bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Sizes on the Lung-Targeting and Biocompatibility of Intravenously Administered Biodegradable PLGA Microspheres
Authors: Lang Fengting , Qu Shaoqi , Li Kang , Zhong Muqi , Wang Cuncai , Hao Zhihui
Published: September 2021

Background: In the treatment of lung diseases, drug showed low bioavailability and efficacy by conventional administration methods. Passive lung-targeting microspheres provide a method to deliver drugs from the vascular side, there is still a paucity of systematic studies on the biocompatibility of biodegradable-polymer microspheres. Results: We used poly (lactic acid-glycolic acid) (PLGA) microspheres with different particle sizes (3, 10, 25, and 40 mm) as a model. The optimal lung-targeting particle size of the PLGA microspheres is 10 mm and the corresponding range of maximum tolerated dose is 125-150 mg/kg. We hypothesized that the decrease of blood oxygen saturation under treatment of microspheres was caused by pulmonary embolism. We found varying degrees of blood circulation loss of lungs by micro computed tomography test, which indicated severe pulmonary embolism subsequent to intravenous injection of microspheres with a particle size >25 mm. Furthermore, we found lung injury and microspheres leaked from the blood vessels into the alveoli by H&E staining. This process was likely induced by increased secretion of matrix metalloproteinases (MMPs), which destroyed the alveolar-capillary barrier and trigger an inflammatory cascade. Finally, we found that optimal particle size and dose conditions did not affect normal physiological activities after the microspheres degraded. The upregulation of vascular endothelial growth factor (VEGF) and platelet endothelial cell adhesion molecule-1 (PECAM-1 or CD31) induced vessel recanalization and reestablishment, which promoted the progress of lung repair. Conclusions: Collectively, our results highlight the importance of accurately designing the optimal size and dose of microspheres for passive lung-targeting delivery.
Experience of Using An e-portfolio In Clinical Practice at a Medical School
Authors: Song Mi Ryoung , Yu Ji Hye , Lee Mi Jin , Lee Su Kyung , Kim Mi Ran , Moon So Young , Lee Jang Hoon
Published: September 2021

Background: The electronic portfolio(e-portfolio) is a useful tool for storing learning-related information, gathering and organizing learning evidence, and demonstrating student learning and growth over time. According to various studies, e-portfolio content criteria should be kept simple and adaptable in relation to educational aims. However, there is a paucity of empirical studies on whether the content composition of an e-portfolio as seen by learners using the real e-portfolio is acceptable. The purpose of this study is to determine whether the appropriateness of electronic portfolio content items and feedback affects self-reflection and learning ability in clinical practice for medical students who used an electronic portfolio.Methods: This research was carried out in 2020 with 40 fifth-grade students at Ajou University College of Medicine in Korea. The benefits and utility of e-portfolios were investigated in clinical practice courses in pediatrics, obstetrics and gynecology, and neurology. Descriptive statistics, analysis of variance (ANOVA), correlation analysis, and a regression analysis were performed on the obtained data.Results: Satisfaction with neurology was the greatest among the clinical practice courses in pediatrics, obstetrics and gynecology, and neurology as compared to clinical practice course using an e-portfolio for the first time. Self-reflection, learning performance improvement, and prompt feedback were all found to be more satisfying than in previous clinical practice courses. Furthermore, as the quantity of content items in the e-portfolio dropped and the faculty in charge rapidly provided feedback, medical students' satisfaction with e-portfolio usage increased.Conclusions: The number of content items in the e-portfolio decreased as the number of content items in the e-portfolio declined in the clinical practice course of the medical school; moreover, the faculty in charge provided timely feedback. This suggests that for medical students to effectively use the e-portfolio in the clinical practice course, a plan should be developed to reduce the number of e-portfolio content items. Subsequently, there should be a focus on the most important items while considering the unique characteristics of each clinical practice course. It also indicates that professors should provide prompt feedback on students' academic performances.
Reconstruction of the Coracoclavicular Ligament With Palmaris Longus Tendon and Mersilene Tape for Acromioclavicular Dislocations
Authors: Lee Yoon Min , Yeo Joo Dong , Hwang Zin Ouk , Whan Seok , Sur Yoo Joon
Published: September 2021

Background

Acromioclavicular (AC) joint dislocation is common among shoulder injuries, and various surgical methods have been introduced for effective ligament reconstruction. Reconstruction of the coracoclavicular (CC) ligament in the anatomical position using autologous tendons is a recent surgical trend. This study is to report clinical and radiologic results of reconstruction of the CC ligament using an autologous palmaris longus tendon interweaved with Mersilene tape (PLMT) with a minimum 2-year follow-up.
Methods

This retrospective study analyzed 76 patients (mean age, 43.4 ± 11.2 years) with AC joint dislocation treated by reconstruction of the CC ligament with PLMT, from March 2004 to February 2017. The mean follow-up period was 28 ± 6.7 months (range, 24–66 months). The Visual Analog Scale (VAS) for pain assessment, American Shoulder and Elbow Surgeons rating scale (ASES), and Constant Score (CS) were used to evaluate clinical outcomes at the final follow-up. CC and AC distances were measured using anteroposterior (AP) X-ray preoperatively, 6 weeks postoperatively, and at the final follow-up for radiologic outcomes. Complications were also assessed.
Results

The mean preoperative VAS, ASES, CS were 5.7 ± 0.7, 77.1 ± 6.2, and 61.5 ± 5.2, respectively. These scores at the last follow-up improved to 2.1 ± 0.5, 90.9 ± 4.3, and 94 ± 7.0, respectively (p = 0.043, p < 0.001, p < 0.001). The mean preoperative CC and AC distances were 16.49 ± 3.73 mm and 13.84 ± 3.98 mm, respectively. They were 7.16 ± 1.22 mm and 3.86 ± 2.34 mm at 6 weeks postoperative, and became 9.29 ± 2.72 mm and 5.30 ± 2.09 mm at the final follow-up. The mean CC and AC distances decreased significantly at the final follow-up (p < 0.001, p < 0.001). Although a slight re-widening of the CC distance occurred in 10 patients (13.1%), most patients regained full range of motion of the affected shoulder at the final follow-up.
Conclusion

The CC ligament reconstruction with PLMT for the treatment of AC joint dislocation showed good clinical and radiological results. This technique could be a good alternative treatment for AC dislocations.
Mapping the unjust global impact of harmful fisheries subsidies
Authors: Skerritt Daniel , Schuhbauer Anna , Villasante Sebastian , Cisneros-Montemayor Andrés , Bennett Nathan , Mallory Tabitha , Lam Vicky W.Y. , Arthur Robert , Cheung William , Teh Louise , Roumbedakis Katina , Sumaila U. Rashid
Published: September 2021

Harmful fisheries subsidies contribute to overfishing leading to environmental and societal impacts1. If only fisheries within the subsidising nations’ jurisdiction were affected, then unilateral actions might be sufficient to help safeguard our ocean and the people reliant upon it. However, just as fish move between jurisdictions2, so too do the subsidised fishing fleets targeting them3. As such, the impacts and solutions to subsidies-induced overfishing are matters of international concern. Mapping that impact is therefore key to understanding these concerns and informing multilateral reform. Here we combine existing datasets4–6 to quantify the amount of harmful fisheries subsidies impacting the high seas, domestic and foreign waters, respectively. We estimate that between 24% and 43% of all harmful fisheries subsidies impact foreign waters or the high seas. We show that harmful subsidies primarily originate from countries with high-Human Development Index (HDI), strong fisheries management capacity and relatively sustainable fish stocks, yet disproportionately impact countries with low-HDI, lower management capacity and more vulnerable stocks. Indeed, over 40% of the harmful subsidies impacting low-HDI countries originate from high-HDI countries. This discrepancy between the source of harmful subsidies and the nations that are ultimately impacted is unsustainable and unjust. Policy-makers from all nations must push for effective multilateral subsidies reform. Prohibiting subsidies to distant-water fishing should be prioritised to support equitable and sustainable fisheries worldwide.
Hybrid Robot-Assisted Gait Training for Motor Function in Subacute Stroke: A Single-Blind Randomized Controlled Trial
Authors: Lin Yen-Nung , Huang Shih-Wei , Kuan Yi-Chun , Chen Hung-Chou , Jian Wen-Shan , Lin Li-Fong
Published: September 2021

Background:Robot-assisted gait training (RAGT) is a practical treatment adjunctive to conventional rehabilitation to provide high-intensity repetitive training for patients with stroke. The robot models designed are usually either the end-effector type or the exoskeleton type. We developed a novel hybrid RAGT system that combines the advantages of both types.Objective:This randomized controlled trial (RCT) evaluated whether the novel RAGT system was beneficial and assessed long-term effects (at the 3-month follow-up) for nonambulatory patients with subacute stroke.Methods:This trial recruited 40 patients with subacute stroke who were equally randomized to receive conventional rehabilitation or 15 add-on RAGT sessions. We assessed lower-extremity motor function, balance, and gait performance by using the following tools: active range of motion (AROM), manual muscle test (MMT), the Fugl-Meyer Assessment (FMA) lower-extremity subscale (FMA-LE) and total (FMA-total), Postural Assessment Scale for Stroke (PASS), Berg Balance Scale (BBS), Tinetti Performance Oriented Mobility Assessment (POMA) balance and gait subscores, and the 3- and 6-m walking speed and Timed Up and Go (TUG) tests. These measurements were performed before and after the intervention and at the 3-month follow-up.Results:Both groups demonstrated significant within-group changes in the AROM, MMT, FMA-LE, FMA-total, PASS, BBS, POMA, TUG, and 3- and 6-m walking speeds before and after intervention and at the 3-month follow-up (p < 0.05). Only FMA-LE (p = 0.014) and total (p = 0.002) scores differed significantly between groups (RAGT vs. control).Conclusion:Although the novel hybrid RAGT was beneficial, no powerful evidence to supported its effectiveness relative to the control group in substantial leg dysfunction after stroke.Trial Registration: The study was registered with an International Standard Randomized Controlled Trial Number, ISRCTN, ISRCTN15088682. Registered 16 September 2016, Retrospectively registered https://www.isrctn.com/ISRCTN15088682
Intermittent Theta Burst Stimulation Modulates Biceps Brachii Corticomotor Excitability in Individuals with Tetraplegia
Authors: Mittal Neil , Majdic Blaize , Peterson Carrie
Published: September 2021

Background: Intermittent theta burst stimulation (iTBS) is a form of repetitive transcranial magnetic stimulation (TMS) that can increase corticomotor excitability of hand muscles in individuals with spinal cord injury (SCI). The objective of this study was to determine the effect of iTBS on the corticomotor excitability of the biceps brachii in individuals with tetraplegia.Methods: Ten individuals with low cervical SCI (C5-C8) and ten nonimpaired individuals completed three independent sessions. Motor evoked potentials (MEPs) served as our measure of corticomotor excitability and were collected before and after iTBS. MEPs were normalized by the electromyography corresponding to maximum voluntary contraction and analyzed using linear mixed effects models to determine the effect of iTBS (active or sham) on normalized MEPs (nMEPs). iTBS effects were compared to a ratio of active and resting motor thresholds as a measurement of corticomotor conductance potential.Results: Relative to sham, active iTBS increased nMEPs over time (p < 0.001) in individuals with SCI, but not nonimpaired individuals (p = 0.915). The amplitude of nMEPs were correlated with the biceps corticomotor conductance potential (p < 0.001), with nMEPs decreasing as the ratio increased at different rates after sham or active iTBS.Conclusions: Preliminary results suggest that iTBS increases biceps corticomotor excitability in individuals with tetraplegia with effects that may be predicted by corticomotor conductance potential. Clinical Trial Registration: NCT03277521 Registered on clinicaltrials.gov on August 24, 2017.
Young People’s Choice and Voice Concerning Sex and Relationships: Effects of the Multicomponent Get Up Speak Out! Programme in Iganga, Uganda
Authors: Kakal Tasneem , Nalwadda Christine , Reeuwijk Miranda van , Veen Maaike van , Chatterjee Ophelia , Owekmeno Charles , Kok Maryse , Kusters Lincie
Published: September 2021

Background

Young people in Uganda face challenges in achieving their sexual and reproductive health and rights (SRHR), such as lack of information, limited access to services, teenage pregnancy and sexually transmitted infections. To address this, their empowerment – including their ability to express themselves and make decisions, is a key strategy. This study assessed how young people’s voice and choice concerning sex and relationships changed over the period of three years of implementation of the GUSO programme.
Methods

Data were collected through a household survey with young people (15–24 years) and through focus group discussions, in-depth interviews and key informant interviews with youth and community stakeholders in 2017 for the baseline and 2020 for the end-line. Using the difference-in-difference technique and thematic analysis, changes in key outcomes were assessed over time between intervention and control area.
Results

There were limited changes over time in the intervention area, which did not differ from changes in the control area. Young people were able to express themselves and expand their decision-making space on sex and relationships, in particular if they were older, male and in a relationship. Young women negotiated their agency, often by engaging in transactional sex. However, youth were still restricted in their self-expression and their choices as speaking about sexuality was taboo, particularly with adults. This was influenced by the political and religious climate around SRHR in Uganda, which emphasised abstinence as the best option for young people to prevent SRHR-related problems.
Conclusions

Young people’s SRHR remains a challenge in Uganda in the context of a conservative political and religious environment. The limited effect of the programme on increasing young people’s voice and choice concerning relationships in Uganda can be understood in the context of a ban on CSE and the COVID-19 pandemic. These structural and emerging contextual factors enforce the taboo around youth sexuality and hinder their access to SRHR information and services. Multi-component and targeted programmes are needed to influence changes at the structural, community and individual level.
Predictive Values of Initial Severity Scores at Intensive Care Unit Admission for Patients With Overnight or Prolonged Stay
Authors: Hosokawa Koji , Shime Nobuaki
Published: September 2021

Background: The predictive value of disease severity scores for intensive care unit (ICU) patients is occasionally inaccurate because ICU patients with mild symptoms are also considered. We, thus, aimed to evaluate the accuracy of severity scores in predicting mortality of patients with complicated conditions admitted for > 24 hours. Methods: Overall, 35,353 adult patients using nationwide ICU data were divided into two groups: (1) overnight ICU stay after elective surgery and alive on discharge within 24 hours and (2) death within 24 hours or prolonged stay. The performance and accuracy of Sequential Organ Failure Assessment (SOFA), Acute Physiology and Chronic Health Evaluation (APACHE) II and III, and Simplified Acute Physiology Score (SAPS) II scores in predicting in-hospital mortality were evaluated. Results: In the overnight stay group, the correlation between SOFA and APACHE III scores or SAPS II was low because many had a SOFA score of 0. In the prolonged stay group, the predictive value of SAPS II and APACHE II and III showed high accuracy but that of SOFA was moderate. Conclusions: When overnight ICU stay patients were not included, the high predictive value for in-hospital mortality of SAPS II and APACHE II and III was evident.
The Prevalence of Hormonal Imbalance Among Namibian Women
Authors: Mungongolo Petrina Venaokatili , Kouame Koffi , Aboua Yapo Guillaume
Published: September 2021

Purpose: Infertility is a complex disorder with significant medical, psychosocial and economic aspects recognized as a public health issue. This study aims to investigate the prevalence of hormonal imbalance in Namibian women.Methods: This was a retrospective study, analysing female hormonal data from 2015 to 2019 after obtaining ethical approval from the Namibia University of Science and Technology, the Ministry of Health and Social Services and the Namibia Institute of Pathology. The medical dada received from NIP were acquired from women aged 16 to 60 years from different hospital wards nationwide.Results: Results indicated a high prevalence (21.1 %) of hormonal imbalance among Namibian women. An average of 47% of the patients experienced critically high or low thyroid hormone values. The prevalence of imbalanced reproductive hormones was 21.1% of which approximately 20% was contributed by progesterone.Conclusion: Based on the statistical analysis it can be concluded that the prevalence of hormonal imbalance in Namibian women is significantly high and alarming. The general population of Namibian women have a high risk in developing conditions linked to hormonal imbalance. To better understand the implications of these results further studies should be conducted.
The Impact of the COVID-19 Pandemic on the Treatment and Prognosis of AMI in Urban and Rural Areas in Developing Country
Authors: Lu Yuan , Chen Lei , Li Chengzong , Yang Yu , Wang Zhirong , Chen Minglong
Published: September 2021

Background COVID-19 continues to spread globally, this study is the first to explore the impact of COVID-19 on the treatment and prognosis of rural and urban acute myocardial infarction (AMI) in developing country.Methods A total of 128 patients with AMI in our hospital during the COVID-19 pandemic (January 25, 2020-March 24, 2020) were enrolled. As a control group, a total of 197 patients diagnosed with AMI from November 25, 2019 to January 24, 2020 were selected. A total of 1 year of follow-up was performed. In addition to basic clinical data, this study focused on the treatment time, Killip class and hospital stay, the event of interest was defined as MACE (all-cause death, reinfarction, new congestive heart failure).Results Compared with Before COVID-19 group, the proportion of killip class≥2 was significantly higher in During COVID-19 group in AMI Total. In Rural AMI, hospital stay and the proportion of killip class≥2 were increased in During COVID-19 group. In STEMI Total and Rural STEMI, the treatment time in During COVID-19 group was longer than that in Before COVID-19 group, while only S to D Total and D to B were extended in Urban STEMI. The proportion of Invasive treatment time within 24 hours in NSTEMI patients was obviously lowered in During COVID-19 group. In AMI Total and Rural AMI, MACE and all-cause mortality were increased in During COVID-19 group compared with Before COVID-19 group. Through Kaplan-Meier analysis, it was found that the survival and the occurrences of MACE in AMI Total and Rural AMI were significantly higher in During COVID-19 group.Conclusion COVID-19 pandemic can lead to delayed treatment and worse prognosis in AMI patients, and rural areas seem to be more worrying.
Combined Analysis of ceRNA Regulatory Network and DNA Methylation in CAD
Authors: Zhao Yue , Wang Chen , Li Wangxia , Jin Bingyu , Xiang Yang , Liang Bin , Zhang Xiaokang , Lu Zhibing , Zheng Fang
Published: September 2021

BackgroundThe mobidity and mortality of coronary artery disease (CAD) is increasing year by year. Hence it is urgent to probe into the molecular mechanism of CAD and seek new therapeutic strategies. The purpose of our study was to screen genes associated with the development of CAD by using bioinformatics tools and clinical samples. MethodsMicroarray datasets from the Gene Expression Omnibus (GEO) database of peripheral blood cells (PBLs) were chosen for this study, and candidate differentially expressed microRNAs (DEMs) were screened using the limma and weighted co-expression network analysis (WGCNA) packages in R (v4.0). Subsequently, we construct a competitive endogenous RNAs (ceRNA) network and perform enrichment analysis of genes in the network. Meanwhile, differentially methylated genes (DMGs) in PBLs were identified using the "ChAMP" package in a DNA methylation chip. We then constructed the methylation-associated ceRNA network in CAD. Eventually, the methylation levels of genes and the relationship with the expression of genes in ceRNA were validated in PBLs samples using the Illumina Methylation 850K chip and transcriptome sequencing, while gene expressions were verified by qRT-PCR. And the regulation of DNA methylation on gene expression was verified in the THP-1 cells treated with 5-Aza-2'-deoxycytidine (5-AZA). ResultsA total of 71 differentially expressed miRNAs were screened by both WGCNA and limma. Then the ceRNA network in CAD was constructed with 269 nodes and 705 edges, which were significantly enriched in the chemokine-mediated signaling pathway and so on. Furthermore, from 4354 identified DMGs in a methylation data, 34 methylation-associated differentially expressed genes (DEGs) and 1 differentially expressed lncRNA (DEL) were obtained. After verification of methylation experiments in study population A, three genes were found to have altered methylation consistent with the bioinformatics results. And these genes were correlated in terms of methylation and expression levels. Corresponding with the bioinformatics results, qRT-PCR results in validation set B also showed that the expression of AGPAT4 and FAM169A were significantly lower in CAD. In addition, 5-AZA treatment could increase the expression of AGPAT4 and FAM169A in THP-1 cells. ConclusionsOur study deepens the understanding of the molecular mechanisms underlying the pathogenesis of CAD and provides new ideas for its treatment.
A Novel Defined Pyroptosis-Related Gene Prognostic Index for Clear Cell Renal Cell Carcinoma
Authors: Li xuexiang , Song Yarong , Liu Bing , Chen Liang , Lu dingheng , Li Yunxue , Cheng Lulin , Lyu Fang , Zhang Pu , xing yifei
Published: September 2021

Background: Clear cell renal cell carcinoma (ccRCC), a common pathological subtype of renal cancer with high aggressiveness, has been reported to be associated with chronic inflammation. Pyroptosis, a newly discovered inflammatory form of programmed cell death, can aggravate the inflammatory response. However, the influence of pyroptosis-related genes on ccRCC patient outcomes is yet unknown.Methods: In this study, 43 differentially expressed pyroptosis-related hub genes were identified by analysing The Cancer Genome Atlas–Kidney Renal Clear Cell Carcinoma dataset. The risk-score model was selected using the least absolute shrinkage and selection operator Cox regression and Cox multivariate methods, and all patients were divided into two risk subgroups based on the risk score. Prognostic value of the risk-score model was verified through survival curve, receiver operating characteristic curve and risk curve. Gene ontology and Kyoto Encyclopaedia of Genes and Genomes analyses suggested that the differentially expressed genes between the two subgroups were enriched in immune-mediated categories. Furthermore, the relationship between the risk-score model and ESTIMATE immune score and immunophenoscore was analysed. Finally, Nomogram was constructed based on the results of cox regression analyses. Results: The training cohort and the validation cohort enrolled 346 and 148 ccRCC patients respectively. The risk-score model was constructed by two genes (AIM2 and GSDMB). The area under curve of the ROC curve in two cohorts were both greater than 0.6. The grade and risk score were selected as independent factors and used to construct a nomogram to predict ccRCC patients' survival rate with the c-index of 0.68. Moreover, high-risk score subgroup was associated with a higher immune score and a lower percentage of PBRM1 mutations. The risk score was positively related to the degree of immune infiltration of CD8+ T, T follicular helper, gamma delta T, and regulatory T cells, and patients with a higher risk score were more likely to benefit from immune checkpoint inhibitor therapy. Conclusion: The risk-score model based on pyroptosis-related genes constructed in our study is a promising biomarker to predict the prognosis, molecular and immune characteristics, and immune benefit from immune checkpoint inhibitor therapy in ccRCC patients.
Significance of Early Acidosis In Predicting Early Mortality Among Flame Burned Patients In A Kenyan National Hospital
Authors: Mackutwa Edward Nandi , Khainga Stanley Ominde , Ndung'u James Muturi , Anangwe Charles Okwemba
Published: September 2021

Introduction: Burn pathophysiology, fluid therapy and mortality have been assessed by various laboratory parameters including lactate and base deficit serum markers. This study targeted flame injured cohort with an objective to determine the significance of early acidosis, through measurement of three acid base indices at admission in predicting 5-day (early) mortality among the flame burned patients.Methodology: A cohort study. Eighty flame injured patients presenting within 24 hours of incident were assessed for arterial blood pH, lactate and base deficit (BD). Mortality was recorded until day 28. Receiver operating characteristics curves were drawn; area under curve, cut offs, sensitivities and specificities for BD, lactate and pH were determined for 5-day mortality. The cut offs were used to derive contingency tables for calculation of predictive values. Odds ratios were calculated at 95% confidence interval. 28 day survival curve was generated. Level of significance was <0.05.Results: 28-day mortality was 39%. Five-day mortality was 24%. The latter was predicted by a lactate level of 2.36 mmol/L, BD of -10.05 mmol/L and pH of 7.344 with 75%,74% and 95% sensitivities respectively. Odds of patients dying at these levels or worse were 6.3, 11.4 and 36.9 respectively all with significant p-values.Conclusion: Arterial pH, base deficit and lactate are good predictors of 5-day mortality among fire victims.
Visual Functional Defects in Patients with type 2 Diabetes Mellitus: A Questionnaire Based Cross-Sectional Study
Authors: Ge Yimeng , Chai Sanbao , Wan Yu , Xia Huaqin , Dong Ruilan , Hou Qingyi , Ren Xiaotong , Yuan Hao , Yang Jiarui , Li Xuemin
Published: September 2021

Purpose To determine the impact of type 2 diabetes mellitus (T2DM) on visual functions, identify different modifiers as risk or protective factors, and find out how these factors affect patients’ visual symptoms and vision-related quality of life as a whole. Methods We performed an online survey among 1242 participants (400 patients, 842 non-patients). Demographic features and severity of disease were documented, while visual functions were evaluated using National Eye Institute Visual Functioning questionnaire-25 (NEI VFQ-25). Independent t-test, analysis of variance, linear and non-linear regression models were used to assess all data. Results Scores other than color vision among T2DM patients were significantly lower compared with non-T2DM participants. There was significant difference after stratification of age and education, but no significant difference between different genders was observed. Parameters including duration of T2DM, fasting plasma glucose (FPG) and glycosylated hemoglobin A1c (HbA1c) negatively impacted on the scores, with 20 years’ of diabetic duration, 10mmol/L of FPG, 7.5% of HbA1c being potential cut-off points. Poorer best corrected visual acuity (BCVA) and diagnosis of diabetic retinopathy were risk factors, while they simultaneously produced mediation effect, contributing 5%-78% of effect in the deterioration of visual functions caused by longer diabetic duration and higher blood glucose. Conclusion Significant visual impairments and faster deterioration in visual functions were seen in T2DM patients, with older age, lower educational level, longer diabetic duration, poorer blood glucose administration, limited BCVA, and the presence of diabetic retinopathy identified as risk factors. Average BCVA and diabetic retinopathy also yielded mediation effect as diabetic duration lengthened and blood glucose elevated.
Videolaringoscopy Beyond Conventional Endotracheal Intubation in HEMS: A Real Flight Simulation
Authors: Facchetti Gianluca , Gyra Aglaia , Angeletti Chiara , Masedu Francesco , Molineris Enrico , Franchi Dario , Introzzi Lorenzo , Lucchelli Matteo , Molesi Andrea , Marinangeli Franco , Bucci† Valter
Published: September 2021

BackgroundIn pre-hospital setting, airway management may be required during hems transportation, when patients deteriorate while en route. Our primary objective was to assess whether in-flight indirect laryngoscopy in frontal right-lateral sitting position (FP) of the operator, is such effective as traditional indirect laryngoscopy methods onshore, considering, also, the association of success rate with influencing flight factors (flying, devices, position, comfort VAS, Lumen VAS). MethodsThis observational prospective study, aimed to estimate the success rate of in-flight FP indirect laryngoscopy intubation. The study conducted on an AW 169 helicopter (©Leonardo Company, Italy) equipped with transversal stretcher, during steady flight. Indirect laryngoscopy devices (GlideScope Ranger and AirTraq) were used on a HAL® manikin (Accurate, Gaumard® Scientific Company,Inc) with cervical collar. ResultsAll of the FP intubations with both devices were successful after two attempts maximum. The mean time for intubation was slightly greater using the Glide Scope Ranger (mean 45.4±32.2”) compared to AirTraq (mean 34.8±26.7”). ConclusionsBoth AirTraq and GlideScope Ranger used in in-flight FP guarantee a comparable level of effectiveness to traditional onshore method with 100% successful rate of intubation, Airtraq seems not been affected by Lumen, indicating that in this specific contest it guarantees a high visualisation regardless the light conditions. On the other hand, the FP results effective using AirTraq in both conditions.
Onset of universality in the dynamical mixing of a pure state
Authors: Carrera-Núñez M. , Martínez-Argüello A. M. , Torres J. M. , Torres-Herrera E. J.
Published: September 2021

We study the time dynamics of random density matrices generated by evolving the same pure state using a Gaussian orthogonal ensemble (GOE) of Hamiltonians. We show that the spectral statistics of the resulting mixed state is well described by random matrix theory (RMT) and undergoes a crossover from the Gaussian orthogonal ensemble to the Gaussian unitary ensemble (GUE) for short and large times, respectively. Using a semi-analytical treatment relying on a power series of the density matrix as a function of time, we find that the crossover occurs in a characteristic time that scales as the inverse of the dimension. The RMT results are contrasted with a paradigmatic model of many-body localization in the chaotic regime, where the GUE statistics is reached at large times, while for short times the statistics strongly depends on the peculiarity of the considered subspace.
Influence of Alexithymia on Somatic Complaints among Japanese Adolescents: A survey research
Authors: Tannaka Ayumi , Umezawa Akio
Published: September 2021

Background

The purpose of this study is to examine alexithymic tendencies in Japanese adolescents (aged 12–20) and their effects on somatic complaints.
Methods

Participants were Japanese adolescents (n = 2,759). Alexithymic tendencies were assessed by the Alexithymia Scale for Adolescents (ASA), and somatic complaints by the Somatic Complaint List (SCL).
Results

The following results were obtained. 1) ASA total scores remained at a high level from early to late adolescence. 2) Among the ASA subfactors, difficulty identifying feelings (DIF) and difficulty describing feelings (DDF), increased during adolescence, whereas externally oriented thinking (EOT) decreased; as a result, the ASA total scores remained high. 3) DIF significantly affected somatic complaints among adolescents irrespective of their academic year and gender. 4) DDF only had an effect of increasing somatic complaints in junior high and high school-aged male participants, and this effect disappeared as respondents’ age grew and they were university students. This shows that the effect of alexithymic tendencies on somatic complaints changed with age.
Conclusion

Compared to the results of previous studies, the results of this study showed that alexithymic tendencies among Japanese adolescents are consistently high. The study further revealed that the increasing somatic complaints were consistently influenced by DIF.
Up-regulating Lipin1 Attenuates High Glucose-Induced Apoptosis in RSC96 cells Through Regulating Mitochondrial Dynamics
Authors: SUN Wenjia , ZHUANG Xianghua , YU Shuyan , Liu Wei , XU Min , XIE Guangai , Li Haizhen , Chen Shihong
Published: September 2021

Diabetic peripheral neuropathy, one of the major complications resulting from diabetes, affects diabetic patients with high morbidity and mortality. It has emerged as a severe public health problem. However, its underlying pathogenesis and effective treatment strategies have not been fully studied. In the present study, we explored the role of lipin1 on mitochondrial function of Schwann cells under diabetic conditions. With high glucose stimulation or lipin1 down-regulation, the cell viability of Schwann cells was inhibited,accompanied with mitochondrial dysfunction and morphological abnormality. Besides, we found that high glucose stimulation or lipin1 silencing also disturbed the balance of mitochondrial dynamics, presented as increased levels of mitochondrial fission-related proteins (including DRP1 and FIS1) and decreased levels of mitochondrial fusion-related proteins (including MFN1 and OPA1). Furthermore, we demonstrated that up-regulating lipin1 ameliorated high glucose-induced disorder of mitochondrial dynamics and functions, and ultimately improved cell viability. Our results suggest that lipin1 may play a protective role on high glucose-stimulated Schwann cells through regulating the balance of mitochondrial dynamics.
Multifractal Detrended Fluctuation Analysis of Insole Pressure Sensor Data to Diagnose Vestibular System Disorders
Authors: Günaydın Batuhan , İkizoğlu Serhat
Published: September 2021

The vestibular system (VS) is a sensory system that has a vital function in human life by serving to maintain balance. In this study, multifractal detrended fluctuation analysis (MFDFA) is applied to insole pressure sensor data collected from subjects in order to extract features to identify diseases related to VS dysfunction. We use the multifractal spectrum width as the feature to distinguish between healthy and diseased people. It is observed that multifractal behavior is more dominant and thus the spectrum is wider for healthy subjects, where we explain the reason as the long-range correlations of the small and large fluctuations of the time series for this group. We directly process the instantaneous pressure values to extract features in contrast to studies in the literature where gait analysis is based on investigation of gait dynamics (stride time, stance time, etc.) requiring long gait cycles. Thus, as the main innovation of this work, we detrend the data to give meaningful information even for a relatively short-duration gait cycle. Extracted feature set was input to fundamental classification algorithms where the Support-Vector-Machine (SVM) performed best with an accuracy of 98.2% for the binary classification as healthy or suffering. This study is a substantial part of a big project where we finally aim to identify the specific VS disease that causes balance disorder and also determine the stage of the disease, if any. Within this scope, the achieved performance gives high motivation to work more deeply on the issue.
The Human Impact of Commercial Delivery Cycling Injuries: a Retrospective Cohort Study
Authors: Sarkies Mitchell N , Hemmert Cameron , Pang Yu Chen , Shiner Christine , McDonell Karon , Mitchell Rebecca , Lystad Reidar , Novy Michael , Christie Lauren
Published: September 2021

Background: Commercial delivery cyclists represent a uniquely vulnerable and poorly understood road user. The aim of this study was to determine whether cyclists could be categorised as commercial or non-commercial from routine medical records and which key demographic, incident and injury characteristics could be identified and attributed to each category.Methods: Retrospective cohort study of adults presenting to an acute public hospital emergency department between May 2019 and April 2020 after sustaining a cycling-related injury. Multinomial logistic regression was used to examine the demographic, incident, and injury characteristics associated with commercial compared to non-commercial cycling.Results: Of the 368 people presenting to the emergency department with a cycling-related injury, we were able to categorise 43 (11.7%) as commercial delivery cyclists, 153 (41.6%) as non-commercial cyclists, and the working status of 172 (46.7%) was unable to be confirmed. Both commercial and unconfirmed cyclists were more likely to be younger than non-commercial cyclists. Compared to non-commercial cyclists, commercial cyclists were 11 times more likely to speak a language other than English (AOR 11.3; 95% CI 4.07-31.30; p<0.001), less likely to be injured from non-collision incidents than vehicle collisions (AOR 0.36; 95% CI 0.15-0.91; p=0.030), and were over 13 times more likely to present to the emergency department between 8.00pm and 12.00am compared to the early morning hours (12.00am to 8.00am) (AOR 13.43; 95% CI 2.20-82.10; p=0.005).Conclusions: The growth of commercial cycling, particularly through online food delivery services, has raised concern regarding commercial cyclist safety. Ongoing surveillance of commercial cyclist injuries is needed to establish the extent and risk factors associated with commercial cycling.
Effect of Bio-Additives and Kinetic Studies of Saccharomyces Cerevisiae on High Purity Alcohol Production Suitable for Medicinal Use
Authors: Masi Chandran , D Jenila Rani , N Partha Sarathy , Rajkumar Johanna
Published: September 2021

Alcohol is an indispensable ingredient in medicinal preparations like cough syrup, antiseptic, antidote, disinfectant, etc. In the present study, the alcohol production using Saccharomyces cerevisiae (yeast) and its growth kinetics were investigated in presence of the following bio-additives: Liquozyromol (plant extract), Avena sativa (oats), and Cicer arietinum (Bengal gram). The yeast’s specific growth rate and generation time for fermentation during alcohol production were determined to be 1.35 h-1 and 1.57 h-1 respectively. The Optimal concentration of Avena sativa (oats), Cicer arietinum (Bengal gram), and Liquozyromol for alcohol production were determined to be 8.6 g/l, 8.9 g/l, and 9.8 g/l respectively. Under the optimal conditions, the introduction of Cicer arietinum (Bengal gram) and Avena sativa (oats) had a minuscule impact on the alcohol quantity produced, while it increased considerably in presence of Liquozyromol. Also, the rate of fermentation decreased and volatile acidity was affected in presence of additives. Thus, the use of Liquozyromol as an additive greatly reduces the effect of secondary metabolites thereby increasing the quantity and the quantity of ethanol produced.
Clinical Value of Two Detection Methods for Mycoplasma Pneumoniae Antibody in the Diagnosis of Mycoplasma Pneumoniae Infection in North China
Authors: Wang Jupeng , Zhu Lina , Ma Mingkun , Chen Hui , Guo Suxiang , Wu Guangye , Li Shaohong , Wen Xuehong , Ren Li
Published: September 2021

Background: To analyze the detection of Mycoplasma pneumoniae in adults and children in North China using two antibody detection methods, and to guide prevention and treatment.Methods: A retrospective study was conducted from September 2017 to May 2021. Mycoplasma pneumoniae total antibody was detected using particle agglutination (PA). Anti-Mycoplasma pneumoniae IgM in patients with respiratory tract infection was detected by indirect immunofluorescence. All patients were divided into 9 groups according to age: ≤1, 2-3, 4-6, 7-14, 15-18, 19-39, 40-59, 60-79, ≥80,Results: The positive rate of Mycoplasma pneumoniae total antibody in 5,666 patients with community-acquired pneumonia was 40.13%. In adults and children, the positive rates were 19.92% and 77.3% (p<0.05), respectively. The positive rates in males and females was 37.89% and 42.40% (p<0.05), respectively. The positive rate for anti-Mycoplasma pneumoniae IgM in 5,746 patients with respiratory tract infection was 28.56%, and 10.37% and 36.82% in adults and children (p<0.05), respectively. In males and females, the positive rate for anti-Mycoplasma pneumoniae IgM was 24.56% and 33.38% (p<0.05). The highest positive rates for total antibody and anti-Mycoplasma pneumoniae IgM were recorded in autumn. Of the 1,975 patients tested for Mycoplasma pneumoniae antibody using both methods simultaneously, 26.71% were negative for total antibody and 8.63% had titers ranging between 1:40 and 1:80 when positive for IgM antibody. When negative for anti-Mycoplasma pneumoniae IgM, total antibody titer was ≥1:160 in 34.94% of the patients.Conclusion: Mycoplasma pneumoniae is the main cause of respiratory tract infection and its incidence is highest in autumn. Because Mycoplasma pneumoniae was more commonly detected in women and children, screening should be strengthened in these groups.
A fetus with a mass in the oral cavity: a rare case of oral eruption cyst
Authors: Gao Qianqian , Wang Yu , Liu Hanmin , Chen Jiao
Published: September 2021

BackgroundAn ultrasonographic examination is widely used for prenatal screening of abnormal findings. The approach to the oral cavity of the fetus requires special attention because many aspects are unique and peculiar to this period of life. Obstetricians and pediatricians should be aware of the characteristics of normal patterns and be prepared to make a correct diagnosis. Congenital eruption cysts(EC) are rarely observed in fetuses and newborns, because at this stage of life, tooth eruption is unusual. Case presentationWe report a 26-year-old woman who had a sonographic examination at 27+5 weeks of pregnancy that showed a fetal oral cyst. During an ultrasound examination, we detected a hyperechogenic solid mass with a homogeneous texture. This mass was well circumscribed with a layer of anechoic area with no abnormal vessel. The cyst appeared to originate from the body of left mandible. Real-time assessment showed that the cyst was fixed and confined to inferior maxilla. Her neonate was finally diagnosed with EC. ConclusionUltrasound can reveal the distinctive features of oral cysts lesion and can be useful for the differential diagnosis. The treatment was required mainly by the symptomatology of the newborn. Therefore, prenatal ultrasonography could be used to conjecture the position and size of the mass, which is considered to be useful for localized and qualitative diagnosis prior to afterbirth treatment. Our findings indicate that ultrasound is an appropriate diagnostic tool to identify antenatal EC.
MicroRNA-29c-3p in Dual-Labeled Exosome is Potential Marker of Alzheimer's Disease
Authors: Li Ying , Xia Ming , Meng Shuang , Wu Di , Ling Sihai , Chen Xiali , Liu Chen-geng
Published: September 2021

ObjectiveWe aimed to establish a method to determine whether peripheral blood NCAM/amphiphysin 1 dual-labeled exosomal proteins and microRNA might be serve as a marker for the diagnosis of Alzheimer's disease.MethodsIt was a multicenter study using a two-stage design. The subjects included 45 SCD, 50 aMCI, 40 AD patients, and 30 controls in the discovery stage; the results were confirmed in the verification stage (47 SCD, 45 aMCI, 45 AD, and 30 controls). Peripheral blood NCAM single-labeled and NCAM/amphiphysin 1 double-labeled exosomes were captured and detected by immunoassay, respectively.ResultsLevels of Aβ42, Aβ42/40, Tau, P-T181-tau, and miR-29c-3p in plasma NCAM single-labeled and NCAM/amphiphysin 1 double-labeled exosomes of the aMCI and AD groups were significantly higher than those of the SCD group, control group and VaD group (all P<0.05). The levels of Aβ42 and miR-29c-3p in peripheral blood NCAM/amphiphysin 1 dual-labeled exosome was higher than that in the control and VaD groups (all P<0.05). The levels of exosomal Aβ42, Aβ42/40, Tau, P-T181-tau, and miR-29c-3p in peripheral blood were correlated with that in CSF (all P<0.05). Conclusion﻿This study first provided a method for sorting specific surface marker exosomes using a two-step immune capture technology. The plasma NCAM/amphiphysin 1 dual-labeled exosomal Aβ42/40 and miR-29c-3p had potential advantages in the diagnosis of SCD.
Association Analysis and Estimation of Breeding Values of Iranian Table Grapevine Germplasm by Integrating Pomological and Molecular Data
Authors: Razi Mitra , Darvishzadeh Reza , Baneh Hamed , Alipour Hadi
Published: September 2021

Genetic resources in each country are valuable assets for sustainable development. An accurate knowledge of genetic behavior and identification of genomic loci associated with important economic traits will help breeders to run efficiently their breeding programs. Fourteen important pomological traits were measured on 45 Iranian table grape cultivars during three successive years. Molecular profile of studied cultivars was prepared with 39 (Simple sequence Repeat) SSR primers pairs. Genetic structure analysis based on the SSR markers revealed two sub-populations (K = 2) in the association panel. In association analysis using mixed linear model seven loci were found to be significantly associated with the studied traits at 5% probability level. Breeding values were also estimated for the pomological traits using the best linear unbiased prediction (BLUP). “Saghal Solian”, “At Ouzum”, “Garmian”, “Rishbaba Qermez”, “Taifi”, “Shahroudi”, “Sahebi Qermez”, “Lal Qermez”, “Alhaghi”, “Sarghola”, “Chava Ga”, “Qzl Ouzum” and “Agh Shani” table grape cultivars showed high and positive breeding value for cluster length, width and weight. Whereas “Garmian”, “Rishbaba Qermez”, “Fakhri”, “Agh Shani”, “Lal Sefid” and “Shirazi” had positive and high breeding value for pollen germination, fruit set in open pollination and fruit set under controlled pollination. Finally, Sarghola” and “Qzl Ouzum” showed the positive and highest breeding value for berry weight, flesh weight, cluster length, cluster width and cluster weight. The cultivar with high and positive breeding value can be used as a good parent for breeding of traits in hybridization programs because they can better transfer the desirable characteristics to the progeny in each case.