bluuebunny/crossref_metadata_2025 huggingface dataset:
Low serum apelin levels are associated with mild cognitive impairment in Type 2 diabetic patients
Authors: Jiang Yongli , Wang Shidi , Liu Xinghui
Published: May 2022

Background

Apelin is a new adipokine that is secreted by adipocytes, and is associated with insulin resistance (IR), inflammation, and obesity. This study was designed to investigate the role of apelin in type 2 diabetes mellitus (T2DM) patients with mild cognitive impairment (MCI).

Methods

A total of 235 patients with T2DM were included. The cognitive function of patients was evaluated using Montreal Cognitive Assessment (MoCA) tool, then patients were divided into MCI group and non-MCI group according to the MoCA score. Blood sample was analyzed for the level of apelin by enzyme-linked immunosorbent assay (ELISA).

Results

The MCI group (n = 73) presented lower serum apelin levels compared with the patients with normal cognitive function (P < 0.001). Apelin levels showed significantly negative correlation with diabetes duration, triglyceride (TG), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C, creatinine and high sensitivity C-reactive protein (hs-CRP), and positive correlation with high-density lipoprotein cholesterol (HDL-C) and brain-derived neurotrophic factor (BDNF). Multivariable logistic regression analysis indicated that serum apelin (OR = 0.304, 95%CI: 0.104–0.886, P = 0.029), as well as education levels, diabetes duration, cardiovascular disease, serum HbA1c, HDL-C, creatinine, and BDNF, were independent risk factors of MCI in patients with T2DM.

Conclusions

Serum apelin level is reduced in T2DM patients with MCI. Apelin might has protective effect against cognitive impairment and serve as a serum biomarker of T2DM.
Multiple regression model to analyze the total LOS for patients undergoing laparoscopic appendectomy
Authors: Trunfio Teresa Angela , Scala Arianna , Giglio Cristiana , Rossi Giovanni , Borrelli Anna , Romano Maria , Improta Giovanni
Published: May 2022

Background

The rapid growth in the complexity of services and stringent quality requirements present a challenge to all healthcare facilities, especially from an economic perspective. The goal is to implement different strategies that allows to enhance and obtain health processes closer to standards. The Length Of Stay (LOS) is a very useful parameter for the management of services within the hospital and is an index evaluated for the management of costs. In fact, a patient's LOS can be affected by a number of factors, including their particular condition, medical history, or medical needs. To reduce and better manage the LOS it is necessary to be able to predict this value.

Methods

In this study, a predictive model was built for the total LOS of patients undergoing laparoscopic appendectomy, one of the most common emergency procedures. Demographic and clinical data of the 357 patients admitted at “San Giovanni di Dio e Ruggi d’Aragona” University Hospital of Salerno (Italy) had used as independent variable of the multiple linear regression model.

Results

The obtained model had an R2 value of 0.570 and, among the independent variables, the significant variables that most influence the total LOS were Age, Pre-operative LOS, Presence of Complication and Complicated diagnosis.

Conclusion

This work designed an effective and automated strategy for improving the prediction of LOS, that can be useful for enhancing the preoperative pathways. In this way it is possible to characterize the demand and to be able to estimate a priori the occupation of the beds and other related hospital resources.
Exploring nurses' experiences of social media and in-person educational interventions for professional development: a qualitative study
Authors: Kazemi Seyedeh-Somayeh , Tavafian Sedigheh-Sadat , Hidarnia Alireza , Montazeri Ali
Published: May 2022

Background

Nurses play an important role in health promotion, prevention strategies, and care. Therefore, nurses need to obtain and update their knowledge and skills via appropriate strategies. This study aimed to explore nurses’ experiences of receiving social media and in-person education to integrate the findings into practice.

Methods

This was a qualitative study using the directed content analysis approach. A sample of nurses with previous experiences of receiving social media and in-person education participated in the study. They were asked to express their experiences and indicate their preferences. The data were collected based on individual semi-structured interviews.

Results

In total 15 participants took part in the study with a mean age of 40.6 ± 8.93 years and work experiences of 15.3 ± 9.21 years. During the process of content analysis, three main themes emerged: Approaches to nursing education and its adoption in the health system, Achieving effectiveness and efficiency in nursing education, and Health care policy and facilitating pathways for nursing education. Participants indicated several barriers to attending an educational program, including motivation, workload, time and place, and hospital politics.

Conclusion

Overall the findings suggest that regardless of any methods of education nurses cannot actively engage in the educational interventions while on duty. However, the findings suggest that nurses believe that the social media approach might be superior in reducing barriers and making the educational interventions work better.
The experiences of patients with diabetes and strategies for their management during the first COVID-19 lockdown: a qualitative study
Authors: Vilafranca Cartagena Mireia , Tort-Nasarre Glòria , Romeu-Labayen Maria , Vidal-Alaball Josep
Published: May 2022

Background

During the pandemic, primary care systems prioritised attention to COVID-19 patients; chronically ill patients, such as people with Type 2 Diabetes were obliged to take more responsibility for their own care. We aimed to analyse the experiences of patients with Type 2 Diabetes Mellitus during the stay-at-home order that was in place during the first wave of the COVID-19 pandemic and identify the strategies and resources used in managing their care.

Method

We conducted a qualitative descriptive study. The participants were ten patients with type 2 Diabetes Mellitus who experienced strict lockdown during the first wave of the COVID-19 pandemic in Catalonia, Spain, selected using intentional sampling. We recorded semi-structured interviews with the participants and conducted thematic analysis.

Results

We identified 14 subthemes, which we then grouped into three overarching themes: 1) anxiety, fear, and vulnerability (anxiety, fear, vulnerability, rethinking life, loneliness, sadness), 2) insufficient diabetes monitoring by the health system (health care received, glycaemic control, view of treatment by health providers) and proactive self-care (changes in daily routine, diet, physical activity, medication, personal protective equipment & social distancing).

Conclusion

Despite the exceptional nature of the situation and the stress, worry, and changes in their daily lives, many respondents reported that they had successfully modified their lifestyles. Self-care was effective during confinement and was based on a process of adaptation using the resources available, without face-to-face contact with primary care health staff.

Relevance to clinical practice

These results can help to guide the design and implementation of self-care-focused strategies and also to explore new ways of empowering patients without access to health care personnel.
Experimental demonstration of tethered gene drive systems for confined population modification or suppression
Authors: Metzloff Matthew , Yang Emily , Dhole Sumit , Clark Andrew G. , Messer Philipp W. , Champer Jackson
Published: May 2022

Background

Homing gene drives hold great promise for the genetic control of natural populations. However, current homing systems are capable of spreading uncontrollably between populations connected by even marginal levels of migration. This could represent a substantial sociopolitical barrier to the testing or deployment of such drives and may generally be undesirable when the objective is only local population control, such as suppression of an invasive species outside of its native range. Tethered drive systems, in which a locally confined gene drive provides the CRISPR nuclease needed for a homing drive, could provide a solution to this problem, offering the power of a homing drive and confinement of the supporting drive.

Results

Here, we demonstrate the engineering of a tethered drive system in Drosophila, using a regionally confined CRISPR Toxin-Antidote Recessive Embryo (TARE) drive to support modification and suppression homing drives. Each drive was able to bias inheritance in its favor, and the TARE drive was shown to spread only when released above a threshold frequency in experimental cage populations. After the TARE drive had established in the population, it facilitated the spread of a subsequently released split homing modification drive (to all individuals in the cage) and of a homing suppression drive (to its equilibrium frequency).

Conclusions

Our results show that the tethered drive strategy is a viable and easily engineered option for providing confinement of homing drives to target populations.
The effectiveness of the Structured Health Intervention For Truckers (SHIFT): a cluster randomised controlled trial (RCT)
Authors: Clemes Stacy A. , Varela-Mato Veronica , Bodicoat Danielle H. , Brookes Cassandra L. , Chen Yu-Ling , Edwardson Charlotte L. , Gray Laura J. , Guest Amber J. , Johnson Vicki , Munir Fehmidah , Paine Nicola J. , Richardson Gerry , Ruettger Katharina , Sayyah Mohsen , Sherry Aron , Di Paola Ana Suazo , Troughton Jacqui , Yates Thomas , King James A.
Published: May 2022

Background

Long distance heavy goods vehicle (HGV) drivers exhibit higher than nationally representative rates of obesity, and obesity-related co-morbidities, and are underserved in terms of health promotion initiatives. The purpose of this study was to evaluate the effectiveness of the multicomponent ‘Structured Health Intervention For Truckers’ (SHIFT), compared to usual care, at 6- and 16–18-month follow-up.

Methods

We conducted a two-arm cluster RCT in transport sites throughout the Midlands, UK. Outcome measures were assessed at baseline, at 6- and 16–18-month follow-up. Clusters were randomised (1:1) following baseline measurements to either the SHIFT arm or usual practice control arm. The 6-month SHIFT programme included a group-based interactive 6-h education and behaviour change session, health coach support and equipment provision (Fitbit® and resistance bands/balls to facilitate a ‘cab workout’). The primary outcome was device-assessed physical activity (mean steps/day) at 6 months. Secondary outcomes included the following: device-assessed sitting, physical activity intensity and sleep; cardiometabolic health, diet, mental wellbeing and work-related psychosocial variables. Data were analysed using mixed-effect linear regression models using a complete-case population.

Results

Three hundred eighty-two HGV drivers (mean ± SD age: 48.4 ± 9.4 years, BMI: 30.4 ± 5.1 kg/m2, 99% male) were recruited across 25 clusters (sites) and randomised into either the SHIFT (12 clusters,n = 183) or control (13 clusters,n = 199) arms. At 6 months, 209 (55%) participants provided primary outcome data. Significant differences in mean daily steps were found between groups, in favour of the SHIFT arm (adjusted mean difference: 1008 steps/day, 95% CI: 145–1871,p = 0.022). Favourable differences were also seen in the SHIFT group, relative to the control group, in time spent sitting (− 24 mins/day, 95% CI: − 43 to − 6), and moderate-to-vigorous physical activity (6 mins/day, 95% CI: 0.3–11). Differences were not maintained at 16–18 months. No differences were observed between groups in the other secondary outcomes at either follow-up.

Conclusions

The SHIFT programme led to a potentially clinically meaningful difference in daily steps, between trial arms, at 6 months. Whilst the longer-term impact is unclear, the programme offers potential to be incorporated into driver training courses to promote activity in this at-risk, underserved and hard-to-reach essential occupational group.

Trial registration

ISRCTN10483894 (date registered: 01/03/2017)
Genetic susceptibility, screen-based sedentary activities and incidence of coronary heart disease
Authors: Kim Youngwon , Yeung Shiu Lun Au , Sharp Stephen J. , Wang Mengyao , Jang Haeyoon , Luo Shan , Brage Soren , Wijndaele Katrien
Published: May 2022

Background

Whether the associations of time spent in screen-based sedentary activities with CHD vary by genetic susceptibility is currently unknown. The objective of this study was to examine the interplay of genetic susceptibility to CHD and two prevalent types of screen-based sedentary activities (television [TV] viewing and computer use) for CHD incidence.

Methods

This prospective cohort study included 373,026 individuals of European ancestry without prevalent CHD/stroke from UK Biobank data. Genetic susceptibility to CHD was assessed using weighted polygenic risk scores, calculated by summing the number of risk-increasing alleles among 300 single-nucleotide polymorphisms, multiplied by their corresponding effect estimates. TV viewing and computer use were assessed through touch-screen questionnaires. CHD incidence (n=9185) was adjudicated over a median 12.6-year follow-up.

Results

Compared with ≥4h/day of TV viewing, the hazard ratio of CHD was 0.84 (95% confidence interval [CI] 0.79–0.90) and 0.94 (0.90–0.99) for ≤1h/day and 2–3h/day of TV viewing, respectively, after adjusting for confounders including the genetic risk. CHD hazards were higher for medium and high genetic risk than for low genetic risk. Across all levels of genetic risk including high-genetic risk, ≤1h/day of TV viewing had lower CHD hazards, compared with ≥4h/day: no evidence of interaction between genetic risk and TV viewing (p value: 0.362). Estimates of the population attributable fraction (PAF) suggested that 10.9% (95% CI 6.1–15.3%) of CHD could be prevented if TV viewing time were reduced to ≤1h/day, assuming causality. The PAF values were relatively larger for medium-to-high genetic risk than for low genetic risk, although the CIs were wide and overlapping. No associations were observed for computer use.

Conclusions

Less TV viewing time was associated with lower CHD risk independently of genetic risk. Clinical trials targeted at individuals with high genetic susceptibility should consider reducing TV viewing as as a behavioural target for prevention of an early onset of cardiovascular events.
Exogenous leptin enhances markers of airway fibrosis in a mouse model of chronic allergic airways disease
Authors: Ihrie Mark D. , McQuade Victoria L. , Womble Jack T. , Hegde Akhil , McCravy Matthew S. , Lacuesta Cyrus Victor G. , Tighe Robert M. , Que Loretta G. , Walker Julia K. L. , Ingram Jennifer L.
Published: May 2022

Background

Asthma patients with comorbid obesity exhibit increased disease severity, in part, due to airway remodeling, which is also observed in mouse models of asthma and obesity. A mediator of remodeling that is increased in obesity is leptin. We hypothesized that in a mouse model of allergic airways disease, mice receiving exogenous leptin would display increased airway inflammation and fibrosis.

Methods

Five-week-old male and female C57BL/6J mice were challenged with intranasal house dust mite (HDM) allergen or saline 5 days per week for 6 weeks (n = 6–9 per sex, per group). Following each HDM exposure, mice received subcutaneous recombinant human leptin or saline. At 48 h after the final HDM challenge, lung mechanics were evaluated and the mice were sacrificed. Bronchoalveolar lavage was performed and differential cell counts were determined. Lung tissue was stained with Masson’s trichrome, periodic acid-Schiff, and hematoxylin and eosin stains. Mouse lung fibroblasts were cultured, and whole lung mRNA was isolated.

Results

Leptin did not affect mouse body weight, but HDM+leptin increased baseline blood glucose. In mixed-sex groups, leptin increased mouse lung fibroblast invasiveness and increased lung Col1a1 mRNA expression. Total lung resistance and tissue damping were increased with HDM+leptin treatment, but not leptin or HDM alone. Female mice exhibited enhanced airway responsiveness to methacholine with HDM+leptin treatment, while leptin alone decreased total respiratory system resistance in male mice.

Conclusions

In HDM-induced allergic airways disease, administration of exogenous leptin to mice enhanced lung resistance and increased markers of fibrosis, with differing effects between males and females.
COVID-19 double jeopardy: the overwhelming impact of the social determinants of health
Authors: Badalov Elizabeth , Blackler Liz , Scharf Amy E. , Matsoukas Konstantina , Chawla Sanjay , Voigt Louis P. , Kuflik Arthur
Published: May 2022

Background

The COVID-19 pandemic has strained healthcare systems by creating a tragic imbalance between needs and resources. Governments and healthcare organizations have adapted to this pronounced scarcity by applying allocation guidelines to facilitate life-or-death decision-making, reduce bias, and save as many lives as possible. However, we argue that in societies beset by longstanding inequities, these approaches fall short as mortality patterns for historically discriminated against communities have been disturbingly higher than in the general population.

Methods

We review attack and fatality rates; survey allocation protocols designed to deal with the extreme scarcity characteristic of the earliest phases of the pandemic; and highlight the larger ethical perspectives (Utilitarianism, non-Utilitarian Rawlsian justice) that might justify such allocation practices.

Results

The COVID-19 pandemic has dramatically amplified the dire effects of disparities with respect to the social determinants of health. Patients in historically marginalized groups not only have significantly poorer health prospects but also lower prospects of accessing high quality medical care and benefitting from it even when available. Thus, mortality among minority groups has ranged from 1.9 to 2.4 times greater than the rest of the population. Standard allocation schemas, that prioritize those most likely to benefit, perpetuate and may even exacerbate preexisting systemic injustices.

Conclusions

To be better prepared for the inevitable next pandemic, we must urgently begin the monumental project of addressing and reforming the structural inequities in US society that account for the strikingly disparate mortality rates we have witnessed over the course of the current pandemic.
Long-term surgical outcomes of gastric neuroendocrine carcinoma and mixed neuroendocrine-non-neuroendocrine neoplasms
Authors: Iwasaki Kenichi , Barroga Edward , Enomoto Masaya , Tsurui Kazushige , Shimoda Yota , Matsumoto Moe , Miyoshi Kenta , Ota Yoshihiro , Matsubayashi Jun , Nagakawa Yuichi
Published: May 2022

Background

Neuroendocrine carcinoma (NEC) and mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN) are extremely rare subtypes of gastric cancer. MiNEN is a mix of carcinomatous components and neuroendocrine neoplasm in the same lesion. NEC and MiNEN have a poor prognosis, are difficult to diagnose, and have no established treatment. Herein, we assessed the clinicopathological characteristics and long-term surgical outcomes of gastric NEC and MiNEN patients in our hospital.

Methods

We retrospectively assessed 1538 patients pathologically diagnosed with gastric cancer and who underwent curative surgical resection at our institution between January 1999 and October 2021. Of these patients, 25 (1.6%) were pathologically diagnosed with neuroendocrine neoplasms. From these 25 patients, we retrospectively analyzed the clinicopathological characteristics and surgical outcomes of 13 (0.8%) patients pathologically diagnosed with NEC or MiNEN.

Results

The NEC and MiNEN patients consisted of 11 men and 2 women [mean age, 74 (62–84) years]. The preoperative histological diagnoses were NEC (n = 4) and adenocarcinoma (n = 9). The final pathological diagnoses were large cell neuroendocrine carcinoma (LCNEC; n = 7) and MiNEN (n = 6). Total gastrectomy was the most common surgical procedure (9/13, 69.2%), followed by distal gastrectomy (3/13, 23.1%) and proximal gastrectomy (1/13, 7.7%). Immunohistochemical staining showed 8 CD56-positive patients. All 13 patients were positive for chromogranin A and synaptophysin. The mean Ki-67 value was 64.8 (0–95)%, and the mean mitotic score was 107.9 (0–400). Nine patients survived without recurrence postresection. The median postresection overall survival time was 68.7 (8.0–129) months. The 5-year survival rate was 0.75 ([95% CI] 0.408–0.912).

Conclusion

The surgical treatment outcomes of NEC and MiNEN patients were relatively favorable. Although evidence concerning the effectiveness of surgery alone is meager, radical resection as part of multidisciplinary treatment including chemotherapy can potentially improve prognosis.
Asperosaponin VI ameliorates the CMS-induced depressive-like behaviors by inducing a neuroprotective microglial phenotype in hippocampus via PPAR-γ pathway
Authors: Jiang Xue , Yi Saini , Liu Qin , Su Dapeng , Li Liangyuan , Xiao Chenghong , Zhang Jinqiang
Published: May 2022

Background

The natural compound asperosaponin VI has shown potential as an antidepressant, but how it works is unclear. Here, we explored its effects on mice exposed to chronic mild stress (CMS) and the underlying molecular pathways.

Methods

Mice were exposed to CMS for 3 weeks followed by asperosaponin VI (40 mg/kg) or imipramine (20 mg/kg) for another 3 weeks. Depression-like behaviors were assessed in the forced swimming test (FST), sucrose preference test (SPT), tail suspension test (TST). Microglial phenotypes were evaluated using immunofluorescence staining, real-time quantitative PCR and enzyme-linked immunosorbent assays in hippocampus of mice. In some experiments, stressed animals were treated with the PPAR-γ antagonist GW9662 to examine its involvement in the effects of asperosaponin VI. Blockade of PPAR-γ in asperosaponin VI-treated primary microglia in the presence of lipopolysaccharide (LPS) was executed synchronously. The nuclear transfer of PPAR-γ in microglia was detected by immunofluorescence staining in vitro and in vivo. A co-cultured model of neuron and microglia was used for evaluating the regulation of ASA VI on the microglia–neuron crosstalk molecules.

Results

Asperosaponin VI ameliorated depression-like behaviors of CMS mice based on SPT, TST and FST, and this was associated with a switch of hippocampal microglia from a pro-inflammatory (iNOS+-Iba1+) to neuroprotective (Arg-1+-Iba1+) phenotype. CMS reduced the expression levels of PPAR-γ and phosphorylated PPAR-γ in hippocampus, which asperosaponin VI partially reversed. GW9662 treatment prevented the nuclear transfer of PPAR-γ in asperosaponin VI-treated microglia and inhibited the induction of Arg-1+ microglia. Blockade of PPAR-γ signaling also abolished the ability of asperosaponin VI to suppress pro-inflammatory cytokines while elevating anti-inflammatory cytokines in the hippocampus of CMS mice. The asperosaponin VI also promoted interactions between hippocampal microglia and neurons by enhancing CX3CL1/CX3CR1 and CD200/CD200R, and preserved synaptic function based on PSD95, CamKII β and GluA levels, but not in the presence of GW9662. Blockade of PPAR-γ signaling also abolished the antidepressant effects of asperosaponin VI in the SPT, TST and FST.

Conclusion

CMS in mice induces a pro-inflammatory microglial phenotype that causes reduced crosstalk between microglia and neuron, inflammation and synaptic dysfunction in the hippocampus, ultimately leading to depression-like behaviors. Asperosaponin VI may ameliorate the effects of CMS by inducing microglia to adopt a PPAR-γ-dependent neuroprotective phenotype.
Saikosaponin D exerts antidepressant effect by regulating Homer1-mGluR5 and mTOR signaling in a rat model of chronic unpredictable mild stress
Authors: Liu Chen-Yue , Chen Jian-Bei , Liu Yue-Yun , Zhou Xue-Ming , Zhang Man , Jiang You-Ming , Ma Qing-Yu , Xue Zhe , Zhao Zong-Yao , Li Xiao-Juan , Chen Jia-Xu
Published: May 2022

Background

Many studies about depression have focused on the dysfunctional synaptic signaling in the hippocampus that drives the pathophysiology of depression. Radix Bupleuri has been used in China for over 2000 years to regulate liver-qi. Extracted from Radix Bupleuri, Saikosaponin D (SSD) is a pharmacologically active substance that has antidepressant effects. However, its underlying mechanism remains unknown.

Materials and methods

A chronic unpredictable mild stress (CUMS) paradigm was used as a rat model of depression. SD rats were randomly assigned to a normal control (NC) group or one exposed to a CUMS paradigm. Of the latter group, rats were assigned to four subgroups: no treatment (CUMS), fluoxetine-treated (FLU), high-dose and low-dose SSD-treated (SSDH and SSDL). SSD was orally administrated of 1.50 mg/kg and 0.75 mg/kg/days for three weeks in the SSDH and SSDL groups, respectively. Fluoxetine was administrated at a dose of 2.0 mg/kg/days. SSD’s antidepressant effects were assessed using the open field test, forced swim test, and sucrose preference test. Glutamate levels were quantified by ELISA. Western blot and immunochemical analyses were conducted to quantify proteins in the Homer protein homolog 1 (Homer1)-metabotropic glutamate receptor 5 (mGluR5) and mammalian target of rapamycin (mTOR) pathways in the hippocampal CA1 region. To measure related gene expression, RT-qPCR was employed.

Results

CUMS-exposed rats treated with SSD exhibited increases in food intake, body weight, and improvements in the time spent in the central are and total distance traveled in the OFT, and less pronounced pleasure-deprivation behaviors. SSD also decreased glutamate levels in CA1. In CA1 region of CUMS-exposed rats, SSD treatment increased mGluR5 expression while decreasing Homer1 expression. SSD also increased expressions of postsynaptic density protein 95 (PSD95) and synapsin I (SYP), and the ratios of p-mTOR/mTOR, p-p70S6k/p70S6k, and p-4E-BP1/4E-BP1 in the CA1 region in CUMS-exposed rats.

Conclusions

SSD treatment reduces glutamate levels in the CA1 region and promotes the expression of the synaptic proteins PSD-95 and SYP via the regulation of the Homer1-mGluR5 and downstream mTOR signaling pathways. These findings suggest that SSD could act as a natural neuroprotective agent in the prevention of depression.
Intensity matters: protocol for a randomized controlled trial exercise intervention for individuals with chronic stroke
Authors: Rodrigues Lynden , Moncion Kevin , Eng Janice J. , Noguchi Kenneth S. , Wiley Elise , de Las Heras Bernat , Sweet Shane N. , Fung Joyce , MacKay-Lyons Marilyn , Nelson Aimee J. , Medeiros Diogo , Crozier Jennifer , Thiel Alexander , Tang Ada , Roig Marc
Published: May 2022

Rationale

Cardiovascular exercise is an effective method to improve cardiovascular health outcomes, but also promote neuroplasticity during stroke recovery. Moderate-intensity continuous cardiovascular training (MICT) is an integral part of stroke rehabilitation, yet it may remain a challenge to exercise at sufficiently high intensities to produce beneficial adaptations to neuroplasticity. High-intensity interval training (HIIT) could provide a viable alternative to achieve higher intensities of exercise by using shorter bouts of intense exercise interspersed with periods of recovery.

Methods and design

This is a two-arm, parallel-group multi-site RCT conducted at the Jewish Rehabilitation Hospital (Laval, Québec, Canada) and McMaster University (Hamilton, Ontario, Canada). Eighty participants with chronic stroke will be recruited at both sites and will be randomly allocated into a HIIT or MICT individualized exercise program on a recumbent stepper, 3 days per week for 12 weeks. Outcomes will be assessed at baseline, at 12 weeks post-intervention, and at an 8-week follow-up.

Outcomes

The primary outcome is corticospinal excitability, a neuroplasticity marker in brain motor networks, assessed with transcranial magnetic stimulation (TMS). We will also examine additional markers of neuroplasticity, measures of cardiovascular health, motor function, and psychosocial responses to training.

Discussion

This trial will contribute novel insights into the effectiveness of HIIT to promote neuroplasticity in individuals with chronic stroke.

Trial registration

ClinicalTrials.govNCT03614585. Registered on 3 August 2018
Transcriptomic perspectives of memory-like NK cells and aging
Authors: Wang Dandan , Malarkannan Subramaniam
Published: May 2022

A recent study highlights the presence of a unique memory-like natural killer (NK) cell subset, which accumulates with aging and appears to associate withdisease severity in COVID-19 patients. While the clinical relevance of memory in NK cells is being debated, the molecular identity of this subset in the form of a single-cell transcriptome is essential to define their origin, longevity, functions, and disease relevance.
Ectopic intrathyroidal thymic tissue in an adult patient: a case report and review of the literature
Authors: Moradian Sadegh , Delazar Sina , Yazdani Farzad , Mohammadzadeh Maryam
Published: May 2022

Background

Ectopic intrathyroidal thymic tissue is a rare diagnosis, specifically in adults. Such ectopic tissue is usually misdiagnosed as benign or malignant thyroid lesions and is mainly investigated by ultrasonography and pathologic examination.

Case presentation

We present the case of an adult 31-year-old Persian female patient with a cervical mass and no other significant medical history. The lesion had hypo- to isoechoic features on sonographic imaging, and needle aspiration examination revealed lymphoid cells suspicious of lymphoid malignancies. However, pathologic examination after resection of the lesion showed normal thymic tissue.

Conclusions

The rare entity of ectopic thymic tissue within the thyroid gland in adult patients requires meticulous examination by clinicians, radiologists, and pathologists to diagnose the condition with high accuracy and plan appropriate management.
Antioxidant and antiproliferative activities of solvent fractions of broccoli (Brassica oleracea L.) sprout
Authors: Kim Ji Soo , Cuong Do Manh , Bae Yu Bin , Cho Somi Kim
Published: May 2022

Crude methanol extract (ME) of broccoli (Brassica oleracea L.) sprout was fractioned by hexane, chloroform, ethyl acetate, butanol, and water. The contents of total polyphenols (19.89 mg GAE/g) and flavonoids (10.06 mg RE/g) were significantly higher in the butanol fraction (BF) than in the other fractions. The BF showed the highest DPPH (EC50 = 0.524 mg/mL) and ABTS (EC50 = 0.180 mg/mL) radical scavenging activities. High-performance liquid chromatography (HPLC) of crude ME showed that the most abundant phenolic compounds were rutin, quercetin, chlorogenic acid, catechin, and p-coumaric acid. The contents of quercetin, chlorogenic acid and p-coumaric acid were higher in the ethyl acetate fraction (EF) and BF than in the other fractions. Antioxidant activity and phenolic compound contents were correlated, suggesting that phenolics were responsible for the antioxidant activity. The hexane fraction (HF) and chloroform fraction (CF) decreased the viability of breast cancer stem cells (BCSCs), and the CF had the highest antiproliferative activity (IC50 = 69.47 mg/mL). The CF also suppressed the stemness characteristics of BCSCs and induced apoptotic cell death. The most abundant characteristic peak in CF was identified as oleic acid (area = 35.05%) by gas chromatography-mass spectrometry (GC–MS). Therefore, the broccoli sprout BF contained high levels of phenolic compounds that contributed to its antioxidant activity, and CF had a marked anti-proliferative effect on BCSCs.
Specially designed and CAD/CAM manufactured allogeneic bone blocks using for augmentation of a highly atrophic maxilla show a stable base for an all-on-six treatment concept: a case report
Authors: Pfaffeneder-Mantai Florian , Meller Oliver , Schneider Benedikt , Bloch Julius , Bytyqi Ditjon , Sutter Walter , Turhani Dritan
Published: May 2022

Background

In terms of a highly atrophic maxilla, bone augmentation still remains very challenging. With the introduction of computer-aided design/computer-aided manufacturing (CAD/CAM) for allogeneic bone blocks, a new method for the treatment of bone deficiencies was created. This case report demonstrates the successful use of two specially designed and CAD/CAM manufactured allogeneic bone blocks for a full arch reconstruction of a highly atrophic maxilla with an all-on-six concept.

Case presentation

We report the case of a 55-year-old male patient with a highly atrophic maxilla and severe bone volume deficiencies in horizontal and vertical lines. In order to treat the defects, the surgeon decided to use a combination of two allogeneic bone blocks and two sinus floor augmentations. The bone blocks were fabricated from the data of a cone beam computed tomography (CBCT) using CAD/CAM technology. After the insertion of the two bone blocks and a healing period of 7 months, six dental implants were placed in terms of an all-on-six concept. The loading of the implants took place after an additional healing time of 7 months with a screw-retained prosthetic construction and with a milled titanium framework with acrylic veneers.

Conclusion

The presented procedure shows the importance of the precise design of CAD/CAM manufactured allogeneic bone blocks for the successful treatment of a highly atrophic maxilla. Proper soft-tissue management is one of the key factors to apply this method successfully.
Review of suicidal ideation during pregnancy: risk factors, prevalence, assessment instruments and consequences
Authors: Legazpi Pilar Carolina Castelao , Rodríguez-Muñoz María F. , Olivares-Crespo María Eugenia , Izquierdo-Méndez Nuria
Published: May 2022

Background

Pregnancy is a period when women are particularly vulnerable to suicidal ideation and a great opportunity for suicide risk prevention.

Aims

This study aimed to establish a comprehensive understanding of suicidal ideation prevalence, risk factors, screening tools, consequences and management during pregnancy.

Method

A literature search was performed in MEDLINE and PsycInfo databases from 2016 to 2021. A narrative synthesis of the literature and a critical overview of the current issues/questions to be addressed within the topic of suicidal ideation during pregnancy was performed.

Results

The prevalence of suicidal ideation during pregnancy was between 2.73 and 18% internationally. The risk factors identified were major depressive disorder, anxiety disorder, difficulties with sleep, previous suicide attempts, high rumination, low incomes, being black, being young, low educational level, partner violence, having poor support, food insecurity, history of child abuse, high obstetric risk, multiparity, previous induced abortion and exposure to tobacco or human immunodeficiency virus diagnosis. The screening tools used for suicidal ideation during pregnancy were item 10 of the Edinburgh Postpartum Depression Scale and item 9 of the Patient Health Questionnaire. Results showed that suicidal ideation during pregnancy is associated with poor cognitive development in children and low birth weight. No case management studies on suicidal ideation were found.

Limitations

The main limitation of the available studies was the lack of articles with a high degree of methodological rigour on this subject.

Conclusions

This narrative review is a state-of-the-art paper about suicidal ideation during pregnancy. Further research is needed, and researchers should carry out systematic reviews and meta-analyses, leading to Clinical Practice Guidelines in this area. This effort would improve our evidence-based practice in Perinatal Psychology and prevent associated suicidal behaviour.
Effectiveness of mindfulness-based intervention on post-traumatic stress symptoms among emergency nursing students
Authors: ElKayal Manal Mohamed , Metwaly Safaa Mohamed
Published: May 2022

Background

Clinical training stress may negatively affect nursing students’ academic achievement, clinical performance, learning outcomes, well-being, general health, and quality of life. This study aimed to evaluate the effect of mindfulness-based intervention on post-traumatic stress symptoms among emergency nursing students. This study was conducted at the technical institute of nursing, Zagazig University. Three tools were used in the current study: the sociodemographic data sheet, the impact of event scale, and the 15-item Five-Facet Mindfulness Questionnaire.

Results

Emergency nursing students had a wide range of PTSS at the pre-intervention period. These symptoms significantly improved after the implementation of a mindfulness-based intervention. Mindfulness level also improved after the intervention. Post-traumatic stress symptoms were positively correlated with the number of training hours and negatively correlated with students’ age, mother’s occupation, and educational level.

Conclusions

Mindfulness-based intervention was effective in reducing post-traumatic stress symptoms among emergency nursing students.
Role of diffusion-weighted imaging in carotid plaque vulnerability assessment
Authors: Alex Ajay , Ayyappan Anoop , Valakada Jineesh , Narasimhaiah Deepti , Pitchai Shivanesan , Sylaja P. N.
Published: May 2022

Background

MR plaque imaging is a valuable tool in characterizing carotid atherosclerotic plaque and identifying high-risk features. There are limited data on the role of the widely available single-shot diffusion-weighted imaging (DWI) in plaque characterization along with histological correlation. This study aimed to correlate the plaque characteristics identified by MR imaging in vivo at the level of maximum stenosis with histological plaque characteristics in the postoperative specimen.

Methods

Patients who underwent carotid endarterectomy in a tertiary care center during one and half years were prospectively recruited for non-contrast MR carotid plaque imaging (including single-shot EPI-DWI sequence) in a 3 Tesla MRI using a dedicated carotid coil. An experienced radiologist correlated DWI sequence findings with histopathology of postsurgical sections to confirm the high-risk features.

Results

Twenty-three patients (mean age 66.1 years ± SD 6.25) were evaluated, of which 65% were males and 96% were symptomatic. Apparent diffusion coefficient (ADC) values in location of plaques could differentiate histopathological unstable from stable plaques (0.83 × 10–3 mm2/s vs 1.7 × 10–3 mm2/s; p 0.001), with a sensitivity and specificity of 75% and 79%, respectively, at an ADC cutoff of 1.24 × 10–3 mm2/s. Plaques with and without lipid-rich necrotic core (0.86 × 10–3 mm2/s vs 1.44 × 10–3 mm2/s; p = 0.042) as well as intraplaque hemorrhage could be differentiated (0.751 × 10–3 mm2/s vs 1.352 × 10–3 mm2/s; p 0.037) using the apparent diffusion coefficients.

Conclusion

The widely available single-shot EPI-DWI in assessing plaque characteristics in carotid stenosis is promising and correlated with histopathological features. Diffusion-weighted imaging will be a helpful adjunct in patients when contrast administration is intolerable.
Use of oblique sagittal and coronal weighted images for diagnosis and grading of ACL graft injury
Authors: ElSayed Mennatallah , Rashwan Amr Samir , Kamal Heba
Published: May 2022

Background

This study was done to evaluate the value of adding the oblique sagittal and oblique coronal MRI to the standard MRI knee protocol for evaluation of suspected ACL graft injuries.

Results

This was a cross-sectional analytic study where we reviewed 36 MRI knee examinations of 36 patients (30 males, 6 females, age range: 17–60 years, mean age: 26 years) who were subjected to ACL reconstruction and follow-up arthroscopy. Two experienced radiologists, blinded to the results of each other, evaluated the status and the severity of the ACL graft injury using the routine knee MRI (protocol A) and using the routine MRI after adding the oblique sagittal and coronal imaging (protocol B). Weighted kappa statistics were used to evaluate the diagnostic accuracies of the knee MRI before and after the addition of the oblique sagittal and coronal weighted images (protocol A and protocol B, respectively) and to assess the interobserver agreement. The weighted kappa values according to the routine knee MRI were 0.357 (reader 1) and 0.399 (reader 2). The inclusion of additional oblique coronal imaging increased the weighted kappa values to 0.505 (reader 1) and 0.528 (reader 2). The interobserver agreement weighted kappa value also increased from 0.606 to 0.759 by adding the oblique sagittal and coronal imaging to the routine knee MRI examination.

Conclusion

The additional use of oblique sagittal and coronal MRI of the knee improves the diagnostic accuracy for diagnosing and grading ACL graft injury with the arthroscopy used as a gold standard.
Comparison of the RSNA chest CT classification system and CO-RADS system in reporting COVID-19 pneumonia in symptomatic and asymptomatic patients
Authors: Sheha Aliaa S. , Mohamed Nada H. , Eid Yara M. , Sheha Dina S. , El-Shayeb Mohamed , Amin Mariam M. , Saeed Alia Mohammed , Abdou Dina , Osman Ahmed M.
Published: May 2022

Background

Coronavirus disease (COVID-19) is a new infection with three pandemic waves up till now. CT plays an important role in diagnosis with multiple reporting systems that can be used during CT analysis. We aimed to compare reporting using the recommendations of the radiological society of North America (RSNA) versus the coronavirus disease reporting and data system (CO-RADS) and to assess the performance of CT if used in asymptomatic patients as a screening. Two hundred and fifty-one patients who underwent chest CT scanning either due to clinical suspicion or as screening before hospital admission were included in this retrospective observational cross-sectional study. This was followed by RT-PCR for confirmation. Three radiologists with different years of experience interpreted the CT findings using the RSNA recommendations and the CO-RADS reporting. The data were collected and compared.

Results

There was no statistically significant difference noted in the diagnostic accuracy obtained while using the RSNA recommendations and the CO-RADS reporting system. Also, a good inter-rater agreement was noticed while using the two reporting systems. The CT showed a highly significant value while used in the assessment of symptomatic patients in controversy to the screening of asymptomatic patients.

Conclusion

Both reporting systems show similar diagnostic accuracy with a good almost similar inter-rater agreement. Both can be used while interpreting the CT images of cases with suspected COVID-19 infection. CT can be used effectively in the detection of COVID-19 infection between symptomatic patients while it is of a lower value in the screening of asymptomatic patients.
Importance of the hounsfield unit value measured by computed tomography in the differentiation of hydronephrosis and pyonephrosis
Authors: Barsoum Nadine R. , Khodair Aya A. , Morsy Samer S. , Shokralla Sally Y.
Published: May 2022

Background

Acute or chronic obstruction of the urinary tract can be due to a lot of different causes. Patients with pyonephrosis usually complain of a triad of fever, loin pain and elevated white blood cell count in cases of acute obstruction; and they may also have hypotension in severe cases of the disease. These patients have to be treated with appropriate decompression, or they may develop septic shock. The urgency of the need for treatment greatly depends on the differentiation between hydronephrosis and pyonephrosis.

There is a lack of reliable clinical prognosticators of pyonephrosis in patients with obstructive hydronephrosis. Hounsfield unit (HU) measurement is considered as an adequate predictor of pyonephrosis and may aid in the diagnosis and management of this disease that may be fatal.

The use of HU values in differentiation between pyonephrosis from hydronephrosis depends on the fact that the pyonephrotic fluid contains infected material, urine, cellular particles and microorganisms, which when combined can increase the HU values on a computed tomography (CT) study.

This study was done to assess the diagnostic value of the HU measured CT in differentiation between hydronephrosis and pyonephrosis.

Results

Thirty-nine patients were included in this study. All patients had loin pain and were diagnosed with pelvicalyceal dilatation by ultrasonographic examination. They then underwent non-contrast CT examination.

Using CT scan, the degree of PC dilatation was significantly higher among hydronephrosis group as hydronephrosis group had 63.1% severe dilatation of PCs versus 30.8% in pyonephrosis group with p value 0.0001.

Pelvic wall thickness > 2 mm was reported in 10 (76.9%) patients of pyonephrosis group versus in three (7.9%) patients among hydronephrosis group with p value 0.0001.

The mean Hounsfield units were significantly higher among pyonephrosis group compared to hydronephrosis group (16 ± 5.2 versus 1.7 ± 5.5) with p value 0.0001.

Sensitivity analysis showed that Hounsfield units can significantly diagnose pyonephrosis using the cutoff point 6.2 units, with sensitivity 92.3%, specificity 93.3%, area under the curve (AUC) 96.9% and p value 0.0001.

Conclusions

Measuring HU in a NCECT scan of the kidney might be helpful for differentiating between hydronephrosis and pyonephrosis especially upon considering 6.2 HU as a cutoff point.
A methodology towards delivery of net zero carbon building in hot arid climate with reference to low residential buildings — the western desert in Egypt
Authors: Fouly Safie El-din Ahmed , Abdin Ahmed Reda
Published: May 2022

Net zero carbon building (NZCB) is considered an important approach for reducing carbon emissions (CE), which may be due to the exponential rise of energy use and greenhouse gas emissions in buildings industry. Delivery of NZCB on its life cycle is considered a challenge due to its complexity and research deficiency for examining CE life cycle assessment (LCA) to reach NZCB in early design phase, especially in hot arid climates. The present proposal aims to develop an experimental methodology for NZCB in hot arid climate, with reference to the western desert region in Egypt as an experimental location due to its hot climatic characteristic, which includes the most common climate in Africa. The study was held on three models for a single floor residential unit with fixed area 110 m2, using DesignBuilder software for annual simulation and One-click LCA software for 50 years LC simulation. The effect of conventional construction materials replacement, as a passive technique, and application of solar panels, as an active technique, was examined. Simulation results indicated that there was a reduction in carbon emissions through LCA reached approximately 85% when applying both passive and active techniques on the experimental models, as well as a reduction of approximately 101% in energy consumption. Implementation and integration between passive and active systems in early design phase are evident for achieving net zero CE target in hot arid climate.