bluuebunny/crossref_metadata_2025_split huggingface dataset:
Dexamethasone&nbsp;Implant Improves Anatomic Response to Anti-VEGF Therapy in Treatment-Resistant Polypoidal Choroidal Vasculopathy
Authors: Mallikarjun Kushanth , Narayanan Raja , Raman Rajiv , Mohamed Ashik , Shanmugam Mahesh , Apte Rajendra , Padhy Srikant 
Published: March 2021

Abstract
Background: A significant proportion of eyes with polypoidal choroidal vasculopathy (PCV) can be resistant to anti-vascular endothelial growth factor (VEGF) injections. We evaluated the efficacy of combination of Dexamethasone intravitreal implant (DXI) and anti-VEGF therapy in eyes resistant to anti-VEGF monotherapy. Materials and Methods: In this retrospective study, polypoidal choroidal vasculopathy (PCV) resistant to anti-VEGF injections were additionally injected with a Dexamethasone implant along with an anti-VEGF agent. Best-corrected visual acuity (BCVA), slit lamp examination, intraocular pressure, fundus evaluation and optical coherence tomography (OCT) data were analyzed. Anatomical response on OCT was the primary outcome measure. Gain in visual acuity, and injection-free interval after the Dexamethasone implant were evaluated as secondary outcome measures. Results: Twelve eyes of 11 patients were included in the study. The mean age of patients was 70.2 ± 11.8 years, and there were 8 females. The mean follow-up duration after DXI was 24.5 ±11 months. The mean number of anti-VEGF injections before DXI was 4.2 ± 1.9. The mean injection-free interval in these patients after DXI was 4.7± 0.6 months, which was significantly greater than the pre-injection mean of 1.6 ± 0.4 months (p<0.001). The median log MAR BCVA immediately prior to DXI was 0.41 (Interquartile Range IQR 0.30-1.02) and after injection was 0.60 (IQR 0.27-1.03), which was not significant (p=0.59). The median OCT thickness after DXI in was 305 microns (IQR 206-417), which was significantly less than the pre-injection OCT thickness of 547 microns (IQR 432-685) (p=0.005). The mean IOP before DXI was 14.7 ± 2.3 mm Hg, and after the injection was 14.3 ± 2.7 mm Hg (p=0.36). Conclusions: Dexamethasone implant combined with anti-VEGF treatment can prolong the treatment-free interval in eyes with PCV resistant to anti-VEGF injection, while maintaining visual acuity.
Lung Adenocarcinoma Complicated with a Carcinoid Microtumor: A Case Report and Literature Review
Authors: Xu Yanzhao , he Ming , Sun Bokang , Su Peng , Zhang Fan , Gai Chunyue , Tian Ziqiang 
Published: March 2021

Abstract
Background: Adenocarcinoma is the most common primary lung malignant tumor. However, pulmonary carcinoid tumorlets are rare neuroendocrine tumors, and the coexistence of adenocarcinoma and pulmonary carcinoid tumorlets is extremely rare. Herein, we describe a case of lung adenocarcinoma complicated with carcinoid tumorlets.Case presentation: A 71-year-old female patient was admitted to the hospital after physical examination, multiple micronodules were in the inferior lobe of the left lung and right lung for 2 years, and a tumor was in the superior lobe of the left lung for 1 month. The patient underwent resection of the superior lobe of the left lung and wedge resection of the inferior lobe of the left lung by Video-assisted Thoracoscopic Surgery(VATS). The pathology of the superior lobe of the left lung was adenocarcinoma (pathological stage pT1cN0M0, IA3 stage), and the pathology of the inferior lobe of the left lung was carcinoid tumorlets. The patient was discharged from the hospital one week after the operation and recovered well after follow-up without recurrence.Conclusions: The lack of understanding of carcinoid tumorlets in the clinic causes their misdiagnosis or missed diagnosis. At the same time, the lack of understand also suggests that we should pay attention not only to mass-type lung tumors but also to pulmonary micronodules.
Chronic Transient Hypoxia Alleviates High Fat Diet-Induced Obesity and Fatty Liver in C57 Mice by Upregulating Epinephrine Levels and Activation of&nbsp;AMPK
Authors: Luo Yunfei , Luo Zhijun 
Published: March 2021

Abstract
Background

According to epidemiologic studies, it was found that people living in high altitude areas have a lower prevalence of obesity and diabetes, and the main environmental differences between high altitude areas and plain areas are temperature and oxygen concentration. In this study, we investigated the effect of chronic transient hypoxia on obesity and fatty liver caused by high-fat diet in mice.
Methods

Put the mice under 10% oxygen concentration for 1 hour every day, this method is different from high altitude hypoxia and will not cause a series of acute altitude sicknesses. Intraperitoneal injection of epinephrine or propranolol was employed to examine the effect of chronic transient hypoxia on HFD-induced obesity, hyperglycemia and hepatic lipid accumulation.
Results

It showed that chronic transient hypoxia environment reduces the weight of mice and improve glucose tolerance, reduce the fat content of mice and alleviate fatty liver, reduces liver fat synthesis, promotes the expression M2 phenotype of macrophage genes in liver and thermogenic genes in brown fat. Furthermore, we showed that blocking the rise of epinephrine will compromise the chronic transient hypoxia environment beneficial ability to obesity and fatty liver, diminished expression of the liver AMPK phosphorylation and CD206.
Conclusions

These results suggest that chronic transient hypoxia activation of AMPK, induction of M2 type macrophage marker CD206 expression in the liver leads to significant weight loss and remission the severity of fatty liver through the adrenergic system.
An Impact of COVID-19 On Dental and Oral Health Care Workers: An Online Survey in Nepal
Authors: Deo Saroj Prasad , Baral Dharanidhar 
Published: March 2021

Abstract
Background

COVID-19 (COrona VIrus Disease-19) outbreak is an alarming situation for all health care workers. Dental and oral health care workers (DOCHWs) are invariably at a higher risk of getting infected or transmitting disease due to the nature and duration of work. The objective is to determine the effect of the COVID-19 pandemic on Nepalese dental and oral health care workers and their practices.
Methods

A cross-sectional observational, online survey was designed and conducted via Google form from 24 June 2020 to 13 July 2020 among DOHCWs of Nepal. The study tool developed after reviewing pertinent literature and international guidelines.
Results

A total of 51.9% were aged 20 to 29 years, 61.7% were male, 52.6% were single; 92.5% had no morbidity. Of the respondents, majority 60.2% of DOCHWs were working in routine duties on the COVID-19 crisis. They reduced their current practice to before the pandemic; 48.2 % of them working less than 20 hours per week, while only 10.5 % of them working more than 40 hours per week. Moreover, 73.7% performed only selective or lesser procedure; 18% closed dental practices / stayed home; only 1.5% worked more; 6.8% shifted practice to online (teledentistry). The majority of the respondents restricted their activity to an emergency (21%) and urgent procedures (22.7%). A considerable proportion of participants reported symptoms of depression (21.9%), anxiety (24.2%), and distress (8.4%). Bivariate analysis showed a statistically significant level of satisfaction with logistic support provided by the administrative agency in the different workplace (oral health service centre) with relation to the availability of masks other than N95, N99 (p = 0.04), availability of PPEs (p = 0.06) and facility of cleaning area (p = 0.01).
Conclusion

The impact of the COVID-19 pandemic among DOHCWs is widespread and adversely affect the personal, professional and academic lives of DOHCWs of Nepal. The participants reported experiencing psychological burden, precipitated by financial burden and worries about an uncertain future.
Eyelid Metastasis as the Initial Presentation of a Renal Cell Carcinoma: a Case Report and Review of the Literature.
Authors: Fang QiXiang , Xie Na , Chen Wei , Zhu Guodong , Zeng Jin , Wu Dapeng 
Published: March 2021

Abstract
Introduction: Renal clear cell carcinoma(ccRCC) accounts for about 85% of patients with renal carcinoma and is the most common pathological type of renal cancer. Renal clear cell carcinomas usually metastasize to the lungs, lymph nodes, liver, bones, and brain, with rare skin metastases, especially to the eyelids. In this study, we report the third current case of renal clear cell carcinoma with eyelid mass as its initial presentation.Case presentation: In this study, we describe in detail the case of a 62-year-old male patient with clear cell carcinoma of the kidney whose first symptom was a mass of the right eyelid. The patient had no clinical manifestations other than eyelid mass before the diagnosis of renal clear cell carcinoma. After resection of eyelid mass, postoperative pathological and immunohistochemical studies showed clear cell carcinoma of the kidney. Subsequently, a computed tomography scan disclosed bilateral renal tumors, bilateral adrenal nodules, and nodules in the upper lobe of the left lung. At the time of writing, the patient was receiving sunitinib treatment and receiving regular outpatient follow-up. Discussion and conclusion: Metastasis of renal carcinoma to the eye is rare, especially with an eyelid mass as the initial presentation. If they occur before the diagnosis of cancer or years after nephrectomy, the diagnosis of the tumor may be missed. In this study, we report the rare case and review reports of renal cell carcinoma metastasizing to the eye to raise our awareness of this rare phenomenon.
Hybrid Learning Model Integrated Into Critical Care Practice in Nursing Students A Mixed Study.
Authors: Gil-Mateu Elsa , Reverté-Villarroya Sílvia , Casanovas-Garrigós Georgina , Albacar-Riboó Núria 
Published: March 2021

Abstract
Background: Active learning methodologies have been widely adopted into undergraduate healthcare, and a strategic framework that guides learning to the students, being blended-learning which combines the best of face-to-face and virtual learning. Therefore, this study aimed to identify the key elements from a virtual forum in achieving competencies in clinical practice in critical care, and to evaluate the b-learning process of undergraduates nursing through a virtual forum on Moodle Platform.Methods: Mixed research conducted. A qualitative descriptive phenomenological methodology informed by virtual forum and quantitative descriptive method from self-reported questionnaire. An intentional sample of nursing students of clinical practice in critical care units from fourth-year undergraduate in Rovira Virgili University (Spain) was employed. Data source included virtual forum (sixteen weeks) and final seminar classroom included face-to-face. Sociodemographic and forum variables were evaluated questionnaire ad hoc (fifty questions): learning, tutoring, satisfaction, and self-evaluation about virtual forum with Likert scores 1:(strongly disagree) to 4:(strongly agree).Results: It was observed 51 nursing students, 70.6% of students were women (n.36) with an average of age of 21.18 years (standard deviation 2,186). In the qualitative analysis of the forums, six main categories were extracted: The humanization of care (n=93), Communication (n=69), Learning (n =92), Professional knowledge (n=55), Clinical Safety (n=66), Complexity (n=101). The analysis of the questionnaire shows: The evaluation learning, tutoring, self-evaluation about virtual forum, and satisfaction. The items that have presented significant differences (p<0.05) are six items and by (p<0.01) one item.Conclusion: The dynamized forum allows accompanying the students while their clinical practice in critically ill patients in their learning process to develop critical thinking. It’s also a useful tool for achieving results, in scenarios that have become the result of social confinements, which will lead to a paradigm change in universal education.
Modified CIM-Test As a Useful Tool to Detect Carbapenemase Activity Among Extensively Drug- Resistant Klebsiella Pneumoniae, Escherichia Coli and Acinetobacter Baumannii
Authors: bialvaei Abed Zahedi , Dehkharghani Alireza Dolatyar , Asgari Farhad , Shamloo Firouzeh , Eslami Parisa , Rahbar Mohammad 
Published: March 2021

Abstract
Background

Timely detection of carbapenemases is essential for developing strategies to control the spread of infections by carbapenem-resistant isolates. The purpose of our study was to determine the epidemiology of carbapenemase genes among carbapenem resistant isolates of Acinetobacter baumannii, Klebsiella pneumoniae and Escherichia coli and to compare efficacy of modified Hodge Test (MHT), Carba NP and modified carbapenem inactivation method (mCIM) tests.
Methods

A total of 122 carbapenem-resistant clinical isolates including 77 K. pneumoniae, 39 A. baumannii, and six E. coli were collected from hospitalized patients. Three phenotypic methods, including MHT, Carba NP test and mCIM were used for investigation of carbapenemase production. In addition, polymerase chain reaction (PCR) was performed to detect carbapenemase encoding genes.
Results

The sensitivity and specificity of the MHT were 75.0% and 100% respectively. In addition, CarbaNP displayed 80.8% sensitivity and 100% specificity, whereas the sensitivity and specificity were 90.4% and 100% for the mCIM test, respectively. Among carbapenem-resistant isolates, 70, 84 and 87 isolates exhibited positive results according to MHT, CarbaNP test and mCIM, respectively. PCR indicated the presence of one or more carbapenemase genes in 119 of carbapenem-resistant isolates, with blaKPC and blaVIM being the most commonly encountered. Co-production of ‘KPC and VIM’, ‘KPC and IMP’ and ‘KPC and OXA-48’ was detected in nine, seven and three isolates, respectively.
Conclusion

Our results confirm that the mCIM test is a useful tool for the reliable detection of carbapenemases-activity in enterobacterial isolates, especially in clinical microbiological laboratories with limited resources.
TERT Mutations Correlated With the Prognosis of Patients With Hepatitis B-Related Hepatocellular Carcinoma Underwent Curative Hepatectomy
Authors: Song Kangjian , Huo Junyu , He Fu , Zhu Qingwei , Wu Liqun 
Published: March 2021

Abstract
Background To explore the value of TERT mutations in predicting the early recurrence and prognosis of hepatitis B-related hepatocellular carcinoma (HCC) patients underwent curative hepatectomy.Methods A total of 81 patients with hepatitis B-related HCC were enrolled and all patients underwent curative hepatectomy. Associations were sought between TERT mutations and recurrence rate within 2 years after hepatectomy, time to progress (TTP) and overall survival (OS).Results TERT mutations (HR: 2.985, 95%CI: 1.158-7.692, p=0.024) and Barcelona clinic liver (BCLC) stage B (HR: 3.326, 95%CI: 1.019-10.856, p=0.046) were independent risk factors for recurrence within 2 years after hepatectomy. Patients with a TERT mutation had poor TTP (p=0.003) and OS (p=0.013) than others. TERT mutations (HR: 2.245, 95%CI: 1.185-4.252, p=0.013) and BCLC stage B (HR: 2.132, 95%CI: 1.082-4.198, p=0.029) were independent risk factors for poor TTP after curative hepatectomy. A predictive model based on TERT mutations and BCLC stage had better ability to predict early recurrence after hepatectomy of HCC patients than any single factor (AUC: 0.688 vs. 0.639, 0.688 vs. 0.607, respectively). Patients with both TERT mutations and BCLC stage B had poorer TTP and OS than others (p=0.001, p<0.001, respectively).Conclusion TERT mutations had ability to predict early recurrence and poor prognosis for hepatitis B-related HCC patients underwent curative hepatectomy.
Transition of the Future Precipitation Types in the Tianshan Mountains Region, China
Authors: Ren Rui , Li Xuemei , Li Lanhai , Huang Yiyu 
Published: March 2021

Abstract
The general circulation models (GCMs) from the coupled model intercomparison project phase 5 (CMIP5) were used to evaluate the simulation capabilities of rainfall-to-precipitation ratio (RPR) from 1961 to 2018 at 28 meteorological stations in the Tianshan Mountains region (TMR). Moreover, it was estimated the change of RPR in the months experiencing freezing-thawing transitions from 2011 to 2100 under three representative concentration pathways (RCPs), RCP2.6, RCP4.5, and RCP8.5. The results indicated that the simulated air temperature from CMIP5 was highly correlated with the observed values, while the performance for precipitation was poor. Therefore, it is feasible to forecast the future RPR employing the temperature provided by CMIP5 and the observed meteorological factors by the BP neural network (BNN). Under three emission scenarios, the RPR in the months experiencing freezing-thawing transitions during 2011-2100 will increase compared to that during the baseline period (1981-2010). Under the same emission scenario, values of RPR will increase as the time goes on. Besides, in terms of spatial variation, values of RPR in the south slope will be larger than that in the north slope under three emission scenarios. Furthermore, values of RPR exhibit different variation characteristics under different emission scenarios. Under the RCP2.6 emission scenario, as the time goes on, values of RPR at more stations will change slightly. Under the RCP4.5 emission scenario, the increase of RPR will occur in the whole TMR and stabilize in the north slope by the end of this century. However, values of RPR will increase significantly through 21st century in the whole TMR under the RCP8.5 emission scenario.
Identification of key survival genes of the tumor microenvironment and immune infiltration in head and neck squamous cell carcinoma
Authors: Wang Min , Lu Tao , Li Yanshi , Pan Min , Wang Zhihai , Hu Guohua 
Published: March 2021

Abstract
Background: Head and neck cancer (HNC) are highly aggressive solid tumors with poor prognoses. The tumor microenvironment (TME) plays a critical role in angiogenesis, invasion, and metastasis of HNC. In the TME, immune and stromal cells influence tumor initiation, response, and therapy. Our study aimed to evaluate the progression and prognosis of HNC by analyzing the key genes involved in immunization and stromal cells. Methods: Gene expression profiles, demographics, and survival data were downloaded from the TCGA database. Patients with HNC were divided into high immune/stromal score groupss or low immune/stromal score groups based on the ESTIMATE algorithm. Differentially expressed genes (DEGs) were identified via functional enrichment analysis and protein-protein interaction networks, and survival analysis based on DEGs was also performed.Results: A total of 522 patients with HNC were enrolled for analysis. The average age was 60.87, and one-third of the patients were HPV-positive. Kaplan-Meier survival analysis showed that patients' median survival time in the low-score group was shorter than that of the high-score group (625 vs. 680 days, log-rank, p = 0.1716). According to immune scores, 925 genes were upregulated, and 72 genes were downregulated in the high-score group compared with the low-score group. Top Gene Ontology terms identified that T-cell costimulation, regulation of immune response, and the external side of the plasma membrane were the most involved pathways. Moreover, Kaplan-Meier analysis revealed that 480 DEGs were upregulated in the high-immune scores group, and a total of 126 DEGs were significantly associated with poor survival. Besides, we identified the hub genes of DEGs through protein-protein interactions and found that PTPRC, CD247, and CD4 are associated with immune infiltration and all-cause mortality.Conclusions: We identified a series of TME‐related genes significantly associated with overall mortality; this information is crucial for further understanding the role of TME and immune infiltration in the prognosis of HNC.
A New Objective Evaluation Method on Image Edge Detection
Authors: Chen Jingshi , Liu Gang , Liu Feng , Wang Ying , Sun Yongxing , Lu Jiaxin 
Published: March 2021

Abstract
In the field of machine vision, image edge detection is an important technology, which can make necessary preparation for the later image processing. Consequently, accurate evaluation of the edge detection effect of the processed image is a more critical technology. In this paper, the new three criteria are proposed, which is based on Canny's three criteria for edge detection. Through theoretical analysis, three quantitative basic evaluation indexes are given to the new three criteria, namely SSIM index of image reconstruction similarity, BIdx index of edge reliability and CIdx index of edge continuity. Additionally, noise evaluation criteria is also considered. Then the four basic evaluation indexes are fused to get the objective evaluation index EIdx of image edge detection.Finally, the experimental data show that the accuracy of the method is better than that of the subjective evaluation system.
A Scale-Dependent Neural System for Human Spatial Navigation
Authors: Dong Weihua , Wang Shengkai , Liu Yu , Wan Xiaohong , Liu Jia , Hu Siyuan , Pei Tao , Meng Liqiu 
Published: March 2021

Abstract
It is currently unclear whether the human brain processes navigation tasks at different scales in the same way. According to the classical view, humans process navigation information using a hierarchical representation system in a unified way. Other theories, such as the dual and multiple systems theories, suggest that the processing of navigation tasks differs between spatial scales. In addition, previous human navigation studies have mainly focused on scales ranging from rooms to small neighborhoods. However, the neural mechanisms underlying the processing of large-scale spatial navigation tasks in the human brain, and the ways in which neural activation changes with scale, have not been examined in detail. In this study, we conducted a functional magnetic resonance imaging (fMRI) based multi-scale mental navigation experiment across six spatial scales. On the basis of cortical activity patterns, we discovered a scale-dependent neural system that included the parahippocampal gyrus, cingulate gyrus, parietal gyrus and temporal gyrus, revealing neural-based divisions based on spatial scale: small scale (room), medium scale (building), large scale (block), and huge scale (city, country and continent). In contrast, scale-free characteristics were observed in middle occipital gyrus. The current findings provide new insight into the neural mechanisms of scale-driven spatial navigation in humans.
Silver-Silica Nanoparticles Induced Dose-Dependent Modulation of Histopathological, Immunohistochemical, Ultrastructural, Proinflammatory, and Immune Status of Broiler Chickens
Authors: Khafaga Asmaa F. , Alwan Ali B. , Abdelsalam Nader R. , Soliman Mohamed M. , Taha Ayman E. , Ghareeb Rehab Y. , Atta Mustafa S. , Dosoky Waleed M. 
Published: March 2021

Abstract
Silver nanoparticles (AgNPs) are a powerful disinfectant, but little information is available on their potential use as a growth promoter and the safety margin of this. In this study, 480 1-day-old Cobb chicks were assigned to one control and three treated groups. The treated groups were supplemented with silver-doped silica nanoparticles (SiO2@AgNPs) at three dietary levels (8, 16, and 20 mg/kg diet) for 35 days. The results revealed no significant changes in the growth performance and oxidative parameters, and in most of the hematological and biochemical parameters among the control and treated groups. In contrast, dose-dependent adverse effects were exerted on the histopathological structure and immunohistochemical expression of CD45 in liver, kidneys, and lymphoid organs (spleen, bursa, and thymus). In addition, the relative weight of lymphoid organs and the serum levels of immunoglobulins M and G were significantly diminished. Moreover, the gene expression of proinflammatory cytokines (IL-β1 and TNF-α) and the ultrastructural morphology in breast muscle showed significant dose-dependent alterations. It could be concluded that the dietary supplementation of SiO2@AgNPs at a level of 8 mg/kg diet or more has dose-dependent proinflammatory and immunosuppressive effects on broiler chickens.