bluuebunny/crossref_metadata_2025 huggingface dataset:
Establishment of Type 2 Diabetes Mellitus Models Using High-Fat Diet and STZ in Bama Minipigs
Authors: Zhao Yuqiong , Niu Miaomiao , Yunxiao Jia , Jifang Yuan , Lei Xiang , Xin Dai , Guisheng Wang , Chen Hua
Published: September 2021

BackgroundIn the past 20 years, the number of adults with diabetes has tripled. For most of the researches are often conducted in rodent T2DM models, and effective drugs developed have low clinical conversion efficiency. Therefore, it is urgent to establish a large animal model to explore the pathogenesis of T2DM and formulate disease prevention and control strategies. MethodsThis study was designed to establish and validate a T2DM model in minipigs with notable hyperglycemia using a high-fat diet and low-dose streptozotocin (STZ)，and examined the influence of STZ infusion time, the difference between a high-fat diet and a high-cholesterol and high-fat diet, and the atherosclerotic lesions accelerated by diabetes. Male Bama minipigs (n=24) were randomly divided into 5 groups; the control group was fed with normal diet for 9 months; STZ+HFD group and STZ+HCFD group were infused with 90 mg/kg STZ and then fed with a high-fat diet or high-cholesterol and high-fat diet for 9 months, respectively; HFD + STZ group and HCFD + STZ group were fed with a high-fat diet or high-cholesterol and high-fat diet, respectively, for nine months (after 3 months, pigs were injected with 90 mg/kg STZ intravenously). ResultsThe results showed the serum glucose concentrations were within the normal range in all groups except for HFD + STZ group and HCFD + STZ group. Animals fed with a high-fat diet for 9 months, did not develop apparent atherosclerotic lesions; nevertheless, atherosclerotic lesions were seen in animals fed with high-cholesterol and high-fat diets. Moreover, hyperglycemia accelerated atherosclerosis (lesions on the intimal surface of the abdominal aorta, 0.44±0.29 vs. 0.28±0.26) in minipigs. ConclusionsHigh-fat/high-cholesterol and high-fat diet combined with low-dose streptozotocin successfully established T2DM in minipigs. High-fat diet could not induce apparent atherosclerosis lesions but high-cholesterol and high-fat diet could during the nine months period. Hyperglycemia accelerated atherosclerosis in the minipigs.
Antimony Immobilization in Primary Explosives Contaminated Soils by Fe-Al Based Amendments
Authors: Wang Ningning , Jiang Yucong , Xia Tianxiang , Xu Feng , Zhang Chengjun , Zhang Dan , Wu Zhiyuan
Published: September 2021

The soil in primary explosives sites have been contaminated by high concentrations of antimony(Sb) and co-occurring heavy metals (Cu and Zn), but which is largely overlooked and neglected. In this study, we investigated the concentrations and species of Sb and studied the effect of Fe based, Fe-Al based sorbents combined application on the mobility of Sb and co-occurring metals. The content of Sb in soil samples was from 26.7 to 4255.0 mg/kg, occurring predominantly as Sb(V) (65.57 ~ 95.46%). In batch experiments, FeSO4 showed ideal sorption of Sb (up to 97% sorption with 10% FeSO4·7H2O), while sorption rates of 10% Fe0 and 10% goethite were 72% and 41% respectively. However, Fe-based sorbents enhanced the mobility of co-occurring Cu and Zn in varying levels, especially FeSO4·7H2O. Al(OH)3 was necessary to prevent mobilization of Cu and Zn. In this study, 5% FeSO4·7H2O and 4% Al(OH)3 mixed with soil was the optimal choice to solve this problem with stabilization effect of Sb, Zn, Cu being 94.6%、74.2% and 82.2% respectively. Column tests spiked with 5% FeSO4·7H2O and 4% Al(OH)3 showed significant retention of Sb (85.85%), Zn (83.9%), Cu (94.8%). pH regulated results indicated that acid condition was more beneficial for retention of Sb than alkaline condition. However, there was no significant difference between sets of acidification and sets without pH regulation. Overall, the experimental results showed that 5% FeSO4·7H2O + 4% Al(OH)3 without pH regulation could be effective for the stabilization of Sb and co-occurring metals in primary explosives soils.
TransMut: a program to predict HLA-I peptide binding and optimize mutated peptides for vaccine design by the Transformer-derived self-attention model
Authors: Chu Yanyi , Zhang Yan , Wang Qiankun , Zhang Lingfeng , Wang Xuhong , Wang Yanjing , Wang Jianmin , Jiang Xue , Salahub Dennis , Xiong Yi , Wei Dong-qing
Published: September 2021

Computational prediction of the interaction between human leukocyte antigen (HLA) and peptide (pHLA) can speed up epitope screening and vaccine design. Here, we develop the TransMut framework composed of TransPHLA for pHLA binding prediction and AOMP for mutated peptide optimization, which can be generalized to any binding and mutation task of biomolecules. Firstly, TransPHLA is developed by using a Transformer-derived self-attention model to predict pHLA binding, which is significantly superior to 11 previous methods on pHLA binding prediction, neoantigen and human papilloma virus vaccine identification. For vaccine design, the AOMP program is then developed to automatically optimize mutated peptides to search for mutant peptides with higher affinity to the target HLA and with high homology to the source peptide. Among 3660 non-binding pHLAs, 3630 were successfully mutated. Of these, 94% were verified by the IEDB recommended method, and 88% have homology higher than 80% to the source peptide.
A Novel Integration of Hodrick-Prescott Filter and Harmonic Analysis with Machine Learning Methods to Enhance Time Series Prediction Accuracy of Daily and Monthly Wind Speeds
Authors: Ozoegwu Chigbogu Godwin
Published: September 2021

In this work, a new hybrid algorithm for modelling time series of daily and monthly wind speed is proposed. The method utilizes Hodrick-Prescott Filter (HPF) to decompose raw wind speed data into trend and cyclic components, and harmonic analysis (HA) is thereafter used to decompose the cyclic component into the periodic and stochastic sub-components. Machine learning (ML) methods are then used to model the time series of both the trend and stochastic components. The predicted wind speeds are finally summed from the individual predictions of the ML methods and harmonic analyses. To highlight the considerably higher predictive accuracy that results from the introduced data pre-treatments with HPF and HA, the proposed hybrid algorithm is compared against the traditional ML methods that are not subjected to the pre-treatments. The proposed hybrid algorithms are highly accurate relative to the traditional ML methods reflecting much higher coefficients of determination and correlation coefficients, and much lower error indices. Artificial neural networks (ANNs), linear regression with interactions (LRI), support vector machine (SVM), rational quadratic Gaussian process regression (RQGPR), fine regression trees (FRTs) and boosted ensembles of trees (BETs) are used as the illustrative machine learning methods. To guarantee both versatility and robustness, the methods are tested on example data drawn from both temperate and tropical conditions.
Physical Benefit of Postoperative Exercise Training on Lung Cancer Patients Comorbid with COPD: A Randomized Controlled Trial
Authors: Yu Zhonghua , Xie Guosheng , He Hongchen
Published: September 2021

Background: The prognosis of lung cancer is heavily affected by the comorbidity of chronic obstructive pulmonary disease. The aim of this trial is to investigate whether postoperative exercise training can improve physical function and lung function of lung cancer patients comorbid with chronic obstructive pulmonary disease.Methods: Both groups were given standard postoperative rehabilitation for one week. After that, oxygen therapy (if needed) and nebulization were given to control group, while patients in exercise group started to participate in exercise programs on the basis of receiving oxygen therapy and nebulization as same as in control group. The exercise programs consisted of 24 training sessions. Cardiopulmonary exercise test and 6-minute walk test were used to assess the physical capacity. Data in pulmonary function test like force vital capacity and forced expiratory volume in first second were used to assess the overall lung function.Results: In both groups, the functional status and the result of pulmonary function test decreased from baseline to endpoint. But after surgery and intervention program, both the maximal oxygen consumption in Cardiopulmonary Exercise Test and walking distance in 6-Minute Walk Test in exercise group were significantly better than control group [13.09(±1.46) mL/kg/min vs 11.89(±1.38) mL/kg/min, P=0.033; 297(46) m vs 243(43) m, P=0.041]. FVC and FEV1 in exercise group were better than control group, but the differences didn’t meet statistically significant level [1.76(±0.19) L vs 1.60(±0.28) L, P=0.084; 1.01(±0.17) L vs 0.96(±0.21) L, P=0.467].Conclusions: Postoperative exercise training program can facilitate recovery of functional capacity of lung cancer patients with comorbidity of chronic obstructive pulmonary disease. Postoperative lung function appears superior in patients who participated in exercise training, only fails to reach a statistically meaningful level.Trial registration: Chinese Clinical Trial Registry, ChiCTR2100042867, Registered 13 May 2021, https://www.chictr.org.cn/index.aspx.
Identification of Novel Tumor Microenvironment-Related Long Non-coding RNAs to Predict the Prognosis for Hepatocellular Carcinoma
Authors: Huang Shenglan , Zhang Jian , Li Dan , Lai Xiaolan , Zhuang Lingling , Wu Jianbing
Published: September 2021

Introduction: Hepatocellular carcinoma (HCC) is one of the most common malignant tumors with poor prognosis. Tumor microenvironment (TME) plays a vital role in the tumor progression of HCC. Thus, we aimed to analyze the association of TME with HCC prognosis, and construct an TME-related lncRNAs signature for predicting the prognosis of HCC patients.Methods: We firstly assessed the stromal/immune /Estimate scores within the HCC microenvironment using the ESTIMATE algorithm based on TCGA database, and its associations with survival and clinicopathological parameters were also analyzed. Then, different expression lncRNAs were filtered out according to immune/stromal scores. Cox regression was performed to built an TME-related lncRNAs risk signature. Kaplan–Meier analysis was carried out to explored the prognostic values of the risk signature. Furthermore, we explored the biological functions and immune microenvironment feathers in high- and low risk groups. Lastly, we probed the association of the risk signature with the treatment responses to immune checkpoint inhibitors (ICIs) in HCC by comparing the immunophenoscore (IPS).Results: Stromal/immune /Estimate scores of HCC patients were obtained based on the ESTIMATE algorithm. The Kaplan-Meier curve analysis showed the high stromal/immune/ Estimate scores were significantly associated with better prognosis of the HCC patients. Then, six TME-related lncRNAs were screened for constructing the prognosis model. Kaplan-Meier survival curves suggested that HCC patients in high-risk group had worse prognosis than those with low-risk. ROC curve and Cox regression analyses demonstrated the signature could predict HCC survival exactly and independently. Function enrichment analysis revealed that some tumor- and immune-related pathways associated with HCC tumorigenesis and progression might be activated in high-risk group. We also discovered that some immune cells, which were beneficial to enhance immune responses towards cancer, were remarkably upregulated in low-risk group. Besides, there was closely correlation of immune checkmate inhibitors (ICIs) with the risk signature and the signature can be used to predict treatment response of ICIs.Conclusions: We analyzed the impact of the tumor microenvironment scores on the prognosis of patients with HCC. A novel TME-related prognostic risk signature was established, which may improve prognostic predictive accuracy and guide individualized immunotherapy for HCC patients.
Social Contagion in Veganville
Authors: Elliot Thomas
Published: September 2021

Meeting the 1.5°C commitment will mean the per capita emissions need to come down to 2.6 tonnes by 2030. Epidemiological contagion modelling principles are applied to transfer of trending climate conscious food choices. This research applies social contagion theory to explore “reproduction values” and “recovery rates” of vegan diets that have potential to facilitate a climate social tipping point to meet Paris Agreement targets by 2030.
Impact of Vegetation Cover Structure on Birds' Community at Tianfu National Wetland Park in Jiangsu Kunshan, China
Authors: Ajloon Fathielrahaman. H. , Xie Dong , Junxue Shao , RuiTing Zhang , Inayng Aniefiok Ini
Published: September 2021

Background: Vegetation cover has an essential role in wetland habitats in controlling avian populations throughout the world. The vegetation cover structure in grassland systems varies dramatically among seasons on the same sites. Variation in vegetation cover-abundance richness and diversity has been studied through one hundred forty-seven quadrate samples during summer and autumn, 2019, winter, and spring 2020. Avian species richness and diversity were recorded during the same period. Results: The correlation analysis results confirmed that: (1) there was no apparent seasonal difference in the abundance of vegetation cover while avian abundance was statistically different. (2) Plant abundance in summer was positively correlated with the number of avian, while in autumn it was negatively correlated. Plant and avian abundance at the genus level showed a positive correlation while maintaining a negative correlation at the species level (p < 0.05). However, during summer and autumn, a strong linear relationship exists between vegetation coverage and avian. The Shannon diversity index and Simpson diversity index have a positive linear relationship between vegetation coverage and avian families and genera. Conclusions: We conclude that vegetation coverage richness significantly impact avian communities. We suggest further research into the relationship between other biological communities and farming practices in the wetlands.
The Quality of Primary Care Performance in Private Sector Facilities in Nairobi, Kenya: A Cross-Sectional Descriptive Survey
Authors: Mohamoud Gulnaz , Mash Robert
Published: September 2021

BackgroundIntegrated health services with an emphasis on primary care are needed for effective primary health care and achievement of universal health coverage. The key elements of high quality primary care are first-contact access, continuity, comprehensiveness, coordination, and person-centredness. In Kenya, there is little information on these key elements and such information is needed to improve service delivery. This study aimed to evaluate the quality of primary care performance in a group of private sector clinics in Nairobi, Kenya.Methods A cross-sectional descriptive study adapted the Primary Care Assessment Tool for the Kenyan context and surveyed 412 systematically sampled primary care users, from 13 PC clinics. Data was analysed to measure 11 domains of primary care performance and two aggregated primary care scores using the Statistical Package for Social Sciences.Results Mean primary care score was 2.64 (SD=0.23) and the mean expanded primary care score was 2.68 (SD=0.19), implying poor overall performance. The domains of first contact-utilisation, coordination (information system), family-centredness and cultural competence had mean scores of >3.0 (acceptable to good performance). The domains of first contact (access), coordination, comprehensiveness (provided and available), ongoing care and community-orientation had mean scores of < 3.0 (poor performance). Older respondents (p=0.05) and those with higher affiliation to the clinics (p=0.01) were more likely to rate primary care as acceptable to good.Conclusion These primary care clinics in Nairobi had a poor overall performance. There was a report of acceptable-to-good performance in first-contact utilisation, the information systems, family centredness and cultural competence. However, patients rated first-contact access, ongoing care, coordination of care, comprehensiveness of services, community orientation and availability of a complete primary health care team, as poor. Performance could be improved by deploying family physicians, increasing the scope of practice to become more comprehensive, improving access after-hours and marketing the use of the clinics to the practice population.
The role of m6A RNA methylation-related lncRNAs in the prognosis and tumor immune microenvironment of papillary thyroid carcinoma
Authors: Wang WenLong , Shen Cong , Zhao Yunzhe , Sun Botao , Qiu Xiangyuan , Yin Shujuan , Li Xinying
Published: September 2021

Background: Emerging evidence has indicated that N6-methylandenosine (m6A) RNA methylation plays a critical role in cancer development. However, the function of m6A RNA methylation-related long noncoding RNAs (m6A-lncRNAs) in papillary thyroid carcinoma (PTC) has never been reported. This study aimed to investigate the role of m6A-lncRNAs in the prognosis and tumor immune microenvironment of PTC.Methods: The gene expression data of lncRNAs and 20 m6A methylation regulators with corresponding clinicopathological information download from the Cancer Genome Atlas database. Based on consensus clustering analysis, LASSO Cox regression, nivariate and multivariate Cox regression analysis were used to determine the role of m6A-lncRNA in the prognosis and tumor immune microenvironment of PTC.Results: Three subgroups (clusters 1, 2, and 3) were identified by consensus clustering of 19 prognosis-related m6A-lncRNA regulators，of which cluster 1 preferentially related with unfavorable prognosis, lower immune scores, and distinct immune infiltrate level. A risk-score model was established based on 8 prognosis-related m6A-lncRNAs. Patients with a high-risk score had a worse prognosis and the ROC indicated a reliable prediction performance for patients with PTC (AUC=0.802). As expected, the immune scores, infiltration levels of immune cells and ESTIMATE scores in the low-risk subgroups were notably higher (p < 0.001) compared with those of high-risk subgroups. Furthermore, GSEA analysis showed that tumor associated pathways, hallmarks, and biological processes were remarkably enriched in the high-risk subgroup. Further analysis indicated that the risk score and age were independent prognostic factors for PTC. An integrated nomogram was constructed that accurately predicted the survival status (AUC = 0.963). Moreover, a lncRNA–miRNA–mRNA regulated network was established based on seven prognosis-related m6A-lncRNAs. Additional, 30 clinical samples and different PTC cells were validated. Conclusions: This is the first study to reveal that m6A-lncRNAs play a vital role in the prognosis and TME of PTC. To a certain degree, m6A-lncRNAs can be considered as new, promising prognostic biomarkers and treatment targets.
Risk Stratification Model for Predicting Coronary Care Unit Readmission
Authors: Chen Tien-Yu , Tseng Chien-Hao , Wu Po-Jui , Chung Wen-Jung , Lee Chien-Ho , Wu Chia-Chen , Cheng Cheng-I
Published: September 2021

Background: Use of statistical models for assessing the clinical risk of readmission to medical and surgical intensive care units is well established. However, models for predicting risk of coronary care unit (CCU) readmission are rarely reported. Therefore, this study investigated the characteristics and outcomes of patients readmitted to CCU to identify risk factors for CCU readmission and to establish a scoring system for identifying patients at high risk for CCU readmission. Methods: Medical data were collected for 40,187 patients with a history of readmission to the CCU of a single multi‐center healthcare provider in Taiwan during 2010-2019. Characteristics and outcomes were compared between a readmission group and a non-readmission group. Data were segmented at a 9:1 ratio for model building and validation.Results: The number of patients with a CCU readmission history after transfer to a standard care ward was 2397 (5.9%). The twelve factors that had the strongest associations with CCU readmission were used to develop and validate a CCU readmission risk scoring and prediction model. When the model was used to predict CCU readmission, the receiver-operating curve characteristic was 0.7217 for risk score model group and 0.7316 for the validation group. A CCU readmission risk score was assigned to each patient. The patients were then stratified by risk score into low risk (-20-5), moderate risk (6-26) and high risk (27-33) cohorts check scores, which showed that CCU readmission risk significantly differed among the three groups.Conclusions: This study developed a model for estimating CCU readmission risk. By using the proposed model, clinicians can improve CCU patient outcomes and medical care quality.
The Integrity of Synthetic Magnesium Silicate in Charged Compounds
Authors: House Krystal , Hao Zhigang , Pan Long , O’Carroll Deirdre , xu shiyou , Liu Yuxin
Published: September 2021

Magnesium silicate is an inorganic compound which can be used as an ingredient in product formulations for many different purposes. Since its compatibility with other ingredients is critical for product quality and stability, it is essential to characterize the integrity of magnesium silicate in different solutions used for various product formulations. In this paper, we have determined the magnitude of dissociation of synthetic magnesium silicate in positive, neutral, and negative charged compounds using Scanning Electron Microscopy (SEM), Energy Dispersive X-ray Spectroscopy (EDS), and verified the results using Liquid Chromatography-High Resolution Mass Spectrometry (LC-HRMS). Negatively charged compounds were found to significantly impact magnesium silicate dissociation, resulting in physio-chemical separation between magnesium and silicate ions while the positively charged compound had a minor effect on dissociation due to ion competition, and the neutral compound did not have such an impact on magnesium silicate dissociation. Further, when the magnesium ions are dissociated from the synthetic magnesium silicate, the morphology is changed accordingly, and the structural integrity of the synthetic magnesium silicate is damaged. The results provide a scientific confidence and guidance for product development using the synthetic magnesium silicate.
Intraosseous Fluid Resuscitation Causes Systemic Fat Emboli in a Porcine Hemorrhagic Shock Model
Authors: Kristiansen Steinar , Storm Benjamin , Dahle Dalia , Josefsen Terje Domaas , Dypwik Knut , Nilsen Bent Aksel , Waage-Nielsen Erik
Published: September 2021

BackgroundIntraosseous cannulation can be life-saving when intravenous access cannot be readily achieved. However, it has been shown that the procedure may cause fat emboli to the lungs and brain. Fat embolization may cause serious respiratory failure and fat embolism syndrome. We investigated whether intraosseous fluid resuscitation in pigs in hemorrhagic shock caused pulmonary or systemic embolization to the heart, brain, or kidneys and if this was enhanced by open chest conditions.MethodsWe induced hemorrhagic shock in anesthetized pigs followed by fluid-resuscitation through bilaterally placed tibial intraosseous cannulas. A subgroup underwent median sternotomy with pericardiectomy and pleurotomy before hemorrhagic shock was induced. We used invasive hemodynamic and respiratory monitoring including Swan Ganz pulmonary artery catheter and transesophageal echocardiography and obtained biopsies from the lungs, heart, brain, and left kidney postmortem.ResultsAll pigs exposed to intraosseous infusion had pulmonary fat emboli in postmortem biopsies. Additionally, seven of twenty-one pigs had coronary fat emboli. None of the pigs with open chest had fat emboli in postmortem lung, heart, or kidney biopsies. During fluid-resuscitation, three pigs developed significant ST-elevations on ECG; all of these animals had coronary fat emboli on postmortem biopsies. ConclusionsSystemic fat embolism occurred in the form of coronary fat emboli in a third of the animals who underwent intraosseous fluid resuscitation. Open chest conditions did not increase the incidence of systemic fat embolization.
The Interaction Between Long Non-Coding RNA LINC01564 and POU2F1 Promotes the Proliferation and Metastasis of Gastric Cancer
Authors: Wang Jixu , Hou Futao , Tang Lusheng , Xiao Ke , Yang Tengfei , Wang Zhiqiang , Liu Gu
Published: September 2021

Background: An increasing number of studies have demonstrated that long non-coding RNAs (lncRNAs) serve as key regulators in tumor development and progression. However, only a few lncRNAs have been functionally characterized in gastric cancer (GC). Methods: Bioinformatics analysis was conducted to find lncRNAs that are associated with GC metastasis. RNA FISH, RIP, and RNA pull down assays were used to study the complementary binding of LINC01564 complementary to the 3’UTR of transcription factor POU2F1. The transcription activation of LINC01564 by POU2F1 as a transcription factor was examined by ChIP assay. In vitro assays such as MTT, cell invasion assay, and clonogenic assay were conducted to examined the impacts of LINC01564 and POU2F1 on GC cell proliferation and invasion. Experiments in vivo were performed to access the impacts of LINC01564 and POU2F1 on GC metastasis. Results: The results showed that LINC01564 complementary bound to the 3’UTR of POU2F1 to form an RNA duplex, whereby stabilizing POU2F1 mRNA and increasing the enrichment in cells. The level of LINC01564 was also increased by POU2F1 through transcription activation. In vitro assays showed that LINC01564 promoted the proliferation, invasion and migration of GC cells through increasing POU2F1. In vivo experiments indicate the promotion of GC proliferation and metastasis by the interaction between LINC01564 and POU2F1. Conclusion: Taken together, our results indicate that the interaction between LINC01564 and POU2F1 promotes the proliferation, migration and invasion of GC cells.
Correlation of MRI and Arthroscopic Findings With Clinical Outcome in Temporomandibular Joint Disorders: A Retrospective Cohort Study
Authors: Vervaeke Kobbe , Verhelst Pieter-Jan , Orhan Kaan , Lund Bodil , Benchimol Daniel , Cruyssen Fréderic Van der , De Laat Antoon , Jacobs Reinhilde , Politis Constantinus
Published: September 2021

Background: Arthroscopy is a minimally invasive diagnostic tool and treatment strategy in patients suffering from temporomandibular disorders (TMD) when conservative treatment fails. This study aimed to find specific variables on pre-operative MRI or during arthroscopy that could predict success of arthroscopic lysis and lavage.Methods: This retrospective analysis compared pre-operative maximum interincisal opening (MIO), pain and main complaint (pain, limited MIO or joint sounds) with results at short-term and medium-term follow-up (ST and MT respectively). Different variables scored on MRI or arthroscopy were used to make a stepwise regression model, subsequently a combined analysis was conducted using variables from both MRI and arthroscopy.Results: A total of 47 patients (50 joints) met the inclusion criteria. The main complaint improved by 62% and 53% at ST and MT respectively. The absolute or probable absence of a crumpled disc scored on MRI predicted success at ST and MT (p=0.0112 and p=0.0054), and remained significant at MT in the combined analysis (p=0.0078). Arthroscopic findings of degenerative joint disease predicted success at ST (p=0.0178), absolute or probable absence of discal reduction scored during arthroscopy significantly predicted success in the combined analysis at ST (p=0.0474).Conclusion: To improve selection criteria for patients undergoing an arthroscopic lysis and lavage of the TMJ, future research might focus on variables visualized on MRI. Although more research is needed, disc shape and in particular the absolute or probable absence of a crumpled disc might be used as predictive variable for success.
Workload Assessment of Medical Doctors at Primary Health Care Centers in the Duhok Governorate
Authors: Al-Dabbagh Samim Ahmed , Sulaiman Hushyar Musa , Abdulkarim Nazik Abdulrahman
Published: September 2021

Background: A shortage in human resources, particularly physicians, has become a challenge confronting health authorities in the Duhok governorate, as these resources are the key input for delivering health care. It has become necessary to identify the most appropriate scientifically sound method for having adequate staffing levels. This study aimed to forecast the required number of physicians to cope with the current workload at the main primary health care centers in the Duhok governorate.Methods: A cross-sectional study was adopted to collect data for one full year. Data collection included both primary and secondary data sources. A semi-structured questionnaire was developed to obtain information every month from health centers on activities related to training and leaves. Data analysis was performed using Workload Indicators of Staffing Need software.Results: Sixty-one primary health care centers met the final criteria for analysis. The study revealed physician shortages and inequity in the distribution of staffing. In these centers, 145 physicians lacked an adequate delivery of health services based on the workload imposed on them. The 'workload indicators of staffing need' ratio was 0.33, indicating high work pressure on medical doctors. Some centers offered more health care than others but had fewer doctors based on the current staffing practices. Conclusions: This study pointed out the importance for the public health sector and academic medical institutions to use Workload Indicators of Staffing Needs software in health policy administration to restructure their efforts to address the physician shortages and distribution imbalances at primary health care facilities.
Driving Pressure is Not Predictive of ARDS Outcome in Chest Trauma Patients Under Mechanical Ventilation
Authors: ramin severin , Arcelli Matteo , Bouchdoug Karim , Laumon Thomas , Duflos Camille , De Jong Audrey , Jaber Samir , Capdevila Xavier , Charbit Jonathan
Published: September 2021

Background: The relationship between the driving pressure of the respiratory system (ΔPrs) under mechanical ventilation and worse outcome has never been studied specifically in chest trauma patients. The objective of the present study was to assess in cases of chest trauma the relationship between ΔPrs and severity of acute respiratory distress syndrome (ARDS) or death and length of stay. Methods: A retrospective analysis of severe trauma patients (ISS >15) with chest injuries admitted to the Trauma Center from January 2010 to December 2018 was performed. Patients who received mechanical ventilation were included in our analysis. Mechanical ventilation parameters and ΔPrs were recorded during the stay in the intensive care unit. Association of ΔPrs and ARDS with mortality and outcomes was specifically studied at the onset of ARDS (ΔPrs-ARDS) by receiver operator characteristic curve analysis, Kaplan-Meier curves and multivariate analysis.Results: Among the 266 chest trauma patients studied, 194 (73%) developed ARDS. ΔPrs was significantly higher in the ARDS group versus in the no ARDS group (11.6±2.4 cm H2O vs 10.9±1.9 cm H2O, p=0.04). Among the patients with ARDS, no difference according to the duration of mechanical ventilation was found between the high ΔPrs group (ΔPrs-ARDS >14 cm H2O) and the low ΔPrs group (ΔPrs-ARDS ≤14 cm H2O), (p=0.75). ΔPrs-ARDS was not independently associated with the duration of mechanical ventilation (hazard ratio [HR], 1.006; 95% CI, 0.95–1.07; p=0.8) or mortality (HR, 1.07; 95% CI, 0.9–1.28; p=0.45).Conclusion: A high ΔPrs-ARDS was not significantly associated with an increase in mechanical ventilation duration or mortality risk in ARDS patients with chest trauma in contrast with medical patients.
Rapid Diagnosis of Biliary Atresia in Infants, a Multicenter Retrospective Analysis
Authors: Long Junshan , Dong Qi , Jiang Mingliang , Fu Cejun , Wang Yixi , Dong Kun , Zhang Jing , Dong Chunqiang
Published: September 2021

Background: Although the laboratory and imaging examinations of Biliary atresia (BA) has improved, some patients have not received timely diagnosis and treatment.Methods: 200 infants with BA and intrahepatic cholestasis(IC) from three centers were included in this study. Before an operation, the stool color and liver function were compared in infants with BA and IC within 90 days. Results: There were 115 patients with BA and 85 patients with IC seeing doctors within 90 days of age. The incidence rate of clay-colored stool, light-colored stool, and normal stool in the two groups was 58.3% vs. 17.7%, 39.1% vs. 65.9%, and 2.6% vs. 16.5%, and the difference was statistically significant (P<0.001). Compared with IC, the direct bilirubin (Dbil) and gamma glutamine transpeptidase (GGT) of BA was higher (PDbil =0.022, PGGT <0.001 ). According to ROC curve analysis, combined clay-colored stool, Dbil>75.3 umol/L and GGT>252 U/L, BA was diagnosed (AUC=0.911; 95% CI, 0.870 to 0.952), with the sensitivity of 88.7% and specificity of 80.0% was better than the single diagnosis (P<0.001).Conclusion: For infants within 90 days of age, stool color, Dbil, and GGT are simple and effective diagnostic indicators in BA.
The SNPs rs429358 and rs7412 of APOE gene are Association With Dyslipidemia but Not Cerebral Infarction in Northern Chinese Han population
Authors: GOU Dongyun , HE Sha , Yuan Mengwei , LIU Ziqian , WANG Yanyong , YANG Jie , xiaowei MA
Published: September 2021

BackgroundTo analyze the relationship between apolipoprotein E(APOE) (including the SNPs rs429358 and rs7412) gene and cerebral infarction(CI) in Northern Chinese Han population.Methods457 CI patients and 416 controls (without CI) in Chinese Han population were recruited for our study to test the SNPs by polymerase chain reaction (PCR)-fluorescence probe technique.ResultsThe distribution of APOE genotypes were in Hardy-Weinberg equilibrium, and the frequencies of ɛ4 allele orɛ4 containing were significantdifference between CI and control groups. Compared to ε2 or ε3 carriers, ε4 carriers had a high level of total cholesterol (TC) and low-density lipoprotein cholesterol(LDL-C) and high presenceof dyslipidemia in recruited peoples. And we found APOE ε4 allele was associated with an increased risk of dyslipidemia in the control and CI groups (OR = 2.232, 95% CI= 1.143-4.361, P<0.000; OR = 3.442, 95% CI= 1.885-6.284, P=0.019). However, further logistic regression showed that ɛ4 allele or carriers were not the independent risk factors of CI (OR = 2.232, 95% CI= 1.143-4.361, P=0.144; OR = 3.442, 95% CI= 1.885-6.284, P=0.162).ConclusionAPOE ε4 allele was associated with an increased risk of dyslipidemia (OR = 2.232, 95% CI= 1.143-4.361; OR = 3.442, 95% CI= 1.885-6.284), but ɛ4 allele or carriers were not the independent risk factors of CI in Northern Chinese Han population (OR = 2.232, 95% CI= 1.143-4.361, P=0.144; OR = 3.442, 95% CI= 1.885-6.284, P=0.162).
Correlation Between Salivary Microbiology and H2S Concentration of Oral Cavity
Authors: Jiang Jiarui , Huang Yufeng , Luo Na , Mi Qili , Li Xuemei , Zhang Wei , Zhu Baokun , Gao Qian
Published: September 2021

Background: Halitosis is caused by metabolites produced by oral microorganisms. Hydrogen sulfide is the most important compound that leads to the oral malodor, and is thought to be closely correlated with the activity of oral microorganism. Therefore, it is important to clarify the correlation between oral microbes and metabolites. Methods: Based on the 16S rRNA gene amplicon and shotgun metagenomic sequencing of oral microorganism, and oral malodor test, this study attempted to explain the contribution of oral microorganisms to the hydrogen sulfide of oral malodor. Results: The data shows that microbial taxa consisted in the H2S low and high groups are different, and most of the enriched taxa in the H2S high group are genus that correlated with H2S concentration. The two species Fusobaeterium periodonticum and Prevotella nanceiensis are significant different in both coverage breadth and depth and LPS biosynthesis contributions in two groups. According to KEGG metabolism pathways detected by HUMAnN2, subjects of the H2S high group may have a high risk to bacterial infection, since the LPS biosynthesis is enrichment. The contribution of F. periodonticum to sulfur metabolism between two groups is significantly different, and the relative abundance of F. periodonticum is higher in the H2S high group as well. Conclusions: The H2S content, is significantly associated with the composition and abundance of microorganisms in the oral cavity. The increase of microbial abundance and metabolism of some sulfide products are the main causes of halitosis. The most of the enriched microorganisms enriched in people with high H2S are associated with oral diseases such as caries and periodontal diseases, indicating that the diseases associated with oral microbes are not independent of each other and have some associations between some oral diseases.
Structural and Surface Modifications by Varying Precursor Concentrations on Spray Deposition of Zno Thin Films
Authors: ES Rajalekshmi , Ferby V. Anslin , Shabu R
Published: September 2021

Zinc Oxide thin films have been deposited on glass substrates using zinc acetate as starting precursor at different concentrations 0.05–0.3 M in steps of 0.05 M by spray pyrolysis method at the constant substrate temperature of 350º C. Lattice structure of the prepared ZnO films were characterized by X-Ray diffraction analysis (XRD). Diffraction pattern revealed hexagonal wurtzite structure with cell edges a = 3.2530 Å, c = 5.2092 Å and density 5.66 g/cm3, which is almost equal to the standard values a = 3.2556 Å, c = 5.2070 Å and 5.6525 g/cm3 (COD No: 96-900-4180). Structural parameters such as dislocation density, lattice stress, unit cell volume, number of crystallites per unit area have been calculated and its dependency with thickness was studied. As the film thickness increases, the crystallite size also increases. Through FTIR, chemical bonds and their stretching vibrations confirmed the metal-oxide phase formation. Scanning electron microscope images showed the formation of good quality film with regularly distributed spherical shaped grains. Roughness values of the films were attained from the Atomic force microscope images. In overall observations, precursor concentration has significant effect on film thickness which in turn modified the structural, optical and morphology properties of the prepared ZnO thin films.
New Challenges Towards the Ecological Management of Paliastomi Lake Will Significantly Improve the Local Environment With Far-Going Global Consequences
Authors: Abramia Grigol , Gverdtsiteli Leila , Eristavi Dimitri , Kalandadze Besik , Girgvliani Akaki , Weber Gero , Honecker Ulrich , Kubiniok Jochen , Golijashvili-Microbiologist Alexander , Japarashvili Nana
Published: September 2021

The publication is addressing the problems of pollution from agricultural sources; municipal wastewater and industry in line with the bacterial pollution caused by migratory waterfowl of Paliastomi Lake that is an internationally recognized habitat, wintery and transit area of the birds and an important tourism site. It reviews: the current state of the environment of Paliastomi Lake at the moment of the chemical and microbiological research and mathematical simulation modeling of possible dissemination of polluting chemicals and bacterial pathogens; pollution by nutrient-rich water causing large blooms of algae and aquatic plants that in its turn leaves little oxygen for fish and other aquatic animals, resulting in the eutrophication followed by suffocation of aquatic life. According to the research provided, the publication recommends ongoing monitoring of not only the lake's inflowing waters, but also seasonal sources of bacterial pollution caused by migratory birds. According to monitoring, the integration of constructed wetlands, localized spraying of bacteriophage cocktails, and feeding the birds, who are potential carriers of pathogenic bacteria, with food supplemented with BCs will help limit bacterial contamination, improve the habitat for local and migratory waterfowl, and ensure the biosecurity of the area.
Treatment of Multiple Sclerosis with Natalizumab: Experiences from a Real-Life Cohort Over 15 Years
Authors: Auer Michael , Zinganell Anne , Hegen Harald , Bsteh Gabriel , Pauli Franziska Di , Berek Klaus , Fava Elena , Wurth Sebastian , Berger Thomas , Deisenhammer Florian
Published: September 2021

BackgroundNatalizumab (NTZ) has been used for treatment of highly active relapsing-remitting multiple sclerosis (MS). When stopping NTZ the risk of severe rebound phenomenon has to be considered. We aimed to investigate the use of NTZ in clinical routine and focused on identification of potential risk factors for disease reactivation after treatment discontinuation.MethodsAt the Medical University of Innsbruck, Austria, we identified all MS patients who were treated with NTZ and performed a retrospective analysis on therapeutic decision making, disease course before, during and after treatment with NTZ and on risk factors for disease reactivation after NTZ discontinuation.Results235 NTZ treated MS patients were included, of whom 105 had discontinued treatment. At NTZ start disease duration was 5.09 (IQR 2.09-10.57) years, average number of total relapses was 4 (IQR 3-6) and median EDSS 2.0 (range 0-6.5), whereby these values significantly decreased over time. Reduction of annualized relapse rate (ARR) on treatment was 93% and EDSS remained stable in 64%. In a multivariate regression model only conversion to secondary progressive MS (SPMS) on treatment was significantly associated with lower risk of disease reactivation after NTZ, while ARR before treatment was associated with earlier disease reactivation. ConclusionsWe could confirm the high therapeutic efficacy of NTZ which trends to be used earlier in the disease course nowadays. Discontinuation of NTZ seems safe only in patients who convert to SPMS during treatment, while higher ARR before NTZ increases the risk of disease reactivation after treatment discontinuation.
Protocol for Sonospeech Cleft Pilot: A Pilot Randomised Control Trial of Ultrasound Visual Biofeedback Versus Standard Intervention for Children with Cleft Lip and Palate.
Authors: Cleland Joanne , Crampin Lisa , Campbell Linsay , Dokovova Marie
Published: September 2021

Background: Children with cleft lip and palate can continue to have problems producing clear speech after surgery. This can lead to social, emotional, and educational challenges. Typical treatment involves teaching children the correct tongue movements to produce speech sounds. This is known as articulation intervention. However, this intervention is challenging because the tongue is hidden from view and movements are difficult to see and describe. This pilot randomized control trial will try a new treatment, ultrasound visual biofeedback (U-VBF). Methods/Design: The Sonospeech project will enroll up to 40 children with cleft lip and palate aged 4;6 to 16 in a single-centre two-arm parallel group pilot randomized controlled trial with blinded assessors. Children will receive either six sessions of U-VBF or articulation intervention. The primary goals of this pilot are to determine recruitment/attrition rates; to measure pre-post follow up completion; and acceptability of the randomization and interventions to families.Discussion: Larger trials of speech interventions for children with cleft lip and palate are needed. This pilot/feasibility study will determine whether a larger randomized control trial comparing ultrasound and articulation interventions is feasible. Trial registration. ISRCTN, ISRCTN17441953. Registered 22 March 2021, http://isrctn.com/ISRCTN17441953. See Appendix 1 for all items.
Niveoporofomes (Basidiomycota, Fomitopsidaceae) in Tropical Africa: Niveoporofomes oboensis sp. nov. and N.widdringtoniae comb. nov., two species from Afromontane Forests
Authors: Decock Cony Antonio , Ryvarden Leif , Amalfi Mario
Published: September 2021

During a survey of polypores in the montane forest of the Ôbo de São Tomé National Park, in the western African, equatorial island of São Tomé, a specimen that was, a priori, related to Fomitopsis, based on the gross morphology of the basidiome and a brown rot, showed deviating features including subglobose basidiospores with a large gutta, what pointed toward Niveoporofomes. Phylogenetic inferences based on multiple loci dataset (ITS-nLSU-nSSU-tef1-rpb2) confirmed these affinities, and Niveoporofomes oboensis is described as new. The species is compared to Fomitopsis widdringtoniae, known from southeast Africa, which is characterized also by subglobose basidiospores; hence, the new combination N. widdringtoniae is proposed. The new combination Niveoporofomes globosporus (basionym Trametes globospora) is also proposed based on phylogenetic analyses. A key to the species of Fomitopsis, Niveoporofomes, Rhodofomes, and Rhodofomitopsis in Tropical Africa is presented.
Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (Pip): A Feasibility Study
Authors: Clarkson Jan E , Ramsay Craig R , Mannocci Francesco , Jarad Fadi , Albadri Sondos , Ricketts David , Tait Carol , Banerjee Avijit , Deery Chris , Boyers Dwayne , Marshman Zoe , Goulao Beatriz , Banister Katie , Bell Rosanne , Brown Lori , Conway David , Donaldson Pina , Duncan Anne , Dunn Katharine , Fee Patrick , Forrest Mark , Glenny Anne-Marie , Gouick Jill , Gupta Ekta , Hamilton Alice R , Jacobsen Elisabet , Kettle Jennifer , MacLennan Graeme , Macpherson Lorna , McGuff Tina , Mitchell Fiona , Pol Marjon Van der , Moazzez Rebecca , Roberston Douglas , Wojewodka Gabriella , Young Linda , Lamont Thomas
Published: September 2021

BACKGROUNDProgression of dental caries can result in irreversible pulpal damage. Partial irreversible pulpitis, is the initial stage of this damage, confined to coronal pulp whilst the radicular pulp show little or no sign of infection. Preserving the pulp with sustained vitality and developing minimally invasive biologically based therapies are key themes within contemporary clinical practice. However, root canal treatment involving complete removal of the pulp is often the only option (other than extraction) given to patients with irreversible pulpitis, with substantial NHS and patient incurred costs. The European Society of Endodontology’s (ESE 2019) recent consenus statement recommends full pulpotomy, where the inflamed coronal pulp is removed with the goal of keeping the radicular pulp vital, as a more minimally invasive technique, potentially avoiding complex root canal treatment. Although this technique may be provided in secondary care, it has not been routinely implemented or evaluated in UK General Dental Practice.METHODThis feasibility study aims to identify and assess in a primary care setting, training needs of General Dental Practitioners, clinical fidelity of the full pulpotomy intervention, estimate likely eligible patient pool and develop recruitment materials ahead of a main randomised controlled trial comparing the clinical and cost-effectiveness of full pulpotomy compared to root canal treatment in pre/molar teeth of adults 16 years and older showing signs indicative of irreversible pulpitis. The feasibililty study will recruit and train 10 primary care dentists in the full pulpotomy technique. Dentists will recruit and provide full pulpotomy to 40 patients with indications of partial irreversible pulpitis. DISCUSSIONThe Pulpotomy for the Management of Irreversible Pulpitis in Mature Teeth (PIP) study will address the lack of high-quality evidence in the treatment of irreversible pulpitis, to aid dental practitioners, patients and policy makers in their decision making. The PIP feasibility study will inform the main study on the practicality of providing both training and provision of the full pulpotomy technique in general dental practice. TRIAL REGISTRATIONTrial registry: ISRCTNTrial registration number: 17973404Date of Registration: 28.01.2021URL of trial registry record: https://www.isrctn.com/ISRCTN17973604PROTOCOL VERSIONProtocol version: 1Date: 03.02.2021