bluuebunny/crossref_metadata_2025 huggingface dataset:
Differences in Pore-forming Efficiency among Organic Macerals and Its Restriction against Reservoir Quality: A Case Study Based on the Marine Shale Reservoir in the Longmaxi Formation, Southern Sichuan Basin, China
Authors: Jia Yunqian , Han Denglin , Zhang Jizhen , Wang Chenchen , Lin Wei , Ren Xiaohai , Yang Chengye , Chang Licheng
Published: September 2021

Organic matter pores are of important significance in the shale formation system rich of organic matters. Although a lot of studies have discussed controlling factors of organic matter pores in the past, it still lacks a quantitative analysis on contributions of organic macerals to organic matter pores. In this study, a case study based on the overmature marine facies shale reservoir in the first submember of the Longmaxi Formation of Silurian in the Weiyuan area was carried out. Besides, qualitative and quantitative identifications of organic macerals and their pore development capacity were provided using the scanning electron microscopy (SEM). The results showed that (1) pore-forming efficiency is one controlling factor over pore development of organic matter. Sapropelinite shows the highest pore-forming efficiency (avg. 38.5%) and while the vitrinite, inertinite, and exinite have the lower pore-forming efficiency. (2) The content of sapropelinite is the highest (avg. 82.4%), and the content of sapropelinite is higher in the Long111 and Long113 layers. (3) The content of sapropelinite has a strong positive correlation with the organic surface porosity. (4) Organic surface porosity, organic porosity, and total porosity present basically consistent variations along the vertical direction of single well. Organic surface porosity restricts the organic porosity which is the dominant type in total porosity. Hence, pore-forming efficiency of organic macerals restricts performances of the reservoir.
Virtual Multiphase Flowmetering Using Adaptive Neuro-Fuzzy Inference System (ANFIS): A Case Study of Hai Thach-Moc Tinh Field, Offshore Vietnam
Authors: Trung Tran Ngoc , Truong Trieu Hung , Tung Tran Vu , Hai Ngo Huu , Khoa Dao Quang , Tinh Nguyen Thanh , Son Hoang Ky
Published: September 2021

For any oil and gas company, well-testing and performance-monitoring programs are expensive because of the cost of equipment and personnel. In addition, it may not be possible to obtain all of the necessary data for a reservoir for a period of time because of production demand constraints or changes in surface process conditions. To overcome these challenges, there are many studies on the implementation and value of virtual flowmetering (VFM) for real-time well performance prediction without any need for a comprehensive well-testing program.

This paper presents the VFM model using an adaptive neuro-fuzzy inference system (ANFIS) at Hai Thach-Moc Tinh (HT-MT) gas-condensate field, offshore Vietnam. The ANFIS prediction model can tune all its membership functions (MFs) and consequent parameters to formulate the given inputs to the desired output with minimum error. In addition, ANFIS is a successful technique used to process large amounts of complex time series data and multiple nonlinear inputs-outputs (Salleh et al. 2017), thereby enhancing predictability. The authors have built ANFIS models combined with large data sets, data smoothing, and k-fold cross-validation methods based on the actual historical surface parameters such as choke valve opening, surface pressure, temperature, the inlet pressure of the gas processing system, etc. The prediction results indicate that the local regression “loess” data smoothing method reduces the processing time and gives both clustering algorithms the best results among the different data preprocessing techniques [highest value of R and lowest value of mean squared error (MSE), error mean, and error standard deviation]. The k-fold cross-validation technique demonstrates the capability to avoid the overfitting phenomenon and enhance prediction accuracy for the ANFIS subtractive clustering model. The fuzzy C-mean (FCM) model in the present study can predict the gas condensate production with the smallest root MSE (RMSE) of 0.0645 and 0.0733; the highest coefficient of determination (R2) of 0.9482 and 0.9337; and the highest variance account of 0.9482 and 0.9334 for training and testing data, respectively. Applied at the HT-MT field, the model allows the rate estimation of the gas and condensate production and facilitates the virtual flowmeter workflow using the ANFIS model.
Online Practical Assessment (Opra) in Biochemistry Designed on Bloom’s Taxonomy to Assess the Student’s Competency: Prior Exposure of the Students to Online Tools Beneficial
Authors: Kempegowda Swetha Nagarahalli , Ramachandra Shobha Chikkavaddaragudi , Arun Brunda , Devaraju Abhijith , Shivashankar Kusuma Kasapura , Raghunathachar Sahana Kabbathy , Nagaraj Shruthi , Bettadapura Anjalidevi Shankarrao , Puttalingaiah Sujatha , Devegowda Devananda , Vishwanath Prashant , Nataraj Suma Maduvanahalli , Prashant Akila
Published: September 2021

Background: Online assessments are the need of the hour during the prevailing pandemic situation to continue the educational activities and at the same time ensuring the safety of the students and faculty. All Higher Educational Institutions must take the necessary steps to design an effective assessment model to assess the various levels of student competency. Here, we analyzed the responses of the students after the conduct of the online practical assessment (OPrA) in Biochemistry.Methods: The blueprint of the OPrA was prepared by the faculty referring to the various levels and domains of Bloom’s taxonomy. Four components were chosen for the online assessment: digital spotters, enumerating the steps of objective structured practical examination, interpretation of quantitative estimation, and case discussion. Detailed instruction was provided to the students and the breakout room option in the Zoom platform was chosen for assessment. About 12-13 students were assessed by each faculty in separate breakout rooms over 15-20 minutes on all four components. Feedback on the conduct of the examination was collected from the students and faculty anonymously and analyzed. Results: Among 200 students who submitted their responses, 20% of them had previous experience of attending the OPrA. They differed in their opinion from the rest of the students on five aspects; time allotted for the assessment (P-value=0.02, χ2=5.07), students using unfair means during the online viva (P-value=0.02, χ2=5.57), their computing skills (P-value=0.001, χ2=19.82), their performance (P-value=0.001, χ2=8.84), and overall conduct of the examination (P-value=0.001, χ2=15.55). Conclusion: OPrA tools may be designed referring to Bloom’s taxonomy and prior exposure to the online tools may be beneficial for the students.
WITHDRAWN: High-throughput Analysis of CircRNA in Cows with Naturally Infected Staphylococcus aureus Mammary Gland
Authors: Bai Zhixian , Cai Weidong , Zhang Xinjiang , Zheng Yuanyuan , Hui Taiyu , Yue Chang , Sun Jiaming , Wang Yanru , Wang Zeying
Published: September 2021

Circular RNAs (CircRNA) is a special type of non-coding RNA molecule with a closed ring structure and is not affected by RNA exonucases. It has stable expression and is not easy to degrade, and exists in most eukaryotes. However, circRNA regulation of cow mastitis has not been widely recognized. Mammary epithelial tissues were collected from healthy Holstein cows (HCN) and mastitis Holstein cows (HCU). RNA sequencing (RNA SEQ) was performed for the differentially expressed circRNAs, and analysis results showed that 19 differentially expressed circRNAs were identified in HCN and HCU, among which 6 circRNAs were up-regulated and 13 circRNAs were down-regulated. We randomly selected 9 circRNAs for Q-PCR verification, and the results showed consistent expression. Three circRNAs: circRNA2860, circRNA5323 and circRNA4027 were confirmed to be significantly differentially expressed circRNAs in cow mastitis. Furthermore, RNA polymerase transcription factor binding and tight junction are most enriched in GO and KEGG pathways, respectively. In addition, the regulatory network of circRNA-miRNA has been inferred from a bioinformatics perspective, which may help to understand the underlying molecular mechanism of circRNAs involved in regulating mastitis in cows.
Identification of a Novel EXT Mutation in A Kindred With Hereditary Multiple Exostoses Using Whole-Exome Sequencing and Overview of Mutation Spectrum
Authors: deng yanhan , liu yujian , tu wei , yang liu
Published: September 2021

Background: Hereditary Multiple Osteochondromas(HMO) is a rare genetic musculoskeletal disorder characterized by multiple osteochondromas that form near to the growth plates of many bones. Loss-of-function mutations in EXT1 or EXT2 that encode glycosyltrasferases are the causal mutations for most HMO patients.Methods: After collecting the family history and clinical information, we used Whole-Exome Sequencing to find the pathogenic mutations in one Chinese Hereditary Multiple Exostoses pedigree. Sanger sequencing and relevant online databases were used to validate the screened variants. Lollipop plots were drew to map the reported mutations from online databases (Multiple Osteochondroma Mutation Database and clinvar)on a linear protein domains by MutationMapper.Results: A novel heterozygous splicing-site mutation in gene EXT1 (NM_000127:exon5:c.1417+1G>C，chr8:118834703) was found in this pedigree and mutation spectrum of genes EXT1 and EXT2 were demonstrated.Conclusions: Our results help this pedigree to identify the pathogenic variant and guide the prenatal diagnosis, also expand the mutation spectrum in Hereditary Multiple Osteochondromas.
Parenting Stress in the Early Years – A Survey of the Impact of Breastfeeding and Social Support for Women in Finland and the UK
Authors: Swanson Vivien , Hannula Leena
Published: September 2021

BackgroundBeing a new parent can be both joyful and stressful. Parenting stress is associated with poorer health and well-being for parents and infant, and increased psychological distress.For new mothers, physical and hormonal changes, expectations of mothering and demands of a new baby may cause additional stress. Breastfeeding is promoted as optimal for maternal and infant health, but can have both positive and negative psychological impacts. Formal and informal social support can offset parenting and breastfeeding stress. Source, content and context of support for new parents are important considerations. This study compares two countries with different parenting and breastfeeding contexts, Finland (more supportive) and the UK (less supportive), investigating the role of breastfeeding stress, self-efficacy and social support as predictors of stress and role strain for new mothers..MethodsA cross-sectional online survey was completed by 1550 breastfeeding mothers of infants up to 2 years old, recruited via social media platforms in Finland and the UK. Predictors of parenting stress and strain, including demograpic factors, childbirth experiences, breastfeeding and social support were investigated. Results We found fewer differences between countries than expected, perhaps due to demographic and contextual differences. Women in Finland reported better childbirth experiences, more positive breastfeeding attitudes, and more self-efficacy than in the UK. Levels of parenting stress were similar in both countries. Women in the UK reported more parental role strain, but fewer breastfeeding stressors. Participants accessed more informal than formal supports, including their partner for parenting, and facebook groups and family for breastfeeding. Analysis suggested breastfeeding stress and social support had significant direct effects – respectively increasing and reducing parenting stress and role strain, but no moderating effects of social supportsuggesting support did not change the relationship between breastfeeding and parenting stress. ConclusionsResults have important implications for the provision of breastfeeding and parenting support for new mothers.Simple interventions to manage stress for mothers in the postnatal period could be beneficial and are easily delivered by supporters. As shown elsewhere, socio-economic and cultural factors are crucial influences on parenting experiences.
Whether Start Time of Elective Lung Surgery Impacts Perioperative Outcomes and Cost?
Authors: A-Lai Gu-Ha , Hu Jian-Rong , Xu Zhi-Jie , Yao Peng , Zhong Xia , Wang Yu-Cheng , Lin Yi-Dan
Published: September 2021

BackgroundFatigue and long work hours of surgeons attracts increasing concerns in recent years. In clinical practice, most patients prefer to receiving surgery in the morning. So, we aimed to explore whether starting time is associated with perioperative outcomes and hospital cost for elective lung surgery. MethodsA retrospective study was conducted on elective lung surgery patients between September 2019-November 2019. Patients were divided into “early start group” if surgery started before 4pm while “late start group” was after 4pm. Perioperative outcomes and total hospital costs were compared between two groups. Besides, multivariable logistic regression analysis was performed for further analysis.ResultsA total of 398 patients were finally enrolled for analysis in this study. Of all the cases, 295 patients were divided into early start group while 103 patients belonged to late start group. There were no differences in postoperative hospital duration, operation time, complication incidence and total hospital cost. In multivariable logistic regression analysis, surgery start late was still found not to be a risk factor.ConclusionIn elective lung surgery, perioperative outcomes and cost were all similar between early start and late start surgery, it was not necessary to worry about surgery order for these patients.
Exercise Regulates Peripheral Blood Serotonin to Improve the Addiction and Impulse of Methamphetamine Withdrawal Patients
Authors: Tang Wanke , Zheng Lan
Published: September 2021

Background: This study aimed to explore the effect of aerobic combined with resistance exercise on the level of 5-HT in the peripheral blood of methamphetamine (METH) withdrawal patients, improving cue-induced craving and impulse. Methods： Fifty methamphetamine withdrawal patients were included. The patients underwent eight weeks of aerobic combined with resistance exercise. The sessions lasted an hour and were conducted five times a week. Impulsivity (BIS-11), craving (VAS craving), and control (VAS control) were assessed before and after the intervention. ELISA was used to detect peripheral blood 5-HT levels. Results： The results showed that peripheral blood 5-HT and VAS control significantly increased after the exercise. In contrast, VAS craving and BIS-11 significantly decreased after the exercise. Conclusions： We present that eight weeks of aerobic combined with resistance exercise can alter the peripheral blood 5-HT levels of METH withdrawal patients and improve the cue-induced craving and impulse levels.
Greenhouse Gas Emission Widens Income Inequality in Africa
Authors: Ashenafi Biruk Birhanu
Published: September 2021

Over the past couple of decades, we have witnessed a rise in greenhouse gas emissions and widening income inequality that threaten human well-being. Addressing these challenges and ensuring sustainable economic growth becomes a pressing issue for the development policy agendas across Africa. This paper offers an answer for the impact of greenhouse gas emissions on income inequality by taking the most vulnerable region. In doing so, a panel data set from 1981–2015 across 49 countries are used and applied a panel data fixed effect regression and instrumental variable method (IV). We establish s causal relationship and show that greenhouse gas emission widens income inequality. We further cemented our baseline finding using alternative emission indicators typical to the Agrarian society. Our findings shed light on alternative development policy choices to the African continent where the traditional policy prescription does not fit the current dynamics in demography, urbanization, and agricultural practices. Hence, we emphasize the Agriculture Development Lead Industrialization (ADLI) policy that places high importance on transforming the livelihood of the people engaged in agriculture. The approach has proven to unlock the trinity challenge posed by environmental degradation, income inequality, and stagnant economic growth. Indeed, industrialization can be realized through transforming agriculture first. Adding value to agriculture reduces emission, redistributes income, and eventually maintains steady per capita income growth in Africa.
Association Between Backfat Thickness at 28 Weeks Old and Production Traits of Primiparous Landrace Sows Raised Under Tropical Conditions
Authors: Thiengpimol Praew , Koonawootrittriron Skorn , Suwanasopee Thanathip
Published: September 2021

Backfat thickness could reflex energy reserve of the female pigs that is required for their productivity, especially gilts that might be selected for the replacements. Therefore, phenotypic and genetic correlations between backfat thickness (BF) and production traits were estimated and considered for the possibility of using BF at pre-selective stage as an early indicator for productivity of the sow. Pedigree information, BF and body weight (BW) at 28 weeks old, age at first farrowing (AFF), transformed proportion of piglet loss at birth (tPL) and transformed weaning to first service interval (tWSI) of 806 primiparous Landrace sows were used to estimate the variance components by restricted maximum likelihood procedure with an average information algorithm for multivariate analysis. Genetic correlation between BF and BW was 0.70 ± 0.13. Both BF and BW had negative genetic correlation with AFF, but not tWSI. Unfortunately, genetic correlation estimates between tPL and other traits was unclear due to high standard error. The genetic correlation between AFF and tWSI was 0.78 ± 0.36. Besides 19.35% of sires, 26.34% of dams and 25.81% of sows had genetic ability for BF, BW, AFF and WSI above the population means. The genetic association between BF, BW, AFF and tWSI indicated the feasibility of using selection index to improve BF and BW at pre-selective stage and reduce AFF and tWSI of replacement gilt simultaneously. However, the estimation of genetic correlation between PL and other traits should be repeated in a larger population.
Mapping of QTL Associated With Heat Tolerance At The Reproductive Stage In Rice(Oryza Sativa L.)
Authors: Jin Liu , Ma Xiaoding , Zhou Huiying , Li Shuhui , Cui Di , Hu Jiaxiao , Han Bing , Li Maomao , Han Longzhi
Published: September 2021

Climate change has a negative effect on rice production and food security. High temperature stress is a major obstacle and can significantly reduce yield. A set of recombinant inbred lines (RILs) derived from the cross between Longdao5 (heat-sensitive) and Zhongyouzao8 (heat-tolerant) was used in the identification of heat tolerant QTL. Spikelet fertility (SF) and heat tolerance (HT) indexes showed a significant difference among the parents and RILs population, and SF and HT have different of effect under natural and artificial high temperature conditions. Sixty-one QTLs were detected on chromosomes 1-8, 10 and 12, while 25, 27 and 14 additive QTLs were identified under the control, natural and artificial high temperature conditions, respectively. Pleiotropic effects and QTL hotspots are the key factors affecting these traits, three key major QTL clusters qHTSF1, qHTSF4, and qHTSF12 can be stably expressed. In addition, epistatic effect is an important component in the regulation of heat tolerance. A total of 17 pairs of epistatic interaction loci were detected, and these additive QTL clusters have a significant epistatic effect. Bulk segregant analysis (BSA) method was proved to be a convenient method to detect major QTLs. Three QTLs, namely qSF1, qSF2 and qSF12 were detected under high temperature environment, and there is a highly significant correlation among these addictive QTLs. These results will lay the foundation for the further fine mapping of these major QTLs and enrich the molecular marker-assisted selection of heat-tolerant gene resources in rice breeding.
Semi-Prone Thoracoscopic Esophagectomy for Esophageal Carcinoma with Aberrant Right Subclavian Artery and Non-Recurrent Inferior Laryngeal Nerve: A Case Report
Authors: Koyama Kazunori , Watanabe Toru , Kato Hideaki , Kawaguchi Masahiko
Published: September 2021

Background

Aberrant right subclavian artery (ARSA) accompanied by non-recurrent inferior laryngeal nerve (NRILN) is a rare anomaly. In cases of thoracic esophageal carcinoma associated with ARSA and NRILN, surgeons must take extra care not to injury these vessels and nerves. We believe semi-prone thoracoscopic esophagectomy to be a surgical approach that can safely deal with such an anomaly.
Case presentation:

A 70-year-old man complained of feelings of chest constriction. Endoscopic examination revealed an esophageal tumor and computed tomography showed an ARSA. we performed semi-prone thoracoscopic esophagectomy for case with ARSA and NRILN. We identified these anomalies during esophagectomy, and we could complete surgery without injury these vessels and nerves. The patient had an uneventful recovery and discharged 22 days after surgery.
Conclusions

Semi-prone thoracoscopic esophagectomy for esophageal carcinoma can be performed safely with a wide operative field, and is an excellent procedure for dissecting esophageal carcinoma in patients with ARSA and NRILN.
Spectacle Lenses With Slightly Aspherical Lenslets for Myopia Control: Clinical Trial Design and Baseline Data
Authors: Chen Junhong , Zhuo Ran , Chen Jiayan , Yang Adeline , Lim Ee Woon , Bao Jinhua , Drobe Björn , Spiegel Daniel P. , Chen Hao , Hou Lijie
Published: September 2021

Objectives: Myopia is a major public health problem and it is essential to find safe and effective means to control its progression. The study design and baseline data are presented for a one-year prospective, double-masked, cross-over, randomized clinical trial evaluating the efficacy of single vision spectacle lenses with concentric rings of slightly aspherical contiguous lenslets technology (SAL) on myopia control. Methods: One hundred 8- to 13-year old Chinese children with a refractive error of -0.75 D to -4.75 D were assigned into two groups. In Group 1, SAL then single vision lenses were each worn for 6 months, and Group 2 wore the lenses in the reversed order. Primary outcomes are axial length and spherical equivalent of cycloplegic refractive error. Secondary outcomes include corneal thickness, anterior chamber depth, lens thickness, visual acuity, and lens adaptation.Results: No significant differences in baseline parameters (cycloplegic spherical equivalent, axial length, age) were found between groups (0.49 < p < 0.94). All children adapted well to the test lenses and there was no significant difference in visual acuity between the SAL and single vision lenses (p = 0.27).Conclusions: The children in the two well balanced groups had comparable visual acuity and adapted well to the test lenses. These results imply the visual acuity can be well improved by SAL lens. Clear visual acuity provide the assurance for good compliance in this longitudinal study.
Autonomic Nervous System Dysregulation in Response To Postural Change in Patients with Pectus Excavatum in Taiwan: A Pilot Study
Authors: Hsu Yu-Ting , Cheng Yeung-Leung , Chang Yi-Wei , Lan Chou-Chin , Wu Yao-Kuang , Yang Mei-Chen
Published: September 2021

Background Pectus excavatum (PE) negatively impacts psychological function, but its effect on autonomic nervous system (ANS) function has not been investigated. We evaluated ANS function following postural changes in patients with PE.Methods The participants were 14 healthy men (control group) and 20 men with PE (study group). Psychological function was assessed using the visual analog scale for pain, Brief Symptom Rating Scale-5, and Beck Depression Inventory-II. Sleep quality was evaluated using the Pittsburgh Sleep Quality Index (PSQI). ANS regulation in response to postural change was measured in the supine position and immediately after sitting. All measurements were compared between the control and study groups at baseline and between the study groups before and after Nuss surgery.ResultsAt baseline, upon postural change, symptomatic activity increased in the control group (50.3% to 67.4%, p=0.035) but not in the study group (55.0% to 54.9%, p=0.654); parasympathetic activity decreased in the control group (49.7% to 32.6%, p=0.035) but not in the study group (45.1% to 45.1%, p=0.654); and overall ANS regulation increased in the control group (1.02 to 2.08, p=0.030) but not in the study group (1.22 to 1.22, p=0.322). In response to postural change after Nuss surgery in the study group, sympathetic activity increased (48.7% to 70.2%, p=0.005), parasympathetic activity decreased (51.3% to 29.8%, p=0.005), and overall ANS regulation increased (0.95 to 2.36, p=0.012).Conclusion ANS function in response to postural change is dysregulated in patients with PE, which improved after Nuss surgery.Trial registration: ClinicalTrials.gov, ID: NCT03346876, November 15, 2017, retrospectively registered,https://register.clinicaltrials.gov/prs/app/action/SelectProtocol?sid=S0007KGI&selectaction=Edit&uid=U0003JZU&ts=2&cx=cstxeg
A Decentralized Threshold Signature Scheme of Blockchain-Based Medical Cyber Physical Systems
Authors: Zhou Xianfei , Huang Jing , Chen Fulong , Tang Yuqing , Wang Canlin
Published: September 2021

With the rapid development of medical information, the medical cyber system is rapidly transforming, and medical information sharing faces new challenges. Blockchain technology is a revolutionary technology. It has the characteristics of tamper-proof and privacy-preserving, and has natural protection for big data systems, that can be used in medical systems. In this paper,we proposed to store medical cyber physical data in a mixed blockchain with private blockchain and consortium blockchain in order to realize the secure storage of medical cyber physical data by the tamper-resistant and sharing of blockchain technology. In the system, a threshold signature system based on blockhain is also proposed. Aiming at the situation that medical accidents are easy to occur in multidisciplinary joint consultation in the medical process, this paper proposes to use threshold signature for joint consultation. Using the security and threshold of threshold signature, treatment can be carried out when the threshold number is reached, and medical data can be uploaded to the consortium blockchain. The security analysis and performance analysis show that the scheme has advantages in safety and performance and is suitable for the medical environment to a certain extent.
Geospatial Assessment of Flood and Drought on the Chure Region of Western Nepal
Authors: Attreya Swagat , Tripathi Shankar , Sharma Puja , Adhikari Yojana
Published: September 2021

Flood troubles people of central chure region and its vicinity almost every year. Besides, the area is also becoming susceptible to the drought currently. In that perspective, it is necessary to assess the vulnerability of floods and drought in the chure region. So this research focused on the assessment of flood and drought geospatially in Butwal city which was the major city and experience flood and drought every year. This study mainly records floods, calculates drought, finds their present condition, studies their trend, and determines drought and flood vulnerable areas within Butwal. Climate data, imagery, soil data, and socioeconomic data, and other relevant information were analyzed and extracted past drought conditions through Temperature and precipitation trend analysis and SPEI model. NDVI, NDDI, NDWI were used to find drought vulnerability status, and AHP and MCDA were used to find flood vulnerability. The city faced extreme drought in 2005, 2011, 2012, and 2013. And, Flood of 1970 and 1981 are the major floods. The area was frequently affected by floods in the past but no flood has been recorded after 2017. About 43% of the area was found high to very highly vulnerable to drought and 68% of the land was found vulnerable to extremely vulnerable to flood. So geospatial vulnerability assessment can enhance the planning decision and effectiveness of activities of the preventive measures by the stakeholders.
Chinese Physicians’ Perceptions of Palliative Care Decision-making for Advanced Cancer Patients: A Qualitative Analysis at a Tertiary Hospital in Changsha, China
Authors: Hahne Jessica , Wang Xiaomin , Liu Rui , Zhong Yuqiong , Chen Xin , Liu Xing , Khoshnood Kaveh , Li Xin
Published: September 2021

Background: Little previous research has been conducted outside of major cities in China to examine how physicians currently perceive palliative care, and to identify specific goals for training as palliative care access expands. This study explored physicians’ perceptions of palliative care decision-making for advanced cancer patients in Changsha, China.Methods: We conducted semi-structured qualitative interviews with physicians (n=24) specializing in hematology or oncology at a tertiary hospital. Results: Most physicians viewed palliative care as equivalent to end-of-life care, while a minority considered it possible to integrate palliative care with active treatment. Almost all physicians maintained separate conversations about palliative care with family members and patients, communicating more directly with family members than with patients about palliative care decisions. Physicians described experiencing ethical tension between the desire of family members to protect the patient from knowing they have advanced cancer, and the patient’s “right to decide” about palliative treatment. Physicians varied overall regarding perceptions of the role they should have in palliative care decision-making.Conclusions: As palliative care access expands in China, medical training should encourage earlier integration of palliative care for advanced cancer, address ethical issues faced by physicians communicating about palliative care, and establish guidance on the role of the physician in palliative care decision-making.
Prevalence and Factors Associated with Anxiety and Depression Amongst Hospitalised COVID-19 patients in Laquintinie Hospital Douala, Cameroon
Authors: Ngasa Stewart Ndutard , Tchouda Leticia Armelle Sani , Abanda Christabel , Ngasa Neh Chang ,   Eric Wah Sanji1,   Therence Nwana Dingana1, Babila Carlson-Sama
Published: September 2021

Introduction: Studies assessing the mental health of patients with COVID-19 infection remain limited. Disasters and major emergencies, not just COVID-19, undoubtedly lead to greater incidence of mental health problems. Previous studies indicate that the novel Coronavirus disease can cause panic and stress in patients. Our literature search didn’t reveal any previous published data from Cameroon and the Central African sub-region. In order to bridge this gap, we assessed the prevalence and factors associated with depression and anxiety in COVID-19 patients.Methods: We carried out a cross-sectional study in a secondary hospital in the Littoral Region of Cameroon. We recruited hospitalised COVID-19 patients during a 4-month period. We collected data on sociodemographic characteristics. The HADS score was used to assess levels of anxiety and depression. All analysis were done using Stata 14. A P value of <0.05 was used as the cut-off for statistical significance.Results: A total number of 285 patients took part in this study with a mean age of 48.47 years. The prevalence of anxiety in COVID-19 patients was 60.35% while the prevalence of depression was 81.40%. At multivariate logistic regression male gender (OR: 1.89, P=0.04), hypoxaemia (OR: 2.20, P=0.01), presence of COVID-19 complications (OR: 1.61, P= 0.02) and current episode of depression (OR: 4.14, P<0.01) were independently associated with anxiety. Similarly, age > 35 years (OR:2.03, P= 0.02), presence of comorbidity (OR: 1.68, P= 0.01), BMI > = 30kg/m2 (OR: 1.78, P= 0.02), presence of COVID-19 complications (OR: 1.28, P= 0.01) and anxiety (OR: 4.60, P<0.001) were independently associated with depression. Conclusion: Hospitalised patients with COVID-19 experienced high levels of anxiety and depression. Treatment of hospitalised patients with COVID-19 should therefore include psychotherapy and psychiatric support.
A Comparison of Postural Responses in a Virtual and a Real Environment, a Randomised Controlled Study.
Authors: Piette Patrice , Blong Emilie Le , Gilliaux Maxime , Collet Mathilde , Cavagna Romain , Fraudet Bastien , Gallien Philippe
Published: September 2021

BackgroundImmersive virtual reality solutions are seeing increasing usage in functional rehabilitation programmes. However, there is no reference that allows us to confirm that these environments present the same characteristics and therefore the same degree of safety and training in postural responses for balance.QuestionThe aim of the study was to compare displacements from centre of gravity (distance covered and surface used) in balance tests, comparing the real situation to an identical virtual situation. Participants 70 healthy subjects aged between 18 and 65 were recruited in two centres. DesignThe study used a one-way repeated-measures design with randomisation of the order in which the two test conditions were performed. Intervention: .The first test condition was "real", taking place in a bedroom of a treatment centre apartment, and the second was virtual, with the room reproduced and seen through a HMD. For each condition, two static tests (left leg, right leg) and two dynamic tests (left and right) were performed. Each test included three attempts. Outcome measuresThe displacement from the centre of gravity was recorded on a force plate.Result69 participants completed all of the tests and were analysed. None of the tests resulted in confirmation that the virtual was equivalent to the real (Two One-Sided Tests for left static, right static, left dynamic, right dynamic; surface respectively p = 0.592, p = 0.151, p = 0.238, p = 0.503; distance respectively p = 1.00, p = 0.91, p = 0.0742, p = 1.00). Furthermore 6 tests of out 8 showed a significant and considerable difference (surface respectively p = 0.00249, p = 0.0664, p = 0.0318, p = 0.00483; distance respectively p = 1.12 x 10-8, p = 5.27 x 10-5, p = 0.153, p = 2.55 x 10-9). ConclusionPostural responses were poorer in the immersive virtual environment, both on the static and dynamic balance tests. The offer of balance rehabilitation in immersive VR raises safety issues and consequently ethical issues that are as yet unresolved. Researchers must test solutions to correct this serious problem. Trial registration: The study is registered at the US National Institutes of Health (ClinicalTrials.gov) NCT04574726
Primary Prophylaxis of Variceal Haemorrhage in Patients with Cirrhosis: An Integrated Pharmacological and Endoscopic Approach.
Authors: Pepe Veronica , Angeli Paolo , Pascoli Marco Di
Published: September 2021

Background: At the present time, in patients with liver cirrhosis and gastroesophageal varices, primary prophylaxis of variceal bleeding made with combination therapy with non-selective b-blockers (NSBBs) and endoscopic band ligation (EBL) is not recommended. The aim of this study was to evaluate if patients who develop an increased bleeding risk from varices while on NSBBs regimen benefit, in terms of bleeding and survival, from adding treatment with EBL. Methods: Patients with endoscopic finding of gastroesophageal varices with increased risk of bleeding (increased variceal size and/or development of red signs) during primary prophylaxis with NSBBs, followed at the Unit of Internal Medicine and Hepatology, University and General Hospital of Padova, Italy, from 2012 to 2019, were retrospectively evaluated. When an increased bleeding risk of the varices was confirmed, patients maintained the pharmacological therapy alone or underwent also EBL. The primary endpoint of the study was the rate of variceal bleeding, the secondary endpoint was mortality at 30 months. Results: Compared to patients treated only with NSBBs (n=56), in patients treated also with EBL (n=45), the 30‐month probability of variceal bleeding (29.1% vs 5.1%; P =0.036) was significantly reduced, while the probability of survival was similar (59.6% vs. 65.7%; P=0.61). On multivariate analysis, treatment with EBL was found to be a weak protective factor for mortality (HR 0.47, P=0.044). Conclusion: In patients with liver cirrhosis, when varices show endoscopic feature of increased haemorrhagic risk, adding EBL to NSBBs is effective in reducing the probability of first bleeding.
Low Bifurcation of The Left Common Carotid Artery Associated With Klippel–Feil Syndrome And Severe Stenosis of The Bilateral Proximal Middle Cerebral Artery
Authors: Li Yan , Lv Minli , Zhong Jianquan
Published: September 2021

BackgroundThe bifurcate position of the common carotid artery is protean. It is most often locating between the C3 and C5 vertebral levels.Intrathoracic bifurcation of common carotid artery is a rare anatomic finding,and an association with bilateral segmental severe stenosis of middle cerebral artery has not been reported in the past literature .we report a case of low bifurcation of the left common carotid artery associated with Klippel–Feil syndrome and severe stenosis of the bilateral proximal middle cerebral artery.Case PresentationA 47-years old woman presented with dizziness and sleep disturbance,whose computed tomography angiography image incidentally revealed an intrathoracic bifurcation of the left common carotid artery associated with bilateral segmental severe narrowing of middle cerebral artery（MCA）.The left transverse process and spinous process of C3-4 fused and posterior arch of atlas did not fuse on Volume rendered（VR） imaging. ConclusionWe should not only pay attention to the variation of the neck vessels, but also to the serious secondary changes of intracranial vessels caused by neck vessels variation. Low carotid bifurcation may cause chronic progressive stenosis /occlusion of the proximal MCA or severe ischemic stroke events .
Application Research of Medical Failure Mode and Effect Analysis in Controlling Packaging Quality Defects
Authors: Chen Yanhua , Hu Ruixue , Hu Juan , Pan Wei , Yi Liangying
Published: September 2021

Purpose This study explores the application effects of medical failure mode and the analysis of device packaging quality defects. Methods In this study, a total of 183,642 equipment kits were assembled in our hospital from January to June 2020. Using medical failure mode and effect analysis methods, we retrospectively analyzed and evaluated the device packaging process. Besides, we used a decision tree model to determine the strategies that need to be acted upon and formulate improvement plans. We also selected a total of 1,90,231 assembly equipment packages in our hospital from July to December 2020, implemented the improved plan for packaging quality control, and compared medical failure modes, including the incidence of equipment packaging defects before and after the application of effective analysis. Results Before implementing medical failure mode and effect analysis, 1,83,642 equipment packages were assembled, 98 defects occurred, with a defect rate of 0.053%. However, after implementing medical failure mode and effect analysis to improve the packaging process, 1,90,231 device packages were assembled, 22 defects occurred, and the defect rate was 0.012%. The results showed that the packaging quality defects of the disinfection supply center were significantly reduced (χ2=50.822, P=0.001). Conclusion Using the medical failure mode and effect analysis method to control device packaging defects can effectively reduce the rate of device packaging quality defects, ensuring patient safety.
Flow-induced Folding in Multi-scaled Bulk Forming of Flanged Parts and its Prediction and Avoidance
Authors: Zheng Jun-Yuan , Fang Jie Yi Chen , Fu Ming Wang
Published: September 2021

The quality of manufactured parts and the efficiency of forming processes are crucial in deformation-based manufacturing. In product miniaturization and micro-manufacturing, size effect induces many unknowns. Flow-induced folding related to size effect is one of them and has not yet been fully studied. In this research, the formation mechanism of folding defects in axisymmetric bulk forming was investigated, and a design-based method was employed to evaluate different tooling and process route designs for making a case-study multi-flanged part with three features and to explore the design-based avoidance of folding defects. In addition, a design evaluating framework of folding-free bulk forming was proposed, implemented and validated. Via analysis of the material flow, energy consumption, folding formation, and product precision of the four proposed forming processes for the case-study part, an upsetting-extrusion forming method via using a nested punch was found to be the most desirable. It was then implemented in the physical forming with three size scales. The results revealed that the flow-induced folding in the macropart was severe and regularly circuitous, but it is slight and irregular in meso and microscale. These findings are useful in the defect-free forming of multi-flanged structures and multi-scaled axisymmetric parts
Difficulties in Emotional Regulation, Suicidal Behaviors and Social Media Posts: A Mixed Method Study Among Young Adults Using Semiotic Analysis
Authors: Mondal Sharmistha , Reddy Jayasankara
Published: September 2021

The study is an explanatory sequential mixed method design aimed at understanding the relationship between difficulties in regulating emotions and suicidal behaviors. Furthermore, we explored their pattern of social media engagement to identify cues or indications, if any. The quantitative component consists of 100 young adults (18-30 years) sampled using convenience and snowball sampling techniques. The Difficulty in Emotion Regulation Scale (DERS) and Suicide Behaviors Questionnaire (SBQ) were administered. Spearman rank-order correlation analysis establishes a moderate positive correlation (rs (100) = .400, p < .0005) between difficulties in regulating emotions and suicidal behaviors. Furthermore, for the qualitative component, 15 participants were chosen, with five in each category of 1) difficulty regulating emotions and suicidal behaviors, 2) difficulty regulating emotions but no suicidal behaviors and 3) no difficulty regulating emotions but suicidal behaviors. Their active social media account was accessed with consent, and semiotic analysis of their posts from June 2020 to February 2021 was performed, as data collection spanned the timespan. Saussure and Pierce’s concept of semiotic analysis is adopted as the framework for the analysis. The results reveal some common and specific categories of signified in the domain of interpersonal relationships, intrapersonal relationships, coping activities, social implications, thought process/cognitions and attitudinal modifications. The connotations and myths associated with the same are also explored within the cultural framework. The results are then triangulated with the quantitative component to provide a broader understanding of the intricate links between the variables.
Bone Marrow Mesenchymal Stem Cells Transplantation Combined with Exercise Training Synergistically Promoted Functional Recovery After Spinal Cord Injury.
Authors: Sun Xin , Huang Liyi , Fu Chenying , Li Lijuan , Wang Lu , Pei Gaiqin , Wang Yang , Zhang Qing , Cheng Hongxin , He Chengqi , Wei Quan
Published: September 2021

Background: Spinal cord injury (SCI) typically results in a devastating loss of neurological function below the level of injury. Although many strategies show considerable potential for SCI treatment, the therapeutic efficacy is limited. Here, we used a mouse model of thoracic contusive SCI to investigate whether the combination of bone marrow mesenchymal stem cells (BMMSCs) transplantation and exercise training has a synergistic effect on functional restoration. Methods: BMMSCs were injected directly into the contusion epicenter immediately after SCI, and the mice started treadmill training (TMT) 3 days after SCI. Locomotor function was evaluated by the Basso Mouse Scale (BMS), horizontal ladder test, and footprint analysis. Histological examination, transmission electron microscopy observation, immunofluorescence staining and western blotting were performed 8 weeks after SCI to further explore the potential mechanism of the synergistic repair effect. Results: The combination of BMMSCs transplantation and TMT showed the best therapeutic effect on motor function recovery compared with the other treatment groups. Further investigations revealed that the combination of BMMSCs transplantation and TMT markedly reduced fibrotic scar tissue, protected neurons, promoted axon and myelin regeneration, and increased synapse formation to a larger extent than either TMT or BMMSCs transplantation alone. Additionally, the synergistic effects of BMMSCs transplantation and TMT on SCI recovery occurred via activation of the PI3K/AKT/mTOR pathway. Conclusions: These findings suggest that BMMSCs transplantation combined with exercise training represents a promising combinatorial strategy to facilitate clinically meaningful recovery after SCI.
Dye Tracing and Concentration Mapping in Coastal Waters Using Unmanned Aerial Vehicles
Authors: Johansen Kasper , Dunne Aislinn F. , Tu Yu-Hsuan , Almashharawi Samir , Jones Burton H. , McCabe Matthew F.
Published: September 2021

Coastal water flows facilitate important nutrient exchanges between mangroves, seagrasses and coral reefs. However, due to the complex nature of tidal interactions, their spatiotemporal development can be difficult to trace via traditional field instrumentations. Unmanned aerial vehicles (UAVs) serve as ideal platforms from which to capture such dynamic responses. Here, we provide a UAV-based approach for tracing coastal water flows using object-based detection of dye plume extent coupled with a regression approach for mapping dye concentration. From hovering UAV images and nine subsequent flight surveys covering the duration of an ebbing tide in the Red Sea, our results show that dye plume extent can be mapped with low omission and commission errors when assessed against manual delineations. Our results also demonstrated that the interaction term of two UAV-derived indices may be employed to accurately map dye concentration (coefficient of determination = 0.96, root mean square error = 7.78 ppb), providing insights into vertical and horizontal transportation and dilution of materials in the water column. We showcase the capabilities of high-frequency UAV-derived data and demonstrate how field-based dye concentration measurements can be integrated with UAV data for future studies of coastal water flow dynamics.