bluuebunny/crossref_metadata_2025 huggingface dataset:
Time course of outcome in poor grade subarachnoid hemorrhage patients: a longitudinal retrospective study
Authors: Gouvêa Bogossian Elisa , Diaferia Daniela , Minini Andrea , Ndieugnou Djangang Narcisse , Menozzi Marco , Peluso Lorenzo , Annoni Filippo , Creteur Jacques , Schuind Sophie , Dewitte Olivier , Taccone Fabio Silvio
Published: May 2021

Background

Neurological outcome and mortality of patients suffering from poor grade subarachnoid hemorrhage (SAH) may have changed over time. Several factors, including patients’ characteristics, the presence of hydrocephalus and intraparenchymal hematoma, might also contribute to this effect. The aim of this study was to assess the temporal changes in mortality and neurologic outcome in SAH patients and identify their predictors.

Methods

We performed a single center retrospective cohort study from 2004 to 2018. All non-traumatic SAH patients with poor grade on admission (WFNS score of 4 or 5) who remained at least 24 h in the hospital were included. Time course was analyzed into four groups according to the years of admission (2004–2007; 2008–2011; 2012–2015 and 2016–2018).

Results

A total of 353 patients were included in this study: 202 patients died (57 %) and 260 (74 %) had unfavorable neurological outcome (UO) at 3 months. Mortality tended to decrease in in 2008–2011 and 2016–2018 periods (HR 0.55 [0.34–0.89] and HR 0.33 [0.20–0.53], respectively, when compared to 2004–2007). The proportion of patients with UO remained high and did not vary significantly over time. Patients with WFNS 5 had higher mortality (68 % vs. 34 %, p = 0.001) and more frequent UO (83 % vs. 54 %, p = 0.001) than those with WFNS 4. In the multivariable analysis, WFNS 5 was independently associated with mortality (HR 2.12 [1.43–3.14]) and UO (OR 3.23 [1.67–6.25]). The presence of hydrocephalus was associated with a lower risk of mortality (HR 0.60 [0.43–0.84]).

Conclusions

Both hospital mortality and UO remained high in poor grade SAH patients. Patients with WFNS 5 on admission had worse prognosis than others; this should be taken into consideration for future clinical studies.
Novel meso-substituted porphyrin derivatives and its potential use in photodynamic therapy of cancer
Authors: Vallecorsa Pablo , Di Venosa Gabriela , Ballatore M. Belén , Ferreyra Dario , Mamone Leandro , Sáenz Daniel , Calvo Gustavo , Durantini Edgardo , Casas Adriana
Published: May 2021

Background

Photodynamic therapy (PDT) is an anticancer treatment that utilizes the interaction of light and a photosensitiser (PS), promoting tumour cell death mediated by generation of reactive oxygen species. In this study, we evaluated the in vitro photoactivity of four meso-substituted porphyrins and a porphyrin coupled to a fullerene.

Methods

The cell line employed was the LM3 mammary adenocarcinoma, and the PS with the best photokilling activity was administered to mice bearing the LM3 subcutaneously implanted adenocarcinoma. The TEMCP4+ porphyrin and its analogue TEMCC4+ chlorine contain four identical carbazoyl substituents at the meso positions of the tetrapyrrolic macrocycle and have A4 symmetry. The TAPP derivative also has A4 symmetry, and it is substituted at the meso positions by aminopropoxy groups. The DAPP molecule has ABAB symmetry with aminopropoxy and the trifluoromethyl substituents in trans positions. The TCP-C604+ dyad is formed by a porphyrin unit covalently attached to the fullerene C60.

Results

The PSs are taken up by the cells with the following efficiency: TAPP> TEMCP4+ = TEMCC4+ > DAPP >TCP-C604+, and the amount of intracellular PS correlates fairly with the photodamage degree, but also the quantum yields of singlet oxygen influence the PDT outcome. TAPP, DAPP, TEMCC4+ and TEMCP4+ exhibit high photoactivity against LM3 mammary carcinoma cells, being TAPP the most active. After topical application of TAPP on the skin of mice bearing LM3 tumours, the molecule is localized mainly in the stratum corneum, and at a lower extent in hair follicles and sebaceous glands. Systemic administration of TAPP produces a tumour: normal skin ratio of 31.4, and high accumulation in intestine and lung.

Conclusion

The results suggest a potential use of topical TAPP for the treatment of actinic keratosis and skin adnexal neoplasms. In addition, selectivity for tumour tissue after systemic administration highlights the selectivity of and potentiality of TAPP as a new PS.
Recurrent dislocation of binocular crystal lenses in a patient with cystathionine beta-synthase deficiency
Authors: Hua Ning , Ning Yuxian , Zheng Hui , Zhao Ledong , Qian Xuehan , Wormington Charles , Wang Jingyun
Published: May 2021

Background

Ectopia lentis is the common ocular manifestation of homocystinuria resulting from cystathionine beta-synthase (CBS) deficiency which has a high risk of thromboembolic complications.

Case presentation

The present study reports the case of a teenager with recurrent lens dislocation and glaucoma. He was diagnosed with CBS deficiency according to a high level of serum homocysteine and compound heterozygous mutations at two different positions on the CBS gene. Antiglaucoma eyedrops and a mydriatic successfully controlled the intraocular pressure, while oral pyridoxine and betaine uptake lowered the serum homocysteine level effectively.

Conclusions

Children with CBS deficiency may suffer from ectopia lentis, glaucoma and/or amblyopia. We firstly discovered a new mutation of CBS c. 697 T > G which had not been reported before. The patient was pyridoxine responsive and well controlled by medicine.
Obesity and occupation in Thailand: using a Bayesian hierarchical model to obtain prevalence estimates from the National Health Examination Survey
Authors: Rittirong Jongjit , Bryant John , Aekplakorn Wichai , Prohmmo Aree , Sunpuwan Malee
Published: May 2021

Background

Like many developing countries, Thailand has experienced a rapid rise in obesity, accompanied by a rapid change in occupational structure. It is plausible that these two trends are related, with movement into sedentary occupations leading to increases in obesity. National health examination survey data contains information on obesity and socioeconomic conditions that can help untangle the relationship, but analysis is challenging because of small sample sizes.

Methods

This paper explores the relationship between occupation and obesity using data on 10,127 respondents aged 20–59 from the 2009 National Health Examination Survey. Obesity is measured using waist circumference. Modelling is carried out using an approach known as Multiple Regression with Post-Stratification (MRP). We use Bayesian hierarchical models to construct prevalence estimates disaggregated by age, sex, education, urban-rural residence, region, and occupation, and use census population weights to aggregate up. The Bayesian hierarchical model is designed to protect against overfitting and false discovery, which is particularly important in an exploratory study such as this one.

Results

There is no clear relationship between the overall sedentary nature of occupations and obesity. Instead, obesity appears to vary occupation by occupation. For instance, women in professional occupations, and men who are agricultural or fishery workers, have relatively low rates of obesity.

Conclusion

Bayesian hierarchical models plus post-stratification offers new possibilities for using surveys to learn about complex health issues.
Barriers to and facilitators of HIV serostatus disclosure to sexual partners among postpartum women living with HIV in South Africa
Authors: Adeniyi Oladele Vincent , Nwogwugwu Charlotte , Ajayi Anthony Idowu , Lambert John
Published: May 2021

Background

Disclosure of HIV serostatus to a sexual partner can facilitate partner’s support and testing and better treatment outcomes. Studies examining changes in disclosure rates of serostatus from delivery and postpartum periods are scarce. Our study fills this gap by using a follow-up survey of postpartum women with HIV to examine if disclosure prevalence has improved compared to the proportion recorded at childbirth. We further assessed the reasons for non-disclosure and correlates of serostatus disclosure to sexual partners.

Methods

We conducted a cross-sectional analytical study (exit interview) with a final sample of 485 postpartum women with HIV drawn from the East London Prospective Cohort study database between January and May 2018. Disclosure of HIV status to partner was based on self-reporting. We fitted adjusted and unadjusted logistic regression models and also conducted descriptive statistical analyses. Sampling weights were used to correct for sampling errors.

Results

Overall, 81.8% of women in the study cohort had disclosed their status to their partners, representing a 7.4 percentage point increase since child delivery. After adjusting for important covariates, women were more likely to disclose their status if they were married [adjusted odds ratio (AOR): 3.10; 95% confidence interval (CI):1.39–6.91] but were less likely to disclose if they used alcohol [AOR: 0.61; 95% CI:0.37–0.99] or had reported adherence to ART [AOR: 0.59; 95% CI:0.36–0.96]. Fear of rejection, stigma or being judged, new or casual relationships, and having a violent partner were the main reasons for not disclosing HIV status to sexual partners.

Conclusion

We found a relatively higher rate of HIV status disclosure in the cohort compared to the rate recorded at childbirth, suggesting an improvement over time. Also, complicated relationship dynamics and fear of social exclusion still constitute barriers to HIV status disclosure to sexual partners despite patients’ counselling.
Association of household socioeconomic status, neighborhood support system and adherence to dietary recommendation among persons with T2DM, a facility-based cross-sectional study in Ghana
Authors: Doglikuu Be-Ikuu Dominic , Abubakari Abdulai , Yaseri Mehdi , Shakibazadeh Elham , Djazayery Abolghassem , Mirzaei Khadijeh
Published: May 2021

Background

Dietary recommendation help persons with diabetes adopt to healthy eating habits to achieve optimal glycemic control. Socioeconomic-status and neighborhood support system can influence adherence to dietary recommendation. The purpose of our study is to assess the association of household-socioeconomic status and neighborhood-support system with adherence to dietary recommendation among persons with type 2 diabetes mellitus (T2DM).

Methods

Facility-based cross-sectional-survey was conducted in Brong Ahafo region, Ghana. Six hospitals were randomly selected and 530 individuals with T2DM consecutively recruited from the selected hospitals for the study. Structured-questionnaires were used to collect socio-demographic variables. Adherence to dietary-recommendation was the outcome-variable, and was assessed using perceived dietary-adherence questionnaire.

Results

Age (years) (P-value = 0.005), Physical-Activity level (P-value = 0.024) Receive-moderate Social-Support (P-value = 0.004) and High-Socioeconomic status (P-value = 0.046) were significantly correlated with adherence to dietary-recommendation. Age (years) regression coefficient (β) -0.089, 95%CI (− 0.12, − 0.001), Being married β0.103, 95%CI (0.002, 0.02), moderate and low-social support system β 0.309, 95%CI (0.17, 0.38) and β-0.192, 95%CI (− 0.26, − 0.06) respectively, and high-socioeconomic status β 0.197, 95%CI (0.06, 0.25) were significantly associated with adherence to dietary-recommendation.

Conclusion

Social-support system and socioeconomic-status could be associated with adherence to dietary-recommendation. Therefore, health workers should consider patients’ social support system and socioeconomic status as modifiable factors for optimum adherence.
Effects of high-flow oxygen therapy on patients with hypoxemia after extubation and predictors of reintubation: a retrospective study based on the MIMIC-IV database
Authors: Liu Taotao , Zhao Qinyu , Du Bin
Published: May 2021

Background

To investigate the indications for high-flow nasal cannula oxygen (HFNC) therapy in patients with hypoxemia during ventilator weaning and to explore the predictors of reintubation when treatment fails.

Methods

Adult patients with hypoxemia weaning from mechanical ventilation were identified from the Medical Information Mart for Intensive Care IV (MIMIC-IV) database. The patients were assigned to the treatment group or control group according to whether they were receiving HFNC or non-invasive ventilation (NIV) after extubation. The 28-day mortality and 28-day reintubation rates were compared between the two groups after Propensity score matching (PSM). The predictor for reintubation was formulated according to the risk factors with the XGBoost algorithm. The areas under the receiver operating characteristic curve (AUC) was calculated for reintubation prediction according to values at 4 h after extubation, which was compared with the ratio of SpO2/FiO2 to respiratory rate (ROX index).

Results

A total of 524,520 medical records were screened, and 801 patients with moderate or severe hypoxemia when undergoing mechanical ventilation weaning were included (100 < PaO2/FiO2 ≤ 300 mmHg), including 358 patients who received HFNC therapy after extubation in the treatment group. There were 315 patients with severe hypoxemia (100 < PaO2/FiO2 ≤ 200 mmHg) before extubation, and 190 patients remained in the treatment group with median oxygenation index 166[157,180] mmHg after PSM. There were no significant differences in the 28-day reintubation rate or 28-day mortality between the two groups with moderate or severe hypoxemia (all P > 0.05). Then HR/SpO2 was formulated as a predictor for 48-h reintubation according to the important features predicting weaning failure. According to values at 4 h after extubation, the AUC of HR/SpO2 was 0.657, which was larger than that of ROX index (0.583). When the HR/SpO2 reached 1.2 at 4 h after extubation, the specificity for 48-h reintubation prediction was 93%.

Conclusions

The treatment effect of HFNC therapy is not inferior to that of NIV, even on patients with oxygenation index from 160 to 180 mmHg when weaning from ventilator. HR/SpO2 is more early and accurate in predicting HFNC failure than ROX index.
A comparison of diagnostic algorithms and clinical parameters to diagnose ventilator-associated pneumonia: a prospective observational study
Authors: Rahimibashar Farshid , Miller Andrew C. , Yaghoobi Mojtaba H. , Vahedian-Azimi Amir
Published: May 2021

Background

Suspicion and clinical criteria continue to serve as the foundation for ventilator-associated pneumonia (VAP) diagnosis, however the criteria used to diagnose VAP vary widely. Data from head-to-head comparisons of clinical diagnostic algorithms is lacking, thus a prospective observational study was performed to determine the performance characteristics of the Johanson criteria, Clinical Pulmonary Infection Score (CPIS), and Centers for Disease Control and Prevention’s National Healthcare Safety Network (CDC/NHSN) criteria as compared to Hospital in Europe Link for Infection Control through Surveillance (HELICS) reference standard.

Methods

A prospective observational cohort study was performed in three mixed medical-surgical ICUs from one academic medical center from 1 October 2016 to 30 April 2018. VAP diagnostic criteria were applied to each patient including CDC/NHSN, CPIS, HELICS and Johanson criteria. Tracheal aspirate cultures (TAC) and serum procalcitonin values were obtained for each patient.

Results

Eighty-five patients were enrolled (VAP 45, controls 40). Using HELICS as the reference standard, the sensitivity and specificity for each of the assessed diagnostic algorithms were: CDC/NHSN (Sensitivity 54.2%; Specificity 100%), CPIS (Sensitivity 68.75%; Specificity 95.23%), Johanson (Sensitivity 67.69%; Specificity 95%). The positive TAC rate was 81.2%. The sensitivity for positive TAC with the serum procalcitonin level > 0.5 ng/ml was 51.8%.

Conclusion

VAP remains a considerable source of morbidity and mortality in modern intensive care units. The optimal diagnostic method remains unclear. Using HELICS criteria as the reference standard, CPIS had the greatest comparative diagnostic accuracy, whereas the sensitivity of the CDC/NHSN was only marginally better than a positive TAC plus serum procalcitonin > 0.5 ng/ml. Algorithm accuracy was improved by adding serum procalcitonin > 0.5 ng/ml, but not positive quantitative TAC.

Trial Registration: Not indicated for this study type.
Femur originated genu varum in a patient with symptomatic ACL deficiency: a case report and review of literature
Authors: Mortazavi Seyed Mohammad Javad , Noori Abbas , Vosoughi Farzad , Rezaei Dogahe Reza , Shariyate Mohammad Javad
Published: May 2021

Background

Anterior cruciate ligament (ACL) injury may be associated with genu varum. There are a few indications in which the varus deformity can be corrected at the time of ACL reconstruction. However, as the genu varum originates mostly from the tibia and the simultaneous presence of ACL deficiency and femur originated genu varum is uncommon, only a few papers have described their management for ACL deficient patients with femur originated genu varum.

Case presentation

A young patient visited our clinic with a complaint of right knee pain and giving way. Further work up revealed a full mid substance ACL tear, mild medial knee osteoarthritis and femur originated genu varum of his right knee. He was managed with simultaneous ACL reconstruction and distal femoral valgus osteotomy.

Conclusions

Any corrective osteotomy for genu varum should be performed at center of rotation angle. Isolated ACL reconstruction in patients with simultaneous ACL deficiency and genu varum may hasten the knee degeneration.

Level of evidence

IV
Effect of photobiomodulation in secondary intention gingival wound healing—a systematic review and meta-analysis
Authors: Ebrahimi Pooya , Hadilou Mahdi , Naserneysari Ferdos , Dolatabadi Amirmohammad , Tarzemany Rana , Vahed Nafiseh , Nikniaz Leila , Fekrazad Reza , Gholami Leila
Published: May 2021

Background

Photobiomodulation is widely being used to improve the wound healing process in dentistry and a vast majority of studies have proven its benefits. But there are plenty of knowledge gaps according to the optimal laser characteristics which should be used to maximize the healing effects of lasers. The goal of this systematic review and meta-analysis was to determine the effect of photobiomodulation (PBM) as an adjunctive treatment to periodontal therapies to evaluate secondary intention gingival wound healing and post-operative pain.

Methods

Five databases (PubMed, Embase, Scopus, ProQuest, and Web of Sciences) were searched up to November 30, 2020, for clinical trials that reported the result of the application of PBM on secondary gingival healing wounds and post-operative pain and discomfort after periodontal surgeries. Two independent reviewers selected the eligible studies and the outcomes of interest were extracted. The quality of eligible studies was assessed using the Cochrane Handbook for Systematic Reviews of Interventions.

Results

Ultimately, twelve studies were included in this review. The application of PBM as an adjunct to periodontal surgeries resulted in a significant improvement in wound healing indices. The Landry wound healing index at the 7th post-operative day was significantly improved (SMD = 1.044 [95% CI 0.62–1.46]; p < 0.01) in PBM + surgery groups compared to the control groups. There was also a statistically significant increase in the complete wound epithelialization (RR = 3.23 [95% CI 1.66–6.31]; p < 0.01) at the 14th post-operative day compared to the control groups. The methods used to assess the post-operative pain were heterogeneous, and therefore the results were limited which made the meta-analysis for post-operative pain assessment not possible.

Conclusion

Based on the results of this review, PBM can be effectively used as a method to improve secondary intention wound healing. High-quality randomized clinical trials, however, are needed in the future to identify the optimal PBM irradiation parameters and the effect of PBM on post-operative pain.
Evaluation of uterine scar healing by transvaginal ultrasound in 607 nonpregnant women with a history of cesarean section
Authors: Zhou Xingchen , Zhang Tao , Qiao Huayuan , Zhang Yi , Wang Xipeng
Published: May 2021

Background

Caesarean scar defect (CSD) seriously affects female reproductive health. In this study, we aim to evaluate uterine scar healing by transvaginal ultrasound (TVS) in nonpregnant women with cesarean section (CS) history and to build a predictive model for cesarean scar defects is very necessary.

Methods

A total of 607 nonpregnant women with previous CS who have transvaginal ultrasound measurements of the thickness of the lower uterine segment. The related clinical data were recorded and analyzed.

Results

All patients were divided into two groups according to their clinical symptoms: Group A (N = 405) who had no cesarean scar symptoms, and Group B (N = 141) who had cesarean scar symptoms. The difference in frequency of CS, uterine position, detection rate of CSD and the residual muscular layer (TRM) of the CSD were statistically significant between groups; the TRM measurements of the two groups were (mm) 5.39 ± 3.34 versus 3.22 ± 2.33,P < 0.05. All patients were divided into two groups according to whether they had CSDs: Group C (N = 337) who had no CSDs, Group D (N = 209) who had CSDs on ultrasound examination. The differences in frequency of CS, uterine position, TRM between groups were statistically significant (P < 0.05). In the model predicting CSDs by TRM with TVS, the area under the ROC curve was 0.771, the cut-off value was 4.15 mm. The sensitivity and specificity were 87.8% and 71.3%, respectively.

Conclusions

Patients with no clinical symptoms had a mean TRM on transvaginal ultrasonography of 5.39 ± 3.34 mm, which could be used as a good reference to predict the recovery of patients with CSDs after repair surgery.
The path toward ectogenesis: looking beyond the technical challenges
Authors: Segers Seppe
Published: May 2021

Background

Breakthroughs in animal studies make the topic of human application of ectogenesis for medical and non-medical purposes more relevant than ever before. While current data do not yet demonstrate a reasonable expectation of clinical benefit soon, several groups are investigating the feasibility of artificial uteri for extracorporeal human gestation.

Main text

This paper offers the first comprehensive and up to date discussion of the most important pros and cons of human ectogenesis in light of clinical application, along with an examination of crucial ethical (and legal) issues that continued research into, and the clinical translation of, ectogenesis gives rise to. The expected benefits include advancing prenatal medicine, improving neonatal intensive care, and providing a novel pathway towards biological parenthood. This comes with important future challenges. Prior to human application, important questions have to be considered concerning translational research, experimental use of human fetuses and appropriate safety testing. Key questions are identified regarding risks to ectogenesis’ subjects, and the physical impact on the pregnant person when transfer from the uterus to the artificial womb is required. Critical issues concerning proportionality have to be considered, also in terms of equity of access, relative to the envisaged application of ectogenesis. The advent of ectogenesis also comes with crucial issues surrounding abortion, extended fetal viability and moral status of the fetus.

Conclusions

The development of human ectogenesis will have numerous implications for clinical practice. Prior to human testing, close consideration should be given to whether (and how) ectogenesis can be introduced as a continuation of existing neonatal care, with due attention to both safety risks to the fetus and pressures on pregnant persons to undergo experimental and/or invasive procedures. Equally important is the societal debate about the acceptable applications of ectogenesis and how access to these usages should be prioritized. It should be anticipated that clinical availability of ectogenesis, possibly first as a way to save extremely premature fetuses, may spark demand for non-medical purposes, like avoiding physical and social burdens of pregnancy.
Identification and validation of signal recognition particle 14 as a prognostic biomarker predicting overall survival in patients with acute myeloid leukemia
Authors: Shi Lingling , Huang Rui , Lai Yongrong
Published: May 2021

Background

This study aimed to determine and verify the prognostic value and potential functional mechanism of signal recognition particle 14 (SRP14) in acute myeloid leukemia (AML) using a genome-wide expression profile dataset.

Methods

We obtained an AML genome-wide expression profile dataset and clinical prognostic data from The Cancer Genome Atlas (TCGA) and GSE12417 databases, and explored the prognostic value and functional mechanism of SRP14 in AML using survival analysis and various online tools.

Results

Survival analysis showed that AML patients with high SRP14 expression had poorer overall survival than patients with low SRP14 expression. Time-dependent receiver operating characteristic curves indicated that SRP14 had good accuracy for predicting the prognosis in patients with AML. Genome-wide co-expression analysis suggested that SRP14 may play a role in AML by participating in the regulation of biological processes and signaling pathways, such as cell cycle, cell adhesion, mitogen-activated protein kinase, tumor necrosis factor, T cell receptor, DNA damage response, and nuclear factor-kappa B (NF-κB) signaling. Gene set enrichment analysis indicated that SRP14 was significantly enriched in biological processes and signaling pathways including regulation of hematopoietic progenitor cell differentiation and stem cell differentiation, intrinsic apoptotic signaling pathway by p53 class mediator, interleukin-1, T cell mediated cytotoxicity, and NF-κB-inducing kinase/NF-κB signaling. Using the TCGA AML dataset, we also identified four drugs (phenazone, benzydamine, cinnarizine, antazoline) that may serve as SRP14-targeted drugs in AML.

Conclusion

The current results revealed that high SRP14 expression was significantly related to a poor prognosis and may serve as a prognostic biomarker in patients with AML.
Epidemiology, species distribution, and outcome of nosocomial Candida spp. bloodstream infection in Shanghai: an 11-year retrospective analysis in a tertiary care hospital
Authors: Zheng Yan-Jun , Xie Ting , Wu Lin , Liu Xiao-Ying , Zhu Ling , Chen Ying , Mao En-Qiang , Han Li-Zhong , Chen Er-Zhen , Yang Zhi-Tao
Published: May 2021

Background

The incidence of Candida bloodstream infections (BSIs), has increased over time. In this study, we aimed to describe the current epidemiology of Candida BSI in a large tertiary care hospital in Shanghai and to determine the risk factors of 28-day mortality and the impact of antifungal therapy on clinical outcomes.

Methods

All consecutive adult inpatients with Candida BSI at Ruijin Hospital between January 1, 2008, and December 31, 2018, were enrolled. Underlying diseases, clinical severity, species distribution, antifungal therapy, and their impact on the outcomes were analyzed.

Results

Among the 370 inpatients with 393 consecutive episodes of Candida BSI, the incidence of nosocomial Candida BSI was 0.39 episodes/1000 hospitalized patients. Of the 393 cases, 299 (76.1%) were treated with antifungal therapy (247 and 52 were treated with early appropriate and targeted antifungal therapy, respectively). The overall 28-day mortality rate was 28.5%, which was significantly lower in those who received early appropriate (25.5%) or targeted (23.1%) antifungal therapy than in those who did not (39.4%; P = 0.012 and P = 0.046, respectively). In multivariate Cox regression analysis, age, chronic renal failure, mechanical ventilation, and severe neutropenia were found to be independent risk factors of the 28-day mortality rate. Patients who received antifungal therapy had a lower mortality risk than did those who did not.

Conclusions

The incidence of Candida BSI has increased steadily in the past 11 years at our tertiary care hospital in Shanghai. Antifungal therapy influenced short-term survival, but no significant difference in mortality was observed between patients who received early appropriate and targeted antifungal therapy.
Dimeric Her2-specific affibody mediated cisplatin-loaded nanoparticles for tumor enhanced chemo-radiotherapy
Authors: Wang Haijun , Jia Dianlong , Yuan Dandan , Yin Xiaolei , Yuan Fengjiao , Wang Feifei , Shi Wenna , Li Hui , Zhu Li-Min , Fan Qing
Published: May 2021

Background

Solid tumor hypoxic conditions prevent the generation of reactive oxygen species (ROS) and the formation of DNA double-strand breaks (DSBs) induced by ionizing radiation, which ultimately contributes to radiotherapy (RT) resistance. Recently, there have been significant technical advances in nanomedicine to reduce hypoxia by facilitating in situ O2 production, which in turn serves as a “radiosensitizer” to increase the sensitivity of tumor cells to ionizing radiation. However, off-target damage to the tumor-surrounding healthy tissue by high-energy radiation is often unavoidable, and tumor cells that are further away from the focal point of ionizing radiation may avoid damage. Therefore, there is an urgent need to develop an intelligent targeted nanoplatform to enable precise enhanced RT-induced DNA damage and combined therapy.

Results

Human epidermal growth factor receptor 2 (Her2)-specific dimeric affibody (ZHer2) mediated cisplatin-loaded mesoporous polydopamine/MnO2/polydopamine nanoparticles (Pt@mPDA/MnO2/PDA-ZHer2 NPs) for MRI and enhanced chemo-radiotherapy of Her2-positive ovarian tumors is reported. These NPs are biodegradable under a simulated tumor microenvironment, resulting in accelerated cisplatin release, as well as localized production of O2. ZHer2, produced using the E. coli expression system, endowed NPs with Her2-dependent binding ability in Her2-positive SKOV-3 cells. An in vivo MRI revealed obvious T1 contrast enhancement at the tumor site. Moreover, these NPs achieved efficient tumor homing and penetration via the efficient internalization and penetrability of ZHer2. These NPs exhibited excellent inhibition of tumor growth with X-ray irradiation. An immunofluorescence assay showed that these NPs significantly reduced the expression of HIF-1α and improved ROS levels, resulting in radiosensitization.

Conclusions

The nanocarriers described in the present study integrated Her2 targeting, diagnosis and RT sensitization into a single platform, thus providing a novel approach for translational tumor theranostics.

Graphic abstract
Does mRNA SARS-CoV-2 vaccine influence patients' performance during IVF-ET cycle?
Authors: Orvieto Raoul , Noach-Hirsh Meirav , Segev-Zahav Aliza , Haas Jigal , Nahum Ravit , Aizer Adva
Published: May 2021

Objective

No information exists in the literature regarding the effect of mRNA SARS-CoV-2 vaccine on subsequent IVF cycle attempt. We therefore aim to assess the influence of mRNA SARS-CoV-2 vaccine on IVF treatments.

Design

An observational study.

Setting

A tertiary, university-affiliated medical center.

Patients and Methods

All couples undergoing consecutive ovarian stimulation cycles for IVF before and after receiving mRNA SARS-CoV-2 vaccine, and reached the ovum pick-up (OPU) stage. The stimulation characteristics and embryological variables of couples undergoing IVF treatments after receiving mRNA SARS-CoV-2 vaccine were assessed and compared to their IVF cycles prior to vaccination.

Main outcome measures

Stimulation characteristics and embryological variables.

Results

Thirty-six couples resumed IVF treatment 7–85 days after receiving mRNA SARS-CoV-2 vaccine. No in-between cycles differences were observed in ovarian stimulation and embryological variables before and after receiving mRNA SARS-CoV-2 vaccination.

Conclusions

mRNA SARS-CoV-2 vaccine did not affect patients’ performance or ovarian reserve in their immediate subsequent IVF cycle. Future larger studies with longer follow-up will be needed to validate our observations.
Correction to: Achyranthes bidentata extract exerts osteoprotective effects on steroid-induced osteonecrosis of the femoral head in rats by regulating RANKL/RANK/OPG signaling
Authors: Jiang Yini , Zhang Yanqiong , Chen Weiheng , Liu Chunfang , Li Xiaomin , Sun Danni , Liu Zhenli , Xu Ying , Mao Xia , Guo Qiuyan , Lin Na
Published: May 2021

An amendment to this paper has been published and can be accessed via the original article.
Identification of sensory and motor nerve fascicles by immunofluorescence staining after peripheral nerve injury
Authors: Zhou Xijie , Du Jian , Qing Liming , Mee Thomas , Xu Xiang , Wang Zhuoran , Xu Cynthia , Jia Xiaofeng
Published: May 2021

Background

Inappropriate matching of motor and sensory fibers after nerve repair or nerve grafting can lead to failure of nerve recovery. Identification of motor and sensory fibers is important for the development of new approaches that facilitate neural regeneration and the next generation of nerve signal-controlled neuro-prosthetic limbs with sensory feedback technology. Only a few methods have been reported to differentiate sensory and motor nerve fascicles, and the reliability of these techniques is unknown. Immunofluorescence staining is one of the most commonly used methods to distinguish sensory and motor nerve fibers, however, its accuracy remains unknown.

Methods

In this study, we aim to determine the efficacy of popular immunofluorescence markers for motor and sensory nerve fibers. We harvested the facial (primarily motor fascicles) and sural (primarily sensory fascicles) nerves in rats, and examined the immunofluorescent staining expressions of motor markers (choline acetyltransferase (ChAT), tyrosine kinase (TrkA)), and sensory markers [neurofilament protein 200 kDa (NF-200), calcitonin gene-related peptide (CGRP) and Transient receptor potential vanillic acid subtype 1 (TRPV1)]. Three methods, including the average area percentage, the mean gray value, and the axon count, were used to quantify the positive expression of nerve markers in the immunofluorescence images.

Results

Our results suggest the mean gray value method is the most reliable method. The mean gray value of immunofluorescence in ChAT (63.0 ± 0.76%) and TRKA (47.6 ± 0.43%) on the motor fascicles was significantly higher than that on the sensory fascicles (ChAT: 49.2 ± 0.72%, P < 0.001; and TRKA: 29.1 ± 0.85%, P < 0.001). Additionally, the mean gray values of TRPV1 (51.5 ± 0.83%), NF-200 (61.5 ± 0.62%) and CGRP (37.7 ± 1.22%) on the motor fascicles were significantly lower than that on the sensory fascicles respectively (71.9 ± 2.32%, 69.3 ± 0.46%, and 54.3 ± 1.04%) (P < 0.001). The most accurate cutpoint occurred using CHAT/CRCP ratio, where a value of 0.855 had 100% sensitivity and 100% specificity to identify motor and sensory nerve with an area under the ROC curve of 1.000 (P < 0.001).

Conclusions

A combination of ChAT and CGRP is suggested to distinguish motor and sensory nerve fibers.
Generation and evaluation of IgY-scFv based mimetics against canine parvovirus
Authors: Ge Shikun , Zhang Xingxing , Zhong Fagang , Liu Xiang , Zhang Xiaoying
Published: May 2021

Antibody mimetics may be used for various biomedical applications, especially those for which conventional antibodies are ineffective. In this study, we developed a smaller molecular chicken IgY mimetic peptide (IgY-peptide) based on the complementarity-determining regions (CDRs) of the anti-canine parvovirus (CPV) IgY-scFv prepared previously. The mimetic peptide showed no cross-reactivity with canine distemper virus (CDV) and canine coronavirus (CCV) and showed excellent protective properties for Crandell-Rees Feline Kidney (CRFK) cells against CPV. This study is the first attempt to develop a mimetic IgY-peptide and demonstrates the ease and feasibility in generating such a novel antibody-like functional molecule for biomedical purposes.
How do Norwegian adolescents experience the role of social media in relation to mental health and well-being: a qualitative study
Authors: Hjetland Gunnhild Johnsen , Schønning Viktor , Hella Randi Træland , Veseth Marius , Skogen Jens Christoffer
Published: May 2021

Background

During the last decade, social media has permeated most parts of society. Adolescents are particularly active users of social media, and their use has been suggested as a contributing factor to mental health issues in this group. Quantitative studies have found associations between the frequency and/or duration of social media use and more mental health issues. However, most studies are cross-sectional and the identified associations are weak and of questionable practical significance. The aim of this study was to investigate adolescents’ lived experiences of using social media, focusing on both negative and positive aspects, using a qualitative approach. Qualitative research enables in-depth explorations of the experiences of individuals, nuance quantitative findings, and offer the perspective of adolescents into policies regarding social media use.

Methods

Experiences and perspectives of 27 adolescents from two senior high schools in Norway were gathered using focus group interviews (mean age 16.8, range 15–18). The data were analysed using thematic analysis.

Results

According to the participants, social media use catalyse changes to how people communicate and relate to each other (theme 1). Some changes were positive, in terms of facilitating social connectedness, while others were negative, such as people behaving worse than in face-to-face interactions. Further, social media use affected the participants at the individual level (theme 2); positively in terms of a sense of belonging and social support, and negatively in terms of perceived stress, body pressure, and displacing other activities such as sleep and homework. The motivations for using, or not using, social media were multifaceted (theme 3), reflecting the positive and negative aspects of social media in terms of interpersonal and personal consequences.

Conclusion

Social media was described as an important part of the participants’ everyday life, with both a positive and negative impact on their mental health and well-being. Considering the compelling nature of social media and adolescents’ relatively limited self-regulatory capacities, efforts to modify social media use should avoid relying on self-regulation, while also recognizing the importance of social media as an arena for peer interaction.
Cardiovascular autonomic neuropathy in people with type 2 diabetes mellitus; investigation of its association with classical cardiovascular risk factors using cardiovascular autonomic reflex tests: a cross-sectional study
Authors: Osailan Ahmad
Published: May 2021

Background

People with type 2 diabetes mellitus (DM) are at increased risk of cardiovascular disease (CVD). Cardiovascular autonomic neuropathy (CAN) is an underdiagnosed risk factor for CVD, which is prevalent among people with 2DM and can lead to CVD and CVD-related mortality. Little is known about the risk factors associated with CAN in type 2DM. Thus, the study was aimed to assess CAN using five cardiovascular autonomic reflex tests (represented by Ewing’s score) and explore the factors associated with CAN in people with type 2DM. The studied factors include traditional and serological CVD risk factors obtained from a fasting blood sample and cardiorespiratory fitness (CRF) obtained via attainment of the highest peak of volumes of O2 (VO2Peak).

Results

Univariate analysis revealed a significant positive correlation between resting systolic blood pressure (SBP) and Ewing’s score (r=0.47, p=.02) and an inverse correlation between VO2Peak and Ewing’s score (r=−0.64, p=.001). Multivariate linear regression revealed that a significant model that included resting SBP and VO2Peak explained 93.8% of Ewing’s score variance.

Conclusion

CAN was associated with two CVD parameters, including resting SBP and CRF, which may indicate the importance of controlling these two factors to prevent or reduce CAN in people with type 2DM.
Specular transmission and diffuse reflection in phonon scattering at grain boundary
Authors: Ong Zhun-Yong
Published: May 2021

It is widely assumed in the literature that the specularity parameters for phonon transmission (forward scattering) and reflection (backward scattering) at a boundary are identical, i.e., the statistical distributions of the transition probabilities between an incident phonon and the range of outgoing phonon modes are the same for both transmission and reflection. However, it is hypothesized by Li and McGaughey that separate specularity parameters are needed to describe the behavior of transmitted and reflected phonons in superlattices and polycrystalline materials correctly. We test this hypothesis by analyzing the mode-resolved specularity parameters computed separately for transmission and reflection processes at a graphene grain boundary. Our results show that backward scattering is considerably more diffuse than forward scattering at most frequencies and polarizations, providing strong evidence for Li and McGaughey's hypothesis, and shed new light on how surfaces and interfaces modify phonon transport within and between domains in nanostructured materials.
“AIDS Knows No Borders”
Authors: Ordaz Jessica
Published: May 2021

This article explores the intersection between migrant detention and HIV/AIDS from the 1980s to the present. “AIDS Knows No Borders” centers histories of exclusion, detention, and deportation. The first part discusses immigration policy that made AIDS screening mandatory as part of the asylum process and the activism that resulted in protest of these measures. AIDS Coalition to Unleash Power/Los Angeles (ACT UP/LA), a grassroots direct-action organization, opposed this legislation throughout the 1980s and 1990s. Activists highlighted the global nature of AIDS; challenged misinformation; conducted guerilla theater, phone zaps, and die-ins; and held demonstrations against the INS, the use of immigration detention, and their treatment of migrants with HIV/AIDS. The article then moves to discuss more contemporary testimonies from HIV/AIDS-positive detention migrants.
Combinatorial patterns of graded RhoA activation and uniform F-actin depletion promote tissue curvature
Authors: Denk-Lobnig Marlis , Totz Jan F. , Heer Natalie C. , Dunkel Jörn , Martin Adam C.
Published: May 2021

During development, gene expression regulates cell mechanics and shape to sculpt tissues. Epithelial folding proceeds through distinct cell shape changes that occur simultaneously in different regions of a tissue. Here, using quantitative imaging in Drosophila melanogaster, we investigate how patterned cell shape changes promote tissue bending during early embryogenesis. We find that the transcription factors Twist and Snail combinatorially regulate a multicellular pattern of lateral F-actin density that differs from the previously described Myosin-2 gradient. This F-actin pattern correlates with whether cells apically constrict, stretch or maintain their shape. We show that the Myosin-2 gradient and F-actin depletion do not depend on force transmission, suggesting that transcriptional activity is required to create these patterns. The Myosin-2 gradient width results from a gradient in RhoA activation that is refined through the balance between RhoGEF2 and the RhoGAP C-GAP. Our experimental results and simulations of a 3D elastic shell model show that tuning gradient width regulates tissue curvature.
Developmental plasticity of texture discrimination following early vision loss in the marsupialMonodelphis domestica
Authors: Ramamurthy Deepa L. , Dodson Heather K. , Krubitzer Leah A.
Published: May 2021

Behavioral strategies that depend on sensory information are not immutable; rather they can be shaped by the specific sensory context in which animals develop. This behavioral plasticity depends on the remarkable capacity of the brain to reorganize in response to alterations in the sensory environment, particularly when changes in sensory input occur at an early age. To study this phenomenon, we utilize the short-tailed opossum, a marsupial that has been a valuable animal model to study developmental plasticity due to the extremely immature state of its nervous system at birth. Previous studies in opossums have demonstrated that removal of retinal inputs early in development results in profound alterations to cortical connectivity and functional organization of visual and somatosensory cortex; however, behavioral consequences of this plasticity are not well understood. We trained early blind and sighted control opossums to perform a two-alternative forced choice texture discrimination task. Whisker trimming caused an acute deficit in discrimination accuracy for both groups, indicating the use of a primarily whisker-based strategy to guide choices based on tactile cues. Mystacial whiskers were important for performance in both groups; however, genal whiskers only contributed to behavioral performance in early blind animals. Early blind opossums significantly outperformed their sighted counterparts in discrimination accuracy, with discrimination thresholds that were lower by ∼75 μm. Our results support behavioral compensation following early blindness using tactile inputs, especially the whisker system.
Susceptibility of several cotton varieties to the cotton flea beetle, Podagrica puncticollis Weise (Coleoptera: Chrysomelidae), in a hot dry tropical environment of Ethiopia
Authors: Abebe Eshetu Agegnehu , BAYEH Mulatu , TEBKEW TEBKEW , MULATU Wakgari
Published: May 2021

Field trials were conducted to determine the reaction of cotton varieties to cotton flea beetle infestation. The experiment was laid out in a Randomized Complete Block Design with three replications comprising twelve cotton varieties. The results showed significant (P < 0.01) differences among varieties in the populations of adult beetle they hosted and the injury they sustained at 15, 22, 29, 36 and 43 days after sowing (DAS). At 15 DAS, the highest numbers of adult beetle per plant (6.3), percent leaf area damaged (60.32 %) and number of shot-holes per attacked leaf (53.4) was recorded in Cucurova variety, whereas the lowest in Bulk-202 (2.05 beetles, 26.15% leaf area damaged and 23.16 shot-holes). The rate of incidence and damages decreased with the increase of the age of the cotton plants. Significant differences were also observed among cotton varieties in some agronomic characteristics i.e. in number of plants counted per plot at harvest and seed cotton yield in terms of kilogram per hectare. Seed cotton yield obtained from all cotton varieties varied from 602.36 to 1644.71 kilogram per hectare and the highest was obtained from Bulk-202, while the lowest from Local variety. Based on these findings, Cucurova, Local, Ionia and Acala SJ-2 varieties showed highly susceptible response, while Candia, Sille-91 and Deltapine-90 were moderately susceptible to cotton flea beetle. However, Bulk-202, Delcero and Claudia were relatively more tolerant varieties followed by CCRI-12 and Cuokra. These results will be important for the most proper management of cotton flea beetle.