bluuebunny/crossref_metadata_2025 huggingface dataset:
Perfil dos trabalhadores acidentados com perfurocortantes na área da saúde
Authors: Vieira Junior Valdir Fernandes , Nunes Junior Agnaldo Egido , Felzener Manoel Carlos Melillo
Published: April 2023

As exposições ocupacionais a materiais biológicos potencialmente contaminados são um sério risco aos profissionais em seus locais de trabalho. Estudos desenvolvidos nesta área de medicina e saúde mostram que os acidentes envolvendo sangue e outros fluidos orgânicos correspondem às exposições mais frequentemente relatadas. Os trabalhadores, sejam eles da saúde ou não, dos estabelecimentos de saúde estão sob o risco de sofrerem acidentes com perfurocortantes em razão da complexidade das atividades desenvolvidas. Com o objetivo de identificar o perfil dos trabalhadores acidentados com perfurocortantes. A metodologia baseou-se em uma revisão integrativa sobre pergunta “como podemos minimizar os acidentes com perfurocortantes em diversas áreas da saúde”. Tem como objetivo geral descrever as ocorrências de acidentes com materiais perfurocortantes e as medidas preventivas para que possa minimizar a ocorrência entre os trabalhadores da área da saúde. Com o objetivo específico discorrer sobre as doenças que podem ser adquiridas pelos profissionais vítimas de acidentes com perfurocortantes. O estudo no qual, trata-se de uma revisão de literatura baseado em artigos subtraídos nos últimos anos. Conclui que é necessário que se faça medidas preventivas e educativas sobre biossegurança, enfatizando o uso de equipamentos de proteção individual e descarte de materiais contaminados.
Caracterização de usuários do programa HiperDia em uma USF do município de Mossoró - RN, na região nordeste do Brasil
Authors: Nunes Kaio Viníccius Zacarias , Oliveira Ana Katarina Dias de , Freire Antônia Brunielle Pessoa , Morais Lourdes Michele Duarte de , Maia Isabelly Santos Lima , Lopes Caio Henrique de Figueiredo , Nunes Victória Suellen Zacarias
Published: April 2023

O objetivo dessa pesquisa foi realizar a caracterização dos usuários portadores de hipertensão e/ou diabetes em uma Unidade de Saúde da Família do município de Mossoró – RN, identificou-se possíveis associações dos fatores de riscos com as comorbidades. Trata-se de uma pesquisa do tipo transversal, descritiva e de natureza quantitativa, por meio de entrevista com elemento semiestruturado. Obteve-se uma alta prevalência do gênero feminino, com faixa etária acima de 60 anos, escolaridade com permanência entre 4 a 8 anos, casado, aposentado e com antecedentes familiares. Dos participantes, 15 (14%) foram registrados como portadores de Diabetes Mellitus, 36 (35%) com Hipertensão Arterial Sistêmica e 53 (51%) com ambas comorbidades associadas. Observou-se significância estatística entre as comorbidades e os fatores de risco tabagismo, consumo de álcool, circunferência abdominal com risco elevado e sobrepeso/obesidade. Evidenciou-se a importância da continuidade da inclusão de ações de prevenção e promoção a saúde relacionadas as doenças crônicas não transmissíveis como Hipertensão Arterial Sistêmica e Diabetes Mellitus.
Profilaxia medicamentosa de lesão aguda da mucosa gástrica: revisão sistemática
Authors: Santana Tamiles Daiane Borges , Mascarenhas Ana Mercia Silva , Lopes Diana Silva , Santos Nara Jacqueline Sousa dos , Lemos Gisele da Silveira
Published: April 2023

Para pacientes criticamente enfermos, a profilaxia medicamentosa de lesão aguda da mucosa gástrica pode ser definida como a prevenção ou redução nas taxas de sangramento gastrointestinal pelo uso de fármacos. O objetivo deste estudo foi reunir evidências científicas sobre a profilaxia medicamentosa de lesão aguda de mucosa gástrica para desenvolvimento de um protocolo institucional para pacientes críticos. Trata-se de uma revisão de literatura a partir da elaboração de uma pergunta orientadora para a pesquisa, utilizando o acrônimo PICO. As bases de dados utilizadas para busca de artigos foram o PubMed, Lilacs e Cochrane, além da literatura cinzenta. Foram encontrados 98 artigos, sendo 78 na PubMed, 19 na Lilacs e 01 na Cochrane. Após estratégias de seleção 13 estudos foram incluídos, aos quais foram lidos na íntegra para construção do protocolo. O viés dos estudos foi avaliado de acordo com a escala de JADAD. É possível concluir que existem evidências que sustentam o uso da profilaxia medicamentosa de lesão aguda de mucosa gástrica em pacientes críticos, com fatores de risco conhecidos. Outras medidas também podem auxiliar na prevenção da úlcera de estresse, e a sua indicação deve ser reavaliada periodicamente.
Understanding Metaverse in Education: Connecting Metaverse to the existing Cultural Education in Indonesia
Authors: Aufa Ari Abi , Anisah Giati
Published: April 2023

Communication technology develops so rapidly that it changes the forms of interaction between people. Digital interaction that brings humans together in a virtual world seems to replace face-to-face interaction that has been a human habit since ancient times. However, digital interaction through media turns out to have many shortcomings and reduce the values that characterize a society. Even so, innovation in communication technology cannot be stopped, and now there is a metaverse. A digital platform that allows man to interact in the virtual world three-dimensional. Although this technology cannot be accessed and enjoyed by all levels of society, it is possible that in the next few decades social interactions in the metaverse will dominate interactions among people. Before that happens, in-depth analysis of all sectors is needed so that humans are not immersed in a virtual world that can actually threaten their existence. This research is a phenomenological research using a philosophical perspective that focuses on the possible use of the metaverse in education. In this study, it was concluded that the use of the metaverse is currently considered unnecessary because there is no urgent reason for the use of this technology, while face-to-face learning is still the best learning method, at least until today.
KOTAK AJAIB BERBASIS COGNITIVE NEUROSAINS UNTUK PENINGKATAN PERILAKU HIDUP SEHAT DI SEKOLAH
Authors: Elizar Elizar , Prihatmojo Agung , Badawi Badawi , Lutfi Mutia
Published: April 2023

The implementation of face-to-face learning requires strict discipline of healthy behavior. Children are expected to be able to adapt to the new habits they have to face. Disciplining children's healthy behavior during the implementation of limited learning is very important, so that children are protected from the risk of virus transmission. The purpose of community service is to provide an alternative to disciplining children in face-to-face learning through the use of Cognitive Neuroscience-Based Magic Box learning media. The service was held at Aisyiyah Bustanul Athfal (ABA) V Kotabumi Kindergarten on October 19 2022. In this activity those involved were lecturers, teachers and students of Muhammadiyah Kotabumi University as well as teachers and students of ABA V Kindergarten as partners. The Magic Box Based on Cognitive Neuroscience is a mystery box as a learning medium for disciplining children's healthy behavior with a game method made for the introduction of concrete objects according to the stages of children's cognitive development. These objects are around children and can be used, such as masks, hand sanitizers, tissues, and so on. The methods in this service activity are socialization, training, mentoring, monitoring and evaluation. The results of this activity are 1. Increasing teacher knowledge and skills in learning neuroscience, 2. Teachers have learning media to increase the introduction of health protocol tools in applying healthy behavior discipline in learning.
Do Preoperative Alpha Blockers Facilitate Ureteroscope Insertion at the Vesico-Ureteric Junction? An Answer from a Prospective Case-Controlled Study
Authors: Sokhal Ashok Kumar , Singh Kawaljit , Goel Sunny , Kumar Manoj , Purkait Bimalesh , Sain Durgesh Kumar , Gupta Ashok Kumar , Sankhwar Satyanarayan
Published: April 2023

Objective: To evaluate whether alpha blockers facilitate the navigation of the ureteroscope through the ureteric orifice, if administered preoperatively, based on the role of alpha blockers, mainly tamsulosin, in medical expulsive therapy of ureteric calculus.

Methods: A prospective, case-control study of 174 patients who underwent ureteroscopic stone removal for lower or mid ureteral calculi between November 2014 and March 2016 was carried out. We included patients >14 years of age who were planned for ureteroscopic stone removal. We divided the patients into two groups, including those who were not prescribed alpha blockers prior to surgery (Group A: no alpha blocker) and those patients who were started on alpha blockers, tamsulosin 0.4 mg, 3 days prior to surgery (Group B: alpha blocker). We excluded patients with stone size >1 cm, spontaneous stone passage prior to surgery, unable to perform ureteroscopy (URS), and previous history of ureteroscopic intervention.

Results: Our study included 124 patients, among whom 60 patients were prescribed alpha blockers preoperatively (Group B). The mean age of the study population was 37.62+9.74 (15–64 years) and the mean stone burden was 38.92+8.21 (15.94–58.12 mm2). The difference in rate of ureteroscope negotiation through the ureteric orifice between Groups A and B was not statistically significant (p=0.57).

Conclusions: In URS, preoperative administration of alpha blockers failed to improve technical ease and lower complication rate. Further large group, multi-centre studies are required todiscover a definitive role of alpha blockers prior to URS.
Efficacy of the Artificial Urinary Sphincter ZSI 375 for Treatment of Post-Radical Prostatectomy Incontinence in Patients with Intrinsic Sphincter Deficiency: A Preliminary Study
Authors: Carvajal Obando Alejandro , Gavira Gil Federico , Gutiérrez Martinez Álvaro , Echeverry Molina Luis Fernando , Castaño Botero Juan Carlos
Published: April 2023

Objectives: To evaluate the efficacy of the ZSI 375 artificial urinary sphincter (AUS) (Zephyr Artificial Sphincter, Geneva, Switzerland) for the treatment of patients with post-radical prostatectomy urinary incontinence.

Methods: This was a retrospective, non-randomised, multicentre study open to patients with moderate-to-severe urinary incontinence due to intrinsic sphincter deficiency after radical prostatectomy. Efficacy and safety was evaluated on continence status, complications, and surgical revision.

Results: Twenty-seven patients were recruited between September 2013 and April 2016 and followed up to April 2017. Mean age was 67.70 years old (range: 55–78). Twenty-six patients (96.30%) presented with incontinence post-radical prostatectomy and one patient (3.70%) after post-radical prostatectomy plus adjuvant radiotherapy. Follow-up ranged from 12 months–42 months (mean: 27.11). The success rate was 88.90% after 12 months follow-up, 94.12% after 24 months follow-up and 83.33% after 36 months follow-up. Three patients (11.11%) presented with a scrotal infection, two patients (7.41%) suffered a urethral erosion, and two patients (7.41%) had a mechanical failure. The revision rate was 22.22% (six patients).

Conclusion: The follow-up time of this preliminary clinical study was long enough to demonstrate that the ZSI 375 AUS offers a good rate of continence to patients with urinary stress incontinence.
Long-term impacts of SARS-CoV-2 on gastrointestinal tract
Authors: He Kaiyue , Lu Liyuan , Xu Zhixiang , Jian Yongping
Published: April 2023

COVID-19 from SARS-CoV-2 has caused a large number of infections and deaths. COVID-19 is a respiratory infectious disease caused by the combination of SARS-CoV-2 with angiotensin converting enzyme 2 (ACE2) receptor into the target organ of the host. COVID-19 patients not only have respiratory symptoms, but also some patients with symptoms such as nausea, abdominal pain, and diarrhea. Even a few patients have atypical symptoms such as diarrhea as the first manifestation, indicating that the severity of COVID-19 patients is closely related to gastrointestinal symptoms. There is currently rare researches on long-term gastrointestinal adverse impacts in patients with COVID-19. We will summarize the etiology, epidemiology and pathogenic mechanism of SARS-CoV-2 as well as the digestive system symptoms and targeted treatment of COVID-19, so as to increase the insight of the long-term gastrointestinal injury caused by SARS-CoV-2, thereby providing new therapeutic strategies and targets for gastrointestinal injury.
“What is the Real Sweden?”
Authors: Blom Karen Ann
Published: April 2023

While the interest and search for identity through genealogy or family history is not new, the increased mediatization, access, and range of vehicles through which one can engage and learn are. What are the effects of this mediatization of identity and genealogy? How do individuals understand and interact with these mediatized representations? Since the expanded availability and marketing of genetic/DNA testing in the 1990s, and media programmes that trace the “roots” of famous people such as “Who do you think you are?” interest in genealogy has exponentially grown. In relation, ancestry tourism has grown in popularity before the Covid-19 pandemic and is projected by many researchers, culture, and government organisations post-pandemic to be instrumental in rebuilding tourism for many affected places and countries. The Swedish reality television programme, “Allt för Sverige” acts as a bridge between the mediatization of genealogy and this ancestry tourism interest. American contestants are introduced to a frame of Swedish identity as produced through the institutional structures of a television show, reflecting larger historical and socio-cultural assumptions, ideologies, and knowledge. This identity encoded by the programme of “Allt för Sverige” is engaged with/decoded and reacted to by the contestant. Utilising the concept of frame and framing, from Goffman and media studies, the presentation of Swedish Identity in “Allt för Sverige’s” is explored in the narratives from semi-structured interviews with 16 previous contestants. This data is analysed through Hall’s theoretical encoding/decoding model. This study contributes with new knowledge to the ongoing research examining the interest and mediatization of genealogy by focusing on the effect on participants in front of the camera instead of the targeted audience.
‘The patriarchy can’t dance with us’
Authors: Lauri Johanna , Linander Ida
Published: April 2023

The music festival Statement was initiated as a response to sexual violence towards women at other festivals, and during the work of creating a safe festival, separatism became the feminist strategy. In this paper we analyse media reporting from Statement, with a focus on the desire for safety. Using psychoanalytical discourse theory, we analyse different media materials, focusing on emotive language and fantasmatic narratives. We argue that in the media representations, a desire for safety is linked to enjoyment, opportunities to be oneself, predictability and lack of conflict. Safety is also strongly represented as linked to a focus on security and the absent man is continuously present in the media articulations. While the media representations tend to reconstruct a heterosexual Woman with a universal experience, the focus on the patriarchy, a common ‘we’ and the emotive language might nevertheless spur political mobilisation.
Modeling and numerical analysis for mechanical characterization of soft tissue mechanism applying inverse finite element technique
Authors: Mulk Md. , Islam Kazi Nusrat , Biswas Md. Haider Ali
Published: April 2023

Tissue-mimicking materials [e.g., polyvinyl alcohol cryogel (PVA-C)] are extensively used in clinical applications such as tissue repair and tissue engineering. Various mechanical testing techniques have been used to assess the biomechanical compatibility of tissue-mimicking materials. This article presents the development of inverse finite element (FE) techniques that are solved using numerical optimization to characterize the mechanical properties of PVA-C specimens. In this study, a numerical analysis where the displacement influence factor was employed in conjunction with a linear elastic model of finite thickness was performed. In the analysis, the effects of Poisson's ratio, specimen aspect ratio, and relative indentation depth were investigated, and a novel mathematical term was introduced to Sneddon's equation. In addition, a robust optimization algorithm was developed in MATLAB that utilized FE modeling for parameter estimation before it was rigorously validated.
The effect of surface nucleation modulation on the mechanical and biocompatibility of metal-polymer biomaterials
Authors: Ye Zhenhong , Zhang Le , Liu Taiwei , Xuan Weicheng , He Xiaodong , Hou Changhao , Han Donglin , Yu Binbin , Shi Junye , Kang Jie , Chen Jiangping
Published: April 2023

The deployment of hernia repair patches in laparoscopic procedures is gradually increasing. In this technology, however, understanding the new phases of titanium from the parent phase on polymer substrates is essential to control the microstructural transition and material properties. It remains a challenging area of condensed matter physics to predict the kinetic and thermodynamic properties of metals on polymer substrates from the molecular scale due to the lack of understanding of the properties of the metal-polymer interface. However, this paper revealed the mechanism of nucleation on polymer substrates and proposed for the first record a time-dependent regulatory mechanism for the polymer-titanium interface. The interconnection between polymer surface chain entanglement, nucleation and growth patterns, crystal structure and surface roughness were effectively unified. The secondary regulation of mechanical properties was accomplished simultaneously to satisfy the requirement of biocompatibility. Titaniumized polypropylene patches prepared by time-dependent magnetron sputtering technology demonstrated excellent interfacial mechanical properties and biocompatibility. In addition, modulation by low-temperature plasma metal deposition opened a new pathway for biomaterials. This paper provides a solid theoretical basis for the research of titanium nanofilms on medical polypropylene substrates and the medical industry of implantable biomaterials, which will be of great value in the future.
Recombinant production, purification, and biochemical characterization of a novel L-lactate dehydrogenase from Bacillus cereus NRC1 and inhibition study of mangiferin
Authors: Esa Sayed S. , El-Sayed Ahmed F. , El-Khonezy Mohamed I. , Zhang Shubing
Published: April 2023

Lactate dehydrogenase (LDH, EC 1.1.1.27) is one of the vital glycolytic conditions, especially during anaerobic conditions. It is a significant diagnostic, prognostic, and monitoring biomarker parameter. A 950-bp DNA fragment containing the gene (LDH) encoding LDH was amplified from Bacillus cereus NRC1. The deduced amino acid sequence reveals that B. cereus LDH (Bc-LDH) is highly homologous to the LDHs of Bacillus organisms. All LDH enzymes have a significant degree of conservation in their active site and several additional domains with unidentified functions. The gene for LDH, which catalyzes lactate synthesis, was cloned, sequenced (accession number: LC706200.1), and expressed in Escherichia coli BL21 (DE3). In this investigation, Bc-LDH was purified to homogeneity with a specific activity of 22.7 units/mg protein and a molecular weight of 35 kDa. It works optimally at pH 8.0. The purified enzyme was inhibited by FeCl2, CuCl2, ZnCl2, and NiCl, whereas CoCl2 was found to boost the activity of Bc-LDH. The molecular docking of the 3D model of the Bc-LDH structure with a natural inhibitor, mangiferin, demonstrated excellent LDH inhibition, with a free binding energy of −10.2 kcal/mol. Moreover, mangiferin is a potent Bc-LDH inhibitor that inhibits Bc-LDH competitively and has one binding site with a Ki value of 0.075 mM. The LDH-mangiferin interaction exhibits a low RMSF value (>1.5 Å), indicating a stable contact at the residues. This study will pave the way for more studies to improve the understanding of mangiferin, which could be considered an intriguing candidate for creating novel and improved LDH inhibitors.
Atomic scale insight into the decomposition of nanocrystalline zinc hydroxynitrate toward ZnO using Mn2+ paramagnetic probes
Authors: Vlaicu Ioana D. , Stefan Mariana , Radu Cristian , Culita Daniela C. , Radu Dana , Ghica Daniela
Published: April 2023

Layered zinc hydroxynitrate (ZHN), with the chemical formula Zn5 (OH)8 (NO3)2·2H2O, exhibits a range of special properties such as anion-exchange and intercalation capacity, as well as biocompatibility, making it attractive for a large variety of applications in fields from nanotechnology to healthcare and agriculture. In this study nanocrystalline ZHN doped with 1,000 ppm Mn2+ was prepared by two synthesis methods (coprecipitation and solid state reaction) using similar environment-friendly precursors. The complex morpho-structural [X-ray diffraction, scanning and transmission electron microscopy, textural analysis] and spectroscopic [Fourier transform infrared and electron paramagnetic resonance (EPR)] characterization of the two ZHN nanopowders showed similar crystalline structures with Mn2+ ions localized in the nanocrystals volume, but with differences in their morphological and textural characteristics, as well as in the doping efficiency. ZHN obtained by coprecipitation consists of larger nanoplatelets with more than two times larger specific surface area and pore volume, as well as a dopant concentration than in the ZHN sample obtained by solid state reaction. The thermal stability and the on-set of the structural phase transformation have been investigated at atomic scale with high accuracy by EPR, using Mn2+ as paramagnetic probes. The on-set of the ZHN structural phase transformation toward ZnO was observed by EPR to take place at 110°C and 130°C for the samples prepared by coprecipitation and solid state reaction, respectively, evidencing a manganese induced local decrease of the transformation temperature. Our results contribute to the selection of the most appropriate ZHN synthesis method for specific applications and in the development of new green, cost-effective synthesis routes for Mn2+ doped nano-ZnO.
Clinical characteristics and management of immune checkpoint inhibitor-related cardiotoxicity: A single-center experience
Authors: Xiao Junjuan , Li Xingyu , Wang Xuan , Guan Yaping , Liu Hairong , Liang Jing , Li Yan , Wang Baocheng , Wang Jun
Published: April 2023

Background

Immune checkpoint inhibitors (ICIs) have revolutionized cancer therapy in the past decade and amplify T-cell-mediated immune responses by disrupting immunoinhibitory signals. The augmented T-cell immune response has led to a range of immune-related adverse effects (irAEs). Immune-related cardiotoxicity has been reported in case series but has been underappreciated due to difficulties in diagnosis. This article describes epidemiological, clinical presentation, subtype, and treatment data and a new systematic framework for the clinical management of cardiotoxicity.

Methods

Data were extracted for cancer patients who received ICIs in a single center between January 1, 2020, and February 28, 2022. ICI-associated cardiotoxicity was clinically diagnosed based on clinical presentations, biochemical biomarkers, and imaging features.

Results

We identified a total of 12 (2.46%) cases of ICI-related cardiotoxicity from 487 patients who received PD-1 or PD-L1 inhibitors. All patients were diagnosed with advanced or metastatic solid tumors. The severity of ICI-related cardiotoxicity ranged from subclinical cardiac abnormalities (subclinical type) with only asymptomatic troponin-I (TnI) elevations (25.0%) to symptomatic cardiac abnormalities (clinical type) (75.0%). Patients with symptomatic cardiac abnormalities had several manifestations, including tachyarrhythmia (16.7%), bradyarrhythmia (41.7%), or cardiac failure (8.3%). The median immunotherapy exposure time was 1.5 doses (range: 1 to 5), and the median time from the initial immunotherapy to the onset of ICI-related cardiotoxicity was 33.5 days (IQR: 20.3 to 46.8). Most patients, including those with subclinical cardiac abnormalities, were administered systemic corticosteroids (58.3%). One (8.3%) patient was put on mechanical ventilation, one (8.3%) received plasma exchange therapy, one (8.3%) was implanted with a pacemaker, and one (8.3%) was admitted to the ICU. Three patients with symptomatic cardiac abnormalities (25.0%) died, and other patients presented with significant clinical improvement with good outcomes.

Conclusion

ICI-related cardiotoxicity is uncommon but critical with a high mortality rate and poor prognosis, especially for a small group of patients with symptomatic cardiac abnormalities. More attention should be given to cardiotoxicity associated with ICIs, and these patients should be given baseline examinations and biochemical analyses before and after the initiation of immunotherapy, intensive cardiac assessments, an accurate and rapid diagnosis, and timely multidisciplinary management with immunosuppressive agents and other necessary clinical interventions.
The natural history of QTc interval and its clinical impact in coronavirus disease 2019 survivors after 1 year
Authors: Mojón-Álvarez Diana , Izquierdo Andrea , Cubero-Gallego Héctor , Calvo-Fernández Alicia , Marrugat Jaume , Pérez-Fernández Silvia , Cabero Paula , Solà-Richarte Claudia , Soler Cristina , Farré Núria , Vaquerizo Beatriz
Published: April 2023

Background and objective

Prolonged QTc interval on admission and a higher risk of death in SARS-CoV-2 patients have been reported. The long-term clinical impact of prolonged QTc interval is unknown. This study examined the relationship in COVID-19 survivors of a prolonged QTc on admission with long-term adverse events, changes in QTc duration and its impact on 1-year prognosis, and factors associated with a prolonged QTc at follow-up.

Methods

We conducted a single-center prospective cohort study of 523 SARS-CoV-2-positive patients who were alive on discharge. An electrocardiogram was taken on these patients within the first 48 h after diagnosis and before the administration of any medication with a known effect on QT interval and repeated in 421 patients 7 months after discharge. Mortality, hospital readmission, and new arrhythmia rates 1 year after discharge were reviewed.

Results

Thirty-one (6.3%) survivors had a baseline prolonged QTc. They were older, had more cardiovascular risk factors, cardiac disease, and comorbidities, and higher levels of terminal pro-brain natriuretic peptide. There was no relationship between prolonged QTc on admission and the 1-year endpoint (9.8% vs. 5.5%, p = 0.212). In 84% of survivors with prolonged baseline QTc, it normalized at 7.9 ± 2.2 months. Of the survivors, 2.4% had prolonged QTc at follow-up, and this was independently associated with obesity, ischemic cardiomyopathy, chronic obstructive pulmonary disease, and cancer. Prolonged baseline QTc was not independently associated with the composite adverse event at 1 year.

Conclusions

Prolonged QTc in the acute phase normalized in most COVID-19 survivors and had no clinical long-term impact. Prolonged QTc at follow-up was related to the presence of obesity and previously acquired chronic diseases and was not related to 1-year prognosis.
Duration and clinical outcomes of dual antiplatelet therapy following percutaneous coronary intervention for acute coronary syndrome: A multicentre “real-world practice” registry-based study
Authors: Vergara-Uzcategui Carlos E. , Moreno Víctor H. , Hennessey Breda , Sánchez-del-Hoyo Rafael , Donis José H. , Gonzalez-Rojas Jorgelys , Salinas Pablo , Nombela-Franco Luis , Gonzalo Nieves , Jimenez-Quevedo Pilar , Mejia-Renteria Hernán , Escaned Javier , Fernández Ortiz Antonio , Macaya Miguel Carlos , Núñez-Gil Iván J.
Published: April 2023

Background

The optimal duration of dual antiplatelet therapy (DAPT) ought to be determined taking into account individual ischaemic or bleeding events risks. To date, studies have provided inconclusive evidence on the effects of prolonged DAPT. We sought to evaluate the long-term outcomes of this strategy following percutaneous revascularization in the context of acute coronary syndrome (ACS).

Methods

Retrospectively from four centers in Madrid, we identified 750 consecutive ACS patients, divided in two groups of DAPT duration: <13 months and >13 months, with a mean follow-up of 48 months.

Results

Patients with DAPT > 13 months had a higher non-adjusted incidence of Major Adverse Cardiovascular Events (11.6% vs. 17.3%) and new revascularization (3.7% vs. 8.7%). Differences in all-cause death, cardiac death, myocardial infarction, stent thrombosis and stroke were non-significant. There was no difference in the incidence of major bleeding (7.4% vs. 6.3%). Multivariable Cox regression analysis showed that the independent risk predictors of MACE were age (HR: 1.04, 95% CI: 1.02–1.06, p < 0.001) and multivessel disease (HR: 2.29, 95% CI: 1.32–3.95, p = 0.003), whereas the independent protective predictor was normal hemoglobin (HR: 0.88, 95% CI: 0.78–0.98, p = 0.022).

Conclusions

In this real-world registry cohort of ACS patients treated with PCI and 1 year of DAPT in Spain, we report a trend of increased rate of MACE and new revascularization not associated with TVR in patients with longer DAPT. Our findings support the need for future randomized controlled trials to confirm or refute these results.
Fast prediction of compressor flow field in nuclear power system based on proper orthogonal decomposition and deep learning
Authors: Yang Jun , Huang Yanping , Wang Dianle , Sui Xi , Li Yong , Zhao Ling
Published: April 2023

Research and development on digital twins of nuclear power systems has focused on high-precision real-time simulation and the prediction of local complex three-dimensional fluid dynamics. Traditional computational fluid dynamics (CFD) methods cannot take into consideration the efficiency and accuracy of fluid dynamics. In this study, a fast-flow field-prediction framework based on proper orthogonal decomposition (POD) and deep learning is proposed. Compressed data containing the original flow field information are obtained using POD and deep neural network (DNN) is used to construct the POD-DNN flow field reduction model to achieve fast flow field prediction. The calculation accuracy and speed of the reduced-order model are analyzed in detail, considering the flow field of the nuclear compressor and key flow equipment of the nuclear power system as objects. The results show that the average relative deviation of the POD-DNN is <10% and calculation time is <1% when compared to those of CFD. This research shows that the high-fidelity model constructed using model reduction and deep learning is a feasible method for the realization of digital twins of the nuclear power system in engineering.
Parent-offspring genotyped trios unravelling genomic regions with gametic and genotypic epistatic transmission bias on the cattle genome
Authors: Id-Lahoucine Samir , Casellas Joaquim , Miglior Filippo , Schenkel Flavio S. , Cánovas Angela
Published: April 2023

Several biological mechanisms affecting the sperm and ova fertility and viability at developmental stages of the reproductive cycle resulted in observable transmission ratio distortion (i.e., deviation from Mendelian expectations). Gene-by-gene interactions (or epistasis) could also potentially cause specific transmission ratio distortion patterns at different loci as unfavorable allelic combinations are under-represented, exhibiting deviation from Mendelian proportions. Here, we aimed to detect pairs of loci with epistatic transmission ratio distortion using 283,817 parent-offspring genotyped trios (sire-dam-offspring) of Holstein cattle. Allelic and genotypic parameterization for epistatic transmission ratio distortion were developed and implemented to scan the whole genome. Different epistatic transmission ratio distortion patterns were observed. Using genotypic models, 7, 19 and 6 pairs of genomic regions were found with decisive evidence with additive-by-additive, additive-by-dominance/dominance-by-additive and dominance-by-dominance effects, respectively. Using the allelic transmission ratio distortion model, more insight was gained in understanding the penetrance of single-locus distortions, revealing 17 pairs of SNPs. Scanning for the depletion of individuals carrying pairs of homozygous genotypes for unlinked loci, revealed 56 pairs of SNPs with recessive epistatic transmission ratio distortion patterns. The maximum number of expected homozygous offspring, with none of them observed, was 23. Finally, in this study, we identified candidate genomic regions harboring epistatic interactions with potential biological implications in economically important traits, such as reproduction.
Schizophrenia and cardiometabolic abnormalities: A Mendelian randomization study
Authors: Saadullah Khani Noushin , Cotic Marius , Wang Baihan , Abidoph Rosemary , Mills Georgina , Richards-Belle Alvin , Perry Benjamin I. , Khandaker Golam M. , Bramon Elvira
Published: April 2023

Background: Individuals with a diagnosis of schizophrenia are known to be at high risk of premature mortality due to poor physical health, especially cardiovascular disease, diabetes, and obesity. The reasons for these physical health outcomes within this patient population are complex. Despite well-documented cardiometabolic adverse effects of certain antipsychotic drugs and lifestyle factors, schizophrenia may have an independent effect.

Aims: To investigate if there is evidence that schizophrenia is causally related to cardiometabolic traits (blood lipids, anthropometric traits, glycaemic traits, blood pressure) and vice versa using bi-directional two-sample Mendelian randomization (MR) analysis.

Methods: We used 185 genetic variants associated with schizophrenia from the latest Psychiatric Genomics Consortium GWAS (n = 130,644) in the forward analysis (schizophrenia to cardiometabolic traits) and genetic variants associated with the cardiometabolic traits from various consortia in the reverse analysis (cardiometabolic traits to schizophrenia), both at genome-wide significance (5 × 10−8). The primary method was inverse-variance weighted MR, supported by supplementary methods such as MR-Egger, as well as median and mode-based methods.

Results: In the forward analysis, schizophrenia was associated with slightly higher low-density lipoprotein (LDL) cholesterol levels (0.013 SD change in LDL per log odds increase in schizophrenia risk, 95% CI, 0.001–0.024 SD; p = 0.027) and total cholesterol levels (0.013 SD change in total cholesterol per log odds increase in schizophrenia risk, 95% CI, 0.002–0.025 SD; p = 0.023). However, these associations did not survive multiple testing corrections. There was no evidence of a causal effect of cardiometabolic traits on schizophrenia in the reverse analysis.

Discussion: Dyslipidemia and obesity in schizophrenia patients are unlikely to be driven primarily by schizophrenia itself. Therefore, lifestyle, diet, antipsychotic drugs side effects, as well as shared mechanisms for metabolic dysfunction and schizophrenia such as low-grade systemic inflammation could be possible reasons for the apparent increased risk of metabolic disease in people with schizophrenia. Further research is needed to examine the shared immune mechanism hypothesis.
Exploration and identification of six novel ferroptosis-related hub genes as potential gene signatures for peripheral nerve injury
Authors: Zhang Yifei , Chen Chun , Li Dawei , Chen Penghui , Hang Lei , Yang Jun , Xie Jin
Published: April 2023

Specific biomarkers of ferroptosis after peripheral nerve injury (PNI) are still under debate. In this study, 52 differentially expressed ferroptosis-related genes (DE-FRGs) were retrieved from publicly accessible sequencing data of intact and injured samples of rats with sciatic nerve crush injury. Functional enrichment analyses revealed that adipogenesis, mitochondrial gene sets, and pathways of MAPK, p53, and CD28 family were predominantly engaged in ferroptosis after PNI. Next, Cdkn1a, Cdh1, Hif1a, Hmox1, Nfe2l2, and Tgfb1 were investigated as new ferroptosis-associated hub genes after PNI. Subsequently, clustering correlation heatmap shows six hub genes are linked to mitochondria. The immunofluorescence assay at 0, 1, 4, 7, and 14 days indicated the temporal expression patterns of Tgfb1, Hmox1, and Hif1a after PNI were consistent with ferroptosis validated by PI and ROS staining, while Cdh1, Cdkn1a, and Nfe2l2 were the opposite. In summary, this study identified six hub genes as possible ferroptosis-related biomarkers for PNI, which may offer therapeutic targets for peripheral nerve regeneration and provide a therapeutic window for ferroptosis.
Prognostic value of various immune cells and Immunoscore in triple-negative breast cancer
Authors: Ren Xinyu , Song Yu , Pang Junyi , Chen Longyun , Zhou Liangrui , Liang Zhiyong , Wu Huanwen
Published: April 2023

Background

This study aimed to evaluate the expression status and prognostic role of various immunoregulatory cells and test in triple-negative breast cancer (TNBC).

Methods

The expression of five markers (CD3/CD4/CD8/CD19/CD163) of tumor immune cells was evaluated retrospectively in tumor sections from 68 consecutive cases of TNBC by immunohistochemistry. Computational image analysis was used to quantify the density and distribution of each immune marker within the tumor region, tumor invasive margin, and expression hotspots. Immunoscores were calculated using an automated approach. Other clinical characteristics were also analyzed.

Results

For all patients, Kaplan–Meier survival analysis showed that high CD3+ signals in the tumor region (disease-free survival (DFS), P=0.0014; overall survival (OS), P=0.0031) and total region (DFS, P=0.0014; OS, P=0.0031) were significantly associated with better survival. High CD4+ levels in the tumor region and total regions were significantly associated with better survival (P<0.05). For Hotspot analysis, CD3+ was associated with significantly better survival for all Top1, Top2, and Top3 densities (DFS and OS, P<0.05). High CD4+ levels were significantly associated with better prognosis for Top1 and Top3 densities (DFS and OS, P<0.05). For stage IIB and IIIC patients, CD3+ in the tumor region and all Top hotspots was found to be significantly correlated with survival (DFS and OS, P<0.05). CD4+ cells were significantly associated with survival in the tumor region, total region, and Top3 density (DFS, P=0.0213; OS, P=0.0728). CD8+ cells were significantly associated with survival in the invasive margin, Top2 density, and Top3 density. Spatial parameter analysis showed that high colocalization of tumor cells and immune cells (CD3+, CD4+, or CD8+) was significantly associated with patient survival.

Conclusion

Computational image analysis is a reliable tool for evaluating the density and distribution of immune regulatory cells and for calculating the Immunoscore in TNBC. The Immunoscore retains its prognostic significance in TNBC later than IIB stage breast cancer. Future studies are required to confirm its potential to predict tumor responses to chemotherapy and immune therapy.
Inflammation-related proteomics demonstrate landscape of fracture blister fluid in patients with acute compartment syndrome
Authors: Long Yubin , Li Yiran , Wang Tao , Ni Andrew , Guo Jialiang , Dong Qi , Yang Shuo , Guo Junfei , Wang Ling , Hou Zhiyong
Published: April 2023

Background

Blisters are tense vesicles or bullae that arise on swollen skin and are found in a wide range of injuries. As a complication of fracture, fracture blisters are considered soft tissue injuries, which often lead to adverse effects such as prolonged preoperative waiting time and increased risk of surgical site infection. However, our previous study found that in patients with acute compartment syndrome, fracture blisters may be a form of compartment pressure release, but the specific mechanism has not been revealed. Here, we mapped out the proteomic landscape of fracture blister fluid for the first time and compared its expression profile to cupping and burn blisters.

Methods

First, fluid samples were collected from 15 patients with fracture blisters, 7 patients with cupping blisters, and 9 patients with burn blisters. Then, the expression levels of 92 inflammatory proteins were measured using the Olink Target 96 Inflammation panel. Protein profiles were compared across the three groups using Differential Protein Expression Analysis and Principal Component Analysis (PCA).

Results

Fracture blisters had significantly higher levels of 50 proteins in comparison to cupping and 26 proteins in comparison to burn blisters. Notably, PCA showed fracture blisters closely resembled the protein expression profile of burn blisters but were distinct from the protein expression profile of cupping blisters.

Conclusion

Our study provides the first characterization of fracture blister fluid using proteomics, which provides a valuable reference for further analysis of the difference between blisters caused by fractures and those caused by other pathogenic factors. This compendium of proteomic data provides valuable insights and a rich resource to better understand fracture blisters.
Single-cell immune profiling reveals immune responses in oral lichen planus
Authors: Li Qionghua , Wang Fei , Shi Yujie , Zhong Liang , Duan Shumin , Kuang Wenjing , Liu Na , Luo En , Zhou Yu , Jiang Lu , Dan Hongxia , Luo Xiaobo , Zhang Dunfang , Chen Qianming , Zeng Xin , Li Taiwen
Published: April 2023

Introduction

Oral lichen planus (OLP) is a common chronic inflammatory disorder of the oral mucosa with an unclear etiology. Several types of immune cells are involved in the pathogenesis of OLP.

Methods

We used single-cell RNA sequencing and immune repertoire sequencing to characterize the mucosal immune microenvironment of OLP. The presence of tissue-resident memory CD8+ T cells are validated by multiplex immunofluorescence.

Results

We generated a transcriptome atlas from four OLP biopsy samples and their paired peripheral blood mononuclear cells (PBMCs), and compared them with two healthy tissues and three healthy PBMCs samples. Our analysis revealed activated tissue-resident memory CD8+ T cells in OLP tissues. T cell receptor repertoires displayed apperant clonal expansion and preferrential gene pairing in OLP patients. Additionally, obvious BCR clonal expansion was observed in OLP lesions. Plasmacytoid dendritic cells, a subtype that can promote dendritic cell maturation and enhance lymphocyte cytotoxicity, were identified in OLP. Conventional dendritic cells and macrophages are also found to exhibit pro-inflammatory activity in OLP. Cell-cell communication analysis reveals that fibroblasts might promote the recruitment and extravasation of immune cells into connective tissue.

Discussion

Our study provides insights into the immune ecosystem of OLP, serving as a valuable resource for precision diagnosis and therapy of OLP.
Construction of BaTiO3/CeO2 heterojunction and comparative study on photocatalytic activity of degradation of different drugs
Authors: Ye Chao , Li Chengui
Published: April 2023

A type II band aligned BaTiO3/CeO2 photocatalysts was constructed by a simple one-step solution synthesis method. The BaTiO3/CeO2 photocatalysts contain only cubic phase BaTiO3 and CeO2, and the particles are approximately spherical with a small amount of adhesion and agglomeration, and the average particle size is about 50 nm. Transmission electron microscopy (TEM) observation and element Mapping characterization confirmed the formation of special heterojunction between BaTiO3 and CeO2 and the presence of a large number of oxygen vacancies, which resulted in high visible optical absorption coefficient. The BaTiO3/CeO2 photocatalysts demonstrated high photocatalytic activity for the degradation of oxytetracycin hydrochloride, and the optimal drug concentration, catalyst content and pH value are 50 mg/L, 1 g/L and 7, respectively. Simultaneously, the BaTiO3/CeO2 photocatalysts were selective for degradation of aureomycin hydrochloride, doxycycline hydrochloride and tetracycline hydrochloride. Other photocatalytic experiments show that the BaTiO3/CeO2 photocatalysts have high chemical and cyclic stability, and the synergistic effect of holes, hydroxyl radicals and superoxide radicals plays an important role in the whole photocatalytic process. This simple synthesis route provides a technical reference for constructing other wide-band gap semiconductors to respond to simulated sunlight.
A retrospective analysis of normal saline and lactated ringers as resuscitation fluid in sepsis
Authors: Isha Shahin , Satashia Parthkumar H. , Yarrarapu Siva Naga S. , Govero Austin B. , Harrison Michael F. , Baig Hassan Z. , Guru Pramod , Bhattacharyya Anirban , Ball Colleen T. , Caples Sean M. , Grek Ami A. , Vizzini Michael R. , Khan Syed Anjum , Heise Katherine J. , Sekiguchi Hiroshi , Cantrell Warren L. , Smith Jeffrey D. , Chaudhary Sanjay , Gnanapandithan Karthik , Thompson Kristine M. , Graham Charles G. , Cowdell Jed C. , Murawska Baptista Aleksandra , Libertin Claudia R. , Moreno Franco Pablo , Sanghavi Devang K.
Published: April 2023

Background

The Surviving Sepsis Campaign suggested preferential resuscitation with balanced crystalloids, such as Lactated Ringer’s (LR), although the level of recommendation was weak, and the quality of evidence was low. Past studies reported an association of unbalanced solutions, such as normal saline (NS), with increased AKI risks, metabolic acidosis, and prolonged ICU stay, although some of the findings are conflicting. We have compared the outcomes with the preferential use of normal saline vs. ringer’s lactate in a cohort of sepsis patients.

Method

We performed a retrospective cohort analysis of patients visiting the ED of 19 different Mayo Clinic sites between August 2018 to November 2020 with sepsis and receiving at least 30 mL/kg fluid in the first 6 h. Patients were divided into two cohorts based on the type of resuscitation fluid (LR vs. NS) and propensity-matching was done based on clinical characteristics as well as fluid amount (with 5 ml/kg). Single variable logistic regression (categorical outcomes) and Cox proportional hazards regression models were used to compare the primary and secondary outcomes between the 2 groups.

Results

Out of 2022 patients meeting our inclusion criteria; 1,428 (70.6%) received NS, and 594 (29.4%) received LR as the predominant fluid (>30 mL/kg). Patients receiving predominantly NS were more likely to be male and older in age. The LR cohort had a higher BMI, lactate level and incidence of septic shock. Propensity-matched analysis did not show a difference in 30-day and in-hospital mortality rate, mechanical ventilation, oxygen therapy, or CRRT requirement. We did observe longer hospital LOS in the LR group (median 5 vs. 4 days, p = 0.047 and higher requirement for ICU post-admission (OR: 0.70; 95% CI: 0.51–0.96; p = 0.026) in the NS group. However, these did not remain statistically significant after adjustment for multiple testing.

Conclusion

In our matched cohort, we did not show any statistically significant difference in mortality rates, hospital LOS, ICU admission after diagnosis, mechanical ventilation, oxygen therapy and RRT between sepsis patients receiving lactated ringers and normal saline as predominant resuscitation fluid. Further large-scale prospective studies are needed to solidify the current guidelines on the use of balanced crystalloids.