bluuebunny/crossref_metadata_2025 huggingface dataset:
Feasibility and Safety of Laparoscopic Transperitoneal Adrenalectomy in Large Adrenal Tumor From 20 Years Single-center Experiences- A Retrospective Cohort Study
Authors: Prakobpon Thanasit , Santi-ngamkun Apirak , Usawachintachit Manint , Ratchanon Supoj , Sowanthip Dutsadee , Panumatrassamee Kamol
Published: November 2020

Background: The role of laparoscopic adrenalectomy (LA) in a large adrenal tumor is controversial due to the risk of malignancy and technical difficulty. In this study, we compared the perioperative outcomes and complications of LA on large (≥ 6 cm) and (< 6 cm) adrenal tumors.Methods: We retrospectively reviewed all clinical data of patients who underwent unilateral LA in our institution between April 2000 and June 2019. Patients were classified by tumor size into 2 groups. Patients in group 1 had tumor size < 6 cm (n=408) and patient in group 2 had tumor size ≥ 6 cm (n=48). Demographic data, perioperative outcomes, complications, and pathologic reports were compared between groups.Results: Patients in group 2 were significant older (p=0.04), thinner (p=0.001) and had lower incident of hypertension (p=0.001), with a significantly higher median operative time (75 vs 120 min), estimated blood loss (20 vs 100 ml), transfusion rate (0 vs 20.8%), conversion rate (0.25 vs 14.6%) and length of stays (6 vs 9 days) than in group 2 (all p<0.001). Group 2 patients also had significantly higher frequency of intraoperative complication (4.7 vs 31.3%; adjust Odds Ratio [OR] =7.73 (95% CI 3.35-17.84), p-value < 0.001) and postoperative complication (5.4 vs 31.3%; adjust OR=6.06, 95% CI 2.84-13.73, p-value < 0.001). Only eight (1.8%) major complications occurred in this study. The most common pathology in group 2 patient was pheochromocytoma and metastasis. Conclusions: Laparoscopic transperitoneal adrenalectomy in large adrenal tumor ≥ 6 cm is feasible but associated with significantly worse intraoperative complications, postoperative complications and recovery. However, most of the complications were minor and could be managed conservatively. Careful patient selection with the expertise surgeon in adrenal surgery are the key factors for successful laparoscopic surgery in a large adrenal tumor. Trial registration: This study was retrospectively registered in the Thai Clinical Trials Registry on 02/03/2020. The registration number was TCTR20200312004.
An Exploratory Qualitative Study of the Prevention of Road Traffic Collisions and Neurotrauma in India: Perspectives From Key Informants in an Indian Industrial City (Visakhapatnam)
Authors: Selveindran Santhani M , Samarutilake Gurusinghe , Rao K Madhu Narayana , Patisappu Jogi , Hill Christine , Kolias Angelos , Pathi Rajesh , Hutchinson Peter , Vijayasekhar N
Published: November 2020

Background: Despite current preventative strategies, road traffic collisions (RTCs) and resultant neurotrauma remain a major problem in India. This study seeks to explore local perspectives in the context within which RTCs take place and identify potential suggestions for improving the current status.Methods: Ten semi-structured interviews were carried out with purposively selected key informants from the city of Visakhapatnam, Andhra Pradesh. Participants were from one of the following categories: commissioning stakeholders; service providers; community or local patient group/advocacy group representatives. Transcripts from these interviews were analysed qualitatively using the Framework Method.Results: Participants felt RTCs are a serious problem in India and a leading cause of neurotrauma. Major risk factors identified related to user behaviour such as speeding and not using personal safety equipment, and the user state, namely drink driving and underage driving. Other reported risk factors included poor infrastructure, moving obstacles on the road, overloaded vehicles and substandard safety equipment. Participants discussed how RTCs affect not only the health of the victim, but are also a burden to the healthcare system, families, and the national economy. Although there are ongoing preventative strategies being carried out by both the government and the community, challenges to successful prevention emerged from the interviews which included resource deficiencies, inconsistent implementation, lack of appropriate action, poor governance, lack of knowledge and the mindset of the community and entities involved in prevention. Recommendations were given on how prevention of RTCs and neurotrauma might be improved, addressing the areas of education and awareness, research, the pre-hospital and trauma systems, enforcement and legislation, and road engineering, in addition to building collaborations and changing mindsets.Conclusions: RTCs remain a major problem in India and a significant cause of neurotrauma. Addressing the identified gaps and shortfalls in current approaches and reinforcing collective responsibility towards road safety would be the way forward in improving prevention and reducing the burden.
High-intensity Interval Training Enhances Hypoxia-mediated Right Cardiac Mechanics in Sedentary Men
Authors: Huang Yu-Chieh , Hsu Chih-Chin , Fu Tieh-Cheng , Wang Jong-Shyan
Published: November 2020

Purpose: Hypoxic exposure increases right ventricular (RV) afterload by triggering pulmonary hypertension, with consequent effects on the structure and function of the right ventricle. Improved myocardial contractility is a critical circulatory adaptation to exercise training. However, the types of exercise that enhance right cardiac mechanics during hypoxic stress have not yet been identified. This study investigated how high-intensity interval training (HIIT) and moderate-intensity continuous training (MICT) influence right cardiac mechanics during hypoxic exercise (HE). Methods: A total of 54 young and healthy sedentary males were randomly selected to engage in either HIIT (3-min intervals at 40% and 80% of VO2max, n = 18) or MICT (sustained 60% of VO2max, n = 18) for 30 min/day and 5 days/week for 6 weeks or were included in a control group (CTL, n = 18) that did not engage in any exercise. Right cardiac mechanics during semiupright bicycle exercise tests under hypoxic conditions (i.e., 50 watts under 12% FIO2 for 3 min) were measured using two-dimensional speckle-tracking echocardiography. Results: After 6 weeks of training, HIIT was superior to MICT in improving VO2max. Furthermore, the HIIT group showed reduced pulmonary vascular resistance (PVR) as well as an elevated RV ejection fraction (RVEF) under hypoxia, coupled with a significant enhancement of the right atrial (RA) reservoir and conduit functions. HIIT is superior to MICT in dilating the right ventricle and ameliorating radial strain rate but reducing radial strain in either systole or diastole. In the correlation analysis, the changes in RVEF were directly associated with improved RA reservoir and conduit functions but inversely associated with the change in radial RV strain caused by HIIT. Conclusion: HIIT is superior to MICT in improving right cardiac mechanics by simultaneously increasing RA reservoir and conduit functions and decreasing PVR during HE.
Maintenance of Blood Pressure in Emotional Context-based Autonomic Switching by the Central Nucleus of the Amygdala in Rats
Authors: Yamanaka Ko , Waki Hidefumi
Published: November 2020

Proper autonomic control is necessary in making appropriate decisions and actions, but neuronal mechanisms for this function are yet to be determined. Here we show that the amygdala plays a role in autonomic cardiovascular tuning in a dynamically changing environment. We recorded blood pressure and heart rate of head-restrained rats during appetitive and aversive classical conditioning tasks. Rats learned varying associations between conditioned stimuli and unconditioned stimuli in three types of contexts: appetitive, neutral, and aversive blocks. Blood pressure and heart rate in the appetitive block gradually increased after reward-predicting cues, followed by a vigorously increased response to the actual reward. The predictive response was found to be significantly higher than the responses in the neutral and aversive blocks. Blood pressure and heart rate responses to the air puff-predicting cue in the aversive block were significantly lower than that of the responses in the neutral block. Pharmacological blockade of the amygdala has significantly decreased reward-predictive pressor responses in the latter phase, but not in the initial phase of context change. Cardiovascular responses are thus adaptively tuned by positive and negative emotional stimuli, and the central nucleus of the amygdala likely assists in maintaining pressor response tuning based on emotional context.
Lymphocytic Profile and Ebv Serology in Sjögren’s Syndrome: Evidences for a Virally Triggered Autoimmune Epithelitis?
Authors: Barcelos Filipe , Martins Catarina , Monteiro Ricardo , Cardigos Joana , Prussiani Tizziano , Sítima Miguel , Alves Nuno , Patto José , Branco Jaime , Borrego Luís-Miguel
Published: November 2020

Sjögren's Syndrome (SjS) is characterized by lymphocytic infiltration of exocrine glands, i.e. autoimmune epithelitis. Lymphocytes are central in SjS pathogenesis, with B-cell hyperactivity mediated by T-cells. B-cells are main targets of Epstein-Barr virus (EBV) infection, a frequently-suggested trigger for SjS.We aimed to evaluate how the EBV infection modulates B and T-cell subsets in SjS, including as controls Rheumatoid arthritis patients (RA) and healthy participants (HC).SjS patients presented decreased CXCR5+T-cells, although IL21-secreting Tfh and Tfc cells were increased. Tfc were positively correlated with ESSDAI scores, suggesting their relevant role in SjS pathogenesis. As previously described, SjS patients showed expanded circulating naïve B-cell compartments. SjS patients had a higher incidence of EBV-EA-D-IgG+ antibodies, characteristic of recent EBV-infection/reactivation. SjS patients with past infection or recent infection/reactivation showed increased CXCR3+Th1 and CXCR3+Tfh1 cells compared to those without active infection. SjS patients with a recent infection/reactivation profile presented increased transitional B-cells compared to patients with past infection and increased plasmablasts, compared to those without infection.Our results suggest EBV-infection contributes to B and T-cell differentiation towards the effector phenotypes typical of SjS. Local lymphocyte activation at ectopic germinal centres, mediated by Tfh and Tfc, can be EBV-driven, perpetuating autoimmune epithelitis which leads to gland destruction in SjS.
Leveraging Electronic Health Records to Improve Management of Noncommunicable Diseases at Primary Healthcare Centres in Saudi Arabia: A Qualitative Study
Authors: Hazazi Ahmed , Wilson Andrew
Published: November 2020

Background: Electronic Health Records (EHRs) can contribute to the earlier detection and better treatment of chronic diseases by improving accuracy and accessibility of patient data. The Saudi Ministry of Health implemented an EHR system in all primary health care clinics (PHCs) as part of measures to improve their performance in managing chronic disease. This study examined the perspective of physicians on the current scope and content of NCDs management at PHCs including the contribution of the EHR system. Methods: Semi-structured interviews were conducted with 22 physicians working in chronic disease clinics at PHCs covering a range of locations and clinic sizes. The participants were selected based on their expertise using a combination of purposive and convenience sampling. The interviews were transcribed, analyzed and coded into the key themes. Results: Physicians indicated that the availability of the EHR helped organise their work and positively influenced NCDs patient encounters in their PHCs. They emphasised the multiple benefits of EHR in terms of efficiency, including the accuracy of patient documentation and the availability of patient information. Shortcomings identified included the lack of a patient portal to allow patients to access information about their health and lack of capacity to facilitate multi-disciplinary care for example through referral to allied health services. Access to the EHR was limited to MOH primary healthcare centres and clinicians noted that patients also received care in private clinics and hospitals. Conclusion: While well regarded by clinicians, the EHR system impact on patient care at chronic disease clinics is not being fully realised. Enabling patient access to their EHR would be help promote self-management, a core attribute of effective NCD management. Co-ordination of care is another core attribute and in the Saudi health system with multiple public and private providers, this may be substantially improved if the patients EHR was accessible wherever care was provided. There is also a need for enhanced capacity to support improving patient’s nutrition and physical activity.
A Molecularly Defined Skin Test Reagent for Bovine Tuberculosis Compatible With Vaccination Against Johne’s Disease
Authors: Middleton Sonya , Steinbach Sabine , Coad Michael , McGill Kevina , Brady Colm , Duignan Anthony , Wiseman Jimmy , Gormley Eamonn , Jones Gareth , Vordermeier H.
Published: November 2020

Tuberculin Purified Protein Derivatives (PPDs) exhibit multiple limitations: they are crude extracts from mycobacterial cultures with largely unknown active components; their production depends on culture of mycobacteria requiring expensive BCL3 production facilities; and their potency depends on the technically demanding guinea pig assay. To overcome these limitations, we developed a molecularly defined tuberculin (MDT) by adding further antigens to our prototype reagent composed of ESAT-6, CFP-10 and Rv3615c (DIVA skin test, DST). In vitro screening using PBMC from infected and uninfected cattle shortlisted four antigens from a literature-based list of 18 to formulate the MDT. These four antigens plus the previously identified Rv3020c protein, produced as recombinant proteins or overlapping synthetic peptides, were formulated together with the three DST antigens into the MDT to test cattle experimentally and naturally infected with M. bovis, uninfected cattle and MAP vaccinated calves. We demonstrated significant increases in MDT-induced skin responses compared to DST in infected animals, whilst maintaining high specificity in unvaccinated or MAP vaccinated calves. Further, MDT can also be applied in in vitro blood-based interferon-gamma release assays. Thus, MDT promises to be a robust diagnostic skin and blood test reagent overcoming some of the limitations of PPDs and warrants full validation.
Snow Algae Blooming Are Benefitable for Microinvertebrates Assemblages (Tardigrada and Rotifera) on the Seasonal Snow Patches in Japan
Authors: Ono Masato , Takeuchi Nozomu , Zawierucha Krzysztof
Published: November 2020

Although studies on snow algae and macroinvertebrates have been frequently conducted on snow patches, no attention have been paid to ubiquitous microinvertebrates which in other cold habitats reach high biomass and play various trophic roles. The aim of this study was to search microinvertebrates in seasonal snow patches in Mt. Gassan, in northern Japan, and identify factors determining their distribution associated with snow algal blooming of various coloration (red, green, and yellow). Microscopic observation revealed presence of two major groups of microinvertebrates Tardigrada and Rotifera. Tardigrades and rotifers were the most abundant and frequent in green snow formed by blooming of Chloromonas sp., but few in red or yellow snow. Body length of tardigrades increased through the melting season and animals laid eggs on colored snow. These results suggest tardigrades successfully grew and reproduced on snow patches. Taking into account the presence of tardigrades and rotifers mostly in green snow (only few found in red and yellow) with high densities, we may assume green snow patches constitute important and unique low-temperature ecosystems for microinvertebrates in a temperate mountainous forest. Area of snow algae blooming worldwide are unrecognized novel habitat for tardigrades and rotifers.
Non-corner Localized Surface Plasmons Resonance Based Ultrathin Metasurface Single-layer Quarter Wave Plate
Authors: Qian Qinyu , Wang Chinhua , Liu Pengfei , Fan Li , Zhao Liang
Published: November 2020

We report on a non-corner quarter wave plate (NCQW) within the single Ag hollow elliptical ring array layer of only 8 nm thickness, where the strong localized surface plasmons (LSP) resonances are excited. By manipulating the parameters of the hollow elliptical ring, the transmitted amplitude and phase of the two orthogonal components are well controlled. The phase difference of π/2 and amplitude ratio of 1 is realized simultaneously at the wavelength of 834 nm with the transmission of 0.46. The proposed NCQW works perfectly at the wavelength of 834 nm and works well at a ultrawide wavelength range of 110 nm, which suggests an efficient way of a new way of exciting LSP resonances and designing wave plates, and provides a great potential for liquid crystal display, optical communication, sensor detection and imaging.
Prevalence of Sexual Dysfunction in Women with Type 1, 2 Diabetes and Thyroid Disorder: A Cross-Sectional Study in Taif City, Saudi Arabia
Authors: Alshehri Khalid , Thobaiti Raghad Al , Alqurashi Athar , Algethami Nada , Alswat Khaled
Published: November 2020

Background: Women with diabetes mellitus or thyroid disorders are at risk of sexual dysfunction. This study aimed to estimate the prevalence of female sexual dysfunction (FSD) in women with diabetes and/or thyroid disorders and the impact of disease control on the ASEX score.Methods: A cross-sectional study for female patients who had a routine clinic visit were included. The Arizona Sexual Experience Scale (ASEX) was used to evaluate for FSD. Those with a total score of ≥ 19 or scored ≥ 5 on any item or ≥ 4 on three items were considered to have FSD.Results: A total of 253 female patients with a mean age of 39.1 ± 7.3 years were included. Two-thirds of the participants have no FSD. More than half (57.7%) of the participants had a strong desire for sex, and about 20% of the participants were unsatisfied with their orgasm. Compared to those with no FSD, those with FSD had lower BMI (P = 0.375), more likely to have a master’s degree or higher (P = 0.117), diabetes (P = 0.879), hypothyroidism (P = 0.625), diabetes-related microvascular and macrovascular complications (P = 0.049), higher HbA1c, fasting glucose, and TSH (P = 0.731, P = 0.161, and P = 0.561, respectively), lower total cholesterol and LDL (P = 0.368 and P = 0.339, respectively), and exercise more regularly (P = 0.929). Conclusion: One-third (32.5%) of the study participants had a FSD. Those with type 1 diabetes had the highest ASEX scores. We detected non-significant negative correlations between total ASEX score and both BMI and TSH, as well as a non-significant positive correlation between total ASEX score and both HbA1c and fasting glucose value.
Food Allergy Adjuvant and Early Immune Effects of Oral Exposure to Known and Suspected Gut Barrier Disruptors 
Authors: Drønen Elena , Nygaard Unni , Namork Ellen , Dirven Hubert
Published: November 2020

Background: Exposure to adjuvants with a food allergen has been shown to promote sensitization and development of food allergy in animal models. Barrier disrupting capacities have been suggested to be one mechanism of adjuvant action. In this study, we investigated how gut barrier disrupting compounds affected food allergy development in a mouse model of peanut allergy. Sensitization and clinical peanut allergy in C3H/HEOuJ mice were assessed after repeated oral exposure to peanut extract together with cholera toxin (CT), the mycotoxin deoxynivalenol (DON), house dust mite (HDM) or the pesticide glyphosate (GLY). In addition, we investigated early effects 4 to 48 hours after a single exposure to the compounds, by assessing markers of intestinal barrier permeability, alarmin production, intestinal epithelial responses, and local immune responses.Results: CT and DON exerted adjuvant effects on peanut allergy development assessed as clinical anaphylaxis in mice. The early markers were consistently only affected by DON, observed as increased IL-33 (interleukin 33) and thymic stromal lymphopoietin (TSLP) alarmin production in intestines and Interleukin 33 receptor ST2 in serum. DON also induced an inflammatory immune response in lymph node cells stimulated with lipopolysaccharide (LPS). HDM and GLY did not promote clinical food allergy and affected few (or none) of the early markers at the present doses.Conclusions: Oral exposure to CT and DON promoted development of clinical anaphylaxis in the peanut allergy mouse model. DON, but not CT, affected the early markers measured in the present study, indicating that DON and CT have different modes of action at the early stages of peanut sensitization.
Efficacy and Safety of Ultrasound-guided Percutaneous Transthoracic Needle Biopsy for Peripheral Pulmonary Lesions: Comparison Between 16-gauge and 18-gauge Core Biopsy Needle- a Propensity Score Matching Analysis
Authors: Huang Weijun , Ye Jieyi , Qiu Yide , Peng Weiwei , Lan Ninghui , Cui Weizhen , Huang Ting , Ou Yinghui , Li Yingjia
Published: November 2020

Background: Definitive diagnosis of peripheral pulmonary lesions (PPLs) depends upon histologic proof obtained via pleural biopsy. Ultrasound-guided sampling is now standard practice. How to determine a suitable needle size and sampling times to improve efficacy and safety remained challenging. This study aimed to compare the efficacy for histology diagnosis and the resulting complications between 16-gauge and 18-gauge core biopsy needle in ultrasound-guided percutaneous transthoracic biopsy for PPLs.Materials and Methods:1169 patients (767 men, 402 women; mean age, 59.4±13.2 years) who received biopsy for PPLs between September2011 and February 2019 were included. Propensity score matching (PSM) analysis was performed to adjust the baseline differences, and the rate of successful specimen assessment and complications were compared between 16-gauge (249 patients) and 18-gauge (920 patients) group. The number of pleural surfaces crossed (NOPSC) was defined as the times visceral pleural surface was transgressed. Stratified analysis was made based on NOPSC.Results: The overall success rate was 92.0% (1076/1169). The overall complication rate was 9.6%, including pneumothorax, hemorrhage and vasovagal reaction, which occurred in 2.5% (29/1169), 6.6% (77/1169), and 0.5% (6/1169) of patients, respectively. When NOPSC was one, the success rate and complication rate in 16-gauge group were comparable to that of 18-gauge group (both P>0.05). When NOPSC was two, the success rate in 16-gauge group was significantly higher than that of 18-gauge group (P=0.017), while the complication rate was comparable (P>0.05). When NOPSC was more than two, the rate of vasovagal reaction was significantly higher in 16-gauge group than that of 18-gauge group (P=0.012).Conclusion: Higher success rate could be achieved using 16-gauge than 18-gauge core biopsy needle in ultrasound-guided percutaneous transthoracic needle biopsy for PPLs when NOPSC was two. However, the rate of vasovagal reaction would be increased by using 16-gauge needle when NOPSC was more than two.
How Experiences in a Medical School Affect Medical Students’ Attitudes Toward Family Medicine as a Career Choice: A Mixed-Method Study
Authors: Homsangpradit Kwanchanok , Hathirat Saipin , Sumrithe Sutida
Published: November 2020

Background: Family practice is the key element of a primary care system. A shortage of family physicians is an important issue in Thailand. However, Thai medical students still show low interest in pursuing a career in family medicine. The objective of this research is to study how a curriculum, an extra-curricular activity, and a hidden curriculum in a medical school affect medical students’ attitude toward family medicine as their career choice.Methods: This research is a mixed-method study with a sequential-explanatory design. The quantitative part is an online questionnaire to obtain a distribution of interest in a career of family physician. It was distributed among 181 senior medical students of Ramathibodi medical school; out of which 64 have participated. In the qualitative part, a total of 14 students who met the inclusion criteria were chosen from the questionnaire and from a snowball sampling to participate in an in-depth interview. Thereafter, a content analysis was done to identify themes.Results: Four out of 64 participants showed interest in a career of family physician, but only one participant was strongly interested. As the whole curriculum focuses mostly on specialty contents, only the family medicine department teaches holistic care and students find it difficult to understand. Some students perceive that a psychosocial assessment intrudes too much into a patient’s personal life and is not a physician task. The examination-based curriculum causes them to lack spare time to participate in any extra-curricular activity. The students received both positive and negative comments about family physicians from other specialists. However, this hidden curriculum does not have a direct impact on the student’s decision to choose their career path. Important factors that influence the decision are their personal interests, masteries, family factors, a work-life balance, and a humanized environment. Conclusions: Experiences in medical school have an impact on medical students’ attitudes toward family physician as a career choice. A disease-oriented care model is still dominating Thai medical education. Therefore, the curriculum needs to be reformed to promote the importance of holistic care. This will lead to an increase in the production of Thai family physicians.
The effect of dietary supplementation of Nigella sativa (black seeds) on cell mediated immunological function of male Wistar rats
Authors: Mahmoud Hany , Almallah Amani , EL-Hak Heba Gad , Aldayel Tahany , Abdelrazek Heba , Khaled Howayda
Published: November 2020

This experiment aimed to investigate the effect of dietary Nigella sativa on cell mediated immune response. A total of eighteen male Wistar rats were divided equally into control and black seeds at 30 and 50 g/kg/diet (Sa30 and Sa50), respectively for 30 days. Weight gain, feed intake, feed conversion ratio (FCR), cell mediated immune response was monitored after injection of 0.1 mL of 10% phytohemagglutinin (PHA). Intumesce Index, serum total antioxidant capacity (TAC), Catalase (CAT), Interleukin-12 (IL-12), gamma interferon (γ-IF) and tumor necrosis factor alpha (TNF-α) were determined. Histopathological examination and immunohistochemistry of splenic caspase-3 and CD 8 were done. Nigella sativa significantly (p<0.05) improved weight gain and FCR in Sa30 and Sa50 groups. Significant increase for Intumesce Index in Sa50 group was observed. Total TAC, CAT, IL-12, γ-IF and TNF-αincreased significantly (P<0.05) in Sa30 and Sa50 groups. Histological examination of PHA stimulated foot pads showed more leukocytes infiltration and edema in a dose dependent pattern. Splenic caspase-3 and CD 8 showed significant (P<0.05) decrease and increase, respectively in Sa30 and Sa50 groups. Nigella sativa seeds had immunostimulatory ability through their antioxidant potential, cytokines induction, CD 8 promotion and reducing splenic apoptosis.
Diversity Oriented Deep Reinforcement Learning for Targeted Molecule Generation
Authors: Pereira Tiago , Abbasi Maryam , Ribeiro Bernardete , Arrais Joel P.
Published: November 2020

In this work, we explore the potential of deep learning to streamline the process of identifying new potential drugs through the computational generation of molecules with interesting biological properties. Two deep neural networks compose our targeted generation framework: the Generator, which is trained to learn the building rules of valid molecules employing SMILES strings notation, and the Predictor which evaluates the newly generated compounds by predicting their aﬃnity for the desired target. Then, the Generator is optimized through Reinforcement Learning to produce molecules with bespoken properties. The innovation of this approach is the exploratory strategy applied during the reinforcement training process that seeks to add novelty to the generated compounds. This training strategy employs two Generators interchangeably to sample new SMILES: the initially trained model that will remain ﬁxed and a copy of the previous one that will be updated during the training to uncover the most promising molecules. The evolution of the reward assigned by the Predictor determines how often each one is employed to select the next token of the molecule. This strategy establishes a compromise between the need to acquire more information about the chemical space and the need to sample new molecules, with the experience gained so far. To demonstrate the eﬀectiveness of the method, the Generator is trained to design molecules with high inhibitory power for the adenosine A2A and κ opioid receptors. The results reveal that the model can eﬀectively modify the biological aﬃnity of the newly generated molecules towards the craved direction. More importantly, it was possible to ﬁnd auspicious sets of unique and diverse molecules, which was the main purpose of the newly implemented strategy.
Regression Based Prediction of Minimental State Examination Score Using the Tablet Based Trail Making Test
Authors: Kubo Kouki , Hama Seiji , Furui Akira , Mizuguchi Tomohiko , Yanagawa Akiko , Kandori Akihiko , Sakai Hiroto , Morisako Yutaro , Orino Yuki , Hamai Maho , Fujita Kasumi , Yamawaki Shigeto , Tsuji Toshio
Published: November 2020

Trail making test (TMT) is one of the most extensively used neuropsychological tests. In this study, we examined the equivalence between the iPad version of TMT part A (iTMT-A) and the paper version of TMT part A (pTMT-A), and predicted the cognitive function with various data extracted from repeated TMT-A. Forty-two patients who performed five repeated TMT-A (1st–3rd: iTMT-A, 4th: pTMT-A, 5th: inverse version of iTMT-A) and Mini-Mental State Examination (MMSE) were included. The Kruskal–Wallis one-way analysis of variance revealed no statistical differences between the completion times of iTMT-A and pTMT-A. Factors contributing to the MMSE prediction were selected by stepwise multiple regression analysis and Bland–Altman plots. Then, the prediction abilities of the three models—multiple linear, partial least squares (PLS), and neural network regression—were compared. When using the completion time, the linear regression model with the 1st–5th results exhibited the highest prediction ability. However, when the move time and dwell time were used, the multiple linear and PLS regression models using the 1st and 2nd iTMT-A data exhibited the highest prediction ability. Compared with pTMT-A, iTMT-A extracted a large amount of data with fewer repetitions, and the prediction accuracy of cognitive function was improved.
Reliability of Urinary Charged Metabolite Concentrations in a Large-Scale Cohort Study Using Capillary Electrophoresis-Mass Spectrometry
Authors: Ishibashi Yoshiki , Harada Sei , Takeuchi Ayano , Iida Miho , Kurihara Ayako , Kato Suzuka , Kuwabara Kazuyo , Hirata Aya , Shibuki Takuma , Okamura Tomonori , Sugiyama Daisuke , Sato Asako , Amano Kaori , Hirayama Akiyoshi , Sugimoto Masahiro , Soga Tomoyoshi , Tomita Masaru , Takebayashi Toru
Published: November 2020

Currently, large-scale cohort studies for metabolome analysis have been launched globally. However, only a few studies have evaluated the reliability of urinary metabolome analysis. This study aimed to establish the reliability of urinary metabolomic profiling in cohort studies.In the Tsuruoka Metabolomics Cohort Study, 123 charged metabolites were identified and routinely quantified using capillary electrophoresis-mass spectrometry (CE-MS). We evaluated approximately 750 quality control (QC) samples and 6,720 participants’ spot urine samples. We calculated inter- and intra-batch coefficients of variation in the QC and participant samples and technical intraclass correlation coefficients (ICC). A correlation of metabolite concentrations between spot and 24-hour urine samples obtained from 32 sub-cohort participants was also evaluated. The coefficient of variation (CV) was less than 20% for 87 metabolites (70.7%) and 20–30% for 19 metabolites (15.4%) in the QC samples. There was less than 20% inter-batch CV for 106 metabolites (86.2%). The 96 metabolites (78.0%) was above 0.75 for the estimated ICC. Among individuals, the Pearson correlation coefficient of 24-hours and spot urine was more than 70% for 59 of the 99 metabolites. These results show that the profiling of charged metabolites using CE-MS in morning spot human urine is suitable for epidemiological studies.
Postoperative Pain After Cesarean Section at University of Gondar Comprehensive Specialized Hospital, Gondar, Northwest Ethiopia, 2019; a Cross-sectional Follow-Up Study
Authors: Woldegerima Yophtahe , Demelash Geta , Hailekiros Amare , Birlie Wubie
Published: November 2020

BackgroundCesarean section is one of the most common obstetric procedures worldwide. Following this, parturients experience moderate to severe pain in the acute postoperative period. Therefore, in resource-limited settings, for full utilization of basic analgesic modalities and to take appropriates interventions, it is vital to know about the magnitude of the problem and its factors.ObjectiveTo assess the prevalence and factors associated with postoperative pain after cesarean section at the University of Gondar Comprehensive Specialized Hospital (UoGCSH), Northwest Ethiopia, 2019.MethodsA hospital-based prospective follow-up study was conducted among parturients who undergo cesarean section in the University of Gondar Comprehensive Specialized Hospital, from mid-February to April 20, 2019, after approval of the ethical review committee. Consecutively, a total of 290 parturients were included with a response rate of 97%. To measure pain severity numerical rating scale was used. Data was entered into Epi-data version 4.2 and analyzed by SPSS version 20 (IBM Corporate). The association between independent factors and the outcome variable was determined at 95% CI with the chi-squared test, bivariate, and multivariate logistic regression. Hosmer-Lemeshow test was used to assess the goodness of fit. Variables with a p-value of < 0.05 were considered significant.ResultsIn this study, the incidence of moderate to severe post-operative pain after cesarean section was 85.5% (95% CI: 81.4%, 89.0%) within the first 24 postoperative hours. On the multi-variable analysis, preoperative anxiety (AOR: 2.3, 95% CI: 1.1, 4.9), history of previous cesarean section (AOR: 2.3, 95% CI: 1.1, 5.0), Pfannenstiel incision (AOR: 3.2, 95% CI: 1.3, 8.0) and absence of regional analgesia (AOR: 3.7, 95% CI: 1.7, 7.9) were significantly associated with moderate to severe postoperative pain after cesarean section.ConclusionsIn this study, a large proportion of parturients had experienced moderate to severe post-cesarean pain in the first 24 postoperative hours. Preoperative anxiety, history of previous cesarean section, Pfannenstiel incision, and parturients with no regional analgesia were significantly associated with post-cesarean pain. Pain severity needs to be assessed and documented by using pain-rating scales and there should be an interdisciplinary approach to provide adequate pain management in our hospital.
Influence of Weekday of Admission and Level of Distress on Length of Hospital Stay in Patients With Low Back Pain: A Retrospective Cohort Study
Authors: Brunner Emanuel , Meichtry André , Vancampfort Davy , Imoberdorf Reinhard , Gisi David , Dankaerts Wim , Graf Anita , Rebsamen Stefanie , Suter Daniela , Wildi Lukas , Buechi Stefan , Sieber Cornel
Published: November 2020

BackgroundLow back pain (LBP) is often a complex problem requiring interdisciplinary management to address patients’ multidimensional needs. The inpatient care for patients with LBP in primary care hospitals is a challenge. In this setting, interdisciplinary LBP management is often unavailable during the weekend. Delays in therapeutic procedures may result in prolonged length of hospital stay (LoS). The impact of delays on LoS might be strongest in patients reporting high levels of psychological distress. Therefore, this study investigates which influence the weekday of admission and distress have on LoS of inpatients with LBP.MethodsRetrospective cohort study conducted between 1 February 2019 and 31 January 2020. ANOVA was used to test the hypothesized difference in mean effects of the weekday of admission on LoS. Further, a linear model was fitted for LoS with distress, categorical weekday of admission (Friday/Saturday vs. Sunday-Thursday), and their interactions.ResultsWe identified 173 patients with LBP. Mean LoS was 7.8 days (SD=5.59). Patients admitted on Friday (mean LoS=10.3) and Saturday (LoS=10.6) had longer stays but not those admitted on Sunday (LoS=7.1). Analysis of the weekday effect (Friday/Saturday vs. Sunday-Thursday) showed that admission on Friday or Saturday was associated with significant increase in LoS compared to admission on other weekdays (t=3.43, p=<0.001). 101 patients (58%) returned questionnaires, and complete data on distress was available from 86 patients (49%). According to a linear model for LoS, the effect of distress on LoS was significantly modified (t=2.51, p=0.014) by dichotomic weekdays of admission (Friday/Saturday vs. Sunday-Thursday).ConclusionsPatients with LBP are hospitalized significantly longer if they have to wait more than two days for interdisciplinary LBP management. This particularly affects patients reporting high distress. Our study provides a platform to further explore whether interdisciplinary LBP management addressing patients’ multidimensional needs reduces LoS in primary care hospitals.
Improving Soybean Production Under Light Supplementation at Field - A Case Study
Authors: Lemes Ernane , Azevedo Breno , Domiciano Matheus , Andrade Samuel
Published: November 2020

In modern agriculture, there is a growing need for cropping efficiency e low environmental impacts. Diverse technologies are becoming available in a recent wave of modernization and integration of knowledge. The use of high-efficiency light supplementation to plant development is scarce to high-productive crops at field conditions (outdoor). The objectives of this study were to evaluate soybean plant and yield responses in an open commercial area (field scale) cultivated with artificial light supplementation. A commercial irrigated (pivot) area received an illumination system for light supplementation (LS) in the inner pivot spans. The light applied was a composition of blue, green and red bands. The outer pivot spans did not receive light supplementation (nLS). About 40 hours of LS were applied to the plants during the soybean crop cycle. Internode number, plant height, pods per plant were weekly evaluated to compose the area under the progress curve (AUPC). The grain yield was also evaluated at harvest. Analysis of variance and test of averages were used to evaluate the data. The AUPC of the internode number, plant height and pods per plant were 15.6, 23.3 and 25.3% higher than for the LS treatment. The regular soybean cycle (nLS) was about 17 weeks; however, the harvest of the LS treatment happened three weeks later. The grain productivity of the nLS was about 4,500 kg ha-1 (75 bags), and of the LS treatment was about 7,080 kg ha-1 (118 bags) - 57.3% superior. Light supplementation at field scale is a challenge; however, affordable and field resistant technologies are now accessible. The present study is the first report of light supplementation used to improve soybean crop production at field scale. The possibility of using light regulation as an additional technique for increasing yields and sustainable production are also discussed.
Development of a Clinical Tool for Rating the Body Function Categories of the ICF Generic-30/Rehabilitation Set in Japanese Rehabilitation Practice, and Examination of its Interrater Reliability
Authors: Senju Yuki , Mukaino Masahiko , Prodinger Birgit , Selb Melissa , Okouchi Yuki , Mizutani Kouji , Suzuki Megumi , Yamada Shin , Izumi Shin-Ichi , Sonoda Shigeru , Otaka Yohei , Saitoh Eiichi , Stucki Gerold
Published: November 2020

BackgroundThe International Classification of Functioning, Disability, and Health (ICF) Generic-30 (Rehabilitation) Set is a tool for assessing the functioning of a clinical population in rehabilitation. The ICF Generic-30 consists of 9 ICF categories from the component “body functions” and 21 from the component “activities and participation”. This study aimed to develop a rating reference guide for the 9 body function categories of the ICF Generic-30 Set using a predefined, structured process and to examine the interrater reliability of the ratings using the rating reference guide.MethodsThe development of the first version of the rating reference guide involved the following steps: (1) A trial of rating patients by several raters; (2) cognitive interviews with each rater to analyze the thought process involved in each rating; (3) the drafting of the rating reference guide by a multidisciplinary panel; and (4) a review by ICF specialists to confirm consistency with the ICF. Subsequently, we conducted a first field test to gain insight on the use of the guide in practice. The reference guide was modified based on the raters’ feedback in the field test, and an interrater reliability test was conducted thereafter. Interrater agreement was evaluated using weighted kappa statistics with linear weights.ResultsThe first version of the rating reference guide was successfully developed and field tested. The weighted kappa coefficient in the field testing ranged from 0.25 to 0.92. The interrater reliability testing of the rating reference guide modified based on the field test results yielded an improved weighted kappa coefficient ranging from 0.54 to 0.85. ConclusionsIn this study, we developed and modified a rating reference guide for the body function categories of the ICF Generic-30 Set. The interrater reliability test using the final version of the rating reference guide showed moderate to excellent interrater agreement, which encourages the use of the ICF in rehabilitation practice.Trial registrationNot applicable.
Multi-Dimensional Optimization of In0.53Ga0.47As Thermophotovoltaic Cell using Real Coded Genetic Algorithm
Authors: Gamel Mansur , Ker Pin Jern , Lee Hui Jing , Rashid Wan Emilin Suliza Wan Abdul , Hannan M.A. , David John , Jamaludin Md Zaini
Published: November 2020

The optimization of thermophotovoltaic (TPV) cell efficiency is essential since it leads to a significant increase in the output power. Typically, the optimization of In0.53Ga0.47As TPV cell has been limited to single variable such as the emitter thickness, while the effects of the variation in other design variables are assumed to be negligible. The reported efficiencies of In0.53Ga0.47As TPV cell mostly remain < 15%. Therefore, this work develops a multi-variable or multi-dimensional optimization of In0.53Ga0.47As TPV cell using the real coded genetic algorithm (RCGA) under various radiation temperatures. RCGA was developed using Visual Basic and it was hybridized with Silvaco TCAD for the electrical characteristics simulation. Under radiation temperatures from 800 K to 2000 K, the optimized In0.53Ga0.47As TPV cell efficiency increases by an average percentage of 11.86% (from 8.5% to 20.35%) as compared to the non-optimized structure. It was found that the incorporation of a thicker base layer with the back-barrier layers enhances the separation of charge carriers and increases the collection of photo-generated carriers near the band-edge, producing an optimum output power of 0.55 W/cm2 (cell efficiency of 22.06%, without antireflection coating) at 1400 K radiation spectrum. The results of this work demonstrate the great potential to generate electricity sustainably from industrial waste heat and the multi-dimensional optimization methodology can be adopted to optimize semiconductor devices, such as solar cell, TPV cell and photodetectors.
Early detection of drug-resistant Streptococcus pneumoniae and Haemophilus influenzae by quantitative flow cytometry
Authors: Sawada Takahiro , Katayama Masayuki , Takatani Shogo , Ohiro Yoshiyuki
Published: November 2020

Early detection of drug resistance contributes to combating drug-resistant bacteria and improving patient outcomes. Microbial testing in the laboratory is essential for treating infectious diseases because it can provide critical information related to identifying pathogenic bacteria and their resistance profiles. Despite these clinical requirements, conventional phenotypic testing is time-consuming. In addition, recent rapid drug resistance tests are not compatible with fastidious bacteria such as Streptococcus and Haemophilus species.In this study, we validated the feasibility of direct bacteria counting using highly sensitive quantitative flow cytometry. Furthermore, by combining flow cytometry and a nucleic acid intercalator, we constructed a highly sensitive method for counting viable fastidious bacteria. These are inherently difficult to measure due to interfering substances from nutrients contained in the medium. Based on the conventional broth microdilution method, our method acquired a few microliter samples in a time series from the same microplate well to exclude the growth curve inconsistency between the samples. Fluorescent staining and FCM measurements were completed within 10 minutes. Therefore, this approach enabled us to determine antimicrobial resistance for these bacteria within a few hours. Highly sensitive quantitative flow cytometry presents a novel avenue for conducting rapid antimicrobial susceptibility tests.
Microstructured Collagen Films for 3D Corneal Stroma Modelling
Authors: Prittinen Juha , Zhou Xin , Backman Ludvig , Danielson Patrik
Published: November 2020

Corneal injury is a major cause for impaired vision around the globe. The fine structure of the corneal stroma plays a pivotal role in the phenotype and behaviour of the embedded cells during homeostasis and healing after trauma or infection. In order to study healing processes in the cornea, it is important to create culture systems that functionally mimic the natural environment as well as possible. In this study, we aimed to create a microstructured collagen film-based culture system that guides keratocytes (stromal cells) to their native, layerwise perpendicular orientation in 3D. By casting a micropattern (1,000 grooves/mm) on collagen vitrigels, we were able to make thin and transparent films that align cells along the grooves. The films provide an easily reproducible stroma model that maintains high cell viability and improves the preservation of the keratocyte phenotype in keratocytes that were subjected to fibroblast differentiation.