bluuebunny/crossref_metadata_2025_split huggingface dataset:
The successful implementation of the ERAS program among Caesarean deliveries to reduce the postoperative length of hospital stay
Authors: Tamang Tshering , Wangchuk Tashi , Zangmo Choning , Wangmo Tshering , Tshomo Karma 
Published: April 2021

Abstract
Background: Enhanced Recovery After Surgery (ERAS) is a multidisciplinary perioperative care program to optimize and enhance postoperative recovery. It has a beneficial role in decreasing the length of hospital stay and improving the quality of care. This study aims to observe the successful implementation of ERAS in reducing the length of hospital stay (LOS) among Caesarean deliveries. Methods: A pre-and post-implementation study of ERAS protocol was conducted, among cohort of women who underwent Caesarean deliveries from January to December 2020 in the department of Obstetrics and Gynaecology, Mongar Regional Referral hospital. Data collected retrospectively and analyzed in SPSS (IBM SPSS trial version); and comparison of length of hospital stay between the two groups were tested by t-test. Results: 171 patients were included in the study: 87 in the pre-ERAS and 84 in the post-ERAS cohort. Post implementation, LOS decreased by an average of 21.0 (CI 16.11-24.64; p-value <0.001) hours in the postoperative period. A greater proportion of patients were discharged on day-2 (2.3% in pre-ERAS and 81% in ERAS; p-value <0.001). Conclusion: Implementation of ERAS protocol can significantly decrease the postoperative length of hospital stay without increasing the complications and readmission rates.
Geotechnical Modelling of The Climate Change Impact on World Heritage Properties in Alexandria, Egypt
Authors: Hemeda Sayed 
Published: April 2021

Abstract
Alexandria is one of the Mediterranean UNESCO World Heritage sites at risk from coastal flooding and erosion due to sea-level rise.The city’s position on the Mediterranean coast means it is especially vulnerable to rising sea levels. Alexandria is one of UNESCO sites in Egypt at risk from flooding. All the archaeological sites in the northern coast of Egypt are also said to be at risk from coastal erosion. The flood risk in Alexandria is expected to reach a tipping point by 2050.This research presents the numerical analysis of geotechnical and structural damage mechanism of Catacombs of Kom El-Shoqafa and El-Shatbi Necropolis, the sites have the lowest topography in Alexandria induced by the sea level rise and heavy rain due to the Climate Change, based on Finite Element PLAXIS Code. The purpose of the study was to investigate the behavior fully-saturated soft rock/ hard soil subjected to ground water intrusions. The main objective of this study is to very accurately record and analyze geotechnical problems and induced structural failure mechanisms that have been observed and accounted for in field, experimental and Numerical studies. The land area is also vulnerable to coastal flooding. It is widely expected that the numerical analysis of such geotechnical problems will contribute to the preservation of cultural heritage. The present research presents an attempt and experimental study to design a PLAXIS 2D FE model to simulate hard soil/hard rock problems, distortion and stress analysis of the complex structure of the catacombs. Plastic modeling or Mohr - Coulomb model was used in advanced soils during various stages of numerical analysis. Results are recorded and discussed regarding stress and volumetric behavior of soil / rocks. Groundwater infiltration into pores or fissures of rock and soil has a great influence on the engineering mechanical properties of rocks and soils.
(-)-Epigallocatechin Gallate Attenuates Spinal Motoneuron Death Induced by Brachial Plexus Root Avulsion in Rats
Authors: Lu Fatai , Zhang Guodong , Zhu Yingkang , Liu Zunpeng 
Published: April 2021

Abstract
BackgroundRecent studies have indicated that epigallocatechin gallate (EGCG) benefits a variety of neurological insults. This study was performed to investigate the neuroprotective effect of EGCG after brachial plexus root avulsion in rats. Methods One hundred twenty rats were randomized into the following three groups: an EGCG group, an Avulsion group, and a Sham group. EGCG (100 mg/kg, i.p.) or normal saline was administered to rats immediately following the injuries. The treatment was continued from day 1 to day 7, and the animals were sacrificed on days 3, 7, 14 and 28 for Nissl staining, immunohistochemistry and western blot analysis.Results We determined that EGCG significantly increased the survival ratio of motoneurons and inhibited the cell apoptosis. The level of phospho-c-jun was reduced at 3d and 7d after the injury.Conclusions Our results indicated that motoneurons were protected by EGCG against the cell death induced by brachial plexus root avulsion,and this effect was correlated with inhibiting c-jun phosphorylation.
Resolution-enhanced OCT and expanded framework of information capacity and resolution in coherent imaging
Authors: Leartprapun Nichaluk , Adie Steven 
Published: April 2021

Abstract
Spatial resolution in optical microscopy has traditionally been treated as a fixed parameter of the optical system. Here, we present an approach to enhance transverse resolution in beam-scanned optical coherence tomography (OCT) beyond its aberration-free resolution limit, without any modification to the optical system. Based on the theorem of invariance of information capacity, resolution-enhanced (RE)-OCT navigates the exchange of information between resolution and signal-to-noise ratio (SNR) by exploiting efficient noise suppression via coherent averaging and a simple computational bandwidth expansion procedure. We demonstrate a resolution enhancement of 1.5× relative to the aberration-free limit while maintaining comparable SNR in silicone phantom. We show that RE-OCT can significantly enhance the visualization of fine microstructural features in collagen gel and ex vivo mouse brain. Beyond RE-OCT, our analysis in the spatial-frequency domain leads to an expanded framework of information capacity and resolution in coherent imaging that contributes new implications to the theory of coherent imaging. RE-OCT can be readily implemented on most OCT systems worldwide, immediately unlocking information that is beyond their current imaging capabilities, and so has the potential for widespread impact in the numerous areas in which OCT is utilized, including the basic sciences and translational medicine.
Genome-Wide Characterization of CDPK Gene Family in Apple (Malus Domestica) and Its Transcriptional Expression During Apple Fruit Development
Authors: Dai Yu , Zhang Xinxin , Tian Juan , Zhu Liufang , Li Dahui 
Published: April 2021

Abstract
Background: Calcium-dependent protein kinases (CDPKs) play important roles both in developments and response to stresses, via mediating Ca2+ signal transduction in plants. To characterize the CDPKs in apple (Malus domestica), the apple CDPK gene family, together with those from pear (Pyrus bretschneideri), peach (Prunus persica), strawberry (Fragaria vesca), and and Arabidopsis thaliana, were analyzed at the genome-wide level in the present study.Results: A total of 116 CDPKs, consisting of 24 MdCDPKs, 28 PbCDPKs, 16 PpCDPKs, 14 FvCDPKs, and 34 AtCDPKs, was identified from apple, pear, peach, strawberry, and Arabidopsis, respectively. An integrated analysis of these CDPKs was performed on their chromosomal distribution, phylogenetic and collinearity relationships, characteristics of gene structures and conserved motifs. As a result, the CDPK gene family members were showed to be highly conserved both at their kinase and EF-hand domains. Among 209 gene-pairs with interspecies collinearity, there existed 22, 36, 21, and 25 ones between MdCDPKs and other CDPKs in Arabidopsis, pear, strawberry, and peach, respectively. And the evaluated Ka/Ks ratios were less than 1 between the CDPK gene pairs with collinearity relationships. Transcriptomic analysis demonstrated that among 24 members of the apple CDPK gene family, two up-regulatory ones (HF05266 and HF09216) and two down-regulatory ones (HF05471 and HF15429), were differentially expressed with significance between the apple fruit developmental stage S4 (mature) and other stages (early growing-S1, mid growing-S2, and late growing-S3), respectively.Conclusions: The whole genome duplication and subsequent purifying selection, might have played an important role in the CDPK gene expansion, leading to structural and functional novelty during evolution of the species lineages. In many cases, the MdCDPK genes within a phylogenetic group could show the different expression patterns at the transcriptional level, suggesting that these MdCDPKs have undergone genetic variant events and potential functional diversification. Some of MdCDPKs with significantly differential expression, were indicated their particular functions at the specific stages of apple fruit development.
Mortality Risk Factors in the China Dialysis Outcomes and Practice Patterns Study (DOPPS)
Authors: Zhao Xinju , Niu Qingyu , Ni Zhaohui , Chen Xiaonong , Chen Yuqing , Hou Fan Fan , Liang Xinling , Zhao Junhui , Bieber Brian , Robinson Bruce , Gan Liangying , Zuo Li 
Published: April 2021

Abstract
Background Mortality risk for hemodialysis (HD) patients varies by country and ethnicity. Here, mortality rate and its related risk factors in Chinese HD patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) were investigated.Methods Data from China DOPPS phase 5 (2012–2015) were used. Patients’ demographics, assigned primary causes of end stage Kidney disease (ESKD), comorbidities, dialysis prescription, laboratory values, date and cause for death were analyzed. Cox proportional hazards models were used to assess the association of patient characteristics and treatments with mortality.Results 1427 HD patients were enrolled. The mean age was 59.4 ± 14.9 years. The median follow-up time was 1.9 (1.1–2.1) years. There was total 205 deaths with at least 103 from cardiovascular disease (50.2%). The overall mortality rate was 8.8 per 100 patient-years. In the multivariate COX model, older, serum albumin (Alb < 4g/dl, blood platelets < 100*109/L, pulse pressure (PP) > 63mmHg, and congestive heart failure history were independent risk factors for all-cause mortality.Conclusions Attention should be paid to patients who were older, with lower Alb and blood platelets level, higher PP and congestive heart failure history. Our results highlighted that there might be some modifiable risk factors for patients’ survival, such as Hgb, Alb, blood platelets, and blood pressure management.
One-year follow-up of the nutritional status of celiac people on a gluten-free diet
Authors: Perez-Junkera Gesala , Vazquez-Polo Maialen , Eizagirre Francisco Jose , Benjumea Laura , Tutau Carlos , Esteban Blanca , Larretxi Idoia , Navarro Virginia , Churruca Itziar , Lasa Arrate 
Published: April 2021

Abstract
Background

The gluten-free diet (GFD), the only effective treatment for celiac disease, is usually nutritionally imbalanced. The present work aimed to analyze the evolution of the nutritional status, dietary profile, and symptoms present among celiac people over one year on a GFD while receiving individualized dietary advice.
Methods

Twenty-seven adults and thirty-one celiac children/adolescents participated in the cohort study. They were followed by 3 visits, at diagnosis (vt0) and after 3 and 12 months (vt3;vt12). Participants filled out dietary and gastrointestinal symptoms questionnaires and received a personalized form from dietitians containing dietary advice and anthropometric and biochemical data evolution.
Results

Most patients presented normal BMI, fat and muscle mass, and biochemical parameters at diagnosis and vt12. By contrast, all participants consumed protein and lipids in excess and carbohydrates in defect, in both vt0 and vt12. Low intakes of cereals, fruits and vegetables and high of meat were observed, these also remain-ing unchanged after dietary counseling. Symptoms present decreased after vt3 but rebounded in vt12.
Conclusions

Few changes in dietary pattern and symptom elimination suggested that the intervention was not effective enough. More research is necessary to evaluate whether closer follow up and face-to-face dietary advice improve dietary habits of celiac people.
Trial registration:

Code PI2016069, Ethical Comitee of the Clinical Investigation of the Basque Country. Registered on 15 July 2016.
Glycation Markers in the Geriatrics Patients
Authors: Kuzan Aleksandra , Królewicz Emilia , Kustrzeba-Wójcicka Irena , Lindner Karolina , Sobieszczańska Małgorzata 
Published: April 2021

Abstract
Background: Medical care for geriatric patients is a great challenge, mainly due to overlapping various deficits relevant to physiologic ageing with numerous coexisting diseases, of which the most common are diabetes mellitus and atherosclerosis. In case of diabetes, glycation process is intensified, which accelerates atherosclerosis development and diabetic complications. Our goal was to investigate the relationship between the classical biochemical parameters of diabetes and atherosclerosis (fasting glucose, glycated hemoglobin (HbA1c), low and high density lipoproteins (LDL, HDL), triglycerides, etc.), as well as parameters which may indicate a nephropathy (creatinine, glomerular filtration rate – GFR), and the parameters strictly related to glycation. Methods: We analyzed the patients' serum concentration of fluorescent glycation products, concentration of soluble receptor for advanced glycation products (sRAGE), lipoprotein receptor-1 (LOX-1), galectin 3 (GAL3), scavenger receptor class A (SR-A) and scavenger receptor class B (SR-BI), as well as the level of lipid peroxidation and free amine content. Results: Among the identified correlations, the most interesting are the following : sRAGE with triglycerides (r = 0.47); sRAGE with SR-BI (r=0.47); SR-BI with LOX-1 (r=0.31), and SR-BI with HDL (r=-0.30). It has been shown that pentosidine and fluorescent AGEs as well as reactive free amine contents are significantly higher in elderly patients with ischemic heart disease. Fluorescent AGEs and pentosidine are also significantly higher in patients with arterial hypertension. The influence of diabetes therapy on parameters related to peroxidation and glycation was also analyzed. Malondialdehyde turned to be higher in patients with diabetes mellitus type 2 not treated with insulin or metformin than in those treated with both medications (p=0.052). GAL3 was found to be lower both in persons without diabetes and in diabetics treated with metformin (p=0.005). LOX1 was higher in diabetic patients not treated with metformin or insulin, and lowest in diabetics treated with both insulin and metformin, with the effect of metformin reducing LOX1 levels (p=0.039). Conclusions: Our results were the basis for a discussion about the diagnostic value in clinial practice of LOX-1 and GAL3 in geriatric patients with diabetes and also provide grounds for inferring the therapeutic benefits of insulin and metformin treatment.
Optimal clustering algorithm for wireless sensor networks using combined turbid ant swarm and improved myopic algorithm for maximizing life of sensors
Authors: S Muthukumar , Rajesh D. Hevin 
Published: April 2021

Abstract
Wireless sensor network (WSNs) consistsof a variety of sensor nodes to sense the environmentalparameters and communicate to the sink knot. The control factor is that controlling the power of the sensor nodes and charging or replacing the battery is an expensive and complicated process, which affects the sensor node lifetime as well as network lifetime. Clustering is one of the schemes that save energy by reducing the amount of intra-cluster communication cost. In this paper, an optimal clustering (OC) algorithm proposed to maximizes the network lifetime at data transmission without compromising energy expenditure. In OC algorithm, first we propose the turbid ant swarm(TAS) algorithm to form the clusters, which reduces much amount of energy consumption. Then, an improved myopic (IM) algorithm proposed to determines the cluster head (CH) of cluster, which minimizes re-clustering frequency and intra-communication charge. The proposed OC-TAS-IM algorithm is concentrate to get better the energy efficiency and extend the network life span. Moreover, the planned algorithm is practical to the low-energy adaptive clustering hierarchy (LEACH) to perform the entire routing. The completion and imitation experiment with Network Simulator (NS2) are obtainable in order to authenticate our planned OC-TAS-IM algorithm. Imitation outcome illustrate that OC-TAS-IM algorithm is stable in terms of energy consumption and network lifetime because of optimal clustering.
Development and Characterization of Microsatellite Markers for Rhododendron Purdomii Using Next-Generation Sequencing
Authors: Zhang Ningning , Qin Mengyun , Zhu Shixin , Huang Ziyang , Dong Hao , Yang Yang , Yang Lili , Lu Yang 
Published: April 2021

Abstract
Rhododendron purdomii, an endangered ornamental species endemic to the Qinling Mountains, is an important component of montane ecosystem in central China. Due to the impact of climate change and human disturbance, management and conservation of this species are in urgent needs. In this study, we developed 13 novel microsatellite markers for R. purdomii based on next-generation sequencing data, and tested these markers’ utility in congeneric species R. concinnum. For the 13 microsatellite markers in three R. purdomii populations, number of alleles ranged from two to 12, number of effective alleles was from 1.000 to 8.892, Shannon’s information index was from 0.000 to 2.320, and the observed and expected heterozygosity were from 0.000 to 1.000 and from 0.000 to 0.888, respectively. Cross-species amplification for R. concinnum indicated eight microsatellite loci were successfully amplified and polymorphic. The microsatellite markers developed in this study will provide opportunities for examining the genetic diversity and population structure of R. purdomii and contribute to the effective conservation of this species.
The Effect of Surgical Technique, Age and Trisomy 21 on Early Outcome of Surgical Management of Complete Atrioventricular Canal Defect
Authors: Azzab Sherief , Samy Ahmed , Singab Hamdy , Zeinah Mohamed , Musollari Gledisa , Axiaq Ariana , Harky Amer , Tarek Ahmed , Ghanam Mohamed EL 
Published: April 2021

Abstract
Background: The optimal timing, surgical technique and the influence of Trisomy 21 on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remain uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome. Methods: A prospective study included 70 patients who underwent repair of CAVC at our institute between July 2016 to October 2019. Primary endpoint was mortality and secondary endpoint was degree of left atrio‐ventricular valve (LAVV) regurgitation.Results: No significant difference noted between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Surgical repair by modified single patch technique showed significant reduction in bypass time (71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.001). Comparison to closure of cleft only, posterior annuloplasty used for repair of LAVV resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVV 2+ 43 % vs 7 %, P value=0.03) and at 6 months of follow up (LAVV 2+ 35.4 % vs 0 %, P value=0.01) respectively.Conclusion: Early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair; Trisomy 21 was not found to be a risk factor for early intervention. Repair of common AV valve by cleft closure with posterior LAVV annuloplasty showed better results with significant decrease in postoperative LAVV regurgitation and early mortality in comparison to closure of cleft only.
Incorporating Interactive Workshops into Bedside Teaching: Completion of a Multi- Modal Rheumatology Rotation Significantly Increases Internal Medicine Residents’ Competency and Comfort with Comprehensive Knee Examinations
Authors: Kwiatkowski Alysia , Shakoor Najia , Manadan Augustine , Block Joel A. , Khandelwal Sonali 
Published: April 2021

Abstract
Background: Studies have elucidated the lack of competency in musculoskeletal (MSK) examination skills amongst trainees. Various modalities have been studied, however, there remains a dearth of literature regarding the effectiveness of bedside teaching versus dedicated workshops. Our aim was to determine if incorporating a workshop into a rheumatology rotation would be effective in increasing medicine residents’ competency and comfort with knee examinations when compared to the rotation alone.Methods: Over 16 months, rotators were randomized to workshop plus rotation versus rotation alone. Participants were tested on their knee examination skills using an objective structured clinical examination (OSCE). Surveys were administered assessing to what degree the rotation was beneficial. Comfort and helpfulness were measured using a 5-point Likert scale. Paired and independent samples t-tests were used for comparisons. Results: Fifty-seven residents participated. For both groups, there were improvements between pre and post OSCE scores (workshop p < 0.001, no workshop p = 0.003), and levels of comfort with examination (workshop p < 0.001, no workshop p < 0.001). When comparing groups, there were differences favoring the workshop in post OSCE score (p = < 0.001), mean change in OSCE score (p < 0.001) and mean change in comfort with knee examination (p = 0.025).Conclusion: An elective in rheumatology augmented residents’ MSK competency and comfort. Incorporation of a workshop further increased knowledge, skills and comfort with diagnosis and treatment. Current educational research focuses on alternatives to traditional methods. This study provides evidence that a multi-modal approach, combining traditional bedside and interactive models, is of benefit.
Differences in Neuronal Numbers, Morphology and Developmental Apoptosis in Mice Nigra Provide Evidence of Ontogenic Origin of Vulnerability to Parkinson’s Disease
Authors: Vidyadhara D J , Yarreiphang Haorei , Raju Trichur R , Alladi Phalguni Anand 
Published: April 2021

Abstract
Parkinson’s disease (PD) prevalence varies by ethnicity. In an earlier study we replicated the reduced vulnerability to PD in an admixed population, using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-susceptible C57BL/6J, MPTP-resistant CD-1 and their F1 crossbreds. In the present study we investigated if the differences have a developmental origin. Substantia nigra was evaluated atpostnatal days 2 (P2), P6, P10, P14, P18, and P22. C57BL/6J mice had smaller nigra and fewer dopaminergic neurons than the CD-1 and crossbreds at P2, which persisted through development. A significant increase in numbers and nigral volume was observed across strains till P14. A drastic decline thereafter was specific to C57BL/6J. CD-1 and crossbreds retained their numbers from P14 to stabilize with supernumerary neurons at adulthood. The neuronal size increased gradually to attain adult morphology at P10 in the resistant strains, vis-à-vis at P22 in C57BL/6J. Accordingly, in comparison to C57BL/6J, the nigra of CD-1 and reciprocal crossbreds possessed cyto-morphological features of resilience, since birth. The considerably lesser dopaminergic neuronal loss in the CD-1 and crossbreds seen at P2, P14 and thereafter was complemented by attenuated developmental cell death. The differences in programmed cell death were confirmed by reduced TUNEL labelling, AIF and caspase-3 expression. GDNF expression aligned with the cell death pattern at P2 and P14 in both nigra and striatum. Earlier maturity of nigra and its neurons appear to be better features that reflect as MPTP-resistance at adulthood. Thus variable MPTP-vulnerability in mice and also differential susceptibility to PD in humans may arise early during nigral development.