bluuebunny/crossref_metadata_2025 huggingface dataset:
An Essay on Railway Track Bed Failure Issues, Analysis and Remedy
Authors: Sakib S M Nazmuz
Published: September 2021

The polymer cures as it enters the ballast, forming a three-dimensional geo-composite reinforcing cage. Although there will be some adherence to the ballast in dry conditions, the polymer's primary job is to construct this reinforcing cage. Polymer penetration is controlled by altering the rheology of the polymer. The method is also said to include a built-in safety system, with the track reverting to a ballast state in the event of a polymer or geo-composite failure. Many of the sites were considered unmaintainable before the polymer was put. The design method was utilized to forecast track behaviour before and after treatment, allowing the most appropriate polymer rheology, polymer distribution, and loading levels to be designed in order to achieve optimum performance and confirm that the procedure worked. This method can be utilized to tackle these types of long-standing problems by displaying actual polymer application profiles at a typical important location.
The Mediating Role of Gender, Age, COVID-19 Symptoms and Changing of Mansion on the Mental Health of Healthcare Workers Operating in Italy during the First Wave of the COVID-19 Pandemic
Authors: Gambaro Eleonora , Gramaglia Carla , Marangon Debora , Azzolina Danila , Probo Manuela , Rudoni Marco , Zeppegno Patrizia
Published: September 2021

The COVID19 pandemic tested the performance of hospitals and intensive care units around the world. Health care workers (HCWs) have been used to develop mental symptoms, but this was especially true during the COVID19 pandemic when HCWs must deal with many other sources of stress and anxiety that can usually be avoided, and long-term shifts and unprecedented population restrictions have weakened people's ability to cope with stress. The research aims to observe the dynamic interplay between burnout, depression, distress, and anxiety in HCWs working in various settings, with specific a focus on Emotional exhaustion, depersonalization, and a diminished sense of personal achievement in mediating a worst mental health status during the first wave of the COVID19 pandemic in Italy. To analyze that we performed a mediation analysis, from which resulted a strong correlation among depression, psychological distress, health perception and anxiety, and the impact of job burnout on anxiety, depression, and distress. Gender seemed to have a strong correlation with burnout, anxiety, and distress; the impact of COVID19 pandemic on Quality of Life seemed to affect anxiety and depression; the changing of mansion influenced depression and job burnout. Encouraging supportive and educational strategies would certainly be recommended to policy makers.
The SPHN Ecosystem Towards FAIR Data
Authors: Österle Sabine , Touré Vasundra , Crameri Katrin
Published: September 2021

Health-related data originating from diverse sources are commonly stored in manifold databases and formats, making it difficult to find, access and gather data for research purposes. In addition, so-called secondary use scenarios for health data are usually hindered by local data codes, missing dictionaries and the lack of metadata and context descriptions. Following the FAIR principles (Findable, Accessible, Interoperable and Reusable), we developed a decentralized infrastructure to overcome these hurdles and enable collaborative research by making the meaning of health-related data understandable to both, humans and machines. This infrastructure is currently being implemented in the realm of the Swiss Personalized Health Network (SPHN), a research infrastructure initiative for enabling the use and exchange of health-related data for research in Switzerland. The SPHN ecosystem for FAIR data consists of the SPHN Dataset (semantic definitions), the SPHN RDF Schema (linkage and transport of the semantics in a machine-readable format), a project RDF template, extensive guidelines and conventions on how to generate SPHN RDF schema, a Terminology Service (converter of clinical terminologies in RDF), and a Quality Assurance Framework (automated data validation with SHACLs and SPARQLs). The SPHN ecosystem has been built in a way that it can easily be adapted and extended by any SPHN project to fit individual needs. By providing such a national ecosystem, SPHN supports researchers in generating, processing and sharing FAIR data.
Epigenetic Modifications in Plant Development and Reproduction
Authors: Brukhin Vladimir , Albertini Emidio
Published: September 2021

Plants are exposed to highly fluctuating effects of light, temperature, weather conditions and many other environmental factors throughout their life. As sessile or-ganisms, unlike animals, they are unable to escape, hide or even change their position. Therefore, the growth and development of plants is largely determined by interaction with the external environment, the success of this interaction depends on the ability of the phenotype plasticity, which is largely determined by epigenetic regulation. In addi-tion to how environmental factors can change the patterns of genes expression, epige-netic regulation determines how genetic expression changes during the differentiation of one cell type into another, and how patterns of gene expression are passed from one cell to its descendants. Thus, one genome can generate many 'epigenomes'. Epigenetic modifications acquire special significance during the formation of gametes and plant reproduction, when epigenetic marks are eliminated during meiosis and early embry-ogenesis and later reappear. However, during asexual plant reproduction, when meio-sis is absent or suspended, epigenetic modifications that have arisen in the parental sporophyte can be transmitted to the next clonal generation practically unchanged. In plants that reproduce sexually and asexually, epigenetic variability has different adap-tive significance. In asexuals, epigenetic regulation is of particular importance for im-parting plasticity to the phenotype, when the genotype remains unchanged for many generations of individuals. Of particular interest is the question of the possibility of transferring acquired epigenetic memory to future generations and its potential role for natural selection and evolution. All these issues will be discussed to some extent in this review. In the last two decades, a lot of data on the epigenetic regulation of plants has appeared, as well as works summarizing the accumulated knowledge (Verhoeven and Preite 2013; Pikaard and Scheid 2014; Gehring 2019; Ono and Kinoshita 2021), nevertheless, many questions remain unclear, and a number of results are contradic-tory. New in this area data is constantly emerging. We tried to take into account and discuss the main findings and conclusions in this field.
Numerical Simulations Using Various Models for Tsunamis Due to a Fluid or Rigid Bodies Falling Down a Uniform Slope
Authors: Kakinuma Taro , Yanagihara Mitsuru , Iribe Tsunakiyo , Nagai Kuninori , Hara Chisato , Hamada Natsuki , Nakagaki Tatsuya , Sujatmiko Karina Aprilia , Magdalena Ikha , Nagai Kaori , Kannonji Rika , Chen Songgui , Shirai Tomoki , Arikawa Taro ,   Graduate School of Science and Engineering, Kagoshima University 1-21-40 Korimoto, Kagoshima, Kagoshima 890-0065, Japan,   Civil Engineering Department, Ehime Prefectural Government, Ehime, Japan,   Faculty of Engineering, University of the Ryukyus, Okinawa, Japan,   Research and Development Center, TOA Corporation, Kanagawa, Japan,   Civil Engineering General Headquarters, TOA Corporation, Tokyo, Japan,   Graduate School of Science, Hokkaido University, Hokkaido, Japan,   Graduate School of Societal Safety Sciences, Kansai University, Osaka, Japan,   Faculty of Mathematics and Natural Sciences, Bandung Institute of Technology, Bandung, Indonesia,   Faculty of Science and Engineering, Chuo University, Tokyo, Japan
Published: September 2021

Tsunami generation due to a landslide has been simulated using various numerical models, and the resulting water surface displacements from the models, as well as the corresponding experimental data, are compared. The numerical models used in this study are a two-layer long-wave model, a two-level non-hydrostatic model, a three-dimensional model, a lattice-Boltzmann-type model, an SPH-type model, and an MPS-type model. Tsunamis generated by a fluid falling down a uniform slope are accurately reproduced by the models, especially when the wave height of the tsunami is not large. When using the two-layer long-wave model, in which the two layers of a falling fluid and seawater are assumed not to mix, the parameters including the seabed friction coefficient, adjusted in one case, are not appropriate for other mixing conditions. The two-level model with non-hydrostatic pressure exhibits wave disintegration owing to the effects of both nonlinearity and dispersion, although the second wave generated by the reflection of a wave traveling towards the shore is not simulated accurately. Tsunamis caused by a group of rigid cylinders falling down a uniform slope have also been simulated using two Lagrangian models, namely the SPH- and MPS-type models. Although the first peak at the water level is accurately reproduced by both models, the water level at the trough between the first and second crests is overestimated.
Inter-Model Comparison for Tsunami Debris Simulation
Authors: Takabatake Tomoyuki , Stolle Jacob , Hiraishi Koji , Kihara Naoto , Nojima Kazuya , Shigihara Yoshinori , Arikawa Taro , Nistor Ioan ,   Kindai University 3-4-1 Kowakae, Higashi Osaka-shi, Osaka 577-8502, Japan,   Centre Eau Terre Environnement, Institut National de la Recherche Scientifique (INRS), Québec, Canada,   Chuo University, Tokyo, Japan,   Central Research Institute of Electric Power Industry, Chiba, Japan,   Research and Development Center, Nippon Koei Co., Ltd., Ibaraki, Japan,   Department of Civil and Environmental Engineering, National Defense Academy (NDA), Kanagawa, Japan,   Department of Civil Engineering, University of Ottawa, Ottawa, Canada
Published: September 2021

Assessing the risk of tsunami-driven debris has increasingly been recognized as an important design consideration. The recent ASCE/SEI7-16 standard Chapter 6 requires all the areas included within a 22.5° spreading angle from the debris source to consider the debris impact. However, it would be more reasonable to estimate the risks using numerical simulation models. Although a number of simulation models to predict tsunami debris transport have been proposed individually, comparative studies for these simulation models have rarely been conducted. Thus, in the present study, an inter-model comparison for tsunami debris simulation model was performed as a part of the virtual Tsunami Hackathon held in Japan from September 1 to 3 in 2020. The blind benchmarking experiment, which recorded the transport of three container models under a tsunami-like bore, was conducted to generate a unique dataset. Then, four different numerical models were applied to reproduce the experiments. Simulated results demonstrated considerable differences among the simulation models. Essentially, the importance of accurate modelling of a flow field, especially a tsunami front, was confirmed to be important in simulating debris motion. Parametric studies performed in each model and comparisons between different models also confirmed that a drag coefficient and inertia coefficient would influence the simulated debris trajectory and velocity. It was also shown that two-way coupled modelling to express the interaction between debris and a tsunami is important to accurately model the debris motion.
VIOLÊNCIA INTRAFAMILIAR: CONHECIMENTO E CONDUTA DOS CIRURGIÕES-DENTISTAS DE CAICÓ (RN).
Authors: Pinheiro Pereira Francisca Janiele , Da Silva Matheus Lopes , Guedes Emiliano Gustavo Barbalho , Bezerra de Oliveira Moura Jamile Marinho , Da Veiga Pessoa Daniela Mendes
Published: September 2021

Introdução: A violência intrafamiliar é amplamente identificada como negligência e abuso de crianças e adolescentes; violência doméstica contra mulheres, maus-tratos de idosos e de pessoas portadoras de deficiência. É dever ético-legal dos cirurgiões-dentistas realizarem a notificação compulsória frente a esses casos. Objetivo: Verificar o conhecimento e a conduta dos cirurgiões-dentistas sobre a violência intrafamiliar no município de Caicó-RN, Brasil. Material e Métodos: Estudo descritivo, transversal, e com abordagem quantitativa. A amostra do estudo foi constituída por 66 cirurgiões-dentistas do município de Caicó-RN. A coleta dos dados foi realizada através da aplicação do questionário adaptado já validado por Mythri (2015). A análise dos dados se deu por estatística descritiva. Resultados: 53% (n=35) dos cirurgiões-dentistas afirmaram ter atendido vítimas de violência intrafamiliar. Dentre os quais, apenas 37,9% questionaram aos seus pacientes sobre os motivos da violência. A conduta do cirurgião-dentista mais citada frente à casos de violência, foi aconselhamento. Pode-se apontar que 87,9% dos profissionais afirmaram conhecer os sinais, sintomas e lesões orofaciais decorrentes da violência intrafamiliar e o mais relatado foi o hematoma. Os profissionais demonstraram ser cientes da  localização anatômica das agressões da violência intrafamiliar na região de atuação do profissional da Odontologia. Conclusão: Os cirurgiões-dentistas possuem conhecimento satisfatório no que diz respeito ao reconhecimento dos sinaise sintomas decorrentes das lesões orofaciais causadas pela violência intrafamiliar. Porém, no que se referem a como proceder diante dos casos, as suas condutas se mostram insuficientes e contraditórias.
Plan de negocio para la comercialización de café orgánico molido en filtrante
Authors:   , Prado Lima Jackeline Celia , Figueroa Alvarado Cinthya Gabriela , Melgar Prada Carlos Enrique , Rodríguez Mendez Marcelo Esteban Junior
Published: September 2021

La empresa con nombre comercial “COFFILT”, resume a continuación aspectos importantes sobre su constitución. Se trata de un proyecto de negocio cuyo propósito es la comercialización del café orgánico molido en presentación de filtrante bajo normas estrictas de calidad como NTP ISO 15161:200, contando con supervisión de expertos para poder brindarle a nuestros clientes un producto saludable y práctico. Según los estándares internacionales de la exportación del café (ICO), menciona que el Perú se ubica entre los primeros productores de café a nivel internacional, aprovecharemos en utilizar dicho insumo proveniente del distrito de Villa Rica, ubicado en el departamento de Pasco, el cual es famoso por su producción cafetalera; de tal manera que ha sido reconocido y premiado en los mejores concursos del mundo. El propósito del presente plan de negocios es lograr que nuestro producto se posicione en el mercado impulsando el desarrollo del sector cafetalero y el consumo en la región, manteniendo los principios y las normas de calidad que exige la agricultura orgánica. Es importante mencionar que en el capítulo II de este proyecto se determina quiénes somos, dando a conocer los datos generales como el origen de nuestro nombre comercial “COFFILT”, además se podrá identificar las bases del presente plan de negocios. En el capítulo III se elaboró el análisis PESTE donde se evalúa el macro-entorno de la empresa tomando como variables a las fuerzas políticas, económicas, sociales, tecnológicas y ecológicas; con la finalidad de determinar el impacto que pudieran generar en el negocio, también se definen quiénes serán nuestros aliados estratégicos. En el capítulo IV, se determina el público objetivo de nuestro proyecto, el cual está dirigido al nivel socioeconómico B y C del sector 5 y conformado por seis distritos de la zona Este de Lima...
Integrative Molecular and Clinical Profiling of Acral Melanoma Identifies LZTR1 as a Key Tumor Promoter and Therapeutic Target
Authors: Halaban Ruth , Newman Aaron , Farshidfar Farshad , Peng Cong , Levovitz Chaya , Knight James , Bacchiocchi Antonella , Su Juan , Rhrissorrakrai Kahn , Yin Mingzhu , Sznol Mario , Ariyan Stephan , Clune James , Olino Kelly , Parida Laxmi , Nikolaus Joerg , Zhang Meiling , Zhao Shuang , Wang Yan , Huang Gang , Wan Miaojian , Li Xianan , Cao Jian , Yan Qin , Chen Xiang
Published: September 2021

Acral melanoma, the most common melanoma subtype among non-Caucasian individuals, is associated with poor prognosis. However, its key molecular drivers remain obscure. Here, we performed integrative genomic and clinical profiling of acral melanomas from a cohort of 104 patients treated in North America or China. We found that recurrent, late-arising amplifications of cytoband chr22q11.21 are a leading determinant of inferior survival, strongly associated with metastasis, and linked to downregulation of immunomodulatory genes associated with response to immune checkpoint blockade. Unexpectedly, LZTR1 – a known tumor suppressor in other cancers – is a key candidate oncogene in this cytoband. Silencing of LZTR1 in melanoma cell lines caused apoptotic cell death independent of major hotspot mutations or melanoma subtypes. Conversely, overexpression of LZTR1 in normal human melanocytes initiated processes associated with metastasis, including anchorage-independent growth, formation of spheroids, and increased levels of MAPK and SRC activities. Our results provide new insights into the etiology of acral melanoma and implicate LZTR1 as a key tumor promoter and therapeutic target
Applicability and Improvement of Different Evapotranspiration Methods of Reference Crops in Jiangxi Province
Authors: Lu Xianghui , Zhang Haina , Han Yixiu , Bai Hua , Li Erhui
Published: September 2021

To achieve accurate evaluation of evapotranspiration of reference crops (ET0) in Jiangxi, China in the absence of systematic climatological data, with reference to the FAO-56 Penman-Monteith (P-M) equation, the Pristley-Taylor (P-T) method, the Makkink method, the Hargreaves-Samani (H-S) method, the Irmak-Allen (I-A) method, the Penman1948 (48PM) method, the Penman-Van Bavel (PVB) method, the Baier-Robertson (B-R) method, the improved Baier-Robertson (M-B-R) method, the Schendel (Sch) method, the Turc method, the Jensen-Haise (J-H) method, and the Brutsaert-Stricker (B-S) method were used to evaluate the daily climatological data collected by 26 weather stations in Jiangxi, China and 17 weather stations in adjacent provinces. The results were compared with each other and parameter rate determination was conducted. The results indicated that the Turc method exhibited optimized applicability before parameter rate determination and the average root mean square error (RMSE) and the average normalized root mean square error (NRMSE) by this method were 0.39 mm/d and 0.157 mm, respectively. However, parameter rate determination led to negligible improvement in accuracy for this method. The Turc method could be directly applied in Jiangxi (except Nanchang). For special distribution of error after parameter rate determination, all methods exhibited significant errors in Northern Jiangxi. Herein, the 48PM method and the B-S method showed good applicability after parameter rate determination and RMSE and NRMSE of data by these methods ranged in 0.06 ~ 0.34 mm/d and 0.08 ~ 0.27, 8 ~ 27% respectively, and their d-indices were close to 1. The annual over-estimations in weather stations in Jiangxi were below 30 mm. In the absence of data about relative humidity and wind speed, the P-T method was an appropriate simplified method for Jiangxi. In this case, α was slightly lower than the default value (1.05 ~ 1.18), RMSE was within 0.21 ~ 0.66 mm/d, and NRMSE was within 0.08 ~ 0.308 ~ 30%. Accuracy of RMSE, d-index, and NRMSE of data by the P-T method, the I-A method, and the PVB method were consistent with all stations, while that by the Mak method was slightly lower, which could be attributed to severe over-estimation in July and August. RMSE of the H-S method, the B-R method, the M-B-R method, the J-H method, and the Sch method were above 0.75 mm/d and these methods were not suitable for accurate evaluation of ET0 in Jiangxi, China. The annual ET0 was calculated by various methods (except the 48PM method and the B-S method) exhibited significant variation around 2003. This may be attributed to significant changes in certain meteorological factors over recent years.
Universality in Decaying Turbulence at High Reynolds Numbers
Authors: Kuechler Christian , Bewley Gergory , Bodenschatz Eberhard
Published: September 2021

In the limit of very large Reynolds numbers for homogeneous isotropic turbulence of an incompressible fluid, the statistics of the velocity differences between two points in space are expected to approach universal power laws at scales smaller than those at which energy is injected. Even at the highest Reynolds numbers available in laboratory and natural flows such universal power laws have remained elusive. On the other hand, power laws have been observed empirically in derived quantities, namely in the relative scaling in statistics of different orders according to the Extended Self Similarity hypothesis. Here we present experimental results from the Max Planck Variable Density Turbulence Tunnel over an unprecedented range of Reynolds numbers. We find that the velocity difference statistics take a universal functional form that is distinct from a power law. By applying a self-similar model derived for decaying turbulence to our data, an effective scaling exponent for the second moment can be derived that agrees well with that obtained from Extended Self Similarity.
Observed Evidences of Frequency-Dependent Site Amplification Due to Structural Control of Active Reverse Faults at Different Localities in Japan
Authors: Thabet Mostafa
Published: September 2021

Observed active fault zone related site amplification is calculated based on Fourier acceleration spectrum (FAS) at three different localities in Japan. The FASs are calculated using 26432 earthquakes recorded at 126 K-NET and KiK-net seismic stations, which are distributed on the fault zones, upthrown and downthrown sides. This observed amplification is strongly frequency-dependent because of the presence of the near-surface low-velocity flower fault structure and the deeper fault zone. Moreover, the amplification patterns at each study area are tectonic-specific patterns. Sources inside the active fault zones could produce amplification at high frequencies at stations on both fault zone and far away from the fault zone, because of the impact of the near-surface fault zone. Sources outside the active fault zones yield remarkable high amplification at low frequencies exhibiting a gradual increase through stations on hanging walls, fault zones, and footwalls. Interestingly, the peaks of the low-frequency amplification are corresponding to wavelengths that approximately equalize the width of the fault zone. The presence of fault zone low-velocity layers could be successfully detected by the diffuse field theory inversion.
The Role of HOX Genes as Potential Biomarkers in Colorectal Cancer: A Systematic Review
Authors: Martinou Eirini , Falgari Giulia , Angelidi Angeliki , Bagwan Izhar
Published: September 2021

Background: Colorectal cancer (CRC) is worldwide the third leading cause of cancer-related death, and despite therapeutic advances, survival remains low. Emerging evidence shows that Homeobox (HOX) genes are important in carcinogenesis, and their dysregulation has been linked with metastatic potential and poor prognosis. This systematic review aims to present the current evidence on the role of HOX genes as biomarkers in CRC and the impact of their modulation in tumour growth and progression. Methods: MEDLINE, EMBASE, Web of Science and Cochrane databases were searched by following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. Eligible studies investigated two research questions: a) the clinicopathological and prognostic significance of HOX gene dysregulation in patients with CRC and b) the functional role of HOX genes in CRC progression. This study was registered in the international prospective register of systematic reviews (PROSPERO), CRD42020190953. Results: Twenty-five studies enrolling 3003 patients with stage I-IV CRC, showed that 26 out of 39 HOX genes were dysregulated in cancerous versus normal colon. Aberrant expression of HOX proteins was significantly related to tumour depth, nodal invasion, distant metastases, advanced stage and poor prognosis. Twenty-two preclinical studies showed that HOX proteins are crucially related to tumour growth and metastatic potential by affecting cell proliferation and altering the expression of epithelial-mesenchymal transition modulators. Conclusions: In conclusion, our findings suggest that HOX proteins play vital roles in CRC progression and significantly affect survival. Further research, though, is required to elucidate their potential role as biomarkers in CRC.
Lessons Learned by Medical Students about Systems-Based Practice as Patients Transition their Care
Authors: Pey Eduard , Sierra Diego , Katz Sydney , Greisman Laura , Jannat-Khah Deanna , Stine Shelene , Esqu Ernie
Published: September 2021

Background: One in five patients suffer an adverse event within two weeks of discharge as they transition from one healthcare setting to another. Systems-based practice is a core competency of physicians and seeks to minimize these events; however, education of trainees is inconsistent. We asked whether structured post-discharge phone calls and reflections on barriers to discharge and practice improvement can enhance students’ understanding of systems-based practice. Method: Medical students in the Internal Medicine Clerkship were assigned to perform a structured post-discharge phone call on hospitalized patients as part of a “Transitions of Care” assignment. Students reflected on issues occurring at the transition from hospitalization to discharge. We performed qualitative analysis of 90 medical student responses and identified themes and sub-themes addressing issues with care transitions. Results: Students consistently identified barriers to safe discharge including issues scheduling follow-up care, poor care coordination, and inadequate social support. The post-discharge phone calls revealed problems with patients’ understanding of their discharge diagnosis, medication-related issues and patients’ failure to attend scheduled follow-up. Common student-proposed practice improvement interventions included: enhanced provider-patient communication and education, improved interdisciplinary collaboration and care coordination, and greater attention to patient’s psychosocial and financial status. Conclusions: Medical students learned about systems-based practice from a transitions of care assignment involving a post-discharge phone call, identifying critical events in over half of patients identified. Self-reflective practice within the context of direct patient care offers insights into practice improvement in care transitions.
A Novel Algorithm-Driven Hybrid Simulation Learning Method to Improve Acquisition of Endotracheal Intubation Skills: A Randomized Controlled Study
Authors: Mankute Aida , Juozapaviciene Laima , Stucinskas Justinas , Dambrauskas Zilvinas , Dobozinskas Paulius , Sinz Elizabeth , Rodgers David , Giedraitis Mantas , Vaitkaitis Dinas
Published: September 2021

Background: Simulation-based training is a clinical skill learning method that can replicate real-life situations in an interactive manner. In our study, we compared a novel hybrid learning method with conventional simulation learning in the teaching of endotracheal intubation.Methods: One hundred medical students and residents were randomly divided into two groups and were taught endotracheal intubation. The first group of subjects (control group) studied in the conventional way via lectures and classic simulation-based training sessions. The second group (experimental group) used the hybrid learning method where the teaching process consisted of distance learning and small group peer-to-peer simulation training sessions with remote supervision by the instructors. After the teaching process, endotracheal intubation (ETI) procedures were performed on real patients under the supervision of an anesthesiologist in an operating theater. Each step of the procedure was evaluated by a standardized assessment form (checklist) for both groups.Results: Thirty-four subjects constituted the control group and 43 were in the experimental group. The hybrid group (88%) showed significantly better ETI performance in the operating theater compared with the control group (52%). Further, all hybrid group subjects (100%) followed the correct sequence of actions, while in the control group only 32% followed proper sequencing.Conclusions: We conclude that our novel algorithm-driven hybrid simulation learning method improves acquisition of endotracheal intubation with a high degree of acceptability and satisfaction by the learners’ as compared with classic simulation-based training.
Co-Pyrolysis of Neem Wood Bark and Low-Density Polyethylene: Lnfluence of Plastic on Pyrolysis Product Distribution and Bio-Oil Characterization
Authors: Kaushik Venkatachalam Selvaraj , Dhanalakshmi Chandrasekaran Sowmya , Madhu Petchimuthu , Tamilselvam Palanisamy
Published: September 2021

In this study, the investigation on effect of plastic during co-pyrolysis with biomass has been carried out in a fixed reactor. Pyrolysis of neem wood bark (NB), low density polyethylene (LDPE) and their blends at different ratios is performed in order to evaluate the product distribution. The effects of reaction temperature, NB-to-LDPE blend ratio on product distribution and chemical compositions of bio-oil are examined. The co-pyrolysis of NB and LDPE increased the yield and quality of the bio-oil. The experiments are conducted under different LDPE addition percentage such as 20%, 40%, 50%, 60% and 80%. Under the optimum experimental condition of 60% addition of LDPE and temperature of 450°C, the maximum yield of bio-oil (64.8 wt%) and hydrocarbon (75.2%) are achieved with the lowest yield of oxygenated compounds. The calorific value of the co-pyrolytic oil is found to be higher than that of NB pyrolytic oil. The relation between NB and LDPE during co-pyrolysis has been validated by GC–MS analysis, which shows in decrease of oxygenated compounds.
Normalization Strategy for Selection of Reference Genes for RT-qPCR Analysis in Left Ventricles of Failing Human Hearts
Authors: Červenák Zdenko , Červenák Filip , Adamičková Adriana , Šalingová Barbara , Gažová Andrea , Kyselovič Ján
Published: September 2021

Introduction: Quantitative RT-PCR is a valuable tool for assessing the gene expression in different human tissues, particularly due to its exceptional sensitivity, accuracy and reliability. However, the choice of adequate control for normalization is a crucial step, greatly affecting the results of all subsequent analyses. So far, only a few studies were focused on the selection of optimal reference genes in left ventricles of failing human hearts, leading to several disparities in experimental results focused on differential gene expression in this area. Therefore, the main objective of this study was to identify a set of suitable reference genes in normal and failing left ventricle tissues, which could increase the reliability of RT-qPCR-based studies in the future. Methods: We analyzed the expression of 15 commonly used housekeeping genes (ACTB, B2M, GAPDH, GUSB, HMBS, HPRT1, IPO8, PGK1, POLR2A, PPIA, RPLP0, TBP, TFRC, UBC and YWHAZ) in left ventricles of normal and failed hearts with two-step approach. In the first step, we excluded genes which are variantly expressed using ANOVA-based statistical method. Afterwards, the remaining genes were analyzed using geNorm, NormFinder and BestKeeper algorithms, together with comparative delta Cq method. Finally, the geometric mean of gene rankings across all five methods was calculated.Results: Our analysis identified IPO8, PGK1 and POLR2A as the most stably expressed genes, whereas ACB2 and B2M were found to be expressed variantly, suggesting a potential role of these genes in the pathophysiological processes in failing human hearts.Discussion/Conclusion: Using our two-step approach, we identified and validated three reference genes expressed invariantly in left ventricles of both healthy and failing human hearts, as well as provided a guideline for the selection of reference genes in studies comparing gene expression in these types of tissues.
Co-Designing a Behavioural Intervention for Reducing the Impact of Chemotherapy-Induced Peripheral Neuropathy Symptoms: An Evidence- and Theory-Driven Approach
Authors: Tanay Mary Anne Lagmay , Armes Jo , Oakley Catherine , Bryson Liz , Johnston Robin , Moss-Morris Rona , Rafferty Anne Marie , Roca Jose , Sage Lesley , Tanner Deb , Urwin Lauren , Wyatt Toni , Robert Glenn
Published: September 2021

PurposeThe processes and mechanisms of action which explain how behavioural interventions for chemotherapy-induced peripheral neuropathy (CIPN) work or not are unclear. We describe a co-design process for developing an evidence and theory-based behavioural intervention to reduce the impact of CIPN symptoms on patients’ quality of life.Methods Guided by the Medical Research Council Framework for developing and evaluating complex interventions, our process of intervention development was informed by: (a) findings of systematic reviews, (b) inductive analysis of thirty-nine hours of observational fieldwork, twelve patient and eleven clinician interviews, (c) deductive analysis using the Common-Sense Self-Regulation Model and (d) fifteen patients and twenty clinicians being actively involved as co-designers. ResultsCIPN perception and coping behaviours (including, for example, self-monitoring of symptoms and engaging in self-management and safety strategies to reduce impact of CIPN symptoms) were highlighted as processes to target when co-designing an intervention. To address these behaviours, a psychoeducational approach was deemed suitable. Four behavioural change techniques informed the co-design of the intervention: (a) information about health consequences, (b) salience of consequences, (c) instruction on how to perform a behaviour and (d) action planning.ConclusionCurrent behavioural interventions for CIPN have rarely involved stakeholders, e.g. patients and clinicians, in their development process. We developed a logic model for documenting the proposed mechanism of action of our co-designed intervention for reducing impact of CIPN symptoms. This model will be refined and tested in a subsequent process evaluation as part of a feasibility trial of the intervention.
Deep Whole Genome Sequencing Identifies Recurrent Genomic Alterations in Commonly-Used Breast Cancer Cell Lines and Patient Derived Xenograft Models
Authors: Deng Niantao , Minoche Andre , Harvey Kate , Li Meng , Winkler Juliane , Goga Andrei , Swarbrick Alex
Published: September 2021

Background: Breast cancer cell lines (BCCLs) and patient-derived xenografts (PDX) are the most frequently used models in breast cancer research. Despite their widespread usage, genome sequencing of these models is incomplete, with previous studies only focusing on targeted gene panels, whole exome or shallow whole genome sequencing. Deep whole genome sequencing is the most sensitive and accurate method to detect single nucleotide variants and indels, gene copy number and structural events such as gene fusions.Results: Here we describe deep whole genome sequencing (WGS) of commonly used BCCL and PDX models using the Illumina X10 platform with an average ~ 60x coverage. We identify novel genomic alterations, including point mutations and genomic rearrangements at base-pair resolution, compared to previously available sequencing data. Through integrative analysis with publicly available functional screening data, we annotate new genomic features likely to be of biological significance. CSMD1, previously identified as a tumor suppressor gene in various cancer types, including head and neck, lung and breast cancers, has been identified with deletion in 50% of our PDX models, suggesting an important role in aggressive breast cancers. Conclusions: Our WGS data provides a comprehensive genome sequencing resource of these models.
External Cephalic Version Success Rate and Associated Factors: Experience from a Tertiary Center in Sub-Saharan Africa: A Cross-sectional Study
Authors: Fessehaye Abraham , Gudu Wondimu , Urgie Tadesse , Masresha Gebeyehu
Published: September 2021

Background: External cephalic version (ECV), which is now routinely offered in developed countries, is not a popular procedure in the developing regions, such as Sub-Saharan Africa (9). There is also scarce data on success rate of ECV from this developing region of Africa. The aim of this study was to determine the success rate of ECV and it’s associated factors in an Ethiopian setting.Methods: A total of 152 ECVs performed at the St. Paul’s Hospital Millennium Medical College, Addis Ababa, Ethiopia from June 1, 2018 up to March 30, 2019 were analyzed, using a cross-sectional study design. Patients with breech presentation were recruited at 36 weeks of gestation or more during antenatal consultations and ECV procedures were provided by Maternal-Fetal-Medicine (MFM) specialist or MFM fellow at Ultrasound room. Data was analyzed using SPSS version 21. Chi-square test of association was done for categorical data analysis. Multivariate logistic regression analysis was used to determine predictors of success of ECV. Odds ratio, 95% CI, and P-value were used to describe findings’ significanceResults: The success rate of ECV was 71.7%. Multiparous women had a 1.4-times higher probability of success than nulliparous women (95% CI, 0.07-2.35); thin abdominal wall had 3.5 fold increased success rate ( 95% CI, 0.29-42.40) ; unengaged breech had a 1.1 higher probably of success than engaged(95% CI, 0.26-4.74); a posterior placental location increased the success rate by 1.14 times compared with an anterior placenta (95% CI, 1.03–2.60); the odds of successful ECV was 14.68((95% CI, 1.65–34.97) when cases experienced no pain during the procedure ; and tense uterine tone was associated a lower success rate as compared to soft tone (AOR= 0.08 ,95% CI, 0.016—0.39). Eighty-four percent of those mothers who had successful ECV had spontaneous vertex vaginal delivery.Conclusion: The success rate of ECV in this study is found to be 71.7%, which is higher than reports from previous studies. Multiparty, absence of pain during procedure, posterior placenta, unengaged breech, soft uterine tone, and thin abdominal wall were significantly associated with ECV success.Précis: The success rate of ECV in this study is found to be 71.7%, which is higher than reports from previous studies.
Identification of the Pyroptosis-related Signature for Predicting Prognosis in Cervical Cancer
Authors: Zhou Cankun , Li Chaomei , Zheng Yuhua , Liu Xiaochun
Published: September 2021

Background: Cervical cancer (CC) is one of the most common malignancies in gynecology. There is still a lack of specific biomarkers for the diagnosis and prognosis of CC. Pyroptosis is one of the methods of programmed cell death, and its various components are related to the occurrence, invasion, and metastasis of tumors. However, the role of pyroptosis in CC has not yet been elucidated.Methods: This study focuses on the development of a prognostic signature associated with pyroptosis for CC patients using integrated bioinformatics to elucidate the relationship between the signature and the tumor microenvironment and immune response.Results: We identified a prognostic signature based on eight pyroptosis-related genes (PRGs), with better prognostic survival in the low-risk group (P<0.05) and AUC values greater than 0.7. The results of the multi-factor Cox regression analysis indicated that the signature could be used as an independent prognostic factor, and both the DCA and the Nomogram suggested that the prognostic signature had good predictive power. Interestingly, this prognostic signature can also be applied to multiple tumors. In addition, the tumor microenvironment and immune infiltration status were significantly different between high and low-risk groups (P<0. 05). The core gene GZMB was screened and the CC-associated GZMB/ miR-378a/TRIM52-AS1 regulatory axis was constructed.Conclusion: The study successfully established the prognostic signature based on eight PRGs and reflected their tumor microenvironment and immune infiltration. The GZMB/ miR-378a/TRIM52-AS1 regulatory axis may play an important regulatory role in the development of CC, and further experimental studies are needed to validate these results subsequently.
Gamified Medical Terminology Learning Through Chatbot-Based Crossword Puzzles: the Termbot
Authors: Hsu Mei-Hua , Yu Chi-Shun
Published: September 2021

Background: Medical terminology is usually difficult for students to memorize such long and unfamiliar sound words. It really makes challenging for healthcare students. Ordinarily, there’re a variety of ways to learn medical terminology such as memorizing root words or making flashcards. However, students often get half the results with double the effort. Methods: In order to help students learn medical terminology more easily and interestingly, an online chatbot, Termbot, has been produced in this research that aims to provide learners with an interesting method to enhance their medical terminology by using Termbot on the online platform ©LINE at any time. Compared to traditional independent learning with online interactive learning, the Termbot is a great tool for students in memorizing English medical terminology by playing the Termbot online crossword puzzles. In this study, the experimental method is used to check whether Termbot affects students’ academic performance in learning medical terminology. Also, the experimental samples are divided into the experimental group and the control group. As the name implies, the experimental group is the group that accepts experimental operations, while the control group does not accept any experimental operations so that the researcher could compare the differences between the two groups to show the results of the experimental operations.Results: The interaction between students and Termbot via Line, students can use the online crossword puzzles provided by Termbot to help improve their learning of medical terminology. The experimental result in this study has shown that students trained with Termbot have made significant progress in learning such long medical term words. In addition, the result has also shown that the online Termbot has the potential to improve the learning process and learning outcomes.Conclusions: As students change their learning behaviors, the use of Termbot has improved their learning effectiveness, which clearly proves that it is a very useful learning tool. Without a doubt, Termbot is not only a great help for students’ learning medical terminology but can also be used to assist word learning in other fields.Trial registration: Not applicable.
A Large Sample Epidemiological Survey of Severe Mental Disorders: Current Status and Prospects
Authors: Fuhao Zheng , Lin Yawen , Wei Qingfei , Zeng Zhaonan , Xiong Duanhua , Wu Siying
Published: September 2021

Objective: To investigate the prevalence, distribution characteristics, medication status, and management status of patients with severe mental disorders (SMD) in Fuzhou. The medication status and management status were compared between patients in urban and non-urban areas to provide scientific evidence for improving SMD prevention, control, and treatment in primary health care institutions. Methods: Data (case types, demographic data, distribution data, medication status, and management status, etc.) of 30,362 SMD patients in 12 districts, counties, and prefectures in the urban and non-urban areas of Fuzhou City were collected From March 2018 to September 2018. Three distributions were used to describe the epidemiological characteristics of SMD. Linear trend chi-square test was used to illustrate the relationship between the prevalence of SMD and monthly changes. χ2 test method was used to compare the severity in urban and non-urban areas (qualitative data of SMD patients). Results: A total of 30,362 registered SMD patients were identified in Fuzhou City (prevalence rate, 4.17‰), of which schizophrenia accounted for the highest number (26204, 86.31%), and paranoid psychosis had the least number (47, 0.15%). Moreover, most SMD patients were aged 18 (inclusive)-44 years old (45.38%). Most patients were farmers (30.23%), had a primary school and below education level (54.17%), were poor, with most below the poverty line standard (55.35%). The time-point prevalence of SMD was highest in Minqing County (5.29‰) and lowest in Mawei District (3.80‰). The prevalence rates of SMD were significantly different among various regions in Fuzhou (P<0.05). There was a linear trend between the month and SMD prevalence, with a statistically significant difference (P<0.05). A total of 22,989 (75.72%) of the patients were taking medications, and only 17,509 (57.67%) were taking medications regularly. Moreover, the rate of taking medications and regular-taking rates were higher in urban areas than in non-urban areas (P＜0.05). A total of 3065 patients were under management (10.09%). The management rate was higher in the urban areas than in the non-urban areas (P<0.05). Conclusion: Schizophrenia needs comprehensive prevention and control in Fuzhou. The management of severe mental disorders should focus on poor groups with low educational backgrounds. Drug usage and management are better in urban areas than in non-urban areas, and thus management should be enhanced in non-urban areas. The medication management and case management of patients with severe mental disorders in Fuzhou need further improvements.
Prompting With Checklist for Early Recognition and Treatment of Acute Illness On The Prevention of Acute Kidney Injury in Patients With Septic Shock
Authors: Wang Jingjing , Li Jing , Wang Yongqiang , Dou Lin , Gao Hongmei
Published: September 2021

Background: Early identification of septic patients at high risk for acute kidney injury (AKI), followed by timely and appropriate interventions, is crucial for improving patients’ outcomes. Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is a tool for evaluating and treating acute illness promptly based on best practices. We hypothesized that the use of CERTAIN would prevent the occurrence of AKI after septic shock. Methods: This was a before-and-after study. CERTAIN, included the care bundles recommended in the Sepsis 3.0 and Kidney Disease: Improving Global Outcomes (KDIGO) 2012 guidelines, used in daily practice to manage patients with septic shock. The primary outcome was the incidence of AKI within 72 hours in patients with septic shock. Secondary outcomes were mortality and major adverse kidney events (MAKEs) at 90 days after exposure to AKI. Results: 124 patients had been treated with CERTAIN, and 112 patients were in the Pre-CERTAIN group. AKI reduced significantly in the Post-CERTAIN group compared to the Pre-CERTAIN group within 72h after enrollment (55.7% vs 68.8%, P=0.045). CERTAIN prolonged ventilator-free days and vasoactive agents free days at 28 days (22 vs 17, P<0.001; 23 vs 19, P=0.044; respectively). The mortality and MAKEs at 90 days were reduced in the Post-CERTAIN group compared to the Pre-CERTAIN group (17.7% vs 29.5%, P=0.045; 41.9% vs 56.3%, P=0.039; respectively). Conclusions: Implementation of CERTAIN reduced the AKI frequency, mortality at 90 days, and the rate of MAKEs at 90 days in septic shock patients. Trial registration: NCT01973829. Date of registration: 1st November 2013.