bluuebunny/crossref_metadata_2025 huggingface dataset:
Individual Compounds of Rhodoila quadrifida Rhizomes and Roots: Isolating and Establishing Structure
Authors: Lezina A. V. , Whaley A. K. , Whaley A. O. , Terninko I. I.
Published: November 2022

Introduction. Medicinal plant raw materials, containing a wide range of various biologically active compounds, are of considerable interest as a likely source of new, pharmacologically active biologically active substances. One of the promising plants is Rhodiola quadrifida (Pall.) Fisch. & C.A. Mey, since the raw materials contain phenolic compounds and their derivatives, which cause anti-inflammatory, antioxidant and anticarcinogenic effects. In addition, this plant has considerable popularity in folk medicine as a dietary supplement.

Aim. Isolation of individual compounds from rhizomes and roots of Rhodiola quadrifida and subsequent determination of their structure by NMR and mass spectrometry for phytochemical profiling.

Materials and methods. Rhizomes and roots of Rhodiola quadrifida, purchased in the pharmacy of St. Petersburg (place and time of procurement according to the information on the package – Altai (near Barnaul), in March 2019. The ethanol extract fractions (ethanol, hexane, butanol, and water) obtained during sequential liquid-liquid extraction were examined on a LC-20 Prominence instrument (Shimadzu, Japan) with an SPD-M20A diode array detector to determine the chromatographic profile. The most promising ethyl acetate fraction was purified by column chromatography on open glass columns with sorbents of different selectivity and preparative chromatography [Smartlina (Knauer, Germany)] with a spectrophotometric detector. The structure of the obtained individual compounds was determined by NMR (Bruker Avance III 400 MHz, Germany) and confirmed by low-resolution mass spectrometry [Flexar FX-15 (PerkinElmer, USA)].

Results and discussion. During the study, 7 individual compounds were isolated from the rhizomes and roots of Rhodiola quadrifida, namely 3,4-dihydroxybenzoic acid, 4-hydroxybenzoic acid, caffeic acid, ethyl gallate, catechin, epicatechin and tyrosol. These compounds were isolated for the first time from the raw materials of Rhodiola quadrifida. They are the major compounds and can characterize the phytochemical profile of raw materials, as well as determine the direction of pharmacological activity.

Conclusion. For the first time, Rhodiola quadrifida was isolated from raw materials and the structure of 7 majority compounds was proved by NMR spectroscopy and mass spectrometry, which can serve as a foundation for further study of this species of Rhodiola and targeted study of its pharmacological activity in vitro and in vivo, considering the individual phytochemical profile.
Approbation of a Model of Fat Liver Disease Induced by Orotic Acid
Authors: Kovanskov V. V. , Ivkin D. Yu. , Semivelichenko E. D. , Plisko G. A. , Kopacheva E. A. , Sidorov K. O.
Published: November 2022

Introduction. For the treatment of non-alcoholic fatty liver disease (NAFLD), hepatoprotective drugs are actively used. The existing models of non-alcoholic fatty liver disease used to study the effectiveness of medicinal products are characterized by a long duration of recovery and high mortality of test systems, in connection with which, the actual task is to test the screening model of this pathology. A number of studies have shown the hepatotoxic activity of orotic acid (OK), species-specific for rats, leading to the development of NAFLD.

Aim. Approbation of the NAFLD model induced by orotic acid on 2 rodent species (mice and rats), research of the reversibility of pathology under the action of a reference drug (ursodeoxycholic acid – UDCA).

Materials and methods. The reseacrh was conducted on outbred male rats weighing 260–265 g (n = 21) and inbred male mice of the C57BL/6 line weighing 16–18 g (n = 30). By randomization, the rats were divided into 3 groups (7 rats each): group 1 – intact animals; group 2 – NAFLD model; group 3 – NAFLD + UDCA model, mice were divided into 2 groups (10 and 20 mice, respectively): group 1 – intact animals; group 2 – NAFLD model. NAFLD was modeled by a high-carbohydrate diet with orotic acid (75 % standard feed, 24 % fructose and 1 % potassium orotate). UDCA was administered after the first control point 1 time a day through a probe in terms of 150 mg/kg. Biochemical and histological examination was carried out.

Results and discussion. It was revealed that a high-carbohydrate diet with the addition of 1 % potassium orotate for 4 weeks causes moderate balloon dystrophy, mild hepatitis and an increase in the content of alanine aminotransferase and aspartate aminotransferase in the blood of rats and less significant changes in mice. Low animal mortality was also noted. The use of UDCA on the claimed model causes a decrease in the severity of liver dystrophy and a decrease in the level of liver enzymes in the blood.

Conclusion. Based on the conducted experiments, rats turned out to be the optimal test system on the reproduced model, and a high-fat diet with the addition of orotic acid allows screening studies of drugs with hepatotropic activity.
Chelidonic Acid and its Derivates: General Spectrum of Biological Activity and Osteogenic Properties (Review)
Authors: Miroshnichenko L. A. , Polyakova T. Yu. , Avdeeva E. Yu. , Krivoshchekov S. V. , Khlusov I. A. , Belousov M. V.
Published: November 2022

Introduction. The development and implementation of new effective and safe drugs with osteogenic activity is an urgent problem of modern medical and pharmaceutical sciences. This is due to the wide prevalence and complexity of the treatment of diseases of the musculoskeletal system, which entails significant economic costs for the treatment and recovery of this group of patients. Recently, standard therapy regimens are increasingly being supplemented with drugs derived from medicinal plants, which is associated with their rather pronounced therapeutic effect and the absence or mild side effects compared to more expensive modern medical analogues. In this regard, the development of new directions in the strategy for the development of pharmacological agents from plant sources becomes relevant. The study of plant secondary metabolites is one such area that has already yielded good results in relation to the development of such drugs, and holds great promise. The review provides information on the biological properties of chelidonic acid and its possible derivatives in order to demonstrate the prospects for the use of these objects for the development of drugs, including those with osteogenic activity.

Text. Chelidonic acid is a substance present in many medicinal plants and has a wide range of pharmacological effects – analgesic, antimicrobial, anti-inflammatory, oncostatic and sedative. At the moment, methods have been developed for obtaining chelidonic acid and its derivatives from natural sources. In addition, chelidonic acid belongs to the so-called “small” molecules with osteogenic properties, which makes it promising in the creation of drugs for the treatment of diseases of the musculoskeletal system caused by impaired formation and regeneration of bone tissue. Native chelidonic acid has a low osteogenic activity, but given its ability to form complex compounds, it can act as a delivery system for osteoprotective micro- and macroelements. So, calcium chelidonate in experiments in vitro and in vivo shows a pronounced osteogenic activity: it stimulates the viability, adhesion and osteogenic differentiation of mesenchymal stem cells, enhances the mineralization of the extracellular matrix.

Conclusion. Taking into account the wide range of biological activity of chelidonic acid, its use in the complex therapy of allergies, depression, diabetes mellitus, inflammatory diseases, malignant neoplasms and other pathological conditions seems relevant. Calcium chelidonate is a promising drug candidate that can be used to accelerate regeneration processes and in bone tissue engineering.
Motivation Profile of Education Degree Students in English Language Learning
Authors: Recuero Jesús Luis , Antropova Svetlana , Obernyer Gretchen , Hertfelder Cynthia
Published: November 2022

The adoption of the English language as lingua franca, has increased the demand for English language teachers, however, the percentage of Education Degree students electing to specialize in English has dropped considerably. The objective of this research is two-fold: to tackle motivation factors which influence ELL in Primary and Early Childhood Education Degree students, and, to analyse any differences in motivation patterns between these degrees. Drawing on Dörnyei’s L2 motivation self-system (2005, 2009), a questionnaire was elaborated to explore 12 factors which influence motivation in ELL. 106 Education Degree students took part in this study. The results obtained showed that there were 7 factors which explain the model’s variance. While Primary Education Degree students opted for career opportunities abroad, living-abroad experiences, and previous L2 learning experiences; Early Childhood Education Degree students chose previous experiences in L2 learning, sociocultural interest and L2 anxiety.
Computational Nanomaterials Design: Towards The Realization of Nanoparticle Use in Radiotherapy - Case Study 1: Adsorption States of I on Au(111) Surface
Authors:   1 Department of Applied Physics, Graduate School of Engineering, Osaka University, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan, Tanudji Jeffrey , Meñez Aspera Susan ,   2 National Institute of Technology, Akashi College, 679-3 Nishioka, Uozumi-cho, Akashi, Hyogo 674-8501, Japan, Kasai Hideaki ,   1 Department of Applied Physics, Graduate School of Engineering, Osaka University, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan 2 National Institute of Technology, Akashi College, 679-3 Nishioka, Uozumi-cho, Akashi, Hyogo 674-8501, Japan 3 Institute of Radiation Sciences, Osaka University, 1-1 Machikaneyama-cho, Toyonaka, Osaka 560-0043, Japan
Published: November 2022

Abstract Radioactive iodine (e.g. I-125, I-131) have been used for decades in the medical community for cancer treatment and imaging. Using gold nanoparticles as a carrier for iodine opens possibilities of new treatments for cancer and also for tracking cancerous cells. To design an optimized version of gold nanoparticle for such purpose, we need to understand the bonding mechanism and gauge the strength of such bonding. To this end we performed theoretical calculations on the adsorption state of iodine on gold (111) surface. The results show good adsorption of iodine to gold, most stably on the hollow sites. The bonding mechanism is via the hybridization of the 5p orbital of the iodine with the 6s and 5d orbitals of the neighboring gold atoms. These results act as a first step to designing an optimized gold nanoparticle that can be used in future radiotherapy treatments
Benchmarking Outcomes That Matter Most to Patients: The Globe Programme
Authors: Dias Andre G. , Roberts Charlotte J. , Lippa Jacob , Arora Jason , Lundström Mats , Rolfson Ola , Tonn Sarah T.
Published: November 2022

Significant variation in health outcomes exists around the world. The International Consortium for Health Outcomes Measurement (ICHOM) has developed Standard Sets of outcomes for important medical conditions and populations to enable outcome measurement and comparision in order to understand variation and stimulate improvement. ICHOM has recently launched a prospective, non-interventional, observational pilot benchmarking programme. This article reviews the pilot methods, timelines, expected outputs, lessons learnt to date, and the next steps. We believe this programme is truly innovative as it will be the first global initiative in Standard Sets benchmarking, provider engagement, and risk-adjustment on the outcomes of care of most importance to patients. It has the potential to bring significant changes to compare the quality of healthcare and health systems around the world and ultimately to improve patient care.
The Role of Telemedicine in Infectious Diseases
Authors: Pham Christina , Badowski Melissa E.
Published: November 2022

The use of telemedicine has been described for various medical conditions. Telemedicine can improve access to care, reduce geographic barriers, and optimise healthcare for patients. The role of telemedicine has been described in antimicrobial stewardship programmes for the management of both acute and chronic infectious diseases, including HIV and hepatitis. The goal of this review is to provide data on the implementation of synchronous telemedicine programmes to provide infectious disease management.
The Influence of ‘Omics’ in Shaping Precision Medicine
Authors: McGrath Scott
Published: November 2022

Precision medicine is quickly emerging as an exciting new medical model in which patient information is extracted from their lifestyle, environmental, and genetic data. These data will be used to augment and refine traditional medical data to provide a higher level of specificity for disease prevention and patient care. Of the three pillars supporting precision medicine, this paper takes a deeper look at the genetic and genomic pillar; in particular, investigating the role the field of ‘omics’ has played in helping to develop precision medicine. The term omics is used to describe the collective research efforts of molecular biology for various subdomains (e.g., genomics, proteomics, metabolomics). While this paper is not exhaustive in scope, cases where omics has impacted both clinical practice and public health are highlighted, as well as a discussion of where omics has yet to bridge the gap between these two areas of medicine. The aim of this manuscript is to provide the reader with insight on the particular challenges and benefits of pursuing precision medicine.
Effect of Initial Microstructure on the High-Temperature Formability of STS 321 Alloy Using a Dynamic Material Model
Authors: Jo Pyeong-Seok , Lee Jae-Gwan , Hwang Hyo-Woon , Lee Yong-Jae , Lee Dong-Geun
Published: November 2022

General austenitic stainless steel has a problem with intergranular corrosion due to volatilizing chromium, which forms chromium carbide in a high temperature environment. By adding titanium as an alloying element, STS 321 stainless steel has excellent creep resistance and intergranular corrosion resistance at high temperatures, because the formation of chromium carbide is suppressed. It is important to find the optimal process conditions for STS 321 stainless steel used in the aerospace field, because high temperature processing is mainly applied, and defects or inhomogeneity of materials that occur during high temperature processing lowers the yield of products. In this study, to investigate the effect of the initial microstructure on the high-temperature deformation behavior of STS 321 stainless steel, a high-temperature compression test was performed on two types of STS321 alloys with different initial microstructures. The temperature range was set at 50°C intervals from 800°C to 1100°C, and the strain rate was set at 10-1/sec intervals from 1 × 100/ sec to 1 × 10-3/sec. Based on the experimental results, the thermal activation energy, which differed depending on differences in the initial microstructure, was calculated. In addition, by deriving flow stress and processing maps, the difference in energy dissipation efficiency depending on temperature and strain rate was explained, along with the initial microstructure and high-temperature deformation mechanism.
Persistent High Fever After Metchloropramide Treatment; Neuroleptic Malignant Syndrome
Authors: Sezer Can , Tekin Fatih Cemal
Published: November 2022

Introduction: Neuroleptic Malignant Syndrome(NMS) is a state neurotransmitter levels fluctuate subsequent to administration of neuroleptic agents. Etiology of NMS is unclear. It’s a neurological emergency includes symptoms like altered mental status, rigidity, fever and dysautonomy. Our aim in here is to mention the side effects of metochlopramide, which is commonly used in Emergency Departments(ED). In our case, subsequent to intravenous admission of metochlopramide, patients clinic worsened with NMS symptoms and this was quite unexpected and unwanted for ED doctors. By this case report it is wanted to raise awareness against, side effects of metoclopramide and NMS.
Case Report: Subsequent to intravenous administration of single dose metoclopramide to relieve abdominal pain into 21 years old male with no history of chronical diseases, symptoms of fever, muscle rigidity, confusion and fluctuating blood pressure levels quickly emerged along with leukocytosis and high levels of Creatine Kinase. ED Doctors suspected NMS. Futher laboratory and imaging stuides has excluded other central nervous system pathologies and infections. Eventually, patients clinic got better with symptomatic theraphy and he was discharged fully recovered.
Conclusion: NMS due to metoclopramide is quite rare, but usage of therapies includes Metoclopramid at ED’s are quite often. Subsequent to administration of this drug, if patients clinical state worsens with fever, confusion and muscle rigidity, phycisians should keep NMS in mind.
Soft Tissue Tuberculosis Mimicking Ewing Sarcoma: A Case Report
Authors: Orhan Mehmet Fatih , Buyukavci Mustafa , Erkun Olena , Çıracı Saliha , İlçe Huri Tilla
Published: November 2022

Introduction: Mycobacterium tuberculosis is a disease seen in every tissue and organ. Although it often involves the lung and pleura, it can also progress into extrapulmonary tuberculosis. Soft tissue and bone tuberculosis are the least common of all tuberculosis types. In some cases, the lesions may appear like bone tumors or metastatic lesions. Bacteriological and histopathological studies reach a definitive diagnosis because of the biopsy. We present a case suggestive of Ewing's sarcoma with clinical and imaging findings diagnosed as soft tissue tuberculosis resulting from the biopsy.

Case: A two-year-old girl was admitted to our clinic with the complaint of palpable swelling on the left side of her chest. Ewing sarcoma was considered with the findings of Computed Tomography (CT), Magnetic Resonance Imaging (MRI), and PET-CT. Biopsy material was reported as casefied granulomatous inflammation, and M. tuberculosis complex DNA was detected by PCR examination of the tissue. The patient was successfully treated with rifampin, isoniazid, pyrazinamide, and ethambutol.

Conclusion: Today, it should be kept in mind that tuberculosis is a common disease, rarely isolated soft tissue or bone involvement, and can be confused with malignancy.
A Rare Postoperative Complication of Acute Appendicitis: Portal Vein Thrombosis Required Small Intestine Resection
Authors: Kalaycı Tolga
Published: November 2022

This case report aims to present the diagnosis and treatment process of portal vein thrombosis, which occurred one week after laparoscopic appendectomy and required small bowel resection. A thirty-eight-year-old man was admitted with abdominal pain in the periumbilical and epigastric regions. He had a history of appendectomy and occlusive cerebrovascular disease. In the physical examination of the abdomen, tenderness was detected in the epigastric region on deep palpation. Leucocytosis, increased levels of alanine transaminase level, aspartate transaminase, gamma-glutamyl transferase, lactate dehydrogenase, c-reactive protein, and d-dimer were detected in laboratory analyses. CT scan revealed total thrombus in the portal vein, oedema in the segment of approximately 10 cm in the distal ileum, and free fluid in the pelvic region. Enoxaparin sodium was started. During follow-up, widespread defence and rebound in all quadrants of the abdomen occurred. 20 cm ileal resection with end ileostomy was performed. Enoxaparin sodium treatment was continued. On the 6th day of the service follow-up, the patient had left leg pain, and a subacute thrombus was detected in the main femoral, superficial femoral and deep femoral veins on doppler USG. Edoxaban tosylate 60 mg tablet every 24 hours started as an anti-coagulant treatment, and the patient was discharged without complications on the 18th day of hospitalisation.
Tek Parti Döneminde Şırnak’ta Nüfus Ve Demografik Yapı [1927-1950]
Authors: YAMAN Hikmet
Published: November 2022

Bu çalışmanın amacı, Cumhuriyet Türkiye’sinde Tek Parti Dönemini simgeleyen 1927-1950 yılları arasında yapılan genel nüfus sayımlarının verilerine dayanarak Şırnak’ın demografik yapısına ışık tutmaktır. Bu amaçla, Türkiye’de ilk kez 1927 tarihinde yapılan nüfus sayımı ve 1935 yılından itibaren de beşer yıl aralıklarla gerçekleştirilen genel sayımlar içerisinde Şırnak’a ilişkin demografik veriler ve sonuçlar, kapsamlı olarak tasnif edilmiş ve Şırnak’a ait özgün dinamiklerle değerlendirilmiştir. Makalenin 1927-1950 yılları arasındaki 5 farklı nüfus sayımı verilerini esas almış olması dolayısıyla çalışmada nicel yönteme başvurulmuştur. Şırnak verilerini içeren çizelgeler, özellikle yerel yerleşimler özelinde yeniden yorumlanmıştır. Bu yöntemden hareketle; 1927, 1935, 1940, 1945 ve 1950 yıllarında yapılmış sayımlar sonucunda tespit edilmiş olan toplam Şırnak nüfusu; dil, din, cinsiyet, köylü-kentli dağılımı ve okuryazarlık gibi özellikler bakımından analiz edilmiştir. Devlet İstatistik Enstitüsü (DİE) tarafından yayımlanan Resmi Nüfus İstatistikleri ve Başbakanlık Cumhuriyet Arşivi (BCA) belgeleri, makalede kullanılmış olan birincil kaynaklardır. Makalenin temel bulguları, 1927-1950 yılları arasındaki Şırnak nüfusunun kendine özgü özelliklerini kapsamaktadır.
Understanding China Through Sharp Power: Dragon's Teeth?
Authors: ARAS İlhan
Published: November 2022

China is making important initiatives in economic and political issues to become a global power. China's initiatives determine the approaches of other countries, especially those who see China as a threat. In this context, “sharp power” (锐实力) as a new concept of International Relations literature has been used to define China. In this study, the emergence of sharp power concept is discussed; China's sharp power policies are illustrated with various examples; and criticisms directed to the concept are mentioned. Also, many problems related to the concept have been shown, and a holistic approach to the concept has been put forward in the study. In this study, based on the literature, it has been shown that there is a “concept war” between the global powers and that China is left behind in this framework. In International Relations studies, the aims of states in international politics or cooperation or conflict situations with other countries are analyzed with smart power, soft power and many other concepts. With this study, it is aimed to contribute to both the International Relations discipline and the Chinese foreign policy literature with sharp power, which is a new concept in the discipline of International Relations.
İkinci Dünya Savaşı Sonrası Türk Bürokrasi Araştırmalarında Modernleşme Paradigmasının Etkisi
Authors: KAYA Vefa Can
Published: November 2022

Osmanlı-Türk bürokrasisi, modernleşme sürecinde üstlendiği kritik yönetici konumu nedeniyle sosyal bilimcilerin ve tarihçilerin her daim gündeminde olan bir konu olagelmiştir. Ancak bu önemine karşın, Türk bürokrasisi literatürü dayandığı kuramsal temeller açısından eleştirel bir perspektifle gereğince ele alınmamıştır. Bu makalenin amacı, İkinci Dünya Savaşı sonrası gelişen çağdaş Türk bürokrasisi literatürünün gelişimini ve dayandığı kuramsal temelleri ortaya koymaktır. Bu çerçevede 1950’li ve 1960’lı yıllarda Batılı böler araştırmacılarının katkılarıyla şekillenen Türk bürokrasisi literatürünün modernleşme paradigmasının öngördüğü problemler etrafında gelişim gösterdiği iddia edilmektedir. Bu iddiayı temellendirmek amacıyla İkinci Dünya Savaşı sonrası dönemde azgelişmiş olarak nitelendirilen bölgelerde bürokrasinin niçin önem kazanmış olduğu modernleşme kuramı bağlamında ortaya konmaktadır. Daha sonra Batılı araştırmacıların Türk bürokrasisi çalışmaları, bürokratik seçkinlere odaklanan araştırmalar ile örgüt olarak bürokrasiyi inceleyen araştırmalar olarak iki başlık üzerinden tartışılmaktadır. Bürokratik seçkinlere odaklanan literatürün temelde Batılı liberal demokrasi modelinin imkânını soruşturduğu, örgüt olarak Türk bürokrasisini inceleyen çalışmalarda ise verimsizlik probleminin ortak bir tema olarak işlevselleştiği ifade edilmektedir. 1970’li yıllarda alanda telif eserlerin artışıyla birlikte öne çıkan yerli sosyal bilimcilerin ise mevcut literatüre modernleşme paradigmasının sınırlılıkları dahilinde yaptıkları katkı tartışılmaktadır. Sonuç olarak 1950’li yıllardan itibaren gelişmeye başlayan Türk bürokrasisi üzerine çağdaş sosyal bilim literatürünün, gelişimi boyunca modernleşme kuramının öngördüğü problemler çerçevesinde normatif bir boyuta sahip olduğu ortaya konmaktadır.
EXAMINATION OF MEANING AND PURPOSE OF LIFE IN WOMEN WITH PREMENSTRUAL SYNDROME
Authors: GÜL Sidar
Published: November 2022

Women's coping behaviors with premenstrual syndrome symptoms can be affected by various factors. Among these factors, the meaning and purpose of life is an important health factor associated with reducing many negative health outcomes. This study was conducted to examine the life purpose and meaning-making tendencies of women with premenstrual syndrome. The sample of this descriptive-correlational study consisted of 384 participants. The study was conducted in March-September 2021 within a province located in the Southeastern Anatolia Region of Turkey. The data were collected by using the Descriptive Questionnaire, the Premenstrual Syndrome Scale, and the Meaning and Purpose of Life Scale. The mean Premenstrual Syndrome Scale scores of the participants were determined as 135.02±25.02 and the mean Scale of Meaning and Purpose of Life was 46.77±7.40. The effect of the meaning and purpose of life was found to be effective on decrease of premenstrual syndrome (p<0.001). The total meaning and purpose of life score explained 21.9% of the total variance in the dependent variable of premenstrual syndrome. In order to make the lives of women diagnosed with premenstrual syndrome more meaningful, it is recommended to organize multi-sectoral collaborative programs in which women's health nurses take an active role.
Backing Out but Backing In Audience Costs? A Replication of Levy et al. (2015)
Authors: Takei Makito , Paolino Phil
Published: November 2022

Levy et al. (2015) propose that inconsistency audience costs are caused in two ways: backing out of military commitment or backing into foreign conflicts. We replicate their experiment in July-August, 2021. Like many other studies, we find evidence for audience costs caused by backing out. However, our findings indicate that, unlike Levy et al., citizens are no less supportive of a leader who backs into a military conflict despite an initial commitment to stay out than one who behaves consistently. This study has significant theoretical and methodological implications. Theoretically, the importance of inconsistency in audience cost literature may be overstated or inconsistency audience costs may be bounded by temporal domains or contexts. Methodologically, our study emphasizes the necessity of replications because major findings can become conventional wisdom without such additional analysis.
Identification of immune characteristic landscapes related to autophagy in ischemic stroke
Authors: Li Shuang , Zhang Yu , Shi Shanshan , Guo Da , Chang Ting
Published: November 2022

Ischemic stroke (IS) is a common and grievous nervous system disease. Both autophagy activation and immune response after cerebral ischemia play important roles in the development of IS. Many studies have revealed a close interplay between autophagy and immunity. However, little is known about how autophagy influences the immune characteristics of IS. Hence, the study aims to systematically explore the role of autophagy and its impact on immune characteristics in IS. We first compared the expression differences of autophagy genes in a training set and identified 20 dysregulated autophagy genes between healthy and IS samples. An autophagy-related classifier composed of seven genes was further established and could well distinguish healthy and IS samples. Then, the association between autophagy and immune characteristics, including infiltrating immunocytes, activity of immune reactions, and HLA gene expression, was investigated. The results showed that autophagy closely correlated with immune characteristics, such as NAMPT and ARNT significantly related to infiltrating immunocytes; PPP1R15A and CASP3 significantly related to activity of immune reactions; and NAMPT and ATG16L2 significantly related to HLA genes. Next, two distinct autophagy expression patterns were identified by unsupervised clustering analysis, and diverse immune characteristics were discovered between them. A total of 5481 autophagy phenotype-related genes were obtained between two expression patterns, and their biological functions revealed that these genes were involved in immune-related biological pathways. Finally, five dysregulated autophagy genes (FOS, MAP1LC3B, ERO1L, ARNT, and PPP1R15A) were proved between IS and healthy samples using another two validation sets. Our results illustrated that autophagy had a dramatic effect on the immunity of IS and provided a novel sight into understanding the pathogenesis of IS.
Association of admission serum calcium level with left ventricular dysfunction in patients with acute coronary syndrome
Authors: Wang Hong , Wang Rongrong , Tian Junping
Published: November 2022

Background

The relationship between serum calcium and left ventricular function in patients with acute coronary syndrome (ACS) has not been explored. Our aim was to investigate the correlation of admission serum calcium with left ventricular dysfunction in ACS patients.

Methods

In this cross-sectional study, 658 ACS patients who were admitted in the Department of Cardiovascular Disease from June 1st, 2019 to December 31st, 2019 were enrolled in the present study. Serum calcium and B-type natriuretic peptide (BNP) were measured at admission. Left ventricular ejection fraction (LVEF) was assessed using echocardiography. The correlation between admission serum calcium and left ventricular dysfunction was analyzed.

Results

When stratified by serum calcium quartiles calculated from all patients, patients with lower serum calcium quartile showed a markedly higher BNP and lower LVEF (P < 0.05). Patients with LVEF ≤ 50% showed a significantly lower serum calcium and higher BNP compared to those with LVEF> 50% (P < 0.05). Admission serum calcium was positively correlated with LVEF (P < 0.01) but negatively correlated with BNP (P < 0.01). Multivariate logistic regression analysis showed that lower serum calcium (adjusted OR: 0.720, 95% CI: 0.519–0.997, P = 0.048) was independently associated with BNP ≥ 300 pg/ml in ACS patients. Using LVEF as a dependent variable, no significant correlation between low serum calcium and left ventricular systolic dysfunction was found in ACS patients.

Conclusions

In patients with ACS, admission serum calcium was positively correlated with LVEF and negatively with BNP. Lower admission serum calcium was an independent risk factor for elevated BNP.
Case report: Different clinical manifestations of the rare Loeffler endocarditis
Authors: Zhao Yuanyuan , Jiang Peiqing , Chen Xiangyun , Yao Guihua
Published: November 2022

Background

Loeffler endocarditis is a rare and fatal disease, which is prone to be misdiagnosed, owing to its various clinical manifestations. Consequently, an early identification of Loeffler endocarditis and its effective treatment are crucial steps to be undertaken for good prognosis.

Case presentation

This report describes two cases of Loeffler endocarditis with different etiologies and clinical manifestations. Case 1 was caused by idiopathic eosinophilia and presented with a thrombus involving the tricuspid valve and right ventricular inflow tract (RVIT). The patient suffered from recurrent syncope following activity. After the patient underwent tricuspid valve replacement and thrombectomy, he took oral prednisone and warfarin for 2 years, consequent to which he discontinued both drugs. However, the disease recurred 6 months later, this time manifesting as edema of both legs. Echocardiography showed that a thrombus had reappeared in the RVIT. Thus, oral prednisone and warfarin therapy was readministered. Three months later, the thrombus had dissolved. Low-dose prednisone maintenance therapy was provided long term. Case 2 involved a patient who presented with recurrent fever, tightness in the chest, and asthma, and whose condition could not be confirmed, despite multiple local hospitalizations. In our hospital, echocardiography revealed biventricular apical thrombi. After comprehensive examinations, the final diagnosis was eosinophilic granulomatosis polyangiitis (EGPA) involving multiple organs, including the heart (Loeffler endocarditis), lungs, and kidneys. After administration of corticosteroid, anticoagulant, and immunosuppressive agents along with drugs to improve cardiac function, the patient's symptoms improved significantly.

Conclusion

In Loeffler endocarditis due to idiopathic eosinophilia, long-term corticosteroid use may be required. Diverse and non-specific symptoms cause Loeffler endocarditis to be easily misdiagnosed. So, when a patient shows a persistent elevation of the eosinophil count with non-specific myocardial damage, the possibility of this disease, should always be considered. Furthermore, even when an invasive clinical procedure such as endomyocardial biopsy (EMB) is not available or acceptable, corticosteroids should be administered promptly to bring the eosinophil count back to the normal range, thereby halting the progression of disease and reducing patient mortality.
Impact of severe valvular heart disease in adult congenital heart disease patients
Authors: Graziani Francesca , Iannaccone Giulia , Meucci Maria Chiara , Lillo Rosa , Delogu Angelica Bibiana , Grandinetti Maria , Perri Gianluigi , Galletti Lorenzo , Amodeo Antonio , Butera Gianfranco , Secinaro Aurelio , Lombardo Antonella , Lanza Gaetano Antonio , Burzotta Francesco , Crea Filippo , Massetti Massimo
Published: November 2022

Background

The clinical impact of valvular heart disease (VHD) in adult congenital heart disease (ACHD) patients is unascertained. Aim of our study was to assess the prevalence and clinical impact of severe VHD (S-VHD) in a real-world contemporary cohort of ACHD patients.

Materials and methods

Consecutive patients followed-up at our ACHD Outpatient Clinic from September 2014 to February 2021 were enrolled. Clinical characteristics and echocardiographic data were prospectively entered into a digitalized medical records database. VHD at the first evaluation was assessed and graded according to VHD guidelines. Clinical data at follow-up were collected. The study endpoint was the occurrence of cardiac mortality and/or unplanned cardiac hospitalization during follow-up.

Results

A total of 390 patients (median age 34 years, 49% males) were included and S-VHD was present in 101 (25.9%) patients. Over a median follow-up time of 26 months (IQR: 12–48), the study composite endpoint occurred in 76 patients (19.5%). The cumulative endpoint-free survival was significantly lower in patients with S-VHD vs. patients with non-severe VHD (Log rank p < 0.001). At multivariable analysis, age and atrial fibrillation at first visit (p = 0.029 and p = 0.006 respectively), lower %Sat O2, higher NYHA class (p = 0.005 for both), lower LVEF (p = 0.008), and S-VHD (p = 0.015) were independently associated to the study endpoint. The likelihood ratio test demonstrated that S-VHD added significant prognostic value (p = 0.017) to a multivariate model including age, severe CHD, atrial fibrillation, %Sat O2, NYHA, LVEF, and right ventricle systolic pressure > 45 mmHg.

Conclusion

In ACHD patients, the presence of S-VHD is independently associated with the occurrence of cardiovascular mortality and hospitalization. The prognostic value of S-VHD is incremental above other established prognostic markers.
Identification of glycolysis genes signature for predicting prognosis in malignant pleural mesothelioma by bioinformatics and machine learning
Authors: Xiao Yingqi , Huang Wei , Zhang Li , Wang Hongwei
Published: November 2022

Background

Glycolysis-related genes as prognostic markers in malignant pleural mesothelioma (MPM) is still unclear. We hope to explore the relationship between glycolytic pathway genes and MPM prognosis by constructing prognostic risk models through bioinformatics and machine learning.

Methods

The authors screened the dataset GSE51024 from the GEO database for Gene set enrichment analysis (GSEA), and performed differentially expressed genes (DEGs) of glycolytic pathway gene sets. Then, Cox regression analysis was used to identify prognosis-associated glycolytic genes and establish a risk model. Further, the validity of the risk model was evaluated using the dataset GSE67487 in GEO database, and finally, a specimen classification model was constructed by support vector machine (SVM) and random forest (RF) to further screen prognostic genes.

Results

By DEGs, five glycolysis-related pathway gene sets (17 glycolytic genes) were identified to be highly expressed in MPM tumor tissues. Also 11 genes associated with MPM prognosis were identified in TCGA-MPM patients, and 6 (COL5A1, ALDH2, KIF20A, ADH1B, SDC1, VCAN) of them were included by Multi-factor COX analysis to construct a prognostic risk model for MPM patients, with Area under the ROC curve (AUC) was 0.830. Further, dataset GSE67487 also confirmed the validity of the risk model, with a significant difference in overall survival (OS) between the low-risk and high-risk groups (P < 0.05). The final machine learning screened the five prognostic genes with the highest risk of MPM, in order of importance, were ALDH2, KIF20A, COL5A1, ADH1B and SDC1.

Conclusions

A risk model based on six glycolytic genes (ALDH2, KIF20A, COL5A1, ADH1B, SDC1, VCAN) can effectively predict the prognosis of MPM patients.
Sex steroid priming in short stature children unresponsive to GH stimulation tests: Why, who, when and how
Authors: Partenope Cristina , Galazzi Elena , Albanese Assunta , Bellone Simonetta , Rabbone Ivana , Persani Luca
Published: November 2022

Despite decades of experience, the diagnosis of growth hormone deficiency (GHD) remains challenging, especially in peripubertal children. Failure to respond to GH stimulation tests (GHSTs) is needed to confirm GHD, but long-standing controversies regarding the number of tests needed and the interpretation of GH peaks are still a matter of debate worldwide. Diagnostic workup is even more problematic in short children with slow growth and delayed sexual development: they often exhibit low GH peaks under GHST, which often normalize as puberty progresses. Consequently, this transient suboptimal response to GHST may result in GH overtreatment, carrying both health and economic concerns. Considering the complex and bound link between GH axis and sex steroids, the use of sex steroid priming prior to GHST might be helpful in peripubertal setting. However, its use is still controversial. There is no consensus regarding patient selection, timing, dose, and preparation of sex steroids. In this review, we aim to overview the use of sex steroid priming in clinical practice, highlighting the need to develop appropriate guidelines in order to overcome diagnostic pitfalls in peripubertal age.
Association of geriatric nutritional risk index with the risk of osteoporosis in the elderly population in the NHANES
Authors: Huang Wei , Xiao Yingqi , Wang Hongwei , Li Kaixiang
Published: November 2022

Background

Osteoporosis is common in the elderly, and malnutrition is considered a major risk factor for osteoporosis. This study investigated the relationship between the Geriatric Nutrition Risk Index (GNRI) and osteoporosis based on a large cross-sectional study of the National Health and Nutrition Examination Survey (NHANES).

Methods

We included 7405 older adults from NHANES (2005 to 2018) and divided them into the High-GNRI and Low-GNRI groups based on GNRI levels to compare the prevalence of osteoporosis among the two groups. A multi-factor logistic regression analysis was used to determine whether GNRI was an independent risk factor for osteoporosis. Spearman’s rank correlation coefficient was computed to investigate the linear relationship between geriatric nutritional risk index (GNRI) and bone mineral density (BMD) T-score. Finally, a generalized additive model (GAM) revealed whether there was a non-linear relationship between GNRI and osteoporosis.

Results

The prevalence of osteoporosis was higher in the Low-GNRI group than those in the High-GNRI group (12.2% vs. 8.2%; P = 0.001). Similarly, the femoral neck BMD T-scores (-1.09 ± 1.42 vs. -0.91 ± 1.31; P = 0.003). However, there was no significant difference between Low-GNRI group and High-GNRI group in lumbar BMD T-scores (1.700 ± 1.69 vs 1.85 ± 1.72; P>0.05). The multi-factor logistic regression analysis identified low GNRI as an independent risk factor for osteoporosis (OR: 1.544; 95% CI: 1.179-2.022; P < 0.001). Besides, GNRI showed a positive linear correlation (P < 0.001) with femoral neck BMD T-scores in older adults, with a progressive trend towards higher BMD as GNRI increased. By contrast, there was no linear correlation between GNRI and lumbar BMD T-score (P = 0.978). Lastly, the dose response curve revealed the non-linear negative correlation between GNRI and the risk of osteoporosis in the elderly (non-linear P < 0.001). With the increase of GNRI, the risk of osteoporosis gradually decreased, especially when GNRI was greater than 100, the downward trend was more significant.

Conclusion

GNRI is an independent risk factor for osteoporosis in the elderly and is negatively and non-linearly associated with the risk of osteoporosis in the elderly population.
Exploring the role of technology innovation and environmental regulation in energy efficiency
Authors: Chen Yushan , Zhao Tong
Published: November 2022

This study adopts a relatively infrequent approach to explore the impact of environmental regulation and technological innovation on energy efficiency (EFF) based on the undesired superefficiency SBM and random Tobit model. To study the universal EFF, we establish the undesired superefficiency SBM model, which is composed of three input indexes such as energy, one expected output index, and three pollution emissions as the undesired output index, consider the EFF of the sample with an effective decision-making unit (DMU) value less than 1, and calculate with the MATLAB software, according to panel data of 30 Chinese provincial-level regions from 2001 to 2019. The empirical results show that the EFF has an N-type trend in the eastern, central, and western regions of China. When exploring the impact of environmental regulation and technological innovation on EFF, we conduct an empirical analysis of the eastern, central, and western regions with the random Tobit model. The regression results indicate that the impact of environmental regulation on EFF in the different regions varies significantly. Technological innovation has different impacts on EFF in different regions and is the main influencing factor of EFF. Moreover, we strive to analyze the impact of cross-term environmental regulation and technological innovation and find that the cross-term has a significant positive impact on EFF in each region. These results emphasize that environmental regulation and technological innovation have positive or negative impacts on EFF, and both impacts may exist simultaneously, which is a perfection of the EFF theory.
Evaluation on the urban green space layout in the central city of Yuxi based on big data
Authors: Zhou Jing , Yang Maoxiao , Chai Jing , Wu Li
Published: November 2022

As an important part of urban public infrastructure, urban green space plays an indispensable role in urban development and public physical, mental, and emotional health. By collecting open data such as POI, OSM, and ASTER GDEM and using spatial analysis software such as ARCGIS, QGIS, and Global Mapper, this study conducted thermal analysis of crowd activities, service pressure analysis, and demand evaluation for the layout of park green space in the central urban area of Yuxi City. The results show that there are great differences in the area and spatial layout of the thermal classes of crowd activity. Class II occupies the largest area, accounting for 60.73%, while class V occupies the least area, accounting for 2.04%. The thermal classes of crowd activity decrease from the center of the city to the periphery, and their area increases with the decrease of the thermal classes. With the increase in the level of green space service pressure, the proportion of the area decreased, among which the proportion of grade I was as high as 53.20%, while that of grade V was only 1.89%, which was mainly affected by the spatial location. The demand level and the area of park green space are obviously different, mainly concentrated in the first level, accounting for 69.68% of the total demand, and the large area is scattered in the periphery of the central urban area, followed by the fourth level, accounting for 10.46%. The area of other levels, especially the high level of demand, is less. Comprehensive analysis shows that the service level, type of green space, service pressure, and demand of green space have a strong correlation with the geographical location. In future planning, Yuxi City should combine the population distribution density and land development intensity and carry out reasonable layout and planning of park green space by reducing the low-demand area, increasing the green space area of high-demand area, improving public transportation, and improving accessibility.
Case Report: A novel KNCH2 variant-induced fetal heart block and the advantages of fetal genomic sequencing in prenatal long-term dexamethasone exposure
Authors: Huang Huiping , Jing Siyuan , Wu Shaoying , Wei Li , Zhang Qian , Hua Yimin , Li Yifei , Yu Haiyan , Zhou Kaiyu
Published: November 2022

Background: Fetal bradycardia is a common but severe condition. In addition to autoimmune-mediated fetal heart block, several types of channelopathies induce high-degree atrioventricular block (AVB). Long QT syndrome (LQTS) is a major cause of non-autoimmune-mediated fetal heart block. Due to the limitations of prenatal diagnostic technologies, LQTS is seldom identified unless fetal genetic screening is performed. Thus, long-term prenatal dexamethasone (DEX) exposure can become a challenge for these patients. We report on a rare case of a novel KCNH2 variant related to LQTS and associated with high-degree fetal AVB with long-term DEX exposure. This case led us to review our prenatal administration strategy for such patients.

Case Presentation: A fetus was identified with high-degree AVB (2:1 transduction at 28 + 2 gestational weeks). Typical tests of immune function in the pregnant woman were conducted including tests for thyroid function, rheumatic screening, autoimmune antibodies (such as anti-Ro/SSA and anti-La/SSB), and anti-nuclear antibodies (anti-ANA). Following the recommended protocol, the pregnant patient received DEX (0.75 mg/day) during pregnancy. Subsequently, the fetal AVB changed from 2:1 to prolonged AV intervals with ventricular tachycardia, which suggested a therapeutic benefit of DEX in some respects. However, a high-degree AVB with a significantly prolonged QTc interval was identified in the neonate following birth. Genetic testing revealed that a KCNH2 c.1868C>A variant induced LQTS. The body length remained approximately -3.2 SD from the reference value after prenatal long-term DEX exposure, which indicated a developmental restriction. Additionally, the functional validation experiments were performed to demonstrate the prolonged duration of calcium transit both in depolarization and repolarization with the KCNH2 c.1868C>A variant.

Conclusion: Genetic screening should be recommended in fetuses with autoimmune antibody negative high-degree AVB, especially for 2:1 transduction AVB and in fetuses with changes in fetal heart rhythm following initial DEX treatment. Genetic screening may help identify genetic variant–related channelopathies and avoid unexpected prenatal exposure of DEX and its possible long-term adverse postnatal complications.