bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Efficacy of Multimodal Prehabilitation in Elderly Patients Undergoing Elective Major Abdominal Surgery: A Systematic Review Protocol
Authors: Tan Yu Xiang , Samuel Miny , Pang Ning Qi 
Published: May 2021

Abstract
Introduction Multimodal prehabilitation has been touted as a potential strategy to better prepare our elderly and frail patients for major surgery. While randomized controlled trials and systematic reviews have been done to investigate the effect of prehabilitation on various surgical cohorts, most of these studies have focused on single modality prehabilitation and without an emphasis on the elderly. This systematic review aims to assess the effect of a multimodal prehabilitation program on elderly patients undergoing major abdominal surgery. MethodsThis protocol has been written according to the PRISMA-P statement and is registered in the International Prospective Register of Systematic Reviews (PROSPERO registration number 250281). MEDLINE, EMBASE, CENTRAL, CINAHL and PsychINFO databases will be searched. Only randomized controlled trials with an average study population age ≥65 that has undergone major abdominal operation with at least two components (physical, nutritional, psychological) of prehabilitation will be included. Clinical outcomes that will be collected include post-operative morbidity and mortality, length of stay, 30-day readmission and peri-operative 6-minute walking distance. The risk of bias in included studies will be assessed. Data will be pooled where possible. DiscussionThis systematic review will evaluate and establish the effectiveness of multimodal prehabilitation for the elderly, who represents the group of patients most likely to benefit from prehabilitation. This review with its focus on the elderly will provide us with fresh insight into the utility of prehabilitation that will better inform policy makers in its implementation.PROSPERO Registration: On 20/04/2021, ID 250281
Outcomes of a Single-Segment Intrastromal Corneal Ring in Early Keratoconus Versus Early Pellucid Marginal Degeneration
Authors: Hashemian Seyed Javad , Abdolalizadeh Parya , Ghiasian Leila , Aghaei Hossein , Hadavandkhani Ali , Semnani Fatemeh Nadjafi , Jafari Mohammad Ebrahim , Hashemian Seyed Mahyar , Hashemian Mahsa Sadat 
Published: May 2021

Abstract
Purpose: To determine the effect of a single-segment intrastromal corneal ring segment (ICRS;Intacs-SK) on early keratoconus (KCN) or pellucid marginal degeneration (PMD).Methods: It is a prospective interventional study. One-hundred-twenty-four eyes (99 patients) with KCN and 36 eyes (26 patients) with PMD at early stage (the maximum keratometric reading less than 55 diopters) were included to ICRS implantation using femtosecond laser at a tertiary university-based hospital and a private outpatient center. The uncorrected distance and spectacle-corrected visual acuity (UDVA and SCDVA), manifest spherical and cylindrical refractions, and keratometry indices were measured preoperatively and postoperatively, 1 week, 2 and 6 months.Results: One week after surgery, significant improvements were observed in UDVA, SCDVA, cylinder and keratometry readings of both KCN and PMD groups (all P<0.05) with no significant changes afterwards. No significant change occurred in the sphere refraction of PMD group (P=0.10) in contrast to KCN group (P<0.001). Corneal irregularity of KCN group in central 3 and 5 mm zones increased at 1 week (both P<0.001) and then continued to decrease up to 6 months. However, the corneal irregularity of PMD group had significant reduction only at 1 week in 5-mm zone (P=0.02) and 2 months in 3-mm zone (P=0.01) postoperatively. The final efficacy indexes were 1.44±0.71 and 0.87±0.40 in KCN and PMD groups, respectively. Conclusion: Visual acuity and keratometry values reached stability at 1 week, after one-segment Intacs-SK implantation in KCN and PMD groups. The short-term efficacy of the procedure was more in early KCN compared to early PMD.
Numerical Simulation of the Coffee-ring Effect Inside Containers with Time-dependent Evaporation Rate
Authors: Kim Hyundong , Yang Junxiang , Kim Sangkwon , Lee Chaeyoung , Yoon Sungha , Kwak Soobin , Kim Junseok 
Published: May 2021

Abstract
In this work, using a mathematical model and numerical simulation, we investigate the effect of time-dependent evaporation rates on stripe formation inside containers, which is driven by the coffee-ring effect. The coffee particles inside a container move according to random walk and under the gravitational force. Because of the non-uniform evaporation rate, we can observe stripe formation inside a container filled with liquid carrying coffee particles. We perform various numerical experiments to demonstrate the proposed model can simulate the stripe formation in a container.
Expecting Mother Nature: Uncertain Hurricane Forecasts Disrupt Prenatal Care and Impair Birth Outcomes
Authors: Hochard Jacob , Li Yuanhao 
Published: May 2021

Abstract
Early forecasts give people in a storm's path time to prepare. Less is known about the cost to society when forecasts are incorrect. We examine over 700,000 births in the path of Hurricane Irene and find exposure led to a decrease in birth weights and increase in preterm and low birth weight outcomes. Additional warning time decreased preterm birth rates for women who experienced intense storm exposures documenting a benefit of avoiding a type II forecasting error. A larger share of this at-risk population experienced a type I forecasting error where severe physical storm impacts were anticipated but not experienced. Disaster anticipation disrupted healthcare services by delaying and canceling prenatal care leading to impaired birth outcomes. Recognizing storm damages depend on human responses to predicted storm paths is critical to supporting the next generation's developmental potential with judicious forecasts that ensure public warning systems mitigate rather than exacerbate climate damages.
Molecular signatures of tumor progression in pancreatic adenocarcinoma identified by energy metabolism characteristics
Authors: Wang Xin , Tan Cong , Weng Weiwei , Ni Shujuan , Zhang Meng , Jiang Hesheng , Wang Lei , Huang Dan , Sheng Weiqi , Xu Midie 
Published: May 2021

Abstract
Background: In this study, we aimed to describe a molecular evaluation of primary pancreatic adenocarcinoma (PAAD) based on comprehensive analysis of energy-metabolism-related gene (EMRG) expression profiles.Methods: Molecular subtypes were identified by non-negative matrix clustering algorithm clustering on 565 EMRGs. The overall survival (OS) predictive gene signature was developed, internally and externally validated based on three online PAAD datasets. Hub genes were identified in molecular subtypes by weighted gene correlation network analysis (WGCNA) co-expression algorithm analysis, and then enrolled for determination of prognostic genes. Univariate, LASSO and multivariate Cox regression analyses were performed to assess prognostic genes and construct the prognostic gene signature. Time-dependent receiver operating characteristic (ROC) curve, Kaplan-Meier curve and nomogram were used to assess the performance of the gene signature.Results: On the basis of EMRGs expression profile, we propose a molecular classification dividing PAAD into two subtypes: Cluster 1, which display more immune and stromal cell components in tumor microenvironment and higher tumor purity; and Cluster 2, which display worse OS. Moreover, by using a three-phase training, test and validation process, we construct a 4-gene signature that can constantly classify the prognostic risk of patients in all three datasets, and which present higher robustness and clinical usability compared with four previous reported prognostic gene signatures. In addition, a novel nomogram constructed by combining clinical features and the 4-gene signature showed confident clinical utility in PAAD. According to gene set enrichment analysis (GSEA), gene sets related to the high-risk group were participated in the neuroactive ligand receptor interaction pathway. Conclusions: In summary, the EMRG-based molecular subtypes and prognostic gene model provides a roadmap for patient stratification and trials of targeted therapies.
Comparing Methods for Handling Missing Cost and Outcome Data in Clinical Trial-based Cost-effectiveness Analysis
Authors: Diop Modou , Epstein David 
Published: May 2021

Abstract
OBJECTIVES: This study compares methods for handling missing data to conduct cost-effectiveness analysis in the context of a clinical study.METHODS: A long-term clinical trial with staggered recruitment was used as a case study (EVRA, NIHR-HTA project 11/129/197). Patients had between 1 year and 5.5 years (median 3 years) of follow-up under “early” or “deferred” treatment. The methods compared were Complete-Case-Analysis (CCA), multiple imputation using linear regression (MILR) and using predictive mean matching (MIPMM), Bayesian parametric approach using the R package missingHE (BPA) and repeated measures mixed model (RMM). The outcomes were total mean costs and total mean quality-adjusted life years (QALYs) at different time horizons (1 year, 3 years and 5 years). RESULTS: All methods found no statistically significant difference in cost at the 5% level in all years, and all methods found statistically significantly greater mean QALY at year 1. At year 3, BPA showed a statistically significant difference while other method did not at later time horizons. Standard errors differed substantially between the methods employed. CONCLUSION: MIPMM seemed to perform better than MILM, confirming findings from simulation studies. RMM and BPA might be feasible options, though they did not perform better than MIPMM in this dataset. Further simulation studies and applications should continue to compare these methods.
Large-scale CRISPRi and transcriptomics of Staphylococcus epidermidis identify genetic factors implicated in commensal-pathogen lifestyle versatility
Authors: Spoto Michelle , Fleming Elizabeth , Nzutchi Yvette Ondouah , Guan Changhui , Oh Julia 
Published: May 2021

Abstract
Staphylococcus (S.) epidermidis is a ubiquitous human commensal skin bacterium and prevalent nosocomial pathogen, but genetic factors underlying this lifestyle plasticity are incompletely understood. We developed a large-scale CRISPR interference (CRISPRi) screen complemented by transcriptional profiling (RNA-seq) across 24 conditions and piloted droplet-based CRISPRi. We identified putative essential genes, demonstrated the importance of trace metal uptake under stress, and identified condition-specific essential genes. Additionally, we demonstrate the considerable transcriptional plasticity of S. epidermidis, postulating a mechanism by which nitrogen metabolism is linked to lifestyle versatility in response to hyperosmotic challenges, and performed a comprehensive analysis of survival under acid stress, hypothesizing a role for cell wall modification as crucial. This study represents one of the first large-scale CRISPRi studies in prokaryotes and the first to integrate transcriptomics data across multiple conditions. Our results provide a valuable benchmarking analysis for CRISPRi screens and are rich resource for other staphylococcal researchers.
The Effect of Chicken Spleen Transfer Factor on Intestinal Mucosa Immunity Barrier of Laying Hens
Authors: yu jiayu , Ma Baochen , Li Jing , Chen Yaoxing , Wang Zixu , Cao Jing , Dong Yulan 
Published: May 2021

Abstract
Background

Chicken spleen transfer factor (TF) is a low-molecular-weight lymphocyte extract composed of polypeptide and nucleotide. This factor is obtained by repeated freeze-thaw dialysis of the specific-pathogen-free chicken spleen and can transfer cell-mediated immunity from immunocompetent donors to recipients. However, its role in regulating intestinal digestion and absorption and mucosal immunity in laying hens has remained largely unknown.
Results

To explore the effect of TF on intestinal mucosa barrier function, 100 one-day-old White Leghorns laying hens were randomly divided into five groups and administered with different doses of TF (0.00 [control], 0.05 mL, 0.10 mL, 0.25 mL, and 1.00 mL). The chickens received orally TF from days 5 to 12, and they were then raised a week without it. Tissue sampling was performed on the 12th and 19th days. The results showed that the high dose of TF (1.00 mL) improved the intestinal mucosa morphology and strengthened the digestive and absorption function. Furthermore, the histology analysis revealed an increase in the number of intraepithelial lymphocytes and goblet cells. Similarly, the results from ELISA demonstrated an increase in the content of IL-10 in the intestinal tract, while the content of TNF-α showed a decrease in this regard. The RT-PCR assay also demonstrated the upregulation of the relative mRNA expressions of Muc2, TLR-2, and TLR-4 genes in the small intestine and rectum. The intestinal antioxidant function was significantly enhanced. After stopping the TF administration for a week, its effect on the intestinal mucosa barrier was still detectable; however, it was followed by a weakened effect.
Conclusions

In conclusion, high-dose (TF-1.00mL) of TF can improve the intestinal mucosa morphology and structure, enhance digestion and absorption functions, enhance the intestinal mucosal barrier immune function and antioxidant function, and up-regulate Muc2, TLR-2 and TLR-4 gene relative expression.
Laughlin anyon complexes with Bose properties
Authors: Kulik Leonid , Zhuravlev Andrey , Musina Liliya , Belozerov Evgenii , Vankov Alexander , Volkov Oleg , Zagitova Azaliia , Kukushkin Igor , Umansky Vladimir 
Published: May 2021

Abstract
Two-dimensional electron systems in a quantizing magnetic field are regarded as of exceptional interest, considering the possible role of anyons – quasiparticles with non-boson and non-fermion statistics – in applied physics. To this day, essentially none but the fractional states of the quantum Hall effect (FQHE) have been experimentally realized as a system with anyonic statistics. In determining the thermodynamic properties of anyon matter, it is crucial to gain insight into the physics of its neutral excitations. Such excitations can be either neutral complexes of several anyons, or “vortex-antivortex” pairs in anyon density, or compositions of an integer number of magnetic flux quanta and electron complexes having fermionic or bosonic statistics. The very abundance of the possible theoretical descriptions of neutral excitations in the anyon matter evidence that they have not been given much consideration in experimental physics so far. We form a macroscopic quasi-equilibrium ensemble of neutral excitations - spin one anyon complexes in the Laughlin state ν = 1/3, experimentally, where ν is the electron filling factor. The ensemble is found to have such a long lifetime that it can be considered the new state of anyon matter. The properties of this state are investigated by optical techniques to reveal its Bose properties.
Recurrent hepatic artery thrombosis following living donor liver transplant as sequelae of SARS-CoV-2 infection: case report
Authors: Raj Anupam , Shankar Vijay , Singhal Saurabh , Goyal Neerav , Arunkumar Venuthurimilli , Garg Hitendra Kumar 
Published: May 2021

Abstract
Background: As the second wave of COVID-19 is gripping the globe, liver transplant centers are increasingly receiving patients with a recent recovery from SARS-CoV-2 infection. Despite full clinical recovery, unexpected, unusual and potentially life-threatening complications in these patients are increasingly being recognized, one such patient is discussed here. By far, this is the first ever reported case of a COVID-19 recovered recipient developing recurrent thrombotic complications, which led us to change our routine anticoagulation protocols.Case presentation: We performed liver transplantation on a 51-year-old gentleman with decompensated liver disease 23-days after recovering from SARS-CoV-2 infection. At the time of surgery, he had no known sequalae of COVID-19. His routine preoperative work-up showed no underlying coagulation disorders. He underwent living related liver transplant (modified right lobe graft) during which, despite massive blood loss and a prolonged anhepatic phase, his thromboelastographic (TEG) parameters persistently revealed hypercoagulability. He received anti-coagulation according to our standard protocol which is based on aPTT ratio and INR. After a brief uneventful early post-operative period, he developed hepatic arterial thrombosis (HAT) on the 14th postoperative day, and again after 4 days, both of which required surgical intervention. He was eventually discharged with normal graft function but was soon readmitted with recurrent HAT and necrosis of anterior sector with cholangiolar abscesses, further leading to graft loss, necessitating re-transplantation, from which he could not recover due to a rejection resistant to all conventional measures.Conclusions: There is emerging evidence that patients following SARS-CoV-2 infection tend to be hypercoagulable. We believe that this hyper coagulability might have played a significant role in the development of hepatic arterial thrombosis and eventual graft loss in this patient. This highlights the importance of revisiting anticoagulation protocols in liver transplant recipients recovered from COVID-19 and base them on TEG rather than routine parameters such as INR and aPTT, which are routinely deranged in such patients.
Direct-Current Generators Based on Conductive Polymers for Self-Powered Flexible Devices
Authors: Meng Yanfang , Zhang Long , Xu Guangyuan , Ma Yinji , Wang Heling , Feng Xue 
Published: May 2021

Abstract
Direct-current generators, especially those based on the Schottky contact between conductive polymers and metal electrodes, are efficient in converting mechanical stimuli into electrical energy. In contrast to triboelectric and piezoelectric generators, direct-current generators readily produce direct-current outputs and high currents that are crucial for integrating multiple energy-harvesting units in large scale and driving some types of devices. To further increase the current/voltage output of direct-current generator, here, we systematically investigate the effects of various conductive polymers and electrodes on the outputs by both computations and experiments. Particularly, the direct-current generator based on Cu/PANI/Ag is found to exhibit overwhelmingly current and voltage outputs over previous ones (current: 800 µA, 4 times larger; voltage: 3.5 V, 5 times larger.) under the same mechanical deformation. The preparation method of electrochemical deposition endows the generators flexibility, the linear relationship of current/voltage output vs. strain applied on the generators, combined with the large outputs offer advantages for the generator to work as flexible sensors. Furthermore, a mechanosensation-active matrix array based on direct-current generator for the strain monitoring demonstrated its promising prospects in flexible electronics. The direct-current generators with improved performance could serve as a stream new blood for versatile sensory systems and human-machine interactive interfaces.
Persistence behavior in African trypanosomes during adipose tissue colonization
Authors: Trindade Sandra , De Niz Mariana , Sequeira Mariana , Bizarra-Rebelo Tiago , Bento Fabio , Dejung Mario , Ferreira Joao , Butter Falk , Bringaud Frederic , Gjini Erida , Figueiredo Luisa 
Published: May 2021

Abstract
Persistence is an important and ancient evolutionary adaptive mechanism used by several organisms to survive environmental changes. During its life cycle Trypanosoma brucei, the causative agent of sleeping sickness, inhabits several microenvironments, including the adipose tissue. Here we used a mathematical model to investigate how this large parasite reservoir contributes to the global parasite population dynamics. By modeling the total number of parasites and the proportion of transmissible forms in the blood and the adipose tissue during an infection, we estimated that adipose tissue parasites proliferate more slowly. Intravital microscopy of parasites stained with CellTraceTM Violet confirmed that adipose tissue forms divide twice slower than the blood counterparts. Consistent with a reduced growth, proteome analysis revealed that adipose tissue forms undergo a metabolic adaptation and downregulate proteins involved in translation. Quantification of protein synthesis using L-Homopropargylglycine confirmed that this rate is 24% lower in adipose tissue forms. We propose that in adipose tissue, T. brucei acquire a persistence-like behavior, which could contribute to disease chronicity and treatment failure.
Telehealth Challenges During COVID-19 As Reported by Primary Healthcare Physicians in Quebec and Massachusetts
Authors: Breton Mylaine , Sullivan Erin E. , Deville-Stoetzel Nadia , McKinstry Danielle , DePuccio Matthew , Sriha Abi , Deslauriers Véronique , Dong Anson , McAlearney Ann Scheck 
Published: May 2021

Abstract
Background: The COVID-19 pandemic has driven primary healthcare (PHC) providers to use telehealth as an alternative to traditional face-to-face consultations. Providing telehealth that meets the needs of patients in a pandemic has presented many challenges for PHC providers. The aim of this study was to describe the positive and negative implications of using telehealth in one Canadian (Quebec) and one American (Massachusetts) PHC setting during the COVID-19 pandemic as reported by physicians.Methods: We conducted 42 individual semi-structured video interviews with physicians in Quebec (N = 20) and Massachusetts (N = 22) in 2020. Topics covered included their practice history, changes brought by the COVID-19 pandemic, and the advantages and challenges of telehealth. An inductive and deductive thematic analysis was carried out to identify implications of delivering care via telehealth.Results: Four key themes were identified, each with positive and negative implications: 1) access for patients; 2) efficiency of care delivery; 3) professional impacts; and 4) relational dimensions of care. For patients’ access, positive implications referred to increased availability of services; negative implications involved barriers due to difficulties with access to and use of technologies. Positive implications for efficiency were related to improved follow-up care; negative implications involved difficulties in diagnosing in the absence of direct physical examination and non-verbal cues. For professional impacts, positive implications were related to flexibility (teleworking, more availability for patients) and reimbursement, while negative implications were related to technological limitations experienced by both patients and practitioners. For relational dimensions, positive implications included improved communication, as patients were more at ease at home, and the possibility of gathering information from what could be seen of the patient’s environment; negative implications were related to concerns around maintaining the therapeutic relationship and changes in patients’ engagement and expectations.Conclusion: Ensuring that health services provision meets patients’ needs at all times calls for flexibility in care delivery modalities, role shifting to adapt to virtual care, sustained relationships with patients, and interprofessional collaboration. To succeed, these efforts require guidelines and training, as well as careful attention to technological barriers and interpersonal relationship needs.