bluuebunny/crossref_metadata_2025 huggingface dataset:
Governance in Lebanese Banks: An Exploratory Research Before the COVID-19 Era
Authors: Hejase Hussin J. , Hejase Ale J. , Nemer Fatima , Fayyad-Kazan Hassan
Published: May 2021

Banks locally and abroad have been subject to several financial crises which led top managers to look critically at their current practices in managing the financial resources in order to avoid losses and to prevent giving a negative image to the community of their customers. Parallel to the aforementioned events, banks have been observing an evolution of the banking investment activities in addition to the transformation of the financial market into an open market system.The different events characterized by higher risks and higher demands for financial services have incited banks to explore and emphasize the importance of governance principles. In this study, the researchers will expose the importance of governance and its main principles in the banking systems. The study will also address the aforementioned pertinent to its implementation according to the activities of Basel Committee on banking supervision. The aim of the study is to assess via a quantitative approach the actual governance practices within a convenient sample of Lebanese banks. The outcomes show that the selected banks abide by the principles of Corporate Governance required by Basel as well as by the Central Bank of Lebanon. Results also address the effect of sound governance on the performance of the Banks in question. Findings will serve to issue recommendations about best practices and to encourage the adoption of sound decisions to adopt Corporate Governance principles.
Reference materials for optic nanosensor systems: reduced glutathione and chloramphenicol
Authors: Yushina A. A. , Alenichev M. K.
Published: May 2021

The research provides enterprise reference material (ERM) development approach for nanosensor system on the basis of dynamic light scattering and fluorescence for qualitative and quantitative determination of nutrition pollutant - chloramphenicol antibiotic (laevomycetin), as well as marker of ischaemic stroke and a number of other diseases - reduced glutathione.

ERM candidate materials were chosen chloramphenicol and reduced glutathione. The attestation procedure based on calculating-experimental approach by preparation procedure was used to determine the certified value of ERM. During the tests there were determined metrological characteristics of reference material. The certified value of ERM for reduced glutathione mass fraction is 98,5 %, the expanded uncertainty of certified value with coverage factor k=2 is ± 0,3 %. The certified value of ERM for chloramphenicol mass concentration is 10,0 g/dm3, the expanded uncertainty of certified value with coverage factor k = 2 is ± 4,0 %.

The implementation of the developed ERMs showed their appropriateness for optic nanosensor systems calibration on the base of dynamic light scattering and fluorescence.

We suppose that the developed enterprise reference materials further may be certified as CRM (certified reference material) and used for verification, calibration and graduation of compact detection devices of the «point of care diagnostics» type under development, which are intended for express analysis on the sampling site directly.
Relationship between Adolescent Students' Motivation in Respect to the Use of Tablets in the Classroom and Sustainable Development Goals 4, 5 and 9
Authors: Mendez David , Mendez Miriam , Anguita Juana María
Published: May 2021

The Sustainable Development Goals (SDGs) 4, 5 and 9 are related to the quality of education, gender equality and the use of new technologies. It is important to bear in mind that a major part of the success of education has to do with students' motivation, which is closely connected to the use of technologies in the classroom. For this reason, a study was carried out with 131 students aged 12 and 13, 58 girls and 73 boys, who use a tablet in their Science classes. The purpose of the study was to determine, based on the Self Determination Theory, the level of intrinsic motivation of those adolescents towards the use of tablets in the classroom. The study measured the interest they have in the tasks and the value they assign to said tasks, as well as their perception of their competence in using tablets. The results reveal that students' motivation is high without significant differences between girls and boys when technological resources are included in teaching-learning processes. This is reflected by the improvement of their academic performance. It is thus possible to state that SDGs 4, 5 and 9 can be achieved.
Safety and Effectiveness of Pharmacologic Conversion of Atrial Fibrillation and Flutter: Results of Multicenter Trial. Part I: Study Rationale, Design and Assessment of Effectiveness
Authors: Mironov N. Yu. , Yuricheva Yu. A. , Vlodzyanovskiy V. V. , Sokolov S. F. , Dzaurova Kh. M. , Golitsyn S. P. , Shubik Yu. V. , Berman M. V. , Medvedev M. M. , Rivin A. E. , Parkhomchuk D. S. , Barybin A. E. , Balandin D. А. , Batalov R. E. , Terekhov D. S. , Evstifeev I. V. , Kildeev I. R. , Pyataeva O. V. , Zenin S. A.
Published: May 2021

Aim.We aimed to assess safety and effectiveness of class III antiarrhythmic drug Refralon for conversion of atrial fibrillation (AFib) and flutter (AFl) in post-registration trial and to compare data of primary center (National medical research center in cardiology) with data of other hospitals.

Material and Methods. We performed retrospective cohort study in 727 patients (451 enrolled in primary center and 276 enrolled in other hospitals) admitted between June 24, 2014 and June 24, 2019. Refralon was administered for conversion of AFib and AFl in intense care units in escalating doses (10-30 mcg/kg) intravenously. Primary endpoints: restoration of sinus rhythm (SR) within 24 hours after the start of infusion of the study drug in a total dose of up to 30 pg / kg; registration of SR on an electrocardiogram (ECG) 24 hours after the start of the study drug infusion. Secondary endpoints: restoration of SR after infusion of the study drug at a dose of 10 pg / kg; restoration of SR after infusion of the studied drug in a total dose of up to 20 pg / kg; no recurrence of AFib/AFl after restoration of AFl within 24 hours of observation after the start of the study drug infusion.

Results.Conversion to SR was achieved in 53,6% (391 of 727) after administration of 10 mcg/kg dose, in 73% (531 of 727) after administration of 20 mcg/kg dose and in 91,6% (666 of 727) after administration in dose up to 30 mcg/kg. SR was restored in 89% (402 of 451) of patients in primary center, and in 96% (264 of 276) of patients in other hospitals; 95% confidence interval (CI): (-0,1;-0,03). SR preserved 24 hours after conversion in 98% (650 of 666) successfully converted patients. In primary center SR preserved in 97% (390 of 402) successfully converted patients. In other hospitals - in 98,5% (260 of 264) successfully converted patients. 95 CI: (-0,09;0,06).

Conclusion:In post-registration multicenter trial Refralon demonstrated high effectiveness in conversion of AFib and AFl to SR. In other hospitals Refralon did not demonstrate lower effectiveness than in primary medical center.
Current Guidelines for the Treatment of Arterial Hypertension in Patients with Diabetes Mellitus and Chronic Kidney Disease
Authors: Demidova T. Yu. , Kislyak O. A.
Published: May 2021

The current understanding of the management of patients with diabetes mellitus (DM) based on the concept of the cardiovascular continuum involves not only the prevention and treatment of cardiovascular diseases (CVD), but also the prevention and treatment of chronic kidney disease (CKD). The fact is that patients with DM and CKD represent a special group of patients with a very high risk of CVD and cardiovascular mortality. Such patients require early diagnosis and timely identification of risk factors for the development and progression of CKD for their adequate correction. Arterial hypertension, along with hyperglycemia, is the main risk factor for the development and progression of CKD in patients with diabetes. In this regard, the choice of antihypertensive therapy (AHT) in patients with diabetes is of particular importance. The basis of AHT in diabetes and CKD is the combination of a blocker of the renin-angiotensin-aldosterone system (an angiotensin-converting enzyme inhibitor [ACE inhibitor] or an angiotensin II receptor blocker [ARB]) and a calcium channel blocker (CCB) or a thiazide / thiazide-like diuretic. The task of the performed AHT is to achieve the target level of blood pressure (BP). At the same time, the optimal blood pressure values in patients with diabetes and CKD are blood pressure values in the range of 130-139/70-79 mm Hg. If the target blood pressure is not achieved, it is necessary to intensify antihypertensive therapy by adding a third antihypertensive drug to the therapy: CCB or a diuretic (thiazide / thiazide-like or loop). In case of resistant hypertension, it is necessary to consider the possibility of adding antagonists of mineralocorticoid receptors, other diuretics or alpha-blockers to the conducted AHT. Beta-blockers can be added at any stage of therapy if the patient has exertional angina, a history of myocardial infarction, atrial fibrillation, and chronic heart failure. The need to normalize blood pressure parameters by prescribing combined antihypertensive therapy in patients with diabetes and CKD is explained by a decrease in renal and cardiovascular risks, and, therefore, a decrease in the risk of mortality in this cohort of patients.
Post-COVID Syndrome and Tachycardia: Theoretical Base and Treatment Experience
Authors: Podzolkov V. I. , Bragina A. E. , Tarzimanova A. I. , Vasil'eva L. V. , Batrakova E. P. , Lobova N. V. , Bykova E. E. , Khachuroeva M. M.
Published: May 2021

The coronavirus pandemic showed not only an increase in levels of excess morbidity and mortality in the acute phase, but also persisting symptoms 4 weeks after the onset of the disease. A review of international studies on the prevalence and diversity of the manifestations of postcoid syndrome is presented. The data on such a manifestation of post-COVID syndrome as postural orthostatic tachycardia syndrome (POTS) are accumulating. Pathogenetic mechanisms, modern diagnostic criteria and research data on the prevalence of this syndrome are presented in the article. The Canadian Cardiovascular Society has proposed medications as a treatment for POTS, including the sinus node If channel inhibitor ivabradine. Data from several studies showing the effectiveness of this drug for POTS, including after suffering COVID-19, are presented in the article. Clinical data on the prevalence of tachycardia among patients admitted to the Sechenov University hospital are presented. About 18% of patients with hypertension and 21% of patients with normal blood pressure had a high heart rate. A clinical example of the use of ivabradine in a patient after a coronavirus infection is presented. Drug interactions and individual tolerance of ivabradine in patients after coronavirus infection are being discussed. The authors put forward the hypothesis about the further prospect of using ivabradine in the treatment of clinical manifestations of postcoid syndrome on the basis of literature data and their own experience.
Treatment of Vasovagal Syncope Associated with Asystole: Literature Review and Case Report of Long-term Follow-up
Authors: Pevzner A. V. , Kuchinskaya E. A. , Kiktev V. G. , Kheimets G. I.
Published: May 2021

Vasovagal syncope (VVS) can occur in every third of human population. Clinical symptoms of VVS areas a result of arterial hypotension with critical global cerebral hypoperfusion due to vasodilatation and bradicardia. Bradicardia is manifested as sinus node dysfunction and atrioventricular conduction disturbances due to activation of nervus vagus. Asystole can take place in some cases. Lack of efficacy of permanent pacemaker founds in patients to prevent of VVS. The results of double blind placebo controlled studies, European and American expert's opinions, probable causes of lack of efficacy of pacemakers in such category of patients and way of solution of this problem are discussed in the review. Syncope recurrences in spite of pacemaker implantation, risk of surgery complications and good life prognosis are arguments for therapeutic approach, now suitable for the most of patients with VVS. Case report (VVS with asystole but without of pacemaker implantation) with successful follow-up is analyzed in the article.
Anticoagulation therapy in atrial fibrillation after intracranial hemorrhage
Authors: Gerasimenko A. S. , Gorbatenko V. S. , Shatalova O. V. , Petrov V. I.
Published: May 2021

Intracerebral hemorrhage (ICH) is severe and fatal complication of anticoagulant therapy with an incidence 0.3-0.7% per year. For patients with atrial fibrillation (AF) anticoagulants are administered for decreasing risk of stroke and systemic embolism. In this case the occurrence of intracranial bleeding is hard task for doctor. From the one side it is necessary to reverse the action of the drug for preventing the growth of hematoma. At the same time the discontinuation of therapy increases the risk of systemic embolism for patients with AF significantly. Clinical guidelines and studies have been reviewed about ICH during anticoagulant therapy. Nowadays there is no quality evidence about reversal of anticoagulant effects after ICH and optimal time of resumption of anticoagulant therapy. Firstly, we do not have large randomized controlled trials on this issue. The majority of clinical guidelines were based on retrospective studies and opinions of experts. Soon several randomized controlled trials will be finished and new data will be presented.
Laboratory predictors of clinical outcomes in patients with atrial fibrillation
Authors: Sokolova A. A. , Goncharova I. V. , Vedernikov A. A. , Morozova N. S. , Napalkov D. A.
Published: May 2021

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice that affects intracardiac hemodynamics and is accompanied by increased mortality due to the risk of stroke and systemic thromboembolism. In recent years, numerous studies, evaluating the use of biomarkers in AF patients, have been conducted to expand the possibility of stratification the complications risks.

The aim of the review is to evaluate the possible isolated and combined predictive significance of NT-proBNP, troponin T (TnT) and D-dimer levels in the development and progression of AF and its thromboembolic complications according to published data. Determining the level of NT-proBNP can be used to diagnose cardioembolic stroke in latent forms of AF. Patients with a cardioembolic stroke have been shown to have higher BNP/NT-proBNP levels than patients with an atherothrombotic stroke and venous thromboembolism. Elevated TnT level is independently associated with AF detection as a cause of stroke. The assessment on the CHADS2 scale significantly correlates with the level of troponin I (TnI). However, it is equally important to take into account TnI level even with a low score of CHADS2. Patients with the level of TnI ≥ 0.040 pg/L are considered to be prescribed anticoagulants in the same way as the patients with high CHADS2 score. Similar results were obtained analyzing high-sensitivity cardiac troponin T (hs-cTnT) data. The level of D-dimer 0.315 mg/L was determined to be the optimal limit level for predicting the adverse functional outcome of stroke owing to AF. Patients with a high level of D-dimer have shown a high risk of developing thromboembolic and cardiovascular complications despite their taking anticoagulant drugs. D-dimer levels positively correlate with the CHA2DS2 and CHA2DS2-VASC scales of stroke risk stratification. The analysis of the biomarkers combination has revealed the increase of hs-cTnT and BNP associated with stroke in AF patients (p<0.05). However, ABC scale, including hs-cTnT and NT- pro BNP, hasn't given more accurate result in stroke predicting than CHA2DS2-VASc scale. The integration of biomarkers in predicting the risk of AF occurrence, progression and appearance of thromboembolic complications is a promising direction. An isolated level of biomarkers (hs-cTnT, NT-proBNP, D-dimer) and their combination with clinical risk factors can improve the quality of cardioembolic strokes prognosis.
Possibilities of Evaluating the Dynamics of Left Ventricular Perfusion and Contractility in Patients with Chronic Heart Failure after Implantation of a Heart Contractility Modulator Using Perfusion Single-Photon Emission Computed Tomography
Authors: Amanatova V. A. , Safiullina A. A. , Uskach T. M. , Ansheles A. A. , Sergienko V. B. , Tereshchenko S. N.
Published: May 2021

Perfusion scintigraphy and single-photon emission tomography of the myocardium are promising methods for complex assessment of the state of the left ventricle myocardium in patients with chronic heart failure. These methods of nuclear cardiology can be performed in patients with reduced renal function, as well as the presence of implanted devices such as implantable cardioverters-defibrillators, resynchronizing devices and cardiac modulating therapy, which is their undeniable advantage. The reproducibility of the method is ensured bu fully automated calculation of parameters of myocardial perfusion and contractility. To date, there are no data in the literature on the use of nuclear cardiology methods as an imaging technique in patients with cardiac contractility modulation devises. This paper describes the current possibilities and prospects of nuclear medicine methods in patients with chronic heart failure after implantation of a heart contractility modulator.
Rotor Drivers in Induction and Maintenance of Atrial Fibrillation
Authors: Kulikov A. A. , Sapelnikov O. V. , Uskach T. M. , Cherkashin D. I. , Grishin I. R. , Akchurin R. S.
Published: May 2021

Atrial fibrillation is the most common arrhythmia in clinical practice. It is associated with an increased risk of stroke, chronic heart failure, and sudden cardiac death. Our options of restoring and maintaining sinus rhythm have a very limited effect, both in the case of antiarrhythmic and catheter treatment. Catheter ablation has proven to be a more effective approach than antiarrhythmic therapy. The success rate of the procedure reaches 70%. However, radiofrequency ablation is associated with a risk of complications, with 4.5% of patients likely to develop major complications, including tamponade (1.31%), femoral pseudoaneurysm (0.71%), and death (0.15%). Given the generally recognized dominant role of the pulmonary veins in the induction of atrial fibrillation, their electrical isolation has become the recommended tactic of the catheter approach. In the case of patients with paroxysmal form of atrial fibrillation, the success rate of the procedure reaches 87%. Unfortunately, in the case of persistent forms of atrial fibrillation, the effectiveness of the primary procedure decreases to 28% and reaches 51% with repeated interventions. In addition to the anatomically oriented isolation of the pulmonary veins, a number of strategies have been proposed to reach the secondary zones of atrial fibrillation induction. The results of recent studies on the effectiveness of strategies for ablation of rotor regions and their role in the induction and maintenance of AF may lead to the further development of catheter ablation techniques and an individual radiofrequency ablation approach in a particular patient.
Narsist Kişilik Özelliklerinin İşkoliklik Eğilimine Etkisi
Authors: ÖZDEMİR Lütfiye , TAŞHAN Ahmet
Published: May 2021

Bir kişilik özelliği olarak narsisizmin, çalışma hayatında çalışanların tutum ve davranışlarında olumlu ve olumsuz yansımaları görülebilmektedir. Bu kapsamda, narsist kişilik özelliğinin, çalışma hayatında görülen işkoliklik eğilimine olan etkisini araştırmak bu çalışmanın amacını oluşturmaktadır. Araştırma verileri, 387 akademik personelden elde edilmiş olup, araştırmada Narsist Kişilik Envanteri (NKE) ölçeği ve Hollanda İş Bağımlılığı Ölçeği (DUWAS) kullanılmıştır. Elde edilen verilerin istatistiksel değerlendirmesinde açıklayıcı faktör analizi (AFA), Cronbach Alfa güvenirlilik analizi, Doğrulayıcı Faktör Analizi (DFA), Pearson Korelasyon analizi ve Yol Analizi kullanılmıştır. Yapılan analiz sonuçlarına göre, narsist kişilik özelliklerinin işkoliklik eğilimi üzerinde anlamlı bir etkisi olduğu tespit edilmiştir. Diğer taraftan, işkoliklik eğiliminin çok çalışma alt boyutu üzerinde, narsist kişilik özellikleri özgüven ve özgün olma alt boyutlarının pozitif yönde, otorite alt boyutunun ise negatif yönde anlamlı bir etkisi olduğu tespit edilmiştir. Narsist kişilik özellikleri kendini beğenme alt boyutunun hem çok çalışma hem de sorumluluk alt boyutları üzerinde pozitif yönde anlamlı bir etkisi olduğu görülmüştür.
MEF Innovation Team (MIT): Discovering and Solving the MEFs Complex Problems
Authors: Mitchell Troy E.
Published: May 2021

Adversaries use cost-effective and timely technologies to counter expensive military acquisitions that undermine the United States’ military capabilities. With the private sector outpacing defense innovation, the speed of technology and business drives future warfare considerations. If technology corporations drive the speed of the future of warfare, then appreciating design thinking’s business model applicability to military strategy shapes how the Marine Corps responds to uncertain operating environments during the next several decades. This article incorporates aspects of design thinking for the Marine Corps to provide variables aiding in future warfare innovation to solve complex problems inherent to the future operating environment.
A Novel Strategy Conjugating PD-L1 Polypeptide with Doxorubicin Alleviates Chemotherapeutic Resistance and Enhances Immune Response in Colon Cancer
Authors: Wang Maolin , Shu Xing-sheng , Li Meiqi , Zhang Yilin , Yao Youli , Huang Xiaoyan , Wei Pengfei , He Zhendan , Lu Jun , ying Ying
Published: May 2021

Background

Chemotherapy is most commonly used for treating colon cancer. However, the destruction to normal cells and resistance to chemical therapeutics still remain as clinical challenges.
Methods

We developed a novel synergistic strategy coupling PD-L1 polypeptide with chemotherapeutic reagent for colon cancer.
Results

A proteolysis resistant PD-L1-targeted peptide (PPA1) was conjugated to doxorubicin (DOX) with a pH sensitive linker, which could trigger the release of DOX near acidic tumor tissues. We found that PPA1-DOX construct showed high binding affinity with PD-L1 in vitro and specifically enriched within tumor when administered in vivo.
Conclusions

PPA1-DOX exhibited a significantly lower toxicity and a remarkably higher antitumor activity in vivo, as compared with free PPA1, random polypeptide-DOX conjugate, DOX, or 5-FU, respectively. Moreover, increased infiltration of both CD4+ and CD8+ T cells was found in tumors from PPA1-DOX treated mice, indicating that PPA1-DOX enhanced immune response. Delivery of chemical regimen guided by PD-L1 polypeptide represents a potential targeted treatment strategy of colon cancer with improved efficacy and reduced toxicity.
KIR2DL4 promotes the proliferation of renal cell carcinoma cells by PI3K/AKT signaling pathway activation
Authors: Ding Xiao-Fei , Ma Huai-Lu , Chen Jie , Liang Yong , Wang Yun-Fei , Chen Guang , Li Xin
Published: May 2021

Background: Killer cell immunoglobulin-like receptor 2DL4 (KIR2DL4) is a transmembrane glycoprotein that is expressed by natural killer (NK) cells and certain subsets of T cells. It has been reported to serve an important role in the immune response. However, its expression profiles and function in solid tumor progression remain poorly defined.Methods: In the present study, using bioinformatics analysis, immunohistochemistry, immunoblotting, MTT assay, soft agar colony formation assay and a renal cell carcinoma (RCC) cell xenograft model in nude mice, we examined whether KIR2DL4 is expressed by RCC and its possible roles in RCC progression. Results: We confirmed that KIR2DL4 is overexpressed by RCC cells. MTT and soft agar cloning assays showed that KIR2DL4 knockdown delayed cell proliferation in RCC cell lines, Caki-1 and 769-P, in vitro. By contrast, KIR2DL4 overexpression promoted Caki-1 cell proliferation both in vitro and in vivo, which was observed in a BALB/c-nu/nu xenograft mouse model. Moreover, RNA sequencing data demonstrated that the differentially expressed genes between vector controlled and KIR2DL4-overexpressed Caki-1 cells were highly associated with cancer development, of which those related to the phosphatidylinositol-3-kinase (PI3K)/ protein kinase B (AKT) signaling pathway were particularly enriched. Immunoblotting data showed that the level of AKT phosphorylation was higher in KIR2DL4-overexpressing Caki-1 cells compared with that in the parallel-controlled cells. Conclusions: Our results indicate that KIR2DL4 is also expressed by RCC cells, which promotes RCC progression through the PI3K/AKT signaling pathway.
Circrhbdd1 Augments M6a-Dependent Metabolic Reprogramming and Restricts Anti-PD-1 Therapy in Hepatocellular Carcinoma
Authors: Cai Juan , Chen Zhiqiang , Zhang Yao , Wang Jinguo , Wang Junfeng , Zhang Zhengrong , Li Haoran , Wu Jindao , Mao Jiading , Wang Xuehao , Zuo Xueliang
Published: May 2021

Background

Metabolic rewiring of cancer cells reshapes the tumor microenvironment, thereby restricting the response to immunotherapy. Circular RNAs (circRNAs) can influence various cellular processes and have been implicated in hepatocellular carcinoma (HCC). Here, we investigated the role of a novel circRNA circRHBDD1 in HCC metabolic transformation and immunotherapy resistance.
Methods

CircRNA sequencing was performed to determine the differentially expressed circRNA profile in HCC. RT-qPCR and in situ hybridization were used to verify the dysregulation of circRHBDD1 in two independent HCC cohorts. Univariate and multivariate survival analyses were employed to assess the prognostic significance of circRHBDD1. Loss- and gain-of-function approaches were adopted to evaluate the effects of circRHBDD1 on glycolysis and glutaminolysis. Patient-derived xenograft models were used for in vivo evaluation. RNA pull-down, mass spectrometry, RNA immunoprecipitation, fluorescence in situ hybridization, polysome profiling, and meRIP assays were utilized to explore the molecular mechanisms of circRHBDD1 in HCC.
Results

We found that circRHBDD1 was significantly upregulated in HCC and associated with unfavorable clinicopathological characteristics and poor survival outcomes. In vitro and in vivo experiments showed that circRHBDD1 facilitated HCC glycolysis and glutaminolysis. Mechanistic studies revealed that circRHBDD1 could recruit YTHDF1 to PIK3R1 mRNA and augment PIK3R1 translation in an m6A-dependent manner, leading to activation of the PI3K/AKT signaling. EIF4A3-mediated exon back-splicing contributed to the upregulation of circRHBDD1. Moreover, targeting of circRHBDD1 was able to improve anti-PD-1 therapy resulting in prolonged survival.
Conclusion

We identified that the circRHBDD1/YTHDF1/PIK3R1 axis was crucial to metabolic reprogramming of HCC. Suppression of circRHBDD1 could potentially sensitize HCC cells to anti-PD-1 therapy.
Factors affecting the mother’s choice of infant feeding method in Poland – a cross – sectional preliminary study in Poland
Authors: Rozensztrauch Anna , Klaniewska Magdalena , Mazur Marta Berghausen -
Published: May 2021

Background The World Health Organization identifies exclusive breastfeeding as the gold standard for child nutrition. Breastfeeding provides many benefits to both the baby and the mother. First days after birth are crucial for breastfeeding and determine its further path. Unfortunately, very often it is also the time of facing the first breastfeeding problems. The aim of this study was to analyze selected factors influencing a mother's decision to breastfeed. Methods This is a cross-sectional study conducted between March 2019 and November 2019 in selected Polish maternity wards. Data were collected through completion of author's questionnaire and a standardized questionnaire, the Multidimensional Perceived Social Support Scale and also through informal interviews with mothers. During statistical analysis the chi-square test of independence, the Kolmogorov-Smirnov test, as well as the non-parametric Mann-Whitney U test in addition to Fisher's exact test were performed. Results The results showed that there is no correlation between the mode of delivery and the mother’s choice of infant feeding method. Whereas knowledge of the benefits of breastfeeding and received support affects the mother’s decision on infant feeding method. The study also showed that the 83% of newborns were put to the breast within the first two hours after birth. However, only 58% continued to be breastfed in the subsequent days. As many as 42% of the newborns were supplemented with formula despite early initiation of breastfeeding. Analyses showed that exclusive breastfeeding was more often chosen by mothers with higher education. And the most common breastfeeding problem reported by 62% of the respondents was perceived insufficient milk supply and also breastfeeding pain, reported in 48,5% mothers. Conclusions It is extremely important to continually promote breastfeeding among women. The role of midwives is crucial in this regard, as they should encourage the initiation of breastfeeding, support mothers during the perinatal and postnatal periods, and increase their sense of competence and confidence in their ability to breastfeed. Accessible, professional, and empathetic support can help reduce the number of women supplementing with modified milk. Undoubtedly, the postpartum period is important for breastfeeding outcomes, but it is significant that breastfeeding education and promotion begin during pregnancy.
Machine Learning Reveals the Unique Biomarkers of Clonal Hematopoiesis in Patient With Early-Stage Colorectal Neoplasia: A Case Control Study
Authors: Hsu Yin-Chen , Huang Sin-Ming , Chang Li-Chun , Chen Yan-Ming , Chiu Wei-Tzu , Lin Jing-Wei , Lin Chien-Chia , Chen Ching-Wen , Chiu Han-Mo , YU SUNG-LIANG
Published: May 2021

BACKGROUND: Blood test has a better uptake for colorectal cancer screening than stool test and colonoscopy but suboptimal detection of early-stage colorectal neoplasia (CRN), including advanced adenoma and stage I cancer, limits its application. The present study aimed to evaluate whether clonal hematopoiesis (CH) from peripheral blood can be used as a biomarker for early-stage CRN screening and improve the detection of blood tests by machine-learning approach.METHODS: The CH profile was evaluated in 63 early-stage CRNs and 32 controls by error-corrected sequencing and classified by machine-learning method. Diagnostic performance was measured by receiver operator characteristic analysis. Additional 20 early-stage CRNs and 10 controls were used to validate the machine-learning model. We simultaneously used mutational signature analysis to study predictors based on CH.RESULTS: We identified 1,446 variants and clarified the uniqueness of variants from the peripheral bloods of early-stage CRNs. The machine learning model identified early-stage CRNs from controls and its AUC, sensitivity and specificity were 0.988, 94.2% and 99.3%, respectively. The CH-based CRN detection model was further verified. The accuracy, sensitivity, and specificity were 0.933 (p=0.00065), 95.0%, and 90.0%, respectively. Furthermore, the mutational signature analysis of those unique variants in CRNs revealed the influence of genetic architecture on DNA damages.CONCLUSIONS: Our results reveal the potential of CH to a mark produced by the carcinogenesis in early-stage CRN. We developed a CH-based blood test with machine learning approach, which not only increase screening uptake but also improve the detection rate of early-stage CRN.
Deep Understanding Degradation Mechanism of Green Biopolyester Nanocomposites with Various Cellulose Nanocrystal Based Nanohybrids
Authors: Lu Gaojun , Zhu Jingli , Yu Hou–Yong , Jin Meijin , Abdalkarim Somia Yassin Hussain , Wei Yong
Published: May 2021

Oceans and soils have been contaminated with traditional plastic due to their lack of degradability. Therefore, green biopolymer composites reinforced with cellulose nanocrystal-zinc oxide hybrids (ZnO hybrids) with good biodegradation ability provide a positive impact on reducing environmental challenges. In this work, the effect of various morphologies of ZnO hybrids on the biodegradation ability of poly(butylene adipate-co-terephthalate), PBAT) under seawater, soil burial, and UV aging conditions were investigated. Sheet-like ZnO hybrids (s-ZnO hybrid) could efficiently enhance mechanical, UV-blocking properties and biodegradation ability of PBAT. Compared to neat PBAT films, the best tensile strength of PBAT nanocomposite with 2 wt.% s-ZnO hybrid was increased by 15.1%, meanwhile this nanocomposite films showed the highest biodegradation rate after 80 days of soil degradation and 90 days of seawater degradation. Besides, three possible biodegradation mechanisms of green PBAT nanocomposite films were presented, hinting that such PBAT nanocomposite have great promising packaging applications.
Robot-Assisted vs. Laparoscopic Radical Prostatectomy for Immediate- and High-Risk Localized Prostate Cancer: A Propensity-Score Matched Analysis
Authors: Wen Deng , Cheng Zhang , Hao Jiang , Yulei Li , Xiaoqiang Liu , Luyao Chen , Weipeng Liu , Xiaochen Zhou , Ting Sun , Gongxian Wang , Fu Bin
Published: May 2021

Background

To evaluate the functional and oncological efficacy of robot-assisted radical prostatectomy (RARP) and laparoscopic radical prostatectomy (LRP) for immediate- and high-risk localized prostate cancer (PCa).
Methods

232 patients bearing immediate- and high-risk localized PCa between January 2016 and October 2019 were enrolled according to the inclusion criteria. The perioperative, functional and oncological outcomes were compared between the RARP and LRP groups after applying the propensity-score matching (PM) (1:1) method, which were employed to attenuate the impact of the potential baseline confounders.
Results

In all, except for 10 patients without a suitable pair, the remaining patients in the LRP group were successfully matched to 85 patients in the RARP arm. All differences in preoperative variables turned to be insignificant after PM. Within the matched cohort, no open conversion was required in both groups. The RARP group was corrected with a significantly shorter mean operative time than the LRP group (p < 0.001). Patients in the RARP arm were also at a lower risk of ≤ Grade II complications than those in the LRP group (p = 0.036). Meanwhile, the proportions of transfusion and ≥ Grade II complications in the RARP group were similar to that in the LRP group (p = 0.192 and p = 1.000, respectively). No significant differences regarding the mean estimated blood loss, rates of pT3 disease and positive surgical margin, median specimen Gleason score and hospital stay length existed between the two groups. RARP vs. LRP tended to a significantly higher percentage of urinary continence at the removal of catheter (p = 0.031), postoperative 6 months (p = 0.043), and last follow-up (p = 0.046). Significant differences were also found between the RARP and LRP arms in erectile function at postoperative 6 months and last follow-up (p = 0.013 and p = 0.009, respectively). The statistical comparability between the two groups was observed in biochemical recurrence-free survival (p = 0.228).
Conclusions

For surgically managing immediate- and high-risk localized PCa, RARP tended to a lower risk of ≤ Grade II complications and superior functional preservation without cancer control being compromised when comparing with LRP.
Prunetin Inhibits Nitric Oxide Activity, Proliferation and Induces Apoptosis in Urinary Bladder Cancer Cells (RT-4) Through the Enhancement of Apoptotic Pathway via CASP3 and TNF-α Genes That Are Involved
Authors: KARAYILDIRIM Cinel KOKSAL , NALBANTSOY Ayse , YAVASOGLU Nefise Ulku KARABAY
Published: May 2021

Urinary bladder cancer is considered one of the most prevalent malignant tumors worldwide. Complementary and integrative approaches for the treatment of bladder cancer, such as the intake of isoflavonoid phytoestrogens, are increasingly explored due to the risk of mortality and long-term morbidity associated with surgical procedures. The biological effects of prunetin, one of the less-studied phytoestrogens, have not yet been examined in this respect. Therefore, this study aimed to explore the efficacy of prunetin on urinary bladder cancer cells (RT-4). Cytotoxicity, nitric oxide synthase activity, apoptotic gene expression and cell cycle assays were performed to determine the biological effect of prunetin exposure on cellular toxicity, cell cycle progression and the expresions of selected apoptosis-related genes. The results suggested that prunetin has cytotoxic effects on RT-4 cells at 21.11 µg/mL. Flow cytometry analysis showed that prunetin induced apoptosis and cell cycle arrested in G0/G1 phase. Prunetin exposure was associated with increases in CASP3 and TNF-α gene expression in RT-4 cells at doses of 21.11 µg/mL and 42.22 µg/mL. Strong nitric oxide inhibition was determined with IC50 of 5.18 µg/mL under macrophage mediated inflammatory circumstances. Based on the experimental data, it is reasonable to conclude that prunetin possesses anti-cancer properties and may be a candidate compound for the prevention of urinary bladder cancer. This is the first study that evaluated prunetin for its in vitro antitumor activities, clarified its possible apoptotic molecular mechanism and provided novel insights into its anti-inflammatory nature and effects on the expression of related key genes.
Benzydamine, a CDK2 Kinase Inhibitor, Suppresses The Growth of Esophageal Squamous Cell Carcinoma in Vitro and in Vivo.
Authors: Zhou Yubing , He Xinyu , Jiang Yanan , Wang Zitong , Yu Yin , Wu Wenjie , Zhang Chenyang , Li Jincheng , Guo Yaping , Chen Xinhuan , Liu Zhicai , Zhao Jimin , Liu Kangdong , Dong Zigang
Published: May 2021

Background: Esophageal squamous cell carcinoma (ESCC) is among one of the leading causes of cancer death worldwide owing to late detection and low survival rate. The clinical outcome of ESCC remains dismal. To date, the disease lacks available targeted therapies. Recently, drugs approved by the Food and Drug Administration have been reported to have potential as cancer chemoprevention agents. Methods: Benzydamine, available as a hydrochloride salt, a locally acting non-steroidal anti-inflammatory drug, was screened out among FDA-approved drugs owing to its effective cytotoxic effect on KYSE450 cells, which remained unexplored. Mass spectrometry, kinase prediction and Swiss Target Prediction were used to verify the potential target(s) of benzydamine. Patient-derived oesophageal xenograft mouse model were used to investigate the effect of benzydamine on tumor growth in vivo.Results: We found that benzydamine inhibited anchorage-dependent and -independent growth of ESCC cells. Kyoto Encyclopedia of Genes and Genomes pathway enrichment revealed that benzydamine attenuated five signaling pathways, including the DNA replication pathway. We further found that benzydamine could bind to CDK2 in its ATP-binding site. Inhibition of the activity of CDK2 suppressed the growth of ESCC cells and led to a G1/S cell cycle arrest. Additionally, knocking-down CDK2 decreased the sensitivity of ESCC cells to benzydamine hydrochloride. Notably, benzydamine suppressed tumour growth in a patient-derived oesophageal xenograft mouse model of ESCC in vivo.Conclusions: We have identified CDK2 as a potential target of benzydamine for the treatment and prevention of ESCC. Benzydamine suppressed the growth of ESCC cells by inhibiting the activity of CDK2.
Health System Factors Serving as Facilitators and Barriers to Rheumatic Heart Disease Care in Sudan
Authors: Edwards Jeffrey Garnet , Barry Michele , Essam Dary , Elsayed Mohammed , Abdulkarim Mohamed , Elhossein Basamat M. A. , Mohammed Zahia H. A. , Elnogomi Abdelmunim , Elfaki Amna S. E. , Elsayed Ahmed , Chang Andrew Y.
Published: May 2021

Background: Rheumatic heart disease (RHD) remains a leading cause of morbidity and mortality in sub-Saharan Africa despite widely available preventive therapies. In this study, we sought to characterize facilitators and barriers to RHD treatment in Sudan. Methods: We conducted a mixed-methods study, collecting survey data from 398 patients who had enrolled in a national RHD registry between July and November 2017. The surveys included information on demographics, healthcare access, and patient perspectives on treatment barriers and facilitators. Factors associated with increased likelihood of RHD treatment adherence were assessed using multivariate logistic regression. These data were enhanced by focus group discussions with 20 participants, further exploring health system factors impacting RHD care. Results: Our analysis revealed that female gender (Odds ratio (OR) = 1.94; 95% CI 1.14-3.29), increased household income (monthly income above 2000 Sudanese pounds; OR = 2.02; 95% CI 1.26-3.25), and a perceived appropriate level of healthcare staffing by doctors and nurses (OR = 2.07; 95% CI 1.16-3.71) were all factors associated with increased odds of treatment adherence. Further, qualitative data revealed significant barriers to RHD treatment arising from health services factors at the systemic level: The primary barriers to RHD treatment included patient lack of understanding of disease, lack of access due to inadequate healthcare staffing, lack of faith in local healthcare systems, and poor ancillary services. Facilitators of RHD treatment included stronger interpersonal support.Conclusions: Enhancing RHD patient education/engagement, while strengthening local health systems, may lead to improved treatment adherence in this vulnerable population.
Clinical outcomes of intravenous immunoglobulin therapy in COVID-19 related acute respiratory distress syndrome: a retrospective cohort study
Authors: Ali Husain Shabbir , Elshafei Moustafa S , Saad Mohamed O , Mitwally Hassan A , Wraidat Mohammad Al , Aroos Asra , Shaikh Nissar , Ananthegowda Dore C , Abdelaty Mohamed A , George Saibu , Nashwan Abdulqadir J , Mohamed Ahmed S , Khatib Mohamad Y
Published: May 2021

Background: Immunomodulatory property of intravenous immunoglobulin (IVIG) has been used to counteract severe systemic inflammation in coronavirus disease 2019 (COVID-19). However, its use in acute respiratory distress syndrome (ARDS) due to COVID-19 pneumonia is not well established.Methods: In this retrospective study, we analyzed electronic health records of COVID-19 patients admitted to intensive care units (ICUs) at Hazm Mebaireek General Hospital, Qatar, between March 7, 2020, and September 9, 2020. Patients receiving invasive mechanical ventilation for moderate-to-severe ARDS were divided into two groups based on whether they received IVIG therapy. The primary outcome was all-cause ICU mortality. Secondary outcomes studied were ventilator-free days and ICU-free days at day-28 and incidence of acute kidney injury (AKI). Propensity score matching was used to adjust for confounders, and the primary outcome was compared using competing-risks survival analysis.Results: Among 590 patients included in the study, 400 received routine care, and 190 received IVIG therapy in addition to routine care. One hundred eighteen pairs were created after propensity score matching with no statistically significant differences between the groups. Overall ICU mortality in the study population was 27.1%, and in the matched cohort, it was 25.8%. Mortality was higher among IVIG-treated patients (36.4% vs. 15.3%; sHR 3.5; 95% CI 1.98- 6.19; P<0.001). Ventilator-free days and ICU-free days at day-28 were lower (P<0.001 for both), and the incidence of AKI was significantly higher (85.6% vs. 67.8%; P=0.001) in the IVIG group.Conclusion: IVIG therapy in mechanically ventilated patients with COVID-19 related moderate-to-severe ARDS was associated with higher ICU mortality. A randomized controlled study is required to confirm this observation further.
Does the Mixture of Species change the C:N:P Ecological Stoichiometric Characteristics of fine Roots? A Case Study of Cupressus Funebris Mixed Forest
Authors: He Wenchun , Wang Yang , Wen Xiaochen , Wang Yu , Xiao Baoru , Chen Gang , Zhao Kuangji , Li Xianwei , fan chuan
Published: May 2021

The growth of fine roots of trees is affected by environmental changes and biological factors. At present, there have been many researches on the physiological plasticity of fine roots caused by environmental changes, but there are still few studies on the influence of biological factors on fine roots. This paper focused on the contents of carbon (C), nitrogen (N), and phosphorus (P), and their ecological stoichiometric ratios in different root orders of Cupressus funebris fine roots in 11 mixed stands with Koelreuteria paniculate or Toona sinensis at different ratios, and the effects of soil physical and chemical properties on the root chemical properties. It aimed to provide new insights into the fine-root nutrient distribution pattern and the transformation or reconstruction of low-efficiency pure forests from the standpoint of forest types. The results showed that: soil pH, and the content of available nitrogen (SAN), available phosphorus (SAP) and available potassium (SAK) differed significantly in the tested mixed forest stands. No significant differences in carbon content of fine roots were observed in different mixed stands. The content of nitrogen and phosphorus in fine roots in mixed forests showed heterogeneity. Species mixing changed the C/N, C/P and N/P of the C. funebris compared the pure stands. The "T. sinensis + C. funebris" forest alleviated the limitation of the lack of phosphorus on fine roots of C. funebris on. The principal component analysis showed that mixed stands of "T. sinensis + C. funebris" had the highest comprehensive score at ratio of "3:1". Thus, our results recommended the adoption of T. sinensis, especially at 75%, to reconstruct the low-efficiency pure C. funebris forest.
A Retrospective Analysis of COVID-19 ARDS Patients Successfully Extubated to High Flow Nasal Cannula Oxygen Therapy
Authors: ALAY GULCIN HILAL , Ozcan Perihan Ergin , Polat Ozlem , Anakli Ilkay , Orhun Gunseli , Tuna Verda , Celiksoy Emre , Kilic Mehmet , Mercan Mutlu , Esen Figen
Published: May 2021

Background

Coronavirus disease- 2019 (COVID-19) related to acute respiratory distress syndrome (ARDS) caused by the highly infectious SARS-CoV-2 novel coronavirus is a major cause of death during the pandemic period. Here we aim to present the retrospective data analysis of extubation success to High Flow Nasal Cannula Oxygen Therapy (HFNO) in COVID-19 ARDS patients.
Methods

The data of 22 laboratory-confirmed COVID-19 ARDS patients who were extubated to HFNO therapy at an intensive care unit (ICU) were analyzed. Respiratory variables as well as demographic characteristics were collected on admission. The mechanical ventilation volumes and pressures together with blood gas measurements were recorded during the intubation period. HFNO flow rate, FiO2, and oxygenation variables were collected 5 consecutive days after extubation. The reintubation rate within the 5 days following planned extubation, duration of ICU stay, and mortality were recorded.
Results

Among 22 patients, 16 were male (72.7%) and the mean age was 69.9 ± 13,2 years with the highest comorbidity being hypertension (59.1%). The duration between symptom initiation to ICU admission was 6.5 ± 7,9 days where nearly all patients were intubated on the same day. Twenty patients were successfully extubated to HFNO and 2 patients experienced reintubation. The mean duration of HFNO treatment was 4.8 ± 3.6 days and the length of ICU stay was 17.4 ± 6 days. The ICU mortality ratio of this complete data was 13.6% (3/22).
Conclusion

Among high-risk ARDS COVID-19 patients who have undergone extubation, HFNO therapy should be considered for preventing reintubation and post-extubation respiratory failure.