bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning curve of trainees performing laparoscopic appendectomy- a register-based study
Authors: Young Nathalie , Boström Lennart , Sandblom Gabriel , Pettersson Hans Järnbert 
Published: July 2021

Abstract
Background

Appendectomy is one of the first procedures that surgical trainees are expected to manage alone. The purpose of this study was to analyse the learning curve of a cohort of surgical trainees and to explore the association between trainee surgeon volume and complication rate.
Method

The study was based on a cohort extracted from the local appendectomy register at Södersjukhuset (transl. South Hospital), Stockholm. The register includes patient characteristics, surgical method, operation time, and 30-day complications. First-year surgical trainees attending the hospital’s trainee programme were included and followed over five years of training. Trainees who had performed less than ten procedures during the period of the study were excluded. The learning curve was described using moving average of order ten for each trainee, studying the trend in operation time with increasing volume. The cumulative sum technique was used to chart changes in complication rates of the trainees.
Results

586 procedures performed by 9 surgical trainees were included, of which 97.6% were performed laparoscopically. A plateau in operation time on the learning curve was reached at 60 procedures. For three of the trainees, the 30-day complication rate decreased after completing the learning curve, whereas for two others it increased. In a multivariate analysis, operation times differed more between the trainees than it did between procedures performed early or late in the programme. Shortest versus longest mean operation time (41 min versus 89 min).
Conclusion

At least 60 procedures are required to reach sufficient proficiency in appendectomy. This highlights the importance of meticulous selection of surgical trainees, structure of training programmes, feedback, and assessment.
Single Nucleotide Polymorphisms (SNPs) Within Vkorc1 in Rodent Populations in a Tropical City-state: Implications for Anticoagulant Rodenticide Use for Rodent Control
Authors: Chua Cliff , Humaidi Mahathir , Ng Lee Ching , Aik Joel 
Published: July 2021

Abstract
Anticoagulant rodenticides are commonly used in rodent control because they are economical and have great deployment versatility. However, rodents with Single Nucleotide Polymorphism (SNP) mutations within the Vkorc1 gene are resistant to the effects of anticoagulant rodenticide use and this influences the effectiveness of control strategies that rely on such rodenticides. This study examined the prevalence of rat SNP mutations in Singapore to inform the effectiveness of anticoagulant rodenticide use. A total of 130 rat tail samples, comprising 83 Rattus norvegicus (63.8%) and 47 Rattus rattus spp. (36.2%) were conveniently sampled from November 2016 to December 2019 from urban settings and sequenced at exon 3 of Vkorc1. Sequencing analysis revealed 4 synonymous and 1 non-synonymous mutations in Rattus rattus spp. samples. A novel synonymous mutation of L108L was identified and not previously reported in other studies. Non-synonymous SNPs were not detected in the notable codons of 120, 128 and 139 in Norway rats, where these regions are internationally recognised to be associated with resistance from prior studies. Our findings suggest that the prevalence of anticoagulant rodenticide resistance in Singapore is low. Continued monitoring of rodenticide resistance is important for informing rodent control strategies aimed at reducing rodent-borne disease transmission.
The potential role of community pharmacy staff in reducing patient delay in consulting with symptoms of rheumatoid arthritis: a qualitative study
Authors: Simons Gwenda , Ismail Nour , Sandhu Karanbir , Mallen Christian D. , Stack Rebecca J. , Raza Karim , Falahee Marie 
Published: July 2021

Abstract
Background

Rheumatoid arthritis (RA) is a chronic inflammatory arthritis which can cause joint damage and reduced quality of life. Early treatment of RA within 3 months of symptom onset is associated with improved clinical outcomes. However, this window of opportunity is often missed. One important factor that contributes to treatment delay is that patients with symptoms of RA often delay consulting their general practitioner (GP). Previous research indicates that patients with inflammatory arthritis are likely to visit pharmacies for advice before consulting their GP. Therefore, pharmacists are well positioned to identify patients with symptoms of early inflammatory arthritis and sign post them appropriately. This research examines community pharmacy staff’s knowledge, perceptions and approaches to management of patients presenting with symptoms of RA in order to identify training needs and other opportunities for intervention to enhance the role of pharmacy staff in the pathway to care.
Methods

Semi-structured interviews were conducted with 19 community pharmacy staff with varying roles in the West Midlands, UK, during a 12 month period (2017–2018). The interviews were audio-recorded, transcribed and analyzed using thematic analysis facilitated by NVivo 12.
Results

Community pharmacy staff (including pharmacists, pharmacy managers, technicians, dispensers and pre-registration pharmacists) had a range of knowledge and differing perceptions of RA and what action should be taken when patients present with symptoms of RA. These can be grouped into four themes: (1) Variations in perceptions and knowledge about RA. (2) The role of the pharmacy in increasing public awareness about RA. (3) The role of the pharmacy staff in facilitating access to the GP. (4) Practical considerations for pharmacy based interventions.
Conclusion

Amongst community pharmacy staff, there is wide variation in the understanding of RA and the importance of early treatment. This study identifies opportunities for enhanced training of community pharmacists and other pharmacy staff in relation to inflammatory arthritis as well as other pharmacy-based interventions, such as public awareness campaigns about RA and other musculoskeletal conditions. This could result in enhanced signposting to rapid GP consultation for inflammatory symptoms and reduced treatment delay.
DLG3 Impairment Caused by Missense Variants in Non-Syndromic X-Linked Mental Retardation
Authors: Alagoz Meryem , Kherad Nasim , Solgun Huseyin Avni , Ozkılıc Alper , Aslan Elif Sibel , Bozkurt Sureyya , Demirkol Şeyda , Yuksel Adnan 
Published: July 2021

Abstract
X-lined intellectual disability (XLID), formerly known as X-lined mental retardation, is defined as genetically heterogeneous disorders with remarkable cognitive impairment and abnormal adaptive behaviour skills. This study demonstrates the Disc-large homolog 3 (DLG3) gene impairment in 2 different unrelated male probands. The results detected two missense mutations in the DLG3 gene, c.2267 G > A (p.Arg756Gln) and c.2359G > A p. (Gly787Ser) using by NGS. Both mutations were run in the PolyPhen2 program for mutation sensitivity check and showed to have 0.709 and 1, respectively. The familial transmission pattern of MR detected both mothers to be heterozygote. The mutations were shown to have caused non-syndromic XLMR (NS-XLMR) as both males did not show any abnormal facial or physiological features. Based on the IQ measurement, proband 1 and 2’ IQs were measured 40 and 33, and they were diagnosed with moderate and severe XLMR, respectively. Both affected males showed significant deterioration in neural development and behaviour abilities, which indicates the significant impact of the mutation on neurotransmitters and maintenance of NMDA receptors in neural functions. However, further molecular and functional studies are necessary to provide more conclusive evidence of the detailed abnormalities caused by the reported mutations.
Immune Checkpoint Inhibitors Induced Autoimmune Haemolytic Anemia: Case Series and Literature Review
Authors: Wu Yuanqiang , Chen Shengchi , Li Jisheng , Pan Yue , Hu Chunhong , Shu Long , Hou Tao , Wu Fang 
Published: July 2021

Abstract
Immune checkpoint inhibitors (ICIs) have brought a revolution to the anti-cancer treatment, however, they also triger a unique spectrum of immune-related adverse events (irAEs). Among irAEs, haemopoietic AEs are rarely reported and mostly severe or even life-threatening, especially autoimmune haemolytic anemia (AIHA). AIHA is presumed to relate to the abnormal formation of circulating autoantibodies against red cell membrane antigens. It usually cannot be discovered timely because of atypical symptoms. It is diagnosed according to presence of hemolysis evidences such as decrease of haemoglobin, increase of indirect bilirubin and lactate dehydrogenase (LDH), urobilinogen, and positive direct antiglobulin test (DAT). Treatments of AIHA are according to clinical experience and consensus, which have not been verified by prospective trial. Here we investigate previous reported ICIs induced AIHA cases including thirty detailedly documented patients. On the other hand, we report three patients who developed AIHA after three different anti-PD-1 antibodies. Most of them were aged patients with melanoma or NSCLC, developed AIHA by anti-PD-1 antibodies and relived with glucocorticoid. 43.3% of previous cases and all of our observed cases had anemia before ICIs treatment, which reminds us of anemia as a risk factor for ICIs induced AIHA. By screening parameters like complete blood examination, reticulocyte, liver function test or DAT test prior to immunotherapy, doctors could exclude pretreatment haemolytic anemia or be aware of post ICIs AIHA. Thus, it is possible to avoid the potentially life-threatening AIHA, or improve the level of pre-alarm and treatment ability of AIHA.
Construction of a Prognostic Model of Non-small Cell Lung Cancer Based on TCGA and ImmPort Databases and Analysis of Its Correlation With Tumor Microenvironment
Authors: Song Peng , Ma Xiaobin , Yang Dongliang 
Published: July 2021

Abstract
PurposeBioinformatics methods are used to construct an immune gene prognosis assessment model for patients with non-small cell lung cancer (NSCLC), and to screen biomarkers that affect the occurrence and prognosis of NSCLC.MethodsThe transcriptomic data and clinicopathological data of NSCLC and cancer-adjacent normal tissues were downloaded from the Cancer Genome Atlas (TCGA) database and the immune-related genes were obtained from the IMMPORT database (http://www.immport.org/); then, the differentially expressed immune genes were screened out. Based on these genes, an immune gene prognosis model was constructed. The Cox proportional hazards regression model was used for univariate and multivariate analyses. Further, the correlations among the risk score, clinicopathological characteristics, tumor microenvironment, and the prognosis of NSCLC were analyzed.ResultsA total of 193 differentially expressed immune genes related to NSCLC were screened based on the "wilcox.test" in R language, and Cox single factor analysis showed that 19 differentially expressed immune genes were associated with the prognosis of NSCLC (P <0.05). After including 19 differentially expressed immune genes with P<0.05 into the Cox multivariate analysis, an immune gene prognosis model of NSCLC was constructed (it included 13 differentially expressed immune genes). Based on the risk score, the samples were divided into the high-risk and low-risk groups. The Kaplan-Meier survival curve results showed that the 5-year overall survival rate in the high-risk group was 32.4%, and the 5-year overall survival rate in the low-risk group was 53.7%. The receiver operating characteristic (ROC) model curve confirmed that the prediction model had a certain accuracy (AUC=0.673). After incorporating multiple variables into the Cox regression analysis, the results showed that the immune gene prognostic risk score was an independent predictor of the prognosis of NSCLC patients. There was a certain correlation between the risk score and degree of neutrophil infiltration in the tumor microenvironment.ConclusionThe NSCLC immune gene prognosis assessment model was constructed based on bioinformatics methods, and it can be used to calculate the prognostic risk score of NSCLC patients. Further, this model is expected to provide help for clinical judgment of the prognosis of NSCLC patients.
Recurrent Myocarditis After the First Dose of SARS-CoV-2 mRNA-1273 Vaccine
Authors: Tano Giuseppe Di , Moschini Luigi , Calvaruso Elva Vicenta , Danzi Gian Battista 
Published: July 2021

Abstract
Background. Several cases of myocarditis associated with COVID-19 mRNA vaccines have recently been reported in which the mechanism of vaccine-induced myocarditis has not been clearly identified. Case presentation. We describe the case of a 29-year-old man who had an episode of recurrent acute myocarditis (confirmed by cardiac magnetic resonance) six days after he received the first dose of SARS-CoV-2 mRNA-1273 vaccine. The causal nature of this recurrent myocarditis remains elusive, but the event appears to be very peculiar as it occurred after the first dose of SARS-CoV-2 vaccine in a subject with a history of previously healed myocarditis.Conclusion. This case raises practical questions concerning the risk/benefit ratio of SARS-COV2 prophylactic vaccination in young people, especially in those with a history of myocardial or pericardial inflammatory disease.
Performance of Flowable Concrete in Underground Structures
Authors: Sonule Sandip , H.Jayarama  , Ojha Partha Sarath , Jadhav C.M , Tayade K.C 
Published: July 2021

Abstract
Flowable concrete gives special combinations of uniformity, performance and consistency requirements that cannot be possible by traditional normal slump concrete. It is superior concrete than the traditional concrete with high workability, no segregation, no bleeding, and it is also suitable for use in the structures with long-distance pumping i.e., more than 120-meter length, for example, in NATM tunnels, cross-passages, and the concrete structure of the station box. Flowable concrete can flow itself without vibration or a little bit of vibration like surface tamping at outer surface of the formwork for achieving a smooth surface finish after de-shuttering. Percentages of concrete ingredients that are used in concrete to ensure a balance between deformability and stability. Type of selected materials and the fixed ratio of concrete materials can be affected on the fresh and harden properties of the concrete. The article presents experimental techniques for mix designing of flowable concrete for grade M40 and application of the same concrete mix at the cast in situ Base slab, Roof slab Rcc walls for underground metro stations, NATM tunnel & cross passages in Mumbai Metro Project, package -UGC-07. The test results for conformity requirements of M40 grade flowable concrete such as flowability, viscosity, passing ability of fresh concrete, durability test and harden concrete tests determined, and results are included here.
Quantifying the Lasting Effects of Resistance and Endurance Exercise Interventions on Mental Wellbeing and Physical Fitness in Women Receiving Adjuvant Treatment for Breast Cancer Compared to Adjuvant Therapy Alone: A Contemporary Systematic Review and Meta-Analysis
Authors: Mok Jonathon , Brown Marie-Juliet , Akam Elizabeth , Morris Mhairi 
Published: July 2021

Abstract
Introduction: Breast cancer is a persisting global burden for health services with cases and deaths projected to rise in future years. Surgery complemented by adjuvant therapy is commonly used to treat breast cancer, however comes with detrimental side effects to physical fitness and mental wellbeing. Aim: The aim of this systematic review and meta-analysis is to determine whether resistance and endurance interventions performed during adjuvant treatment can lastingly ameliorate these side effects.Methods: A systematic literature search was performed in various electronic databases. Papers were assessed for bias and grouped based on intervention design. RStudio was used to perform the meta-analyses for each group using the ‘meta’ package. Publication bias and power analyses were also conducted. These methods conform to PRISMA guidelines.Results: Combined resistance and endurance interventions elicited significant long-lasting improvements in global fatigue and were beneficial to the remaining side effects. Individually, resistance and endurance interventions non-significantly improved these side effects. Resistance interventions elicited higher benefits overall.Conclusion: Exercise interventions have lasting clinical benefits in ameliorating adjuvant therapy side effects, which negatively impact physical fitness and mental wellbeing. These interventions are of clinical value to enhance adherence rates and avoid comorbidities such as sarcopenia, thus improving disease prognosis.
Effects of Selenium–Zinc Interactions on the Bioavailability of Selenium/Zinc in Soil and Its Mechanism
Authors: Xue Mingyue , Wang Min , Zhou Fei , Zhai Hui , Li Huinan , Yan Ying , Liang Dongli 
Published: July 2021

Abstract
Purpose Biofortification is a core strategy in solving the malnutrition of selenium (Se) and zinc (Zn) for global human being. However, whether Se and Zn co-biofortification can manipulate soil Se/Zn bioavailability and its mechanism still remains unclear. Methods The pot experiment was conducted to investigate the co-amendment of selenate and Zn sulfate on the growth of pak choi, especially on the uptake of Se and Zn, and to elucidate the effect of soil pH and soil enzyme activity on the bioavailability of Se/Zn in soil and its mechanism. Results Results showed that plant growth inhibition caused by the application of high Se rate was significantly alleviated with Zn supplements, and the biomass in the shoots and roots of pak choi in Se2.5Zn20 and Se2.5Zn50 treatments significantly increased (67.0%–112.8%) compared with the Se2.5Zn0 treatment. Additionally, Se and Zn co-amended application significantly enhanced soil available Se/Zn content compared with correspond single Se/Zn treatments. The increase of soil available Zn content could be attributed to the significant decrease in the soil pH, while the increase of soil available Se was from the biochemical conversion caused by the activity of catalase, urease, and alkaline phosphatase. Conclusion Se–Zn co-amendment can ameliorate bioavailability of Se/Zn in soil by regulate the pH and enzyme activity of soil.
Characterizations of Larval Gut Bacteria of Anopheles Subpictus Grassi and Their Role in Mosquito Development in Hooghly, West Bengal, India.
Authors: Seal Madhurima , Chatterjee Soumendranath 
Published: July 2021

Abstract
Malaria is a serious vector borne disease transmitted by different species of Anopheles mosquitoes. The present study was aimed to isolate & characterize the bacterial flora from the gut of An. subpictus larvae prevalent in Hooghly and explore their roles in host survival and development. Mosquito larvae and adults were collected from field and were maintained in laboratory. Bacterial load in the larval midgut was determined, predominant strains were isolated and characterized by polyphasic approach. Role of these bacteria in larval survival & development were assayed. Bacterial load in the gut of larvae was found to vary in field collected and lab reared mosquitoes in different seasons. Morphological, bio-chemical and molecular analysis explored four common bacterial isolates namely Bacillus subtilis, Bacillus pumilus, Bacillus cereus & Proteus vulgaris in the larval gut throughout the year. Larval survival rate was greatly reduced (0.06) & time of pupation was prolonged (17.8±0.57) in absence of their gut bacteria. Total tissue protein (7.78±0.56), lipid (2.25±0.19) & carbohydrate (16.5±0.79) contents of larvae and body weight & wing length of adult male (0.17±0.02 & 1.74±0.43) & female (0.19±0.02 & 1.99±0.46) mosquitoes were also found to be greatly reduced in the absence of gut bacteria. Developmental characteristics were restored with the introduction of culture suspension of all four resident gut bacterial isolates. Present study indicates that the mosquitoes solely depend on their gut bacteria for their survival & development. So, manipulation or control of this gut bacterial communities might inhibit survival & development of vector mosquitoes.
Cutting Force and Nonlinear Chatter Stability of Ball-end Milling Cutter
Authors: Zhang Ce , LI Changyou , Xu Mengtao , Yao Guo , Liu Zhendong , Dai Weibing 
Published: July 2021

Abstract
Ball-end milling cutters are one of the most widely used cutters in the automotive, aerospace, die and machine parts industries. In addition, milling chatter will reduce the surface quality and production efficiency, resulting in noise. It is particularly important to model the cutting force and analyze the flutter stability of ball-end milling cutters. In this paper, a simplified milling force model of ball-end milling cutter with three degrees of freedom was established based on Merchant bevel cutting theory. The model simplified the milling force coefficient. The expressions of instantaneous milling area considering the vibration displacements in X, Y and Z directions were derived. The nonlinear dynamic cutting force model of ball-end milling cutter with three degrees of freedom was established. The nonlinear chatter vibration mechanical model of ball-end milling cutter with three degrees of freedom was established by introducing the time delay term, the stability analysis is carried out by time domain simulation. The proposed models were experimentally verified.
Inside a Schwarzschild Black Hole Approach
Authors: Ramírez José Enrique Hernández 
Published: July 2021

Abstract
Our goal in this paper is to explain the internal properties of the black hole by considering its density as a function of the reciprocal of its radius and the temperature as a function of the reciprocal of the density. We then set the temperature to the Hawking temperature. This gives all the macroscopic quantities of the black hole, such as heat capacity, pressure, surface gravity, and equation of state. In this work, we only consider a black hole with mass M, radius r+ and vacuum. Two internal forces and the corresponding potential are obtained.
Production of bioethanol from wheat straw via optimization of co-culture conditions of Bacillus licheniformis and Saccharomyces cerevisiae
Authors: Sharma Shweta , Jha Paras Kumar , Panwar Amit 
Published: July 2021

Abstract
Bioethanol production has been a challenge for the researchers to enhance the bioethanol yield. In this study, we are reporting an efficient novel method to produce bioethanol. The process comprises co-culture technique to produce bioethanol from wheat straw by co-culturing Bacillus licheniformis and Saccharomyces cerevisiae. Simultaneous saccharification and fermentation allows wheat straw hydrolysis by cellulase enzyme produced by Bacillus licheniformis and conversion of produced reducing sugar into ethanol by Saccharomyces cerevisiae. Pre-treatment of wheat straw and optimization of co-culturing parameters like, time, pH, substrate concentrations and nitrogen source concentrations gave a net yield of 5.67% v/v bioethanol. Scale up of optimised media to fermenter has resulted in a significant enhancement of bioethanol production to 18.64% (v/v).