bluuebunny/crossref_metadata_2025 huggingface dataset:
Physical Exercise and Economic Burden Associated With Anxiety Symptoms in Pregnant Women During the COVID-19 Pandemic
Authors: Deng Jie , Hu Chun Hui , Ning Yu Xin , Xu Ping , Lu Chen , Wang Jia Qi , Sun Jun yi , Shou Shi cong , Chen Min , Duan Peng
Published: March 2022

Background: COVID-19 with high infectivity and high concealment has been widely spread around the world. This major public health event has caused anxiety among the public, including pregnant women. The aim of this study was to assess the incidence of anxiety symptoms in pregnant women during the COVID-19 pandemic and its influencing factors.Methods: Using an ongoing prospective pregnancy registry, we performed a single center cross-sectional analysis to investigate the overall prevalence of anxiety symptoms among pregnant women during the COVID-19 pandemic. Online questionnaires were used to collect information including sociodemographic data, physical activity and economic situations. The Zung Self-Rating Anxiety Scale (SAS) was used to assess anxiety symptoms. The univariate regression analysis was performed to detect factors potentially influencing anxiety symptoms among pregnant women. The multivariate regression analysis was also conducted to analyze the association of physical exercise and economic burden with anxiety symptoms by adjusting for other variables.Results: A total of 1,517 pregnant women entered the analysis. The study reported that 31.64% of the respondents had anxiety symptoms. Those with bank loans were at higher odds of suffering from anxiety symptoms compared to those without bank loans [(adjusted odds ratio (aOR) 1.494, 95% confidence interval (CI) 1.181~1.889]. Those who took 2,000~5,000 steps/day (aOR 0.825, 95% CI 0.603~0.875) and >5,000 steps/day (aOR 0.924, 95% CI 0.439~0.945) were at lower odds of suffering from anxiety symptoms compared to those who took <500 steps/day. Similarly, the adjusted odds ratios for anxiety symptoms was 0.750 (95% CI 0.663~0.790) and 0.800 (95% CI 0.226~0.889) lower in participants with exercise frequencies of 4-6, and ≥7 times/week, compared to those with a frequency of <2 times/week.Conclusions: Three in ten pregnant women experienced anxiety symptoms during the COVID-19 pandemic, and anxiety symptoms showed association with bank loans and physical exercise. To prevent anxiety of pregnant women, the promotion of healthy lifestyles, improvement of mental health services, and expansion of social support should be implemented during epidemics. In parallel, the integration of psycho-educational interventions with mental health services among public health centers is required to minimize anxiety symptoms in pregnancy women.
Psychometric properties of the mental health continuum-short form (MHC- SF) in Iranian adolescents
Authors: Afrashteh Majid Yousefi
Published: March 2022

Background
Psychological tests are necessary to assess and assess the mental state of individuals. Mental health is one of the important psychological indicators and is increasingly considered as having various aspects of well-being. The Mental Health Continuum-Short Form (MHC-SF) is a 14-item instrument that assesses mental health, focusing on emotional, psychological, and social well-being. The present study examined the psychometric properties of the Persian version of the MHC-SF among adolescents, focusing on its factor structure, internal consistency, construct validity, and gender measurement invariance.
Methods
The population of this study was Iranian adolescents between 11 and 18 years old who were enrolled in the seventh to twelfth grades. A convenience sample of 822 Adolescents from four large cities in the Iran (Tehran, Zanjan, Hamedan and Ghazvin) participated in the present study. Questionnaires were completed online. Statistical analyses to evaluate the factor structure, internal consistency, construct validity, gender and age factorial invariance were performed in SPSS and LISREL.
Results
The results of confirmatory factor analysis supported the 3-factor structure of MHC-SF (emotional, psychological, and social well-being). Reliability was confirmed by Cronbach's alpha method and composite reliability (> .7). Measurement invariance were confirmed among girls and boys. Convergent and divergent validity were also evaluated and confirmed by correlating the test score with similar and different tests.
Conclusion
This study examined and confirmed the psychometric properties of MHC-SF in the Iranian adolescent community. This instrument can be used in psychological research and diagnostic evaluations.
Clinical, Biochemical and Molecular Characterizations of Patients With Glutaric Aciduria Type 1 in Henan Province, China
Authors: Zhu Xinyun , Li Xiaole , Liu Suna , Ni Min , Guo Yaqing , Xu Yizhuo , Jia Liting , Li Linfei , Zhao Dehua
Published: March 2022

Background: Glutaric acidemia type 1 (GA1) is a rare organic acid metabolism disorder resulted from the deficiency of glutaryl-CoA dehydrogenase (GCDH). There are few studies on GA1 in China. This article is designed to investigate the clinical, biochemical and molecular characterizations of patients with GA1 in Henan province, in order to get further understanding of this disease .Results: The incidence of neonatal GA1 in Henan population was 1/172483. All patients had increased glutarylcarnitine (C5DC), glutaric acid (GA) and 3-hydroxyglutaric acid (3-OH-GA) levels. Twenty mutations were discovered in 14 patients. Four of them were novel: c.523G>A (p.G175S), c.1297G>C (p.A433P), c.467G>A (p.G156D) and c.1125T>G (p.C375W). The most common mutation was c.1064G>A (p.R355H), of which the allelic frequency was 17.86% (5/28), following by c.1109T>C (p.L370P), c.648G>A (p.S216S), c.395G>A (p.R132Q) and c.938G>A (p.R313Q), which had the same allelic frequency 7.14% (2/28). 84.6%(11/13) patients displayed abnormal brain MRI findings, of which cerebral dysplasia and arachnid/ependyma cysts(38.5%,5/13) were most commonly. Clinical features varied widely from asymptomatic to severe encephalopathy. Patients diagnosed by newborn screening had better outcome. A strong correlation was discovered among increasing disability in motor, speech and cognitive function. There were statistical significance differences in motor function(p=0.024) and speech function (p=0.008), but no statistical significance difference in cognitive function (p=0.106) between NBS group and non-NBS group.Conclusions: Our study provided comprehensive information about GA1 in Henan population, including morbidity, clinical, biochemical, molecular and outcome features. The novel variants expanded the GCDH variant spectra. This work emphasize that professional management of NBS programs and experienced genetic metabolic disease experts will be very important and urgent.
Experimental Analysis on the Influence of Compression Ratio, Flow Rate, Injection Pressure and Injection Timing on the Acetylene - Diesel Aspirated Dual Fuel Engine
Authors: Thodda Gavaskar , Kathapillai Arun , Madhavan Venkata Ramanan , Saravanamuthu Murugapoopathi
Published: March 2022

The predicted scarcity, increasing cost of petroleum fuels and environmental degradation are encouraging researchers to search for alternative fuels throughout the world. Hence, it is intended to utilize acetylene-based DF in the compression ignition (CI) engine with minor modifications. An engine of 5 Hp, four stroke, single-cylinder, water-cooled operated in dual-fuel (DF) mode (acetylene gas-diesel), aiming to reduce the emissions, was deployed to investigate its characteristics. In DF mode, gaseous fuel is injected through a gas velocity of 2, 4, and 6 Lpm constantly. According to the research findings, the gas velocity of 6 Lpm provides the best results, having a superior BTE of 30.7%. Various compression ratios (16:1, 18:1, and 20:1) were used to determine the optimal compression ratio (CR) under a gas velocity of 6 Lpm with diesel. Fuel Injector pressure (200, 220, and 240 bar) with injector intervals (19o, 23o, and 27o bTDC) were changed consecutive sequence while adjusting CR, and the best outcomes for improved CI fuel efficiency were determined. From the investigational analysis, the peak in-cylinder pressure and net HRR (heat release rate) are assessed for being better by the increment in CR in DF mode of operation with an acetylene gas of 6 Lpm at all operating settings. At a 240 bar injection pressure, the BTE is recorded highest (35.1%) and smoke was decreased. An IT of 23obTDC, the CO and HC were found as to be minimum as 28ppm and 0.04ppm.
Antibacterial activity of green gold and silver nanoparticles using ginger root extract
Authors: Yadi Morteza , Akbarzadeh Abolfazl , Dianat-Moghadam Hassan , Azizi Mehdi , Milani Morteza
Published: March 2022

BackgroundRecent studies demonstrated that the speed of synthesis, biocompatibility, and antimicrobial activity of gold (Au) and silver (Ag) metals is enhanced when biosynthesized in nano-sized particles. In the present study, Au NPs and Ag NPs were synthesized via a biological process using aqueous Ginger root extract and characterized by various spectroscopic methods. Methods & ResultsThe NPs were found to be in hexagonal and spherical shapes. The average particle size for Au and Ag NPs was found to be 20 nm and 15 nm, respectively. The dynamic light scattering (DLS) method has shown that the zeta potential values of synthesized NPs were found to be 5.7 mv and 7.11mv, respectively. Gas chromatography-mass spectrometry (GC-MS) analysis of Ginger root extract revealed 25 compounds. The synthesized NPs showed significant activity against Staphylococcus aureus and Escherichia coli in vitro with IC50 and IC90 values for Au and Ag NPs, respectively, noted to be 7.5 and 7.3 µg/ml and 15 and 15.2 µg/ml for both bacterial strains. The protein leakage level was high and morphological changes occurred in bacteria treated with biosynthesized NPs. ConclusionThese results suggest that the biosynthesized metallic NPs show potential for application as antibacterial agents with enhanced activities.
Association of platelet-to-white blood cell ratio and platelet-to-neutrophil ratio with the risk of fatal stroke occurrence in older Chinese
Authors: Hu Zhi-bing , Zhong Qiong-qiong , Lu Ze-xiong , Zhu Feng
Published: March 2022

Background
White blood cell (WBC) and neutrophil (NEUT) counts, which are commonly inflammatory markers, have been related to an increased risk of fatal stroke. However, it is unclear whether platelet-to-white blood cell ratio (PWR) and platelet-to-neutrophil ratio (PNR) are related to the risk of fatal stroke in elderly populations.
Methods
In total, 27811 participants without a stroke history at baseline were included and followed up for a mean of 14.3 years (standard deviation = 3.2), and 838 stroke deaths were recorded. The Cox proportional hazards regression was used to assess the relationships between the PWR and the PNR and the risk of fatal strokes.
Results
Compared to the 1st quartile, an increased risk of fatal all stroke showed among the participants in the highest quartiles of both the WBC (adjusted hazard ratio (aHR) = 1.35, 95% confidence interval (CI) 1.09–1.66) and the NEUT (aHR = 1.45, 95% CI 1.18–1.79). The restricted cubic splines showed decreased trends in associations of the PWR and the PNR with the risk of fatal all stroke. A decreased risk of fatal all stroke showed in those with the highest quartiles for both the PWR (aHR = 0.73, 95% CI 0.53-1.00) and the PNR (aHR = 0.74, 95% CI 0.54–1.01). The participants with the 2nd, the 3rd and the 4th change quartiles for the PWR and the PNR had weak decreasing trends for the risk of fatal all stroke, compared to those in the 1st change quartile, and the significant associations were observed in those with an increase of 20% for the PWR with the risk of fatal haemarragic stroke (aHR = 0.47, 95% CI 0.22–0.95) and a decrease of 20% for the PNR with the risk of fatal all stroke (aHR = 1.33, 95% CI 0.99–1.79), compared to those with stable dynamic changes.
Conclusions
Higher neutrophil count and platelet-to-neutrophil ratio were associated with a contrary risk of fatal stroke, with an increased for the former and a decreased for the later. A potentially chronic inflammation should be paid close attention to stroke occurrence in relatively healthy elderly populations.
Vascular Impulse Technology vs. Elevation for the Reduction of Swelling of Upper and Lower Extremity Joint Fractures – Results of a Prospective Randomised Controlled Trial
Authors: Barbari Jan Siad El , Schnetzke Marc , Bergmann Moritz Benedikt , Baumann Lukas , Vetter Sven , Swartman Benedict , Grützner Paul , Franke Jochen
Published: March 2022

Introduction
Soft tissue conditioning due to posttraumatic oedema after complicated joint fractures is a central therapeutic aspect both pre- and postoperatively. Six to ten days are passing on average until the patient is suitable for surgery. The aim was to compare the decongestant effect of vascular impulse technology (VIT) with that of conventional elevation.
Materials and Methods
In this monocentric RCT, 68 patients with joint fractures of the upper (n = 36) and lower (n = 32) extremity were included and randomised after consent in a 1:1 ratio. The variables were evaluated for all fractures together and additionally subdivided into upper or lower extremity for better clinical comparability. The primary endpoint was the time in days from hospital admission to operability. Secondary endpoints were total length of stay, oedema reduction, pain intensity, complications and revisions.
Results
The time from admission until operability was reduced by 1.4 (95% CI: -0.4; 3.1) days in the mITT analysis (p = 0.120), being statistically significant with 1.7 (95% CI: 0.1; 3.3) days in the as-treated sensitivity analysis (pAT = 0.038). Significant less pain was found in the intervention group and a significantly faster oedema reduction. Due to rare occurrences, nothing can be derived in regard to complications and revisions.
Conclusion
Administration of VIT therapy did not lead to a significant reduction in the time until operability but was superior to elevation in regard of soft tissue conditioning and pain reduction. Thus, it seems like a helpful tool in the treatment of posttraumatic oedema after complex joint fractures of the lower and upper extremity, especially in tibial head and lower leg fractures.
Reducing Global Health Inequalities For A Rare Disorder: Evaluating The International Prader-Willi Syndrome Organisation's Echo® Program
Authors: Rujeedawa Tanzil , McNairney Nora , Cordner Shelly , O’Brien James , Loughnan Georgina , Holland Anthony
Published: March 2022

Background: people with rare disorders face significant global health inequalities, the challenge is how to raise awareness and develop a nucleus of experts in a country who are then able to provide guidance to others in that country. The International Prader-Willi Syndrome Organisation (IPWSO) established Project ECHO® with the aim of facilitating the sharing of knowledge and the building of international partnerships to reduce global health inequalities for a particular rare neurodevelopmental disorder, Prader-Willi Syndrome (PWS). Four different ECHO programmes were established for the following groups: a) Individuals (usually parents) who had taken on a leadership role in their country; b) health professionals interested in PWS; c) professional care providers supporting children and adults with PWS; and d) a Latin American ECHO in Spanish. The programme started in 2020 and an evaluation was undertaken after one year to determine: the extent to which we had been able to recruit and retain individuals globally; the nature and extent of any benefits gained from the sessions; and examples of how individual involvement in the programme had led to local benefits. The methods included analysing routinely kept process indicators and survey data from the attendees of one component of the program (the Leadership ECHO), together with a qualitative analysis of survey data and recorded interviews with attendees from countries of differing socio-economic status.Results: We describe the IPWSO ECHO programme and report on the outcomes from the evaluation of one aspect of the program, the Leadership ECHO. Program attendance was satisfactory, with a mean of 24.7 participants for the Leadership ECHO, with participants attending a mean of 5.67 sessions, i.e., 30% of sessions. There was also good global reach, with individuals attending from 34 countries, although there were notable geographic regions with very limited representation. Feedback and interviews demonstrated the positive impact of the program with some early evidence of positive developments at national level.Conclusions: Families and professionals from countries with a range of expertise and services they offer to people with PWS remained engaged throughout the ECHO program, established networks of support and fostered the development of good practice.
Effect of llama (Lama glama) manure and Trichoderma strain T1R3 on arsenic uptake by Swiss chard and broad bean crops
Authors: Yañez Luciano Matias , Alfaro Jimena Agustina , Carreras Natalia Maria Elisa Ávila , Mitre Graciela Bovi
Published: March 2022

The town of Pastos Chicos (Jujuy-Argentina), presents arsenic (As) concentrations in soil (49 mgAs kg− 1) and water (1.44 mgAs L− 1) significantly above the maximum allowable limits set by National Laws No 24,585 and N° 24,051. This study aimed to evaluate the effect of llama manure (Lama glama) and Trichoderma strain T1R3 on As uptake and toxicity in Swiss chard (Beta vulgaris var. cicla) and broad bean (Vicia faba L.) crops while assessing potential human health risks. Results indicated that Trichoderma strain T1R3 inoculation stimulated broad bean plant growth by reducing As stress. Swiss chard crops treated with 5% manure and a manure/Trichoderma T1R3 combination reduced As absorption from 32.46 to 64.02% in roots, and from 35.2 to 44.5% in leaves. Broad bean crops inoculated with Trichoderma T1R3 showed significant mitigation of toxicant accumulation in the leaves (67.42%). Also, the manure/Trichoderma T1R3 combination reduced As accumulation (57.46%) in broad bean roots. The efficacy of llama manure and of the llama manure/Trichoderma T1R3 combination in reducing health hazards that derive from As intake by consuming chard leaves was also reflected in Hazard Quotient < 1 values. Although Cancer Risk values decreased considerably, these showed there was a considerable carcinogenic risk for humans consuming chard leaves. These observations reveal that adding llama manure and Trichoderma T1R3 might mitigate As uptake by crops, thus reducing human health risks. This study advanced our understanding of the complex llama manure/Trichoderma strain interactions in As-contaminated soils, which are imperative for developing effective mitigations strategies.
Anomaly credit data detection based on Enhanced isolation forest
Authors: xiaodong zhang , Yao Yuan , Lv Congdong , Wang Tao
Published: March 2022

In the view of credit data falsity and errors problem in real world, and the performance degradation of the credit evaluation model caused by this problem. This paper proposed an outlier detection algorithm, which considered two characteristics of class-imbalance and cost-imbalance. We use an anomaly detection models called EIF to optimize the credit evaluation models. EIF uses the EasyEnsemble algorithm to construct balanced data sets, and train an Isolation Forest model for anomaly detection by the balanced data set with different disturbances. Experiments were performed on UCI German dataset, and the test set with fake data was constructed by correlation. Compared with other anomaly detection algorithms in common credit evaluation models, the EIF-optimized model has a higher F1 score and a lower cost-sensitive error rate. In conclusion, the EIF model is effective in enhancing the performance of the credit evaluation model for forged credit datasets.
Occupational and geographical differentials in financial protection against healthcare out-of-pocket payments in Nepal: evidence for universal health coverage
Authors: Sapkota Vishnu Prasad , Bhusal Umesh Prasad , Adhikari Govinda Prasad
Published: March 2022

Background
. The low-and middle-income countries including Nepal aim to address financial hardship against healthcare out-of-pocket (OOP) payments through risk-pooling arrangements. World Health Organization (WHO) has recommended member states to establish pooling arrangements so that the financial risks owing to health uncertainty can be spread across population. This study aims to analyse the situation of financial protection across occupations and geography using nationally representative annual household survey (AHS) in Nepal.
Methods.
We measured catastrophic health expenditure (CHE) due to OOP using two approaches: budget share approach at 10% and 25% threshold, and capacity-to-pay approach at 40% threshold. Impoverishment impact due to OOP was measured at absolute and relative poverty lines. These estimates were disaggregated across occupations and geography. The inequality in financial risk protection was measured using concentration index. The analysis was based on the cross-sectional AHS 2014-15, the most recent round that provided information on occupations and consumption. AHS employed standard consumption measurement tool (COICOP). International Standard Classification of Occupations (ISCO) was used to categorize occupations.
Results.
Among the agricultural workers, we found a CHE of 10.7% at 10% threshold and 5.2% at 40% threshold. Among ‘plant operators and craft workers’, the corresponding figures were 10% and 4.8%. Impoverishment impact was higher in these households at all poverty lines. CHE was higher among unemployed households. A negative concentration index for CHE and impoverishment impact was found for agricultural workers and ‘plant operators and craft workers’. In rural areas, we found a CHE of 11.5% at 40% threshold and a high impoverishment impact. Across province, CHE was 12% in Madhesh and 14.3% in Lumbini at 10% threshold, and impoverishment impact was 1.9% in Madhesh, Karnali and Sudurpachim at US $1.90 a day poverty line.
Conclusion.
Households belonging to informal occupations such as agricultural workers, plant operators and craft workers, elementary occupations and unemployed were more prone to CHE and impoverishment impact due to healthcare OOP payments. There was wide urban/rural and provincial differential in financial protection status. The results can be useful to policymakers engaged in designing risk-pooling arrangements to make progress towards UHC.
Study Protocol: Multicenter Randomized Clinical Trial to Assess the Effect of Active versus Passive Recharge Burst Spinal Cord Stimulation on Pain Relief in Persistent Spinal Pain Syndrome Type II (“the Burst-Recharge Active Versus Passive (Burst-RAP) Protocol”)
Authors: Mons Martijn , Zuidema Xander , Bürger Katja , Elzinga Lars , de Vries Jessica , Kuijk Sander van , Joosten Elbert A. , Kallewaard Jan-Willem
Published: March 2022

Background: Spinal cord stimulation (SCS) has shown to be an effective treatment for patients with persistent spinal pain syndrome Type 2 (PSPS Type II). Important in SCS is the method used to deliver electrical charge. One such method is burst stimulation. Within burst stimulation, a recharge pattern is used to prevent buildup of charge in stimulated tissue. Two variations of burst waveforms are currently in use: one that employs active recharge and one that uses passive recharge. It has been suggested that differences exist between active and passive recharge paradigms related to both efficacy of pain relief and their underlying mechanism of action. Active recharge has been shown to activate both the medial spinal pathway, engaging cortical sensorimotor areas involved in location and intensity of pain, and lateral pathway, reaching brain areas involved with cognitive-emotional aspects of pain. Passive recharge has been suggested to act via modulation of thalamic neurons, which fire in a similar electrical pattern, and thereby modulate activity in various cortical areas including those related to motivational and emotional aspects of pain. The objective of this Randomized Clinical Trial (RCT) is to assess and compare the effect of active versus passive recharge Burst SCS on pain relief in PSPS Type II patients.Methods: This multicenter RCT will take place in 6 Dutch hospitals. PSPS Type II patients (n=96) will be randomized into a group receiving either active or passive recharge burst. Following a successful trial period, patients are permanently implanted. Patients complete the pain catastrophizing score (PCS), numeric pain rating scale (NRS), patient vigilance and awareness questionnaire (PVAQ), hospital anxiety and depression scale (HADS), quality of life (EQ-5D), Oswestery disability index (ODI), patient global impression of change (PGIC) and painDETECT questionnaires at baseline, after trial, 1, 3, 6 and 12 months following implantation.Discussion: The BURST-RAP trial protocol will shed light on possible clinical differences and effectivity of pain relief (including emotional-motivational aspects between active and passive burst SCS in PSPS Type II patients. Trial registration: This trial is registered in the Netherlands Trial Register under registration number NL9194.
Role of 2D BLADE Turbo Gradient- and Spin-Echo Diffusion-Weighted Imaging in the Quantitative Diagnosis of Recurrent Temporal Bone Cholesteatoma
Authors: Lin Mengyan , Geng Yue , Sha Yan , Zhang Zhongshuai , Zhou Kun
Published: March 2022

Background: Diffusion-weighted imaging (DWI) has become an important tool for the detection of cholesteatoma. The purpose of this study was to explore the value of 2D BLADE turbo gradient- and spin-echo imaging (TGSE BLADE) DWI in the quantitative diagnosis of recurrent temporal bone cholesteatoma (CS).Methods: From March 2018 to October 2021, 67 patients with suspected recurrence of temporal bone CS after assessment by clinical otorhinolaryngologists who had undergone previous ear surgery for CS were prospectively evaluated by magnetic resonance imaging (MRI). Two radiologist assessed images independently. Quantitative parameters such as signal intensity (SI), signal intensity ratio (SIR), apparent diffusion coefficient (ADC) value, and ADC ratio measured on TGSE BLADE sequences were assessed. Using receiver operating characteristic (ROC) curve analysis, the optimal threshold and diagnostic performance for diagnosing recurrent CS were determined. Pair-wise comparison of the ROC curves was performed using the area under the ROC curve (AUC).Results: Finally, 44 patients were included in this study, including 25 CS and 19 non-cholesteatoma (NCS). Mean SI and mean SIR on TGSE BLADE DWI were significantly higher for CS than NCS lesions (p<0.001). Meanwhile, mean ADC values and mean ADC ratios on ADC maps were significantly lower in the CS group than in the NCS group (p<0.001). According to ROC analysis, the diagnostic efficacy of quantitative parameters such as SI (AUC = 0.983), SIR (AUC = 0.967), ADC value (AUC = 1.0), and ADC ratio (AUC = 0.983) was significantly better than that of qualitative DWI (AUC = 0.867; p = 0.025, 0.026, 0.011 and 0.037, respectively).Conclusions: Residual/recurrent temporal bone CS can be accurately detected using quantitative evaluation of TGSE BLADE DWI.
Groundwater level fluctuations in coastal aquifer: Using artificial neural networks to predict the impacts of climatical CMIP6 scenarios
Authors: Roshani Adib , Hamidi Mehdi
Published: March 2022

The groundwater resources play a crucial role in satisfying water for use in domestic, industrial, and agricultural applications. The aim of this study was to investigate the changes in groundwater level in the Sari-Neka coastal aquifer near the Caspian Sea in Iran by ANN based on the emission scenarios of the sixth IPCC report for the next two decades. Three models selected from Coupled Model Intercomparison Project Phase 6 (CMIP6), including ACCESS-CM2, HadGEM3-GC31-LL, and NESM3, are validated. The result shows that ACCESS-CM2 had the best performance, and by using LARS-WG simulation, the temperature and precipitation were done based on two emission scenarios, SSP2-4.5 and SSp5-8.5, during 2021-2040. In addition, the K-means method used for clustering, and the Elbow method was utilized to select the optimal number of piezometers. In the following, the monthly maximum and minimum temperature, precipitation, and water table of previous month from 4 observation piezometers are used as input variables to forecast the groundwater level in the forthcoming months. The results of r, R2, RMSE, and MAE are evaluated for the model and indicate the good performance of the model. The results imply that under such mentioned scenarios, the mean monthly temperature will rise approximately 0.1-1.2 °C; also, the mean monthly precipitation will witness changes from -10% to 78% in the next two decades. As a result, this is likely to lead to improvement and recharge of groundwater level for the near future. The results can help managers and policymakers to identify adaptation strategies more precisely for basins with similar climates.
Intra- and Inter-operator variability in manual tumor segmentation: Impact on radionuclide therapy dosimetry
Authors: Dewaraja Yuni K , Covert Elise C. , Fitzpatrick Kellen , Mikell Justin K. , Kaza Ravi K. , Millet John D. , Barkmeier Daniel , Gemmete Joseph , Christensen Jared , Schipper Matthew J.
Published: March 2022

Purpose The aim was to quantify inter- and intra-observer variability in manually delineated lesion contours and the resulting impact on radionuclide therapy dosimetry. Methods Ten patients with hepatocellular carcinoma lesions treated with 90Y radioembolization (RE) and imaged with post-therapy 90Y PET/CT were selected for retrospective analysis. Three radiologists contoured 20 lesions manually on baseline multiphase contrast-enhanced MRIs and two of the radiologists re-contoured at two additional sessions. Contours were transferred to co-registered PET/CT-based 90Y dose-maps. Volume-dependent recovery-coefficients (RCs) were applied for partial volume correction when reporting mean absorbed dose. To understand how uncertainty varies with tumor size, we fit power models regressing relative uncertainty in volume and in mean absorbed dose on contour volume. Finally, we determined effects of uncertainty on tumor control probability (TCP), as calculated using logistic models developed in a previous report for lesions treated with RE. Results The average lesion volume ranged from 1.8 mL to 194.5 mL and the mean absorbed dose ranged from 23.4 to 1,629.0 Gy. The mean inter-observer Dice coefficient for lesion contours was significantly less than the mean intra-observer Dice coefficient (0.79 vs. 0.85, p < 0.001). Uncertainty in volume, as measured by the Coefficient of Variation (CV) ranged from 4.2% to 34.7% with a mean of 17.2%. For lesions > 8 mL, the CV in mean absorbed dose had an average value of 7.2% (range 1.5% to 12.6%) while for smaller lesions it was 21.7% (range 8.4 to 55.2%). The fitted uncertainty curves as a function of volume, v (in mL), were: %CV (volume) = 23.0* v-0.17 and %CV (mean dose) = 32.4* v-0.44. With this model for uncertainty, the mean change in TCP was 16.2% (maximum 48.5%). Conclusion Though we find relatively high inter- and intra-observer reliability overall, uncertainty in tumor contouring propagates into non-negligible uncertainty in dose metrics and outcome prediction for individual cases that should be considered in dosimetry-guided treatment.
Characteristics Of Internal Oblique Muscle Strain In Professional Baseball Players: A Retrospective Cohort Study
Authors: Komatsu Shuro , Kaneko Hironori , Nagashima Masaki
Published: March 2022

Background: Internal oblique muscle strains can develop in professional baseball players, rendering the players unable to continue playing for a certain period. However, the characteristics of this injury are not well known. The purpose of the present study was to investigate the details of the injury and the post injury course of internal oblique muscle strain in professional baseball players.Methods: The subjects were members of a single Japanese professional baseball team with a total of 188 players (81 fielders and 107 pitchers) who developed internal oblique muscle strains from January 2012 to December 2021. The diagnosis of muscle strain was made on the basis of local pain and magnetic resonance imaging findings. The incidence of internal oblique muscle strain, the details of the site of the injury, and the time to return to play were examined.Results: There were 28 cases in 23 players (12.2%) of internal oblique muscle strain. The players were 16 fielders (24.7%) and 7 pitchers (7.5%), with a significantly greater incidence in fielders (p=0.006). Although internal oblique muscle strain was more common on the side contralateral to the batting or pitching side, it occurred on either side. Most of the injury sites were at the region of the muscle insertion to the lower ribs. At a mean time of 36.5 months after the initial injury, 5 players (21.7%) developed another internal oblique muscle strain. The mean time to return to play was 29.4±10.6 days (4–53 days).Conclusions: Baseball players who have symptoms at the side of the trunk should be regarded as having possible internal oblique muscle strain, and proactive examination should be considered.Trial registrations: Not applicable
Acute Toxicities and Cumulative Dose to the Brain of Repeated Sessions of Stereotactic Radiotherapy (SRT) for Brain Metastases: a Retrospective Study of 184 Patients
Authors: Kuntz L. , Fèvre C. Le , Jarnet D. , Keller A. , Meyer P. , Thiery Alicia , Cebula H. , Noel Georges , Antoni D.
Published: March 2022

BackgroundStereotactic radiation therapy (SRT) is a focal treatment for brain metastases (BMs); thus, 20 to 40% of patients will require salvage treatment after an initial SRT session, either because of local or distant failure. SRT is not exempt from acute toxicity, and the acute toxicities of repeated SRT are not well known. The objective of this study was to analyze the acute toxicities of repeated courses of SRT and to determine whether repeated SRT could lead to cumulative brain doses equivalent to those of whole-brain radiotherapy (WBRT).Material and MethodsBetween 2010 and 2020, data from 184 patients treated for 915 BMs via two to six SRT sessions for local or distant BM recurrence without previous or intercurrent WBRT were retrospectively reviewed. Patients were seen via consultations during SRT, and the delivered dose, the use of corticosteroid therapy and neurological symptoms were recorded and rated according to the CTCAEv4. The dosimetric characteristics of 79% of BMs were collected, and summation plans of 76.6% of BMs were created.Results36% of patients developed acute toxicity during at least one session. No grade 3 or 4 toxicity was registered, and grade 1 or 2 cephalalgy was the most frequently reported symptom. There was no significant difference in the occurrence of acute toxicity between consecutive SRT sessions. In the multivariate analysis, acute toxicity was associated with the use of corticosteroid therapy before irradiation (OR=2.6; p=0.01), BMV grade (high vs. low grade OR=5.17; p=0.02), and number of SRT sessions (3 SRT vs. 2 SRT: OR=2.64; p=0.01). The median volume equivalent to the WBRT dose (VWBRT) was 47.9 mL. In the multivariate analysis, the VWBRT was significantly associated with the total GTV (p<0.001) and number of BMs (p<0.001). Even for patients treated for more than 10 cumulated BMs, the median BED to the brain was very low compared to the dose delivered during WBRT.ConclusionRepeated SRT for local or distant recurrent BM is well tolerated, without grade 3 or 4 toxicity, and does not cause more acute neurological toxicity with repeated SRT sessions. Moreover, even for patients treated for more than 10 BMs, the VWBRT is low.
One-Step Biosynthesis Of 7β-Hydroxy-Androst-4-Ene-3,17-Dione From Phytosterols By Cofactor Regeneration System In Engineered Mycolicibacterium Neoaurum
Authors: Zhao Yun-Qiu , Liu Yong-Jun , Ji Wei-Ting , Liu Kun , Gao Bei , Tao Xin-Yi , Zhao Ming , Wang Feng-Qing , Wei Dong-Zhi
Published: March 2022

Background: 7β-hydroxylated steroids (7β-OHSt) possess significant activities in anti-inflammatory and neuroprotection, and some of them have been widely used in clinics. However, the production of 7β-OHSt is still a challenge due to the lack of cheap 7β-hydroxyl precursor and the difficulty in regio- and stereo-selectively hydroxylation at the inert C7 site of steroids in industry. The conversion of phytosterols by Mycolicibacterium species to the commercial precursor, androst-4-ene-3,17-dione (AD), is one of the basic ways to produce different steroids. This study presents a way to produce a basic 7β-hydroxyl precursor, 7β-hydroxy-androst-4-ene-3,17-dione (7β-OH-AD) in Mycolicibacterium, for 7β-OHSt synthesis. Results: A mutant of P450-BM3, mP450-BM3, was mutated and engineered into an AD producing strain for the efficient production of 7β-OH-AD. The enzyme activity of mP450-BM3 was then increased by 1.38 times through protein engineering and the yield of 7β-OH-AD was increased from 34.24 mg L-1 to 66.25 mg L-1. To further enhance the performance of 7β-OH-AD producing strain, the regeneration of nicotinamide adenine dinucleotide phosphate (NADPH) for the activity of mP450-BM3-0 was optimized by introducing an NAD kinase (NADK) and a glucose-6-phosphate dehydrogenase (G6PDH). Finally, the engineered strain could produce 164.52 mg L-1 7β-OH-AD in the cofactor recycling and regeneration system.Conclusions: This was the first report on the one-step biosynthesis of 7β-OH-AD from the conversion of cheap phytosterols by an engineered microorganism, and the yield was significantly increased through the mutation of mP450-BM3 combined with overexpression of NADK and G6PDH. The present strategy may be developed as a basic industrial pathway for the commercial production of high value products from cheap raw materials.
Genomic Surveillance of Rift Valley fever Virus: from Sequencing to Lineage assignment
Authors: Juma John , Fonseca Vagner , Konongoi Samson L. , Heusden Peter , Roesel Kristina , Sang Rosemary , Bett Bernard , Christoffels Alan , Oliveira Tulio , Oyola Samuel O.
Published: March 2022

The evolutionary history of Rift Valley fever virus (RVFV) is complex and has been greatly influenced by dramatic environmental changes throughout Africa in the past few decades. Over this time period, RVFV gene flow has been impacted on various levels such as geographic dispersal and reassortment events. Overall, there are 15 lineages, designated from A to O. In many cases, viruses from these lineages have been detected outside enzootic regions through probable movement of infected animals and/or mosquitoes. This has led to large outbreaks in countries where the disease had not been previously reported. Genomic surveillance of the virus diversity is crucial in developing intervention strategies. Therefore, we have developed a user-friendly computational tool for rapidly classifying and assigning lineages of partial or whole genome sequences of the virus using the glycoprotein Gn gene within the M-segment. The computational method is presented both as a command line tool and a web application hosted at https://www.genomedetective.com/app/typingtool/rvfv/. Validation of the tool has been performed on a large dataset comprising of partial and whole genome sequences of the M segment collected from the GenBank database. The Rift Valley Virus typing tool was able to correctly classify all 129 RVFV sequences at species level with 100% specificity, sensitivity and accuracy. All the sequences in lineages A (n = 13), B (n = 1), C(n = 44), D(n = 1), E(n = 7), F(n = 1), I(n = 2), J(n = 1), M(n = 2), N(n = 13) and O(n = 2) were correctly classified at phylogenetic level. We further tested our tool using genomic data that we generated through sequencing of samples collected following RVF outbreaks in Kenya. The tool is useful in tracing the origin of outbreaks and supporting surveillance efforts. Availability: https://github.com/ajodeh-juma/rvfvtyping
Relationship between characters of chest pain and pre-hospital delay in patients with acute myocardial infarction: a multicenter cross-sectional study
Authors: Zhang Youyang , Wu Shihao , Pan Jiangqi , Hoschar Sophia , Wang Zhen , Ladwig Karl-Heinz , Ma Wenlin
Published: March 2022

ObjectiveAtypical symptoms of patients with acute myocardial infarction (AMI) are associated with more delays in care-seeking. Still, patients with typical chest pain have not received enough attention. This study aimed to investigate the effect of pain characters on pre-hospital delays in AMI patients with chest pain.MethodsParticipants from the Multicenter Delay in Patients Experiencing AMI in Shanghai (MEDEA FAR-EAST) included 257 AMI patients (215 males). The data collection procedure consisted of three parts- basic epidemiological and medical information collection, bedside interview, and self-administered questionnaire. Patients were divided into two groups of persistent (n=171) or intermittent (including fluctuating, n=86) chest pain.ResultsCompared with patients with persistent pain, patients with intermittent pain have longer pre-hospital delay time (PHT) and patient decision time (DT) and DT/PHT, and they had a more positive response when symptoms occur. Further multiple regression analysis showed that intermittent pain was a risk factor for the delay. And in the analysis of different subgroups of chest pain, there was a significant negative correlation between the severity of pain and the impact of pain on daily life and the delay time.ConclusionsIn AMI patients, intermittent chest pain is an independent predictor of longer pre-hospital delays and should be given sufficient attention by patients and medical personnel.
ICT Specialists in Europe
Authors: Leogrande Angelo , Magaletti Nicola , Cosoli Gabriele , Giardinelli Vito , Massaro Alessandro
Published: March 2022

The following article estimates the value of ICT Specialists in Europe between 2016 and 2021 for 28 European countries. The data were analyzed using the following econometric techniques, namely: Panel Data with Fixed Effects, Panel Data with Random Effects, WLS and Pooled OLS. The results show that the value of ICT Specialists in Europe is positively associated with the following variables: "Desi Index", "SMEs with at least a basic level of digital intensity", "At least 100 Mbps fixed BB take-up" and negatively associated with the following variables: "4G Coverage","5G Coverage", "5G Readiness", "Fixed broadband coverage", "e-Government", "At least Basic Digital Skills", "Fixed broadband take-up", "Broadband price index", "Integration of Digital Technology". Subsequently, two European clusters were found by value of "ICTG Specialists" using the k-Means clustering algorithm optimized by using the Silhouette coefficient. Finally, eight different machine learning algorithms were compared to predict the value of "ICT Specialists" in Europe. The results show that the best prediction algorithm is ANN-Artificial Neural Network with an estimated growth value of 12.53%. Finally, "augmented data" were obtained through the use of the ANN-Artificial Neural Network, through which a new prediction was made which estimated a growing value of the estimated variable equal to 3.18%.
Optimization Based Control of Pressure regulation for Mechanical Ventilation System using Artificial Bee Colony Optimization (ABC) algorithm
Authors: Thilakar Anitha , Govindasamy Gopu
Published: March 2022

This study proposes a lung mechanics model that replicates respiratory alveolar ventilation. A PC-based algorithm for mechanical ventilation support system is becoming increasingly popular because of its superior performance, efficiency, and ease of operation, A person having problem in the respiratory tract, an artificial ventilator machine with respiratory support is used. In the framework of proportional assist ventilation, optimization based feedback controller design for life support medical ventilators are explored. Investigated systematically persistence of the lungs pressure–volume with residual volume all accord with the model (RV). A typical time-delay system is a pressure and volume regulated mechanical ventilation system, which is used to treat patients who are unable to breathe effectively under their own. The proposed work an Artifcial Bee Colony optimization (ABC) can be practiced along with PID to identify optimal solutions to the tradeoffs inherent in mechanical Ventilation, in conjunction with a validated pulmonary physiology simulator. The Artificial Bee Colony (ABC) method is an optimization technique based on honeybee swarms unique inventive observance. The proposed research work discusses the instant phase of the art in the field of algorithms like Artificial Bee Colony, Harmony Search(HS),Grey Wolf Optimization (GWO) for mechanical ventilation. The proposed investigation deliberates the optimization for the ventilation and among these Artificial Bee Colony optimization gives the refined output of 200 cm of H2O at 20 cm of H2O while confronting with the Harmony Search (HS) provides 100 cm of H2O at 20 cm of H2O and Grey Wolf Optimization (GWO) 60 cm of H2O at 20 cm of H2O. Artificial Bee Colony optimization furnishes the enhanced amount of pressure and volume respectively.
Uric Acid and Hemoglobin as Prognostic Factors in Lung Cancer with COVID-19
Authors: OzkanOzturk Semra , Kocaman Zehra , İnal Ali
Published: March 2022

Background
Cancer patients have an increased risk of COVID-19 compared to the healthy population. Due to increased proinflammatory cytokine excess, unopposed excessive immune response, that is, systemic inflammatory response; is the most important reason that increases the risk of mortality. In this study, we aimed to examine the parameters and inflammatory indices affecting mortality in lung cancer patients with COVID-19.
Methods
This single-center retrospective study included 66 patients diagnosed with lung cancer and treated for COVID-19 between April 2020 and July 2021. Neutrophil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), prognostic index (PI), modified Glasgow prognostic score (mGPS), and COVID inflammatory score (OIS) were calculated for all patients. Twenty-seven potential prognostic variables were chosen for univariate and multivariate analyses.
Results
A total of 28 variables were analyzed univariable. Seven variables were identified to have prognostic significance: receiving chemotherapy in the last 28 days, hospitalization in the intensive care unit, mechanical ventilation requirement, COVID 19 corticosteroid treatment doses, hemoglobin, platelet count, uric acid. Multivariate analysis by Cox proportional hazard model, including seven prognostic significance factors evident in univariate analysis. In the multivariate logistic regression analysis; hemoglobin, uric acid were independent risk factors for severe COVID-19 in lung cancer.
Conclusion
Serum hemoglobin and uric acid level were identified as important prognostic factors in lung cancer patients with COVID-19. These findings may facilitate the prediction of survival in lung cancer patients with COVID-19. In the literature, there is no previous study on the effect of uric acid on prognosis in patients with COVID-19 and lung cancer. Prospective studies with larger patient populations are needed to confirm this study.