bluuebunny/crossref_metadata_2025 huggingface dataset:
Predictive Model of Chemotherapy-induced Myelosuppression for Patients With Esophageal Cancer
Authors: Zheng Ziming , Zhang Qilin , Han Yong , Wu Tingting , Zhang Yu
Published: September 2021

Background: The influential factors of chemotherapy-induced myelosuppression in esophageal cancer in central China are unclear. This study aimed to develop a model for prediction of incidence of myelosuppression during chemotherapy among patients with esophageal cancer. Methods: A total of 1446 patients with esophageal cancer who underwent five different chemotherapy regimens between 2013 and 2020 at our institute were randomly assigned in a 7:3 ratio to training and validation data sets. Clinical and drug-related variables were used to develop the prediction model from the training data set by the machine learning method of random forest. Finally, this model were tested in the validation data set.Results: The prediction model were established with 16 indispensable variables selected from 46 variables. The model obtained an area under the receiver-operating characteristic curve of 0.883 and accompanied by prediction accuracy of 80.0%, sensitivity of 77.8% and specificity of 81.8%. Conclusion: This new prediction model showed excellent predictive ability of incidence of myelosuppression in turn providing preventative measures for patients with esophageal cancer during chemotherapy.Trial registration: This study protocol was approved by the institutional ethics board of the Union Hospital of Huazhong University of Science and Technology (retrospectively registered No. 2018S333). This study was performed in accordance with the ethical guidelines of the Declaration of Helsinki and Strengthening the Reporting of Observational Studies in Epidemiology (STROBE).
Top-Emitting 940-nm Thin-film VCSELs Transferred Onto Aluminum Heatsinks
Authors: Moon Sunghyun , Yun Yeojun , Lee Minhyung , Kim Donghwan , Choi Wonjin , Lee Jaejin
Published: September 2021

Thin-film vertical cavity surface emitting lasers (VCSELs) mounted onto heatsinks open up the way toward low-power consumption and high-power operation, enabling them to be widely used for energy saving high-speed optical data communication and three-dimensional sensor applications. There are two conventional VCSEL polarity structures: p-on-n and n-on-p polarity. The former is more preferably used owing to the reduced series resistance of n-type bottom distributed Bragg reflection (DBR) as well as the lower defect densities of n-type GaAs substrates. In this study, the p-on-n structures of thin-film VCSELs, including an etch stop layer and a highly n-doped GaAs ohmic layer, were epitaxially grown in upright order by using low-pressure metalorganic chemical vapor deposition (LP-MOCVD). The p-on-n structures of thin-film VCSELs were transferred onto an aluminum heatsink via a double-transfer technique, allowing the top-emitting thin-film VCSELs to keep the p-on-n polarity with the removal of the GaAs substrate. The threshold current (Ith) and voltage (Vth) of the fabricated top-emitting thin-film VCSELs were 1 mA and 2.8 V, respectively. The optical power was 7.7 mW at a rollover point of 16.1 mA.
Potential Biomarkers of Colon Adenocarcinoma Based on Weighted Gene Co-Expression Network Analysis
Authors: Cui Zhongze , He Shuang , Wen Feifei , Xu Xiaoyang , Li Yangyang , Lu Lizhen , Wu Shuhua
Published: September 2021

Background: Colon adenocarcinoma (COAD) is one of the most common malignancies worldwide. Although a large number of studies have elucidated the aetiology of colorectal cancer, the exact mechanism of colorectal cancer development remains to be determined.To identify key modules and prognostic genes that may be involved in the occurrence and development of COAD, weighted gene coexpression network analysis (WGCNA) and differential expression analysis were performed on datasets GSE41657 and GSE74602 from the Gene Expression Omnibus (GEO) database to screen for prognostic differentially expressed genes. Gene expression profiles and clinical information were collected from The Cancer Genome Atlas (TCGA) database for verification.Results: Through WGCNA and DEGs analysis, 439 genes in key functional modules were obtained, and 26 prognostic related genes were finally obtained through prognostic analysis: (1) We screened 5 genes（RPP40, DUSP18, PPRC1, MFSD11 and PDCD11） that have not been studied in COAD.（2）We obtained the most critical module in the occurrence and development of colon cancer and obtained one prognosis-related gene, NUP85, from the most critical module.The relationship between it and tumor immune microenvironment was verified.（3） A prognostic model comprising four coexpressed differential genes was constructed; TIMP1, PMM2, E2F3 and MORC2 were selected as the key prognosis-related genes.Conclusions: （1）As new biomarkers，prognostic genes RPP40, DUSP18, PPRC1, MFSD11 and PDCD11 may be potential therapeutic targets for COAD, and provide new ideas for future research on the mechanism of COAD. （2）NUP85 may be an immune-related gene which was negatively correlated with CD4+ T cell and M2 macrophagesthat plays an important role in inhibiting the occurrence and development of colorectal adenocarcinoma. （3）A Cox proportional risk model based on gene expression can be used to predict the prognosis and survival time of patients with colon cancer.
Controlling for Background Genetic Effects Using Polygenic Scores Improves the Power of Genome-wide Association Studies
Authors: Bennett Declan , O'Shea Dónal , Ferguson John , Morris Derek , Seoighe Cathal
Published: September 2021

Ongoing increases in the size of human genotype and phenotype collections offer the promise of improved understanding of the genetics of complex diseases. In addition to the biological insights that can be gained from the nature of the variants that contribute to the genetic component of complex trait variability, these data bring forward the prospect of predicting complex traits and the risk of complex genetic diseases from genotype data. Here we show that advances in phenotype prediction can be applied to improve the power of genome-wide association studies. We demonstrate a simple and efficient method to model genetic background effects using polygenic scores derived from SNPs that are not on the same chromosome as the target SNP. Using simulated and real data we found that this can result in a substantial increase in the number of variants passing genome-wide significance thresholds. This increase in power to detect trait-associated variants also translates into an increase in the accuracy with which the resulting polygenic score predicts the phenotype from genotype data. Our results suggest that advances in methods for phenotype prediction can be exploited to improve the control of background genetic effects, leading to more accurate GWAS results and further improvements in phenotype prediction.
Microbial and Molecular Differences According To The Location of Head and Neck Cancers
Authors: Kim Yun Kyeong , Kwon Eun Jung , Yu Yeuni , Kim Jayoung , Woo Soo-Yeon , Choi Hee-Sun , Kwon Munju , Jung Keehoon , Kim Hyung-Sik , Park Hae Ryoun , Lee Dongjun , Kim Yun Hak
Published: September 2021

Background
Microbiome has been shown to substantially contribute to some cancers. However, the diagnostic implications of microbiome in head and neck squamous cell carcinoma (HNSCC) remain unknown. Here, we report for the first time, the molecular difference in the microbiome of oral and non-oral HNSCC.
Methods
Primary data was downloaded from the Kraken-TCGA dataset. The molecular differences in the microbiome of oral and non-oral HNSCC were identified using the linear discriminant analysis effect size method. Using phylogenetic investigation of communities by reconstruction of unobserved states (PICRUST) and ANOVA-like differential expression (ALDEx2), we predicted bacterial metabolic contributions of oral rich and non-oral rich bacteria, common rich bacteria in two groups and their pathways. A Correlation analysis was performed between RNA expression data and common bacteria data and protein-protein interaction (PPI) analysis was performed using correlated genes. Finally, to find out unique microbial signatures, we performed Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways and Gene ontology (GO) analysis using the PPI results.
Results
The common microbiomes in oral and non-oral cancers were Fusobacterium, Treponema, and Selenomonas and Clostridium and Massilia, respectively. We found unique microbial signatures that positively and negatively correlated with Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways in oral cancer and negatively correlated KEGG pathways in non-oral cancer. In oral cancer, positively correlated genes were mostly found in bacterial infection pathways, while negative correlated genes were involved in HTLV-I infection, signal transduction, cell adhesion, and cancer-associated pathway. In non-oral cancer, positively correlated genes did not show any significant results, and negatively correlated genes showed results from focal adhesion pathway and regulation of actin cytoskeleton pathway.
Conclusions
These results could help in understanding the underlying biological mechanisms of the microbiome of oral and non-oral HNSCC. Microbiome-based oncology diagnostic tool warrants further exploration.
Comparative Analysis of Two Flap Designs for the Extraction of Impacted Mandibular Horizontal Third Molars: a Multicenter Randomized Control Trial
Authors: Naruse Tomofumi , Rokutanda Satoshi , Inokuchi Satoshi , Omori Keisuke , Yanamoto Souichi , Umeda Masahiro
Published: September 2021

Most patients experience postoperative complications caused by the extraction of impacted mandibular horizontal third molars. The aim of the present study was to compare the effects of two flap designs as a refinement on the reduction of postoperative complications. One hundred eighty-eight patients with impacted mandibular horizontal third molars were included in this single-blind, multicenter, randomized control trial. The allocation was determined using a modified envelope flap (mEF) and triangular flap (TF) at 1:1 by the data manager. Postoperative complications (pain, hemorrhage, nerve paralysis, dry socket, and infection) and operation time were assessed 7 ± 1 days after surgery. In all cases, postoperative pain was significantly lower in the mEF group (P<0.05). In the subgroup analysis, postoperative pain was significantly lower in patients with low difficulty (IA, IIA, IIA, IB), which were classified by G.B. Winter classification (P<0.05). Other factors were not significantly associated with the flap design. Our study suggests that mEF resulted in less postoperative pain with a low difficulty of impacted mandibular horizontal third molars. However, the evidence at present is not sufficient to suggest the use of either flap design.
Gene Expression Profiles for Recurrence of Lymph Node-positive Primary Breast Cancer in Women Over 40 Years of Age
Authors: Ma Sean Si Qian , Ye Luyi , Zhang Fan , Xu Tiansheng , Ji Zai-Si , Liu Enuo
Published: September 2021

Background: Specific gene expression profiles correlate with recurrence of breast cancer in lymph node-negative patients. In contrast, insufficient knowledge is available regarding tumor-specific gene expression in patients with lymph node metastasis before surgery. Furthermore, such patients experience cumulative incidences of relapse greater than 50%. Methods: Sections of formalin-fixed paraffin embedded (FFPE) were prepared from breast tumors of 37 patients who were followed for at least 5 years. FFPE samples of patients with recurrent ductal breast cancer (n = 25) and 12 FFPE samples of such patients without recurrence were subjected to microarray analysis to identify gene expression profiles specifically associated with positive lymph nodes confirmed during surgery that were accompanied by lymphocytic invasion. Immunohistochemistry was employed to determine the estrogen receptor (ER) status of cancer tissues. All patients were administered tamoxifen after surgery, and this treatment continued for more than 5 years, or until cancer recurred. This strategy eliminated interactions between different therapeutics as potential confounding factors that influenced patients' outcomes.Results: Sixteen genes were expressed at significantly higher levels in patients with ER-positive (+) breast cancer with recurrence compared with those without recurrence. Gene Set Enrichment Analysis of The Kyoto Encyclopedia of Genes and Genomes (KEGG) identified 73 genes encoding olfactory receptors included in the “Olfactory transduction” pathway that were enriched in the ER+ recurrence group (FDR P < 0.05). The KEGG “Histidine metabolism” and “Retinol metabolism” pathways were enriched in patients with ER-negative (–) breast cancer with recurrence (FDR P < 0.05). Conclusions: The present study is the first, to our knowledge, to identify 16 genes encoding proteins with diverse functions as well as 73 genes encoding olfactory receptors. These genes may serve as presurgical biomarkers for the recurrence of ER+ breast cancers with lymph node metastasis before surgery. These findings identify potential therapeutic targets for preventing cancer relapse, particularly after lymph nodes metastasis.
Establishment of a 8 Immune-Related LncRNA Signature for Predicting the Prognosis of Soft Tissue Sarcoma
Authors: Liu Yuhang , Liu Changjiang , Yu Aixi
Published: September 2021

Background: Soft tissue sarcoma is relatively rare and highly heterogeneous, which brings great difficulties to treatment. Long non-coding RNA acts a vital role in the occurrence and progression of soft tissue sarcoma, especially in the tumor-related immune process, which has become a hot spot of current research. Therefore, we are committed to developing lncRNA markers related to immunity to promote the treatment and prognosis of patients with soft tissue sarcoma.Methods：Based on the TCGA-SARC and GTEx data set, we screened out 8 prognostic-related immune lncRNAs and constructed a nomogram, which was verified in the test set. Furthermore, immune infiltration analysis was carried out on patients of high and low risk.Results: Based on the results of Pearson's correlation coefficient, we obtained 859 immune-related lncRNAs. After difference analysis, we finally determined 54 different lncRNAs. Univariate and multivariate cox regression analysis finally determined 8 immune-related lncRNAs to construct prognostic models and nomograms to predict the prognosis of STS patients. The above results have been verified in external data sets, indicating that this model has good predictive ability. Gene Set Enrichment Analysis and ESTIMATE analysis showed obviously differences exist in the immune infiltration status and immune cell subtypes of high- and low-risk patients.Conclusion: We constructed an immune-related lncRNA pattern to predict the survival status of soft tissue sarcoma patients.
WITHDRAWN: Suppression Application of Copper Oxide Nanoparticles for Wilt-Inducing Fusarium Equiseti in Wheat
Authors: Abdelghany Tarek , Alharbi Asmaa A. , Al-Rajhi Aisha M. H.
Published: September 2021

Background: Recently, nanoparticles has proposed as a different and ecofriendly tools for solving many problems in agricultural field. Aim: The current investigation is an attempt to assess the antifungal activity of Copper oxide nanoparticles (CuONPs) against wheat wilt disease. Results: Isolates of Fusarium sp., Alternaria sp. and Rhizoctonia sp. species were recovered from wheat roots showed willt symptoms. Highest frequency (77.12%) was associated to Fusarium sp. Fusarium sp. isolates from pathogenicity test indicated that isolate (F1) out the highest frequency isolates caused high percentage of wilt reached to 65.1%. Molecular identification of F1 isolate was performed using ITS rRNA gene, and confirmed that it belong to F. equiseti. Inhibition (%) of F. equiseti growth was 3.45 and 16.66% at 100 ppm, and it was 74.14 and 78.21% at 400 ppm of CuONPs at 5 and 8 days, respectively. The action mechanism of CuONPs on F. equiseti inhibition was elucidated by transmission electron microscopy. CuONPs induced morphological changes and damage of the cell membranes of the F. equiseti. Healthy wheat plant without F. equiseti infection exhibited 11.24 ug. g-1dry weight of total phenol content (TPC), while infected plant showed highest content 14.25 ug. g-1dry weight. CuONPs at 200ppm induced TPC of infected plant by F. equiseti to 16.67 ug. g-1dry weight. Increment in Peroxidase, polyphenol oxidase, superoxide dismutase activities in wheat plant cultivated in soil inoculated by F. equiseti and amended with 400 ppm of CuONPs were recorded comparatively to wheat plant cultivated in soli inoculated by F. equiseti but without CuONPs. Conclusion:The inhibitory effects of CuONPs are very actual management strategies for the control wheat wilt disease caused by F. equiseti in respective to present and future studies.
“attitudes of the Spanish Police Towards Patients With Schizophrenia or Depressive Disorders”
Authors: Mengual-Pujante Miguel , Morán-Sánchez Inés , Luna-Ruiz Aurelio , Pérez-Cárceles María-Dolores
Published: September 2021

Background: Police officers have become an important part of psychiatric patients´ care; however, few studies have assessed the Police´s attitudes toward these patients. Our aim is to analyze the effect of the stigma associated with different mental illnesses on police officers.Methods: the attitudes of 927 officers of the Spanish National Police Force towards a person with schizophrenia or depressive disorder in the role of person in need of assistance, victim, witness, or suspect, were assessed by means of the Attribution Questionnaire adapted to the police context. Different socio-demographic variables were also collected. Results: Police officers expressed more willingness to help, felt more pity and considered psychiatric patients to be less responsible for their situation than people who were not described as being mentally ill. They also showed increased feelings of anger and avoidance, greater danger perception and need for segregation and coercion for medical treatment, especially in schizophrenia. Being a woman, the elderly and having more working experience, are associated with less stigmatizing attitudes among officers. Conclusions: Police officers have certain attitudes about mental illness particularly schizophrenia, that require special attention, as they may disrupt police action. We found several factors associated with the persistence of these stigmatizing attitudes in the Police that can guide us to implement training programs to promote attitude changing especially at the beginning of the professional career.
Healthcare Costs of Patients With Chronic Obstructive Pulmonary Disease in Denmark – Hospital Treated Versus Primary Care Only
Authors: Lykkegaard Jesper , Nielsen Jesper Bo , Storsveen Maria Munch , Jarbøl Dorte Ejg , Søndergaard Jens
Published: September 2021

Background: Many patients are treated for chronic obstructive pulmonary disease (COPD) in primary care but have never received COPD treatment in secondary care. They are seldom included in COPD cost studies but may account for a substantial proportion of the total costs.Objective: To estimate and specify the total healthcare costs of patients treated for COPD in Denmark comparing those who have- and have not had COPD treatment in secondary care.Setting: Denmark, population 5.7 million citizens.Methods: Via national registers, we specified the total healthcare costs of all +30-years-old current users of respiratory pharmaceuticals. We then compared those with at least one episode of hospital treatment for COPD (=secondary-care) to those with no hospital treatment for COPD but who redeem prescriptions specifically for COPD (=primary-care-only).Results: Among totally 329,428 users of respiratory drugs, we identified 46,084 with secondary-care- and 68,471 with primary-care-only COPD. Primary-care-only accounted for 40% of the two groups’ total healthcare costs. The age- and gender-adjusted coefficient relating the individual total costs secondary-care versus primary-care-only was 2.19. The individual costs ranged widely and overlapped considerably (p25-75: secondary-care 2,175€ - 12,625€, primary-care-only 1,110€ - 4,350€). Hospital treatment accounted for most of the total cost (secondary-care 78%, primary-care-only 62%; coefficient 2.81), pharmaceuticals (secondary-care 16%, primary-care-only 27%; coefficient 1.28), and primary care costs (secondary-care 6%, primary-care-only 11%; coefficient 1.13).Conclusion: Healthcare cost estimators and planners should consider the substantial volume of patients who are treated for COPD in primary care, but do not appear in hospital statistics.
Synthesis of BiSI/Ag2CO3 Composite Material for Photocatalytic Degradation of Rhodamine B under Visible Light
Authors: Zhang Rui , chen ziyin , Zhao Chen , Zeng Kunlin , Cai Lu , Yu Junrong , Yang Ze , Jiang Jiacheng
Published: September 2021

A novel binary BiSI/Ag2CO3 photocatalyst with excellent visible light-driven photocatalytic performance was prepared. The products were characterized by X-ray powder diffraction (XRD), scanning electron microscopy (SEM), ultraviolet-visible diffuse reflectance spectroscopy (UV-Vis DRS) and electrochemical impedance spectroscopy (EIS). The photocatalytic activity of the samples were evaluated by photocatalytic degradation of rhodamine B(RhB) under the irradiation of visible light. The results showed that the BiSI improves the photocatalytic activity of BiSI/Ag2CO3. Moreover, when the mass ratio of BiSI in BiSI/Ag2CO3 composites was 40%, the as-prepared BiSI/Ag2CO3 composite exhibited the best photocatalytic activity for degrading RhB. Finally, the possible mechanism for photodegradation over the BiSI/Ag2CO3 composites is also proposed.
Dynamic Behaviors of Soliton Solutions for a Three-Coupled Lakshmanan-Porsezian-Daniel Model
Authors: Hu Beibei , Lin Ji , Zhang Ling
Published: September 2021

In this paper, we use the Riemann-Hilbert (RH) approach to examine the integrable three-coupled Lakshmanan-Porsezian-Daniel (LPD) model, which describe the dynamics of alpha helical protein with the interspine coupling at the fourth-order dispersion term. Through the spectral analysis of Lax pair, we construct the higher order matrix RH problem for the three-coupled LPD model, when the jump matrix of this particular RH problem is a 4×4 unit matrix, the exact N-soliton solutions of the three-coupled LPD model can be exhibited. As special examples, we also investigate the nonlinear dynamical behaviors of the single-soliton, two-soliton, three-soliton and breather soliton solutions. Finally, an integrable generalized N-component LPD model with its linear spectral problem is discussed.
Silicon on-chip Electro-optic Modulation With Ito Film Stacks
Authors: Lotkov Evgeniy S. , Baburin Alexander S. , Ryzhikov Ilya A. , Sorokina Olga S. , Ivanov Anton I. , Zverev Alexander V. , Bykov Igor V. , Baryshev Alexander V. , Panfilov Yuri V. , Rodionov Ilya A.
Published: September 2021

Indium tin oxide (ITO) platform is one of the promising solutions towards state-of-the-art integrated optical modulators for silicon photonics applications. We demonstrate the way to obtain both high extinction ratio and low insertion loss electro-optic modulation with ITO-based film stack. By investigating e-beam evaporated 20 nm-thick ITO films with amorphous, heterogeneously crystalline, homogeneously crystalline with hidden coarse grains and pronounced coarsely crystalline structure, a low carrier concentration (from 1·1020 to 2·1020 cm-3) is achieved. The mechanism of oxygen migration in ITO film crystallization is proposed based on morphological features observed under low-energy growth conditions. We compare three electro-optic modulator active elements (current-voltage and optical characteristics) and reach strong ITO dielectric permittivity variation induced by charge accumulation/depletion (Δn = 0.199, Δk = 0.240 at λ = 1550nm under ±16V). Our simulations and experimental results demonstrate the unique potential to create integrated GHz-range electro-optical modulators with sub-db losses.
Activation of the NLRP3 Inflammasome and Elevation of Interleukin-1β Secretion in Infection by Sever Fever with Thrombocytopenia Syndrome Virus
Authors: Li Zhifeng , Hu Jianli , Bao Changjun , Gao Chengfeng , Zhang Nan , Cardona Carol J. , Xing Zheng
Published: September 2021

Severe fever with thrombocytopenia syndrome virus (SFTSV) is an emerging phlebovirus that causes a hemorrhagic fever known as the severe fever with thrombocytopenia syndrome (SFTS). Inflammasomes are a molecular platform that are assembled to process pro-caspase 1 and subsequently promote secretion of interleukin (IL)-1β/IL-18 for proinflammatory responses induced upon infection. We hypothesize that inflammasome activation and pyroptosis induced in SFTS results in elevated levels of IL-1β/IL-18 responsible for high fever and hemorrhage in the host, characteristic of SFTS. Here we report that IL-1β secretion was elevated in SFTS patients and infected mice and IL-1β levels appeared to be reversibly associated to disease severity and viral load in patients’ blood. Increased caspase-1 activation, IL-1β/IL-18 secretion, cell death, and processing of gasdermin D were detected, indicating that pyroptosis was induced in SFTSV-infected human peripheral blood monocytes (PBMCs). To characterize the mechanism of pyroptosis induction, we knocked down several NOD-like receptors (NLRs) with respective shRNAs in PBMCs and showed that the NLR family pyrin domain containing 3 (NLRP3) inflammasome was critical for processing pro-caspase-1 and pro-IL-1β. Our data with specific inhibitors for NLRP3 and caspase-1 further showed that activation of the NLRP3 inflammasome was key to caspase-1 activation and IL-1β secretion which may be inhibitory to viral replication in PBMCs infected with SFTSV. The findings in this study suggest that the activation of the NLPR3 inflammasome and pyroptosis, leading to IL-1β/IL-18 secretion during the SFTSV infection, could play important roles in viral pathogenesis and host protection. Pyroptosis as part of innate immunity might be essential in proinflammatory responses and pathogenicty in humans infected with this novel phlebovirus.
Analysis of Temperature Characteristics of High-speed Rail Bearings based on Dynamics Model and Thermal Network Method
Authors: Wang Bao-sen , Liu Yongqiang , Zhang Bin
Published: September 2021

This paper establishes a dynamics model of the axle box bearing of high-speed trains. The model can obtain contact force and its change law. Between rollers and raceway when the bearing contains outer ring faults, inner ring faults, and rolling element faults. Based on the model, the thermal network method is introduced to study the temperature characteristics of axle box bearings of high-speed trains. In this model, the bearing can be divided into some isothermal nodes. The heat generation, conduction, and dispersion of these isothermal nodes can be solved. The results show that the temperature of the contact point between the outer ring raceway and the rolling elements is the highest. By analyzing the relationship between the node and the speed and fault size, it is obtained that the higher the speed, the higher the node temperature. When the fault size increases, the node temperature first increases and then decreases.
Quality and Efficacy of Multidisciplinary Team (MDT) Quality Assessment Tools and Discussion Checklists: A Systematic Review
Authors: Brown George T F , Bekker Hilary L , Young Alastair L
Published: September 2021

Background
MDT discussion is the gold standard for cancer care in the UK. With the incidence of cancer on the rise, demand for MDT discussion is increasing. The need for efficiency, whilst maintaining high standards, is therefore clear. Paper-based MDT quality assessment tools and discussion checklists may represent a practical method of monitoring and improving MDT practice. This reviews aims to describe and appraise these tools, as well as consider their value to quality improvement.
Methods
Medline, EMBASE and PsycInfo were searched using pre-defined terms. The PRISMA model was followed throughout. Studies were included if they described the development of a relevant tool, or if an element of the methodology further informed tool quality assessment. To investigate efficacy, studies using a tool as a method of quality improvement in MDT practice were also included. Study quality was appraised using the COSMIN risk of bias checklist or the Newcastle-Ottawa scale, depending on study type.
Results
The search returned 6888 results. 17 studies were included. In total 6 tools were identified. Overall, methodological quality in tool development was adequate to very good for assessed aspects of validity and reliability. Clinician feedback was positive. In one study, the introduction of a discussion checklist improved MDT ability to reach a decision from 82.2–92.7%. Improvement was also noted in the quality of information presented and the quality of teamwork.
Conclusions
Several tools for assessment and guidance of MDTs are available. Although limited, current evidence indicates sufficient rigour in their development and their potential for quality improvement.
Preoperative factors associated with intraoperative maximum arterial pressures in patients with pheochromocytoma and paraganglioma: a single-center retrospective study
Authors: Ohsugi Haruyuki , Takizawa Nae , Matsuda Tadashi , Kinoshita Hidefumi
Published: September 2021

Surgery for pheochromocytoma and paraganglioma (PPGL) can lead to life-threatening complications, such as intraoperative hypertensive crises, even when adequate doses of preoperative α-receptor blockades are administered. The aim of this study was to identify preoperative factors associated with maximum arterial pressure (AP) during surgery in patients with PPGL. We retrospectively reviewed the cases of 61 PPGL patients who underwent surgical resection in our hospital between 2006 and 2020. The primary outcome was intraoperative maximum AP as a single index for continuous variables. The normal distribution of the results was confirmed by the Kolmogorov–Smirnov test. Simple and multiple linear regression model were used for statistical analysis. The median maximum systolic AP during surgery was 165 mmHg (interquartile range: 150–180 mmHg). Although the 24-h urinary-fractionated metanephrine (MN) and normetanephrine (NMN) (mg/day) was not normally distributed, the logarithmic representation (base = 10) of the combination of these continuous variables showed a normal distribution (p = 0.549). Log24 − h urinary−fractionated MN and NMN was correlated with intraoperative maximum AP (R = 0.481, p < 0.001). Multiple regression analyses showed that diabetes mellitus (β = 15.835, standard error [SE] = 7.550, t statistic = 2.097, P = 0.040), the classic triad (β = 14.081, SE = 5.668, t statistic = 2.484, P = 0.016), and log24 − h urinary−fractionated MN and NMN (β = 14.641, SE = 5.842, t statistic = 2.506, P = 0.015) were independent factors associated with intraoperative maximum AP. Patients with PPGL accompanied by diabetes mellitus, the classic triad, and high log 24−h urinary−fractionated MN and NMN values may be at risk for hypertensive crises during surgery regardless of whether preoperative α-receptor blockades are used. Clinicians should manage these patients more carefully and effectively.
Selection of an Appropriate Bedrock for Site Amplification Studies.
Authors: Pandey Bhavesh , Jakka Ravi S
Published: September 2021

The selection of half-space or reference sites significantly influences site amplification studies. However, there are no well-defined guidelines in the literature. Generally, a layer with a local shear wave velocity (VS) of more than 760 m/s is considered a bedrock/half-space/reference site. This study attempts to formulate a rationale for selecting bedrock stiffness to be used as a half-space/reference site. For this study, VS,30 (average shear wave velocity of top 30-meter soil strata from shear wave velocity measurements) and the site's fundamental frequency (obtained from Horizontal to vertical spectral ratio of ambient vibration records) were used as proxies to study the influence of bedrock/half-space and development of a rationale for their selection. This study uses strong-motion data from India's sixty-two strong motion stations and a few from Japan (Kik-Net). The results suggest that considering a site with a shear wave velocity of 760 m/s may not be suitable as a half-space/bedrock for most geomorphological conditions. The results also recognize a pattern that can help in the development of a mathematical model for determining the bedrock for a site using VS,30 and its fundamental frequency as a proxy.
Cellular heterogeneity of circulating CD4+CD8+ double-positive T cells characterized by single-cell RNA sequencing
Authors: Choi Sung Min , Park Hi Jung , Choi Eun A , Jung Kyeong Cheon , Lee Jae Il
Published: September 2021

Circulating CD4+CD8+ double-positive (DP) T cells are associated with a variety of disease states. However, unlike conventional T cells, the composition of this population is poorly understood. Here, we used single-cell RNA sequencing (scRNA-seq) to analyze the composition and characteristics of the DP T cell population circulating in the peripheral blood of cynomolgus monkeys. We found that circulating DP T cells not only contain a large number of naïve cells, but also comprise a heterogeneous population (Th1-, Th2-, Th17-, Tfh-, Treg-, Eomes+ Tr1-, CD4 CTL-, CD8 CTL-, and innate-like cells) with multiple potential functions. Flow cytometry analysis revealed that a substantial number of the naïve DP T cells expressed CD8αβ, as well as CD8αα, along with high expression of CD31. Moreover, the CD4hiCD8lo and CD4hiCD8hi populations, which express high levels of the CD4 coreceptor, comprised subsets characterized by helper and regulatory functions, some of which also exhibited cytotoxic functions. By contrast, the CD4loCD8hi population with high CD8 coreceptor expression comprised a subset characterized by CD8 CTL- and innate-like properties. Taken together, the data show that scRNA-seq analysis identified a more diverse subset of the circulating DP cells than is currently known, despite this population being very small.
Multiplexed identification of RAS paralog imbalance as a driver of lung cancer growth
Authors: Tang Rui , Shuldiner Emily , Kelly Marcus , Murray Christopher , Hebert Jess , Andrejka Laura , Tsai Min , Hughes Nicholas , Parker Mitchell , Cai Hongchen , Li Yao-Cheng , Wahl Geoffrey , Dunbrack Roland , Jackson Peter , Petrov Dmitri , Winslow Monte
Published: September 2021

Oncogenic KRAS mutations occur in approximately 30% of lung adenocarcinoma. Despite several decades of effort, oncogenic KRAS-driven lung cancer remains difficult to treat, and our understanding of the positive and negative regulators of RAS signaling is incomplete. To uncover the functional impact of diverse KRAS-interacting proteins on lung cancer growth in vivo, we used multiplexed somatic CRISPR/Cas9-based genome editing in genetically engineered mouse models with tumor barcoding and high-throughput barcode sequencing. Through a series of CRISPR/Cas9 screens in autochthonous lung tumors, we identified HRAS and NRAS as key suppressors of KRASG12D-driven tumor growth in vivo and confirmed these effects in oncogenic KRAS-driven human lung cancer cell lines. Mechanistically, RAS paralogs interact with oncogenic KRAS, suppress KRAS-KRAS interactions, and reduce downstream ERK signaling. HRAS mutations identified in KRAS-driven human tumors partially abolished this effect. Comparison of the tumor-suppressive effects of HRAS and NRAS in KRAS- and BRAF-driven lung cancer models confirmed that RAS paralogs are specific suppressors of oncogenic KRAS-driven lung cancer in vivo. Our study outlines a technological avenue to uncover positive and negative regulators of oncogenic KRAS-driven cancer in a multiplexed manner in vivo and highlights the role of RAS paralog imbalance in oncogenic KRAS-driven lung cancer.
Household quarantine of second degree contacts is an effective non-pharmaceutical intervention to prevent tertiary cases in the current SARS-CoV pandemic
Authors: Weigl Josef A. I. , Feddersen Anna-Katharina , Stern Mona
Published: September 2021

Background
Given the characteristics of SARS-CoV2 with regard to transmission before the onset of symptoms and varying manifestation indices according to age, isolation and quarantine have limited efficacy in the current pandemic. Household quarantine in second degree contacts (Hh-Q2°) outside the case household has so far only been addressed by modellers. In the literature there is no publication based on field data.
Methods
In a retrospective cohort study on real field data from a county health department (CHD), all PCR-confirmed cases and related contact persons put into quarantine were analysed. Hh-Q2° was used in our CHD from the onset of the pandemic.
Results
From 9 March to 8 December 2020, 353 PCR-confirmed cases were registered in the CHD Ploen, Northern Germany: 225 (63.7%) primary, 107 (30.3%) secondary and 21 (5.9%) tertiary cases. The 107 secondary cases resulted out of 470 (22.8%) close or 1°contacts and 21 tertiary cases out of 179 (11.7%) indirect or 2°contacts put into quarantine. The efficacy of Hh-Q2° was 51.5% (11.7%/22.8%) of that of quarantine in 1°contacts; 16.4% of all converted cases in quarantined persons were ascertained by Hh-Q2°. One in ten 1°contacts in households with tertiary cases remained asymptomatic.
Conclusion
The impact of Hh-Q2° in preventing further spread of SARS-CoV2 was considerable. With 51% of the conversion rate in 2°contacts compared to 1°contacts, the efficacy of Hh-Q2° is substantial. Hh-Q2° should definitely be used routinely to control the spread of SARS-CoV2 more efficiently and national authorities should include it in their guidelines.
Induction of robust cellular and humoral immunity against SARS-CoV-2 after a third dose of BNT162b2 vaccine in previously unresponsive elderly
Authors: Olmedo Addi Romero , Schulz Axel , Hochstäter Svenja , DasGupta Dennis , Virta Iiris , Hirseland Heike , Staudenraus Daniel , Camara Bärbel , Münch Carina , Hefter Véronique , Sapre Siddhesh , Mei Henrik , Keller Christian , Lohoff Michael
Published: September 2021

Herein, we compared SARS-CoV-2-specific antibody and T-cell responses to two doses of BNT162b2 mRNA in 51 vaccinees > 80 years old and 46 (20–53 years old) controls. The responses of the elderly were much lower and 10% non-responders were identified. Importantly, in four of them, a third vaccination raised the immune response to levels seen in responders after two vaccinations, thus implying that non-response is not fateful even in the elderly.
Analysis of cardiac involvement in patients recovered from Covid-19 without troponin elevation, evaluated by cardiovascular magnetic resonance.
Authors: Carlessi Adrian , Perello Leonel , Pantaley Cristian , Borsini Armando , Rossi Lucia , Gimenez Florencia , Leonardi Julian , Ballina Ariel , Maillo Martin , Rienzo Paula Di , Gonzalo Paula , Vara Martin Gonzalez , Vegetti Luciana , Wustten Sebastian , Costa Lucas , Vergara Diego , Froullet Cristian
Published: September 2021

Background

The disease caused by coronavirus (COVID-19) affects the cardiovascular system, whether by direct viral aggression or indirectly through systemic inflammation and multiple organ compromise. A widely used method to determine cardiac injury is troponin measurement. The aim of this study is to evaluate the prevalence of cardiac involvement (CINV) in a population recovered from COVID-19, referred to cardiac MRI (CMR), who did not present troponin elevation.
Methods

There were 156 patients that recovered from COVID-19 and who did not present troponin elevation referred to CMR. CINV was considered to be the presence of: late gadolinium enhancement (LGE), edema, myocarditis, pericarditis, left ventricular systolic dysfunction (LVSD) and/or depressed right ventricular systolic dysfunction (RVSD).
Results

Prevalence of CINV was 28.8%, being more frequent in men (p = 0.002), in patients who required hospitalization (p = 0.04) and in those who experienced non-mild cases of infection (p = 0.007). RVSD (17.9%) and LVSD (13.4%) were the most frequent findings. The rate of myocarditis was 0.6%. LGE manifested in 7.1% of patients and its presence was related to less left ventricular ejection fraction (LVEF) (p = 0.0001) and right ventricular ejection fraction (RVEF) (p = 0.04).
Conclusion

In patients who recovered from COVID-19, 28.8% of CINV was found. It was more frequent in men, in patients who required admission and in patients with cases of non-mild infection. The patients that presented LGE had less LVEF and RVSF.
Evidence of Plasmodium falciparum infection after 12 years from the exposure: cryptic malaria or recrudescence?
Authors: Patamia Ildebrando , Cappello Elisa , Calvo Maddalena , Migliorisi Giuseppe , Franco Antonina
Published: September 2021

BackgroundMalaria infections affect a high percentage of the world's population, especially in tropical and subtropical regions. Specifically, Plasmodium falciparum is the most relevant species involved in the etiopathogenesis of this infection. The duration of P. falciparum infections is often undefined, as some reported episodes of suspected recrudescence occur several years after initial exposure.Case presentationWe present a case report of malaria infection with low parasitaemia in a man whose last stay in an endemic region or contacts with the local population was twelve years ago. The patient recovered fully with adequate antimalarial treatment, but some aspects of his clinical history were not clearly defined.ConclusionsWe discuss here the possibility that this is either a P. falciparum recrudescence or an episode of cryptic malaria, as we cannot carefully verify some details of our patient's life and history.
Radiological pleuroparenchymal fibroelastosis-like lesion in idiopathic interstitial pneumonias
Authors: Fujisawa Tomoyuki , Horiike Yasuoki , Egashira Ryoko , Sumikawa Hiromitsu , Iwasawa Tae , Matsushita Shoichiro , Sugiura Hiroaki , Kataoka Kensuke , Hashisako Mikiko , Yasui Hideki , Hozumi Hironao , Karayama Masato , Suzuki Yuzo , Furuhashi Kazuki , Enomoto Noriyuki , Nakamura Yutaro , Inui Naoki , Suda Takafumi
Published: September 2021

BackgroundPleuroparenchymal fibroelastosis (PPFE) is characterised by predominant upper lobe pleural and subpleural lung parenchymal fibrosis. Radiological PPFE-like lesion has been associated with various types of interstitial lung diseases. However, the prevalence and clinical significance of radiological PPFE-like lesion in patients with idiopathic interstitial pneumonias (IIPs) are not fully understood. We aimed to determine the prevalence and clinical impact on survival of radiological PPFE-like lesion in patients with IIPs.MethodsA post-hoc analysis was conducted using data from the Japanese nationwide cloud-based database of patients with IIPs. All the patients in the database were diagnosed as having IIPs by multidisciplinary discussion. Patients diagnosed with idiopathic PPFE were excluded. Clinical data and chest computed tomography (CT) image of 419 patients with IIPs were analysed. The presence of radiological PPFE-like lesion was independently evaluated by two chest radiologists blind to the clinical data.ResultsOf the 419 patients with IIPs, radiological PPFE-like lesions were detected in 101 (24.1%) patients, mainly in idiopathic pulmonary fibrosis (IPF) and unclassifiable IIPs, but less in idiopathic nonspecific interstitial pneumonia. Prognostic analyses revealed that radiological PPFE-like lesion was significantly associated with poor outcome in patients with IIPs, which was independent of age, IPF diagnosis and %FVC. In survival analyses, the patients with radiological PPFE-like lesions had poor survival compared with those without (log-rank, p < 0.0001). Subgroup analyses demonstrated that radiological PPFE-like lesion was significantly associated with poor survival both in patients with IPF and those with unclassifiable IIPs.ConclusionRadiological PPFE-like lesion is a condition that could exist in IIPs, mainly in IPF and unclassifiable IIPs. Importantly, the radiological PPFE-like lesion is a non-invasive marker to predict poor outcome in patients with IIPs, which should be carefully considered in clinical practice.
Elevated circulating stem cells level is observed one month after implantation of Carmat bioprosthetic total artificial heart
Authors: Guyonnet Léa , Detriché grégoire , Gendron Nicolas , Philippe Aurélien , Latremouille Christian , Soret Lou , Capel Antoine , Peronino Christophe , Jansen Piet , Ivak Peter , Carpentier Alain , Mirault Tristan , Netuka Ivan , Guerin Coralie L , Smadja David
Published: September 2021

The Aeson® total artificial heart (A-TAH) has been developed as a total heart replacement for patients at risk of death from biventricular failure. We previously described endothelialization of the hybrid membrane inside A-TAH probably at the origin of acquired hemocompatibility. We aimed to quantify vasculogenic stem cells in peripheral blood of patients with long-term A-TAH implantation. Four male adult patients were included in this study. Peripheral blood mononuclear cells were collected before A-TAH implantation (T0) and after implantation at one month (T1), between two and five months (T2), and then between six and twelve months (T3). Supervised analysis of flow cytometry data confirmed the presence of the previously identified Lin−CD133+CD45− and Lin−CD34+ with different CD45 level intensities. Lin−CD133+CD45−, Lin−CD34+CD45− and Lin−CD34+CD45+ were not modulated after A-TAH implantation. However, we demonstrated a significant mobilization of Lin−CD34+CD45dim (p = 0.01) one month after A-TAH implantation regardless of the expression of CD133 or c-Kit. We then visualized data for the resulting clusters on a uniform manifold approximation and projection (UMAP) plot showing all single cells of the live Lin− and CD34+ events selected from down sampled files concatenated at T0 and T1. The three clusters upregulated in T1 are CD45dim clusters, confirming our results. In conclusion, using a flow cytometry approach, we demonstrated in A-TAH-transplanted patients a significant mobilization of Lin−CD34+CD45dim in peripheral blood one month after A-TAH implantation.
Trust-Enabled Energy Effective Optimal Framework for Detection of Intrusions in the Network Using AI Scheme
Authors: Srivi Putty , Devi Lavadya Nirmala
Published: September 2021

Wireless Sensor Networks (WSN) are self-possessed of the devices that are capable of actuating/sensing, processing, and communicating. This is employed for enhancing the day-to-day life, moreover secure data transmission was regarded as the major challenging aspect for the deployment of data. Data dissemination is a crucial in the complex communications framework for transferring messages for any given condition on the network. The dilemma of fixing the safest efficient route was a tedious issue. Hence the secure and most reliable way will give the appropriate solution for the routing issues. Here in this paper the Trust based energy efficient route path identification by Multi-faceted biologically-inspired probabilistic Cuckoo search Node optimization algorithm (TEERP-MFBPCS)is employed to find the efficient safest route within a short period. After seeing the efficient route, the node can be distinguished upon the traffic and security. Then in the selected route, the nodal distance can be calculated through applying weighted-biased end-to-end delay-based approach for traffic analysis. Finally, the intrusion node can be detected and the performance analysis is carried.