bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of cerebral oximetry in mechanically ventilated newborns: a protocol for the SafeBoosC-IIIv randomised clinical trial
Authors: Vestager Maria Linander , Hansen Mathias Lühr , Rasmussen Marie Isabel , Hahn Gitte Holst , Hyttel-Sørensen Simon , Pellicer Adelina , Heuchan Anne Marie , Hagmann Cornelia , Dempsey Eugene , Dimitriou Gabriel , Pichler Gerhard , Naulaers Gunnar , Fuchs Hans , Tkaczyk Jakub , Mintzer Jonathan , Fumagalli Monica , Nesargi Saudamini , Fredly Siv , Szczapa Tomasz , Gluud Christian , Jakobsen Janus Christian , Greisen Gorm
Published: July 2023

Background: The SafeBoosC project aims to test the clinical value of non-invasive cerebral oximetry by near-infrared spectroscopy in newborn infants. The purpose is to establish whether cerebral oximetry can be used to save newborn infants’ lives and brains or not. Newborns contribute heavily to total childhood mortality and neonatal brain damage is the cause of a large part of handicaps such as cerebral palsy. The objective of the SafeBoosC-IIIv trial is to evaluate the benefits and harms of cerebral oximetry added to usual care versus usual care in mechanically ventilated newborns.
Methods/design: SafeBoosC-IIIv is an investigator-initiated, multinational, randomised, pragmatic phase-III clinical trial. The inclusion criteria will be newborns with a gestational age more than 28+0 weeks; postnatal age less than 28 days; predicted to require mechanical ventilation for at least 24 hours; and prior informed consent from the parents or deferred consent or absence of opt-out. The exclusion criteria will be no available cerebral oximeter; suspicion of or confirmed brain injury or disorder; or congenital heart disease likely to require surgery.
A total of 3000 participants will be randomised in 60 neonatal intensive care units from 16 countries, in a 1:1 allocation ratio to cerebral oximetry versus usual care. Participants in the cerebral oximetry group will undergo cerebral oximetry monitoring during mechanical ventilation in the neonatal intensive care unit for as long as deemed useful by the treating physician or until 28 days of life. The participants in the cerebral oximetry group will be treated according to the SafeBoosC treatment guideline. Participants in the usual care group will not receive cerebral oximetry and will receive usual care. There aretwo co-primary outcomes: 1) a composite of death from any cause or moderate to severe neurodevelopmental disability at two years of corrected age and 2) the non-verbal cognitive score of The Parent Report of Children’s Abilities-Revised (PARCA-R) at two years of corrected age.
Discussion: There is need for a randomised clinical trial to evaluate cerebral oximetry added to usual care versus usual care in mechanically ventilated newborns.
Study registration: The protocol is registered at www.clinicaltrials.gov (NCT05907317; registered 18 June 2023)
Accumulation of podophyllotoxin in root culture of Hyptis suaveolens (L.) Poit: a potential natural lignan for clinically useful anticancer drugs
Authors: Silva Sâmia Torres , de Assis Rafael Marlon Alves , Coelho Adriane Duarte , Mendonça Simony Carvalho , de Carvalho Alexandre Alves , Pinto José Eduardo Brasil Pereira , Bertolucci Suzan Kelly Vilela
Published: July 2023

Podophyllotoxin (PTOX) is a natural antiviral, antirheumatic and anticancer molecule but its chemical synthesis is expensive. The present study aimed to develop and validate an analytical method by HPLC for the quantification of PTOX in roots of Hyptis suaveolens, as well as to evaluate the culture of its roots in vitro in liquid medium supplement with different concentrations of Indole-3-butyric acid (IBA), 1-Naphthaleneacetic acid (NAA), vitamins and myo-inositol. The analytical method was developed and validated. Root culture was used for biomass production and PTOX content was quantified using the developed analytical method after successful validation. The parameters that confirmed the analytical method were selectivity (peak purity: > 99%), system suitability (Rs = 2.92; N = 7064; k = 1.23; As = 1.31; DPR = 0.61%), intra-day and inter-day precision (DPR = 2.43% and 2.96%, respectively), linearity (R² = 0.997), recovery percentage (90.47–101.85%), limit of quantification (5.25 ng) and limit of detection (0.5 ng). Root culture in MS medium containing 1 mg L-1 IBA + 0.5 mg L-1 NAA showed the highest root dry weight (248.76 mg) and the highest PTOX concentration in the root (179, 97 µg-1). The vitamins and myo-inositol in the medium produced 198.88 mg of root dry weight and 6.01 µg g-1 of PTOX. The roots cultured in liquid MS medium supplemented with 1 mg L-1 of IBA + 0.5 mg L-1 of NAA maximized the root biomass and PTOX content. The adequate balance of vitamin and myo-inositol supplementation in liquid MS culture medium increased the production of root dry weight and PTOX accumulation.
The association of ICSI outcomes with semen and blood Bisfenol A concentrations of the male partner
Authors: Ozelci Runa , Yenigül Nefise Nazlı , Dilbaz Serdar , Dilbaz Berna , Aldemir Oya , Kaplanoğlu İskender , Güçel Funda , Başer Emre , Tekin Özlem Moraloğlu
Published: July 2023

This study investigates the association of blood and semen Bisfenol A (BPA) levels of the male partner on the reproductive outcome in intracytoplasmic sperm injection treatment cycles (ICSI). For this prospective study (clinicaltrials.gov identifier: NCT02703584) blood and semen samples of the male partner of the seventy five women who had ICSI were analyzed. The study group consisted of men who had ICSI for male factor infertility other than azoospermia, while men with normal spermiogram whose partnets underwent ICSI due to tubal factor infertility were taken as the study group. Habitual consumption of drinking water from plastic carboys/bottles (PBW) at home was also questioned in both groups as it was considered as chronic BPA exposure. The association of ICSI outcome with blood BPA (bBPA) and semen BPA (sBPA) levels were analyzed in both groups. In the patients who failed to get pregnant, bBPA levels of the male partner was statistically significantly higher then the ones who achieved pregnancy in both groups. Embryo development arrest was found significantly higher in the patients who have high sBPA levels. No significant correlation was found between sperm parameters and bBPA levels in both groups. A negative correlation was found between sBPA levels and total sperm count and progressive sperm motility in men who consumed PBW. Although, PBW BPA levels were not different, bBPA levels were found to be significantly lower in those who consumed tap water than those who used PBW. Elevated serum BPA level was associated with a significantly lower clinical pregnancy rate.
Effect of thermal softening of double-lumen endobronchial tubes on postoperative sore throat in patients with prior SARS-CoV-2 infection: a randomized controlled trial
Authors: Yan Wenlong , Cai Jianyue , Zhu Chenchen , Chen Yu , Fang Jun , Xu Hui , Zheng Xiaojing , Zhou Yingting , Xie Yanhu , Zhang Min , Shu Shuhua
Published: July 2023

Background: The incidence of postoperative sore throat (POST) after tracheal intubation using double-lumen endobronchial tubes (DLTs) is higher in patients with prior severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection than in the general population. This prospective trial was conducted to determine whether thermal softening of DLTs could decrease the incidence of POST or other airway injuries in patients with prior SARS-CoV-2 infection.
Methods:A total of 120 patients with prior SARS-CoV-2 infection undergoing thoracoscopic surgery were randomly assigned to two groups (n=60 each). In the thermal softening group, the distal portion of the DLT was placed in thermostatic saline (50°C) for 10 min before endotracheal intubation. In the control group, the distal portion of the DLT was placed in room temperature saline for 10 min before endotracheal intubation. The incidence and severity of POST and hoarseness were assessed at 1,6 and 24 h postoperatively. The primary outcomes were the incidence and severity of POST at 6 h postoperatively. The secondary outcomes were the incidence and severity of hoarseness, vocal cord and tracheal injuries, and hemodynamic changes in patients at intubation.
Results:The incidence of POSTat 6 h postoperatively was greater in the control group than in the thermal softening group [41 (68%) vs. 22 (37%), P=0.001]. The overall incidence of POSTat 24 h postoperatively was greater in the control group than in the thermal softening group [46 (76%) vs. 24 (40%), P< 0.001].The overall incidence of tracheal injuries was also greater in the control group than in the thermal softening group (P=0.016). Vocal cord injuries occurred more frequently in the control groupthan in the thermal softening group (P=0.006).
Conclusion: Thermal softening of DLTs before intubation can reduce the incidence of POST and airway injuries in patients with prior SARS-CoV-2 infection undergoing DLT insertion
Trial registration:This trial has been registered at www.chictr.org.cn(registration number: ChiCTR2200066821; registration date:December 19, 2022).
ABO Blood Type and Thromboembolic Complications after Intracerebral Hemorrhage: an exploratory analysis
Authors: Ironside Natasha , Melmed Kara , Chen Ching-Jen , Omran Setareh , Park Soojin , Agarwal Sachin , Connolly E. Sander , Claassen Jan , Hod Eldad A. , Roh David
Published: July 2023

Background and Purpose
Non-O blood types are known to be associated with thromboembolic complications (TECs) in population-based studies. TECs are known drivers of morbidity and mortality in intracerebral hemorrhage (ICH) patients, yet the relationships of blood type on TECs in this patient population are unknown. We sought to explore the relationships between ABO blood type and TECs in ICH patients.
Methods
Consecutive adult ICH patients enrolled into a prospective observational cohort study with available ABO blood type data were analyzed. Patients with cancer history, prior thromboembolism, and baseline laboratory evidence of coagulopathy were excluded. The primary exposure variable was blood type (non-O versus O). The primary outcome was composite TEC, defined as pulmonary embolism, deep venous thrombosis, ischemic stroke or myocardial infarction, during the hospital stay. Relationships between blood type, TECs and clinical outcomes were separately assessed using logistic regression models after adjusting for sex, ethnicity and ICH score.
Results
Of 301 ICH patients included for analysis, 44% were non-O blood type. Non-O blood type was associated with higher admission GCS and lower ICH score on baseline comparisons. We identified TECs in 11.6% of our overall patient cohort. Although TECs were identified in 9.9% of non-O blood type patients compared to 13.0% in O blood type patients, we did not identify a significant relationship of non-O blood type with TECs (adjusted OR = 0.776, 95%CI: 0.348–1.733, p = 0.537). The prevalence of specific TECs were also comparable in unadjusted and adjusted analyses between the two cohorts. In additional analyses, we identified that TECs were associated with poor 90-day mRS (adjusted OR = 3.452, 95% CI: 1.001–11.903, p = 0.050). We did not identify relationships between ABO blood type and poor 90-day mRS (adjusted OR = 0.994, 95% CI:0.465–2.128, p = 0.988).
Conclusions
We identified that TECs were associated with worse ICH outcomes. However, we did not identify relationships in ABO blood type and TECs. Further work is required to assess best diagnostic and prophylactic and treatment strategies for TECs to improve ICH outcomes.
Determining the failure mechanism and analyzing numerical stability of a Loess slope in seismic zones: a case study
Authors: Yazarloo Rasool , Nabizadeh Farhad
Published: July 2023

In this paper, with a set of engineering tools including field visits, laboratory experiments, geophysical methods, and numerical simulations, it’s been studied and determined the mechanism of the landslide in AghEmam village, northeast of Iran in Golestan Province. By performing a series of triaxial tests, the mechanical properties of loess soil were calculated, and by performing spectral ratio analysis (H/V) of the microtremor waves, the dynamic properties of the site were determined. The subsurface conditions of the landslide were identified by the high-density resistivity geoelectrical method. The results showed that the output of the numerical simulations carried out by PLAXIS software is in good agreement with the geophysical method and field observations. Based on the results, failure surface of the AghEmam landslide was curved and occurred due to seepage caused by continuous precipitation. With the continuation of precipitation, the loess layer was gradually saturated, and with the formation of a homogeneous flow field, rain directly reached the deep layers; with the dissolution of the cement between the loess grains at the depth, a critical slip surface was formed. The results showed that during the earthquake, stresses were gradually trapped in the slope and facilitated landslide by increasing the horizontal dynamic force. Earthquake also helping seepage and accelerate slide by destroying the porous structure of the loess and creating cracks. Finally, the applying of both precipitation and earthquake factors to the numerical model caused a considerable decrease in the safety factor, which indicates the inevitable occurrence of landslide in such conditions.
Physics Enhanced Sparse Identification of Dynamical Systems with Discontinuous Nonlinearities
Authors: Lathourakis Christos , Cicirello Alice
Published: July 2023

A method is introduced for the identification of the nonlinear governing equations of dynamical systems in the presence of discontinuous and nonsmooth nonlinear forces, such as the ones generated by frictional contacts, based on noisy measurements. The so-called Physics Informed Sparse Identification of Nonlinear Dynamics (PhI-SINDy) builds upon the existing RK4-SINDy identification scheme, incorporating known physics and domain knowledge in three different ways (biases). In this way, it addresses the discontinuous behavior of frictional systems when stick-slip phenomena are observed, which can not be captured by existing state-of-the-art approaches. The potential of PhI-SINDy is highlighted through a plethora of case studies, starting from a simple yet representative Single Degree of Freedom (SDOF) oscillator with a Coulomb friction contact under harmonic load, using both synthetic and experimental noisy measurements. An alternative friction law, namely the Dieterich-Ruina one, is also considered as well as a more realistic excitation time series, which was generated based on the Jonswap spectrum. Lastly, a Multi Degree of Freedom system with single and multiple friction contacts is used as a testbed, showcasing the applicability of PhISINDy to more complicated systems and/or multiple sources of discontinuous nonlinearities.
Giant Muscle Hydatid in Lower Extremity: A Rare Case with Neurological Symptoms as the First Manifestation
Authors: Jia Qiyu , Wu Shuo , Guo Jian , Alimujiang Abudusalamu , Zheng Hao , Zhang Jun , Wang Yingbo , Xie Zengru , Ma Chuang
Published: July 2023

Background: Human hydatid disease typically occurs in organs such as the liver and kidney. Primary solitary intramuscular hydatid disease, however, is rare.
Case Presentation: We report a case of a giant muscle hydatid in the lower extremity, with neurological symptoms as the first manifestation. The symptoms specifically manifested as intermittent pain in the right lower extremity and numbness in the sole of the right foot. However, there were no obvious abnormalities detected in electromyography and lumbar MRI. Subsequent ultrasonography and calf MRI showed that the patient had cystic lesions in the calf. The patient was initially diagnosed with a muscle hydatid cyst. Treatment involved complete surgical excision of the lesion, and the diagnosis of a hydatid cyst was confirmed through macroscopic and microscopic histopathological examination after the mass was excised. The patient was given oral albendazole, and no recurrence was observed during the 12 months of follow-up.
Conclusions: This case underscores the importance of considering hydatid disease in the differential diagnosis of soft tissue masses in the muscular system, particularly in endemic areas. Patients may also present with atypical symptoms, such as peripheral nerve symptoms, as their primary complaint.
On the Stability of Artificial Collinear Points in the Restricted Three Body Problem under a Force Acting between the Primaries
Authors: Mostafa A. , Yousef M. A.
Published: July 2023

In this work, the collinear libration points in the circular ristricted three body problem are studied under the influence of applying a radial force. The problem is formulated with the addition of a force acting in the direction of the line between the two primaries. The positions of the collinear libration points and the stability conditions are found. The points L1 and L3 are poved to be always unstable under the existence of of a radial accelration, and the conditions for stability of L2 are found.
Interaction of Caveolin-1 gene polymorphism with processed meats on anthropometric measurements and body composition in obese and overweight women: A cross-sectional study
Authors: Mohamadi Azam , Mirzababaei Atieh , Abaj Faezeh , Roumi Zahra , Khorraminezhad Leila , Mirzaei Khadijeh
Published: July 2023

Background: It has been shown in different studies that Caveolin (CAV-1) gene variants can play a role in causing obesity and changes in anthropometric measurements and body composition. Further, the consumption of processed meats can also cause obesity and changes in the anthropometric parameters. Therefore, this study sought to investigate the relationship between the interaction of processed meats and the CAV-1 gene polymorphism on anthropometric parameters and body composition.
Methods: This cross-sectional study was conducted on 389 obese and overweight women with a body mass index (BMI) 25-30 kg/m2 and 18-48 years from 20 health centers in Tehran. Dietary assessment was done using a 147-question semi-quantitative food frequency questionnaire (FFQ). Furthermore, anthropometric parameters, body composition, and biochemical assessments were measured. The CAV-1 genotyping was performed by the polymerase chain reaction -restriction fragment length polymorphism (PCR-RFLP) method.
Results: It was observed that (AA+AG) group was younger than GG group (P-value<0/05). The mean ± SD of systolic blood pressure (SBP), diastolic blood pressure (DBP) waist hip ratio (WHR), and waist circumference (WC) were 111.68 ±13.71 (mmHg) 77.53 ±10.44 (mmHg), 1.16 ±4.61 and 99.12 ± 9.41 (cm), respectively. Our findings also showed, after controlling for age, BMI, physical activity and energy intake, significant interactions were found between processed meat and the A allele carrier group on WC (p = 0.04), body mass index (BMI ) (p = 0.02), body fat mass (BFM) (p = 0.01), body roundness index (BRI) (p = 0.006) and fat mass index (FMI) (p = 0.01). Moreover, in interaction, WC, WHR, visceral fat level (VFL) and a body shape index (ABSI) had higher level compared to GG homozygotes but these differences were not significant (P>0.05).
Conclusion: The results of the present study showed that high consumption of processed meats may be associated with higher anthropometric parameters and body composition in AA and AG genotypes with rs-3807992. These results showed that diet, gene type and their interaction should be considered in the evaluation of anthropometric measurements and body composition.
Post-SARS-CoV-2 vaccine small vessel vasculitis in a 13-year-old girl: A case report
Authors: Hajiani Shabnam , Johari Leila , Moshfeghinia Reza , Alyasin Soheila Sadat , Nabavizadeh Seyed Hesamedin , Esmaeilzadeh Hossein
Published: July 2023

Background
Cutaneous small vessel vasculitis (CSVV) or leukocytoclastic vasculitis (LCV) is a subgroup of vasculitis localized to the skin. Regarding the COVID-19 vaccine, it is postulated that some patients develop an inflammatory reaction to vaccine components encoding the SARS-CoV‐2 spike glycoprotein, which targets the endothelium and results in CSVV with endothelial cell inflammation and dysfunction. Although post-COVID-19 vaccination small vessel vasculitis has been reported in the literature and some cases had necrotic reactions after receiving Pfizer and AstraZeneca.
Case presentation:
We report the first pediatric case of post-Sinopharm COVID-19 vaccine small vessel vasculitis. Five months after receiving the second dose of the mentioned vaccine, a 13-year-old girl developed gangrene-like symptoms, starting as painful, tingling sensations on the left forefinger. Spiral CT angiography of both upper extremities showed vasculitis and narrowing of the left radial and ulnar arteries. Pathology specimen from a punch biopsy of the skin was consistent with acute neutrophilic LCV involving small blood vessels, and the bone marrow aspiration biopsy noted a moderately hypocellular marrow. Our treatment included a single dose of cyclophosphamide, 2 doses of rituximab, 5 episodes of plasmapheresis (QOD), vasodilators, and sympathetic blockade. A good outcome was achieved.
Conclusions
Post-COVID-19 small vessel vasculitis in pediatric patients is rare but can be diagnosed and treated effectively using histopathological analysis and specific treatments.
The clinical significance of inflammatory biomarkers, IL-6 cytokine, and systemic immune inflammatory index in rabbit model of acute and chronic Methicillin-resistant Staphylococcus epidermidis-induced osteomyelitis
Authors: Ancuta Diana-Larisa , Lovati Arianna Barbara , Coman Cristin
Published: July 2023

Infections are a major complication of open fractures and fracture fixation. In this study, an innovative bioactive medical device was used to experimentally treat MRSE-induced osteomyelitis in rabbit tibia. This paper investigates the clinical significance of inflammatory biomarkers (NLR, PLR, MLR and PMR), SII and IL-6 and assesses their role in the development of osteomyelitis. The main objective is to identify the utility of hematological reports derived from neu-trophils, leukocytes, monocytes and platelets in the evolution of implant-related osteomyelitis and the estimation of treatment efficiency. In particular, this study compares the response of these inflammatory markers to different treatments in the presence or absence of bioactive materials and/or topical antibiotics over time. The analysis of the threads showed that NLR, PLR and SII had high values in the acute phase of the disease, so that after chronicization, they decrease. The animals treated with vancomycin nano-functionalized peptide-enriched silk fibroin-coated implants showed lower levels of inflammatory biomarkers compared to the other groups (empty implants and peptide-enriched silk fibroin-coated implants). NLR, PLR and SII, complemented by IL-6 can be used as fairly accurate biomarkers for the diagnosis of osteomyelitis.
The Impact of Perioperative Enhanced Recovery Nursing Model on Postoperative Delirium and Rehabilitation Quality in Elderly Patients with Femoral Neck Fractures
Authors: Wang Cheng , Tan Bingyin , Qian Qing
Published: July 2023

Background
The aim of this study was to investigate the effects of introducing the Enhanced Recovery After Surgery (ERAS) nursing model on postoperative delirium occurrence and rehabilitation quality in elderly patients with femoral neck fractures.
Methods
A total of 160 elderly patients with femoral neck fractures, who met the inclusion criteria and were admitted between March 2021 to March 2023, were divided into two groups: the traditional care group and the ERAS nursing model group. In addition to traditional care measures, the ERAS nursing model group received interventions based on the principles of the ERAS nursing model. The occurrence of delirium and sleep quality were observed at 24, 48, and 72 hours postoperatively, as well as during the overall hospital stay. The duration of hospitalization, time to first mobilization, and post-discharge follow-up on quality of life were compared between the two groups.
Results
The ERAS nursing model group exhibited a significant difference in the occurrence of delirium at 48 and 72 hours postoperatively, as well as during the overall hospital stay (P < 0.05). However, there was no significant difference in the occurrence of delirium at 24 hours postoperatively (P > 0.05). The sleep quality of the two groups showed a statistically significant difference (P < 0.05). The ERAS nursing model group had shorter time to first mobilization, reduced hospitalization duration, and higher Harris and SF-36 scores during post-discharge follow-up, compared to the traditional care group (P < 0.05).
Conclusions
The implementation of the ERAS nursing model in elderly patients with femoral neck fractures improved postoperative sleep quality, reduced delirium occurrence, shortened average hospitalization duration, and enhanced patients' quality of life.
Anticancer Medicinal Plants Used by the Natives in the Elgon Sub-region, Eastern Uganda
Authors: Kudamba Ali , Kasolo Josephine N , Bbosa Godfery S , Lugaajju Allan , Wabinga Henry , Niyonzima Nixon , Ocan Moses , Damani Ali M , Kafeero Hussein M , Walusansa Abdul , Ssenku Jamilu E , Alemu Shaban O , Lubowa Muhammad , Muwonge Haruna
Published: July 2023

Introduction: Medicinal plants have been used to treat several diseases, including cancer in Uganda. However, very few studies have been reported on the anticancer medicinal plants used in the Elgon sub-region. The main aim of this study was to describe the anticancer medicinal plants used to treat cancer, with an emphasis on prostate cancer, in the Elgon sub-region of Eastern Uganda.
Methods: Information was gathered using a semi-structured, researcher-administered questionnaire, interview guides, and guided field walks. Quantitative indices such as fidelity level (FL), preference ranking, and informant consensus factor (ICF) were evaluated. To summarize ethnobotanical data, a descriptive statistical analysis and graphs were created by SPSS version 21.0 and GraphPad Prism version 8.125, respectively, and narratives were explained using theories and major hypotheses in ethnobotany.
Results: A total of 50 plant species from 36 families were described; of them, 45% were herbs and 10% were parasites. Additionally, 60% of plants were gathered from forest reserves, and 86% of the materials used by herbalists were leaves. The most effective treatment for cancer overall was Tylosema fassoglensis due to its versatility. Hydnora abyssinica A. Br., Hydnora africana, Rhoicissus tridentata (L.f.) Wild & R.B. Drumm., Prunus africana, and Kigelia africana, respectively, are used to cure prostate cancer. Herbs make up 45% of all medical plant use, with the fidelity level (FL) for Hydnora abyssinica A. Br being 93.9%, Rhoicissus tridentata (L.f.) Wild & R.B. Drumm (89.7%), Hydnora africana (84.8%), and Prunus africana (82.4%). Herbalists predominantly used leaves (86%), and 60% of the plants used as medicines were gathered from peripheral forest areas, according to their preferred ranking. The most popular methods of preparation and administration (86%) were oral routes and concoctions. Hydnora abyssinica A. Br. was the herb that was most sought after for treating prostate cancer. ICF values larger than 0.5 were only attained by plant species used to treat cervical and prostate cancer, indicating that herbalists often lack awareness of herbs used in cancer treatment.
Conclusions and recommendation: All the first ten frequently used plants in the treatment of cancer received faithfulness levels more than 50%, suggesting that herbalists have faith in the ability of these plants to treat cancer. Therefore, it is crucial to conduct additional research into their phytochemistry, toxicity, efficacy, and effectively enforced conservation.
Evaluation of Salivary Anti-CCP in Relation to Some Oral Manifestations in Rheumatoid Arthritis Patients, Sulaimaniyah, Iraq
Authors: Fadhil Hevi Nihad Mohammed , Ahmed Khadija Mohammed
Published: July 2023

Background
Rheumatoid arthritis (RA) affects the oral cavity, mainly the exocrine salivary gland function causing decreased salivary flow rate.
Objectives
To determine the salivary flow rate, pH, and the main oral manifestations in RA patients. Also, to evaluate the level of antibodies to the cyclic citrullinated peptide (CCP) in the saliva.
Subjects and methods
A matched case-control study was conducted at Rheumatology Centre, Sulaimaniyah, Iraq, on 90 subjects (50 RA patients and 40 healthy controls) from January 2021 to January 2022. The oral cavity was thoroughly examined for signs of oral and temporomandibular joint (TMJ) involvement and to assess the Decayed, Missed, Filled Teeth (DMFT) index and oral health status. Saliva samples were taken from each subject to measure flow rate, pH, and immunological determination of anti-CCP antibodies using ELISA.
Results
Salivary flow rate was substantially reduced in RA patients. The main oral manifestations were oral ulcerations, redness of the tongue, dry/cracked lips, buccal mucosal dryness, taste disturbances, angular cheilitis, and candidiasis. In addition, TMJ involvement and DMFT were also suggestively more in the RA patients. There was no significant difference between both groups regarding oral hygiene index and the level of salivary anti-CCP antibodies.
Conclusions
Patients with RA exhibited decreased salivary flow rate and generally poorer oral health status.
Lung function impairment may increase secondary thrombocytopenia susceptibility: a Mendelian randomization
Authors: Liu Yuxin , Bin Chengli , Ran Qiang , Liu Yuan , Zhang Jieying , Liu YanKun
Published: July 2023

Purpose
This study explored the relationship between lung function and secondary thrombocytopenia by analyzing Mendelian randomization (MR).
Methods
As instrumental genetic variables, appropriate single nucleotide polymorphisms (SNPs) were extracted from genome-wide association study (GWAS) data on lung function. We choose secondary thrombocytopenia as the outcome. Inverse variance weighting, weighted median methods, and MR- Egger's method were used to explore the association between lung function and the risk of secondary thrombocytopenia. The analysis results were shown as odds ratio (OR) and 95% confidence interval to evaluate the causal association between lung function parameters and secondary thrombocytopenia.
Results
The inverse variance weighted (IVW) analysis showed that forced expiratory volume in the first second (FEV1) significantly led to the occurrence of secondary thrombocytopenia [OR: 0.2126; 95% confidence interval (CI): 0.0508–0.8886, P = 0.0339], reduced peak expiratory flow (PEF) increased the occurrence of secondary thrombocytopenia [OR: 0.1018; 95% CI: 0.0143–0.7234, P = 0.0224]. The decline of FEV1 and PEF contributed to the risk of secondary thrombocytopenia. Furthermore, FVC (Forced Vital Capacity), FEV1/FVC, and lung volume were not associated with secondary thrombocytopenia.
Conclusion
FEV1 and PEF could be important precipitating factors of secondary thrombocytopenia, which provided new ideas for treating and preventing secondary thrombocytopenia.
Protocol of a Parallel, Randomized Controlled Trial on the Effects of a Novel Personalized Nutrition Approach by Artificial Intelligence in Real World Scenario
Authors: Feng Jingyuan , Liu Hongwei , Mai Shupeng , Su Jin , Sun Jing , Zhou Jianjie , Zhang Yingyao , Wang Yinyi , Wu Fan , Zheng Guangyong , Zhu Zhenni
Published: July 2023

Background Nutrition service needs are huge in China. Previous studies indicated that personalized nutrition (PN) interventions were effective. The aim of the present study is to identify the effectiveness and feasibility of a novel PN approach supported by artificial intelligence (AI). Methods This study is a two-arm parallel, randomized, controlled trial in real world scenario. The participants will be enrolled among who consume lunch at a staff canteen. In Phase I, a total of 170 eligible participants will be assigned to either intervention or control group on 1:1 ratio. The intervention group will be instructed to use the smartphone applet to record their lunches and reach the real-time AI-based information of dish nutrition evaluation and PN evaluation after meal consumption for 3 months. The control group will receive no nutrition information but be asked to record their lunches though the applet. Dietary pattern, body weight or blood pressure optimizing is expected after the intervention. In phase II, the applet will be free to all the diners (about 800) at the study canteen for another one year. Who use the applet at least 2 days per week will be regarded as the intervention group while the others will be the control group. Body metabolism normalization is expected after this period. Generalized linear mixed models will be used to identify the dietary, anthropometric and metabolic changes. Discussion This novel approach will provide real-time AI-based dish nutrition evaluation and PN evaluation after meal consumption in order to assist users with nutrition information to make wise food choice. This study is designed under a real-life scenario which facilitates translating the trial intervention into real-world practice. Trial registration This trial has been registered with the Chinese Clinical Trial Registry (ChiCTR2100051771; date registered: 03/10/2021).
Quantitative size-resolved characterization of mRNA nanoparticles by in-line coupling of asymmetrical-flow field-flow fractionation with small angle X-ray scattering
Authors: Haas Heinrich , Graewert Melissa , Wilhelmy Christoph , Bacic Tijana , Schumacher Jens , Blanchet Clement , Meier Florian , Drexel Roland , Welz Roland , Kolb Bastian , Bartels Kim , Nawroth Thomas , Klein Thorsten , Svergun Dmitri , Langguth Peter
Published: July 2023

We present a generically applicable approach to determine an extensive set of size-dependent critical quality attributes inside nanoparticulate pharmaceutical products. By coupling asymmetrical-flow field-flow fractionation (AF4) measurements directly in-line with solution small angle X-ray scattering (SAXS), vital information such as (i) quantitative, absolute size distribution profiles, (ii) drug loading, (iii) size-dependent internal structures, and (iv) quantitative information on free drug is obtained. Here the validity of the method was demonstrated by characterizing complex mRNA-based lipid nanoparticle products. The approach is particularly applicable to particles in the size range of 100 nm and below, which is highly relevant for pharmaceutical products – both biologics and nanoparticles. The method can be applied as well in other fields, including structural biology and environmental sciences.
Schnurri-3 inhibition rescues skeletal fragility and vascular skeletal stem cell niche pathology in a mouse model of osteogenesis imperfecta
Authors: Xu Ren , Li Na , Shi Baohong , Li Zan , Han Jie , Sun Jun , Yallowitz Alisha , Bok Seoyeon , Xiao Shuang , Wu Zouxing , Chen Yu , Xu Yan , Qin Tian , Lin Zhiming , Zheng Haiping , Shen Rong , Greenblatt Matthew
Published: July 2023

Osteogenesis imperfecta (OI) is a disorder of low bone mass and increased fracture risk due to a range of genetic variants that prominently include mutations in genes encoding type Ⅰ collagen. While it is well known that OI reflects defects in the activity of bone-forming osteoblasts, it is currently unclear whether OI also reflects defects in the many other cell types comprising bone, including defects in skeletal vascular endothelium or the skeletal stem cell populations that give rise to osteoblasts and whether correcting these broader defects could have therapeutic utility. Here, we find that numbers of skeletal stem cells (SSCs) and skeletal arterial endothelial cells (AECs) are augmented in Col1a2oim/oim mice, a well-studied animal model of moderate to severe OI, suggesting that disruption of a vascular SSC niche is a feature of OI pathogenesis. Moreover, crossing Col1a2oim/oim mice to mice lacking a negative regulator of skeletal angiogenesis and bone formation, Schnurri 3 (SHN3), not only corrected the SSC and AEC phenotypes but moreover robustly corrected the bone mass and spontaneous fracture phenotypes. As this finding suggested a strong therapeutic utility of SHN3 inhibition for the treatment of OI, a bone-targeting AAV was used to mediate Shn3 knockdown, rescuing the Col1a2oim/oim phenotype and providing therapeutic proof-of-concept for targeting SHN3 for the treatment of OI. Overall, this work both provides proof-of-concept for inhibition of the SHN3 pathway and more broadly addressing defects in the stem/osteoprogentior niche as is a strategy to treat OI.
Assessment of S. Aureus Growth on Biocompatible 3D Printed Materials: A Step Toward Tailored 3D Printed Laryngectomy Tubes
Authors: Senderovich Nicole , Shah Sharan , Ow Thomas J. , Rand Stephanie , Nosanchuk Joshua , Wake Nicole
Published: July 2023

The customizability of 3D printing allows for the manufacturing of personalized medical devices such as laryngectomy tubes, but it is vital to establish the biocompatibility of printing materials to ensure that they are safe and durable. The goal of this study was to assess the presence ofS. aureusbiofilms on a variety of 3D printed materials (two surgical guide resins, a photopolymer, an elastomer, and a thermoplastic elastomer filament) as compared to standard, commercially available laryngectomy tubes. C-shaped discs (15 mm in height, 20 mm in diameter, and 3 mm in thickness) were printed with five different biocompatible 3D printing materials andS. aureusgrowth was compared to Shiley™ laryngectomy tubes made from polyvinyl chloride. Discs of each material were inoculated withS. aureuscultures and incubated overnight. All materials were then removed from solution, washed in phosphate-buffered saline to remove planktonic bacteria, and sonicated to detach biofilms. Some solution from each disc was plated and colony-forming units were manually counted the following day. The resulting data was analyzed using a Kruskal-Wallis and Wilcoxon Rank Sum test to determine pairwise significance between the laryngectomy tube material and the 3D printed materials. The Shiley™ tube grew a median of 320 colonies (IQR 140–520), one surgical guide resin grew a median of 640 colonies (IQR 356–920), the photopolymer grew a median of 340 colonies (IQR 95.5–739), the other surgical guide resin grew a median of 431 colonies (IQR 266.5–735), the thermoplastic elastomer filament grew a median of 188 colonies (IQR 113.5–335), and the elastomer grew a median of 478 colonies (IQR 271–630). Using the Wilcoxon Rank Sum test, manual quantification showed a significant difference between biofilm formation only between the Shiley™ tube and a surgical guide resin (p = 0.018). This preliminary study demonstrates that bacterial colonization was comparable among most 3D printed materials as compared to the conventionally manufactured device. Continuation of this work with increased replicates will be necessary to determine which 3D printing materials optimally resist biofilm formation.
Proton Pump Inhibitors and Chronic Kidney Disease Risk: A Comparative Study with Histamine-2 Receptor Antagonists
Authors: Kweon Takhyeon , Kim Yerim , Lee Kyungju , Seo Won-Woo , Seo Seung In , Shin Woon Geon , Shin Dong Ho
Published: July 2023

This observational study explored the association between proton pump inhibitor (PPI) and histamine-2 receptor antagonist (H2RA) use and the risk of chronic kidney disease (CKD). Using the National Health Insurance Service-National Sample Cohort (NHIS-NSC) and six-hospital electronic health record (EHR) databases, CKD incidence was analyzed among PPI and H2RA users. Propensity score matching was used to balance baseline characteristics, with 1,858 subjects each in the PPI and H2RA groups from the NHIS-NSC, and 5,772 in EHR databases. CKD incidence was similar for both groups (7.39/1000 person-years vs. 7.03/1000 person-years; HR, 1.00; 95% CI, 0.56-1.79). A meta-analysis of the EHR databases showed no significant increased CKD risk associated with PPI use (HR = 1.01, 95% CI: 0.85-1.20). These results suggest PPI use may not increase CKD risk compared to H2RA use, but the potential role of PPI-induced CKD needs further research. Clinicians should consider this when prescribing long-term PPI therapy.
Meningeal solitary fibrous tumor cell states phenocopy cerebral vascular development and homeostasis
Authors: Raleigh David , Mirchia Kanish , Choudhury Abrar , Joseph Tara , Birrueta Janeth , Phillips Joanna , Bhaduri Aparna , Crouch Elizabeth , Perry Arie
Published: July 2023

Meningeal solitary fibrous tumors (SFTs) are rare mesenchymal neoplasms that are associated with hematogenous metastasis, and the cell states and spatial transcriptomic architecture of SFTs are unknown. Here we use single-cell and spatial RNA sequencing to show SFTs are comprised of regionally distinct gene expression programs that resemble cerebral vascular development and homeostasis. Our results shed light on pathways underlying SFT biology in comparison to other central nervous system tumors and provide a framework for integrating single-cell and spatial transcriptomic data from human cancers and normal tissues.
Understanding Suboptimal Insulin Use in Type 1 and 2 Diabetes: A Cross-sectional Survey of Healthcare Providers who Treat People With Diabetes
Authors: Newson Rachel S. , Spaepen Erik , Liao Birong , Bower Julie , Bhattacharya Indranil , Artime Esther , Polonsky William
Published: July 2023

Background: The purpose of this study was to understand the healthcare provider (HCP) perspective on the extent of suboptimal insulin dosing in people with diabetes (PwD), as well as specific challenges and solutions to insulin management.
Methods: An online survey of general practitioners and specialists (N=640) who treat people with diabetes in Germany, Spain, the United Kingdom, and the United States was conducted. Responses regarding HCP background and their patients, HCP perceptions of suboptimal insulin use, and challenges associated with optimal insulin use were collected. Categorical summary statistics were presented.
Results:Overall, for type 1 diabetes (T1D) and type 2 diabetes (T2D), most physicians indicated <30% of PwD missed or skipped a bolus insulin dose in the last 30 days (T1D: 83.0%; T2D: 74.1%). The top 3 reasons (other than skipping a meal) HCPs believed caused the PwD to miss or skip insulin doses included “they forgot,” (bolus: 75.0%, basal: 67.5%) “they were too busy/distracted,” (bolus: 58.8%, basal: 48.3%), and “they were out of their normal routine” (bolus: 57.8%, basal: 48.6%). HCPs reported similar reasons that they believed caused PwD to mistime insulin doses. Digital technology and improved HCP-PwD communication were potential solutions identified by HCPs to optimize insulin dosing in PwD.
Conclusions: The results of this study reveal HCPs believe the extent of suboptimal insulin dosing is less widespread than studies in PwD of self-reported insulin dosing. This discrepancy could lead to difficulties in HCPs giving PwD the best advice on optimal insulin management. Approaches such as improving the objectivity of dose measurements for both PwD and HCPs may improve associated communications and help reduce suboptimal insulin dosing, thus enhancing treatment outcomes.
Ethical considerations for Biobanking and Use of Genomics Data in Africa: A narrative review
Authors: Amoakoh-Coleman Mary , Vieira Dorice , Abugri James
Published: July 2023

Background
Biobanking and genomic research requires collection and storage of human tissue from study participants. From participants’ perspectives within the African context, this can be associated with fears and misgivings due to a myriad of factors including myths and mistrust of researchers. From the researchers angle ethical dilemmas may arise especially with consenting and sample reuse during storage. The aim of this paper was to explore these ethical considerations in the establishment and conduct of biobanking and biogenomic studies in Africa.
Methods
We conducted a narrative synthesis following a comprehensive search of nine (9) databases and grey literature. Ethical issues studied related to community knowledge and understanding of biobanking and genomic research, regulation, and governance of same by research ethics committees, enrolment of participants, types of informed consents, data collection, storage, usage and sharing as well as material transfer, returning results and benefit sharing.
Results
Of 2,663 title and abstracts screened, 94 full texts were retrieved and reviewed for eligibility. We included 12 studies (7 qualitative; 4 quantitative and one mixed methods). More education of study participants is needed, as well as appropriate community engagement processes that allow community confidence in enrolment into such studies. Competence of review and ethics committees (RECs) should be enhanced to adequately review and govern biobanking and genomic research in Africa. Biospecimen collection and storage is given in trust and participants expect confidentially of data and results generated. Most participants are comfortable with broad consent due to trust in researchers, though a few would like to be contacted for reconsenting in future studies, and this would depend on whether the new research is for good cause. Sharing data with external partners is welcome in some contexts but some research participants did not trust foreign researchers.
Conclusion
With these varying ethical considerations, we recommend that stakeholders, including research ethics committees, work together to adapt and use clearly defined ethical frameworks, guidelines, and policy documents to harmonize the establishment and running of biobanking and genomic research in Africa.
Case Report: Application of HoloLens for Intra-Operative Assessment of a Retrosternal Thyroid Goitre
Authors: Leong Eugene Kwong Fei , Cheng Aldred , Lee James Wai Kit , Gao Yujia , Ngiam Kee Yuan
Published: July 2023

Thyroidectomy is a common surgical procedure performed to treat a myriad of thyroid pathologies. 2-19% of thyroidectomies involve a retrosternal goitre, which is an extension of thyroid tissue into the thoracic cavity. Resection of retrosternal goitres are more challenging that standard thyroidectomies and typically have higher complication rate of recurrent laryngeal nerve injury, hypoparathyroidism and post op bleeding. Goitres can be removed either via a transcervical approach, transthoracic approach or a combination of both. A transcervical approach is generally favoured. Direct visualisation of the lower poles of the goitre is challenging in such scenarios, making it difficult to confirm full removal of the goitre. Retrosternal goitres are usually evaluated and characterised with cross-sectional imaging such as a computed tomography (CT) scan, in order to estimate the size and location of the goitre. We demonstrate a mixed reality technique of visualising retrosternal goitres, involving projecting three-dimensional (3D) reconstruction of the CT scan onto the patient to directly visualise the size and location of the goitre. This guides surgeons in the removal of retrosternal goitres, with the aim to reduce complications and facilitate complete excision of the goitre. We believe that HoloLens2 is a novel new adjunct which will aid surgeons in future surgeries involving a retrosternal goitre.