bluuebunny/crossref_metadata_2025 huggingface dataset:
The association of alcohol with circulating total fibrinogen and plasma clot density is mediated by fibrinogen and FXIII genotypes
Authors: Rautenbach Petro Hannie , Nienaber-Rousseau Cornelie , Pieters Marlien
Published: September 2020

Background Alcohol consumption is associated with haemostasis and so may influence cardiovascular conditions. It is unknown whether the association of alcohol with total and γ’ fibrinogen concentrations, as well as clot structure, are modulated by fibrinogen and factor (F)XIII single nucleotide polymorphisms (SNPs). Methods Total fibrinogen, γ’ fibrinogen and clot properties of 2010 healthy black South Africans were measured in relation to alcohol intake as well as its markers – gamma-glutamyltransferase (GGT), percentage carbohydrate deficient transferrin (%CDT), aspartate aminotransferase (AST), and alanine aminotransferase (ALT). Fourteen fibrinogen and two SNPs in the FXIII gene were genotyped to determine their influence. Results Alcohol intake and its markers correlated negatively with fibrinogen and clot lysis time (CLT) as well as with most of the clot properties. Percentage γ’ fibrinogen correlated positively with AST and negatively with alcohol intake. We then stratified for alcohol intake and found inverse associations between γ’ fibrinogen and both %CDT and GGT–CDT in consumers, but the positive association with AST remained only in abstainers. Alcohol intake and its markers modulated the influence of fibrinogen SNPs on total fibrinogen concentrations and the fibrinogen SNPs as well as an FXIII SNP on clot density (all p <0.004). Conclusion/s We show for the first time that some individuals harbour certain genotypes that, in combination with alcohol consumption, might predispose or protect them from haemostatic factors that might lead to the development of cardiovascular disease. Studies are needed to clarify the mechanisms related to the interplay between alcohol and gene variants observed here.
“Double hit” B-lymphoblastic lymphoma with concurrent IGH/BCL2 and 8q24/MYC translocations: a case report
Authors: He Lu , Li Zhiwen , Fan Xiangshan , Chen Jieyu , Wu Hongyan , Fu Yao
Published: September 2020

BackgroundB-lymphoblastic lymphomas (B-LBLs) with a documented “double-hit” (DH) (IGH/BCL2 and 8q24/MYC rearrangement) are rare and their clinical, cytogenetic and immunophenotypic features have not been well elucidated. Here we describe an unusual case of de novo DH B-LBL.Case presentationA 39-year-old man presented with abdominal distention at admission. Radiological findings revealed a retroperitoneal lump and multiple lymphadenopathy. Histologic examination of the abdominal mass showed a predominant population of neoplastic lymphoblasts with round nuclei, which focally formed single files surrounded by fibrotic septa. These cells have high nuclear to cytoplasmic ratio, fine chromatin, and no inconspicuous nucleoli. Necrosis, apoptotic bodies and mitotic figures were common. Prominent starry-sky appearance was not observed. The typical immunophenotype of malignant cells was positive for TdT, CD99, CD10, PAX-5, Bcl2 (70%), MYC (70%), and negative for CD34,Cyclin-D1, SOX11, CD56, and CD123. The proliferation index was high with Ki-67 of 80%. Fluorescence in situ hybridization (FISH) studies demonstrated 8q24/MYC rearrangement and IGH/BCL2 gene fusion. Subsequent bone marrow biopsy showed no involvement. Normal chromosome karyotype was observed. Finally, the diagnosis of “double-hit” B-LBL was clinically rendered. The patient showed an initial response to six cycles of hyper-CVAD chemotherapy (hyper-fractionated cyclophosphamide, vincristine, doxorubicin, and dexamethasone) and was alive at the last follow-up (2020.4.10, six months after the diagnosis).ConclusionsFew guidelines regarding DH B-LBL are available in the literature or in the WHO scheme. The optimal clinical management of such patients has not been fully established attributed to the small number of reported cases. Multicenter data is warranted to better make clinical strategies on patients with DH B-LBL.
Better Health Related Quality of Life Reduced Elevated Lp(a) Levels in Man
Authors: Bao Jinlan , Wen ZhuZhi , Tang Ying , Sun Runlu , Huang Canxia , Wang JingFeng , Zhang Yuling
Published: September 2020

Background: Elevated Lipoprotein(a) (Lp(a)) is an independent risk factor for premature coronary heart disease (PCHD), but drug therapy rarely changes. Recently, health related quality of life (HRQOL) has been used to measure the prognosis of PCHD, but it is unclear whether HRQOL can improve Lp(a) levels. Aim: To explore whether HRQOL score in PCHD patients is closely related to increased Lp(a) level.Methods: The retrospective study included 448 male patients, 218 male patients with PCHD (49.63±3.72 years) and 230 male healthy controls, the two groups were matched in age. According to Lp(a) levels, they were divided into normal Lp(a) group (Lp(a)<30mg/dL) and elevated Lp(a) group (Lp(a)≥30mg/dL). All participants received HRQOL scores. HRQOL scores were assessed using the health Survey of 36 items (SF-36).Results: Elevated Lp(a) subgroup had more PCHD patients 150(65.5%) than normal Lp(a) subgroup 68(31.1%), P<0.001. In elevated Lp(a) subgroup and normal Lp(a) subgroup, the Lp(a) level of PCHD patients were significantly higher than health healthy controls, and HRQOL scores were significantly lower than healthy controls(P<0.001). HRQOL scores significantly reduced the risk of PCHD (P<0.001), while Lp(a) levels significantly increased the risk of PCHD (P<0.001). HRQOL scores in the whole Lp(a) group were negatively correlated with Lp(a) levels (r=-0.131, P=0.006), but not with the elevated Lp(a) and normal Lp(a) subgroups.Conclusion: Better HRQOL may be an important indicator to reduce the risk of high Lp(a) and PCHD in man.
Penetrating Atheromatous Ulcer as a Precursor of Aortic Dissection: A Case Report
Authors: Shah Priya , Polan Erik
Published: September 2020

Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case.Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management.Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.
P2X7R-mediated Autophagic Impairment Contributes to Central Sensitization in a chronic Migraine Model with Recurrent Nitroglycerin Stimulation in Mice
Authors: Jiang Li , Zhang Yixin , Jing Feng , Long Ting , Qin Guangcheng , Zhang Dunke , Chen Lixue , Zhou Jiying
Published: September 2020

Background: Central sensitization is an important pathophysiological mechanism of chronic migraine (CM). According to our previous studies, microglial activation and subsequent inflammation in the trigeminal nucleus caudalis (TNC) contribute to the central sensitization. The P2X7 receptor (P2X7R) is a purinergic receptor expressed in microglia and participates in central sensitization in chronic pain, but its role in CM is unclear. Numerous studies have shown that P2X7R regulates the level of autophagy and that autophagy affects the microglial activation and inflammation. Recently, autophagy has been shown to be involved in neuropathic pain, but there is no information about autophagy in CM. Therefore, the current study investigated the role of P2X7R in CM and its underlying mechanism, focusing on autophagy regulation.Methods: The CM model was established by repeated intraperitoneal injection of nitroglycerin (NTG) in mice. A Von Frey filament and radiant heat were used to assess the mechanical and thermal hypersensitivity. Western blotting and immunofluorescence assays were performed to detect the expression of P2X7R, autophagy-related proteins, and the cellular localization of P2X7R. To determine the role of P2X7R and autophagy in CM, we detected the effects of the autophagy inducer, rapamycin (RAPA) and P2X7R antagonist, Brilliant Blue G (BBG), on pain behavior and the expression of calcitonin gene-related peptide (CGRP) and c-fos. In addition, the effect of RAPA and BBG on microglial activation and subsequent inflammation were investigated.Results: The expression of P2X7R was increased and was mainly colocalized with microglia in the TNC following recurrent NTG administration. The autophagic flux was blocked in CM, which was characterized by up-regulated LC3-II, and accumulated autophagy substrate protein, p62. RAPA significantly improved the basal rather than acute hyperalgesia. BBG alleviated both basal and acute hyperalgesia. BBG activated the level of autophagic flux. RAPA and BBG inhibited the activation of microglia, limited the inflammatory response, and reduced the expression of CGRP and c-fos. Conclusions: Our results demonstrate the dysfunction of the autophagic process in CM. Activated autophagy may have a preventive effect on migraine chronification. P2X7R contributes to central sensitization through mediating autophagy regulation and might become a potential target for CM.
Exciton–phonon coupling strength in single-layer MoSe2 at room temperature
Authors: Li Donghai , Trovatello Chiara , Conte Stefano Dal , Nuß Matthias , Soavi Giancarlo , Wang Gang , Ferrari Andrea , Cerullo Giulio , Brixner Tobias
Published: September 2020

Single-layer transition metal dichalcogenides (1L-TMDs) are at the center of an ever increasing research effort both in terms of fundamental physics and applications. Exciton–phonon coupling (EXPC) plays a key role in determining the photonic and (opto)electronic properties of 1L-TMDs. However, the EXPC strength has not been measured at room temperature. Here, we develop two-dimensional (2D) micro-spectroscopy to determine EXPC of 1L-MoSe2. We detect beating signals as a function of waiting time T, induced by the coupling between the A exciton and the A'1 optical phonon. Analysis of 2D beating maps provides the EXPC with the help of simulations. The Huang–Rhys factor of ~1 is larger than in most other inorganic semiconductor nanostructures. Our technique offers a unique tool to measure EXPC also in other 1L-TMDs and heterogeneous semiconducting systems with a spatial resolution ~260 nm, and will provide design-relevant parameters for the development of novel optoelectronic devices.
Sulpiride-Induced Dystonia in Tourette Syndrome; A Stroke Mimicking Presentation
Authors: Abdelnaby Ramy , Abosrea Mona Ali , Rudek Markus A. , Elsayed Mohamed
Published: September 2020

We report a case of sulpiride induced dystonia, which was misleading to identify because of the acute onset during exercise mimicking stroke in a Tourette syndrome patient. After excluding artery dissection through MR-Angiography, Biperiden was infused, which lead to the immediate disappearance of the dystonic symptoms.
2D Visual Analysis of SARS-CoV-2
Authors: Zheng Jeffrey , Qiao Mu , Wu Ruoxue
Published: September 2020

COVID-19 is outbreaking in worldwide. It caused millions of infections, killing hundreds of thousands of people and making all countries loss immeasurable trade. For finding the secret of SARS-CoV-2, researchers need to analyze various variation information such as multiple coronaviruses in different times over distinct countries. In this paper, the metagenetic analysis system MAS is used to analyze SARS-CoV-2 genomes collected from different countries as input datasets, and special genomic indices are provided to be a global characteristic quantity based on the A1 and C1 modules of the MAS for visualizations. In this method, one RNA sequence is split into M segments and counting the number of genetic probability measures for 16 combinations of four genomic symbols. After statistical probability processes, each probability distribution can be transferred into an entropy quantity on both 2D and 1D histograms to show these results for all collected genomes. Under this approach, a pair of combinatorial entropies determine a 2D genomic index map to generate a heatmap for more massive clusters of genomes with similarity contents to provide basic quantitative in variants to organize further collected genomes as a construction of a phylogenetic tree. Further explorations are required.
Effects of Various Conditions Related to Circadian Rhythm Disturbances on Plasma and Erythrocyte Lipids in Rats: A Peroxisomal Perspective
Authors: Otlu Hüsniye Gül , Uğur Yılmaz , Yıldız Azibe , Erdoğan Selim , Yoloğlu Saim , Vardı Nigar , Güldür Tayfun
Published: September 2020

Background: It was aimed to investigate effects of various conditions known to cause circadian rhythm disturbances (i.e. calorie restriction, time-restricted feeding, constant light exposure) on various peroxisomal parameters and to compare those effects with that of fenofibrate, a PPARα agonist, in rats. Methods: Plasmalogens and some fatty acids in erythrocyte lysates were analyzed by GC. Peroxisomal metabolites including very long chain fatty acids as well as phytanic and pristanic acids in plasma were measured by GC-MS. Results: Unlike calorie restricted feeding, fenofibrate treatment yielded lower level of plasma phytanic acid concentration implying higher peroxisomal α-oxidation rate. However both calorie restriction and fenofibrate treatment exhibited lower plasmalogen, DHA and arachidonic acid contents of erythrocyte lysates. Conclusion: Shared effects of conditions associated with circadian rhythm disturbances and peroxisomal induction by fenofibrate on erythrocyte membrane lipids might indicate a link between them.
Index Analysis of Osteonecrosis and Related Causes
Authors: Liu Tingting , Cao Yuju , Wu Huiqiang , An Feimeng , Han Changxu , Wang Tiantian , Sun Menghu , Tian Ye , Wang Kunzheng , Wang Jianzhong
Published: September 2020

Background: The pathogenesis of non-traumatic osteonecrosis of the femoral head (ONFH ) is related to the interruption of blood supply caused by lipid metabolism and hypercoagulability. The purpose of this study was to explore the relationship between clinical biochemical parameters and non-traumatic ONFH. Methods: The basic information and biochemical indexes of 1292 patients with non- traumatic ONFH and 1880 healthy controls were collected. SPSS software (version 22.0) was used to process and analyze the data. T-test was used for quantitative analysis. Chi-square test was used for categorical variables.p< 0.05 were the index with statistical significance. Results: In the population sample, TC (p= 0.00004), LDL (p= 0.014) and PLT (p= 0.000005) levels were statistically significant between the two groups.In men, levels of TC (p = 0.004), LDL (p= 0.011), and PLT (p= 0.00005) were statistically significant between the two groups.In women, TC (p= 0.001) and PLT (p= 0.048) levels were statistically significant between the two groups.There were differences in TC (p= 0.00001) and PLT (p= 0.031) levels between the case group and the control group in samples aged less than 45 years.There were differences in LDL (p= 0.00002) and PLT (p= 0.022) levels between the two groups in samples older than 45 years.Compared with the control group, patients with alcohol-induced ONFH had HDL (p = 0.002).LDL (p= 0.00002);The level of PLT (p= 0.0001) was significantly different.HDL (p = 0.005) was found in alcohol-induced ONFH patients younger than 45 years of age.The PLT level (p=0.045) was different from that of the control group.There was a difference in LDL (p= 0.000003) levels between control and alcohol-induced ONFH patients older than 45 years.The older the onset age, the TC in vivo;HDL;LDL;ApoA1;ApoB;The lower the PLT level.With the prolongation of the onset time, the PLT level in the patient's body is decreasing continuously.Conclusion: The changes of biochemical indexes are closely related to the occurrence of non-traumatic ONFH. Our research can provide a new direction for the prevention of ONFH.
Sleep Disturbance is Associated With Cognitive Impairment: a Community Population-based Cross-sectional Study
Authors: Gao Fan , Wei Shan , Dang Liangjun , Gao Yao , Gao Ling , Shang Suhang , Chen Chen , Huo Kang , Wang Jingyi , Wang Jin , Qu Qiumin
Published: September 2020

Background: Sleep is an important physiological process and conducive to the elimination of brain metabolites and the recovery of brain function. However, the relationship between sleep disturbance and cognitive impairment is not fully been determined.Methods: This was a community population-based cross-sectional study. A total of 1,461 participants from a village in the suburbs of Xi’an, China were enrolled from January 3 to March 26, 2017. Sleep quality was evaluated using the Pittsburgh sleep quality index (PSQI), and sleep disturbance was defined as a PSQI score >5. Mini-mental state examination (MMSE) was used to assess cognitive function and cognitive impairment was defined as the MMSE score less than cutoff values and meets the diagnostic criteria. Univariate and multivariate analyses were used to analyze the relationships between sleep disturbance and cognitive impairment.Results: Among 1,461 subjects, 87(5.95%) had cognitive impairment, and 842 (57.63%) had sleep disturbance. In bivariate analysis, cognitive impairment was associated with insomnia (ρ=1.000, P＜0.001), age (ρ=0.172, P＜0.001) and educational level (ρ=-0.160, P＜0.001). In the binary logistic regression, cognitive impairment was positively associated with the sleep disturbance (OR=1.779, 95%CI=1.055-3.001, P=0.031). In the internal constitution of PSQI, cognitive impairment was positively associated with the sleep interference (OR=1.678; 95%CI=1.029-2.736, P=0.038), and negatively associated with the habitual sleep efficiency (OR=0.115, 95%CI=0.043-0.306, P<0.001). However, people sleep more than 8 hours a day are more likely to suffer from cognitive impairment (OR=3.174, 95%CI=1.570-6.417, P=0.001). Conclusions: Sleep disturbance is associated with cognitive impairment. However, the causal relationships between sleep disturbances and cognitive impairment are not clear. It needs to be further studied.
A New Method for Error Modeling in the Kinematic Calibration of Redundantly Actuated Parallel Kinematic Machine
Authors: He Lei-Ying , Wang Zhen-Dong , Li Qin-Chuan , Chai Xin-Xue
Published: September 2020

This paper presents a new method for error modeling and studies the kinematic calibration of redundantly actuated parallel kinematic machines (RA-PKM). First, a n-DOF RA-PKM is split into several n-DOF non-redundantly actuated sub-mechanisms by removing actuators in limbs in an ergodic manner without changing the DOF. The error model of the sub-mechanisms is established by differentiating the forward kinematics. Then, the complete error model of the RA-PKM is obtained by a weighted summation of errors for all sub-mechanisms. Finally, a kinematic calibration experiments are performed on a 3-DOF RA-PKM to verify the method of error modeling. The positioning and orientation error of the moving platform is replaced by the positioning error of the tool center point, which was reduced considerably from 3.427 mm to 0.177 mm through kinematic calibration. The experimental results demonstrate the improvement of the kinematic accuracy after kinematic calibration using the proposed error modeling method.
Tannic acid-modified silver nanoparticles enhance anti-Acanthamoeba activity without increasing cytotoxicity of the contact lens solutions
Authors: Hendiger Edyta Beata , Padzik Marcin , Żochowska Agnieszka , Baltaza Wanda , Olędzka Gabriela , Zyskowska Diana , Bluszcz Julita , Jarzynka Sylwia , Chomicz Lidia , Grodzik Marta , Hendiger Jacek , Piñero Jose E. , Grobelny Jarosław , Ranoszek-Soliwoda Katarzyna , Lorenzo-Morales Jacob
Published: September 2020

Background: Free living amoebae of Acanthamoeba genus are cosmopolitan, widely distributed protozoans causing severe, vision-threatening corneal infection known as Acanthamoeba keratitis (AK). Majority of the increasing number of AK cases are associated with contact lenses use. Due to lack of effective therapies against AK, proper eye hygiene and effective contact lenses disinfection are crucial in prevention of this infection. Currently available multipurpose contact lens disinfection systems are not fully effective against Acanthamoeba trophozoites and cysts. There is an urgent need to increase the disinfecting activity of these systems to prevent Acanthamoeba keratitis infections. Synthesized nanoparticles have been recently studied and proposed as a new generation of anti-microbial agents. It is also known that plant metabolites, including tannins, present anti-parasitic activity. The aim of this study was to evaluate the anti-amoebic activity and cytotoxicity of the tannic acid-modified silver nanoparticles (AgTANPs) conjugated with selected multipurpose contact lens solutions. Methods: The anti-amoebic activity of pure contact lens care solutions and nanoparticles conjugated with contact lens care solutions were examined in vitro by colorimetric assay, based on the oxido-reduction of AlamarBlue. The cytotoxicity assays were performed using a fibroblast HS-5 (ATCC CRL-11882) cell line. Results were statistically analyzed by ANOVA and Student-Newman-Keuls tests using the p<0.05 level of statistical significance. Results: The obtained results showed that nanoparticles enhanced anti-Acanthamoeba activity of the tested contact lens solutions without increasing their cytotoxicity profile. The activity is enhanced within minimal disinfection time recommended by the manufacturer. Conclusions: The conjugation of selected contact lens solutions with AgTANPs might be a novel and promising approach as part of preventive actions of Acanthamoeba keratitis infections among contact lens users.
Phosphaturic mesenchymal tumor of the occipitocervical region: Report of two rare cases and literature review
Authors: Zhang Linxiang , Hu Yiwei , Yan Jijie , Yang Jian , Bai Guangjian , Jiang Lijun , Guo Kai , Huang Xing , Liu Tielong
Published: September 2020

BackgroundTumor-induced osteomalacia (TIO) is regarded as a rare paraneoplastic syndrome mainly caused by phosphaturic mesenchymal tumor (PMT). To our known, only 5 occipitocervical PMTs have been described in the world’s English literature. We reported two rare cases of occipitocervical PMT, and conducted a retrospective analysis of these 7 cases. The purpose of this study is to discuss the clinical characteristics and treatment of occipitocervical PMT.Case PresentationBoth patients were middle-aged females, and had a long-standing bone pain. In case 1, there were no abnormalities in biochemical indicators. The blood phosphorus was normal and alkaline phosphatase (ALP) was elevated in case 2. Magnetic resonance imaging (MRI) suggested that osteolytic bone destruction accompanied by a soft tissue mass in left C1-2 vertebra (case 1). In case 2, the bone destruction was located on the right C1-2 and the clivus. Then both patients underwent complete resection of tumor, and case 2 also received adjuvant radiotherapy, the histopathology revealed a PMT. Case 2 suffered recurrence during 5-year follow-up.ConclusionsOccipitocervical PMT is quite rare, and only 5 cases have been reported in the literature. Currently, complete resection of the tumor is the best option. The surgery is difficult, and requires delicate operation due to the complex anatomy of the occipitocervical region. Postoperative radiotherapy has little effect on local control. And further research is needed to confirm the effectiveness of the newly-emerged therapies.
Triple Threat; pancreatic cystic lesion presenting with spontaneous hemorrhage is found to harbor three distinct neoplasms
Authors: Cha Da Eun , Horn Callie , Passeri Michael
Published: September 2020

BackgroundPancreatic serous cystadenoma (SCA) is a benign, cystic lesion with an indolent growth pattern. Spontaneous hemorrhage from SCA is extremely rare, as is malignant transformation. Our case report describes an unusual presentation of a patient with a previously diagnosed SCA, made unique by the presence of three separate neoplasms in the final specimen.Case PresentationA 74-year-old male with a previous diagnosis of SCA presented emergently with epigastric pain and non-bilious vomiting. Laboratory results were notable for a hemoglobin of 8.3 g/dl. CT scan of the abdomen demonstrated a complex, solid-cystic mass in the pancreatic head with a large hematoma and questionable focus of active hemorrhage. The patient was resuscitated, and surgical resection was recommended due to the risk of malignant potential, risk of re-bleeding, and severe duodenal compression. Pancreaticoduodenectomy was performed, and final pathology demonstrated three separate neoplasms: serous cystadenoma, intraductal papillary mucinous neoplasm, and neuroendocrine tumor.ConclusionWhile pancreatic SCA are benign tumors that can be surveilled safely in the majority of cases, surgical intervention is often indicated in patients with large, symptomatic cysts or those with unclear diagnosis. During surveillance of SCA, it is crucial for both the patient and the care team to be aware of the possibility of rare, but life-threatening complications, such as hemorrhage. Likewise, the possibility of misdiagnosis or concurrent neoplasia should be considered.
Total saponins from Trillium Tschonoskii Maxim alleviate myocardial ischemia reperfusion injury in rat
Authors: Zhang Xiujing , Wang Wei , Tang Jie , Xie Qin , Ma Di
Published: September 2020

BackgroundTo investigate the effect and possible mechanisms of total saponins from Trillium Tschonoskii Maxim. (TST) on myocardial ischemia reperfusion injury in rat.Methods and ResultsRats were pre-treated with TST in 100 and 200 mg/kg, respectively. After 14 days intragastric administration, the model of myocardial ischemia-reperfusion injury was established by ligation of the left anterior descending coronary artery for 30 min and then releasing the ligated artery for 120 min. The hemodynamic indexes, anti-oxidation index, and the anti-inflammation factors were detected. Pathological changes in myocardia tissue were observed by H&E staining. Apoptosis protein expression of caspase 3, 9, 12, AMPK, phosphorylation AMPK (p-AMPK) and Sirt1 was detected by Western blot. Pretreating the rats with TST dramatically decreased the levels of MDA, TNF-α, IL-6 and IL-1β, increased the levels of SOD and GSH-Px, and the apoptosis protein expression were all significantly decreased. In addition, the protein expression of p-AMPK and Sirt1 were markedly increased in TST pre-treated group. Furthermore, TST pre-treatment also improved the histopathological changes.ConclusionTST protect the myocardium by reducing the levels of inflammation factors, peroxides and cell apoptosis, increasing the anti-oxidase, and improving the pathological changes. The possible mechanism maybe through the activating of the AMPK/Sirt1 signaling pathway.
The miR-146a SNP Rs2910164 and miR-155 SNP rs767649 are risk factors for non- small cell lung cancer in Iranian population
Authors: KakaDezfuli Neda , Adcock Ian M. , Alipour Shamila D. , Seyfi Sharareh , Salimi Babak , Golchin Maryam Mafi , Roofchayee Neda Dalil , Varhram Mohammad , Mortaz Esmaeil
Published: September 2020

Background: Lung cancer is a leading cause of death worldwide. MicroRNAs (miRNAs) are small noncoding RNAs that regulate gene expression and may act as both tumor suppressors and as oncogenes. The presence of single nucleotide polymorphisms (SNPs) inside the miRNA genomic region could affect target miRNA maturation, expression and binding to its target mRNA and contribute to cancer development. Previous studies on the SNPs Rs2910164 in miR-146a and Rs767649 in miR-155 showed association with non-small cell lung cancer (NSCLC) development. Thus, the aim of study was to detect any correlation between those SNPs in Iranian NSCLC patients.Methods: In a small cohort study, 165 NSCLC patients and 147 non-cancer controls were enrolled between Apr 2015 – Sep 2019 at the Masih Daneshvari Hospital, Tehran-Iran. Allele frequencies from genomic DNA of blood PBMC was studied using PCR-RFLP and their association with the risk of lung cancer was evaluated.Results: The frequency of the C allele of the miR-146a rs2910164 polymorphism was increased in NSCLC patients (OR=1.56, 95%CI=1.10 -2.21, P= 0.012). In contrast, the frequency of the A allele of the miR-155 rs767649 polymorphism was significantly increased in the control group (TT vs. AA+AT: OR=0.58, 95%CI=0.35-0.98, P= 0.043).Conclusion: The findings of this study suggest that miR-146a rs2910164 and miR-155 rs767649 polymorphisms could be related with the risk of NSCLC in an Iranian population. However, a larger multi center study across Iran is needed to confirm these findings.
Severe Paediatric Multisystem Inflammatory Syndrome (PIMS) in a 23 months old baby post COVID-19 effectively managed with IVIG and pulse Steroid: Case report 
Authors: Gupta Yogesh Kumar , Shenoy Sowmya , Paike Kuldip G , Tudu Mrigendra Nath
Published: September 2020

Coronavirus disease (COVID-19) in children largely causes mild disease. Some of these recovered children may present with delayed manifestations described as Hyperinflammatory syndrome resembling closely with Kawasaki disease (KD) or Toxic Shock Syndrome (TSS). Timely identification, supportive treatment and treatment with immunomodulatory drugs make a significant difference in the outcome.
Intraoperative and Postoperative Dexmedetomidine Combined With Sufentanil and Dezocine-based Patient-Controlled Intravenous Analgesia Increases Female Patients' Global Satisfaction Degree After Thoracoscopic Surgery: A Randomised Double-blind Controlled Trial
Authors: Li Qiongzhen , Yao Haixia , Xu Meiying , Wu jingxiang
Published: September 2020

Background：There are no studies on the use of dexmedetomidine combined with sufentanil and dezocine-based patient-controlled intravenous analgesia (PCIA) in females undergoing thoracic surgery. We postulate that introducing dexmedetomidine to a combination of dezocine-based PCA drugs and sufentanil will increase female patients' global satisfaction degree.Methods：One hundred fifty-two female patients with physical classification type I or II according to the American Society of Anesthesiologists undergoing thoracoscopic surgery were arbitrarily classified into two categories, either receiving sufentanil and dezocine-based PCIA (group C) or incorporating dexmedetomidine with sufentanil and dezocine-based PCIA (group D). The patients' global satisfaction degree, postoperative nausea and vomiting (PONV), PCA bolus, rescue analgesia requirements, drug-related adverse effects, rest and coughing visual analogue scale (VAS) ratings, and Ramsay sedation scores (RSS) were measured at 6, 12, 24, 36 and 48 h after surgery.Results：Compared with the C group, the patient satisfaction degree was significantly higher; pain scores at rest and coughing were significantly different at 6, 12, 24, 36 and 48 h postoperatively; less rescue analgesia and PCA bolus were required; and a lower incidence of PONV was found in the D group. There were non-significant trends for the sedation scores and drug-related adverse effects in both groups.Conclusions：Dexmedetomidine combined with sufentanil and dezocine increased female patients' global satisfaction degree after thoracoscopic surgery. This effect could be linked to the improvement in postoperative analgesia and reduction in postoperative nausea and vomiting; the combined treatment did not increase drug-related adverse effects in female patients.Trial registration: Chinese Clinical Trial Registry number, ChiCTR2000030429. Registered on March 1, 2020.
The Effect of Health Financing Reforms on incidence and management of childhood infections in Ghana: A matching difference in differences impact evaluation
Authors: Odjidja Emmanuel Nene , Saha Manika , Kwanin Charles
Published: September 2020

IntroductionIn 2003, Ghana abolished direct out of pockets payments and implemented health financing reforms including the national health insurance scheme in 2004. Treatment of childhood infections is a key component of services covered under this scheme, yet, outcomes on incidence and treatment of these infections after introducing these reforms have not been covered in evaluation studies. Combining propensity score matching and difference in differences technique, this study fills this gap by assessing the impact on the reforms on the two most dominant childhood infections; fever (malaria) and diarrhoea. Methods Nigeria was considered as a control country and using four data points (pre and post reforms periods) from the demographic health surveys, we calculate the probability of treatment based on background covariates. Those treated in Ghana were matched with appropriate controls using kernel matching technique and quality of matching was assessed. A linear probability model which comprises of pre and post health reforms in Ghana and Nigeria was conducted to determine the net impact of child outcomes under study. All analysis were conducted in STATA (psmatch2, psgraph and pstest) and statistical significance was considered when p-value ≤ 0.05. ResultsAfter matching, it was determined that health reforms significantly increased general medical care for children with diarrhoea (25 percentage points) and also for those receiving care specifically in government managed facilities (14 percentage points). Furthermore, there was marginal net impact on access to medical care for children with fever (40 percentage points) and care in government facilities (24 percentage points). Access to antimalarial was also positively impacted after the introduction of these reforms (5 percentage points). Conclusions Introduction of health reforms in Ghana showed marginal effect on some aspects of incidence and treatment of childhood infections. This denotes that introducing health financing reforms can have marginal impact on child health outcomes.
Critically Ill Patients with COVID-19: A Narrative Review on Prone Position
Authors: Qadri Syeda Kashfi , Ng Priscilla , Toh Theresa Shu Wen , Loh Sin Wee , Tan Herng Lee , Lin Cheryl Bin , Fan Eddy , Lee Jan Hau
Published: September 2020

Introduction: Prone position improves mortality in patients with acute respiratory distress syndrome (ARDS). The impact of prone position in critically ill COVID-19 patients remains to be determined. In this review, we describe mechanisms of action of prone position, systematically appraise current experience of prone position in COVID-19 patients and highlight unique considerations for prone position practices during this pandemic.Methods: For our systematic review, we searched PubMed, Scopus and EMBASE from January 1, 2020 to April 16th 2020. After completion of our search, we became aware of four relevant publications during article preparation that were published in May and June 2020 and these studies were reviewed for eligibility and inclusion. We included all studies reporting clinical characteristics of patients admitted to hospital with COVID-19 disease who received respiratory support with high flow nasal cannula, non-invasive or MV and reported the use of prone position. Full text of eligible articles was reviewed and data regarding study design patient characteristics, interventions and outcomes were extracted.Results: We found 7 studies (total 1899 patients) describing prone position in COVID-19. Prone position has been increasingly used in non-intubated patients with COVID-19; studies show high tolerance, improvement in oxygenation and lung recruitment. Published studies lacked description of important clinical outcomes (e.g., mortality, duration of mechanical ventilation).Conclusions: Based on the findings of our review, we recommend prone position in patients with moderate to severe COVID-19 ARDS as per existing guidelines. A trial of prone position should be considered for non-intubated COVID-19 patients with hypoxemic respiratory failure, as long as this does not result in a delay in intubation.
Developing a Thai national critical-care allocation guideline during the COVID-19 pandemic: a rapid review and stakeholders’ consultation 
Authors: Marshall Aniqa Islam , Archer Rachel , Witthayapipopsakul Woranan , Sirison Kanchanok , Chotchoungchatchai Somtanuek , Sriakkpo Pisit , Srisookwat Orapan , Teerawattananon Yot , Tangcharoensathien Viroj
Published: September 2020

Background: At the height of the COVID-19 pandemic, Thailand had almost depleted its critical care resources, particularly ICU beds and ventilators. This prompted the necessity to develop a national guideline for resource allocation. This paper describes the development process of a national guideline for critical resource allocation in Thailand during the COVID-19 pandemic. Methods: The guideline development process consisted of three steps (1) rapid review of existing rationing guidelines and literature; (2) interviews of Thai clinicians experienced in caring for COVID-19 cases; and (3) multi-stakeholder consultations. At steps 1 and 2, data was synthesized and categorized using a thematic and content analysis approach and this guided the formulation of the draft guideline. Within Step 3, the draft Thai critical care allocation guideline was debated and finalized before entering the policy-decision stage. Results: Three-order prioritization criteria consisting of (1) clinical prognosis using four tools (Charlson Comorbidity Index, Sequential Organ Failure Assessment, Frailty Assessment, and Cognitive Impairment Assessment); (2) number of life years saved; and (3) social usefulness, were proposed by the research team based on literature reviews and interviews. At consultations, stakeholders rejected using life years as a criterion due to potential age and gender discrimination, as well as social utility due to a concern it would foster public distrust as this judgment can be arbitrary. It was agreed that attending physician is required to be the decision maker in the Thai medico-legal context while a patient review committee would play an advisory role. Allocation decisions are to be documented for transparency and no appealing mechanism is to be applied.This guideline will be triggered only when demand exceeds supply after the utmost efforts to mobilize surge capacity. Once implemented, it is applicable to all patients, COVID-19 and non-COVID-19, requiring critical care resources prior to ICU admission and during ICU stay.Conclusions: The guideline development process for the allocation of critical care resources in the context of the COVID-19 outbreak in Thailand was informed by scientific evidence, medico-legal context, existing norms and societal values to reduce risk of public distrust given the sensitive nature of the issue and ethical dilemmas of the guiding principle though it was conducted at recorded speed. Our lessons can provide an insight for the development of similar prioritization guidelines, especially in other LMICs.
The biochemical markers associated with TCD to evaluate the curative effect after Carotid Artery Stenting
Authors: Yuan Xiaofan , Wang Jianhong , Guo Lei , Wang Duozi , Yang Shu , Guo Fuqiang
Published: September 2020

Introduction：This study associated the expression of GFAP and S100B in serum with the imaging tools (TCD and DWI) to confirm these cerebral biochemical markers as surrogate outcome methods for evaluating the curative effect after CAS.Methods and materials：72 patients with unilateral carotid stenosis who underwent CAS were enrolled in the operation group. The blood samples of the operation patients were collected on four different time points: T1: the day before operation; T2: 1 day (24 hours) after operation; T3: 3 days (72 hours) after operation; T4: 30 days after operation. The operation patients were performed on the MRI after CAS to evaluate the post-operative lesion and received the TCD to monitor the changes of hemodynamics. 47 patients who were excluded for carotid artery stenosis by DSA were selected as the control group. The blood samples of patients in control group were collected at D1 (before DSA) and D2 (24 hours after DSA). The concentrations of GFAP and S100B in serum were measured with ELISA.Results：(1) The MFV (pre-operation, post-operation, 30 days follow-up: 47.65±17.24, 62.37±18.25, 70.29±16.89; P<0.05) and PI (pre-operation, post-operation, 30 days follow-up: 0.78±0.21, 0.98±0.19, 1.02±0.20; P<0.05) increased significantly in the ipsilateral MCA after CAS. And at 30 days follow-up, the CVR improved significantly (post-operation, 30 days follow-up: 27.47±12.13, 31.92±10.94; P<0.05). Patients with different degrees of stenosis, the more severe stenosis in carotid artery, the more obvious improvement of CVR at the 30 days follow-up. (2) After CAS, the serum concentrations of GFAP and S100B increased to the peak at 24 hour after operation (T2), and then decrease gradually (T2>T3>T4; P < 0.05). Furthermore, the serum concentrations of GFAP (r=0.71, P<0.05) and S100B (r=0.78, P<0.05) correlated positively with CVR at 30 days after CAS. (3) 29/72 patients (40.28%) were shown the emerging hyperintense in DWI after CAS.Conclusion：Our finding proven that the trend of GFAP and S100B in serum after CAS had a positive correlation to the improved hemodynamics which was verified by TCD. We recommend the biochemical markers (GFAP and S100B) associated with TCD to evaluate the curative effect after CAS.
Mitochondria-targeted antioxidant supplementation improves 8 km time trial performance in middle-aged trained male cyclists
Authors: Broome Sophie , Braakhuis Andrea , Mitchell Cameron , Merry Troy
Published: September 2020

BackgroundExercise increases skeletal muscle ROS production, which may contribute to the onset of muscular fatigue and impair athletic performance. Mitochondria-targeted antioxidants such as MitoQ are becoming popular amongst active individuals as they are designed to accumulate within mitochondria and may provide targeted protection against exercise-induced oxidative stress. However, the effect of MitoQ supplementation on cycling performance is currently unknown. Here we investigate whether MitoQ supplementation can improve cycling performance measured as time to complete an 8 km time trial.MethodIn a randomised, double-blind, placebo-controlled crossover study, 19 middle-aged (age: 44 ± 4 years) recreationally trained (VO2peak: 58.5 ± 6.2 ml·kg·min− 1, distance cycled per week during six months prior to study enrollment: 158.3 ± 58.4 km) male cyclists completed 45 min cycling at 70% VO2peak followed by an 8 km time trial after 28 days of supplementation with MitoQ (20 mg/day) and a placebo. Free F2-isoprostanes were measured in plasma samples collected at rest, after 45 min cycling at 70% VO2peak and after completion of the time trial. Respiratory gases and measures of rate of perceived exertion (RPE) were also collected.ResultsMean completion time for the time trial was 1.3% faster with MitoQ (12.91 ± 0.94 min) compared to placebo (13.09 ± 0.95 min, P = 0.04 95% CI [0.05, 2.64], d = 0.2). There was no difference in RPE during the time trial between conditions (P = 0.82) despite average power output during the time trial being higher following MitoQ supplementation (280 ± 53 W) compared to placebo (270 ± 51 W, P = 0.04). Plasma F2-isoprostanes were lower on completion of the time trial following MitoQ supplementation (35.89 ± 13.6 pg/ml) compared to placebo (44.7 ± 16.9 pg/ml P = 0.03).ConclusionThese data suggest that MitoQ supplementation may be an effective nutritional strategy to attenuate exercise-induced increases in oxidative damage to lipids and improve cycling performance.Trial registrationThis study was registered with the Australia New Zealand Clinical Trial Registry (ACTRN12619000451101) on 19th March 2019.
Is Mass Media Exposure Associated with Tobacco and Alcohol Consumption Behaviour: Evidence from India
Authors: Rashmi  , Paul Ronak , Majumdar Bhavna
Published: September 2020

Tobacco and alcohol consumption are one of the leading lifestyle-related causes of avoidable mortality worldwide. India is the second-largest consumer of tobacco globally after China. The pattern of tobacco smoking, tobacco chewing and alcohol consumption varies across the states and regions of India. Past literature has provided varying evidence regarding the influence of media on the tobacco and alcohol consumption behaviour of Indian people in specific regions and/or specific age brackets. The current study examined the association between media exposure in households and the individual consumption behaviour of tobacco and alcohol in the Indian population while simultaneously accounting for unobserved heterogeneity at the state level. The analysis was performed separately for both rounds of India Human Development Survey (IHDS) cross-sectional datasets. Multivariable standard logit regression models and random-intercept logit regression models were used to fulfil the study objectives. The study showed that exposure to radio and television media in households was associated with a high risk of smoking tobacco and drinking alcohol in both rounds of IHDS. However, exposure to newspaper media in households translated to a lower risk of tobacco and alcohol consumption in both rounds. People aged 20-59 years were highly likely to consume tobacco or alcohol compared to younger individuals in both rounds of data. Additionally, females are more likely to chew tobacco compared to their male counterparts. The study also provides evidence of the presence of a high level of heterogeneity in the risk of smoking tobacco, chewing tobacco and drinking alcohol across the states of India. The findings of the study highlight the need for devising effective policies that curb the role of radio and television mass media as a promotional medium for tobacco and alcohol consumption among the Indian population.