bluuebunny/crossref_metadata_2025 huggingface dataset:
The Association Between Bronchoscopy and the Prognoses of Patients With Ventilator-Associated Pneumonia in Intensive Care Units: A Retrospective Study Based on the MIMIC-IV Database
Authors: Zhang Luming , Li Shaojin , Yuan Shiqi , Lu Xuehao , Li Jieyao , Liu Yu , Huang Tao , Lyu Jun , Yin Haiyan
Published: June 2022

Background: In intensive care units (ICUs), the morbidity and mortality of ventilator-associated pneumonia (VAP) are relatively high, and this condition also increases medical expenses for mechanically ventilated patients, which will seriously affect the prognoses of critically ill patients. The purpose of this study was to determine the impact of bronchoscopy on the prognosis of patients with VAP undergoing invasive mechanical ventilation (IMV).

Methods: This was a retrospective study based on patients with VAP from the Medical Information Mart for Intensive Care IV database. The outcomes were ICU and in-hospital mortality. Patients were divided based on whether or not they had undergone bronchoscopy during IMV. Kaplan-Meier (KM) survival curves and Cox proportional-hazards regression models were used to analyze the association between groups and outcomes. Propensity score matching (PSM) and propensity score based inverse probability of treatment weighting (IPTW) were used to further verify the stability of the results. The effect of bronchoscopy on prognosis was further analyzed by causal mediation analysis (CMA).

Results: This study enrolled 1,560 patients with VAP: 1,355 in the no-bronchoscopy group and 205 in the bronchoscopy group. The KM survival curve indicated a significant difference in survival probability between the two groups. The survival probabilities in both the ICU and hospital were significantly higher in the bronchoscopy group than in the no bronchoscopy group. After adjusting all covariates as confounding factors in the Cox model, the HRs (95% CI) for ICU and in-hospital mortality in the bronchoscopy group were 0.33 (0.20–0.55) and 0.40 (0.26–0.60), respectively, indicating that the risks of ICU and in-hospital mortality were 0.67 and 0.60 lower than in the no-bronchoscopy group. The same trend was obtained after using PSM and IPTW. CMA showed that delta-red blood cell distribution width (RDW) mediated 8 and 7% of the beneficial effects of bronchoscopy in ICU mortality and in-hospital mortality.

Conclusion: Bronchoscopy during IMV was associated with reducing the risk of ICU and in-hospital mortality in patients with VAP in ICUs, and this beneficial effect was partially mediated by changes in RDW levels.
Celastrol Inhibited Human Esophageal Cancer by Activating DR5-Dependent Extrinsic and Noxa/Bim-Dependent Intrinsic Apoptosis
Authors: Chen Xihui , Wang Shiwen , Zhang Li , Yuan Shuying , Xu Tong , Zhu Feng , Zhang Yanmei , Jia Lijun
Published: June 2022

Esophageal squamous cell carcinoma (ESCC) is one of the deadliest digestive system cancers worldwide lacking effective therapeutic strategies. Recently, it has been found that the natural product celastrol plays an anti-cancer role in several human cancers by inducing cell cycle arrest and apoptosis. However, it remains elusive whether and how celastrol suppresses tumor growth of ESCC. In the present study, for the first time, we demonstrated that celastrol triggered both extrinsic and intrinsic apoptosis pathways to diminish the tumor growth of ESCC in vivo and in vitro. Mechanistic studies revealed that celastrol coordinatively induced DR5-dependent extrinsic apoptosis and Noxa-dependent intrinsic apoptosis through transcriptional activation of ATF4 in ESCC cells. Furthermore, we found that the FoxO3a-Bim pathway was involved in the intrinsic apoptosis of ESCC cells induced by celastrol. Our study elucidated the tumor-suppressive efficacy of celastrol on ESCC and revealed a previously unknown mechanism underlying celastrol-induced apoptosis, highlighting celastrol as a promising apoptosis-inducing therapeutic strategy for ESCC.
Carbocisteine as a Modulator of Nrf2/HO-1 and NFκB Interplay in Rats: New Inspiration for the Revival of an Old Drug for Treating Ulcerative Colitis
Authors: Abdelhamid Amir Mohamed , Youssef Mahmoud E. , Cavalu Simona , Mostafa-Hedeab Gomaa , Youssef Amal , Elazab Sara T. , Ibrahim Samar , Allam Shady , Elgharabawy Rehab Mohamed , El-Ahwany Eman , Amin Noha A. , Shata Ahmed , Mohammed Osama A. , Ibrahim Abdeldaiem Mahmoud Said , Alhowail Ahmed , El-Saber Batiha Gaber , El-Mahmoudy Engy A. , Attia Maram , Allam Alaa , Zaater Mona Y. , Osman Mona M. , Nader Manar , Taha Aya , Makarem Nada Abul , Saber Sameh
Published: June 2022

Ulcerative colitis (UC), an inflammatory bowel disease, is a chronic condition of a multifaceted pathophysiology. The incidence of UC is increasing internationally. The current therapies for UC lack relative effectiveness and are associated with adverse effects. Therefore, novel therapeutic options should be developed. It has been well documented that modulating the Nrf2/NFκB is a promising therapeutic target in inflammation. Carbocisteine is a mucoregulatory medication and its efficacy in COPD was found to be more closely related to its antioxidant and anti-inflammatory properties. Carbocisteine has not yet been examined for the management of UC. Hence, our approach was to investigate the potential coloprotective role of carbocisteine in acetic acid-induced colitis in rats. Our results revealed that carbocisteine improved colon histology and macroscopic features and subdued the disease activity as well. Additionally, carbocisteine attenuated colon shortening and augmented colon antioxidant defense mechanisms via upregulating catalase and HO-1 enzymes. The myeloperoxidase activity was suppressed indicating inhibition of the neutrophil infiltration and activation. Consistent with these findings, carbocisteine boosted Nrf2 expression along with NFκB inactivation. Consequently, carbocisteine downregulated the proinflammatory cytokines IL-6 and TNF-α and upregulated the anti-inflammatory cytokine IL-10. Concomitant to these protective roles, carbocisteine displayed anti-apoptotic properties as revealed by the reduction in the Bax: BCL-2 ratio. In conclusion, carbocisteine inhibited oxidative stress, inflammatory response, and apoptosis in acetic acid-induced UC by modulating the Nrf2/HO-1 and NFκB interplay in rats. Therefore, the current study provides a potential basis for repurposing a safe and a commonly used mucoregulator for the treatment of UC.
L-Cysteine Alleviates Myenteric Neuron Injury Induced by Intestinal Ischemia/Reperfusion via Inhibitin the Macrophage NLRP3-IL-1β Pathway
Authors: Gao Yifei , Zhang Haojie , Wang Yujin , Han Ting , Jin Jing , Li Jingxin , Tang Yan , Liu Chuanyong
Published: June 2022

Ischemia/reperfusion injury is a common pathophysiological process in the clinic. It causes various injuries, multiple organ dysfunction, and even death. There are several possible mechanisms about ischemia/reperfusion injury, but the influence on intestinal myenteric neurons and the underlying mechanism are still unclear. C57BL6/J mice were used to establish the ischemia/reperfusion model in vivo. Peritoneal macrophages were used for ATP depletion and hypoxia/reoxygenation experiment in vitro. L-cysteine, as the substrate of hydrogen sulfide, is involved in many physiological and pathological processes, including inflammation, metabolism, neuroprotection, and vasodilation. In the current study, we confirmed that intestinal ischemia/reperfusion led to the injury of myenteric neurons. From experiments in vitro and in vivo, we demonstrated that L-cysteine protected myenteric neurons from the injury. AOAA reversed the protective effect of L-cysteine. Also, L-cysteine played a protective role mainly by acting on intestinal macrophages via decreasing the expression of NLRP3, cleaved caspase-1, and mature IL-1β. L-cysteine increased cystathionine beta synthase and H2S produced by intestinal macrophages to protect myenteric mature neurons and enteric neural precursor cells from apoptosis. Moreover, the addition of IL-1β-neutralizing antibody alleviated the injury of myenteric neurons and enteric neural precursor cells caused by intestinal ischemia/reperfusion. Our study provided a new target for the protection of myenteric neurons in clinical intestinal ischemia/reperfusion injury.
Furfural Produces Dose-Dependent Attenuating Effects on Ethanol-Induced Toxicity in the Liver
Authors: Cheng Zhuo , Luo Xuanmei , Zhu Zixin , Huang Yonghui , Yan Xiue
Published: June 2022

Background: Alcohol-associated liver disease (ALD) increases the health burden worldwide, but effective drugs to prevent ALD are lacking. Furfural is a small molecule that can limit alcohol production in microorganisms and may have the capacity to attenuate ethanol-induced toxicity.

Methods: Human HepG2 cells were incubated with ethanol and furfural, and cell viability, NAD+/NADH ratio, and mitochondrial function assays were performed. RNA sequencing (RNA-seq) data were used to annotate enriched pathways, and these findings were confirmed by reverse transcription-quantitative PCR (RT–qPCR) and Western blotting. C57BL/6J mice were fed a Lieber-DeCarli liquid diet. After 4 weeks, biochemical analysis of mouse serum and histological analysis of mouse livers were performed.

Results: Different concentrations of furfural exerted different effects on mitochondria: low-dose furfural reduced reactive oxygen species (ROS) production, maintained mitochondrial transmembrane potential, and inhibited apoptosis pathway activation, while high-dose furfural led to the opposite effects. In mice, furfural mitigated transaminase increases and attenuated the lipid metabolism disorder that had been induced by ethanol.

Conclusion: Low-dose furfural reduced ethanol-induced toxicity in the liver. Consuming food or beverages containing the appropriate level of furfural when drinking alcohol may be a convenient and useful way to prevent ALD.
Expanding the Biological Properties of Alkannins and Shikonins: Their Impact on Adipogenesis and Life Expectancy in Nematodes
Authors: Arampatzis Athanasios S. , Tsave Olga , Kirchweger Benjamin , Zwirchmayr Julia , Papageorgiou Vassilios P. , Rollinger Judith M. , Assimopoulou Andreana N.
Published: June 2022

Alkannin, shikonin (A/S) and their derivatives are naturally occurring hydroxynaphthoquinones biosynthesized in some species of the Boraginaceae family. These natural compounds have been extensively investigated for their biological properties over the last 40 years, demonstrating a plethora of activities, such as wound healing, regenerative, anti-inflammatory, antitumor, antimicrobial and antioxidant. This study aims to extend the current knowledge by investigating the effects of various A/S compounds on two model systems, namely on 3T3-L1 pre-adipocytes and the nematodeCaenorhabditis elegans. The former constitutes an establishedin vitromodel for investigating anti-obesity and insulin-mimetic properties, while the latter has been widely used as a model organism for studying fat accumulation, lifespan and the anthelmintic potential. A set of chemically well-defined A/S derivatives were screened for their effect on pre-adipocytes to assess cell toxicity, cell morphology, and cell differentiation. The differentiation of pre-adipocytes into mature adipocytes was examined upon treatment with A/S compounds in the presence/absence of insulin, aiming to establish a structure-activity relationship. The majority of A/S compounds induced cell proliferation at sub-micromolar concentrations. The ester derivatives exhibited higher IC50values, and thus, proved to be less toxic to 3T3-L1 cells. The parent molecules, A and S tested at 1 μM resulted in a truncated differentiation with a reduced number of forming lipids, whereas compounds lacking the side chain hydroxyl group projected higher populations of mature adipocytes. InC. elegansmutant strain SS104, A/S enriched extracts were not able to inhibit the fat accumulation but resulted in a drastic shortage of survival. Thus, the set of A/S compounds were tested at 15 and 60 μg/ml in the wild-type strain N2 for their nematocidal activity, which is of relevance for the discovery of anthelmintic drugs. The most pronounced nematocidal activity was observed for naphthazarin and β,β-dimethyl-acryl-shikonin, followed by isovaleryl-shikonin. The latter 2 A/S esters were identified as the most abundant constituents in the mixture of A/S derivatives isolated fromAlkanna tinctoria(L.) Tausch. Taken together, the findings show that the structural variations in the moiety of A/S compounds significantly impact the modulation of their biological activities in both model systems investigated in this study.
Abnormally Expressed Ferroptosis-Associated FANCD2 in Mediating the Temozolomide Resistance and Immune Response in Glioblastoma
Authors: Song Liying , Wu Jiali , Fu Hua , Wu Cuifang , Tong Xiaopei , Zhang Mingyu
Published: June 2022

Ferroptosis-related genes (FRGs) have been identified as potential targets involved in oncogenesis and cancer therapeutic response. Nevertheless, the specific roles and underlying mechanisms of FRGs in GBM and temozolomide (TMZ) resistance remain unclear. Through comprehensive bioinformatics, we found that ferroptosis-related Fanconi anemia complementation group D2 (FANCD2) was significantly up-regulated in GBM tissues, and the high expression level of FANCD2 was related to the poor prognosis in primary and recurrent GBM patients. Furthermore, FANCD2 could promote TMZ resistance by attenuating ferroptosis in GBM cells. Knockdown of FANCD2 could increase reactive oxygen species (ROS) levels and inhibit cell survival. The two characteristics were associated with ferroptosis in TMZ-resistant GBM cells T98G-R and U118-R. The Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway analysis indicated that aberrantly expressed FANCD2 was potentially linked with several cancer-associated signaling pathways, including chromosome segregation, DNA replication, and cell cycle transition. In addition, we demonstrated that FANCD2 expression was positively correlated with several tumor-infiltrating lymphocytes (TILs) and multiple immune-associated signatures in GBM. Therefore, up-regulated FANCD2 could protect GBM cells from ferroptosis and promote TMZ resistance. FANCD2 may be a novel therapeutic target in GBM.
Braiding Dynamics in Active Nematics
Authors: Smith Spencer Ambrose , Gong Ruozhen
Published: June 2022

In active matter systems, energy consumed at the small scale by individual agents gives rise to emergent flows at large scales. For 2D active nematic microtubule (ANMT) systems, these flows are largely characterized by the dynamics of mobile defects in the nematic director field. As these defects wind about each other, their trajectories trace out braids. We introduce a minimal model of ANMT systems based on the topological properties of these braids. In particular, we consider the topological entropy of braids, which quantifies how chaotic the associated flow must be. Since microtubule bundles, an extensile system, stretch out exponentially in time, the resultant defect movement must correspond to braids with positive topological entropy. Indeed, we conjecture that the emergent defect dynamics are often optimal in that they give braids which maximize the, suitably normalized, topological entropy. We will look at the dynamics of four +1/2 defects on a sphere as a case study, using both simulations and a reinterpretation of experimental data from the literature.
Assessing the Risk of Spatial Spreading of Diseases in Hospitals
Authors: Lu Dan , Aleta Alberto , Moreno Yamir
Published: June 2022

In recent years, the transmission of healthcare-associated infections (HAIs) has led to substantial economic loss, extensive damage, and many preventable deaths. With the increasing availability of data, mathematical models of pathogen spreading in healthcare settings are becoming more detailed and realistic. Here, we make use of spatial and temporal information that has been obtained from healthcare workers (HCWs) in three hospitals in Canada and generate data-driven networks that allow us to realistically simulate the spreading of an airborne respiratory pathogen in such settings. By exploring in depth the dynamics of HAIs on the generated networks, we quantify the infection risk associated with both the spatial units of the hospitals and HCWs categorized by their occupations. Our findings show that the “inpatient care” and “public area” are the riskiest categories of units and “nurse” is the occupation at a greater risk of getting infected. Our results provide valuable insights that can prove important for measuring risks associated with HAIs and for strengthening prevention and control measures with the potential to reduce transmission of infections in hospital settings.
Multi-Domain Variational Autoencoders for Combined Modeling of MRI-Based Biventricular Anatomy and ECG-Based Cardiac Electrophysiology
Authors: Beetz Marcel , Banerjee Abhirup , Grau Vicente
Published: June 2022

Human cardiac function is characterized by a complex interplay of mechanical deformation and electrophysiological conduction. Similar to the underlying cardiac anatomy, these interconnected physiological patterns vary considerably across the human population with important implications for the effectiveness of clinical decision-making and the accuracy of computerized heart models. While many previous works have investigated this variability separately for either cardiac anatomy or physiology, this work aims to combine both aspects in a single data-driven approach and capture their intricate interdependencies in a multi-domain setting. To this end, we propose a novel multi-domain Variational Autoencoder (VAE) network to capture combined Electrocardiogram (ECG) and Magnetic Resonance Imaging (MRI)-based 3D anatomy information in a single model. Each VAE branch is specifically designed to address the particular challenges of the respective input domain, enabling efficient encoding, reconstruction, and synthesis of multi-domain cardiac signals. Our method achieves high reconstruction accuracy on a United Kingdom Biobank dataset, with Chamfer Distances between reconstructed and input anatomies below the underlying image resolution and ECG reconstructions outperforming multiple single-domain benchmarks by a considerable margin. The proposed VAE is capable of generating realistic virtual populations of arbitrary size with good alignment in clinical metrics between the synthesized and gold standard anatomies and Maximum Mean Discrepancy (MMD) scores of generated ECGs below those of comparable single-domain approaches. Furthermore, we observe the latent space of our VAE to be highly interpretable with separate components encoding different aspects of anatomical and ECG variability. Finally, we demonstrate that the combined anatomy and ECG representation improves the performance in a cardiac disease classification task by 3.9% in terms of Area Under the Receiver Operating Characteristic (AUROC) curve over the best corresponding single-domain modeling approach.
Characterization of Affective Behaviors and Motor Functions in Mice With a Striatal-Specific Deletion of Bmal1 and Per2
Authors: Schoettner Konrad , Alonso Mariana , Button Margo , Goldfarb Cassandra , Herrera Juliana , Quteishat Nour , Meyer Christiane , Bergdahl Andreas , Amir Shimon
Published: June 2022

The expression of circadian clock genes, either centrally or in the periphery, has been shown to play an integral role in the control of behavior. Brain region-specific downregulation of clock genes revealed behavioral phenotypes associated with neuropsychiatric disorders and neurodegenerative disease. The specific function of the clock genes as well as the underlying mechanisms that contribute to the observed phenotypes, however, are not yet fully understood. We assessed anxiety- and depressive-like behavior and motor functions in male and female mice with a conditional ablation of Bmal1 or Per2 from medium spiny neurons (MSNs) of the striatum as well as mice lacking one copy of Gpr88. Whereas the conditional knockout of Bmal1 and Per2 had mild effects on affective behaviors, a pronounced effect on motor functions was found in Bmal1 knockout mice. Subsequent investigation revealed an attenuated response of Bmal1 knockout mice to dopamine receptor type 1 agonist treatment, independently of the expression of targets of the dopamine signaling pathway or mitochondrial respiration in MSNs. The study thus suggests a potential interaction of Bmal1 within the direct dopamine signaling pathway, which may provide the link to a shared, MSN-dependent mechanism regulating affective behavior and motor function in mice.
A Pilot Study Testing the Efficacy of dCBT in Patients With Cancer Experiencing Sleep Problems
Authors: Chung Kyong-Mee , Suh Yung Jae , Chin Siyung , Seo Daesung , Yu Eun-Seung , Lee Hyun Jeong , Kim Jong-Heun , Kim Sang Wun , Koh Su-Jin
Published: June 2022

Objective

This pilot study aimed to evaluate the efficacy of a digital cognitive behavioral therapy (dCBT) in patients with cancer experiencing sleep problems.

Methods

A total of 57 participants aged 25–65 years (6M/51F with a mean of 42.80 years and a standard deviation of 14.15 years) were randomly assigned to three groups—21 participants to a dCBT program (HARUToday Sleep), 20 participants to an app-based attentional control program (HARUCard Sleep), and 16 participants to a waitlist control group—and evaluated offline before and after the program completion. Of the 57 participants, there were a total of 45 study completers, 15 participants in each group. The dependent variables were sleep quality scores, measured by the Pittsburgh Sleep Quality Index (PSQI) and health-related quality of life scores, measured using the Short-Form 36 (SF-36), and attentional bias scores from a dot-probe computer task.

Results

For both the intention-to-treat (N = 57) and study-completers analyses (N = 45, 15 for each group), a significant increase supported by a large effect size was found in the quality of sleep score of the HARUToday Sleep group compared to both the app-based attentional control and the waitlist control group. However, no significant changes were found in the quality of life and attentional bias scores.

Conclusion

Our results suggest that the HARUToday Sleep app has the potential to serve as an intervention module to enhance the sleep quality of patients with cancer experiencing sleep problems.
An Observational Study of Physicians' Workflow Interruptions in Outpatient Departments in China
Authors: Zhu Ximin , Hu Yinhuan , Wang Liuming , Li Dehe , Wu Xiaoyue , Xia Shixiao , Cheng Siyu
Published: June 2022

Background

Workflow interruptions are frequent in hospital outpatient clinics. Eventually, not only reducing the work efficiency and quality, but also further threatening patient safety. Over the last 10–15 years, research on workflow interruptions in inpatient care has increased, but there is a lack of research on the interruptions in outpatient clinics. The present study aimed to study the differences in physicians' workflow interruptions among outpatient departments in the tertiary hospital in China.

Methods

In a tertiary hospital, a standardized observational study of 32 doctors' workflow in outpatient department of four typical clinical specialties was conducted. The record of workflow interruptions was based on a self-made observation instrument after verifying its reliability and validity. Linear regression methods were used to assess outpatient characteristics as predictors of the number of interruptions. The Kruskal-Wallis test was used to analyze the difference about the duration of interruptions among specialties, and the Chi-Square Test was used to examine the sources of interruptions among different specialties, to determine whether interruption source is associated with specialty.

Results

The number of patients was the significant independent predictor of the number of interruptions (p < 0.001). In terms of work tasks being interrupted, the highest interruption rate occurred when physicians were asking health history: 19.95 interruptions per hour. The distribution of interruption sources among the four clinical specialties were statistically different (X2 = 16.988, p = 0.049).

Conclusion

The findings indicate that physicians' workflow interruptions are connected with many contents in the work system. Further emphasis should be placed on the effective application of hospital management measures in an interrupted environment to promote a safe and efficiency outpatient care.
Engaging the Guatemala Scientific Diaspora: The Power of Networking and Shared Learning
Authors: Bonilla Kleinsy , Romero-Oliva Claudia S. , Arrechea Susana , Ortiz Osejo Nereyda Y. , Mazariegos Sofia , Alonzo Margarita , Orellana-Corrales Gabriela , del Valle Andrea C. , Montenegro-Bethancourt Gabriela
Published: June 2022

The underdevelopment of the higher education system in Guatemala and the fragility of its science and technology (S&T) contexts have compelled a significant number of talented Guatemalan scientists to be trained, educated, and employed abroad. The relocation of such skilled human power to different countries and regions has resulted in a growing Guatemalan Scientific Diaspora (GSD). Until recently, the emigration of scientists from the Global South to scientifically advanced countries in the North was studied as it negatively impacted the countries of origin. However, technological upgrades and globalization have progressively shifted the paradigm in which such scientific diasporas interact and connect, thus enabling them to influence their home countries positively. Due to the lack of knowledge-based evidence and functioning connecting platforms, the value and potential of the GSD in their involvement in proposing solutions to complex socio-economic, environmental, and other challenges faced by Guatemalan society remain unknown. Moreover, the lack of interaction of relevant stakeholders (S&T policy agents, international partners, higher education institutions and research centers, industry, and relevant not governmental organizations) represents a pervasive obstacle to the untapped impact of the GSD in the country. This study outlines the Guatemalan scientific diasporas' networking as a mechanism for building research excellence and intellectual capital. This force could respond to the need to strengthen the national science capacities and meet the demands for knowledge production and access to broader sectors of society. This research applied qualitative methodology that, through the conduction of focus group discussions and semi-structured interviews with members of the Guatemalan scientific community and relevant key stakeholders, delved into the existence and articulation of the GSD and potential stages for their engagement with their country of origin. Findings highlight the importance of digital and technological pathways that might leverage the GSD's knowledge and experience, channeling skills, and international connections for better interaction with the Guatemalan society. Furthermore, the discussion addresses how technology might turn brain drain into brain circulation, enabling the articulation of the GSD as a viable opportunity to generate collaboration between scientists abroad and local actors, ultimately impacting the building and development of Guatemalan science and national research capacities.
Resolving Space Plasma Species With Electrostatic Analyzers
Authors: Nicolaou Georgios , Haythornthwaite Richard P. , Coates Andrew J.
Published: June 2022

Electrostatic analyzers resolve the energy-per-charge distributions of charged plasma particles. Some space plasma instruments use electrostatic analyzers among other units, such as aperture deflectors and position sensitive detectors, in order to resolve the three-dimensional energy (velocity) distribution functions of plasma particles. When these instruments do not comprise a mass analyzer unit, different species can be resolved only if there are measurable differences in their energy-per-charge distributions. This study examines the ability of single electrostatic analyzer systems in resolving co-moving plasma species with different mass-per-charge ratios. We consider examples of static plasma consisting of two species of heavy negative ions measured by a typical electrostatic analyzer design, similar to the electron spectrometer on board Cassini spacecraft. We demonstrate an appropriate modeling technique to simulate the basic features of the instrument response in the specific plasma conditions and we quantify its ability to resolve the key species as a function of the spacecraft speed and the plasma temperature. We show that for the parameter range we examine, the mass resolution increases with increasing spacecraft speed and decreasing plasma temperature. We also demonstrate how our model can analyze real measurements and drive future instrument designs.
Preoperative CT-Guided Near-Infrared Dye Marking for Thoracoscopic Resection of Pulmonary Nodules: A Case Report
Authors: Voulaz Emanuele , Testori Alberto , D'Antuono Felice , Cariboni Umberto , Alloisio Marco , Mangiameli Giuseppe
Published: June 2022

Localization of small-sized pulmonary nodules is challenging during video-assisted thoracoscopic surgery. Several preoperative strategies have been developed to mark these targets. We describe our localization strategy using a preoperative computed tomography-guided near-infrared dye marking.
Case Report: A Child With Hemophilia A Serves as Donor for Hematopoietic Stem Cell Transplantation to Cure His Brother’s Severe Aplastic Anemia
Authors: Kertész Gabriella , Kállay Krisztián , Kassa Csaba , Zombori Marianna , Bodó Imre , Kiss Csongor , Szegedi István , Kriván Gergely
Published: June 2022

The first-line treatment of severe aplastic anemia is allogeneic hematopoietic stem cell transplantation with a matched sibling donor. However, co-morbidities of the identical donor can make donation difficult. We present a transplantation where in parallel with the patient’s conditioning treatment, the preparation of the donor with severe hemophilia A required a special management with perioperative factor VIII substitution. Donation was successful without complications, and 18 months after transplantation, the patient and his donor are well without any long-term sequelae. To our knowledge, this is the first reported succesfull transplantation with hemophilic child serving as a bone marrow donor. The procedure did not mean a significant risk to donor health, so donors with hemophilia should not be excluded from donation.
Elevated Cardiac Troponin to Detect Acute Cellular Rejection After Cardiac Transplantation: A Systematic Review and Meta-Analysis
Authors: Liu Zhengyang , Perry Luke A. , Penny-Dimri Jahan C. , Handscombe Michael , Overmars Isabella , Plummer Mark , Segal Reny , Smith Julian A.
Published: June 2022

Cardiac troponin is well known as a highly specific marker of cardiomyocyte damage, and has significant diagnostic accuracy in many cardiac conditions. However, the value of elevated recipient troponin in diagnosing adverse outcomes in heart transplant recipients is uncertain. We searched MEDLINE (Ovid), Embase (Ovid), and the Cochrane Library from inception until December 2020. We generated summary sensitivity, specificity, and Bayesian areas under the curve (BAUC) using bivariate Bayesian modelling, and standardised mean differences (SMDs) to quantify the diagnostic relationship of recipient troponin and adverse outcomes following cardiac transplant. We included 27 studies with 1,684 cardiac transplant recipients. Patients with acute rejection had a statistically significant late elevation in standardised troponin measurements taken at least 1 month postoperatively (SMD 0.98, 95% CI 0.33–1.64). However, pooled diagnostic accuracy was poor (sensitivity 0.414, 95% CrI 0.174–0.696; specificity 0.785, 95% CrI 0.567–0.912; BAUC 0.607, 95% CrI 0.469–0.723). In summary, late troponin elevation in heart transplant recipients is associated with acute cellular rejection in adults, but its stand-alone diagnostic accuracy is poor. Further research is needed to assess its performance in predictive modelling of adverse outcomes following cardiac transplant.

Systematic Review Registration: identifier CRD42021227861
Stereotactic radiosurgery of recurrent malignant gliomas
Authors:   Radiosurgery Center, N.V. Sklifosovsky Clinical and Research Institute for Emergency Medicine, Moscow, Tokarev Aleksey Sergeevich , Gretskikh Konstantin V. ,   N.V. Sklifosovsky Research Institute of Emergency Medicine, Radiosurgery Center, Talypov Aleksandr Ernestovich ,   N.V. Sklifosovsky Clinical and Research Institute for Emergency Medicine, Moscow, Sinitsyn Valentin Evgenievich ,   aculty of Fundamental Medicine, Lomonosov Moscow State University, President of the Russian Society of Radiology, Moscow
Published: June 2022

High-grade gliomas (HGG) are the most aggressive primary neuroepithelial tumors. In this group of patients, high mortality rates persist, and the median survival rate fluctuates around 24.5 months. In order to clarify the issue of choosing adequate doses of the necessary stereotactic radiosurgery (SRS), as well as to elucidate the factors affecting the effectiveness of radiosurgical treatment, we have undertaken this study. The N.V. Sklifosovsky Clinical and Research Institute for Emergency Medicine uses SRS on the gamma knife device, which is a successful combination of surgical and radio-oncological treatment technologies. All patients underwent SRS procedure with a relapse of HGG. The prescribed dose was in the range of 10–24 Gy. In all cases, before SRS, in addition to MRI in T1 mode with contrast enhancement, PET-CT with amino acids (11C-methionine, 18F-fluoroethylthyrosine) was also performed. The median overall survival for the entire HGG group from the date of surgical treatment was recorded at the level of 23,66 months, the median overall survival after SRS was 13,51 months, relapse-free survival after SRS for the entire HGG group was noted at the level of 7,1 months. Radiation toxicity was observed in 16,33 % of cases. SRS is a promising method of choice in a case of small local and distant relapses of HGG, allowing for a fairly long period of time to control the progression of the disease while maintaining a high quality of patients’ life. Meanwhile, the minimum of pronounced toxic effects of SRS makes it possible to use it repeatedly, up to a significant volume of tumor relapse.
Gender features of clinical manifestations, diagnosis and treatment of Рarkinson’s disease in North Ossetia-Alania Republic
Authors:   SOGMA, Russia, Vladikavkaz, Kumakhov Amirkhan Alimovich , Tlapshokova Larisa Betalovna ,   KBSU named after H.M. Berbekov, Russia, Nalchik, Pshybieva Svetlana Vladimirovna ,   KGBU named after H.M. Berbekov, Russia, Nalchik, Dyshekova Milana Ruslanovna ,   KBSU named after H.M. Berbekov, Russia, Nalchik
Published: June 2022

The article considers the features of the clinic, diagnosis and treatment of female and male patients with Parkinson’s disease in the NO-Alania Republic in order to improve the quality of medical care in the future. The data were collected by interviewing patients and conducting a thorough analysis of their outpatient and inpatient records. The systematization of these data was carried out by distributing patients into groups depending on gender and age characteristics. A comparative analysis of the characteristics in each of the groups was carried out, the distinctive features of the clinical symptoms, diagnosis, treatment and complications of this disease were identified. The possibilities of developing special regional programs for providing specialized medical care to patients with Parkinson’s disease and other extrapyramidal diseases are determined.
Features of endoscopic transsphenoidal surgery of neoplasms of the chiasmal-sellar region in children
Authors:   FSBI Almazov National Medical Research Centre, Burmistrova Aleksandra Vasilievna , Cherebillo Vladislav Yurievich ,   FSBEI HE Pavlov First Saint Petersburg State Medical University, Khachatryan William Aramovich ,   FSBI Almazov National Medical Research Centre, St. Petersburg
Published: June 2022

The aim of the study was to optimize the treatment of children with volumetric formations of the chiasmal-sellar region using endoscopic transsphenoidal access. The article presents a comparative analysis of the results of examination and surgical treatment of 95 patients with neoplasms of the chiasmal-cellular region. 3 study groups were formed: by age and surgical access. Anatomical, physiological and surgical features were revealed in children with neoplasms of the chiasmal-cellular region, subsequently removed by endoscopic transsphenoidal access. A scale has been formed to evaluate the effectiveness of the studied accesses. This study was the first in Russia to demonstrate the effectiveness of endoscopic transsphenoidal access in children.
Provision of psychiatric community treatment in the context of a pandemic of a new coronavirus infection abroad (review article)
Authors:   State Budgetary Healthcare Institution of the Moscow region «Central Clinical Psychiatric Hospital», Berezantsev A.Yu. , Surikova V.V. ,   State Budgetary Healthcare Institution «Psychiatric Clinical Hospital No. 1 named after N.A. Alekseev of the Moscow Department of Health», Moscow, Masyakin A.V. ,   State Budgetary Healthcare Institution of the Moscow region «Central Clinical Psychiatric Hospital»
Published: June 2022

This review analyzes the foreign experience of providing community psychiatric care in the context of a pandemic of a new coronavirus infection. The situation that has arisen in the context of a pandemic of a new coronavirus infection has become unprecedented and has made adjustments in the provision of medical care, including psychiatric. Patients with mental illness are themselves more vulnerable to infection, spread and complications of coronavirus infection. They often violate the self-isolation regime, do not perform protective measures, and suffer from comorbid pathology (obesity, diabetes, hypertension). As it turned out, the coronavirus affects the concentration of some psychotropic drugs in the blood, and it also becomes difficult to prescribe others with the development of complications of COVID-19. The need to convert the hospital bed capacity into infectious diseases has led to a reduction in the number of places in round-the-clock psychiatric hospitals and the duration of treatment in them. All these aggravating factors contributed to the priority development of outpatient psychiatric care in comparison with inpatient in a pandemic. Assertive community treatment has undergone a number of changes: the number of home visits compared to visits to health facilities has increased, prescription durations or medication provision have been increased for stable patients, and there has been an increase in the switch from oral to long-acting injectables. Many researchers note that the pandemic has positively contributed to the rapid introduction and spread of telemedicine, but also emphasize that this should not be to the detriment of the patient. The experience of providing psychiatric care in a pandemic is gradually accumulating and systematizing, which is necessary in the future, since these realities are likely to be repeated.
Strength exercises on special weight machines for students with scoliosis
Authors:   FSBEI HE Kuban State University, branch in Slavyansk-on-Kuban, Russian Federation, Vasin S.G.
Published: June 2022

The article considers the influence of weight loads on weight machines associated with a certain stage of the work of the musculoskeletal system that have a physical effect on the muscle group and motor functions of the body as a whole. The expediency of broad involvement of students with problems of the musculoskeletal system in physical exercises with the use of weight machines is indicated.
IMPROVED LOW-DOSE CT-IMAGE QUALITY WITH ITERATIVE RECONSTRUCTION ALGORITHMS
Authors: Hoang Ngoc Thanh , Tran Hong Phuong Dung , Tran Van Hung , Hoang Van Thuyet , Nguyen Thanh Thao
Published: June 2022

Low-dose computed tomography (LDCT) is widely applied to limit the harmful effects of radiation on patients, especially those who need multiple CT follow-up. However, LDCT may raise concern about diagnostic image quality. Iterative reconstruction algorithm (IR) was released and developed as a competitive tool among various vendors to improve LDCT image quality. The efficiency of using IR in combination with LDCT has been published abundantly in the last two decades. The conjunction can be reduced the radiation dose by up to 80% compared to the standard protocol. Furthermore, image quality is sufficient for diagnosis. This article introduces an overview of the definition and values of IR in LDCT.
Key words: Iterative reconstruction algorithms (IR), Low-dose computed tomography (LDCT).
INCIDENTAL DURAL TEAR IN LUMBAR DECOMPRESSION SURGERY: INCIDENCE, POSITIONS, MANAGEMENT PROTOCOL AND RESULTS
Authors: Tran Duc Duy Tri , Nguyen Thanh Minh , Truong Van Tri
Published: June 2022

Objective: The aim of this study was to define incidence, position of dural tear in lumbar decompression interventions and evaluate the outcome of the management protocol. Methods: The records of consecutive patients with different types of posterior decompress-sive and reconstructive procedures in the lumbar region are investigated retrospectively for the period 2014 – 2018. Incidence of this complication regarding kinds of indications and surgical techniques, and common areas of breaches were analyzed. All the patients were applied our protocol to deal with this problem. We also analyzed the possibility of suturing, clinical symptoms (headache), and delayed complications (dural ﬁstula or meningoceles). Results: The 1024
procedures included 62 dural tear complications (6.05%). The most common position of breachs were posterior and lateroposterior aspects (82.21%). There were no late complications detected: no symptomatic ﬁstula or meningocele. There was one of the patients had a second surgery. Conclusions: Dural tear is a severe complication and badly affect to outcome. Thus, it is important to be careful in decompression surgery. If resolving this problem approximately can provide satisfactory results for patients
Key words: Lumbar decompression surgery, dural tear, CSF leak
STUDY ON RELATIONSHIP BETWEEN VITAMIN D DEFICIENCY/INSUFFICIENCY AND BELLY FAT AND INSULIN RESISTANCE IN PATIENTS WITH TYPE 2 DIABETES IN HUE CITY IN VIETNAM
Authors: Tran Huu Thanh Tung , Tran Huu Dang , Hoang Bui Bao
Published: June 2022

Introduction: Recent studies show that Vitamin D deficiency/insufficiency is common in patients with type 2 diabetes, and Vitamin D is associated with pathogenic factors of type 2 diabetes, including obesity and insulin resistance. This study aims to clarify the relationship between Vitamin D and belly fat and insulin resistance in diabetic patients through their waist circumference (WC) and quantitative insulin sensitivity check index (QUICKI). Methods: A descriptive cross-sectional study was carried out on 110 diabetic patients examined and treated at Hue Central Hospital and Hue University of Medicine and Pharmacy Hospital. These patients underwent waist circumference measurement, fasting venous blood sampling, 25-hydroxy vitamin D (25 Oh vitamin D) test, fasting plasma glucose test, fasting insulin test and QUICKI calculation. Results: Percentage of participants with Vitamin D deficiency and insufficiency, belly fat and insulin resistance were 51.8%, 73.6% and 59.1%, respectively. Average concentration of 25 OH Vitamin D (ng/ml) in belly fat patients was 29.49±8.22, lower than in non-belly fat patients at 33.98±8.70 with p=0.014; Quicki in patients with and without belly fat were 0.31±0.03 and 0.33±0.04 respectively, with p=0.001; concentration of 25 OH Vitamin D in patients with insulin resistance was 29.16±8.12 and without insulin resistance was 32.85±8.76 with p=0.025; waist circumference (cm) in groups of patients with and without insulin resistance were 90.52±6.21 and 86.18±6.30 respectively, with p=0.001. The Chi-square test showed that percentage of Vitamin D deficiency and insufficiency in belly fat and non-belly fat groups were respectively 60.5% and 27.6% with p=0.003; this percentage in insulin resistance and non-insulin resistance groups were respectively 61.5% and 38.8% with p=0.020; insulin resistance rate in belly fat and non-belly fat groups were respectively 66.7% and 37.9% with p=0.009.
The correlation analysis indicated that 25 OH Vitamin D concentration positively correlated with Quicki with r= 0.253, p=0.008; the waist circumference negatively correlated with Quicki, with r=-0.321 and p=0.001; there were no statistically significant correlation between 25 OH Vitamin D concentration and waist circumference. Conclusions: The diabetic patients with belly fat or insulin resistance had lower 25 OH Vitamin D concentration and higher Vitamin D deficiency and insufficiency ratio, and belly fat had a high statistically significant correlation with insulin resistance. There might be intercorrelations among Vitamin D, belly fat and insulin resistance.
Key words: Diabetes, Vitamin D, insulin resistance, belly fat
PERCENTAGE OF LOW BONE MINERAL DENSITY (BMD) AND RELATED FACTORS IN RHEUMATOID ARTHRITIS
Authors: Nguyen Linh Giang , Trac Hoai Hai , Truong Huu Hung , Nguyen Hoang Thanh Van
Published: June 2022

Objectives: To estimate percentage of low bone mineral density (BMD) in rheumatoid arthritis patients; survey the relationship between bone mineral density and factors such as age, sex, body mass index (BMI), menopause, disease duration, disease activity level, low factor (RF), Anti Cyclic Citrullinated Peptide (anti-CCP), C-reactive Protein (CRP), 1st- hour erythrocyte sedimentation rate (ESR), cortisol. Subjects and methods: This cross-sectional study was conducted on 74 patients which diagnosed with rheumatoid arthritis (RA) at General Internal Medicine – Endocrinology Department of Hue University Hospital and Nephrology – Rheumatology Department of Hue Central Hospital from April 2020 to May 2021. Statistical analysis methods were description, compare means, bivariate correlation, univariate logistic analysis was performed. Result: In the RA patients,
31.08% had osteoporosis, 44.59% had osteopenia, and 24.33% had normal BMD. The mean of BMD at lumbar spine is 0.788±0.155 g/cm2 and at femoral neck is 0.779 ± 0.186 g/cm2. BMD had associated with sex, menopause, and significantly correlated with age, BMI, duration of disease. Conclusion: In RA patients, 63.51% had low BMD. Osteoporosis screening should be considered in clinical practice to promptly detect, treat and prevent the risk of osteoporosis fractures in patients with rheumatoid arthritis.
Key words: bone mineral density, osteoporosis, rheumatoid arthritis
APPLICATION OF MINIMUM INVASIVE TECHNIQUE ENDOSCOPIC VACUUM – ASSISTED CLOSURE FOR THE TREATMENT OF ESOPHAGEAL ANASTOMOTIC LEAKAGE: THE FIRST CASE AT HUE UNIVERSITY OF MEDICINE AND PHARMACY HOSPITAL
Authors: Pham Anh Vu , Doan Phuoc Vung , Nguyen Minh Thao , Vinh Khanh
Published: June 2022

Background: Today, the treatment of anastomotic leakage is still a challenging issue associated with high morbidity and mortality, especially esophageal surgery. Endoscopic vacuum-assisted closure (EVAC) is a technique that uses negative pressure wound therapy to treat fistula endoscopically. Recently, endoscopic approaches have been applied with a high success rate. An endo-SPONGE connected to a nasogastric tube under endoscopic guide into a fistula cavity. This procedure facilitates healing, obtains source control, and aid in reperfusion of the adjacent tissue with debridement. Case report: We report a post-thoracoscopicesophagectomy case of a 74-year-old man who successfully treated anastomotic leakage using EVAC. Result:
This is the first case report of applying this new technique in our country and achieving successful outcomes