bluuebunny/crossref_metadata_2025 huggingface dataset:
BTK-Inhibitoren und CAR-T-Zell-Therapie bei der Behandlung des Mantelzelllymphoms – einen Tanzpartner finden
Authors: Munoz Javier L. , Wang Yucai , Jain Preetesh , Wang Michael
Published: September 2022

Diese Übersichtsarbeit konzentriert sich auf die Machbarkeit der Kombination von Bruton-Tyrosinkinase (BTK)-Inhibitoren (BTKi) mit einer chimären Antigenrezeptor (CAR)-T-Zell-Therapie bei Patienten mit rezidiviertem oder refraktärem (R/R) Mantelzelllymphom (MCL). Es werden mögliche Szenarien für eine Kombinationsbehandlung mit diesen Wirkstoffen vorgestellt. Jüngste Erkenntnisse: BTKi und die CAR-T-Zell-Therapie haben das Behandlungsparadigma für R/R MCL revolutioniert. Ibrutinib, Acalabrutinib und Zanubrutinib sind kovalente irreversible BTKi, die für R/R MCL zugelassen sind. Brexucabtagen-Autoleucel war die erste CAR-T-Zell-Therapie, die in Folge der Ergebnisse der ZUMA-2-Studie für R/R MCL zugelassen wurde. Es gibt Hinweise darauf, dass eine kombinierte Behandlung mit BTKi und einer CAR-T-Zell-Therapie die Wirksamkeit der CAR-T-Zellen verbessern kann. Zusammenfassung: Da BTKi und CAR-T-Zell-Therapien in der R/R-MCL-Therapie immer wichtiger werden, sollten Kombinationsbehandlungsstrategien für R/R-MCL auf ihren potenziellen Nutzen untersucht werden.
Protecting Cardiovascular Health From Wildfire Smoke
Authors: Hadley Michael B. , Henderson Sarah B. , Brauer Michael , Vedanthan Rajesh
Published: September 2022

Wildfire smoke is a rapidly growing threat to global cardiovascular health. We review the literature linking wildfire smoke exposures to cardiovascular effects. We find substantial evidence that short-term exposures are associated with key cardiovascular outcomes, including mortality, hospitalization, and acute coronary syndrome. Wildfire smoke exposures will continue to increase over the majority of Earth’s surface. For example, the United States alone has experienced a 5-fold increase in annual area burned since 1972, with 82 million individuals estimated to be exposed to wildfire smoke by midcentury. The associated rise in excess morbidity and mortality constitutes a growing global public health crisis. Fortunately, the effect of wildfire smoke on cardiovascular health is modifiable at the individual and population levels through specific interventions. Health systems therefore have an opportunity to help safeguard patients from smoke exposures. We provide a roadmap of evidence-based interventions to reduce risk and protect cardiovascular health. Key interventions include preparing health systems for smoke events; identifying and educating vulnerable patients; reducing outdoor activities; creating cleaner air environments; using air filtration devices and personal respirators; and aggressive management of chronic diseases and traditional risk factors. Further research is needed to test the efficacy of interventions on reducing cardiovascular outcomes.
Does a History of Cancer Influence the Effectiveness of Statins on Outcomes After Stroke?
Authors: Olaiya Muideen T. , Andrew Nadine E. , Dalli Lachlan L. , Ung David , Kim Joosup , Sundararajan Vijaya , Cadilhac Dominique A. , Thrift Amanda G. , Nelson Mark R. , Churilov Leonid , Kilkenny Monique F. ,   on behalf of PRECISE Investigators
Published: September 2022

Background:

Evidence is growing on anticancer effects of statins. We investigated whether the effectiveness of treatment with statins after ischemic stroke on mortality is influenced by a history of cancer.

Methods:

Analyses of 90-day survivors of ischemic stroke (2012–2016; 45 hospitals) using linked registry and administrative data. Dispense of statins within 90 days postdischarge was determined from pharmaceutical records. Participants were followed from 91 days postdischarge until death or June 30, 2018. History of cancer was determined from hospital data. Propensity score–adjusted Cox proportional hazards regression model was used to determine the association between being dispensed statins and survival. The influence of history of cancer on this association was assessed based on the concepts of (1) statistical interaction and (2) biological interaction using 3 indices: relative excess risk due to interaction>0, attributable proportion due to interaction >0, or synergy index >1.

Results:

Among 9948 eligible participants (median age=72 years, 42% female), there were 1463 deaths. In adjusted analyses, there was no statistical interaction between being dispensed statins and history of cancer on mortality (
P
=0.156). However, being dispensed statins had a significant positive biological interaction with having a history of cancer on mortality: relative excess risk due to interaction, 2.80 (95% CI, 1.56–5.05), attributable proportion due to interaction, 0.45 (95% CI, 0.23–0.66), and synergy index, 2.14 (95% CI, 1.32–3.49).

Conclusions:

Treatment with statins after ischemic stroke may confer additional survival benefits for people who also have had cancer.
Germination and Growth Characteristics of Perilla frutescens and Nutrients by the Mixed Seeding Rate of Medicago sativa in Indoor Urban Agriculture
Authors: Ju Jin-Hee , Jin Hyo-Jung , Yoon Yong-Han
Published: September 2022

Background and objective: This study aims to provide basic data to investigate an efficient and stable environment for indoor urban agriculture by comparing plant growth depending on seeding rate and media nutrients (nitrogen, phosphorous, and potassium) using leguminous plant Medicago sativa favorable for nitrogen fixation and Lamiaceae plant Perilla frutescens in indoor urban agriculture.Methods: To investigate plant growth by mixed seeding rate, this study set up 6 treatments: single seeding of M. sativa (AC); 2 : 1 M. sativa to P. frutescens (A2P1); 1 : 1 M. sativa to P. frutescens (A1P1); 1 : 2 M. sativa to P. frutescens (A1P2) and single seeding of P. frutescens (PC). Experimental plastic containers were completely randomized designed with 9 replications for each seeding rate. Nutrient content of the media and germination and growth parameters of P. frutescens were measured.Results: The nitrogen and phosphorous contents in the media were the highest in the AC treatment, and potassium did not differ according to the mixed seeding rate. Germination percentage and velocity were highest in order of A1P2 > PC > A2P1 > A1P1 > AC due to interspecies competition. Growth of P. frutescens was increased with the increasing seeding rate, whereas biomass was higher in A2P1 compared to other treatments.Conclusion: Our results indicated that the 2:1 seeding rate of M. sativa and P. frutescens was a more effective way to achieve high plant growth and productivity. These results suggest that mixed seeding can promote the interaction of positive neighbor effects in indoor urban agriculture.
The Neoliberal State and Management of the Covid-19 Pandemic in Nigeria
Authors: Okolie Aloysius-Michaels , Nnamani Kelechi Elijah , Ononogbu Olihe Adaeze , Nwoke Ikemefuna Sunday , Nzekwe Florence Ifeoma , Ike Chinedu Cyril , Ngoka Ruth Obioma , Okoro Chinonso Akudo , Ekwu Hope Olilanya
Published: September 2022

This study examines how neoliberalism affected the management of Covid-19 in Nigeria. As a result of its emphasis on privatisation and austerity, neoliberalism discouraged social investment programmes and provisioning. The privatisation of Nigeria’s health sector severely stifled health financing, which led to the collapse of public health institutions and the proliferation of private and informal health delivery systems. It limited universal access to quality healthcare, worsened the health conditions of poor Nigerians and rendered the health sector incapable of managing emergency health situations, such as Covid-19. The absence of well-coordinated social investment programmes to cushion the effects of lockdown widened social inequality and misery, making it impossible for citizens in the informal economy to adhere to the Covid-19 guidelines. The state responded with repression to enforce the rules. This study recommends overhauling the Nigerian state and its political economy as a condition for reducing citizen’s vulnerability to a pandemic.
Jesus’ Concern for Children: A Stance for the Kingdom of God in the Church in Africa
Authors: Mrio Vincent
Published: September 2022

Jesus’ concern for children was evident in his ministry in an episode when he rebuked the disciples who scolded them (Luke 18:15–17). This article considers why Jesus cared for and safeguarded little children in his mission. The Church in Africa as a steward of the kingdom of God has to review its methods of caring for and protecting children. The contribution of the article will be to urge the Church in Africa to take more seriously its concern for children. The methodological approach engages qualitative thought with quantitative research into critical findings from particular churches.
What Does Generation Z Believe? The Religiosity and Spirituality of Contemporary Czech Youth in Practical-Theological Reflection
Authors: Landová Tabita
Published: September 2022

The study deals with the religiosity and spirituality of contemporary Czech youth. Czech Republic is characterized by a high level of secularization. Are the expectations that religious faith will increasingly disappear in each generation coming true? How do Czech practical theologians reflect on the current situation? The study explores these questions against a background of generational theory and religious sociology. It has four parts. First, it introduces Mannheim’s theory of generations and applies it to the setting of Christian churches. In the second part, it characterizes the current Czech generation of youth with the help of generational typologies. In the third part, it presents the religiosity and spirituality of Czech youth based on recent sociological research. In the fourth part, it focuses on how Czech Catholic and Protestant theologians reflect on youth-work. The conclusion offers practical-theological suggestions that are relevant for pastoral work with youth in secularized contexts.
Two new species of Tanacetum (Anthemideae, Asteraceae) from western Iran
Authors: RASTEGAR AZAD , MAROOFI HOSEIN , TABAD MOHAMMAD AREF
Published: September 2022

Tanacetum kurdistanicum and T. urmiense (Anthemideae, Asteraceae), from Abidar Mountain, and Dalanpar Mountain, respectively, are hereby described as new to science and illustrated. Their morphology and ecology are discussed in detail and a distribution map is provided.
Saussurea khunjerabensis (Asteraceae, Cardueae), a new species from Pamir
Authors: LI TIAN , XU LIAN-SHENG , CHEN YOU-SHENG
Published: September 2022

Saussurea khunjerabensis (Asteraceae, Cardueae), a new species from Taxkorgan county, Xinjiang, China, is described and illustrated. It belongs to Saussurea subgen. Eriocoryne because its capitula is aggregated in a densely congested hemispheric synflorescence and surrounded or half-surrounded by densely lanate uppermost leaves. This new species is similar to S. simpsoniana in its habit and linear uppermost stem leaves reflexed. However, it differs from S. simpsoniana by its stems usually unbranched and 11–25 cm high (versus usually branched and 2–12 cm high), lower leaf blade on both surfaces light green and densely white arachnoid lanate (versus adaxially dark green or purplish, sparsely arachnoid; abaxially grayish white, arachnoid tomentose to lanate), leaf margin usually pinnately lobed or divided (versus usually dentate to pinnately lobed, revolute), and lanate indumentum white or yellowish (versus lanate indumentum white or purple).
Processes Controlling the Southern Ocean Temperature Change
Authors: Chen Jia-Jia , Swart Neil C. , Cheng Xuhua
Published: September 2022

Observations show that since the 1950s, the subsurface Southern Ocean has been rapidly warming in the south and cooling in the north. However, what drives these opposing latitudinal patterns of change is not well understood. By analyzing the outputs of atmosphere–ocean general circulation models, we examine and quantify the processes controlling the temperature change in the Southern Ocean. We find that subsurface cooling in the north results from the combined effect of weak warming driven by greenhouse gases and cooling forced by aerosols. Contrary to previous work, we find that the influence of stratospheric ozone forcing is small and unnecessary to explain the observed patterns. Analysis of heat budget diagnostics shows that ocean heat content change between 400 and 1200 m in the Southern Ocean is primarily driven by slight imbalances between the large and opposing changes in residual mean advection and isopycnal diffusion. We show that while surface heat flux anomalies are the main contributor to the warming in the Southern Ocean, changes in wind stress are also required to produce the observed pattern of temperature change. These results highlight the importance of ocean dynamics in subsurface ocean heat content change. The counterbalancing effects of aerosols and greenhouse gases on ocean heat content change in the Southern Ocean will change with aerosols declining in the future, while our results suggest that changes in stratospheric ozone forcing will have only a minor effect on future patterns of Southern Ocean thermohaline structure.
The Simulation and Subseasonal Forecasting of Hydrological Variables: Insights from a Simple Water Balance Model
Authors: Koster Randal D. , DeAngelis Anthony M. , Liu Qing , Schubert Siegfried D. , Molod Andrea M.
Published: September 2022

Past work has shown that a land surface model’s (LSM) implicit (not explicitly coded) relationships between soil moisture and both evapotranspiration (ET) and runoff largely determine the LSM’s hydrological behavior. Here we estimate the relationships that appear to be operating in the real world and compare them to those of the LSM component of a state-of-the-art Earth system model (ESM). The two sets of relationships are determined by calibrating them within a simple water balance model (WBM): once using stream gauge observations from small, unregulated rivers over the eastern half of the United States, and once using the runoffs generated by the LSM as part of a state-of-the-art atmospheric reanalysis. Hydrological simulations and subseasonal hydrological forecasts performed with the two calibrated versions of the WBM provide two key results. First, the version calibrated to the LSM-generated runoffs does successfully reproduce, to first order, the hydrological behavior of the full LSM within its ESM environment. Second, of the two WBM versions, the one calibrated to the observations reproduces more accurately a broad collection of fully independent streamflow observations as well as a similarly broad collection of in situ soil moisture measurements. Taken together, the two results suggest that the observations-calibrated ET and runoff efficiency functions do successfully represent, at least to some degree, soil moisture controls over hydrological variability in nature and can serve as potentially useful targets for further LSM development.

Significance Statement

For all their complexity, and for all the work that underlies their development, the land surface model components of Earth system models may be suboptimal in fundamental yet unstudied ways. Here we estimate how the joint control of soil moisture over evapotranspiration and runoff processes in nature differs from that built implicitly into a state-of-the-art land model. Validation exercises demonstrate how this difference appears to lead to reduced accuracy in the land model’s simulation and forecasting of such hydrological variables as streamflow and soil moisture. Our results indicate that the relationships estimated for nature could serve as a potentially valuable target for further land model development.
Hearing Outcomes of a New Cartilage Conduction Device vs Bone Conduction Devices
Authors: Nairn Emily M. , Chen Alyssa S. , Nishimura Tadashi , Berezovsky Anna , Stucken Emily Z.
Published: September 2022

Objective

To compare audiometric outcomes of a new cartilage conduction hearing device (CCD) with traditional bone conduction hearing devices (BCDs).

Study Design

Clinical trial and crossover study design.

Setting

Tertiary academic center.

Methods

Sixteen adults (19 ears) with congenital aural atresia or overclosed ear canals who previously underwent BCD implantation were fitted with a CCD. Audiometric data were collected with use of the BCD and the CCD.

Results

The mean pretreatment 4‐frequency pure tone average was 81 dB. The mean aided pure tone averages with the BCD and CCD were 27 and 32 dB (P = .002), and the mean functional gains were 54 and 49 dB (P = .002), respectively. The mean consonant‐nucleus‐consonant scores with the BCD were 90% (best aided) and 80% (aided ear isolated), and those with the CCD were 86% and 76%. Mean AzBio scores were 90% (quiet), 77% (+10 dB SNR [signal to noise ratio]), and 52% (+5 dB SNR) when isolating the BCD ear and 90%, 73%, and 41% when isolating the CCD ear. No difference in speech scores achieved statistical significance except the AzBio isolated to the aided ear in the +5–dB SNR condition, which favored the BCD (P = .01).

Conclusion

Pure tone audiometric outcomes with the BCD show a small advantage over the CCD, with the difference driven mainly by high‐frequency responses. Speech outcomes were equivalent apart from the +5–db SNR condition, which favored the BCD.
The lesser evil? Experimental evidence on the strength of nuclear and chemical weapon “taboos”
Authors: Smetana Michal , Vranka Marek , Rosendorf Ondrej
Published: September 2022

We present findings of a survey experiment on a sample of 2350 American and British citizens, in which we examined attitudes towards nuclear and chemical strikes. Our findings demonstrate that even though the public accurately judges nuclear weapons as more destructive and indiscriminate, it is still more averse to the use of chemical than nuclear weapons. Our follow up study has shown that individuals are significantly more likely to associate chemical weapons with “rogue states” and terrorists, and associate nuclear weapons with modern powers. The findings contribute to scholarship on the “taboos” surrounding the (non-)use of WMDs in world politics.
Stem cell therapy as a promising strategy in necrotizing enterocolitis
Authors: Di Si-Jia , Wu Si-Yuan , Liu Tian-Jing , Shi Yong-Yan
Published: September 2022

Necrotizing enterocolitis (NEC) is a devastating gastrointestinal disease that affects newborns, particularly preterm infants, and is associated with high morbidity and mortality. No effective therapeutic strategies to decrease the incidence and severity of NEC have been developed to date. Stem cell therapy has been explored and even applied in various diseases, including gastrointestinal disorders. Animal studies on stem cell therapy have made great progress, and the anti-inflammatory, anti-apoptotic, and intestinal barrier enhancing effects of stem cells may be protective against NEC clinically. In this review, we discuss the therapeutic mechanisms through which stem cells may function in the treatment of NEC.
The correlation of pericoronary adipose tissue with coronary artery disease and left ventricular function
Authors: You Deshu , Yu Haiyang , Wang Zhiwei , Wei Xiaoyu , Wu Xiangxiang , Pan Changjie
Published: September 2022

Objective

We sought to investigate the correlation of pericoronary adipose tissue with coronary artery disease and left ventricular (LV) function.

Methods

Participants with clinically suspected coronary artery disease were enrolled. All participants underwent coronary computed tomography angiography (CCTA) and echocardiography followed by invasive coronary angiography (ICA) within 6 months. Pericoronary adipose tissue (PCAT) was extracted to analyze the correlation with the Gensini score and LV function parameters, including IVS, LVPW, LVEDD, LVESD, LVEDV, LVESV, FS, LVEF, LVM, and LVMI. The correlation between PCAT and the Gensini score was assessed using Spearman’s correlation analysis, and that between the PCAT volume or FAI and LV function parameters was determined using partial correlation analysis.

Results

One hundred and fifty-nine participants (mean age, 64.55 ± 10.64 years; men, 65.4% [104/159]) were included in the final analysis. Risk factors for coronary artery disease, such as hypertension, diabetes, dyslipidemia, and a history of smoking or drinking, had no significant association with PCAT (P > 0.05), and there was also no correlation between PCAT and the Gensini score. However, the LAD-FAI was positively correlated with the IVS (r = 0.203,P = 0.013), LVPW (r = 0.218,P = 0.008), LVEDD (r = 0.317,P < 0.001), LVESD (r = 0.298,P < 0.001), LVEDV (r = 0.317,P < 0.001), LVESV (r = 0.301,P < 0.001), LVM (r = 0.371,P < 0.001), and LVMI (r = 0.304,P < 0.001). Also, the LCX-FAI was positively correlated with the LVEDD (r = 0.199,P = 0.015), LVESD (r = 0.190,P = 0.021), LVEDV (r = 0.203,P = 0.013), LVESV (r = 0.197,P = 0.016), LVM (r = 0.220,P = 0.007), and LVMI (r = 0.172,P = 0.036), and the RCA-FAI was positively correlated with the LVEDD (r = 0.258,P = 0.002), LVESD (r = 0.238,P = 0.004), LVEDV (r = 0.266,P = 0.001), LVESV (r = 0.249,P = 0.002), LVM (r = 0.237,P = 0.004), and LVMI (r = 0.218,P = 0.008), respectively. Finally, the total volume was positively correlated with FS (r = 0.167,P = 0.042).

Conclusion

The FAI was positively correlated with the LV function but was not associated with the severity of coronary artery disease.
Association between dietary antioxidant index and risk of Helicobacter pylori infection among adults: a case–control study
Authors: Ebrahimi Zohreh , Masoodi Mohsen , Aslani Zahra , Naghshi Sina , Khalighi Sikaroudi Masoumeh , Shidfar Farzad
Published: September 2022

Backgrounds and aims

One of the most important risk factors for Helicobacter pylori (H. pylori) infection is nutrition. Balanced diets with high antioxidant properties may have protective effects against the consequences of this infection. In the current study, we aimed to investigate the association between the dietary antioxidant index and the risk of H. pylori infection among adults.

Methods

In a case–control study the dietary intake of patients with H. pylori infection was compared with healthy subjects. The dietary antioxidant index (DAI) was calculated using dietary intakes derived from a validated food frequency questionnaire (FFQ). Demographic information was obtained by a related questionnaire and Physical Activity was measured by International Physical Activity Questionnaire (IPAQ) were used to obtain information. Using logistic regression models, we evaluated the association between the DAI and H. pylori infection risk. The significance level was determined asP < 0.05.

Results

Finally, dietary data of 148 cases and 302 controls (mean age: 38.72 ± 10.61 (were analyzed. The mean of total DAI was significantly higher in controls (7.67) when compared with H. pylori cases (3.57) (P < 0.001). After adjustment for covariates, participants with less than median DAI values had an increased risk of H. pylori onset (adjusted OR 1.08, 95% CI: 1.02–1.12,P < 0.001).

Conclusions

Appropriate intake of nutrient antioxidants may have a role in decreasing the likelihood of H. pylori infection risk.
Molecular beacon based real-time PCR p1 gene genotyping, macrolide resistance mutation detection and clinical characteristics analysis of Mycoplasma pneumoniae infections in children
Authors: Li Lifeng , Ma Jiayue , Guo Pengbo , Song Xiaorui , Li Mingchao , Yu Zengyuan , Yu Zhidan , Cheng Ping , Sun Huiqing , Zhang Wancun
Published: September 2022

Background

Mycoplasma pneumoniae can be divided into different subtypes on the basis of the sequence differences of adhesive protein P1, but the relationship between different subtypes, macrolide resistance and clinical manifestations are still unclear. In the present study, we established a molecular beacon based real-time polymerase chain reaction (real-time PCR) p1 gene genotyping method, analyzed the macrolide resistance gene mutations and the relationship of clinical characteristics with the genotypes.

Methods

A molecular beacon based real-time PCR p1 gene genotyping method was established, the mutation sites of macrolide resistance genes were analyzed by PCR and sequenced, and the relationship of clinical characteristics with the genotypes was analyzed.

Results

The detection limit was 1–100 copies/reaction. No cross-reactivity was observed in the two subtypes. In total, samples from 100 patients with positive M. pneumoniae detection results in 2019 and 2021 were genotyped using the beacon based real-time PCR method and P1-1 M. pneumoniae accounted for 69.0%. All the patients had the A2063G mutation in the macrolide resistance related 23S rRNA gene. Novel mutations were also found, which were C2622T, C2150A, C2202G and C2443A mutations. The relationship between p1 gene genotyping and the clinical characteristics were not statistically related.

Conclusion

A rapid and easy clinical application molecular beacon based real-time PCR genotyping method targeting the p1 gene was established. A shift from type 1 to type 2 was found and 100.0% macrolide resistance was detected. Our study provided an efficient method for genotyping M. pneumoniae, valuable epidemiological monitoring information and clinical treatment guidance to control high macrolide resistance.
Stroke in young adults, stroke types and risk factors: a case control study
Authors: Namaganda Priscilla , Nakibuuka Jane , Kaddumukasa Mark , Katabira Elly
Published: September 2022

Background

Stroke is the second leading cause of death above the age of 60 years, and the fifth leading cause in people aged 15 to 59 years old as reported by the World Health Organization global burden of diseases. Stroke in the young is particularly tragic because of the potential to create long-term disability, burden on the victims, their families, and the community at large. Despite this, there is limited data on stroke in young adults, and its risk factors in Uganda. Therefore, we determined the frequency and risk factors for stroke among young adults at Mulago hospital.

Methods

A case control study was conducted among patients presenting consecutively to the general medical wards with stroke during the study period September 2015 to March 2016. A brain Computerized Tomography scan was performed to confirm stroke and classify the stroke subtype. Controls were patients that presented to the surgical outpatient clinic with minor surgical conditions, matched for age and sex. Social demographic, clinical and laboratory characteristics were assessed for both cases and controls. Descriptive statistics including frequencies, percentages, means, and standard deviation were used to describe the social demographics of case and controls as well as the stroke types for cases. To determine risk factors for stroke, a conditional logistic regression, which accounts for matching (e.g., age and sex), was applied. Odds ratio (with 95% confidence interval) was used as a measure for associations.

Results

Among 51 patients with stroke, 39(76.5%) had ischemic stroke and 12(23.5%) had hemorrhagic stroke. The mean age was 36.8 years (SD 7.4) for stroke patients (cases) and 36.8 years (SD 6.9) for controls. Female patients predominated in both groups 56.9% in cases and 52.9% in controls. Risk factors noted were HIV infection, OR 3.57 (95% CI 1.16–10.96), elevated waist to hip ratio, OR 11.59(95% CI 1.98–68.24) and sickle cell disease, OR 4.68 (95% CI 1.11–19.70). This study found a protective effect of oral contraceptive use for stroke OR 0.27 95% CI 0.08–0.87. There was no association between stroke and hypertension, diabetes, and hyperlipidemia.

Conclusion

Among young adults with stroke, ischemic stroke predominated over hemorrhagic stroke. Risk factors for stroke were HIV infection, elevated waist to hip ratio and sickle cell disease.
Quality of emergency obstetric and newborn care services in Wolaita Zone, Southern Ethiopia
Authors: Alemayehu Mihiretu , Yakob Bereket , Khuzwayo Nelisiwe
Published: September 2022

Background

Globally, nearly 295,000 women die every year during and following pregnancy and childbirth. Emergency obstetric and newborn care (EmONC) can avert 75% of maternal mortality if all mothers get quality healthcare. Improving maternal health needs identification and addressing of barriers that limit access to quality maternal health services. Hence, this study aimed to assess the quality of EmONC service and its predictors in Wolaita Zone, southern Ethiopia.

Methodology

A facility-based cross-sectional study was conducted in 14 health facilities. A facility audit was conducted on 14 health facilities, and 423 women were randomly selected to participate in observation of care and exit interview. The Open Data Kit (ODK) platform and Stata version 17 were used for data entry and analysis, respectively. Frequencies and summary statistics were used to describe the study population. Simple and multiple linear regressions were done to identify candidate and predictor variables of service quality. Coefficients with 95% confidence intervals were used to declare the significance and strength of association. Input, process, and output quality indices were created by calculating the means of standard items available or actions performed by each category and were used to describe the quality of EmONC.

Result

The mean input, process, and output EmONC services qualities were 74.2, 69.4, and 79.6%, respectively. Of the study participants, 59.2% received below 75% of the standard clinical actions (observed quality) of EmONC services. Women’s educational status (B = 5.35, 95% C.I: 0.56, 10.14), and (B = 8.38, 95% C.I: 2.92, 13.85), age (B = 3.86, 95% C.I: 0.39, 7.33), duration of stay at the facility (B = 3.58, 95% C.I: 2.66, 4.9), number of patients in the delivery room (B = − 4.14, 95% C.I: − 6.14, − 2.13), and care provider’s experience (B = 1.26, 95% C.I: 0.83, 1.69) were independent predictors of observed service quality.

Conclusion

The EmONC services quality was suboptimal in Wolaita Zone. Every three-in-five women received less than three-fourths of the standard clinical actions. The health system, care providers, and other stakeholders should emphasize improving the quality of care by availing medical infrastructure, adhering to standard procedures, enhancing human resources for health, and providing standard care regardless of women’s characteristics.
Menstrual cycle irregularity during examination among female medical students at King Abdulaziz University, Jeddah, Saudi Arabia
Authors: Alhammadi Maisam H. , Albogmi Afaf M. , Alzahrani Manar K. , Shalabi Bashayer H. , Fatta Fatma A. , AlBasri Samera F.
Published: September 2022

Background

Menstrual irregularity is defined as any differences in the frequency, irregularity of onset, duration of flow, or volume of blood from the regular menstrual cycle. It is an important medical issue that many medical students suffer from. The study aimed to determine the menstrual cycle abnormalities women experienced during exams and to investigate the most common types of irregularities among female medical students at King Abdulaziz University in Jeddah, Saudi Arabia.

Methods

A cross-sectional study was conducted among female medical students between September and October 2021 at King Abdulaziz University in Jeddah, Saudi Arabia. For this study, the estimated sample size (n = 450) was derived from the online Raosoft sample size calculator. Thus, 450 female medical students from second to sixth year were selected through stratified random sampling. A validated online questionnaire collected data about demographics, menstrual irregularities during exams, type of irregularities, menstrual history, family history of menstrual irregularities, premenstrual symptoms, medication use, medical and family consultations, and absenteeism. The chi-squared test (χ2) was used to analyze the associations between variables.

Results

A total of 48.2% of participants had menstrual irregularities during exams. The most common irregularity was dysmenorrhea (70.9%), followed by a lengthened cycle (45.6%), and heavy bleeding (41.9%). A total of 93% of medical students suffered from premenstrual symptoms and 60.4% used medication such as herbal medication and home remedies to relieve menstrual irregularities, and 12.1% of the students missed classes due to menstrual irregularities. A non-significant relationship was found between menstrual irregularities during exams and students’ demographics, academic year, and age at menarche, while oligomenorrhea, a heavier than normal bleed, a longer than normal cycle, and missing classes due to menstrual irregularities were significantly higher among single students as opposed to married students.

Conclusion

The results showed that female medical students have a significant frequency of menstruation abnormalities during exams period. Colleges should raise awareness among medical students about coping with examination stress and seeking medical care for menstrual abnormalities.
Clinician reports of self-awareness after traumatic brain injury: a retrospective chart review
Authors: Mamman Rinni , Cheng Anika , Tsow Rebecca , Schmidt Julia
Published: September 2022

Background

Impaired self-awareness (i.e., a lack of insight) is experienced by most individuals who have sustained a moderate to severe traumatic brain injury (TBI). During the early recovery period post-injury, these individuals may not be able to recognize their abilities and limitations, hence, negatively impacting their daily life and function. Although there are assessments and interventions to improve self-awareness after TBI, little is known about how clinicians assess and address this impairment in an inpatient rehabilitation setting.

Objective

To examine how clinicians assess, report, and provide interventions for impaired self-awareness after TBI.

Methods

A retrospective chart review was conducted on interdisciplinary rehabilitation clinician entries for individuals with TBI (n = 67) who received inpatient rehabilitation within a five-year period (2014–2019). A reflexive thematic analysis was used to identify themes pertaining to self-awareness.

Results

Three themes were generated to explore clinician responses to their clients’ impaired self-awareness: 1) ‘recalling and understanding’ described clinician observations of client behaviors and expressions of self-awareness, 2) ‘applying and analyzing’ identified clinicians providing relevant tasks and advice to clients, and 3) ‘evaluating and creating’ described clinicians actively interacting with clients by providing feedback, guided prompts, and a follow-up plan.

Conclusion

Clinicians produced varied responses to clients’ impaired self-awareness after TBI. Findings may help to develop research priorities and integrated knowledge translation initiatives to increase evidence-based practice for impaired self-awareness after TBI.
Degradation kinetics of artesunate for the development of an ex-tempore intravenous injection
Authors: Gashe Fanta , Wynendaele Evelien , De Spiegeleer Bart , Suleman Sultan
Published: September 2022

Background

Artesunate is recommended by the World Health Organization (WHO) for parenteral treatment of severe Plasmodium falciparum malaria. However, artesunate is inherently unstable in an aqueous solution and hydrolyses rapidly after its preparation for injection. Therefore, the aim of the study was to evaluate the stabilizing effects of phosphate buffer and mannitol against short-term (ex-tempore) artesunate hydrolysis.

Methods

A HPLC–UV isocratic method was developed using a reversed-phase fused core column (HALO RP-C18) and a mobile phase consisting of a mixture of 45% ammonium formate 10 mM in water (pH 4.5) and 55% methanol. Artesunate was formulated as aqueous solutions using a design of experiment (DOE) to investigate the artesunate stabilizing effects of pH (8–10), phosphate buffer strength (0.3–0.5 M), and mannitol (0–0.22 mmol/mL). The solutions were incubated at predefined temperatures (5, 25, and 40 °C) with subsequent analysis. Arrhenius equation was applied to model and evaluate the stability results.

Results

The developed HPLC-based method using fused-core stationary phase allowed to selectively quantify artesunate in the presence of its main hydrolysis degradants; namely β-dihydroartemisinin (β-DHA) and α-dihydroartemisinin (α-DHA) within 10 min. By applying the Arrhenius equation, the rate of hydrolysis of the drug increased approximately by 3.4 as the temperature raised by 10 °C. Buffer strength was found to be the main factor affecting the hydrolysis rate constants at 5 and 25 °C (p < 0.05), the activation energy (p = 0.009), and the frequency factor (p = 0.045). However, the effect of the buffer was predominant on the activation energy and hydrolysis rate constants, revealing its stabilizing effect on the drug at lower buffer strength (0.3 M). Within the investigated range (pH = 8–10), pH was found to influence the activation energy, with a positive stabilizing effect in the pH range of 8–9. The addition of mannitol as stabilizing agent into artesunate aqueous formulation did not show an improved response.

Conclusion

Phosphate buffer was the main stability determining factor of artesunate in the aqueous intravenous (i.v.) formulation and was found to be more effective in stabilizing artesunate at a buffer strength of 0.3 M in pH 8–9, while mannitol lacked stabilizing effect.
Long-term outcomes of cryoablation for biopsy-proven T1 stage renal cell carcinoma
Authors: Song Shangqing , Yang Qing , Gu Chengyuan , Yu Guopeng , Hua Bao , Gu Xin , Wang Linhui , Wang Zhong , Shi Guohai , Xu Bin
Published: September 2022

Background

To summarize our clinical experience of cryoablation in renal cell carcinoma (RCC) of Chinese population and to evaluate the long-term outcomes of laparoendoscopic single-site (LESS) cryoablation (LCA) as well as percutaneous CT-guided cryoablation (PCA) for biopsy-proven T1a and T1b RCC.

Methods

This was a multi-center, retrospective study investigating T1 stage RCC patients from 2011 to 2021. The patients were treated by LCA or PCA according to individual situation. Overall survival (OS), cancer-related survival (CSS), and progression-free survival (PFS) were evaluated for oncological outcomes, and kidney function, complications, and hospital stay were used to estimate technical outcomes.

Results

A total of 163 consecutive patients were included. Among them, 59 cases were treated by LCA and PCA was performed in 104 cases. All operations were processed successfully. Mean diameter of the mass was (2.9±1.4) cm; median blood volume was 45ml (10~200 ml). The mean operation time was 84.0 ± 24.5 min. The median postoperative hospital stay was 3 days (1~6 days). Compared with LCA, procedure time of PCA was shortened, the volume of bleeding was reduced, and the hospital stay was decreased. The overall adverse events rate was 9.8% (16/163). The mean preoperative and postoperative eGFR of LCA were 77.6±15.3 ml/min and 75.6±17.4 ml/min, respectively. Analogously, the values of PCA were 78.7±12.9 ml/min and 76.7±14.3 ml/min. Mean follow-up time was 64.2 ± 30.2 months (range, 7–127 months). Local recurrence was observed in 13 patients (8.0%), 4 (6.8%) cases of LCA and 9 (8.7%) cases of PCA. PFS at 5 and 10 years were 95.5% and 69.2% for LCA and 96.7% and 62.8% for PCA. In total, 26 patients (16.0%) (11 patients from LCA and 15 from PCA) died throughout the follow-up period. OS at 5 and 10 years were 93.8% and 31.4% for LCA, and 97.4% and 52.7% for PCA. Six patients (3.7%) (3 cases from LCA and 3 from PCA) died of metastatic RCC. CCS for LCA were 98.0% and 82.8% at 5 and 10 years, while the data were 100% and 86.4% for PCA.

Conclusion

LCA and PCA for T1 stage RCC provides satisfactory long-term oncological and renal function preservation outcomes, with acceptable complication rates.
Diagnostic biomolecules and combination therapy for pre-eclampsia
Authors: Qi Jingqi , Wu Bingbing , Chen Xiuying , Wei Wei , Yao Xudong
Published: September 2022

Pre-eclampsia (PE), associated with placental malperfusion, is the primary reason for maternal and perinatal mortality and morbidity that can cause vascular endothelial injury and multi-organ injury. Despite considerable research efforts, no pharmaceutical has been shown to stop disease progression. If women precisely diagnosed with PE can achieve treatment at early gestation, the maternal and fetal outcomes can be maximally optimized by expectant management. Current diagnostic approaches applying maternal characteristics or biophysical markers, including blood test, urine analysis and biophysical profile, possess limitations in the precise diagnosis of PE. Biochemical factor research associated with PE development has generated ambitious diagnostic targets based on PE pathogenesis and dissecting molecular phenotypes. This review focuses on current developments in biochemical prediction of PE and the corresponding interventions to ameliorate disease progression, aiming to provide references for clinical diagnoses and treatments.
Browning of the white adipose tissue regulation: new insights into nutritional and metabolic relevance in health and diseases
Authors: Machado Sabrina Azevedo , Pasquarelli-do-Nascimento Gabriel , da Silva Debora Santos , Farias Gabriel Ribeiro , de Oliveira Santos Igor , Baptista Luana Borges , Magalhães Kelly Grace
Published: September 2022

Adipose tissues are dynamic tissues that play crucial physiological roles in maintaining health and homeostasis. Although white adipose tissue and brown adipose tissue are currently considered key endocrine organs, they differ functionally and morphologically. The existence of the beige or brite adipocytes, cells displaying intermediary characteristics between white and brown adipocytes, illustrates the plastic nature of the adipose tissue. These cells are generated through white adipose tissue browning, a process associated with augmented non-shivering thermogenesis and metabolic capacity. This process involves the upregulation of the uncoupling protein 1, a molecule that uncouples the respiratory chain from Adenosine triphosphate synthesis, producing heat. β-3 adrenergic receptor system is one important mediator of white adipose tissue browning, during cold exposure. Surprisingly, hyperthermia may also induce beige activation and white adipose tissue beiging. Physical exercising copes with increased levels of specific molecules, including Beta-Aminoisobutyric acid, irisin, and Fibroblast growth factor 21 (FGF21), which induce adipose tissue browning. FGF21 is a stress-responsive hormone that interacts with beta-klotho. The central roles played by hormones in the browning process highlight the relevance of the individual lifestyle, including circadian rhythm and diet. Circadian rhythm involves the sleep–wake cycle and is regulated by melatonin, a hormone associated with UCP1 level upregulation. In contrast to the pro-inflammatory and adipose tissue disrupting effects of the western diet, specific food items, including capsaicin and n-3 polyunsaturated fatty acids, and dietary interventions such as calorie restriction and intermittent fasting, favor white adipose tissue browning and metabolic efficiency. The intestinal microbiome has also been pictured as a key factor in regulating white tissue browning, as it modulates bile acid levels, important molecules for the thermogenic program activation. During embryogenesis, in which adipose tissue formation is affected by Bone morphogenetic proteins that regulate gene expression, the stimuli herein discussed influence an orchestra of gene expression regulators, including a plethora of transcription factors, and chromatin remodeling enzymes, and non-coding RNAs. Considering the detrimental effects of adipose tissue browning and the disparities between adipose tissue characteristics in mice and humans, further efforts will benefit a better understanding of adipose tissue plasticity biology and its applicability to managing the overwhelming burden of several chronic diseases.
Hemothorax caused by costal exostosis injuring diaphragm: a case report and literature review
Authors: Pan Ruonan , Lu Xiaoqian , Wang Zhijun , Duan Lijun , Cao Dianbo
Published: September 2022

Background

Osteochondromas, also known as exostoses, are the most common benign tumors of bone and can be classified into isolated and multiple osteochondromas. A great majority of osteochondromas is asymptomatic, painless, slow-growing mass, and incidentally found. However, osteochondromas occurring in adolescence or in adult patients can grow in size and become symptomatic as a result of mechanical irritation of the surrounding soft tissues or peripheral nerves, spinal cord compression, or vascular injury.

Case presentation

We present a case of a 13-year-old girl with spontaneous hemothorax, the cause of which was identified by limited thoracotomy with the aid of video-assisted thoracic surgery to be bleeding from a diaphragmatic laceration incurred by a costal exostosis on the left sixth rib. Preoperative chest computed tomography (CT) depicted a bony projection arising from the rib and bloody effusion in the intrathoracic cavity, but was unable to discern the bleeding cause from the lung or the diaphragm. This case will highlight our awareness that costal exostosis possibly results in bloody pleural effusion. Meanwhile, English literatures about solitary costal exostosis associated with hemothorax were searched in PubMed and nineteen case reports were obtained. Combined our present case with available literature, a comprehensive understanding of this rare disease entity will further be strengthened.

Conclusions

Injury to the diaphragm is the primary cause of hemothorax caused by costal osteochondroma, including the present case. Thoracic CT scan can help establish a diagnosis of preoperative diagnosis of costal osteochondroma. Surgical intervention should be considered for those patients with symptomatic osteochondroma of the rib. Combined with our case and literature, prophylactic surgical removal of intrathoracic exostosis should be advocated even in asymptomatic patients with the presentation of an inward bony spiculation.
A large deletion encompassing exon 2 of the ectodysplasin A (EDA) gene in a British blue crossbred calf with hypohidrotic ectodermal dysplasia
Authors: Capuzzello Giovanni , Jacinto Joana Gonçalves Pontes , Häfliger Irene Monika , Chapman Gail E. , Martin Sara Soto , Viora Lorenzo , Jonsson Nicholas N. , Drögemüller Cord
Published: September 2022

Background

Hypohidrotic ectodermal dysplasia (HED) is a congenital syndrome of mammals affecting organs and tissues of ectodermal origin characterized by absence or hypoplasia of hair, teeth, and eccrine glands. The disorder has been reported in several species, including humans, mice, dogs and cattle, associated with variants in genes affecting the ectodysplasin pathway, including the X-linked ectodysplasin A (EDA) gene. Until now, nine pathogenic variants have been found in the bovine EDA gene. Here we report a novel variant in EDA in a crossbreed male Belgian Blue calf with HED, and provide an overview of the phenotypic and allelic heterogeneity of EDA-related forms of HED in cattle.

Case presentation

A 45-day-old male crossbreed British Blue calf was referred with congenital hypotrichosis, oligodontia and omphalitis. On histopathological examination of the nasal planum, nasolabial glands and ducts were not observed. The density of hair follicles was low, and they were small, with a predominance of telogen-phase hairs, and some serocellular crusts. The phenotype of the calf resembled that of HED. Whole-genome sequencing (WGS) was performed and revealed a 21,899 base-pair deletion encompassing the coding exon 2 of EDA, predicted to result in an altered transcript and aberrant protein.

Conclusions

The clinicopathological and genetic findings were consistent with a case of X-linked HED. A very similar EDA deletion has been previously reported in a family of Holstein cattle with HED. The newly identified hemizygous EDA loss-of-function variant is certainly pathogenic and therefore is the genetic cause for the observed phenotype. This case report provides an additional example of the potential of WGS-based precise diagnostics in livestock species such as cattle to increase the diagnostic yield in rare diseases.