bluuebunny/crossref_metadata_2025 huggingface dataset:
Everolimus Versus Sirolimus for Angiomyolipoma Associated with Tuberous Sclerosis Complex: A Multi-Institutional Retrospective Study in China
Authors: cong luo , Zhang Yu-shi , Zhang Ming-Xin , Chen Min-Feng , Li Yuan , Qi Lin , Li Han-Zhong , Zu Xiong-Bin , cai yi
Published: March 2021

Purpose

To evaluate the efficacy and safety of everolimus and sirolimus in patients with tuberous sclerosis complex-associated angiomyolipomas (TSC-AML).
Materials and Methods

We performed a multi-institutional
retrospective study of TSC-AML patients treated with oral
everolimus or sirolimus.

Angiomyolipoma volume was estimated using orthogonal measurements by MRI or CT. Adverse events (AEs) were assessed according to the National Cancer Institute Common Terminology Criteria for Adverse Events. All analyses were performed using SPSS 19.0 software.
Results

There were high response rates in both two groups. With the prolonged medication time, the therapeutic efficacy of two agents became more significant. Everolimus had a more significant TSC-AML volume reduction after 6 and 12 months than sirolimus. More than 1/2 of everolimus patients had ≥ 50% reduction and approximately 80% of them had ≥ 30% reduction, higher than that of the sirolimus patients. Regarding safety, there was no significant difference in the incidence of AEs between the two groups.
And the most common AE was oral
mucositis.
Conclusions

Both everolimus and sirolimus are excellent therapeutic choices for TSC-AML. However, everolimus had a better therapeutic efficacy than sirolimus, especially in reducing TSC-AML volume. Therefore, everolimus is recommended as the first choice.
Case of Breast Cancer Discovered by Repeated Hematomas After Blunt Trauma to the Breast
Authors: Wang Zhaorui , Wang Jingjing , Sun Qiang , Pei Jing
Published: March 2021

Background: Breast hematoma is a manifestation of blunt force injury to the breast. Hematomas without obvious clinical complications were treated conservatively and most of them were self-healing. If there is no history of tumor and no need for emergency treatment, the possibility of tumor is often ignored by clinicians due to the history of trauma. The repeated hematoma in this case did not attract the attention of the clinician, and the lack of cytological and histological examination is a mistake. This case gives us more clues that recurrent hematomas in the breast need to be looked for abnormal causes.Case presentation: This study describes a 62-year-old woman who underwent 6 times of puncture drainage and local compression bandaging for a breast hematoma caused by blunt chest trauma. After each treatment, hematoma was restored to its original size and about 200 ml of blood was drained each time. Hematoma resection was performed 7 months later and the patient was diagnosed with breast cancer. Cytology and histological examination were not performed during the seven months, and patient’s early diagnosis and treatment were delayed. Conclusions: Recurring hematoma of the breast requires active search for the cause of abnormal bleeding, and tumor bleeding is a key point that cannot be ignored.
G-Cocktail: An Algorithm to Address Cocktail Party Problem of Gujarati Language using CatBoost
Authors: Gupta Monika , Singh R K , Singh Sachin
Published: March 2021

The pandemic caused due to COVID-19, has seen things going online. People tired of typing prefer to give voice commands. Most of the voice based applications and devices are not prepared to handle the native languages. Moreover, in a party environment it is difficult to identify a voice command as there are many speakers. The proposed work addresses the Cocktail party problem of Indian language, Gujarati. The voice response systems like, Siri, Alexa, Google Assistant as of now work on single voice command. The proposed algorithm G- Cocktail would help these applications to identify command given in Gujarati even from a mixed voice signal. Benchmark Dataset is taken from Microsoft and Linguistic Data Consortium for Indian Languages(LDC-IL) comprising single words and phrases. G-Cocktail utilizes the power of CatBoost algorithm to classify and identify the voice. Voice print of the entire sound files is created using Pitch, and Mel Frequency Cepstral Coefficients (MFCC). Seventy percent of the voice prints are used to train the network and thirty percent for testing. The proposed work is tested and compared with K-means, Naïve Bayes, and LightGBM.
From Waste to Reuse: Manufacture of Ecological Composites Based on Biopolyethylene/Wood Powder with PE-g-MA and Macaíba oil
Authors: Silva Fabiano Santana da , Luna Carlos Bruno Barreto , Siqueira D D , Ferreira Eduardo , Araujo Edcleide Maria
Published: March 2021

This work aimed to investigate the biopolyethylene (BioPE)/wood powder (WP) composites compatibilized with polyethylene-grafted maleic anhydride (PE-g-MA), using macaíba oil (OM) as a processing aid. The composites were prepared, initially, in an internal mixer and, later, the crushed flakes were molded by injection. Mechanical properties (impact, tensile, flexural and Shore D hardness), heat deflection temperature (HDT), Vicat softening temperature, differential scanning calorimetry (DSC), thermogravimetry (TG), water absorption, torque rheometry and scanning electron microscopy (SEM) were evaluated. The addition of 30% wood powder to the BioPE matrix increased the elastic modulus (tensile and flexural), Shore D hardness and heat deflection temperature (HDT), compared to neat BioPE. These properties were improved when 10% of the PE-g-MA compatibilizer was added, compared to neat BioPE and the non-compatibilized composite. There was a significant reduction in the torque of the composites with the addition of macaíba oil, indicating that it improved the processability. In addition, the incorporation of macaíba oil into the composites helped to reduce water absorption, as well as to increase impact strength. SEM micrographs illustrated a greater degree of interfacial adhesion when PE-g-MA and macaiba oil were added.
Microwave-assisted synthesis and enhanced photocatalytic performance of Bi2O2CO3 nanoplates
Authors: Plubphon Nitjawan , Thongtem Somchai , Phuruangrat Anukorn , Randorn Chamnan , Thongtem Titipun
Published: March 2021

In this research, Bi2O2CO3 (BOC) nanoplates as a semiconductor-based photocatalyst composed of [Bi2O2]2+ configuration layers were used for environmental treatment. Highly crystalline and pure phase of BOC nanoplates were successfully synthesized by a microwave-assisted method. Effect of irradiation time and microwave heating power on phase, purity, crystallinity, particle size and morphology of the as-synthesized products was investigated. The as-synthesized BOC nanoplates were characterized by X-ray diffraction (XRD), Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM), transmission electron microscopy (TEM), dynamic light scattering (DLS) spectroscopy, Brunauer-Emmett-Teller (BET) surface area analysis, photoluminescence (PL) spectroscopy and UV-visible spectroscopy. Upon increasing microwave heating power, purity and crystallinity of the as-synthesized products were improved. Due to the existence of double internal electric field, the separation of photo-induced charged carriers was enhanced, leading to promote photocatalytic activity of the BOC nanoplates in degrading of methyl orange (MO) under UV radiation. The highest photocatalytic performance was achieved by using the BOC nanoplates synthesized by 600 W microwave for 60 min. A formation mechanism of BOC nanoplates was also proposed and discussed according to the experimental results.
Higher PEEP versus Lower PEEP Strategies for Patients in ICU without Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis
Authors: Yi Hongyu , Li Xiaoming , Mao Zhi , Liu Chao , Hu Xin , Song Rengjie , Qi Shuang , Zhou Feihu
Published: March 2021

Background: The application of high PEEP remains to be a controversial issue when it comes to ICU patients underwent ventilation. There are studies supporting the usage of high PEEP in patients with ARDS, while for those without ARDS, the conclusion is of great ambiguity. We performed this systematic review and meta-analysis to compare the effects of high and low level of PEEP on ICU patients without ARDS.Methods: We searched public databases (including PubMed, EMBASE, Cochrane Library and Clinicaltrial.gov) to find eligible randomized controlled trials (RCTs). The primary outcomes included in this meta-analysis were in-hospital mortality, 28-day mortality and the duration of ventilation, ICU stay, and hospital stay. We used the Cochrane risk of bias assessment tool to evaluate risk of bias. Trial Sequential Analysis (TSA) was conducted. Results: We included 2307 patients from 24 trials using high and low PEEP. Although no significant difference was found between high and low PEEP applications in in-hospital mortality (risk ratio[RR] 0.98, 95% confidence interval[CI] [0.81, 1.19], P=0.87), 28-day mortality (RR 0.68, 95% CI [0.33, 1.40], P=0.30) and the duration of ventilation (mean difference[MD] -0.30, 95% CI [-0.64, 0.04], P=0.09), ICU stay (MD -0.38, 95% CI [-1.03, 0.27], P=0.25), and hospital stay (MD -0.56, 95% CI [-1.44, 0.32], P=0.22), high PEEP indeed increased the level of PaO2/FIO2 (MD 32.39, 95% CI [13.06, 51.72], P=0.001), and therefore decreased the incidences of ARDS (RR 0.57, 95% CI [0.37, 0.89], P=0.01) and hypoxaemia (RR 0.60, 95% CI [0.41, 0.88], P=0.009). In addition, although total results did not reveal the advantage of high PEEP on other secondary outcomes regarding atelectasis, barotrauma, ventilator associated pneumonia (VAP), hypotension, mean arterial pressure (MAP), SaO2 and lactate, subgroup analysis seemed to obtain different results. The TSA results suggested more RCTs were needed. Conclusion: Ventilation with high PEEP in ICU patients without ARDS may improve the level of oxygenation (PaO2/FIO2) resulting in low incidences of ARDS and hypoxaemia. Nevertheless, other clinical outcomes including in-hospital and 28-day mortality, duration of ventilation, ICU stay and hospital stay, pulmonary complications, hemodynamics and post-operative fluid balance did not show any significant difference.
Transmembrane Signaling Molecules Play a Key Role in Progression of IgA Nephropathy: A Weighted Gene Co-expression Network Analysis Study
Authors: Gholaminejad Alieh , roointan Amir , Gheisari Yousof
Published: March 2021

Background: Immunoglobulin A nephropathy (IgAN) is one of the most common primary glomerulonephritis and a serious health concern worldwide; though, still the underlying molecular mechanisms of IgAN are yet to be known and there is no efficient treatment for this disease. The main goal of this study was to explore the IgAN underlying pathogenic pathways, plus identifying the disease correlated modules and genes using weighted gene co-expression network analysis (WGCNA) algorithm. Results: GSE104948 dataset was analyzed and the identified differentially expressed genes (DEGs) were introduced to the WGCNA algorithm for building co-expression modules. Genes were classified into six co-expression modules. Genes of the disease most correlated module were mainly enriched in the immune system, cell-cell communication and transmembrane cell signaling pathways. The PPI network was constructed by genes in all the modules and after hub-gene identification and validation steps, 11 genes, mostly transmembrane proteins (CD44, TLR1, TLR2, GNG11, CSF1R, TYROBP, ITGB2, PECAM1), as well as DNMT1, CYBB and PSMB9 were identified as potential key players in the IgAN progression. In the constructed regulatory network, miR-129-2, miR-34a and miR-27a, as well as STAT3 were spotted as top molecules orchestrating the regulation of the hub genes.Conclusions: The excavated hub genes from the hearts of co-expressed modules and PPI network were mostly transmembrane signaling molecules. These genes and their upstream regulators could deepen our understanding of IgAN and be considered as potential targets for hindering its progression.
Momordica Janarthanamii (Cucurbitaceae); A Remarkable New Species From Northern Western Ghats, India
Authors: Gosavi Kumar Vinod C. , Gholave Avinash R. , Madhav Nilesh A. , Kambale Sharad S.
Published: March 2021

Momordica janarthanamii, a new species L., is described and illustrated from northern Western Ghats, India. The new species is closely related to Momordica dioica Roxb. ex Willd. Colored photographs, economical value, ecological note and distribution of the new species are provided. A key for the dioecious species of Momordica from India has also been provided to facilitate identification.
Design of Precision Finishing Method for Cold Extruded Sun Gear With Internal External Tooth Shapes
Authors: Liu Zuofa , Wang Qiuyun , Zhou Jie , Feng Wenjie , Liang Qiang
Published: March 2021

Due to the complex metal flow in the cold extrusion of sun gear, the teeth accuracy of formed sun gear is poor. In order to improve the accuracy of the extruded sun gear, a novel precision f inishing method was proposed in this study. A new finite element ( prediction strategy was developed to obtain an in-depth understanding of the deviation distribution laws of the finished sun gear. Then, the forming laws of internal-external gears such as material flow, tooth deformation, forming load and tooth accuracy were analyzed using FE simulation and verified experiment. The investigation results show that the single deviations in profile and helix both first diminished remar ka bly , and then rose gradually while the single M value deviation decreased remarkably with increasing the tooth width The simulation results of teeth deviations are well agreed with the experimental ones, which verifies the reliability of the FE prediction strategy Moreover, the profile accuracy of external gear can be improved from ninth to seventh class, lead accuracy can be enhanced from tenth to eighth class, and total M value deviation of internal spline is reduced to 72.3 μm which proves the feasibility and effectiveness of t he precision finishing method
A Novel Technique of Full-Thickness Scleral Debridement in Fulminant Necrotising Infectious Scleritis and Its Outcomes - A Consecutive Case Series
Authors: KARKHUR SAMENDRA , SONI DEEPAK , SHARMA BHAVANA
Published: March 2021

PurposeWe report the outcomes of a novel technique of scleral debridement in five consecutive cases of relentlessly progressive and fulminant infectious scleritis following corticosteroid exposure.MethodsFive consecutive patients of infectious scleritis with a common history of corticosteroids exposure; resulting from either an initial misdiagnosis of autoimmune scleritis or as an adjunct to specific antimicrobial therapy. Data collection included presentation details including photographs, clinical findings, microbiological analysis, treatment details and audit of surgical videos. Cases with undisputed diagnosis of infectious scleritis with microbiological evidence; without corticosteroid use, were excluded from study.ResultsAfter full-thickness scleral debridement and cessation of corticosteroids, favourable anatomical and visual outcome was observed in all cases; however, two patients required multiple scleral debridements due to progressive scleritis. Scleral patch graft was not used in any case. Microbiology detected infective organisms in two cases, while the remaining revealed negative results. Therefore, specific antimicrobial therapy was initiated in former, whereas empirical broad-spectrum regimen in patients with repeatedly negative results. No recurrence of scleritis or development of ciliary staphyloma was noted and anatomical integrity was maintained at normal intraocular pressure during follow-up.ConclusionThis study highlights the fulminant and relentlessly progressive clinical course, that infectious scleritis can metamorphose into, despite specific anti-microbial therapy, if inadvertent corticosteroid therapy is administered. Full-thickness debridement without scleral patch graft could achieve elimination of infectious foci with favourable long-term anatomical and visual outcome. This technique could offer a potential last resort approach in such cases where standard therapeutic modalities have not been successful.
A Comparison between Placement of three interrupted sutures after Triangular Three-snip Punctoplasty vs conventional Triangular Three-snip Punctoplasty for treatment of lower punctal stenosis
Authors: Abdulhady Hesham Mohammed , Khairy Hany , Awara Amr , Mandour Sameh S.
Published: March 2021

Aim

is to evaluate surgical outcome of Triangular Three-snip Punctoplasty (TSP) with three interrupted sutures and compare it to conventional Triangular Three-snip Punctoplasty (TSP) in treatment of acquired lower punctal stenosis.
Methods

This prospective study included 40 eyelids of 24 patients with acquired lower punctal stenosis grade 1 or grade 2 were classified in two groups. Group A was treated by triangular 3-snip punctoplasty of the lower punctum followed by three interrupted sutures at the posterior ampulla and group B was treated by conventional triangular 3-snip punctoplasty of the lower punctum. Grade of epiphora and grade of FDDT were measured preoperative then post-operative after 1 week, 1 month, 3 months and 6 months. Success was defined as postoperative improvement of epiphora and FDDT grading with no restenosis to occur.
Results

from 20 eyelids in group A, 16 cases showed success (80%) with patent puncta, 2 cases (10%) showed no change and 2 cases (10%) showed failure with restenosis. While from 20 eyelids in group B, 14 cases showed success (60%) with patent puncta, 4 cases (20%) showed no change and 4 cases (20%) showed failure with restenosis.
Conclusion

proposed triangular 3-snip punctoplasty of the lower punctum followed by three interrupted sutures seems to have better results compared to conventional triangular 3-snip punctoplasty of the lower punctum in treatment of grade 1 or 2 lower punctal stenosis.
Glaucoma Profile at the Tertiary Ophthalmic Centers in Ankara, Turkey
Authors: Bayer Atilla , Elgin Ufuk , Tekeli Oya , Takmaz Tamer , Ekşioğlu Ümit , Yarangümeli Alper , Mumcuoğlu Tarkan , Aktaş Zeynep , Güngör Sirel Gür , Karakurt Ahmet , Kemer Özlem Evren , Akman Ahmet
Published: March 2021

Purpose: This study aimed to investigate the demographic and clinical characteristics of the patients with glaucoma, who presented at the tertiary ophthalmology clinics in Ankara, Turkey.Patients and Methods: This cross-sectional study included all of the consecutive glaucoma patients or glaucoma suspects who presented at ten different tertiary ophthalmology clinics in Ankara between March 2015 and May 2015. The demographic characteristics and clinical findings of the patients were evaluated. Glaucoma was diagnosed according to the International Society for Geographical and Epidemiological Ophthalmology Classification. In the patients with binocular glaucoma, only the data of the worse eye was included for statistical analyses. Results: A total of 4604 eyes of 2541 patients fulfilled the inclusion criteria and were classified as having glaucoma. Binocular involvement was present in 2063 (81.2%) patients. Primary open angle glaucoma (POAG) was the most common glaucoma type (38.8%), followed by exfoliative glaucoma (XFG; 26.2%), and primary angle-closure glaucoma (PACG; 7.7%). The distribution of the sexes was significantly different among the diagnosis groups (P < 0.001). The cup/disk ratio was the highest among the patients with secondary angle-closure glaucoma (SACG; P < 0.001). The visual field MD parameter was significantly higher in the patients with SACG and XFG (P < 0.001). Monocular and binocular blindness ratios were 21% and 2.8%, respectively.Conclusions: The predominant type of glaucoma in Turkish clinic patients was found to be POAG, followed by XFG and PACG.
A mass casualty incident of infectious diseases at the port of Hamburg: an analysis of organizational structures and emergency concepts
Authors: Klein Angelina , Heuser Julian , Henning Esther , Spössel Nadine , Kordsmeyer Ann-Christin , Oldenburg Marcus , Mojtahedzadeh Natascha , Heidrich Jan , Militzer Kristina Carolin , Belz Lukas , Münster Thomas von , Harth Volker , Ehlers Lena , Boer Jens de , Kleine-Kampmann Scarlett , Boldt Matthias , Dirksen-Fischer Martin , Haralambiev Lyubomir , Gümbel Denis , Ekkernkamp Axel , Bakir M. Sinan
Published: March 2021

BACKGROUND

The project “ARMIHN” (Adaptive Resiliency Management in Port) focuses on strengthening the capability to act in a mass casualty incident (MCI) due to an outbreak of infectious diseases (MCI-ID). In addition to the current threat from the COVID-19 pandemic and associated outbreaks on cruise ships, an MCI-ID can also be caused by pathogens such as Influenzavirus or Norovirus. The first step was, to get an overview of processes and resources using the example of the Port of Hamburg, and to show the relating interaction of involved parties. This will serve as a basis for developing an operational strategy and offers the opportunity to optimize current work processes.
METHODS

A selective literature research using specified key words was performed and existing MCI concepts were received from local authorities. Identified structures and processes were analyzed in a multiple step process and also brought together through discussions in workshops with involved organizations and other experts. Additionally, the distances between the nearest rescue stations and selected hospitals from the Port of Hamburg were analyzed.
RESULTS

The current available concepts are proven, but an adaptation to an MCI-ID shows opportunities for a further cross-organizational development. The organizational structure of an MCI-ID in the Port of Hamburg was described, including a large number of involved organizations (n = 18). There are 17 involved fire and rescue stations and the port can be reached from these locations within 6 to 35 minutes. Based on their specialist expertise, 14 of the 31 listed clinics were selected.
CONCLUSION

Based on identified existing structures and the determination of medical resources, an operational concept for an MCI-ID in the port can be adapted and can contribute to enhanced coping with this situation. Subsequently, the derived operational concept will be tested for practical suitability in several exercises within the present project.
Intramedullary Nailing for Pathological Fractures of the Proximal Humerus Caused by Multiple Myeloma: A Case Report and Literature Review
Authors: xu guoqiang , wang gang , bai xiaodong , liu zhenyu , wang xinjia , wang baojun
Published: March 2021

Background: Multiple myeloma bone disease(MMBD) is indicative of multiple myeloma (MM), and it will reduce patient life quality. In addition to oncological, antineoplastic systemic therapy, surgical therapy in patients with MM represents an essential treatment pillar within the framework of supportive therapy measures and is the task of orthopedic tumor surgery. Nevertheless, there are few reports about applying intramedullary (IM) nailing in treating MM-induced proximal humeral fracture to prevent fixation loss. This paper aims to describe a case of pathological fracture of the proximal humerus caused by multiple myeloma effectively treated with IM nailing without removal of tumors and review the current literature.Case presentation: This study reported a 64-year-old male patient complaining of serious left shoulder pain and limited movement. X-ray films showed left proximal humeral fracture accompanying with osteoporosis and bone destruction. During the preoperative examinations, tumor markers, whole-body bone imaging and bone marrow biopsy were performed. The patient was finally diagnosed with multiple myeloma (IgAλ, IIIA/II). After the treatment of pathological fracture with IM nailing, the patient's function recovered and the pain was relieved rapidly. The visual analogue scale (VAS) reduced by 7 points to 2 points postoperatively compared with that preoperatively. Histopathological examination results presented plasma cell myeloma. Next, the patient received chemotherapy in the hematology department. Humeral fracture displayed good union in the 40-month follow-up, with complete healing of fracture, and the clinical outcome was still satisfactory.Conclusion: The pathological fracture of proximal humerus caused by multiple myeloma should be treated by surgery early. IM nail can be used for this kind of fracture without removal of tumors, bone cement augmentation for bone defect or local adjuvant therapy was also employed. Under the combined treatment, the proximal humerus fracture can eventually heal.
A computational model based on cortico-spinal fMRI for asymmetrically organized motor corticospinal networks in humans
Authors: Takasawa Eiji , Abe Mitsunari , Takagishi Kenji , Chikuda Hirotaka , Hanakawa Takashi
Published: March 2021

Evolution of the direct connection from primary motor cortex to motoneurons in the spinal cord parallels acquisition of hand dexterity and lateralization of hand preference. Recent studies indicated that the phylogenetically older pathway consisting of multi-synaptic connections from primary motor cortex to spinal motoneurons also participate in controlling dexterous hand movement. However, it remains unknown how the two corticospinal pathways work in concert to control unilateral hand movement with lateralized preference. Using corticospinal functional magnetic resonance imaging, we discovered the asymmetric organization of the two corticospinal networks that modelled monosynaptic or polysynaptic control from primary motor cortices over spinal motoneurons. Moreover, the degree of the involvement of the two corticospinal networks paralleled the lateralization of hand preference. The present results pointed to the functionally lateralized motor nervous system that underlies the behavioural asymmetry of handedness, a uniquely human trait which could have phylogenetically differentiated humans from other primates.
Evaluation on Influences of Inertial Mass on Seismic Responses and Structure-soil Interactions of Pile-soil-piers
Authors: XIE Wen , Sun Limin , He Tiantao
Published: March 2021

This research is to assess the influences of the inertial mass from the girder on the dynamic characteristic, dynamic response, and structure-soil interaction of a pile-soil-pier subsystem in a scale-model of a cable-stayed bridge. Therefore, both connection configurations between the pile-soil-pier and girder, including the sliding and fixed connections, were designed to present various inertial mass from the superstructure delivered to the pile-soil-pier. The pile-soil-pier supported by a 3×3 pile-group in mixed soil placed in a shear box was tested using shaking tables. The dynamic characteristics, seismic responses, inertial interactions, and pile group effects of the pile-soil-pier between the sliding and fixed connections were analyzed under three input motions with different shaking amplitudes. These results showed that more inertial mass from the girder significantly increased the reinforcement strain and bending moment at the column bottom and pile top, displacement at the column top, inertial interaction effects, and pile group effects of the pile-soil-pier due to the sliding connection changing to the fixed connection. The inertial mass increment from the girder noticeably decreased the peak accelerations of the column of the pile-soil-pier when subjected to three input motions with different amplitudes. However, the inertial mass insignificantly affected the accelerations of the pile and free-soil. Therefore, the corresponding kinematic interaction effects were almost unaffected by the inertial mass. Additionally, the evident pile group effects were observed in the sliding and fixed connections between the pile-soil-pier and girder. 24 The numerical model could approximately reproduce the macroscopic seismic responses of the pile-soil-piers with sliding and fixed connections and capture the typical response variations induced by the connection configuration change.
Identification of climate change induced heat stress sensitive environments and prediction for diverse representative concentration pathways – A novel approach for tracking hotspots
Authors: R Sendhil , Ghimire Uttam , HM Mamrutha , K Rinki , G Balaganesh , Singh GP
Published: March 2021

Climate change is unequivocal across economies and India owing to its distinct geography has been exposed to several climatic risks, especially in agriculture. Heat stress is a serious environmental problem posed by climate change, wherein mean temperature is expected to increase relatively more during wheat growing season affecting production and food security. In the milieu , the investigation is pioneered to predict heat stress sensitive wheat growing environments in India for research prioritization using a long term (30 years) historical daily data. The study has developed a methodological approach by integrating statistical downscaling of climate information and principal component analysis for computing heat stress intensity index (HSII) for 17 experiment locations across wheat growing environments. HSII were estimated for existing locations post testing for Levene’s homogeneity of variance, followed by prediction for three periods’ viz., early-future (2026-2050), mid-future (2051-2075) and far-future (2076-2100) under two emission scenarios namely RCP4.5 and RCP8.5. The results alarmed a radical shift in HSII of experiment locations from one period to another in both scenarios. Experiment locations with high index values for the existing environment has moved almost to lower category in the early future and subsequently shifted to higher position in the mid-future and far-future. The investigation also found that under projected RCP4.5, trial locations in peninsular zone need more emphasis, whereas in RCP8.5, peninsular zone coupled with central zone and north eastern plains zone have to be focused. Overall, the study develops a pragmatic approach in location prioritization across predicted periods which can be replicated to other regions. On policy front, rational allocation of research funds has been suggested to carry out field trials on climate change induced heat stress sensitive environments for sustaining the national wheat production apart from developing micro-level adaptation strategies to counter adverse effects of climate change.
Study on the Optimization and Stability of Single-dose Streptozotocin-induced Diabetic Modelling in Rats
Authors: Zhang Yao , Zhang Jiao , Hong Ming , Huang Jingyi , Wang Rui , Tan Bo , Huang Ping , Cao Hongying
Published: March 2021

Aim: This study was performed to optimize the experimental conditions in streptozotocin (STZ)-induced diabetic model by using Sprague-Dawley (SD) rats to evaluate the stability of the model.Methods: In addition to the control group, the male and female SD rats were randomly divided into the following treatment groups (with six rats per group): STZ 45 (45 mg/kg STZ); STZ 65 (65 mg/kg STZ); STZ 85 (85 mg/kg STZ); high-fat diet with STZ 45; high-fat diet with STZ 65; and high-fat diet with STZ 85. Changes in the body weight and blood glucose were observed dynamically. Results: No significant differences were found in the blood glucose or body weight between the STZ 45 and control groups in both male and female rats, whether or not the rats were on a high-fat diet. However, significant differences were found in the blood glucose between the high-dose STZ and control groups in both male and female rats, regardless of whether the rats were on a high-fat diet or not (P<0.05 or P<0.01). Compared with the control group, significant differences in the blood glucose levels (P<0.05 or P<0.01) and higher blood glucose levels were found in the male rats fed with normal diet than those of rats fed with high-fat diet.Conclusions: In this study, male rats fed with ordinary feed and injected with 65 mg/kg STZ were the most stable and ideal diabetic rats.
Analysis of the Clinical Characteristics of 19 Cases of Bacterial Liver Abscesses in Children and A Review of the Literature
Authors: Yuanxi Bian , Yanqun Jiang , Qihua Feng
Published: March 2021

Background

To analyze the clinical characteristics of 19 children with bacterial liver abscesses and to explore the diagnosis, treatment and prognosis of children with bacterial liver abscesses.
Methods

Children with bacterial liver abscesses were selected from July 01, 2011, to July 31, 2020, at the Affiliated Children's Hospital of Suzhou University. The onset age, sex, clinical manifestations, imaging and laboratory examination data, treatment and outcomes were analyzed and summarized, and a literature review was performed.
Results

The average diagnostic age of 19 cases of bacterial liver abscesses was 5 ± 6.7 years old, and the ratio of males to females was 1.7. Ten cases had underlying diseases, including 8 cases of hematological diseases (including leukemia and aplastic anemia) (42.1%), 1 case of a choledochal cyst (5.3%) and 1 case of abdominal trauma (5.3%). The most common clinical manifestations were fever (16 cases, 84.2%), followed by right upper abdominal pain (9 cases, 44.4%) and cough and pleural effusion (6 cases, 31.6% each). Among the laboratory indexes, increases in serum C-reactive protein and leukocytosis were the most common, with 19 cases (100%) and 9 cases (44.4%), respectively. The proportion of patients with abnormal liver function was not high, and there were no cases of elevated bilirubin. The most common pathogens in pus and blood cultures were Klebsiella pneumoniae and Escherichia coli. Nineteen children with bacterial liver abscesses were treated with intravenous antibiotics, and the average duration of intravenous antibiotic use was 28.4 ± 14.7 days. Among the cases, 13 cases (68.4%) were treated with antibiotics alone, and 5 cases (26.3%) and 1 case (5.3%) were treated with percutaneous needle aspiration and surgical drainage, respectively. All 19 children with bacterial liver abscesses improved, and there were no complications or deaths.
Conclusion

The most common underlying disease was a hematological malignant tumor. Klebsiella pneumoniae and Escherichia coli were the most common pathogens in blood and abscess cultures. Through appropriate antibacterial treatment and timely drainage, the prognosis is usually good.
Multiscale PHATE Exploration of SARS-CoV-2 Data Reveals Multimodal Signatures of Disease
Authors: Kuchroo Manik , Huang Jessie , Wong Patrick , Grenier Jean-Christophe , Shung Dennis , Tong Alexander , Lucas Carolina , Klein Jon , Burkhardt Daniel , Gigante Scott , Godavarthi Abhinav , Israelow Ben , Mao Tianyang , Oh Ji Eun , Silva Julio , Takahashi Takehiro , Odio Camila , Casanovas-Massana Arnau , Fournier John , Farhadian Shelli , Cruz Charles Dela , Ko Albert , Hirn Matthew , Wilson Francis , Hussin Julie , Wolf Guy , Iwasaki Akiko , Krishnaswamy Smita
Published: March 2021

The biomedical community is producing increasingly high dimensional datasets, integrated from hundreds of patient samples, which current computational techniques struggle to explore. To uncover biological meaning from these complex datasets, we present an approach called Multiscale PHATE, which learns abstracted biological features from data that can be directly predictive of disease. Built on a coarse graining process called diffusion condensation, Multiscale PHATE learns a data topology that can be analyzed at coarse levels for high level summarizations of data, as well as at fine levels for detailed representations on subsets. We apply Multiscale PHATE to study the immune response to COVID-19 in 54 million cells from 168 hospitalized patients. Through our analysis of patient samples, we identify CD16-hi,CD66b-lo neutrophil and IFNγ+,GranzymeB+ Th17 cell responses enriched in patients who die. Furthermore, we show that population groupings Multiscale PHATE discovers can be directly fed into a classifier to predict disease outcome. We also use Multiscale PHATE-derived features to construct two different manifolds of patients, one from abstracted flow cytometry features and another directly on patient clinical features, both associating immune subsets and clinical markers with outcome.
Quantifying how urban landscape heterogeneity affects land surface temperature: A comparison of discrete and continuous approaches
Authors: Rahimi ehsan , Barghjelveh Shahindokht , Dong Pinliang
Published: March 2021

The present study examines the efficiency of discrete and continuous approaches to measuring urban heterogeneity effects on land surface temperature (LST). In the discrete approach, landscape metrics have been widely applied to quantifying the relationship between land surface temperature and urban spatial patterns and have received acceptable verification from landscape ecologists but some studies have shown their inaccurate results. The objective of the study is to compare landscape metrics and alternative approaches to measuring urban heterogeneity effects on LST. We compared landscape metrics results with nine texture-based measures, and two local spatial autocorrelation indices (local Moran’s I and Gi statistics) applied to NDVI and BAI indices as a proxy of the spatial patterns of Tehran vegetation and built-up classes. The statistical results showed that urban landscape heterogeneity had significant impacts on the LST variations, and there was a compatibility between landscape metrics and alternative measures results. Overall results showed that the less-fragmented, the more complex, larger, and the higher number of patches, the lower LST. The most significant relationship was between patch density (PD) and LST (r= -0.71). Higher values of PD have mostly been interpreted to show higher fragmentation, but other landscape metrics and alternative measures declined this conclusion. Our study demonstrated that PD was not a reliable metric and presented no information about the spatial distribution of landscape elements. This study confirms alternative measures for overcoming landscape metrics shortcomings in estimating the effects of landscape heterogeneity on LST variations and gives land managers and urban planners new insights into the urban design.
All-trans-Retinoic Acid Alleviates Coronary Stenosis by Regulating the Migration of Smooth Muscle Cells in a Mouse Model of Kawasaki Disease
Authors: Suganuma Eisuke , Sato Satoshi , Honda Satoko , Nakazawa Atsuko
Published: March 2021

Coronary artery (CA) stenosis is a detrimental and often life-threatening sequela in Kawasaki disease (KD) patients with coronary artery aneurysm (CAA). Therapeutic strategies for these patients have not yet been established. All-trans-retinoic acid (atRA) is a modulator of smooth muscle cell functions. The purpose of this study was to investigate the effect of atRA on CA stenosis in a mouse model of KD. Lactobacillus casei cell wall extract (LCWE) was intraperitoneally injected into 5-week-old male C57BL/6J mice to induce CA stenosis. Two weeks later, the mice were orally administered atRA (30 mg/kg) 5 days per week for 14 weeks (LCWE+atRA group, n=7). Mice in the untreated group (LCWE group, n=6) received corn oil alone. Control mice were injected with phosphate-buffered saline (PBS, n=5). Treatment with atRA significantly suppressed CA inflammation (19.3±2.8 vs 4.4±2.8, p<0.0001) and reduced the incidence of CA stenosis (100% vs 18.5%, p<0.05). In addition, atRA suppressed the migration of human coronary artery smooth muscle cells (HCASMCs) induced by platelet-derived growth factor subunit B homodimer (PDGF-BB). In conclusion, atRA dramatically alleviated CA stenosis by suppressing SMC migration. Therefore, it is expected to have clinical applications preventing CA stenosis in KD patients with CAA.
A prospective evaluation of AI-augmented epidemiology to forecast COVID-19 in the USA and Japan
Authors: Ledsam Joseph , Arik Sercan , Shor Joel , Sinha Rajarishi , Yoon Jinsung , Le Long , Dusenberry Michael , Yoder Nate , Popendorf Kris , Epshteyn Arkady , Euphrosine Johan , Kanal Elli , Jones Isaac , Li Chun-Liang , Luan Beth , Mckenna Joe , Menon Vikas , Singh Shashank , Sun Mimi , Ravi Ashwin Sura , Zhang Leyou , Sava Dario , Kayama Hiroki , Tsai Thomas , Yoneoka Daisuke , Nomura Shuhei , Miyata Hiroaki , Pfister Tomas
Published: March 2021

The COVID-19 pandemic has highlighted the global need for reliable models of disease spread. We propose an AI-augmented forecast modeling framework that provides daily predictions of the expected number of confirmed COVID-19 deaths, cases and hospitalizations during the following 4 weeks and we present an international, prospective evaluation of our models' performance across all states and counties in the USA and prefectures in Japan. National mean absolute percentage error (MAPE) for predicting COVID-19 associated deaths before and after prospective deployment remained consistently <2% (US) and <10% (Japan). Average statewide (US) and prefecture wide (Japan) MAPE was 6% and 26% respectively (14% when looking at prefectures with more than 10 deaths). We show that our models perform well even during periods of considerable change in population behavior, and that it is robust to demographic differences across different geographic locations. We further demonstrate that our framework provides meaningful explanatory insights with the models accurately adapting to local and national policy interventions. Our framework enables counterfactual simulations, which indicate continuing Non-Pharmaceutical Interventions alongside vaccinations is essential for faster recovery from the pandemic, delaying the application of interventions has a detrimental effect, and allow exploration of the consequences of different vaccination strategies. The COVID-19 pandemic remains a global emergency. In the face of substantial challenges ahead, the approach presented here has the potential to inform critical decisions.
Adrenal Stereotactic Body Radiation Therapy: The Effects of a Full and Empty Stomach on Radiation Dose to Organs at Risk
Authors: Tanaka Osamu , Taniguchi Takuya , Ono Kousei , Nakaya Shuto , Kiryu Takuji , Makita Chiyoko , Matsuo Masayuki
Published: March 2021

IntroductionAdrenal recurrence after radical resection of the primary lesion is common. However, the adrenal glands are surrounded by radiosensitive organs such as the pancreas, kidneys, small intestine, and stomach. Treatment planning therefore requires many regulations due to the dose limit to the organ at risk. Radiotherapy can be adjusted for gastric capacity. We therefore performed an OAR analysis for SBRT to the left adrenal gland based on gastric state (empty or full stomach) at the time of irradiation. We examined whether it was possible to reduce the dose to OAR.Materials and MethodsA sample of 20 randomly selected stomachs was arranged in descending order from largest to the smallest size and divided into two groups of 10. The “empty group” is defined as the smaller stomach group (n = 10), while the “full group” is the larger stomach group (n = 10). Planning target volume (PTV) adds a 3 mm margin to the GTV. The prescribed PTV dose was 54 Gy / 6 fx and D 95 coverage of PTV(CTV) (the dose to 95% of the PTV volume). We compared the difference in OAR radiation dose between the two stomach volume groups.ResultsGastric OAR dose in the empty group was significantly lower than in the full group (D5 and D10). However, the OAR dose to the left kidney in the empty group was statistically significantly higher than in the full group (V12, V15, and V21).ConclusionWhen SBRT was performed on the left adrenal gland, it was found that the smaller the stomach size, the lower the radiation dose to the stomach. The stomach is an abdominal organ that can be artificially resized. It is therefore better to perform SBRT on patients who have an empty stomach.
Influence of Structure on the Aseismic Stability and Dynamic Responses of Liquefiable Soil
Authors: Dou Pengfei , Xu Chengshun , Du Xiuli , Chen Su
Published: March 2021

In previous major earthquakes, the damage and collapse of structures located in liquefied field which caused by site failure a common occurrence, and the problem of evaluation and disscusion on site liquefaction and the seismic stability is still a key topic in geotechnical earthquake engineering. To study the influence of the presence of structure on the seismic stability of liquefiable sites, a series of shaking table tests on liquefiable free field and non-free field with the same soil sample was carried out. It can be summarized from experimental results as following. The natural frequency of non-free field is larger and the damping ratio is smaller than that of free field. For the weak seismic loading condition, the dynamic response of sites show similar rules and trend. For the strong ground motion condition, soils in both experiments all liquefied obviously and the depth of liquefaction soil in the free field is significantly greater than that in the non-free field, besides, porewater pressure in the non-free field accumulated relately slow and the dissapited quikly from analysis of porewater pressure ratios(PPRs) in both experiments. The amplitudes of lateral displacements and acceleration of soil in the non-free field is obviously smaller than that in the free field caused by the effect of presence of the structure. In a word, the presence of structures will lead to the increase of site stiffness, site more difficult to liquefy, and the seismic stability of the non-free site is higher than that of the free site due to soil-structure interaction.
Adherence to Clinical Guidelines in Integration of Mental Health Services Into Primary Health Care in Mbarara, Southwestern Uganda: a Medical Record Review
Authors: Wakida Edith K , Ocan Moses , Rukundo Godfrey Zari , Sebutinde Peter , Maling Samuel , Okello Elialilia S , Talib Zohray M , Obua Celestino
Published: March 2021

Background: The Ugandan Ministry of Health decentralized mental health care delivery to the district level; developed the Uganda Clinical Guidelines (UCG); and trained primary health care (PHC) providers in identification, management, and referral of individuals with common mental disorders. This was intended to promote the integration of mental health services into PHC in the country. However, the extent of integration of mental health into general health care service delivery remains unknown. This study aimed to establish the level of adherence of PHC providers to the UCG in the identification and management of mental disorders. Methods: This was a prospective medical record review study of patient information collected in November and December 2018, and March and April 2019 at two health centers (III and IV) in southwestern Uganda. Data (health facility level; sex and age of the patient; and mental disorder diagnosis, management) was collected using a checklist. Continuous data was analyzed using means and standard deviation while categorical data was analyzed using Chi-square. Multivariable logistic regression analysis was performed to establish predictors of PHC provider adherence to the clinical guidelines on integration of mental health services into PHC. The analysis was conducted at a 95% level of significance.Results: Of the 6093 records of patients at the study health facilities during the study period, 146 (2.4%) had a mental or neurological disorder diagnosis. The commonly diagnosed disorders were epilepsy 91 (1.5%) and bipolar 25 (0.4%). The most prescribed medications were carbamazepine 65 (44.5%), and phenobarbital 26 (17.8%). The medicines inappropriately prescribed at health center III for a mental diagnosis included chlorpromazine for epilepsy 3 (2.1%) and haloperidol for epilepsy 1 (0.7%). Female gender (aOR: 0.52, 95%CI: 0.39 -0.69) and age 61+ years (aOR: 3.02, 95%CI: 1.40 – 6.49) were predictors of a mental disorder entry into the HMIS register.Conclusion: There was a noticeable change of practice by PHC providers in integrating mental health services in routine care as reflected by the rise in the number of mental disorders diagnosed and treated and entered into the modified paper based HMIS registers.