bluuebunny/crossref_metadata_2025 huggingface dataset:
Recombinant Growth Hormone Therapy in Children With Turner’s Syndrome in Korea: A Phase III Randomized Trial
Authors: Kim Jinsup , Kim Min-Sun , Suh Byung-Kyu , Ko Cheol Woo , Lee Kee-Hyoung , Yoo Han-Wook , Shin Choong Ho , Hwang Jin Soon , Kim Ho-Seong , Chung Woo Yeong , Kim Chan Jong , Han Heon-Seok , Jin Dong-Kyu
Published: September 2021

Background

Short stature is the most consistent characteristic feature of Turner syndrome (TS). To improve final heights of children with TS effectively, it is important to provide them with early and appropriate treatment using growth hormone (GH). The objective of this study was to assess the efficacy and safety of a new recombinant human GH, Growtropin®-II (DA-3002, Dong-A ST Co., Ltd) in comparison with a comparator (Genotropin®, Pfizer Inc.) for Korean children with TS.
Methods

This open-label, active-controlled, parallel-group, randomized controlled phase III trial was conducted at 11 hospitals in Korea. Eligible patients (n = 58) were randomized to two groups: 1) DA-3002 group (administrated with DA-3002 at 0.14 IU /kg/day); and 2) comparator group (administrated with the comparator at 0.14 IU /kg/day).
Results

The change from baseline in annualized height velocity (HV) after a 52-week treatment was 4.15 ± 0.30 cm/year in the DA-3002 group and 4.34 ± 0.29 cm/year in the comparator group. The lower bound of 95% two-sided confidence interval for group difference in the change of annualized HV (-1.02) satisfied the non-inferiority margin (-1.5). The change in height standard deviation score (HtSDS) at 52-week was 0.70 ± 0.23 for the DA-3002 group and 0.66 ± 0.39 for the comparator group, showing no significant (p = 0.685) difference between the two groups. Skeletal maturity defined as a change in bone age or a change in chronological age between the two groups was not significantly different (1.25 ± 0.58 for the DA-3002 group and 1.47 ± 0.45 for the comparator group, p = 0.134). Changes of serum insulin-like growth factor-1 (IGF-1) and insulin-like growth factor binding protein-3 (IGFBP-3) after 52 weeks of treatment did not differ significantly between the two groups (p = 0.565 and p = 0.388, respectively) either. Adverse events were not significant in either group.
Conclusions

This study demonstrates that the efficacy and safety of GH treatment with DA-3002 in children with TS are comparable with those of the comparator. Thus, treatment with DA-3002 can be used to improve their growth. DA-3002 is also well tolerated in children with TS.
Trial registration:

The study was registered at ClinicalTrials.gov. ClinicalTrials.gov identifier: NCT01813630 (19/03/2013)
Modeling of Chaotic Processes by Means of Antisymmetric Neural ODEs
Authors: Belozyorov Vasiliy , Dantsev Danylo
Published: September 2021

The main goal of this work is to construct an algorithm for modeling chaotic processes using special neural ODEs with antisymmetric matrices (antisymmetric neural ODEs) and power activation functions (PAFs). The central part of this algorithm is to design a neural ODEs architecture that would guarantee the generation of a stable limit cycle for a known time series. Then, one neuron is added to each equation of the created system until the approximating properties of this system satisfy the well-known Kolmogorov theorem on the approximation of a continuous function of many variables. In addition, as a result of such an addition of neurons, the cascade of bifurcations that allows generating a chaotic attractor from stable limit cycles is launched. We also consider the possibility of generating a homoclinic orbit whose bifurcations lead to the appearance of a chaotic attractor of another type. In conclusion, the conditions under which the found attractor adequately simulates the chaotic process are discussed. Examples are given.
TP53 and NRAS are the Most Frequently Mutated Genes in Stool DNA of CRC Patients from Central Part of Iran
Authors: Saberi Farideh , Sarhadi Virinder , Youssef Omar , Kokkola Arto , Puolakkainen Pauli , Knuutila Sakari , Salehi Rasoul
Published: September 2021

Colorectal cancer (CRC) rated among the three most diagnosed cancers and the fourth main cause of death worldwide. CRC is a curable cancer provided to be diagnosed at its early-stage. Colonoscopy, stool and blood-based tests are in use for CRC diagnosis/screening. Due to low patient compliance, low specificity and high rate of false results, more reliable methods with desired level of detection accuracy and high patients’ compliance are highly demanded. Detecting hotspot mutations in stool DNA emerged as a robust noninvasive alternative, but due to the different genetic background of various populations and hence varied mutation spectrum/prevalence, prior assessment of CRC mutations in the population is essential. Here, we have evaluated stool DNAs from CRC patients and controls using a NGS based 22 genes panel. Hotspot mutations in NRAS, FGFR3, SMAD4 and TP53 genes had higher prevalence among the CRC patients compare to normal controls. Patients were followed up in their post-surgical period. Six of them (12%) with TP53 mutations (2 patients had NRAS mutation as well) were died of cancer. Those harboring mutations in TP53 and/or NRAS would be regarded as high risk and should be provided with special care.
Transcriptome and Proteome Profiling Revealed Molecular Mechanism of Selenium Responses in Bread Wheat (Triticum Aestivum L.)
Authors: Ma Qian , Feng Xiaoqing
Published: September 2021

Background: Although selenium (Se) plays important roles in scavenging free radicals, alleviating oxidative stresses, and strengthening immune system, the knowledge about Se response in bread wheat is still limited. In order to clarify the molecular mechanism of Se response in bread wheat, 2-week-old wheat seedlings of cultivar ‘Jimai22’ treated with 10 μM disodium selenate (Na2SeO4) for 0 h, 3 h, and 24 h were collected and analyzed by transcriptional sequencing and tandem mass tag-based (TMT) quantitative proteomics. Results: At least 11656 proteins and 133911 genes were identified, and proteins including ATP sulfurylase (APS), cysteine synthase (CS), SeCys lyase, sulfate transporters, glutathione S-transferase (GSTs), glutathione peroxidase (GSH-Px), glutaredoxins (GRXs), superoxide dismutases (SODs), catalases (CATs), heat shock proteins (HSPs), UDP-glycose flavonoid glycosyltransferases (UFGTs), sucrose-6-phosphate hydrolases (Suc-6-PHs), archaeal phosphoglucose isomerases (APGIs), malate synthases (MSs), and endo-1,4-beta-xylanase (Xyn) in Se accumulation, ROS scavenging, secondary metabolism, and carbohydrate metabolism were significantly differently expressed.Conclusions: This is the first complementary analyses of the transcriptome and proteome related with selenium responses in bread wheat. Our work enhances the understanding about the molecular mechanism of selenium responses in bread wheat.
Novel Variants of the Sternal Muscle in an Adult and an Anencephalic Infant: Embryological Insights and Clinical Implications
Authors: Cabello Emilio Farfán , Gaete Marcia , H. Oscar Inzunza , M. Mark Echeverría , R. Verónica Inostroza
Published: September 2021

Background
The sternal muscle is a supernumerary variant of the thoracic muscles found in 3–8% of the population. When present, it can be unilateral or bilateral, which can produce confusions during surgeries and imagenological examinations.
Methods
We report the finding of the sternalis muscle in two human cadavers, one adult and one anencephalic infant. The muscles were dissected from the fixed bodies and their morphometry analysed.
Results
In the case of the adult, we observed two sternal muscles connected in the superior portion by a central tendon. In the case of the anencephalic infant, we found a bilateral sternal muscle, in which the bellies came from the contralateral pectoralis major muscles. The two sternalis muscle variants found here were impossible to categorise according to the current classifications.
Conclusions
The sternalis muscle displays variants that are still not classified, as observed in the case of the adult and the infant, in which its presence was correlated with anencephaly. We discuss about this muscular variation in the clinical, imagenological and surgical context and propose a developmental link with the occurrence of neural tube closure defects.
Disruption of the Gut Microbiota Attenuates Epithelial Ovarian Cancer Sensitivity to Cisplatin Therapy
Authors: Chambers Laura M. , Esakov Emily , Braley Chad , Trestan Lexie , Alali Zahraa , Bayik Defne , Lathia Justin D. , Sangwan Naseer , Bazeley Peter , Joehlin-Price Amy S. , Dwidar Mohammed , Hajjar Adeline M. , Ahern Philip P. , Claesen Jan , Rose Peter G. , Vargas Roberto , Brown J. Mark , Michener Chad , Reizes Ofer
Published: September 2021

Background: Epithelial Ovarian Cancer (EOC) is the second most common gynecologic malignancy in the United States, but the leading cause of gynecologic cancer death. Despite many achieving remission with first-line therapy, up to 80% of patients will recur and require additional treatment. Antibiotic therapy is frequently used during cancer treatments for both prophylaxis and treatment of infections, although this profoundly impacts the gut microbiome. Multiple studies suggest that an unperturbed gut microbiome may provide a protective microenvironment, and disruption may be permissive to tumor growth and chemotherapy resistance, including platinum agents. Experimental Design: We assessed whether antibiotic therapy would impact growth of EOC and sensitivity to cisplatin in murine models. Immune competent or compromised mice were given control or antibiotic (ABX) containing water (metronidazole, ampicillin, vancomycin, and neomycin) for two weeks before being intraperitoneally injected with murine ID8 or ID8-VEGF EOC cells. Tumors were monitored and cisplatin therapy was administered weekly until endpoint. Stool was collected throughout the study to assess for microbial population effects over time. Cecal microbiota transplants (CMTs) of contents derived from ABX or control treated donor mice were performed on ABX treated recipient mice. Results: Both immune competent and immune compromised ID8 and ID8 VEGF tumor-bearing mice demonstrated a decreased response to cisplatin therapy in ABX treated groups with an increase in overall tumor burden. RNAseq analysis showed enrichment of multiple cell proliferation and stem cell pathways, and stem cell genes SOX2, WNT and PAX2. The self-renewal of cancer cells derived from tumors of ABX treated mice was increased compared to tumors from control mice, indicative of a microbiota derived tumor suppressor. Conclusion: Collectively, these studies indicate an intact microbiome provides a tumor suppressor and maintains chemosensitivity that is disrupted by ABX treatment.
Severe Mitral Valve Insufficiency Caused by Standard Surgical Aortic Valve Implantation and Its Reparation Using Suture-Less Prosthesis. Case report
Authors: Al-obeidallah Mahmoud , Marián Kohut , Štengl Milan
Published: September 2021

Background: aortic valve stenosis is the most frequent cardiac valve pathology in the western world. Surgical aortic valve replacement is the gold standard for the treatment of significant degenerative aortic valve diseases.Case presentation: this case report highlights an unexpected abnormal iatrogenic shortening of the aorto-mitral continuity and its deformity, during traditional AVR using sutured stented aortic prosthesis as the first choice, which caused significant mitral valve regurgitation. The suture-less prosthesis was a rescue choice to restore the geometry and eliminate the deformation of the aorto-mitral continuity.Conclusions: aortic valve replacement using suture-less prosthesis could be a valuable optional choice for lowering the risk of deformation of the aortic annulus and aorto-mitral continuity. It might provide better outcomes in combined procedures.
SPOCK1 and POSTN are Valuable Prognostic Biomarkers and Correlate with Tumor Immune Infiltrates in Colorectal Cancer
Authors: Gan Caiqin , Li Mengting , Peng Ganjing , Li Wenjie , Wang Haizhou , Peng Yanan , Hu Qian , Wei Wanhui , Wang Fan , Liu Lan , Zhao Qiu
Published: September 2021

Background: Immune cells and stromal cells in the tumor microenvironment (TME) play a vital role in the initiation and progression of colorectal cancer (CRC). The study aimed to screen valuable prognostic biomarkers in CRC based on stromal and immune scores.Method: We used the ESTIMATE algorithm to calculate the immune and stromal scores of CRC samples in TCGA. Then the CRC samples were divided into high and low score groups based on the median value of the immune and stromal scores. Differentially expressed genes (DEGs) associated with immune score and stromal score were screened. WGCNA and univariate COX regression analysis were performed to further identify key prognostic genes. The prognostic value of key genes was validated based on The Gene Expression Profiling Interactive Analysis (GEPIA) and GSE17536 dataset.TIMER and CIBERSORT algorithms were applied to analyze the correlations among key genes and tumor-infiltrating immune cells. Several pairs of colon cancer tissue were used to be proven.Result: 1314 upregulated and 4 downregulated genes associated with immune score and stromal score were identified, which were significantly enriched in immune-related biological processes and pathways. Among these DEGs, SPOCK1 and POSTN were identified as key prognostic genes. High expression of SPCOK1 and POSTN was associated with advanced clinical stage, T stage, N stage, and poor prognosis of CRC. The results from CIBERSORT and TIMER revealed that SPOCK1 and POSTN were associated with tumor-infiltrating immune cells, especially macrophages and neutrophils. Meanwhile, in several pairs of human colorectal tissue samples, SPOK1 and POSTN were found to be significantly overexpressed in colorectal tissue compared with para-cancer tissue, and macrophage surface markers CD68 (co-expressed by M1 and M2 macrophages) and CD206 (M2-specific macrophage expression) were also overexpressed in cancer tissue. Besides, SPOCK1 and POSTN expression were positively correlated with the expression of immune checkpoints.Conclusion: Collectively, our results indicate that SPOCK1 and POSTN may be novel prognostic biomarkers in CRC and correlate with immune infiltrates.
Energy Efficiency Optimization in Adaptive Massive MIMO Networks for 5G Applications Using Genetic Algorithm
Authors: Salah Ibrahim , Mabrook M. Mourad , Rahouma Kamel Hussein , Hussein Aziza I.
Published: September 2021

Given that the exponential pace of growth in wireless traffic has continued for more than a century, wireless communication is one of the most influential innovations in recent years. Massive Multiple-Input Multiple-Output (M-MIMO) is a promising technology for meeting the world's exponential growth in mobile data traffic, particularly in 5G networks. The most critical metrics in the massive MIMO scheme are Spectral Efficiency (SE) and Energy Efficiency (EE). For single-cell MMIMO uplink transmission, energy and spectral-efficiency trade-offs have to be estimated by optimizing the number of base station antennas versus the number of active users. This paper proposes an adaptive optimization technique focusing on maximizing Energy Efficiency at full spectral efficiency using a Genetic Algorithm (GA) optimizer. The number of active antennas is estimated according to the change in the number of active users based on the proposed GA scheme that optimizes the EE in the M-MIMO system. Simulation results show that the GA optimization technique achieved the maximum energy efficiency of the 5G M-MIMO platform and the maximum efficiency in the trade-off process.
Identification of An Epithelial-Mesenchymal Transition-Related lncRNA Prognostic Signature For Patients With Glioblastoma
Authors: Yang XinJie , Niu Sha , Liu JiaQiang , Wu ZeYu , Ling Shizhang , Di GuangFu , Jiang XiaoChun
Published: September 2021

Purpose: Glioblastoma (GBM) is a class of strikingly heterogeneous and lethal brain tumor with very poor prognosis. LncRNAs play critical roles in the tumorigenesis and progression of GBM through regulation of various cancer-related genes and signaling pathways. Here, we aimed to establish an epithelial-mesenchymal transition (EMT)-related lncRNA signature for GBM and explore its underlying mechanisms. Methods: Differential expression analysis and Gene set enrichment analysis (GSEA) were performed to explore key genes and signaling pathways associated with GBM. Spearman correlation analysis, Univariate and multivariate Cox regression analyses were used to construct a lncRNA prognostic signature for GBM patients. Kaplan-Meier analysis and receiver-operating-characteristic (ROC) analysis were applied to assess the performance of the prognostic signature. Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genome (KEGG) enrichment analyses were performed to explore the underlying mechanisms of the signature. Single-sample GSEA (ssGSEA) was employed to explore the relationship of the signature and immune activities in GBM.Results: We focused on the essential role of EMT in GBM and identified 78 upregulated EMT-related genes in GBM. A total of 301 EMT-related lncRNAs were confirmed in GBM and a prognostic signature consisting of seven EMT-related lncRNAs (AC012615.1, H19, LINC00609, LINC00634, POM121L9P, SNHG11, and USP32P3) was established, which could divide GBM patients into low- and high-risk subgroups. The accuracy and efficiency of the signature were validated to be satisfactory. Functional enrichment analysis revealed multiple EMT and metastasis-related pathways were associated with the EMT-related lncRNA prognostic signature. In addition, we found the degree of immune cell infiltration and immune responses were significantly increased in high-risk subgroup compared with low-risk subgroup. Conclusion: we established an effective and robust EMT-related lncRNA signature which is expected to predict the prognosis and immunotherapy response for GBM patients.
Shone’s Complex and Aortic Dissection: Case Report and Review of a Rare, Underdiagnosed Congenital Heart Disease
Authors: Sinfield Steven , Ranasinghe Sachini , Wang Stephani , Mendoza Fernando , Khoynezhad Ali
Published: September 2021

BackGround Shone’s complex is a rare congenital heart disease consisting of a variety of left ventricular inflow and outflow tract lesions. Patients typically present in childhood and require early surgical intervention. However, with improved surgical techniques these patients are surviving later into adulthood which comes with a new set of medical complications providers need to be aware of. Case Presentation We present a case of a patient with a complex cardiac history including an incomplete Shone’s complex diagnosed in childhood with multiple surgical interventions who presents with persistent symptomatic atrial flutter and a type A aortic dissection in the setting of severe patient prosthesis mismatch. The patient was being followed outpatient for an enlarging chronic aortic aneurysm and was non-compliant with his medications when he presented with sharp chest pain radiating to his back. He was found to have an acute type A aortic dissection and was taken emergently to the operating room for a skirted Bentall procedure, aortic valve replacement, and right sided MAZE. Conclusions Shone’s complex is a rare congenital heart disease associated with significant morbidities in adulthood, such as atrial flutter, patient prosthesis mismatch, and aortic dissection. As patients continue to live longer into adulthood with this disease, it is important to raise awareness of this rare syndrome for providers and highlight its potential complications. Further research is needed to determine appropriate guidelines for when to intervene on aortopathy-associated CHD.
Effect of Thoracic Duct Ligation During VATS Esophagectomy On T Cell Subset and DFS in Squamous Cell Carcinoma Patients With T1b-3N0M0 Stage
Authors: Yang Ruifeng , Zhang Yan , Li Xiao-mei , Sun Ya-chen , Zhang Run-qi , Wang Peng
Published: September 2021

Objective: To study whether the ligation of thoracic duct during video-assisted thoracic surgery esophagectomy will cause damage to the immune system, thus affecting the disease-free survival(DFS) of patients with cT1b-3N0M0 stage. Methods: We studied the esophageal squamous cell carcinoma confirmed by endoscopic ultrasound biopsy and PET-CT. They were randomly divided into thoracic duct ligation group and non ligation group. In addition to thoracoscopic resection of esophageal cancer, thoracic duct ligation was also performed in the experimental group. The peripheral blood T lymphocyte subsets were detected by flow cytometry during perioperation. All patients were reexamined regularly after operation in order to find recurrence or metastasis early. The Chi-square test and t-test were employed for statistical analysis with statistical significance at p<0.05.The effect of thoracic duct ligation on DFS curves were calculated by the Kaplan–Meier method and compared by the log-rank test. A Cox regression model with stepwise selection was used for the multivariate analyses.Result: After early screening and late exclusion, a total of 67 patients entered the study and completed the follow-up. There was no significant difference in gender, age, tumor location, depth of invasion, degree of differentiation and presence of tumor thrombus between the ligation group (32 cases) and the non ligation group (35 cases). There was no significant difference in T lymphocyte subsets before and 3 weeks after operation, but there was significant difference on the 1st days after operation. Cox regression analysis showed that depth of invasion (P= 0.0020), degree of differentiation (P= 0.0262), presence of tumor thrombus (P = 0.0158) and thoracic duct ligation (P= 0.0036) were independent factors affecting DFS.Conclusion: Thoracic duct ligation can affect the short-term immune function after thoracoscopic esophagectomy in squamous cell carcinoma patients with pT1b-3N0M0 stage, and the thoracic duct ligation, depth of invasion, degree of differentiation and presence of tumor thrombus are independent factors affecting DFS. Trial registration: Chinese Clinical Trial Registry, ChiCTR-IOR-17010437 . Registered 15 January 2017, https://www.chictr.org.cn/edit.aspx?pid=17254&htm=4
Comparison of Valveplasty and Replacement for Surgical Treatment of Infective Tricuspid Valve Endocarditis
Authors: Linfeng Xie , Xiaodong Chen , Jian He , Sixian Lin , Xingfeng Chen , Qingsong Wu , Ling Chen , Jingxiang Zhuang , Zhihuang Qiu , Chen Liangwan
Published: September 2021

Background
In recent years, due to the increase in intravenous drug injection and intracardiac and vascular interventional treatments among drug users, infective endocarditis involving the right heart of the tricuspid valve has gradually increased.At present, there is no systematic report on surgical treatment of tricuspid infective endocarditis. This paper summarizes the experience of surgical treatment of 56 patients with tricuspid infective endocarditis in our hospital and analyzes its clinical effect.
Methods
From January 2006 to August 2019, 56 cases of tricuspid infective endocarditis treated by tricuspid valve surgery in our hospital were analyzed retrospectively.including 23 cases of tricuspid valvuloplasty (TVP) and 33 cases of tricuspid valve replacement (TVR). All patients were complicated with tricuspid valve vegetations or moderate and severe tricuspid regurgitation and had surgical indications.The perioperative data were collected and followed up for 6 months to 14 years to summarize and analyze the clinical effect of surgical treatment of tricuspid infective endocarditis.
Results
Compared with TVR group, the CPB time (79.68 ± 19.02min VS 107.39 ± 25.64min, P < 0.01), ACC time (50.29 ± 16.14min VS 65.52 ± 20.62min, P < 0.01), postoperative mechanical ventilation time (18.65 ± 8.18h VS 44.85 ± 57.68h, P < 0.01) and ICU stay time (38.13 ± 21.80h VS 102.64 ± 142.11h, P = 0.015) in TVP group were shorter. The perioperative red blood cell transfusion (4.87 ± 3.81U VS 7.55 ± 5.42U, P < 0.01) and the incidence of postoperative complications (8.7% VS 33.3%, P < 0.01) were lower.Perioperative death occurred in 1 case in the TVR group, and there was no perioperative death in the TVP group, There was no significant difference between the two groups(3.03% VS 0, P = 0.855). A total of 52 cases were followed up for an average of (5.50 ± 3.79) years.The postoperative 3-year, 5-year and 7-year survival rate were 100%,100%,91.7% in TVP group and 95.2%, 93.8% and 87.5%.The 5-year and 10-year reoperation rate were 0%, 0% in TVP group and 6.7%, 20% in TVR group.
Conclusion
Surgical treatment of severe tricuspid valve endocarditis has achieved good mid-term clinical results, and the rate of avoiding reoperation is better in TVP group than in TVR group.
Absorbance or Organization into Ankylosis: A Microarray Analysis of Haemarthrosis in a Sheep Model of Temporomandibular Joint Trauma
Authors: Jiao Mai-Ning , Zhang Tong-Mei , Yang Kun , Xu Zhao-Yuan , Zhang Guan-Meng , Tian Yuan-Yuan , Liu Hao , Yan Ying-Bin
Published: September 2021

Background: Traumatic haemarthrosis was hypothesized to be the etiology of temporomandibular joint (TMJ) ankylosis. Here, taking haematoma absorbance as a control, we aimed to reveal the molecular mechanisms involved in haematoma organizing into ankylosis using transcriptome microarray profiles.Material/Methods: Disk removal was performed to building haematoma absorbance (HA) in one side of TMJ, while removal of disk and articular fibrous layers was performed to induced TMJ ankylosis through haematoma organization (HO) in the contralateral side in a sheep model. Haematoma tissues harvested at days 1, 4 and 7 postoperatively were examined by histology, and analyzed by Affymetrix OviGene-1_0-ST microarrays. The DAVID were recruited to perform the Gene Ontology and Kyoto Encyclopedia of Genes and Genomes pathway analysis for the different expression genes (DEGs). The DEGs were also typed into protein–protein interaction (PPI) networks to get the interaction data. Six significant genes screened from PPI analysis, were confirmed by real-time PCR.Results: We found 268, 223 and 17 DEGs at least 2-fold at days 1, 4 and 7, respectively. At day 1, genes promoting collagen ossification (POSTN, BGN, LUM, SPARC), cell proliferation (TGF-β), and osteogenic differentiation of mesenchymal stem cells (BMP-2) were up-regulated in the HO side. At day 4, several genes involved in angiogenesis (KDR, FIT1, TEK) shower higher expression in the HO side. While HA was characterized by a continuous immune and inflammatory reaction.Conclusions: Our results provide a comprehensive understanding of the role of haematoma in the onset and progress of TMJ ankylosis. Further study of key genes may provide new ideas for future treatment of the disease.
What Are The Strategies for Implementing Primary Care Models in Maternity? A Systematic Review On Midwifery Units
Authors: Batinelli Laura , Thaels Ellen , Leister Nathalie , McCourt Christine , Bonciani Manila , Rocca-Ihenacho Lucia
Published: September 2021

Background
Midwifery Units (MUs) are associated with optimal perinatal outcomes, improved service users’ and professionals’ satisfaction as well as being the most cost-effectiveness option. However, they still do not represent the mainstream option of maternity care in many countries (1, 2). Understanding effective strategies to integrate this model of care into maternity services could support and inform the MU implementation process that many countries and regions still need to approach.
Methods
A systematic search and screening of qualitative research about implementation of new MUs was conducted (Prospero protocol reference: CRD42019141443) using PRISMA guidelines (3). Included articles were appraised using the CASP checklist (4). A meta-synthesis approach to analysis was used (5). No exclusion criteria for time or context were applied to ensure inclusion of different implementation attempts even under different historical and social circumstances. A sensitivity analysis was conducted to reflect the major contribution of higher quality studies.
Results
From 1037 initial citations, twelve studies were identified for inclusion in this review after a screening process. The synthesis highlighted two broad categories: drivers to open the new MUs and barriers or facilitators to the MU implementation. The latter category included eight key themes: “culture and perceptions”, “healthcare system”, “midwives’ identity and role”, “knowledge, skills and training”, “leadership”, “collaborative approach”, “integration” and “environment”. A logic model was created to explain the role of each during the implementation process.
Conclusions
the studies selected were from a range of settings and time periods and used varying strategies. Nonetheless, consistencies were found across different implementation processes. These findings can be used in the systematic scaling up of MUs and can help addressing barriers at system, service and individual levels. All three levels need to be addressed when implementing this model of care.
Factors Associated With Willingness To Join a Health Insurance Scheme Among Females in Uganda
Authors: Candia Douglas Andabati
Published: September 2021

Background

Access to quality and affordable health services is a fundamental human right. Therefore, there is a need for more reliable, affordable, and sustainable approaches to financing health services. This study sought to identify factors associated with willingness to join a health insurance scheme among females in Uganda.
Methods

The assessment was done using a logistic regression model and secondary data from the 2016 Uganda Demographic and Health Survey.
Results

The majority of females were willing to join health insurance schemes (85.28%). The willingness to join health insurance schemes increased among females with primary or secondary education as well as among females who used the internet less than once a week or almost every day.
Conclusion

There is a need for government to increase literacy among women since it will have an implication on their understanding of health insurance information and subsequently influence their willingness to join and pay. There is a need for the government of Uganda to revise the tax on the internet and internet-enabled devices to increase affordability and access to the internet which provides a cheaper and faster way to disseminate health-related information.
Postpartum Reversible Cerebral Vasoconstriction with Cortical Subarachnoid Hemorrhage and　Posterior　Reversible　Encephalopathy Syndrome Concomitant with Vertebral Artery Dissection Diagnosed by MRI MSDE Method; A Case Report and Review of Literature.
Authors: Sano Kenshi , Kuge Atsushi , Kondo Rei , Yamaki Tetsu , Homma Hiroshi , Saito Shinjiro , Sonoda Yukihiko
Published: September 2021

Background: Headache is one of the most common symptoms that are encountered in the postpartum period. We experienced a rare case of multiple phenomena of postpartum stroke occurred at the same time. Case: A 38-year-old woman experienced sudden onset of thunderclap headache after delivery. We diagnosed cervicocephalic arterial dissection (CAD), and posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) with cortical subarachnoid hemorrhage on the basis of clinical course and neuroradiological findings. Conclusion: Our case was rare in that multiple phenomena of postpartum stroke occurred at the same time. What is remarkable about this case was the confirmation of the reversibility of these pathological conditions through multifaceted evaluations, including the MRI motion-sensitized driven equilibrium 3D turbo spin echo (MSDE) sequencing method.
WITHDRAWN: A Parametric Analysis of Femoral Stem Impaction
Authors: Bishop Nicholas E , Wright Phil , Preutenborbeck Martin
Published: September 2021

BackgroundPress-fitted implants are implanted by impaction to ensure adequate seating, but without overloading the components, the surgeon, or the patient. To understand this interrelationship a uniaxial discretised model of the hammer/introducer/implant/bone/soft-tissues was developed. A parametric analysis of applied energy, component materials and geometry, and interaction between implant-bone and bone-soft-tissue was performed, with implant seating and component stresses as outcome variables. ResultsTo reduce stresses without compromising seating, the following outcomes were observed: Less energy per hit with more hits / Increase hammer mass / Decrease introducer mass / Increase implant-bone resistance (eg stem roughness). Material stiffness and patient mechanics were found to be less important.ConclusionsThis simple model provides a basic understanding of how stress waves travel through the impacted system, and an understanding of their relevance to component design.
Development and Selection of Integrative Measurement Descriptors: Application for Investigating Physical Properties of Biopolymers in Hairs
Authors: Takamura Ayari , Tsukamoto Kaede , Sakata Kenji , Kikuchi Jun
Published: September 2021

Integrative measurement analysis of complex subjects, such as polymers is a major challenge to obtain comprehensive understanding of the properties. In this study, we describe analytical strategies to extract and selectively associate compositional information measured by multiple analytical techniques, aiming to reveal their relationships with physical properties of biopolymers derived from hair. Hair samples were analyzed by multiple techniques, including solid-state nuclear magnetic resonance (NMR), time-domain NMR, Fourier transform infrared spectroscopy, and thermogravimetric and differential thermal analysis. The measured data were processed by different processing techniques, such as spectral differentiation and deconvolution, and then converted into a variety of “measurement descriptors” with different compositional information. The descriptors were associated with the mechanical properties of hair by constructing prediction models using machine learning algorithms. Herein, the stepwise model refinement based on importance evaluation identified the most contributive descriptors, which provided an integrative interpretation about the compositional factors, such as a-helix keratins in cortex; and bounded water and thermal resistant components in cuticle. These results demonstrated the efficacy of the present strategy to generate and select descriptors from manifold measured data for investigating the nature of sophisticated subjects, such as hair.
Bioinformatics Analysis Predicts ceRNA Regulatory Axes Related to Melanoma Pathogenesis
Authors: Liu Lina , Yang Feng , Lei Saiyun
Published: September 2021

Background Melanoma is a highly malignant skin tumour, with an incidence and mortality rates accounting for approximately 5% and >75% of all tumours, respectively. In the present study, we aimed to screen mRNAs, microRNAs, and circRNAs related to the pathogenesis of melanoma via bioinformatics methods. Materials and methods The microarray data correlating with melanoma were obtained from the GEO database, and the differentially expressed genes between melanomatissues and non-melanoma tissues were screened using GEO2R. Moreover, the Hub genes were screened using the STRING database, Cytoscape software, and GEPIA database. The DAVID database was used for gene enrichment analysis. Thereafter, the ceRNA network diagram was constructed using the starBase database and was analysed for survival in order to predict the molecular markers for diagnosis and treatment of skin cutaneous melanoma; the most probable ceRNA mechanism was screened via pan-cancer analysis. Furthermore, the ceRNA network was verified using the GEPIA and UALCAN databases. Results In total, 266, 20, and 10 differentially expressed mRNAs, microRNAs, and circRNA10 were screened. Using Cytoscape software, 59 Hub and 31 key genes were screened, followed by construction of the ceRNA and ceRNA-gene enrichment analysis networks. Conclusion Clinical verification revealed that SIPA1L1 could regulate the expression of DSC3 by sponge adsorption of has-miR-106b and has-miR-20b, and thereby affect the pathogenesis and progression of skin cutaneous melanoma.
Computed Tomography-Guided Lung Biopsy for Molecular Tests: A Meta-Analysis
Authors: Zhang Jian-Hua , Xia Feng-Fei , Yang Xiao-Shan , Shi Yi-Bing , Fu Yu-Fei , Li Yu
Published: September 2021

Background
To evaluate the potential clinical effectiveness of computed tomography (CT)-guided lung biopsy in the molecular tests.
Materials and Methods
We searched the related studies from the PubMed, Embase, and Cochrane Library until July 2021. The endpoints included adequacy rates for molecular tests, positive rates of epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) translocation, and Kirsten rat sarcoma viral oncogene homolog (KRAS) mutations.
Results
Initially, we were able to identify 1783 potentially relevant studies among which, only 12 were ultimately included in the present meta-analysis. All the studies were retrospective in nature. A total of 2559 patients underwent CT-guided lung biopsy and 1414 of them received molecular testing. We found that pooled adequacy rate for molecular tests, positive rate of EGFR mutations, and positive rate of ALK translocation were 95% (95% CI: 0.93–0.98), 49% (95% CI: 0.42–0.56), and 7% (95% CI: 0.04–0.09), respectively. Moreover, only 1 article reported the positive rate of KRAS mutation of 6% but a significant heterogeneity was detected in the endpoints of adequacy rate for molecular tests (I2 = 86.2%, P < 0.001) and positive rate of EGFR mutations (I2 = 77.7%, P < 0.001). While conducting a meta-regression analysis, we did not identify any variables that could significantly influence adequacy rate for molecular tests and positive rate of EGFR mutations. A high risk of publication bias was also found in the endpoint of adequacy rate for molecular tests (Egger test: P = 0.043).
Conclusions
CT-guided lung biopsy can serve as an effective method to provide sufficient lung cancer samples for molecular testing. EGFR gene was found to be the most frequently mutated during the analysis.
Analyses of Cell Type-Specific Effects of MicroRNA-298 on Native Protein Expression Via Truncated 3’UTR Hold Translational Promise
Authors: Wang Ruizhi , Lahiri Debomoy K.
Published: September 2021

Alzheimer’s disease (AD) is marked by neurofibrillary tangles and senile plaques comprising amyloid β (Aβ) peptides. However, specific contributions of different cell types to Aβ deposition remain unknown. Non-coding microRNA (miRNA) play important roles in AD by regulating major proteins involved, like Aβ precursor protein (APP) and β-site APP-cleaving enzyme (BACE1), two key proteins associated with Aβ biogenesis. MiRNAs typically silence protein expression via binding specific sites in 3’- untranslated region (3’UTR) mRNA. MiRNA regulates protein levels in a cell-type specific manner; however, mechanism of miRNA’s variable activities remains unknown. We developed “miRNA-associated native protein expression” (miRnape) assays to determine a natural "UTR limit" for a miRNA’s function in a particular cell type. We report that miR-298 treatment reduced native APP protein levels in an astrocytic but not in a neuronal cell line. From miR-298’s effects on APP-3’UTR activity and native protein levels, we infer that APP 3’-UTR length could explain the differential miR-298’s activity. Such truncated, but natural, 3’-UTR found in a specific cell type provides an opportunity to regulate native protein levels by particular miRNA. Thus, miRNA’s effect tailoring to a specific cell type bypassing another undesired cell type with a truncated 3’-UTR would potentially advance translational research.
Ultrasound-guided Preoperative Localization of Radial Nerve in the Treatment of Extra-articular Distal Humeral Shaft Fractures
Authors: Li Weifeng , Wang Qian , Wang Haiying , wang shunyi
Published: September 2021

Background: The aim of this study was to discuss the treatment of extra-articular distal humeral shaft fractures using ultrasound-guided preoperative localization of radial nerve.Methods: Between May 2014 and December 2019, 56 patients with extra-articular distal humeral shaft fractures were retrospectively reviewed. 28 patients were received examination by using preoperative localization of radial nerve guided by ultrasound-guided preoperative localization (group A) and 28 control patients without ultrasound-guided (group B). All patients were treated surgically for distal humeral shaft fractures by posterior approach techniques. Operative time, radial nerve exposure time, intraoperative bleeding volume, union time and iatrogenic radial nerve palsy rate were compared between the two groups. Elbow function was also evaluated using the Mayo Elbow Performance Score (MEPS). Results: A significant difference was observed between the two groups, Operative time (113.25 min vs 135.86 min) (p < 0.001), radial nerve exposure time (20.82 min vs 32.53 min) (p < 0.001), intraoperative bleeding volume (246.80 ml vs 335.52 ml) (p < 0.001) and iatrogenic radial nerve palsy rate (0 vs 10.7% ) (p< 0.001). However, the fracture union time (13.52 months vs 12.96 months) (p = 0.796) and the MEPS sscore (87.56 vs 86.38) (p = 0.594) were no significantly different in both groups. Conclusion: The study demonstrates that ultrasound-guided preoperative localization is an effective approach in the treatment of extra-articular distal humeral shaft fracture by revealing radial nerve, which may help reduce the incidence of iatrogenic radial nerve injury and the intraoperative bleeding volume. In addition, it has the advantages of operability, safety, efficiency and repeatability.
Prognostic And Immunological Implications of BTK Expression In Pan-Cancer
Authors: Yang Tao , Hao Lizheng , Chen Jian , Zhu Xueying , Sun Keyi , Zeng Yu , Zhang Yayue , Li Zhong
Published: September 2021

Background: Cancer poses a serious threat to human health. Clarifying the potential significance of Bruton's tyrosine kinase (BTK)in cancer has potential clinical value. This study examined the prognostic and immunological value of BTK gene expression in pan-cancer.Methods: We evaluated the gene expression of BTK in tumor tissues and normal tissues in different cancers. Survival analysis, including Kaplan–Meier analysis and Cox analysis, were performed to explore the prognostic value of BTK for pan-cancer based on survival data from The Cancer Genome Atlas (TCGA) database. Spearman’s method was conducted to analyze the interrelation between BTK gene expression and tumor mutational burden (TMB)and microsatellite instability (MSI). We explored the association of BTK expression with the tumor microenvironment based on Estimation of STromal and Immune cells in MAlignant Tumour tissues using Expression data (ESTIMATE) algorithm. Co-expression analysis of BTK expression and immune-related genes was performed. We used Gene Set Enrichment Analysis (GSEA) to examine the molecular mechanisms and pathways of BTK in pan-cancer.Results: High BTK expression in cervical squamous cell carcinoma and endocervical adenocarcinoma (CSEC), head and neck squamous cell carcinoma (HNSC), lung adenocarcinoma (LUAD) and skin cutaneous melanoma (SKCM) was positively correlated with patient prognosis, while high expression of BTK in lymphoid neoplasm diffuse large B cell lymphoma (DLBC), brain lower grade glioma (LGG) and esophageal carcinoma (ESCA) corresponded with a worse prognosis. Cox analysis showed that BTK was closely associated to the prognosis of HNSC, LGG, SKCM and LUAD. BTK expression was correlated with clinical stage, TMB and MSI of 10 types of tumors. In HNSC, LGG, LUAD and SKCM, the expression of BTK was positive correlated with immune and stromal scores. Conclusion: BTK expression can act as a prognostic factor in various cancers, especially in HNSC, LGG, LUAD and SKCM, and this may be from its close association with TMB, MSI and immune cell infiltration.
Treatment of Osteoporotic Thoracolumbar Burst Fractures by Bilateral Pedicle Vertebroplasty Combined With Postural Reduction
Authors: Wang Haoyu , Zhang Lifeng , Wu Xiaotao
Published: September 2021

Background: Osteoporotic thoracolumbar burst fracture (OTLBF) is common in seniors. Due to the fracture of the posterior vertebra and spinal canal occupancy, the risk of cement leakage and spine injury is high in OTLBF patients, thus the application of vertebroplasty is limited in these patients. This study aims to investigate the efficacy and safety of vertebroplasty for treating OTLBF via bilateral pedicle approach combined with postural reduction. To determine whether percutaneous vertebroplasty (PVP) combined with body reduction is an alternative method for treating OTLBF that prevents major surgical complications.Methods: Thirteen patients (aged≥65years) with thoracolumbar fractures but without neurological deficits underwent vertebroplasty. In all fracture cases, the anterior and middle columns of the vertebrae were affected and the canal was mildly compressed. To assess the clinical symptoms and the effects of the procedure, patient mobility and pain were assessed prior to the procedure and at 1 day and 3 months after the procedure. Kyphosis correction, wedge angle, and height restoration were also observed and measured. Results: Improvements in pain and mobility were observed immediately after vertebroplasty in all patients. These results were observed for 6 months. Significant improvements were also noted at 1 day and 6 months after vertebroplasty. Pain was reduced by at least 4 levels after 6 months. No comorbidities were observed. Kyphosis Correction, Wedge Angle and height recovery were improved. Postoperative computed tomography revealed polymethylmethacrylate leakage through the endplate fracture site into the disc space and paravertebral spacein one patient. No intraspinal leakage was found in all patients. Conclusions: Vertebroplasty is assumed to be contraindicated in patients with osteoporotic thoracolumbar fractures with posterior body involvement. However, this procedure was successfully performed to safely treat such fractures without causing neurological deficits. PVP combined with body reduction may be an alternative method for treating OTLBF that prevents major surgical complications. Moreover, it helps patients achieve early mobilization and pain relief.
MFVT:An Anomaly Traffic Detection Method Merging Feature Fusion Network and Vision Transformer Architecture
Authors: Li Ming , Han Dezhi , Li Dun , Liu Han , Chang Chin- Chen
Published: September 2021

Network intrusion detection, which takes the extraction and analysis of network traffic features as the main method, plays a vital role in network security protection. The current network traffic feature extraction and analysis for network intrusion detection mostly uses deep learning algorithms. Currently, deep learning requires a lot of training resources, and have weak processing capabilities for imbalanced data sets. In this paper, a deep learning model (MFVT) based on feature fusion network and Vision Transformer architecture is proposed, to which improves the processing ability of imbalanced data sets and reduces the sample data resources needed for training. Besides, to improve the traditional raw traffic features extraction methods, a new raw traffic features extraction method (CRP) is proposed, the CPR uses PCA algorithm to reduce all the processed digital traffic features to the specified dimension. On the IDS 2017 dataset and the IDS 2012 dataset, the ablation experiments show that the performance of the proposed MFVT model is significantly better than other network intrusion detection models, and the detection accuracy can reach the state-of-the-art level. And, When MFVT model is combined with CRP algorithm, the detection accuracy is further improved to 99.99%.