bluuebunny/crossref_metadata_2025_split huggingface dataset:
Therapeutic Effect of The Combination of Short-Term Massage Manipulation With Remote Guided Self-Exercise On The Post-Mastectomy Axillary Web Syndrome In Patients With Breast Cancer: A Randomized, Single-Blind Trial.
Authors: Qiao Jia , Yang Qi-hui , Zhan Jing , Li YI , Bai Ding-qun , Kong Yu-han 
Published: August 2021

Abstract
Background: Although the axillary web syndrome (AWS) is a common post-mastectomy complication. A small number of studies have reported treatment strategies for the AWS that showed interventions for one month were an effective strategy. The current study in AWS patients investigated the clinical efficacy of short-term massage manipulation (STMM) combined with remote guided self-exercise (RGS).Method: The patients were randomized into either short-term massage manipulation combine with remote guided self-exercise group (STMM+RGS group) or treatment without massage manipulation and remote guided self-exercise group (T- STMM+RGS group). STMM+RGS group received massage manipulation for 20 min per day for 7 days as total hospitalized therapy and then received telephone-guided therapy for 9 weeks, rehabilitation gymnastics provided during hospitalization.T- STMM+RGS group received rehabilitation gymnastics only. The primary outcome was changes in upper limb range of movement (ROM), assessed at 3, 6, and 9 weeks after intervention. The secondary outcomes were scores of visual analog scales (VAS), disability of arm, shoulder and hand (DASH) index, and activities of daily living (ADL) index assessed at 3, 6, 9 weeks of follow-up.Results: 106 patients were enrolled in the trial, 86 were randomized to treatment groups, with 79 completing the trial (41 in STMM+RGS group, 38 in T-STMM+RGS group). At 6 and 9 weeks of follow-up ROM had improved in STMM+RGS group compared with that observed in T-STMM+RGS group(p<0.05). This improvement was more pronounced and significantly different at 9 weeks(p<0.01).. There was also a significant difference in VAS at 6 and 9 weeks between the two groups. The DASH score improved significantly in STMM+RGS group compared with that in T-STMM+RGS group at 3, 6, and 9 weeks of follow-up(p<0.01), while the ADL score was significantly different (p<0.05) in the two groups at 3 and 6 weeks , but showed no significant difference after 9 weeks of follow-up.Conclusion: The combination of STMM and RGS improves upper limb ROM, relieves upper limb pain, and reduces the occurrence of disabilities in post-mastectomy patients with the AWS.
Design and Analysis of Fiber Bragg Grating Sensor to Monitor Strain and Temperature for Structural Health Monitoring
Authors: Dhingra Ishant , Kaur Gurpreet , Kaler R. S. 
Published: August 2021

Abstract
In this paper, we have proposed a bragg grating based sensor to monitor health of civil structures at distinct temperatures. We have considered increased number of gratings with suitable refractive index to enhance sensitivity of fiber bragg grating sensor. Analysis of Bragg wavelength with respect to load and temperature is successfully studied. The simulation results reveal that when independently strain (50 units per simulation) and temperature (25 ℃) are increased uniformly, a linear shift in Bragg wavelength 0.064 nm and 0.347 nm is observed, respectively. Similarly, when both strain and temperature are increased (ε = 50 & T= 25 ℃) concurrently, a directly proportional relation is found in bragg wavelength (0.403 nm). The results verify the enhanced performance of as-proposed sensor, employing it could be potentially used in civil, bio-medical and military domains.
Effects of Long-Term Exposure to Cd2+ on the Common Carp (Cyprinus Carpio) HO Gene Family and Intestinal Immune Mechanisms
Authors: JIANG ZHOU , Zhang Meng , Liu Kaiyue , Xue Yaguo , Xu Peng , Li Xuejun , Dong Chuanju 
Published: August 2021

Abstract
Heavy metal Cadmium (Cd2+) is an environmental pollutant that poses serious health hazards. Due to the increasing contamination of aquatic systems with Cd2+, the increased accumulation of Cd2+ in fish has become a food safety and public health concern. Heme oxygenase(HO) is an important antioxidant enzyme that plays a key role in defending the body against oxidative damage, but less research has been done in common carp. In this study, 6 HO genes were identified in the common carp genome database. Comparative genomics analysis showed considerable expansion of the HO genes and verified the four-round whole genome duplication (WGD) event in common carp. Phylogenetic analysis revealed all HO genes of common carp were clustered into orthologous groups indicating the highly conservative during evolution. In addition, the results of tissue distribution showed that most HO genes had extensive tissue distribution and showed tissue-specific expression patterns. Exposure to 0.5 mg/L Cd2+ significantly reduced the expression of TGF-β and IL-10 in common carp, which may indicate that Cd2+ exposure can destroy the physical barrier function of the intestine, inhibit intestinal immune defense and induce intestinal inflammation. In order to find a suitable concentration of Bacillus coagulans that could activate HO-1 genes and the immunity of the organism, we investigated the changes of HO-1 gene expression levels in the intestinal tract of common carp under Cd2+ stress at 30d and 60d by adding different concentrations of B. coagulans to the feed. The results showed that L2 upregulated HO-1 gene expression at different infection time points compared to the control/stressed group, but L1 and L3 almost inhibited the expression of most HO-1 genes. This result suggests that the optimum concentration of 2.0´108 CFU/g for activation of HO-1 gene expression by B. coagulans when subjected to Cd2+ stress may have an important role in organism resistance to oxidative stress and immune response. Also compared to the Cd2+ stressed group, the addition of B. coagulans to the diet provoked an upregulation of IL10 and TGF-β gene expression in almost all periods and reduced the ability to suppress intestinal immune defenses in L1, L2 and L3, with the L2 group showing the best induction level. Therefore, the addition of appropriate concentrations of B. coagulans may be a good way to activate HO-1 genes and reduce oxidative damage.
Thromboembolism in COVID-19 Patient with Unilateral Congenital Absent ICA with Intracranial Aneurysm: First Case Report
Authors: Shankar Diwakar , Singh Deepak Kumar , Chand Vipin , Yadav Kuldeep 
Published: August 2021

Abstract
We here discuss an interesting case of COVID-19 patient suffering from ruptured right supra-clinoid intracranial aneurysm with congenital absence of right ICA. COVID-19 has been responsible for over 175 million reported cases and over 3.8 million deaths world-wide. Severe cases of COVID-19 is characterized with cytokine outburst and hyperinflammation, platelet activation, endothelial dysfunction and sepsis related coagulopathy. This predisposes for thromboembolic events and aneurysm formation and rupture. Agenesis, aplasia and hypoplasia of internal carotid artery (ICA) is a rare congenital anomaly. ICA agenesis is associated with increased incidence of intracranial aneurysm as compared with general population.
Privacy Preserving Partially Homomorphic Encryption with Optimal Key Generation Technique for VANETs
Authors: G Tamilarasi , K Rajiv Gandhi , V Palanisamy 
Published: August 2021

Abstract
In recent days, vehicular ad hoc networks (VANETs) has gained significant interest in the field of intelligent transportation system (ITS) owing to the safety and preventive measures to the drivers and passengers. Regardless of the merits provided by VANET, it faces several issues, particularly with respect to security and privacy of users/messages. Because of the decentralized structure and dynamic topologies of VANET, it is hard to detect malicious or faulty nodes or users. With this motivation, this paper designs new privacy preserving partially homomorphic encryption with optimal key generation using improved grasshopper optimization algorithm (IGOA-PHE) technique in VANETs. The goal of the proposed IGOA-PHE technique aims to achieve privacy and security in VANET. The proposed IGOA-PHE technique involves two stage processes namely ElGamal public key cryptosystem (EGPKC) for PHE and IGOA based optimal key generation process. In order to improve the security of the EGPKC technique, the keys are optimally chosen using the IGOA. Besides, the IGOA is derived by incorporating the concepts of Gaussian mutation (GM) and Levy flights. The experimental analysis of the proposed IGOA-PHE technique is examined in a wide range of experiments. The resultant outcomes exhibited the maximum performance of the presented IGOA-PHE technique over the recent state of art methods.
Chronic Parenchymal Lung Changes after COVID-19 Infection
Authors: Touman Abdelfattah , Khayat Mohammed , Bulkhi Adeeb , Khairo Mutaz , Alyamani Wael , aldobyany Ahmad , Ghaleb Nabil , Ashi Hadeel , Alsobai Mohammed , Alqurashi Eid 
Published: August 2021

Abstract
Background: Persistent parenchymal lung changes are an important long-term sequela of COVID-19. There are limited data on the disease characteristics and trajectories. This study aims to evaluate persistent COVID-19-related parenchymal lung changes after 10 weeks of acute viral pneumonia and to identify its risk factors. Methods: This was a retrospective case-control observational study involving 38 COVID-19 confirmed cases using nasopharyngeal swab reverse-transcriptase-polymerase-chain-reaction (RT-PCR) at King Abdullah Medical City (KAMC) hospital, Makkah. Patients were recruited from the Post-COVID interstitial lung disease (ILD) clinic. Referral to this clinic was based on the pulmonology consultants’ assessment of hospitalized patients suspected of developing COVID-19-related ILD changes during hospitalization. Measurements and Main Results: Nineteen patients with persistent parenchymal lung changes after 10 weeks of the acute illness (group-1) were compared with 19 control patients referred for assessment of post-COVID-19 ILD and had accelerated clinical and/or radiological features (group-2). Group-1 was found to have more severe clinical and radiological disease, with higher peak value of inflammatory biomarkers. Two risk factors were identified, NLR >3.13 at admission increases the odds ratio (OR) of chronic parenchymal changes by 6.42 and 13.09 in the univariate and multivariate analyses, respectively. Invasive mechanical ventilation had a more profound effect with ORs of 5.92 and 44.5 in the univariate and multivariate analyses, respectively.Conclusion: Herein, persistent parenchymal lung changes were observed in several patients 10 weeks after acute COVID-19 infection. We found that only receiving invasive mechanical ventilation and NLR >3.13 at admission were strong risk factors for persistent parenchymal lung changes.
Supercritical CO2-Assisted Atomization for Deposition of Cellulose Nanocrystals: An Experimental and Computational Study
Authors: Shariatnia Shadi , Jangale Prajesh , Mishra Rohit , Asadi Amir , Jarrahbashi Dorrin 
Published: August 2021

Abstract
Nanoparticle spray deposition finds numerous applications in pharmaceutical, electronics, manufacturing, and energy industries and has shown great promises in engineering the functional properties of the coated parts. However, current spray deposition systems either lack the required precision in controlling the morphology of the deposited nanostructures or do not have the capacity for large-scale deposition applications. In this study, we introduce a novel spray system that uses supercritical CO2 to assist the atomization process and create uniform micron-size water droplets that are used as cellulose nanocrystal (CNC) carriers. CNCs are selected in this study as they are abundant, possess superior mechanical properties, and contain hydroxyl groups that facilitate interaction with neighboring materials. We fundamentally investigate the effect of different process parameters, such as injection pressure, gas-to-liquid ratio, the axial distance between the nozzle and substrate, and CNC concentration on the final patterns left on the substrate upon evaporation of water droplets. To this end, we show how tuning process parameters control the size of carrier droplets, dynamics of evaporation, and self-assembly of CNCs, which in turn dictate the final architecture of the deposited nanostructures. We will particularly investigate the morphology of the nanostructures deposited after evaporation of micron-size droplets that has not been fully disclosed to date. Different characterization techniques such as laser diffraction, polarized microscopy, and high-resolution profilometry are employed to visualize and quantify the effect of each process parameter. Numerical simulations are employed to inform the design of experiments. Finally, it is shown that the fabricated nanostructures can be engineered based on the size of the carrier droplets controlled by adjusting spray parameters and the concentration of nanoparticles in the injected mixture. Process parameters can be selected such that nanoparticles form a ring, disk, or dome-shaped structure. Moderate operational conditions, simplicity and time efficiency of the process, and use of abundant and biodegradable materials, i.e., water, CNC, and CO2 promote the scalability and sustainability of this method.
Tunnel-redesigned O2-tolerant CO dehydrogenase for removal of CO in real flue gas
Authors: Kim Suk Min , Lee Jinhee , Kang Sung Heuck , Heo Yoonyoung , Hanh Ji Sook , Lee Hyung Ho , Kim Yong Hwan 
Published: August 2021

Abstract
Carbon monoxide dehydrogenase (CODH)-catalyzed oxidation of CO to CO2 provides a promising means of removal of toxic and waste CO from industrial flue gas despite of the lack of active and stable enzymes in the atmosphere. Herein we present rationally and selectively redesigned ChCODH-II (Carboxydothermus hydrogenoformans) variants by engineering gas tunnels in order for O2-tolerant CODHs to catalyze efficient CO oxidation under oxygen (O2). Using the redesigned ChCODH-II A559W and A559H variants showing 42- and 128-fold elevation of O2 tolerance, respectively, complete CO removal was achieved under a near-atmospheric condition. Moreover, these variants efficiently removed CO from industrial flue gas (Linz–Donawiz converter Gas: LDG) discharged from a steel mill despite the high O2 level (13.4%) during successful and repeated reuse after immobilized on Ni-NTA agarose beads. Our study will provide insights into redesigning the transformation of O2-sensitive CODHs into tolerant enzymes for use as workhorses for conversion of toxic or waste gases into safe or value-added chemicals.
A Cost-Effectiveness Analysis of Atezolizumab and Bevacizumab Verses Sorafenib in Patients With Advanced Hepatocellular Carcinoma
Authors: Li Meiyue , Lin Peili , Luo Shaohong , Huang Xiaoting , Huang Xiaojia , Nian Dongni , Lin Shen , Weng Xiuhua 
Published: August 2021

Abstract
Background: Several studies have evaluated the cost-effectiveness of treatment for advanced hepatocellular carcinoma (HCC), but the economics of atezolizumab plus bevacizumab (Ate plus Beva) remains unclear. Method: A three-state Markov model was established to simulate the life-time cost and effectiveness of advanced liver cancer, which included costs and health outcomes. Medical costs were sourced from Red Book, Healthcare Cost and Utilization Project (HCUP) and literatures. Also, the utility values of health state were deprived from references. The primary outcomes were measured by life-years (LYs), quality-adjusted life-years (QALYs), incremental cost-benefit ratio (ICER) and incremental net-health benefit (INHB). The robustness of the model was verified by one-way and probabilistic sensitivity analysis.Results: Ate plus Beva generated a gain of 0.84 QALYs (1.17 LYs ), an additional incremental cost of $242,447.40 per patient as compared with sorafenib, which resulted in the ICER of $288,663.09/QALY ($206,906.76/LY) at the willingness-to-pay (WTP) threshold of $150,000/QALY, and the INHB was -0.78/QALY. The sensitivity analysis demonstrated that the ICER was most affected by the price of atezolizumab.Conclusion: From the U.S. health care payer perspective, compare with sorafenib, Ate plus Beva regimen seems unlikely to be cost-effective in advanced HCC patients at a WTP threshold of 150,000 /QALY. If the price of atezolizumab was reduced by 75%, the probability of atezolizumab being cost-effective was over 50% at the WTP threshold.
Evaluation of an Educational Strategy to Improve Medication Reconciliation in Ambulatory Care
Authors: Jones Laney K , Duboski Vanessa , Romagnoli Katrina M. , Flango Alison , Marks Jami , Graham Jove , Gionfriddo Michael R. 
Published: August 2021

Abstract
Introduction. Improper medication reconciliation can result in inaccurate medication lists which can lead to adverse events including hospitalizations. Interventions targeting medication reconciliation have had varying levels of success. To improve medication reconciliation practices in our ambulatory care clinics, we developed an educational program for clinic personnel. The objective of this study is to describe the educational program, its implementation in a healthcare system, pharmacist and clinic personnel perception of the program, and its impact on clinic personnel knowledge and practice. Methods. Guided by the Conceptual Model of Implementation Research, we conducted an evaluation of a pharmacist-led educational program on evidence-based practices for medication reconciliation by examining implementation outcomes. The implementation outcomes measured include penetration, fidelity, acceptability, appropriateness, feasibility, and adoption. Data was collected through direct observations, administrative data, pre- and post-surveys, and semi-structured interviews. Results. A total of 37/46 (80%) primary care sites implemented the pharmacist delivered medication reconciliation education from April to June 2021 with representation from each of Geisinger’s regions. Ten (27%) clinic sites completed the medication reconciliation educational program as originally designed, with the remainder adapting the program. A total of 296 clinic personnel completed the pre-survey, while 178 completed the post-survey. There were no statistically significant differences in baseline characteristics between clinic personnel who completed the pre- vs. post-survey. Interviews were completed with 11 clinic personnel who attended the educational program and 4 pharmacists who delivered the educational program. All clinic personnel interviewed felt satisfied with the educational program and felt it was appropriate since it directly impacted their job. While clinic personnel felt the educational program was acceptable and appropriate, two major concerns were discussed: lack of patient knowledge about their medications and lack of time to complete the medication reconciliation. We found the adherence rate to the elements of the medication reconciliation which were covered in the education program ranged from 0% to 95% in the 55 observations conducted.Conclusion. An educational program for medication reconciliation was found to be acceptable and appropriate but was often adapted to fit site specific needs. Additional barriers affected adoption of best practices and should be addressed in future studies. Trial registration. N/A
Relationship Between Fluid Therapy Strategies and Mortality Among Sepsis Patients in ICU with high CVP: A Retrospective Analysis of the eICU Database
Authors: Yang Penglei , Tan Rui , Zheng Ruiqiang , Shao Jun , Yuan Jing , Liu Xiaoyun , Chen Hanbing , Wang Jing , Li Xianghui , Yu Jiangquan 
Published: August 2021

Abstract
Objective: It is still debated whether sepsis patients with high CVP (central venous pressure) benefit from it. We performed a retrospective study of sepsis patients with CVP ≥ 12 mmHg to analyze mortality resulting from the different amounts of fluid administered in the fluid therapy at the first 6, 24, and 48 h of the course.Methods: This study included sepsis patients from the eICU database who met the sepsis-3 diagnostic criteria and showed CVP ≥ 12 mmHg on admission. We analyzed the differences between the survivors and the non-survivors at baseline and the difference in fluid balance at 6, 24, and 48 h. Restricted cubic spline (RCS) and logistic regression model were used to identify the association between fluid balance and mortality.Results: Out of the 1150 sepsis patients that showed a high CVP obtained from the eICU database, 847 were survivors and 303 were non-survivors. Compared to survivors, non-survivors had a larger positive fluid balance at 6, 24, and 48 h. The fluid balance and mortality in sepsis patients with high CVP showed an inverted U-type relationship. At 6 h, lower mortality was found in patients who required less than -5 ml/kg fluid therapy. At 24 h, mortality was the lowest at -40~-20 ml/kg. At 48 h, low mortality was observed in patients with < -40 ml/kg fluid balance. In septic shock patients with high CVP, positive balance decrease mortality. In sepsis patients with high CVP without a history of chronic heart failure, and with a history of heart failure negative fluid balance can decrease mortality.Conclusion: In the sepsis group without shock, achieving negative fluid balance possible may significantly improve the prognosis of patients with high CVP, and patients with no history of chronic heart failure and patients with history of chronic heart failure should limit fluid infusion. In patients with septic shock whose CVP ≥ 12 mmHg, positive fluid balance may decrease mortality.
Integrated Bioinformatical Analysis Identified HTRA4 As An Immune-Related Prognostic Biomarker In The Gastric Cancer Microenvironment
Authors: Ji Ce , Dai Jingwei , Wang Zhen , Hu Xiangchen , Kou Youwei 
Published: August 2021

Abstract
HtrA serine peptidase 4 (HTRA4), which belongs to the AB family of proteases/chapterones, participates in multiple signal pathways and plays an important regulatory role in some malignancies; however, its role in the prognosis and immune infiltrates of gastric cancer (GC) remains unclear. HTRA4 expression was thus investigated in tumor tissues, and its association with immune infiltrates was assessed, to determine its prognostic roles in GC patients. Data for patients with GC was collected from three GEO datasets. This study has investigated if high expression levels of HTRA4 are associated with a poor prognosis in GC patients, especially in T2,T3,N1,NI&N2&N3,M1,stage3 and HER2+ subgroups. HTRA4 was positively correlated with CD8+ T cells, CD4+ memory activated T cells, gamma delta T cells, and M2 macrophages in the GC microenvironment. Gene Ontology and Gene set Enrichment Analysis showed that HTRA4 was enriched in some immune-related pathways. High expression levels of HTRA4 were significantly correlated with tumors in the T stage, N stage, and clinical stage, as well as those of histological grade. In summary, HTRA4 was found to play a vital role in the progression of GC and may be a predictive biomarker for the survival of GC patients.