bluuebunny/crossref_metadata_2025 huggingface dataset:
Prevalence of Vertebral Fractures and Serum Sclerostin Levels in Acromegaly
Authors: Uygur Meliha Melin , Yazici Dilek Dereli , Buğdayci Onur , Yavuz Dilek Gogas
Published: February 2021

ObjectiveAn increased prevalence of vertebral fractures (VFs) has been reported in previous studies. The aim of this study was to evaluate the association between bone mineral density (BMD), bone turnover markers, serum sclerostin levels, and vertebral fractures (VFs) in acromegaly patients. We also evaluated the effects of gonadal status, disease activity, treatment modality, age, sex, and body mass index (BMI) on skeletal endpoints.DesignCase-control study.Patients and measurementsSeventy acromegaly patients (M/F:36/34, mean age 45,5±11,9 years) and 70 controls (M/F:31/39; mean age 45.66±11.9 years) were included. VFs, BMD, calcium metabolism, markers of bone turnover, and sclerostin levels were evaluated. BMD was measured by dual-energy X-ray absorptiometry (Hologic QDR 4500). Conventional lateral radiography of the spine was performed and the Genant method was used for the assessment of fractures of T4–L5 vertebrae.ResultsThe prevalence of vertebral fractures was higher in acromegalic patients as compared with the control group (72.9% vs. 20%; p<0.001). Serum phosphate (P) levels (3.46±0.59 mg/dl vs. 3.11±0.44 mg/dl; p<0.001) and b-cross laps (CTx) levels (0.47 µg/l, range 0.04-2.38 vs. 0.28 µg/l, range 0.11-0.80; p<0.001) were significantly higher in acromegaly patients than control subjects. Serum sclerostin levels were similar between either acromegaly patients and control subjects or acromegaly patients with VF and without VF. In the means of treatment modality, VFs were more frequent in patients treated with adjuvant gamma-knife radiosurgery (GKS) (p=0.07). In the binary logistic regression analysis, the age of the acromegaly patients, the presence of hypogonadism, and GKS treatment were the factors significantly correlated with the occurrence of spinal fractures.ConclusionThe prevalence of VFs in patients with acromegaly is higher than in control subjects. Since advanced age, the presence of hypogonadism and GKS treatment were the factors predicting VFs in acromegaly; radiological evaluations should be considered as an emerging tool especially in those patients. Although markers of bone turnover elevated in acromegaly, they were not useful for the prediction of fractures. Serum sclerostin levels showed no discrepancy between the two groups and further studies are required for assessment of sclerostin role in this form of secondary osteoporosis.
Comparison of CMIP6 and CMIP5 Model Performance in Simulating Historical Precipitation and Temperature in Bangladesh: A Preliminary Study
Authors: Kamruzzaman Mohammad , Shahid Shamsuddin , Islam ARM Towfiqul , Hwang Syewoon , Cho Jaepil , Zaman Md. Asad Uz , Ahmed Minhaz , Rahman Md. Mizanur , Hossain Md. Belal
Published: February 2021

The relative performance of global climate models (GCMs) of phases 5 and 6 of the Coupled Model Intercomparison Project (CMIP5 and CMIP6, respectively) was assessed in this study based on their ability to simulate annual and seasonal mean rainfall and temperature over Bangladesh for the period 1977–2005. The multiple statistical metrics were used to measure the performance of the GCMs at 30 meteorological observation stations. Two robust multi-criteria decision analysis methods were used to integrate the results obtained using different metrics for an unbiased ranking of the GCMs. The results revealed MIROC5 as the most skilful among CMIP5 GCMs and ACCESS-CM2 among CMIP6 GCMs. Overall, a significant improvement in CMIP6 MME compared to CMIP5 MME was noticed in simulating rainfall over Bangladesh at annual and seasonal scales. CMIP6 MME also showed significant reduction in maximum and minimum temperature biases over Bangladesh. However, systematic wet and cold biases still exist in CMIP6 models for Bangladesh. CMIP6 GCMs showed higher spatial correlation with observed data compared to CMIP5 GCMs, but higher difference in terms of standard deviations and centered root mean square errors, indicating better performance in simulating geographical distribution but lower performance in simulating spatial variability of most of the climate variables for different timescales. In terms of Taylor skill score, the CMIP6 MME showed higher performance in simulating rainfall but lower performance in simulating temperature compared to CMIP5 MME for most of the timeframes. The findings of this study suggest that the added value of rainfall and temperature simulations in CMIP6 models is incompatible with the climate models used in this research.
Retinal Tissue Develops an Inflammatory Reaction to Tobacco Smoke and Electronic Cigarette Vapor in Mice
Authors: Wang Feng , Hadzic Stefan , Roxlau Elsa T. , Fuehler Baerbel , Janise-Libawski Annabella , Wimmer Tobias , Lei Bo , Li Shao-Wei , Weissmann Norbert , Stieger Knut
Published: February 2021

Cigarette smoke has been identified as a major risk factor for the development of age-related macular degeneration (AMD). As an alternative of conventional cigarette (C-cigarette), electronic cigarette (E-cigarette) has been rapidly promoted and used globally. The increasing usage of E-cigarette raises concerns with regard to long-term consequences related to retinal tissue. In the present study, a controlled study in mice models was conducted to probe the comprehensive effects of E-cigarette on retina, RPE and choroid tissues by (1) comparing the effect of C-cigarette smoke and E-cigarette smoke on retina; (2) determining the effects of E-cigarette vapor on the RPE and analyzing the changes with regard to inflammatory and angiogenic mediators in retina/RPE/choroid. The data showed that C-cigarette smoke exposure promoted an inflammatory reaction in the retina in vivo. Mice exposed to E-cigarette (nicotine-free) vapor developed inflammatory and angiogenic reactions more pronounced in RPE and choroid, while nicotine-containing E-cigarette vapor caused even a more serious reaction. Both, inflammatory and pro-angiogenic reactions increased with the extension of exposure time. These results demonstrate that exposure to C-cigarette smoke is harmful to the retina. Likewise, the exposure to E-cigarette vapor (with or without nicotine) increases the occurrence and progression of inflammatory and angiogenic stimuli in the retina, which might be similar effects causing the onset of wet AMD in humans.
Usefulness of Dual Isotope 123I-IMP and 201Tl SPECT for the Diagnosis of Primary Central Nervous System Lymphoma and Glioblastoma
Authors: Osawa Sho , Tosaka Masahiko , Horiguchi Keishi , Tokue Azusa , Higuchi Tetsuya , Tsushima Yoshito , Yoshimoto Yuhei
Published: February 2021

IntroductionPreoperative differential diagnosis between glioblastoma (GBM) and primary central nervous system lymphoma (PCNSL) is important because these tumors require different surgical strategies. This study investigated the usefulness of dual isotope, iodine-123-labeled N-isopropyl-p-iodoamphetamine (123I-IMP) and thallium-201 chloride single photon emission computed tomography (201Tl SPECT) for the differential diagnosis.MethodsTwenty-five PCNSL patients and 27 GBM patients who underwent dual isotope, 123I-IMP and 201Tl SPECT are included. Tumor to normal (T/N) ratio was calculated from the ratio of maximum tracer counts in the contrast-enhanced lesion to the mean counts in the contralateral cerebral cortex. The mean and minimum apparent diffusion coefficient values (ADCmean, and ADCmin, respectively) on magnetic resonance imaging were also analyzed. ResultsTumor to normal (T/N) ratios of PCNSL were significantly higher than that of GBM for both isotopes and phases (P < 0.001). Both ADC values of PCNSL were significantly lower than those of GBM (P < 0.001). Delayed phase 123I-IMP gave the most accurate findings for differentiation between PCNSL and GBM with the optimum cut-off value of 1.009, sensitivity 92.0%, specificity 88.9%, and area under the curve 0.945 (95% confidence interval, 0.883-1.000). Fifty of 52 patients (96.2%) showed retention index of 201Tl SPECT 0.7 or higher, which indicates malignant brain tumors. ConclusionsDelayed phase 123I-IMP SPECT could differentiate between PCNSL and GBM with the highest accuracy. 201Tl SPECT was useful for estimation of the malignancy and localization of the tumors. Dual isotope 123I-IMP and 201Tl SPECT was useful for the preoperative diagnosis of PCNSL and GBM.
Polarity Independent Resistive Switching in MoS2 Nanosheets and PEO based Nanocomposite Films
Authors: Deb Rajesh , Pathak Prashanta , MOHAPATRA SAUMYA RANJAN , Das Ujjal
Published: February 2021

Here, we report the exfoliation of bulk MoS 2 (molybdenum disulfide) into few layer nanosheets and then prepared nano-composite films with poly (ethylene oxide) (MoS 2 -PEO). We observed non-polar or polarity independent bistable resistive switching memory in two-terminal devices with Indium tin oxide (ITO) and aluminum (Al) as bottom and top electrode. In both bipolar and unipolar operations, it is observed that the biasing direction controls the current conduction mechanism. When positive bias is applied at the top Al electrode, the low resistance state (LRS) conduction is Ohmic type. But in opposite biasing condition, LRS conduction is space charge controlled. The current-voltage characteristics of the bipolar and unipolar switching are distinctly different in terms of their RESET process. In bipolar, the RESET process is very sharp whereas in unipolar operation it is staggered and step-wise.
Perceptions of Facilitators and Barriers to Mental Health Treatment Engagement Among Decision-making Competent Adolescents in Greece
Authors: Tsamadou Eftychia , Voultsos Polychronis , Emmanouilidis Anastasios , Ampatzoglou Grigorios
Published: February 2021

Background: A subset of adolescents with mental disorders are likely to be (share) decision making competent and hence can make their treatment engagement more effective. Treatment engagement is decisive in achieving successful outcomes. However, there are high rates of drop-out in mental health settings.Aim: This study aims at identifying barriers to or facilitators of mental health care engagement among adolescents with decision-making competence in Greece. Methods: Participants were adolescents in therapy for mental disorders recruited from an outpatient tertiary hospital setting. First, potential participants with decision making competence were identified. Second, 50 participants were interviewed about their perceptions of treatment. The interviews were auto-recorded. A transcription verbatim and data analysis were conducted. All the requirements of a qualitative research and ethical considerations were observed.Results: All the participants highlighted their experience with facilitators rather than barriers to their treatment engagement. Facilitators included: a) positive treatment outcomes and adolescent's perceived usefulness of treatment, b) a meaningful adolescent-therapist relationship, c) family’s supportive role, d) symptoms and negative self-image, and e) developing social relationships and acceptance by peers. The participants equally highlighted the importance of getting rid of their symptoms and improve their socialization skills. Other facilitators included: achieving professional and personal goals in life, enhancing their independence and self-esteem / self-image, or even just confessing to another trustworthy person. Friends were reported as having a neutral or mild supportive role. The barriers included ineffective and unhelpful treatment, negative experiences with their therapist, relief from symptoms and mental health therapy-related stigma. Conclusion: For the most part, the findings enhance prior studies. Participants highlighted facilitators rather than barriers to treatment engagement. For the most part, the findings enhance prior studies. However, we identified some nuances which might be used by therapists to enhance the adolescents’ treatment engagement. For instance, bearing in their mind that by the subsiding of symptoms adolescents are most likely to terminate the treatment prematurely and highlighting the achievement of adolescents’ future goals as well as the potential family’s enhanced well-being because of the improvement of adolescents’ mental health may contribute to reducing the attrition rate.
Contemporary Treatment Patterns and Survival of Cervical Cancer Patients in Ethiopia
Authors: Deressa Biniyam Tefera , Assefa Mathewos , Tafesse Ephrem , Kantelhardt Eva Johanna , Soldatovic Ivan , Cihoric Nikola , Rauch Daniel , Jemal Ahmedin
Published: February 2021

Background: Cervical cancer is the second commonly diagnosed cancer and the second leading cause of cancer death in women in Ethiopia, with rates among the highest worldwide. However, there are limited data on cervical cancer treatment patterns and survival in the country. Herein, we examine treatment patterns and survival of cervical cancer patients treated in Tikur Anbessa Hospital Radiotherapy Center (TAHRC), the only hospital with radiotherapy facility in the country. Methods: Women with histologically verified cervical cancer who were seen in 2014 at TAHRC were included. Information about clinical characteristics and treatments were extracted from the patients’ medical record files. The information on vital status was obtained from medical chart and through telephone calls. Result: Of the 349 cervical cancer patients treated at the radiotherapy center of TAHRC in 2014, medical records were retrieved for 242 patients. The median age at diagnosis was 48 years. The median waiting time for radiotherapy was 5.58 months. Stage migration occurred in 13% of patients while waiting for radiotherapy. Consequently, the proportion of patients with stage III or IV disease increased from 66% at first consultation to 74% at the initiation of radiotherapy. Among 151 patients treated with curative intent, only 34 (22.5%) of the patients received concurrent chemotherapy while the reaming patients received radiotherapy alone. Fifty-two months overall survival rate was 21.5% (14.6% in the worst-case scenario). As expected, survival was lower in patients with advanced stage at initiation of radiotherapy and in those treated as palliative care. Conclusion: The survival of cervical cancer patients remains low in Ethiopia because of late presentation and delay in receipt of radiotherapy, leading to stage migration in substantial proportion of the cases. Concerted and coordinated multisectoral efforts are needed to promote early presentation of cervical cancer and to shorten the unacceptable, long waiting time for radiotherapy.
Antibodies against dextransucrase from Streptococcus mutans display anti-biofilm and growth suppressing activities
Authors: Rather Shabeer Ahmad , Mahmood Akhtar , Singh Lakhvinder , Bhatia Alka , Sharma Sukesh Chander , Rather Abid Majid
Published: February 2021

Dextransucrase produced by Streptococcus mutans play an essential role in the formation of dental caries by synthesizing exopolysaccharides from sucrose, an important metabolite of the organism. In this study we report the location of dextransucrase in Streptococcus mutans cells and describe that antibodies raised against dextransucrase inhibited biofilm formation and reduced the adherence and hydrophobic properties of Streptococcus mutans. Western blot analysis and immunoelectron microscopy revealed that dextransucrase is located abundantly in the membrane fraction in S. mutans cells. Scanning electron microscopy and fluorescence microscopy revealed reduced cell density, impaired bioflim (plaque) formation in presence of dextransucrase antibodies. Genes associated with bioflim formation in S. mutans such as GtfB, GtfC, BrpA, relA, Smu630, vicK were down regulated (50–97%) in presence of the enzyme antibody. Presence of enzyme antibodies reduced adherence of S. mutans cells to glass surfaces by 58% and hydrophobicity by 55.2%. However dextransucrase antibodies did not affect acid production by S. mutans, under the experimental conditions. Immunohistochemistry studies with certain human samples displayed no cross reactivity with dextransucrase antibody. These findings suggest that antibodies against dextransucrase exhibit a profound inhibitory effect on the vital cariogenic factors of S. mutans and have no cross reactivity with human tissues tested, thus implying that dextransucrase could be a promising antigen to study its anticariogenic potential.
The Association between Urine Elements and Fasting Glucose Levels in a Community-Based Elderly People in Beijing
Authors: Liu Liu , Li Ang , Xu Qun , Wang Qin , Han Feng , Xu Chunyu , Liu Zhe , Xu Dongqun , Xu Donggang
Published: February 2021

Epidemiological studies have demonstrated that various kinds of urinary element concentrations were different between healthy, prediabetes, and diabetes patients. Meanwhile, many studies have explored the relationship between element concentration and fasting blood glucose (FBG), but the association between joint exposure to co-existing elements and FBG level has not been well understood. The study explored the associations of joint exposure to co-existing urinary elements with FBG level in a cross-sectional design. 275 retired elderly people were recruited from Beijing, China. The questionnaire survey was conducted, and biological samples were collected. The generalized linear model (GLM) and two-phase Bayesian kernel machine regression (BKMR) model were used to perform in-depth association analysis between urinary elements and FBG. The GLM analysis showed that Zn, Sr, and Cd were significantly correlated with the FBG level, under control potential confounding factors. The BKMR analysis demonstrated 8 elements (Zn, Se, Fe, Cr, Ni, Cd, Mn, and Al) had a higher influence on FBG (Posterior inclusion probabilities >0.1). Further intensive analyses result of the BKMR model indicated that the overall estimated exposure of 8 elements was positively correlated with the FBG level and was statistically significant when all element concentrations were at their 65th percentile. Meanwhile, the BKMR analysis showed that Cd and Zn had a statistically significant association with FBG levels when other co-existing elements were controlled at different levels (25th, 50th or 75th percentile), respectively. The results of the GLM and BKMR model were inconsistent. The BKMR model could flexibly calculate the joint exposure to co-existing elements, evaluate the possible interaction effects and nonlinear correlations. The meaningful conclusions were found that it was difficult to get by traditional methods. This study will provide methodological reference and experimental evidence for the association between joint exposure to co-existing elements and FBG in elderly people.
Beyond conceptual understanding of barriers to national adaptation policy: A comparative analysis of South Korea and the UK
Authors: Lee Seunghan , Paavola Jouni , Dessai Suraje
Published: February 2021

Despite progress with national adaptation policies, the adaptation deficit is growing. Barriers to adaptation are a key reason for the adaptation deficit. Past research on barriers only offers a conceptual understanding of the barriers, with limited insight into real adaptation processes. Common causality, interrelationships and dynamics of the barriers remain under-researched. Examining the cases of South Korea and the UK, this research aims to improve our understanding of the common barriers to national adaptation policy. Drawing from semi-structured interviews and documentary material, we identify 54 common factors in the two countries (17 barriers, 17 origins, 20 influences), and eight key barriers: conflicts between government departments, frequent rotating of civil servants, lack of political will, unclear range of participants in national adaptation policy, low priority of adaptation, uncertainty about the effectiveness of adaptation policy, differences between adaptation and election timelines, and lack of understanding of adaptation. We explain the origins and links between factors and the common causal mechanisms of barriers to national adaptation policy, as well as their influences by mapping them. Based on the mapping, we argue that there are barriers that are easier to address than others, and that there is a need to focus on them to reduce the adaptation deficit effectively. We conclude by discussing the policy implications of our findings.
The impact of participant engagement activities in supporting dapivirine ring use among participants enrolled in the Phase III MTN-020/ASPIRE study
Authors: Garcia Morgan , Luecke Ellen , Mayo Ashley , Scheckter Rachel , Ndase Patrick , Kiweewa Flavia Matovu , Kemigisha Doreen , Mansoor Leila E. , Singh Nishanta , Woeber Kubashni , Morar Neetha S. , Jeenarain Nitesha , Gaffoor Zakir , Gondwe Daniel K. , Makala Yvonne , Reddy Krishnaveni , Palanee-Philips Thesla , Baeten Jared M. , Straten Ariane van der , Soto-Torres Lydia , Torjesen Kristine , Musara Petina
Published: February 2021

Background: Low adherence to investigational products can negatively impact study outcomes, limiting the ability to demonstrate efficacy. To continue advancing potential new HIV prevention technologies for at-risk individuals, efforts are needed to improve adherence among study participants. In MTN-020/ASPIRE, a phase III randomized, double-blind, placebo-controlled study of the dapivirine vaginal ring carried out across 15 sites in sub-Saharan Africa, a multifaceted approach to adherence support was implemented, including a strong focus on participant engagement activities (PEAs). In this manuscript, we describe PEAs and participant attendance, and analyze the potential impact of PEAs on ring use. Methods: All sites implemented PEAs and submitted activity and attendance reports to the study management team throughout the study. Participant demographics were collected via case report forms. Ring use was estimated based on residual dapivirine remaining in the last returned ring by each participant and connected to PEA attendance using participant identification numbers. We used multivariate logistic regression to explore differences in ring use between PEA attendance groups and reviewed qualitative reports for illustrative quotes highlighting participant experiences with PEAs. Results: 2,312 of 2,629 study participants attended at least one of 389 PEAs conducted across sites. Participant country and partner knowledge of study participation were most strongly associated with PEA attendance (p < 0.005) with age, education, and income status also associated with event attendance (p < 0.05). When controlling for these variables, participants who attended at least one event were more likely to return a last ring showing at least some use (AOR=3.52) than those who never attended an event. There was an even stronger correlation between a last returned ring showing use and participant attendance at multiple events (AOR=4.03). Conclusions: Our analysis supports the growing body of work illustrating the importance of meaningfully engaging research participants to achieve study success and aligns with other analyses of adherence support efforts during ASPIRE. While causation between PEA attendance and product use cannot be established, residual drug levels in returned rings strongly correlated with participant attendance at PEAs, and the benefits of incorporating PEAs should be considered when designing future studies of investigational products.
Targeting adaptation to safeguard sustainable development against climate-change impacts
Authors: Fuldauer Lena , Thacker Scott , Haggis Robyn , Nerini Francesco Fuso , Nicholls Robert , Hall Jim
Published: February 2021

The international community has committed to achieve 17 Sustainable Development Goals (SDGs) by 2030 and to enhance climate action under the Paris Agreement. Yet achievement of the SDGs is already threatened by climate-change impacts. Here we show that further adaptation this decade is urgently required to safeguard 68% of SDG targets against acute and chronic threats from climate change. We analyse how the relationship between SDG targets and climate-change impacts is mediated by ecosystems and socio-economic sectors, which provides a framework for targeting adaptation. Adaptation of wetlands, rivers, cropland, construction, water, electricity and housing in the most vulnerable countries should be a global priority to safeguard sustainable development by 2030. We have applied our systems framework at the national scale in Saint Lucia and Ghana, which is helping to align National Adaptation Plans with the SDGs, thus ensuring that adaptation is contributing to, rather than detracting from, sustainable development.
Cerebrospinal Fluid Rhinorrhea Post COVID-19 Nasopharyngeal Swab: a Case Report
Authors: Berdouk Sabrina , AlHefeiti Suhailah
Published: February 2021

Background: Cerebrospinal fluid rhinorrhea is a potentially life threatening condition and it is a rare emergency presentation. Most cases has been related to head trauma. However, CSF leak post COVID swab has been rarely reported.Case presentation: We report a 10 year old Emirati male, who presented to emergency department complaining of unilateral clear watery nasal discharge for 14 days, the discharge started after COVID-19 nasopharyngeal swab. The patient is a known case of 3MC syndrome and he underwent surgical repair for cleft lip and cleft palate. From the history and physical examination CSF rhinorrhea was highly suspected and nasal endoscopy confirmed the diagnosis of cribriform defect on the left side. The patient underwent surgical repair and his symptoms resolved after the surgery.Conclusion: We can conclude that COVID-19 nasopharyngeal swab has potential life threatening complications and one should consider the contraindications and the alternative methods available to detect COVID-19 to minimize the potential risks.
Development and Validation of a Risk Score for Predicting 1-Year Mortality Risk of STEMI Based on a Nationwide Cohort in China
Authors: Chen Si , Che Qianzi , Zhang Yan , Jia Jia , Wu Yiqun , Huo Yong , Chen Dafang
Published: February 2021

BackgroundA risk assessment for identifying long-term risk of post-discharge mortality in Chinese STEMI patients remains a concern. The aim of this study is to establish a bedside available risk scoring system for predicting 1-year mortality risk among Chinese STEMI patients. Methods STEMI patients(n=12611) were enrolled from the China STEMI Care Project Phase 2(CSCAP-2) collected between 2015 and 2016. Confounding bias was controlled using propensity score matching. Epidemiological, clinical, laboratory, and imaging variables, treatment strategy and medicine records were screened using extreme gradient boosting and nomogram according to the hazard ratio of Cox regression analysis to construct a predictive score. A validation cohort included 7342 patients collected in 2017 from CSCAP-2 was analyzed using receiver ROC and expectation (E)/observation (O) ratio to validate the risk scoring system. Results From 39 potential predictors, 8 variables were independent predictive factor and were included in the risk score: Killip class, early reperfusion strategy, Non-PCI intraoperative anticoagulants, heart rate, gender, age, anterior-wall myocardial infarction (AWMI) and inferior-wall myocardial infarction (IWMI). The new model demonstrated an excellent discrimination and calibration. The c-statistic and E/O ratio were 0.87(95%CI, 0.80-0.93) and 1.14(95%CI, 0.93-1.39) in the train set, 0.88 (95%CI, 0.78-0.96) and 1.15(95%CI, 0.85-1.56) in the test set, meanwhile, 0.89(95%CI, 0.82-0.95) and 1.00(95%CI, 0.81-1.23) in the validation cohort. The score has better sensitivity than the GRACE score and can recognize risk stratification among STEMI patients (P<0.001).Conclusions We developed a risk scoring system for predicting 1-year mortality risk of STEMI in a large Chinese population. The new score is easy-to-use and demonstrating a good discriminatory accuracy in predicting both short-term and long-term mortality risk in Chinese patients with STEMI.
Entropy analysis of n-grams and estimation of the number of meaningful language texts. Cyber security applications
Authors: Malashina Anastasia
Published: February 2021

We estimate the n-gram entropies of English- language texts, using dictionaries and taking into account punctuation, and find a heuristic method for estimating the marginal entropy. We propose a method for evaluating the coverage of empirically generated dictionaries and an ap- proach to address the disadvantage of low coverage. In ad- dition, we compare the probability of obtaining a meaning- ful text by directly iterating through all possible n-grams of the alphabet and conclude that this is only possible for very short text segments.
Anoplasty For Fused Anus Following Fournier’s Gangrene Debridement: A Case Report
Authors: Muniandy Jothinathan , Henry Fitjerald , Teh Yong Sim
Published: February 2021

Anal stenosis is a rare debilitating surgical condition. The severity and level of the impacted region determines the management options. Numerous tension free anoplasty techniques and its varying success rates have been reported. A patient-tailored anoplasty approach depending on the severity, location, and extent of anal stenosis is rudimentary. We present a case of fused anus following extensive surgical debridement for Fournier’s Gangrene. Colonoscopy illumination guided neo-anal creation was performed, which resulted in low severe anal stenosis six weeks later. Subsequently, Y-V anoplasty, lateral internal sphincterotomy, and colostomy closure were done which showed good initial recovery. However, six months later, the anal stenosis recurred, for which diamond-shaped anoplasty was offered but patient had refused any further surgical intervention. The clinical management challenge and learning experience is shared within the report.
Intestine epithelial cell-derived extracellular vesicles alleviate inflammation induced by Clostridioides difficile TcdB through the activity of TGF-β1
Authors: Wan Shuangshuang , Song Guangzhong , Hu Hui , Xu Yaqing , Zeng Peng , Lin Shan , Song Xiaojun , Jin Dazhi
Published: February 2021

Objective: Clostridioides difficile infection (CDI) has been primarily associated with the toxin B (TcdB), which can activate the intestinal immune system and lead to pathological damage. Even though the biological functions of intestine epithelial cell-derived extracellular vesicles (I-Evs) have been well documented, the role of I-Evs in the process of CDI is still unknown. Methods: I-Evs were isolated from mouse intestine tissues by ultracentrifugation protocol, identified by electron microscopy, nanoparticle tracking, sucrose density gradient centrifugation, and western blotting. Intestinal pathological damage was measured after intraperitoneal injection of TcdB into mice. Results: We isolated I-Evs ranging from 100–200 nm in mean diameter, with a density of 1.09-1.17 g/mL. These I-Evs expressed the extracellular vesicle-associated specific surface markers, CD63 and TSG101. In vitro, 50 µg I-Evs decreased the expression of IL-6, TNF-a, IL-1β, and IL-22 induced by 0.8 ng/mL C. difficile TcdB, and increased expression of TGF-b1. In vivo, I-Evs also promoted regulatory T cell induction, which improved the survival rate of mice up to 80% relative to C. difficile TcdB mice, dependent on the TGF-b1 signalling pathway. Conclusion: As an emerging immunotherapy, I-Evs can reduce the intraperitoneal infection induced by C. difficile TcdB and improve survival in mice.
Evaluation of Rivaroxaban- and Dabigatran-Associated Hemorrhagic Events Using the FDA-Adverse Event Reporting System Database (FAERS)
Authors: Guo Mingxing , Thai Sydney , Zhou Junwen , Wei Jingkai , Zhao Ying , Xu Wanyi , Wang Tiansheng , Cui Xiangli
Published: February 2021

Background Rivaroxaban and dabigatran are non-vitamin K antagonist oral anticoagulants that are widely used for treatment and prevention of venous thrombo-embolism and prevention of stroke in patients with atrial fibrillation.Objective To estimate and compare hemorrhagic events reported for rivaroxaban and dabigatran.Setting FDA Adverse Event Reporting System (FAERS) database.Methods The reporting odds ratio (ROR) was used to analyze the reporting of hemorrhagic events.Main outcome measure The overall hemorrhagic events and hemorrhagic events in different physiological systems and indications.Results A total of 53,085 reports of hemorrhage related to rivaroxaban, accounting for 49.79% of all rivaroxaban-related ADR reports and 13151 hemorrhagic reports related to dabigatran, accounting for 38.51% of all dabigatran-related ADR reports. The overall ROR (95% CI) for hemorrhagic event reporting for rivaroxaban compared with dabigatran was 1.58 (95% CI 1.54-1.62). The RORs (95% CI) in gastrointestinal systems, nervous system, renal and urinary system, skin and subcutaneous tissue, and eye system were 1.38 (1.34-1.42), 0.94 (0.90-0.98), 1.07 (1.01-1.13), 0.80 (0.70-0.90), and 1.38 (1.19-1.60), respectively. The RORs (95% CI) for hemorrhagic events in patients with atrial fibrillation, pulmonary embolism and deep vein thrombosis comparing rivaroxaban with dabigatran were 1.85 (1.79-1.91), 2.02 (1.67-2.47) and 2.17 (1.82-2.59).Conclusions Overall, a moderate signal for hemorrhage associated with rivaroxaban use was observed when compared with dabigatran. Hemorrhagic events in different physiological systems were not have a higher risk in case reports of rivaroxaban compared to dabigatran. But for the treatment of patients with pulmonary embolism or deep vein thrombosis, rivaroxaban are associated with more hemorrhagic events compared to dabigatran.
Long COVID: A Protocol for Systematic Review and Meta-analysis of Symptomatology and Treatment Approaches
Authors: Nna Emmanuel Okechukwu , Alao Michael Abel , Anyachukwu Canice , Asinobi Adanze Onyenonachi , Ogunbosi Babatunde , Okeke Uchenna , Osunkwo Damaris
Published: February 2021

Background:The burden of SAR COV-2 infection is not limited to the acute viraemia and its symptomatology but extends far beyond to include the long COVID, also known as post-COVID-19 syndrome,which may soon reach public health significance. We set out to produce a protocol for reliable and accurate systematic review and meta-analysis of the symptomatology and treatment approaches of long COVID globally.Methods:We developed a search strategy using MeSH terms, text words and entry terms. Nine databases will be searched: PubMed, Embase, CINAHL, AJOL, Google Scholar, Web of Science, Cochrane Library, Researchgate and Scopus. Only observational studies retrievable in the English Language will be included. The primary measurable outcome is the pooled prevalence of the symptoms of long COVID. The secondary outcomes include the summary effect sizes of the treatment approaches to the long COVID; the geographic, race, gender and age variations in symptomatology, and the quality of life of patients with long COVID. Identified studies will be screened, deduplicated, selected and data items extracted using DistillerSR software. All studies will be assessed for methodological, clinical and statistical heterogeneity. Assessment of meta-bias in the selected studies will be performed using the NIH Quality assessment tool for observational studies. Publication bias will be assessed using the funnel plot and Egger’s regression intercept. The pooled prevalence will be expressed with SE and 95% CI. The strength of evidence from this analysis will be assessed using the NIH Quality Assessment for Systematic Reviews and Meta-analysis.Discussion: This analysis will map globally the symptoms of long COVID and its correlates, exploring the influences of geographic locations, race, age and gender, thereby enabling a severity index on a global scale. It will examine in detail the treatment approaches to the long COVID and their impacts on the quality of life of patients. The evidence from this study will inform health policies toward the management of post-COVID-19 syndrome. The outcome of this study will be published in peer-reviewed scientific journal.Trial Registration Number:This protocol is registered with PROSPERO, registration number CRD42021236457
Seismic Behaviour of Piles in Non-Liquefiable and Liquefiable Soil
Authors: Hussein Fouad , Naggar Hesham El
Published: February 2021

This paper investigates the nonlinear soil-pile-structure interaction (SPSI) employing three-dimensional (3D) nonlinear finite element (FE) models verified with the results of large-scale shaking table tests of model pile groups-superstructure systems. The responses of piles in both liquefiable and non-liquefiable soil sites to ground motion with varying intensities were evaluated considering both kinematic and inertial interaction. The calculated piles and soil responses agreed well with the responses measured during the shaking events. The numerical models correctly predicted the different pile deformation modes that were exhibited in the experiments. The FEA was then employed to perform a parametric study to evaluate the kinematic and inertial effects on the piles' response considering different ground motion levels and piles characteristics. It was found that the bending moment of piles in the liquefiable site increases significantly, compared to the non-liquefiable site, due to the loss of lateral support of the liquified soil, and the maximum bending moment occurs at the interface between the liquified and non-liquefied sand layers. The inertial interaction contributes the most to the bending moments at the pile top and the interface between the top clay and liquefied loose sand layers. For piles with a larger diameter, the bending moment due to kinematic interaction increases significantly and the bending moment distribution corresponds to short (rigid) pile behaviour. In addition, the piles at the saturated site displace laterally as a rigid body during strong ground motions because the pile base loses the lateral support due to the liquefaction of the bottom dense sand. Finally, the kinematic interaction effect becomes more significant for piles with higher elastic modulus.
The genotype analysis and prenatal genetic diagnosis among 244 pedigrees with methylmalonic aciduria in China
Authors: Hu Shuang , Liu Lina , Jiao Zhihui , Kong Xiangdong
Published: February 2021

To investigate the phenotypes, biochemical features and genotypes for 244 pedigrees with methylmalonic aciduria (MMA) in China, and to perform the prenatal genetic diagnosis by chorionic villus for these pedigrees. Gene analyses were performed for 244 pedigrees. There are 130 families, chorionic villus sampling was performed on the pregnant women to conduct the prenatal diagnosis. Among 244 patients, 168 (68.9%) cases were combined methylmalonic aciduria and homocystinuria, 76 (31.1%) cases were isolated methymalonic aciduria. All the patients were diagnosed with MMA by their clinical manifestation, elevated blood propionylcarnitine, propionylcarnitine to acetylcarnitine ratio, and/or urine/blood methylmalonic acid with or without hyperhomocysteinemia. MMACHC, MUT, SUCLG1 and LMBRD1 gene variants were found in 236 (96.7%) pedigrees included 6 probands with only one heterozygous variant out of 244 cases. For the 130 pedigrees who received a prenatal diagnosis, 22 foetuses were normal, 69 foetuses were carriers of heterozygous variants, and the remaining 39 foetuses harboured compound heterozygous variants or homozygous variants. The follow-up results were consistent with the prenatal diagnosis. The present study indicates genetic heterogeneity in MMA patients. Genetic analysis is a convenient method for prenatal diagnosis that will aid in avoiding the delivery of MMA patients.
Modeling and experimental verification of the dead metal zone for cutting force prediction in micro milling
Authors: Song Bowen , jing xiubing , Xu Jian , Wang Fujun , Li Huaizhong
Published: February 2021

In micro-cutting process, ploughing phenomenon occurring due to the dead metal zone (DMZ) leads to substantial ploughing force resulting in an obvious contribution to the total cutting force. To improve accuracy of the cutting force predicted, this paper aimed to explore the DMZ geometry related to the cutting depth and tool edge radius and thereof effect on cutting force. The prominent contribution of this research is to establish a new DMZ model by employing the slip-line field theory of the plastic formation. Based on the proposed model, DMZ are divided into shearing-dominated, mixed shearing and ploughing, and pure ploughing according to the minimum uncut chip thickness (MUCT). It is firstly proposed that the inner vertex of DMZ is the separation point of shearing effect and ploughing effect during metal cutting. The shape of the DMZ is theoretically calculated by an analytical way and verified by the simulation software. Finally, a cutting force model including shear force and ploughing force is established and verified by a series of experiments. The predicted cutting forces show remarkable agreement with those measured. The result proves that the separation point model is correct and can effectively demonstrate the ploughing force to accurately predict cutting force.
Simultaneous multi-nuclide imaging via double-photon coincidence method with parallel hole collimators
Authors: Uenomachi Mizuki , Shimazoe Kenji , Ogane Kenichiro , Takahashi Hiroyuki
Published: February 2021

Multi-tracer imaging can provide useful information in the definitive diagnosis and research of medical, biological, and pharmaceutical sciences. Single-photon emission computed tomography (SPECT) is one of the nuclear medicine imaging modalities widely used for diagnosis or medical research and has a multi-tracer imaging capability. One of the drawbacks of multi-tracer imaging is crosstalk from other gamma rays, which affects the reconstructed image. Scattering correction methods, such as the dual- and triple-energy window methods, are used for conventional SPECT imaging to reduce the background caused by the crosstalk. This study proposes another crosstalk reduction method. Some nuclides emit two or more gamma rays through intermediate levels. Thus, detecting these gamma rays with the coincidence method allows us to distinguish a true gamma ray signal and a background signal. The nuclide position can be estimated at the intersection of two gamma rays using collimators. We demonstrate herein simultaneous 111In and 177Lu imaging via the double-photon coincidence method using GAGG detectors and parallel hole collimators. The double-photon coincidence method greatly reduces the background caused by other gamma rays and offers higher-quality images than does conventional imaging.
Evidence of element volatility at ambient conditions
Authors: Yurkevich Nataliya V. , Bortnikova Svetlana B. , Kozlov Aleksander S. , Petrov Aleksander K. , Makas Alexey L. , Volynkin Sergey S. , Podolinnaya Valentina A.
Published: February 2021

Tailings represent a significant risk to the environment globally, but very little is known about the composition of the near-surface air. We conducted the laboratory experiments to determine the sizes of the particles and the chemical composition of the flow above the mine waste. A condensate of vapor–gas flow was collected in parallel with particle control by an aerosol diffusion spectrometer (ADS). We reveal that there were no aerosol particles bigger than 3 nm in the flow. The collected condensate contained chemical elements, ions of sulfates, chlorides, phosphates, and formates and a wide range of sulfur-, selenium-, and carbon-containing gases. The main findings of the study are the presence of the metals Zn, Cu, Fe, Al, Cd, Ni, and Ba and the metalloids As, Sb, Se, Ag, Co, Ti, and V in the true-gas phase or in the form of particles smaller than 3 nm in the air above the mine tailings. The surprising fact is that the migration of metals and metalloids in a true-gas form or in ultrafine particles (< 3 nm) is possible, which opens up a new research direction on the volatile forms of chemical elements in various climatic conditions and their bioavailability and toxicity.
Investigations of microstructural and impedance spectroscopic properties of Mg0.5Co0.5Fe1.6Al0.4O4 ferrite prepared using sol-gel method
Authors: Dabbebi Touka , Hcini S. , Alzahrani B. , Rahmouni H. , Mallah A. , Dhahri E. , Bouazizi M.L.
Published: February 2021

Polycrystalline Mg0.5Co0.5Fe1.6Al0.4O4 ferrite was prepared with sol-gel method. This sample was characterized by powder X-ray diffraction (XRD), Scanning electron microscopy, and impedance spectroscopy. X-ray diffraction analysis combined with the Rietveld refinement confirmed that the sample crystallizes in a single-phase cubic spinel structure with (SG: \(Fd\stackrel{-}{3}m\)). Electrical conductivity obeying the Jonscher power law indicates that the prepared material exhibits semiconductor behavior, and the conduction process follows the “non-overlapping small polaron tunnelling” model between neighbors’ sites. The behavior of dielectric constants such as permittivity and loss coefficient has been interpreted based on the Maxwell-Wagner's theory of interfacial polarization. The curves of imaginary parts of impedance (Z'') and modulus (M'') show a dielectric-relaxation phenomenon in the sample with activation energy near to that determined from the dc conductivity study. Nyquist plots (Z″ vs. Z') show a monotonic decrease in both grain resistance (Rg) and grain boundary resistance (Rgb) with increasing temperature such as Rgb > > Rg. This result confirms that the transport mechanism for Mg0.5Co0.5Fe1.6Al0.4O4 compound is governed by the grain boundaries effect.
Association of Lipid Accumulation Product With Chronic Kidney Disease in Chinese Community Adults: A Report From the REACTION Study
Authors: yan pijun , Xu Yong , Miao Ying , Tang Qian , Wu Yuru , Bai Xue , Wan Qin
Published: February 2021

Background: Limited studies regarding the relationship between lipid accumulation product (LAP), a novel surrogate marker of visceral adiposity, and declined estimated glomerular filtration rate (eGFR) have yielded conflicting findings, and no report has demonstrated the relationship of LAP with chronic kidney disease (CKD), defined by lower eGFR and/or the presence of albuminuria. This study aimed to estimate the possible association between LAP and CKD in Chinese community adults. Method: This cross‐sectional study, drawn from the REACTION study, included 7072 participants aged ≥40 years in Luzhou city, Sichuan Province. LAP was determined based on a combination of waist circumference (WC) and fasting triglycerides (TG). CKD was defined as eGFR <60mL/min/1.73m² and/or presence of albuminuria [urinary albumin‐creatinine ratio (ACR) ≥30mg/g]. A multiple logistic regression model was performed to evaluate the possible association between LAP and CKD in Chinese community adults. Results: Participants with CKD had significantly higher LAP, age, WC, weight, body mass index, systolic blood pressure, diastolic blood pressure, pulse pressure (PP), TG, total cholesterol (TC), fasting blood glucose, 2 h postload blood glucose, glycated hemoglobin A1C, serum creatinine, urinary ACR, prevalence of obesity, type 2 diabetes mellitus, hypertension, myocardial infarction, coronary heart disease, peripheral arterial disease, cardiovascular disease (CVD), users of hypoglycemic drugs, and lower high density lipoprotein cholesterol, eGFR, and users of drinking (P<0.01 or P<0.05). Multiple logistic regression analysis demonstrated that LAP quartiles were positively associated with an increased risk of prevalent CKD (Q2: odds rate [OR]: 1.083, 95% confidence intervals [CI] 0.850-1.381; Q3: OR: 0.961, 95% CI 0.741-1.247; Q4: OR: 1.497, 95% CI 1.139-1.966, P for trend = 0.004) even after adjustment for potential confounding factors. Stratified analysis revealed that the associations of LAP quartiles with increased risk of prevalent CKD also occurred in people who were older, women, overweight, with hypertension, normal glucose tolerance, normal PP, low-density lipoprotein cholesterol < 3.4 mmol/L, without CVD events, no smoking and drinking. Conclusions: These findings suggest that LAP is significantly associated with increased risk of prevalent CKD in Chinese community adults, and may inform both public health recommendations and clinical practice.