bluuebunny/crossref_metadata_2025 huggingface dataset:
Characteristics, Hospital Referrals and 60-Day Mortality of Older Patients Living In Nursing Homes With Covid-19 Assessed by a Liaison Geriatric Team During The First Wave: A Research Article.
Authors: García-Cabrera Lorena , Pérez-Abascal Noelia , Montero-Errasquín Beatriz , Cano Lourdes Rexach , Mateos-Nozal Jesús , Cruz-Jentoft Alfonso
Published: September 2021

Background: The infection by SARS-CoV-2 (COVID-19) has been especially serious in older patients. The aim of this study is to describe baseline and clinical characteristics, hospital referrals, 60-day mortality, factors associated with hospital referrals and mortality in older patients living in nursing homes (NH) with suspected COVID-19.Methods: A retrospective observational study was performed during March and April 2020 of institutionalized patients assessed by a liaison geriatric hospital-based team. Were collected all older patients living in 31 nursing homes of a public hospital catchment area assessed by a liaison geriatric team due to the suspicion of COVID-19 during the first wave, when the hospital system was collapsed. Sociodemographic variables, comprehensive geriatric assessment, clinical characteristics, treatment received including care setting, and 60-days mortality were recorded from electronic medical records. A logistic regression analysis was performed to analyze the factors associated with mortality. Results: 419 patients were included in the study (median age 89 years old, 71.6% women, 63.7% with moderate-severe dependence, and 43.8% with advanced dementia). 31.1% were referred to the emergency department in the first assessment, with a higher rate of hospital referral in those with better functional and mental status. COVID-19 atypical symptoms like functional decline, delirium, or eating disorders were frequent. 36.9% had died in the 60 days following the first call. According to multivariate logistic regression age (p 0.010), Barthel index <60 (p 0.002), presence of tachypnea (p 0.021), fever (p 0.006) and the use of ceftriaxone (p 0.004) were associated with mortality. No mortality differences were found between those referred to the hospital or cared at the nursing home.Conclusions and implications: 31% of the nursing home patients assessed by a liaison geriatric hospital-based team for COVID-19 were referred to the hospital, being more frequently referred those with a better functional and cognitive situation. The 60-days mortality rate due to COVID-19 was 36.8% and was associated with older age, functional dependence, the presence of tachypnea and fever, and the use of ceftriaxone. Geriatric comprehensive assessment and coordination between NH and the hospital geriatric department teams were crucial.
Slope Aspect Affects The Soil Microbial Communities In Karst Tiankeng Negative Landforms
Authors: Jiang Cong , Shui Wei , Zhu Su-Feng , Feng Jie
Published: September 2021

Background: Karst tiankeng is a large-scale negative surface terrain, and slope aspect affect the soil conditions, vegetation and microbial flora in the tiankeng. However, the influence of the slope aspect on the soil microbial community in tiankeng has not been elucidated. Methods: In this study, metagenomic sequencing technology was used to analyzed the soil microbial communities and metabolic function on the shady and sunny slopes of karst tiankeng. Results: The Shannon-Wiener diversity of microbial communities on shady slopes was significantly higher than that on shady slopes. Shady and sunny slopes have similar microbial community composition, but there are differences in abundance. The linear discriminate analysis (LDA) results showed that biomarkers mainly belongs to Actinobacteria, Chloroflexi and Proteobacteria. Functional pathways and CAZy (Carbohydrate-Active Enzymes) genes also had a remarkable response to slope aspect change. LEfSe results indicated several biomarker pathways in sunny slope involved in human disease. Moreover, the abundance of CAZy genes was higher in shady slope and had stronger ability in decomposing litter. The microbial communities were mainly correlation with the vegetation characteristics (species richness and coverage) and soil properties (SOM and pH). Conclusions: These results indicate slope aspect has a pronounced influence on microbial community composition, structure and function at karst tiankeng. In the future, the conservation of karst tiankeng biodiversity should pay more attention to topographical factors.
Selected Skill Sets As Building Blocks for Secondary-To-Tertiary Education Bridge: A Retrospective Longitudinal Study Among Undergraduate Medical Students
Authors: Alsuwaidi Laila , Otaki Farah , Khamis Amar Hassan , AlGurg Reem , Lakhtakia Ritu
Published: September 2021

Background: The secondary-to-tertiary education transition is a significant milestone in the students’ academic journeys. This is particularly relevant to entry into medical schools, which is characterized by multiple stressors. Although this crucial transition has been repetitively explored, the concept of proactively intervening to support this transition, by fostering Self- Regulated Learning, is still novel. Accordingly, through this study, the authors investigate the efficacy of an online Multi-dimensional Resilience Building Intervention and analyse the association between the students' proficiency of selected skill sets and their academic performance over time. Methods: A retrospective longitudinal study was conducted on one cohort of undergraduate medical students. The students were offered an online learning and development intervention around four skill sets during the first curricular year of an undergraduate Bachelor of Medicine, Bachelor of Surgery program. Deidentified data, related to the students' proficiency of the four selected skill sets and the students’ academic performance: Grade-Point-Average, were retrieved. The data was analysed using SPSS for Windows version 27.0. Results: Out of the 63 admitted students, 28 participated in the offered intervention. The correlational analysis showed how increase in the overall score of skill sets proficiency was significantly associated with Year 1 GPA and cGPA. The students’ proficiency in the respective skill sets, however, was independent from their Year 2 GPA. Additionally, the performance of the students seemed to be not associated with their proficiency scores in each of the selected skill sets, independently. Conclusions: The innovative intervention of developing selected skill sets constituted an efficacious bridge to facilitate the secondary-to-tertiary education transition. Adapting such a multi-dimensional, resilience building intervention holds the potential of facilitating the students’ entry into medical school and improving their performance. As the medical student progresses, the acquired skills need to be continuously reinforced and effectively built upon.
Intraseasonal Variability and Possible Causes of Large Scale and Convective Precipitations Over the Gangetic Plain of India
Authors: Sarthi Pradhan Parth , Kumar Praveen
Published: September 2021

In India, summer monsoon rainfall during June-July-August-September (JJAS) along the river Ganga is the lifeline. Since its variability predominantly affects the agriculture production, drought and flood over the densely populated meteorological subdivisions of the Gangetic West Bengal, Jharkhand, Bihar, East and West Uttar Pradesh. Owing to its importance, a large number of research on the variability of Indian Summer Monsoon Rainfall (ISMR) has been conducted. However, the types of rainfall (or precipitation), i.e. Large Scale Precipitation (LSP) and Convective Precipitation (CP), is less discussed. The LSP is precipitated out from the stratus or nimbostratus clouds, while CP occurs from the cumulus and cumulonimbus clouds, and both of them coexists during summer monsoon months. The current research aims to know the climatological characteristics and possible cause of occurrence of these two types of precipitation over the meteorological subdivisions. For this purpose, the data of LSP, CP, zonal, meridonal (u and v component) wind and Relative Humidity (RH) at the spatial resolution of 0.25° x 0.25° (25km) for the period of 1980-2019 are taken from the European Centre for Medium-Range Weather Forecasts (ECMWF), UK. The Outgoing Longwave Radiation (OLR) data at a surface resolution of 1° x 1° for the same months and periods are obtained from the National Centre for Environmental Information (NOAA), USA. The observed rainfall data of the India Meteorological Department (IMD) at the same resolution and period is considered and compared with ERA data. The spatial and temporal distribution of both types of precipitation is analyzed as well as their linkage with OLR, zonal winds and RH at pressure levels of 1000, 850 and 700hPa is examined.
The Symmetric and Asymmetric impact of FDI Inflows, Economic growth, and Capital Investment on CO2 Emission in Oman-Evidence from ARDL and NARDL Approach
Authors: Hamid Ishfaq , Alam Md Shabbir , Murshed Muntasir , Jena Pabitra Kumar , Sha Nadia , Alam Mohammed Noor
Published: September 2021

This study examines the symmetric and asymmetric nexus between capital investment, economic growth, foreign direct investment, and CO2 emissions in Oman during 1980- 2019. For this purpose, we applied ARDL Model for linear cointegration and NARDL model for nonlinear cointegration between capital investment, economic growth, foreign direct investment, and CO2 emissions. The bound test shows the long-term equilibrium relationship among CO2 emissions, capital investment, economic growth, and FDI in both models. The error correction mechanism demonstrates that CO2 emissions congregate to their long-run equilibrium level at a 50.1 percent annual pace of adjustment by integrating capital investment, economic growth, and FDI under the symmetric model. The causality test results show that carbon emissions and FDI, economic growth, and CO2 emissions exhibit bidirectional causal links. While, on the other hand, unidirectional causal links are running from capital investment to GDP. The asymmetric results show that positive shocks to FDI and economic growth have significant tumbling consequences on Oman's carbon dioxide emissions.In contrast, negative shocks in FDI and economic growth substantially increase carbon dioxide emissions. The research findings also reveal that carbon dioxide emissions are more resilient to negative shocks in FDI and economic growth. Based on these results, this study accomplishes that abatement measures should consist of strategies to enhance the deepness of FDI and economic growth in the Oman economy.JEL Classification: F21, Q56, C22
Session-by-Session Improvements in Subjective Wellbeing and Satisfaction with Life Prospectively Predicts Session-by-Session Improvements in Bulimia Nervosa Symptoms.
Authors: Boyajian Laura E , Srivast Paakhi , Pitts Alexandra L. , Juarascio Adrienne S.
Published: September 2021

PurposeBehavioral treatments (BT) have been credited for improving both subjective wellbeing (SWB) and satisfaction with life (SWL) among those with bulimia nervosa (BN); However, researchers have yet to examine whether the improvements in SWB and SWL during BTs occur prior to or after BN symptom reduction. The current study examines session-by-session change in SWB and SWL and BN symptoms.MethodsThe sample was comprised of 35 patients with BN-spectrum disorders. Participants received 20 sessions of BT and completed weekly pre-session surveys assessing their symptom frequency, SWB, and SWL. Data was analysed using linear mixed effect modelling.ResultsBN symptom reduction during preceding sessions prospectively predicted improvements in SWB and SWL during succeeding sessions. In addition, improvements in SWB and SWL during preceding sessions prospectively predicted reductions in BN symptoms in succeeding sessions.ConclusionThis study provides preliminary evidence of a bidirectional relationship between SWB and SWL and BN symptoms. Future research should test whether incorporating content focused on improving SWB and SWL into BT models could optimize treatment outcomes for BN.Level I, randomized controlled trials
Maximum Glacier Extent of the Penultimate Glacial Cycle in the Upper Garonne Basin (Pyrenees): New Chronological Evidence
Authors: Fernandes Marcelo Vieira , Oliva Marc , Vieira Gonçalo , Palacios David , Fernández-Fernández José María , Delmas Magali , García-Oteyza Julia , Schimmelpfennig Irene , Ventura Josep , Team Aster
Published: September 2021

The Upper Garonne Basin included the longest glacier in the Pyrenees during the Late Pleistocene. During major glacial advances, the Garonne palaeoglacier flowed northwards along ~ 90 km from peaks of the axial Pyrenees exceeding 2,800-3,000 m until the foreland of this mountain range at the Loures-Barouse-Barbazan basin, at only 420–440 m. Here, the palaeoglacier formed a terminal moraine complex that is examined in this work. Based on geomorphological observations and a 12-sample dataset of 10Be Cosmic-Ray Exposure (CRE) ages, we have constrained the timing of the maximum glacial extent as well as the onset of the deglaciation from the end of the Last Glacial Cycle (LGC). Chronological data shows evidence that the external moraines in this basin were abandoned by the ice at the end of the Penultimate Glacial Cycle (PGC) and the onset of the Eemian Interglacial, at ~ 129 ka. No evidence of subsequent glacial advances or standstills occurred during the LGC in this basin were found, as the few existing datable boulders provided in the internal moraine showed inconsistent ages, thus probably being affected by post-glacial processes. The terminal basin was already deglaciated during the global Last Glacial Maximum at 24 − 21 ka, as revealed by exposure ages of polished surfaces at the confluence of the Garonne-La Pique valleys, 13 km south of the entrance of the Loures-Barousse-Barbazan basin. This study introduces the first CRE ages in the Pyrenees for the glacial advance occurred during the PGC and provides also new evidence that glaciers had already significantly shrunk during the LGM.
Effect of Flipped Classroom Approach in The Teaching of A Haematology Course
Authors: Qutob Haitham Mohammed Habib
Published: September 2021

Background

Flipped classroom is a teaching strategy used to enhance the engagement of students in the learning process. Replacing didactic lectures with active learning strategies through flipped classroom sessions fosters independence and the opportunity for students to engage in different passive learning styles. Although many studies of the flipped classroom approach have been conducted with medical students, few have focused on the effect of flipped classroom sessions on students in other medical professional fields. The aim of this study was to assess the effect of the flipped classroom approach on the performance of medical laboratory science students in a haematology course and their perception of the flipped classroom as an active learning strategy. In addition, students’ perceptions regarding the flipped classroom as an active learning strategy were assessed.
Methods

Of two cohorts in haematology courses, cohort 2 attended flipped classroom sessions, whereas cohort 1 underwent traditional class sessions. Students’ learning outcomes, achievements and performance on examinations in haematology courses were assessed. In addition, a satisfaction survey was distributed to the students to evaluate their perception of the flipped classroom as a student-centred learning strategy.
Results

Students in cohort 2 performed significantly better in the knowledge and cognitive domains than did those in cohort 1 (p < 0.001). Cohort 2 students completed the course successfully with an average grade of 81%, and few students received low grades; in comparison, cohort 1 students completed the course with an average grade of 73%, and 7 students received a grade of F. Of students in cohort 2, 83% believed that the flipped classroom provided a better understanding of the subject matter and appropriate knowledge and skills.
Conclusion

The results indicate the effectiveness of flipped classroom as an active learning style in enabling students to obtain desirable knowledge and improve their academic performance. Moreover, students recognised that the flipped classroom as an active leaning style was more beneficial than the traditional teaching approach.
Cesarean Delivery in Iran: A Population-Based Analysis Using The Robson Classification System
Authors: Pourshirazi Maryam , Heidarzadeh Mohammad , Taheri Mahshid , Esmaily Habibollah , Babaey Farah , Talkhi Nasrin , Gholizadeh Leila
Published: September 2021

Background
The rise of Cesarean Section (CS) is a global concern. In Iran, the rate of CS increased from 40.7% in 2005 to 53% in 2014. This figure is even higher in the private sector.
Objective
To analyze the CS rates in the last two years using the Robson Classification System in Iran.
Methods
A retrospective analysis of all in-hospital electronically recorded deliveries in Iran was conducted using the Robson classification. Comparisons were made in terms of the type of hospital, CS rate, and obstetric population, and contributions of each group to the overall cesarean deliveries were reported.
Results
2322500 women gave birth, 53.63% delivered through CS. Robson group 5 was the largest contributing group to the overall number of cesarean deliveries (47.1%) at a CS rate of 98.36%. Group 2 and 1 ranked the second and third largest contributing groups to overall CSs (20.57% and 10.78%, respectively). The latter groups had CS rates much higher than the WHO recommendation of 67.23% and 33.07%, respectively. “Fetal Distress” and “Undefined Indications” were the most common reasons for cesarean deliveries at CS rates of 13.6% and 13.4%, respectively. There was a significant variation in CS rate among the three types of hospitals for Robson groups 1, 2, 3, 4, and 10.
Conclusion
The study revealed significant variations in CS rate by hospital peer-group, especially for the private maternity unit, suggesting the need for further attention and audit of the Robson groups that significantly influence the overall CS rate. The study results will help policymakers identify effective strategies to reduce the CS rate in Iran, providing appropriate benchmarking to compare obstetric care with other countries that have better maternal and perinatal outcomes.
Quetiapine Augmentation of Cognitive Processing Therapy in Veterans with Posttraumatic Stress Disorder. Design and Methodology of a Pilot Study
Authors: Baig Muhammad Rais , Wilson Jennifer L. , Beck Robert D. , Lemmer Jennifer A. , Meraj Adeel , Hernandez Anna , Meyer Eric C. , Mintz Jim , Peterson Alan L. , Roache John D.
Published: September 2021

BackgroundThe limited efficacy of first-line treatment of posttraumatic stress disorder (PTSD) with selective serotonergic reuptake inhibitors commonly leads to the use of multiple medications that still fail to achieve symptomatic remission. VA/DOD guidelines identify trauma-focused psychotherapies as the evidence-based treatment for PTSD, but overall effectiveness is limited by reduced levels of patient engagement. Cognitive processing therapy (CPT) is the most widely-used trauma-focused therapy in the VA system for Veterans with PTSD. Our previous results based on a case series suggested that quetiapine monotherapy, but not risperidone or valproate, could increase engagement in CPT, thereby improving clinical outcomes through direct medication effects and indirectly through greater engagement in CPT.Methods & ResultsWe report the study protocol of a pilot study. This randomized, double blind placebo-controlled study was designed to evaluate the feasibility, safety, and preliminary efficacy of completing a randomized trial of quetiapine vs. placebo as an adjunct to promote patient engagement in CPT treatment for PTSD.ConclusionsWe expect that the success of this ongoing study should provide us with the preliminary data necessary to design a full-scale randomized trial.Trial Registration:NCT04280965
Can salt-tolerant sludge mitigate the salt inhibition to acidogenic fermentation of food waste? Insight into volatile fatty acid production microbial community
Authors: Yin Jun , He Xiaozheng , Chen Ting
Published: September 2021

For treatment of saline wastewater, the feasible approach to mitigate the salt inhibition is using the acclimated salt-tolerant sludge. The aim of this work was to verify if the use of the acclimated sludge (AS) also could alleviate salinity stress on acidogenic fermentation of food waste (FW) under saline environment. The responses of volatile fatty acid (VFA) production and the microbial community to salt stress were investigated. Results showed that VFA production was reduced by high salinity (30 g/L and 70 g/L NaCl) compared with the control (0 g/L NaCl), especially for groups inoculated with the AS, whereas inoculating with the non-acclimated sludge (non-AS) caused less reduction. The impact of salinity was seen on VFA production with accumulation of more propionic acid and acetic acid along with traces of butyric acid. Significant shift on microbial community composition occurred upon biomass exposure to salt. The microbial communities of the non-AS and AS groups at the same NaCl concentrations converged over time. The non-AS groups contained a more proportion of the phyla Bacteroidetes, Atribacteria and Chloroflexi at high salt levels. These findings demonstrate that the non-AS was more conducive to VFA production due to the presence of higher proportions of hydrolytic and fermenting bacteria.Statement of NoveltyAlthough anaerobic digestion (AD) would be the most cost‐effective and sustainable technology, the salinity is considered to be inhibitory to anaerobic biological treatment processes. The recent applications of salt‐tolerant cultures for the treatment of saline wastewaters suggest that biological treatment is promising. Previous studies also reported that acidogenic fermentation as the first step of AD process is inhibited under saline conditions. However, no study to date has focused on acidogenic fermentation for volatile fatty acid production from food waste using salt-tolerant sludge. Therefore, there is a need for improved understanding of high salt stress to resource recovery from organic wastes. This understanding can help in the design of an operating strategy to alleviate the inhibition of waste treatment by salinity.
Role of Raphe Magnus 5-HT1A Receptor in Increased Ventilatory Responses Induced by Intermittent Hypoxia in Rats
Authors: Su Jiao , Meng Yang , Fang Yifei , Sun Linge , Wang Mengge , Liu Yanjun , Zhao Chunling , Dai Liping , Ouyang Songyun
Published: September 2021

Background: Intermittent hypoxia induces increased ventilatory responses in a 5-HT-dependent manner. This study aimed to explore that effect of raphe magnus serotonin 1A receptor (5-HT1A) receptor on the increased ventilatory responses induced by intermittent hypoxia.Methods: Stereotaxic surgery was performed in adult male rats, and acute and chronic intermittent hypoxia models were established after recovery from surgery. The experimental group received microinjections of 5-HT1A receptor agonist 8-hydroxy-2-(di-n-propylamino)tetralin (8-OH-DPAT) into the raphe magnus nucleus (RMg). Meanwhile, the control group received microinjections of artificial cerebrospinal fluid instead of 8-OH-DPAT. Whole-body plethysmography was performed, and ventilatory responses were compared among the different groups of oxygen status.Results: Compared with the normoxia group, the acute intermittent hypoxia group exhibited higher ventilatory responses (e.g., shorter inspiratory time and higher tidal volume, frequency of breathing, minute ventilation, and mean inspiratory flow) (P<0.05). 8-OH-DPAT microinjection partly weakened these changes in the acute intermittent hypoxia group. Further, compared with the acute intermittent hypoxia group, rats in chronic intermittent hypoxia group exhibited higher measures of ventilatory responses after 1 day of intermittent hypoxia (P<0.05). These effects peaked after 3 days of intermittent hypoxia treatment and then decreased gradually. Moreover, these changes were diminished and even disappeared in the experimental group.Conclusions: The results indicate that RMg 5-HT1A receptor is involved in the modulation of the increased ventilatory responses induced by intermittent hypoxia.
A Panel of Emerging EMT Genes Identified in Malignant Mesothelioma
Authors: Wu Licun , Amjad Shaheer , Yun Hana , Mani Sendurai , de Perrot Marc
Published: September 2021

Malignant mesothelioma (MESO) is a highly aggressive cancer with poor prognosis. Epithelial-mesenchymal transition (EMT) is a critical process in malignancies involved in tumor angiogenesis, progression, invasion and metastasis, immunosuppressive microenvironment and therapy resistance. However, there is a lack of specific biomarkers to identify EMT in MESO. Biphasic MESO with dual phenotypes could be an optimal model to study EMT process. Using a powerful EMTome to investigate EMT gene signature, we identified a panel of EMT genes COL5A2, ITGAV, SPARC and ACTA2 in MESO. In combination with TCGA database, Timer2.0 and other resources, we observed that overexpression of these emerging genes is positively correlated with immunosuppressive infiltration, and an unfavorable factor to patient survival in MESO. The expression of these genes was confirmed in our patients and human cell lines. Our findings suggest that these genes may be novel targets for therapeutics and prognosis in MESO and other types of cancers.
Alterations in Heart rate Variability in Blind Patients
Authors: Moreno Renaldo D. , Moreno-Mantilla Natália P. , Lima Marcos V. M. , Morais Mauro J. D. , Valenti Vitor E. , Abreu Luiz C. , Raimundo Rodrigo D. , Sato Monica A.
Published: September 2021

Blindness affect the daily life activities and the causes and prevalence are different worldwide. This study aimed to investigate the pattern of the autonomic nervous system modulation on the heart in blind and normal vision subjects submitted acutely to low vision. Normal vision (NV) subjects (N = 32) and blind patients (N = 24) were submitted to HRV analysis during resting, intervention and recovery periods. Intervention consisted of handling objects, short walking, and cognitive activities performed with pedagogic games while using sleeping masks. No difference was observed in indexes in the time and frequency domain, and in the geometric indexes comparing blind and NV subjected to acute low vision during resting and recovery. Nevertheless, during intervention, RMSSD, pNN50, and SD1were found lower in blind than in NV subjects. Therefore, blind patients showed similar HRV at resting or upon possible stressful challenges compared to NV subjects acutely subjected to low vision, indicating absence of differences in the cardiovascular risk between groups. In addition, blind patients show a smaller reduction in parasympathetic modulation on the heart during possible stressful challenges than NV individuals submitted to low vision, which is likely an important physiological adaptation for an adequate function of the cardiovascular system in blindness.
Seal Tightly and Store in a Cool Dry Place: Exploring Soil Phosphorus Storage in a Subtropical Treatment Wetland.
Authors: II Paul Julian , Osborne Todd Z. , Nair Vimala D.
Published: September 2021

Oligotrophic wetlands of the Everglades are often the final recipients of nutrients from adjacent ecosystems and tend to accumulate phosphorus (P) in their soils. Understanding P source and sink dynamics in wetlands are critical for managing wetland ecosystems and protecting downstream resources. In this study, soil P storage capacity (SPSC) was evaluated within two treatment flow-ways of the Everglades Stormwater Treatment Areas (STAs). This study hypothesized that SPSC will vary between flow-ways, soil depth, and spatially along the inflow-to-outflow gradient. The P storage capacity in the STAs depend on the proportion of iron, aluminum, calcium, and magnesium (Fe, Al, Ca, and Mg, respectively) to P with floc and recently accreted soils (RAS) being associated more with Ca and Mg and pre-STA soils being associated more with Fe and Al. Phosphorus loss, as indicated from SPSC values would vary between systems and soil depths suggesting a variable condition of P sink and source within and along flow-ways. This result, while limited, demonstrates the applicability of SPSC to wetlands systems and provides information that will aid operational or management decisions associated with improving P retention of the Everglades STAs.
Should Calibration Curve Retire From Real-Time	PCR Assays?
Authors: An David
Published: September 2021

Real-time polymerase chain reaction (real-time PCR) is a biological technique that collects data of target nucleotides as PCR occurs by integrating fluorescent dyes as visual indicators into the amplification cycles. This enables the detection and quantification of the DNA segments in a sample through measurements of the fluorescent's intensity. The cycle threshold (Ct) is defined as the number of cycles required for the fluorescent signal to pass a specified threshold and is inverse to the copy number, the initial number of nucleotides in the sample. Calibration curves are commonly used to approximate the copy numbers of experimental samples using standards with known copy numbers. This study is a retrospective review of historical data to help evaluate the efficacy and accuracy of calibration curves in a real-time PCR assay which have been used for screening of a genetic disorder in laboratories. The hypothesis is that including calibration curves in real-time PCR assays may decrease the screening specificity and accuracy, resulting in more false positives and additional retests. Three different scenarios were designed to replay the historical data and evaluate the relative accuracy of assays without calibration curves. The outcomes of all the scenarios conclude that calibration curves are not helpful for detecting target DNA fragments with low copy numbers, suggesting a reconsideration of their implantation in real-time PCR assays.
Intensity-Based Computation Tomography (CT) Evaluation of Temporal Changes in Lung Abnormalities During the Recovery Stage in COVID-19 In-Hospital Patients
Authors: Wang Yanjing , Lakin Robert , Jiang Nan , Yang Bo , Si Daoyuan , Ding Mei , Liu Guohui , Ma Peiyong , Wu Han , Ge Xiaoyu , Yu Bo , He Yuquan , Li Jiayu , Yang Ping , Sun Huan , Liu Lin
Published: September 2021

Background: The coronavirus disease-19 (COVID-19) and its variants have increased rapidly worldwide since December 2019, with respiratory disease being a prominent complication. As such, optimizing evaluation methods and identifying factors predictive of disease progress remain critical. The purpose of the study was to assess late phase (≥3 weeks) pulmonary changes using intensity-based computed tomography (CT) scoring in COVID-19 patients and determine the clinical characteristics predicting lung abnormalities and recovery.Methods: We conducted a retrospective study on 42 patients (14 males, 28 females; age 65±10 years) with COVID-19. Only patients with at least 3 CT scans taken at least 3 weeks after initial symptom onset were included in the study. Two scoring methods were assessed: (1) area-based scoring (ABS) and (2) intensity-weighted scoring (IWS). Temporal changes in the average lung lesion were evaluated by the calculating the averaged area under the curve (AUC) of the CT score-time curve. Correlations between averaged AUCs and clinical characteristics were determined. Results: Using the ABS system, temporal changes in lung abnormalities during recovery were highly variable (P=0.934). By contrast, the IWS system detected more subtle changes in lung abnormalities during in COVID-19 patients, with consistent week-to-week relative reductions in IWS (P=0.025). Strong relationships were observed with D-dimer and C-reactive protein (CRP) levels on admission, with hazard ratios (HR)(95%CI) of 5.32 (1.25-22.6)(P=0.026) and 1.05 (1.10-1.09)(P=0.017), respectively. Conclusion: Our results suggest COVID-19-mediated pulmonary abnormalities persist well-beyond 3-weeks of symptom onset, with intensity-weighted rather than area-based scoring being more sensitive. Moreover, D-dimer and CRP levels were predictive of the recovery from the disease.
Use of Near-Infrared Imaging using Indocyanine Green Associates with the Lower Incidence of Postoperative Complications After Surgery for Intestinal and Mesenteric Injury
Authors: Yamaguchi Keishi , Abe Takeru , Nakajima Kento , Watanabe Chikara , Kawamura Yusuke , Suwa Hirokazu , Minami Yuta , Nojiri Kazunori , Ono Hidetaka , Yoshida Kenichi , Masui Hidenobu , Doi Tomoki , Takeuchi Ichiro
Published: September 2021

BackgroundAnastomotic leakage after intestinal resection is one of the most serious complications of surgical intervention for hollow viscus injury. Adequate vascular perfusion of the anastomotic site is essential to prevent anastomotic leakage. Near-infrared imaging using indocyanine green (NIR-ICG) is useful for the objective assessment of vascular perfusion. The aim of this study was to evaluate the association of NIR-ICG with intestinal and mesenteric injuries.MethodsThis was a retrospective, single-center study of patients undergoing surgery for intestinal and mesenteric injuries due to abdominal trauma from December 2006 to March 2021. NIR-ICG was used to evaluate vascular perfusion. Postoperative complications were assessed between NIR-ICG and non-NIR-ICG groups. ResultsThe use of NIR-ICG was associated with a lower incidence of Clavien-Dindo grade ≥ III complications with a statistical tendency (p = 0.076). No Clavien-Dindo grade ≥ II intestinal complications were observed in the NIR-ICG group. When limited to patients that underwent intestinal resection, the use of NIR-ICG was significantly associated with a lower risk of perioperative complications (p = 0.009).ConclusionsThe use of NIR-ICG tended to associate with the lower incidence of postoperative complications after intestinal and mesenteric trauma surgery. NIR-ICG was associated with a significantly lower risk of complications in patients undergoing intestinal resection. The NIR-ICG procedure is simple and quick and is expected to be useful for intestinal and mesenteric trauma.
Associations Between Asthma/Asthma Exacerbation and Previous Proton-Pump Inhibitor use: A Nested Case-Control Study using a National Health Screening Cohort
Authors: Choi Hyo Geun , Min Chanyang , Yoo Dae Myoung , Tan Bruce K , Kim Joo-Hee , Kim Hwan Il , Park Ji-Young , Park Sunghoon , Hwang Yong Il , Jang Seung Hun , Jung Ki-Suck
Published: September 2021

Background: Proton-pump inhibitors (PPIs) block acid secretion from gastric parietal cells; however, recent studies have reported that PPIs have antioxidant and anti-inflammatory properties in various cells. Newer PPIs are stronger inhibitors of acid secretion; however, the anti-inflammatory effects of these drugs have not been assessed. We evaluated anti-inflammatory effect of PPIs on the development of asthma/asthma exacerbation (AE) in a national health screening cohort.Methods: This case-control study comprised 64,809 participants with asthma who were 1:1 matched with controls from the Korean National Health Insurance Service-Health Screening Cohort. Conditional logistic regression analysis was used to evaluate the effect of previous PPI use on an asthma diagnosis in all participants. Unconditional logistic regression was used to assess the effect of PPI use on AE in participants with asthma. These relationships were estimated in a subgroup analysis according to PPI generation.Results: Overall, PPI use increased the risk of asthma diagnosis (adjusted odds ratio [aOR]=1.29, 95% confidence interval [CI]=1.23-1.35, P<0.001). Use of the first-generation PPIs was associated with asthma (aOR=1.34, 95% CI=1.18-1.52, P<0.001), while use of 2nd-generation PPIs was not (aOR= 0.97, 95% CI=0.82-1.15, P=0.748). In contrast, overall PPI use decreased the risk of AE in participants with asthma (aOR=0.79, 95% CI=0.75-0.84, P<0.001), although this effect was observed only for 2nd-generation PPIs (aOR=0.76, 95% CI=0.65-0.89, P=0.001).Conclusions: PPI use increased the risk for subsequent asthma diagnosis. However, this effect was confined to first-generation PPIs. Second-generation PPIs decreased the risk of AE.
Supporting Family Care: A Systematic App Review
Authors: Bidenko Katharina , Bohnet-Joschko Sabine
Published: September 2021

Background: Mobile applications (apps) provide family caregivers of people with chronic diseases and conditions with better access to support and information. However, thorough understanding of how these apps meet the main needs and requirements of the users is currently lacking. The aim of this study was to review the currently available apps and evaluate their relevance to (1) caregivers’ needs in main caregiving domains, (2) caregivers’ personal needs, and (3) different caregivers’ groups.Methods: We conducted a systematic review on apps for family caregivers on two major app stores: Google Play Store and iOS App Store. Apps were included if the main target group were family caregivers. Data were extracted from the app descriptions found in the app stores.Results: The majority of the apps assisted caregivers in their caregiving activities. Apps were rarely tailored to specific groups of family caregivers and their needs. Further, apps addressing caregivers’ personal health, financial security, and work issues were scarce. Commercial apps dominated the market, often intermediating paid services or available for users of specific hardware. Public and non-profit organizations provided best-rated and free-of-charge apps but had a very limited range of offers with focus on caregivers’ health and training. Conclusions: Our results indicate that current apps for family caregivers do not distinguish specific groups of family caregivers, also they rarely address caregivers’ personal needs.
Short-Term of Malathion Intoxication on Lipid Peroxidation, Antioxidant Activity, and down-regulation of pro-Inflammatory Cytokines: Organophosphorus Pesticide Toxicity in Rat Model
Authors: Sayadi Mehran , Kiani Mohammad , Alipanah Hiva , Mazloomi Seyed Mohammad , Nejati Roghayeh , Nematollahi Amene
Published: September 2021

Malathion (MAL), a kind of organophosphate pesticides (OPs), is one of the oldest phosphoric pesticides, which used for both domestic and commercial agricultural purposes. However, it possesses adverse effects and organ-specific toxicity in relation to the heart, kidney and other vertebrate organs. The exact effects of the short-term toxicity of MAL on lipid peroxidation, antioxidant activity, and pro-inflammatory cytokines is not yet clear enough. We evaluated lipid peroxidation (MDA level), antioxidant activity [superoxide dismutase (SOD) and catalase (CAT)], TNF-alpha, and IL-1 bet in different tissues of MAL-treated Wistar rats, at doses of 50, 100, 200 and 150 mg/kg. After 14 days exposure, CAT and SOD activity, MDA level increased in most tissues. The histopathological results showed that the most sensitive tissues to MAL toxicity were liver, kidney, and heart. Also, in general, increased TNF-alpha measured as inflammatory cytokine compared to untreated rats. IL-1 beta levels showed a dual response to the toxic effects of MAL; increased in testis, kidney and lung tissues and decreased in liver, heart and blood tissues.The present findings reinforce the concept that short-term MAL toxicity can cause tissue damage while enhancing the activity of antioxidant enzymes and reducing cytokine levels.
Treatment of Degenerated Intervertebral Discs using a Viable Disc Tissue Allograft for Chronic Discogenic Low Back Pain: A Randomized Controlled Trial Comparing Single-Site Outcomes with Aggregate and Longer-term Follow-Up Data
Authors: Davis Timothy , Sara Afrida , Nguyen Terry , Burkus John Kenneth
Published: September 2021

BackgroundDisruption of the internal structure of the nucleus pulposus commonly occurs with the development of painful degenerative lumbar disc disease. Supplementing disc tissue through autologous or allogeneic human cellular and tissue therapies has been tested in small sample clinical trials. A few investigators have reported substantial improvements in pain and function. A viable disc tissue allograft was developed to supplement tissue loss associated with intervertebral disc degeneration. MethodsWe assessed results in a subgroup of patients from a large trial comparing this allograft with other treatments. A multicenter randomized controlled trial of 218 subjects with chronic low back pain secondary to degenerative disc disease was conducted. Patients were treated with the allograft, saline, or nonsurgical management and studied for 12 months. We assessed longer-term results in a single-site subgroup from this prospective trial.ResultsAt 12 months, subjects from the single-site subgroup who had been randomly assigned to the active allograft group (n=17) showed improvements in both mean Oswestry Disability Index (ODI) and Visual Analog Scale (VAS) scores. There was an overall reduction of 28.69 points in the ODI and 33.06 points in the VAS. This was similar to the aggregate ODI and VAS scores of the active allograft group. At 24 months postprocedure, 9 of the 10 patients remaining in the active allograft group at the single study site had mean ODI and VAS score improvements of 28.23 and 36.13, respectively. A similar improvement in pain scores occurred in the 4 patients at 36 months with mean ODI and VAS score improvements from preoperative scores of 25.21 and 51.35, respectively.ConclusionsClinically meaningful improvements demonstrated in this single-site analysis were comparable to the aggregate study population at 12 months. Longer-term results from this single site at 24 and 36 months suggested durability of viable disc tissue allograft supplementation for patients with discogenic back pain.Trial registration﻿The trial was retrospectively registered 17 October 2018 on www.clinicaltrials.gov (NCT03709901) and was approved by the Sterling Institutional Review Board, Atlanta, Georgia (IRB no. 5792).
CBX3 Is a Prognostic Biomarker That Is Correlated With Lymphocyte Infiltration in Hepatocellular Carcinoma
Authors: Zhang Jia-Ning , TAO Qi fei , Ding Dong yang , YANG YUAN , Zhou Wei-Ping
Published: September 2021

Background: CBX3 is a key gene that is involved in immune cell regulation, however, its prognostic values and its correlation with infiltrating lymphocytes in various cancers have not been clearly established. This study aims to investigate the role CBX3 in hepatocellular carcinoma (HCC).Methods: We first reviewed the expression of CBX3 in different cancers and adjacent tissues using oncomine database. Next, the authors focus on the expression of CBX3 in hepatocellular carcinoma. Therefore, the expression of CBX3 in hepatocellular carcinoma were analyzed through UALCAN online analysis website and the Human Protein Atlas (www.proteinatlas.org) website. In addition, we further found that CBX3 can be identified as an effective marker for the prognostic guidance of hepatocellular carcinoma according to the Kaplan-Meier plotter database and the Bioinformatics analysis online websites (www.aclbi.com). Next, we used the Bioinformatics analysis online websites to explore whether the expression level of CBX3 in liver cancer is related to the infiltration of certain immune cells. In addition, we also predicted the correlation between immune checkpoint and CBX3 in liver cancer.Results: The analysis results preliminarily show that CBX3 be expressed abnormally in many cancers, and CBX3 was significantly up-regulated in HCC. The high expression of CBX3 indicated survival outcomes and it showed a huge potential as a effective marker for the prognostic guidance of hepatocellular carcinoma. Furthermore, we found that CBX3 in liver cancer is related to the infiltration of certain immune cells, including CD4+ T cells, macrophages and B cells. In addition, the results showed HAVCR2 is most likely to become an effective immune checkpoint for HCC patients immunotherapy with high CBX3 expression.Conclusions: CBX3 is a potential diagnostic and prognostic marker in HCC and related to the infiltration of certain immune cells. It is expected to become a breakthrough point in immunotherapy in the future.
Prediction of Hemorrhagic Transformation and Functional Prognosis in Patients With Acute Ischemic Stroke Using One-stop CT Examination: A Study on the Plateau Region of China
Authors: Li Meng , Hu Huiying , Li Weixia , Bai Chengpin , Bai Xin , Wang Xueyan , Wu Yousen , Lu Guangshun , Bao Haihua
Published: September 2021

There are few studies on the early hemorrhagic transformation of ischemic stroke in plateau area. This study aimed to analyze the value of one-stop CT in predicting HT and functional outcomes in patients with acute ischemic stroke (AIS) caused by occlusion of great vessels before treatment in the high plateau region. Data were obtained from patients who underwent non-enhanced CT (NCCT), CTP and CTA examination within 24 hours from October 2019 to December 2020. Follow-up CT/MRI was performed within one month to determine if HT occurred later. The clinical data, laboratory results and imaging data of patients with and without HT were compared. Of the 74 patients included, 32(43.3%) had HT during follow-up, and HT was more likely to occur in poor collateral circulation (p = 0.029). The values of MTT, Tmax, PS, rCBV, rMTT, rPS in HT group were higher than those in non-HT group (p < 0.05). The results showed that PS > 1.315 ml/100 g/min (AUC, 0.753, p = 0.001) and rCBV > 1.470(AUC, 0.764; p=0.001) had better diagnostic value for HT. One-stop CT examination was performed before treatment in patients with AIS. Quantitative perfusion parameters and multi-phase CTA were used to evaluate the prognosis of HT after recanalization of proximal great vessels.
Improving Animal-Specific Radiotherapy Quality Assurance For Kilovoltage X-Ray Radiotherapy Using A 3D Printed Dog Skull Water Phantom
Authors: Tanabe Yoshinori , Iseri Toshie , Onizuka Ryouta , Ishida Takayuki , Eto Hidetoshi , Nakaichi Munekazu
Published: September 2021

Accurate dose assessment during animal radiotherapy is beneficial for veterinary medicine and medical education. We evaluated the dose distributions of kilovoltage X-ray orthovoltage radiotherapy and created a dog skull water phantom for animal-specific radiotherapy. EGSnrc-based BEAMnrc and DOSXYZnrc codes were used to simulate orthovoltage dose distributions. At 10, 20, 30, 40, 50 and 80 mm in a water phantom, depth dose was measured with waterproof Farmer dosimetry chambers and the diagonal off-axis ratio was measured with Gafchromic EBT3 film to simulate orthovoltage dose distributions. Energy differences between orthovoltage and linear accelerated radiotherapy were assessed with a heterogeneous bone and tissue virtual phantom. The animal-specific phantom for radiotherapy quality assurance was created from CT scans of a dog and printed with a three-dimensional printer using polyamide 12 nylon, with insertion points for dosimetry chambers and Gafchromic EBT3 film. Monte Carlo simulated and measured dose distributions differed by no more than 2.0% along the central axis up to a depth of 80 mm. The anode heel effect occurred in shallow areas. The orthovoltage radiotherapy percentage depth dose in bone was >40%. Build-up was >40%, with build-down after bone exit, whereas linear accelerator radiotherapy absorption changed little in the bone. A highly water-impermeable, animal-specific dog skull water phantom could be created to evaluate dose distribution.Animal-specific water phantoms and Monte Carlo simulated pre-treatment radiotherapy is useful quality assurance for orthovoltage radiotherapy and yields a visually familiar phantom that will be useful for veterinary medical education.