bluuebunny/crossref_metadata_2025 huggingface dataset:
Factors Associated with Intensive Care Unit (ICU) Admission Among Inpatients with and without Diabetes in South Western Sydney Public Hospitals Using the New South Wales Admission Patient Data Collection (2014 and 2017).
Authors: Osuagwu Uchechukwu L , Xu Matthew , Piya Milan K , Agho Kingsley E , Simmons David
Published: October 2021

Background

South Western Sydney (SWS) is a hotspot for diabetes in Australia. We compared intensive care unit (ICU) admission risk between people with and without diabetes admitted to public hospitals in this metropolitan health district.
Methods

Retrospective study of all admissions to ICU in the New South Wales Admitted Patient Data Collection (APDC) over three years. Data on demographic and health insurance status, primary admission diagnosis, comorbidities including death in admission for public hospital inpatients aged ≥18 years residing in South Western Sydney were analysed. The ICU length of stay was the main outcome variable classified into short stay (≤48hrs) and long stay (>48 hrs) were analysed. Potential predictors were analysed for possible association with long ICU stay among people with and without diabetes admitted to the hospital.
Results

Of the 187660 inpatients from SWS in the three years, 3.5% spent at least one hour in ICU [5.0% with diabetes versus 3.3% without diabetes, P<0.001]. The median length of ICU stay was similar between people with and without diabetes [40hrs IQR 16-88 hrs versus 43hrs IQR 19-79hrs] as well as the prevalence of long ICU stay [44.9%, 95%CI 42.1, 47.7% versus 43.6%, 95%CI 42.2, 44.9%], respectively. A primary admission diagnosis of circulatory system disease was associated with long ICU stay in both groups, while male sex and a primary diagnosis of nervous system disease was associated with long ICU stay in the non-diabetes group only. Long ICU stay was associated with 1.6 times higher in-hospital mortality in people with diabetes.
Conclusions

ICU admission was more common in people with diabetes. One in every two admissions to ICU had a long stay, thereby increasing the resource utilization and was associated with higher in-hospital mortality. The predictors identified in the study can target this group to improve resource utilization and efficiency of ICU care. Additional population-based approaches to diabetes care are needed to reduce the risks of acute hospital admission.
Nasopharyngeal Microbiome of COVID-19 Patients Using 16S Amplicon Analysis Revealed Distinct Bacterial Profile in Demised and Recovered Individuals
Authors: Kumar Dinesh , Pandit Ramesh , Sharma Sonal , Raval Janvi , Patel Zarna , Joshi Madhvi , Joshi Chaitanya
Published: October 2021

Background

COVID-19 pandemic has shaken the entire world and the socio-economic life on the planet. The implications of the bacterial co-infections in SARS-CoV-2 patients remained the least explored subject of clinical manifestations among the COVID-19. Identification and association of the nasopharyngeal microbial community structure within SARS-CoV-2 infected patients could reveal microbiota dynamics that may determine and/or influence the disease outcome in the COVID-19 patients.
Results

Here, in this study, we present distinct nasopharyngeal microbiome in the demised (N=48) and recovered (N=29) COVID-19 patients as compared to the control group (N=33). The nasal microbiome composition in the three groups vary significantly (PERMANOVA, p-value <0.001), where demised patients showed higher species richness as compared to the recovered and control groups. Pathogenic genera including Corynebacterium (LAD score 5.51), Staphylococcus, Serratia, Klebsiella and their corresponding species were found as biomarkers (p-value <0.05, LDA cutoff 4.0) in the patients those who demised due to SARS-CoV-2 infection. Except for a few pathogenic species in the genera, Ochrobactrum (LDA score 5.79), and Burkholderia (LDA 5.29), the recovered group harbors ordinal bacteria (p-value <0.05, LDA-4.0) as biomarkers. Similarly, Pseudomonas (LDA score 6.19), and several healthy oral/nasal cavity commensal including Veillonella, and Porphyroonas, were biomarkers for the control individuals.
Conclusions

Dysbiosis in the commensal nasopharyngeal microbiota, especially due to infection of opportunistic pathogens could lead to more complex and severe COVID-19 disease dynamics. Whereas, healthy commensal bacteria may trigger the immune response and alter the viral infection susceptibility and thus, may help in preventing the viral infection and possible recovery which is yet to be explored. The findings in the present study provide key considerations and have significant implications for the COVID-19 treatment and control measures. However, further study is required to address the microbiome based therapeutic aspects.
Ashing of Bone: Errors Due to Loss of CO2 and Its Correction
Authors: Thotakura Aasritha , Quenneville Cheryl , Schwarcz Henry P.
Published: October 2021

Background: Ashing is widely used to determine weight fraction of water-free bone that is mineral, but no standard procedure exists and the range of techniques used spans a range of temperatures and times over which the amount of weight loss is variable. We show that variability is largely due to progressive loss of CO2 from CO3 2- ions in the apatite crystal lattice, beginning at 600⁰C, typically used for ashing. We test the effect of varying temperature, time and weight of sample and develop a reliable method, using small samples.Methods: Replicate samples of bovine cortical bone were tested at 500⁰, 600⁰ and 700⁰C for times ranging up to 24h. We also tested samples of multiple humans at what we concluded to be the optimal conditionsResults: Varying conditions of ashing resulted in variations in apparent ash weight % by up to 7%. Samples between 5 and 20 mg heated to 600⁰C for 1 h gave results agreeing with generally accepted values, but with much smaller variability. Ash wt% values for multiple human bone samples differed by up to 4.8% but replicate data for individuals agree to ± 1 wt%. Conclusions: A satisfactory method is given for ash weight determination using small samples, and yielding highly reproducible data. If accepted widely, ash weight values between laboratories could be used to study variations due to diet, age, drug treatment and disease.
Awareness on presentation of obstetric fistula and associated factors among reproductive age women in south eastern zone of tigray,ethiopia,2020.cross sectional study
Authors: Asfaha Berhane Teklay , Gebru Haftu Berhe , Belay Desta Siyoum , Gebremeskel Teferi Gebru
Published: October 2021

Background
Worldwide, around one million girls and women are currently living with fistula. Less than 20,000 women with obstetric fistula are treated each year. Lack of awareness is a frequently mentioned barrier to seeking fistula treatment; many women suffering from obstetric fistula do not know what fistula is, as it is treatable, or where to get treatment. Even though obstetric fistula has likely weighed down women since the beginning of time, few researches proportionally exists.
Methods
A community based quantitative cross-sectional survey was undertaken in south eastern zone of Tigray. A multistage random sampling technique was implemented to select total participants of 605 reproductive age women. Two districts were randomly selected and from those districts, 12 kebels were selected randomly and the calculated sample size (605) was proportionally allocated to each selected kebeles. The data were collected by using face to face/interview with structured questionnaire from February 26-March 24/2020 after ensuring that all requirements of ethical considerations were fulfilled. The collected data were entered in to Epidata version 4.2 then exported to SPSS version20 for analysis. Descriptive statistics with frequency, percentage, table and graph and cross tabulation were used for presentation of result. Bivariable and multivariable analysis were used to examine the association. Odds ratios with 95% confidence interval and P-value <0.05 were used to determine the statistical association.
Result
Overall, about 31.6% of respondents had good awareness on presentation of obstetric fistula. The major determinant factors identified to awareness on presentation of obstetric fistula were educational level (above secondary)[AOR(95%CI=2.9(1.42-9.6)],history of institutional delivery (for the index child)[AOR (95%CI=4.1(1.76-9.56)] and having prior information about obstetric fistula[AOR (95%CI=2.2(1.01-4.75)].
Conclusion
In this study majority of reproductive age women in the study area had poor awareness regarding presentation of obstetric fistula. Several interventions like health education and information should be implemented to enhance the awareness of the community towards obstetric fistula.
Towards elimination of Lymphatic Filariasis in Kenya: Improving advocacy, communication and social mobilization activities for mass drug administration, a qualitative study.
Authors: Kibe Lydiah W. , Kimani Bridget W. , Okoyo Collins , Omondi Wyckliff P. , Sultani Hadley M. , Njomo Doris W.
Published: October 2021

IntroductionA major pillar in the Kenya Neglected Tropical Diseases (NTD) breaking transmission strategy of 2019 -2023 is that of intensifying advocacy, coordination and partnerships in NTD control and elimination. The purpose of this study was to explore views and experiences of stakeholders and health workers on ways of improving Advocacy, Communication and Social Mobilization (ACSM) activities of MDA for LF programmes through participatory approaches in Kilifi County, Kenya.Methods: Two wards were purposely selected in Kaloleni sub county, Kilifi County where there was average treatment coverage of 56% in 2015, 50.5% in 2016. Qualitative data collection methods were employed which included participatory meetings with county stakeholders to understand their views, experiences and suggestions on how ACSM strategies can be improved in MDA for LF. 12 In-Depth Interviews (IDI) were conducted (six with opinion leaders and six with Community Health Extension Workers (CHEWs) and two Semi structured interviews (SSIs) were held with county and sub-county coordinators involved in MDA administration. The aim was better understanding their perceptions of the NTD program about ACSM, challenges to ACSM strategies, and ways to improve the strategies for ACSM in MDA for LF. Data was organized and classified into codes and themes using QSR NVIVO version 12.Results: The study observed a low participation of stakeholders in ACSM activities of MDA for LF and identified potential areas for stakeholders’ involvement to strengthen the activities. Challenges hindering effective implementation of ACSM activities included late delivery of Information Educational and Communication (IEC) and few IEC materials, insufficient funding, inadequate time allocated to reach to the assigned households with messages, messaging and packaging of information for dissemination and vastness of the area. The stakeholders recommended innovative strategies and techniques to improve ACSM activities.Discussion and Conclusion: The results of this study show key challenges to ACSM implementation of MDA for LF. Implementers need to pay attention to these challenges to enhance effectiveness of MDA in accordance to the Kenya NTD breaking transmission Strategy. ACSM efforts in MDA for LF control and elimination should be linked with overarching efforts to mainstream partnerships and coordination in control and elimination.
Diagnostic Accuracy of Palpitation Versus Ultrasound-Guided Fine Needle Aspiration Biopsy for Diagnosis of Malignancy in Thyroid Nodules : A Systematic Review and Meta-Analysis
Authors: Tarigan Tri Juli Edi , Anwar Budiman Syaeful , Sinto Robert , Wisnu Wismandari
Published: October 2021

Thyroid nodule is a common health problem in endocrinology. Thyroid fine-needle aspiration biopsy (FNAB) cytology performed by palpation guided FNAB (PGFNAB) and ultrasound-guided FNAB (USGFNAB) are the preferred examinations for the diagnosis of thyroid cancer and part of the integration of the current thyroid nodule assessment. Although studies have shown USGFNAB to be more accurate than PGFNAB, inconsistencies from several studies and clinical guidelines still exist.The purpose of this study is to compare the diagnostic accuracy of Palpation versus Ultrasound-Guided Fine Needle Aspiration Biopsy in diagnosing malignancy of thyroid nodules.The systematic review and meta-analysis were prepared based on the PRISMA standards. Literature searches were carried out on three online databases, namely Pubmed/MEDLINE, Embase, Proquest, and other literature sources. Data extraction was carried out manually from various studies that met the eligibility, followed by analysis to obtain pooled data on sensitivity, specificity, Diagnostic Odds Ratio (DOR) and Area Under Curve (AUC), and the comparison of the two methods. Total of 2517 articles were obtained, with 11 studies were included in this systematic review. The total sample was 2382, including 1128 subjects using PGFNAB and 1254 subjects using USGFNAB. The risk of bias was assessed using QUADAS-2 with mild-moderate results. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using PGFNAB were 76% (95% CI, 49-89%), 77% (95% CI, 56-95%), 0.827 and 11.6 (95% CI, 6-21) respectively. The results of sensitivity, specificity, AUC and DOR in diagnosing thyroid nodules using USGFNAB were 90% (95% CI, 81-95%), 80% (95% CI, 66-89%), 0.92 and 40 (95% CI, 23-69), respectively the results of the comparison test between PGFNAB and USGFNAB; Tsens USGFNAB of 0.99 (p = 0.023), AUC difference test of 0.093 (p = 0.000023) The diagnostic accuracy of USGFNAB is higher than PGFNAB in diagnosing malignancy of thyroid nodules. If it is accessible, the author recommends using USGFNAB as a diagnostic tool for thyroid nodules.
Novel Image Features of Optical Coherence Tomography for pathological classification of lung cancer: results from a prospective clinical trial
Authors: zhu qiang , yang zhen , yu hang , Liang Zhixin , zhao wei , zhu minghui , xu yi , guo mingxue , jia yanhong , zou chenxi , chen Liangan
Published: October 2021

Background

This study aimed to explore the characteristics of Optical coherence tomography (OCT) imaging for differentiating between benign and malignant lesions, and different pathological types of lung cancer in bronchial lesions, and to preliminarily evaluate the clinical value of OCT.
Methods

Patients who underwent bronchoscopy biopsy and OCT between February 2019 and December 2019 at the Chinese PLA General Hospital were enrolled in this study. White-light bronchoscopy (WLB), auto-fluorescence bronchoscopy (AFB) and OCT were performed at the lesion location. The main characteristics of OCT imaging for the differentiation between benign and malignant lesions and the prediction of the pathological classification of lung cancer in bronchial lesions were identified and their clinical value was evaluated.
Results

A total of 135 patients were included in this study. The accuracy of OCT imaging for differentiating between benign and malignant bronchial lesions was 94.1%, which was significantly higher than that of AFB (67.4%). For the OCT imaging of SCC, adenocarcinoma and small cell lung cancer the accuracies were 95.6%, 94.3% and 92%, respectively. The accuracy, sensitivity and specificity of OCT were higher than those of WLB. In addition, these main OCT image characteristics are independent influencing factors for predicting the corresponding diseases through Logistic regression analysis between the main OCT image characteristics in the study and the general clinical features of patients(p༜0.05).
Conclusion

As a non-biopsy technique, OCT can be used to improve the diagnosis rate of lung cancer and promote the development of non-invasive histological biopsy.
Nutritional Knowledge, Practices, Nutritional Status and the Associated Factors Among HIV Positive Mothers On Antiretroviral Therapy: Evidence from Cross Sectional Survey in Abay Choman Health Centers, Western Ethiopia
Authors: Gemede Habtamu Fekadu , Kaba Feyisa , Dufera Mebrate
Published: October 2021

Background

Lack of nutritional knowledge, inadequate nutritional practice and under nutrition in HIV positive mothers contribute to accelerate the progression of HIV/AIDS.
Methods

An institutional based cross-sectional study was conducted on nutritional knowledge, practice and status among 394 HIV positive mothers by systematic sampling techniques in Abay Choman health centers from February 2019 to August 2019. Structured and pre-tested questionnaires were used to collect data and analysis was done using SPSS for windows version 22.0. Binary and multiple logistic regressions were computed to identify the presence of association at p<0.05.
Results

This study revealed that more than half (58.9%) and (54.1%) of participants had good nutritional knowledge and practice, respectively. The prevalence of underweight, normal weight and overweight of the respondents were 31.2%, 59.1% and 9.7%, respectively. Age of mothers (AOR = 2.1, 95%CI: 1.01, 4.6), marital status (AOR = 4.26, 95%CI: 1.23, 14.81), educational level (AOR = 3.57, 95%CI: 1.99, 6.43) and average monthly income (AOR = 1.69, 95%CI: 1.03, 2.79) were significantly associated with level of nutritional knowledge during multivariate analysis. Educational level (AOR = 3.83, 95%CI: 2.06, 7.13), family size (AOR = 0.43, 95%CI: 0.23, 0.82), average monthly income (AOR =2.14, 95%CI: 1.10, 4.17) and mothers’ occupation (AOR = 0.40, 95%CI: 0.22, 0.71) were significantly associated with the level of nutritional practice. Furthermore, marital status (AOR = 0.34, 95%CI: 0.13, 0.86), educational level (AOR = 0.54, 95%CI: 0.29, 0.99), average monthly income (AOR = 0.44, 95%CI: 0.23, 0.85) and mothers’ occupation (AOR = 1.86, 95%CI: 1.06, 3.26) were significantly associated with nutritional status.
Conclusions

The level of nutritional knowledge and practice of respondents was poor and their under nutrition was higher. This is associated to educational level, average monthly income, mothers’ occupation and marital status of the respondents. Therefore, health centers should have to work in the above gaps of nutritional knowledge and practice of HIV positive mothers through awareness creation in study area.
Acute Mast Cell Leukemia Preceded by Malignant Mediastinal Germ Cell Tumor: A Rare Case Report and Literature Review
Authors: Wang Huafang , Chen Yuan , Lin Huijun , Lan Jianping , Jin Lai
Published: October 2021

Background: Mast cell leukemia (MCL) is a highly life-threatening and extremely rare subtype of systemic mastocytosis (SM). MCL, divided into de novo subtype and secondary to mastocytosis subtype, often genetically contains one or more somatic mutations, particularly the activating mutations of KIT. In this study, an acute MCL case was reported, who had rare phenotype and genetic mutants with a history of primary malignant mediastinal germ cell tumor (GCT).Case presentation: A male patient aged 30, who underwent two rounds of surgery and chemotherapy with a history of malignant mediastinal GCT, was admitted to our hospital due to persistent chest pain and severe fatigue. The diagnosis of acute MCL was confirmed by morphology analysis and chemical staining of marrow aspirate and biopsy, with the addition of C-findings including splenomegaly and cytopenia. The atypical MCs phenotypically expressed CD9, but no CD2 and CD25. Next gene sequencing of marrow aspirate identified heterozygous mutations in TP53 P301Qfs*44, FLT3 R973X, SETBP1 N272D, and JAK3 I688F, whereas the mutations in KIT were not found. Although the initial therapy of corticosteroids and dasatinib-based regimen was effective, he died of acute respiratory distress syndrome after the first cycle of chemotherapy with cladribine and cytarabine. The survival time of the patient was 2.4 months after the initial presentation of MCL. Conclusion: In this case, MCL preceded by malignant mediastinal GCT has similar clinical symptoms and morphological manifestations but distinctly different genetic profiles in contrast to primary MCL. The characteristic morphology of MCL provides the most pivotal evidence that led our diagnosis in the right direction. A hypothesis was speculated that there is a common embryonal cancer stem cell between primary malignant GCT and secondary de novo MCL, whereas the latter is gradually developed in the context of additional “driver mutations”.
Socioeconomic Factors Influencing Knowledge and Consumption of Food Plants By a Human Group in a Mountainous Environment in The Semi-Arid Region of Bahia, Northeast Brazil.
Authors: Souza Luciana Vitor da Silva , Marques Juracy , Campos Letícia Zenóbia de Oliveira , Neto Ernani Machado de Freitas Lins
Published: October 2021

Background: The relationship of people with natural resources is guided by different socio-cultural, ecological and evolutionary factors. Regarding food plants, it is not different. Studies around the world have evaluated the effects of socioeconomic factors, such as age, gender, income, profession, education level, time of residence, ethnic diversity, religion, festive rituals, access to urban areas and migrations. In this sense, the objective of the present study was characterize the diversity of knowledge and use of food plants by people from Serra dos Morgados and evaluate if the socioeconomic factors influence knowledge and consumption of food plants in the community. Methodology: This research was conducted in the village of Serra dos Morgados, municipality of Jaguarari, Bahia, with the purpose of evaluating the factors that influence in the knowledge and use of food plants. Socioeconomic data such as age, gender, time of residence, and monthly income were collected. The free list technique was applied during the collection of ethnobotanical data in order to analyze the preference of the plants based on the salience index (SI). To analyze the factors that influence knowledge and use forms, we used GLM Lasso. Results: A total of 33 people were interviewed, 8 men and 25 women, their age ranged from 30 to 82 years. People cited 93 ethnospecies of plants, of these 41 species of spontaneous occurrence. The plant with the highest salience index (SI) was cheirosa (Psidium ganevii) (SI = 0.5679), followed by massaranduba (Manilkara sp.) (SI = 0.4323); araça (Psidium sp.) (SI = 0.3320); cambuí (Myrcia sp.) (SI = 0.3144). Conclusions: The main factors that influence knowledge and use forms in the locality, were family income and the collection site, with homegardens cited as the preferred area for collection of food plants. This study provided an overview related to potentially important species for a community located in a region where there are few ethnobiological studies. The results presented here can be used in future studies, providing clues for investigations. the ethnoculinary and nutritional aspects of food plants. Also, there is a contributes to the conservation of biocultural aspects related to the use of food plants in a community living in mountainous regions
Formalisms for Enterprise Application Integration (EAI): A Survey of Methodologies
Authors: Kotha Siva Sankara Rao , V Gopal T
Published: October 2021

Over the years, the number of applications supporting enterprise business pro- cesses has increased. The challenge of integrating diverse systems is one of the many rea- sons why many organizations fail to achieve greater automation. To overcome this obstacle, they are turning to Enterprise Application Integration (EAI). Enterprise Application Integra- tion is a process that enables the integration of different applications. This allows the users to easily modify the functionality, share the information among the various applications and reusing the methods. The paper presents a formal method that includes the various levels of EAI. It highlights the various formal methods that can be used to achieve EAI’s seamless interoperation. It also supports the concurrent and dynamic system. This paper also proposes a new architecture for EAI that will help them achieve their goals. There are many formal methods for programming languages in software engineering, but most of them are not ad- equate for the development of complex systems. The author proposes a new methodology based on Petri net which is a graphical representation of semantics.
High Frequency of CTNNB1 Mutation in Low Grade Fetal Adenocarcinoma of the Lung: Two Case Series and Literature Review
Authors: Yanagawa Naoki , Uesugi Noriyuki , Nishiya Masao , Sugimoto Ryo , Osakabe Mitsumasa , Maemondo Makoto , Saitoh Hajime , Sugai Tamotsu
Published: October 2021

Background

Low-grade fetal adenocarcinoma of the lung (L-FLAC) is a rare pulmonary tumor resembling fetal lung histologically. Due to its rarity, there is limited information about L-FLAC pathogenesis and biological characteristics. Here, we describe two cases of L-FLAC treated at our hospital and summarize L-FLAC cases reported in the literature.
Case presentation:

We examined one woman and one man who were 30-years-old and 67-years-old, respectively. Histologically, tumor tissue from both cases had a complex glandular component with clear cuboidal and columnar cells that resembled histological features of fetal lung. In some areas, squamous morules were prominent. Immunohistochemically, nuclear/cytoplasmic expression of β-catenin was detected in both cases. Mutation analysis revealed a CTNNB1 mutation in both cases and a DICER1 mutation in 1 case. No mutations in EGFR, BRAF, KRAS, PIK3CA mutation were found.
Conclusions

L-FLAC showed a high frequency of CTNNB1 mutation and low frequency of EGFR, KRAS, BRAF and PIK3CA mutation in our examined cases and in previous studies. This rare tumor has unique clinicopathological characteristics with specific genetic aberrations involving the Wnt pathway. These results provide a molecular basis for development of new therapies to treat these tumors.
Influence of Weight-bearing Portion on Collapse Risk of Femoral Head Necrotic After Intertrochanteric Curved Varus Osteotomy: A Finite Element Analysis
Authors: Wang Yuzhu , Wang Mincong , Pan Chenglong
Published: October 2021

Background The influence of the insufficient developmental shape of acetabulum on the collapse occurrence of osteonecrosis of the femoral head (ONFH) was reported rarely after intertrochanteric curved varus osteotomy (CVO). The purpose of the study was to quantitatively evaluate the influence of different weight-bearing portions on collapse risk of femoral head necrosis after CVO with a finite element method.Methods Insufficient weight-bearing portion and normal weight-bearing portion hip joint finite element models of CVO (15°, 20°, 25° and 30°) for osteonecrosis of the femoral head with a lesion of 60°, dividing into three types (A, B and C1) were simulated. The Mises strain and collapse index were analyzed in terms of the lesion.ResultsThe maximum and mean Mises strain were higher in insufficient weight-bearing portion models with a positive quantitative increment of strain, especially for type C1 and B in no osteotomy situation. However, the collapse index was more than 1.0 in type C1, even after some degree of this CVO, and in type B of insufficient weight-bearing situation. ConclusionsProgressive collapse risk was increased in the insufficient weight-bearing portion situation. Thus, the decision-making of CVO for the treatment of osteonecrosis of the femoral head should be different with insufficient weight-bearing portion of the acetabulum. We recommended that the unfavorable biomechanical shape of acetabulum should be treated before this CVO was performed when the necrotic type was more than B.
Treatment of lung recurrence after radical resection of non-small cell lung cancer: a single-center retrospective analysis using body stereotactic radiotherapy vs. reoperation
Authors: Wu Qing , Dong Baiqiang , Jin Jianan , Hang Qingqing , Liu Xiaohui , Xu Yujin , ming Chen
Published: October 2021

Purpose

After radical surgery for non-small cell lung cancer (NSCLC) patients, 3-10% of patients have recurrent lung lesions. For these patients, stereotactic body radiation therapy (SBRT) and recurrence surgery are optional treatments. This study aimed to compare the efficacy of SBRT and surgery in treating lung recurrence after radical NSCLC.
Methods

A retrospective analysis of NSCLC patients who had undergone radical surgery at the Cancer Hospital of the University of Chinese Academy of Sciences (Zhejiang Cancer Hospital) from November 2012 to December 2018 and had received SBRT or reoperation because of postoperative lung recurrence was performed. The Kaplan–Meier method was used to calculate the survival rates, and the log-rank test was used to compare groups. Cox regression was used for univariate and multivariate analysis.
Results

Among 62 eligible patients, 33 received SBRT and 29 received reoperation. The median follow-up times of the two patient groups were 45.8 months and 37.4 months. The 3-year locoregional control rate (LRCR) of SBRT and surgical patients was 79.8% vs. 90.2% (P=0.936); progression-free survival (PFS) was 58.5% vs. 42.3% (P=0.072); and overall survival (OS) was 78.0% vs. 85.5% (P=0.714). Multivariate analysis suggested that the treatment method and Charlson comorbidity index (CCI) were independent prognostic factors for PFS (P=0.033 and P=0.001, respectively).
Conclusion

For patients with lung recurrence after radical NSCLC, no significant difference exists in the efficacy of SBRT and surgery.
Iatrogenic Pulmonary Artery Perforation
Authors: Hong Jihoon , Lee Sang Yub , Cha Jung Guen , Lee Jaehee , Kim Donghyeon
Published: October 2021

Background: Vascular plugs have been increasingly used for lower recanalization compared with coil embolization in pulmonary arteriovenous malformation (PAVM) embolization. To deliver the vascular plug close to the PAVM, a large-diameter delivery catheter should be advanced into the feeding pulmonary artery. However, the pulmonary artery has a complex branching pattern and the risk of injury increases when a larger catheter is used in negotiating the PAVM feeder.Case Presentation: We describe a patient who developed pulmonary artery perforation during the selection of the distal feeding artery with a 5-Fr catheter in PAVM embolization. We immediately treated the PAVM and life-threatening complication by using a type IV vascular plug and coil embolization in a single session.Conclusion: To prevent catheter-related complications during PAVM embolization, a smaller diameter delivery system should be used for small, tortuous feeding arteries, and use of a soft, tip-angled catheter for vascular plug delivery should be considered.
Modification of Activated Carbon (Prepared From Flaxseed) With Fe3O4, Its Application As Adsorbent And Antibacterial
Authors: Fekri M. H. , Mohamareh S. Isanejad , Hosseini M. , Mehr M. Razavi
Published: October 2021

In this work, magnetic activated carbon (MGAC) was investigated to remove the antibiotic cefazolin from aqueous solutions as well as its antibacterial properties. To determine the optimal process conditions and achieve maximum efficiency, the effect of temperature, contact time, initial concentration of the drug, composite dosage, and pH using the response surface method (RSM) and the central composite design model (CCD) were investigated by DOE software. Structural characteristics and morphology of the nanocomposite were analyzed by using FTIR, XRD, EDAX, SEM, TEM, BET, TGA, VSM, analyzes. The results showed that pH = 6, the temperature of 30 ℃, contact time 150 minutes, initial concentration of drug 20 mg/l, and composite dosage 0.03 g were the best conditions for removing cefazolin from aqueous solution. In these conditions, the magnetically activated carbon was able to remove 96% of cefazolin. The Langmuir, Freundlich, and Temkin isotherms were also studied and the results showed that the absorption behavior is most consistent with the Temkin isotherm. The results of thermodynamic experiments also showed that the adsorption process is exothermic and spontaneous. Finally, the antibacterial properties of the prepared nano composite on Streptococcus and Salmonella were investigated and the results showed that the prepared sample has antibacterial properties.
Stability Analysis of Fractional Order Memristor Synapse-coupled Hopfield Neural Network with Ring Structure
Authors: Eftekhari Leila , Amirian Mohammad
Published: October 2021

A memristor is a non-linear two-terminal electrical element that incorporates memory features and nanoscale properties, enabling us to design very high-density artificial neural networks. To examine the embedded memory property, we should use mathematical frameworks like fractional calculus, which is capable of doing so. Here, we first present a fractional-order memristor synapse-coupling Hopfield neural network on two neurons and then extend the model to a neural network with a ring structure that consists of $n$ sub-network neurons. Necessary and sufficient conditions for the stability of equilibrium points are investigated, highlighting the dependency of the stability on the fractional-order value and the number of neurons. Numerical simulations and bifurcation analysis, along with Lyapunov exponents, are given in the two-neuron case that substantiates the theoretical findings, suggesting possible routes towards chaos when the fractional order of the system increases. In the $n$-neuron case also, it is revealed that the stability depends on the structure and number of sub-networks.
High Strength and Fatigue Resistant Welds in NiTi and Brass by Impact Welding
Authors: Li Jianxiong , Panton Boyd , Mao Yu , Vivek Anupam , Daehn Glenn
Published: October 2021

Vaporizing foil actuator welding (VFAW) was used to create high strength and fatigue resistant dissimilar welds between NiTi and a brass alloy for the first time. VFAW uses the high pressure resulting from a vaporized aluminum foil to impact weld NiTi to brass. Advanced techniques were used to characterize the structure, mechanical and functional properties of these impact welds. The results show that NiTi/brass welds had solid-state wavy interfaces with no thermally induced defects. The adjoining area of the interfaces were strengthened compared to the base metals. Martensitic transformation temperature ranges were widened in these dissimilar impact welds. Lap shear tests show that the dissimilar NiTi impact welds exhibited a similar pseudoelastic plateau and maximum stress as the NiTi base metal. The resultant joint efficiencies were near 100 % compared to less than 50 % in traditional welding technologies. Cycling tests show that the NiTi/brass impact welds exhibited very similar pseudoelastic responses as the NiTi base metal with less than 0.5 % irrecoverable strains. Dissimilar impact welding of NiTi to brass provides stronger joining and more design flexibility compared to mechanical crimping, positioning the technology to be a solution to producing high strength actuators and sensors.
Research on Dynamic Modeling Method of Clearance Joint based on 1D-CNN
Authors: LIU Zhen , HU Sanbao , HU Junhua , XIANG Chao , FANG Zhigang
Published: October 2021

The contact force of the clearance joints in the mechanical system is strongly nonlinear, which is influenced by the amount of clearance, the material property of the parts and the contact state during movement. In some fields which need to control the dynamic response of mechanical system accurately, it is very important to predict the contact process of clearance joints and the time-frequency characteristics of contact force. In this paper, a dynamic modelling method combining neural network model and co-simulation technology is proposed, which can effectively model and simulate the mechanical system with clearance. The contact friction data set is generated based on the friction experiment of sliding bearing, and the contact collision force data set is generated based on the theoretical model of impact force. The nonlinear contact force neural network model of clearance joints is constructed by deep learning method, and transplanted to Simulink. According to the 3D model of transmission test bench, the dynamic simulation model of mechanical system is established by using ADAMS, and the fusion of neural network model and traditional dynamics model is finally realized based on Simulink/ADAMS co-simulation technology. The creativity of this method lies in the use of neural network model to describe the clearance joints and the use of ideal constraints to describe other kinematic pairs. The combination of force and constraint can not only improve the accuracy of solution, but also ensure the fast calculation speed, which provides a feasible idea for the application of deep learning method in the direction of nonlinear system dynamics modelling.
Cement-Based Solidification/Stabilization of Soil Contaminated by Polycyclic Aromatic Hydrocarbons Using Organophilic Clay
Authors: Heidarzadeh Nima , Jebeli M. , Gitipour S.
Published: October 2021

The solidification/stabilization (S/S) method is the most widely used to remediate all types of inorganic pollutants, which has not been developed for organic matters. In this research, the application of cement and organophilic clay (OC) was investigated for the S/S of contaminated soil by polycyclic aromatic hydrocarbons (PAHs). Pyrene, Acenaphthene, Benzo[a]Pyrene, and Benz[a]Anthracene were spiked in a soil specimen. X-ray diffraction analysis (XRD) indicated that OC has a considerable ability to absorb PAHs in its inter-laminar molecular spaces, unlike ordinary bentonite. Toxicity characteristic leaching procedure (TCLP) results showed that application of OC increased PAHs' removal efficiency from contaminated soil up to 80% on average compared to the use of cement only. Samples containing 30% cement and 30% OC with a 14-day curing time had the best removal efficiency. Also, the removal efficiency of heavier PAHs was lower than the lighter ones. Additionally, unconfined compressive strength (UCS) showed a linear descending by increasing OC's proportion. Scanning electron microscopy (SEM) analysis indicated that two reasons have effectively increased the PAHs' removal efficiency of solid samples: a) increasing the amount of OC that increases the PAHs absorption capacity, b) reducing the size of pores in the matrix reduces the pollutant leaching.
Adrenal Findings in FDG-PET– Analysis of a Cohort of 1021 Patients From a Cancer Center
Authors: Maciel Joana , Cavaco Daniela , Fraga Davide , Donato Sara , Simões Helder , Sousa Rita , Simões-Pereira Joana
Published: October 2021

Purpose: The use of FDG-PET/TC for cancer staging has been leading to the increasing diagnosis of adrenal lesions, which usually represent a clinical challenge. Our aim was to characterize the adrenal lesions found in FDG-PET of patients followed in a cancer center.Methods: Retrospective analysis of all FDG-PET studies performed in our center in the last 10 years. Exams reporting adrenal lesions in the CT component and/or anomalous adrenal FDG uptake were selected. Cases were characterized regarding clinical, laboratorial, imaging and pathological findings. Results: We identified 27,427 FDG-PET studies. Of those, 7.6% evidenced adrenal findings. We included 1364 exams corresponding to 1021 patients. Only 15.6% were referred to the endocrinology department and 38% of the lesions were not studied.Malignant lesions were present in 38.9% of the studied patients: metastases in 37.5%, carcinoma in 1.2% and other malignant tumors in 0.4%. Median SUVmax of malignant lesions was significantly higher than the SUVmax of the benign findings (p<0.05). We also observed a higher median SUVmax in adrenal metastases than in adenomas (p<0.05). There was a tendency for higher SUVmax of adrenal carcinomas when comparing with other malignant lesions (p=0.066). The median SUVmax was not different between pheochromocytomas and other tumors (p>0.05). Conclusion: Occult adrenal lesions discovered during FDG-PET/CT are common in cancer context and are frequently benign. SUVmax may be a useful tool in the workup of adrenal lesions but with several important caveats.
Impact of Insecticide Treated Nets and Indoor Residual Spraying on prevalence of Malaria Among Women of reproductive age in Ghana: Implication for Malaria Control and Elimination
Authors: Alhassan Yakubu , Dwomoh Duah , Amuasi Susan Ama , Nonvignon Justice , Bonful Harriet , Tetteh Mary , Agyabeng Kofi , Kotey Martha , Yawson Alfred E. , Bosomprah Samuel
Published: October 2021

BackgroundThe Global Fund alone contributed 56% of all international financing for malaria and has invested more than US$13.5 billion in malaria treatment, prevention, and control programs as of June 2021. However, there is paucity of studies assessing whether these investments in different malaria interventions (use of mosquito nets, indoor residual spraying and preventive treatment for children and pregnant women) have contributed to a reduction in malaria prevalence. This study aims to quantify the impact of household access to insecticide treated nets (ITNs) and the indoor residual spraying (IRS) on malaria prevalence among women of reproductive age in Ghana. .MethodThis study analyzed the 2016 Ghana Malaria Indicator Survey (MIS), a nationwide survey among women aged 15 to 49 years. The study employed the Poisson regression model with inverse probability to treatment weighting to determine the average treatment effect estimate of the two malaria interventions on the prevalence of malaria among women in Ghana. Results A total sample of 4,861 women interviewed from the 2016 Ghana MIS was used for the analysis. The prevalence of malaria in 2016 was 34.4% (95% CI: [32.4%, 36.4%]). Approximately 80.0% of the women lived in households with access to ITNs (Pr=79.9% , (95% CI: [78.0%, 81.7%])), 12.4% (95% CI: [7.5%, 19.8%]) of the households had access to IRS and 11.4% (95% CI: [7.0%, 18.0%]) of the households had access to both ITNs and IRS. Household access to only ITN contributed to 7.1% (95% CI: [-12.0%, -2.1%], p=0.005) reduction in the prevalence of malaria among women whilst IRS at the households contributed to 6.8% (95% CI: [-13.1%, -0.55%], p=0.033) reduction in malaria prevalence. Households with access to both ITNs and IRS contributed to a 27.1% (95% CI: [-34.9%, -19.25%]) reduction in malaria prevalence among women. ConclusionAccess to both ITNs and the application of IRS at the household level contributed to a significant reduction of malaria prevalence among women of reproductive age in Ghana. This finding confirms the call for integrating malaria control interventions to facilitate attainment of malaria elimination in Ghana.
The Effects of COVID-19 Pandemic on Stock Market Performance in Africa
Authors: Raifu Isiaka Akande
Published: October 2021

This study is conducted to investigate the response of stock market returns to daily growth in COVID-19 confirmed cases and deaths in 14 African countries using both time series and panel approaches. The study employs three estimation methods, Ordinary Least Squares/Robust Ordinary Least Squares (OLS/ORLS), Pooled Ordinary Least Squares (POLS) and Panel Vector Autoregressive (PVAR). While the OLS and POLS are used to examine a conditional mean effect of COVID-19 confirmed cases and deaths on stock market returns PVAR is used to estimate and trace the response of stock market return to shocks from daily growth in COVID-19 confirmed cases and deaths. OLS results show that stock market returns react negatively and significantly to daily growth in COVID-19 confirmed cases in countries like Botswana, Kenya, Tanzania, Tunisia and Uganda while the negative effects of daily growth in COVID-19 confirmed deaths on stock market returns are negligible. Evidence from POLS reveals that the impacts of an increase in COVID-19 confirmed cases and deaths are insignificant. This is corroborated by the results of FEVD. IRF results show that stock market returns react positively to COVID-19 confirmed cases and deaths shocks before declining and returning towards normal returns in the long-run. Our findings underscore the importance of analysing individual country’s socioeconomic reaction to COVID-19 pandemic instead of pooling countries together.JEL Classification: I12, G1
Recombinant Activated Factor VII in Aortic Surgery for Patients With Coagulation Disorders and Hypothermic Circulatory Arrest: a Single-center Retrospective Study
Authors: Ise Hayato , Ushioda Ryohei , Kanda Hirotsugu , Kimura Fumiaki , Saijo Yasuaki , Akhyari Payam , Lichtenberg Artur , Kamiya Hiroyuki
Published: October 2021

Background: We aimed to identify the risk factors of uncontrollable bleeding and investigate the safety of recombinant activated factor VII (rFVIIa) in aortic surgery under hypothermic circulatory arrest (ASHCA).Methods: The present single-center retrospective study compared the baseline characteristics of 144 patients who underwent ASHCA at our institute the total cohort. Of the 144 patients, 42 received rFVIIa (group rFVIIa), while the remaining 102 patients did not (group non-rFVIIa). Perioperative bleeding and transfusions, postoperative 30-day mortality, and adverse events (AEs) were analyzed in 29 propensity score-matched pairs.Results: Before surgery, the rFVIIa group demonstrated a greater number of shocks (p=0.019), higher JapanSCOREx II mortality rate (p=0.033), low platelet count (p=0.015), fibrinogen (p<0.001), prolonged activated partial thromboplastin time (p=0.005), prothrombin time international normalized ratio (p=0.006), and longer aortic cross cramp (ACC) time (p=0.049). Postoperative bleeding, transfusion, 30-day mortality, and AEs were comparable between the groups.Conclusions: Preoperative shock, higher JapanSCORE II mortality rates, low platelet and fibrinogen levels, prolonged aPTT and PT-INR, and longer ACC time might be risk factors for excessive bleeding and indicate the need for rFVIIa treatment. The present study suggests that rFVIIa can be safely used to address uncontrollable bleeding in ASHCA without inducing an increase in 30-day mortality and AEs.
Yeasts Associated With The Worker Caste of The Leaf-Cutting Ant Atta Cephalotes Under Experimental Conditions In Colombia
Authors: Giraldo Carolina , Chaves-López Clemencia , Tofalo Rosanna , Angrisani Roberto , Rodrigues Andre , Montoya-Lerma James
Published: October 2021

Yeasts isolated from the worker caste of the Colombian leaf-cutting ant, Atta cephalotes (Hymenoptera: Myrmicinae) were cultured and identified by molecular methods. Abundant, persistent and omnipresent species were classified as “prevalent”. Experimental data were compared with information gathered from published reports on the yeast species composition in other leaf-cutting ant species. Diversity analysis was conducted using diversity values (q0, q1, and q2) to compare richness and abundance of yeasts present in different leaf-cutting ant species Clustering analysis was carried out to assess similarity of yeast community according to ant species. The yeast species composition was highly variable among the ant species. Atta laevigata and A. capiguara showed the highest degree of similarity and differed from the group composed by A. cephalotes, A. sexdens, A. sexdens rubropilosa, and A. texana. The isolation of dominant yeasts in different ant castes within the different compartments of a colony strongly suggests that the identified microorganisms are not transient but are native to the soil surrounding ant colonies and the substrates used by the ants to grow their fungal cultivars. It is apparent that the ant-fungus mutualism does not operate in an environment devoid of other microbes, but rather that the association must be seen within the context of a background of other microorganisms, particularly the dominant yeasts.