bluuebunny/crossref_metadata_2025 huggingface dataset:
Designing a Multi-Epitope Vaccine against Dracunculus medinensis by Employing Immuno-Informatics and In Silico Approaches
Authors: Sarfraz Mian Talha , Rana Marvah Mehmood
Published: May 2021

Dracunculiasis (also known as Guinea worm disease) is caused by Dracunculus medinensis parasite and it spreads by drinking water containing Larvae of Guinea worm. The lack of safe water facilities, preventions and treatments resulted in highly dangerous consequences in its endemic regions. The economy of the affected regions totally falls down due to less production which is the result of agricultural field worker’s bad health. In this study, a multi epitope vaccine was designed against Dracunculus medinensis by using immune-informatics. The vaccine was designed by using T-Cell and B-Cell epitopes derived from Dracunculus medinensis proteins (Lactamase-B domain-containing protein, G-Domain containing protein and Ferrochelatase) in addition to Adjuvants and Linkers. The tertiary structure, physiochemical properties and immunogenic elements of vaccine were achieved. The validation of tertiary structure was accessed, and quality was achieved. In addition, the world coverage of parasite’s CTL and HTL epitopes is 95.61%. The stability of the chimeric vaccine was achieved through disulfide engineering. The molecular docking with Toll Like Receptor 4 (TLR-4) of vaccine showed its binding efficiency followed by Molecular Dynamic Simulation. The immune simulation suggested the mediated cell immunity and repeated antigen clearance. At the end, the optimized codon was used in in silico cloning to ensure vaccine’s higher exposure in bacterium E. coli strain K12. With further assessments, it is believed that the proposed multi epitope vaccine has strong immunogen to control Dracunculus medinensis which may result in better social and economic conditions of endemic regions.
Anti-Fibrotic Agents Could Be the Game Changer for Post‑COVID Pulmonary Fibrosis Treatment – A Mini Review
Authors: Chakraborty Pallab , Chakraborty Kaustav
Published: May 2021

Total 219 countries and territories globally suffering from the recent pandemic COVID-19 is now in its second wave with more brutality, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) . It has several symptoms like as persistent fever; respiratory illnesses; cough; fatigue; shortness of breath; loss of appetite; persistent pain or pressure in the chest; dysgeusia; acute respiratory distress syndrome (ARDS) etc., and here the things to worry about is the development of pulmonary fibrosis after COVID-19 in both peoples who had died of due to acute respiratory distress syndrome (ARDS) or those who survived. Due to COVID-19, dysregulated immune response and wound repair mainly in elderly patients causes this secondary pulmonary fibrosis. Thus using anti-fibrotic agents could be meaningful in these circumstances although their efficacy in treating COVID-19 is subject to more detailed laboratory research works. In this review article you will get to know about the lung fibrosis generation due to COVID-19 infection, about anti-fibrotic agents and the currents challenges of this field.
Changes in Crop Layout, Effects on Farmland Nutrient Balance: A Case Study in The West Liaohe River Basin, China
Authors: Zhao Zijuan , Fan Beilei
Published: May 2021

Abstract: Estimating regional soils Nitrogen and phosphorus balance in cropland is essential to improve management practices, reduce environmental risks and develop sustainable agriculture. In this study,spatial and temporal variations in crop layout, the impact on soil N and P nutrient balance were assessed from 2000 to 2015 in the West Liaohe River Basin between 2000 and 2015. The result shows that the area of cropland is on the rise, and the spatial distribution of arable land is consistent with the distribution of the main tributaries of the West Liaohe River basin. The change in planting layout for maize and soybeans has a significant impact on the nutrient balance of farmland, which plays a critical role in modifying surplus nutrients. Nutrient surpluses on farmland were mostly concentrated in areas where maize planting layout changed between 2000 and 2015. The N nutrient surplus rate decreased by 39.3%, N utilization efficiency, increased by 70.7%; P nutrient surplus rate decreased by 3.8%, and P utilization efficiency increased by 49.3%. The average utilization efficiencies of N and P nutrients were 27.8% and 9.1%, respectively, and the utilization efficiency was low. Chemical manure is the main source of nutrients. The risk of phosphorus pollution was higher than the risk of nitrogen pollution in the West Liaohe River Basin. The lower Liaohe River Basin (below the Sujiapu) was the region with the most violent changes in nitrogen and phosphorus nutrient balance. It is recommended that reduce the amount of chemical fertilizer application, especially, reduce the amount of P application, improve the ef-ficiency of nutrient use, and focus on strengthening pollution control in key areas such as the West Liaohe River lower reaches basin (below Sujiabao), reducing the risk of agricultural nonpoint source pollution.
Does Green Innovation Promote New Urbanization development? From the Perspective of Coupling Coordination between Green Innovation and New Urbanization
Authors: Xu Weixiang , Ma Lindong , Hong Yuanxiao , Quan Xiaoyong
Published: May 2021

Green innovation has become the mainstream of the era, and New Urbanization is an inevitable choice in the process of urbanization in China. Focusing on the topics of green innovation and new urbanization, much work has been done to find their factors respectively while the relationship between the two remains to be explored. Hence, in this article, representative indicators of new urbanization and green innovation are selected to study the Yangtze River Delta City Group from the perspective of both the entire urban agglomeration and a single city, in terms of time and space, using the entropy method and the coupling model. The results show that (1). Green innovation promotes the new urbanization development and there is a synergistic effect between the two systems. (2). The level of economic development is an important factor that affects the degree of coupling degree and coordination degree between the two interactions, and its influence is better than the spatial effect. (3). Green innovation and new urbanization have positive spatial autocorrelation and regional agglomeration (there are High-High, Low-Low, and High-Low collections).
Design and Optimization of Microring Resonators Integrated with Graphene Oxide Films for FWM
Authors: Moss David
Published: May 2021

We theoretically investigate and optimize the performance of four-wave mixing (FWM) in microring resonators (MRRs) integrated with two-dimensional (2D) layered graphene oxide (GO) films. Owing to the interaction between the MRRs and the highly nonlinear GO films as well as to the resonant enhancement effect, the FWM efficiency in GO-coated MRRs can be significantly improved. Based on previous experiments, we perform detailed analysis for the influence of the GO film parameters and MRR coupling strength on the FWM conversion efficiency (CE) of the hybrid MRRs. By optimizing the device parameters to balance the trade-off between the Kerr nonlinearity and loss, we achieve a high CE enhancement of ~18.6 dB relative to the uncoated MRR, which is ~8.3 dB higher than previous experimental results. The influence of photo-thermal changes in the GO films as well as variations in the MRR parameters such as the ring radius and waveguide dispersion on the FWM performance is also discussed. These results highlight the significantly improved FWM performance that can be achieved in MRRs incorporating GO films
Speech & Song Emotion Recognition Using Multilayer Perceptron and Standard Vector Machine
Authors: Javaheri Behzad
Published: May 2021

herein, we have compared the performance of SVM and MLP in emotion recognition using speech and song channels of the RAVDESS dataset. We have undertaken a journey to extract various audio features, identify optimal scaling strategy and hyperparameter for our models. To increase sample size, we have performed audio data augmentation and addressed data imbalance using SMOTE. Our data indicate that optimised SVM outperforms MLP with an accuracy of 82 compared to 75%. Following data augmentation, the performance of both algorithms was identical at ~79%, however, overfitting was evident for the SVM. Our final exploration indicated that the performance of both SVM and MLP were similar in which both resulted in lower accuracy for the speech channel compared to the song channel. Our findings suggest that both SVM and MLP are powerful classifiers for emotion recognition in a vocal-dependent manner.
On the properties of the classifier in case of significant deviations of blood parameters from the norm
Authors: Gavrikov Boris Mikhailovich , Gavrikov Mikhail Borisovich , Pestryakova Nadejda Vladimirovna
Published: May 2021

A mathematical model is described and implemented, intended for the numerical study of the ability of the statistical classification method to interpolate and extrapolate. The classifier developed by the authors is based on the polynomial-regression approach and has probabilistic estimates. It is used to assess the state of human health based on the parameters of laboratory analysis of peripheral blood. The blood base is considered with a significant deviation from the norm.
“Ọrọ, nwa, ẹkọ”, the talk, the look, the education: reflections on a pedagogy of cosmoperception
Authors: Mesquita Roseane Santos , Rocha Késia dos Anjos
Published: May 2021

The present text bets on the power of reflections on a pedagogy guided by cosmoperception. It is a collective call for the enchanted ways of perceiving and relating to the other. “Ọrọ, nwa, ẹkọ”, the talk, the look, the education, insurgent forces that grow in the cracks, just like moss, alive, reborn. That is the way we think about education, as a living practice, turned to freedom. Freedom understood as a force that enables us to question certain hegemonic truths entrenched in our ways of being, thinking and producing knowledge. In dialogue with the criticisms on the decolonial thought and by authors and authoresses who are putting themselves into thinking about an epistemology from a diasporic place, from the edges of the world, we will try to problematize the effects of the epistemic erasures promoted by the colonial processes and how that has affected our educative practices. The look at the educational experience that happens in the sacred territory of candomblé, will be our starting point to think about politically and poetically transformative educational practices.
Oxidative Stress and Osteoporosis
Authors: Kimball Jeff S. , Johnson Joey P. , Carlson DuWayne A.
Published: May 2021

➤ Oxidative stress has been implicated as a causative factor in many disease states, possibly including the diminished bone mineral density in osteoporosis.

➤ Understanding the effects of oxidative stress on the development of osteoporosis may lead to further research improving preventative and therapeutic measures that can combat this important contributor to morbidity and mortality worldwide.

➤ A diet rich in whole plant foods with high antioxidant content along with antioxidant-preserving lifestyle changes may improve bone mineral density and reduce the risk of fragility-related fractures. While it is not explicitly clear if antioxidant activity is the effector of this change, the current evidence supports this possibility.

➤ Supplementation with isolated antioxidants may also provide some osteoprotective benefits, but whole plant food-derived antioxidants potentially have more overall benefits. Larger-scale clinical trials are needed to give credence to definitive clinical recommendations.
Comparative Safety of the TFN-ADVANCED Proximal Femoral Nailing System
Authors: Wallace Anna , Amis James , Cafri Guy , Coplan Paul , Wood Jennifer
Published: May 2021

Background:

Proximal femoral fractures are often treated with cephalomedullary nails. Although nail breakages following fracture repair are infrequent, a recent implant retrieval study suggested that the TFN-ADVANCED (TFNA) Proximal Femoral Nailing System (DePuy Synthes) was susceptible to post-implant breakage. It is unclear whether the risk of breakage among patients who receive the TFNA implant is higher than patients who receive other comparable cephalomedullary nails. The current study was designed to evaluate the comparative risk of breakage of the TFNA nail.

Methods:

Using data from a large U.S. health-care database, the current study was designed to determine whether TFNA nails have equal, lower, or higher risk of breakage relative to all other comparable, single-head-element (with no additional lag screws), cephalomedullary nails, the Stryker Gamma3 and the Zimmer Natural Nail, referred to in this study as the non-TFNA group. Data were from patients who received the TFNA implant or non-TFNA nails in 365 hospitals between February 1, 2014, and September 30, 2019. Analysis of nail breakage post-implantation was prespecified as the difference between the TFNA group and the non-TFNA group in cumulative incidence at 18 months, with a prespecified equivalence margin of 0.5%, using data balanced on measured covariates by propensity score weighting.

Results:

Within the first 18 months of implantation, in 14,370 patients with TFNA nails, there were 27 nail breakages, and in 8,260 patients with non-TFNA nails, there were 29 nail breakages. The mean time to nail breakage was 4.72 months for the TFNA group and 4.05 months for the non-TFNA group. In the balanced data, the risk of breakage at 18 months was 0.26% (95% confidence interval [CI], 0.17% to 0.36%) for the TFNA group and 0.25% (95% CI, 0.05% to 0.45%) for the non-TFNA group, with a risk difference of 0.01% (95% CI, −0.21% to 0.24%). This result indicates that the cumulative incidence of nail breakage was equivalent (between −0.5% and 0.5%) for both nail groups. The risk differences were also within the equivalence margin in subgroup analyses: pertrochanteric fractures only (−0.08% [95% CI, −0.34% to 0.19%]), pertrochanteric or subtrochanteric fractures (−0.04% [95% CI, −0.29% to 0.21%]), and those with International Classification of Diseases, Tenth Revision (ICD-10) data only (0.03% [95% CI, −0.18% to 0.25%]).

Conclusions:

The risk of nail breakage was equivalent for TFNA and comparator cephalomedullary nails.

Level of Evidence:

Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Socioeconomic Disparities in Drugs and Substance Abuse: Results from a Household Cross-sectional Survey in Murang’ a County, Kenya
Authors: Were Vincent Omondi , Okoyo Collins Omondi , Araka Sylvie Biyaki , Kanyi Henry Muriuki , Echoka Elizabeth Echoka , Mwandawiro Charles , Njomo Doris Wairimu
Published: May 2021

Background: Drug and substance abuse has adverse health effects and a substantial economic burden to the global economies and at the household level. There is, however, limited data on socio-economic disparities in drugs and substance abuse in low-to-middle income countries such as Kenya. This study aimed to assess the socio-economic disparities in Murang’a county of central Kenya.Method: The study design was cross-sectional, and data collection was conducted between November and December 2017. A total of 449 households with at least one person who uses any drug or substance of abuse were randomly sampled from 4 purposively selected sub-locations of Murang’ a County. Structured questionnaires were used to collect data on types of drugs used, economic burden, and gender roles at the household level. Household socio-economic status (SES) was established (low, middle, and high SES ) using principal component analysis f(PCA) from a set of household assets and characteristics. Multivariate logistic regression analysis was used to assess the association between SES, gender, and other factors on the uptake of drugs and substance abuse. Results: Individuals in higher SES were more likely to use cigarettes ( OR=2.13; 95%CI=1.25-3.61, p=0.005) or piped tobacco (OR=11.37; 95% CI, 2.55-50.8; p-value=0.001) than those in low SES. The wealthier individuals were less likely to use legal alcohol (OR=0.39; 95%CI=0.21-0.71, p=0.002) than the poorest individuals. The use of prescription drugs did not vary with SES. A comparison of the median amount of money spent on acquiring drugs showed that richer individuals spent a significantly higher amount than the poorest individuals (Ksh 1500 vs. Ksh 1000, p=0.0310). Deaths related to drugs and substance abuse were more likely to occur in middle SES than amongst the poorest households (OR=2.96; 95%CI=1.03-8.45). Conclusion: Socioeconomic disparities exist in the use of drugs and substance abuse. The low-income individuals are at a higher risk of abuse and thus of economic burden due to catastrophic expenditure in acquiring the drugs. Cases of deaths were likely to occur in middle-income groups. Strategies to reduce drugs and substance abuse must address socio-economic disparities through targeted approaches to individuals in low-income groups.
ACTION-1: study protocol for a randomised controlled trial on ACT guided heparinization during open abdominal aortic aneurysm repair {1}
Authors: Wiersema Arno M. , Roosendaal Liliane C. , Koelemaij Mark J.W. , Tijssen Jan G.P. , Dieren Susan van , Blankensteijn Jan D. , Debus E. Sebastian , Middeldorp Saskia , Heyligers Jan M.M. , Fokma Ymke S. , Reijnen Michel M.P.J. , Jongkind Vincent
Published: May 2021

BackgroundHeparin is used worldwide for 70 years during all non-cardiac arterial procedures (NCAP) to reduce thrombo-embolic complications (TEC). But heparin also increases blood loss causing possible harm for the patient. Heparin has an unpredictable effect in the individual patient. The Activated Clotting Time (ACT) can measure the effect of heparin. Currently this ACT is not measured during NCAP as standard of care, contrary to during cardiac interventions, open and endovascular. A RCT will evaluate if ACT guided heparinization results in less TEC than the current standard: a single bolus of 5 000 IU of heparin and no measurements at all. A goal ACT of 200-220 seconds should be reached during ACT guided heparinization and this should decrease (mortality caused by) TEC, while not increasing major bleeding complications. This RCT will be executed during open abdominal aortic aneurysm (AAA) surgery, as this is a standardized procedure throughout Europe.MethodsSeven-hundred-fifty patients, who will undergo open AAA repair of an aneurysm originating below the superior mesenteric artery, will be randomised in 2 treatment arms: 5 000 IU of heparin and no ACT measurements and no additional doses of heparin, or a protocol of 100 IU/kg bolus of heparin and ACT measurements after 5 min., and then every 30 min. Goal ACT is 200-220 sec. If the ACT after 5 min. is < 180 sec. 60 IU/kg will be administered, if the ACT is between 180 and 200 sec. 30 IU/kg. If the ACT is > 220 sec. no extra heparin is given, and the ACT is measured after 30 minutes and then the same protocol is applied. The expected incidence for the combined endpoint of TEC and mortality is 19% for the 5 000 IU group and 11% for the ACT guided group.DiscussionThe ACTION-1 trial is an international RCT during open AAA surgery, designed to show superiority of ACT guided heparinization compared to the current standard of a single bolus of 5 000 IU of heparin. A significant reduction in TEC and mortality, without more major bleeding complications, must be proven with a relevant economic benefit.Trial registration {2a}NTR: NL8421Clinicaltrials.gov: NCT04061798. Date of registration: 20-08-2019. https://clinicaltrials.gov/ct2/show/NCT04061798?cond=NCT04061798&draw=2&rank=1 EudraCT: 2018-003393-27
A Dynamic Damage Model for the Rock-Shed Roof Under the Rockfall
Authors: liu hongyan
Published: May 2021

The dynamic response of the rock-shed roof under the rockfall is a complicated mechanical process, which mainly includes the following three deformation stages, e.g. the elastic compression, plastic damage compression and elastic resilience stages of the rock-shed roof. However, the existing models based on Hertz elastic-perfectly plastic contact theory cannot perfectly reflect the above mechanical process. Therefore, on basis of the classical Hertz contact theory, the damage of the rock-shed roof induced by the rockfall is firstly introduced to consider its effect on the material elastic modulus, and then the revised Hertz contact theory considering the damage is proposed. Secondly, in view of the existing calculation method of the maximum rockfall impact force based on the theorem of impulse, a new calculation method is proposed by combining the revised Hertz contact theory. Thirdly, according to the dynamic mechanical response process of the rock-shed roof under the rockfall and in view of the revised Hertz contact theory, a dynamic damage model for the rock-shed roof under the rockfall is proposed, which can perfectly illustrate the variation law of the impact force with the deformation of the rock-shed roof during the rockfall. Finally, the proposed model is verified with other models for the maximum rockfall impact force. In all, the proposed model can perfectly describe the dynamic mechanical behavior of the rock-shed roof under the rockfall, which can be referred for the engineering design.
Examining the Cost-effectiveness of Personal Protective Equipment for Formal Healthcare Workers in Kenya during the COVID-19 Pandemic
Authors: Kazungu Jacob , Munge Kenneth , Werner Kalin , Risko Nicholas , Ortiz Andres Vecino , Were Vincent
Published: May 2021

Background: Healthcare workers are at a higher risk of COVID-19 infection during care encounters compared to the general population. Personal Protective Equipment (PPE) have been shown to protect COVID-19 among healthcare workers, however, Kenya has faced PPE shortages that can adequately protect all healthcare workers. We, therefore, examined the health and economic consequences of investing in PPE for healthcare workers in Kenya. Methods: We conducted a cost-effectiveness and return on investment (ROI) analysis using a decision-analytic model following the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) guidelines. We examined two outcomes: 1) the cost per healthcare worker death averted, and 2) the cost per healthcare worker COVID-19 case averted. We performed a multivariate sensitivity analysis using 10,000 Monte Carlo simulations. Results: Kenya would need to invest $3.12 million to adequately protect healthcare workers against COVID-19. This investment would avert 416 and 30,041 healthcare worker deaths and COVID-19 cases respectively. Additionally, such an investment would result in a societal ROI of $170.64 million – equivalent to an 11.04 times return. Conclusion: Despite other nationwide COVID-19 prevention measures such as social distancing, over 70% of healthcare workers will still be infected if the availability of PPE remains scarce. As part of the COVID-19 response strategy, the government should consider adequate investment in PPE for all healthcare workers in the country as it provides a large return on investment and it is value for money.
Integrated photonic metasystem for image classifications at telecommunication wavelength
Authors: Wang Zi , Chang Lorry , Wang Feifan , Li Tiantian , Gu Tingyi
Published: May 2021

Miniaturized image classifiers are potential for revolutionizing their applications in optical communication, autonomous vehicles, and healthcare. With deep diffractive neuron networks trained subwavelength structures, we demonstrate image recognitions by a passive silicon photonic metasystem. The metasystem implements high-throughput vector-by-matrix multiplications, enabled by 103 passive subwavelength phase shifters as weight elements in 1 mm2 footprint. The large weight matrix size incorporates the fabrication variation related uncertainties, and thus the pre-trained metasystem can perform machine learning tasks without post-tuning. A 15-pixel spatial pattern classifier reaches near 90% accuracy with femtosecond inputs. The metasystem’s superior parallelism (1015 bit/s) dramatically expand data processing capability of photonic integrated circuits, towards next generation low latency and low power photonic accelerators compatible with complementary metal-oxide-semiconductor manufacturing.
How Resilience and Social Support Promote Post-Traumatic Growth after Wenchuan Earthquake: An Integrated Perspective
Authors: Xin Yong , Liu Chuanjun , Peng Xiaoyan , Fu Haojie , Li Ling
Published: May 2021

People could recover and obtain growth after traumatic experience. Two vital protective factors for post-traumatic growth (PTG) are resilience and social support. However, it remains unclear how the two factors affect PTG. Some research demonstrated that resilience could indirectly promote PTG though social support, while other researchers found that social support could indirectly promote PTG through resilience. Integratively considering, the present study tested whether these two perspectives simultaneously tenable. We recruited 2336 high school students from the Wenchuan earthquake-stricken area to participate in our survey. Scales of Connor-Davidson Resilience, Perceived Social Support and Post-traumatic Growth were joined in one questionnaire. After filtering the invalid questionnaires, 2150 samples (aged 15–18 years old, M = 16.21, SD = .79; 844 females) remained for further analyses. The results demonstrate that resilience, social support and PTG are significantly correlated with each other. Resilience partly mediates the relationship between social support and PTG, meanwhile social support partly mediates the relationship between resilience and PTG. It supports the integrated perspective that resilience and social support can directly promote PTG and indirectly promote PTG through each other. Therefore, in the psychological assistance of people endured adversity, we can cultivate their internal resilience and help them reconstruct their external social support resources, so that they would integrate internal and external resources to achieve more post-traumatic growth.
Intelligent speed control of a Stirling engine using artificial neural network
Authors: Hojati Mohammadreza , Mansouri Ehsan
Published: May 2021

The Stirling engine is a kind of external combustion engine that is ideal for converting renewable energies to electricity or mechanical energy forms. Therefore, monitoring and controlling some of its parameters such as its speed is important. The purpose of this paper is to control a Stirling engine flywheel rotation speed using an intelligent parameter predictor. Since various parameters affect motor performance, determining the optimal value of them manually is impossible. Therefore, linking these parameters together and finding a relationship between them would be beneficial. Hence, using artificial intelligence (AI) to find a quick and efficient solution is particularly important. At the studied Stirling engine, speed, cold sink and ambient temperatures are defined as input parameters, and hot sink temperature is considered as the output parameter that should be calculated. To discover the relationship between inputs and output, an artificial neural network (ANN) is used. The results of this study showed that the use of ANNs can be significantly helpful in controlling engine speed.
Twinning Project between the Japanese Midwives Association and Mongolian Midwives Association for Organisational Strengthening as Shown by MACAT
Authors: Taniguchi Hatsumi , Suetsugu Yoshiko , Sato Yoko , Nakamichi Yuki , Dashdondog Nasantogtokh , Orosoo Sayanlkham , Serdamba Davaasuren , Jargalsaikhan Badarch , Yamamoto Utako , Okamoto Kiyoko
Published: May 2021

BackgroundThe Japanese Midwives Association (JMA) collaborated with the Mongolian Midwives Association (MMA) on the twinning project under the guidance of the International Confederation of Midwives (ICM) towards the achievement of the Sustainable Development Goals. The purpose of this study was to evaluate the outcomes of the organisational strengthening of the MMA through the twinning project with the JMA. ICM’s Member Association Capacity Assessment Tool (MACAT) was used as an indicator of MMA’s organisational strengthening—first in the year 2015 and then at the end of 2018—for a comparative analysis. For a comprehensive evaluation, qualitative interviews were conducted with the board members and general members of the MMA in 2018, and the results were compared with the issues identified during the first visit to MMA in 2014. ResultsIn 2015, 27 (28.1%) of the 96 MACAT items were achieved, while in 2018, 66 items (68.8%) were achieved. The average progress rate was 40.7%. Items with a high progress rate corresponded to: Governance (50.0%), Management Practices and Leadership (50.0%), Functions (43.8%), and Financial Resource Management (37.5%). Four themes emerged from the interviews: Professional identity, Strengthening midwifery services, Advocacy for midwives, and Recognition of midwives as autonomous professionals.ConclusionsThe organisational strengthening of the MMA through the twinning project resulted in more positive outcomes than expected. These outcomes were apparent from the evaluation of the MACAT items and the opinions and impressions of the MMA members, as elicited through the qualitative interviews. The MACAT was selected as an easy-to-understand index. However, instead of following the concept of ‘equal participation on the ground level’, a mentorship approach was adopted in line with the concept of equity. Equity and a mentorship approach can serve as key variables of success in international co-operation.
Impact of Socioeconomic Inequalities on the Spread of COVID-19
Authors: Arı Alpay , Özdemir Hülya , Kabadurmus Fatmanur , Tosun Selma , Özdemir Durmuş
Published: May 2021

BackgroundTo examine the role of medical, economic and social inequalities affecting the prevalence of COVID-19 in Turkey. MethodsThis paper clarifies the medical and socio-economic factors affecting the prevalence of COVID-19 by using clinical and survey data in a binary probit model (BPM). Socio-economic factors affect the prevalence of COVID-19 to different degrees. Socio-economic variables are associated with risk of infection and can increase exposure to and mortality from COVID-19. ResultsThe factors that increase the probability that a person will get COVID-19 are gender (males have a 9.4% higher probability), income, household work status, interacting with a COVID-19 case (31.4% higher), using public transportation (6.97% higher), and visiting a hospital (35.7% higher probability for individuals who visited a hospital) or a mosque (15.1% higher). The factors that decrease the probability of testing positive are smoking (14.3% lower for smokers), being employed, having a university education compared to no education (24.7% lower), and wearing gloves (15.4% lower). ConclusionIn the case of Turkey, the estimations of the BPM show that economic and social variables are important factors for determining COVID-19 prevalence. Inequalities in socio-economic variables affect the prevalence to different degrees. Disparities in education and poverty are more important than being employed or being a smoker for the spread of COVID-19.
Associations of the Polymorphisms of the NHEJ Pathway Genes With HIV-1 Infection and Aids Progression Among Men Who Have Sex With Men in Northern China
Authors: Zhang Xuelong , Wang Kaili , Mo Han , Hu Yuanting , Yang Xun , Wu Jiawei , Liu Bangquan , Xu Lidan , Sun Haiming , Jia Xueyuan , Wang Ping , Sun Wenjing , Fu Songbin , Qiao Yuandong
Published: May 2021

Background: Men who have sex with men (MSM) are at high risk of HIV infection. Non-homologous end joining (NHEJ) pathway is the main way of double-stranded DNA break (DSB) repair in the higher eukaryotes, and can repair the DSB timely at any time in cell cycle. The objective of this study was to investigate the association of SNPs of the NHEJ pathway genes with susceptibility to HIV-1 infection and AIDS progression among MSM residing in northern China.Results: In the present study, a total of 481 HIV-1 seropositive men and 493 HIV-1 seronegative men were included. And genotyping of 22 SNPs in NHEJ pathway genes was performed using the SNPscanTM Kit. Our results disclosed significant associations of XRCC6 rs132770 and XRCC4 rs1056503 genotypes with susceptibility to HIV-1 infection. The generalized multifactor dimensionality reduction (GMDR) analysis found a significant SNP-SNP interaction between the XRCC6 and XRCC4 variants in the risk of HIV-1 infection. In stratified analysis, the positive effects of XRCC5 rs16855458 and LIG4 rs1805388 on the CD4+ T cell count and clinical phase of disease were validated.Conclusions: Our results confirmed that the NHEJ gene polymorphisms played an important role in HIV-1 infection and AIDS progression in the northern Chinese MSM population.
N6-methyladenosine Methylation Related Immune Biomarkers Correlates With Clinicopathological Characteristics and Prognosis in Clear Cell Renal Cell Carcinoma
Authors: Xiong Hui , Kang Weiting , Zhang Qi
Published: May 2021

Background: This study aimed to explore N6-methyladenosine (m6A) methylation-related immune biomarkers and their clinical value in clear cell renal cell carcinoma (ccRCC).Methods: The RNA-seq data and clinical phenotype of ccRCC were downloaded from TCGA database. Immune-related genes list was downloaded from InnateDB database. Correlation analysis, survival analysis, univariate and multivariate Cox regression analysis were used to investigate the prognostic independent m6A-related immune genes, followed by prognosis risk model establishment. Patients were divided into high/low risk groups, followed by survival analysis, clinical factors, immune checkpoint genes and gene set variation analysis in high-risk vs. low-risk group. Results: Five prognostic independent m6A-related immune genes (PKHD1, IGF2BP3, RORA, FRK and MZF1) were identified. Low expression of PKHD1, RORA and FRK were associated with poor survival, while high expression of IGF2BP3 and MZF1 were associated with poor survival for ccRCC patients. Their expression showed correlations with multiple m6A genes. The risk model could stratify ccRCC patients into high/low risk group, and patients with high-risk were associated with short survival time. High-risk group had an high proportion of patients in tumor stage Ⅲ-Ⅳ and patients with pathologic T3-T4 tumors, lymph node metastasis (N1) and distant metastasis (M1). Ten immune checkpoint genes were differentially expressed in high/low risk groups, such as PD1 and CTLA-4. The risk group could be an independent prognostic factor (HR=1.69, 95% CI 1.07-2.68, P=0.0246). Conclusion: In this study, we developed a five genes risk model, which had independent prognostic value and associated with tumor stage, pathologic T/N/M and immune checkpoint expression in ccRCC.
Troxerutin Preconditioning Modulates the Activity of TLR4/NF-κB Signaling Pathway and Mitochondrial ATP-Sensitive Potassium Channels in a Rat Model of Myocardial Ischemia/Reperfusion Injury
Authors: Masoud Farid , Mokhtari Behnaz , Gholami Sanaz , Javadi Aniseh , Badalzadeh Reza
Published: May 2021

Purpose

Given the rising prevalence of ischemic heart diseases (IHD), investigations for achieving effective treatments are required. The purpose of this study is further understanding of troxerutin's impact on inflammatory response induced by myocardial ischemia/reperfusion (MI/R) injury, and the role of toll-like receptor 4 (TLR4)-nuclear factor kappa B (NF-κB) signaling pathway and mitochondrial ATP-sensitive potassium (mitoKATP) channels in this scenario.
Methods

Sixty male Wistar rats were randomly divided into six groups: Control, troxerutin-receiving, MI/R, MI/R plus troxerutin, MI/R plus 5-hydroxydecanoate (5-HD), and MI/R plus troxerutin and 5-HD. The Langendorff-perfused hearts of animals were subjected to 30 min of left anterior descending coronary artery (LAD) ligation and 45 min of reperfusion. Troxerutin (150 mg/kg/day) was administered for 4 weeks prior to MI/R. 5-HD (100 µM) was added to the perfusion solution 20 min before the ischemia. Myocardial infarct size (IS), lactate dehydrogenase (LDH) release, the expressions of TLR4 and NF-κB, and the levels of tumor necrosis factor-alpha (TNF-α) and interleukin-1beta (IL-1β) were measured.
Results

Troxerutin preconditioning significantly reduced IS (P < 0.05) and LDH release (P < 0.05). Pretreatment with troxerutin decreased the expressions of TLR4 (P < 0.05) and NF-κB (P < 0.01), and reduced the levels of TNF-α (P < 0.01) and IL-1β (P < 0.05). Inhibition of mitoKATP channels by 5-HD significantly reversed the cardioprotective effects of troxerutin (P < 0.05).
Conclusion

The present work revealed that troxerutin preconditioning has cardioprotective effects against MI/R damage, which are partly mediated through anti-inflammatory effects and the activation of mitoKATP channels.
Transverse magnetoresistance, Hall mobility and Hall constant of thin Cu films deposited onto cleaved mica: Evidence of weak Anderson localization.
Authors: Díaz Eva , Herrera Guillermo , Oyarzún Simón , Munoz Raul
Published: May 2021

We report the resistivity of 5 Cu films approximately 65 nm thick, measured between 5 K and 290 K, and the transverse magnetoresistance and Hall effect measured at temperatures 5 K< T<50 K. The mean grain diameters are D=(8.9, 9.8, 20.2, 31.5, 34.7) nm, respectively. The magnetoresistance signal is positive in samples where D>L/2 (where L=39 nm is the electron mean free path in the bulk at room temperature), and negative in samples where D<L/2. The sample where D=20.2 nm exhibits a negative magnetoresistance at B < 2 Tesla and a positive magnetoresistance at B > 2 Tesla. A negative magnetoresistance in Cu films has been considered evidence of charge transport involving weak Anderson localization. These experiments reveal that electron scattering by disordered grain boundaries found along L leads to weak Anderson localization, confirming the localization phenomena predicted by the quantum theory of resistivity of nanometric metallic connectors. Anderson localization becomes a severe obstacle for the successful development of the circuit miniaturization effort pursued by the electronic industry, for it leads to a steep rise in the resistivity of nanometric metallic connector with decreasing wire dimensions (D<L/2) employed in the design of Integrated Circuits.
Mass Spectrometry Detection of Inhaled Drug in Distal Fibrotic Lung
Authors: Mikolasch Theresia , Obella Eunice , Vahdati-Bolouri Mitra , Morrell Josie , Jarvis Emily , Cui Yi , Cahn Anthony , Terry Rebecca , Sahota Jagdeep , Thakrar Ricky , Marshall Peter , PORTER Joanna
Published: May 2021

BackgroundCurrently the only available therapies for fibrotic Interstitial Lung Disease are administered systemically, often causing significant side effects. Inhaled therapy could avoid these but to date there is no evidence that drug can be effectively delivered to distal, fibrosed lung. We set out to combine mass spectrometry and histopathology with rapid sample acquisition using transbronchial cryobiopsy to determine whether an inhaled drug can be delivered to fibrotic, distal lung parenchyma in participants with Interstitial Lung Disease.MethodsPatients with radiologically and multidisciplinary team confirmed fibrotic Interstitial Lung Disease were eligible for this study. Transbronchial cryobiopsies and endobronchial biopsies were taken from five participants, with Interstitial Lung Disease, within 70 minutes of administration of a single dose of nebulised ipratropium bromide. Thin tissue cryosections were analysed by Matrix Assisted Laser Desorption/Ionization-Mass Spectrometry imaging and correlated with histopathology. The remainder of the cryobiopsies were homogenised and analysed by Liquid Chromatography – tandem Mass Spectrometry. ResultsDrug was detected in proximal and distal lung samples from all participants. Fibrotic regions were identified in research samples of four of the five participants. Matrix Assisted Laser Desorption/Ionization-Mass Spectrometry imaging showed co-location of ipratropium with fibrotic regions in samples from three participants.ConclusionsIn this proof of concept study, using mass spectrometry, we demonstrate for the first-time that an inhaled drug can deposit in distal fibrotic lung parenchyma in patients with Interstitial Lung Disease. This suggests that drugs to treat pulmonary fibrosis could potentially be administered by the inhaled route.Trial RegistrationA prospective clinical study approved by London Camden and Kings Cross Research Ethics Committee and registered on clinicaltrials.gov (NCT03136120)
Emergency responses to COVID-19 in the hospital outpatient-emergency department under diversified decision scenarios: A case study in Wuhan, China
Authors: Peng Yingying , Li Jiang , Li Suyun , Li Xianglin , Jia Erping , Xiong Liming , Xiong Juyang
Published: May 2021

The authors have requested that this preprint be removed from Research Square.
An Open-Access and Inexpensive 3D Printed Otoscope for Low-Resource Settings
Authors: Capobussi Matteo , Moja Lorenzo
Published: May 2021

Limited access to key diagnostic tools is detrimental to priority health needs of populations. Ear pain, tenderness, itching, and different degree of hearing loss are common problems which require otoscopy as first diagnostic assessment. Where an otoscope is not available because of budget constraints, a self-fabricated low-cost otoscope might represent a feasible opportunity. In this paper, we share the design and construction process of an open-source, 3D printed, otoscope. The prototype was compared to a commercial solution, demonstrating similar overall quality between the instruments.
Activation of Invariant Natural Killer T Cells Further Ameliorates Post-Infarct Cardiac Remodeling in Mice With MSC Transplantation
Authors: Li Wentao , HUANG YI , GAO CHUANYU , ZHU ZHONGYU , DAI GUOYOU
Published: May 2021

Background：The purpose of this study was to examine the effect of MSCs on the infiltration of iNKT cells and further observe whether the activation of iNKT cells could assist the therapeutic action of MSCs on ventricular remodeling.Methods：Mice with MI were sacrificed at day 7, 14, 28 and hearts were excised. qRT-PCR for Vα14Jα18 (a special marker of iNKT cell for C57BL/6) was carried out. 25μL serum-free medium(Me)、complete medium with 1×106 MSCs or without MSCs were respectively injected into myocardium in five points. After 7, 14, 28 days, qRT-PCR for Vα14Jα18 was respectively preformed. Gene expressions of Vα14Jα18 in PLV with the injection of cMe alone and cMe with PGE2, L-NMMA, indomethacin, anti-TGF at day 7 were also analyzed. Then, the experiment was performed in five groups: MI+Me, MI+MSCs, MI+MSCs+indome, MI+α-GC and MI+MSCs+ α-GC. After 28 days, heart tissue fibrosis was accessed by Masson trichrome dyeing and apoptosis was evaluated by TUNEL staining and western blotting for caspase-3 protein.Results：The iNKT cells infiltrating into the PLV was significantly increased at day 7 after MI (1.72-fold changes from baseline, P<0.05), but almost returned to baseline level at day 14 and 28. Compared to MI+Me group(1.76±0.20-fold), iNKT cells infiltration was significantly suppressed at day 7 in MI+MSCs (1.25±0.29-fold, P<0.05) and MI+cMe groups (1.19±0.25-fold, P<0.05). In MI+cMe+indome and MI+cMe+PGE2 group, the changes of iNKT cells infiltration were respectively 1.74- and 1.04-fold (vs 1.20-fold in MI+cMe group, P<0.05). Combined MSCs transplantation with iNKT cells activation, myocyte apoptosis and interstitial fibrosis in PLV were both significantly attenuated. Conclusions:In the infarcted mouse model, MSCs suppressed the infiltration of iNKT cells by secreting PGE2. Activating iNKT cells could assist the therapeutic effect of MSCs on ventricular remodeling, with attenuated apoptosis and interstitial fibrosis.
Effects of Nitric Oxide On The Growth of The Marine Microalgae And The Parameters of Carbonate Chemistry
Authors: Peifeng Li , Min Zhao , Chunying Liu , Guipeng Yang
Published: May 2021

Nitric oxide (NO) is a non-traditional regulator for the growth of plant and phytoplankton. This study monitored the growth of five marine phytoplankton species, namely, Platymonas helgolandica var. tsingtaoensis, Platymonas subcordiformis, Skeletonema costatum, Gymnodinium sp., and Prorocentrum donghaiense, and examined the parameters of the carbonate system in the culture media after adding different concentrations of NO and sodium nitroprusside (SNP, NO donor) solutions. The different concentrations of exogenous NO had various roles in the growth of these microalgae. The two food algae,namely, P. helgolandica var. tsingtaoensis, P. subcordiformis, and three red tide algae, namely S. costatum, Gymnodinium sp., and P. donghaiense showed different responses to the same NO concentration. The red tide algae were more sensitive to exogenous NO than the food algae. NO with the concentration of 1.4 × 10− 6 mol L− 1 had the optimum stimulatory effect on the growth of the microalgae, the cell density increased by 9.8 ~ 38.3%. SNP solution with the concentration of 100 µmol L− 1 inhibited the growth of the two food algae, the cell density decreased by 38.8 ~ 84.3%. Meanwhile, 10 µmol L− 1 SNP solution additions to the three red tide algae declined the cell density by 95.3 ~ 99.9%. Low concentrations of SNP (0.1 µmol L− 1 for the two food algae and 0.01 µmol L− 1 for the red tide algae) promoted the growth of microalgae slightly. Different concentrations of exogenous NO could also influence parameters of the carbonate system in the culture media. NO participates in the regulation of marine microalgae photosynthesis, which may influence the parameters of carbonate system.
Critical Chains and Its Randomness Study
Authors: Han Xiaokang , Yan Wenzhou , Liu Ting
Published: May 2021

It has been widely accepted in the academic community that the Critical Chain Method (CCM) has significant advantages over the Critical Path Method (CPM) in solving the problem with resource constraints. However, this paper conducted a study on comparing the two methods of Critical Chain Method and Critical Path Method, and found that the only difference between those two methods lies in how to determine the priority of resources allocating, and on the assumption of not setting buffer zone, those two methods have no essential distinctions at all. By establishing the relationship between CCM and CPM, this paper also enriched and improved CCM to some extent, and pointed out that the buffer zone setting in CCM is merely subjective and short of scientificity. In the meantime, for the problem of unclear representation of critical chains, it proposed two ways of representing critical chains and related rules to follow. To verify the conclusion of this paper, further detailed case study of comparing CCM and CPM was performed. Affected by various uncertain factors, the project construction sequence is random, the total construction duration is random, and the critical chain is also random, so it is unable to determine how to direct construction. Aiming at the randomness of the critical chain, this article analyzed various uncertain factors of the critical chain, and on the basis of solving the critical chain sequence time, it proposed the approach to determine the completion probability of the total construction duration and control the construction of the critical chain to direct the construction, in the meantime, the inverse algorithm was adopted to determine of the construction duration under the condition of required completion probability.