bluuebunny/crossref_metadata_2025 huggingface dataset:
Treatment of Residual, Recurrent, or Metastatic Intracranial Hemangiopericytomas With Stereotactic Radiotherapy Using CyberKnife
Authors: Huang Lichao , Bai Jingmin , Zhang Yanyang , Cui Zhiqiang , Zhang Zhizhong , Li Jiwei , Wang Jinyuan , Yu Xinguang , Ling Zhipei , Qu Baolin , Pan Longsheng
Published: March 2021

Purpose

Hemangiopericytomas are aggressive tumors known for their recurrence. The purpose of this study was to evaluate the management of residual, recurrent, and metastatic intracranial hemangiopericytomas using CyberKnife (CK) stereotactic radiotherapy (SRT).

Materials and Methods

Data were collected from 15 patients (28 tumors; eight men and seven women; 32–58 years) with residual, recurrent, or metastatic intracranial hemangiopericytomas, who were treated with stereotactic radiotherapy using CyberKnife between January 2014 and August 2019. All patients had previously been treated with surgical resection. Initial tumor volumes ranged from 0.84 to 67.2 cm3, with a mean volume of 13.06 cm3. The mean marginal and maximum radiosurgical doses to the tumors were 21.1 and 28.76 Gy, respectively. The mean follow-up time for tumors was 34.5 months, ranging from 13 to 77 months.

Results

15 patients were alive after treatment; the mean post-diagnosis survival at censoring was 45.6 months (range 13–77 months). The volumes of the 28 tumors in the 15 followed patients were calculated after treatment. Postoperative magnetic resonance imaging revealed a mean tumor volume of 6.72 cm3 and a range of 0–67.2 cm3, with the volumes being significantly lower than pretreatment values. Follow-up imaging studies demonstrated tumor disappearance in seven (25%) of 28 tumors, reduction in 14 (50%), stability in one (3.57%), and recurrence in six (21.4%). Total tumor control was achieved in 22 (78.5%) of 28 tumors. The tumor grade and fraction time were not significantly associated with progression-free survival. Intracranial metastasis occurred in three patients, and extraneural metastasis in one patient.

Conclusions

On the basis of the current results, stereotactic radiotherapy using CyberKnife is an effective and safe option for residual, recurrent, and metastatic intracranial hemangiopericytomas. Long-term close clinical and imaging follow-up is also necessary.
Effect of PRM1201 Combined With Adjuvant Chemotherapy on Preventing Recurrence and Metastasis of Stage III Colon Cancer: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial
Authors: Jia Ru , Liu Ningning , Cai Guoxiang , Zhang Yun , Xiao Haijuan , Zhou Lihong , Ji Qing , Zhao Ling , Zeng Puhua , Liu Huaimin , Huo Jiege , Yue Xiaoqiang , Zhang Yi , Wu Chaojun , Sun Xiaoting , Feng Yuanyuan , Liu Hongjie , Liu Hui , Han Zhifen , Lai Youying , Zhang Yanbo , Han Gang , Gong Hangjun , Wang Yan , Li Qi
Published: March 2021

Background

Chemotherapy is the standard adjuvant treatment for colon cancer. Chinese herbal formula PRM1201 improves the efficacy of chemotherapy when used in combination with Cetuximab or Bevacizumab in patients with metastatic colorectal cancer. This study aims to explore the benefits of treatment with chemotherapy plus PRM1201 in the postoperative adjuvant setting.

Methods

In this parallel-group study, patients who had undergone curative resection for stage III colon cancer were randomly assigned to receive adjuvant chemotherapy (FOLFOX q2w for 6 months, or CapeOx q3w for 6 months) plus PRM1201 (chemo+PRM1201 group) or adjuvant chemotherapy plus placebo (chemo+placebo group). The primary endpoint was disease-free survival (DFS), and the secondary endpoints were quality of life (QOL) and toxicity.

Results

A total of 370 patients were randomly assigned to chemotherapy plus PRM1201 group (n = 184) and chemotherapy plus placebo group (n = 186). Up to October 30, 2019, 96 events of recurrence, metastasis, or death had been reported, of which 38 events were in the group of chemotherapy plus PRM1201 and 58 events in the chemo+placebo group. The 3-year DFS rate was 77.1 and 68.6% in the chemo+PRM1201 and chemo+placebo group, respectively (hazard ratio [HR], 0.63; 95% CI, 0.42 to 0.94). The QOL of patients in the chemo+PRM1201 group were significantly improved in terms of global quality of life, physical functioning, role functioning, emotional functioning, fatigue, and appetite loss. The incidence of grade 3 or 4 treatment-related adverse event (TRAEs) were similar between the two arms.

Conclusions

Chemotherapy in combination with PRM1201 improved the adjuvant treatment of colon cancer. PRM1201 can be recommended as an effective option in clinical practice.

Clinical Trial Registration

Chinese Clinical Trials Registry, identifier ChiCTR-IOR-16007719.
Establishment of a Macrophage Phenotypic Switch Related Prognostic Signature in Patients With Pancreatic Cancer
Authors: Li Mu-xing , Wang Hang-yan , Yuan Chun-hui , Ma Zhao-lai , Jiang Bin , Li Lei , Zhang Li , Xiu Dian-rong
Published: March 2021

Introduction

Macrophage phenotype switch plays a vital role in the progression of malignancies. We aimed to build a prognostic signature by exploring the expression pattern of macrophage phenotypic switch related genes (MRGs) in the Cancer Genome Atlas (TCGA)—pancreatic adenocarcinoma (PAAD), Genotype-Tissue Expression (GTEx)-Pancreas, and Gene Expression Omnibus (GEO) databases.

Methods

We identified the differentially expressed genes between the PAAD and normal tissues. We used single factor Cox proportional risk regression analysis, Least Absolute Shrinkage and Selection Operator (LASSO) analysis, and multivariate Cox proportional hazard regression analysis to establish the prognosis risk score by the MRGs. The relationships between the risk score and immune landscape, “key driver” mutations and clinicopathological factors were also analyzed. Gene-set enrichment analysis (GSEA) analysis was also performed.

Results

We detected 198 differentially expressed MRGs. The risk score was constructed based on 9 genes (KIF23, BIN1, LAPTM4A, ERAP2, ATP8B2, FAM118A, RGS16, ELMO1, RAPGEFL1). The median overall survival time of patients in the low-risk group was significantly longer than that of patients in the high-risk group (P < 0.001). The prognostic value of the risk score was validated in GSE62452 dataset. The prognostic performance of nomogram based on risk score was superior to that of TNM stage. And GSEA analysis also showed that the risk score was closely related with P53 signaling pathway, pancreatic cancer and T cell receptor signaling pathway. qRT-PCR assay showed that the expressions of the 9 MRGs in PDAC cell lines were higher than those in human pancreatic ductal epithelium cell line.

Conclusions

The nine gene risk score could be used as an independent prognostic index for PAAD patients. Further studies validating the prognostic value of the risk score are warranted.
Effect of Weekly Antibiotic Round on Antibiotic Use in the Neonatal Intensive Care Unit as Antibiotic Stewardship Strategy
Authors: Wang Bo , Li Geng , Jin Fei , Weng Jingwen , Peng Yaguang , Dong Shixiao , Liu Jingyuan , Luo Jie , Wu Hailan , Shen Yanhua , Meng Yao , Wang Xiaoling , Hei Mingyan
Published: March 2021

Background: Antibiotics are commonly used in the neonatal intensive care unit (NICU). The objective was to observe the effect of weekly antibiotic round in NICU (WARN) to the antibiotic use in NICU.

Methods: A retrospective observational study was performed. Departmental-level diagnosis categories and the parameters of antibiotic usage in NICU for the period of 2016-2017 (Phase 1) and 2018-2019 (Phase 2) were collected. WARN in NICU was started since January 2018. A time series forecasting was used to predict the quarterly antibiotic use in Phase 2, based on data from Phase 1. The actual antibiotic use of each quarter in Phase 2 was compared with the predicted values.

Results: Totally 9297 neonates were included (4743 in Phase 1, 4488 in Phase 2). The composition of the disease spectrum between Phase 1 and Phase 2 was not different (P > 0.05). In Phase 1 and Phase 2, the overall antibiotic rate was 94.4 and 74.2%, the average accumulative defined daily dose per month was 199.00 ± 55.77 and 66.80 ± 45.64, the median antibiotic use density per month was 10.31 (9.00-13.27) and 2.48 (1.92-4.66), the median accumulative defined daily dose per case per month was 0.10 (0.09-0.13) and 0.03 (0.02-0.47), the number of patients who received any kind of antibiotic per 1000 hospital days per month was 103.45 (99.30-107.48) and 78.66 (74.62-82.77), rate of culture investigation before antibiotics was 64 to 92%, respectively, and all were better than the predicted values (P < 0.01).

Conclusion: The implementation of periodical antibiotic rounds was effective in reducing the antibiotics use in the NICU.
Evaluating Patients' and Neonatologists' Satisfaction With the Use of Telemedicine for Neonatology Prenatal Consultations During the COVID-19 Pandemic
Authors: Lapadula Maria C. , Rolfs Shanna , Szyld Edgardo G. , Hallford Gene , Clark Tracie , McCoy Mike , McKnight Stephanie , Makkar Abhishek
Published: March 2021

Background: During the COVID-19 pandemic, telemedicine plays a critical role in providing safe, effective healthcare services, while reinforcing social distancing and optimizing the use of personal protective equipment. In this context, the Oklahoma Children's Hospital implemented virtual neonatology prenatal visits for pregnant women with a diagnosis of fetal anomalies. While tele-consultations have been broadly used with a high degree of acceptance in rural and remote areas, satisfaction has not been assessed in this particular scenario, where patients and physicians discussing sensitive healthcare information had to rapidly adjust to this new modality.

Objectives: To evaluate patients' and neonatologists' satisfaction with virtual prenatal consultations in the context of the COVID-19 pandemic and to compare satisfaction levels of patients receiving virtual consultation with those receiving in-person consults.

Methods: This cross-sectional study evaluated patients' and neonatologists' satisfaction with virtual consultations. Participants included pregnant women with diagnosis of fetal anomalies who received neonatology prenatal consultations at Oklahoma Children's Hospital, either in-person or through telemedicine, from May to mid-November 2020, and neonatologists providing virtual prenatal consultations in the same period. Virtual visits were delivered via Zoom Pro™. Patients and physicians who agreed to participate rated acceptability completing an anonymous 5-point Likert scale survey. Item frequencies and means for categories of items were computed by group (video-consult patients, in-person patients, physicians) and analyzed, using Welch's t for unequal sample size.

Results: Overall consultation quality was rated good or excellent by 35 (100%) video-consult patients and 12 (100%) in-person patients. Patient group means computed on six 5-point Likert items about patient-physician communication did not differ significantly, video-consult: M = 28.71 (2.22); in-person consult: M = 28.92 (1.78) (p = 0.753263). All eight physicians (100%) agreed or strongly agreed that telemedicine was effective, using a 5-point Likert scale, and their combined consultation quality score computed on 10 survey questions was high: M = 46.4 (3.11).

Conclusion: Despite patient inexperience with tele-consultations, the quick implementation of telemedicine, and the sensitive reason for the visit, patients and physicians were highly satisfied with virtual visits. Telemedicine is a safe, effective alternative for providing neonatology prenatal consultations for pregnant women with diagnosis of fetal anomalies during the pandemic.
Case Report: Neonatal Varicella Acquired From Maternal Zoster
Authors: Lai Jeffrey W. , Ford Timothy , Cherian Sarah , Campbell Anita J. , Blyth Christopher C.
Published: March 2021

The incidence of neonatal varicella has decreased dramatically since the introduction of the varicella vaccination. Although the varicella zoster virus is often associated with a mild infection, it may cause severe morbidity and mortality, particularly in the neonatal period and immunocompromised hosts. We report a case of neonatal varicella acquired from maternal zoster in a mother on biological immunosuppressive therapy. Following the diagnosis, the baby improved on antiviral therapy without any neurological sequelae. This case highlights the limited published data on neonatal varicella following herpes zoster reactivation to inform practice. This includes the role of varicella zoster immunoglobulin in neonates exposed to maternal zoster, the degree of trans-placental immunity and optimum antiviral dosing and duration.
Analysis of Shoot Architecture Traits in Edamame Reveals Potential Strategies to Improve Harvest Efficiency
Authors: Dhakal Kshitiz , Zhu Qian , Zhang Bo , Li Mao , Li Song
Published: March 2021

Edamame is a type of green, vegetable soybean and improving shoot architecture traits for edamame is important for breeding of high-yield varieties by decreasing potential loss due to harvesting. In this study, we use digital imaging technology and computer vision algorithms to characterize major traits of shoot architecture for edamame. Using a population of edamame PIs, we seek to identify underlying genetic control of different shoot architecture traits. We found significant variations in the shoot architecture of the edamame lines including long-skinny and candle stick-like structures. To quantify the similarity and differences of branching patterns between these edamame varieties, we applied a topological measurement called persistent homology. Persistent homology uses algebraic geometry algorithms to measure the structural similarities between complex shapes. We found intriguing relationships between the topological features of branching networks and pod numbers in our plant population, suggesting combination of multiple topological features contribute to the overall pod numbers on a plant. We also identified potential candidate genes including a lateral organ boundary gene family protein and a MADS-box gene that are associated with the pod numbers. This research provides insight into the genetic regulation of shoot architecture traits and can be used to further develop edamame varieties that are better adapted to mechanical harvesting.
Medical Cannabis and Industrial Hemp Tissue Culture: Present Status and Future Potential
Authors: Adhikary Dinesh , Kulkarni Manoj , El-Mezawy Aliaa , Mobini Saied , Elhiti Mohamed , Gjuric Rale , Ray Anamika , Polowick Patricia , Slaski Jan J. , Jones Maxwell P. , Bhowmik Pankaj
Published: March 2021

In recent years high-THC (psychoactive) and low-THC (industrial hemp) type cannabis (Cannabis sativaL.) have gained immense attention in medical, food, and a plethora of other consumer product markets. Among the planting materials used for cultivation, tissue culture clones provide various advantages such as economies of scale, production of disease-free and true-to-type plants for reducing the risk of GMP-EuGMP level medical cannabis production, as well as the development and application of various technologies for genetic improvement. Various tissue culture methods have the potential application with cannabis for research, breeding, and novel trait development, as well as commercial mass propagation. Although tissue culture techniques for plant regeneration and micropropagation have been reported for different cannabis genotypes and explant sources, there are significant variations in the response of cultures and the morphogenic pathway. Methods for many high-yielding elite strains are still rudimentary, and protocols are not established. With a recent focus on sequencing and genomics in cannabis, genetic transformation systems are applied to medical cannabis and hemp for functional gene annotation via traditional and transient transformation methods to create novel phenotypes by gene expression modulation and to validate gene function. This review presents the current status of research focusing on different aspects of tissue culture, including micropropagation, transformation, and the regeneration of medicinal cannabis and industrial hemp transformants. Potential future tissue culture research strategies helping elite cannabis breeding and propagation are also presented.
Household and Community Social Capital Links to Smallholder Food Security
Authors: Niles Meredith T. , Rudnick Jessica , Lubell Mark , Cramer Laura
Published: March 2021

Agricultural adaptation to climate change is critical for ensuring future food security. Social capital is important for climate change adaptation, but institutions and social networks at multiple scales (e.g., household, community, and institution) have been overlooked in studying agricultural climate change adaptation. We combine data from 13 sites in 11 low-income countries in East Africa, West Africa, and South Asia to explore how multiple scales of social capital relate to household food security outcomes among smallholder farmers. Using social network theory, we define three community organizational social network types (fragmented defined by lack of coordination, brokered defined as having a strong central actor, or shared defined by high coordination) and examine household social capital through group memberships. We find community and household social capital are positively related, with higher household group membership more likely in brokered and shared networks. Household group membership is associated with more than a 10% reduction in average months of food insecurity, an effect moderated by community social network type. In communities with fragmented and shared organizational networks, additional household group memberships is associated with consistent decreases in food insecurity, in some cases up to two months; whereas in brokered networks, reductions in food insecurity are only associated with membership in credit groups. These effects are confirmed by hierarchical random effects models, which control for demographic factors. This suggests that multiple scales of social capital—both within and outside the household—are correlated with household food security. This social capital may both be bridging (across groups) and bonding (within groups) with different implications for how social capital structure affects food security. Efforts to improve food security could recognize the potential for both household and community level social networks and collaboration, which further research can capture by analyzing multiple scales of social capital data.
Does Income Inequality Impair Health? Evidence from Rural China
Authors: Cai Wencong , Deng Yuanjie , Zhang Qiangqiang , Yang Haiyu , Huo Xuexi
Published: March 2021

In the context of the Healthy China strategy and the targeted poverty alleviation policy, based on the survey data of 1710 apple planters in Shandong, Yunnan, Shaanxi, and Gansu provinces, we selected the Probit model and the mediating effect test model to analyze the impact of income inequality on the self-rated health of farmers in this paper. The main results are as follows: First, income inequality within villages and townships had a significant negative impact on self-rated health, with both showing inverted U-shaped relationships, while income inequality within counties had no significant impact on self-rated health. Second, income inequality can impact the health of farmers, in terms of tobacco and alcohol behaviors, social trust, and sense of relative deprivation, where the mediating effect ratio of these three factors combined accounted for 32.4% of the total effect. Furthermore, the effect of income inequality on health was heterogeneous among different income groups, where the negative impact of income inequality on the self-rated health of the high-income group was less than that of the low-income group, indicating that an increase in income inequality serves to aggravate the degree of health inequality. Therefore, the government should adopt differentiated policies to improve the health of farmers. In rural areas with high income inequality, the government should focus on increasing the income of low-income groups, guide them to develop a healthy lifestyle, improve their social trust, and reduce their sense of relative deprivation. In rural areas where incomes are generally low, the government should first guide qualified farmers to become rich, then encourage others to become rich later.
Revamping Ecosystem Services through Agroecology—The Case of Cereals
Authors: Sethuraman Gomathy , Mohd Zain Nurul Amalina , Yusoff Sumiani , Ng Yin Mei , Baisakh Niranjan , Cheng Acga
Published: March 2021

Globally, farming systems are mostly dominated by monoculture, which has the advantage of profitability at the expense of ecological systems. Recent years have witnessed an increasing momentum in global efforts to deploy sustainable agriculture practices that mimic ecological processes, with agroecology at the forefront. In addition to the ecological aspect, agroecology also encompasses economic and social aspects targeting the whole food system. Transformative agroecology has been recognized as a stepping stone to achieving several Sustainable Development Goals (SDGs), due to its great potential to build climate change-resilient farming systems while enhancing ecosystem services and reducing biodiversity loss. Nonetheless, the available literature on the recent developments and future trajectories of the adoption of agroecology approaches for improving the production of cereals, the most important group of food crops, is limited. This review aims to highlight the blueprint of agroecology that can contribute to the achievements of the SDGs, allowing explicit interpretation of the term that will benefit twenty-first century agriculture. Using cereal crops as the case study, we provide insights into how far this field has come and the main barriers to its adoption, and conclude that this approach of “science for and with society” is the way forward for building a resilient future.
Human Activity Recognition through Recurrent Neural Networks for Human–Robot Interaction in Agriculture
Authors: Anagnostis Athanasios , Benos Lefteris , Tsaopoulos Dimitrios , Tagarakis Aristotelis , Tsolakis Naoum , Bochtis Dionysis
Published: March 2021

The present study deals with human awareness, which is a very important aspect of human–robot interaction. This feature is particularly essential in agricultural environments, owing to the information-rich setup that they provide. The objective of this investigation was to recognize human activities associated with an envisioned synergistic task. In order to attain this goal, a data collection field experiment was designed that derived data from twenty healthy participants using five wearable sensors (embedded with tri-axial accelerometers, gyroscopes, and magnetometers) attached to them. The above task involved several sub-activities, which were carried out by agricultural workers in real field conditions, concerning load lifting and carrying. Subsequently, the obtained signals from on-body sensors were processed for noise-removal purposes and fed into a Long Short-Term Memory neural network, which is widely used in deep learning for feature recognition in time-dependent data sequences. The proposed methodology demonstrated considerable efficacy in predicting the defined sub-activities with an average accuracy of 85.6%. Moreover, the trained model properly classified the defined sub-activities in a range of 74.1–90.4% for precision and 71.0–96.9% for recall. It can be inferred that the combination of all sensors can achieve the highest accuracy in human activity recognition, as concluded from a comparative analysis for each sensor’s impact on the model’s performance. These results confirm the applicability of the proposed methodology for human awareness purposes in agricultural environments, while the dataset was made publicly available for future research.
Sulphate-Reducing Bacteria’s Response to Extreme pH Environments and the Effect of Their Activities on Microbial Corrosion
Authors: Tran Thi Thuy Tien , Kannoorpatti Krishnan , Padovan Anna , Thennadil Suresh
Published: March 2021

Sulphate-reducing bacteria (SRB) are dominant species causing corrosion of various types of materials. However, they also play a beneficial role in bioremediation due to their tolerance of extreme pH conditions. The application of sulphate-reducing bacteria (SRB) in bioremediation and control methods for microbiologically influenced corrosion (MIC) in extreme pH environments requires an understanding of the microbial activities in these conditions. Recent studies have found that in order to survive and grow in high alkaline/acidic condition, SRB have developed several strategies to combat the environmental challenges. The strategies mainly include maintaining pH homeostasis in the cytoplasm and adjusting metabolic activities leading to changes in environmental pH. The change in pH of the environment and microbial activities in such conditions can have a significant impact on the microbial corrosion of materials. These bacteria strategies to combat extreme pH environments and their effect on microbial corrosion are presented and discussed.
Aerodynamic Shape Optimization of NREL S809 Airfoil for Wind Turbine Blades Using Reynolds-Averaged Navier Stokes Model—Part II
Authors: Akram Md Tausif , Kim Man-Hoe
Published: March 2021

Sustainability has become one of the most significant considerations in everyday work, including energy production. The fast-growing trend of wind energy around the world has increased the demand for efficient and optimized airfoils, which has paved the way for energy harvesting systems. The present manuscript proposes an aerodynamically optimized design of the well-known existing NREL S809 airfoil for performance enhancement of the blade design for wind turbines. An integrated code, based on a genetic algorithm, is developed to optimize the asymmetric NREL S809 airfoil by class shape transformation (CST) and the parametric section (PARSEC) parameterization method, analyzing its aerodynamic properties and maximizing the lift of the airfoil. The in-house MATLAB code is further incorporated with XFOIL to calculate the coefficient of lift, coefficient of drag and lift-to-drag ratio at angles of attack of 0° and 6.2° by the panel technique and validated with National Renewable Energy Laboratory (NREL) experimental results provided by The Ohio State University (OSU). On the other hand, steady-state CFD analysis is performed on an optimized S809 airfoil using the Reynolds-averaged Navier–Stokes (RANS) equation with the K–ω shear stress transport (SST) turbulent model and compared with the experimental data. The present method shows that the optimized airfoil by CST is predicted, with an increment of 11.8% and 9.6% for the lift coefficient and lift-to-drag ratio, respectively, and desirable stability parameters obtained for the design of the wind turbine blades. These characteristics significantly improve the overall aerodynamic performance of new optimized airfoils. Finally, the aerodynamically improved results are reported for the design of the NREL Phase II, Phase III and Phase VI HAWT blades.
Lipid Metabolism and Ferroptosis
Authors: Lee Ji-Yoon , Kim Won Kon , Bae Kwang-Hee , Lee Sang Chul , Lee Eun-Woo
Published: March 2021

Ferroptosis is a type of iron-dependent regulated necrosis induced by lipid peroxidation that occurs in cellular membranes. Among the various lipids, polyunsaturated fatty acids (PUFAs) associated with several phospholipids, such as phosphatidylethanolamine (PE) and phosphatidylcholine (PC), are responsible for ferroptosis-inducing lipid peroxidation. Since the de novo synthesis of PUFAs is strongly restricted in mammals, cells take up essential fatty acids from the blood and lymph to produce a variety of PUFAs via PUFA biosynthesis pathways. Free PUFAs can be incorporated into the cellular membrane by several enzymes, such as ACLS4 and LPCAT3, and undergo lipid peroxidation through enzymatic and non-enzymatic mechanisms. These pathways are tightly regulated by various metabolic and signaling pathways. In this review, we summarize our current knowledge of how various lipid metabolic pathways are associated with lipid peroxidation and ferroptosis. Our review will provide insight into treatment strategies for ferroptosis-related diseases.
Insights from Cardiopulmonary Exercise Testing in Pediatric Patients with Hypertrophic Cardiomyopathy
Authors: Gallo Giovanna , Mastromarino Vittoria , Limongelli Giuseppe , Calcagni Giulio , Maruotti Antonello , Ragni Luca , Valente Fabio , Musumeci Maria Beatrice , Adorisio Rachele , Rubino Marta , Autore Camillo , Magrì Damiano
Published: March 2021

The usefulness of cardiopulmonary exercise test (CPET) in adult hypertrophic cardiomyopathy (HCM) patients is well-known, whereas its role in pediatric HCM patients has not yet been explored. The present study investigates possible insights from a CPET assessment in a cohort of pediatric HCM outpatients in terms of functional and prognostic assessment. Sixty consecutive pediatric HCM outpatients aged <18 years old were enrolled, each of them undergoing a full clinical assessment including a CPET; a group of 60 healthy subjects served as controls. A unique composite end-point of heart failure (HF) related and sudden cardiac death (SCD) or SCD-equivalent events was also explored. During a median follow-up of 53 months (25th–75th: 13–84 months), a total of 13 HF- and 7 SCD-related first events were collected. Compared to controls, HCM patients showed an impaired functional capacity with most of them showing peak oxygen uptake (pVO2) values of <80% of the predicted, clearly discrepant with functional New York Heart Association class assessment. The composite end-point occurred more frequently in patients with the worst CPETs’ profiles. At the univariate analysis, pVO2% was the variable with the strongest association with adverse events at follow-up (C-index = 0.72, p = 0.025) and a cut-off value equal to 60% was the most accurate in identifying those patients at the highest risk. In a pediatric HCM subset, the CPET assessment allows a true functional capacity estimation and it might be helpful in identifying early those patients at high risk of events.
Qiime Artifact eXtractor (qax): A Fast and Versatile Tool to Interact with Qiime2 Archives
Authors: Telatin Andrea
Published: March 2021

Qiime2 is one of the most popular software tools used for analysis of output from metabarcoding experiments (e.g., sequencing of 16S, 18S, or ITS amplicons). Qiime2 introduced a novel and innovative data exchange format: the ‘Qiime2 artifact’. Qiime2 artifacts are structured compressed archives containing a dataset and its associated metadata. Examples of datasets are FASTQ reads, representative sequences in FASTA format, a phylogenetic tree in Newick format, while examples of metadata are the command that generated the artifact, information on the execution environment, citations on the used software, and all the metadata of the artifacts used to produce it. While artifacts can improve the shareability and reproducibility of Qiime2 workflows, they are less easily integrated with general bioinformatics pipelines. Accessing metadata in the artifacts also requires full Qiime2 installation. Qiime Artifact eXtractor (qax) allows users to easily interface with Qiime2 artifacts from the command line, without needing the full Qiime2 environment installed (or activated).
Numerical Assessment of Earth to Air Heat Exchanger with Variable Humidity Conditions in Greenhouses
Authors: Qi Di , Zhao Chuangyao , Li Shixiong , Chen Ran , Li Angui
Published: March 2021

Earth to air heat exchangers are widely utilized to cool or heat passive buildings for energy savings. They often need to deal with high humidity air conditions, especially in the greenhouse due to plant transpiration, and the condensation phenomenon is frequently observed during the cooling process. To evaluate the effect of humidity and condensation on thermal performance, a three dimensional computational fluid dynamic (3D-CFD) model was developed. The distribution of relative humidity in each pipe was investigated, and the impact of inlet air relative humidity on the integrated performance of the earth to air heat exchanger was discussed. The effects of inlet air temperature and volume flow rate were also analyzed. Moreover, the influence of the heat exchanger configurations on the performance of the air condensation was researched. The results indicated that condensation had few effects on the airflow distribution uniformity of the earth to air heat exchanger, while it acted observably on the thermal performance. In addition, humid air in a small diameter pipe tended to condense more easily. Humidity and condensation should be taken into consideration for the design of earth to air heat exchangers in greenhouses during engineering applications.
Collaborative 3D Monitoring for Coastal Survey: Conclusive Tests and First Feedbacks Using the SELPhCoAST Workflow
Authors: Cariou Elsa , Baltzer Agnes , Leparoux Donatienne , Lacombe Vincent
Published: March 2021

“Structure from Motion” by smart devices photography (SfM-S) is a current promising tool to support 3D participatory monitoring of heritage and geosites. Within the ODySéYeu scientific project, which aims to analyze the sedimentary dynamics around the isle of Yeu (France), a consortium of different local actors was invited to collectively develop an integrated solution to monitor the coastal evolution of the isle in 3D. This new solution is composed of a combination of an application (SENTINELLES de la côte) and a specific workflow (SELPhCoAST), which guides citizens to acquire reliable in-situ photo datasets with their own smart device, facilitates data transmission, and allows both a reliable data treatment and a public presentation of matters and results. This study presents the results of reproducibility and accuracy tests performed on a test-site to validate the SELPhCoAST workflow, over 20 months of monitoring, with multiple operators and devices. Tests show that at least 95% of each SfM-S model is identical to the terrestrial laser scans models within a range of ±5 cm, almost independently of the operator or smartphone model. This study highlights the interest of this cost-effective participatory solution to understand coastal erosion processes, and facilitate the establishment of soft and nature-based solutions of protection, management or restoration of sites.
Research Trends on Mobile Mental Health Application for General Population: A Scoping Review
Authors: Hwang Won Ju , Ha Ji Sun , Kim Mi Jeong
Published: March 2021

Background: Scoping reviews of the literature on the development and application of mental health apps based on theoretical suggestions are lacking. This study systematically examines studies on the effects and results of mental health mobile apps for the general adult population. Methods: Following PICOs (population, intervention, comparison, outcome, study design), a general form of scoping review was adopted. From January 2010 to December 2019, we selected the effects of mental health-related apps and intervention programs provided by mobile to the general adult population over the age of 18. Additionally, evaluation of methodological quality was assessed using the Scottish Intercollegiate Guidelines Network (SIGN) checklist. Results: Fourteen studies were analyzed of 1205 that were identified; duplicate and matching studies were excluded. One was a descriptive study and 13 were experimental, of which randomized control trials (RCTs) accounted for 71.4%. Four of the mobile apps were developed based on cognitive behavior theory, one based on stress theory, and one on ecological instant intervention theory. These apps included breathing training, meditation, and music therapy. Stress, depression, and anxiety decreased using these apps, and some were effective for well-being. Conclusion: With the rapid development of technology related to mental health, many mobile apps are developed, but apps based on theoretical knowledge and well-designed research are lacking. Further research and practices should be conducted to develop, test, and disseminate evidence-based mHealth for mental health promotion. RCT studies are needed to expand the application to mental health services to various populations.
Psychological Distress among Caregivers of Children with Neurodevelopmental Disorders in Nepal
Authors: Maridal Hans Kristian , Bjørgaas Hanne Marit , Hagen Kristen , Jonsbu Egil , Mahat Pashupati , Malakar Shankar , Dørheim Signe
Published: March 2021

Parenting a child with neurodevelopmental disorder (NDD) is related to a higher rate of anxiety and depression, increased stress, and reduced quality of life. Although there is reason to believe that parenting children with NDD in low- and middle-income countries (LMIC) can be challenging, there is a lack of knowledge on the psychological distress among these caregivers, especially in rural areas. The aim of the study was to examine the psychological distress among caregivers having children with NDD in rural Nepal. Sixty-three caregivers were visited in their homes and interviewed by experienced mental health professionals. This study examined demographic information, severity of disability, perceived caregiver burden, and psychological distress, measured by the General Health Questionnaire-12 (GHQ-12). The study found a high level of psychological distress in the caregivers (M = 5.38, SD = 2.8). A majority (90.5%) scored two or higher, indicating the presence of a common mental disorder (CMD). Almost half (46%) scored six or higher, indicating a high level of distress. A majority of the caregivers reported that caring for their disabled child had a negative effect on the caregiver’s economy (70%), physical health (65%), social life (64%), and dreams and expectations for the future (81%). There was a significant relationship between the caregiver’s psychological distress (GHQ-12) and degree of disability in the child (Gross Motor Function Classification System), degree of caregiver burden, feeding problems, having health workers as a possible source of help, receiving incentive from the government, having somebody to confide in, and caregiver illiteracy. A forward regression analysis entering the significant factors indicated that caregiver burden, having someone to confide in, and having health workers as a possible source of help were significant related to psychological distress. The final step of the model explained 42.4% of the variance in psychological distress among the caregivers. The study indicates a high level of psychological distress and high overall burden in caregivers of children with NDD in rural Nepal. Further implications for research and service development are discussed.
Effects of Neuromuscular Electrical Stimulation Combined with Exercises versus an Exercise Program on the Physical Characteristics and Functions of the Elderly: A Randomized Controlled Trial
Authors: Jang Eun Mi , Park So Hyun
Published: March 2021

(1) Background—The application of neuromuscular electrical stimulation (NMES) combined with low-intensity exercise to the elderly can be more efficient than low-intensity exercise only in terms of delaying the loss of muscle mass. We aimed to assess the adjunct of NMES to low-intensity lower limb strengthening exercise to prevent falls in frail elderly for a relatively short period of 4 weeks. (2) Methods—Thirty elderly women aged 65 or above were randomly categorized into three groups: control group (CON, n = 8), exercise group (EX, n = 10), and NMES with exercise group (EX + NMES, n = 9). The exercise group took part in a lower limb strengthening exercise program for one hour three times a week for four weeks. Furthermore, the NMES with exercise group had added NMES stimulation when exercising. The limbs’ muscle mass, body fat mass, calf circumference, grip force, five times sit-to-stand test, timed up-and-go test (TUG), one-leg stand test, and Y-balance test (YBT) were evaluated at baseline and 4 weeks after. (3) Results—Comparisons between the three groups showed that the TUG was significantly decreased and the YB was significantly increased in NMES with exercise group (p < 0.05). (4) Conclusions—These results suggested that a combination of NMES stimulation and exercises was more helpful in strengthening balance than exercises alone in the short term.
Disciplinary Approaches for Cannabis Use Policy Violations in Canadian Secondary Schools
Authors: Magier Megan J. , Leatherdale Scott T. , Wade Terrance J. , Patte Karen A.
Published: March 2021

The objective of this study was to examine the disciplinary approaches being used in secondary schools for student violations of school cannabis policies. Survey data from 134 Canadian secondary schools participating in the Cannabis use, Obesity, Mental health, Physical activity, Alcohol use, Smoking, and Sedentary behaviour (COMPASS) study were used from the school year immediately following cannabis legalization in Canada (2018/19). Despite all schools reporting always/sometimes using a progressive discipline approach, punitive consequences (suspension, alert police) remain prevalent as first-offence options, with fewer schools indicating supportive responses (counselling, cessation/educational programs). Schools were classified into disciplinary approach styles, with most schools using Authoritarian and Authoritative approaches, followed by Neglectful and Permissive/Supportive styles. Further support for schools boards in implementing progressive discipline and supportive approaches may be of benefit.
Possible Role for Imagery-Based Therapy in Managing PTSD in Pakistani Women Experiencing Domestic Abuse: A Pilot Study Using Eidetic Therapy
Authors: Kamran Ehsan Mehwish , Rowland David L.
Published: March 2021

Domestic abuse of women is a serious problem worldwide that has economic, physical, and psychological consequences, yet in many countries and cultures, victims often have little access to psychological support. Using a pre-post design, we investigated the effects of psychological intervention using an imagery-based therapy in women showing post-traumatic stress disorder (PTSD) resulting from spousal domestic abuse. Forty women, referred from outpatient clinics in Pakistan and meeting inclusion criteria, underwent individual trauma counseling for 10–12 weeks using the principles of Eidetic Therapy, an imagery-based therapy that circumvents heavy reliance on verbal skills and narratives. Women showed significant reductions in PTSD by the end of treatment. Predictors of treatment gains included type of abuse, PTSD level at the outset of therapy, and years in the relationship. Neither economic resources or literacy, nor abuser or victim characteristics, predicted the amount of improvement. In conclusion, therapy was associated with a reduction in PTSD symptoms regardless of literacy level of participants. This reduction in PTSD was notable because, unlike many situations involving spousal abuse, these women were generally not in a position to leave their relationship, and hence the women might have experienced continued exposure to abuse. Context/cultural-based explanations for these findings are presented and discussed.
Effectiveness of SARS-CoV-2 Decontamination and Containment in a COVID-19 ICU
Authors: Brune Zarina , Kuschner Cyrus E. , Mootz Joseph , Davidson Karina W. , Pena Robert C. F. , Ghanem Mustafa H. , Fischer Austin , Gitman Michael , Teperman Lewis , Mason Christopher , Becker Lance B.
Published: March 2021

Background: Health care systems in the United States are continuously expanding and contracting spaces to treat patients with coronavirus disease 2019 (COVID-19) in intensive care units (ICUs). As a result, hospitals must effectively decontaminate and contain severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in constructed and deconstructed ICUs that care for patients with COVID-19. We assessed decontamination of a COVID-19 ICU and examined the containment efficacy of combined contact and droplet precautions in creating and maintaining a SARS-CoV-2–negative ICU “antechamber”. Methods: To examine the efficacy of chemical decontamination, we used high-density, semi-quantitative environmental sampling to detect SARS-CoV-2 on surfaces in a COVID-19 ICU and COVID-19 ICU antechamber. Quantitative real-time polymerase chain reaction was used to measure viral RNA on surfaces. Viral location mapping revealed the distribution of viral RNA in the COVID-19 ICU and COVID-19 ICU antechamber. Results were further assessed using loop-mediated isothermal amplification. Results: We collected 224 surface samples pre-decontamination and 193 samples post-decontamination from a COVID-19 ICU and adjoining COVID-19 ICU antechamber. We found that 46% of antechamber objects were positive for SARS-CoV-2 pre-decontamination despite the construction of a swinging door barrier system, implementation of contact precautions, and installation of high-efficiency particulate air filters. The object positivity rate reduced to 32.1% and viral particle rate reduced by 95.4% following decontamination. Matched items had an average of 432.2 ± 2729 viral copies/cm2 pre-decontamination and 19.2 ± 118 viral copies/cm2 post-decontamination, demonstrating significantly reduced viral surface distribution (p < 0.0001). Conclusions: Environmental sampling is an effective method for evaluating decontamination protocols and validating measures used to contain SARS-CoV-2 viral particles. While chemical decontamination effectively removes detectable viral RNA from surfaces, our approach to droplet/contact containment with an antechamber was not highly effective. These data suggest that hospitals should plan for the potential of aerosolized virions when creating strategies to contain SARS-CoV-2.
Improving the Reprocessing Quality of Flexible Thermolabile Endoscopes: How to Learn from Mistakes
Authors: Casini Beatrice , Tuvo Benedetta , Marciano Emanuele , Del Magro Giuliana , Gemignani Giulia , Luchini Grazia , Cristina Maria Luisa , Costa Anna Laura , Arzilli Guglielmo , Totaro Michele , Baggiani Angelo , Privitera Gaetano
Published: March 2021

Background: Failure in the reprocessing of thermolabile flexible endoscopes has been reported as one of the most important threats to patient health. Method: A case report and observational study was conducted, from August 2014 to December 2019, in the Digestive Endoscopy Unit of a University Hospital in Italy, where two cases of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae infections in patients undergoing endoscopic retrograde cholangio-pancreatography were observed. Following the risk/safety management practices, an epidemiological investigation was started, duodenoscopes were removed from use and the reprocessing practices reviewed. Moreover, microbiological surveillance of endoscopes was carried out according to the CDC guidelines. Results: In the first phase of sampling, 10/10 (100%) endoscopes were found to be non-compliant, of which 7 showed results for high-concern organisms (HCOs), such as KPC-K. pneumoniae, P. aeruginosa and E. coli. After implementing corrective actions, 12 out of 17 endoscopes were found to be non-compliant (70.5%), of which 8 showed results for HCOs, such as KPC-K. oxytoca and P. aeruginosa. During the last year of regular microbiological surveillance, only 23% of endoscopes (35/152) were found to be non-compliant, of which 7 showed results for HCOs, such as NDM-K. pneumoniae, P. aeruginosa and A. baumannii. The crucial issues were related to samples collected from the internal channels of duodenoscopes. Conclusion: Managing the risk associated with the reprocessing of digestive endoscopes, through risk assessment at every stage of the process, is important for the prevention of infections associated with the use of these device.