bluuebunny/crossref_metadata_2025 huggingface dataset:
An FMRI-compatible System for Targeted Electrical Stimulation
Authors: Jørgensen Louise Møller , Baandrup Anders Ohlhues , Mandeville Joseph , Glud Andreas Nørgaard , Sørensen Jens Christian Hedemann , Weikop Pia , Jespersen Bo , Hansen Adam Espe , Thomsen Carsten , Knudsen Gitte Moos
Published: March 2021

BackgroundElectroceutical therapy, applied in various forms, is a rapidly growing therapeutic option to be considered across different medical disorders, particularly within psychiatry, neurology, chronic pain and rehabilitation therapy. Combining targeted electric stimuli with feedback from fMRI can provide valuable information about the mechanisms underlying the therapeutic effects. So far, however, such studies have been hampered by the lack of technology to conduct such experiments in a both accurate and safe manner. We here present a patented system, a fMRI compatible electrical stimulator, developed for fMRI data acquisition during deep brain stimulation (DBS), as well as the first proof-of-concept neuroimaging data in pigs obtained with a prototype of the device.MethodsThe system consists of two modules, placed in the control and scanner room, with corresponding optical modules and signal converters, connected by optical fiber led through wave guides and back looped for quality assurance. The system is also connected to the MRI scanner to timely initiate the stimulation sequence at start of scan. We evaluated the system in four pigs with DBS in the subthalamic nucleus (STN) where we acquired the BOLD response in the STN and neocortex, with stimulation turned on and off in a block design synchronized to the scanning sequence.ResultsWe found that the system delivered a robust electrical stimulus to the implanted electrode during the entire experimental period. The stimulus was confirmed to be in sync with the preprogrammed fMRI block design. All pigs displayed a DBS-STN induced neocortical BOLD response, but none in the site of the implanted electrode. The system solves three major problems related to electrical stimuli and fMRI examinations, namely preventing distortion of the fMRI signal, enabling communication that synchronize the experimental conditions, and surmounting the safety hazards caused by interference from the powerful magnetic field and RF emission. ConclusionsThe patented fMRI compatible electrical stimulator, based on an optic fiber solution, circumvents previous problems related to DBS electroceuticals and fMRI. The system allows flexible modifications for fMRI designs and stimulation parameters but can also be customized to electroceutical applications beyond DBS, applicable for a broad range of medical conditions.
Intensive care–treated cardiac arrest: A retrospective study on the impact of extended age on mortality, neurological outcome, received treatments and healthcare-associated costs
Authors: Holmström Ester Elisabet , Efendijev Ilmar , Raj Rahul , Pekkarinen Pirkka T. , Litonius Erik , Skrifvars Markus B.
Published: March 2021

Background: Cardiac arrest (CA) is a leading cause of death worldwide. As population ages, the need for research focusing on CA in elderly increases. This study investigated treatment intensity, 12-month neurological outcome, mortality and healthcare-associated costs for patients aged over 75 years treated for CA in an intensive care unit (ICU) of a tertiary hospital. Methods: This single-centre retrospective study included adult CA patients treated in a Finnish tertiary hospital’s ICU between 2005 and 2013. We stratified the study population into two age groups: <75 and 75 years. We compared interventions defined by the median daily therapeutic scoring system (TISS-76) between the age groups to find differences in treatment intensity. We calculated cost-effectiveness by dividing the total one-year healthcare-associated costs of all patients by the number of survivors with a favourable neurological outcome. Favourable outcome was defined as a cerebral performance category (CPC) of 1–2 at 12 months after cardiac arrest. Logistic regression analysis was used to identify independent association between age group, mortality and neurological outcome. Results: This study included a total of 1,285 patients, of which 212 (16%) were 75 years of age. Treatment intensity was lower for the elderly compared to the younger group, with median TISS scores of 116 and 147, respectively (p < 0.001). The effective cost in euros for patients with a good one-year neurological outcome was €168,000 for the elderly and €120,000 for the younger group. At 12 months after CA 24% of the patients in the elderly group and 47% of the patients in the younger group had a CPC of 1-2 (p < 0.001). Age was an independent predictor of mortality (multivariate OR = 3.36, 95% CI:2.21-5.11, p < 0.001) and neurological outcome (multivariate OR = 3.27, 95% CI: 2.12-5.03, p < 0.001). Conclusions: The elderly ICU-treated CA patients in this study had worse neurological outcomes, higher mortality and lower cost-effectiveness than younger patients. Further efforts are needed to recognize the tools for assessing which elderly patients benefit from a more aggressive treatment approach in order to improve the cost-effectiveness of post-CA management.
Bio-surveillance of environmental pollutants in the population of Kinshasa, Democratic Republic of Congo (DRC): A small pilot study
Authors: Bayebila Trésor , Dufour Patrice , Pirard Catherine , Nsangu Jean , Mufusama Jean-Pierre , Mbinze Jérémie , Marini Roland , Charlier Corinne
Published: March 2021

BackgroundEnvironmental pollutants are known to be ubiquitous and may present toxic effects (endocrine-disruption properties, carcinogenicity…). Therefore, they represent a real threat to human health. The aim of the present study was to assess the content of environmental pollutants (inorganic, persistent, and non-persistent pollutants) in biological samples (urine, serum, and whole blood), collected from volunteers in Kinshasa, capital of Democratic Republic of Congo, in order to estimate the exposure level in the population of Kinshasa to environmental pollutants.MethodsFrom randomly selected 15 volunteers living in Kinshasa, aged from 25 to 66 years, including 10 men and 5 women, urine, whole blood, and serum samples were used in this study to estimate the contents in these environmental pollutants, using Inductively Coupled Plasma Mass Spectrometry, Gas Chromatography coupled to Mass Spectrometry, and Liquid Chromatography coupled to Mass Spectrometry.ResultsWhen compared to data nationally and internationally available, the preliminary outcomes of this study indicated a high level of exposure to environmental pollutants in the population of Kinshasa, especially for arsenic, cadmium, lead, benzophenone-3, methyl-paraben, propyl-paraben, triclosan, mono-ethyl phthalate, mono-n-butyl phthalate, 3-phenoxybenzoic acid, cis-3-(2,2-dichlorovinyl)-2,2-dimethylcyclopropane-1-carboxylic acid, and for 3,5,6-trichloro-2-pyridinol. The levels of 4,4’dichloro-diphenyl-dichloro-ethylene and glyphosate were also significant although some heavily exposed populations showed higher level of contamination. In contrast, the investigated population of Kinshasa was found to weakly exposed to other pollutants like bisphenol A, dialkyl phosphates, polychlorinated biphenyls, brominated flame retardants, phenolic organo-halogens, and perfluoroalkyl substances.ConclusionAlthough the biologic fluids were collected from a limited number of volunteers (n = 15), the results of the present report clearly indicate that the population of Kinshasa is not spared by the investigated environmental pollutants.Trial registration: this study was retrospectively registered by the national health ethics committee in the Congo under the series number of 159/CNES/BN/PMMF/2020.
Behavioral Responses of Pyrethroid-resistant Anopheles Gambiae Mosquitoes to Insecticide-treated Bed Net
Authors: Machani Maxwell G. , Ochomo Eric , Amimo Fred , Githeko Andrew K. , Yan Guiyun , Afrane Yaw A.
Published: March 2021

Background: Long-lasting insecticidal nets are an effective tool in reducing malaria transmission. However, with increasing insecticide resistance little is known about how physiologically resistant malaria vectors behave around a human-occupied bed net, despite their importance in malaria transmission. We assessed the host-seeking behavior of the major malaria vector Anopheles gambiae s.s, when an intact human-occupied treated bed net is in place, with respect to their insecticide resistance status under semi-field conditions. Methods: Pyrethroid resistant and susceptible colonies of female Anopheles gambiae s.s aged 3-5 days that have been bred in our insectary, were color-marked with fluorescent powder and released inside a semi-field environment housing a hut which was occupied by a human host. Inside the hut, the occupant slept under an insecticide-treated bed net trap or untreated bed net trap. The window exit trap was installed to catch mosquitoes exiting the hut. A prokopack aspirator was used to collect indoor and outdoor resting mosquitoes in the morning. Clay pots were placed outside the hut to collect mosquitoes resting outdoors. Results: The proportion of resistant mosquitoes caught in the treated bed net trap was higher 43% (95% CI= [40.6-45.3]) compared to the susceptible mosquitoes 28.3% (OR=1.445; P<0.00019). The proportion of susceptible mosquitoes caught in the untreated bed net trap was higher 51.3% (95% CI= [48.8-53.6]) compared to the treated bed net trap 28.3% (95% CI= [26.3-30.5]) (OR=2.65; P<0.0001). Resistant mosquitoes were less likely to exit the house when a treated bed net was present (5.2%; 95% CI= [4.2-6.4]) compared to the susceptible mosquitoes (11.5%; 95% CI= [9.6-12.6]). The proportion of susceptible mosquitoes avoiding contact with the treated bed net and caught resting indoors in the hut (53.8%) and outdoors (64.5%) was higher compared to the resistant mosquitoes (indoors: 46.2%, outdoor: 35.4%). The susceptible females were 2.3 times more likely to stay outdoors away from the treated bed net (OR=2.25; 95% CI= [1.7-2.9]; P<0.0001).Conclusion: The results show that in the presence of a treated net, the host-seeking performance was not altered for the resistant mosquitoes, unlike the susceptible females that were observed to exit the house and remained outdoors when a treated net was used. However, further investigations of the behavior of resistant mosquitoes under natural conditions should be undertaken to confirm these observations and improve the current intervention which are threatened by insecticide resistance and altered vector behavior.
Clinicopathological Characteristics and Endoscopic Features of Early Gastric Cancers Diagnosed After Helicobacter pylori Eradication
Authors: Ishibashi Hideki , Takedatsu Hidetoshi , Tanabe Taro , Imakiire So , Matsuoka Hiroki , Yasuda Hideki , Sakisaka Hideto , Matsuoka Satoshi , Kayashima Yoshiyuki , Kuno Nobuaki , Abe Koichi , Funakoshi Sadahiro , Hirai Fumihito
Published: March 2021

Background. Helicobacter pylori (H. pylori) infection is an important risk factor for developing gastric cancer. However, even after H. pylori eradication, early gastric cancer (EGC) can develop. We elucidated the characteristics of EGCs diagnosed after H. pylori eradication. Methods. Thirty-six EGCs in 32 patients diagnosed after H. pylori eradication were defined as the eradication group (H. pylori-EG). The clinicopathological and endoscopic features were compared with those of 156 EGCs in 140 patients in the H. pylori-positive group (H. pylori-PG). Twenty-nine EGC lesions in the H. pylori-EG were further divided into two subgroups: the first included six lesions of none to mild atrophic mucosa around the EGC, and the second included 23 lesions of moderate to severe atrophic mucosa around the EGC. We compared them between the two subgroups. Results. Endoscopic features of EGCs in the H. pylori-EG were characterized as small (P = 0.049) and of the depressed type (P = 0.022) compared with those in the H. pylori-PG. EGCs in the H. pylori-EG were detected on the upper region of the stomach more frequently than those in the H. pylori-PG (P = 0.002). As for submucosal ECGs in the H. pylori-EG, it was more likely to be seen in the none to mild atrophic mucosa subgroup compared to the moderate to severe atrophic gastric mucosa subgroup (P = 0.003). Conclusions. EGCs after H. pylori eradication were characterized as small and of the depressed type. Submucosal invasive EGCs developed more frequently in the none to mild atrophic mucosa after H. pylori eradication. Therefore, careful patient follow-up is important after H. pylori eradication.
Ag Nanoparticles capped TiO2 Nanowires Array based Capacitive Memory
Authors: Pandey Amit Kr. , Deb Prasenjit , Dhar Jay Chandra
Published: March 2021

Glancing angle deposition technique was used to fabricate Ag nanoparticles (NPs) capped TiO2 Nanowire (NW) array structure for capacitive memory application. Electron microscopes confirmed the sandwiched structure of Ag NPs between TiO2 thin-film (TF) and NW. The average length of the vertical TiO2 NW and diameter of Ag NPs (with density ~1012 cm2) were found to be ~ 350 nm ±5 nm and ~3.2 nm ± 0.4 nm, respectively. An enhanced photoluminescence was observed in case of Ag NPs capped TiO2 NWs due to the presence of high carriers as compared to bare TiO2 NW. The capacitance (C) - voltage (V) hysteresis was measured for both Ag NPs capped TiO2 NW and bare TiO2 NW at different sweeping voltage (±3V to ±10 V) at 1 MHz frequency. A high capacitive memory window of 7.12 V was obtained for Ag NP capped TiO2 NW at ±10 V with an excellent endurance upto 1000 cycle. Significantly lesser charge loss of 23% was obtained after a span of 104 s with a hole and electron loss of 10.6% and 17.8% respectively. The program and erase process in the device was explained with the help of a band diagram.
Al-enabled, implantable, multichannel wireless telemetry for photodynamic therapy
Authors: Kim Woo Seok , Khot M. Ibrahim , Woo Hyun-Myung , Baek Dong-Hyun , Hong Sungcheol , Maisey Thomas , Daniels Brandon , Coletta Patricia , Yoon Byung-Jun , Jayne David , Park Sung Il
Published: March 2021

Photodynamic therapy (PDT) is an alternative method for treating cancers, and its outcomes are highly dependent on light delivery to tumor cells to activate a photosensitizer. Existing approaches paired with advances in wireless technologies enable remote delivery of light to tumors but suffer from poor spatiotemporal resolution due to inabilities to minimize oxygen depletion in a tumor. Here, we introduce AI-informed low-power wireless telemetry with an integrated thermal/light simulation platform that bypasses all constraints above. The simulator leads to the optimized combination of wavelengths and light sources, and AI-assisted wireless telemetry uses the parameters from the simulator to enable adequate illumination of tumors through high-throughput (< 20 mice) and multi-wavelength operation. They establish a range of guidelines for effective PDT regimen design. Hypericin and Foscan mediated PDT demonstrated substantial suppression of tumor growth, suggesting that the proposed platform provides the potential for widespread use in fundamental research and/or clinical settings.
Nitrogen, Phosphorus, and Potassium Influence Rice Growth and Development by Regulating the Efficiency of Energy Production
Authors: Ma Jiaying , Chen Tingting , Lin Jie , Fu Weimeng , Feng Baohua , Li Guangyan , Li Hubo , Li Juncai , Wu Zhihai , Tao Longxing , Fu Guanfu
Published: March 2021

Background: Nitrogen (N), phosphorus (P), and potassium (K) are important essential nutrients for plant growth and development, but how they regulate plant energy status remains unclear. Results: In this study, we grew Nipponbare rice (Oryza sativa) seedlings in a growth chamber for 20 d at 30/24 ℃ (day/night) under natural sunlight conditions with different nutrient regimes. N appeared to play the most important role in plant growth and development, followed by P and K. The highest nonstructural carbohydrate (NSC) content, dry weight, net photosynthetic rate (PN), ATP content, and NADH dehydrogenase, cytochrome oxidase, and ATPase activities were found in the plants that received sufficient N, P, and K. The lowest values of these parameters were measured in the N-deficient plants. Higher dry matter accumulation was observed in the −K treatment than in the −P treatment, but there was no difference in the ratio of respiration rate to photosynthetic rate between these two treatments, suggesting that differences in energy production efficiency may have accounted for this result. This hypothesis was confirmed by higher ATP contents and activities of NADH dehydrogenase, cytochrome oxidase, and ATPase in the K-deficient plants than in the P-deficient plants. Conclusion: We inferred that N, P, and K controlled rice plant growth and development by regulating the efficiency of energy production.
Management of Metastatic Disease in Campania (MAMETIC): Epidemiologic Data and Palliative Radiotherapy in an Italian Region. Study Protocol
Authors: FRANCO Rossella DI , Cascella Marco , Fusco Mario , Borzillo Valentina , Ferraioli Piera , Scipilliti Esmeralda , D'Ippolito Emma , Petito Angela , Cuomo Arturo , Pignata Sandro , Napoli Marilena Di , Rossetti Sabrina , Celentano Egidio , Crispo Anna , Grimaldi Maria , Muto Paolo
Published: March 2021

Background. In the Italian Campania Region, 30.517 new cases of solid cancer have been diagnosed, in 2019. Of those, patients with metastatic disease are up to 20%. This class of patients is extremely diversified and copious, and the offer of radiotherapy may vary in different geographical areas within the same region. The aim of this observational multicenter retrospective and prospective trial is to evaluate the occurrence of metastatic disease in several areas of a great Italian region, the management of the disease through RT approaches, and its impact on cancer-related pain and overall HRQoL. Methods. This is a multicenter, retrospective and prospective observational investigation. The retrospective part of the study concerns all patients enrolled with a diagnosis of metastatic disease and treated in RT centers within the Campania Region between January 2019 to July 2020. The prospective phase is going to involve all the metastatic patients with an indication of palliative RT. Considering regional epidemiological data, we expect an enrollment of 12.500-21.000 patients in 5 years. Conclusion. The MAMETIC Trial is an epidemiological study designed for investigating the different prevalence of tumors in the metastatic phase within a regional area, and for evaluating the local response to the patient's request. It can be a unique opportunity, not only to highlight possible geographic differences but also to regularly collect and share data to standardize the therapeutic offer within the regional area. ClinicalTrials.gov ID NCT04595032.
Creep Strain Analysis and an Improved Creep Model of Granite Based on the Ratio of Deviatoric Stress-Peak Strength under Different Confining Pressures
Authors: Qian Li , Zhang Jianhai , Wang Xianliang , Li Yonghong , Zhang Ru , Xu Nuwen , Li Zhiguo
Published: March 2021

Creep refers to the deformation of rock with time under long-term applied stress, which occur in most underground engineering. The creep behavior of granite in Shuang jiangkou underground powerhouse in Western Sichuan Province, China, was studied by creep tests. Based on test results, a new parameter DPR, the ratio of deviatoric stress to peak strength, is proposed. DPR is found to be a key parameter to describe creep parameters such as instantaneous elastic modulus, creep elastic modulus, and viscosity coefficient of rock under different confining pressures. Creep tests show that instantaneous elastic modulus increases with the increase of DPR. Creep elastic modulus increases when DPR changes from 0.54 to 0.7004, but decreases when DPR is from 0.7004 to 0.88, indicating fractures in rock closes firstly and then new fractures are generated. The viscosity coefficient of the rock increases first and then decreases with the increase of DPR, and when DPR = 0.7171, viscosity coefficient is maximum, indicating the time for rock to reach stability is the longest in creep tests. By introducing DPR and confining pressure into creep model, which interconnect creep parameters in a unified expression, an improved generalized Kelvin creep model is proposed which can accurately describe the primary and the secondary creep behavior of granite under given deviatoric stresses and confining pressures.
Contamination of Single Fluid-Filled Intragastric Balloons with Orogastric Fluid is not Associated with Hyperinflation: An Ex-vivo Study and Systematic Review of Literature
Authors: Hawa Fadi , Vargas Eric J. , Acosta Andres , McRae Alison , Bazerbachi Fateh , Dayyeh Barham K. Abu
Published: March 2021

Background
Spontaneous hyperinflation is reported to the Food and Drug Administration as a complication of intragastric balloons. It is postulated that orogastric contamination of the intragastric balloon may cause this phenomenon. We sought to investigate the effects of intentional balloon contamination with gastric contents on intragastric balloon diameter and contents, whether methylene blue plays a role in preventing spontaneous hyperinflation, and review the available literature on spontaneous hyperinflation.
Methods
Four pairs of balloons with different combinations of sterile saline, contaminants, and methylene blue were incubated in a 37° Celsius water bath for 6 months to simulate physiological conditions with serial measurements of balloon diameter. Our findings were compared against a systematic review across multiple databases to summarize the available literature.
Results
Balloon mean diameter decreased from 33.5 cm ± 0.53 cm to 28.5 cm ± 0.46 cm (p < 0.0001). No significant differences were seen with the methylene blue group. Only 11 cases were found reported in the literature.
Conclusions
Despite contaminating intragastric balloons with gastric aspirates, hyperinflation did not occur, and other factors may be in play to account for this phenomenon, when observed. Rates of hyperinflation remain under-reported in the literature. Further controlled experiments are needed.
De-implementation and Substitution of Clinical Care Processes: Stakeholder Perspectives on the Transition to Primary Human Papillomavirus (HPV) Testing for Cervical Cancer Screening
Authors: Hahn Erin E , Munoz-Plaza Corrine , Altman Danielle , Hsu Chunyi , Cannizzaro Nancy , Ngo-Metzger Quyen , Wride Patricia , Gould Michael K , Mittman Brian S , Hodeib Melissa , Tewari Krishnansu , Ajamian Lena , Eskander Ramez , Tewari Devansu , Chao Chun R
Published: March 2021

Background: New cervical cancer screening guidelines recommend primary human papillomavirus (HPV) testing for women age 30-65 years. Healthcare organizations are preparing to de-implement the previous recommended strategies of Pap testing or co-testing (Pap plus HPV test) and substitute primary HPV testing. However, there may be significant challenges to replacement of this entrenched clinical practice, even with an evidence-based substitution. We sought to identify stakeholder-perceived barriers and facilitators to this substitution within a large healthcare system, Kaiser Permanente Southern California.Methods: We conducted semi-structured qualitative interviews with clinician, administrative and patient stakeholders regarding: (a) acceptability and feasibility of the planned substitution; (b) perceptions of barriers and facilitators, with an emphasis on those related to the de-implementation/implementation cycle of substitution; and (c) perceived readiness to change. Our interview guide was informed by the Consolidated Framework for Implementation Research (CFIR). Using a team coding approach, we developed an initial coding structure refined during iterative analysis; the data were subsequently organized thematically into domains, key themes, and sub-themes using thematic analysis, followed by framework analysis informed by CFIR.Results: We conducted 23 interviews: 5 patient and 18 clinical/administrative. Clinicians perceived that patients feel more tests equals better care, and clinicians and patients expressed fear of missed cancers (“…it’ll be more challenging convincing the patient that only one test is…good enough to detect cancer.”). Patients perceived practice changes resulting in “less care” are driven by desire to cut costs. In contrast, clinicians/administrators viewed changing from two tests to one as acceptable and a workflow efficiency (“…It’s very easy and half the work.”). Stakeholder-recommended strategies included focusing on the increased efficacy of primary HPV testing and developing clinician talking points incorporating national guidelines to assuage ‘cost-cutting’ fears. Conclusions: Substitution to replace an entrenched clinical practice is complex. Leveraging available facilitators is key to ease the process for clinical and administrative stakeholders—e.g., emphasizing the efficiency of going from two tests to one. Identifying and addressing clinician and patient fears regarding cost-cutting and perceived poorer quality of care is critical for substitution. Multicomponent and multilevel strategies for engagement and education will be required.Trial registration: ClinicalTrials.gov #NCT04371887
Modulation of COX-2 and NADPH oxidase-4 by Alpha-lipoic acid ameliorates busulfan-induced pulmonary injury in rats.
Authors: Elhadidy Mona , Elmasry Ahlam , Elsayed Hassan Reda Hassan , El-Nablaway Mohammad H , Hamed Shereen , Elalfy Mahmoud M. , Rabei Mohammed R.
Published: March 2021

purpose: Busulfan is an antineoplastic drug that produces pulmonary fibrosis. This study aimed to explore the potential protective effect of α-lipoic acid on busulfan-induced pulmonary fibrosis in rats.Methods: Twenty-four adult male rats were divided into four groups: control, α-lipoic acid (ALA), busulfan, and busulfan plus α-lipoic acid. Lung index ratio, serum level of proinflammatory cytokine were assessed. The activities of antioxidant enzymes and lipid peroxidation products were estimated in the lung tissues in addition to histopathological analyses. The deposition of the collagen in the lung tissues was evaluated by Sirius red staining. The expressions of α-smooth muscle actin (α-SMA), TNF-α, and Caspase 3 were determined immunohistochemically. The pulmonary expression of COX-2 and NOX-4 mRNA were assessed using qRT-PCR.Results: administration of ALA significantly ameliorated BUS-induced pulmonary fibrosis, besides the upregulation of antioxidants, and downregulation of pro-inflammatory cytokines. Also, it reduced collagen deposition associated with a decreased expression of α-SMA, TNF-α, and Caspase 3 in the lung tissues. Moreover, ALA significantly upregulated the expression of COX-2 concomitant with the downregulation of elevated NOX-4.Conclusion: ALA attenuates the lung cytotoxicity of busulfan through its anti-inflammatory, anti-apoptotic, and antifibrotic effects that may be mediated by upregulation of COX-2 and downregulation of NOX-4.
Delayed Onset Postoperative Retropharyngeal Hematoma After Anterior Cervical Surgery With a Sequela of Tracheal Stricture: a Case Report
Authors: Chang Dong-Gune , Park Jong-Beom , Hwang Zin Ouk , Kim Hong Jin
Published: March 2021

Background: Among the several complications associated with anterior cervical discectomy and fusion (ACDF), airway compromise is considered one of the serious life-threatening conditions and usually requires emergent treatment, including airway establishment and hematoma evacuation surgery. Postoperative retropharyngeal hematoma commonly occurred during the on immediate phase with airway compromise but have a rarity on late onset of this complication. Enlightened by this existing fact, we report the first case of delayed onset postoperative retropharyngeal hematoma after anterior cervical surgery with a sequela of tracheal stricture. Case presentation: A 55-year-old male underwent ACDF for disc herniation at C5-6 that had not responded to conservative treatment over three months. The symptoms significantly improved after surgery, and he was discharged on postoperative day 3. On the seven days after ACDF, the patient complained of sudden onset left-deviated neck swelling. The follow-up plain radiographs and neck-enhanced computed tomography (CT) scans showed anterior and right lateral displacement of the airway including the trachea by a large retropharyngeal hematoma. We performed an emergent forceful endotracheal intubation that was maintained for two days until the patient underwent hematoma evacuation surgery. On the second day after hematoma evacuation surgery, the patient complained of hoarseness with a foul breath odor. Laryngoscopy showed tracheal ischemic mucosal damage that had been induced by forceful endotracheal intubation. Antibiotics and systemic corticosteroids were administered, and the symptoms improved. One month after hematoma evacuation surgery, he complained of dyspnea on exertion, and laryngoscopy showed tracheal stricture. The patient underwent bronchoscopic dilatation and is doing well without recurrence of symptoms. Conclusions: Early surgery to remove the delayed onset retropharyngeal hematoma, rather than forceful endotracheal intubation followed by delayed surgery, might yield better results and avoid unexpected complications of tracheal stricture.
Transcriptional profiles reveal deregulation of lipid metabolism and inflammatory pathways in neurons exposed to palmitic acid
Authors: Leon Manuel Flores , Millman Nicolas Alcaraz , Dominguez Martha Perez , Arciga Karla Marisa Torres , Vega Rosa Rebollar , Velazquez Inti Alberto De la Rosa , Canon Cristian Arriaga , Herrera Luis A , Arias Clorinda , Barrios Rodrigo González
Published: March 2021

The effects of the consumption of high-fat diets (HFD) have been studied to unravel the molecular pathways they are altering in order to understand the link between increased caloric intake, metabolic diseases, and the risk of cognitive dysfunction. The saturated fatty acid, palmitic acid (PA), is the main component of HFD and it has been found increased in the circulation of obese and diabetic people. In the central nervous system, PA has been associated with inflammatory responses in astrocytes, but the effects on neurons exposed to it have not been largely investigated. Given that PA affect a variety of metabolic pathways, we aimed to analyze the transcriptomic profile activated by this fatty acid to shed light on the mechanisms of neuronal dysfunction. In the current study, we profiled the transcriptome response after PA exposition at non-toxic doses in primary hippocampal neurons. Gene ontology and Reactome pathway analysis revealed a pattern of gene expression which is associated with inflammatory pathways, and importantly, with the activation of lipid metabolism that is considered not very active in neurons. Validation by qRT-PCR of Hmgcs2, Angptl4, Ugt8 and Rnf145 support the results obtained by RNAsEq. Overall, these findings suggest that neurons are able to respond to saturated fatty acids changing the expression pattern of genes associated with inflammatory response and lipid utilization that may be involved in the neuronal damage associated with metabolic diseases.
Linking COVID-19 and heme-driven pathophysiologies: A combined computational-experimental approach
Authors: Hopp Marie-T. , Domingo-Fernandez Daniel , Gadiya Yojana , Detzel Milena S. , Graf Regina , Schmalohr Benjamin F. , Kodamullil Alpha T. , Imhof Diana , Hofmann-Apitius Martin
Published: March 2021

The SARS-CoV-2 outbreak has been declared a worldwide pandemic in 2020. Infection triggers the respiratory tract disease COVID-19, which is accompanied by serious changes of clinical biomarkers such as hemoglobin and interleukins. The same parameters are altered during hemolysis, which is characterized by an increase in labile heme. We present two computational-experimental approaches that aim at analyzing a potential link between heme-related and COVID-19 pathophysiologies. Herein, we performed a detailed analysis of the common pathways induced by heme and SARS-CoV-2 by superimposition of knowledge graphs covering heme biology and COVID-19 pathophysiology. Focus was laid on inflammatory pathways and distinct biomarkers as the linking elements. In a second approach, four COVID-19-related proteins, the host cell proteins ACE2 and TMPRSS2 as well as the viral protein 7a and S protein, were computationally analyzed as potential heme-binding proteins with an experimental validation. The results contribute to the understanding of the progression of COVID-19 infections in patients with different clinical backgrounds and might allow for a more individual diagnosis and therapy in the future.
Cu2Se-based thermoelectric cellular architectures for efficient and durable power generation
Authors: Choo Seungjun , Ejaz Faizan , Ju Hyejin , Kim Fredrick , Lee Jungsoo , Yang Seong Eun , Kim Gyeonghun , Kim Hangeul , Jo Seungki , Baek Seongheon , Cho Soyoung , Kim Ju-Young , Ahn Sangjoon , Chae Han Gi , Kwon Beomjin , Son Jae Sung
Published: March 2021

Thermoelectric (TE) power generation offers a promising way to recover waste heat. The geometrical design of TE legs in modules is important to ensure sustainable power generation but cannot be easily achieved by traditional fabrication processes. Herein, we propose the design of cellular TE architectures for efficient and durable power generation, realized by the extrusion-based 3D printing process of Cu2Se TE materials. We designed the optimum aspect ratio of a cuboid TE leg to maximize the power output and extended this design to the mechanically stiff cellular architectures of hollow hexagonal column- and honeycomb-based TE legs. Moreover, we developed organic binder-free Cu2Se-based 3D-printing inks with desirable viscoelasticity, tailored with an additive of inorganic Se82- polyanion, fabricating the designed topologies. The computational simulation and experimental measurement demonstrated the superior power output and mechanical stiffness of the proposed cellular TE architectures to other designs, unveiling the importance of topological designs of TE legs toward higher power and longer durability.
Investigating the Factors Affecting the Self-care Behaviors Status of Patients With Type II Diabetes and the Role of Demographic Variables: a Case Study in Iran
Authors: Kianipour Neda , Chaboksavar Fakhrodin , Rahimi Mehrali , Lebni Javad Yoosefi , Abbas Jaffar , Ziapour Arash
Published: March 2021

Background: Self-care practices in diabetes patients are crucial to keep the illness under control and prevent complications. Effective management of diabetes will be a difficult task without an adequate understanding of the current level of practice related to diabetes self-care. Therefore, this study aims to assess the factors affecting the self-care behaviors status of patients with Type II diabetes and the role of demographic variables in Iran. Methods: The present study is a descriptive-analytical study that was designed and conducted in 2020. This study's statistical population was type II diabetic patients at the Diabetes Research Center of Ayatollah Taleghani Hospital in Kermanshah who were selected by available sampling method of 280 samples. Data collection tools included demographic characteristics questionnaire and standard self-care questionnaire for the Glasgow and Tobert diabetic patients. Data were analyzed using SPSS-23 software, independent t-tests, one-way analysis of variance, and stepwise regression.Results: The mean of self-care scores was 2.07±2.08 and indicated an unfavorable condition. The highest mean scores of self-care were in the field of regular use of medications, and the lowest scores were in the field of blood-glucose testing. The mean scores of self-care were significantly different based on marital status, occupation status, residence, type of treatment, duration of diabetes, years, smoking status (P<0.05). Regression results showed that the variables predictors; type of treatment, smoking status, the complication of diabetes, education level status, place of residence explained 515% of the variance of self-care.Conclusion: The study showed that the extent to which individuals adhere to Type II diabetes recommended management is substantially low. Improving awareness of patients and the community at large is imperative, especially on the diet, exercise, blood-glucose testing, foot care, and no smoking.
“Assessment of Heavy Metal Pollution in Soil of Chattogram Hill Tracts, Bangladesh and Concomitant Health Risk”
Authors: Barua Troyee , Bhuian AKM Saiful Islam , Khandaker Mayeen Uddin , Deb Nipa , Hossain Shahadat , Rashid Md. Abdur
Published: March 2021

The increased human population and associated activities may create a risk in the ecological balance of Chattogram Hill Tracts (CHT), Bangladesh via contamination of soil with toxic heavy metals. Thus, the present study was conducted to assess the concentration of heavy metals (Lead, Cadmium, Copper, Zinc, Iron, Manganese, Chromium and Nickel) in forest soils of the CHT area by using an atomic absorption spectrometer. The degree of contamination of soil was evaluated by five indices: geo-accumulation index (I geo ), enrichment factor (EF), contamination factor (CF), pollution load index (PLI) and potential ecological risk index (PERI). According to these criteria, these soils can be classified as moderately contaminated with some metals. Furthermore, the identification of pollution sources based on principal component analysis and hierarchical cluster analysis have revealed that all analyzed metals are anthropogenic except Fe. Calculated hazard index>1 indicates the possibility of noncarcinogenic effect due to higher value of Fe. Carcinogenic risks through the ingestion, inhalation and dermal pathway for carcinogenic elements (Pb, Cd, Cr, and Ni) shows a non-significant risk (CR<10 -6 ) for both children and adults living in the studied area.
Measured data may help the policymakers to reduce the potential effects of soil contamination on eco-environment and human health.
A Low-Cost and Highly Efficient Method of Reducing Coolant Leakage for Direct Metal Printed Injection mold with Cooling Channels Using Optimum Heat Treatment Process Procedures
Authors: Kuo Chil-Chyuan , Qiu Shao-Xuan , Yang Xin-Yi
Published: March 2021

Metal additive manufacturing (MAM) provides lots of benefits and potentials in manufacturing molds or dies with sophisticated conformal cooling channels. It is known that the conformal cooling technology provides effective cooling to reduce cycle time for increasing productivity. Ordinarily, mold inserts fabricated by general printing procedures will result in coolant leakage in the injection molding process. The yield in the manufacturing of fully dense injection molding tools was limited to the very narrow working widow. In addition, high costs of fully dense injection mold fabricated by MAM constitute the major obstacle to its application in the mold or die industry. In general, the high cost of MAM is approximately 50-70% more expensive than conventional computer numerical control machining. In this study, a low-cost and highly efficient method of reducing coolant leakage for direct metal printed injection mold with cooling channels was proposed. This new method employs general process parameters to manufacture the green injection mold rapidly and then uses optimum heat treatment (HT) procedures to improve microstructure of the green injection mold. The results of this study revealed that optimum HT procedures can prevent coolant leakage and save manufacturing time of the injection mold fabricated by direct metal laser sintering. The evolution mechanisms of microstructure were investigated experimentally. The save in the injection mold manufacture time about 67% can be obtained.
Triggers of Migraine during COVID-19 Pandemic Lockdown
Authors: Al-Hashel Jasem Yousef , Abokalawa Fathi , Ahmed Samar Farouk
Published: March 2021

Background: Lock down caused sudden lifestyle changes and represented a massive impact on human health. Environmental factors can trigger migraine headache. The aim of this study was to report the triggers of migraine attacks due to lifestyle changes during coronavirus disease 2019 (COVID-19) Pandemic lockdown. Methods: This cross-sectional survey included patients diagnosed as migraine according to The International Classification of Headache Disorders, 3rd edition (ICDH-3). During the lockdown, we submitted an online self-reported web-based questionnaire to patients already diagnosed with primary headache disorders and attends headache clinic at Ibn Sina Hospital in Kuwait. Questions explored triggers of migraine headache attacks during COVID-19 Pandemic lockdown. Answers were transformed into data for statistical analysis. Results: A total of 340 migraine patients responded to online questionnaire. The mean age of them is 34.65 years. Females were predominant 79.1%. Majority of the cohort 85 % has more than one trigger of migraine headache attack. The common triggers were smell of strong odors in 214 (62.9%), followed by certain food in 175 (51.8%), sleep disturbance in 120 (35.3%), Emotional or mental stress in 80 (23.6%), caffeine in 80 (23.6%), flickers of Light in 78 (22.9), weather changes in 68(20%), smoking in 65 (19.12), noise in 56 (16.5), sun light exposure in 41 (12.1), Fasting/ Hypoglycemia in 40 (11.7), hormonal changes in 37 (10.6%), physical excretion/fatigue in 24 (7.1), screen exposure in 20 (5.9%), and dehydration in 14 (4.1%).Conclusions: Lifestyle changes during lock down may negatively impact migraine through patients exposure to many triggers. Strong odors, food, sleep disturbance and stress were the most migraine triggers during COVID-19 lockdown.
Metagenome-validated Parallel Amplicon Sequencing and Text Mining-based Annotations for Simultaneous Profiling of Bacteria and Fungi: Vaginal Microbiome and Mycobiota in Healthy Women
Authors: Virtanen Seppo , Saqib Schahzad , Kanerva Tinja , Nieminen Pekka , Kalliala Ilkka , Salonen Anne
Published: March 2021

Background: Amplicon sequencing of kingdom-specific tags such as 16S rRNA gene for bacteria and internal transcribed spacer (ITS) region for fungi are widely used for investigating microbial populations. So far most human studies have focused on bacteria while studies on host-associated fungi in health and disease have only recently started to accumulate. To enable cost-effective parallel analysis of bacterial and fungal communities in human and environmental samples, we developed a method where 16S rRNA gene and ITS-1 amplicons were pooled together for a single Illumina MiSeq or HiSeq run and analysed after primer-based segregation. Taxonomic assignments were performed with Blast in combination with an iterative text-extraction based filtration approach, which uses extensive literature records from public databases to select the most probable hits that were further validated by shotgun metagenomic sequencing. Results: Using 50 vaginal samples, we show that the combined run provides comparable results on bacterial composition and diversity to conventional 16S rRNA gene amplicon sequencing. The text-extraction-based taxonomic assignment guided tool provided ecosystem specific annotations that were confirmed by Metagenomic Phylogenetic Analysis (MetaPhlAn). The metagenome analysis revealed distinct functional differences between the bacterial community types while fungi were undetected, despite being identified in all samples based on ITS amplicons. Co-abundance analysis of bacteria and fungi did not show strong between-kingdom correlations within the vaginal ecosystem of healthy women.Conclusion: Combined amplicon sequencing for bacteria and fungi provides a simple and cost-effective method for simultaneous analysis of microbiota and mycobiota within the same samples. Text extraction-based annotation tool facilitates the characterization and interpretation of defined microbial communities from rapidly accumulating sequencing and metadata readily available through public databases.
Risk Factors and Clinical Analysis for PICC Related Fungal Colonization in Premature Infants
Authors: Zhang Lingping , Yang Liu , Dong Wenbin , Liu Xingling , Lei Xiaoping , Zhang Lianyu
Published: March 2021

Objective: The present study aimed to analyze the risk factors for positive peripherally inserted central catheter (PICC) related fungal colonization in preterm infants. Methods: A retrospective study was conducted in a tertiary hospital in southwest China between January 1, 2018 and December 31, 2020. The enrolled infants who underwent ultrasound-guided PICC insertion during hospitalization were born at < 32 weeks gestation or birth weight < 1500 grams. The demographics, the PICC related characteristics, the use of antibiotic, glucocorticoid and parenteral nutrition (PN) were collected from the medical record. Univariate and multivariate analyses were performed to investigate risk factors for PICC-related fungal colonization. Receiver operating characteristic (ROC) curve was used to determine the optimal cut-off value by calculating the Yoden index. Results: A total of 124 premature infants underwent ultrasound-guided PICC insertion. Among them, 19 patients had positive results of fungi at PICC tips.PN infusion duration (OR 1.37, 95%CI 1.05-1.79) and postnatal glucocorticoid exposure(OR 9.19, 95%CI 1.04-81.65) were independent risk factors for fungal colonization in PICC. The optimal cut-off value was 15days,28days, respectively. Conclusion: PICC tips fungal colonization is affected by postnatal glucocorticoid exposure and PN infusion duration. Appropriate clinical management should be adopted to avoid fungal colonization and fungemia.
Possible Implication of Intermolecular Epitope Spreading in the Production of Anti-Glomerular Basement Membrane Antibody in Anti-Neutrophil Cytoplasmic Antibody-associated Vasculitis
Authors: Nishibata Yuka , Nonokawa Mayu , Tamura Yuto , Higashi Rio , Suzuki Ku , Hayashi Hideyuki , Masuda Sakiko , Nakazawa Daigo , Tanaka Satoshi , Tomaru Utano , Ishizu Akihiro
Published: March 2021

ObjectiveAnti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is sometimes complicated by anti-glomerular basement membrane (GBM) disease. Proteases, including elastase, released from neutrophils activated by ANCA are implicated in the pathogenesis of AAV. Epitopes of anti-GBM antibody exist in the α3-subunit non-collagenous (NC1) domain of collagen type IV [Col (IV)]. This region, called α3(IV)NC1, is structurally cryptic. This study aimed to determine the production mechanism of anti-GBM antibody in AAV.MethodsWe first examined whether α3(IV)NC1 could be revealed by the digestion of formalin-fixed, paraffin-embedded (FFPE) normal kidney sections and Col (IV) by proteases, including neutrophil elastase, using immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA). Next, the reveal of α3(IV)NC1 and the infiltration of CD11c+ macrophages in the affected kidneys were evaluated by IHC and immunofluorescent staining using FFPE sections. Finally, the production of anti-GBM antibody in AAV rats was determined by ELISA.Resultsα3(IV)NC1 was revealed by the digestion of FFPE normal kidney sections and Col (IV) by proteases. Although the reveal of α3(IV)NC1 was observed in sclerotic glomeruli regardless of causative diseases, CD11c+ macrophages near α3(IV)NC1 were characteristics of AAV. Anti-GBM antibody was produced subsequent to ANCA in some AAV rats. IHC demonstrated the reveal of α3(IV)NC1 in affected renal tissues and the infiltration of CD11c+ macrophages around the sites.ConclusionThe collective findings suggest that, in AAV, proteases released from neutrophils activated by ANCA digest Col (IV) and result in the reveal of α3(IV)NC1, CD11c+ macrophages present GBM epitopes, and then the host’s immune system produce anti-GBM antibody.