bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploring use of activity monitors for patients with obesity during weight-loss treatment - a qualitative study
Authors: Følling Ingrid S. , Oldervoll Line M. , Hilmarsen Christina , Ersfjord Ellen M. I. 
Published: March 2021

Abstract
Background
Obesity is a major health concern in western countries. In Norway, patients with obesity can attend weight-loss programmes, which focus on changes in dietary and physical activity habits. Use of self-monitoring is advocated when changing dietary and physical activity habits for adults with obesity. This study aimed to explore the experiences of patients with obesity who used activity monitors while attending a weight-loss programme.

Methods
Patients with body mass index (BMI) > 35 kg/m2 with weight related comorbidities or a BMI > 40 kg/m2 referred to an intermittent weight-loss programme were recruited into this study. They were introduced to one of three different activity monitors, Fitbit Zip™, Mio Fuse™, or Mio Slice™. Semi-structured interviews were performed with patients six months into the weight-loss programme. Thematic analysis was applied when analysing the data.

Results
Of the 29 informants (aged 21 to 66 years) interviewed, 59% were female. Their experience with activity monitors was related to their adherence to the weight-loss programme. Two main themes emerged from the informants stories: 1. “Activity monitors visualize proof of effort or failure to change health habits”. 2. “Activity monitors act as a positive or negative enforcer when incorporating change”.

Conclusions
Using activity monitors either strengthens or undermines patients’ attempts to change health habits when attending a weight-loss program. Our findings suggest a need for more individualized weight-loss programmes for patients with obesity.
Evaluation of a school-based multicomponent behavioural intervention in deprived urban areas for children classified as overweight, obese or at risk for overweight
Authors: Kloek Gitte C. , Jongert Martien W. A. , de Vries Sanne I. 
Published: March 2021

Abstract
Objective
This study evaluated the effect of an after-school group-based medium-intensity multicomponent behavioural intervention programme for children aged 8–12 years classified as overweight, obese or at risk for overweight on body mass index standard deviation score (BMI SDS). In accordance with standardized protocols body weight and height were measured in 195 participants (88 boys, 107 girls) at baseline and at the end of the programme. A total of 166 children derived from a school-based monitoring system served as control group. Multivariate regression analyses examined the effect of the intervention and the independent factors associated with better outcomes in the intervention group.

Results
Analysis of covariance showed a significant intervention effect on BMI SDS in favour of the intervention group (b-coefficient − 0.13 ± 0.03; p < 0.01) compared with the control group. Change in BMI SDS between baseline and follow-up in the intervention group was associated with baseline age (b-coefficient 0.03 ± 0.02; p = 0.04) but was independent from gender, ethnicity, baseline BMI SDS, time between baseline and follow-up, school year and attendance rate.
Improvement and prediction of secondary metabolites production under yeast extract elicitation of Azadirachta indica cell suspension culture using response surface methodology
Authors: Farjaminezhad Reza , Garoosi Ghasemali 
Published: March 2021

AbstractNeem is a medicinal plant used as antimalarial, antibacterial, antiviral, insecticide, and antimicrobial drug. This study aimed to investigate and predict the effect of yeast extract and sampling time on cell growth, secondary metabolites synthesis, SQS1 and MOF1 genes expression by response surface methodology. The highest fresh and dry cell weights were 580.25 g/L and 21.01 g/L, respectively obtained 6 days after using 100 mg/L yeast extract. The highest azadirachtin accumulation and production were 16.08 mg/g DW and 219.78 mg/L obtained 2 and 4 days, respectively after using 25 mg/L yeast extract. Maximum mevalonic acid accumulation (1.75 mg/g DW) and production (23.77 mg/L) were observed 2 days after application of 50 mg/L yeast extract. The highest amount of squalene accumulation (0.22 mg/g DW) and production (4.53 mg/L) were achieved 4 days after using 50 mg/L yeast extract. Prediction results exhibited the highest azadirachtin accumulation (13.61 mg/g DW) and production (190.50 mg/L), mevalonic acid accumulation (0.50 mg/g DW) and production (5.57 mg/L), and squalene accumulation (0.30 mg/g DW) by using 245 mg/L yeast extract for 2 days, 71 mg/L yeast extract for 2 days, 200 mg/L yeast extract for 4.96 days, without yeast extract for 6.54 days and 4 days, respectively. Also, it was predicted that the highest squalene production is achieved by long-term exposure to high concentrations of yeast extract. The qRT-PCR analysis displayed the maximum relative gene expression of SQS1 and MOF1 by using 150 and 25 mg/L yeast extract for 4 and 2 days treatment.
Energy-aware task offloading with deadline constraint in mobile edge computing
Authors: Li Zhongjin , Chang Victor , Ge Jidong , Pan Linxuan , Hu Haiyang , Huang Binbin 
Published: March 2021

AbstractWith the development of the wireless network, increasing mobile applications are emerging and receiving great popularity. These applications cover a wide area, such as traffic monitoring, smart homes, real-time vision processing, objective tracking, and so on, and typically require computation-intensive resources to achieve a high quality of experience. Although the performance of mobile devices (MDs) has been continuously enhanced, running all the applications on a single MD still causes high energy consumption and latency. Fortunately, mobile edge computing (MEC) allows MDs to offload their computation-intensive tasks to proximal eNodeBs (eNBs) to augment computational capabilities. However, the current task offloading schemes mainly concentrate on average-based performance metrics, failing to meet the deadline constraint of the tasks. Based on the deep reinforcement learning (DRL) approach, this paper proposes an Energy-aware Task Offloading with Deadline constraint (DRL-E2D) algorithm for a multi-eNB MEC environment, which is to maximize the reward under the deadline constraint of the tasks. In terms of the actor-critic framework, we integrate the action representation into DRL-E2D to handle the large discrete action space problem, i.e., using the low-complexity k-nearest neighbor as an approximate approach to extract optimal discrete actions from the continuous action space. The extensive experimental results show that DRL-E2D achieves better performance than the comparison algorithms on all parameter settings, indicating that DRL-E2D is robust to the state changes in the MEC environment.
Effect of using electronic medication monitors on tuberculosis treatment outcomes in China: a longitudinal ecological study
Authors: Wang Ni , Guo Lei , Shewade Hemant Deepak , Thekkur Pruthu , Zhang Hui , Yuan Yan-Li , Wang Xiao-Meng , Wang Xiao-Lin , Sun Miao-Miao , Huang Fei , Zhao Yan-Lin 
Published: March 2021

Abstract
Background
In China, an indigenously developed electronic medication monitor (EMM) was designed and used in 138 counties from three provinces. Previous studies showed positive results on accuracy, effectiveness, acceptability, and feasibility, but also found some ineffective implementations. In this paper, we assessed the effect of implementation of EMMs on treatment outcomes.

Methods
The longitudinal ecological method was used at the county level with aggregate secondary programmatic data. All the notified TB cases in 138 counties were involved in this study from April 2017 to June 2019, and rifampicin-resistant cases were excluded. We fitted a multilevel model to assess the relative change in the quarterly treatment success rate with increasing quarterly EMM coverage rate, in which a mixed effects maximum likelihood regression using random intercept model was applied, by adjusting for seasonal trends, population size, sociodemographic and clinical characteristics, and clustering within counties.

Results
Among all 69 678 notified TB cases, the treatment success rate was slightly increased from 93.5% [95% confidence interval (CI): 93.0–94.0] in second quarter of 2018 to 94.9% (95% CI: 94.4–95.4) in second quarter of 2019 after implementing EMMs. There was a statistically significant effect between quarterly EMM coverage and treatment success rate after adjusting for potential confounders (P = 0.0036), increasing 10% of EMM coverage rate will lead to 0.2% treatment success rate augment. Besides, an increase of 10% of elderly or bacteriologically confirmed TB will lead to a decrease of 0.4% and 0.9% of the treatment success rate.

Conclusions
Under programmatic settings, we found a statistically significant effect between increasing coverage of EMM and treatment success rate at the county level. More prospective studies are needed to confirm the effect of using EMM on TB treatment outcomes. We suggest performing operational research on EMMs that provides real-time data under programmatic conditions in the future.
Heart rate variability change during a stressful cognitive task in individuals with anxiety and control participants
Authors: Held Judith , Vîslă Andreea , Wolfer Christine , Messerli-Bürgy Nadine , Flückiger Christoph 
Published: March 2021

Abstract
Background
Individuals suffering from an anxiety disorder are characterized by chronically low heart rate variability (HRV) compared to healthy individuals during resting state conditions. However, when examining HRV and HR in response to a stressor, mixed results have been obtained when comparing anxious and non-anxious groups.

Methods
The primary aim of the present study was to investigate HRV and HR responding in 26 clinically anxious and 14 control individuals before, during and after a stressful working memory task.

Results
Results indicate no between-group differences in HRV and HR at baseline. When starting the working memory task, the control group decreased significantly in HRV and the anxious group did not differ substantially in their change pattern from baseline to the start of the stressor. Finally, during the recovery phase of the working memory task, the clinically anxious and control individuals did not differ in their HFV or HR response compared to baseline.

Conclusions
From a clinical perspective, the results suggest that screening for the presence of anxiety disorders may help to identify patients with impaired HRV and HR functioning and to intervene on these important patient characteristics early in the treatment process.
Preliminary study of the toxicity and radioprotective effects of zymosan in vitro and in vivo
Authors: Zhang Yue-zhi , Ge Shu-jing , Leng Qing-zhen , Ma Jian-jun , Liu Han-chen 
Published: March 2021

Abstract
Background
This study aimed to confirm the cytotoxicity of zymosan in vitro and in vivo and determine the appropriate treatment time and the dose of zymosan.

Methods
AHH-1 cells and HIECs were administered by 0, 20, 40, 80 or 160 μg/mL zymosan. The CCK-8 assay and flow cytometry were used to evaluate the cell viability and apoptosis 24 h, 48 h, and 72 h after administration. Furthermore, 12 h before irradiation, the cells were treated with 0, 5, 10, or 20 μg/mL zymosan and then irradiated with 4 Gy X-rays. Cell viability and apoptosis were measured by the CCK-8 assay and flow cytometry at 24 h. In addition, the protective effect of zymosan against radiation in vitro was compared to that of 20 μg/mL LPS. In vivo, weight, the spleen index, and the thymus index were measured to evaluate the toxicity of 0, 5, 10, 20, and 10 mg/kg zymosan. In addition, rats were treated with 0, 2, 4, 8, or 10 mg/kg zymosan and then irradiated with 7 Gy X-rays. The survival rate, organ index were evaluated. The protective effect of zymosan against radiation in vivo was compared to that of 10 mg/kg LPS a positive control.

Results
The viability and apoptosis of cells treated with different doses and treatment times of zymosan were not different from those of control cells (p < 0.05). Furthermore, cell viability and apoptosis were clearly improved after zymosan preadministration (p < 0.05). The radioprotective effect of zymosan was dose-dependent. In addition, the viability of cells pretreated with zymosan was higher than that of cells pretreated with LPS, and the apoptosis rate of zymosan-treated cells was lower than that of cells pretreated with LPS (p < 0.05). In vivo, weight, the spleen index and the thymus index were significantly decreased by zymosan at a concentration of 20 mg/kg (p < 0.05). Further experiments showed that the concentration at which zymosan exerted radioprotective effects was 10 mg/kg. The survival curves in the irradiated rats were barely separated between the LPS treatment and zymosan treatment.

Conclusion
Zymosan administration before radiation exposure significantly increased cell viability and the survival rates of rats.
Nomogram for prediction of fatal outcome in patients with severe COVID-19: a multicenter study
Authors: Yang Yun , Zhu Xiao-Fei , Huang Jian , Chen Cui , Zheng Yang , He Wei , Zhao Ling-Hao , Gao Qian , Huang Xuan-Xuan , Fu Li-Juan , Zhang Yu , Chang Yan-Qin , Zhang Huo-Jun , Lu Zhi-Jie 
Published: March 2021

Abstract
Background
To develop an effective model of predicting fatal outcomes in the severe coronavirus disease 2019 (COVID-19) patients.

Methods
Between February 20, 2020 and April 4, 2020, consecutive confirmed 2541 COVID-19 patients from three designated hospitals were enrolled in this study. All patients received chest computed tomography (CT) and serological examinations at admission. Laboratory tests included routine blood tests, liver function, renal function, coagulation profile, C-reactive protein (CRP), procalcitonin (PCT), interleukin-6 (IL-6), and arterial blood gas. The SaO2 was measured using pulse oxygen saturation in room air at resting status. Independent high-risk factors associated with death were analyzed using Cox proportional hazard model. A prognostic nomogram was constructed to predict the survival of severe COVID-19 patients.

Results
There were 124 severe patients in the training cohort, and there were 71 and 76 severe patients in the two independent validation cohorts, respectively. Multivariate Cox analysis indicated that age ≥ 70 years (HR = 1.184, 95% CI 1.061–1.321), panting (breathing rate ≥ 30/min) (HR = 3.300, 95% CI 2.509–6.286), lymphocyte count < 1.0 × 109/L (HR = 2.283, 95% CI 1.779–3.267), and interleukin-6 (IL-6) >  10 pg/ml (HR = 3.029, 95% CI 1.567–7.116) were independent high-risk factors associated with fatal outcome. We developed the nomogram for identifying survival of severe COVID-19 patients in the training cohort (AUC = 0.900, 95% CI 0.841–0.960, sensitivity 95.5%, specificity 77.5%); in validation cohort 1 (AUC = 0.811, 95% CI 0.763–0.961, sensitivity 77.3%, specificity 73.5%); in validation cohort 2 (AUC = 0.862, 95% CI 0.698–0.924, sensitivity 92.9%, specificity 64.5%). The calibration curve for probability of death indicated a good consistence between prediction by the nomogram and the actual observation. The prognosis of severe COVID-19 patients with high levels of IL-6 receiving tocilizumab were better than that of those patients without tocilizumab both in the training and validation cohorts, but without difference (P = 0.105 for training cohort, P = 0.133 for validation cohort 1, and P = 0.210 for validation cohort 2).

Conclusions
This nomogram could help clinicians to identify severe patients who have high risk of death, and to develop more appropriate treatment strategies to reduce the mortality of severe patients. Tocilizumab may improve the prognosis of severe COVID-19 patients with high levels of IL-6.
Isolated middle mediastinal mass associated with immunoglobulin G4-related disease
Authors: Hino Haruaki , Tanaka Noriyuki , Matsui Hiroshi , Utsumi Takahiro , Maru Natsumi , Taniguchi Yohei , Saito Tomohito , Tsuta Koji , Murakawa Tomohiro 
Published: March 2021

Abstract
Background
Immunoglobulin G4-related disease (IgG4-RD) is a multi-organ disorder predominantly occurring in middle-aged to elderly male patients characterized by multi-organ fibrosis, specific pathological findings of storiform fibrosis with IgG4-positive plasma cell infiltration, and elevated serum IgG4 level. We herein report a rare presentation of IgG4-RD forming an isolated mass in the middle mediastinum mimicking a mediastinal tumor and discuss the clinical significance of mediastinal IgG4-RD.

Case presentation
An 82-year-old male patient without any symptom was referred due to left middle mediastinal mass (3.8 × 2.4 cm). Because of suspected lymphoma, Castleman’s disease, and lymphangitis due to tuberculosis, we performed a thoracoscopic resection for diagnosis and treatment. The mass was yellowish white with well-encapsulated, and storiform fibrosis with plasma cell infiltration, and obliterative phlebitis were observed microscopically. Additional immunohistochemical stain revealed IgG4-RD. Other radiological findings and serological results did not show evidence of other organs being affected from IgG4-RD nor autoimmune diseases. He is now followed at outpatient clinic without additional treatment for over a year, and an enhanced computed tomography does not show any recurrence.

Conclusion
It was a rare presentation of IgG4-RD forming isolated middle mediastinal mass, which suggests that we might suspect IgG4-RD for undetermined mediastinal mass in case of middle to elderly male patient.
Role of debt-to-equity ratio in project investment valuation, assessing risk and return in capital markets
Authors: Nukala Vasishta Bhargava , Prasada Rao S. S. 
Published: March 2021

AbstractIn this paper, a case study was performed with an aim to analyze the asset returns for two different companies and the risk and returns from capital projects using standard capital asset pricing method. To demonstrate how the present values of future cash flows are influenced by discount rates when the debt-to-equity capital structure ratio is varied between 0 and 2.5 debt-to-equity. The breakeven sensitivity was also conducted in relation to different gross margin ratios of company. It was found that high value of debt-to-equity ratio yielded a flatter net present value with increase in gross margins. Capital appraisal techniques were applied to illustrate the project returns and annual cash flows and its relationship with change in cost of capital. Analysis showed that when average cost of capital is increased beyond threshold value, the net present value from the firm’s project investments reduced significantly. A covariance analysis was performed to determine individual returns from two stocks traded in BSE Sensex and S&P 500 indices using the beta values. Comparing the individual and total returns of two stocks revealed that returns not only increased with increasing beta values–but also varied with earnings potential, growth rate of firm, dividend payout ratios and trading stock price. The standard deviation on portfolio of two stocks has been computed for varying asset weight ratios. It has been found that positive correlation between two stocks increased equity risk when weight ratios are not balanced in portfolio, while a negative correlation reduced equity risk.
Retrospective Analysis of Presentation, Treatment, and Outcomes of Multiple Myeloma at a Large Public Referral Hospital in Eldoret, Kenya
Authors: Manyega Kelvin M. , Lotodo Teresa C. , Oduor Mercy A. , Namaemba Diana F. , Omondi Austin A. , Oyolo Yvette L. , Oguda John , Loehrer Patrick J. , Vik Terry A. , Asirwa Fredrick C. 
Published: March 2021

PURPOSETreatment patterns and survival outcomes of patients with multiple myeloma (MM) in Kenya have not been adequately characterized. The objectives of this study were to describe the clinical, laboratory, and imaging findings at diagnosis, to describe the treatment offered, and to determine the survival outcomes of patients with MM over an 11-year period.PATIENTS AND METHODSA retrospective chart review was carried out for all patients who were diagnosed and treated for MM at Moi Teaching and Referral Hospital from 2009 to 2019. The Kaplan-Meier method was used to estimate survival. Factors affecting survival were identified using univariate and multivariate analyses.RESULTSA total of 221 patient charts were analyzed of which 124 belonged to male patients (56.1%). The median age at diagnosis was 61 years. Bone pain was the most common presenting complaint observed in 69.6% of 194 patients assessed. Out of 102 patients who received imaging studies, 60 (58.8%) had lytic lesions, 30 (29.4%) had fractures, whereas 30 (29.4%) had spinal cord compression. Anemia, renal failure, and hypercalcemia were observed in 87/187 (46.5%), 22/161 (13.7%), and 23/42 (54.8%) patients, respectively. Thalidomide and dexamethasone (65.2%); bortezomib, thalidomide, and dexamethasone (14.6%); and melphalan and prednisolone (11.9%) were the most prescribed initial chemotherapy regimens among 219 patients analyzed. Overall survival at 1 and 5 years was 70% and 21%, respectively; median overall survival was 29.0 months. In multivariate analysis, male sex (hazard ratio [HR] 1.9), baseline anemia (HR 1.8), and baseline renal failure (HR 3.2) were associated with significantly shorter survival.CONCLUSIONSurvival outcomes were poor despite increased use of multiagent-based chemotherapy regimens. Greater access to available diagnostics and treatments is required to achieve rational treatment and increased survival.
AMH Highly Correlates With Cumulative Live Birth Rate in Women with Diminished Ovarian Reserve Independent of Age
Authors: Tal Reshef , Seifer David B , Tal Renana , Granger Emily , Wantman Ethan , Tal Oded 
Published: March 2021

Abstract

Context
Antimüllerian hormone (AMH) level is strongly associated with ovarian response in assisted reproductive technology (ART) cycles but is a poor predictor of live birth. It is unknown whether AMH is associated with cumulative live birth rates (CLBRs) in women with diminished ovarian reserve (DOR).

Objective
To examine the association between serum AMH and CLBR among women with DOR undergoing ART.

Methods
Retrospective analysis of Society for Assisted Reproductive Technology Clinic Outcome Reporting System database 2014-16. A total of 34 540 index retrieval cycles of women with AMH &lt;1 ng/mL. The main outcome measure was cumulative live birth.

Results
A total of 34 540 (25.9%) cycles with AMH &lt;1 ng/mL out of 133 442 autologous index retrieval cycles were analyzed. Cycles with preimplantation genetic testing or egg/embryo banking were excluded. Data were stratified according to AMH and, age and regression analysis of AMH and CLBR was performed for each age stratum. Multiple logistic regression demonstrated that AMH is an independent predictor of CLBR (odds ratio [OR] 1.39, 95% CI 1.18-1.64). Serum AMH was strongly associated with number of oocytes retrieved, embryos cryopreserved, mean number of cumulative embryos transferred, and percentage of cycles that had an embryo transfer. Linear regression analysis demonstrated that AMH highly correlated with CLBR in each age stratum.

Conclusion
Serum AMH is highly correlated with CLBR in women with DOR independent of age. The addition of AMH to current age-based prognostication counseling particularly in women with DOR would provide more informative and personalized CLBR prediction prior to ART.