bluuebunny/crossref_metadata_2025 huggingface dataset:
Glycemic Variability is Independently Associated with Poor Prognosis in Main PICU Centers in Southwest China
Authors: li jing , dong milan , liu wenjun , luo yetao , huang bo , zou yingbo , liu fuyan , zhang guoying , chen ju , jiang jianyu , duan ling , xiong daoxue , fu hongmin , yu kai
Published: August 2021

Background: Glucose variability (GV) is one of the common complications in critically ill patients, and studies investigating the role of GV in the prognosis of pediatric patients are scarce in China. And there is no consensus on the measurement of GV. Thus, this study took a prospective, multi-center cohort observational study to identify the ‘best’ index of variability in non-diabetic critically ill children and to confirm whether GV is associated with unfavorable outcomes and whether this association persists after control of hypoglycemia and hyperglycemia. Materials and Methods: Four GV indices were chosen and calculated in our study, namely, mean absolute glucose (MAG), standard deviation (SD), glycemic lability index (GLI), and another metric-average consecutive absolute change percentage (ACACP), which can be used in the real-time clinical decision. The primary outcome was 28-day mortality. Multivariate Cox regression analysis was used to identify the potential predictors for the outcome. And the area under the curve (AUC), net reclassification improvement (NRI), and integrated discrimination improvement (IDI) were calculated to assess the predictability of dysglycemia (glucose variability and hypo/hyperglycemia) on the unfavorable outcome. Results: Of the total of 780 participants, 12.4% (n=97) died within 28 days after PICU admission. There were statistical differences in terms of four GV indices (SD, GLI, MAG, and ACACP) between survivors and non-survivors, in which MAG obtained the largest area under the curve and showed a strong connection to ICU mortality independently. Subsequent addition of MAG to the multivariate Cox model for hyperglycemia resulted in further quantitative evolution of the model statistics (AUC 0.651 to 0.681, P=0.001; IDI: 0.017, P=0.044; NRI:0.224, P=0.186). And the impact of hyperglycemia (adjusted HR1.419, 95% CI 0.815-2.471, p=0.216) on outcome was attenuated and no longer statistically relevant after adjustment for MAG (adjusted HR 2.455, 95%CI 1.411-4.270, p=0.001). Conclusions: GV is closely associated with unfavorable outcomes, and may be a more powerful negative predictor of outcome than hypoglycemia and hyperglycemia. These findings emphasize the crucial role of GV in PICU children. GV index that contains information such as time, rate of change, etc. is the focus of future research. MAG may be a good choice. Trial registration: Chinese clinical registration (ChiCTR), ChiCTR2000030846. Registered 15 March 2020, https://www.chictr.org.cn/showproj.aspx?proj=50760.
Exploring the Influencing Factors of Pathologic Complete Response in Estrogen Receptor-Positive Breast Cancer after Neoadjuvant Chemotherapy: A Retrospective Study
Authors: Tang Lingfeng , Shu Xiujie , Tu Gang
Published: August 2021

Background: The purpose of this study was to evaluate the factors associated with achieving pathologic complete response (pCR) after neoadjuvant chemotherapy (NACT) in estrogen receptor-positive(ER+) breast cancer patients, and develop a nomogram that predict the probability of achieving pCR after NACT in ER+ breast cancer patients.Methods: A total of 431 ER+ breast cancer patients who received four cycles of thrice-weekly standard NACT and subsequently underwent surgery in the first affiliated hospital of Chongqing medical university were retrospectively enrolled, and data on their pretreatment clinicopathologic features and multiple laboratory indexes were collected. The optimal cut-off values of age, NLR, PLR and FBG were determined by the Youden index. The least absolute shrinkage and selection operator regression model was used to optimize feature selection. Forward stepwise multivariable logistic regression analysis was applied to identify predictive factors for achieving pCR after NACT. A nomogram was then developed according to the logistic model. Discrimination, calibration, and clinical usefulness of the predicting model were assessed using the C-index, receiver operating characteristic curve, calibration plot, and decision curve analysis.Results: pCR was achieved in 59 (13.7%) patients after NACT. Multivariate analysis identified four independent factors, including tumor size, ER expression, Ki67 index and histological grade. The nomogram established based on these factors showed its discriminatory ability, with the area under the curve (AUC) of 0.774 (95% confidence interval 0.708–0.841) and the C-index was 0.809 (95% CI: 0.751–0.867). The calibration curve showed that the predictive ability of the nomogram was a good fit to actual observation. The decision curve showed that if the threshold is 13% and 65%, using this nomogram can obtain more benefit.Conclusions: The nomogram exhibited a sufficient discriminatory ability for predicting pCR of NACT in ER+ breast cancer patients.
Biochemical and Instrumental Characterization of Vermicompost Produced From Patchouli Bagasse: A Waste by-product of Essential Oil Industries
Authors: Ahmed Refad , Deka Hemen
Published: August 2021

Biochemical and instrumental analysis was carried out for understanding the maturity and stability of the vermicomposted patchouli bagasse (PB) and cow dung (CD) mixtures. Two important enzymes namely urease and dehydrogenase were evaluated to understand the biological changes. On the other hand, instrumental study includes scanning electron microscopy (SEM) imaging; X-ray diffraction (XRD) pattern and UV-VIS spectrophotometer analysis of the vermicomposting end products. The results showed enhancement in urease (1.14-2.84 folds) and dehydrogenase (1.7-3.1 folds) activities confirming the maturity and stability of the vermicomposting end products. The spectrophotometric analysis revealed that there was significant decrease in humification index (1.5 to 3.4 folds) in the vermicompost samples than the initial level. The SEM images depicted the porous, fragmented and granular structure of end vermicompost samples. Further, the XRD analysis showed the micromorphological crystalline structure and enhanced decomposition of the substrate mixture during vermicomposting process. As a whole, the end vermicompost product was found to be much stable and mature for agronomic use.
Size Attenuated Copper Doped Zirconia Nanoparticles Enhances in Vitro Antimicrobial Properties
Authors: S Nishakavya , Girigoswami Agnishwar , R Deepa , A Divya , S Ajith , Girigoswami Koyeli
Published: August 2021

Biofilm formation hinders the activity of antimicrobial drugs at the site of infections and any agent that can act on both Gram- positive and Gram- bacteria by inhibiting the bacterial growth and rupture the biofilm is needed for the management of infection. In the present study, we have synthesized ZrO2 NPs and copper doped zirconia nanoparticles (Cu-ZrO2 NPs) and characterized them using dynamic light scattering, X-ray diffractometry and scanning electron microscopy (SEM). The size of the Cu-ZrO2 NPs drastically reduced compared to ZrO2 NPs and the antimicrobial activity was studied against Gram- positive bacteria (Lactobacillus sp.) and Gram- negative bacteria (Pseudomonas aeruginosa), respectively. The synthesized Cu-ZrO2 NPs showed superior inhibitory action against Lactobacillus sp. compared to ZrO2 NPs, due to the negatively charged cell wall of Lactobacillus sp. which could attract readily the positively charged Cu-ZrO2 NPs, thereby inhibiting its activity. The biocompatibility was tested using XTT assay in FL cells and the results demonstrated that Cu-ZrO2 NPs were non- toxic to mammalian cells. Hence, it could be proposed that the synthesized Cu-ZrO2 NPs possess possible biomedical applications and can be used as antibacterial agents without causing toxicity in mammalian cells.
Construction of immune-related lncRNA signature to predict aggressiveness, immune landscape, and drug resistance of colorectal cancer
Authors: Xue Yonggan , Ning Bobin , Liu Hongyi , JIa Baoqing
Published: August 2021

Background

Colorectal cancer (CRC) remains one of the most common malignancies across the world, threatening almost millions of lives every year and increasingly adding the social-economical burden. Thus far, a biomarker, which can comprehensively predict the survival outcomes, clinical characteristics, and therapeutic sensitivity, is still lacking.
Results

This study established a pair-risk model, together with, an exp-risk model to predict biological characteristics of CRC based on immune-related lncRNA (irlncRNA) expression patterns. We retrieved transcriptomic data of CRC, including 473 tumor samples and 41 normal samples, and identified 739 irlncRNA through co-expression analysis, and constructed irlncRNA pairs. After integrating with clinical survival data, we established an 11 irlncRNA pairs signature using Lasso regression analysis. We next drew the 1-, 5-, 10-year curve line of receiver operating characteristic (ROC), calculated the areas under the curve (AUC), and recognized the optimal cutoff point. Patients with CRC were stratified into high- and low-risk groups based on the optimal cutoff value. Then, we validated the pair-risk model in terms of the survival outcomes of the patients. Moreover, we tested the reliability of the pair-risk model for predicting tumor aggressiveness and therapeutic responsiveness of CRC. Additionally, we reemployed the 11 of irlncRNAs involved in the pair-risk model to constructed an expression risk model that was also highly predictive of prognostic outcomes of CRC patients. Importantly, combining the pair-risk model and exp-risk model yielded a more robust approach for predicting the survival outcomes of patients with CRC.
Conclusions

We suggest that the irlncRNA-based risk models can be utilized as prognostic tools to predict survival outcomes and clinical characteristics and guide treatment regimens of CRC.
Genome Mining Discovery of Hydrogen Production Pathway of Klebsiella sp. WL1316 Fermenting Cotton Stalk Hydrolysate
Authors: Li Yanbin , Zhang Qin , Liu Zhanwen , Jiang Hui , Jia Qinghua
Published: August 2021

Genome sequencing was used to identify key genes for the generation of hydrogen gas through cotton stalk hydrolysate fermentation by Klebsiella sp. WL1316. Genome annotation indicated that the genome size was 5.2 Mb with GC content 57.6%. Xylose was metabolised in the pentose phosphate pathway via the conversion of xylose to xylulose in Klebsiella sp. WL1316. This strain contained diverse formate-hydrogen lyases and hydrogenases with gene numbers higher than closely related species. A metabolic network involving glucose, xylose utilisation, and fermentative hydrogen production was reconstructed. Metabolic analysis of key node metabolites showed that glucose and xylose metabolism influenced biomass synthesis and biohydrogen production. Formic acid accumulated during fermentation at 24–48 h but decreased sharply after 48 h, illustrating the splitting of formic acid to hydrogen gas during early-to-mid fermentation. The Kreb’s cycle was the main competitive metabolic branch of biohydrogen synthesis at 24 h of fermentation. Lactic and acetic acid fermentation and late ethanol accumulation competed the carbon skeleton of biohydrogen synthesis after 72 h of fermentation, indicating that these competitive pathways are regulated in middle-to-late fermentation (48–96 h). This study is the first to elucidate the metabolic mechanisms of mixed sugar utilisation and biohydrogen synthesis based on genomic information.
Mechanistically Informed Non-invasive Peripheral Nerve Stimulation for Peripheral Neuropathic Pain: a Randomised Double-blind Sham-controlled Trial.
Authors: johnson selina , Marshall Anne , Hughes Dyfrig , Holmes Emily , Henrich Florian , Nurmikko Turo , Sharma Manohar , Frank Bernhard , Bassett Paul , Marshall Andrew , Magerl Walter , Goebel Andreas
Published: August 2021

Background: Induction of long-term synaptic depression (LTD) is proposed as a treatment mechanism for chronic pain but remains untested in clinical populations. Two interlinked studies; 1. A patient-assessor blinded, randomised, sham-controlled clinical trial and 2. an open-label mechanistic study, sought to examine therapeutic LTD for persons with chronic peripheral nerve injury pain. Methods: 1. Patients were randomised using a concealed, computer-generated schedule to either active or sham non-invasive low-frequency nerve stimulation (LFS), for 3 months (minimum 10 mins/day). The primary outcome was average pain intensity (0-10 Likert scale) recorded over one week, at three months, compared between study groups. 2. On trial completion, consenting subjects entered a mechanistic study assessing somatosensory changes in response to LFS. Results: 1. 76 patients were randomised (38 per group), with 65 (31 active, 34 sham) included in the intention to treat analysis. The primary outcome was not significant, pain scores were 0·3 units lower in active group (95% CI -1·0, 0·3; p=0·30) giving an effect size of 0·19 (Cohen’s D). Two non-device related serious adverse events were reported. 2. In the mechanistic study (n=19) primary outcomes of mechanical pain sensitivity (p=0.006) and dynamic mechanical allodynia (p=0.043) significantly improved indicating reduced mechanical hyperalgesia. Conclusions: Results from the RCT failed to reach significance. Results from the mechanistic study provide new evidence for effective induction of LTD in a clinical population. Taken together results add to mechanistic understanding of LTD and help inform future study design and approaches to treatment. Funding: National Institute for Health Research. ISRCTN53432663
PGRMC1-dependent lipophagy promotes ferroptosis in paclitaxel-tolerant persister cancer cells
Authors: You Ji Hyeon , Lee Jaewang , Roh Jong-Lyel
Published: August 2021

Background

Progesterone receptor membrane component 1 (PGRMC1) is a heme-binding protein inducing dimerization with cytochrome P450, which mediates chemoresistance. Increased PGRMC1 expression is found in multiple types of resistant cancers but the role of PGRMC1 in ferroptosis of cancer cells remains unrevealed. Therefore, we examined the role of PGRMC1 in promoting ferroptosis in paclitaxel-tolerant persister cancer cells (PCC).
Methods

The effects of ferroptosis inducers and PGRMC1 gene silencing/overexpression were tested on head and neck cancer (HNC) cell lines and mouse tumor xenograft models. The effects were analyzed about cell viability, death, lipid ROS and iron production, mRNA/protein expression and interaction, and lipid assays.
Results

PCC had more free fatty acids, lipid droplets, and fatty acid oxidation (FAO) than their parental cells. PCC was highly sensitive to inhibitors of system xc− cystine/glutamate antiporter (xCT), such as erastin, sulfasalazine, and cyst(e)ine deprivation, but less sensitive to (1S,3R)-RSL3. PGRMC1 silencing in PCC reduced ferroptosis sensitivity by xCT inhibitors and PGRMC1 overexpression in parental cells increased ferroptosis by xCT inhibitors. Lipid droplets were degraded along with autophagy induction and autophagosome formation by erastin treatment in PCC. Lipophagy was accompanied by increased tubulin detyrosination, which was increased by SIRT1 activation but decreased by SIRT1 inhibition. FAO and lipophagy were also promoted by the interaction between lipid droplets and mitochondria.
Conclusion

PGRMC1 expression increased FAO and ferroptosis sensitivity from in vivo mice experiments. Our data suggest that PGRMC1 promotes ferroptosis by xCT inhibition in PCC.
A Clinical Study of A CD44v6-targeted Fluorescent Agent for the Detection of Non-muscle Invasive Bladder Cancer
Authors: Shang Wenting , Peng Li , He Kunshan , Guo Pengyu , Deng Han , Liu Yu , Chen Ziyin , Tian Jie , Xu Wanhai
Published: August 2021

Purpose
Bladder cancer is the fifth most common malignancy in humans. Cystoscopy under white light imaging is the gold standard for bladder cancer diagnosis, but some tumors are difficult to visualize and can be overlooked, resulting in high recurrence rates.
Method:
We developed a phage display-derived peptide-based near-infrared imaging probe, PLSWT7-DMI, which binds specifically to bladder cancer cells and is nontoxic to animals. Here, we report a clinical research of this probe for near-infrared fluorescence endoscopic detection of bladder cancer.
Results
The purity, efficacy, safety, and nontoxicity of PLSWT7-DMI were confirmed prior to its clinical application. Twenty-two patients diagnosed with suspected non-muscle invasive bladder cancer were enrolled in the present study. Following intravesical administration of the probe, the entire mucosa was imaged under white and near-infrared imaging using an in-house developed endoscope that could switch between these two modes. The illuminated lesions under near-infrared light were biopsied and sent for histopathological examination. We observed a 5.1-fold increase in the fluorescence intensity in the tumor samples compared to normal tissue, and the probe demonstrated a sensitivity and specificity of 91.2% and 90%, respectively. Common diagnostic challenges, such as small satellite tumors, carcinoma in situ, and benign suspicious mucosa, were visualized and could be distinguished from cancer. Further, no adverse effects were observed in humans.
Conclusion
These first-in-human results indicate that PLSWT7-DMI-based near-infrared fluorescence endoscopy is a safe and effective approach for the improved detection of bladder cancer, and may enable thorough resection to prevent recurrence.
Impact of Home Healthcare on End-of-life Outcomes for People With Dementia: a Systematic Review
Authors: Chen Ping-Jen , Smits Lisanne , Miranda Rose , Liao Jung-Yu , Petersen Irene , Block Lieve Van den , Sampson Elizabeth L
Published: August 2021

Background: Home healthcare (HHC) may reduce acute hospital utilization, but its effect on homebound people living with dementia (PLWD) at end-of-life remains unclear. We aim to describe the impact of HHC on acute healthcare utilization and end-of-life outcomes in PLWD.Methods: Design: A systematic review of quantitative and qualitative studies regarding the association between HHC (exposure) and targeted outcomes. Interventions: HHC provided by health care professionals, including physicians or nurses. Participants: At least 80% of study participants had dementia and lived at home. Measurements: Primary outcome was acute healthcare utilization in the last year of life. Secondary outcomes included palliative care use, advance care planning (ACP), continuity of care in the last year of life, and place of death. We identified contextual information about policy changes in HHC for these outcomes.Results: We included five studies from USA, Japan, and Italy, none of which received a high-quality rating. At micro-level, HHC may be associated with a lower risk of acute healthcare utilization in the early period (e.g., last 90 days before death) and a higher risk in the late period (e.g. last 15 days) of the disease trajectory toward end-of-life in PLWD. ACP with written decisions may be an important mediator of this. HHC increases referrals to palliative care. At meso-level, HHC providers’ difficulty in making treatment decisions for PLWD at the end-of-life may require further training and external support. Coordination between HHC and social care is mentioned but not well examined in the existing literature.Conclusions: The review highlights the dearth of dementia-specific research regarding the impact of HHC on end-of-life outcomes. In PLWD, the core components of HHC for achieving better quality end-of-life, the integration between health and social care, and coordination between primary HHC and palliative care should be further investigated in future studies.
Dosimetric Analysis of Patients Receiving Radiotherapy with VMAT Technique in Localized Prostate Cancer and Its Correlation with Side Effects
Authors: Akay Sıtkı Utku , Çetin İlknur Alsan , Bekiroğlu Gülnaz Nural
Published: August 2021

Aim: It is aimed whether there is a relationship between dosimetric data of localized prostate cancer patients who have been treated with curative radiotherapy and gastrointestinal (GIS), genitourinary (GUS), anal and sexual side effects and whether there is a difference between dosimetric data and clinical findings between risk groups. Method : Eighty-seven patients who received curative radiotherapy for localized prostate cancer between 2014 - 2019 were included in the study. Dosimetrically; whether there was a relationship between V30, V40, V50, V60, V65, V70, V75 for rectum and bladder; D90 for the penile bulb, V72, V74, V76 for the bulbomembranous urethra, V30, V45, V53, Dmax for the anus and V45 (cc) for the intestine data and the side effects was analyzed. It was evaluated whether there was a relationship between testosterone values and sexual side effects. The Kolmogorov-Smirnov test, One Way ANOVA (F-test), and paired-sample T-test were used as statistical methods. For statistical significance, p <0.05 was accepted. Results : The mean age of the patients was 69 (50-86), the mean PSA (ng/dl) before RT was 25.1 (0.9-339), the median RT dose was 76 Gy (74-78 Gy), and the mean follow-up period was 38.2 months. PTVmax, PTVmean, PTVmin, bladder V40, bladder V50, rectum V30, rectum V40, rectum V50 and intestinal V45 (cc) were determined as dosimetric data showing differences between risk groups. A statistically significant relationship was found between rectum V30 (p = 0.017), V60 (p = 0.019), V65 (p = 0.008), V70 (p = 0.007) and V75 (p = 0.034) and chronic GIS side effects. G2 GIS side effects were observed in 4 patients (4.6%) in the entire patient group in the acute period. A statistically significant relationship was found between the patients receiving hormonotherapy (p = 0.021) and testosterone values ​​at the last control (p = <0.001) and chronic sexual side effects. Conclusion: Attention should be paid to the rectum V30, V60, V65, V70, and V75 values to minimize the long-term GIS side effects of patients who have undergone RT. Testosterone level and HT status affect chronic sexual toxicity.
Nobiletin Protects Against Diabetes-induced Testicular Injury via Hypophysis-gonadal Axis Up-regulation and Amelioration of Oxidative Stress
Authors: Salah Marwa , Ismail Khadiga Ahmed , khadrawy sally mostafa
Published: August 2021

Background: Testicular injury is one of the most serious problems of Diabetes mellitus. The present study aims to compare the effect of two different doses of nobiletin and the probable mechanisms against diabetes-induced testicular impairment in rats. Methods and Results: Streptozotocin injection was used to induce diabetes. Diabetic rats received nobiletin (10 mg/kg) or (25 mg/kg) daily and orally for 30 days. Diabetic rats displayed a significant elevation in glucose, glycosylated hemoglobin (HbA1c), homeostasis model of insulin resistance (HOMA-IR), and pro-inflammatory cytokines. Levels of serum insulin, testosterone, luteinizing hormone (LH), and follicle-stimulating hormone (FSH) were significantly reduced. Histological changes with positive caspase-3 and decreased Androgen receptors (AR) immunoexpressions were observed in diabetic rats. Both doses of nobiletin improved hyperglycemia, reduced pro-inflammatory cytokines, and augmented insulin, testosterone, LH, and FSH levels. Gene and protein manifestation of LH and FSH receptors and cytochrome P450 17 α-hydroxylase (CYP17A1) was markedly down-regulated in testicular tissues of diabetic group, an effect which was markedly increased with both doses of nobiletin. In addition, both doses significantly reduced lipid peroxidation, and caspase-3 immuno-expression and improved the activity of the antioxidant enzymes and AR in testicular tissues of diabetic group. Conclusion: Both doses showed protective effects against diabetes-induced testicular injury by diminution of oxidative stress, hyperglycemia, inflammation, caspase-3 and up-regulation of the hypophysis-gonadal axis and androgen receptors. The high dose of nobiletin was more effective than the lower dose.
Increased Number of Corpora Lutea by Creating Additional Corpus Luteum Leads to Enhanced Progesterone Concentrations and Improved Fertility in Bovine Repeat-breeder Females Undergoing the Short-term Fixed-time Artificial Insemination Protocol
Authors: Pirokad Wilasinee , Yadmak Chayanon , Yama Punnawut , Jitjumnong Jakree , Chaikol Warunya , Sangkate Molarat , Promsao Nalinthip , Sudwan Paiwan , Mektrirat Raktham , Panatuk Julakorn , Intawicha Payungsuk , Lumsangkul Chompunut , Tang Pin-Chi , Moonmanee Tossapol
Published: August 2021

Background: Lower concentrations of endogenous progesterone (P) after fertilization, due to corpus luteum (CL) dysfunction, leads to an increased embryonic loss and reduced pregnancy outcomes not only in female cattle but also in women. Therefore, an increase in the number of corpora lutea (CLs) may improve fertility in infertile bovine females. The aim of the current study was to investigate the influence of increased number of CLs by creating accessory CL on plasma P concentration and fertility in bovine repeat-breeder females undergoing the short-term fixed-time artificial insemination (FTAI) protocol.Methods: In experiment 1, 32 female cattle had induced ovulation with the short-term (5-day) P-based protocol. To induce additional CL, cows were treated with gonadotropin releasing hormone (GnRH) on day 5 post-induction. On day 14, only female cattle with at least one CL on their ovaries were classified into two groups: 1CL (original CL; n = 14) and 2CLs groups (original CL + accessory CL; n = 8). In experiment 2, 213 bovine repeat-breeder females were bred using the short-term FTAI protocol. On day 5 post-FTAI, cows were divided into two groups: treatment with (GnRH5-treated group; n = 113) or without (GnRH5-untreated group; n = 100) GnRH. On day 14 post-FTAI, cows were sub-divided into two groups: 1CL (n = 115) and 2CLs (n = 39) groups.Results: In experiment 1, the ovarian luteal diameter, area, and volume per total CLs were greater in 2CLs group compared with 1CL group (P < 0.001). On days 12 and 14 post-induction, female cattle bearing two CLs had greater P concentrations than female cattle bearing only one CL on their ovaries (P < 0.05). In experiment 2, CL number and pregnancy rates were greater in GnRH5-treated group compared with GnRH5-untreated group (P < 0.01). Pregnancy rates were greater in 2CLs cows compared with 1CL cows (P < 0.01). Moreover, female cattle bearing two CLs had a greater likelihood of pregnancy (odds ratio = 20.86) than female cattle bearing only one CL on their ovaries (P = 0.001). Conclusions: In bovine model, our findings confirmed a beneficial effect of an additional CL on ovarian hormone and fertility in infertile female cattle. The results highlighted that increased number of CLs by creating additional CL leads to enhanced peripheral P concentrations and improved pregnancy outcomes in bovine repeat-breeder females undergoing the short-term FTAI protocol.
Factors that impact acceptance of COVID-19 vaccination in different community-dwelling populations in China
Authors: Pan Jinhua , A Kezhong , Liu Zhixi , Zhang Peng , Xu Zhiyin , Guo Xiaoqin , Liu Guangtao , Xu Ao , Wang Jing , Wang Xinyu , Wang Wei-bing
Published: August 2021

Background
It is important to improve vaccination strategies and immunization programs to achieve herd immunity to infectious diseases, particularly in general community-dwelling populations.
Methods
To assess the acceptance of COVID-19 vaccination, we conducted face-to-face surveys and online surveys in Shanghai, Zhejiang, and Qinghai province. A fixed effects model and a random effects model were used to analyze factors associated with acceptance of COVID-19 vaccination.
Findings
The results indicated that 82·6% of participants (77·0% in Shanghai and 87·3% in Zhejiang) were willing to receive vaccination when it was available in the community, and 57·2% of deliverymen, 43·3% of medical workers, 78·2% of parents of primary and secondary school children, and 72·2% of parents of preschool children were willing to receive vaccination. The models showed that participants who were male, 60 to 69 years-old, from rural areas, had less education, had good health status, and had positive attitudes and trust in vaccines approved by National Health Commission were more likely to accept vaccination. Participants also had increased vaccination acceptance if it was recommended by government sources, doctors, relatives, or friends. Most participants learned about COVID-19 vaccination from television, radio, and newspapers, followed by community or hospital campaigns and the internet. Those who did not want to receive vaccination were mainly concerned about safety (288, 59·6%) and efficacy (196, 40·6%).
Conclusions
Government sources and doctors could increase acceptance of vaccination by promoting the efficacy and safety of COVID-19 vaccination by use of mass media and emphasizing the necessity of vaccination for everyone.
Aminopolycarboxylate Chelators Are Effective for Whole-body Clearance of Free 225ac: A Method to Reduce Unexpected Radiation Exposure During Targeted Alpha Therapy
Authors: Yoshimoto Mitsuyoshi , Yoshii Yukie , Matsumoto Hiroki , Shinada Mitsuhiro , Takahashi Masashi , Igarashi Chika , Hihara Fukiko , Tachibana Tomoko , Doi Ayano , Higashi Tatsuya , Fujii Hirofumi , Washiyama Kohshin
Published: August 2021

Purpose: Actinium-225 (225Ac) is a promising radionuclide used in targeted alpha therapy (TAT). Although 225Ac labelling of bifunctional chelating ligands is effective, previous in vivo studies have reported that free 225Ac can be released from the drugs. Notably, such free 225Ac predominantly accumulates in the liver and can cause unexpected toxicity. To accelerate the clinical development of 225Ac TAT, methods for addressing unexpected toxicity are therefore needed. In this study, we evaluated various chelators in vitro and in vivo with regard to reducing and excreting free 225Ac and compared their chemical structures. Methods: Nine candidate chelators (D-penicillamine, dimercaprol, Ca-DTPA, Ca-EDTA, CyDTA, GEDTA TTHA, Ca-TTHA, and DO3A) were tested. In vitro interaction of 225Ac and chelators was investigated. Biodistribution and dosimetry of free 225Ac were examined in mice prior to the in vivo chelating study. For in vivo chelation, nine candidate chelators were administered 1 h after free 225Ac injection, and biodistribution was compared 4 h after 225Ac injection in mice. Two favourable chelators were then investigated intensively for biodistribution 24 h after the 225Ac injection.Results: The liver exhibited pronounced 225Ac uptake corresponding to an estimated human absorbed dose of 4.76 SvRBE5/MBq. Aminopolycarboxylate chelators with five and six carboxylic groups, Ca-DTPA and Ca-TTHA, significantly reduced 225Ac retention in the liver (22% and 30%, respectively). Significant 225Ac reductions were observed in the heart and the remainder of the body with both Ca-DTPA and Ca-TTHA, and in the lung, kidney, and spleen for Ca-TTHA. In vitro interaction analysis supported the in vivo reduction ability of Ca-DTPA and Ca-TTHA.Conclusions. Aminopolycarboxylate chelators with five and six carboxylic groups, Ca-DTPA and Ca-TTHA, were effective for whole-body clearance of free 225Ac, with a significant reduction in the liver. This method could reduce undesirable radiation exposure from free 225Ac during 225Ac TAT.
Incidence of Adverse Drug Reactions in Two Tertiary Hospitals: A Prospective Observational Study
Authors: Khalili Malahat , Sharifi Hamid , Mesgarpour Bita , Dabaghzadeh Fatemeh , Haghdoost Ali Akbar
Published: August 2021

Background: Monitoring and detecting adverse drug reactions (ADRs) in hospitals is crucial to improving drug safety and healthcare delivery quality. Nevertheless, there was not enough information on ADR incidence and its figure in Iran. Aim: this study aimed to determine the incidence of ADRs in hospitalized patients and investigate their characteristics in Iran.Methods: We conducted a three-month prospective study in two tertiary hospitals in 2019. All admitted patients were intensively monitored for all suspected ADRs through daily visiting hospital wards and soliciting information from physicians, nurses and interviewing suspicious patients. We calculated the incidence of ADRs, and 95% confidence intervals (95% CI). Poisson regression was used to evaluate risk factors for ADR incidence. Results: Among 13,613 admitted patients, we detected 115 ADRs in 114 patients. The incidence of ADR was 8.4 per 1000 admissions (95% CI: 7.0-10.1), and 13.9% of them were ADR-related hospital admissions. The risk of ADRs was significantly predicted by age, length of hospital stay, patients’ diagnostics, number of drug usage, and using respiratory system agents and anti-infectives for systemic use. The most common ADRs were skin and subcutaneous manifestations (52.2%), and 62.6% of ADRs were caused by anti-infectives (commonly vancomycin, ceftriaxone, and ciprofloxacin). Conclusion: This study indicated that ADRs occurrence during the hospital stay or resulting in hospital admissions are considerable. Given that ADR occurrence could be associated with increased morbidity, mortality, and economic burden, constant intensive monitoring is required to address the drug safety issue and promote actions to improve patient safety and reduce the health and economic burden.
The Results of Conversion Therapy for Initially Unresectable Gastric Cancer: a Respective Analysis of 191 Patients
Authors: Zhang Shaopeng , Wu Song , Kong Yuan , Li Wei
Published: August 2021

【Objective】

To analyze the clinical efficacy of systemic chemotherapy combined with intraperitoneal hyperthermic perfusion in the treatment of locally invasive stage III gastric cancer and stage IV gastric cancer.

【Methods】

The clinical data of 191 patients with gastric cancer who received systemic chemotherapy combined with intraperitoneal hyperthermic perfusion from June 2010 to December 2018 were retrospectively analyzed.

【Results】

The unresectable factors in 191 patients with gastric cancer included peritoneum metastasis (106), local invasion (67), liver metastasis (25), lung metastasis (3), bone metastasis (4), adnexal metastasis (3) and adrenal metastasis (4). After conversion therapy, 191 patients were divided into finished conversion group and non-finished group. There were significant differences in T stage, M stage and tumor differentiation between the two groups. During the course of chemotherapy, 11 patients had grade 3 or 4 chemotherapy adverse reactions. The median survival was 36 months in the finished conversion group and 14 months in the non-finished group. The median survival of the 69 R0 resected patients was 38 months, which was higher than that of chemotherapy alone (14 months), best supportive care (13 months) and patients who completed chemotherapy without R0 resection (19 months). Univariate Cox survival analysis found that N stage, R0 resection, response to chemotherapy and unresectable factors were prognostic factors. Multivariate Cox survival analysis showed that N-stage, response to chemotherapy and unresectable factors were independent prognostic factors.

【 Conclusion 】 For unresectable gastric cancer patients, surgical treatment after chemotherapy can prolong survival. Radical surgical treatment after conversion therapy and chemotherapy response are important factors related to patient survival. Chemotherapy alone can prolong survival in primary unresectable gastric cancer, but with limited effect.
A case of Brucellosis with Large Periaortic Mass And Secondary Vasculitis In A Patient Presenting Intermittent Abdominal Pain
Authors: Liu Huilan , Zhang Yutong , Leng Xiaomei , Yang Yunjiao , Zeng Xiaofeng
Published: August 2021

Background Brucellosis is still highly prevalent and causes high morbidity. It can involve any organ system and has been implicated in protean complications. Cardiovascular involvement is the main cause of mortality. This case described a female patient infected by Brucella with large periaortic mass and secondary vasculitis whose manifestation was abdominal pain. The aim was to raise the awareness of earlier recognition of Brucella infections without fever and remitting risk by taking appropriate treatments for those with cardiovascular involvement.Case presentation A case was reported regarding a female present intermittent abdominal pain. Two months later, she was admitted to the Department of Rheumatology and Immunology in our hospital due to high inflammatory markers, the large periaortic mass and vasculitis manifestations in aortic computed tomography angiography. By detailed examination, Brucellosis was highly suggestive based on positive blood cultures. Finally, no discomfort has ever occurred, and the mass was prominently reduced after antibiotic therapy of half a year.Conclusions The clinical manifestations of brucellosis are protean. For those without fever and cardiovascular involvement as the main manifestation, especially vasculitis, we must not just set the standard rigidly, instead, it is recommended to carry out the relevant differential diagnosis to avoid misdiagnosis or missed diagnosis.
Exploring Medical Response Preparation Strategies for Terrorist Subway Dirty Bomb Explosion Based on A Simulation System
Authors: Yan Tiecheng , Yang Yuxuan , Yu Min
Published: August 2021

Introduction: London bombings on July 7, 2005 presented serious difficulties for medical response, moreover, if a dirty bomb attack had occurred in an underground train, it would have been more difficulties to cope with. Based on this possibility, it is critical to take strategies on medical response to dirty bomb attacks in underground transport systems into account beforehand. Method: In the Windows 10 operating system, visual studio 2019 environment, we used C ++ language to develop a system that can simulate the process of nuclear or radiological emergency medical rescue based on discrete event simulation, mainly considering the designs of professional rescue groups, staffs’ energy consumption, injured and uninjured persons on site, and competence value of key staffs.Results: In the scenario of a subway dirty bomb terrorist attack causing 2.6 casualties per minute and 208 casualties in total, the manpower needed for the emergency medical response were 5 pre-triage groups, 7 contamination triage groups, 23 decontamination groups, 5 first-aid groups, and 12 comprehensive treatment groups. Besides, 5 first-aid groups and 45 decontamination groups were added to implement on-site rescue. The total number of actual participants in the medical response should be about 337. More than 337 PPE should be prepared.Conclusion: We designed and constructed a simulation system, and used it to explore the medical response preparation strategies for subway terrorist dirty bomb explosion, including preparation of sufficient staffs and equipment, consideration of the rotation needs of the staffs, and perception of real-time situation on site and agile command, especially obtained the prediction method of staff and equipment resources for specific disaster background, which could provide constructive references for the security protection of urban subway systems in the future.
Performance of Sustainable Self-Compacting Fiber Reinforced Concrete with Substitution of Marble Waste (MW) and Coconut fibers (CFs)
Authors: Ahmad jawad , Aslam Fahad
Published: August 2021

Self compacting concrete (SSC) is also brittle nature, resulting in abrupt failure without giving any warning, which is unacceptable for any construction materials. Therefore, SCC requires tensile reinforcement to increase tensile capacity and avoid the undesirable brittle failure of SCC. However, fiber improved tensile capacity more efficiently than compressive strength. Therefore, it important add pozzolanic material to fiber reinforced concrete to obtain high strength, durable and ductile concrete. This research is carried out to evaluate the qualities of concrete with addition of waste marble and coconut fiber in concrete. Marble waste used as binding (pozzolanic) materials in proportion of 5.0 to 30% by weight of cement in increment of 5.0% and concrete is reinforced with coconut fiber in proportion of 0.5% to 3.0% by weight of cement in increment of 0.5 %. Rheological properties were assessed through its passing ability and flowability by using Slump flow, Slump T50, L-Box, and V-funnel tests while mechanical performance were evaluated through compressive, split tensile, flexure and pull out tests. Tests results indicate that marble waste and coconut fiber decrease the passing ability and filling ability of SCC. Furthermore, tests results indicate that marble waste up to 20% and coconut fiber addition 2.0% by weight of cement have a tendency to enhance the mechanical strength of SCC. Finally, Statistical analysis (RSM) was used to optimize the combined substitution of marble waste and coconut fiber to obtain high strength concrete.
Microbial profile in infectious keratitis over 8 years in Sao Paulo, Brazil: pathogens and microbial resistance
Authors: de Oliveira Luiza Manhezi Shin , Tanaka Tatiana , Kato Juliana Mika , Shiotuki Regina Sayuri Yamashiro , Corrêa Karoline de Lemes Giuntini , Gioia Thaís Sabato di , Rossi Flavia , Santo Ruth Miyuki
Published: August 2021

Objective

Infectious keratitis remains a sight-threatening disease and its prompt diagnosis and treatment are critical. This study investigated the microbiological patterns of isolates in corneal ulcers in a tertiary health center in an 8-year period.
Methods

Retrospective analysis of scrapes of microbial keratitis performed from January 2013 to December 2020. Demographics and microbiological data were collected.
Results

A total of 446 scrapes were performed on eyes of 433 patients, 270 male (62.4%), mean age 51.7 years. 304 organisms were isolated from 248 (55.6%) positive samples. Polymicrobial infections occurred in 47 samples (19.0%). Bacterial isolates represented 86.8%: 53.3% gram-positive (GP), 33.5% gram-negative (GN). Cutibacterium acnes (12.2%) and Pseudomonas aeruginosa (9.9%) were the most common bacteria. Fungal keratitis comprised 11.8% of the isolates; Fusarium sp (6.2%) was the main fungus isolated. GP tested were sensitive to vancomycin, 98.7% of the GN were sensitive to ceftazidime. All Pseudomonas aeruginosa were sensitive to gentamicin and ciprofloxacin.
Conclusion

Gram-positive bacteria were predominant in keratitis isolates. In severe bacterial keratitis in our area, vancomycin should be considered as empirical treatment.
­­­Bilateral Reduction of Corneal Sub-basal Nerves in Eyes with Recurrent Unilateral Posner-Schlossman Syndrome: An In Vivo Laser Scanning Confocal Microscopy Study
Authors: Huang Ruiping , Tan Li , Xie Xiaoling , Ng Tsz Kin , Huang Chukai
Published: August 2021

PURPOSE. To evaluate the circumstances of corneal sub-basal nerves (CSNs) in the affected and contralateral unaffected eyes of patients with unilateral Posner-Schlossman Syndrome (PSS) through in vivo laser scanning confocal microscopy (LSCM) analysis. METHODS. Total 74 eyes from 37 unilateral PSS patients and 38 eyes of control subjects were recruited. Sub-basal corneal nerve parameters in the in vivo LSCM, including the number and density of total nerves, main nerve trunks, and nerve branches were evaluated. Corneal epithelial and endothelial cell densities were also calculated.RESULTS. The affected eyes of the patients with unilateral PSS demonstrated a significant decrease in all CSN parameters (P<0.005), including the number and density of total nerves, main nerve trunks and nerve branches, as compared to the control eyes. Lower CSN value was observed in contralateral unaffected eyes for total nerve density as well as the number and density of main nerve trunks (P<0.03) as compared to the control eyes. Moreover, corneal endothelial cell density was significantly reduced in affected eyes with PSS as compared to the control eyes (P<0.015). Yet, significant reduction could only be observed in the affected and contralateral unaffected eyes of the patients with recurrent unilateral PSS. In addition, a positive correlation was found between endothelial cell density and the density of main nerve trunks in PSS-affected eyes (r = 0.33, P<0.05).CONCLUSIONS. In vivo LSCM analysis revealed the reduction of CSNs in the affected and contralateral unaffected eyes of the patients with recurrent unilateral PSS. The positive correlation between corneal endothelial cell density and CSNs could suggest a potential link between corneal innervation and corneal endothelial cells.Retrospectively registered ChiCTR2000037630, August 29, 2020
Decoupling of regional neural activity and inter-regional functional connectivity in Alzheimer’s Disease – a simultaneous PET/MRI study
Authors: Balajoo Somayeh Maleki , Rahmani Farzaneh , Khosrowabadi Reza , Meng Chun , Eickhoff Simon B. , Grimmer Timo , Zarei Mojtaba , Drzezga Alexander , Sorg Christian , Tahmasian Masoud
Published: August 2021

Purpose: Alzheimer’s disease (AD) and mild cognitive impairment (MCI), a syndrome at-risk for AD, are characterized by both aberrant regional neural activity and disrupted inter-regional functional connectivity (FC). It is, however, not clear how aberrant regional neural activity and inter-regional FC interact across MCI and AD. Thus, we investigated the interplay between regional neural activity and inter-regional topological measures of FC in MCI and AD using simultaneous PET/MR measurement.Methods: We scanned 19 patients with MCI, 33 patients with AD, and 26 healthy individuals by simultaneous FDG-PET/resting-state fMRI. First, we assessed regional glucose metabolism identified through FDG-PET (as a proxy of regional neural activity), and inter-regional FC topology through clustering coefficient and degree centrality (as surrogates of local segregation and global connectivity, respectively, based on fMRI blood oxygenation). Next, we examined the potential moderating effect of disease status (MCI or AD) on the link between regional metabolism and inter-regional FC topology using hierarchical moderated multiple regression analysis.Results: Not only regional metabolism and inter-regional FC metrics were disrupted in in MCI and AD patients, but also AD significantly alters coupling between regional metabolism and inter-regional FC, particularly in the right inferior temporal, supplementary motor area and planum temporal areas, where AD moderated the effect of their regional glucose metabolism on predicting their inter-reginal FC. Conclusion: Our findings demonstrated that AD decouples the association between regional neural activity and functional segregation.