bluuebunny/crossref_metadata_2025 huggingface dataset:
Etiologies of Fever of Unknown Origin in HIV/AIDS Patients, Hanoi, Vietnam
Authors: Nguyen Kim Thu , Nguyen Hai Yen , Nguyen Thi Hao , Khong Minh Quang , Tran Kim Ngoc
Published: July 2021

Background: Prolonged fever is a challenge for clinicians in managing patients with HIV/AIDS. Their TCD4 counts can be helpful in the diagnosis and treatment. This study aimed to determine several common etiologies of prolonged fever and their distribution in different TCD4 count levels in HIV/AIDS patients.Methods: A cross-sectional, retrospective and prospective study was conducted on 195 HIV/AIDS patients with fever of unknown origin admitted to National Hospital for Tropical Diseases from January 2016 to June 2019. Clinical parameters, immune status, and etiologies for each patient were recorded. Odds ratio was used to compare the distribution of common etiologies in two different TCD4 count levels, including <50 cells/mm3 and ≥50 cells/mm3.Results: The proportion of opportunistic infections and non-infectious etiologies was 93.3% and 3.6%, respectively. Tuberculosis was the most common opportunistic infection (46.7%), followed by Talaromycosis (29.2%) and Pneumocystis jiroveci (20.5%). Tuberculosis was predominant in all stratified CD4 levels. Most cases with Talaromycosis had CD4 counts below 50 cells/mm3. 53.8% of cases were infected by one pathogen. There was no difference between the number of concurrent etiologies and T-CD4 levels. Conclusions: Opportunistic infections, especially tuberculosis, are still the leading cause of prolonged fever in HIV/AIDS patients. Talaromyces marnefei should be screened in patients with CD4 <50 cells/mm3. This study implies that guidelines regarding providing the appropriate treatment for FUO-HIV patients based on the CD4 cells count should be developed that may reduce the burden of clinicians in managing HIV/AIDS patients.
Survival of Lateral Unicompartmental Knee Arthroplasty in Short-to-long-term Follow-ups: Meta-analysis
Authors: Guo Zhao , Qian Ligang , Gao Wenshan , Wang Yunfei , Gao Fei , Zhao Baohui
Published: July 2021

BackgroundThe effectiveness of unicompartmental knee arthroplasty by lateral UKA remains poorly characterized as a limit of lateral UKA were operated for osteoarthritis (OA). However, the field of UKA surgery has rapidly expanded the usage of partly knee replacement in KOA patients with increased satisfaction, survivorship and functional outcomes. Methods A meta-analysis was conducted to evaluate the survivorship of lateral UKA with assessment with short-to midterm (<10years) and long-term (>10years) follow-up. Five databases were searched for eligible studies with search terms modified to the instructions of different databases. Twenty-three studies met the inclusion criteria and the pooling data were summarized in forest plots.ResultsThe implant survivorship of lateral UKA in short-term (3 year) was 96% (95%CI, 0.95-0.97, P<0.001), mid-term (5 year) 95% (0.93-0.96, P<0.001), long-term (10 year) 89% (0.85-0.93, P<0.001), and 15 year (85.5%, 0.79-0.92, P<0.001). Sensitivity and subgroup analysis was conducted for potential source of heterogeneity. ConclusionLateral UKA is a promising method of 90% survivorship over a short- to long-term follow up. Lateral UKA is a viable option in primary treatment of OA.
High Seroprevalence of Anti-SARS-CoV-2 Antibodies Among Ethiopian Healthcare Workers
Authors: Gelanew Tesfaye , Seyoum Berhanu , Mulu Andargachew , Mihret Adane , Abebe Markos , Wassie Liya , Gelaw Baye , Sorsa Abebe , Merid Yared , Muchie Yilkal , Teklemariam Zelalem , Tesfaye Bezalem , Osman Mahlet , Jebessa Gutema , Atinafu Abay , Hailu Tsegaye , Habte Antenehe. , Kenea Dagaga , Gadissa Anteneh , Admasu Desalegn , Tesfaye Emmet , Bates Timothy A. , Bulcha Jote , Tschopp Rea , Tsehay Dareskedar , Mullholand Kim , Howe Rawleigh , Genetu Abebe , Tafesse Fikadu G. , Abdissa Alemseged
Published: July 2021

BackgroundCOVID-19 pandemic has a devastating impact on the economies and health care system of sub-Saharan Africa. Healthcare workers (HWs), the main actors of the health system, are at higher-risk because of their occupation. Serology-based estimates of SARS-CoV-2 infection among HWs represent a measure of HWs’ exposure to the virus and a guide to the prevalence of SARS-CoV-2 in the community. This information is currently lacking in Ethiopia and other African countries. This study aimed to develop an in-house antibody testing assay, assess the prevalence of SARS-CoV-2 antibodies among Ethiopian high-risk frontline HWs.MethodsA cross-sectional seroprevalence study was conducted among HWs in five public hospitals located in different geographic regions of Ethiopia. Socio-demographic and clinical data were collected using questionnaire-based interviews. From consenting HWs, blood samples were collected between December 2020 and February 2021, the period between the two peaks of COVID-19 in Ethiopia. The collected sera were tested using an in-house immunoglobin G (IgG) enzyme-linked immunosorbent assay (ELISA) for SARS-CoV-2 specific antibodies on sera collected from HWs. Results Of 1,997 HWs who provided a blood sample, demographic and clinical data, 50.5% were female, 74.0% had no symptoms compatible with COVID-19, and 29.0% had history of contact with suspected or confirmed patient with SARS-CoV-2 infection. The overall seroprevalence was 39.6%. The lowest (24.5%) and the highest (48.0%) seroprevalence rates were found in Hiwot Fana Specialized Hospital in Harar and ALERT Hospital in Addis Ababa, respectively. Of the 821 seropositive HWs, 224(27.3%) had history of symptoms consistent with COVID-19. A history of close contact with suspected/confirmed COVID-19 cases was strongly associated with seropositivity (Adjusted odds Ratio (AOR) =1.4, 95% CI 1.1-1.8; p=0.015). ConclusionHigh SARS-CoV-2 seroprevalence levels were observed in the five Ethiopian hospitals. These findings highlight the significant burden of asymptomatic infection in Ethiopia, and may reflect the scale of transmission in the general population.
Improved (DFT) Generalized k-nearest information systems on Molecular QSAR-QMMM Cryptographic Mining and Chern-Simons Weighted ℓneuron(ι):=φ∘D∘R2∘S∘R1 Topologies for the generation of the Roccustyrna Ligand Targeting SARS-COV-2 D614G Binding Sites.
Authors: Grigoriadis Ioannis
Published: July 2021

SARS coronavirus 2 (SARS-CoV-2) in the viral spike (S) encoding a SARS-COV-2 SPIKE D614G mutation protein predominate over time in locales revealing the dynamic aspects of its key viral processes where it is found, implying that this change enhances viral transmission. In this paper, we strongly combine topology geometric methods for generalized formalisms of k-nearest neighbors as a Tipping–Ogilvie and Machine Learning application within the quantum computing context targeting the atomistic level of the protein apparatus of the SARS-COV-2 viral characteristics. In this effort, we propose computer-aided rational drug design strategies efficient in computing docking usage, and powerful enough to achieve very high accuracy levels for this in-silico effort for the generation of AI-Quantum designed molecules of GisitorviffirnaTM, Roccustyrna_gs1_TM, and Roccustyrna_fr1_TM ligands targeting the COVID-19-SARS-COV-2 SPIKE D614G mutation by unifying Molecular Pairs (MMP), Lindenbaum-Tarski logical spaces and Adaptive Weighted KNN Positioning for Matched Bemis and Murko (BM) driven eigenvalue statements into Shannon entropy quantities as composed by Tipping–Ogilvie driven Machine Learning potentials on a (DFT) ℓneuron(ι):=φ∘D∘R2∘S∘R1 𝑐0𝜁2(1+∑𝑖)=[A∧A’(p)] ⊗[∂vˆ∂qˆ,∂uˆ∂pˆ] − [∂vˆ⊗∂pˆ,⊗∂uˆ⊗∂qˆ]=1𝑐𝑖𝜉𝑖{−ℏ20<≡===〈ψ⁎∣∣ψ⁎〉=[A∧A’(p)] ↦(𝑐𝑜𝑠𝜙−𝑠𝑖𝑛𝜙𝑠𝑖𝑛𝜙𝑐𝑜𝑠𝜙) (𝑥𝑝),𝐷(𝛼):(𝑥𝑝)↦(𝑥+𝑅𝑒(𝛼)𝑝+𝐼𝑚(𝛼)),𝑆(𝑟): (𝑥𝑝)↦(𝑒−𝑟00𝑒𝑟)(𝑥𝑝),𝐵𝑆(𝜃) :𝑥1𝑥2𝑝1𝑝2↦𝑐𝑜𝑠𝜃𝑠𝑖𝑛𝜃−𝑠𝑖𝑛𝜃𝑐𝑜𝑠𝜃𝑐𝑜𝑠𝜃𝑠𝑖𝑛𝜃00−𝑠𝑖𝑛𝜃𝑐𝑜𝑠𝜃𝑥1𝑥2𝑝1𝑝2𝑣=0,1,2….𝜆=1/2+𝛾2+1/4𝑐1⟨ψi∣∣(𝟙ˆ−ρˆ0)∣∣ψj⟩[A∧A’(p)] ↦(𝑐𝑜𝑠𝜙−𝑠𝑖𝑛𝜙𝑠𝑖𝑛𝜙𝑐𝑜𝑠𝜙) (𝑥𝑝),𝐷(𝛼):(𝑥𝑝)↦(𝑥+𝑅𝑒(𝛼)𝑝+ j<i⟨ψi∣∣ρˆ0∣∣ψj⟩𝑎22vKS1(r)a 4cos2θ+a2r2+r4) Σ3’⟨ψi∣∣ρˆ0∣∣ψj⟩𝑎22vKS1(r)=vext(r)+∫dr′ρ(r′)∣∣r−r′∣∣+ vXC1,(r)𝑚𝑏2𝑟2𝑒𝑑2πˆ2B2mB∇ [𝑃‾‾√𝑄‾‾(𝑟𝑟𝑦𝑣Γ(𝑏+𝑣)Γ(𝑐)𝑣!𝑐0𝑎2√−‾‾√𝑄‾‾(𝑟𝑟𝑦𝑣Γ(𝑏+𝑣)Γ(𝑐)𝑣!𝑐0𝑎2𝑄‾‾√𝑃‾‾√]≡∣CmdπCdπ2∣ϕ(Wxˆ+α)⟩, 𝑑𝑦2ΣΣ¯Ǫ ⊗ ¯σ − ¯σσ¯ǫ −i_+𝑐0𝑎2[1−𝑦𝑦]2}𝜓(𝑦)𝑣) improver for Chern-Simons Topology Euclidean Geometrics.
A Method Combining the Use of an Application and a Dedicated Pelvic Positioner for Acetabular Cup Insertion
Authors: Kamimura Atsushi , Enokida Makoto , Enokida Shinpei , Nagashima Hideki
Published: July 2021

Background: We developed a mobile device application and dedicated pelvic positioner with the aim of improving the acetabular cup placement accuracy in patients undergoing total hip arthroplasty (THA). The function of the application was to display the intra-operative cup angle. The accuracy and clinical usefulness of this combined method was verified through comparison with the conventional alignment guide method.Methods: In total, 60 patients who underwent cementless THA were included in this study. We compared the cup alignment when using this combined method with that when using the conventional alignment guide method. The absolute value error between the intra- and post-operative angles of inclination and anteversion of the cup was calculated.Results: The absolute value error of inclination was 2.4° ± 2.1° in the study group and 4.0° ± 3.3° in the control group (P = 0.107). The absolute value error of anteversion was 2.8° ± 2.6° in the study group and 7.4° ± 5.3° in the control group (P < 0.001).Conclusion: Using the application and pelvic positioner is simple and can be introduced at a low cost. The more accurate measurement of the intra-operative cup angle using this combined method has improved the cup insertion accuracy compared with that of the conventional alignment guide method.
A Novel Ensemble Based Recommendation Approach using Network Based Analysis for Identification of Effective Drugs for Tuberculosis
Authors: Haldar Rishin , Narayanan Swathi Jamjala
Published: July 2021

Tuberculosis (TB) is a fatal infectious disease which affected millions of people worldwide for many decades and now with mutating drug resistant strains, it poses bigger challenges in treatment of the patients. Computational techniques might play a crucial role in rapidly developing new or modified anti-tuberculosis drugs which can tackle these mutating strains of TB. This research work applied a computational approach to generate a unique recommendation list of possible TB drugs as an alternate to a popular drug, EMB, by first securing an initial list of drugs from a popular online database, PubChem, and thereafter applying an ensemble of ranking mechanisms. As a novelty, both the pharmacokinetic properties and some network based attributes of the chemical structure of the drugs are considered for generating separate recommendation lists. The work also provides customized modifications on a popular and traditional ensemble ranking technique to cater to the specific dataset and requirements. The final recommendation list provides established chemical structures along with their ranks, which could be used as alternatives to EMB. It is believed that the incorporation of both pharmacokinetic and network based properties in the ensemble ranking process added to the effectiveness and relevance of the final recommendation.
The Lateral Femoral Wall Thickness on the Risk of Post-Operative Lateral Wall Fracture in Intertrochanteric Fracture: A Finite Element Analysis
Authors: Fan Jixing , Xu Xiangyu , Zhou Fang
Published: July 2021

Background Patients with a lateral femoral wall (LFW) fracture were reported to have high rates of re-operation and complication. Although the LFW thickness was a reliable predictor of post-operative or intra-operative LFW fracture, no biomechanical studies had evaluated the critical stress distributions on the femur and screws of intertrochanteric fractures treated with dynamic hip screw (DHS). This study aimed to investigate the biomechanical performance of intertrochanteric fractures with different LFW thickness treated with DHS device.Methods A three-dimensional model of the proximal femur was established by computed tomography images. The intertrochanteric fracture model with three different LFW thickness (10mm, 20.5mm and 30mm respectively) was created, which was fixed by DHS. The von Mises stress on the proximal femur, lateral femoral wall, DHS and the total displacement of the device components were evaluated and compared for three different LFW thickness model.Results The maximum von Mises stress in the proximal fragment of the 10mm and 20.5mm model increased by 80.56% and 57.97% when compared with the 30mm model. The peek von Mises stress around the blade entry point of the 10mm and 20.5mm model increased by 89.26% and 66.39% when compared with the 30mm model. The peek von Mises in the DHS located near the junction of the barrel and side plate of each model and the 30mm model had the smallest von Mises stress compared with the other two models. Furthermore, the maximum displacement in the 30mm model was much smaller than that in the10mm model and 20mm model.Conclusions The intertrochanteric fracture with a thinner LFW tended to have a higher risk of LFW fracture stabilized by a DHS device. Thus, the intertrochanteric fractures with a thinner LFW should not be treated by DHS alone and the intramedullary nail or an addition of trochanteric stabilization plate(TSP) was recommended.
Relationship between Climatic Variables and Reproduction Number (R0) of Confirmed COVID-19 Cases
Authors: Rasul Azad
Published: July 2021

Most transmittable diseases appear in a specific season and the effect of climate on COVID-19 is of special interest. This study aimed to investigate the relationship between climatic variables and R0 of COVID-19 cases in one hundred areas around the world. The daily confirmed cases COVID-19 and climatic data of each area per day from January 2020 to March 2021 are utilized in the study. The GWR and MLR methods were used to identify the relationship between R0 of COVID-19 cases and climatic variables. The MLR results showed a significant (p-value < 0.05) weak inverse relationship between R0 of COVID-19 cases and wind speed, but a positive significant (p-value < 0.01) relationship with precipitation. It implies that lower COVID-19 cases were recorded with high wind speed and low precipitations. Based on GWR, R0 of COVID-19 infection against principal climatic variables has found statistically significant using Monte Carlo p-value test and the effect of climatic variables on COVID-19 infection appears to vary geographically. However, besides climatic variables, many socio-economic factors could influence the virus transmission and will be considered in future studies.
Tomographic Analysis of Incision Sequence on Anterior and Posterior Surgically Induced Astigmatism in Cataract Surgery
Authors: Adam Mehmet , Sayın Osman , Ağca Okan , Altınkaynak Hasan
Published: July 2021

Purpose: To evaluate of effect incision sequence on anterior and posterior astigmatism and SIA at cataract surgery using Scheimpflug tomography measurements.Methods: We evaluated 86 patients who had gone cataract surgery between October 2018 to March 2019. All eyes were measured with a Scheimpflug tomography system preoperatively and at 1 month after surgery which included anterior and posterior corneal surfaces. The surgery was begin with side incision in group 1 differently the main incision was done first in group 2. Student t test and Pearson’s correlation were performed. P values < 0.05 were considered statistically significant.Result: Surgically induced anterior astigmatism (SIA-A) 0.76±0.43, 0.67±0.38 and surgically induced posterior astigmatism(SIA-P) 0.27±0.19 0.23±0.19 respectively in group 1 and group 2. 1D or greater SIA-A was found 24.4 % and 15.6% and 0.5 D or greater SIA-P was found 14.6% and 12.2% respectively in group 1 and group 2. There was a significant increase in anterior astigmatism (p=0.002, 0.005 respectively in group 1 and 2), but not in the posterior astigmatism (p=0.471 and 0.247 respectively in group 1 and 2). In the subgroup analysis, group 2 has lower SIA-A then group 1 except oblique subgroup and group 2 has lower SIA-P for all subgroups but it wasn't statistically significant.Conclusion: Making the main incision first caused less SIA on both anterior and posterior surfaces however this difference was not significant.
An Immunosuppressive Status Classifier to Predict Recurrence and Assist in Decision Regarding Postoperative Adjuvant Treatment in Gastric Cancer
Authors: Wang Jia-Bin , Qiu Qing-Zhu , Lian Ning-Zi , Wang Hua-Gen , Zheng Qiao-Ling , Yang Ying-Hong , Ma Yu-Bin , Zhao Ya-Jun , Li Ping , Lin Jian-Xian , Lu Jun , Chen Qi-Yue , Cao Long-Long , Lin Mi , Huang Chang-Ming , Xie Jian-Wei
Published: July 2021

Background: Suppression of the immune microenvironment is a crucial cause of postoperative tumor recurrence. We constructed an immune infiltration classifier based on immunosuppressive indicators to predict recurrence and guide postoperative treatment for gastric cancer (GC).Methods: Immunohistochemical analysis was performed for 825 GC tissues to evaluate immunosuppressive indicators. An immunosuppressive recurrence score (IRS) based on six immunosuppressive indicators was determined using the Lasso Cox method to predict recurrence outcomes. The association between immune infiltration and IRS was assessed using immunohistochemistry and multiplexed immunofluorescence staining. A nomogram predicting recurrence-free survival (RFS) was constructed by integrating IRS and significant clinicopathological features using the Cox regression model.Results: The IRS and IRS-based nomogram showed remarkable accuracy and reliability for predicting the recurrence outcome. Moreover, elevated IRS was associated with locoregional recurrence and failure of postoperative adjuvant chemotherapy. We also identified that the increased IRS indicated the inhibition of anti-tumor effect of CD8+ tumor-infiltrating lymphocytes (TILs) in the invasive margin (IM).Conclusion: IRS can predict the recurrence outcome of GC patients by comprehensively distinguishing the immune infiltration status, which assists in the selection of different adjuvant treatment options
Colloid Carcinoma of the Pancreas: A Case Report
Authors: He Jun , Yu Heng-hai , Wei Xiao-ping
Published: July 2021

Background: Pancreatic colloid carcinoma is a rare pancreatic cancer, which is a subtype of pancreatic ductal adenocarcinoma. Case: a 71-year-old woman with a tumor of about 1.9x1.3cm in size located in the neck and body of the pancreas without invasion of surrounding organs. The patient underwent body and tail pancreatectomy, and the pathology revealed an intraductal papillary mucinous tumor of the pancreas with associated infiltrating colloid carcinoma. The patient recovered well after surgical treatment. Conclusion: ﻿Pancreatic colloid carcinoma is a malignant tumor, but it has a lower degree of malignancy and a better prognosis compared with pancreatic ductal adenocarcinoma. Currently, radical surgical resection is the main treatment principle.
Dominant drivers of the human plasma metabolome
Authors: Fu Jingyuan , Chen Lianmin , Andreu-Sánchez Sergio , Wang Daoming , Augustijn Hannah E. , Zhernakova Daria , Kurilshikov Alexander , Vila Arnau Vich , Weersma Rinse , Medema Marnix , Netea Mihai , Kuipers Folkert , Wijmenga Cisca , Zhernakova Alexandra
Published: July 2021

The human plasma metabolome contains thousands of metabolites that are dependent on an individual’s diet, genetics and gut microbiome, and on their interactions. By assessing 1,183 plasma metabolites in 1,368 extensively phenotyped individuals from the LifeLines-DEEP and GoNL cohorts, we quantified the proportion of inter-individual variation of the plasma metabolome explained by different factors and characterized 605 metabolites that are dominantly driven by diet, 85 driven by the gut microbiome, and 56 driven by genetics. We also developed a model that reflects the quality of an individual’s diet using 76 mostly diet-driven metabolites. By applying Mendelian randomization (MR) and mediation analyses, we reveal putative causal relationships between diet, gut microbiome and metabolites. For example, MR supports the causal effect of Eubacterium rectale in decreasing plasma levels of toxic p-cresol and p-cresol sulfate, two metabolites related to cardiometabolic risk and chronic kidney disease. We further followed-up the plasma metabolome profile in 311 individuals after 4 years and observe that the metabolites with more variance explained by genetics, microbiome or diet are also more temporarily stable. Altogether, our characterization of the dominant drivers of plasma metabolites can help in the design of therapeutic approaches that target the diet, human genome, or gut microbiome to drive a healthy metabolome.
A Cross-Sectional Study of The Background Factors Associated With Academic Motivation Upon Admission To A Medical School in Japan
Authors: Nobuhiro Nagai , Kono Kaori , Onigata Kazumichi , Watari Takashi
Published: July 2021

Background

To become a doctor with a high level of professionalism and ethical standards, it is important to have and maintain a high level of motivation from the time of admission to medical school. However, no studies in Japan have quantitatively investigated the factors related to motivation immediately after enrollment. In this study, we identified the background factors that influence the motivation of medical students immediately after admission.
Methods

A cross-sectional study was conducted. First-year medical students answered our questionnaire three weeks after admission. The questionnaire comprised 16 demographic items, and the 28-item Academic Motivation Scale was used to quantify motivation.
Results

Our analysis showed that amotivation, representing low self-determinant motivation, was significantly higher in students whose parents were medical professionals and in students who did not talk about their problems than in those whose parents were not medical professionals and those who did talk about their problems, respectively. Intrinsic motivation, which indicates the level of self-determinant motivation, was significantly lower in students who belonged to a sports club.
Conclusions

No previous studies have suggested that having parents who are medical professionals might be a factor associated with their children’s decreased motivation when entering medical school in Japan. However, further research is needed to analyze this relationship.
bFGF could be a Biomarker of Malignancy in RS3PE Syndrome: an Ambispective Single Center Cohort Analysis of 51 Patients
Authors: Gan Yuzhou , Sun Yi , Jin Jiayang , Wang Yifan , Chen Jiali , Zhong Yuchao , Li Xue , Ye Hua
Published: July 2021

ObjectivesRemitting seronegative symmetrical synovitis with pitting edema (RS3PE) is a rare inflammatory arthritis, with a higher incidence of malignancy. The aim of this study is to identify biomarkers for predicting malignancy in RS3PE.MethodsA total of 51 patients with RS3PE from September 2007 to May 2019 were retrospectively reviewed and followed for up to 5 years, with 15 patients with osteoarthritis (OA) and 14 patients with elderly-onset rheumatoid arthritis (EORA) as disease controls. Serum levels of angiogenesis cytokines were measured by electrochemiluminescent immunoassay and Luminex Human Magnetic Assay. Clinical data and laboratory parameters were analyzed to identify risk factors for malignancy.ResultsA total of forty-eight RS3PE patients (94.1%) were available with follow-up data, 8 patients (16.7%) were diagnosed with malignancy, of which 6 patients were hematological tumor, and 2 patients were solid tumor. Serum levels of basic fibroblast growth factor (bFGF) were exclusively higher in RS3PE patients with malignancy [14.21 (7.52, 23.18) ng/mL] than RS3PE patients without malignancy [4.32 (2.88, 7.42) ng/mL], OA [3.20 (2.20, 5.30) ng/mL] and EORA [3.20 (2.20, 5.30) ng/mL]. The optimal cut-off value of bFGF for malignancy was 10ng/mL in RS3PE. Logistic regression analysis indicated that elevation of bFGF was a risk factor for malignancy in RS3PE.Conclusions﻿This study indicated that bFGF was elevated in RS3PE patients with malignancy and could serve as a biomarker for predicting paraneoplastic RS3PE.
Cervical Spine Clearance on Trauma Intensive Care: Can We Trust a Negative CT Scan?
Authors: Hasandarras Abdalla K H , Strandvik Gustav F , Faramawy Ahmed El , Areibi Noreddin Nasereldin , Younis Basil , Mekkodothil Ahammed , El-Menyer Ayman , Rizoli Sandro , Al-Thani Hassan
Published: July 2021

Background: Cervical spine clearance in intubated victims of blunt trauma remains contentious; accumulating high level evidence suggests that a normal CT cervical spine can be used to clear the c-spine and remove the collar in obtunded emergency department patients to prevent collar-related complications. However, it is unclear whether this holds true for intubated patients in the trauma intensive care unit (TICU).Methods: We performed a retrospective review of 730 intubated trauma patients who presented to the Level 1 Trauma center of a tertiary hospital. We reviewed the rate of missed cervical injuries in patients who had their cervical collars removed based on a normal computed tomography (CT) scan of the cervical spine, as well as rates of collar-related complications.Results: Three hundred and fifty patients had their cervical collars removed in the TICU based on the findings of a high-quality, well-interpreted normal CT cervical spine. Seventy percent of patients were intubated and sedated at the time of collar removal. Fifty-one percent of patients had concomitant traumatic brain injury. The average GCS at time of collar removal was 9. The incidence of missed neurological injury discerned clinically at time of both ICU and hospital discharge was nil (negative predictive value 100%). The rate of collar-related complications was 2%.Conclusion: Based on our findings, it is safe to remove the cervical collar for patients in the TICU following normal CT cervical spine, provided certain quality conditions related to the CT scan are met. Not removing the collar early may be related to increased complications. We provide an algorithm to assist critical-care clinicians in decision-making in this patient cohort
THz Absorber for Breast Cancer Early Detection based on Graphene as Multi-layer Structure
Authors: Soheilifar Mohammad Reza , Rezazadeh Afrooz
Published: July 2021

Today, the cost of treating cancer is very high, so early detection of cancer is essential, and one of the possible ways to diagnose cancer in the early stages is to use sensors that are made in the terahertz area. The proposed structure is a multilayer structure in which graphene is used in the upper and middle layer and the middle layer has a ribbon form. A disk form element is used in the upper layer. Finally, a ring is added to the structure. In the final structure of the ring, it actually inhibits the field, and this will increase the Q-factor at 6.7 THz. The interaction of layers on each other and their effect on reflection is studied to modify the final structure by variation of the chemical potential of the graphene layer in the range of 0.2 to 0.6 eV. Finally, the proposed absorber is used to discriminate cancer and healthy breast tissue. The effect of the thickness and distance of the tissue from the absorber are examined to realize the material effect on sensitivity and figure of merit (FOM) as two main factors for detecting the cancer tissue.
Tissue Losses and Metabolic Adaptations Both Contribute to the Reduction in Resting Metabolic Rate following Weight Loss
Authors: Martin Alexandra , Fox Darius , Murphy Chaise , Hofmann Hande , Koehler Karsten
Published: July 2021

Objective To characterize the contributions of the loss of energy-expending tissues and metabolic adaptations to the reduction in resting metabolic rate (RMR) following weight loss.Methods A secondary analysis was conducted on data from the Comprehensive Assessment of Long-term Effects of Reducing Intake of Energy study. Changes in RMR, body composition, and metabolic hormones were examined over 12 months of calorie restriction in 109 individuals. The contribution of tissue losses to the decline in RMR was determined by weighing the changes in the size of energy-expending tissues and organs (skeletal muscle, adipose tissue, bone, brain, inner organs, and residual mass), as assessed by dual-energy X-ray absorptiometry, with their tissue-specific metabolic rates. Metabolic adaptations were quantified as the remaining reduction in RMR.Results RMR was reduced by 101 ± 12 kcal/d as participants lost 7.3 ± 0.2 kg (both p < 0.001). On average, 60% of the total reduction in RMR were explained by losses of energy-expending tissues, while 40% were attributed to metabolic adaptations. The loss of skeletal muscle mass was not significantly related to RMR changes (p = 0.17), whereas adipose tissue losses were positively associated with the reduction in RMR (p = 0.02) and metabolic adaptations (p < 0.001). Metabolic adaptations were further correlated with declines in leptin (r = 0.27, p < 0.01), triiodothyronine (r = 0.19, p < 0.05), and insulin (r = 0.25, p < 0.05).Conclusions During weight loss, tissue loss and metabolic adaptations both contribute to the reduction in RMR, although their contribution is variable. Contrary to popularly belief, it is not skeletal muscle, but rather adipose tissue losses that seem to drive RMR reductions following weight loss. Future research should be directed at personalized strategies addressing the predominant cause of RMR reduction for weight maintenance.
Intranasal Delivery of Mesenchymal Stem Cell Exosomes Modulates the Immune Response of Allergic Rhinitis via the MAPK Pathway in a Mouse Model
Authors: Yu Chenjie , Chen Yin , Xu Xinyun , Dou Xin , Liu Shuo , Wang Handong , Wei Xianmei , Xu Zhengrong , Wang Bin , Cui Xinyan , Gao Xia
Published: July 2021

BackgroundAllergic rhinitis (AR) is a non-infectious chronic inflammatory disease of the nasal mucosa, which is mainly mediated by IgE after the body is exposed to allergens. It has been shown that transplantation of human mesenchymal stem cells (MSCs) into AR animal models can improve the AR behavioral phenotype. Furthermore, there are recent studies that states exosomes are the main mediators of MSC therapy. However, the effect of exosomes on AR has not been investigated.MethodsIn the established AR mouse model, different concentrations of MSC-derived exosomes (MSCs-Exo) were applied via intranasal delivery. The AR symptom scores, the eosinophils in the nasal mucosal section, the inflammation infiltration in the spleen section, and IgE, ovalbumin-specific IgE (OVA-sIgE), histamine, IgG1, IgG2a and other Th1/Th2 related inflammatory factors were evaluated by Hematoxylin–eosin staining, Elisa, real-time PCR.ResultsWe found that intranasal administration of MSCs-Exo could not only reduce the behavior of nasal scratching and sneezing in mice, but also cause a decline in related immune indicators via the MAPK pathway, including the spleen index, tissue staining, and the expression of inflammation-related cytokines. Moreover, we found that the optimal concentration of MSCs-Exo was 4×108/mL. ConclusionThe significant beneficial effects of exosomes may be exploited to develop a new, non-invasive treatment strategy for AR.
Sparganum in the Lumbosacral Canal: a Case Report
Authors: Fan Jian Feng , Huang Sheng , Li Jing , Peng Ren-Jun , Huang He , Ding Xi-Ping , Jiang Li-Ping , Xi Jian
Published: July 2021

Background: Sparganosis is a rare parasitic infection caused by invasion of the larvae of tapeworms Spirometra mansoni called sparganum. It often lodges in human eyes, subcutaneous body of limbs, oral and maxillofacial regions. However, lumbosacral spinal canal invasion is extremely rare and the diagnosis is very difficult. We herein report a case of spinal sparganosis.Case presentation: A 56-year-old man presented at the hospital after having experienced perianal pain for a week. MRI of the lumbosacral spine with gadolinium contrast study revealed an enhancing mass at the S1-S2 level that was clinically suggestive of a tumor. The patient underwent laminectomy from S1 to S2. We detected a live worm in inferior margin of L5 and spinal sparganosis was diagnosed by histological examination. He had a history of ingesting undercooked frog meat in his youth. Both in CSF and serum samples, we detected anti-sparganum antibodies. A dose of praziquantel, albendazole and dexamethasone was administered to the patient because we did not remove the parasitic mass completely.Conclusions: Sparganosis of the central nervous system is extremely rare, especially spinal sparganosis. The mainly treatments spinal sparganosis are surgical removal of the larva and administration of high-dose praziquantel, albendazole and dexamethasone.
Structural Modularization of Cu2Te Leading to High Thermoelectric Performance near the Mott-Ioffe-Regel Limit
Authors: Zhao Kunpeng , Zhu Chenxi , Zhu Min , Chen Hongyi , Lei Jindan , Ren Qingyong , Wei Tian-Ran , Qiu Pengfei , Xu Fangfang , Chen Lidong , He Jian , Shi Xun
Published: July 2021

To date, thermoelectric materials research stays focused on optimizing the material’s band edge details and disfavors low mobility. Here, we shifts the paradigm from the band edge to the mobility edge, exploring high thermoelectricity near the border of band conduction and hopping. Through co-alloying iodine and sulfur, we modularize the plain crystal structure of liquid-like thermoelectric material Cu2Te with mosaic nanodomains and the highly size mismatched S/Te sublattice that chemically quenches the Cu sublattice and drives the electronic states from itinerant to localized. A state-of-the-art figure of merit of 1.4 is obtained at 850 K for Cu2(S0.4I0.1Te0.5); and remarkably, it is achieved near the Mott-Ioffe-Regel limit unlike mainstream thermoelectric materials that are band conductors. Broadly, pairing structural modularization with the high performance near the Mott-Ioffe-Regel limit paves an important new path towards the rational design of high-performance thermoelectric materials. Thermoelectric (TE) material-based energy conversion technology has attracted increasing global attention in virtue of the technical merits such as no moving parts, no greenhouse emission, noiseless, friendliness for miniaturization, and reliability.1–4 Based on the Seebeck and Peltier effects, thermoelectricity enables a direct energy conversion between temperature difference and electricity.5, 6 The performance of a TE material is primarily gauged by the material’s figure of merit, zT = S2T/ρκ, where S is the Seebeck coefficient, T is the absolute temperature, ρ is the electrical resistivity, and κ is the total thermal conductivity (consisting of the lattice thermal conductivity κL and the electronic thermal conductivity κE).
Mapping the Purple Menace: Spatiotemporal Distribution of Purple Loosestrife (Lythrum Salicaria) Along Roadsides in Northern New York State
Authors: Rogers Jessica , Humagain Kamal , Pearson Adam
Published: July 2021

Purple loosestrife (Lythrum salicaria L.) is an invasive herbaceous plant, frequently found in wetlands and along roadsides throughout northern New York State. Its propensity to create monoculture stands in wetlands has resulted in intensive management in parts of its range, including central New York and Ontario and Quebec. The goal of this study was identifying the extent of infestations and to determine factors that promote the spread of purple loosestrife in order to determine best land use practices to reduce the spread of this highly invasive wetland plant." We attempted to answer several questions: What is the level of infestation along roadsides? Does mowing contribute to the spread? How do culverts under roadways influence the spread? Between mid-July and mid-August in 2017–2019, we mapped all infestations along 150 km (93 miles) of state highway north of the Adirondack Park and south of the St. Lawrence River using the Environmental Systems Research Institute (ESRI) Collector app. We mapped the size and locations of infestations, in addition to collecting information on the plants within 1 m, recording over 100 additional species. The results of our preliminary analysis revealed significant increase in the number of plants over the study time (P < 0.001), including several hundred more infestations than had previously been recorded. We did not find any evidence that mowing promotes the spread of loosestrife. There were many more individual infestations in ditches along highways, but much larger and denser infestations in wetlands (P = 0.003 in 2019). We observed that culverts, drainage conduits under roadways, frequently had purple loosestrife on both sides of the road. We also found that culverts appear to serve as corridors that promote the spread of purple loosestrife from one side of the road to the other. We recommend working with the local landowners and NYS Department of Transportation to contain the spread and continue to propagate and spread the biological control.
Behaviour-directed Interventions for Problematic Person Transfer Situations in Two Dementia Care Dyads: A Single-case Design Study
Authors: Lagerlund Hanna , Thunborg Charlotta , Sandborgh Maria
Published: July 2021

Background:Persons with dementia living in nursing homes need assistance with moving and transfers; however, caregivers assisting persons with dementia in their daily person transfers report strain-related and complicated transfer-related behavioural problems. The reciprocity of complex dyadic transfer-related behaviours is affected by environmental factors, the health status of the person with dementia and the caregiver’s skills and knowledge. The aim of this study was to explore tailored interventions guided by a functional behaviour analysis for problematic person transfer situations in two dementia care dyads.Methods:This study was a quasi-experimental single-case study with an A-B design. Tailored interventions were developed in a five-step model for functional behavioural analysis. The study was conducted in a dementia special care unit at a nursing home, and the inclusion criteria were caregivers’ experiences of physical strain and/or resistiveness to care, which led to complex transfer-related behaviour. Two care dyads were included. Transfer situations were video-recorded and evaluated with the Dyadic Interaction in Dementia Transfer Assessment Scale, Pain Assessment in Advanced Dementia Scale, and Resistiveness to Care Scale for Dementia of the Alzheimer’s Type. The caregiver experience was evaluated with study-specific items addressing caregiver self-efficacy, catastrophizing thoughts, perceived control, and perceived physical strain. Scorings were graphically displayed. The graphs were inspected visually to identify changes in trend, level, latency, and variability. Nonoverlap of all pairs (NAP), including 90% confidence intervals (CIs), was calculated to complement the visual inspection.Results:Verbal and nonverbal discomfort decreased in care dyad 1, which mirrored the caregiver changes in adapting their actions to the needs of the person with dementia. High variability was seen in both the intervention and the baseline phases in care dyad 2. In both care dyads, caregiver transfer-related behaviour improved significantly.Conclusions:The results indicate that the transfer-related behaviours of the care dyad might be improved through a behaviour-directed intervention tailored to meet the care dyad´s needs. The study is a replication of a previous study in a new clinical setting, which in turn strengthens the generalizability for a functional behavioural analysis-guided intervention for problematic transfer situations in dementia care dyads.
Time Fractional Analysis of Channel Flow of Couple Stress Casson Fluid using Fick’s and Fourier’s Laws
Authors: Ahmad Shafiq , Haq Sami Ul , Ali Farhad , Khan Ilyas , Nisar Kottakkaran Sooppy
Published: July 2021

This study aim to examine the channel flow of a couple stress Casson fluid. The flow is generated due to the motion of the plate at y = o, while the plate at y = d is at rest. This physical phenomenon is derived in terms of partial differential equations. The subjected governing PDE’s are non-dimensionalized with the help of dimensionless variables. The dimensionless classical model is generalized by transforming it to the time fractional model using Fick’s and Fourier’s Laws. The general fractional model is solved by applying the Laplace and Fourier integral transformation. Furthermore, the parametric influence of various physical parameters like Casson parameter, couple stress parameter, Grashof number, Schmidt number and Prandtl number on velocity, temperature, and concentration distributions is shown graphically and discussed. The heat transfer rate, skin friction, and Sherwood number are calculated and presented in tabular form. It is worth noting that the increasing values of the couple stress parameter λ deaccelerate the velocity of Couple stress Casson fluid.
Synthesis and characterization of Hydrogels based on Potato Starch/Poly(vinyl Alcohol)/N, N'-Methylenebisacrylamide
Authors: PINZON-MORENO DIEGO DAVID , Vicuña-Galindo Eder Clidio , Gonzáles-Fernández José Vulfrano , Soto-Gonzales José Luis , Carranza-Oropeza María Verónica
Published: July 2021

Several hydrogels were synthesized by free-radical polymerization in an aqueous medium based on potato starch (PS), poly(vinyl alcohol) (PVA), and N,N'-Methylenebisacrylamide (MBAm), being possible to study these hydrogels as a function of the proportion of components incorporated. In this way, the products generated from the synthesis were characterized by swelling and deswelling kinetics, the first swelling being verified with Schott and statistical models, allowing to contrast the proximity between the experimental and theoretical behavior. Additionally, spectroscopy (FTIR), morphological (SEM), and thermal (TGA and DSC) analysis allowing to know the intrinsic characteristics of the material, increasing in general terms the knowledge of this type of material. In this context, it was possible to verify the characteristics and effectiveness of the synthesis and crosslinking of the main components. The experimental results obtained show that the synthesized hydrogels present representative first swellings consistent with kinetic and statistical models; however, there are significant changes in the second swelling derived from polymer degradation that occurs during the same swelling/deswelling cycles processes.
Trends in Extreme Climate Indices in Cherrapunji for the period 1979 to 2020
Authors: Kalita Raju , Kalita Dipangkar , Saxena Atul
Published: July 2021

We have used Mann-Kendall trend test and Sen’s slope estimator method to find out significant changes in extreme climate indices for daily temperature as well as precipitation over the period 1979 to 2020 in Cherrapunji. In the present study, a total of 24 precipitation and temperature based extreme climate indices were calculated using RClimDex v 1.9-3. Among 24 indices, 7 were derived from number of days above nn mm rainfall (Rnn) according to Indian Meteorological Department (IMD) convention and the rest were in accordance with the Expert Team on Climate Change Detection and Indices (ETCCDI). It was observed that, among all the indices, consecutive dry days (CDD), summer days (SU25) and very light rainfall (VLR) days increased significantly with 0.54, 1.58 and 0.14 days/year respectively, while only consecutive wet days (CWD) decreased significantly with 0.36 days/year. A slight negative trend was also observed in case of tropical nights (TR20) and among the other precipitation indices as well. Again, the indices associated with daily maximum temperature increased significantly with annual change of 0.06 to 0.07 ⁰C/year. And for indices associated with daily minimum temperature, almost no change or a slight negative change was observed, except a significant positive trend in February and significant negative trend in November for TNN only. The analysis reveals that some of the extreme climate indices which explains the climatic conditions of Cherrapunji has changed a lot over the period of 42 years and if this trend continues then Cherrapunji will be under threat when it comes to climate change.
Overexpression of YALI0B07117g Encoding Erythrose Reductase Homolog Results in Enhanced Erythritol Synthesis From Glycerol by the Yeast Yarrowia Lipolytica.
Authors: Szczepańczyk Mateusz , Rzechonek Dorota A. , Dobrowolski Adam , Mirończuk Aleksandra Maria
Published: July 2021

BackgroundPolyols are a group of sweet alcohols, frequently used as food additives. The constantly rising demand for polyols requires the application of new strategies to increase the production. Erythritol is synthesized by the yeast Yarrowia lipolytica under high osmotic pressure as an osmoprotectant. The metabolic pathway resulting in erythritol production remains partially unknown. However, the last reaction resulting in erythritol synthesis is conducted by an erythrose reductase (ER).ResultsThe Y. lipolytica strain was genetically modified to increase the erythritol yield and productivity, using glycerol as a sole carbon source. The modification focused on the ER homologue YALI0B07117g after the in silico analysis of the protein sequences of all reported ER homologues. Initial results in shake-flask experiments proved the influence of the gene YALI0B07117g in erythritol synthesis. Deletion of the gene resulted in 3-fold and 2-fold increased production of mannitol and arabitol, respectively. Overexpression of the native ER homologue gene showed a positive influence on erythritol production. Bath cultures were conducted and the obtained strain reached the yield of 0.4 g/g. The specific consumption rate (qs) increased from 5.83 g/g/L for the WT strain to 8.49 g/g/L for the engineered strain, while the productivity of erythritol increased from 0.28 g/L/h for the A101 strain to 0.41 g/L/h for the modified strain.ConclusionsOverexpression of the gene YALI0B07117g resulted in increased production of erythritol in the yeast Y. lipolytica. Disruption of the metabolic pathway by deletion of the gene results in higher production titers of mannitol and arabitol. Application of the research may prove positive for shortening the cultivation time due to the increased consumption rate of the substrate combined with increased parameters of erythritol synthesis.
Obesity and Non-Obesity Obstructive Sleep Apnoea Hypertension Syndromes (OOHS & NOOHS): New Clinical Discoveries
Authors: Hu Chunsong , Wu Qinghua , Li Juxiang , Wu Yanqing , Wang Menghong , Ge Yuzhi , Tian Xiaoli , Tkebuchava Tengiz , Hollands Peter , Hu Dayi
Published: July 2021

Obesity, obstructive sleep apnoea (OSA) and hypertension are common clinical risk factors. Their coexistence is termed Obesity and Non-Obesity OSA Hypertension Syndromes (OOHS & NOOHS) due to high linkage. This study reported the clinical characteristics of OOHS and NOOHS. A total of 163 patients, aged 23–74 years, were randomly enrolled at the outpatients department who were either obese or non-obese, suffered OSA and hypertension. Subjects with a Body Mass Index (BMI) of ≥25 (Chinese criteria), of ≥27 (criteria of this study), and of ≥30 (WHO criteria) were defined as obese or non-obese, respectively. Cases with snoring were classified as mild, moderate and severe OSA by using the Apnoea-Hypopnoea Index where mild is 5–15, moderate is 15–30, and severe is > 30. Daytime blood pressure (BP) was measured to assess any correlation. Data from those with isolated obesity, OSA, hypertension, and metabolic syndrome were compared. Long-term follow-up was carried out. 7 typical cases with OOHS and NOOHS were assessed and included general patient information, initial diagnosis, medical history, related risk factors, BMI, and BP. 163 cases with OOHS and NOOHS often have similar or different clinical characteristics. Both potentially suffer from major adverse cardiovascular events (MACEs) which are associated with increased BMI, OSA, and increased BP. Long-term follow-up showed the outcomes consistently linked to their lifestyle and adherence to treatment. Our new clinical discoveries suggest that both OOHS and NOOHS are high risk conditions in MACEs. There is an urgent need for early lifestyle interventions and related treatments.