bluuebunny/crossref_metadata_2025 huggingface dataset:
Full-duplex Reflective Beamsteering Metasurface Featuring Magnetless Nonreciprocal Amplification
Authors: Taravati Sajjad , Eleftheriades George
Published: January 2021

Nonreciprocal radiation refers to electromagnetic wave radiation in which a structure provides different response under the change of the direction of the incident field. Modern wireless telecommunication systems demand versatile apparatuses which are capable of full-duplex nonreciprocal wave processing and amplification, especially in the reflective state. Here, we propose full-duplex reflective beamsteering metasurfaces for magnetless nonreciprocal wave amplification. To realize such a unique, extraordinary and versatile functionality, we propose a completely new architecture in which a chain of series cascaded radiating patches are integrated with nonreciprocal phase shifters, providing an efficient mechanism for wave reception, signal amplification, nonmagnetic nonreciprocal phase shifting and steerable wave reflection. Having accomplished all these functionalities in the reflective state, the metasurface represents a conspicuous apparatus for efficient, controllable and programmable wave engineering for wireless telecommunications. Such an ultrathin reflective metasurface can provide directive and diverse radiation beams, and steerable beams by simply changing the bias of the gradient active nonmagnetic nonreciprocal phase shifters. The proposed structure provides large wave amplification and is immune to undesired time harmonics, yielding a highly efficient full-duplex reflective beamsteering apparatus.
Longitudinal Trajectories of Pneumonia Lesions and Lymphocyte counts Associated with Disease Severity among Convalescent COVID-19 Patients: A Group-based Multi-trajectory Analysis
Authors: shi nannan , huang chao , zhang qi , shi chunzi , liu fengjun , song fengxiang , hou qinguo , shen jie , shan fei , su xiaoming , liu jia , zhang zhiyong , shi lei , shi yuxin
Published: January 2021

BackgroundTo explore the long-term trajectories considering pneumonia volumes and lymphocyte counts with individual data in COVID-19. MethodsA cohort of 257 convalescent COVID-19 patients (131 male and 126 females) were included. Group-based multi-trajectory modelling was applied to identify different trajectories in terms of pneumonia lesion percentage and lymphocyte counts covering the time from onset to post-discharge follow-ups. We studied the basic characteristics and disease severity associated with the trajectories.ResultsWe characterised four distinct trajectory subgroups. (1) Group 1 (13.9%), pneumonia increased until a peak lesion percentage of 1.9% (IQR 0.7~4.4) before absorption. The slightly decreased lymphocyte rapidly recovered to the top half of the normal range. (2) Group 2 (44.7%), the peak lesion percentage was 7.2% (IQR 3.2~12.7). The abnormal lymphocyte count restored to normal soon. (3) Group 3 (26.0%), the peak lesion percentage reached 14.2% (IQR 8.5~19.8). The lymphocytes continuously dropped to 0.75 × 109/L after one day post-onset before slowly recovering. (4) Group 4 (15.4%), the peak lesion percentage reached 41.4% (IQR 34.8~47.9), much higher than other groups. Lymphopenia was aggravated until the lymphocytes declined to 0.80 × 109/L on the fourth day and slowly recovered later. Patients in the higher order groups were older and more likely to have hypertension and diabetes (all P values < 0.05), and have more severe disease.ConclusionsOur findings provide new insights to understand the heterogeneous natural courses of COVID-19 patients and the associations of distinct trajectories with disease severity, which is essential to improve the early risk assessment, patient monitoring, and follow-up schedule.
Low Bone Mineral Density Following Gastric Bypass Is Not Explained by Lifestyle and Lack of Exercise
Authors: Hultin Hella , Stevens Katharina , Sundbom Magnus , Hellman Per
Published: January 2021

Background: Bariatric surgery, Roux-en-Y gastric bypass (RYGBP) in particular, is associated with weight loss as well as low bone mineral density. Bone mineral density relies upon multiple factors, some of which are lifestyle factors. The aim of this study was to compare lifestyle factors in order to eliminate them as culprits of the suspected difference in BMD in RYGBP operated and controls. Materials and Methods: Study participants included 71 RYGBP-operated women (42.3 yrs, BMI 33.1) and 94 controls (32.4 years, BMI 23.9). Each completed a DEXA scan, as well as survey of lifestyle factors (e.g. physical activity in daily life, corticosteroid use, and calcium intake). All study participants were premenopausal Caucasian women living in the same area. Blood samples were taken in RYGBP-patients.Results: BMD was significantly lower in RYGBP, femoral neck 0.98 vs. 1.04 g/cm2 compared to controls, despite higher BMI (present and at 20 years of age) and similar physical activity and calcium intake. In a multivariate analysis, increased time since surgery and age were negatively associated with BMD of the femoral neck and total hip in RYGBP patients. Conclusion: Despite similar lifestyle, RYGBP was followed by a lower BMD compared to controls. Thus, the reduced BMD in RYGBP cannot be explained, seemingly nor prevented, by lifestyle factors. As the reduction in BMD was associated with time since surgery, strict follow-up is a lifelong necessity after bariatric surgery, and especially important in younger bariatric patients.
Novel Application of Automated Machine Learning With Maldi-Tof-Ms For Rapid High-Throughput Screening of Covid-19: A Proof Of Concept
Authors: Tran Nam , Howard Taylor , Walsh Ryan , Pepper John , Loegering Julia , Phinney Brett , Salemi Michelle , Rashidi Hooman
Published: January 2021

The 2019 novel coronavirus infectious disease (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has created an unsustainable need for molecular diagnostic testing. Molecular approaches such as reverse transcription (RT) polymerase chain reaction (PCR) offers highly sensitive and specific means to detect SARS-CoV-2 RNA, however, despite it being the accepted “gold standard”, molecular platforms often require a tradeoff between speed versus throughput. Matrix assisted laser desorption ionization (MALDI) – time of flight (TOF) – mass spectrometry (MS) has been proposed as a potential solution for COVID-19 testing and finding a balance between analytical performance, speed, and throughput, without relying on impacted supply chains. Combined with machine learning (ML), this MALDI-TOF-MS approach could overcome logistical barriers encountered by current testing paradigms. We evaluated the analytical performance of an ML-enhanced MALDI-TOF-MS method for screening COVID-19. Residual nasal swab samples from adult volunteers were used for testing and compared against RT-PCR. Two optimized ML models were identified, exhibiting accuracy of 98.3%, positive percent agreement (PPA) of 100%, negative percent agreement (NPA) of 96%, and accuracy of 96.6%, PPA of 98.5%, and NPA of 94% respectively. Machine learning enhanced MALDI-TOF-MS for COVID-19 testing exhibited performance comparable to existing commercial SARS-CoV-2 tests.
Efficacy of Doxycycline in treating COVID-19 Positive Patients: A Case Series
Authors: Meybody Zohreh Akhoundi , Owlia Mohammad Bagher , Owlia Sina , Mousavinasab Seyed Rohollah
Published: January 2021

Background: Given the high morbidity and mortality caused by Coronavirus Disease 2019 (COVID-19), scientific research is necessary to achieve a proper treatment regimen. Since doxycycline is effective in reducing inflammatory factors, including IL-6 and TNF-alpha that play an important role in initiating cytokine storms and probably causing death in patients with COVID-19, its use is associated with low side effects and can be used orally, the present study was attempted to evaluate the efficacy of doxycycline in the treatment of inpatients and outpatients with COVID-19.Methods: This descriptive and prospective study was performed on inpatients and outpatients were diagnosed with COVID-19 based on polymerase chain reaction (PCR) test from nasopharyngeal secretions or computerized tomography scan (CT Scan). Patients who met the inclusion criteria received doxycycline at a dose of 100 mg every 12 hours for 7 days and then were evaluated on the baseline day and on days 3, 7, and 14 after admission for cough, Shortness of breath, temperature and oxygen saturation.Results: Out of 21 patients, 11 patients were male and 10 patients were female. Cough, SOB, temperature, and O2 sat improved in both of outpatients and inpatients compared to baseline. In general, the results showed that doxycycline was more effective in improving cough, SOB, temperature, and O2 sat in outpatients than inpatients.Conclusion: It can be concluded that doxycycline with the dose and duration prescribed in our study could play an effective role in the treatment of patients with COVID-19.
Adipose Tissue Transplant Impregnated with Collagen Increases Engraftment by Promoting Cell Proliferation, Neovascularization, and Macrophage Activity in a Rat
Authors: Suzuki Chika , Komiya Takako , Inoue Hana , Yoshimoto Takayuki , Matsumura Hajime
Published: January 2021

Objectives: To clarify the effect of impregnating transplanted adipose tissue with collagen on angiogenesis, cell proliferation, and tissue remodeling process and to reveal whether collagen impregnation contributes to improving the engraftment of transplanted adipose tissue in rats.Methods: Adipose tissue was harvested from the inguinal and injected into the back of the rat, in addition to collagen. Engraftment tissue was harvested, semi-quantitatively evaluated and underwent HE or Perilipin staining. Moreover, we evaluated viable adipocyte counts and neovascularization. Macrophages were evaluated using flow cytometry, and the adiponectin or VEGF mRNA was detected using real-time PCR. Results: By impregnating transplanted adipose tissue with collagen, higher engraftment rate semi-quantitatively and a greater number of new blood vessels histologically were identified. Perilipin staining revealed a higher adipocyte number. The total cell, M1 macrophage, and M2 macrophage count were higher. There was increased adiponectin mRNA significantly at week 4 compared to that at week 1 after transplantation. Note that the expression levels of VEGF mRNA increased.Discussion: In rats, collagen impregnation enhanced cell proliferation, induced M2 macrophages, which are involved in wound healing, and promoted adipocytes and neovascularization. Therefore, impregnating transplanted adipose tissue with collagen could increase the engraftment rate of adipose tissue.
Protective Effect of Alamandine on Doxorubicin‑Induced Nephrotoxicity in Rats
Authors: Hekmat Ava Soltani , Chenari Ameneh , Alipanah Hiva , Javanmardi Kazem
Published: January 2021

Background: The objective of this study was to evaluate the protective effects of alamandine, a new member of the angiotensin family, against doxorubicin (DOX)-induced nephrotoxicity in rats.Methods: Rats, intraperitoneally injected with DOX (3.750 mg/kg/week) to reach total cumulative dose of 15 mg/kg on day 35. Alamandine (50µg/kg/day) was administered to the rats via mini-osmotic pumps for 42 days. At the end of experiment, rats were placed in the metabolic cages for 24 h for measurement of water intake and urine output. After scarification, Serum and kidney tissues were collected, and biochemical, histopathological and immunohistochemical studies were carried out.Results: Inflammatory cytokines (IL-1β, IL-6), pro-fibrotic mediator (TGF-β), pro-inflammatory transcription factor (NF-kB), renal MDA, creatinine clearance, BUN, and water intake were increased by DOX administration. On the other hand, renal SOD, renal GPx activity and urinary output were decreased in the DOX-treated group. Alamandine co-therapy decreased these effects, as confirmed by histopathology and immunohistochemical analysisConclusion: The results of this study suggest that alamandine has the potential in preventing the nephrotoxicity induced by DXR in rats.
Terlipressin for Hepatorenal Syndrome-Acute Kidney Injury in Acute-On-Chronic Liver Failure: A Single-Center Retrospective Cohort Study
Authors: liu songtao , Meng Qinghua , Hu Zhongjie , Lu Jun , Liu Mei , Wang Meiping , Xu Yuan , Zhou Jianxin
Published: January 2021

Objectives: Patients with hepatorenal syndrome-acute kidney injury (HRS-AKI) based on acute-on-chronic liver failure (ACLF) have a high rate of mortality. Terlipressin combined with albumin is the first line therapy for HRS-AKI in cirrhosis, however, whether it is more effective than albumin alone in ACLF is unclear. We aimed to analyze therapeutic effects of terlipressin in these patients. Methods: A retrospective study was conducted on patients with HRS-AKI based on ACLF at Beijing You’an Hospital between October 2010 and October 2019. The primary endpoint was a reversal rate of HRS-AKI, which was defined as serum creatinine (sCr) reduced to within 0.3 mg/dL of baseline. The secondary endpoints included a reversal rate of HRS in patients with sCr<1.5mg/dL and 28-day survival. Results: 221 of 755 patients meet inclusion criteria. 113 cases were treated with terlipressin plus albumin (TA group), whereas 108 cases with albumin alone (AA group). The reversal rate of HRS-AKI in TA group was higher compared to in AA group (35.39% vs 23.15%, P = 0.046). Additionally, reversal time in TA group was 8.18 ± 4.39 days, compared to 11.29 ± 3.67 days in AA group ( P = 0.005). In patients with sCr < 1.5mg/dL, reversal rate of HRS-AKI in TA group was 41.46% (17/47) compared to 19.61% (10/51) in AA group (P = 0.067). Furthermore, reversal time in TA group was 8.12±5.75 days, compared to 9.40±2.67 days in AA group (P=0.117). Notably, 28-day overall survival and transplantation-free survival in TA group was better than AA group (P < 0.001).Conclusions: Terlipressin combined albumin was effective for HRS-AKI in ACLF. Combination therapy tends to be more beneficial for patients with sCr level <1.5 mg/dL.
Hunting for Influential Nodes in Complex Networks Using Local Information
Authors: Dong Zhihao , Chen Yuanzhu , Tricco Terrence S. , Li Cheng , Hu Ting
Published: January 2021

Complex networks in the real world are often with heterogeneous degree distributions. The structure and function of nodes can vary significantly, with influential nodes playing a crucial role in information spread and other spreading phenomena. Identifying high-degree nodes enables change to the network’s structure and function. Previous work either redefines metrics used to measure the nodes’ importance or focus on developing algorithms to efficiently find influential nodes. These approaches typically rely on global knowledge of the network and assume that the structure of the network does not change over time, both of which are difficult to achieve in the real world. In this paper, we propose a decentralized strategy that can find influential nodes without global knowledge of the network. Our Joint Nomination (JN) strategy selects a random set of nodes along with a set of nodes connected to those nodes, and together they nominate the influential node set. Experiments are conducted on 12 network datasets, including both synthetic and real-world networks, both undirected and directed networks. Results show that average degree of the identified node set is about 3–8 times higher than that of the full node set, and the degree distribution skews toward higher-degree nodes. Removal of influential nodes increase the average shortest path length by 20–70% over the original network, or about 8–15% longer than the other decentralized strategies. Immunization based on JN is more efficient than other strategies, consuming around 12–40% less immunization resources to raise the epidemic threshold to 𝜏 ~ 0:1. Susceptible-Infected-Recovered (SIR) simulations on networks with 30% influential nodes removed using JN delays the arrival time of infection peak significantly and reduce the total infection scale to 15%.
Secondhand Smoke Exposure, Diabetes, Elevated Glucose Level Are Risk Factors for Uterine Cervical Cancer: A Cross-Sectional Study From the Korea National Health and Nutrition Examination Survey (2010-2018)
Authors: Kim Ji Young , Lee Dae Woo , Kim Min Jeong , Shin Jae Eun , Shin Yeun Joo , Lee Hae Nam
Published: January 2021

Background: Human papilloma virus infection and tobacco smoking are the major risk factors for cervical cancer. There are limited studies searching other risk factors for cervical cancer and the results are not consistent. This study investigated the relations between cervical cancer and possible risk factors, including secondhand cigarette smoke exposure, diabetes, work schedule. Methods: In this cross-sectional study, 29,557 women completed a cervical cancer questionnaire and were selected using 2010–2018 data from the Korea National Health and Nutrition Examination Survey. Details in secondhand smoke exposure, diabetes, work schedule were assessed from participants’ health interviews and blood test results were used for fasting glucose level and hemoglobin A1c (HbA1c) level.Results: Two hundred sixty-two women (0.89%) in the sample were diagnosed with cervical cancer. Domestic secondhand smoke exposure, diabetes, high fasting glucose level, and high HbA1c significantly increased cervical cancer risk. The respective odd ratios and 95% confidence intervals were: 1.488 (1.002–2.207), 2.369 (1.713–3.274), 1.008 (1.005–1.009), and 1.304 (1.193–1.425). Weekly work hours and work schedule were not significantly related to cervical cancer incidence.Conclusion: Among Korean women, passive exposure to cigarette smoke at home, diabetes, elevated fasting glucose level, and high HbA1c level all increase risk for cervical cancer.
Material Resources and Body Fatness in an East German Adult Population: Insights From the LIFE-adult-study 
Authors: Enzenbach Cornelia , Kowall Bernd
Published: January 2021

Background. Obesity has been postulated to be a consequence of economic disadvantage. However, epidemiological studies failed to demonstrate a consistent link between income and body fatness. We examined income as a possible cause of obesity in an East German general population, focusing on appropriate representation of study variables, as well as on confounding and modification of the income-obesity association.Methods. We used data of 9,599 participants in the baseline examination of the LIFE-Adult-Study, conducted in the city of Leipzig from 2011 to 2014. Body mass index (BMI) and waist circumference (WC) as obesity measures were based on standardised measurements, net equivalised income (NEI) on self-reports. We estimated adjusted means of BMI and WC within NEI categories representing the range from risk of poverty to affluence. We stratified the analyses by gender, age, and education. Results. A substantial part of the age-adjusted associations of income with obesity measures was attributable to other SES indicators. Adjusted for these variables, NEI was comparably associated with BMI and WC. Among women, BMI and WC decreased across NEI categories. The inverse associations tended to be stronger at non-working age (≥ 65 years) than at working age (< 65 years). Conversely, among working-age men, BMI and WC increased with increasing NEI. Among older men, risk of poverty was related to higher values of the obesity measures. The aforementioned associations were predominantly stronger in highly educated participants compared to those with medium/low education. The differences in mean BMI and WC between persons at risk of poverty and higher income groups were rather small, ranging from 1 to 2 kg/m2 for BMI and 2 to 4 cm for WC. Conclusions. Our investigation indicates an association between material resources and body fatness in an East German adult population that depends on the sociodemographic context of the people. However, it does not suggest that income disparities are a major driver of body fat accumulation in this population. Differential selection of study participants, error in the measurement of long-term income, and possibly reverse causality may have affected our conclusions.
Correlation of Background Parenchymal Enhancement on Breast Magnetic Resonance Imaging with Quantitative Mammographic Parameters Derived using fully Automated Volumetric Software
Authors: Lim Gayeong , Bae Kyoungkyg , Lim Soyeoun , Park Gyoungmin , Bang Minseo
Published: January 2021

Background: Background parenchymal enhancement (BPE) and mammographic breast density are risk factors for breast cancer. However, existing evidence regarding the association between these risk factors is inconclusive. This study aimed to evaluate the relationship between BPE and quantitative and subdivided mammographic density parameters, such as fibroglandular tissue (FGT) volume, entire breast volume, and volumetric density (%), measured using a fully automated volumetric software.Methods: From July 2017 to August 2018, patients with newly diagnosed breast cancer who had undergone preoperative mammography and magnetic resonance imaging (MRI) at our hospital were identified. Mammographic density analysis was performed using a fully automated volumetric software. Two breast radiologists consensually rated BPE and the amount of FGT in each contralateral normal breast MRI based on four categories of the Breast Imaging-Reporting and Data System. The Pearson correlation coefficient was used to analyze the relationship between mammographic density and the FGT and BPE observed on breast MRI.Results: A total of 364 women were included, of whom 153 (42%) were premenopausal (mean age, 44.22±6.29 years) and 211 (58%) were postmenopausal (mean age, 57.91±9.59 years).The premenopause group had significantly higher levels of BPE and FGT on MRI and FGT volume and volumetric density (%) on mammography. FGT and BPE observed on breast MRI were correlated in the overall sample and postmenopause group(r=0.352and 0.265, respectively). The FGT volume on mammography was significantly correlated with BPE in the overall sample and in the pre- and postmenopause groups (r=0.290, 0.166, and 0.294, respectively). Volumetric density (%) on mammography and BPE were correlated in the total sample and postmenopause group(r=0.369 and 0.281, respectively). Conclusion: Mammographic breast density and BPE on MRI are significantly correlated in patients with breast cancer. The mammographic FGT volume is particularly correlated with BPE on MRI, regardless of the patient’s menopausal state.
Pre-operative ankle–brachial index for cardiovascular risk assessment in simultaneous pancreas–kidney transplant recipients: a simple and elegant strategy!
Authors: Hau Hans-Michael , Jahn Nora , Brunotte Maximilian , Wagner Tristan , Rademacher Sebastian , Branzan Daniela , Sucher Elisabeth , Seehofer Daniel , Sucher Robert
Published: January 2021

Background: Patients with insulin-dependent diabetes mellitus type 1 (IDDM1) and end-stage kidney disease (ESKD) undergoing simultaneous pancreas kidney transplantation (SPKT) are a population with diffuse atherosclerosis and elevated risk of cardio- and cerebrovascular morbidity and mortality. We aimed to investigate the feasibility of preoperative screening for peripheral arterial disease (PAD), specifically ankle-brachial index (ABI) testing, to predict peri- and postoperative outcomes in SPKT recipients. Methods: Medical data (2000–2016) from all patients with IDDM and ESKD undergoing SPKT at our transplant center were retrospectively analyzed. The correlation between PAD (defined by an abnormal ABI before SPKT and graft failure and mortality rates as primary end points, and the occurrence of acute myocardial infarction, cerebrovascular and peripheral vascular complications as secondary end points were investigated after adjustment for known cardiovascular risk factors.Results: Among 101 SPKT recipients in our transplant population who underwent structured physiological arterial studies, 17 patients (17%) were diagnosed with PAD before transplantation. PAD, as defined by a low ABI index, was an independent and significant predictor of death (HR, 2.99 (95% CI, 1.00-8.87), p = 0.049) and pancreas graft failure (HR, 4.3 (95% CI 1.24-14.91), p = 0.022). No significant differences were observed for kidney graft failure (HR 1.85 (95% CI 0.76-4.50), p = 0.178). In terms of the secondary outcomes, patients with PAD were more likely to have myocardial infarction, stroke, limb ischemia, gangrene or amputation (HR, 2.90 (95% CI, 1.19-7.04), p = 0.019).Conclusions: Pre-transplant screening for PAD and cardiovascular risk factors with non-invasive ABI testing may help to reduce perioperative complications in high-risk patients. Future research on long-term outcomes might provide more in depth insights in optimal treatment strategies for PAD among SPKT recipients.
Frailty-independent Undertreatment Negative Impact on Survival in Older Patients With Breast Cancer
Authors: Osório Fernando , Barros António , Peleteiro Bárbara , Barradas Ana Rita , Urbano Joana , Fougo José Luis , Leite-Moreira Adelino
Published: January 2021

Introduction: The management of older patients with breast cancer remains controversial. The difficult assessment of ageing idiosyncrasies and the insufficient evidence of therapeutic guidelines can lead to undertreatment. Our goal was to measure undertreatment and assess its impact on survival.Materials and methods: Consecutive patients with breast cancer aged 70 years or older were prospectively enrolled in 2014. Three frailty screening tools (G8, fTRST, GFI) and two functional status scales (KPS, ECOG-PS) were applied. Disease characteristics, treatment options and causes of mortality were recorded in a 5-year follow-up. We defined undertreatment and correlated its survival impact with frailty. Results: A total of 92 patients were included. Median age was 77 (range 70-94) years. The prevalence of frailty was discordant (G8: 41,9%, fTRST: 74.2%, GFI: 32.3%). A low-risk disease was not found (51.2% were N+) probably due to a late diagnosis (76.1% based on self-examination). Thirty-three patients (35.6%) died 15 of them from breast cancer. We found a considerable high proportion (53.3%) of undertreatment, which had a frailty-independent negative impact on 5-year survival (HR=5.1 [95% CI: 2.1-12.5]). Additionally, omission of surgery had a frailty-independent negative impact on overall survival (HR=3.9 [95% CI: 1.9-7.9]). Conclusion: Breast cancer treatment in older adults ought to be individualized. More important than assessing frailty (not to treat) is essential to be aware of the risk-benefit profile and the patient's well-informed willingness to be treated. The undertreatment in daily practice is frequent and might have, as we report, a negative impact on survival.
A 40 Month Double-Blind, Randomized, Placebo-Controlled Trial on the Effect of BCc1 Nanomedicine on Survival of Metastatic and Non-Metastatic Gastric Cancer Patients
Authors: Hafizi Maryam , Kalanaky Somayeh , Moaiery Hassan , Noorian Sajad , Khayamzadeh Maryam , Kaveh Vahid , Gharib Behrooz , Fudazi Hossein , Razavi Mohsen , Jenabian Arash , Salimi Saeid , Sereshki Mohammad Mahdi Adib , Fakharzadeh Saideh , Mirzaee Hamid Reza , Akbari Mohammad Esmaeil , Nazaran Mohammad Hassan
Published: January 2021

Background: Complementary experiments on nanomedicines as proper candidates for the control and treatment of cancer are widely being conducted nowadays. In the previous study, the effect of BCc1 nanomedicine, which is synthetized based on nanochelating technology, on overall survival (OS) and quality of life of gastric cancer patients was evaluated after 18 months of consumption. The OS of the same patients is reported in this study after 40 months. Methods: A double-blind, randomized, placebo-controlled, parallel, multicenter design was used in this study. 123 metastatic and non-metastatic gastric cancer patients of both genders (between 25 and 85 years old) participated in this experiment to evaluate their OS after consuming BCc1 for 40 months and to identify the adverse events of this nanomedicine. Results: The median OS of metastatic patients was 257 days in the BCc1 group [95% confidence interval (CI): 144. 142-369.858], while it was 161 days in the placebo [95% CI: 118.462-203.538]; hazard ratio (HR): 0.802 [95% CI: 0.483-1.333] (P-Value = 0.395). Similarly, the median OS of non-metastatic patients was 718 days in the BCc1 group [95% CI; 577.706-860.213], while it was 520 days in the placebo [95% CI: 460.280- 580.690]; HR: 0.807 [95% CI: 0.343,1.902] (P-Value = 0.624). There was no evidence of adverse events after 40 months.Conclusion: The OS improvement of metastatic and non-metastatic gastric cancer patients in the previous (18 months of follow-up) and current (40 months of follow-up) studies showed that BCc1 can be used along with base treatments to improve cancer patients’ OS. Trial registration: IRCTID, IRCT2017101935423N1.Registered on 19 October 2017, http://www.irct.ir/ IRCT2017101935423N1.
The TLR-2/TonEBP Signaling Pathway Regulates 29-kDa Fibronectin Fragment-dependent Expression of Matrix Metalloproteinases
Authors: Hwang Hyun Sook , Lee Mi Hyun , Kim Hyun Ah
Published: January 2021

Tonicity-responsive enhancer-binding protein (TonEBP; nuclear factor of activated T cells 5) is a transcription factor that responds to changes in osmolality. However, recent studies have shown that it also modulates immune responses under inflammatory conditions independently of hyperosmolality. Fibronectin fragments (FN-fs), which are abundant in the synovial fluid of patients with osteoarthritis (OA), induce expression of matrix metalloproteinases (MMPs) via the toll-like receptor-2 (TLR-2) signaling pathway. In this study we examined whether TonEBP is involved in 29-kDa FN-f-induced expression of MMPs. The expression of TonEBP was significantly higher in human osteoarthritis compared with normal cartilage samples. 29-kDa FN-f affected the expression of MMPs 1, 3, and 13 via TonEBP, and expression and nuclear accumulation of TonEBP were induced by activation of the phospholipase C/NF-κB/MAPK signaling pathway and, in particular, modulated by TLR-2. In addition, 29-kDa FN-f induced the expression of osmoregulatory genes, including Tau-T, SMIT, and AR, as well as voltage-dependent calcium channels via the TonEBP/TLR-2 signaling pathway. These results show that 29-kDa FN-f upregulates MMPs in chondrocytes via the TLR-2/TonEBP signaling pathway.
Development of a physically-informed neural network interatomic potential for tantalum
Authors: Lin Yi-Shen , Pun G. Purja , Mishin Yuri
Published: January 2021

Large-scale atomistic simulations of materials heavily rely on interatomic potentials, which predict the system energy and atomic forces. One of the recent developments in the field is constructing interatomic potentials by machine-learning (ML) methods. ML potentials predict the energy and forces by numerical interpolation using a large reference database generated by quantum-mechanical calculations. While high accuracy of interpolation can be achieved, extrapolation to unknown atomic environments is unpredictable. The recently proposed physically-informed neural network (PINN) model significantly improves the transferability by combining a neural network regression with a physics-based bond-order interatomic potential. Here, we demonstrate that general-purpose PINN potentials can be developed for body-centered cubic (BCC) metals. The proposed PINN potential for tantalum reproduces the reference energies within 2.8 meV/atom. It accurately predicts a broad spectrum of physical properties of Ta, including (but not limited to) lattice dynamics, thermal expansion, energies of point and extended defects, the dislocation core structure and the Peierls barrier, the melting temperature, the structure of liquid Ta, and the liquid surface tension. The potential enables large-scale simulations of physical and mechanical behavior of Ta with nearly first-principles accuracy while being orders of magnitude faster. This approach can be readily extended to other BCC metals.
Ascertaining Cause of non-Facility Deaths and Associated Demographic Characteristics: An Application of Verbal Autopsy in Routine Civil Registration in Lusaka District of Zambia
Authors: Mapoma Chabila , Munkombwe Brian , Mwango Chomba , Bwalya Bwalya , Kalindi Audrey , Gona Phil
Published: January 2021

BACKGROUND: Ascertaining the cause for deaths occurring outside health facilities is a significant problem in many developing countries where civil registration systems are poor or non-functional. Standardized and rigorous verbal autopsy methods is a potential solution determine the cause of death. We conducted a demonstration project in Lusaka District of Zambia where verbal autopsy (VA) method was implemented in routine civil registration system. METHODS: About 3400 VA interviews were conducted for the “brought-in-dead” cases at Lusaka’s two major hospital mortuaries using a SmartVA questionnaire between October 2017 and September 2018. Probable underlying causes of deaths using VA and cause-specific mortality fractions were determined for each cause. Demographic characteristics associated with each cause were analyzed. RESULTS: Opportunistic infections associated with HIV/AIDS such as pneumonia, tuberculosis and malaria were among leading causes of deaths among cases of “brought-in-dead”. Over 21% and 27% of deaths were attributable to external causes and non-communicable diseases, respectively. The VA-ascertained causes of death varied by age-group and sex. External causes were more prevalent among males in middle ages (put an age range like 30-54 years old) and NCDs highly prevalent among those aged 55 years and older CONCLUSIONS: VA application in civil registration system can provide the much needed cause of death information for non-facility deaths in countries with poor civil registration system.
Shock Index in Obstetric Hemorrhage as an Applicable Method to Anticipate Adverse Outcome
Authors: Saleh Hend , Sherif Hala E , Elsayad Ahmed H , Mahfouz Eman M. , Abdou Ahmed Mahmoud , Mahdy Entesar , Radwan mohamed
Published: January 2021

BackgroundTo establish the ability of shock index and the different vital signs to predict the adverse maternal outcomes in the cases of obstetric hemorrhage . MethodsThis prospective - retrospective study comprised patients with primary PPH or hemorrhage due to obstetric cause who were referred to zagazig University hospital Egypt , from January 2018, to December 2019 . Data of vital signs of them ; systolic and diastolic blood pressure, pulse rate, pulse pressure, mean arterial pressure and shock index (heart rate divided by systolic blood pressure) at time of arrival were investigated . Adverse outcome like ,death , admission to the intensive care unit , massive transfusion and invasive procedures were revised and analyzed. AUROC (area under the receiver operating characteristic curve ) was used for shock index in comparison to each vital sign for predicting the adverse maternal outcomes. Sensitivity, specificity, and negative and positive predictive values were assessed to detect the best predictor. ResultsThe mean age of participants years (SD)was 29.2 ( ±7.3). of admission and 44% had altered. The most Common cause of hemorrhage was Iatrogenic ; either misuse of uterotonic or traumatic 30.2% The mean value of HR 108.1±26.6 , SBP 101± 28.7 mmHg , DBP 58.9±21.3 mmHg , SI 1.153±0.541 and mean blood loss 1922 (0.862) .For death, SI and SBP had the highest AUC value at 0.88 ( 0.81–0.95)with P=0.213 .). For ICU blood transfusion ≥ 5iu , admission and invasive surgical interventions, SI had the uppermost AUROC value at 0.76, 0.78 and 0.61. Sensitivity for all adverse outcomes of SI ≥ 0.7,is h from 99 to 90.0 . For death prediction SI≥ 0.7 had very low specificity ;0.6{0.2-1.3}and of SI ≥ 0.9 ;6.4{2.8-7.1}ConclusionShock index is a strapping applicable predictor of adverse outcomes. for patients who suffering from hypovolemic shock due to obstetric hemorrhage,
Assessment of Left Atrial Function in Essential Hypertension Patients With Normal Left Ventricle Function by Volume-derived Values and Two-dimensional Strain
Authors: Huang Jun , Yang Chao , Yan Zi-ning , Fan Li , Ni Cai-Fang
Published: January 2021

Background: To investigate left atrial(LA) function in essential hypertension(EHT) patients by using volume-derived values, two-dimensional strain. Methods: 51 normal subjects and 95 EHT patients(without LVH: 50, and with LVH: 45) were enrolled for this research. LA Volume-derived index was measured in apical 4-, 2-chamber views by Simpson′s method. LA strain(S-reservoir, S-conduit, S-booster pump) and strain rate (SR-reservoir, SR-conduit, SR-booster pump), representing the reservoir, conduit and booster pump functions, respectively, were measured by two-dimensional speckle tracking echocardiography(STE).Results: Volume-derived values(contain Total LAEF, passive LAEF and active LAEF) and strain-derived values(S-reservoir, S-conduit, Sr-reservoir, Sr-conduit and Sr-booster pump) in EHT patients were significantly lower than normal subjects. Correlation test showed LA stiffness had a strong correlation with LA conduit function in EHT patients. The AUC values were higher for detection LA conduit function than LA reservoir and booster pump function in EHT patients. LA expansion index and LA stiffness also have the higher AUC with higher sensitivity and specificity values for detection the LA dysfunctions in EHT patients. Conclusions: In this study, we concluded that LA functions were damaged in EHT patients, which could be detect by LA volume-derived values and two-dimensional strain sensitively and reproductively. LA stiffness maybe a predictor for LV remodelling in EHT patients.
Late-onset Pompe disease (LOPD): may axial myopathy influence respiratory dysfunction?
Authors: carlucci annalisa , Barbarito nicola , malovini alberto , ceriana piero , cirio serena , piran manuela , pichiecchio anna , filippi paola de , danesino cesare , ravaglia sabrina
Published: January 2021

Background

Respiratory dysfunction in Late Onset Pompe Disease (LOPD) is attributed primarily to diaphragm weakness; it is not always proportional to skeletal muscle weakness. Beyond diaphragm and rib cage muscles, we know that posterior trunk muscles participate to inspiration, and abdominal wall muscles contribute to forced expiration. We aimed to investigate whether the involvement of axial muscles detected by muscle MRI may correlate with respiratory dysfunction or influence respiratory functional tests.
Methods

In 19 patients with LOPD in different stages of disease, we analyzed trunk muscle MRI and upright forced vital capacity FVC, postural drop in VC, and maximal inspiratory and expiratory pressures (MIP, MEP).
Results

While upright FVC did not correlate with trunk muscle involvement, postural drop in VC, reflecting diaphragm weakness, was strongly influenced by the severity of involvement of all posterior and anterior muscles.
Conclusion

Trunk muscles involvement in LOPD may reveal respiratory dysfunction and contribute to postural drop in VC. It is likely that axial muscle weakness may impair the compensatory mechanisms occurring in clinostatism, and mainly operated by the abdominal muscles. Detection of axial muscle damage by MRI may thus suggest the need of more extensive respiratory assessment, i.e. by polysomnography, even when upright VC is still within normal ranges.
Structural Equation Modelling of Perception for Sustainable Agriculture as Climate Change Mitigation Strategy in Ghana
Authors: Ankamah Jacob , Kodua Theophilus Tweneboah , Addae Mary
Published: January 2021

Background
Ghana’s agriculture sector has contributed significantly to the country’s Gross Domestic Product (GDP) over the past decades even though there has been persistent decline of about 12.8% in the last seven years. It decreased from 31.8% in 2009 to merely 19% as of September 2015, a period of seven years. In spite of these trends, sustainable agriculture has been observed to be a game changer in agricultural development and growth globally. Sustainable agriculture is partly dependent on the attitude of the present agriculture students who represent the potential officers to impart sustainable agriculture knowledge to farmers. It is therefore relevant to assess the perception of students toward the concept of sustainable agriculture on climate change to inform policy decisions and interventions.
Methods
To assess the perception of students’ toward sustainable agriculture, this study sampled 120 final year undergraduate students’ in the School of Agriculture at the College of Basic and Applied Sciences, University of Ghana, Legon. The study used a well-structured questionnaire to solicit students’ perception for sustainable agriculture, its’ adoption barriers and perceived strategies to address the barriers in Ghana.
Results
Findings indicated that students’ perception for sustainable agriculture is positive. Majority of the students (78%) were of the view that sustainable agricultural practices would help protect the environment and our natural resources, therefore could mitigate adverse effects of climate change on agricultural activities.
Conclusions
Students ranked perceived barriers to sustainable agriculture adoption as; economic costs, lack of knowledge and land tenure constraints. Strategic ways to address the barriers were identified as farmer-to-farmer education, provision of financial incentives, developing training and partnership programs, and participatory learning.
Phase-Contrast MRI Indices can Reflect Intracranial Compliance Deterioration Induced by Intra-Abdominal/ Thoracic Hypertension
Authors: Feng Jie , Yu Xiao , Liu Jie , Liu Wenjia , Ma Lin
Published: January 2021

BackgroundIdentifying elevated intracranial pressure (ICP) and decreased intracranial compliance (ICC) is imperative for optimizing patient management in neurocritical care settings. Intra-abdominal hypertension (IAH) and intrathoracic hypertension (ITH) is common in trauma patients, which affects homeostasis of ICP/ICC. Knowledge of this effects is little and monitoring this effect is difficult. In the current study, we examined whether the indices generated from 2D cine phase contrast MRI (2D cine PC-MRI) could reflect ICC/ICP alterations induced by elevated IAH/ITH during VM.MethodsA total of 50 healthy young volunteers participated in this study (male: female = 24:26), and took a 2D cine PC-MRI during normal breath and VM respectively. Cross-section area (CSA) of dominant IJV and ipsilateral ICA, the maximum blood flow (Fmax), minimum blood flow (Fmin), mean blood flow (MBF), pulsatility index (PI), arteriovenous delay (AVD) and time to peak of arterial pulse (TTP) were gauged from images or calculated from the blood flow curves generated from 2D cine PC-MRI. ResultsDuring VM state, in comparison to NB, CSAIJV increased significantly (p<0.0001), indicating an elevation of cerebral venous outflow resistance; Fmax_ICA, Fmax_IJV, Fmean_ICA and Fmean_IJV decreased significantly (p<0.0001, p<0.0001, p<0.001, p<0.0001, respectively); PI_ICA and PI_IJV decreased significantly (p<0.0001, p<0.0001); both absolute and normalized AVD decreased significantly (p<0.0001, p<0.0001), while absolute and normalized TTP increased significantly (p=0.0329, p=0.0376).Conclusions Indices generated from 2D cine PC-MRI, especially AVD and TTP, can reveal the ICC/ICP dynamics induced by elevated IAP/ITP. These indices have potential clinical application in ICC/ICP monitoring in patients who was speculated with an IAH or ITH.
Pancreatic Cancer Patients Who Cannot Undergo Curative Surgery Live As Much As Patients Over 70 Years Old
Authors: Yıldırım Serkan , Erdoğan atike pinar , Yılmaz cengiz , Özveren ahmet , Ekinci ferhat , Bulut gülcan
Published: January 2021

İNTRODUCTİONPatients over the age of 65 (≥65) constitute approximately 54% of newly diagnosed cancers and approximately 70% of cancer-related deaths .These patients aged ≥65 years, who form the majority of clinical practice, are represented less in clinical studies than in real life. We designed this retrospective study to examine the treatment and response of patients to pancreatic cancer in patients over 70 years of age.MATERİAL-METHODOur study is a retrospective study that included patients from 5 centers in Turkey. Inclusion criteria were being over the age of 18 years, diagnosed with pancreatic cancer, and with ECOG performance score between 0-2. These patients were divided into two groups according to their age. The classification was made as patients over 70 years of age in the first group (geriatric group) and patients under 70 years of age (<70 age group) in the second group.RESULTSOverall survival of the <70 age group was found to be statistically significantly longer (median 10 months vs 9.1 months p = 0.027).When the patients who only underwent curative surgery were examined, the survival was statistically significant in favor of the <70 age group (median 20.96 months vs 14.5 months p = 0.011).No statistically significant difference was found between the two groups in terms of the overall survival of patients with metastatic diagnosis (median 8.1 months vs 8.4 months p = 0.182).CONCLUSSİONThe survival of patients with a diagnosis of pancreatic cancer aged 70 and over was shorter than other age groups. While this difference was significant in patients who could undergo surgery at an early stage, it was not found in the metastatic patient group. Prospective larger-scale studies are needed to evaluate the treatment of geriatric patients better.
Application of First-Order Feature Analysis of DWI-ADC in Rare Malignant Mesenchymal Tumours of the Maxillofacial Region
Authors: Yu Baoting , Huang Chencui , Liu Shuo , Liu Tong , Guan Yuyao , Zheng Xuewei , Ding Jun
Published: January 2021

Objective: To research the first-order features of magnetic resonance (MR) diffusion-weighted imaging (DWI)-apparent diffusion coefficient (ADC) in maxillofacial malignant mesenchymal tumours. Methods: Eight patients that the patients' diagnoses were confirmed by pathology, and the clinical and imaging data were determined to be accurate. The patients were all examined by 1.5T MR imaging (MRI). Results: PyRadiomics were used to extract radiomics imaging features. The ADCmean and ADCmedian of sarcoma tissues were 42.2689 and 42.7275, respectively, significantly higher than those in lymphoma tissues (ADCmean (-61.3343) and ADCmedian (-70.2335)). Conclusion: While the statistical difference is not significant, it is consistent with the outcome of the manual measurement of the ADC mean value of the most significant cross-section of five cases of lymphoma. Development of tumour volume based on the ADC parameter map of DWI demonstrates that the first-order ADC radiomics features analysis can provide new imaging markers for the differentiation of maxillofacial sarcoma and lymphoma. Therefore, first-order ADC features of ADCkurt combined ADCskew may improve the diagnosis level.