bluuebunny/crossref_metadata_2025 huggingface dataset:
The Efficiency of 18F-FDG-PET/CT in Assessment of Tumor Response to Preoperative Chemoradiation Therapy for Locally Recurrent Rectal Cancer
Authors: Uemura Mamoru , Ikeda Masataka , Handa Rio , Danno Katsuki , Nishimura Junichi , Hata Taishi , Takemasa Ichiro , Mizushima Tsunekazu , Yamamoto Hirofumi , Sekimoto Mitsugu , Doki Yuichiro , Eguchi Hidetoshi
Published: March 2021

Background:Locally recurrent rectal cancer (LRRC) remains a major problem after curative resection of primary rectal cancer. A noninvasive biomarker that accurately evaluates the disease status and assesses the treatment response with prognostic value is critically needed to optimize the treatment plan. This study assesses the effectiveness of PET/CT evaluation of preoperative chemoradiation therapy (CRT) in patients with LRRC.Patients and Methods:Since 2004, we have been performing preoperative CRT to improve local tumor control and survival. Between 2004 and 2013, 40 patients with LRRC underwent preoperative CRT (radiation; 50 Gy/25 fractions, chemotherapy; irinotecan plus UFT/leucovorin ) and radical surgery, and underwent 18F-FDG-PET/CT before and 3 weeks after the completion of CRT. The maximum standardized uptake value (SUVmax) of the pre-CRT scan (Pre-SUV) and the post-CRT scan (Post-SUV) were measured. The predictive ability of 18F-FDG-PET and CT/MRI response assessment were evaluated.Results:The mean Pre-SUV was significantly higher than Post-SUV (8.2±6.1, vs 3.8±4.0; P < 0.0001). Following CRT, 17/40 patients (42.5%) were classified as responders according to Mandard tumor regression grade (TRG1-2). The mean Post-SUV was significantly lower in responders than in nonresponders (2.0±1.7 vs 5.1±3.9; P = 0.0038). Pathological response was not correlated with the response as evaluated by CT (P > 0.9999) or MRI (P > 0.9999). Multivariate regression analysis identified Post-SUV as an independent predictor of local re-recurrence-free survival (P = 0.0383) and for overall survival (P = 0.0195). Conclusions:PET/CT is useful in assessing tumor response to preoperative CRT for LRRC and predicting prognosis after surgery.
A Protein Moonlighting Based Model to Reveal Transcription Factor Druggability for Prostate Carcinoma
Authors: Sen Sagnik , Dey Ashmita , Maulik Ujjwal
Published: March 2021

BackgroundProstate cancer is the second leading cause of cancer-related death in men in the United States. Metastasis shows poor survival even though the recovery rate is high. In spite of numerous studies regarding prostate carcinoma, multiple questions are stilled unanswered. In this regards, gene regulatory network can uncover the mechanisms behind cancer progression, and metastasis. In the regulatory network, among the three prime molecular members, transcription factors and microRNAs are known for their regulatory activity where transcription factor can target both microRNAs and genes. Under a feed forward loop, transcription factors can be a good druggable candidate. However, due to the dynamic nature of transcription factors, designing an appropriate drug becomes challenging.ResultWe have proposed a computational model to study the uncertainty of transcription factors and suggest the appropriate cellular conditions for drug targeting. We have selected feed-forward loops depending on the shared list of the functional annotations among transcription factors, genes, and miRNAs. From the potential feed forward loop cores, six transcription factors were identified as druggable targets, which include AR, CEBPB, CREB1, ETS1, NFKB1, and RELA. The selected transcription factors have been investigated based on the evolutionary co-variance study, post-translation modifications, and disordered region identification. The structural unrest of the selected transcription factors can be observed from outcomes. Comparing the results of the aforementioned analyses, probable binding clefts have also been identified. transcription factors are known for their Protein Moonlighting properties, which provide unrelated multi-functionalities within the same or different subcellular localizations. Following that, we have identified such functions that are suitable for drug targeting. Finally, we have tried to identify membraneless organelles for providing more specificity to the proposed time and space theory.ConclusionThe study has provided certain possibilities on TF based therapeutics. The controlled dynamic nature of the TF may have enhanced the chances where TFs can be consider as one of the prime drug targets. The usual presence of TF at nucleus cannot explain its functional multiplicity whereas nucleus speckles can help to explain it. Finally, the combination of membranless phase separation and protein moonlighting has provided possible druggable period within the biological clock.
Acute myocarditis associated with secondary cerebral edema in a patient with Covid-19: Case report
Authors: Rossa Isabella Cristina Mendes , Marques Gustavo Lenci , Twardowschy Carlos Alexandre
Published: March 2021

Female patient, 44 years old, admitted with symptoms of COVID-19. She presented elevation of cardiac troponin I, as well as diffuse hypokinesia in transthoracic echocardiography, which suggested the diagnosis of myocarditis. Next, a skull tomography showed diffuse cerebral edema and tonsilar herniation, and the patient evolved with brain death
Thymic Cavernous Hemangioma Misdiagnosed as Thymoma: A Case Report and Review of the Literature
Authors: Chen Yi , Yan Liping , zhang Fangbiao , Tu Shaosong , Wu Zhijun
Published: March 2021

Introduction: Thymic cavernous hemangioma, a rare mediastinal tumor, is difficult to diagnose by imaging examinations. Case presentation: We treated a 63-year-old woman with thymic cavernous hemangioma. She was found to have an anterior mediastinal mass during a routine examination, and enhanced chest CT showed that it was approximately 3.5×2.4×2.1 cm in size. Enhanced abdominal CT indicated a 2.5cm space-occupying lesion in the right kidney. We considered it to be thymoma and renal carcinoma, so we resected it by using thoracoscope and laparoscope. The postoperative pathological reports showed that the mass was thymic cavernous hemangioma and renal clear cell carcinoma. Twenty months postsurgery, the patient was alive with no evidence of tumor recurrence.Conclusions: We report a rare case of thymic cavernous hemangioma misdiagnosed as thymoma. It is difficult to obtain pathological results by needle biopsy before surgery because the location of the anterior mediastinal mass is very challenging to reach. Therefore, a thorough CT evaluation before the operation can prevent inappropriate operations from being performed.
Type 2 Diabetes Mellitus with Plantar Malignant Melanoma: Report of Two Cases and Literature Review
Authors: Huang Bi-ling , Tan Min , Liang Jie-Yu , Li Ming-Liu , Liao Lan , Zhou Min , Wang Min
Published: March 2021

Background: Malignant melanoma is a highly malignant tumour that originates from melanocytes. Its prognosis is poor and motality rate is high. Malignant melanoma usually occurs in the skin, also known as cutaneous melanoma,but rarely in the foot. Case report: Here we report two cases of type 2 diabetes diagnosed as malignant melanoma of the foot and provides a review of literature. The first patient was a 70-year-old woman with a 7 year history of diabetes, who had a ulcer in the right heel for half a year. The second case, which occurred in a 66-year-old woman whose third toe of the right foot had been red, swollen and blackened for 2 months. Both of them had been treated as diabetic foot at first , and then been diagnosed of malignant melanoma by a pathological biopsy of the lesions. Conclusion: From two rare cases of plantar malignant melanoma,we suggest that clinicians should be alert to the occurrence of acral malignant melanoma in diabetic foot patients. When diabetic foot ulcers occur repeatedly and continue not to heal, and the pathological features of the lesions are similar to malignant melanoma, a pathological biopsy of the lesions should be performed promptly to obtain a clear diagnosis, avoid a missed diagnosis and improve the survival rate.
B-cell lymphoma as well as breast cancer contributes to the development of hemophagocytic lymphohistiocytosis: A rare case report
Authors: Zhou Neng , Yin Zongxiu Yanbiao , Chang Yali , Xing Chunyan , Chu Yanbiao
Published: March 2021

BackgroundHemophagocytic lymphohistiocytosis (HLH), which is also known as hemophagocytic syndrome (HPS), can be caused by various factors leading to the reactive proliferation of lymphocytes as well as tissues and cells and the release of inflammatory cytokines, which then impair vital organs. Hemophagocytic lymphohistiocytosis, especially malignancy-associated HLH, which is difficult to differentiate from other diseases in the early stage because of its nonspecific and overlapping manifestations, has a high mortality rate once it occurs. Cases of hemophagocytic lymphohistiocytosis triggered by both solid tumors and lymphomas have rarely been reported before. There is still no consensus regarding the first-line treatment for HLH in adults. More attention should be paid to its early diagnosis and treatments.Case presentationA 55-year-old woman who had undergone thyroidectomy in 2014, left mastectomy for left breast cancer in 2013 and twelve rounds of chemotherapy had continuous fever approximately twenty days prior to admission. Tumor cells were found in her right axillary lymph node aspiration smear in the hospital on January 23. The patient was first diagnosed with pneumonia and treated with antibiotics, with little effectiveness. The etiology of fever remained unclear after a series of examinations, which excluded infection and rheumatic diseases and led us to consider noninfectious fever. Continuous hyperpyrexia, pancytopenia and continuous decreases in blood platelets and plasma albumin were suggestive of HLH. Then, bone marrow puncture confirmed this finding and indicated B-cell lymphoma invading the bone. Unexpectedly, during this time, the disease progressed rapidly, culminating in the patient’s death, and no examinations or treatments were performed in time.ConclusionsSecondary hemophagocytic lymphohistiocytosis can be caused by various factors. Malignancy-associated HLH (M-HLH), as a kind of secondary HLH, is difficult to distinguish from primary cancer due to its nonprominent clinical manifestation, thus leading to misdiagnosis and delayed treatment.
Glomus tumor of small intestine: case report and review of literature
Authors: Tan Yan , Wang Xinyi , Yang Guifang , Liu Lan , Fang Jun , Chang Ying , Zhao Qiu , Zhang Yafei
Published: March 2021

BackgroundGlomus tumors are exceedingly rare tumors arising from the normal glomus body. Only a very few cases of glomus tumors located in the small intestine were reported to date. Here, we present a case of glomus tumor of the jejunum in a 30-year-old female patient, and discuss its clinical, imaging, and pathologic features.Case presentationA 30-year-old female referred to our hospital with the chief complain of melena and fatigue for 3 weeks. Oral single-balloon enteroscopy discovered a 2.0*2.0cm tumor without epithelial lining in the jejunum. The patient then underwent partial enterectomy. HE stain illustrated that the tumor was interspersed with congestive capillaries of various size, and admixed with smooth muscle bundles. Immunohistochemical study showed that the tumor cells were strongly positive for SMA and collagen type Ⅳ. The Ki-67 proliferation index was less than 1% and mitotic activity is very low (about 1/50 HPF). The case was finally diagnosed as benign glomus tumor.ConclusionsGlomus tumors arising from the small intestine are extremely rare. The final diagnosis is made by histological and immunohistochemical examination. Although there is no standardized management pathway for these patients, early diagnosis and treatment are important for a good prognosis.
Association of plasma and CSF cytochrome P450, soluble epoxide hydrolase and ethanolamides metabolism with Alzheimer’s disease
Authors: Borkowski Kamil , Pedersen Theresa L. , Seyfried Nicholas T. , Lah James J. , Levey Allan I. , Hales Chadwick M. , Dammer Eric B. , Blach Colette , Louie Gregory , Kaddurah-Daouk Rima , Newman John W.
Published: March 2021

Background

Alzheimer’s disease, cardiovascular disease and other cardiometabolic disorders may share inflammatory origins. Lipid mediators, including oxylipins, endocannabinoids, bile acids and steroids regulate inflammation, energy metabolism and cell proliferation with well-established involvement in cardiometabolic diseases. However, their roles in Alzheimer’s disease and their potential as biomarkers are poorly understood. Here we describe the analysis of plasma and cerebrospinal fluid lipid mediators in a case-control comparison of individuals with Alzheimer’s disease and healthy controls to investigate these knowledge gaps.
Methods

Lipid mediators were measured using targeted quantitative mass spectrometry. Data were analyzed using analysis of covariates, adjusting for sex, age, and ethnicity. Partial least square discriminant analysis identified plasma and cerebrospinal fluid lipid mediator discriminates of Alzheimer’s disease. Alzheimer’s disease predictive models were constructed using machine learning combined with stepwise logistic regression.
Results

In both plasma and cerebrospinal fluid, individuals with Alzheimer’s disease had elevated cytochrome P450/soluble epoxide hydrolase pathway components and decreased fatty acid ethanolamides compared to healthy controls. Circulating metabolites of soluble epoxide hydrolase and ethanolamides provide Alzheimer’s disease predictors with areas under receiver operator characteristic curves ranging from 0.82 to 0.92 for cerebrospinal fluid and plasma metabolites, respectively.
Conclusions

Previous studies report Alzheimer’s disease-associated soluble epoxide hydrolase upregulation in the brain and that endocannabinoid metabolism provides an adaptive response to neuroinflammation. This study supports the involvement of P450-dependent and endocannabinoid metabolism in Alzheimer’s disease, yielding potential biomarkers of the disorder. The results further suggest that combined pharmacological intervention targeting both metabolic pathways may have therapeutic benefits for Alzheimer’s disease.
Probabilistic threshold analysis by pairwise stochastic approximation for decision-making under uncertainty
Authors: Goda Takashi , Yamada Yuki
Published: March 2021

The concept of probabilistic parameter threshold analysis has recently been introduced as a way of probabilistic sensitivity analysis for decision-making under uncertainty, in particular, for health economic evaluations which compare two or more alternative treatments with consideration of uncertainty on outcomes and costs. In this paper we formulate the probabilistic threshold analysis as a root-finding problem involving the conditional expectations, and propose a pairwise stochastic approximation algorithm to search for the threshold value below and above which the choice of conditionally optimal treatments changes. Numerical experiments for both a simple synthetic testcase and a chemotherapy Markov model illustrate the effectiveness of our proposed algorithm, without any need for accurate estimation or approximation of conditional expectations which the existing approaches rely upon. Moreover we introduce a new measure called decision switching probability for probabilistic sensitivity analysis in this paper.
Natural Pathogenic Fungi Infection Attributes of Malarial Vectors Anopheles Maculipennis S. L. and Anopheles Superpictus S. L. in Central Iran
Authors: Kazemi Seyed Hassan Moosa , Asgarian Tahereh Sadat , Sedaghat Mohammad Mehdi , Javar Saeedeh
Published: March 2021

Background: Due to the effect of synthetic and commercial insecticides on non-target organisms and the resistance of mosquitoes, in recent years non-chemical and environmentally friendly methods have become prevalent. In this research, we aimed to isolate entomopathogenic fungi with toxic effects on mosquitoes in natural larval habitats.Methods: Larval mosquitos were collected from Central, Qamsar, Niasar and Barzok Districts in Kashan County, Central Iran by standard dipping method, from April to late December 2019. Dead larvae and larvae with signs of infection to fungal mycelium detectable on the outer surface of its body were isolated from the rest of the larvae and were sterilized with 10% sodium hypochlorite for two minutes, then washed twice with distilled water and transferred to PDA (potato-dextrose-agar) and WA (water-agar) media and incubated at a temperature of 25 ± 2° C for 3 - 4 days. Larvae and fungi were identified morphologically based on identification keys.Results: A total of 9789 larvae were collected from urban and rural areas in Kashan County. The genera i.e. Anopheles (7.89%), Culiseta (17.42%), and Culex (74.69%) including 13 species were identified. A total of 105 larvae including Anopheles superpictus s. l., An. maculipennis s. l., Culex deserticola, Cx. perexiguus, and Culiseta longiareolata were found to be infected by Nattrassia mangiferae, Aspergillus niger, A. fumigatus, Trichoderma spp. and Penicillium spp. Fungi. Penicillium spp. was the most abundant fungus isolated and identified from the larval habitats while An. superpictus s.l. was the most infected mosquito species. Conclusions: Based on the observations and results obtained from our study, isolated fungi had the potential for pathogenicity on mosquito larvae. Therefore, it is suggested that their effects on mosquito larvae be investigated in the laboratory. The most important point, however, is the proper way of exploiting these biocontrol agents to maximize their effect on reducing the population of vector mosquito larvae without any negative effect on non-target organisms.
Technoeconomic energy system data for modeling of India and the GCC countries
Authors: Weinstein Miles , Almulla Youssef , Vijay Avinash , Shivakumar Abhishek , Usher Will , Arderne Chris , Hawkes Adam , Howells Mark
Published: March 2021

India has seen rapid increases in GDP, energy access, and population in recent decades, more than doubling its overall energy consumption since 2000. Meanwhile, India produces approximately 70% of its electricity from coal. With electricity demand only projected to grow in the coming years, the Government of India has pledged to install 450 GW of renewable energy by 2030. The Gulf Cooperation Council (GCC) countries[1], meanwhile, have comparatively small populations with excellent renewable energy resources, particularly solar. The ability to trade power between these two regions could potentially provide India with a highly reliable carbon-free power source. At the same time, it can motivate the shift to low carbon economy in the GCC and add a new market for its solar power. The provided data in this article relate to the current makeup of the energy systems of both regions, renewable resource potentials, and projections of future demand. The data have been compiled from numerous sources, mainly government and international agencies.[1] GCC countries are Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and the United Arab Emirates
An improved and highly efficient geometry for facemasks
Authors: Cappa Christopher , Ristenpart William , Barreda Santiago , Bouvier Nicole , Wexler Anthony , Roman Sanziana , Department The San Francisco Opera Costume
Published: March 2021

Wearing masks and face coverings helps reduce transmission of respiratory diseases. Various mask designs exist that target different populations, occupations, and environments. Here, we present evidence that a new facemask design, originally made for professional singers, offers advantages that will strongly benefit the public. Specifically, we show that with proper fitting the reusable cloth singing mask achieves overall filtering efficiencies for both exhaled expiratory aerosols and for inhaled ambient aerosols of >93%, better than surgical masks and approaching N95 respirators. We attribute the high efficiency largely to the mask design, rather than material. The mask design also provides for less inhibited mouth and jaw movement and overall lower humidity within the mask, suggesting it may provide a more palatable, high-efficiency alternative to medical-grade masks for the public.
Crack detection using modified spectral clustering method assisted with FE analysis for distress anticipation in cement-based composites
Authors: Vedrtnam Ajitanshu , Kumar Santosh , Barluenga Gonzalo , Chaturvedi Shashikant
Published: March 2021

The present work aimed to develop an efficient way of capturing real-time crack propagation in concrete structures. The image processing was utilized for crack detection, while finite element modeling (FEM) and scanning electron microscopy (SEM) were used for quantitative and qualitative analysis of crack propagation. A green cement-based composite (CBC) containing saw dust was compared to a reference M20 grade concrete under compressive loading. Crack propagation during compression tests was captured using an 8-megapixel mobile phone camera. The randomly selected images showing crack initiation and propagation in CBCs were used to assess the crack capturing capability of a spectral analysis based algorithm. A measure of oriented energy was provided at crack edges to develop a similarity spatial relationship among the pairwise pixels. FE modelling was used for distress anticipation, by analyzing stresses during the compressive test in constituents of CBCs. SEM analyses were also done to evaluate cracked samples. It was found that FE modeling could predict the crack prone regions that can be used jointly with the image analysis algorithm, providing real-time inputs from the crack-prone areas. Green CBC were compared to reference concrete samples, showing reliable results. The replacement of OPC with wood dust reduced compression strength and produced a different fracture pattern regarding reference concrete. The results of the study can be used for distress anticipation and early crack detection of concrete structures for preventive support and management.
The Lived Experience of Internationally Recruited Nurses in Oman a Phenomenological Study
Authors: Ph Glenn Ford D. Valdez , MSN RM RN Arcalyd Rose R. Cayaban , PhD Muna B. Ajzoon , PhD Gina M. Molina , Bumalay Visitacion O.
Published: March 2021

Aim- The study aimed at exploring the lived experience of internationally recruited nurses in Oman that seeks to know how culture affects their adjustment process. The study also explored the acculturation that nurses undertake to adapt to a new culture from a personal and nursing perspective and the study also identified the support mechanisms that are in place to assist in the transition.Methods- The study is a qualitative phenomenological study defined as an approach to understanding people’s everyday life experience utilizing Collaizi’s 9 Phenomenological Steps. The samples were taken from four (4) major governorates in Oman namely Dhofar, Dhak​liya​, ​ ​North Batinah & Muscat. Out of 45 Nurses, 18 met the inclusion criteria and volunteered to undergo the structured phone interviews and conferences. Data Analysis was performed using the analytical software NVivo ver 12.Results-18 nurses consented to participate in the interview, most Internationally recruited nurses holding a bachelor's degree with an average age of 33.5 years. Most participants reported challenges in their transition to Oman upon being deployed. The primary area of concern arose from not having a structured ethical recruitment system and orientation programs. Conclusion- There is a need for a more systematic and ethical recruitment strategy that enhances IRN’s full integration into the host country’s social, religious, and cultural system. It was also found that language is an integral part of the IRN’s assimilation therefore the need for a formal and structured training and orientation program must be in place in both recruiting agencies and the catchment facilities in Oman
The Lived Experience of Internationally Recruited Nurses in Oman a Phenomenological Study
Authors: Ph Glenn Ford D. Valdez , MSN RM RN Arcalyd Rose R. Cayaban , PhD Muna B. Ajzoon , PhD Gina M. Molina , Ph Visitacion O. Bumalay
Published: March 2021

Aim: The study aimed at exploring the lived experience of internationally recruited nurses in Oman that seeks to know how culture affects their adjustment process. The study also explored the acculturation that nurses undertake to adapt to a new culture from a personal and nursing perspective and the study also identified the support mechanisms that are in place to assist in the transition. Methods- The study is a qualitative phenomenological study defined as an approach to understanding people’s everyday life experience utilizing Collaizi’s 9 Phenomenological Steps. The samples were taken from four (4) major governorates in Oman namely Dhofar, Dhak​liya​, ​ ​North Batinah & Muscat. Out of 45 Nurses, 18 met the inclusion criteria and volunteered to undergo the structured phone interviews and conferences. Data Analysis was performed using the analytical software NVivo ver 12. Results-18 nurses consented to participate in the interview, most Internationally recruited nurses holding a bachelor's degree with an average age of 33.5 years. Most participants reported challenges in their transition to Oman upon being deployed. The primary area of concern arose from not having a structured ethical recruitment system and orientation programs. Conclusion- There is a need for a more systematic and ethical recruitment strategy that enhances IRN’s full integration into the host country’s social, religious, and cultural system. It was also found that language is an integral part of the IRN’s assimilation therefore the need for a formal and structured training and orientation program must be in place in both recruiting agencies and the catchment facilities in Oman.
Potential benefits and pitfalls of skin-to-skin contact transport from birth room to neonatal unit
Authors: Clénet Nolwenn , Carneiro Laure , Jeanneaud Carole , Favrais Geraldine
Published: March 2021

Background: Early and repeated skin-to-skin contact (SSC) between infants and their parents during neonatal hospitalization has positive effects on maternal bonding, breastfeeding, parent-child interactions and preterm infant neurodevelopmental outcomes.Purpose: Transfers through SSC of newborn infants requiring intensive care over 300 meters between the birth room and neonatal unit have been implemented since 2018. The safety of SSC transfer with the infant’s father was questioned when compared to the more common transfer method in incubators.Methods: Singletons born from May to December 2019 at our three-level maternity ward that required intensive neonatal care were eligible. The infants’ axillary temperature, heart rate, and oxygen need were reported at four timepoints during transfer in an incubator or through SSC and at 30 minutes after arrival in the neonatal unit. Infant characteristics, blood gas, glycemia, time-lapse between birth and first SSC in the unit and feeding modes were also reported.Results: Median gestational age was higher in the SSC group (incubator (n=54): 32 weeks vs SSC (n=57): 36 weeks, p=.003). All infants requiring mechanical ventilation were transported in an incubator. A decrease in temperature was observed during incubator installation in the SSC group (incubator: 0°C vs SSC: -0.2°C, p< .001), but the first SSC in the unit was earlier in this group (incubator: 22 h vs SSC: 11 h, p= .001 and p= .008 after adjustment for gestational age). Implications for practice: Although thermal stability was compromised, encouraging results regarding the first SSC in the unit promote the continuation of SSC transfers.
Idiopathic Granulomatous Mastitis Presented with Reactive Arthritis and Erythema Nodosum: Case Report  from Iraqi
Authors: Gorial Faiq I. , J. Farah
Published: March 2021

Idiopathic Granulomatous Mastitis (IGM) is a rare chronic inflammatory disease that involves the development of an inflammatory mass in the breast, which may be difficult to differentiate from malignancy. Few patients have been reported in the literature presenting with arthritis accompanying IGM of breast. Here we report a case of Iraqi patient presented as IGM with reactive arthritis and erythema nodosum.
One-Year Follow-Up After Treatment of Proximal and/or Middle One-Third Humeral Shaft Fractures with a Helical Plate: Healing Rates, Complications and Functional Outcome Measures
Authors: Maes Vincent , Putzeys Guy
Published: March 2021

Background: Conventional plate osteosynthesis is a valuable treatment option in displaced proximal and/or middle one-third humeral shaft fractures. Nonetheless, this procedure can be complicated by a radial nerve palsy. To date, many surgical techniques have been developed in an attempt to minimize this high-impact complication. However, a helical plate has the potential to avoid an iatrogenic radial nerve palsy due to its design. This article aims to evaluate safety and functional outcomes of patients treated with a helical plate compared to conventional plate osteosynthesis. In particular healing rates, complications and functional outcome measures.Methods: We retrospectively included all patients with displaced proximal and/or middle one-third humeral shaft fractures who were treated with a helical plate from October 2016 until August 2018 at a single level-1 trauma center (AZ Groeninge, Kortrijk, Belgium). A self-molded long PHILOS plate (DePuy Synthes®) or a pre-contoured A.L.P.S proximal humeral plating system (Zimmer Biomet®) were used. Patient baseline characteristics and standard radiographs were obtained pre- and postoperatively. We retrospectively searched for complications. Patients were reassessed using the Disabilities of the Arm, Shoulder and Hand (DASH), Constant Murley (CMS) and EQ-5D-5L scores with a minimal follow-up of one year.Results: The humeral shaft fractures of all sixteen patients consolidated within three months and no iatrogenic radial nerve palsies were observed. One plate had to be removed after one year due to a late infection. With a minimum follow up of one year, the mean DASH score was 22 \ 19 and the mean normalized CMS was 80 B 19.Conclusion: Operative treatment of proximal and/or middle one-third humeral shaft fractures with a helical plate is a safe procedure with good to excellent shoulder function at one-year follow-up. Contrary to conventional plate osteosynthesis, a helical plate has the potential to completely avoid a radial nerve palsy, while maintaining similar healing rates and functional outcomes.Trial registration: B396201939564. Registered on 6 MAY 2019 – retrospectively registred. Ethics Committee: Medical Ethics Committee, AZ Groeninge, Kortrijk, Belgium.
Mast Cells and COVID-19: a case report implicating a role of mast cell activation in the prevention and treatment of Covid-19
Authors: Brock Isabelle , Maitland Anne
Published: March 2021

Coronavirus disease (COVID-19) is a heterogeneous syndrome following severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection of the upper respiratory tract. ln adults, the clinical condition can range from asymptomatic cases to severe acute respiratory syndrome and multi-organ dysfunction. Those at risk of developing COVID-19 related hyperinflammatory syndrome likely had an ineffective, innate immune response to this novel pathogen. Mast cells are associated with the epithelium, contributing to tissue homeostasis and epithelial barrier defense. Equipped with an array of pathogen receptors, mast cells exhibit distinct cytokine profiles, dependent on the tissue and the triggered pathogen receptors. Following viral infections, mast cells produce pro-inflammatory chemical mediators, such as interleukin-1 (IL-1) and IL-6, and these cytokines has been shown to be elevated in severe COVID-19 cases. Here, we present a case of a patient with a longstanding history of signs and symptoms, worrisome for a mast cell activation syndrome (MCAS), but never had laboratory confirmation of this non-clonal mast cell activation disorder, until she contracted COVID-19. This case illustrates the need to recognize the rate of mast cell activation in SARS-CoV-2 infection, not only to optimize anti-SARS-CoV-2 therapy, including the development of vaccine, but to potentially curb the risk of SARS­ CoV-2 triggered hyperinflammatory syndrome.
Important Physical Regulatory Roles of Erythrocytes on Platelet Adhesion Under Blood Flow Conditions.
Authors: Tamura Noriko , Shimizu Kazuya , Shiozaki Seiji , Sugiyama Kazuyasu , Nakayama Masamitsu , Goto Shinichi , Takagi Shu , Goto Shinya
Published: March 2021

Aim: Functional roles of erythrocytes on platelet adhesion to vessel wall under blood flow condition is still to be elucidated. Methods: Blood specimens containing native, biochemically fixed, or artificial erythrocytes, at various hematocrits were perfused on immobilized von Willebrand factor (VWF) at a shear rate of 1,500 s− 1. Number of platelets adhered on VWF within the region of interest (ROI: 5x103 µm2) was serially measured for 2 minutes using the fluorescent microscopy system. Regression analyses were conducted to evaluate the relationship between the rates of platelet adhesion and the hematocrit values. Computer simulation of platelet adhesion on the wall of von Willebrand factor (VWF) at a shear rate of 1,500 s− 1 was conducted by solving governing equations with a finite-difference method on K-computer. Calculations were conducted at various hematocrits conditions in the computational domain of 100 µm (x-axis) x 400 µm (y-axis) x 100 µm (z-axis). Results: Biological experiments demonstrated the positive correlations between the rates of platelet adhesion and hematocrit values in native, fixed, and artificial erythrocytes. (r = 0.992, 0.934, and 0.825, p < 0.05 for all) The number of platelets adhered after 2 minutes blood perfusion at 24% hematocrit of 221.7 ± 22.6/5x103 µm2 (fixed erythrocytes) and 208.0 ± 26.5/5x103 µm2(artificial ones), respectively, were comparable to that with native ones of 195.9 ± 28.3/5x103 µm2. The simulation results demonstrated the hematocrit dependent increase in platelet adhesion rates (94.3/sec at 10%, 185.2/sec at 20%, and 327.9/sec at 30%, respectively) suggesting the importance of augmented z-axis fluctuation of flowing platelet by erythrocytes as the cause of platelet adhesion. Conclusions: Our experimental results indicate the importance of the physical roles of erythrocytes inducing wall-normal fluctuations of flowing platelets on their vessel adhesion under blood flow conditions.
SARS-CoV-2 B.1.1.7 reinfection after previous COVID-19 in two immunocompetent Italian patients.
Authors: Novazzi Federica , Baj Andreina , Genoni Angelo , Spezia Pietro Giorgio , Colombo Alberto , Cassani Gianluca , Zago Cristian , Pasciuta Renee , Gasperina Daniela Dalla , Ageno Walter , Severgnini Paolo , Dentali Francesco , Focosi Daniele , Maggi Fabrizio
Published: March 2021

To date only one case of SARS-COV-2 B.1.1.7 reinfection has been reported. We report here two more such reinfection cases in Lombardy residents.
Knowledge, Awareness and Associated factors of Telemedicine Services among Health Professionals Working at Amhara Region Referral hospitals, northwest Ethiopia, 2020.
Authors: Assaye Bayou Tilahun , Jemere Adamu Takele , Nigatu Araya Mesfin
Published: March 2021

Background: -Telemedicine is the delivery of healthcare services at a distance. Despite it is an emerging and infancy technology in a developing country, utilizing the technology for delivering healthcare services is low in Ethiopia. To maximize and facilitate Telemedicine adoption it prominently requires information about the knowledge and awareness of telemedicine services among health professionals.Methods: - An institution-based cross-sectional study design was conducted among 423 health professionals working at Amhara Region Referral Hospitals from February 12-March 20/2020. The data were collected using a self-administered structured questionnaire. Desk review was done to assure the data quality and then data was entered into EPI INFO version 7 and exported into SPSS version 20 for statistical analysis. Descriptive statistics, bivariable and multivariable logistic regression analyses were done. The odds ratio with a 95% confidence interval (95% CI) was used to identify associated factors.Result: About 56% of health professionals had good knowledge and 57.4% had high awareness towards telemedicine services with a 411 (97.2%) response rate. Information sharing culture [AOR=3.01, 95% CI: 1.89, 4.80], having IT support staff [AOR=1.87, 95%CI: 1.06, 3.29], internet as information source [AOR=1.80, 95%CI:1.1, 2.94], awareness [AOR=1.35,95% CI: 1.03, 2.40], being male [AOR=1.73,95% CI:1.06, 2.81] were significantly associated with the knowledge of the respondents towards telemedicine services and telemedicine training [AOR= 2.33, 95% CI: 1.15, 4.72] and computer accessibility in their hospitals [AOR= 1.54, 95% CI: 1.01, 2.35] were significantly associated with the awareness of the respondents towards telemedicine services.Conclusion: More than half of the respondents had good knowledge and high awareness of telemedicine services. Information sources, having IT support staff, information sharing culture, gender and awareness were significant factors for the knowledge of telemedicine service, and telemedicine training and computer access were significant factors of awareness of health professionals towards telemedicine services. Therefore Appropriate and regular awareness creation training of telemedicine systems should be given to the health professional.
Challenges in antibiotics prescription in pediatrics: A national survey among Lebanese pediatricians
Authors: ISSA Amale , SALEH Nadine , HLEYHEL Mira , ZEIDAN Rouba Karen , ASSAF Sara , LAHOUD Nathalie
Published: March 2021

Background

Antibiotics are the most prescribed drugs especially in pediatrics and for Upper Respiratory tract Infections (URI). Physicians are facing many challenges in their practice regarding antibiotics prescription. The aim of this study, the first of its kind in Lebanon, is to evaluate attitudes and practices of Lebanese pediatricians towards antibiotics prescription with a special focus on URI in order to identify challenges facing physicians.
Methods

This is a cross-sectional study conducted in 2018 among pediatricians registered in the Orders of Physicians. A 63-item questionnaire in English was sent by e-mail or by message to the mobile phone of all pediatricians with subsequent reminders. Data was collected from May 1st through July 2nd 2018. Statistical analysis was done using SPSS 21.0. The analysis involved descriptive quantitative statistics (means and standard deviations, frequencies and percentages).
Results

From a total of 1213 physicians approached, 117 agreed to participate in the study giving a response rate of ~ 10%. A high proportion of Lebanese pediatricians replied correctly on avoiding antibiotics in cases of cough (86.3%), URI (74.4%), tympanic membrane dysfunction (64.1%) and prevention of secondary infection (63%). Eighty percent of physicians prescribed antibiotics for pharyngitis without requesting a throat culture. The majority of physicians admitted that antibiotic use is considerable in their community and that antibiotic resistance is a threat on the national and international level. Forty percent of pediatricians agreed and strongly agreed that giving advice to parents reduces their antibiotic demand. The same percentage disapproved that they might prescribe antibiotics in order to gain parents’ trust.
Conclusion

National campaigns are required to increase parents’ education and promote judicious antimicrobials use. Implementing national guidelines, ensuring continuing medical education for doctors and regulating over the counter sale of antibiotics are highly recommended.
Synergistic Experimental and Computational Approach Identifies Novel Strategies for PHB Overproduction
Authors: Alsiyabi Adil , Brown Brandi , Immethun Cheryl , Wilkins Mark , Saha Rajib
Published: March 2021

Polyhydroxybutyrate (PHB) is a sustainable bioplastic produced by bacteria that is a potential replacement for conventional plastics. This study delivers an integrated experimental and computational modeling approach to decipher metabolic factors controlling PHB production and offers engineering design strategies to boost production. In the metabolically robust Rhodopseudomonas palustris CGA009, PHB production significantly increased when grown on the carbon- and electron-rich lignin breakdown product p-coumarate (C9H8O3) compared to acetate when the same amount of carbon was supplied. However, the maximum yield did not improve further when grown on coniferyl alcohol (C10H12O3). In order to obtain a systems-level understanding of factors driving PHB yield, a model-driven investigation was performed. The model yielded several engineering design strategies including utilizing reduced, high molecular weight substrates that bypass the thiolase reaction. Overall, these findings uncover key parameters controlling PHB production and design strategies that can potentially be expanded to any bacterium for optimizing PHB production.
Development and Validation of a Nomogram Based on CA125 Levels for Predicting Progression-free Survival in Patients with Ovarian Cancer
Authors: He Minjun , Peng Hongyu , Liu Zhifeng , Gao Quanyang
Published: March 2021

Background Ovarian cancer is the leading cause of death in patients with gynecological cancers, and it has very low survival. CA125 have been shown to be an important prognostic factor for PFS, Therefore, we aimed to develop and validate a nomogram incorporating CA125 levels after three cycles of chemotherapy for predicting progression-free survival (PFS) in patients with ovarian cancer.Methods The nomogram was developed in a primary cohort of 491 patients with stage II-IV ovarian cancer. Performance was assessed by concordance index (C-index), calibration curve, and decision curve analysis, and compared with the International Federation of Gynecology and Obstetrics (FIGO) staging system. The predictive value of CA125 levels after three cycles of chemotherapy was evaluated. The model was subjected to bootstrap internal validation. An independent cohort of 81 patients was used for external validation.Results CA125 levels after three cycles of chemotherapy were significantly associated with PFS. Five variables, including CA125 levels were selected to develop the nomogram. The nomogram demonstrated adequate discrimination, with a bootstrap-corrected C-index of 0.708, and good calibration. External validation of the nomogram achieved excellent discrimination (C-index, 0.724) and calibration. CA125 levels after three adjuvant chemotherapy cycles showed a marginally significant increment of discrimination to the nomogram in the primary cohort (C-index, 0.708 vs 0.668; P = 0.097). Superior discriminative ability was observed in the nomogram when compared with the FIGO staging system only in the primary cohort (C-index, 0.708 vs 0.578; P < 0.001). Decision curve analysis demonstrated that our nomogram was clinically useful.Conclusion We developed and validated a nomogram incorporating CA125 levels after three chemotherapy cycles for PFS prediction in ovarian cancer. This nomogram showed well-predictive performance and easy clinical application.
Synthesis of 7, 8 –dihydroxyflavone functionalized gold nanoparticles and its mechanism of action against Leishmania donovani
Authors: Prasanna Pragya , Kumar Prakash , Mandal Saptarshi , Kumar Saurabh , Payal Tanvi , Sk. Ugir Hossain , Das Prolay , Ravichandiran V. , Mandal Debabrata
Published: March 2021

Background – The synthesis of gold nanoparticles (GNPs) using drugs, synthetic and natural compounds, proteins, nucleic acids have become beneficial due to improved biological activity coupled with reduced cytotoxicity. In this regard, green synthesis of GNPs using plant extract enriched with flavonoids has shown increased attention due to improved antimicrobial efficacy, greater solubility, and better bioavailability of the flavonoid conjugated with GNPs. We have used 7, 8 dihydroxyflavone (DHF), a flavonoid that is enriched in plants and known for neurotropic and antioxidant activities, for the synthesis of GNP. In this report, we have investigated the synthesis, characterization, and biological activity of DHF synthesized GNP against the parasite Leishmania donovani. Results – Synthesized DHF functionalized GNPs (DHF-GNPs) are ~35 nm in size with zeta potential values of -34.1 mV, as observed from DLS studies. UV-Visible spectroscopy and FT-IR analysis confirm successful conjugation of DHF over GNP. TEM imaging shows the uniform size and spherical distribution of NPs. Against L. donovani promastigotes IC50 for DHF and DHF-GNP is ~120 µM and ~40 µM respectively. In ex vivo, amastigote model IC50 for DHF and DHF-GNP is ~40 µM and ~22 µM respectively. A dose-dependent increase of gold content as measured by atomic absorption spectroscopy (AAS) confirms the internalization of GNPs by macrophages. Even with 1000 µM of DHF-GNP, cytotoxicity is only ~30% compared to ~50% cytotoxicity of 40 µM c-GNP, on THP1 cells. It indicates high biocompatibility of DHF-GNP over c-GNP. In DHF-GNP treated parasites, the activity of arginase decreases in a dose-dependent manner as evident from gene expression and enzyme-based studies. Supplementation of treated cells with ornithine, metabolite of arginase, shows the highest recovery from death. This indicates inhibition of arginase as the main reason for parasite death. Induction of IFN-γ and reduction IL-12 cytokine response shows a possible Th1/Th2-mediated cell death. Also, DHF and DHF-GNP are equally effective against sensitive and drug-resistant strains of L. donovani. Conclusion – Low cytotoxicity and high biological activity may provide an alternative but improved delivery of DHF whose solubility increases due to conjugation with GNP. Further efficacy against drug-resistant strains could be beneficial instead of conventional chemotherapy for leishmaniasis.