bluuebunny/crossref_metadata_2025 huggingface dataset:
(Invited) Material Development and Equipment Improvement for 3D Gel Printing Using a Commercially-Available Stereolithography Printer
Authors: Sato Yosuke , Saito Azusa , Watanabe Yosuke , Shiblee MD Nahin Islam , Ogawa Jun , Khosla Ajit , Kawakami Masaru , Furukawa Hidemitsu
Published: September 2020

World's first 3D gel printer “SWIM-ER” was developed at Yamagata University by Prof. Hidemitsu Furukawa. SWIM-ER can print complicated 3D shapes of hydrogel, which are impossible to achieve by traditional gel manufacturing methods. Therefore, using SWIM-ER we can print gels that can be used in soft robotics, education and medical technology. However, SWIM-ER being an expensive instrument, it's availability to general users is limited. In work we have modified a commercial low cost LCD stereolithography 3D printer that enables 3D gel printing. The target commercial 3D printer price is around $500. Results indicate, in order to realize gel printing with a commercially available printer, it is necessary to compose a gel with right formulation of an initiator and an absorber that cause a gelation reaction with ultraviolet rays of 405 nm. We were successfully able to 3D print Inter-Cross-linking Network (ICN) gel using the modified printer.
A Qualitative Study of Barriers to Personal Protective Equipment Use among Laundry Workers in Government Hospitals, Hawassa, Ethiopia
Authors: Tamene Aiggan , Afework Abel , Mebratu Lewam
Published: September 2020

Background. The need to reduce the transmission of infectious diseases makes the use of personal protective equipment and safety medical devices compulsory among hospital laundry staff. The practice, however, remains to be low among hospital laundry staff members. Globally, not many studies seem to have been carried out to sufficiently tell us about the barriers to personal protective equipment use among hospital laundry workers. Related studies in Ethiopia are even fewer. This study assessed the barriers to personal protective equipment use among laundry staff of government hospitals in Hawassa City, Southern Ethiopia, 2019. Methods. Two qualitative data-gathering methods—focus group discussions and key informant interviews—were used to collect data for this study. Eight focus group discussions were conducted with hospital laundry workers. Similarly, six key informant interviews were held with Infection Prevention and Patient Safety Officers. Thematic analysis was performed using Open Code 4.02. Result. Organizational- and individual-level barriers such as unavailability of essential personal protective equipment, a disharmonious work environment, low perception of susceptibility, and belief about personal protective equipment interference with work performance were identified as the major barriers to personal protective equipment use in the present study. Conclusion. Organizational- and individual-level barriers have been identified as causes for the low level of personal protective equipment use among hospital laundry workers. Therefore, improving institutional supplies in quantity and quality may have a positive implication for the improvement of infection prevention practices in the study area. Also, designing sustainable strategies and raising laundry workers’ awareness of a safe work environment may lead to the improvement of infection prevention practices.
An Extension of the Mittag-Leffler Function and Its Associated Properties
Authors: Rahman Gauhar , Saboor Abdus , Anjum Zunaira , Nisar Kottakkaran Sooppy , Abdeljawad Thabet
Published: September 2020

Inspired by certain fascinating ongoing extensions of the special functions such as an extension of the Pochhammer symbol and generalized hypergeometric function, we present a new extension of the generalized Mittag-Leffler (ML) function εa,b;p,vκz1 in terms of the generalized Pochhammer symbol. We then deliberately find certain various properties and integral transformations of the said function εa,b;p,vκz1. Some particular cases and outcomes of the main results are also established.
Hypoxia Helps Maintain Nucleus Pulposus Homeostasis by Balancing Autophagy and Apoptosis
Authors: Kim Han-Jun , Lee Hye-Rim , Kim Hyosung , Do Sun Hee
Published: September 2020

Intervertebral disc degeneration (IVDD) is a common cause of lower back pain. Programmed cell death (PCD) including apoptosis and autophagy is known to play key mechanistic roles in the development of IVDD. We hypothesized that the nucleus pulposus cells that make up the center of the IVD can be affected by aging and environmental oxygen concentration, thus affecting the development of IVDD. Here, we evaluated the phenotype changes and PCD signaling in nucleus pulposus cells in two different oxygen percentages (5% (hypoxia) and 20% (normoxia)) up to serial passage 20. NP cells were isolated from the lumbar discs of rats, and the chondrogenic, autophagic, and apoptotic gene expressions were analyzed during cell culture up to serial passage 20. Hypoxia significantly increased the number of autophagosomes, as determined by monodansylcadaverine staining and transmission electron microscopy. Furthermore, hypoxia triggered the activation of autophagic flux (beclin-1, LC3-II/LC3-I ratio, and SIRT1) with a concomitant decrease in the expression of apoptotic proteins (Bax and caspase-3). Despite injury and age differences, no significant differences were observed between the ex vivo lumbar disc cultures of groups incubated in the hypoxic chamber. Our study provides a better understanding of autophagy- and apoptosis-related senescence in NP cells. These results also provide insight into the effects of aging on NP cells and their PCD levels during aging.
Analysis of Clinical Efficacy of Traditional Chinese Medicine in Recovery Stage of Stroke: A Systematic Review and Meta-Analysis
Authors: Zhang Xue , Zhang Xiao-Fei , Wang Lin , Guo Dong-Yan , Zhang Jia-Min , Chen Yong-Gang , Wang Zhi-Chao , Pei Li-Shan , Chen Jiang-Xue , Shi Ya-Jun , Zou Jun-Bo
Published: September 2020

Background. We provide an updated meta-analysis with detailed information on a combination of TCM and routine treatment. Methods. Retrieve appropriate articles with no language restrictions on keywords until 8 July 2019 in an electronic database. All trajectories are screened according to certain criteria. The quality of certified research was also evaluated. We made a detailed record of the results of the measurement. Meta-analysis was carried out by using the Revman 5.3 software. Results. Sixty-seven RCTs were included, and 6594 subjects were analyzed. Compared with routine treatment, the total effective rate (TER) of TCM combined with routine treatment was improved, and the recovery of stroke was also significantly accelerated. Regulation of blood lipids by notably shrinking the contents of TC, TG, and LDL and enhancing the levels of HDL. The levels of serum hs-CRP, WHV, and WLV decreased significantly, indicating that the expression of thrombomodulin was decreased after the comprehensive treatment of traditional Chinese medicines (TCMs). The combination of TCM treatment could enhance the protection of neural function by decreasing the NIHSS scoring while increasing the BI scoring. Paeoniae Radix Rubra, Angeticae Sinensis Radix, etc., can effectively improve the clinical symptoms of stroke convalescent patients and promote the recovery of neurological function. ACU of Baihui, Renzhong, etc., can improve the clinical rehabilitation effect of patients. However, our findings must be handled with care because of the small sample size and low quality of clinic trials cited. Other rigorous and large-scale RCTs are in need to confirm these results. Conclusion. A combination of TCM and routine treatment in the treatment of stroke could improve TER, and it is beneficial to the rehabilitation of patients in the recovery period of apoplexy. These effects can be mediated by a combination of several mechanisms. Nevertheless, due to the limitations of this study, these results should be handled with caution.
Variation of the Penetration Effort in an Artificial Tissue by Hypodermic Needles
Authors: Gonçalves Aparecido Carlos , Cavassana Sidnei , Chavarette Fábio R. , Outa Roberto , Casarin Samuel J. , Corazza Adalberto Vieira
Published: September 2020

Fear of injection-related pain is a drawback to injectable therapy. Hypodermic injections are a cause for great anxiety and reduced adherence to the subcutaneous application of insulin for glycemic control in diabetics or in the treatment of multiple sclerosis, increasing the risk of complications and mortality. Injured or sick people have to undergo several daily injections, forcing them to rotate the veins and regions used to recover from the trauma caused by the perforation of the skin, tissue, muscles, veins, and arteries. People who suffer from type 1 diabetes mellitus (DM1) need to have their glycemic control 3 to 5 times a day and to take insulin up to 3 times a day. In both cases, the patient needs to perforate the skin. To quantify the pain perceived by the patients depends on the evaluation of each patient and therefore is subjective. This study aims to understand the application and self-application of hypodermic injections and decrease pain during its application and the phobia of the patient, following the reasoning that the lower the effort to penetrate the needle, the less trauma in the tissue and therefore the pain provoked. For that, it was analyzed how some of the characteristics of the needle can influence the sensation of pain in the injection. The needle penetration effort was measured in an artificial tissue (substitute skin model) for different cannula diameters, roughness, depth of penetration, lubrication, and angles of the perforating tip bevel. This study aimed to find alternatives to facilitate the application and self-application of hypodermic injections, increase safety and comfort, and reduce the pain intensity perceived by the patient. To do this, the bevel of needles used repeatedly was analyzed in the profile projector and SEM to verify the loss of the profile or the formation of burrs that could hamper the penetration or traumatize the tissue during the reuse of needles. It has also been mechanically analyzed, which can be done to prevent that the needles used in the subcutaneous application do not inadvertently reach the muscle. The greater penetration effort observed in the needles with greater angle of the bevel is responsible for the patient’s perception of pain.
Impossible Differential Distinguishers of Two Generalized Feistel Structures
Authors: Wang Huili , Ma Wenping , Liao Lang , Li Yushan , Zheng Linfeng
Published: September 2020

Generalized Feistel structures are widely used in the design of block ciphers. In this paper, we focused on retrieving impossible differentials for two kinds of generalized Feistel structures: CAST256-like structure with Substitution-Permutation (SP) or Substitution-Permutation-Substitution (SPS) round functions (named CAST256SP and CAST256SPS, respectively) and MARS-like structure with SP/SPS round function (named MARSSP and MARSSPS, respectively). Known results show that for bijective round function, CAST256-like structures and MARS-like structures have (m2−1) and (2m−1) rounds impossible differentials, respectively. By our observation, there existed (m2+m) rounds impossible differentials in CAST256SP and (3m−3) rounds impossible differentials in MARSSPS (this result does not require the P layer to be invertible). When the diffusion layer satisfied some special conditions, CAST256SPS had (m2+m−1) rounds impossible differentials and MARSSPS had (3m−3) rounds impossible differentials.
Exploration of Digital Twin Design Mechanism of the Deep in Situ Rock Insulation Coring Device
Authors: Yu Bo , Xie Heping , Chen Ling , Zhao Wu , He Zhiqiang
Published: September 2020

With the development of the resource exploration and environmental science drilling, strict and scientific requirements are put forward for the samples taken from drilling. It is significant to keep the original appearance of the core and obtain the in situ core for the analysis of deep geological fluid and the exploration of the law of geological disasters caused by large-scale geological exploitation. To achieve the high-fidelity in situ core of deep rock, the development of the corresponding deep in situ fidelity coring device should involve the insulation coring device. The development of deep in situ fidelity coring device is a typical sophisticated product design. There are many problems in the design process, such as multimodules, multidisciplinary, crossdomain, and high coupling, which makes it more difficult for users to participate in product design and understand the product design intention. Digital twin technology, such as time data collection, accelerated iterative optimization, and high-fidelity rendering, provides users with an immersive experience and deepens their understanding of the product design intention. The exploration of the novel design model combined digital twin technology with innovative design theory. Digital twin innovative design of the deep in situ insulation coring device is based on the innovative design method, which built a digital connection between the pre-research test platform and the corresponding simulation models. This digital twin to help users participate in product design and understand the product design process. Finally, the TOPSIS evaluation model was used to calculate the user’s score on the design scheme, which increased by 27.64%, which improves the overall efficiency of product design. This paper provides a practical design method and technical means for the design of the deep in situ insulation coring device based on the geological mechanism and control theory of thermal insulation core.
Establishment of a Micropropagation Protocol for Elite Accessions of Bael (Aegle marmelos (L.) Corr.), a Tropical Hardwood Species
Authors: Pathirana Chamila , Attanayake Udayanthi , Dissanayake Udula , Gamlath Lakshman , Ketipearachchi Kalyani , Madhujith Terrence , Eeswara Janakie
Published: September 2020

The limited availability of high-quality planting material hinders the popularization of bael (Aegle marmelos (L.) Corr.) as a profitable cash crop in Sri Lanka. Five elite bael accessions, namely, Beheth Beli, Paragammana, Mawanella, Rambukkana, and Polonnaruwa-Supun, have been identified and used for mass propagation through budding and grafting. However, this process gets hampered by the limitations in large-scale production of planting material. Micropropagation is an alternative technique to produce clonal plants in large-scale; however, no established protocol is available for the field-grown elite bael accessions in Sri Lanka, and hence, the present study was conducted. The best sterilization method was found to be the washing of explants in a 2.5% fungicide solution for two hours. The full MS and ½MS media provided significantly similar performance in shooting, as indicated by the measured parameters. The twig plants did better than leaf explants concerning shoot extension, in which twig explants yield 1.33 cm taller shoots. The 1 mg/l of BAP concentration generated the highest number of shoots (6.20) and the most extended shoots (3.83 cm). The most successful rooting (60% success) was spotted with full MS, 1 mg/ml NAA, and 3% sugar. As previously reported, the successful micropropagation is possible if the explants are harvested from April to June, immediately after the fruiting season of the plant. The established protocol can mass-produce clonal bael plants from the elite accessions.
Productivity Evaluation for Long Horizontal Well Test in Deep-Water Faulted Sandstone Reservoir
Authors: Yuan Zhiwang , Yang Li , Zhang Yingchun , Duan Rui , Zhang Xu , Gao Yihua , Yang Baoquan
Published: September 2020

For deep-water faulted sandstone reservoirs, the general practice is to design long horizontal wells improving well productivity. During the project implementation stage, well tests are performed on all drilled wells to evaluate well productivity accurately. Furthermore, multisize chokes are often utilized in a shorten test time for loosen formation, high test cost, and high well productivity. Nevertheless, the conventional productivity evaluation approach cannot accurately evaluate the well test productivity and has difficulty in determining the underneath pattern. As a result, the objective of this paper is to determine a productivity evaluation method for multisize chokes long horizontal well test in deep-water faulted sandstone reservoir. This approach introduces a productivity model for long horizontal wells in faulted sandstone reservoir. It also includes the determination of steady-state test time and the productivity evaluation method for multisize chokes. In this paper, the EGINA Oilfield, a deep-water faulted sandstone reservoir, located in West Africa was chosen as the research target. Based on Renard and Dupuy’s steady-state equation, the relationship between the productivity index per meter and the length of horizontal section was derived. Consequently, this relationship is used to determine the productivity pattern for long horizontal wells with the same geological features, which can provide more accurate productivity evaluations for tested wells and forecast the well productivity for untested wells. After implementing this approach on the EGINA Oilfield, the determined relationship is capable to accurately evaluate the test productivity for long horizontal wells in reservoirs with similar characteristics and assist in examination and treatment for horizontal wells with abnormal productivity.
Surface Electromyography as a Method for Diagnosing Muscle Function in Patients with Congenital Maxillofacial Abnormalities
Authors: Szyszka-Sommerfeld Liliana , Lipski Mariusz , Woźniak Krzysztof
Published: September 2020

Electromyography (EMG) is the most objective and reliable method available for imaging muscle function and efficiency, which is done by identifying their electrical potentials. In global surface electromyography (sEMG), surface electrodes are located on the surface of the skin, and it detects superimposed motor unit action potentials from many muscle fibers. sEMG is widely used in orthodontics and maxillofacial orthopaedics to diagnose and treat temporomandibular disorders (TMD) in patients, assess stomatognathic system dysfunctions in patients with malocclusions, and monitor orthodontic therapies. Information regarding muscle sEMG activity in subjects with congenital maxillofacial abnormalities is limited. For this reason, the aim of this review is to discuss the usefulness of surface electromyography as a method for diagnosing muscle function in patients with congenital malformations of the maxillofacial region. Original papers on this subject, published in English between 1995 until 2020, are located in the MEDLINE/PubMed database.
Myocardin-Related Transcription Factor A (MRTF-A) Regulates the Balance between Adipogenesis and Osteogenesis of Human Adipose Stem Cells
Authors: Hyväri Laura , Vanhatupa Sari , Halonen Heidi T. , Kääriäinen Minna , Miettinen Susanna
Published: September 2020

Previous studies have demonstrated that myocardin-related transcription factor A (MRTF-A) generates a link between the dynamics of the actin cytoskeleton and gene expression with its coregulator, serum response factor (SRF). MRTF-A has also been suggested as a regulator of stem cell differentiation. However, the role of MRTF-A in human mesenchymal stem cell differentiation remains understudied. We aimed to elucidate whether MRTF-A is a potential regulator of human adipose stem cell (hASC) differentiation towards adipogenic and osteogenic lineages. To study the role of MRTF-A activity in the differentiation process, hASCs were cultured in adipogenic and osteogenic media supplemented with inhibitor molecules CCG-1423 or CCG-100602 that have been shown to block the expression of MRTF-A/SRF-activated genes. Our results of image-based quantification of Oil Red O stained lipid droplets and perilipin 1 staining denote that MRTF-A inhibition enhanced the adipogenic differentiation. On the contrary, MRTF-A inhibition led to diminished activity of an early osteogenic marker alkaline phosphatase, and export of extracellular matrix (ECM) proteins collagen type I and osteopontin. Also, quantitative Alizarin Red staining representing ECM mineralization was significantly decreased under MRTF-A inhibition. Image-based analysis of Phalloidin staining revealed that MRTF-A inhibition reduced the F-actin formation and parallel orientation of the actin filaments. Additionally, MRTF-A inhibition affected the protein amounts of α-smooth muscle actin (α-SMA), myosin light chain (MLC), and phosphorylated MLC suggesting that MRTF-A would regulate differentiation through SRF activity. Our results strongly indicate that MRTF-A is an important regulator of the balance between osteogenesis and adipogenesis of hASCs through its role in mediating the cytoskeletal dynamics. These results provide MRTF-A as a new interesting target for guiding the stem cell differentiation in tissue engineering applications for regenerative medicine.
Autophagy-Associated lncRNAs: Promising Targets for Neurological Disease Diagnosis and Therapy
Authors: Xu Xiangming , Cui Lili , Zhong Wangtao , Cai Yujie
Published: September 2020

Neurological diseases are a major threat to global public health and prosperity. The number of patients with neurological diseases is increasing due to the population aging and increasing life expectancy. Autophagy is one of the crucial mechanisms to maintain nerve cellular homeostasis. Numerous studies have demonstrated that autophagy plays a dual role in neurological diseases. Long noncoding RNAs (lncRNAs) are a vital class of noncoding RNAs with a length of more than 200 nucleotides and cannot encode proteins themselves but are expressed in most neurological diseases. An early phase, emerging knowledge has revealed that long noncoding RNAs (lncRNAs) are crucial in autophagy regulation. Furthermore, autophagy-associated lncRNAs can promote the development of neurological diseases or slow their progression. In this review, we introduce a general overview of lncRNA functional mechanisms and summarizes the recent progress of lncRNAs on autophagy regulation in neurological diseases to reveal possible novel therapeutic targets or useful biomarkers.
Aβ-Induced Repressor Element 1-Silencing Transcription Factor (REST) Gene Delivery Suppresses Activation of Microglia-Like BV-2 Cells
Authors: Yu Tongya , Quan Hui , Xu Yuzhen , Dou Yunxiao , Wang Feihong , Lin Yingying , Qi Xue , Zhao Yanxin , Liu Xueyuan
Published: September 2020

Compelling evidence from basic molecular biology has demonstrated the crucial role of microglia in the pathogenesis of Alzheimer’s disease (AD). Microglia were believed to play a dual role in both promoting and inhibiting Alzheimer’s disease progression. It is of great significance to regulate the function of microglia and make them develop in a favorable way. In the present study, we investigated the function of repressor element 1-silencing transcription factor (REST) in Aβ1-42-induced BV-2 cell dysfunction. We concluded that Aβ1-42 could promote type I activation of BV-2 cells and induce cell proliferation, migration, and proinflammation cytokine TNF-α, IL-1β, and IL-6 expression. Meanwhile, REST was upregulated, and nuclear translocalization took place due to Aβ1-42 stimulation. When REST was knocked down by a specific short hairpin RNA (sh-RNA), BV-2 cell proliferation, migration, and proinflammation cytokine expression and secretion induced by Aβ1-42 were increased, demonstrating that REST may act as a repressor of microglia-like BV-2 cell activation.
Fluoroscopy-Guided Blockade of the Greater Occipital Nerve in Cadavers: A Comparison of Spread and Nerve Involvement for Different Injectate Volumes
Authors: Song Zhanfeng , Zhao Shuming , Ma Jianqing , Wu Zhanyong , Yang Sidong
Published: September 2020

Background. Fluoroscopy-guided blockade of the greater occipital nerve (GON) is an accepted method for treating the symptoms of cervicogenic headaches (CGHs). However, the spread patterns among different injectate volumes of fluoroscopy-guided GON blocks are not well defined. Objective. A cadaveric study was established to determine the spread patterns of different volumes of dye injectate within a fluoroscopic GON block. Study Design. Cadaveric study. Setting. Xingtai Institute of Orthopaedics; Orthopaedic Hospital of Xingtai. Methods. 15 formalin-fixed cadavers with intact cervical spines were randomized in a 1 : 1 : 1 ratio to receive a fluoroscopy-guided GON injection of a 2, 3.5, or 5 ml volume of methylene blue. The suboccipital regions were dissected to investigate nerve involvement. Results. The suboccipital triangle regions, including the suboccipital nerves and GONs, were deeply stained in all cadavers. The third occipital nerve (TON) was stained in 7 of 10 administered 2 ml injections and in all the 3.5 ml and 5 ml injections. Compared to the 3 ml injectate group, the 5 mL cohort consistently saw injectate spreading to both superficial and distant muscles. Limitations. Given that cadavers were used in this study, cadaveric soft tissue composition and architecture can potentially become distorted and consequently affect injectate diffusion. Conclusions. A 3.5 or 5 mL fluoroscopy-guided GON injection of methylene blue successfully stains the GON, TON, and suboccipital nerves. This suggests that such an injection would generate blockade of all three nerve groups, which may contribute to the efficacy of the block for CGH. A volume of 3.5 ml may be enough for the performance of a fluoroscopy-guided GON block for therapeutic purposes.
Factors Associated with Postnatal Depression among Mothers Attending at Bharatpur Hospital, Chitwan
Authors: Chalise Mariya , Karmacharya Isha , Kaphle Maheshor , Wagle Ayurma , Chand Natasha , Adhikari Laxmi
Published: September 2020

Postnatal depression is linked with adverse outcomes for mothers, offspring, and her entire family, which stands as a significant public health problem and is often taken as a neglected issue of maternal and child health in the developing world. Postnatal depression is often falsely interpreted as common consequences related to the recent delivery. The main objective of this study is to find out the status of postnatal depression and the factors associated with it among the postnatal mothers attending at Bharatpur Hospital. Methodology. A total of 242 postnatal women were included in a hospital-based cross-sectional descriptive study. A systematic random sampling technique was done to get the sampling interval. Face to face interview technique was used for data collection, and depressive symptoms were measured by the Edinburgh Postnatal Depression Scale. Data was entered in Epi-Data and imported to SPSS for analysis. The data were summarized in terms of frequency (percentage), mean (SD), or median (IQR) as per necessity for descriptive analysis. The chi-square test and binary logistic regression were performed to find out the association between the covariates and depression status, assuming significance at p value <0.05. Results. The study revealed that the prevalence of postnatal depression was 16.9% by EPDS at cutoff point ≥12. It was found that postnatal depression was associated with current age, smoking, pressure to conceive a child, intent of pregnancy, and delivery-related complications. Conclusion. Postnatal depression within six months of delivery was found among nearly one-fifth of women, where 13.6% also had suicidal thoughts. More than half of the postnatal women had an early marriage. It is recommended that mothers with high risk should be routinely screened for postnatal depression followed by necessary interventions as well as safe motherhood counseling.
Clinical Characteristics of Visual Dysfunction in Carbon Monoxide Poisoning Patients
Authors: Bi Wei-Kang , Wang Jin-Lin , Zhou Xu-Dong , Li Ze-Kun , Jiang Wen-Wen , Zhang Shao-Bin , Zou Yong , Bi Ming-Jun , Li Qin
Published: September 2020

Purpose. The aim of the present study was to analyze the clinical characteristics of visual dysfunction in patients with carbon monoxide (CO) poisoning. Methods. A total of 436 patients with CO poisoning were enrolled in our hospital from October 2012 to December 2018, including 193 patients with moderate poisoning (MP group), 165 with severe poisoning (SP group), and 78 with delayed encephalopathy (DE group). The clinical characteristics of visual dysfunction in patients with CO poisoning were analyzed through the collection of medical history, regular physical examination, brain magnetic resonance imaging (MRI), ophthalmological examination, the National Eye Institute Visual Function Questionnaire (NEI-VFQ), and its influencing factors. Results. Some patients in the three groups had visual dysfunction. The main ocular symptoms were local pain, eye movement disorder, and visual field defect. The key pathological factors were keratopathy, retinal nerve cell damage, optic nerve damage, retinal vascular disease, macular disease, and occipital visual center damage. The clinical symptoms of visual dysfunction after CO poisoning lasted for a long time (>12 months) and were not completely consistent with the positive results of the ophthalmological examination. A few sequelae of ophthalmology were still left after the help of medicine. Conclusion. The incidence of visual dysfunction in patients with CO poisoning was high, the clinical symptoms were rich and diverse, the duration of disease was long, and the prognosis was poor. Thus, the relevant ophthalmological examination and intervention treatment should be perfected as soon as possible.
Recompensation of Decompensated Hepatitis B Cirrhosis: Current Status and Challenges
Authors: Zhao Hong , Wang Qi , Luo Changling , Liu Ligai , Xie Wen
Published: September 2020

Liver‐function decompensation or hepatocellular carcinoma (HCC) gradually appears after chronic hepatitis B progresses to cirrhosis. Effective antiviral treatment can significantly improve the long‐term prognosis of decompensated patients, and some patients present recompensation of decompensated hepatitis B cirrhosis. At present, there are limited research data on the recompensation of decompensated hepatitis B cirrhosis. There is still controversy regarding the evaluation time, evaluation indicators, influencing factors, and long‐term prognosis of recompensation.
Vertical Gradient Temperature Difference of the Main Arch with Single Pipe Section in Tibet Based on Statistical Analysis
Authors: Shi Tuo , Deng Nianchun , Chen Zheng , Li Haoxu
Published: September 2020

A 75 m long experimental arch with a 1.6 m diameter was constructed in Tibet for a one‐year test to determine the most unfavourable vertical temperature difference for a single pipe in the main arch of a concrete‐filled steel tube arch bridge. Actual temperature observation data were used to analyse the vertical temperature difference in the single circular pipe arch rib using statistical methods. The standard value for the vertical temperature difference in the single pipe under a return period of 50 years was calculated. The results showed that the influence range of the vertical gradient temperature was 25 cm. The vertical temperature difference followed a lognormal distribution, and the standard values of the positive temperature difference at the upper and lower ends of the single pipe were 16 and 10°C, respectively; the standard values of the negative temperature difference at the upper and lower ends of the single pipe were both ‐8°C under a return period of 50 years. These results are considerably different from the values specified in the current Chinese code. These could serve as references for calculations involving arch bridges in Tibet with single circular pipes in the main arches.
HPV Types in Cervical Precancer by HIV Status and Birth Region: A Population-Based Register Study
Authors: Carlander Christina , Lagheden Camilla , Eklund Carina , Nordqvist Kleppe Sara , Dzabic Mensur , Wagner Philippe , Yilmaz Aylin , Elfgren Kristina , Sönnerborg Anders , Sparén Pär , Dillner Joakim
Published: September 2020

Background:

Data are lacking regarding which human papillomavirus (HPV) types cause high-grade cervical neoplasia (CIN2+) in people with HIV in Europe. We assessed which HPV types are associated with CIN2+ in women living in Sweden by HIV status.

Methods:

The Swedish National HIV Registry, the Swedish Population Registry, and the Swedish National Cervical Screening Registry were linked. CIN2+ tissue blocks of 130 women living with HIV (WLWH) and 234 HIV-negative women, matched for country of birth (1:2), were retrieved from bio-banks and HPV genotyped. Adjusted ORs (adjOR), stratified by country of birth, were calculated using conditional logistic regression. Matching was broken for cross-group comparisons.

Results:

WLWH with CIN2 were less likely to have HPV16 [14% vs. 40%; adjOR 0.1; 95% confidence interval (CI), 0.04–0.56] than HIV-negative women, but among women with CIN3, there was no difference in HPV16 prevalence by HIV status (adjOR 0.9; 95% CI, 0.51–1.70). WLWH were six times more likely to have HPV35 in CIN3 than HIV-negative women (adjOR 6.2; 95% CI, 1.3–30.4). WLWH from sub-Saharan Africa (SSA) had less 9-valent vaccine types, compared with both HIV-negative women born in Sweden (adjOR 0.1; 95% CI, 0.02–0.44) and WLWH born in Sweden (adjOR 0.1; 95% CI, 0.01–0.73), mostly because of decreased HPV16 and increased HPV35.

Conclusions:

WLWH from SSA were less likely to be covered by the 9-valent vaccine, mostly due to less HPV16 and more HPV35.

Impact:

This could have implications for HPV vaccines, currently not including HPV35, and for HPV-screening algorithms in women with origin from SSA.
Prognostic Value and Influence of Receptor Conversion on Treatment Regimen in Metastatic Breast Cancer at the First Time of Recurrence
Authors: Shen Jiming , Xu Lu , Shi Jing , Zhao Lei , Shi Sha , Feng Jing , Han Xu , Shi Yu , Wei Qiaochu , Wang Dongni , Sun Mingfang , Mi Xiaoyi , Teng Yue'e
Published: September 2020

Purpose: At the first time of metastatic breast cancer recurrence, conversion of the receptors status may occur between primary lesions and metastatic lesions, including the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). Whether the decision of the treatment regimen is based on the primary receptor status or that of metastatic lesions is still unclear. Methods: This study enrolled 411 female patients with a diagnosis of metastatic breast cancer at the first time of recurrence to explore the influence of receptor conversion on prognosis prediction and treatment regimen of patients with metastatic breast cancer. Results: ER and PR changes from negative to positive are both prognostic factors for patients with breast cancer. Patients receiving endocrine therapy showed a better survival after recurrence than those using chemotherapy alone in the ER or PR Prim– Met+ subgroup. Patients in the HER2 Prim– Met+ subgroup using HER2-targeted therapy in multilines showed a post-recurrence survival advantage. In the bone re-biopsy subgroup, the PR change from positive to negative appeared to be more frequent than at other re-biopsy sites. Conclusions: Patients with metastatic breast cancer should perform re-biopsy to clarify the receptor status of the first metastatic lesions, which may provide clinicians valuable evidence to conduct treatments with higher precision.
A Thorough Examination of Morning Activity Patterns in Adults with Arthritis and Healthy Controls Using Actigraphy Data
Authors: Keogh Alison , Sett Niladri , Donnelly Seamas , Mullan Ronan , Gheta Diana , Maher-Donnelly Martina , Illiano Vittorio , Calvo Francesc , Dorn Jonas F. , Mac Namee Brian , Caulfield Brian
Published: September 2020

Background: Wearable sensors allow researchers to remotely capture digital health data, including physical activity, which may identify digital biomarkers to differentiate healthy and clinical cohorts. To date, research has focused on high-level data (e.g., overall step counts) which may limit our insights to whether people move differently, rather than how they move differently. Objective: This study therefore aimed to use actigraphy data to thoroughly examine activity patterns during the first hours following waking in arthritis patients (n = 45) and healthy controls (n = 30). Methods: Participants wore an Actigraph GT9X Link for 28 days. Activity counts were analysed and compared over varying epochs, ranging from 15 min to 4 h, starting with waking in the morning. The sum, and a measure of rate of change of cumulative activity in the period immediately after waking (area under the curve [AUC]) for each time period, was calculated for each participant, each day, and individual and group means were calculated. Two-tailed independent t tests determined differences between the groups. Results: No differences were seen for summed activity counts across any time period studied. However, differences were noted in the AUC analysis for the discrete measures of relative activity. Specifically, within the first 15, 30, 45, and 60 min following waking, the AUC for activity counts was significantly higher in arthritis patients compared to controls, particularly at the 30 min period (t = –4.24, p = 0.0002). Thus, while both cohorts moved the same amount, the way in which they moved was different. Conclusion: This study is the first to show that a detailed analysis of actigraphy variables could identify activity pattern changes associated with arthritis, where the high-level daily summaries did not. Results suggest discrete variables derived from raw data may be useful to help identify clinical cohorts and should be explored further to determine if they may be effective clinical biomarkers.
Effectiveness, Safety, and Health-Related Quality of Life of Chronic Migraine Patients Treated with Onabotulinum Toxin A
Authors: Beckmann Yesim , Çetin Üncü Fatma , Kurt İncesu Tülay , Türe Sabiha
Published: September 2020

Objective: The present study aims to describe the efficacy and safety of onabotulinum toxin A (BonT-A) with evaluation of treatment satisfaction and impact on quality of life in chronic migraine (CM) patients in real life. Methods: This study was conducted in CM patients who were treated with BoNT-A with 12 months of follow-up. Data about outcome, adverse events, and patients’ pre- and post-treatment status including health-related quality of life data were analyzed. Health-related quality of life scores were measured at baseline and months 6 and 12 after the beginning of BoNT-A administration. Results: Of 42 enrolled patients, 30 were included in the analysis. At 12 months, all patients showed a reduction in number of headaches and analgesic use per month and none reported adverse events. After BoNT-A supplementation, health-related quality-of-life scores improved significantly. There was a direct association between health-related quality of life with reduction of headache days at the end of study. Conclusion: This study confirms that BoNT-A treatment is effective on CM and improves the functional well-being and quality of life of patients.
Inflammatory Dietary Patterns and Risk of Keratinocyte Cancers in Kidney Transplant Recipients: Prospective Cohort Study
Authors: Shao Emily , Green Adele C. , Miura Kyoko
Published: September 2020

Background: Kidney transplant recipients (KTRs) are at increased risk of cutaneous squamous (SCC) and basal cell carcinomas (BCC) due to immunosuppression and sun exposure. Skin carcinogenesis involves inflammation, and foods that promote inflammation may promote carcinogenesis. Methods: We prospectively examined the association between pro-inflammatory diets and SCC and BCC incidence in KTRs in Queensland, Australia. We recruited KTRs at high risk of skin cancer (aged ≥18 years and previously affected; or aged ≥40; or immunosuppressed ≥10 years) between 2012 and 2014 and followed up until June 2016. A baseline dietary questionnaire was used to calculate modified-Empirical Dietary Inflammatory Pattern (EDIP) scores to indicate dietary inflammatory capacity; higher scores indicated pro-inflammatory diets. EDIP scores were ranked into 3 groups. Outcomes were histologically confirmed SCC and BCC. Adjusted relative risks (RRadj) and 95% CIs were estimated using negative binomial regression. Results: Among 260 KTRs, 100 (38%) and 93 (36%) developed at least 1 new SCC and BCC, with 426 SCC and 343 BCC diagnosed in the follow-up period. The highest modified-EDIP score group (vs. lowest) were at increased risk of SCC (RRadj 1.79, 95% CI 1.01–3.16) but not BCC. Pro-inflammatory diets may increase SCC but not BCC risk among KTRs. Conclusions: Inflammatory diets may increase the risk of SCC in KTRs.
Four-Factor Prothrombin Complex Concentrate: An Indispensable Adjunct in Coagulopathy of Trauma Management – A Comparative Review of the Literature over 2 Decades
Authors: Osama Muhammad , Syed Sohaib Hasan , Nasir H.M. Saad Abdul , Zaidi Syeda Ramsha
Published: September 2020

Background: Damage control resuscitation forms the cornerstone of management in trauma surgery. Several blood products have been widely used for preoperative transfusions prior to emergency surgeries and for hemorrhage control in trauma. Prothrombin complex concentrate (PCC) is now being introduced as an essential component of damage control resuscitation. Summary: We did a comparative descriptive analysis of several single and multi-institutional clinical trials and retrospective cohort studies. The primary focus of these studies was a comparison between PCC and other transfusion modalities including recombinant factor VIIa, fresh-frozen plasma, and fibrinogen based on several vital parameters. The parameters included rapid international normalized ratio reversal, hospital length of stay, cost-effectiveness, mortality rate, and rate of thromboembolic complications. Key Points: Although still awaiting its approval from the FDA for use in traumatic coagulopathy, 4-factor PCC has shown far more convincing results in contrast to former transfusion modalities, even 3-factor PCC. However, more prospective extensive clinical trials on national levels are needed to compare its effectiveness to 3-factor PCC and gather promising recognition in the trauma care fraternity.
Primary Intraocular Malignant Rhabdoid Tumor Mimicking Retinoblastoma in a Child
Authors: Kasturi Nirupama , Gera Pratik , Panicker Gayatri , Jossy Ajax , Rangarajan Vidhyalakshmi , Hanuman Srinivas Bheemanathi 
Published: September 2020

Primary rhabdoid tumors are highly malignant, rare tumors occurring in the renal, extrarenal soft tissue or central nervous system. They have non-specific radiological features and present with several histological components that create a problem in differential diagnosis with other embryonal tumors. We report a rare case of malignant rhabdoid tumor of the retina that presented with clinical features like those of retinoblastoma.
Merkel Cell Polyomavirus Gene Expression and Mutational Analysis of Large Tumor Antigen in Non-Merkel Cell Carcinoma Tumors of Iranian Patients
Authors: Motavalli Khiavi Farhad , Nasimi Maryam , Rahimi Hamzeh
Published: September 2020

Introduction: The presence of Merkel cell polyomavirus (MCPyV) was identified in Merkel cell carcinoma (MCC). However, there was sparse information on the link of other common nonmelanoma skin cancers – basal cell carcinoma (BCC) and squamous cell carcinoma (SCC) – to MCPyV infection. The current study describes the phylogenetic information of MCPyV isolated from Iranian non-MCC (nonmelanoma skin cancers) focusing on tumorigenesis of mutations in large tumor (LT) antigen (LT-Ag) fragment. Methods: Sixty patients with BCC and 20 patients with SCC were included in this study (48 males and 32 females; average age 65 years). The MCPyV-DNA copy number in positive samples was measured by quantitative real-time PCR. Then, mutational analysis of the MCPyV LT gene was carried out by direct sequencing. Results: While MCPyV DNA was detected in 6 (10%) of 60 BCC samples, no viral genome was found in SCCs. There was no distinct association of MCPyV positivity with gender, age, or type of tumor (BCC or SCC) (p value >0.05). Quantitative real-time PCR revealed that the median number of viral DNA copies per cell was 0.7 in 6 MCPyV-positive BCC samples. Furthermore, full-length LT-Ag sequencing of positive samples indicated no stop codon or frameshift mutations compared to reference sequences. Conclusion: Considering the important role of the LT-Ag in the pathogenicity of MCPyV, non-synonymous mutations compared with the reference proteins triggered relevant amino acid substitutions. Overall, the results showed no tumor-associated mutations in the LT-Ag sequence of MCPyVs from positive samples.
Modulation of Immune Cell Subsets by Hepatitis C Virus and Antiviral Therapy in Early Virological Response HCV Genotype 4-Infected Patients with Compensated Liver Disease
Authors: Essa Sahar , Al-Attiyah Raja’a , Siddique Iqbal , Al-Nakib Widad
Published: September 2020

Background: Resolution of chronic hepatitis C virus (HCV) infection requires a complicated interaction between immune cell subsets. The effect of antiviral therapy on immune cell subsets remains to be defined. This study aimed to investigate the absolute count of certain immune cell subsets during therapy with pegylated interferon-α and ribavirin (PegIFN/RBV). Materials and Methods: Sixty HCV genotype 4-infected patients with compensated liver disease were treated with PegIFN/RBV therapy for 52 weeks. Efficacy was measured by studying the early virological response (EVR) at post-therapy week 12. Absolute counts of mature T cells, T helper cells, T cytotoxic cells, activated T cells, natural killer cells, natural killer/T (NKT) cells, B cells, and T regulatory cells (Treg), and the ratio of T helper to T cytotoxic cells were longitudinally analyzed by flow cytometry throughout the treatment and follow-up course. Results: Of the 60 genotype 4-infected subjects, 39 (65%) had EVR and 21 (35%) were non-EVR patients. In the first part of this study, there were significantly lower mean absolute count values of mature T, T cytotoxic, B, and NKT cells. Also, we detected statistically significantly lower mean values for the percentages of T cytotoxic, NKT, Treg, and activated T cells of HCV-infected patients at baseline values when compared with healthy subjects. After the initiation of PegIFN/RBV therapy, frequencies of T helper cells, activated T cells, Treg cells, B cells, and T helper:T cytotoxic ratio were found to be significantly lower in EVR patients than in non-EVR patients (p < 0.05). In contrast, frequencies of T cytotoxic and NKT cells were significantly increased in EVR patients when compared to non-EVR patients (p < 0.05). Conclusion: These results suggest a pattern of higher levels of T cytotoxic and NKT cells, and lower levels of T helper, activated T, Treg, and B cell populations in patients who respond favorably to PegIFN/RBV therapy.