerosis, especially in developed countries. In contrast, sudden cardiac death in adults younger than 40 (young adults) may be caused by aortic hypoplasia (AH). In 1968, Laurie described 14 young adults who died suddenly, and AH was a possible cause of death. In 2002, Gouveia also described AH as a cause of death in young adults. To date, few detailed studies of AH exist. This study evaluated AH patients in our hospital for sudden cardiopulmonary arrest in young adults. Methods: We selected young adult patients who transferred to our center with cardiopulmonary arrest status between April 2010 and March 2020. Their cause of death was supposed to be cardiac or unknown. In the chart review, sex, age, rate of computed tomography (CT) being performed, and outcome were described. For patients with CT being performed, we assessed the diameters of the aortic root (outlet and inlet), ascending aorta, descending aorta, abdominal aorta, and right femoral artery.Results: There were 1268 cardiopulmonary arrest cases during the study period. Thirteen young adults died of intrinsic diseases, such as sudden cardiac death or unknown cause of death. Twelve patients underwent CT scans, and eight (61.5%) had AH.Conclusions: For a decade, 61.5% of young adults who died of intrinsic diseases had AH. Further studies should be conducted to reveal AH’s clinical significance in young adults.
Association Between the Food Security Status and Dietary Patterns With Polycystic Ovary Syndrome (PCOS) in Overweight and Obese Iranian Women: A Case-Control Study
Authors: Badri-Fariman Mahtab , Naeini Amirmansour Alavi , Mirzaei Khadijeh , Moeini Ashraf , Hosseini Mostafa , Bagheri Seyedeh Elaheh , Daneshi-Maskooni Milad
Published: June 2021

Background

Polycystic ovary syndrome (PCOS) as one of the major types of endocrine disorders is common among women worldwide. Frequently reported that food insecurity (FI) and unhealthy diets can exert negative effects on reproductive health. There are contradictory results on optimal lifestyle modification especially dietary components with PCOS. This paper aimed to assess the association between PCOS with food security status and dietary patterns of overweight and obese Iranian women.
Methods

This case-control study was performed on 240 overweight and obese adult women with PCOS (n = 120) and without PCOS (n = 120) referred to the infertility clinic of Arash Hospital in Tehran, Iran. Participants' data on anthropometry, scio-economic factors, and physical activity were collected. Food security status and dietary intakes were assessed by validated questionnaires.
Results

The prevalence of FI was 60% in women with PCOS and 30% in healthy women. There was a positive association between the risk of PCOS with FI, quasi-western dietary pattern, low economic level, waist circumference, and menstrual age and a negative association between physical activity and healthy dietary pattern with this risk even after controlling the potential confounders (P < 0.05). PCOS women had a higher intake of saturated fats, monounsaturated fats, oleic acid, fluorine, sucrose, and caffeine and a lower intake of vitamins A, B5, B6, B12, C, and D, potassium, proteins, carbohydrates, cholesterols, docosahexaenoic acid, potassium, carotenes, lutein, beta-cryptoxanthin, lycopene, calcium, iron, thiamine, riboflavin, niacin, tetra- and dihydrofolate, biotin, phosphorus, magnesium, zinc, copper, total, insoluble, and crude fiber, glucose, galactose, fructose, and lactose compared to the healthy group (P < 0.05).
Conclusions

FI, quasi-western dietary pattern, low economic status, and waist circumference were significantly associated with the higher risk of PCOS. Modifying lifestyle especially in dietary patterns may be an important strategy for the reduction of PCOS. Future prospective studies are warranted to confirm these findings and to identify the underlying mechanisms.
A Local Perspective: Experiences and Handling of Mental Health Burden during the COVID-19 Pandemic in Uganda.
Authors: Muzyamba Choolwe , Munyati Bob Mwiinga , Makova Ogylive , Mushibi Geofrey
Published: June 2021

Background The COVID-19 pandemic has increased the prevalence of mental health illness around the world. While research has espoused these realities from the context of western countries, however, similar evidence from low income countries like Uganda is still missing. This is despite the fact that scholars have pointed out that given inadequate funding, health facilities and personnel to treat people with mental health challenges, the impact of the COVID-19 pandemic could be severe. Further, it is still unclear how locals in low income countries like Uganda manage to cope with mental health challenges given the lack of adequate skilled response, especially during a pandemic that has increased the pressure on the healthcare system. Therefore, this study aims to fill this gap by investigating local people’s experience and handling of mental health burden during the COVID-19 pandemic n Uganda. Methods Qualitative primary data was collected from Uganda in November and December 2020. The sample selection involved a two-staged cluster sampling technique via the AfriSight online platform. Our study included a total of 1249 participants picked from the 4 different regions of Uganda. On the basis of this, thematic analysis was used to analyze the data. Results Our study revealed that the COVID-19 pandemic and its associated interventions contributed to the increasing mental health burden in Uganda. The four most pronounced forms of mental health illnesses included stress, anxiety, depression and traumatic disorders with the leading causes being closure of income-generating activities, fear of dying, sexual and domestic abuse. While a few people had access to skilled mantel health care, the majority of the people struggled to access this form of care. Skilled maternal care remained an attractive yet unattainable form of care for many. Thus, most people relied on various forms of local strategies that were feasible.Conclusion Our study revealed that Uganda was home to various local survival strategies that counter the inadequacies presented by the weak health care system. Particularly, a culture of reciprocity, family and community network forms important coping avenues for many left stranded by the lack of adequate skilled care. Thus, in the context of Uganda during the COVID-19 pandemic, it seemed more logical to promote scaling up feasibly and locally-available solutions rather than idealistically focusing on attractive yet unattainable forms of care.
Micro/Nanostructured Lignonanocellulose Obtained from Steam-Exploded Sugarcane Bagasse
Authors: Fontes André Mazega , Pirich Cleverton L. , Tanobe Gustavo Ryo Oliveira de Andrade , Tarrés Quim , Delgado-Aguilar Marc , Ramos Luiz Pereira
Published: June 2021

This work demonstrates the isolation of lignocellulose micro-nanofibrils, nanocrystals and nanospheres from steam-exploded sugarcane bagasse (SEB). First, steam-explosion was carried out in sugarcane bagasse at 195 °C for 7.5 and 15 min (SEB-7.5 and SEB-15). Untreated sugarcane bagasse was also pretreated by mechanical refining (MRB) in a PFI mill for comparison. Then, SEB and MRB fibers were submitted to alkaline delignification, hypochlorite bleaching for 60 or 180 min (HB60 and HB180), enzymatic hydrolysis (endoglucanase), and high-pressure homogenization. The resulting materials were characterized regarding chemical composition by high-performance liquid chromatography, width and morphology by transmission electron microscopy, crystallinity by X-ray powder diffraction and aspect ratio (length/diameter) by rheology. Levels of glucans (mostly cellulose), hemicelluloses and lignin were: 53.8%, 19.7% and 11.6% in MRB-HB180; 87.8%, <0.1% and 7.2% in SEB-7.5-HB60; 84.3%, <0.1% and 4.8% in SEB-7.5-HB180, 85.9%, <0.1% and 8.4% in SE-15-HB60; and 82.2%, <0.1% and 5% in SE-15-HB180, respectively. Aspect ratios and crystallinity indexes were similar among all groups (~100 and ~73%, respectively), except for SE-15-HB180 (~ 78.5 and 77%, respectively). MRB-HB180 and SE-15 (HB60 and HB180) had the lowest fiber widths (<20 nm) with the presence of nanocrystals in SE-15-HB180, while in the SE-7.5 (HB60 and HB180), fiber widths were greater than 50 nm with the presence of lignin nanospheres in SE-7.5-HB60. Hence, lignocellulose nanomaterials with aspect ratios ranging from micro/nanofibers to nanocrystals were isolated from SEB using a cost-effective production process.
Sustainable Purchase Behavior Through Religious Orientation, Psychological Contract & Intention-evidence From Pakistani Retail Industry
Authors: Sulehri Numair , Dar Imran , Hussain Sajjad
Published: June 2021

The purchase patterns have been shifted from tangibles to societal orientations, where religious orientation is the way forward for sustainable purchase behavior in expanding urban areas of a middle-income country. The ethical and responsiveness considerations through the connection between Islamic religious orientation (IsRO), purchase intention (PI), and total psychological contract (TPsC) is a research gap projected to be filled from multiple dimensions. Captivating the purchase intention and total psychological contract as mediating variables and analytical approach for religious orientation on purchase behavior constructed in the present research. The empirical assessment was executed through Structural Equation Modeling (SEM) approach based on the cross-sectional research design. There were 669 participants selected from large superstores, with ages ranging from 16 to 55 (M=3.38, SD=1.06), from Islamabad and Rawalpindi in Pakistan, from September 2018 to March 2019. The findings revealed that religious orientation level positively enhanced customer purchase behavior, purchase intention and psychological contract in organized retail stores and psychological contract played a mediating role in the influencing on the purchase behavior; whereas, the purchase intention also played a mediating role between religious orientation and customer purchase behavior. Therefore, the religious orientation stimulated a higher level of purchase behavior since it favored of the higher level of psychological contract and purchase intention in organized retail store customer. The study highlighted the value of cognitive and moral processes and psychological needs could be one of the crucial factors for improvement of perceptual change in terms of purchase behavior of retail consumers that connect psychological dimension with suitability indicators of being responsiveness and ethical consideration sourced from religious orientation. The implications pave the way forward for product development, purchase strategies, and retail market sensing for corporate retail chains and government utility stores for ethical business processes. Meanwhile, the government and enterprises need to strengthen the popularization and dissemination of environmental protection and food safety knowledge to enhance consumers’ environmental and food safety awareness, improving the social environment of the cultivation of the organic food market.
Toxicity of Hypofractionated Whole Breast Radiotherapy Without Boost in a Large “Real-Life” Cohort of Consecutive Early-Stage Breast Cancer Patients
Authors: Fodor Andrei , Brombin Chiara , Mangili Paola , Tummineri Roberta , Pasetti Marcella , Zerbetto Flavia , Longobardi Barbara , Galvan Ariadna Sanchez , Deantoni Chiara L. , Dell'Oca Italo , Rancoita Paola M.V. , Fiorino Claudio , Vecchio Antonella Del , Serio Mariaclelia S. Di , Muzio N.G. Di
Published: June 2021

AimTo report toxicity of hypofractionated whole-breast radiotherapy (HWBRT) in a large cohort of early-stage breast cancer (BCA) patients.Methods and MaterialsFrom 02/2009-05/2017, 1325 consecutive BCA patients were treated with 40.05 Gy/15 fractions, without boost with manually optimized IMRT. Median age: 62 (IQR:51.1-70.5) years. Chemotherapy was prescribed for 28% of patients, hormonal therapy for 80.3%, monoclonal antibodies for 8.2%. Ten% of patients <45 years, 23.8% obese, 5.9% diabetic, 34% hypertensive. ResultsMedian follow-up: 72.4 (IQR: 44.6-104.1) months. Acute RTOG toxicity was: 69.8% Grade(G)1, 14.3% G2 and 1.7% G3. Late SOMA-LENT toxicities were: edema-hyperpigmentation(E-H): G1 28.67%, G2 4.41%, G3 0.15%; fibrosis-atrophy-telangiectasia-pain(F-A-T-P): G1 14.6%, G2 3.2%, G3 0.8%, G4 0.1%. Median time to first occurrence was 6 and 18 months, respectively.Aesthetic result after surgery was excellent in 28.7%, good in 41.5%, acceptable in 20.3% and poor in 9.5% of patients. Change in breast appearance after radiotherapy was mild in 6.9%, moderate in 2.3% and marked in 1.3% of patients.Concomitant chemotherapy, obesity, smoking, use of bolus and planning target volume (PTV) were associated with higher acute toxicity. Patients ≥55 years old were less likely to experience acute toxicity. PTV and acute G2 toxicity were associated with ≥G2 E-H. PTV, concomitant chemotherapy, hypertension and ≥G2 acute toxicity were associated with increased risk of F-A-T-P. ConclusionHWBRT without boost demonstrated mild acute and late toxicity in a large cohort of consecutive patients. Timing of changes in breast appearance after radiotherapy was registered and patient, therapy and dosimetric predictive toxicity factors were identified.
Scaling Theory of Rubber Sliding Friction
Authors: Hentschke Reinhard , Plagge Jan
Published: June 2021

Current theoretical descriptions of rubber or elastomer friction are complex-usually due to extensive mathematical detail describing the topography of the solid surface. In addition, the viscoelastic properties of the elastomer material itself, in particular if the rubber is highly filled, further increase the complexity. On the other hand, experimental coefficients of sliding friction plotted versus sliding speed, temperature or other parameters do not contain much structure, which suggests that a less detailed approach is possible. Here we investigate the coefficient of sliding friction on dry surfaces via scaling and dimensional analysis. We propose that adhesion promotes viscoelastic dissipation by increasing deformation amplitude at relevant length scales. Finally, a comparatively simple expression for the coefficient of friction is obtained, which allows an intuitive understanding of the underlying physics and fits experimental data for various speeds, temperatures and pressures.
Effects of the Number of Removed Lymph Nodes on Survival Outcome in Patients With Sentinel Node-negative Breast Cancer.
Authors: Cipolla Calogero , Galvano Antonio , Vieni Salvatore , Saputo Federica , Lupo Simona , Latteri Mario , Graceffa Giuseppa , Valerio Maria Rosaria
Published: June 2021

Background It is still uncertain what is the optimal number of sentinel lymph nodes (SLN) to be removed to reduce the false negative rate. The aim of this study was to investigate whether patients with a single negative SLN have a worse prognosis than those with two or more negative SLNs.Methods A retrospective review was conducted on a large series of SLN-negative breast cancer patients. Survival outcomes were evaluated according to the number of removed SLNs. Statistical analysis included Chi-square, Wilcoxon Mann Whitney test and Kaplan–Meier survival analysis.Results There was no relevant difference in median DFS (64.9 vs 41.4) for SLN=1 vs SLN>1 groups (HR 0.76, CI 95% 0.39 – 1.46; p = 0.38). A statistically significant difference in mDFS was showed only for HT treated patients who were SLN= 1 if compared to SLN>1 (100.6 months versus 35.3 months). Conclusions Our results showed no relevant difference in median DFS for SLN=1 vs SLN>1 group, except for a subset of the patients treated with hormone therapy.
Community Knowledge and Practice on Sanitation, Hygiene and Household Water Utilization in Afabet City, Northern Red Sea Zone of Eritrea: Cross Sectional Study
Authors: Tesfai Berhe , Milkyas Hagos , Kibreab Fitsum , Goitom Meron , Berhe Hermon , Amine Asrat
Published: June 2021

Background: Water and sanitation entitles the human right to affordable access and sanitation. The objective of this study was to determine the knowledge and practice on sanitation, hygiene and water utilization and to estimate the prevalence of diarrhea in Afabet city.Methods: It was a community-based descriptive cross-sectional type of study with a multistage cluster sampling technique. First, 12 clusters were selected from the city and 30 households were nominated from each cluster. Then, a total of 360 individuals were sampled and every family head was interviewed. A structured interviewer administered questionnaire and field observation was used for data collection from December 05-20, 2020. Cross tabulation and association of variables using chi-square test was determined and results were weighted as cluster sampling was used. Results: A total of 360 respondents were enrolled in the study with females (75.3%) and Muslin (99.0%) predominance. About 66.2% and 66.9% respondents were satisfied with the amount and quality of water they received respectively. The prevalence of diarrhea in the community in the last six months of 2020 was 13.0%. The investigators practically approved that 90.7% of the communities revealed functional toilets and feces were observed in only 5.7% of the living area of the community. The community’s comprehensive good knowledge and practice was 99.4% and 93.0% respectively. Their comprehensive knowledge and practice showed significant association with age, sex, marital status, level of education, household size and distance to municipality water source (p<0.001). Furthermore, their comprehensive knowledge and practice, prevalence of diarrhea, presence of latrine, distance from their home to municipality water source and hand washing practice were significantly associated with the administrative area of the study participants (p<0.001).Conclusion: The community had good level of knowledge and practice but the prevalence of diarrhea was relatively high. Latrines were highly utilized but the usage of soap, personal and food hygiene was slightly low. The level of comprehensive practice, prevalence of diarrhea, distance to municipality water source and hand washing practice was associated to the administrative areas. Enhancing environmental sanitation, personal hygiene and provision of adequate and clean water are highly recommended.