bluuebunny/crossref_metadata_2025 huggingface dataset:
A Case Report of Acute Food Protein-Induced Enterocolitis Syndrome to Walnut
Authors: Zhu Wen Zheng , Perkins Siobhan
Published: February 2023

Background:
Food protein-induced enterocolitis syndrome (FPIES) is a delayed, non-IgE-mediated food allergy. This syndrome was once thought to be rare, but emerging literature suggest an increasing incidence along with more foods being implicated. Also, with the introduction of guidelines on early peanut introduction, peanut-induced FPIES seems to be increasing in Australia and USA. Although most patients are diagnosed with FPIES within the first year of life, most commonly with food trigger to cow’s milk or soy, other phenotypes exist in comparison to this classic presentation. In this case report, we present a patient with late onset of acute FPIES at age 3 to walnut.
Case Presentation:
We describe a case of FPIES in a 12-year old boy who had recurrent episodes of repetitive emesis that began from age 3 each time after consuming walnuts. He also described possible reactions with pine nuts and macadamia. He was assessed with an oral food challenge to walnut, which triggered an episode of acute FPIES. He developed vomiting with onset 2 hours post ingestion, pallor, lethargy, and required an emergency department visit for anti-emetic medications and oral rehydration therapy. He improved on the therapy and now avoids walnuts, pecans, pine nuts, and macadamia nuts.
Conclusions:
This case report adds to limited literature that exist on culprit food allergens in FPIES. We present a previously unreported food trigger for FPIES - walnuts. The diagnosis, common food triggers, and natural history of FPIES are described. There remains a lack of information on the natural history of FPIES, especially towards uncommon food triggers and on FPIES that present beyond infancy.
Women’s and midwives’ views on the optimum process for informed consent for research in a feasibility study involving an intrapartum intervention: a qualitative study
Authors: Alvarez Mary , Hotton Emily J , Harding Sam , Ives Jonathan , Crofts Joanna F , Wade Julia
Published: February 2023

Background
Recruitment to intrapartum research is complex. Women are expected to understand unfamiliar terminology and assess potential harm versus benefit to their baby and themselves, often when an urgent intervention is required. Time pressures of intrapartum interventions are a major challenge for recruitment discussions taking place during labour, with research midwives expected to present, discuss, and answer questions whilst maintaining equipoise. However, little is known about these interactions. An integrated qualitative study (IQS) was used to investigate information provision for women invited to participate in the ASSIST II feasibility study investigating the Odon Device - a novel device for use in assisted vaginal birth with an aim to generate a framework of good practice for information provision.
Methods
Transcripts of in-depth interviews with women participants (n=25), with recruiting midwives (n=6) and recruitment discussions between midwives and women (n=21), accepting or declining participation, were coded and interpreted using thematic analysis and content analysis to investigate what was helpful to women and what could be improved.
Results
Recruiting women to intrapartum research is complicated by factors that impact on women’s understanding and decision making. Three key themes were derived from the data: i) a woman centred recruitment process, ii) optimising the recruitment discussion and iii) making a decision for two.
Conclusion
Despite evidence from the literature that women would like information provision and the research discussion to take place in the antenatal period, intrapartum studies still vary in the recruitment processes they offer women. Particularly concerning is that some women are given information for the first time whilst in labour, when they are known to feel particularly vulnerable, and contextual factors may influence decision making, therefore we propose a framework for good practice for information provision for research involving interventions initiated in the intra-partum period as a woman centred, and acceptable model of recruitment, which addresses the concerns of women and midwives and facilitates fair inclusion into intrapartum trials.
Trial registration
ISRCTN This qualitative research was undertaken as part of the ASSIST II Trial (trial registration number: ISRCTN38829082. Prospectively registered 26/06/2019).
A Novel Atom Pair Attention Methodology for Molecular
Representation Learning
Authors: Sun Haotong , Jiang Yinghui , Wang Minhao , Xiao Xianglu , Wan Xinchen , Tang Miru , Jin Xurui , Niu Zhangming , Chen Hongming
Published: February 2023

Rapid and accurate prediction of molecular properties is a fundamental task in drug discovery. In recent years, deep learning-based molecular property prediction methods have received much attention and recent successes have shown that learning the representations of molecular structures by applying graph neural networks (GNNs) can achieve better prediction results. However, most previous approaches typically focus on learning atomic embedding, while in this paper, we propose a novel attention method based on atom pair embedding, and it was applied to two types of prediction task. Firstly, learning of atom pair embedding was done on 2D molecular graphs for predicting a series of ligand properties and secondly, the atom pair embedding was learned on ligand/protein 3D complex structures together with axial attention network to predict protein-ligand interaction. In MolecularNet benchmark datasets, our method achieved better performance than previous state-of-the-art models in ten property prediction tasks and in the task for protein-ligand interaction prediction, our method also obtained superior results on the PDB2016 dataset than a collection of reference models. Our source code will be publicly available upon the acceptance of the manuscript.
Biomarkers in neurodegeneration: A beginner’s guide into curated analyses using publicly available datasets
Authors: Moreira Diana Gomes , Jan Asad
Published: February 2023

The availability of bioassays for the discovery of surrogate biomarkers reflecting neuronal dysfunction in neurodegenerative diseases (NDDs) remains a significant challenge. With the advent of the next generation omics technologies and refinements in analytical algorithms, a substantial number of annotated datasets have recently been made available in the public domain. However, without sufficient background in programming or statistical analyses, many researchers find it a daunting task to parse such datasets and translate these data into impactful paradigms. It is also likely that several researchers, especially younger researchers, are not sufficiently aware of these resources. The purpose of this brief Method/Resource article is to demonstrate the utility of publicly available datasets for probing disease relevance of candidate markers in neurodegeneration. As a starting point, we introduce the readers to several open-access resources which contain genomics and proteomics datasets from human studies in common NDDs. Then, using a step-by-step approach- as well as without adopting any a priori hypothetical bias-, we present findings from curated gene expression analyses probing glutathione biogenesis, calcium signaling and autophagy related gene expression across select brain regions of four cohorts of PD patients (and from one study in common NDDs). This is accompanied by summary of reports on the detection of select markers in the cerebrospinal fluid (CSF). Lastly, we enclose a compilation of several annotated microarray studies and additional curated CSF protemics data in common NDDs, which the readers can utilize for translational purposes. We anticipate that this “beginner’s guide” will be of great benefit to the research community in neurodegenerative diseases, and can serve as a useful educational tool.
Tilt Angle Filter Effect on Noise Cancelation and Structural Edges Detection in hydrocarbon Sources in a Gravitational Potential Field
Authors: Hosseini Seyed Aliakbar , Khah Nasser Keshavarz Faraj , Kianoush Pooria , Arjmand Yaser , Ebrahimabadi Arash , Jamshidi Emad
Published: February 2023

Noise cancelation is the process done to remove out-of-range anomalies and make better edge boundaries interpretation. One of the most challenging issues in describing gravitational maps is separating the anomalies related to shallow sources from the deep ones. Furthermore, Existing noises can make it arduous to separate shallow blurred boundaries. In this study in SE Iran, gravitational surveying was carried out in shallow areas from the west of Qeshm to the Hormuz islands in a regular network with a distance of one kilometer. The range of gravitational Bouguer was -297 to -330 mGal. Modeling and determining geometrical parameters revealed five negative anomalies from salt penetration. The residual gravity was computed by deducting gravitational effects related to deep sources from measured gravitational data. The hyperbolic tangent function was preferred by comparing the results and employing the tilt angle filter on different gravitational field maps using numerical coding. Correspondingly, estimating the boundary and edge of the subsurface masses will be better than local filters, and anomalies will be highlighted with more intensity. Furthermore, three major fault systems in the Zagros basin were determined as the primary origin of activity and expansion of Hormuz salt. Sensitivity analysis was employed utilizing analytical signals and maps of tilt angle filtering, which both revealed the same satisfying results of -297 to -330 mGal. In this article, the effect of the tilt angle local phase filter on a synthetic model was accomplished through numerical coding. Then the results were analyzed on the gravity data.
Comparative Outcomes of different interventions in ARDS: A systematic review and network meta-analysis
Authors: Xu Zhiyuan , Liu Haonan , Zhou Shuaishuai , Zhang Ruiqi , Meng Chao , Li Shengli , Liu Xiao , Yan Xianliang
Published: February 2023

OBJECTIVES: Acute respiratory distress syndrome (ARDS) is linked to high rates of morbidity and mortality. Evidence examining commonly used corticosteroids, neuromuscular blocking agents (NMBAs) and inhaled nitric oxide (iNO) remains uncertain. The aim of the study was to compare and rank these three treatments to identify the best one.
DATA SOURCES: We searched Pubmed, Embase, Cochrane Library, and Web of Science from the earliest records to May 1, 2022 for clinic trials.
STUDY SELECTIONT AND DATA EXTRACTION: Clinical trials of three interventions compared with control group for ARDS, no language restricted. Data were extracted by 2 independent reviewers. Frequentist network meta-analyses (NMA) were performed to identify the best intervention and treatments were ranked using the surface under the cumulative ranking (SUCRA) curve. Primary outcome was 28-day mortality. Secondary outcomes varied ventilator-free days at 28 days, ICU mortality, In-hospital mortality and new infection events.
DATA SYNTHESIS: Data were combined from 26 clinical trials which included 5071 patients. Vecuronium bromide was the best strategy to reduce 28-day mortality compared with the conventional treatment, iNO, methylprednisolone and placebo (OR 0.38, 95% CI 0.15-1.00 and OR 0.30, 95% CI 0.10-0.85 and OR 0.25, 95% CI 0.08-0.74 and OR 0.23, 95% CI 0.08-0.65; SUCRA: 96.6%). Dexamethasone was the best treatment option for increasing ventilator-free days at 28 days compared to conventional therapy and cisatracurium (MD 3.60, 95% CI 1.77-5.43 and MD 3.40, 95% CI 0.87-5.92; SUCRA: 93.2%). Methylprednisolone was the most effective treatment option to prevent ICU mortality (SUCRA: 88.5%). Though dexamethasone, cisatracurium, conventional therapy, methylprednisolone and iNO treatment showed no significant superiority of in-hospital mortality protection over placebo, suggesting that it had the highest probability of being the best treatment option (SUCRA: 79.7%) for reducing in-hospital mortality. Dexamethasone treatment showed the highest safety for decreasing the incidence of new infection events compared with placebo and iNO (OR 0.61, 95% CI 0.42-0.88 and OR 0.33, 95% CI 0.19-0.58; SUCRA: 91.8%).
Conclusions: This NMA suggested that corticosteroids are possibly beneficial in the patients with ARDS while application of NMBAs may reduce 28-day mortality, iNO as a therapeutic measure which did not show a prominent beneficial effect.
Study registration:PROSPERO, CRD42022333165
Core protocol development for phase 2/3 clinical trials in the leukodystrophy Vanishing White Matter
Authors: Schoenmakers Daphne H. , Leferink Prisca S. , Vanderver Adeline , Bonkowsky Joshua L. , Krägeloh-Mann Ingeborg , Bernard Geneviève , Bertini Enrico , Fatemi Ali , Fogel Brent L. , Wolf Nicole I. , Skwirut Donna , Buck Allyson , Holberg Brett , Saunier-Vivar Elise F. , Rauner Robert , Dekker Hanka , Bokhoven Pieter , Stellingwerff Menno D. , Berkhof Johannes , Knaap Marjo S.
Published: February 2023

Background: The leukodystrophy “Vanishing White Matter” (VWM) is an orphan disease with neurological decline and high mortality. Currently, VWM has no approved treatments, but advances in understanding pathophysiology have led to identification of promising therapies. Several investigational medicinal products are either in or about to enter clinical trial phase. Clinical trials in VWM pose serious challenges, as VWM has an episodic disease course; disease phenotype is highly heterogeneous and predictable only for early onset; and study power is limited by the small patient numbers. To address these challenges and accelerate therapy delivery, the VWM Consortium, a group of academic clinicians with expertise in VWM, decided to develop a core protocol to function as a template for trials, to improve trial design and facilitate sharing of control data, while permitting flexibility regarding other trial details. Overall aims of the core protocol are to collect safety, tolerability, and efficacy data for treatment assessment and marketing authorization.
Methods: To develop the core protocol, the VWM Consortium designated a committee, including clinician members of the VWM consortium, family and patient group advocates, and experts in statistics, clinical trial design and alliancing with industries. We drafted three age-specific protocols, to stratify into more homogeneous patient groups, of ages ≥18 years, ≥6 to <18 years and <6 years. We chose double‐blind, randomized, placebo-controlled design for patients aged ≥6 years; and open-label non-randomized natural-history-controlled design for patients <6 years. The protocol describes study populations, age-specific endpoints, inclusion and exclusion criteria, study schedules, sample size determinations, and statistical considerations.
Discussion: The core protocol provides a shared uniformity across trials, enables a pool of shared controls, and reduces the total number of patients necessary per trial, limiting the number of patients on placebo. All VWM clinical trials are suggested to adhere to the core protocol. Other trial components such as choice of primary outcome, pharmacokinetics, pharmacodynamics, and biomarkers are flexible and unconstrained by the core protocol. Each sponsor is responsible for their trial execution, while the control data are handled by a shared research organization. This core protocol benefits the efficiency of parallel and consecutive trials in VWM, and we hope accelerates time to availability of treatments for VWM.
Trial registration: NA
Case report: Traumatic carotid and vertebral arteries Pseudoaneurysm associated with vertebral arteriovenous fistula
Authors: Zhou Yusen , Zhang Shuai , Hu Lijun , Yin Jiangliu
Published: February 2023

Background

Penetrating injury to the neck may cause damage to the carotid or vertebral artery. However, Pseudoaneurysm (PSA) of the carotid and vertebral artery associated with vertebral arteriovenous fistula (AVF) caused by trauma is extremely rare. In order to avoid serious neurological complications, prompt treatment is indispensable. To our knowledge, there has never been a similar report before.

Case presentation

We report the case of a 37-year-old man who was admitted to the hospital with an hour history of consciousness disorder due to criminal cervical and pectoral stab wounds. Based on clinical symptoms and imaging examination, this patient was diagnosed as carotid and vertebral artery PSA associated with vertebral AVF. With the combination of endovascular and surgical treatment, the patient had no occurrence of neurological complications over one year of follow-up.

Conclusion

In patients with neck severe injury, the possibility of carotid and vertebral artery injuries must be considered, even in the absence of manifestations. For PSA of the carotid and vertebral arteries associated with vertebral AVF, treatment is necessary, digital subtraction angiography is the gold standard diagnostic tool.
Impact of Lumpy Skin Disease in India: Socio-behavioural Analysis, Epidemiology and Economics
Authors: Singh Amandeep , Kour Gurpreet , Dhillon Sehajpal Singh , Brar Parkash Singh
Published: February 2023

The outbreak of animal diseases has both explicit and implicit economic repercussions. In the present study, a simple mathematical model has been developed to estimate the economic impact of Lumpy Skin Disease (LSD) in India along with socio-behavioral factors and epidemiological metrics. The econometrics is based on all the direct and indirect losses and expenditures incurred during the entire course of disease in a dairy farm specifically considering production losses, reproduction losses, treatment costs, preventive costs and other costs. Primary data were collected from 100 dairy farms located in Indian state of Punjab in which LSD outbreak occurred. Based on the results, the economic impact of the disease was extrapolated for the total bovines effected due to the disease in the LSD outbreak occurred in India from July, 2022 to October, 2022. Results revealed 45.25 percent morbidity in cattle, 0.19 percent in buffaloes and 27.04 in pooled sample of bovines with 12.40 percent mortality in cattle. A net economic loss of INR 1135.26 crores (USD 137.26 million) in Punjab and INR 18337.76 crores (USD 2217.26 million) in India was estimated due to LSD outbreak in bovines. The modelling approach along with socio-behavioural analysis and epidemiology provided an evidence of coherence among the prevailing factors and aided to estimate economic impact precisely.
Stochastic analysis of a bistable piezoelectric energy harvester with a matched electrical load
Authors: Bonnin Michele , Song Kailing , Traversa Fabio Lorenzo , Bonani Fabrizio
Published: February 2023

We present the analysis of a bistable piezoelectric energy harvester with matched electrical load, subject to random mechanical vibrations. The matching network optimizes the average energy transfer to the electrical load. The system is described by a set of nonlinear stochastic differential equations. A perturbation method is used to find an approximate solution of the stochastic system in the weak noise limit, and this solution is used to optimize the circuit parameters of the matching network. In the strong noise limit, the state equations are integrated numerically to determine the average power absorbed by the load and the power efficiency. Our analysis shows that the application of a properly designed matching network improves the performances by a significant amount, as the power delivered to the load improves of a factor about 9 with respect to a direct connection.
Bioinformatics identification of potential protein glycosylation genes associated with glioma stem cell signature
Authors: Kazuya Tokumura , Sadamori Koki , Yoshimoto Makoto , Lyu Jiajun , Tanaka Yuki , Fukasawa Kazuya , Hinoi Eiichi
Published: February 2023

Glioma stem cells (GSCs) contribute to the pathogenesis of glioblastoma (GBM), which is the most malignant form of glioma. The implications and underlying mechanisms of protein glycosylation in GSC phenotypes and GBM malignancy are not fully understood. In this study, we aimed to investigate the implication of protein glycosylation and the corresponding candidate genes on the stem cell properties of GSCs and poor clinical outcomes in GBM, using single-cell RNA sequencing and bulk RNA sequencing datasets of clinical GBM specimens deposited in the Gene Expression Omnibus database, in addition to The Cancer Genome Atlas and the Chinese Glioma Genome Atlas databases of patients with glioma. We demonstrated that N-linked glycosylation was significantly associated with GSC properties and the prognosis of GBM by conducting integrated bioinformatics analyses of clinical specimens. N-linked glycosylation was associated with the glioma grade, molecular biomarkers, and molecular subtypes. The expression levels of the asparagine-linked glycosylation (ALG) enzyme family, which is essential for the early steps in the biosynthesis of N-glycans, were prominently associated with GSC properties and poor survival in patients with GBM with high stem-cell properties. Finally, the oxidative phosphorylation (OXPHOS) pathway was primarily enriched in GSCs with a high expression of the ALG enzyme family. Collectively, these findings uncover a pivotal role for N-linked glycosylation in the regulation of GSC phenotypes and GBM malignancy through, possibly in part, the ALG-OXPHOS axis, thereby revealing a potential target for GSC-directed therapy.
Similarities and differences in general practices with and without nurse practitioners: multiple case study design
Authors: Schlunegger Margarithe Charlotte , Palm Rebecca , Zumstein-Shaha Maya
Published: February 2023

Background: New care models are needed for the increasing elderly, chronically ill, and multimorbid population, especially in primary healthcare. Rural regions are particularly affected where bottlenecks in supply provisions and a shortage of health professionals are emerging. To address these challenges, nurse practitioners (NPs) have been introduced in Swiss general practices to improve primary healthcare of chronically ill people. We aimed to explore Swiss primary healthcare delivery for chronically ill people in general practices with and without NPs and identify similarities and differences in these general practices.
Methods: We conducted a multiple case study design with interviews, observations, questionnaires, and patient records. The EQUATOR reporting standards for organisational case studies were used. We described the similarities and differences by drawing on Wagner’s Chronic Care Model and applied deductive thematic analysis. We included five general practices located in rural areas in Switzerland. A total of 34 patients and 26 health professionals were included. Each general practice team consisted of general practitioners (GPs), medical practice coordinators (MPCs), medical practice assistants (MPAs), and a NP (in two general practices).
Results: Similarities in all five general practices included the presence of specific framework conditions such as the shortage of health professionals or the lack of billing options. By law, the final decisional responsibility lays with the GPs. GPs had trust in the general practice teams. Patients wanted to be perceived as a whole person. Differences included that NPs filled gaps in interfaces with the local community and regarding complex, unstable patient situations. Teams with NPs found themselves in a larger process of change.
Conclusions: NPs, MPCs, MPAs, and GPs in Swiss general practices make major contributions to the care of chronically ill patients in local communities. NPs provide additional care to patients at home and in general practices that was previously unavailable; however, adaptation of existing general practice structures to the new healthcare delivery model needs to be explored. The identified similarities and differences can help general practices to conceptualize new roles of health care professionals with different educational backgrounds and restructure the workflow, especially in countries where new roles are emerging.
Usefulness of the Xerostomia Inventory and Oral Health Impact Profile-14 questionnaires to assess patient-reported outcomes associated with xerostomia in polymedicated patients
Authors: Ramirez Lucia , Sánchez Isabel , González-Serrano José , Muñoz Marta , Martínez–Acitores María Luisa , Garrido Estela , Hernández Gonzalo , Muñoz Rosa María López-Pintor
Published: February 2023

Objective:The aim of this study was to investigate the association and correlation between patient-reported outcomes associated with xerostomia and salivary flow in polymedicated patients.Subjects and Methods:A cross-sectional study was conducted. Unstimulated (UWS) and stimulated (SWS) salivary flows were collected. Xerostomia was assessed by a question and the use of Xerostomia Inventory (XI). Oral Health-related quality of life was assessed using the Oral Health Impact Profile-14 (OHIP-14).Results:218 patients were included. 51.8% suffered from xerostomia and 38.1% and 27.5% suffered from UWS and SWS hyposalivation, respectively. Patients with xerostomia, UWS and SWS hyposalivation scored significantly higher on the XI questionnaire than patients without these disorders. However, only patients with xerostomia and UWS hyposalivation were observed to score significantly higher on the OHIP-14 than patients without these alterations. A significant positive correlation was observed between XI and OHIP-14. Significant negative correlations were observed between XI and UWS, and XI and SWS. OHIP-14 was negatively correlated with both salivary flows, but this correlation was only significant between OHIP-14 and UWS flow.Conclusions:Questionnaire XI scores are higher in patients with xerostomia and reduced UWS and SWS flows. However, OHIP-14 is increased in patients with xerostomia and reduced UWS flow. Clinical Relevance: The XI reflects changes in xerostomia and salivary flow so it could be a good questionnaire to assess drug-associated xerostomia in future research studies. However, the OHIP-14 reflects changes in xerostomia level and UWS flow but is not as reliable for assessing changes in SWS flow.Clinical Relevance:The XI reflects changes in xerostomia and salivary flow so it could be a good questionnaire to assess drug-associated xerostomia in future research studies. However, the OHIP-14 reflects changes in xerostomia level and UWS flow but is not as reliable for assessing changes in SWS flow.Trial Registration:None
Line-Bound Vectors, Plane-Bound Bivectors, and Heron's Formula for Tetrahedra
Authors: Havel Timothy
Published: February 2023

The representation of some elementary geometric concepts in the conformal geometric algebra of three dimensions are reviewed, and their connections to a recently discovered extension of Heron's formula for the area of a triangle to the volume of a tetrahedron are discussed.
Mathematics Subject Classification (2010). Primary 51M04; Secondary 11E88, 15A67, 51M25, 51M30, 52A38, 52B10.
Prevalence of intestinal parasitoses in canines within a vulnerable area of Ensenada, Buenos Aires province, Argentina
Authors: Gamboa María Inés , Butti Marcos J. , Corbalán Valeria V. , Osen Beatriz A. , Paladini Antonela , Lagala Fiamma , Bonzo Estela , Radman Nilda
Published: February 2023

The potential role of dogs as reservoirs of zoonotic infections is one of the major public health problems. Water emergency areas are generally vulnerable zones with a lack of care from the owners who do not have the basic sanitary service conditions. Canines often feed on waste detecting coprophagia of human faeces facilitated by the final disposal of excreta in open-air defecation. The objective of this research was to determine the presence of intestinal parasitoses in canines from a sanitary risk area inhabited by a vulnerable human population. Dog faeces were collected by an enema with a soapy solution and processed by the Telemann’s sedimentation technique as well as the Sheather’s ﬂotation procedure besides a direct examination. A number of 703 (79.3%) analyzed canine faeces were parasitized from a total of 886. Ancylostoma caninum (57%), Toxocara canis (24%) and Uncinaria stenocephala (21%) were the most frequent species. The specific richness in the canine population was 17 species. The highest parasitosis frequency was observed among male canines and those under one-year aged for the total parasitized ones with T. canis, Cistoisospora canis, C. ohioensis, and Giardia spp. High prevalences found in canines from the present study could indicate that both diagnosis and treatment are not enough to achieve sustainable changes in vulnerable areas. Actions addressed to the environmental factor are essentials in order to avoid reinfections.
Exercise and prediabetes after renal transplantation: - The EXPRED-I study
Authors: Febles Raúl Morales , Miranda Domingo Marrero , Sosa Alejandro Jiménez , Rinne Ana González , Perera Coriolano Cruz , Rodríguez Ana Elena Pérez , González Alejandra Álvarez , Martín Laura Díaz , Mena Natalia Negrín , Sørensen Cristian Acosta , Tamajón Lourdes Pérez , Hernández Aurelio Rodríguez , Rinne Federico González , González Aday Dorta , Pérez Eusebio Ledesma , Delgado Alejandra González , Rodríguez Alberto Domínguez , Baute Maria Del Carmen García , Ramírez Armando Torres , Porrini Esteban
Published: February 2023

Background
Post-transplant diabetes mellitus (PTDM) beyond 12 months (late PTDM) is a severe complication after renal transplantation. Late PTDM develops mostly in subjects with prediabetes. Although exercise may have a potential role in preventing late PTDM, there is no previous data on the effect of exercise in patients with prediabetes.
Material and methods
we designed a 12-month exploratory study to test the capacity of exercise in reverting prediabetes in order to prevent late-PTDM. The outcome was the reversibility of prediabetes, assessed every 3 months with an oral glucose tolerance test (OGTT). The protocol included an incremental plan of aerobic and/or strength training as well as an active plan for promoting adherence (telephone calls, digital technology, and visits).
Results
the study included 27 prediabetic patients and was early interrupted due to efficacy. At the end of follow-up, 16 (60%) patients reverted to normal glucose levels at fasting and at 120 min after the OGTTs, two time higher than the 25–30% reversibility rate shown in a previous publication, p value < 0.05. 11 subjects (40%) had persistent prediabetes. Most patients needed at least one increment of exercise prescription and extra measures to achieve compliance. Compliance measures improved the adherence to the protocol in 22 patients.
Conclusions
exercise training is effective to improve glucose metabolism in renal transplant patients with prediabetes. Exercise prescription must be conducted considering both the clinical characteristics of the patients and pre-defined strategy to promote adherence. The trial registration number of the study was NCT04489043.
Magnitude and Factors Associated with Depressive Symptoms among Post-Partum Mothers Visiting Rural health center in Ethiopia, A Cross Sectional Study
Authors: Mesfin Abigael Abiy , Yimer Abdurahman , Begashaw Abraham , Nigusu Amir , Assefa Amanuel , Zewde Amesiyas , Mesfin Samuel , Genetu Abraham
Published: February 2023

Background
Due to their propensity for pregnancy, childrearing, and caring for others, women are twice more likely than males to develop depression during their lifetime. Social stresses like poverty, intimate partner abuse, a history of miscarriage, and unwanted pregnancy are risk factors for postpartum depression, and these factors have a negative impact on maternal health. The mother and her children may suffer long-term negative effects if postpartum depression is left untreated. This research aims to address the gap in studies in Oromia region and contribute to building strong and a more representative evidence for postpartum depression in Ethiopia.
Methods
The study is a health facility-based cross-sectional study, among postnatal mothers visiting Batu health center. Descriptive and analytical cross-sectional study design was used among postnatal women who have given birth within the past 12 months. The Edinburgh postpartum depression scale was used to assess postpartum depression. Social support was assessed using the maternal social support scale. Chi-square test analysis was used to determine the association of post-partum depressive symptoms with socio-demographic, obstetric and psychosocial factors.
Results
Based on the cut-off points of Edinburgh Postnatal Depression Scale (≥11), 24.6 percent of the total respondents had post-partum depression whereas 75.4 percent did not have depressive symptoms. Among the mothers who had postpartum depression, majority (85.4%) had not even heard about the disease before. Among those mothers who had postpartum depression, 25% had low social support. Significant association was found between abortion history, unplanned pregnancy, history of mental illness, family history of mental illness, social support and PPD.
Conclusions
Despite the high magnitude of postpartum depression, measures to help depressed mothers are not brought to action. This highlights the need to advocate for postpartum depression services. Although the mothers with postpartum depression have made it to the health center, our study showed that they go back unnoticed. Postpartum depression screening is a simple but profound step that can be implemented. Moreover, antenatal care visits can be used as an opportunity to give health education on postpartum depression.
Satisfaction rates and preferences of men using testosterone replacement therapy.
Authors: Miller Jake , Loeb Charles , Miller Jake , Schneider Douglas , Grimaud Logan , Hammad Muhammed Moukhtar , Yafi Faysal
Published: February 2023

Despite a well-documented increase in both the prevalence of Testosterone Deficiency (TD) and prescription of testosterone replacement therapy (TRT), few studies have investigated the preferences of patients receiving TRT and factors associated with increased treatment satisfaction. To the preferences of patients receiving TRT and factors associated with improved treatment satisfaction, a survey was completed by 140 men receiving TRT at a single institution. Survey questions investigated demographics, symptom burden of TD, TRT regimen, treatment preferences, and treatment satisfaction. 62.7% of patients were satisfied with their current TRT regimen. Those using auto-injectors (91.7%, odds ration [OR] = 9.3), subcutaneous pellets (90.0%, OR = 15.2), and intramuscular injections (67.5%, OR = 5.7), were with significantly increased satisfaction rates (p < 0.05). The majority of patients indicated that they would prefer to receive TRT injections when self-administered or administered at home. While patients noted that treatment efficacy was a significant driving factor when evaluating a TRT regimen, few patients felt that cost was the most significant factor.
Management of severe cerebral venous sinus thrombosis after post-vaccination breakthrough COVID-19 infection: a case report and review of the literature
Authors: Giammello Fabrizio , Grillo Francesco , Tessitore Agostino , Gardin Anna , Iatì Domenico , Caragliano Antonio Armando , Velo Mariano , Buonomo Orazio , Ferraù Ludovica , Toscano Antonio , Spina Paolino La , Vinci Sergio Lucio
Published: February 2023

Introduction: Neurological manifestations related to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection may involve both peripheral and central nervous system, including acute ischemic stroke and cerebral venous sinus thrombosis (CVST).
Case Presentation: Hereby, we present an adult patient with post-vaccination breakthrough COVID-19 infection and CVST, treated with venous mechanical thrombectomy (MT). The patient manifested continuous tonic-clonic seizures, after an insidious presentation with headache and left-sided weakness. SARS-CoV-2 testing was positive, despite fully vaccination, using two approved mRNA platforms. Factor V Leiden polymorphism was detected. The patient was initially managed with anticoagulation, followed by MT with a positive response. We provided a comparison to similar cases of COVID-19 associated CVST undergoing mechanical thrombectomy.
Conclusions: High index of suspicion and prompt diagnosis are extremely important to ensure immediate hospitalization and therapy, since CVST associated with either vaccines or COVID-19 seems to evolve rapidly and with a high mortality rate. Even a breakthrough infection may present severe vascular complications. In addition, evaluation of acquired and hereditary thrombophilia may be beneficial in acute phase, also without a previous history of thrombosis. Clinicians should start early medical treatment, and additionally consider the endovascular approach as an optimistic choice in refractory CVST related to SARS-CoV-2 infection.
Impact of physical activity as an adjuvant treatment in the healing of venous ulcers in Primary Care. RCT protocol study. "Active Legs".
Authors: Herraiz-Ahijado Borja , Folguera-Álvarez Carmen , Soriano José Verdú , Vara Pilar Mori , Rico-Blázquez Milagros
Published: February 2023

Background: Venous ulcers usually present a torpid evolution with a negative impact on patients' quality of life. In primary care, they account for 2.5% of nursing consultations and their treatment represents high costs for national health systems. These patients usually have a low level of physical activity, with muscle pump dysfunction of the lower limbs, which may improve with increased physical activity. The purpose of this study is to analyse the effectiveness of a structured intervention involving physical activity and exercise (Active Legs) as an adjuvant treatment in improving healing of chronic venous ulcers at 3 months follow-up.
Methods:A randomized, multicentre clinical trial. A total of 224 individuals receiving primary nursing care with a diagnosis of venous ulcer, with a diameter of 1 cm or greater and an ankle-brachial index between 0.8 and 1.3, able to comply with the study requirements and consenting to participate, will be sequentially included (112 per group).
Both groups will receive the standard treatment in primary care, with cleansing, debridement and healing in a moist environment together with multilayer compression therapy. The intervention group will also receive a structured educational intervention involving lower limb physical exercise and daily ambulation guidelines.
The primary response variables will be complete healing –understood as complete and sustained epithelialisation for at least 2 weeks– and time to healing. The secondary variables will be degree of healing, ulcer area, quality of life, pain and variables related to the healing process, prognosis, and recurrences. Sociodemographic variables, adherence to treatment and satisfaction variables will also be recorded. Data will be collected at baseline, at 3 months and at 6 months follow-up. Survival analysis (Kaplan-Meier and Cox) will be performed to measure primary effectiveness. Intention-to-treat analysis.
Discussion: If the intervention is effective, a cost-effectiveness analysis could be conducted and implemented as an additional intervention in the usual venous ulcer treatment in primary care.
Trial registration: NCT04039789. [https://ClinicalTrials.gov]. 07/11/2019.
Should adjustable gastric band be abandoned as a bariatric surgery option? Private center’s experience with adjustable gastric band conversion.
Authors: Almayouf Mohammad , Alqahtani Awadh
Published: February 2023

Background:
The literature is lacking experience of revising adjustable gastric band at private centers in Saudi Arabia.
Methods:
A retrospective review at a private hospital was conducted. Primary endpoints were weight loss after 1 year, operative time, and complications. Conversion patients were matched with similar patient subjected to primary BS in a 1:2 ratio.
Results:
Twenty six patients were managed in a single stage conversion of AGB to laparoscopic sleeve gastrectomy (LSG). One third of the patients had weight regain (WR) and band intolerance (BI). Patients converted to LSG had mean preoperative weight and BMI of 104.9 ± 23.7 kg and 39.2 ± 5.8 kg/m2, respectively. One-year percentage of total weight loss (%TWL) and percentage of excess weight loss (%EWL) were 26.1 ± 9.6 and 76.9 ± 29.7, respectively. One patient (3.3%) developed staple-line leak and needed readmission. After 1 year, primary LSG had better weight loss compared to conversional LSG.
Conclusion:
Most patients with AGB end up with conversion mainly due to WR and BI. Conversion of AGB to other BS is safe and effective at private centers in Saudi Arabia. Weight loss after conversional LSG is inferior to primary LSG.
Functioning of local strains of bacteria under heavy metal stress (Uzbekistan)
Authors: Usmonkulovaa Aziza , Kadirova Gulchekhra , Shukurov Nosir
Published: February 2023

Cadmium (Cd) and nickel (Ni) are among the most toxic metals and high levels of Cd and Ni in soil have been observed in several studies to slow down plant growth, mainly biomass, chlorophyll content and photosynthetic properties. Beneficial soil bacteria are promising targets for reducing Cd and Ni toxicity and increasing plant tolerance to heavy metal stress. Different strains of bacteria were isolated from soil contaminated with heavy metals. These isolates were identified at the species level and investigated for their involvement in mitigating the deleterious effects of heavy metal stress. In this study, the minimum inhibitory concentration, biosorption of bacteria with high resistance to heavy metals to Ni(II) and Cd(II), and stimulating properties of plant productivity under conditions of heavy metal stress were studied. Isolates 5, 11, 18 and 10, 16, 11, 8 was determined against high viability to concentrations of Ni (II) and Cd (II) cations. These isolates were identified as Enterobacter cloacae (5), Enterobacter ludwigii (11), Pseudomonas aeruginosa (18), Bacillus licheniformis (10), Bacillus megaterium (16) and Bacillus simplex (8) by morphological-cultural and biochemical identification. Growth and multiplication of Bacillus megaterium (16), B. licheniformis (10) and B.subtilis (13) strains at 1–3 mM concentration of CdEnterobacter ludwigii (11) was the most effective in reducing Cd and Ni, reaching values of 36% and 41%, respectively. Pseudomonas aeruginosa (18) synthesized auxin 4, 4.8, 5.3 times higher amount compared to control and Enterobacter ludwigii (11), Bacillus licheniformis (10), Bacillus simplex (8) synthesized auxin in equal amount compared to the control at different concentrations of Cd cation (2.4, 4.1, 8.2 mg/l). Pseudomonas aeruginosa (18) strain produced 78 mg/l EPS at the concentration of 24.6 mg/l Cd cation on the 7th day of cultivation. Using microorganisms tolerant of high concentrations of heavy metals and their activity, bioremediation of ambience contaminated with heavy metals is possible. Their reduction of Ni and Cd cations, increased synthesis of phytohormones and exopolysaccharides under heavy metal stress conditions indicate that these microorganisms are promising objects in the future.
A Rare Case of Coccidioidomycosis of the Thyroid Gland
Authors: Solis-Pazmino Paola , Merchant Natalie , Padilla Osvaldo , Alkhalili Eyas
Published: February 2023

Infection of the thyroid gland with Coccidioides is rare, with fewer than 50 cases reported since 1970. Disseminated infection complicates less than one percent of cases and occurs most often in immunocompromised patients. Since most patients are asymptomatic, they may experience a delay in diagnosis and treatment. aspiration thyroid biopsy proved helpful in establishing the diagnosis of coccidioidomycosis. The ideal management is unclear, but some studies suggest three years of oral azoles after disseminated coccidioidomycosis to other soft tissue organs.
We report a case of disseminated coccidioidomycosis involving the thyroid gland, a sporadic infection. The overall mortality is high due to delayed diagnosis and treatment. The diagnosis is determined by the culture of a - aspirate or/and a biopsy followed by direct microscopy. However, the optimal treatment, duration, and medication dosage remain controversial.
Autophagy-prominent cell clusters among human lens epithelial cells: integrated single-cell RNA-sequencing analysis
Authors: Liu Jiasheng , Zhu Mengchao , Xu Yitong , Zhang Mengdi , Sun Haisen , Wang Yaqi , Yang Qingwen , Li Jin
Published: February 2023

Background:Autophagy is an important process that maintains the quality of intracellular proteins and organelles. There is extensive evidence that autophagy has an important role in the lens. Human lens epithelial cells (HLECs) play a key role in the internal homeostasis of the lens. HLEC subtypes have been identified, but autophagy-prominent cell clusters among HLECs have not been characterized.
Purpose: To explore the existence of autophagy-prominent cell clusters in HLECs.
Methods: Three donated lenses (HLECs from two whole lenses and HLECs from 1 lens without the anterior central 6-mm zone) were used for single-cell RNA sequencing (scRNA-seq). AUCell and AddModuleScore analysis were used to identify potential autophagy-prominent cell clusters. Transmission electron microscopy (TEM) was used to confirm the results.
Results: High-quality transcripts from 18,120 cells were acquired by scRNA-seq of the two intact lenses. Unsupervised clustering classified the cells into four clusters. AUCell and AddModuleScore analysis revealed the presence of autophagy-prominent cell cluster 1. scRNA-seq analysis of HLECs from the lens lacking the central zone revealed minimal expression of C8orf4, a specific marker of cell cluster 1; moreover, these HLECs exhibited less autophagy. TEM further supported the presence of an autophagy-prominent cell cluster and showed that it was located in the central zone of the lens.
Conclusions: We identified an autophagy-prominent cell cluster among HLECs and revealed that it was localized in the central zone of the lens. Our findings will aid investigations of autophagy in HLECs and provide insights to guide related research.