bluuebunny/crossref_metadata_2025 huggingface dataset:
Metformin Use and Subsequent Alzheimer’s Disease Incidence in Patients With Newly Diagnosed Type 2 Diabetes: a Population-based Nested Case-control Study
Authors: Ha Junghee , Choi Dong Woo , Kim Kwang Joon , Cho So Yeon , Kim Hyunjeong , Kim Keun You , Koh Yongseung , Nam Chung Mo , Kim Eosu
Published: April 2021

Background: Metformin reduces insulin resistance, which may be shared pathophysiology between diabetes mellitus (DM) and Alzheimer’s disease (AD). Thus, it has been hypothesized that metformin may be effective against AD; however, evidence of metformin effects on AD development remains insufficient and conflicting. We investigated Alzheimer’s disease risk in patients with newly diagnosed type 2 diabetes mellitus treated with metformin.Methods: This retrospective, observational, nested case-control study included enrolled patients with newly diagnosed type 2 diabetes mellitus in the Korean National Health Insurance Service diabetes mellitus cohort (2002–2017). Among 70,499 DM patients who were dementia-free at the time of DM diagnosis, 1,675 AD cases identified were matched to 8,375 controls by age, sex, and DM onset and duration. Association of AD with metformin use were analyzed using multivariable conditional logistic regression analyses adjusted for comorbidities and cardiometabolic risk profile. Results: Metformin use was associated with an increased adjusted odds ratio (AOR) of AD (1.50; 95% CI, 1.23–1.83). The strength of the association increased with the cumulative daily defined dose per day in metformin users. The risk was more pronounced among patients with a longer duration of DM (1.48; 95% CI, 1.14 to 1.91, for a DM duration of 5–9 years; 2.18; 95% CI, 1.41 to 3.39 for a duration greater than 10 years), while no statistical significance was found in the patients with DM duration less than 5 years (AOR 0.88; 95%CI 0.54–1.43). Furthermore, the risk of AD was significantly higher in DM patients with depression (AOR 2.05; 1.02–4.12). Conclusions: Given the huge number of patients with DM who are taking metformin worldwide, a double-blinded, prospective study is required to determine the long-term cognitive safety of metformin.
Hepatocyte Growth Factor Protects Endothelial Barrier Against Oxidative Stress and Mitochondria-dependent Apoptosis
Authors: Meng Shan-Shan , Xia Fei-Ping , Xu Jing-Yuan , Zhang Xi-Wen , Xue Ming , Gu Ming-Yuan , Guo Feng-Mei , Huang Ying-Zi , Qiu Hai-Bo , Yang Yi
Published: April 2021

Background: Pulmonary microvascular endothelial cells(PMVECs) were incomplex and endothelial barrier was destroyed in the pathogenesis progress of acute lung injury(ALI)/acute respiratory distress syndrome(ARDS). Previous studies have demonstrated that hepatocyte growth factor (HGF) could decrease endothelial apoptosis. Nevertheless, the mechanism by which HGF-suppressed oxidative stress contributes to endothelial mitochondria-dependent apoptosis is poorly understood. Methods: In our current study, we introduced lipopolysaccharide(LPS)-induced PMEVCs with HGF treatment. To investigate the effects of mTOR/STAT-3 pathway in endothelial oxidative stress and mitochondria-dependent apoptosis, mammalian TOR (mTOR) inhibitor rapamycin and signal transducer and activator of transcription 3 (STAT-3) inhibitor S3I-201 were respectively used to inhibit mTOR/STAT-3 signaling. Moreover, lentivirus vector-mediated HGF, mTORC1(raptor) and mTORC2(rictor) gene knockdown modification were introduced to evaluate mTORC1 and mTORC2 pathway. Calcium measurement, ROS production, mitochondrial membrane potential and protein complex I expression, cell proliferation, apoptosis and endothelial junction protein were detected to evaluate HGF effects.Results: Our study demonstrated that HGF protected endothelium via the suppression of ROS production and intracellular calcium uptake, which leading to increased mitochondrial membrane potential (JC-1 and mitochondria tracker green detection)and specific proteins(complex I), decreased endothelial apoptosis specific protein(Caspase-3), raised anti-apoptosis mRNA level(Bcl-2 and Bcl-xL), and increased endothelial junction proteins (VE-cadherin and occludin). Reversely, mTOR inhibitor rapamycin and STAT-3 inhibitor S3I-201 could raise oxidative stress and mitochondria-dependent apoptosis even with HGF treatment in LPS-induced endothelial cells. Similarly, mTORC1 as well as mTORC2, have the same protective effects in mitochondria damage and apoptosis. Conclusion: In all, these reveal that mTOR/STAT-3 signaling mediate the HGF suppression effects to oxidative level, mitochondria-dependent apoptosis and endothelial junction protein in LPS-stimulated PMVECs, which contributing to the endothelial survival and barrier integrity.
Brain Connectivity Dynamics in Untreated Transmen and Cisgender Individuals
Authors: Uribe Carme , Junque Carme , Gómez-Gil Esther , Díez-Cirarda María , Guillamon Antonio
Published: April 2021

Large-scale brain network interactions have been described between trans- and cis-gender identities. However, a temporal perspective of the brain spontaneous fluctuations is missing. We investigated the functional connectivity dynamics in transmen with gender incongruence and its relationship with interoceptive awareness. We describe four states in native and meta-state spaces: i) one state highly prevalent with sparse overall connections; ii) a second with strong couplings mainly involving components of the salience, default and executive control networks. Two states with global sparse connectivity but positive couplings iii) within the sensorimotor network, and iv) between salience network regions. Transmen had more dynamical fluidity than cismen, while cismen presented less meta-state fluidity and range dynamism than transmen and ciswomen. A positive association between attention regulation and fluidity, and meta-state range dynamism was found in transmen. There exist gender differences in the temporal brain dynamism, characterized by distinct interrelations of the salience network as catalyst interacting with other networks. We provide a functional explanation to the neurodevelopmental hypothesis proposing different brain phenotypes in the construction of the gendered-self.
Sintering Behavior and Microwave Dielectric Properties of MgO-2B 2 O 3 - Xwt %H 3 BO 3 - Ywt %BCB Ceramics
Authors: WANG Haiquan , LI Shixuan , WANG Kangguo , ZHOU Huanfu , Chen Xiuli
Published: April 2021

The bulk density, sintering behavior and microwave dielectric properties of MgO-2B2O3 series ceramics synthesized by solid-state reaction method were systematically studied in this paper. X-ray diffraction and microstructural analysis revealed that the as-prepared MgO-2B2O3 ceramics possessed a single-phase structure with rod-like morphology. Through the investigation of the effects of different dosages of H3BO3 and BCB on bulk density, sintering behavior and microwave dielectric properties of MgO-2B2O3 ceramics, the optimum sintering temperature was obtained at an addition of 30wt%H3BO3 and 8wt%BCB and the sintering temperature was reduced to 825 oC. The addition of 40wt %H3BO3 and 4 wt%BCB increased the quality factor Q×f, permittivity εr and temperature coefficient of resonance frequency τf of MgO-2B2O3 to 44,306 GHz, 5.1 and -32 ppm/oC, respectively, meeting the criteria of low-temperature co-fired ceramics.
Effect of The Calcination Process On The Magnetotransport Properties in Co-Precipitation Derived La0.67Ca0.33MnO3 Ceramics
Authors: Li Yule , Yu Ping , Wang Xiaojin , Ling Fuxin , Chen Qingming , Zhang Hui
Published: April 2021

La0.67Ca0.33MnO3 (LCMO) attracts considerable attention as a quintessential example for colossal magnetoresistance (CMR), metal-insulator transition and related temperature coefficient of resistance (TCR) studies. Here, co-precipitation method was utilized to prepare the LCMO ceramics, whose magnetotransport properties as a function of calcination temperature (Tcal) and calcination time (tcal) were investigated. The magnetotransport properties of these LCMO ceramics were significantly enhanced compared with LCMO derived by sol-gel methods. The TCR of LCMO increased firstly and then decreased as the Tcal increased, whereas the metal-insulator transition temperature (TMIT) shifted towards to the lower temperature. Magnetoresistance (MR) increased as Tcal rose and reached 82.4 % at Tcal = 800 ℃. The mechanism of such magnetotransport properties with different temperature ranges was discussed. The optimal TCR of 32.3%·K-1 in LCMO was prepared with Tcal = 500 ℃ and tcal = 8 h, showing that co-precipitation method would facilitate the potential application of LCMO in infrared detecting and magnetoresistive switching.
A Novel Monitoring Method for Belt Wear State Based on Machine Vision and Image-processing Under Varying Grinding Parameters
Authors: Wang Nina , zhang guangpeng , Ren Lijuan , Pang Wanjing , Li Yongchang
Published: April 2021

The wear state of abrasive belt is one of the important factors affecting the grinding precision of belt grinding processes. Accurate monitoring of abrasive belt wear can not only provide the basis for accurate material removal model to improve grinding accuracy, but also can replace the belt to avoid surface burn in time. However, most of the existing abrasive belt wear monitoring methods are only suitable for monitoring the belt wear state under specific grinding parameters, are not universal. This paper introduces a method of belt wear state monitoring based on machine vision and image-processing. All the surface images of the belt were obtained from the new belt to the worn-out of the belt by a non-contact electron microscope. The features of abrasive belt surface images are extracted from RGB color space and wavelet texture. By analyzing the trendency of the extracted features in the whole grinding process, the wear state is divided into three categories. Three image features related to the wear state are selected: the first order distance of color component R, the entropy of horizontal subgraph, and vertical subgraph of texture feature. Based on the selected features and the random forest classification algorithm, the wear state classifier of abrasive belt is established. The performance of the classifier is verified and evaluated by using the data subset of different images. The results show that the proposed method has high recognition accuracy for the belt wear state, and the accuracy can reach 99% in the accelerated wear stage. The proposed method is suitable for the monitoring of the belt wear state by the surface images of the abrasive belt measured under different grinding parameters and different measurement parameters.
Off-Label Use of Bevacizumab in Age-Related Macular Degeneration: Protocol for a Systematic Review and Meta-Analysis
Authors: Estarreja João , Valente Carina , Silva Carina , Camacho Pedro , Mateus Vanessa
Published: April 2021

Background: Age-related macular degeneration (AMD) is considered the leading cause of vision loss in elderly people. Taking into account the phenomenon of aging worldwide, the prevalence of AMD is expected to increase gradually in the future. AMD can be divided into early, intermediate and late stages, where early and intermediate are mainly asymptomatic and, late-stage can be classified in non-vascular AMD and vascular AMD. Current pharmacological treatment in vascular AMD is associated with the administration of anti-VEGF agents, such as ranibizumab, pegaptanib, and aflibercept. Additionally, it has been reported the off-label use of bevacizumab, commonly associated with oncology, in this condition through intravitreal administrations, demonstrating efficacy allied with a lower cost in comparison to other agents used, which makes it a new possible pharmacological approach. In this sense, this review aims to evaluate the off-label use profile of bevacizumab in the treatment of neovascular AMD. Methods/design: To identify and select relevant articles present in current literature, it will be developed a highly sensitive search strategy. To develop this search, it will be used MEDLINE via the Pubmed platform. It will be only considered clinical studies, where it is compared the use of bevacizumab with another pharmacological agent, such as ranibizumab, or even a placebo, in patients aged 50 years and older, diagnosed with vascular AMD.Discussion: This review will provide a synthesis of the current information and underlying evidence, about the influence of the off-label use of bevacizumab in this disease. Altogether, it will allow having a clearer vision on a new possible accepted pharmacological approach for the treatment of vascular AMD.Systematic review registration: The protocol for this review will be submitted and registered with the International Prospective Register of Systematic Reviews (PROSPERO).
Low-level Chlorpyrifos Exposure Affects Synaptic Plasticity in Hippocampal Neurons
Authors: Zhou Wenjuan , Zhang Chen , Wang Peipei , Deng Yuanying , Dai Hongmei , Xi Qiong , Tian Jing , Zhao Mengwen , Wu Guojiao , Zhao Lingling
Published: April 2021

Chlorpyrifos (CPF) is a widely used organophosphorus pesticide and exhibits environmental persistence and bioaccumulation. Increasing evidence has shown that exposure to CPF in early life might induce neurodevelopmental disorders in adulthood. Synaptic plasticity plays a crucial role in neurodevelopment. This study aimed to investigate the effect of CPF on synaptic plasticity in hippocampal neurons and establish the cellular mechanism of these effects. We analysed the impact of CPF on the expression level of a presynaptic protein, a postsynaptic protein, and ionotropic glutamate receptors, as well as the effects on the Wnt7a/β-catenin pathway in primary hippocampal neurons. We found that CPF decreased the expression of synaptophysin, PSD-95, NMDAR1, GluR1, and Wnt7a, as well as active β-catenin, in primary hippocampal neurons. Our study suggests that low-level CPF exposure affects synaptic plasticity in hippocampal neurons.
Secondary Attack Rates of COVID-19 in Norwegian Families: A Nation-Wide Register-Based Study
Authors: Telle Kjetil , Jørgensen Silje B. , Hart Rannveig , Greve-Isdahl Margrethe , Kacelnik Oliver
Published: April 2021

To characterize the family index case for detected SARS-CoV-2 and describe testing and secondary attack rates in the family, we used individual-level administrative data of all families and all PCR tests for SARS-CoV-2 in Norway in 2020. All families with at least one parent and one child below the age of 20 who lived at the same address (N=662 582), where at least one member, i.e. the index case, tested positive for SARS-CoV-2 in 2020, were included. Secondary attack rates (SAR7) were defined as the share of non-index family members with a positive PCR test within seven days after the date when the index case tested positive. SARs were calculated separately for parent- and child-index cases, and for parent- and child-secondary cases. We identified 7548 families with an index case, comprising 26 991 individuals (12184 parents, 14808 children). The index was a parent in 66% of the cases. Among index children, 42% were in the age group 17-20 and only 8% in the age group 0-6. When the index was a parent, SAR7 was 24% (95%CI 24 to 25), whilst SAR7 was 14% (95%CI 13 to 15) when the index was a child. However, SAR7 was 24% (95%CI 20 to 28) when the index was a child aged 0-6 years and declined with increasing age of the index child. SAR7 from index parent to other parent was 35% (95%CI 33 to 36), and from index child to other children 12% (95%CI 11 to 13). SAR7 from index child aged 0-6 to parents was 27% (95%CI 22 to 33). The percent of non-index family members tested within 7 days after the index case, increased from about 20% in April to 80% in December, however, SAR7 stabilized at about 20% from May. We conclude that parents and older children are most often index cases for SARS-CoV-2 in families in Norway, while parents and young children more often transmit the virus within the family. This study suggests that whilst the absolute infection numbers are low for young children because of their low introduction rate, when infected, young children and parents transmit the virus to the same extent within the family.
Interleukin 6 (rs1800795) and Pentraxin 3 (rs2305619) Polymorphisms - Association with Inflammation and All-Cause Mortality in End-stage-renal Disease Patients on Dialysis
Authors: Rocha Susana , Valente Maria João , Coimbra Susana , Catarino Cristina , Rocha-Pereira Petronila , Oliveira José Gerardo , Madureira José , Fernandes João Carlos , Sameiro-Faria Maria , Miranda Vasco , Belo Luís , Santos-Silva Alice , Bronze-da-Rocha Elsa
Published: April 2021

Chronic inflammation plays an important role in the progression and outcome of chronic kidney disease (CKD). The inflammatory biomarkers interleukin-6 (IL6) and pentraxin 3 (PTX3) are enhanced in CKD patients and associated with progression of the disease and higher risk for cardiovascular events, the major cause of death in these patients. Our aim was to study how the polymorphisms of their encoding genes affect the inflammatory response and outcome of end-stage renal disease (ESRD) patients on dialysis. We analyzed two single nucleotide polymorphisms (SNP), the IL6 (rs1800795) polymorphism in the promoter region (-174G/C), and the PTX3 polymorphism in the intron 1 (+ 281A/G), in ESRD patients on dialysis and in heathy individuals. The allelic frequencies, genotype distribution and their association with the circulating levels of the inflammatory markers high sensitivity C-reactive protein (hsCRP), interleukin (IL6), growth differentiation factor 15 (GDF15) and PTX3, were determined in ESRD patients; events of death were recorded along one year to evaluate all-cause mortality and the association between inflammation and the studied polymorphisms. The allelic frequencies and genotyping distribution for IL6 and PTX3 in controls and ESRD patients were similar and in agreement with European reports. For the IL6 polymorphism, we found an association of the GG and CC genotype with higher IL6 levels; the CC genotype showed also high PTX3, hsCRP and GDF15 levels. For the PTX3 polymorphism, the AA genotype was linked to the highest values of hsCRP and IL6. The mortality rate after 1-year follow-up was 10.4%. The CC genotype (IL6 polymorphism), in deceased patients, was associated to increased levels of hsCRP, IL6 and PTX3, with low levels of GDF15 and with a highest mortality risk. The AA genotype for PTX3 polymorphism, in spite of the enhancement in inflammation, showed no significant impact on mortality. Our results show that the CC genotype of the IL6 polymorphism was associated with an enhanced inflammatory state and a poorer survival rate. Both IL6 and PTX3 polymorphisms seem to modulate the inflammatory response and, therefore, disease progression and outcome. Our data also highlights the importance of research on genetic variants that, although less frequent, may have significant biological value.
Prediction of Distant Metastatic Recurrence By Tumor-Infiltrating Lymphocytes in Hormone Receptor-Positive Breast Cancer
Authors: Takada Koji , Kashiwagi Shinichiro , Asano Yuka , Goto Wataru , Kouhashi Rika , Yabumoto Akimichi , Ishihara Sae , Morisaki Tamami , Shibutani Masatsune , Tanaka Hiroaki , Hirakawa Kosei , Ohira Masaichi
Published: April 2021

Background: Breast cancer subtypes are known to have different metastatic recurrence sites. Distant metastases are often observed during the post-operative course in patients with human epidermal growth factor receptor 2 (HER2)-enriched breast cancer and triple-negative breast cancer, but are relatively rare in those with hormone receptor-positive and HER2-negative (HR+/HER2-) breast cancer. Tumor-infiltrating lymphocytes (TILs) serve as an index to monitor tumor immune microenvironment and may possibly predict the prognosis and therapeutic effect in breast cancer. This study aimed to investigate the correlation between TIL density and recurrence site in HR+/HER2- breast cancer.Methods: Four-hundred and seventy-one patients with HR+/HER2- breast cancer underwent surgery as the first treatment and received adjuvant endocrine therapy (except adjuvant chemotherapy) at the Osaka City University Hospital from April 2007 to October 2015. Needle biopsy specimens were obtained from all patients to evaluate tumor morphology and examine TILs. Morphological assessment was conducted using conventional hematoxylin and eosin staining.Results: Breast cancer recurrence was observed in 42 patients. In patients with no TIL density, local recurrence was significantly less (p = 0.022), while distant metastases were significantly more (p = 0.015) compared to those in patients with TIL density. Therefore, for the prediction of distant metastases in HR+/HER2- breast cancer without chemotherapy, TILs could be used as predictors in univariate analysis (p = 0.015, odds ratio [OR] = 0.127), although not as independent factors (p = 0.285, OR = 0.144).Conclusions: Our findings indicate that TILs may predict distant metastatic recurrence in stages I–II of HR+/HER2- breast cancer.
Community Pharmacists' Roles in Optimising Opioids Therapy for Chronic Non-malignant Pain Patients: a Qualitative Study.
Authors: Alenezi Aziza Ali , Paudyal Vibhu , Yahyouche Asma
Published: April 2021

Background: Opioids are currently widely used to manage chronic non-malignant pain, but there is a growing concern about harm resulting from opioid misuse, and the need for medicine optimisation, in which pharmacists could potentially play a key role.Objective: This study seeks to identify challenges to community pharmacists’ role in optimizing prescribed opioids for Chronic Non-Malignant Pain (CNMP).Setting: Community pharmacies in the UK.Method: Semi-structured interviews based on the Theoretical Domains Framework were conducted with 20 community pharmacists recruited through professional networks and analysed thematically.Result: Pharmacists perceive themselves as guardians of patients’ welfare and aspire to contribute to prescribed opioid optimisation. However, they are challenged by the lack of relevant training, inadequate time and resources, infrastructural and systemic constraints (such as repeat prescribing and prescription delivery services, lack of access to medical records and information about diagnosis), personal factors, including communication with doctors, and relationship with patients.Conclusion: The role of community pharmacists in optimising chronic opioid therapy is neither well-defined nor implemented in the UK. Utilisation of their potential skills and knowledge in this area requires an appropriate training curriculum, tackling the infrastructural and systemic constraints, support and resources to facilitate pharmacists’ engagement in patient monitoring and education. The findings in this study can contribute to inform policy makers with potentials to enhance pharmacists’ role in opioids therapy optimisation and, hence, ensure patients' safety when using prescribed opioids.
Investigation on the Properties of Sustainable Reactive Powder Concrete by Utilization of Coir Pith Aggregates and Pyrogenic Silica
Authors: A Oorkalan , S Chithra
Published: April 2021

The present study investigates the properties of RPC developed using low cost eco-friendly materials such as pyrogenic silica (PS) and coir pith (CP) fine aggregates. This study investigates the effects of PS as silica fume replacement which is the main constituent for the production of reactive powder concrete which contained coir pith as a fine aggregate replacement instead of quartz sand up to 25%. The use of silica fume increases the particle packing density of RPC but increases the shrinkage phenomenon in RPC due to the minimum w/b ratio adopted. Therefore, in this research PS is used as a partial substitute for SF up to 30% and its effect on the mechanical and durability properties of coir pith containing RPC is studied. The test results showed that the mechanical strength values decreased with an increase in the addition of CP aggregate beyond 5% whereas the decrement in compressive strength was partially reduced when PS is used as silica fume replacement up to a maximum of 30%. The chloride penetration resistance was also improved with increasing PS substitution in RPC containing CP aggregates. The autogenous shrinkage and drying shrinkage were also significantly reduced due to the internal curing ability of the CP aggregates in combination with PS. The development of dense CSH gels from hydration is also evident from low CaO/ SiO2 ratio obtained from the EDS analysis. Hence the combination of PS with CP aggregates can reduce the shrinkage characteristics of RPC thereby providing eco-friendly sustainable concrete at low cost.
Towards Accurate Detection of Axial Spondyloarthritis by Using Deep Learning to Capture Sacroiliac Joints on Plain Radiographs.
Authors: Grauhan Nils Friedrich , Bressem Keno Kyrill , Manzoni Yves Nicolas , Adams Lisa Christine , Rios-Rodgriguez Valeria , Proft Fabian Nikolai , Haibel Hildrun , Rudwaleit Martin , Niehues Stefan Markus , Poddubnyy Denis , Vahldiek Janis Lucas
Published: April 2021

BackgroundWell-informed decisions about how to best treat patients with axial spondyloarthritis (SpA) regularly include an evaluation of the sacroiliac joints (SIJ) on plain radiographs. However, grading radiographic findings correctly has proven to be a considerable challenge to expert readers as well as to state-of-the-art convolutional neural networks (CNNs). A method to reduce image information to the clinically relevant core would undoubtedly lead to more accurate results. We, therefore, trained a CNN only to detect SIJs on radiographs and evaluated its potential as a preprocessing pipeline in the automated classification of SpA.Materials and MethodsWe employed a CNN of the RetinaNet architecture, which was trained on a total of 423 plain radiographs of the sacroiliac joints (SIJs). Images were taken from two completely independent datasets. Training and tuning were performed on image data from the Patients With Axial Spondyloarthritis (PROOF) study and testing was executed using images from the German Spondyloarthritis Inception Cohort (GESPIC). Performance was evaluated by manual review and standard object detection metrics from PASCAL and Microsoft COCO.ResultsThe CNN produced excellent results in detecting SIJs on the tuning (n =106) and on the holdout dataset (n =140). Object detection metrics for the tuning data were AP = 0.996 and mAP = 0.538; values for the independent holdout data were AP = 0.981 and mAP = 0.515. ConclusionsThe developed CNN was highly accurate in detecting SIJs on radiographs. Such a model could increase the reliability of deep learning-based algorithms in detecting and grading SpA.
Natural progression of lamellar macular holes in high myopia: a long-term follow-up study
Authors: Ho Mary , Mok Eugenie , Lai Felix , Sin Helena PY , Mohamed Shaheeda , Chen Li Jia , Brelen Marten , Lai Timothy , Tham Clement , Young Alvin L.
Published: April 2021

Background
To determine the long-term prognosis of lamellar macular holes (LMH) in highly myopic eyes.
Methods
This was a retrospective observational study. Patients with LMH associated with high myopia (>-6 dioptres) were examined at regular 6-month intervals for a minimum of 36 months to detect for any structural and functional deterioration. Assessment included visual acuity checking, fundal examination, and optical coherence tomography (OCT) scanning. The risk factors for visual deterioration and progression to full-thickness macular hole (MH) were analysed using Kaplan-Meier survival analysis. The main outcome measures included the changes in mean best-corrected visual acuities, evidence of lamellar hole progression on OCT scans and complication rates of full-thickness macular hole (FTMH), and foveal detachment (FD) development.
Results
A total of 37 highly myopic eyes with optical coherence tomography confirmed LMH were recruited from 36 patients. The mean age was 63.4 ± 9.8 years and the mean spherical equivalent refractive error was − 9.01 ± 3.6 D with axial length of 27.74 ± 1.45 mm. The mean follow-up duration was 57.6 ± 10.9 months. The mean baseline visual acuity was 0.272 logMAR ± 0.22. A gradual decline in visual acuity was noted, and the change reached statistical significance from 36 months onwards. Visual acuity was 0.648 ± 0.41 logMAR at 36 months (p = 0.034) and 0.604 ± 0.455 at 48 months (p = 0.046). Twelve eyes (32.4%) had foveoschisis at baseline. Coexistence of a lamellar macular hole with foveoschisis was shown to be a risk factor for the development of a FTMH or FD (p = 0.002).
Conclusion
LMH in highly myopic eyes was generally stable, while a small proportion of patients progressed to full-thickness MH. Patients with coexisting LMH, foveoschisis, and vitreomacular traction had a higher risk of visual decline and progression to full-thickness MH.
Metabolic Syndrome in Patients With First-ever Ischemic Stroke: Prevalence and Association With Coronary Heart Disease
Authors: Liang Yajun , Yan Zhongrui , Hao Yanlei , Wang Qiqi , Zhang Zuoji , She Rui , Wang Peng , Du Yifeng , Lau Joseph , Dekker Joost , Bai Bo , Qiu Chengxuan
Published: April 2021

Background: Most studies of metabolic syndrome (MetS) and coronary heart disease (CHD) have been carried out in the general population, and their association among stroke patients has been rarely explored. We seek to describe the prevalence of MetS among patients with acute ischemic stroke and to assess its association with CHD. Methods: This hospital-based study included 1851 patients with first-ever acute ischaemic stroke (mean age 61.2 years, 36.5% women) who were hospitalized into two university hospitals in Shandong, China (January 2016-February 2017). Data were collected through interviews, physical examinations, and laboratory tests. MetS was defined following the National Cholesterol Education Program (NCEP) criteria, the International Diabetes Federation (IDF) criteria, and the Chinese Diabetes Society (CDS) criteria. CHD was defined according to clinical and electrocardiogram examinations. Binary logistic regression was performed to determine the associations between MetS and CHD. Results: The overall prevalence of MetS was 34.0% by NECP criteria, 47.8% by IDF criteria, and 32.9% by CDS criteria. The prevalence of MetS decreased with age and was higher in women than men (p<0.05). Abdominal obesity, high blood pressure, high triglycerides, and low HDL-C were significantly associated with CHD (multi-adjusted OR range: 1.27-1.43, p<0.05). Compared with those without MetS, the multi-adjusted OR (95% CI) of CHD associated with MetS defined by the NECP criteria, IDF criteria, and CDS criteria was 1.29 (1.04-1.59), 1.46 (1.20-1.78), and 1.29 (1.05-1.59), respectively. In addition, having 1-2 abnormal components (vs. none) was associated with CHD (OR range: 1.63-1.73, p<0.05). Conclusions: MetS affects over one-third of patients with first-ever ischemic stroke. MetS is associated with an increased likelihood of CHD in stroke patients, but treating MetS as a binary entity would underestimate its association with CHD.
CBF Oscillations Induced by Trigeminal Nerve Stimulation Protect the Pericontusional Penumbra in Traumatic Brain Injury Complicated By Hemorrhagic Shock
Authors: Li Chunyan , Shah Kevin A. , Powell Keren , Wu Yi-Chen , Chaung Wayne , Sonti Anup , White Timothy G. , Doobay Mohini , Yang Weng-Lang , Wang Ping , Becker Lance B. , Narayan Raj K.
Published: April 2021

Traumatic peri-contusional penumbra represents crucial targets for therapeutic interventions after traumatic brain injury (TBI). Current resuscitative approaches may not adequately alleviate impaired cerebral microcirculation and, hence, compromise oxygen delivery to peri-contusional areas. Low-frequency oscillations in cerebral blood flow (CBF) may improve cerebral oxygenation in the setting of oxygen deprivation. However, no method has been reported to induce controllable oscillations in CBF and it hasn’t been applied as a therapeutic strategy. Electrical stimulation of the trigeminal nerve (TNS) plays a pivotal role in modulating cerebrovascular tone and cerebral perfusion. We hypothesized that TNS can modulate CBF at the targeted frequency band via the trigemino-cerebrovascular network, and TNS-induced CBF oscillations would improve cerebral oxygenation in peri-contusional areas. In a rat model of TBI complicated by hemorrhagic shock, TNS-induced CBF oscillations conferred significant preservation of peri-contusional tissues leading to reduced lesion volume, attenuated hypoxic injury and neuroinflammation, increased eNOS expression, improved neurological recovery and better 10-day survival rate, despite not significantly increasing CBF as compared with those in immediate and delayed resuscitation animals. Our findings indicate that low-frequency CBF oscillations enhance cerebral oxygenation in peri-contusional areas, and play a more significant protective role than improvements in non-oscillatory cerebral perfusion or volume expansion alone.
Prediction of Future Healthcare Expenses of Patients from Chest Radiographs Using Deep Learning: A Pilot Study
Authors: Sohn Jae Ho , Chen Yixin , Lituiev Dmytro , Yang Jaewon , Ordovas Karen , Hadley Dexter , Vu Thienkhai H. , Franc Benjamin L. , Seo Youngho
Published: April 2021

Our objective was to develop deep learning models with chest radiograph data to predict healthcare costs and classify top-50% spenders. 21,872 frontal chest radiographs were retrospectively collected from 19,524 patients with at least 1-year spending data. Among the patients, 11,003 patients had 3 years of cost data, and 1678 patients had 5 years of cost data. Model performances were measured with area under the receiver operating characteristic curve (ROC-AUC) for classification of top-50% spenders and Spearman ρ for prediction of healthcare cost. The best model predicting 1-year (N=21,872) expenditure achieved ROC-AUC of 0.806 [95% CI, 0.793-0.819] for top-50% spender classification and ρ of 0.561 [0.536-0.586] for regression. Similarly, for predicting 3-year (N=12,395) expenditure, ROC-AUC of 0.771 [0.750-0.794] and ρ of 0.524 [0.489-0.559]; for predicting 5-year (N=1,779) expenditure ROC-AUC of 0.729 [0.667-0.729] and ρ of 0.424 [0.324-0.529]. Our deep learning model demonstrated the feasibility of predicting health care expenditure as well as classifying top 50% healthcare spenders at 1, 3, and 5 year(s), implying the feasibility of combining deep learning with information-rich imaging data to uncover hidden associations that may allude physicians. Such a model can be a starting point of making an accurate budget in reimbursement models in healthcare industries.
The Post-Liver Transplant Quality of Life Instrument: Translation, Reliability, and Validity of the Persian Version
Authors: Javaherian Mohammad , Abazari Nader , Nejatisafa Ali-Akbar , Nasiri-Toosi Mohsen , Jafarian Ali , Soleimani Mehdi , Moghaddam Behrouz Attarbashi
Published: April 2021

Background: The Post-Liver Transplant Quality of Life (PLTQ) instrument is a specific, disease-based questionnaire to evaluate health-related quality of life (HRQOL) of liver transplantation (LTx) recipients. The aim of this study is translation, cross-cultural adaptation, and evaluation of the psychometric properties of the Persian version of PLTQ (PV-PLTQ) questionnaire.Methods: All of the stages of translation and cross-cultural adaptation of the original PLTQ instrument was carried out according to the published guideline. A total of 175 LTx recipients completed the PLTQ and short form-36 (SF-36) questionnaires. Sixty-eight randomly selected patients were asked to complete the PLTQ, 2 to 3 months later. Face validity, content validity, acceptability internal consistency, test-retest reliability, sensitivity to change, and convergent validity were evaluated.Results: The results of face validity, content validity, and missing data proportion indicate that PV-PLTQ questionnaire is acceptable and easy to understand. Cronbach’s alpha coefficient for the PV-PLTQ questionnaire was 0.97 (0.82 to 0.95) for domains. The results of test-retest reliability show moderate to good intraclass correlation coefficient from 0.6 to 0.86 (P< 0.05). Also, the results of the Kruskal-Wallis test shows that this questionnaire is sensitive to HRQOL changes. The correlations between PV-PLTQ domains and physical and mental components of SF-36 present a good convergent validity (P< 0.05).Conclusio: In general, The PV-PLTQ questionnaire is a valid, reliable and sensitive to change instrument to evaluate HRQOL in LTx recipients and can be applied in further researches and clinical settings in the Persian speaking population.
Inter-Specific and Inter-Individual Trait Variability Matter in Surface Sediment Reworking Rates of Intertidal Benthic Foraminifera
Authors: Deldicq Noémie , Seuront Laurent , Bouchet Vincent M.P.
Published: April 2021

Although benthic foraminifera are an important component of meiofauna and contribute to carbonate production and carbon/nitrogen cycles, their role in bioturbation processes remains poorly known. Five dominant intertidal benthic foraminifera were recently classified into functional bioturbator groups according to their sediment reworking mode and intensity. Our study aimed at identifying potential drivers (i.e. size and/or travelled distance) of species-specific surface sediment reworking rate. The travelled distance and surface sediment reworking rate of Haynesina germanica, Cribroelphidium williamsoni, Ammonia tepida, Quinqueloculina seminulum and Miliammina fusca were assessed through image analysis. Our results show that the surface sediment reworking performed by these species is not size-dependent, but dependent on their motility traits through interspecific differences in the travelled distance. Smaller species (i.e. Quinqueloculina seminulum and Haynesina germanica) contribute more to surface sediment reworking than larger ones (i.e. Ammonia tepida, Cribroelphidium williamsoni and Miliammina fusca). These observations stress the critical role of motion behaviour in surface sediment reworking processes by intertidal foraminifera. Finally, we stress that the high inter-individual variability observed in conspecific motion behaviour may be important to decipher the role of foraminifera in sediment bioturbation. Noticeably, the species characterized by a strong inter-individual variability are also the species that have the highest surface sediment reworking rates. This last observation may inform on the species-specific phenotypic plasticity and therefore the potential for the functional role of these species to be maintained in their natural environment. This is particularly relevant in an era of global change where ecosystem balance is increasingly threatened by various stressors such as heat-waves, ocean acidification and plastic pollution.
Study on Electrical Characteristics of Magmatic Rock Intrusions in Metamorphic Rock Formations—Taking the Mupi Tunnel of Jiuzhaigou-Mianyang Highway as an Example
Authors: Li Bin , Feng Chongde , Cheng Qiang , Yu Jianhua , Zhao Hu , Xiao Xuepei
Published: April 2021

The stratum lithology and geological structure of the highway tunnel in the mountainous areas of western China are complex, and the engineering geological conditions are complicated. When the highway tunnel passes through different lithological strata, its structural design and construction are completely different. Therefore, the design and construction of the supporting tunnel are used in the tunnel survey. The identification of the contact boundary between magmatic rock and metamorphic rock and the grade of surrounding rock is very important. The data processing, forward numerical simulation, 1D, 2D, and 3D inversion of the G8513 Jiuzhaigou-Mianyang Expressway Mupi Tunnel survey by magnetotelluric method reveals the ground level along the design line of the tunnel to the depth of 50m depths within the design elevation of the tunnel. Electrical characteristics, focusing on the identification of the contact boundary between magmatic rock and metamorphic rock. This study provides the electrical characteristics of the magmatic rock and metamorphic rock contact boundary of the Mupi Tunnel. It is speculated that the boundary is revealed by the tunnel construction excavation, which verifies the correctness of the geophysical inversion model and provides a more detailed design basis for the tunnel design. It is believed that taking the Mupi tunnel survey as an example, this research can provide detailed geophysical basis for the identification of magmatic rock and metamorphic rock in highway tunnels, as well as the geological survey and design of highway tunnels.
National-scale Changes in Crop Diversity Through the Anthropocene
Authors: Mariani Rachel O. , Cadotte Marc W. , Isaac Marney E. , Vile Denis , Violle Cyrille , Martin Adam R.
Published: April 2021

Expansion of crops beyond their centres of domestication is a defining feature of the current Anthropocene Epoch. These patterns have been quantified at large spatial scales, but the drivers and consequences of change in crop diversity and biogeography at national-scales remains less explored. We use production data on 339 crops, grown in over 150 countries from 1961–2017, to quantify changes in country-level crop richness and evenness. Virtually all countries globally have experienced significant increases in crop richness since 1961, with the early 1980s marking a clear onset of a ~ 9 year period of increase in crop richness worldwide. While these changes have increased the similarity of diversity of croplands among countries, only half of countries experienced increases in crop evenness through time. Ubiquitous increases in crop richness within nearly all countries between 1980–2000 are a unique biogeographical feature of the Anthropocene. At the same time, opposite changes in crop evenness, and only modest signatures of increased homogenization of croplands among countries, underscores that the understanding or predicting of consequences of crop diversity change requires context-dependent and, at least, national-scale assessments.
Effect of Average Ionic Radius of A-site, B-site in Ba0.85X0.15TiO3, BaY0.15Ti 0.85O3 Systems Respectively (X = Pb, Ca, Co), (Y = Zr, Mn, Si) as a Perovskite Structure Ceramics (ABO3) on Crystal Structure, Curie Temperature
Authors: Yaseen Jasim
Published: April 2021

Barium titanate BaTiO3 is one of the most ferroelectrics. Its commonly used in capacitors due to its high dielectric constant. In this study, our goal is to determine the extent to which the change in the average ionic radius of A, B sites affects the structural, dielectric properties of this ceramic. In this study, barium titanate (Ba0.85X0.15TiO3, BaY0.15Ti0.85O3) (X = Pb, Ca, Co, Y= Zr, Si, Mn) was prepared by solid state reaction method in which the calcination temperature was 1200 °C for 2 hours. Structural characterization and dielectric properties were determined and calculated by using x-ray diffractometer, RCL-Meter (PM6303) at frequency 20 Hz using different temperature respectively. The results of the work showed that the average ionic radius at the A, B sites plays a large and clear role in determining the values of the dielectric constant and Curie temperature in perovskites in addition to the structural parameters.
Vascular Tissue-Specific Expression of Bnac4.BOR1;1c, an Efflux Boron Transporter Gene, is Regulated in Response to Boron Availability for Efficient Boron Acquisition in Brassica Napus
Authors: Wang Sheliang , Liu Ling , Zou Dan , Huang Yupu , Zhao Zhe , Ding Guangda , Cai Hongmei , Wang Chuang , Shi Lei , Xu Fangsen
Published: April 2021

AimsBnaC4.BOR1;1c is required for B acquisition in Brassica napus (B. napus) under low B stress. This study aimed to reveal the B regulatory mechanism of BnaC4.BOR1;1c and its physiological roles in B translocation from roots to shoots and B distribution in shoots. MethodsTransgenic Arabidopsis plants expressing GUS (β-glucuronidase) under different promoters were generated and the mRNA, and GUS activity was quantitatively measured. The in-situ PCR and immunohistochemistry in B. napus were performed to investigate BnaC4.BOR1;1c expression pattern and localization. Furthermore, assays of B transport and distribution in wild type B. napus and BnaC4.BOR1;1c RNAi lines were carried out to elucidate its physiological roles. ResultsResults showed that BnaC4.BOR1;1c mRNA abundance is negatively correlated with B availability, which was mediated by the 29 nt sequence in the 5’ terminal region of 5’-UTR. Besides, the 5’-UTR simultaneously regulates protein expression level, most probably depending on the translation efficiency. BnaC4.BOR1;1c mainly localizes on the plasma membrane of vascular bundle cells in roots and shoots with a polar localization manner that is probably beneficial to B xylem loading in roots and B unloading from xylem to phloem in vascular bundle of shoots. Short-term 10B uptake analysis demonstrates that BnaC4.BOR1;1c preferentially distributes B to developing leaves and flowers under B deficiency. ConclusionThis study reveals combined regulatory action of mRNA abundance and translation efficiency mediated by the 5’-UTR in BnaC4.BOR1;1c in response to B availability and its physiological role in preferential B acquisition in developing tissues of B. napus.
Erythema Elevatum Diutinum: A Neutrophilic Dermatosis Presenting as Bullae
Authors: Ye Binrong , Xu Minyuan , Liu Yeqiang
Published: April 2021

Background: Erythema elevatum diutinum (EED) is a rare disease that is associated with streptococcal infection, blood disorders, and autoimmunity. It is a chronic inflammatory dermatosis in the spectrum of cutaneous leukocytoclastic vasculitis. Typical skin lesions include nodules, erythema, and plaques; however, the presence of blister lesions is rare, especially on the limbs. Case presentation: We report a rare case of EED that presented as blisters on both limbs and the trunk of a 62-year-old woman. She responded well to oral corticosteroid and hydroxychloroquine treatment. The lesions were significantly improved after 2 weeks of treatment. Conclusions: EED is a rare form of cutaneous vasculitis. It is a good mimic of other types of skin diseases because of its diverse clinical presentations. It can even rarely present as blisters.
Can the Simplified Magnetic Resonance Index of Activity be Used to Evaluate the Degree of Activity in Crohn's Disease?
Authors: Tao Yongli , Li Hong , Xu Han , Tang Wen , Fan Guohua , Yang Xiaochun
Published: April 2021

Background and Aims: A simplified magnetic resonance index of activity (MaRIAs) was proposed recently. Our aim was to verify whether the MaRIAs can accurately assess the activity degree of CD. Methods: We retrospectively analyzed the data of MRI, ileal colonoscopy, fecal calprotectin (FC), erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) of 93 CD patients. With the SES-CD as the gold standard, MaRIAs’ accuracy, The correlation of MaRIAs and SES-CD, FC, ESR, CRP, and interevaluator reliability were assessed. Results: MaRIAs≥1 detected segments with active CD with 90.80% specificity and 81.37% sensitivity (area under the curve was 0.91, 95% confidence interval 0.87-0.94). MaRIAs score of 2 or more detected severe lesions with 88.89% specificity and 95.12% sensitivity (AUC was 0.96, 95% confidence interval was 0.94-0.98). The MaRIAs score showed a high correlation with the SES-CD in the terminal ileum, transverse colon, right colon, left colon (r=0.85, 0.91, 0.88, 0.86,P < 0.001) and a moderate correlation with the SES-CD in the rectum (r=0.74, P < 0.001). The global MaRIAs score was highly correlated with the global SES-CD (r=0.90, P < 0.001). The global MaRIAs score was positively correlated with the fecal calprotectin (FC) level, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) level (r=0.77, r=0.64, and r=0.68). The intra-group correlation coefficient (ICC) of the two physicians in the terminal ileum, right colon, transverse colon,and left colon was 0.91, ICC in the rectum was 0.78, and ICC in the total bowel was 0.95 (95% confidence interval was 0.95-0.98). Conclusion: The MaRIAs can accurately evaluate the disease activity level of CD, high correlated with the SES-CD and biomarker. The interrater reliability of the two physicians was excellent.