bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluasi Risiko Ergonomi dengan Analisis Postur Tubuh untuk Mengurangi Keluhan Musculoskeletal Disorders pada Pekerja
Authors: Laurinda Cindy
Published: January 2022

The economy is an important thing in a country, without an economy, a country can't run. The economy of a country is certainly supported by an industrial sector, one of which is the metal and iron processing industry. Workers in the company will certainly have regulations that will regulate the workforce when doing work at the company. PT. Smart Teknik Utama Bandung is a company engaged in the processing of metal, iron, and others that produces various products derived from iron and plates. The main product of this company is Roding China. The company has a problem, namely the work posture of the employees on the production floor. Wrong work posture results in MSDs complaints among workers which reduce the quality of workers. The purpose of this research is to analyze the work posture used by the workforce is already ergonomic or not. Work posture analysis used the Nordic Body Map method, Ovako Work Posture Analysis, and Rapid Entire Body Assessment. The analysis was carried out on 12 employees from 7 workstations. With the analysis carried out, it is known that all employees have MSDs complaints which are caused by incorrect and unergonomic work postures, then suggestions are given to improve work posture to reduce MSDs complaints experienced by employees.
Profile of Infrastructure and Pedagogic Competencies of Teachers in SMP and SMA/SMK in Waisai District, Raja Ampat Regency, West Papua Province
Authors: Watem Maikel , Nunaki Jan Hendrik , Wambrauw Hengky L
Published: January 2022

This study aims to find out an overview of Infrastructure Facilities and Pedagogic Competencies of Teachers in SMP and SMA/MK in Waisai District, Raja Ampat Regency, West Papua Province. This research was a descriptive study, data collection using questionnaires, namely infrastructure principal questionnaire for school principals and teacher pedagogic competency questionnaire divided by each teacher in the education unit conducted by the study. The results of the analysis in this study infrastructure in 3 junior high schools the average percentage shows that SMP Negeri 14 has a very high percentage of up to 98%, in SMP Negeri 21 reaches 55%, and SMP YPK Alfa Omega 67% so that both schools are still in low category. In the high school / vocational school, the results showed that the State High School 1 and SMK 2 were in the very high percentage category, namely SMA Negeri 1 reached 97%, and SMK Negeri 2 reached 92%, while SMA Negeri 14 reached 66%, so it was still in the low category. While the pedagogic competence of teachers in the 3 SMP results showed that each school had not achieved a significant percentage value, namely in SMP Negeri 14 reached 7,352%, SMP Negeri 21 reached 5,617%, and YPK Alfa Omega SMP reached 8,333%. in high school and vocational high school results also show that each school has not achieved a significant percentage value, namely at State 1 High School reached 6.410%, State High School 14 reached 8.196%, and State Vocational High School 2 reached 5.813%
Application of problem-solving learning models to improve the activity and students' learning outcomes of SMA Kristen YABT Manokwari
Authors: Samara Nengsi , Yohanita Aksamina M , Iwan Iwan
Published: January 2022

The study aims to improve students activity and achievement cognitive in glade XI IPA Kristen YABT Manokwari school year 2017/2018 on the material of Human Circulation System by applying Problem Solving Learning. Classroom action research is conducted in two cycles, each cycle consists of four stage s of planning, implementation, observation, and reflection involving students as much as 13 people. Data collection is done through observation sheets and test provision. The result of this research shows that the students activity cycle average is 64,9% and on the second cycle the average of student activity reach 77,8% and most of student have reached active criteria. On the result of student learning in cycle I that is 59,61 not yet completed by minimum masteri criteria but has reached the completeness i n classical that is 76,92%. The average grade obtained by students in the second cycle 74.61% and students' classical learning completeness on the second cycle increased to reach 92.3%. Based on the results of research that has been done can be concluded that the application of problem solving learning can improve the activity and achievement of students in the learning process.
MODEL STUDIES WITH IDENTIFICATION OF ENERGY EFFICIENT MODES OF FUNCTIONING OF MAIN FAN UNITS
Authors:   Kryvyi Rih National University, Sinchuk I. , Peresunko I. , Somochkyn A.
Published: January 2022

Purpose. The paper analyzes the system and methods of starting synchronous electric motors of fans of the main ventilation of iron ore mines. It is concluded that it is necessary to modernize the method of starting a synchronous electric motor, despite the fact that the installed direct start-up system has a number of disadvantages, and negatively affects the energy indicators of the electromechanical complex of the main ventilation fan of mines. The priority direction in solving the complex of the above problems is the use of modern achievements in the field of semiconductor conversion technology, in terms of the development of effective circuits and methods for starting and controlling a synchronous electric drive. Originality. The method of separate regulation of size and frequency of output voltage of the multilevel converter of a clock at quasi-frequency start of the synchronous electric drive is offered, limits admissible values of starting currents to admissible values. Methodology. Simulation of transient processes of starting a synchronous electric motor with step-by-step changes in voltage and frequency of supply, which made it possible to determine the energy efficiency of this method. Result. A new method of starting with a step-by-step change in the voltage and frequency of a synchronous motor is proposed. The modeling of the proposed starting method for a synchronous electric motor with a fan torque on the motor shaft was carried out, while it allowed to get rid of the main drawback, namely, a large starting current and made it possible to increase the energy efficiency of the electromechanical complex of the main ventilation fans due to the fact that the consumed active energy during start-up will decrease approximately 50% compared to a direct starting system. Practical value. The proposed method and the obtained results of the study made it possible to prove that the effectiveness of the proposed method is very high and this will save most of the electrical energy when starting the fans of the main ventilation of iron ore mines. Figures 15, references 15
USE OF ROBOTIC COMPLEXES IN THE TRAINING OF SPECIALISTS IN ELECTRONICS, AUTOMATION AND COMPUTER ENGINEERING
Authors:   Kremenchuk Mykhailo Ostrohradskyi National University, Perekrest A. , Bilyk O. , Kushch-Zhyrko M.
Published: January 2022

Purpose. The use of robotic systems in the training of specialists in electronics, automation and computer engineering. Involvement of which will improve the quality of training of students in the direction of robot design, programming and research. Methodology. Physical and logical principles of operation of components for building robots, computer simulation, programming on languages Scratch and Python, processes description in the form of block diagrams. Results. An example of program has been developed the main functions of which are: communication of Robomaster S1 with sensors via UART interface, recognition and tracking of a given trajectory, data collection from sensors with a certain time interval, return to the starting point of the trajectory, subtraction of average values measurement on the liquid crystal display. The general algorithm of interaction with a robotic complex, an example of interaction with the accompanying software, the basic technical characteristics, the detailed description of the main constituent elements of a complex and the main list of its functions and possibilities of application were presented. Originality. A method of training future specialists in electronics, automation and computer engineering using the robotic complex Robomaster S1 to improve the quality of learning. Practical Value. The use of robotic devices in learning through the involvement of the complex Robomaster S1, promotes the activation of cognitive activity, creates a basis for the development of creative potential and is the basis for individualization of learning. Thus, one of the promising areas of further research in the fields of electronics, automation and computer engineering is the improvement of the system of training of future professionals through the use of such systems. Figures 12, tables 1, references 16.
MINIMIZATION OF ELECTRIC CONSUMPTION BY A FREQUENCY-REGULATED INDUCTION MOTOR IN START-BRAKING REGIMES
Authors:   Zaporizhzhia Polytechnic National University, Volkov V.
Published: January 2022

Purpuse. To minimize the total energy consumption in start-braking regimes of a three-phase frequency-regulated induction motor loaded with a constant static moment, as well as to take into account the effect of iron power losses of this motor on electrical losses of power and energy in its stator winding. Metodology. Based on the established similarity of mathematical dependences for calculating the electrical component of power losses in the stator winding of this motor, caused by the influence of iron power losses of the motor or the application of an additional fictitious static moment to it, the analytical dependences were refined to determine the total power and energy consumed by the motor in steady-state and start-braking regimes. Using the methods of calculus of variations and simulation, the form of energy-saving tachograms was determined, which ensure, in start-braking regimes, the minimization of the total power consumption of this motor, loaded with a constant static torque. Results. Analytical calculated dependencies are proposed for determining the energy consumption in the start-braking regimes of a frequency-regulated squirrel-cage induction motor loaded with a constant static moment, for various types of trajectories of speed change. Analytical dependencies are obtained, by means of which a quantitative assessment of the influence of iron power losses of the investigated motor on the values of the stator current modulus and electrical power and energy losses in its stator winding is carried out under steady-state and start-braking regimes. With regard to the constant load of this motor, the minimization of the active energy consumed by it in the start and braking regimes has been performed. For start-braking regimes with the proposed quasi-optimal and known types of tachograms, the optimal durations of acceleration and deceleration times, at which the consumption of active energy by the induction motor is minimal. Originality. The "U"-shaped form of dependences of the total consumed energy by the frequency-regulated induction motor on the durations of the acceleration and deceleration times has been established. For start-braking regimes, the minimization of the total energy consumed by this motor was carried out and quantified, achieved through the use of energy-saving tachograms and optimal durations of acceleration and deceleration times. Practical value. For start and braking regimes, a quantitative assessment of transient electromechanical and energy processes in a frequency-regulated short-circuited induction motor for driving vertical slab rolls was carried out and the expected annual saving of energy consumed by this motor in these regimes, achieved from the use of the proposed energy-saving tachograms, was determined. Figures 4, tables 5, references 19.
Analyzing the detrimental effects of female chronic hepatitis B virus DNA on ovarian reserve function and results of in vitro fertilization
Authors: Liu Liu , Liang Hua , Yang Jing , Shen Fujin , Li Wei
Published: January 2022

Background: To evaluate both the impact of hepatitis B virus (HBV)-DNA copies in women with HBV infection on the ovarian reserve function and outcomes of in vitro fertilization (IVF). Methods: We conducted a retrospective study on a total of 9927 couples undergoing their first IVF cycle. After filtering, 1570 couples (546 HBV-seropositive women and 1024 HBV-seronegative women whose partners were HBV-seronegative) failed to meet inclusion criteria. According to the HBV-DNA titers in serum, the HBV-seropositive group was divided into three groups: DNA-high copy group (n = 139), DNA-low copy group (n = 241), and DNA-negative group (n = 166). All patients underwent controlled ovarian hyperstimulation using the long downregulation protocol followed by IVF. Results: Compared with the HBV-negative group, HBV-positive women with high DNA copy exhibited lower antral follicle count (AFC) (11.9 ± 4.3 vs 13.3 ± 3.2), lower number of oocyte retrieved (9.2 ± 5.7 vs 13.1 ± 6.1), larger proportion of AFC <8 (7.9% vs 3.1%) and anti-mullerian hormone (AMH) <2 μg/L (8.6% vs 4.3%). Both high-DNA copy and low-DNA copy groups exhibited a lower fertilization rate (70.9% and 72.5% vs 75.1%), lower high-grade embryo rate (51.5% and 53.8% vs 56.9%), lower implantation rate (31.3% and 32.7% vs 38.5%), lower clinical pregnancy rate (40.3% and 42.3% vs 49.6% per cycle with OR; 45.5% and 48.8% vs 56.8% per cycle with ET) than the HBV-negative group. Moreover, a higher early abortion rate (19.6% and 15.7% vs 7.1%) was observed in the above two groups. Conclusion: HBV-DNA may have a negative effect on women’s ovarian reserve function which in turn results in poor fertilization rate, clinical pregnancy rate and high early abortion rate in IVF treatment.
A retrospective comparative analysis of systemic inflammatory response after laparoscopic, vaginal, and abdominal hysterectomy
Authors: Kim Hyesook , Cho Hye-yon , Jeong Soo Young , Park Sung Taek , Park Sung-ho
Published: January 2022

Background: Lymphocyte to neutrophil ratio (NLR) is a rapid and simple marker for systemic inflammation and stress after major surgery. In this study, we aimed to compare NLR changes according to surgical methods of hysterectomy. Methods: A retrospective chart review for all patients who underwent hysterectomy for benign uterine disease from 2016 to 2020 was performed. A total of 1549 women were assigned to total laparoscopic hysterectomy (TLH) (n = 419), vaginal hysterectomy (VH) (n = 608), and total abdominal hysterectomy (TAH) (n = 522) groups. Patient characteristics, surgical outcomes, and NLR changes were compared among women who underwent TLH, VH, and TAH. Results: Preoperative mean NLR was similar among three groups (p = 0.056). However, mean NLR on postoperative day 1 (p< 0.0001) and day 3 (p = 0.011) was significantly lower in TLH group than others. Also, mean NLR change on postoperative day 1 was significantly lesser in TLH group than others (1.9 in TLH vs. 5.4 in VH vs. 4.7 in TAH; p < 0.0001). Mean NLR change on postoperative day 3 was greater in TAH group than others, although there were no statistically significant differences (0.2 in TLH vs. 0.3 in VH vs. 0.7 in TAH; p = 0.354). Multivariate analysis revealed that massive NLR change (>5.0) on postoperative day 1 was significantly associated with types of hysterectomy (p < 0.0001). Conclusion: Our data showed that acute NLR change was lesser in TLH group comparing to VH and TAH group, which suggests that TLH might be associated with less systemic inflammation and tissue trauma after surgery.
A case of heterotopic pregnancy with intrauterine and cervical pregnancy coexisting: intrasacular KCl injection, intrauterine pregnancy being preserved, and then massive bleeding at 32 weeks
Authors: Sierra Javier Navarro , Romera Andrea Espiau , Puente Luján María Jesús , Herrero Serrano Rebeca , Franco Royo María Jesús , De Bonrostro Torralba Carlos , Solanilla Belén Rodríguez
Published: January 2022

Background: Heterotopic pregnancy is the condition in which intrauterine and ectopic pregnancy coexist. The conservative management of the ectopic pregnancy, with the intrauterine pregnancy preserved, has been reported. Case(s): Here, we report a very rare case: intrauterine and cervical pregnancy coexist: intrasacular Potassium chloride (KCL) injection successfully terminated cervical pregnancy with intrauterine pregnancy preserved, but later massive bleeding occurred from the cervix. A 39-year-old woman at 7+1 weeks was diagnosed with a heterotopic cervical gestation, with intrauterine and cervical sac, both with live embryos. The ectopic pregnancy was successfully terminated with intrasacular injection of KCl, preserving the intrauterine pregnancy. At 32+4 weeks of gestation the patient started with a profuse bleeding from the cervical sac, causing maternal hypotension (80/45 mmHg) and tachycardia (160 bpm) and a decelerative pattern in the cardiotocographic fetal monitoring, prompting us to perform caesarean section. The cessation of bleeding was achieved using a double balloon intracervical catheter, which was withdrawn 24 hours after its insertion without observing a new bleeding episode. The patient was discharged after 8 days and the newborn after 35 days of life, both in good health. Conclusions: Conservative treatment of a heterotopic gestation is possible, managing to preserve the viability of the intrauterine pregnancy.
Characteristics of maternal cardiac disease and pregnancy outcomes: results from a 4-year observational cohort survey in Central Vietnam
Authors: Le Minh Tam , Tran Minh Thang , Nguyen Thao Nguyen Tran , Tran Doan Tu , Truong Quang Vinh , Huy
						Vu
						Nguyen Quoc
Published: January 2022

Background: Pregnant women with cardiac diseases present a challenge for both obstetricians and cardiologists, especially in developing countries with limited medical resources. This study aimed to determine the clinical features and pregnancy outcomes of pregnant women with cardiac diseases in Vietnam. Methods: In this patient registry descriptive study, pregnant women with heart disease, admitted to the Department of Obstetrics and Gynecology, Hue Central Hospital, Vietnam, between January 2017 and December 2020, were recruited. Pregnant women were classified into the high-risk group if at least one of the following risk clinical features was present: (1) left ventricular ejection fraction (EF) <50%, and (2) New York Heart Association—NYHA classification—NYHA class >II or cyanosis, or (3) left heart obstruction; patients without these risk conditions were categorized into the low-risk group. Results: A total of 134 pregnant women were included, with a mean age of 27.8 ± 4.8 years old; 32.1% had mitral valve disease, 23.9% had rhythm disorders, 15.7% had congenital heart disease, 9.0% had aortic valve disease, and 3.0% had both mitral and aortic valve disease. Maternal complications during pregnancy included heart failure (37.3%), irregular heart rhythm (35.8%), thrombosis (0.7%), and valve blockage (0.7%). A total of 66.7% of the high-risk patients underwent cesarean section, 22.2% with therapeutic abortion, and 11.1% with miscarriage. The frequency of gestational age over 35 weeks in the high-risk and low-risk groups were 55.6% and 92.8%, respectively (Odds ratios = 0.097, 95% Confidence Interval: 0.02–0.43, p < 0.05). The mean birth weight in the high-risk and low-risk groups was 2800.0 ± 438.2 and 2988.4 ± 390.6 g, p > 0.05, respectively. Conclusions: Cardiovascular disorders in pregnant women have a higher rate of complications that affect mother and fetus. Risk stratification plays an important role in management during pregnancy and is essential to improve the outcomes in developing countries with limited medical resources.
Potential of ultrasound in the evaluation of acute appendicitis during pregnancy: a systematic review and meta-analysis
Authors: Li Yunlong , Li Shikuan
Published: January 2022

Objective: To assess the accuracy of ultrasound in diagnosing acute appendicitis in pregnant women. Mechanism: The National Library of Medicine (MEDLINE, 1990–2020), Excerpta Medica Database (EMBASE,1946–2020) and the Cochrane Controlled Trials Register (CENTRAL) were used to extract articles that were published in English. A total of five studies involving 521 patients were selected. The DerSimonian and Laird random-effects model and Quality Assessment Tool for Diagnostic Accuracy (QUADAS-2) were used to analyze the data. Findings in brief: We identified 140 related articles and included 5 articles enrolling 521 patients. The values obtained using ultrasound for appendicitis during pregnancy were sensitivity of 0.62 (95% Confidence interval (CI): 0.43–0.78), the specificity of 0.91 (95% CI: 0.74–0.97), and the Positive Likelihood Ratio of 7.0 (95% CI: 2.5–19.7), the Negative Likelihood Ratio of 0.41 (95% CI: 0.27–0.63) and the Diagnostic Odds Ratio of 17 (95% CI : 6–49). Conclusion: Ultrasound had medium-level sensitivity and high specificity for the diagnosis of appendicitis in pregnant women.
Fertile window and biophysical biomarkers of cervical secretion in subfertile cycles: a look at biotechnology applied to NaProTechnology
Authors: Murcia Lora José María , Martínez Martínez Oscar , Simoni Jennifer , Martínez Calvo Marian , de Andrés Alberto Falces , Enrique Mejía Jorge , Simoni Diglio , Alcázar Juan Luis
Published: January 2022

Background: The principal objective of this study was to correlate biophysical properties of vaginal discharge present in the cervical mucus with the timing of the fertile window. In particular, we produce measures of the viscoelasticity of the cervical secretion using two methods. The first uses only the elasticity extracted from the Creighton Model Fertility Care System (CrMs) scale, calculated P-6 ovulation estimated day (OED) with respect to the peak day of the CrMs. The second uses a numerical method that takes into account the changes in viscoelasticity, but without reference to the peak day calculated using the CrMs model. Using both methods, twelve records were obtained from a single female subject. Methods: The methodology used to evaluate the viscoelasticity factor was by measuring the approximate length in centimeters (cm) of the vaginal discharge of cervical discharge. For this, the scale of the stretching graph established by observing the stretching of CrMS was used, taking into account the previous 6 days at peak day P-6. The first method, which we termed CFW (Clinical Fertile Window), uses a measure based on the approximate length (cm) of the maximal stretchiness of the vaginal discharge. The second method we termed SFW (Software-CrMS/strectching) (Software-based Fertile Window). Results: The fertile window was detected correctly in 100% of the cases using either method, and a correlation value of 0.71 was observed between the two methods. Conclusions: We conclude that the assessment of viscoelasticity using SFW algorithm allowed in this pilot study to detect the fertile window and to describe the evolution pattern of cervical discharge throughout the fertile window. Our study provides support for the use of computational methods in detecting the fertile window, taking only into account the time evolution of the cervical discharge throughout the menstrual cycle.
Differential-diagnostic and therapeutic challenges in the management of ruptured corpus luteum cyst with undiagnosed intrauterine pregnancy in the early first trimester and ruptured ovarian pregnancy
Authors: Takeda Akihiro , Tsuge Shiori , Iyoshi Shohei
Published: January 2022

Background: The similarities in clinical features between ruptured corpus luteum cyst (RCLC) with undiagnosed intrauterine pregnancy in the early first trimester (RCLC-P) and ruptured ovarian pregnancy are well established. However, the identification of differences between these two morbid conditions is important to determine the causes and manage the hemoperitoneum without devastation of pregnancy in RCLC-P. Furthermore, the pregnancy outcomes after laparoscopic surgery in women with RCLC-P are not recognized. Methods: Retrospective observational study of six women with RCLC-P and seven women with ruptured ovarian pregnancy. Results: All cases were referred under strong suspicion of ruptured ectopic pregnancy due to lower abdominal pain and positive urinary pregnancy test after spontaneous conception. The estimated median number of gestational weeks in RCLC-P (5 weeks) was significantly lower than that for ruptured ovarian pregnancy (7 weeks). At triage, the median serum levels of beta-human chorionic gonadotropin (β-hCG) were significantly lower in RCLC-P (592 IU/L) than ruptured ovarian pregnancy (3723 IU/L) (p = 0.01). In all six cases with RCLC-P, laparoscopic ovary-sparing surgery was performed. Among the four women who received postoperative supplementation of progesterone, uneventful vaginal delivery occurred at term in three cases. Conclusions: Early gestational age and lower serum β-hCG levels at triage, as well as non-declining levels of serum β-hCG on the day after surgery, were significant predictors of RCLC-P rather than ruptured ovarian pregnancy. Laparoscopic surgery was a feasible option for the management of RCLC-P with appropriate postoperative luteal support to achieve successful obstetric outcomes.
Development of patient-centered outcomes for labour and birth: a qualitative study
Authors: Johnson Geoffrey E. , Kan Lauren , Nguyen Jennifer , Campbell Kim , Ralph Laura , Koenig Nicole , Sanaee May , Maher Ciana , Cundiff Geoffrey W.
Published: January 2022

Background: Current quality improvement models in obstetrics focus on prevention of adverse perinatal outcomes. The development of these metrics was based on expert opinion that did not account for patients’ values. The ultimate aim of our research is to develop performance indicators for labour and birth that reflect the patient perspective. Methods: A qualitative interview design was used to engage a convenience sample, of recent (<1 year) postpartum patients, in semi-structured interviews, where they shared their experiences of their recent birth. Patients were also asked to assess descriptions of adverse perinatal outcomes for readability and comprehension, towards developing accurate unbiased descriptions for a subsequent survey of patients to weight complications. Responses were recorded, transcribed, coded and analyzed using thematic analysis. thematic analysis. Results: Five themes emerged during the analysis: (1) desire for patient-centred care, (2) improved communication, (3) labour/birth, expectations and outcomes, (4) care team support during labour and birth, (5) continuing emotional and physical postpartum care. Conclusions: Patient-centred care and good health outcomes were the major values expressed by the patients in this study. Good communication and shared decision making led to patients describing their labour and birth as a satisfying experience. This study lays the foundation for developing a quality tool to measure the outcomes of birth and adverse outcomes from the patients’ perspective.
Autism and associated disorders: cannabis as a potential therapy
Authors: Babayeva Mariana , Assefa Haregewein , Basu Paramita , Loewy Zvi
Published: January 2022

Autism spectrum disorder (ASD) is a group of disabilities with impairments in physical, verbal, and behavior areas. Regardless the growing frequency of autism, no medicine has been formed for the management of the ASD primary symptoms. The most frequently prescribed drugs are off-label. Therefore, there is necessity for an advance tactic for the treatment of autism. The endocannabinoid system has a central role in ruling emotion and social behaviors. Dysfunctions of the system donate to the behavioral deficits in autism. Therefore, the endocannabinoid system represents a potential target for the development of a novel autism therapy. Cannabis and associated compounds have produced substantial research attention as a capable therapy in neurobehavioral and neurological syndromes. In this review we examine the potential benefits of medical cannabis and related compounds in the treatment of ASD and concurrent disorders.
In vivo and in vitro neuroprotective effects of maca polysaccharide
Authors: Zhou Yi , Zhu Lemei , Li Haigang , Xie Wenqing , Liu Juan , Zhang Yuan , Li Yusheng , Wang Chenggong
Published: January 2022

Objective: To explore the protective effect of MP on oxidative damage in vivo and in vitro. Methods: A mouse aging model was induced by intraperitoneal injection of D-galactose (D-gal), and pathological changes in the hippocampal ultrastructure were observed by transmission electron microscopy. The activity of glutathione peroxidase (GSH-Px) and the levels of malondialdehyde (MDA) in brain tissues were evaluated with GSH-Px and MDA assay kits. An MTT assay was used to detect the viability of the model SH-SY5Y cells with H2O2-induced damage, and a lactate dehydrogenase (LDH) kit was used to evaluate LDH leakage. Reactive oxygen species (ROS) levels and cell cycle arrest were analyzed by flow cytometry, and cleaved caspase 3 and P53 protein expression was determined by western blot analysis. Results: Demonstrated that MP increased GSH-Px activity, reduced MDA levels, and attenuated the cell damage induced by H2O2. Furthermore, MP protected neuronal cells from oxidative stress through a mechanism including a decrease in LDH leakage and reversal of H2O2-induced cell morphological damage. MP treatment alleviated the H2O2-induced increases in ROS levels, inhibited apoptosis, relieved cell cycle arrest, and downregulated cleaved caspase 3 and P53 protein expression. Conclusions: MP is a novel antioxidant with neuroprotective effects.
Developing a clinical and PET/CT volumetric prognostic index for risk assessment and management of NSCLC patients after initial therapy
Authors: Liu Liu , Zhang Jingmian , Ferguson Mark K. , Appelbaum Daniel , Zhang James X. , Pu Yonglin
Published: January 2022

Background: Currently, individual clinical prognostic variables are used sequentially with risk-stratification after TNM staging in clinical practice for the prognostic assessment of patients with NSCLC, which is not effective for estimating the collective impact of multiple individual variables on patient outcomes. Here, we developed a clinical and PET/CT volumetric prognostic (CPVP) index that integrates the prognostic power of multiple clinical variables and metabolic tumor volume from baseline FDG-PET, for use immediately after definitive therapy. Patients and methods: This retrospective cohort study included 998 NSCLC patients diagnosed between 2004 and 2017, randomly assigned to two cohorts for modeling the CPVP index using Cox regression models examining overall survival (OS) and subsequent validation. Results: The CPVP index generated from the model cohort included pretreatment variables (whole-body metabolic tumor volume [MTVwb], clinical TNM stage, tumor histology, performance status, age, race, gender, smoking history) and treatment type. A clinical variable (CV) index without MTVwb and PET/CT volumetric prognostic (PVP) index without clinical variables were also generated for comparison. In the validation cohort, univariate Cox modeling showed a significant association of the index with overall survival (OS; Hazard Ratio [HR] 3.14; 95% confidence interval [95% CI] =2.71 to 3.65, p < 0.001). Multivariate Cox regression analysis demonstrated a significant association of the index with OS (HR = 3.13, 95% CI =2.66 to 3.67, p < 0.001). The index showed greater prognostic power (C-statistic = 0.72) than any of its independent variables including clinical TNM stage (C-statistic ranged from 0.50 to 0.69, all p < 0.003), CV index (C-statistic = 0.68, p < 0.001) and PVP index (C-statistic = 0.70, p = 0.006). Conclusions: The CPVP index for NSCLC patients has moderately strong prognostic power and is more prognostic than its individual prognostic variables and other indices. It provides a practical tool for quantitative prognostic assessment after initial treatment and therefore may be helpful for the development of individualized treatment and monitoring strategy for NSCLC patients.
Bone marrow mesenchymal stem cell-derived exosomes improve renal fibrosis via regulating Smurf 2/Smad 7
Authors: Liu Yingjie , Guo Weikang , Guo Yan , Chen Xinpan , Liu Wenhu
Published: January 2022

Background: Exosomes can be secreted from bone marrow mesenchymal stem cells (BMSCs) to extracellular space and exert anti-fibrotic effects, but the underlying mechanisms remain to be elucidated. Methods: 5/6 subtotal nephrotomy (SNx) rat models and TGF-β1-induced human renal proximal tubular epithelial cells (HRPTEpiCs) were established to simulate renal fibrosis. Renal function and fibrosis were assessed by Hematoxylin and Eeosin (HE) staining, Masson staining, immunohistochemistry, and western blot. The expression of Smad 7/Smurf 2 was detected in rats and HRPTEpiCs by western blot, and a further potential mechanism was explored using si-Smurf 2. Results: BMSC-Exo improved renal function, reduced the fibrotic region, down-regulated the expression of fibronectin, Collagen-I, α-SMA, and up-regulated E-cadherin in SNx models. In vitro study demonstrated that knocking down the expression of Smurf 2 significantly increased the expression of Smad 7, which could be enhanced by BMSC-Exo. BMSC-Exo could alleviate the fibrosis induced by TGF-β1 in tubular epithelial cells and enhanced the protective effect of si-Smurf 2 on renal fibrosis. Conclusions: BMSC-Exo inhibited renal fibrosis both in vivo and in vitro, partially, by regulating the Smurf 2/Smad 7 axis. BMSC-Exo enhanced the protective effect of si-Smurf 2 on fibrosis induced by transforming growth factor-β1 (TGF-β1).
Calpain activation and progression of inflammatory cycles in Parkinson’s disease
Authors: Gao Andrew , McCoy Hannah M. , Zaman Vandana , Shields Donald C. , Banik Naren L. , Haque Azizul
Published: January 2022

Parkinson’s disease (PD) is a progressive, neurodegenerative condition of the central nervous system (CNS) affecting 6.3 million people worldwide with no curative treatments. Current therapies aim to mitigate PD’s effects and offer symptomatic relief for patients. Multiple pathways are involved in the pathogenesis of PD, leading to neuroinflammation and the destruction of dopaminergic neurons in the CNS. This review focuses on PD pathology and the role of calpain, a neutral protease, as a regulator of various immune cells such as T-cells, microglia and astrocytes which lead to persistent neuroinflammatory responses and neuronal loss in both the brain and spinal cord (SC). Calpain plays a significant role in the cleavage and aggregation of toxic α-synuclein (α-syn), a presynaptic neural protein, and other organelles, contributing to mitochondrial dysfunction and oxidative stress. α-Syn aggregation results in the formation of Lewy bodies (LB) that further contribute to neuronal damage through lipid bilayer penetration, calcium ion (Ca2+) influx, oxidative stress and damage to the blood brain barrier (BBB). Dysfunctional mitochondria destabilize cytosolic Ca2+ concentrations, raising intracellular Ca2+; this leads to excessive calpain activation and persistent inflammatory responses. α-Syn aggregation also results in the disruption of dopamine synthesis through phosphorylation of tyrosine hydroxylase (TH), a key enzyme involved in the conversion of tyrosine to levodopa (L-DOPA), the amino acid precursor to dopamine. Decreased dopamine levels result in altered dopamine receptor (DR) signaling, ultimately activating pro-inflammatory T-cells to further contribute to the inflammatory response. All of these processes, together, result in neuroinflammation, degeneration and ultimately neuronal death seen in PD. 1-Methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP—a prodrug to the neurotoxin 1-methyl-4-phenylpyridinium (MPP+)), rotenone (an environmental neurotoxin), and 6-hydroxydopamine (6-OHDA - a neurotoxic synthetic organic compound) induce PD-like conditions when injected into rodents. All three agents work through similar mechanisms and lead to degeneration of dopaminergic neurons in the substantia nigra (SN) and more recently discovered in motor neurons of the spinal cord (SC). These neurotoxins also increase calpain activity, furthering the neuroinflammatory response. Hence, calpain inhibitors have been posited as potential therapeutics for PD to prevent calpain-related inflammation and neurodegenerative responses in not only the SN but the SC as well.
How we deal with Staphylococcus aureus (MSSA, MRSA) central nervous system infections
Authors: Antonello Roberta Maria , Riccardi Niccolò
Published: January 2022

Among central nervous system (CNS) infections (e.g., meningitis, brain abscess, ventriculitis, transverse myelitis), those caused by Staphylococcus aureus (SA) are particularly challenging both in management and treatment, with poor clinical outcomes and long hospital stay. It has been estimated that SA is responsible for around 1%–7% of meningitis (up to 19% in healthcare-associated meningitis). Recent neurosurgical procedures and immunocompromisation are major risk factors for SA CNS infections. Hand hygiene, surveillance nasal swabs and perioperative prophylaxis are crucial points for effective SA infections prevention. In case of SA-CNS infections, pending microbiological results, anti-methicillin-resistant SA (MRSA) antibiotic, with good CNS penetration, should be included, with prompt de-escalation as soon as MRSA is ruled out. Consultation with an expert in antimicrobial therapy is recommended as well as prompt source control when feasible. In this narrative review, we reviewed current literature to provide practical suggestions on diagnosis, prevention, management, and treatment of SA CNS infections.
Bleeding risk in patients with atrial fibrillation treated with combined anti-platelet and non-vitamin K antagonist oral anticoagulant therapy
Authors: Shin Dong Geum , Kim Sunhwa , Kim Yoo Ri
Published: January 2022

Background: The use of non-vitamin K antagonist oral anticoagulants (NOACs) in patients with non-valvular atrial fibrillation (AF) has been increasing. Accordingly, the combined use of antiplatelet agents (APT) and NOAC therapy is commonly encountered in clinical practice. The purpose of this study was to compare the clinical outcomes between combination therapy (NOAC and APT) vs. monotherapy (NOAC only) in patients with AF. Methods: We retrospectively analyzed patients who were prescribed NOACs between January 2012 and December 2016. The primary outcome was major bleeding and any bleeding events, and the secondary outcomes were stroke/systemic embolic (SE) events and major adverse cardiac events (MACE). Results: Of the 1068 participants, there were 264 (24.7%) patients in the combination therapy group. The prevalence of diabetes (p = 0.017) and history of stroke and transient ischemic attacks (p < 0.001) was higher in the combination group than in the monotherapy group. During the mean 14.6 ± 9.8 months of follow-up, the incidence of any bleeding was significantly higher in the combination therapy group than in the monotherapy group (p < 0.001). The rate of major bleeding, stroke/SE, and MACE between the two groups was similar. The rate of under-dosage NOAC prescriptions was higher in the combination therapy group than in the monotherapy group (p = 0.024). Conclusions: The combination therapy group had higher incidences of any bleeding events compared to the monotherapy in patients with appropriate dosing. However, there was no difference in stroke/SE, and MACE. The bleeding risk in AF patients taking the combination of NOACs and APT should be carefully evaluated.
Genetic risk scores used in cardiovascular disease prediction models: a systematic review
Authors: Yun Hyunok , Noh Nan Iee , Lee Eun Young
Published: January 2022

Background: Cardiovascular disease is caused by a combination of genetic and environmental risk factors. Some risk factors can change with age, but a genetic predisposition is permanent. Therefore, identifying the genotype of cardiovascular disease and using it alone or in combination with existing risk algorithms can improve risk prediction. This systematic review was conducted to examine existing studies on predictive models for cardiovascular disease using genetic risk score and to determine the clinical utility. Methods: An electronic database search was conducted to identify studies published from January 2005 to July 2020. The literature search was performed using the search terms “coronary artery disease”, “coronary heart disease”, “cardiovascular diseases”, “genetic risk score”, and “polygenic risk score”. Results: Through systematic review, 29 studies were identified. In most studies, genetic risk score was associated with the incidence of cardiovascular disease. In 23 studies, clinical utility was improved based on discrimination between or reclassification of subjects who did and did not experience an event, but the improvement was modest. Conclusions: The predictive model for cardiovascular disease using genetic risk score has limited usefulness in clinical practice due to methodological heterogeneity of genetic risk score constructs. Further research to develop a standardized protocol of genetic risk score constructs and validation studies with various cohorts from diverse populations are required.
Disparities between guideline statements on acute and post-acute management of cervical artery dissection
Authors: Mayer-Suess Lukas , Peball Tamara , Komarek Silvia , Dejakum Benjamin , Moelgg Kurt , Kiechl Stefan , Knoflach Michael
Published: January 2022

Even though cervical artery dissection is one of the main reasons for ischemic stroke in young patients, acute management and post-acute primary or secondary prevention of cerebral ischemia differ significantly in different centers and countries. These discrepancies are reflected by the differences in guideline recommendations of major stroke societies. Our narrative review aims to shed light on the different recommendations in guideline-statements of stroke societies and to give an overview of the current literature concerning acute management and post-acute treatment of cervical artery dissection patients. In general, intravenous thrombolysis and mechanical thrombectomy are recommended, irrespective of stroke etiology, if administered within the label. Secondary prevention of cerebral ischemia can be achieved by antiplatelet intake or anticoagulation, with, to date, neither treatment establishing superiority over the other. Duration of antithrombotic treatment, statin use as well as optimal endovascular approach are still up for debate and need further evaluation. Additionally, it is still unknown, whether the recommendations given in any of the guideline statements are similarly relevant in spontaneous and traumatic cervical artery dissection, as none of the stroke societies differentiates between the two.
Impact of aortic atheroma and distensibility on diastolic function and prognosis in patients with ischemic stroke
Authors: Kim Dae-Young , Kim In-Soo , Jung Yo Han , Lee Kyung Yul , Kim Jong-Youn , Min Pil-Ki , Yoon Young Won , Lee Byoung Kwon , Hong Bum-Kee , Rim Se-Joong , Kwon Hyuck Moon , Choi Eui-Young
Published: January 2022

Background: Patients with ischemic stroke are vulnerable to heart failure with preserved ejection fraction (HFpEF) because these conditions share common risk factors. Although evaluation of the ascending aorta, aortic arch, and proximal descending thoracic aorta is an essential step to determine the source of the causative embolism, the relationship between the degree of aortic atheroma and left ventricular (LV) diastolic function has not been extensively investigated. Methods: We analyzed the transesophageal and transthoracic echocardiography in ischemic stroke patients. Patients with previous coronary artery disease, valvular heart disease of more than moderate degree, and an LV ejection fraction of less than 50% were excluded. The relationships between the grade of the aortic atheroma, aortic stiffness indexes, and diastolic functional indexes were evaluated. Results: In 295 patients, the atheroma grade was significantly correlated with aortic stiffness index, ratio of mitral annular and inflow velocities (E/e’), left atrial volume index, and LV diastolic elastance. With further adjustment for age, hypertension, diabetes, estimated glomerular filtration rate, left atrial volume index, and LV mass index, the significance of the atheroma grade was attenuated. In the subgroup analysis, the atheroma grade was significantly and independently related to E/e’ in women (β = 0.181, p = 0.032), but not in men. However, atheroma grade was not associated with poor clinical outcomes in either sex. Conclusions: Aortic atheroma grade was significantly and independently related to LV diastolic function, especially in women. This suggests that aortic atheroma is an index of arterial stiffness and a potential risk factor for HFpEF through ventricular-vascular interactions, especially in women.
Current status and outcomes in heart transplantation: a narrative review
Authors: Awad Morcos A. , Shah Aakash , Griffith Bartley P.
Published: January 2022

The first human heart transplantation was performed by Christian Barnard in 1967. While the technical aspect had been worked out, allograft rejection was a major limitation in the early days of heart transplant. The discovery of cyclosporine revolutionized the field and led to the modern era of transplant. Heart transplantation now offers the best survival benefit for patients with end-stage heart failure with a median survival over 12 years. However, there are still limitations including the impact of limited availability of graft, graft dysfunction, and rejection, and long-term non-cardiac complications. This review serves as an update on the short- and long-term outcomes following heart transplantation focusing on the new donor allocation system, efforts to expand the donor pool, primary graft dysfunction, acute cellular and antibody-mediated rejection, cardiac allograft vasculopathy, and post-transplant malignancy and renal dysfunction.
Importance of right heart catheterization in advanced heart failure management
Authors: Cochran John M. , Alam Amit , Guerrero-Miranda Cesar Y.
Published: January 2022

Patients with chronic congestive heart failure belong to a population with reduced quality of life, poor functional class, and increased risk of mortality and morbidity. In these patients, assessment of invasive hemodynamics both serves therapeutic purposes and is useful for stratification roles. The right heart catheterization has become a cornerstone diagnostic tool for patients in refractory heart failure or cardiogenic shock, as well as for the assessment of candidacy for heart replacement therapies, and the management of patients following mechanical circulatory assist device implantation and heart transplantation.