bluuebunny/crossref_metadata_2025 huggingface dataset:
In vitro anti‐bacterial activity and network pharmacology analysis of Sanguisorba officinalis L. against Helicobacter pylori infection
Authors: Shen Xue , Zhang Weijia , Peng Chang , Yan Jiahui , Chen Pengting , Jiang Cheng , Yuan Yuemei , Chen Donglian , Zhu Weixing , Yao Meicun
Published: April 2021

Background

Helicobacter pylori (H. pylori) infection has become an international public health problem, and antibiotic-based triple or quadruple therapy is currently the mainstay of treatment. However, the effectiveness of these therapies decreases due to resistance to multiple commonly used antibiotics. Sanguisorba officinalis L. (S. officinalis), a traditional Chinese medicine clinically used for hemostasis and treatment of diarrhea, has various pharmacological activities. In this study, in vitro antimicrobial activity was used for the preliminary evaluation of S. officinalis against H. pylori. And a pharmacology analysis approach was also utilized to elucidate its underlying mechanisms against H. pylori infection.

Methods

Micro-broth dilution method, agar dilution method, checkerboard assay, scanning electron microscopy (SEM), and transmission electron microscopy (TEM) were used for the assessment of anti-bacterial activity. Active ingredients screening, GO analysis, KEGG analysis, construction of PPI network, molecular docking, and RT-qPCR were used to elucidate the underlying pharmacological mechanisms of S. officinalis against H. pylori infection.

Results

The minimum inhibitory concentration (MIC) values of S. officinalis against multiple H. pylori strains including clinically isolated multi-drug resistant (MDR) strains were ranging from 160 to 320 µg/ml. These results showed that S. officinalis had additive interaction with four commonly used antibiotics and could exert antibacterial effect by changing the morphology of bacteria without developing drug resistance. Through network pharmacology analysis, 8 active ingredients in S. officinalis were screened out for subsequent studies. Among 222 putative targets of S. officinalis, 49 targets were identified as potential targets for treatment of H. pylori infection. And these 49 targets were significantly enriched in GO processes such as protein kinase B signaling, protein kinase activity, protein kinase binding, and KEGG pathways such as Pathways in cancer, MicroRNAs in cancer, and TNF signaling pathway. Protein-protein interaction analysis yielded 5 core targets (AKT1, VEGFA, EGFR, SRC, CCND1), which were validated by molecular docking and RT-qPCR.

Conclusions

Overall, this study confirmed the in vitro inhibitory activity of S. officinalis against H. pylori and explored the possible pharmacological mechanisms, laying the foundation for further research and clinical application.
Assessment of tuberous sclerosis-associated neuropsychiatric disorders using the MINI-KID tool: a pediatric case–control study
Authors: Ding Yifeng , Wang Ji , Zhou Hao , Li Taoli , Zhou Shuizhen , Wang Yi
Published: April 2021

Background

The tuberous sclerosis-associated neuropsychiatric disorders (TAND) have not previously been studied in China. We aimed to assess the psychiatric level of individuals with TAND using the Mini International Neuropsychiatric Interview for Children (MINI-KID) in China.

Results

A total of 83.16% of individuals (79/95) had at least one TAND, and 70.53% (67/95) had an intellectual disability. The MINI-KID tool diagnosed 16 neuropsychiatric diseases, the most common of which were attention-deficit/hyperactivity disorder (ADHD) (51.58%, 49/95) and social anxiety disorder (30.53%, 29/95). The number of children with psychiatric diseases in the tuberous sclerosis complex (TSC) group was significantly greater than the number in the typically developing group (P < 0.0001). Notably, 69.47% (66/95) had two or more psychiatric disorders. Pervasive developmental disorder (PDD) was often co-morbid with other psychiatric disorders.

Conclusions

This study used the structured and systematic MINI-KID scale to determine the diagnosis of psychiatric co-morbidities in a relatively large sample, suggesting a higher rate. By comparing the status of individuals with TSC with typically developing children, the results suggests that neuropsychiatric co-morbidities are significantly higher in individuals with TSC. Research has revealed the frequent presence of two, three or more neuropsychiatric diseases in individuals with TSC.
Development of the child’s ego strength scale: an observation-based assessment of the board game behaviors in play therapy in Korea
Authors: Lee Ji Yoen , Lee Young-ae , Yoo Mee Sook
Published: April 2021

Background

The purpose of this study was to develop a scale for assessing children’s ego strength through the observation of children playing board games in a therapeutic setting. Because ego strength is an index of psychosocial health, it is important to assess ego strength in childhood. In particular, children aged 7 to 9 exhibit their ego-strength characteristics in a situation challenged by self-competence due to their latency period. Therapists can identify such ego strength through game behaviors of children aged 7 to 9 in the play therapy setting. Thus, it is needed to develop a scale by selecting game play behaviors that grasp ego-strength.

Method

Data were collected from 127 play therapists and play therapist-supervisors, who observed 468 play therapy sessions and 55 children aged 7–9 who received play therapy in Korea. The scale was created through content validity verification, factor analysis and verification of criterion-related validity.

Results

We generated a Child’s Ego Strength Scale (CESS) consisting of five sub-factors (Coping Strategy, Cognitive Strategy, Ego Restriction, Interpersonal Functioning, Frustration Tolerance) through exploratory factor analysis. The scale met the goodness of fit criteria in a confirmatory factor analysis. The analysis of therapy sessions of children with strong and weak ego strength, as identified by play therapists, showed a significant difference between the two groups in all five sub-variables. There was a significant correlation between the CESS scores and scores of ego strength-related variables of the Rorschach scale, indicating good criterion-related validity.

Conclusion

The CESS appears to be a practical method for the assessment of ego strength in the field of child counseling.
Impact of the COVID-19 pandemic on diagnosis, stage, and initial treatment of breast cancer in the Netherlands: a population-based study
Authors:   the NABON COVID-19 Consortium and the COVID and Cancer-NL Consortium, Eijkelboom Anouk H. , de Munck Linda , Vrancken Peeters Marie-Jeanne T. F. D. , Broeders Mireille J. M. , Strobbe Luc J. A. , Bos Monique E. M. M. , Schmidt Marjanka K. , Guerrero Paez Cristina , Smidt Marjolein L. , Bessems Maud , Verloop Janneke , Linn Sabine , Lobbes Marc B. I. , Honkoop Aafke H. , van den Bongard Desirée H. J. G. , Westenend Pieter J. , Wesseling Jelle , Menke-van der Houven van Oordt C. Willemien , Tjan-Heijnen Vivianne C. G. , Siesling Sabine
Published: April 2021

Background

The onset of the COVID-19 pandemic forced the Dutch national screening program to a halt and increased the burden on health care services, necessitating the introduction of specific breast cancer treatment recommendations from week 12 of 2020. We aimed to investigate the impact of COVID-19 on the diagnosis, stage and initial treatment of breast cancer.

Methods

Women included in the Netherlands Cancer Registry and diagnosed during four periods in weeks 2–17 of 2020 were compared with reference data from 2018/2019 (averaged). Weekly incidence was calculated by age group and tumor stage. The number of women receiving initial treatment within 3 months of diagnosis was calculated by period, initial treatment, age, and stage. Initial treatment, stratified by tumor behavior (ductal carcinoma in situ [DCIS] or invasive), was analyzed by logistic regression and adjusted for age, socioeconomic status, stage, subtype, and region. Factors influencing time to treatment were analyzed by Cox regression.

Results

Incidence declined across all age groups and tumor stages (except stage IV) from 2018/2019 to 2020, particularly for DCIS and stage I disease (p < 0.05). DCIS was less likely to be treated within 3 months (odds ratio [OR]wks2–8: 2.04, ORwks9–11: 2.18). Invasive tumors were less likely to be treated initially by mastectomy with immediate reconstruction (ORwks12–13: 0.52) or by breast conserving surgery (ORwks14–17: 0.75). Chemotherapy was less likely for tumors diagnosed in the beginning of the study period (ORwks9–11: 0.59, ORwks12–13: 0.66), but more likely for those diagnosed at the end (ORwks14–17: 1.31). Primary hormonal treatment was more common (ORwks2–8: 1.23, ORwks9–11: 1.92, ORwks12–13: 3.01). Only women diagnosed in weeks 2–8 of 2020 experienced treatment delays.

Conclusion

The incidence of breast cancer fell in early 2020, and treatment approaches adapted rapidly. Clarification is needed on how this has affected stage migration and outcomes.
The predictive value of urine specific gravity in the diagnosis of vasovagal syncope in children and adolescents
Authors: Liu Ping , Zeng Xingfang , Mei Wanzhen , Wang Yuwen , Zou Runmei , Wang Cheng
Published: April 2021

Background

Vasovagal syncope (VVS) is a kind of common neurally mediated syncope in children and adolescents. Decreased blood volume is one of the pathogenesis of VVS. The diagnosis of VVS is mainly based on head-up tilt test (HUTT), but some complications may easily occur when HUTT induces syncope. To find a simple and safe VVS diagnosis method can improve the VVS diagnosis efficiency.

Aims of the study

This was a prospective study. The study will explore the predictive value of urine specific gravity (USG) in the diagnosis of VVS in children and adolescents.

Patients and methods

Ninety-seven cases (43 males and 54 females, aged 4 to 16 years old, with an average age of 10.91 ± 2.18 years old) hospitalized due to unexplained premonitory syncope or syncope and diagnosed with VVS through HUTT from September 2014 to September 2018 were selected as VVS group. During the same period, 91 cases of children and adolescents, including 45 males and 46 females, aged from 5 to 15 years old, who underwent a healthy examination were matched as a control (control group). USG was measured in both groups.

Results

The USG of VVS group was significantly lower than that of the control group (P < 0.01), and USG of females was lower than that of males in VVS group (P = 0.045). The sensitivity and specificity of USG in predicting VVS were evaluated by ROC curve. The area under the ROC curve was 0.751, standard error was 0.035, and 95% CI (0.683, 0.819) suggested that USG was of moderate predictive value in the diagnosis of VVS. As cut-off value of USG was 1.0185, the sensitivity and specificity and diagnostic coincidence rate of VVS were 74.39, 66.04 and 69.68%, respectively.

Conclusion

There are less USG in children and adolescents with VVS, especially lower USG in females. Therefore, USG has predictive value in the diagnosis of VVS in children and adolescents.
Improvements in cholesterol efflux capacity of HDL and adiponectin contribute to mitigation in cardiovascular disease risk after bariatric surgery in a cohort with morbid obesity
Authors: Thakkar Himani , Vincent Vinnyfred , Shukla Sakshi , Sra Manraj , Kanga Uma , Aggarwal Sandeep , Singh Archna
Published: April 2021

Background

Bariatric surgery can alleviate cardiovascular risk via effects on cardiovascular disease (CVD) risk factors such as diabetes mellitus, hypertension, and dyslipidemia. Our study aimed to assess the cholesterol efflux capacity (CEC) of HDL as a negative risk factor for CVD in individuals with obesity and identify the factors associated with improvement in CEC 3 months following bariatric surgery.

Methods

We recruited 40 control individuals (mean BMI of 22.2 kg/m2) and 56 obese individuals (mean BMI of 45.9 kg/m2). The biochemical parameters, inflammatory status and CEC of HDL was measured for the obese individuals before bariatric surgery and at 3 months after surgery. The CEC was measured using a cell-based cholesterol efflux system of BODIPY-cholesterol-labelled THP-1 macrophages.

Results

A significant reduction in BMI (− 17%, p < 0.001), resolution of insulin sensitivity (HOMA2-IR = − 23.4%, p = 0.002; Adipo IR = − 16%, p = 0.009) and inflammation [log resistin = − 6%, p = 0.07] were observed 3 months post-surgery. CEC significantly improved 3 months after surgery [Pre: 0.91 ± 0.13; Post: 1.02 ± 0.16; p = 0.001] despite a decrease in HDL-C levels. The change in CEC correlated with the change in apo A-I (r = 0.39, p = 0.02) and adiponectin levels (r = 0.35, p = 0.03).

Conclusion

The results suggest that improvements in CEC, through improvement in adipose tissue health in terms of adipokine secretion and insulin sensitivity could be an important pathway in modulating obesity-related CVD risk.
Global analysis of HBV-mediated host proteome and ubiquitylome change in HepG2.2.15 human hepatoblastoma cell line
Authors: Yuan Sen , Tanzeel Yousaf , Tian Xuezhang , Zheng Dandan , Wajeeha Naz , Xu Jiaqi , Ke Yujia , Zhang Zuopeng , Peng Xiaojun , Lu Long , Sun Guihong , Guo Deyin , Wang Min
Published: April 2021

Hepatitis B virus (HBV) infection remains a major health issue worldwide and the leading cause of cirrhosis and hepatocellular carcinoma (HCC). It has been reported previously that HBV invasion can extensively alter transcriptome, the proteome of exosomes and host cell lipid rafts. The impact of HBV on host proteins through regulating their global post-translational modifications (PTMs), however, is not well studied. Viruses have been reported to exploit cellular processes by enhancing or inhibiting the ubiquitination of specific substrates. Nevertheless, host cell physiology in terms of global proteome and ubiquitylome has not been addressed yet. Here by using HBV-integrated HepG2.2.15 model cell line we first report that HBV significantly modify the host global ubiquitylome. As currently the most widely used HBV cell culture model, HepG2.2.15 can be cultivated for multiple generations for protein labeling, and can replicate HBV, express HBV proteins and secrete complete HBV Dane particles, which makes it a suitable cell line for ubiquitylome analysis to study HBV replication, hepatocyte immune response and HBV-related HCC progression. Our previous experimental results showed that the total ubiquitination level of HepG2.2.15 cell line was significantly higher than that of the corresponding parental HepG2 cell line. By performing a Ubiscan quantification analysis based on stable isotope labeling of amino acids in cell culture (SILAC) of HepG2.2.15 and HepG2 cell lines, we identified a total of 7188 proteins and the protein levels of nearly 19% of them were changed over 2-folds. We further identified 3798 ubiquitinated Lys sites in 1476 host proteins with altered ubiquitination in response to HBV. Our results also showed that the global proteome and ubiquitylome were negatively correlated, indicating that ubiquitination might be involved in the degradation of host proteins upon HBV integration. We first demonstrated the ubiquitination change of VAMP3, VAMP8, DNAJB6, RAB8A, LYN, VDAC2, OTULIN, SLC1A4, SLC1A5, HGS and TOLLIP. In addition, we described 5 novel host factors SLC1A4, SLC1A5, EIF4A1, TOLLIP and BRCC36 that efficiently reduced the amounts of secreted HBsAg and HBeAg. Overall, the HBV-mediated host proteome and ubiquitylome change we reported will provide a valuable resource for further investigation of HBV pathogenesis and host-virus interaction networks.
A collocation method based on cubic trigonometric B-splines for the numerical simulation of the time-fractional diffusion equation
Authors: Yaseen Muhammad , Abbas Muhammad , Riaz Muhammad Bilal
Published: April 2021

Fractional differential equations sufficiently depict the nature in view of the symmetry properties, which portray physical and biological models. In this paper, we present a proficient collocation method based on cubic trigonometric B-Splines (CuTBSs) for time-fractional diffusion equations (TFDEs). The methodology involves discretization of the Caputo time-fractional derivatives using the typical finite difference scheme with space derivatives approximated using CuTBSs. A stability analysis is performed to establish that the errors do not magnify. A convergence analysis is also performed The numerical solution is obtained as a piecewise sufficiently smooth continuous curve, so that the solution can be approximated at any point in the given domain. Numerical tests are efficiently performed to ensure the correctness and viability of the scheme, and the results contrast with those of some current numerical procedures. The comparison uncovers that the proposed scheme is very precise and successful.
Global exponential stability of Clifford-valued neural networks with time-varying delays and impulsive effects
Authors: Rajchakit G. , Sriraman R. , Boonsatit N. , Hammachukiattikul P. , Lim C. P. , Agarwal P.
Published: April 2021

In this study, we investigate the global exponential stability of Clifford-valued neural network (NN) models with impulsive effects and time-varying delays. By taking impulsive effects into consideration, we firstly establish a Clifford-valued NN model with time-varying delays. The considered model encompasses real-valued, complex-valued, and quaternion-valued NNs as special cases. In order to avoid the issue of non-commutativity of the multiplication of Clifford numbers, we divide the originaln-dimensional Clifford-valued model into$2^{m}n$2mn-dimensional real-valued models. Then we adopt the Lyapunov–Krasovskii functional and linear matrix inequality techniques to formulate new sufficient conditions pertaining to the global exponential stability of the considered NN model. Through numerical simulation, we show the applicability of the results, along with the associated analysis and discussion.
Changes in brain and behavior during food-based decision-making following treatment of anorexia nervosa
Authors: Foerde Karin , Walsh B. Timothy , Dalack Maya , Daw Nathaniel , Shohamy Daphna , Steinglass Joanna E.
Published: April 2021

Background

Anorexia nervosa is a severe illness with a high mortality rate, driven in large part by severe and persistent restriction of food intake. A critical challenge is to identify brain mechanisms associated with maladaptive eating behavior and whether they change with treatment. This study tested whether food choice-related caudate activation in anorexia nervosa changes with treatment.

Methods

Healthy women (n = 29) and women hospitalized with anorexia nervosa (n = 24), ages 18 to 40 years, completed a Food Choice Task during fMRI scanning at two timepoints. Among patients, procedures occurred upon hospital admission (Time 1) and again after patients had gained to normal weight (Time 2). Healthy controls were tested twice at an interval group-matched to patients. Choice-related caudate activation was assessed at each timepoint, using parametric analyses in an a priori region of interest.

Results

Among patients, the proportion of high-fat foods selected did not change over time (p’s > 0.47), but decreased neural activity in the caudate after treatment was associated with increased selection of high-fat foods (r23 = − 0.43,p = 0.037). Choice-related caudate activation differed among women with anorexia nervosa vs healthy control women at Time 1 (healthy control:M = 0.15 ± 0.87, anorexia nervosa:M = 0.70 ± 1.1, t51 = − 2.05,p = 0.045), but not at Time 2 (healthy control:M = 0.18 ± 1.0, anorexia nervosa:M = 0.37 ± 0.99, t51 = − 0.694,p = 0.49).

Conclusions

Caudate activity was more strongly associated with decisions about food among individuals with anorexia nervosa relative to healthy comparison individuals prior to treatment, and decreases in caudate engagement among individuals with anorexia nervosa undergoing treatment were associated with increases in high-fat food choices. The findings underscore the need for treatment development that more successfully alters both eating behavior and the neural mechanisms that guide it.
Specific dietary practices in female athletes and their association with positive screening for disordered eating
Authors: de Borja Celina , Holtzman Bryan , McCall Lauren M. , Carson Traci L. , Moretti Laura J. , Farnsworth Nicole , Ackerman Kathryn E.
Published: April 2021

Background

To determine if following specific diets was associated with reporting behaviors that are consistent with disordered eating compared to non-diet-adherent athletes. We hypothesized that athletes adhering to specific diets were more likely to report disordered eating than those not following a diet.

Methods

One thousand female athletes (15–30 years) completed a comprehensive survey about athletic health and wellness. Athletes were asked to specify their diet and completed 3 eating disorder screening tools: the Brief Eating Disorder in Athletes Questionnaire, the Eating Disorder Screen for Primary Care, and self-reported current or past history of eating disorder or disordered eating. Descriptive statistics were calculated for all study measures and chi-squared tests assessed relationships between athletes’ dietary practices and their responses to eating disorder screening tools. Statistical significance was defined as p < 0.05.

Results

Two hundred thirty-four of 1000 female athletes reported adherence to specific diets. 69 of the 234 diet-adhering athletes (29.5%) were excluded due to medically-indicated dietary practices or vague dietary descriptions. Of the 165 diet-adherent athletes, 113 (68.5%) screened positively to ≥1 of the 3 eating disorder screening tools. Specifically, athletes practicing a low-carbohydrate diet were more likely to report disordered eating vs. athletes without dietary restrictions (80% vs. 41.8%; p < 0.0001).

Conclusion

Specific diet adherence in female athletes may be associated with reporting behaviors that are consistent with disordered eating. Health practitioners should consider further questioning of athletes reporting specific diet adherence in order to enhance nutritional knowledge and help treat and prevent eating disorders or disordered eating.
A computed tomography cadaveric study of the radiological anatomy of the patella: the size of the patella correlates with bone bridge between tunnels and R angles are introduced for safe tunnel drilling during MPFL reconstruction
Authors: Raoulis Vasileios , Tsifountoudis Ioannis , Fyllos Apostolos , Hantes Michael , Malahias Michael-Alexander , Karantanas Apostolos , Zibis Aristeidis
Published: April 2021

Purpose

To measure the safe range of angles during tunnel drilling and map ideal patella tunnel placement with the use of preoperative computed tomography (CT) scan and compare results after medial patellofemoral ligament (MPFL) reconstruction using a hardware-free patellar fixation technique with two semi-patellar tunnels between a) a free-hand technique, and b) its modification with the use of an anterior cruciate ligament (ACL) tibia aiming device.

Methods

CT scan was performed on 30 fresh-frozen cadaveric knees a) prior to any intervention and b) after MPFL reconstruction. For MPFL reconstruction, specimens were randomly allocated to 1) Group A, which consisted of knees operated with free-hand, hardware-free patellar fixation technique with two semi-patellar tunnels and 2) Group B, which consisted of knees operated on with a technique modification with the ACL tibia device.

Patellar measurements

L1 was the maximal patellar length. L2 was the minimum possible distance of placement for the upper tunnel from the proximal pole of the patella. The maximum bone bridge between tunnels was calculated as half of L1 minus the L2 distance (L1/2-L2). We also measured R1 and R2 angles at the proximal and distal tunnel that represent safe angles at the entry point during tunnel drilling (without breaching the anterior cortex or articular cartilage).

Results

Preoperatively, mean L1 was 3.45 cm (range 3.05–4.52). Mean L2 was 0.62 cm (range 0.49–0.89). The mean maximum possible bone bridge between tunnels (L1/2-L2) was 1.1 cm (range 0.77–1.58).

R1 was 6.050(range 4.78–7.44), R2 was 6.640(range 4.57–9.03), and their difference reached statistical significance (p = 0.03). Postoperatively, in group A, in 4 out of 15 patellas, multiple attempts were made during tunnel drilling in order to avoid anterior cortex or cartilage breaching. In group B, all tunnels were correctly drilled with the first attempt. Bone bridge between tunnels was significantly shorter postoperatively (0.93 cm,p < 0.01).

Conclusion

Small-size patellae correlate with short maximum bone bridge between tunnels, which makes anatomic, double-bundle, hardware-free patella fixation, with two semi-patellar tunnels MPFL reconstruction challenging. Furthermore, R angles create a narrow window to avoid intraoperative breaching, rendering the use of the ACL tibia device an extremely useful instrument.

Level of evidence

II
Spurious electroencephalographic activity due to pulsation artifact in the depth of anesthesia monitor
Authors: Kamata Kotoe , Lipping Tarmo , Yli-Hankala Arvi , Jäntti Ville , Yamauchi Masanori
Published: April 2021

Background

The depth of anesthesia (DOA) is estimated based on the anesthesia-induced electroencephalogram (EEG) changes. However, the surgical environment, as well as the patient him/herself, generates electrical interferences that cause EEG waveform distortion.

Case presentation

A 52-year-old patient required general anesthesia due to the right femur necrotizing fasciitis. He had no history of epilepsy or head injury. His cardiovascular status was stable without arrhythmia under propofol and remifentanil anesthesia. The DOA was evaluated with Root® with SedLine® Brain Function Monitoring (Masimo Inc, Irvine, CA). The EEG showed a rhythmic, heart rate time-locked pulsation artifact, which diminished after electrode repositioning. Offline analysis revealed that the pulse wave-like interference in EEG was observed at the heart rate frequency.

Conclusions

We experienced an anesthesia case that involves a pulsation artifact generated by the superficial temporal artery contaminating the EEG signal. Numerous clinical conditions, including pulsation artifact, disturb anesthesia EEG.
DNA metabarcoding of forensic mycological samples
Authors: Giampaoli Saverio , De Vittori Elisabetta , Barni Filippo , Anselmo Anna , Rinaldi Teresa , Baldi Marina , Miranda Kevin Charles , Liao Arnold , Brami Daniel , Frajese Giovanni Vanni , Berti Andrea
Published: April 2021

Background

DNA metabarcoding and massive parallel sequencing are valuable molecular tools for the characterization of environmental samples. In forensic sciences, the analysis of the sample’s fungal population can be highly informative for the estimation of post-mortem interval, the ascertainment of deposition time, the identification of the cause of death, or the location of buried corpses. Unfortunately, metabarcoding data analysis often requires strong bioinformatic capabilities that are not widely available in forensic laboratories.

Results

The present paper describes the adoption of a user-friendly cloud-based application for the identification of fungi in typical forensic samples. The samples have also been analyzed through the QIIME pipeline, obtaining a relevant data concordance on top genus classification results (88%).

Conclusions

The availability of a user-friendly application that can be run without command line activities will increase the popularity of metabarcoding fungal analysis in forensic samples.
Management and endovascular therapy of ureteroarterial fistulas: experience from a single center and review of the literature
Authors: Simon Bjoern , Neubauer Jakob , Schoenthaler Martin , Hein Simon , Bamberg Fabian , Maruschke Lars
Published: April 2021

Background

Ureteroarterial fistula (UAF) is a rare but potentially life threatening disease. The aim of this study was to evaluate the outcome of endovascular therapy for UAF treatment.

Methods

This retrospective case series evaluates a single center experience of percutaneous stent graft (SG) angioplasty and/or coil embolization for UAF. Patient follow-up included technical and early clinical success, complications and revisional procedures. We also conducted a systematic review of the literature reporting on endovascular UAF management.

Results

We identified 17 UAF in 16 patients (12 male, 4 female, mean age 69.8 ± 11.3 years) who underwent endovascular UAF therapy at our tertiary hospital. All patients presented with hematuria. 5/17 (29.4%) presented with flank pain, in 7 (41.2%) cases patients were in hypovolemic shock. Risk factors of UAF included chronic indwelling ureteral stents in all fistulas, major pelvic surgery in 13 cases (76.5%). In 6 cases (35.3%) SG were placed from the common iliac artery (CIA) to the external iliac artery (EIA) following coil embolization of the proximal internal iliac artery (IIA). SG placement without previous coil embolization was performed in 10 fistulas (58.8%). In one case only coil embolization of the IIA was performed. Mean follow-up was 654 (range: 1–3269) days. All procedures were technically successful and no procedure related deaths occurred during follow-up. During the initial hospital stay hematuria disappeared in 14/17 cases (82.4%). Overall, four patients suffered recurrent hematuria, which in three cases resolved after a secondary intervention. One recurrent UAF related death occurred during follow-up 229 days after initial treatment.

A total of 152 UAF cases were additionally analyzed from our systematic literature review: SG placement with or without embolization was performed in 140 cases (92.1%) while embolization alone was done in 12 cases (7.9%). Complications included UAF recurrence (18/152, 11.8%), SG thrombosis (7/140, 5%), and SG infections (5/140, 3.6%) with an overall complications rate of 13.8%. Five patients died due to UAF (3.3%).

Conclusion

Endovascular therapy offers high technical success rates and rapid bleeding control of UAF. Severe complications like SG occlusions or SG infections are rare but significant. Antibiotic treatment and single anti-platelet therapy improve SG durability as well as close and long follow-up to timely perform repeated endovascular or surgical treatment if necessary.

Evidence-based medicine

Level 4, case series.
Morphology and histology of the olfactory organ of two African lungfishes, Protopterus amphibius and P. dolloi (Lepidosirenidae, Dipnoi)
Authors: Kim Hyun Tae , Park Jong Young
Published: April 2021

The olfactory organs of two African lungfishes,Protopterus amphibiusandP. dolloi, were investigated using a stereo microscope and a compound light microscope and were described anatomically, histologically, and histochemically. Like other lungfishes, these species present the following general features: i) elongated olfactory chamber (OC), ii) anterior nostril at the ventral tip of the upper lip, iii) posterior nostril on the palate of the oral cavity, iv) lamellae with multiple cell types such as olfactory receptor neurons, supporting cells, basal cells, lymphatic cells, and mucous cells (MC), and vi) vomero-like epithelial crypt (VEC) made of glandular epithelium (GE) and crypt sensory epithelium. Some of these features exhibit differences between species: MCs are abundant in both the lamellar and inner walls of the OC inP. amphibiusbut occur only in lamellae inP. dolloi. On the other hand, some between feature differences are consistent across species: the GE of bothP. amphibiusandP. dolloiis strongly positive for Alcian blue (pH 2.5)-periodic acid Schiff (deep violet coloration), and positive with hematoxylin and eosin and with Masson’s trichrome (reddish-brown staining), unlike the MCs of the two species which stain dark red with both Alcian blue (pH 2.5)-periodic acid Schiff and Masson’s trichrome but respond faintly to hematoxylin and eosin. The differing abundance of MCs in the two lungfishes might reflect different degrees in aerial exposure of the olfactory organ, while the neutral and acid mucopolysaccharide-containing VEC, as indicated by staining properties of the MCs, is evolutionary evidence thatP. amphibiusandP. dolloiare the closest living relatives to tetrapods, at least in the order Dipnoi.
Detection of activating mutations in liquid biopsy of Egyptian breast cancer patients using targeted next-generation sequencing: a pilot study
Authors: Kassem Neemat , Kassem Hebatallah , Kassem Loay , Hassan Mohamed
Published: April 2021

Background

Breast cancer (BC) is the 2ndmost prevalent malignancy worldwide and is the most prevalent cancer among Egyptian women. The number of newly described cancer-associated genes has grown exponentially since the emergence of next-generation sequencing (NGS) technology. We aim to identify activating mutations in liquid biopsy of Egyptian breast cancer patients using targeted NGS technology. We also demonstrate the microsatellite instability (MSI) status using BAT25, BAT26, and NR27 markers which are tested on the Bioanalyzer 2100 system.

Results

Twenty-one variants were detected in 15 genes: 7 Substitution-Missense, 12 Substitution-coding silent, and 2 Substitution-intronic. Regarding ClinVar database, out of 21 variants there were 14 benign variants, 3 variants with conflicting interpretations of pathogenicity, 3 variants not reported, and 1 drug response variant.TP53p.(Pro72Arg) missense mutations were found in 75% of patients.PIK3CAp.(Ile391Met),KDRp.(Gln472His) missense mutations were detected in 25% of patients each. Two patients revealed APC gene missense mutation with p.(Ile1307Lys) and p.(Glu1317Gln) variants. Only one patient showedATMp.(Phe858Leu) gene mutation and one showed FGFR3 p.(Ala719Thr) variant. Regarding microsatellite instability (MSI) status, 2/8 (25%) patients were MSS, 3/8 (37.5%) patients were MSI-L, and 3/8 (37.5%) patients were MSI-HI.

Conclusion

It is essential to use and validate minimally invasive liquid biopsy for activating mutations detection by next-generation sequencing especially in patients with inoperable disease or bone metastasis. This work should be extended with larger patient series with comparison of genetic mutations in liquid-based versus tissue-based biopsy and longer follow up period.
In vitro investigation of antioxidant and antihemolytic activities of three Lamiaceae species from Morocco
Authors: Hmidani Abdelbassat , Bouhlali Eimad dine Tariq , Ajebli Mohammed , Khouya Tarik , Benlyas Mohamed , Alem Chakib
Published: April 2021

Background

Lkhzama (Lavandula officinalis), Mard-doch (Origanum majorana), and Lahbak (Ocimum basilicum) are aromatic and medicinal plants widely used in Moroccan folk medicine as a treatment for numerous diseases including liver diseases, rheumatism, and diabetes. This study was undertaken to examine the antioxidant and antihemolytic activities of the aqueous extracts of these plants. The antioxidant activity was evaluated using three in vitro tests: DPPH (2,2-diphenyl-1-picryl-hydrazyl-hydrate) radical scavenging activity, FRAP (ferric reducing antioxidant power assay), and ABTS (2,2′-azino-bis (3-ethylbenzothiazoline-6-sulfonic acid) radical scavenging assay. The antihemolytic activity of plant extracts was evaluated against AAPH (2,2′-azobis(2-amidino-propane) dihydrochloride)-induced erythrocyte hemolysis.

Results

Our findings showed that all plant extracts displayed significant antioxidant and antihemolytic effects. In fact, among the studied plant extracts, the highest antioxidant power was recorded in Origanum majorana, based on DPPH (IC50 = 12.29 μg/mL), ABTS (226.13 μmol TE/g DW), and FRAP (477.82 μmol TE/g DW) assays. Moreover, the same plant also showed the best membrane protective effect (269.55%). Whereas, Ocimum basilicum exhibited the lowest antioxidant activity using DPPH (IC50 = 42.85 μg/mL), ABTS (IC50 = 226.13 μmol TE/g DW), and FRAP (IC50 = 172.84 μmol TE/g DW) and, thus, the lowest membrane protective effect (182.70%).

Conclusion

This result supports the use of these plants in folk medicine for preventing and treating many diseases, especially those related to oxidative stress.
Correlation between nocturnal oxygen desaturation and glycemic control in diabetic patients with obstructive sleep apnea
Authors: Shoukri Amr Mounir
Published: April 2021

Background

Nocturnal hypoxia occurring in obstructive sleep apnea (OSA) is associated with different metabolic disturbances. The present study aims to correlate between nocturnal oxygen desaturation and levels of glycemic control in patients with type 2 diabetes mellitus (T2DM) and undiagnosed OSA.

Results

The present study included 107 patients with T2DM referred for assessment of sleep-related breathing disorder, there were 62 males (57.94%) and 45 females (42.05%), and their age ranged from 42 to 72 years with an average age of 61.29 ± 6.68 years. The patients were divided into 2 groups according to the results of overnight pulse oximetry (OPO) and apnea-hypopnea index (AHI) detected by polysomnography. Group 1 included 68 patients, they had moderate to severe OSA and significant nocturnal desaturation, and group 2 included 39 patients with no or mild OSA. The baseline characteristics of the two groups were not significantly different. Group 1 patients showed significantly higher mean Epworth score and more symptoms related to OSA. There was statistically significant difference between the values of ODI (24.88 ± 9.21 versus 8.94 ± 2.38), AHI (27.10 ± 7.68 versus 9.02 ± 3.90), and hemoglobin A1c levels (8.04 ± 0.64 versus 6.79 ± 0.38) between the two groups. A positive correlation was found between nocturnal oxygen desaturation and levels of HbA1c in group 1 patients reflecting worse glycemic control in patients with moderate to severe OSA.

Conclusion

Nocturnal oxygen desaturation occurring in obstructive sleep apnea is associated with poor glycemic control in patients with type 2 diabetes mellitus.

Trial registration

ClinicalTrials.gov, Protocol ID: OPO10-18. Trial registry number: NCT04711083. Date of registration: 14 January 2021, retrospectively registered.
True amplitude depth migration using curvelets
Authors: Sanavi Hamideh , Moghaddam Peyman P. , Herrmann Felix J.
Published: April 2021

We have developed a true amplitude solution to the seismic imaging problem. We derive a diagonal scaling approach for the normal operator approximation in the curvelet domain. This is based on the theorem that states that curvelets remain approximately invariant under the action of the normal operator. We use curvelets as essential tools for approximation and inversion. We also exploit the theorem that states that the curvelet-domain approximation should be smooth in phase space by enforcing the smoothness of curvelet coefficients in the angle and space domains. We analyze our method using a reverse time migration-demigration code, simulating the acoustic wave equation on different synthetic models. Our method produces a good resolution with reflecting dips, reproduces the true amplitude reflectors, and compensates for incomplete illumination in seismic images.
Geohazard characterization using remote sensing to model flash floods of the southeast Sinai, Egypt
Authors: Obiegbu Okechukwu Livinus
Published: April 2021

Flash floods have led to disruptions of human activities and the destruction of properties particularly in the Nuweiba region of southeast Sinai. Despite the arid nature of Sinai, flash floods still pose a great hazard to the region. Using remote sensing characterization, geohazard models were developed to identify flash flood areas; delineate and discriminate morphological features, active channels areas, and soil physiography with a view to categorize risk areas exposed to flash floods hazards in a hazard map; and proffer measures for mitigation. The characterization was achieved using a workflow model developed from spatial data sets of the Shuttle Radar Topography Mission (SRTM) digital elevation model (DEM) and the red-green-blue (RGB) composites from Landsat bands 7 Enhanced Thematic Mapper (ETM+). The data were used to investigate and assess flash flood areas for morphological attributes, watershed basin characterization, and generation of false color composite from the Landsat 7 ETM+ 7, 4, and 2 RGB bands, and the principal component analysis band from a composite of 742 RGB. Multivariate analysis of generated raster layer attributes provided enhancements and attribute discrimination for delineating areas of active flood channels, upslope zones, and soil physiography discrimination from their spectral reflectance. The results are presented in an integrated approach of remote sensing with geographic information systems (GIS) and indicate that the soil types and geologic units contribute greatly toward activation of these flash floods, which is triggered by intense rainstorms. Components of the generated map attributes of SRTM DEM, gradient of DEM, and Landsat 7 ETM+ composite of 742 bands in GIS were used to generate a hazard map using spatial analysis to depict the nature and scale of the issues identified. Due to the flash flood vulnerabilities, the study area was classified into stable/low-, moderate-, and high-risk areas. Mitigation measures to control flash floods were proposed to enable adequate preparations to mitigate impending flash flood disasters.
Utility of 18F-AlF-NOTA-Octreotide PET/CT in the Localization of Tumor-Induced Osteomalacia
Authors: Long Tingting , Hou Jiale , Yang Nengan , Zhou Ming , Li Yulai , Li Jian , Tang Yongxiang , Chen Dengming , Hu Shuo
Published: April 2021

Context

Tumor-induced osteomalacia (TIO) is a paraneoplastic disorder, usually caused by benign mesenchymal tumors that produce high levels of fibroblast growth factor 23. The only curative therapy is resection of the causative tumors.

Objective

This research was conducted to evaluate the efficacy of 18F-AlF-NOTA-octreotide (18F-OC) positron emission tomography/computed tomography (PET/CT) in detecting TIO and its impact on patient management.

Methods

Retrospective analysis was conducted of 17 patients with hypophosphatemic osteomalacia suspected to be TIO. A  18F-OC PET/CT study was performed in all 17 patients to localize the tumor and 68Ga-DOTATATE PET/CT was performed in 4 out of 17 patients; both studies were performed within 1 week of each other. Both studies were interpreted blindly without the knowledge of other imaging findings. The image findings were compared with the results of histopathological examinations and clinical follow-ups.

Results

The 18F-OC PET/CT scans were positive in 14 patients. Furthermore, 4 of 14 patients were scanned with both 18F-OC and 68Ga-DOTATATE PET/CT. Both studies were able to localize the tumor in all 4 patients. In total, 14 patients had surgery to remove the lesions. Postsurgical pathological examination confirmed causative tumors in these patients, whose symptoms diminished promptly. Serum phosphate levels normalized, confirming the diagnosis of TIO. 18F-OC PET/CT sensitivity, specificity, and accuracy were 87.5%, 100%, and 88.2% respectively. 18F-OC PET/CT findings affected patient management in 88.2% of cases.

Conclusion

18F-OC PET/CT scan is useful in the detection of tumors causing TIO. Further studies with larger patient populations are needed to validate the result.
Practical Considerations for Initiating and Utilizing Flash Continuous Glucose Monitoring in Clinical Practice
Authors: Wysham Carol H , Kruger Davida F
Published: April 2021

Use of continuous glucose monitoring (CGM) has been shown to improve clinical outcomes in patients with type 1 diabetes (T1D) and type 2 diabetes (T2D), including improved glycemic control, better treatment adherence, and an increased understanding of their treatment regimens. Retrospective analysis of CGM data allows clinicians and patients to identify glycemic patterns that support and facilitate informed therapy adjustments. There are currently 2 types of CGM systems: real-time CGM (rtCGM) and flash CGM. The FreeStyle Libre 2 (FSL2) is the newest flash CGM system commercially available. Because the FSL2 system was only recently cleared for use in the US, many endocrinologists and diabetes specialists may be unfamiliar with the strengths, limitations, and potential of the FSL2 system. This article focuses on practical approaches and strategies for initiating and using flash CGM in endocrinology and diabetes specialty practices.
The Neural Circuits Underlying General Anesthesia and Sleep
Authors: Moody Olivia A. , Zhang Edlyn R. , Vincent Kathleen F. , Kato Risako , Melonakos Eric D. , Nehs Christa J. , Solt Ken
Published: April 2021

General anesthesia is characterized by loss of consciousness, amnesia, analgesia, and immobility. Important molecular targets of general anesthetics have been identified, but the neural circuits underlying the discrete end points of general anesthesia remain incompletely understood. General anesthesia and natural sleep share the common feature of reversible unconsciousness, and recent developments in neuroscience have enabled elegant studies that investigate the brain nuclei and neural circuits underlying this important end point. A common approach to measure cortical activity across the brain is electroencephalogram (EEG), which can reflect local neuronal activity as well as connectivity among brain regions. The EEG oscillations observed during general anesthesia depend greatly on the anesthetic agent as well as dosing, and only some resemble those observed during sleep. For example, the EEG oscillations during dexmedetomidine sedation are similar to those of stage 2 nonrapid eye movement (NREM) sleep, but high doses of propofol and ether anesthetics produce burst suppression, a pattern that is never observed during natural sleep. Sleep is primarily driven by withdrawal of subcortical excitation to the cortex, but anesthetics can directly act at both subcortical and cortical targets. While some anesthetics appear to activate specific sleep-active regions to induce unconsciousness, not all sleep-active regions play a significant role in anesthesia. Anesthetics also inhibit cortical neurons, and it is likely that each class of anesthetic drugs produces a distinct combination of subcortical and cortical effects that lead to unconsciousness. Conversely, arousal circuits that promote wakefulness are involved in anesthetic emergence and activating them can induce emergence and accelerate recovery of consciousness. Modern neuroscience techniques that enable the manipulation of specific neural circuits have led to new insights into the neural circuitry underlying general anesthesia and sleep. In the coming years, we will continue to better understand the mechanisms that generate these distinct states of reversible unconsciousness.
Pharmacologically Induced Ventilatory Depression in the Postoperative Patient: A Sleep-Wake State-Dependent Perspective
Authors: Doufas Anthony G. , Weingarten Toby N.
Published: April 2021

Pharmacologically induced ventilatory depression (PIVD) is a common postoperative complication with a spectrum of severity ranging from mild hypoventilation to severe ventilatory depression, potentially leading to anoxic brain injury and death. Recent studies, using continuous monitoring technologies, have revealed alarming rates of previously undetected severe episodes of postoperative ventilatory depression, rendering the recognition of such episodes by the standard intermittent assessment practice, quite problematic. This imprecise description of the epidemiologic landscape of PIVD has thus stymied efforts to understand better its pathophysiology and quantify relevant risk factors for this postoperative complication. The residual effects of various perianesthetic agents on ventilatory control, as well as the multiple interactions of these drugs with patient-related factors and phenotypes, make postoperative recovery of ventilation after surgery and anesthesia a highly complex physiological event. The sleep-wake, state-dependent variation in the control of ventilation seems to play a central role in the mechanisms potentially enhancing the risk for PIVD. Herein, we discuss emerging evidence regarding the epidemiology, risk factors, and potential mechanisms of PIVD.