bluuebunny/crossref_metadata_2025 huggingface dataset:
Guía para la caracterización de la gobernanza en paisajes rurales
Authors: Osejo Alejandra , Garrido Ana María , Alvarez Juana , Martínez Santiago , Lara Diana , Ruiz Omar , Posada Bernardo
Published: July 2021

Este documento contiene definiciones, procedimientos y protocolos para el diseño y ejecución de estudios de gobernanza ambiental en paisajes rurales. Se enmarca en un enfoque desarrollado el Instituto Humboldt denominado transiciones socioecológicas hacia la sostenibilidad, las cuales son entendidas como procesos de gestión de la biodiversidad basados en acuerdos entre los actores sociales con el fin de modificar las trayectorias de cambio indeseado en los ecosistemas y la sociedad. El objeto de esta guía es orientar el diseño y ejecución de estudios de gobernanza en paisajes rurales que sustenten procesos de construcción de dichos acuerdos. Para tal fin, basados en los enfoques de la gobernanza adaptativa, reflexiva, deliberativa y coproducida, se definen conceptos como sostenibilidad, justicia ambiental y equidad. Adicionalmente se presenta definiciones acerca del paisaje como categoría analítica y se presentan líneas de indagación asociadas a las cuestiones fundamentales de la gobernanza. En consecuencia con el marco conceptual, se detallan los pasos para el desarrollo de dichos estudios, incluyendo orientaciones para la formulación del problema y la pregunta de investigación.
p16 Represses DNA Damage Repair via a Novel Ubiquitin-Dependent Signaling Cascade
Authors: Molkentine David , Molkentine Jessica M. , Bridges Kathleen A. , Sheth Aakash , Valdecanas David R , Bahri Rishi , Hefner Andrew J. , Kumar Manish , Yang Liang , Abdelhakiem Mohamed , Pifer Phillip M. , Sandulache Vlad C. , Beadle Beth M. , Thames Howard D. , Mason Kathryn A. , Pickering Curtis R. , Meyn Raymond E. , Skinner Heath D.
Published: July 2021

Squamous cell carcinoma driven by human papillomavirus (HPV) is more sensitive to DNA-damaging therapies, such as radiation, than its HPV-negative counterpart. Here we show that p16, the clinically utilized surrogate for HPV positivity, renders cells more sensitive to radiation via a ubiquitin-dependent signaling pathway, linking high levels of this protein to increased activity of the transcription factor SP1, increased HUWE1 transcription and degradation of ubiquitin-specific protease 7 (USP7). Activation of this pathway in HPV-positive disease leads to an absence of TRIP12, decreased DNA damage repair, improved response to radiation and better clinical outcomes. Conversely, repression of this pathway in HPV-negative disease is druggable via USP7 inhibitors under clinical development, resulting in potentiation of radiation response. Our findings may lead to improved outcomes for patients with HPV-negative radioresistant tumors, while allowing decreased intensity of therapy for patients with HPV-positive tumors.
Experimental Study on Shear Strength of Saturated Remolded Loess
Authors: Lai Jie , Yun Liu , Xiang Yuzhou , Wang Wei , xu jiangbo , Cao Baohua , Zhao Danni , Wei Wei , Bao Han , Yan Changgen , Lan Hengxing
Published: July 2021

Loess has the characteristic of macropore, loose structure, homogeneous composition and collapsibility. It is easy to saturate when it encounters heavy rainfall and irrigation, resulting in landslides, roadbed subsidence and dam instability in the loess area. To study the influence of dry density and shear rate on shear strength of saturated remolded loess, an SLB-6A stress-strain controlled triaxial shear penetration tester was used to conduct Consolidated Undrained(CU) test in the Yan'an area. During the test, three variables of shear rate, confining pressure and dry density were controlled. The dry densities of the samples were 1.5g/cm3, 1.6g/cm3 and 1.7g/cm3 respectively. The CU test of the saturated remolded loess at a confining pressure of 100kPa, 150kPa, and 200kPa was performed at a shear rate of 0.04mm/min, 0.08mm/min, 0.16 mm/min, and 0.4mm/min respectively. It is found that the stress-strain curve of saturated remolded loess gradually moves up with the increase of dry density. When the dry density is equal to ρd = 1.5g/cm3, the deviatoric stress under different confining pressures there is a tendency to increase first and then decrease with increases of shear rate. When the dry density is equal to ρd = 1.6g/cm3 and ρd = 1.7g/cm3, the deviational stress under different confining pressures shows the trend of increasing first, decreasing and then increasing with the increase of shear rate, which is different from that at the dry density ρd = 1.5g/cm3 at a shear rate v = 0.4mm/min. When the dry density ρd = 1.5g/cm3, the cohesive force decreases first and then increases with the increase of shear rate. When the dry density ρd = 1.6g/cm3 and ρd = 1.7g/cm3, the cohesive force first increases at 0.08 mm/min, and then decreases with the increase of shear rate. The cohesion and internal friction angles tend to increase as the dry density increases.
Combining Bone Collagen Matrix with HUC-MSCs for Application to Alveolar Process Cleft in a Rabbit Model
Authors: Sun Xue-Cheng , Wang Hu , Zhang Dan , Li Jian-Hui , Yin Li-Qiang , Yan Yu-Fang , Ma Xu , Xia Hong-Fei
Published: July 2021

Background: Most materials used clinically for filling severe bone defects either cannot induce bone re-generation or exhibit low bone conversion, therefore, their therapeutic effects are limited. Human umbilical cord mesenchymal stem cells (hUC-MSCs) exhibit good osteoinduction. However, the mechanism by which combining a heterogeneous bone collagen matrix with hUC-MSCs to repair the bone defects of alveolar process clefts remains unclear.Methods: A rabbit alveolar process cleft model was established by removing the bone tissue from the left maxillary bone. 48 young Japanese white rabbits (JWRs) were divided into normal, control, material and MSCs groups. An equal volume of a bone collagen matrix alone or combined with hUC-MSCs was implanted in the defect. X-ray, micro-focus computed tomography (micro-CT), blood analysis, histochemical staining and TUNEL were used to detect the newly formed bone in the defect area at 3 and 6 months after the surgery. Results: The bone formation rate obtained from the skull tissue in MSCs group was significantly higher than that in control group at 3 months (P<0.01) and 6 months (P<0.05) after the surgery. The apoptosis rate in the MSCs group was significantly higher at 3 months after the surgery (P<0.05) and lower at 6 months after the surgery (P<0.01) than those in the normal group.Conclusions: Combining bone collagen matrix with hUC-MSCs promoted the new bone regeneration in the rabbit alveolar process cleft model through promoting osteoblasts formations and chondrocyte growth, and inducing type 1 collagen formation and BMP-2 generation.
Gaussian Processes Regression for Cyclodextrin Host-Guest Binding Prediction
Authors: Carvalho Ruan M , Rosa Iago G. L. , Gomes Diego E. B. , Goliatt Priscila V. Z. C. , Goliatt Leonardo
Published: July 2021

Machine Learning (ML) techniques are becoming an integral part of rational drug design and discovery. Data-driven modeling regularly outperforms physics-based models for predicting molecular binding affinities, placing ML as a promising tool. Cyclodextrins are nano-cages used to improve the delivery of insoluble or toxic drugs. Due to chemical similarity to proteins, ML approaches could vastly profit to improve affinity prediction and enhance their carriable drug portfolio. Here we evaluate the performance of the Gaussian Process Regression (GPR) to predict the binding affinity of cyclodextrin and known ligands. GPR performance is compared with two well-known ML methods - Support Vector Regression (SVR), and eXtreme Gradient Boosting (XGB). We perform hyperparameter tuning through a Random Search strategy. GPR was able to increase the prediction performance when compared to SVR and XGB, leading to better performance to adjust the data ($R^2$ = 0.803) with low prediction errors (RMSE = 1.811 kJ/mol and MAE = 1.201 kJ/mol).
Effects of forest cover pattern on water quality of low-order streams in an agricultural landscape in the Pirapora river basin, Brazil
Authors: de Mello Kaline , Valente Roberta Averna , Ribeiro Marina Pannunzio , Randhir Timothy
Published: July 2021

Low-order streams are important regions for river formation and are highly vulnerable to changes in terrestrial systems. Thus, the land-use/land-cover plays an important role in the maintenance of water quality. However, only its composition may not explain the spatial variation in water quality, because it does not consider landscape configurations. In this context, the study aimed to evaluate the forest cover pattern effects on water quality on low-order streams, which integrated an agricultural landscape. Applying a paired watershed method, we selected watersheds classified according to their morphometry and average slope to discard other physical factors that could influence the water quality. Land-use/land-cover pattern was analyzed for composition and forest cover configuration using landscape metrics, including the riparian zone composition. Water quality variables were obtained every two weeks during the hydrological year. This way, watersheds had similar morphometry, slope, and land-use/land-cover composition but differed in landscape configuration. Watershed with more aggregated forest cover had a better water quality than the other one. The results show that forest cover contributes to water quality maintenance, while forest fragmentation influences the water quality negatively, especially in sediment retention. Agricultural practices are sources of sediment and nutrients to the river, especially in steep relief. Thus, in addition to land-use/land-cover composition, landscape pattern must be considered in management of low-order streams in tropical agricultural watersheds.
Machine Learning Methods for Intrusive Detection of Wormhole Attack in Mobile Ad-Hoc Network (MANET)
Authors: Abdan Masoud , Seno Seyed Amin Hosseini
Published: July 2021

A wormhole attack is a type of attack on the network layer which reflects the issue of routing protocols. The classification is performed with several methods of machine learning consisting of K-Nearest Neighbor (KNN), Support Vector Machine (SVM), Decision Tree (DT), Linear Discrimination Analysis (LDA), Naive Bayes (NB), and Convolutional neural network (CNN). Moreover, for feature extraction, we used the properties of nodes, especially nodes speed in the MANET. We have collected 3997 distinct (normal 3781 and malicious 216) samples that comprise normal and malicious samples. Results of the classification show that the accuracy of KNN, SVM, DT, LDA, NB, and CNN methods are 97.1%, 98.2%, 98.9%, 95.2%, 94.7%, and 96.4%, respectively. Based on our findings, the DT method's accuracy is 98.9% and higher than other methods. In the next priority, SVM, KNN, CNN, LDA, and NB indicate high accuracy, respectively.
Big Data Palaeoecology reveals significant variation in Black Death mortality in Europe
Authors: Izdebski Adam , Guzowski Piotr , Poniat Radosław , Masci Lucrezia , Palli Jordan , Vignola Cristiano , Bauch Martin , Cocozza Carlo , Fernandes Ricardo , Ljungqvist Fredrik , Newfield Timothy , Seim Andrea , Abel-Schaad Daniel , Alba-Sánchez Francisca , Björkman Leif , Brauer Achim , Brown Alex , Czerwiński Sambor , Ejarque Ana , Fiłoc Magdalena , Florenzano Assunta , Fredh Erik , Fyfe Ralph , Jasiunas Nauris , Kołaczek Piotr , Kouli Katerina , Kozáková Radka , Kupryjanowicz Mirosława , Lagerås Per , Lamentowicz Mariusz , Lindbladh Matts , López-Sáez Jose Antonio , Luelmo-Lautenschlaeger Reyes , Marcisz Katarzyna , Mazier Florence , Mensing Scott , Mercuri Anna Maria , Milecka Krystyna , Miras Yannick , Noryśkiewicz Agnieszka , Novenko Elena , Obremska Milena , Pędziszewska Anna , Pérez-Díaz Sebastián , Piovesan Gianluca , Pluskowski Aleks , Pokorný Petr , Poska Anneli , Reitalu Triin , Rösch Manfred , Sadori Laura , Ferreira Carla Sá , Sebag David , Słowiński Michał , Stančikaitė Migle , Stivrins Normunds , Tunno Irene , Veski Siim , Wacnik Agnieszka , Masi Alessia
Published: July 2021

The Black Death is the most reknown pandemic in human history, believed by many to have killed half of Europe's population. However, despite the advances in ancient DNA research that allowed for the successful identification of the pandemic's causative agent (bacterium Yersinia pestis), our knowledge of the Black Death is still limited, based primarily on medieval texts available for single areas of Western Europe. In our study we remedy this situation and we focus in particular on the scale of the Black Death mortality. We collected data on landscape change from 261 coring sites (lakes and wetlands) located in 19 European countries. We used two independent methods of analysis to evaluate whether the changes we see in the landscape at the time of the Black Death agree with the hypothesis that half of the population died within a single year in each of the 21 regions we studied. We discovered that while the Black Death had devastating impact in some regions, it had negligible or no impact in others. The inter-regional differences in the Black Death mortality across Europe demonstrate the significance of cultural, ecological, economic and climatic factors that mediate the dissemination and impact of the disease. The complex interplay of these factors, along with the identification of the pathogen that caused disease outbreaks, should be the focus of future research on historical pandemics.
Achieving increased resolution and reconstructed image quality with gradient variance modified super-resolution radial fluctuations
Authors: Gong Xingyu , Zhou Li , Yao Longfang , Zhang Li , Chen Liwen , Fei Yiyan , Mi Lan , Wang Baoju , Ma Jiong
Published: July 2021

Based on the calculation of the degree of gradient convergence, the super-resolution radial fluctuations (SRRF) algorithm can achieve higher resolution by combining temporal fluctuation analysis with localization microscopy methods. The algorithm is also capable of processing high-density fluorescence images. However, there are considerable artifacts due to high density, which lead to a loss of image resolution and low fidelity of images. This study demonstrates the use of fluorescence gradient fluctuations in super-resolution analysis and proposes gradient variance modified SRRF (gmSRRF) algorithm. The gmSRRF algorithm resolves finer structures and compensates for the loss of resolution caused by artifacts in SRRF images using relatively high-density stochastic optical reconstruction microscopy (STORM) data and conventional widefield, confocal, or structured illumination microscopy (SIM) imaging sequences. The effectiveness of this algorithm is proven by means of relevant simulations and experiments, which allow the reconstructed SRRF image to improve resolution and reduce artifacts and background noise.
Weathering controls on the Phanerozoic phosphate cycle
Authors: Sharoni Shlomit , Halevy Itay
Published: July 2021

Although phosphate is an essential macronutrient for marine biota, critical to our understanding of marine productivity, biogeochemistry, and evolution, its long-timescale geologic history is poorly constrained. We constrain weathering-derived fluxes and seawater concentrations of phosphate throughout the Phanerozoic (541 Ma to present), by developing a model for the coupled, long-term biogeochemical cycles of phosphate, carbon, oxygen, and calcium. We find that the relative contribution of continental and seafloor weathering to the total weathering rate exerts a first-order control on ocean productivity, through a previously uninvestigated mechanism. Specifically, continental weathering is a source of the limiting nutrient phosphate, but seafloor weathering is not. As a result, times in Earth history in which seafloor weathering constitutes a large fraction of the total weathering rate (e.g., the early Paleozoic and Mesozoic), are also times in which phosphate delivery to the ocean is relatively low. A lower concentration of phosphate in seawater likely affected primary productivity, oceanic and atmospheric oxygen concentrations, with possible implications for the evolution of marine fauna over Earth history.
Associations Between Physical Activity and Cognitive Function, Daily Physical Function in Chinese With Heart Disease: A Cross-Sectional Study
Authors: Ding Meng , Jia Ningxin , Zhou Yanan , Dong Xiaosheng , Tian Caijun
Published: July 2021

Background: To investigate the associations between different dimensions (intensity, frequency, duration, volume, metabolic equivalent) of physical activity (PA) and cognitive function, daily physical function in Chinese with heart disease. Methods: This study included 2792 individuals from the China Health and Retirement Longitudinal Study (CHARLS) conducted in 2015. PA was divided into vigorous PA (VPA), moderate PA (MPA), and light PA (LPA). Linear regression models and binary logistic regression models were established to assess the associations be-tween indicators respectively. Results: Compared with taking no PA, MPA and VPA with a frequency of 6-7 d/w had lower risks of impaired daily physical function (OR=0.47, 95%CI: 0.25, 0.91; OR= 0.57, 95%CI: 0.37, 0.88) and higher cognitive function scores (β=1.22, 95%CI: 0.42, 2.03; β=1.08, 95%CI: 0.43, 1.73), while VPA of 3-5 d/w had lower cognitive function scores (β=-1.96, 95%CI: -3.51, -0.40). LPA with a duration of 30-119 min/d had lower risks of impaired daily physical function (OR=0.59, 95%CI: 0.36, 0.97). MPA and VPA of 30-119 min/d had higher cognitive function scores (β=1.43, 95%CI: 0.49, 2.37; β=1.30, 95%CI: -0.56, 2.06). Lower cognitive function scores in volume of ≥ 300 min/w. (β=-1.18, 95%CI: -2.14, -0.23). 1800-8999 METs had lower risks of impaired daily physical function and higher cognitive function scores. 1800-2999 METs had lowest risks of impaired daily physical function and highest cognitive function scores. (OR=0.18, 95%CI: 0.04, 0.75; β=2.94, 95%CI: 1.67, 4.21). Conclusions: This study found that VPA are associated with lower cognition, MPA and LPA are beneficial to cognition and daily physical function.Trial registration: IRB00001052-11015.
Onset location of periventricular white matter hyperintensities co-localizes with peak ependymal cell stretch
Authors: Visser Valery , Rusinek Henry , Weickenmeier Johannes
Published: July 2021

Deep and periventricular white matter hyperintensities (dWMH/pvWMH) are bright appearing white matter tissue lesions in T2-weighted fluid attenuated inversion recovery magnetic resonance images and are frequent observations in the aging human brain. While early stages of these white matter lesions are only weakly associated with cognitive impairment, their progressive growth is a strong indicator for long-term functional decline. DWMHs are typically associated with diffuse vascular degeneration; for pvWMHs, however, no unifying theory exists to explain their characteristic onset locations and progression patterns. We use structural and functional patient imaging data to create anatomically accurate finite element models of the lateral ventricles, white and gray matter, and cerebrospinal fluid. We simulated the mechanical loading of the ependymal cells forming the primary brain-fluid interface, the ventricular wall, and its surrounding tissues at peak ventricular pressure during the hemodynamic cycle. We observe that both the maximum principal tissue strain and the largest ependymal cell stretch consistently localize in the anterior and posterior horns. Strikingly, these locations coincide with the pvWMHs observed in FLAIR images. We submit that the tight junctions between ependymal cells experience significant loads that cause the ventricular wall to be stretched thin and ultimately begin to leak. Besides age-related vascular degeneration, progressive wall failure causes neurotoxic fluid to diffuse into surrounding white matter structures and appear as growing pvWMHs. The physics-based approach presented here provides a novel model system to systematically study the progressive tissue deterioration associated with pvWMHs.
NOS and SONOS redox switches in proteins
Authors: von Pappenheim Fabian Rabe , Wensien Marie , Ye Jin , Uranga Jon , Funk Lisa-Marie , Mata Ricardo , Tittmann Kai
Published: July 2021

We recently reported on the discovery of a lysine-cysteine redox switch in proteins with a covalent NOS bridge. Here, a systematic survey of the whole protein structure database discloses that NOS bridges are ubiquitous, hitherto overlooked redox switches in proteins of all domains of life and are found in diverse structural motifs and chemical variants. In several instances, lysines are observed in simultaneous linkage with two cysteines forming a SONOS bridge with a trivalent nitrogen, which constitutes the first native branching crosslink in proteins. In many proteins, the NOS switch contains a functionally essential lysine with direct roles in enzyme catalysis or binding of substrates, DNA or effectors linking lysine chemistry and redox biology as a novel regulatory principle. The NOS/SONOS switches are frequently found in proteins from human and plant pathogens including i.a. SARS-CoV-2 but also in many human proteins with established roles in gene expression, redox signaling and homeostasis in both physiological and pathophysiological conditions. Targeting, mimicking, controlling and engineering the NOS and SONOS redox switches appear to open novel avenues in drug, antiviral, antibiotic and herbicide development, in biocatalytic applications as well as in protein design and bioorganic chemistry.
Transcriptome change in Staphylococcus aureus in infecting mice
Authors: Hamamoto Hiroshi , Panthee Suresh , Paudel Atmika , Suguru Ohgi , Suzuki Yutaka , Sekimizu Kazuhisa
Published: July 2021

We performed in vivo RNA-sequencing analysis of Staphylococcus aureus in infected mouse liver using the 2-step cell-crush method. We compared the transcriptome of S. aureus at 6, 24, and 48 h post-infection (h.p.i) in mice and in culture medium. Genes related to anaerobic respiration were highly upregulated at 24 and 48 h.p.i. The gene expression patterns of virulence factors differed depending on the type of toxin. For example, hemolysins, but not leukotoxins and serine proteases, were highly upregulated at 6 h.p.i. Gene expression of metal transporters, such as iron transporters, gradually increased at 24 and 48 h.p.i. We also analyzed the transcriptome of mouse liver infected with S. aureus. Hypoxia response genes were upregulated at 24 and 48 h.p.i., and immune response genes were upregulated from 6 h.p.i. These findings suggest that gene expression of S. aureus in the host changes in response to changes in the host environment, such as oxygenation status or immune system attacks during infection.
Numerical investigations of micro bubble drag reduction effect for container ships
Authors: Gamal Mohammed , Kotb Mohammed , naguib ahmed , elsherbiny khaled
Published: July 2021

In the course of the most recent thirty years reduction of ship resistance and saving fuel consumption to accomplish higher speed with reduction of pollutants has been the significant subject for researchers. Micro bubble drag reduction technique is the one of the most interesting thoughts in this field owing to its great advantages, such as considerable potential drag reduction, easy operations, environmental friendliness and low costs. In this study a 3-D numerical investigation into frictional drag reduction by air micro bubbles is applied on KRISO container ship model. The objective is to understand the mechanism of resistance reduction through micro bubbles injection under model ship at different Froude numbers, injection rate and of course volume fractions. The numerical simulations are performed using a commercial CFD code solving Reynolds averaged Navier-Stokes (RANS) equations. For more than 36 simulations has performed to investigate the effect of injection of micro bubble under ship model hull and to estimate the local Coefficient of friction values along ship hull model. The results show that at all of the examined Froude number, frictional resistance reduction attained but at different rates and a maximum drag reduction of 27.6 % obtained at 0.282 Froude number with 4.8 % air volume fraction.
Realization of ZnCdO Coated Films: Under Laser Irradiation
Authors: Zargar Rayees
Published: July 2021

Promising Zinc Oxide (ZnO) and Cadmium Oxide (CdO) alloying (ZnCdO) films were fabricated on glass substrates by screen printing route for optoelectronic applications. The Nd:YAG green diode laser of wavelength 532 nm and laser fluence of 1.8 J/cm2 was used to irradiate the fabricated films at room temperature. The characterization of these films were systematically studied by means of X-ray diffraction (XRD), UV–vis, photoluminescence (PL), Raman spectroscopy and two probe method for conductivity measurement. The XRD pattern shows that all the films were well crystallized with maximum diffraction of (101) plane and mixed phases of ZnO and CdO were detected. The structure, space group and other crystal related parameters were confirmed from Rietveld refinement of XRD data.The basic optical parameters (band gap, refractive index and extinction coefficient) have estimated using absorbance spectra. The PL spectrum of ZnCdO composite films exhibits red shift and blue- green emissions shift upon laser irradiation were confirmed from CIE 1931 diagram.The Raman spectroscopy indicates that the quality of the ZnCdO films was increased while their structure defects were increased.DC conductivity measurement confirms semiconductor behaviour. All the parameters such as particle size, optical constants, colour emission and activation energy have been significantly improved upon laser irradiations dose of 1.8 J/cm2 for different durations of time. This study could be opting for optoelectronic applications.
In-Hospital Death Due to COVID-19 Disease in Iranian Patients: A Systematic Review and Meta-Analysis Study
Authors: Ghanei Mostafa , Saadat Seyed Hassan , Najimi-Varzaneh Alireza , Fesharaki Mohammad Gholami
Published: July 2021

Context: The prevalence of in-hospital death due to COVID-19 hospital is one of the qualitative indexes, which can be used to assess the quality of care, as well as the mortality patterns in COVID-19 pandemic.Objectives: Therefore, this systematic and meta-analysis study has been done with the aim of estimating overall prevalence in-hospital death due to COVID-19 disease in iranian patients Evidence Acquisition: Articles were identified through international searching databases including PubMed, Scopus, Elsevier, Google Scholar, and Web of Science and Iranian scientific information database (SID), Health.barakatkns, IranDoc, Civilica and MagIran. We reviewed systematically all studies reporting the prevalence of in-hospital death due to COVID-19 disease. In this study meta-analysis method with random effect model has been used to estimate the pooled prevalence. Results: 118 records were identified by the electronic search, of which 43 studies were identified as relevant papers that were meta-analyzed for the pooled in-hospital death due to COVID-19 prevalence. Overall, prevalence of death were 12.16% (95% CI: 10.72%-13.61%). The highest and lowest death prevalence has been reported in Northern Provinces (Gilan, 27.27% (95% CI: 8.66%-45.88%) and Mazandaran, 21.27% (95% CI: 18.14%-24.40%)) and Turkish-speaking provinces (Azerbaijan, East, 3.29% (95% CI: 2.11%-4.47%) and Zanjan, 3.42% (95% CI: 1.82%-5.02%)) respectively. Conclusions: Considering the death rate obtained in this study and its comparison with other countries, it can be said that the performance of the Iranian medical system in COVID-19 pandemic is acceptable.
Stem Cell, Fibrin Glue, and Normal Saline On Partially Torn Tendons: A Randomized Controlled Trial
Authors: Chun Se-Woong , Kim Won , Lee Sang Yoon , Lim Chai-Young , Kim Keewon , Kim Jeong-Gil , Park Chul-Hyun , Hong Sung Hwan , Yoo Hye Jin , Chung Sun G.
Published: July 2021

Background

Tendons have limited reparative ability. With less specialized tissue characteristics, tendon injury might be one of the most promising tissues to be successfully treated by stem cell transplantation. We performed a randomized, controlled study to investigate the effects of mesenchymal stem cell injection for treating partial tears in the supraspinatus tendon.
Methods

We enrolled 24 patients with shoulder pain lasting more than 3 months and partial tears in the supraspinatus tendon. Participants were assigned to three groups: stem cells in fibrin glue, normal saline/fibrin glue mixture, and normal saline only, with which intra-lesional injection was performed. Pain at activity and rest, shoulder function and tear size were evaluated. For safety measures, laboratory tests were taken and adverse events were recorded at every visit. Participants were followed up at 6, 12 weeks, 6, 12 months and 2 years after injection. The primary outcome measure was the improvement in pain at activity at 3 months after injection.
Results

Twenty-three patients were included in the final analysis. Primary outcome did not differ among groups (p = 0·35). A mixed effect model revealed no statistically significant interactions. Only time significantly predicted the outcome measure. All participants reported transient pain at the injection site. There were no differences in post-injection pain duration or severity. Safety measures did not differ between groups, and there were no persistent adverse events.
Conclusions

Stem cell injection into supraspinatus partial tears in patients with shoulder pain lasting more than 3 months was not more effective than control injections. (ClinicalTrials.gov Identifier: NCT02298023)
Is Minimally Invasive Mitral Valve Surgery Inappropriate for Redo-surgery or Elderly Patients? – Study of 55 Consecutive Cases Following Minimally Invasive Mitral Valve Replacement Via Right Mini-thoracotomy
Authors: Nakayama Taisuke , Nakamura Yoshitsugu , Yasumoto Yuto , Yoshiyama Daiki , Kuroda Miho , Nishijima Shuhei , Tsuruta Ryo , Narita Takuya , Ito Yujiro
Published: July 2021

Background: Minimally invasive mitral valve surgery has been established as a routine procedure at our institution. In the present study, early and mid-term outcomes of patients who underwent minimally invasive mitral valve replacement (MIMVR), including redo-operations and elderly patients, during the 5-year post-surgery period were analyzed to review short-term morbidity and mortality, and mid-term results.Methods: Preoperative variables, intraoperative findings, and postoperative outcomes of MIMVR patients treated from January 2014 to November 2020 and prospectively stored in a database were reviewed. Survival and freedom from cerebrovascular events were evaluated using life tables and Kaplan-Meier analysis. Results: A total of 445 patients underwent minimally invasive mitral valve surgery during the study period, of whom 55 received mitral valve replacement (MVR), including 18 cases of redo-MVR and 10 elderly (≥80 years old) patients. Mean age at the time of surgery was 70.7±11.3 years. The number of patients who underwent conversion to a sternotomy was 0, while 30-day mortality was noted in one (2%). For all MIMVR cases, 1- and 5-year survival was 90.8±3.9 % and 76.5±7.1%, respectively. Furthermore, freedom from cerebrovascular events and anticoagulation-related complications was 94.3±3.2% and 84.2±6.3% at 1 and 5 years, respectively. In univariate analysis, independent predictors of hospital mortality and prolonged hospital stay included infectious endocarditis, while previous cardiac surgery and elderly status were not significant factors.Conclusions: MIMVR can be performed safely and effectively for redo-MVR and in elderly patients with very few perioperative complications. Early and mid-term outcomes in the present cohort were acceptable.
Surgical Management of Gastroschisis With the Use of Primary and Staged Closure on the Basis of the Department's 20-Year Experience
Authors: Sosnowska-Sienkiewicz Patrycja , Skinder Dominika , Mankowski Przemysław
Published: July 2021

BACKGROUND: Gastroschisis belongs to common developmental anomalies. The aim of surgical management is to restore the integrity of the abdominal wall and to insert the bowel into the abdominal cavity with the use of the primary or staged closure technique.The objective of this paper is to analyze our 20-year experience with surgical treatment of gastroschisis with primary and staged closure, to compare the postoperative course for the said techniques as well as to identify factors influencing the course and early results of treatment.METHODS: The research materials comprise of a retrospective analysis of medical history of patients treated at the Surgery Clinic in Poznan in the years 2000-2019. 59 patients were operated on: 30 girls and 29 boys.Surgical treatment was performed with the use of primary closure in 33% of the cases, whereas the staged silo closure was performed in 67% of the cases. RESULTS: Postoperative analgosedation was used for 6 days on average after primary closures, and for 13 days on average after staged closures. Incidence frequency of generalized bacterial infection was 21% for primary closures and 37% for staged closures. Infants treated with staged closure began enteral feeding considerably later (day 22) than those treated with primary closure (day 12). CONCLUSIONS: It is not possible to indicate clearly which surgical technique is superior to the other on the basis of the results obtained. When choosing the treatment method, the patient's clinical condition, associated anomalies and the medical team's experience must be taken into consideration.
Holoprosencephaly and other morphological abnormalities in the silky shark Carcharhinus falciformis
Authors: Whitehead Darren Andrew , Becerril-GarcíaA Edgar , Ketchum James Thomas , Weaver Amy hudson , Lugo Tomas Plomozo , Galván-Magaña Felipe , Hoyos-Padilla Mauricio
Published: July 2021

This study constitutes the first descriptions of morphological abnormalities in the silky shark Carcharhinus falciformis from a near term embryo obtained in the Gulf of California, Mexico. External exploration and X-ray images were taken to describe the specimen, which revealed that the embryos deformities were located in the cephalic region suggesting a holoprosencephaly disorder. The analyzed images evidenced a deformed oval chondrocranium with both nasal capsules pointing upwards and the rostrum pointing downwards, in which the palatoquadrate cartilage was deformed with signs of prognathism.
Strategies of relief organizations for improvement of disaster risk communication process in Iran
Authors: Fathollahzadeh Abazar , Salmani Ibrahim , Morowatisharifabad Mohammad Ali , Khajehaminian Mohammad-Reza , Babaie Javad , Fallahzadeh Hossein
Published: July 2021

Background: The frequency and severity of disaster occurrence and emergency situation, and the importance of disaster risk communication of relief organizations to increase the readiness of societies in the case of disaster is increasing around the world. This study aimed to identify relief organizations' strategies to improve disaster risk communication in Iran. Methods: This qualitative study was conducted with the participation of 25 managers, relief workers, and people who had experiences in response to one of the disasters. The data were collected using semi-structured interviews and analyzed using conventional content analysis.Results: The analysis of the data of this study led to the identification of 3 categories and 9 sub-categories regarding strategies of relief organizations to improve risk communication. These categories are 1) management of information and training communication (facilitation of training processes, diverse training strategies, and integrated informing), 2) management of communication barriers (trust building, managing people's demands and efforts to respect affected people), and 3) Inter-organizational communication management (coordination to meet people's demands, improve communication coordination and strengthen communication platforms)Conclusion: Relief organizations use different strategies to improve disaster risk communication, and communication barrier management is vital for improving organizations' communication with people. Developing risk communication improvement strategies can help planners and managers design and implement effective risk management programs.
Angiomyxoma of the Lower Eyelid with Orbital Extension: A Rare Entity and Review of Literature
Authors: Agrawal Sahil , Deora Aarush , Modaboyina Sujeeth , Das Deepsekhar , Bajaj Mandeep Singh , Sen Seema
Published: July 2021

A 60-year-old male sought medical advice for painless progressive swelling in the left eye associated with protrusion of the eyeball and diminution of vision for the past 6 months. A computed tomography scan was done which revealed a heterogeneous lesion in the inferotemporal orbit lying close to the globe without any bony erosions or intracranial extension. Incisional biopsy revealed spindle or stellate cells in a myxoid matrix with abundant thin-walled vessels. On Immunohistochemistry, the tumour was positive for vimentin and SMA. It was negative for Desmin and S-100. A diagnosis of superficial angiomyxoma of the eyelid with orbital extension was thus made. Surgical excision under general anaesthesia was planned and the mass removed in toto. The histopathological examination of the same revealed findings similar to the incision biopsy. The patient is being followed up with no recurrences till date.
Clinicopathological Analysis of Anterior-Superior Mediastinal Masses
Authors: Priyadarshini Sarah Grace , Alavandar Ezhilvizhi
Published: July 2021

Background: The mediastinum is the space between the two lungs, bounded anteriorly by the sternum and posteriorly by the vertebral column. A spectrum of neoplastic and non-neoplastic lesions can arise in the mediastinum.

Methods: A total of 14 cases were retrospectively retrieved from the Histopathology department. The cases had histopathological diagnosis either in image guided, thorocoscopic, transbronchial or excision biopsies.

Results: The majority of cases (43% n=6) were of thymic origin, which included both neoplastic lesions of thymoma group and non-neoplastic lesion like thymic cysts. The thymoma group included 3 cases of thymoma B3 and 1 case of thymoma AB. The lymphoid lesions include Hodgkin lymphoma (14.3%; n=2) and non-Hodgkin lymphoma (7.1%; n=1). The mesenchymal lesions (21.4%; n=3) included lipoma, solitary fibrous tumor and schwannoma which accounts for one case each. A rare case of ectopic parathyroid adenoma (7.1%; n=1).  and a case of metastatic papillary carcinoma (7.1%; n=1) were also reported.

Conclusion: The diagnosis of mediastinal mass lesions can pose difficulties due to its wide clinicopathologic spectrum to the clinician, radiologists and pathologist. A multimodal approach with histopathological examination and immunohistochemistry can help in arriving at an accurate diagnosis.
Bacteriological Profile of Healthcare Workers and Patients’ Hands at Aga Khan University Hospital, Nairobi Outreach Centres
Authors: Wamalwa Martin Wanyama , Muna Kennedy Kuria , Omuse Geoffrey , Kamwati Stanley Kang’ethe , Gunturu Revathi
Published: July 2021

Background: Hand hygiene is the precursor to improved health standards among healthcare workers and patients seeking outpatient services. Unhygienic hands may escalate the transmission of multi-drug resistance bacteria that poses serious pathological manifestation to the vulnerable and susceptible patients. The study aims at establishing the possible pathogen and susceptibility pattern of Staphylococcus aureus carried on hands of healthcare provider and their patients.

Methods: Cross sectional study design and random sampling of patients and convenient sampling of healthcare workers was carried out between May to August 2020 at Aga Khan University hospital Nairobi satellites. The participant’s hands palm and finger tips imprints were made on Blood agar during sample collection. The antimicrobial susceptibility pattern of Staphylococcus aureus was established using Vitek-2 automated system.

Result: The study had 374 participants out of which 14% were colonized by possible pathogens. The overall Staphylococcus aureus hand carriage prevalence 6.9% (26/374) isolated from healthcare provider and patient at outpatient facility. The methicillin resistant staphylococcal in this study was 0.56% (2/374) showing resistance to both Oxacillin and Cefoxitin. Healthcare workers are prone to colonization with possible pathogens as compared to patient P-value .049.  Staphylococcus aureus isolates were all resistant to penicillin.

Conclusion: Hand hygiene mitigating measures in outpatient healthcare facilities should be sustained on the counts that 14% of possible pathogens in this study were isolated. Healthcare providers at the point of care in outpatient should strictly follow the hand hygiene protocols provided by WHO to curb the transmission of possible pathogenic bacteria.
Utility of Automated Hematology Analyzers in Diagnosis of Infective Etiologies: An Adjunct to Conventional Diagnostic Tools
Authors: Patel Keyuri Bharat , Ranapurwala Mustafa Fakaruddin , Mansuri Neelofar Safilmohmad , Singh Rohit Kumar , Patel Anjali Nimeshkumar , Padharia Dharti Pravinbhai
Published: July 2021

Background: Febrile illnesses such as malaria and dengue are challenging to differentiate clinically. For more than a century, the diagnostic approach is by clinical features and microscopy or manual immune-chromatographic tests. Automated cellular (WBC) indices from hematology analyzers may afford a preliminary rapid distinction. Several abnormal scattergrams during routine CBC analysis appear for the malaria and dengue.

Material and Methods: The present study is an observational, prospective study undertaken to evaluate the diagnostic utility of Sysmex XN-L series hematology analyzer as a screening tool to trigger specific testing for malaria and dengue. It includes patients suffering from either of the two febrile illnesses (malaria or dengue) at Hematology and microbiology section of Central Diagnostic Laboratory of a tertiary care centre in Central Gujarat. The sensitivity, specificity, PPV and NPV was performed for each abnormal pattern noted on scattergram for malaria and/or dengue. Interobserver variation is also taken in consideration.

Results: Malaria cases showed a significant statistical association with the presence of an extended neutrophil zone and dengue positive cases with NS1 antigen, IgG and IgM antibodies testing showed significant association with the hourglass pattern. Higher degree of agreement was noted for the hourglass pattern, doubling of neutrophil zone pattern among the observers

Conclusion: Significant statistical correlation was observed for extended neutrophil zone and malaria cases, hourglass pattern and dengue cases with a good agreement among the observers.
Intravascular Papillary Endothelial Hyperplasia: The Diagnostic Challenges
Authors: P Kaushika , Thanka J , Lilly S Mary , Gali Vinutha
Published: July 2021

Masson’s tumor or intravascular papillary endothelial hyperplasia is a benign lesion of the skin and subcutaneous tissue. It is due to reactive proliferation of endothelial cells with papillary formations related to a thrombus. It poses an interesting diagnostic differential as the clinical signs and symptoms are nonspecific. The diagnosis is based on histopathology. We report a case of Masson’s hemangioma occurring on the right ring finger.
Cytodiagnosis of Primary Ewing Sarcoma of the Skull: Diagnostic Clues and Difficulties
Authors: Sukumaran Renu , Nayak Nileena
Published: July 2021

Ewing sarcoma is a rare primary neoplasm of bone representing approximately 6-8% of all malignant bone tumours. Because of its aggressive clinical behaviour and rapid dissemination to other sites, an early accurate diagnosis is of utmost importance. It shares morphological features with other round cell tumors. Common differentials include lymphoblastic lymphoma, neuroblastoma, rhabdomyosarcoma and neuroendocrine tumours. Due to the morphological overlap, critical evaluation of the cellular details is essential. Fine needle aspiration cytology becomes a successful diagnostic tool when the subtle diagnostic clues and difficulties are considered during diagnosis. Judicious use of ancillary techniques will also aid in arriving at an accurate diagnosis. We present the case of a seven-year-old boy who presented with painful swelling of the scalp. Aspiration smears were cellular and showed atypical small round cells. Evaluation of morphological details along with special stains and immunohistochemistry in cell block preparation aided in rendering a diagnosis of Ewing sarcoma. The awareness of overlapping features in clinical presentation, morphology and immunohistochemical findings will help to arrive in the proper diagnosis. Early diagnosis on cytology samples can help in timely initiation of treatment, thus improve prognosis.
Superficial CD34 Positive Fibroblastic Tumour, A Mesenchymal Tumour with Borderline Malignant Potential: A New Entity
Authors: Walia Gurpreet Kaur , Kinra Prateek , Malik Ajay
Published: July 2021

Superficial CD34 positive fibroblastic tumour (SCD34FT) is a distinct mesenchymal tumour of superficial soft tissues which has an intermediate malignant potential and is a recently introduced entity in the WHO classification. We present a case report of a 32-year-old male patient with SCD34FT. The tumour was located on right forearm and was essentially superficial in location. Wide local excision of the tumour was done. On histopathological examination, the tumour was composed of highly pleomorphic spindled as well as epithelioid cells with granular eosinophilic cytoplasm and numerous bizarre lobulated nuclear forms with few showing intranuclear inclusions. However, the mitotic count was very low. On immunohistochemistry (IHC), tumour cells were diffusely positive for vimentin and CD34 (characteristic of SCD34FT). During clinical follow-up, the patient is asymptomatic since the time of his surgery one year back. SCD34FT is a mesenchymal tumour of borderline malignant potential which is restricted to the superficial location.
Psychometric evaluation of the Swedish Child Sheehan Disability Scale in adolescent psychiatric patients
Authors: Soler Catalina Torres , Vadlin Sofia , Olofsdotter Susanne , Ramklint Mia , Sonnby Karin , Nilsson Kent
Published: July 2021

Background: Assessment of disability is part of the psychiatric diagnostic process, and validated scales are needed for the assessment of functioning. The Swedish translations of the Child Sheehan Disability Scale (CSDS) for adolescents and parents (CSDS-P) have been adapted for use in psychiatric settings.

Objective: The purpose of the study was to explore the psychometric properties of the Swedish CSDS and the CSDS-P among adolescent psychiatric patients.

Method: Patients (n = 107) were assessed with the CSDS, the Strengths and Difficulties Questionnaire (SDQ adolescent), and the Schedule for Affective Disorders and Schizophrenia for School-Age Children-Present and Lifetime version (K-SADS-PL) diagnostic interview. Their parents participated in the interview and completed the CSDS-P and SDQ parent.

Results: Internal consistency was α =.813 for the CSDS (three items) and α =.842 for the CSDS-P (five items). For both scales, principal component analyses showed one component. The correlations between the total scores of the CSDS and CSDS-P in relation to a general K-SADS-PL symptom summation index were rs
= .332, p < .001 and rs
= .237, p = .014, respectively. Correlations with the total K-SADS function summation index were rs
< .300 for both. The correlation between the CSDS and the total difficulties score on the SDQ was rs
= .433, p < .001.

Conclusions: The Swedish translations of the CSDS and CSDS-P had similar psychometric properties to Whiteside’s CSDS and the Adult Sheehan Disability Scale. Concurrent validity and correlation between the CSDS and CSDS-P were weak.