bluuebunny/crossref_metadata_2025 huggingface dataset:
Pathological and genomic phenotype of second neuroendocrine carcinoma during long-term follow-up after radical radiotherapy for nasopharyngeal carcinoma
Authors: Peng Ying-peng , Liu Qiao-dan , Lin Yu-jing , Peng Shun-li , Wang Rong , Xu Xi-wei , Wei Wei , Zhong Gui-hua , Zhou Yu-ling , Zhang Ya-qin , Liu Ye , Wang Si-yang , Hong Hai-yu , Liu Zhi-gang
Published: October 2021

Background

Second head and neck neuroendocrine carcinoma (NEC) after radical radiotherapy for nasopharyngeal carcinoma (NPC) treatment is rarely reported. The prognosis of second cancer is poor, and our research focuses on finding a breakthrough in the treatment. In this study, we aimed to investigate clinicopathological characteristics and to identify the genomic landscape of second head and neck NECs.

Methods

We collected five second head and neck NEC cases in the recent three years from our patient database. Clinicopathological data and images were obtained. Genomic analysis was performed using high-throughput second generation sequencing. KEGG pathway enrichment analyses between high-frequency mutations were performed using the STRING database.

Results

All patients had been diagnosed with second NEC, according to the pathological observations. The interval between diagnosis of NPC and NEC ranged from 10 to 18 years. Two patients had brain or liver metastasis at three and nine months, respectively, after the diagnosis of NEC. Three patients died of the disease with the overall survival time ranging from three to nine months. Commonly altered genes (50%) in second head and neck NECs included TP53, RB1, NOTCH2, PTEN, POLG, KMT2C, U2AF1, EPPK1, ELAC2, DAXX, COL22A1, and ABL1. Those genetic lesions might affect p53 signaling, MAPK signaling, PI3K-Akt signaling, sphingolipid signaling, and neurotrophin signaling pathways.

Conclusions

Second head and neck NECs had poor prognosis. We revealed, for the first time, the mutational landscape, high-frequency somatic mutations, and potential signaling pathways of second head and neck NECs. Its optimal treatment model needs to be further studied in future clinical trials.
Epigenetic targeting of the ACE2 and NRP1 viral receptors limits SARS-CoV-2 infectivity
Authors: Saiz Maria Laura , DeDiego Marta L. , López-García Darío , Corte-Iglesias Viviana , Baragaño Raneros Aroa , Astola Ivan , Asensi Victor , López-Larrea Carlos , Suarez-Alvarez Beatriz
Published: October 2021

Background

SARS-CoV-2 uses the angiotensin-converting enzyme 2 (ACE2) and neuropilin-1 (NRP1) receptors for entry into cells, and the serine protease TMPRSS2 for S protein priming. Inhibition of protease activity or the engagement with ACE2 and NRP1 receptors has been shown to be an effective strategy for blocking infectivity and viral spreading. Valproic acid (VPA; 2-propylpentanoic acid) is an epigenetic drug approved for clinical use. It produces potent antiviral and anti-inflammatory effects through its function as a histone deacetylase (HDAC) inhibitor. Here, we propose VPA as a potential candidate to tackle COVID-19, in which rapid viral spread and replication, and hyperinflammation are crucial elements.

Results

We used diverse cell lines (HK-2, Huh-7, HUVEC, Caco-2, and BEAS-2B) to analyze the effect of VPA and other HDAC inhibitors on the expression of the ACE-2 and NRP-1 receptors and their ability to inhibit infectivity, viral production, and the inflammatory response. Treatment with VPA significantly reduced expression of the ACE2 and NRP1 host proteins in all cell lines through a mechanism mediated by its HDAC inhibitory activity. The effect is maintained after SARS-CoV-2 infection. Consequently, the treatment of cells with VPA before infection impairs production of SARS-CoV-2 infectious viruses, but not that of other ACE2- and NRP1-independent viruses (VSV and HCoV-229E). Moreover, the addition of VPA 1 h post-infection with SARS-CoV-2 reduces the production of infectious viruses in a dose-dependent manner without significantly modifying the genomic and subgenomic messenger RNAs (gRNA and sg mRNAs) or protein levels of N protein. The production of inflammatory cytokines (TNF-α and IL-6) induced by TNF-α and SARS-CoV-2 infection is diminished in the presence of VPA.

Conclusions

Our data showed that VPA blocks three essential processes determining the severity of COVID-19. It downregulates the expression of ACE2 and NRP1, reducing the infectivity of SARS-CoV-2; it decreases viral yields, probably because it affects virus budding or virions stability; and it dampens the triggered inflammatory response. Thus, administering VPA could be considered a safe treatment for COVID-19 patients until vaccines have been rolled out across the world.
The impact of feature extraction and selection for the classification of gait patterns between ACL deficient and intact knees based on different classification models
Authors: Zeng Wei , Ismail Shiek Abdullah , Pappas Evangelos
Published: October 2021

The anterior cruciate ligament (ACL) plays an important role in stabilizing translation and rotation of the tibia relative to the femur. Individuals with ACL deficiency usually demonstrate alterations in gait characteristics. Evidence indicates that walking speed, alterations in kinetics and kinematics on the ACL deficient limb, and inter-limb asymmetries between deficient and intact knees may contribute to poor long-term outcomes following ACL deficiency. They corrode function of the knee joint and put it at higher risk of degeneration. For the purpose of developing an automatic and highly accurate system for detection of ACL deficiency, this study investigated the classification capability of different dynamical features extracted from gait kinematic and kinetic signals when evaluating their impact on different classification models. A general feature extraction framework was proposed and various dynamical features, such as recurrence rate, determinism and entropy from the recurrence quantification analysis, fuzzy entropy, Teager-Kaiser energy feature and statistical analysis, were included. Different classification models, including support vector machine (SVM), K-nearest neighbor (KNN), naive Bayes (NB) classifier, decision tree (DT) classifier and ensemble learning based Adaboost (ELA) classifier, derived for discriminant analysis of multiple dynamical gait features were evaluated for a comparative study. The effectiveness of this strategy was verified using a dataset of knee, hip and ankle kinematic and kinetic waveforms from 43 patients with unilateral ACL deficiency. When evaluated with 2-fold, 10-fold and leave-one-out cross-validation styles, the highest classification accuracy for discriminating between groups of ACL deficient and contralateral ACL intact knees was reported to be 91.22 $$\%$$
%
, 95.12$$\%$$
%
and 96.34$$\%$$
%
, respectively,by using the SVM classifier and the optimal feature set. For other four classifiers, KNN achieved the accuracy of 78.05$$\%$$
%
, 85.37$$\%$$
%
and 87.80$$\%$$
%
, respectively. NB achieved the accuracy of 57.56$$\%$$
%
, 60.98$$\%$$
%
and 61.22$$\%$$
%
, respectively. DT achieved the accuracy of 77.56$$\%$$
%
, 80.49$$\%$$
%
and 83.66$$\%$$
%
, respectively. ELA achieved the accuracy of 73.66$$\%$$
%
, 78.05$$\%$$
%
and 79.27$$\%$$
%
, respectively. Compared with other state-of-the-art methods, the results demonstrate superior performance and support the validity of the proposed method.
Delineating investment opportunities for stakeholders in sorghum seed systems: a logit model perspective
Authors: Ndossi Judith , Akpo Essegbemon , Ojiewo Chris O. , Ringo Justin , Kongola Eliud , Vernooy Ronnie , Muricho Geoffrey , Lukurugu Gerald Alex , Makoye Lameck Nyaligwa , Tabo Ramadjita , Varshney Rajeev
Published: October 2021

Background

Seed systems are considered as a vehicle through which the sustainable agricultural intensification can be achieved. However, most sub-Saharan African countries have been ineffective to provide sufficient incentives for stakeholders to consistently invest in the seed systems specifically for crops like sorghum. This study was therefore conducted to uncover investment opportunities for stakeholders in the sorghum seed systems to attain an impact-oriented seed production and delivery systems.

Results

The study applied descriptive statistics, Logit regression model, and Gross margin to analyze possible areas for investments. Descriptive statistics analyzed the percentage of farmers using sorghum improved varieties and sources used to obtained improved variety seeds. Logit regression model was applied to analyze factors correlating with planting of improved seeds. Gross margin was applied to show profitability of growing improved sorghum seeds and grain. Findings revealed that 39.2% of the sampled farmers were growing improved sorghum variety seeds. Farmers obtained improved variety seeds from both informal (57.8%) and formal (42.2%) sources. Logit estimates indicate that variety preference, unavailability of seeds, resistance to diseases, and drought had significant correlation with planting of improved variety seeds. Seed companies and quality declared seed (QDS) producers earned high margin of 53,08,900 Tanzanian Shillings per hectare (TZS/ha, 1 USD = 2315 TZS during the period of data collection) and 33,94,709 TZS/ha, respectively. Farmers using improved variety seed earned higher margin (8,19,805 TZS/ha) than farmers who did not use improved variety seeds (3,17,373 TZS/ha)

Conclusions

The identified investment opportunities were increasing number of farmers using improved variety seeds that would drive increased production, distribution, and marketing of quality seed. The large number of farmers still sourcing seed from the informal channel provides avenue to reach out to these farmers through demand creation and wide variety popularization meeting farmer preferences. The huge margin seed producers make provides good incentive to drive private seed companies and individual seed entrepreneurs to make sustainable business out of sorghum seed. The policy implications for reviving sorghum production and productivity are further discussed.
The underlying components of data-driven smart sustainable cities of the future: a case study approach to an applied theoretical framework
Authors: Bibri Simon Elias
Published: October 2021

The increased pressure on cities has led to a stronger need to build sustainable cities that can last. Planning sustainable cities of the future, educated by the lessons of the past and anticipating the challenges of the future, entails articulating a multi-scalar vision that, by further interplaying with major societal trends and paradigm shifts in science and technology, produce new opportunities towards reaching the goals of sustainability. Enabled by big data science and analytics, the ongoing transformative processes within sustainable cities are motivated by the need to address and overcome the challenges hampering progress towards sustainability. This means that sustainable cities should be understood, analyzed, planned, designed, and managed in new and innovative ways in order to improve and advance their contribution to sustainability. Therefore, sustainable cities are increasingly embracing and leveraging what smart cities have to offer in terms of data-driven technologies and applied solutions so as to optimize, enhance, and maintain their performance and thus achieve the desired outcomes of sustainability—under what has been termed “data-driven smart sustainable cities.” Based on a case study analysis, this paper develops an applied theoretical framework for strategic sustainable urban development planning. This entails identifying and integrating the underlying components of data-driven smart sustainable cities of the future in terms of the dimensions, strategies, and solutions of the leading global paradigms of sustainable urbanism and smart urbanism. The novelty of the proposed framework lies in combining compact urban design strategies, eco-city design strategies and technology solutions; data-driven smart city technologies, competences, and solutions for sustainability; and environmentally data-driven smart sustainable city solutions and strategies. These combined have great potential to improve and advance the contribution of sustainable cities to the goals of sustainability through harnessing its synergistic effects and balancing the integration of its dimensions. The main contribution of this work lies in providing new insights into guiding the development of various types of strategic planning processes of transformative change towards sustainability, as well as to stimulate and inspire future research endeavors in this direction. This study informs policymakers and planners about the opportunity of attaining important advances in sustainability by integrating the established models of sustainable urbanism and the emerging models of smart urbanism thanks to the proven role and untapped potential of data-driven technologies in catalyzing sustainable development and thus boosting sustainability benefits.
Deciphering genes associated with diffuse large B-cell lymphoma with lymphomatous effusions: A mutational accumulation scoring approach
Authors: Abdollahi Sina , Dehghanian Seyedeh Zahra , Hung Liang-Yi , Yang Shiang-Jie , Chen Dao-Peng , Medeiros L. Jeffrey , Chiang Jung-Hsien , Chang Kung-Chao
Published: October 2021

Introduction

Earlier studies have shown that lymphomatous effusions in patients with diffuse large B-cell lymphoma (DLBCL) are associated with a very poor prognosis, even worse than for non-effusion-associated patients with stage IV disease. We hypothesized that certain genetic abnormalities were associated with lymphomatous effusions, which would help to identify related pathways, oncogenic mechanisms, and therapeutic targets.

Methods

We compared whole-exome sequencing on DLBCL samples involving solid organs (n = 22) and involving effusions (n = 9). We designed a mutational accumulation-based approach to score each gene and used mutation interpreters to identify candidate pathogenic genes associated with lymphomatous effusions. Moreover, we performed gene-set enrichment analysis from a microarray comparison of effusion-associated versus non-effusion-associated DLBCL cases to extract the related pathways.

Results

We found that genes involved in identified pathways or with high accumulation scores in the effusion-based DLBCL cases were associated with migration/invasion. We validated expression of 8 selected genes in DLBCL cell lines and clinical samples:MUC4, SLC35G6, TP53BP2, ARAP3, IL13RA1, PDIA4, HDAC1andMDM2, and validated expression of 3 proteins (MUC4, HDAC1 and MDM2) in an independent cohort of DLBCL cases with (n = 31) and without (n = 20) lymphomatous effusions. We found that overexpression of HDAC1 and MDM2 correlated with the presence of lymphomatous effusions, and HDAC1 overexpression was associated with the poorest prognosis. 

Conclusion

Our findings suggest that DLBCL associated with lymphomatous effusions may be associated mechanistically with TP53-MDM2 pathway and HDAC-related chromatin remodeling mechanisms.
Anatomic survey of seeding in Alzheimer’s disease brains reveals unexpected patterns
Authors: Stopschinski Barbara E. , Del Tredici Kelly , Estill-Terpack Sandi-Jo , Ghebremedhin Estifanos , Yu Fang F. , Braak Heiko , Diamond Marc I.
Published: October 2021

Tauopathies are heterogeneous neurodegenerative diseases defined by progressive brain accumulation of tau aggregates. The most common tauopathy, sporadic Alzheimer’s disease (AD), involves progressive tau deposition that can be divided into specific stages of neurofibrillary tangle pathology. This classification is consistent with experimental data which suggests that network-based propagation is mediated by cell–cell transfer of tau “seeds”, or assemblies, that serve as templates for their own replication. Until now, seeding assays of AD brain have largely been limited to areas previously defined by NFT pathology. We now expand this work to additional regions. We selected 20 individuals with AD pathology of NFT stages I, III, and V. We stained and classified 25 brain regions in each using the anti-phospho-tau monoclonal antibody AT8. We measured tau seeding in each of the 500 samples using a cell-based tau “biosensor” assay in which induction of intracellular tau aggregation is mediated by exogenous tau assemblies. We observed a progressive increase in tau seeding according to NFT stage. Seeding frequently preceded NFT pathology, e.g., in the basolateral subnucleus of the amygdala and the substantia nigra, pars compacta. We observed seeding in brain regions not previously known to develop tau pathology, e.g., the globus pallidus and internal capsule, where AT8 staining revealed mainly axonal accumulation of tau. AT8 staining in brain regions identified because of tau seeding also revealed pathology in a previously undescribed cell type: Bergmann glia of the cerebellar cortex. We also detected tau seeding in brain regions not previously examined, e.g., the intermediate reticular zone, dorsal raphe nucleus, amygdala, basal nucleus of Meynert, and olfactory bulb. In conclusion, tau histopathology and seeding are complementary analytical tools. Tau seeding assays reveal pathology in the absence of AT8 signal in some instances, and previously unrecognized sites of tau deposition. The variation in sites of seeding between individuals could underlie differences in the clinical presentation and course of AD.
Touchable 3D hierarchically structured polyaniline nanoweb for capture and detection of pathogenic bacteria
Authors: Kim Kyung Hoon , Yang MinHo , Song Younseong , Kim Chi Hyun , Jung Young Mee , Bae Nam-Ho , Chang Sung-Jin , Lee Seok Jae , Kim Yong Tae , Choi Bong Gill , Lee Kyoung G.
Published: October 2021

A bacteria-capturing platform is a critical function of accurate, quantitative, and sensitive identification of bacterial pathogens for potential usage in the detection of foodborne diseases. Despite the development of various nanostructures and their surface chemical modification strategies, relative to the principal physical contact propagation of bacterial infections, mechanically robust and nanostructured platforms that are available to capture bacteria remain a significant problem. Here, a three-dimensional (3D) hierarchically structured polyaniline nanoweb film is developed for the efficient capture of bacterial pathogens by hand-touching. This unique nanostructure ensures sufficient mechanical resistance when exposed to compression and shear forces and facilitates the 3D interfacial interactions between bacterial extracellular organelles and polyaniline surfaces. The bacterial pathogens (Escherichia coli O157:H7, Salmonella enteritidis, and Staphylococcus aureus) are efficiently captured through finger-touching, as verified by the polymerase chain reaction (PCR) analysis. Moreover, the real-time PCR results of finger-touched cells on a 3D nanoweb film show a highly sensitive detection of bacteria, which is similar to those of the real-time PCR using cultured cells without the capturing step without any interfering of fluorescence signal and structural deformation during thermal cycling.

Graphic Abstract
Morphometric relationships between dimensions the anterior talofibular ligament and calcaneofibular ligament in routine magnetic resonance imaging
Authors: Szaro Pawel , Ghali Gataa Khaldun , Solidakis Nektarios , Pękala Przemysław
Published: October 2021

Purpose

This study aimed to test the hypothesis that routine MRI ankle can be used to evaluate dimensions and correlations between dimensions of single and double fascicular variants of the ATFL and the CFL.

Methods

We reviewed ankle MRIs for 251 patients. Differences between the length, thickness, width, and length of the bony attachments were evaluated twice. P < .05 was considered as significant.

Results

For the ATFL, we observed a negative correlation between thickness and width, with a positive correlation between thickness and length (p < 0.001). The average values for the ATFL were thickness, 2.2 ± 0.05 mm; length, 21.5 ± 0.5 mm; and width, 7.6 ± 0.6 mm. The average values for the CFL were thickness, 2.1 ± 0.04 mm; length, 27.5 ± 0.5 mm; and width, 5.6 ± 0.3 mm. A negative correlation was found between length and width for the CFL (p < 0.001).

Conclusions

Routine MRI showed that most dimensions of the ATFL and CFL correlate with each other, which should be considered when planning new reconstruction techniques and developing a virtual biomechanical model of the human foot.

Level of evidence

III
Intravitreal corticosteroids for diabetic macular edema: a network meta-analysis of randomized controlled trials
Authors: Gao Lu , Zhao Xu , Jiao Lei , Tang Luosheng
Published: October 2021

Background

To evaluate the efficacy and safety of different intravitreal corticosteroids for treating diabetic macular edema (DME).

Methods

Four databases were systematically searched for randomized controlled trials comparing different intravitreal corticosteroids for treating DME. The primary outcome was the change in best-corrected visual acuity (BCVA) within 6 months after the first injection (short-term BCVA). Secondary outcomes were the change in BCVA over 1 year (long-term BCVA) and changes in central macular thickness (CMT) and intraocular pressure (IOP) within 6 months after the first injection. Network meta-analysis was performed to aggregate the results from the individual studies.

Results

Nineteen trials involving 2839 eyes were included. Intravitreal triamcinolone acetonide (TA) injections (≥ 8 mg and 4–8 mg), fluocinolone acetonide (FA) implants (0.5 µg/day) and dexamethasone (DEX) implants (700 µg) improved short-term BCVA (mean changes in logMAR [95% confidence interval] − 0.27 [− 0.40, − 0.15]; − 0.12 [− 0.18, − 0.06]; − 0.10 [− 0.21, − 0.01]; and − 0.06 [− 0.11, − 0.01]). Intravitreal TA injections (4 mg, multiple times), FA implants (0.5 µg/day and 0.2 µg/day), and DEX implants (350 µg) improved long-term BCVA (mean changes in logMAR [95% confidence interval] − 0.11 [− 0.21, − 0.02]; − 0.09 [− 0.15, − 0.03]; − 0.09 [− 0.14, − 0.02]; and − 0.04 [− 0.07, − 0.01]). All intravitreal corticosteroids reduced CMT, and different dosages of TA did not show significant differences in increasing IOP.

Conclusions

Intravitreal corticosteroids effectively improved BCVA in DME patients, with higher dosages showing greater efficacies. TA was not inferior to FA or DEX and may be considered a low-cost alternative choice for DME patients. The long-term efficacy and safety of different corticosteroids deserve further investigation.

Trial registration Prospectively registered: PROSPERO, CRD42020219870
Screening Tools as a Predictor of Injury in Gymnastics: Systematic Literature Review
Authors: Armstrong Ross , Relph Nicola
Published: October 2021

Background

Gymnastics requires a high level of physical ability and technical skill which utilises short sets of athleticism and artistry to perform complex and intense movements which can overload musculoskeletal tissues and result in acute injuries which can develop into chronic injuries. The aim of this systematic literature review was to investigate which screening tools predict injury in gymnasts and encompasses all genres, levels and ages.

Methods

An electronic search of seven databases from their inception until March 2021 was conducted. The databases were the Allied and Complementary Medicine Database, CINAHL, eBook Collection (EBSCOhost), MEDLINE, Cochrane Database of Systematic Reviews, SPORTDiscus and PEDro (the Physiotherapy Evidence Base). A combination of the following search terms was used: (1) Gymnastics AND injury AND Screening, (2) Screening AND Gymnastics and (3) Musculoskeletal AND Screening AND Gymnastics. These terms were searched in all text, abstract, title and subject terms. Studies were assessed using a 20-point scoring tool.

Results

The mean methodological quality score was 13.1 points (range 10–17 points). Range of motion, anthropometric and postural measurements, hypermobility, clinical diagnostic tests, movement screening tools, muscle strength, power and endurance were reported in the included studies. Some evidence existed for screening measurement of height and mass as taller and heavier gymnasts might be more susceptible to injury; however, the different methodologies utilised and lack of acknowledgment of confounding variables limit the clinical relevance of these findings.

Conclusions

Height and mass should be recorded during the screening process. A lack of heterogeneity in study methodology prevented a meta-analysis. Studies were limited by a lack of prospective injury design, poor injury definition, self-reporting of injury and only 2 studies reported reliability of screening tools. Further research is required to determine the role of injury screening in gymnastics.

Registration: The review protocol was registered with the International Prospective Register of Systematic Reviews (PROSPERO) with the registration number CRD42020218339.
Evaluation of clinical trials of the plants, which have ethnobotanical uses for skin disorders in Turkey: a review
Authors: Alan Zinar , Özgüldü Halil , Erdal Meryem Sedef , Bucak Ayşenur Yaman , Üresin A. Yağız , Akalın Emine
Published: October 2021

Background

Ethnobotanical studies investigating a large number of traditional herbs and uses have an important role in the discovery of new drugs. Nowadays, some of these traditional herbs are researched directly in the clinical trials. In this study, it is aimed to evaluate the 19 plant species that have been identified in the clinical trials among 300 plant species belonging to 79 families with traditional use for skin problems in Turkey.

Main body

Natural sources are very important to treat diseases for thousands of years. The ethnopharmacological research of natural products ranges from the collection of biogenic samples such as plants to preclinical and clinical studies with the aim of developing drug templates or new drugs. In the ethnopharmacological approach, it is aimed to reach the result based on the traditional and modern knowledge about natural resources. The biggest advantage of this approach is synthesizing new and old information. After the plant or natural compound is determined, other processes work similarly with conventional drugs.

Methods

Ethnobotanical papers, thesis and projects in Istanbul University Faculty of Pharmacy Department of Pharmaceutical Botany and databases (PubMed and Google Scholar) have been sought and results were synthesized.

Results

Most of the clinical uses of herbs have been seen similar to their traditional uses. On the other hand, there are some plants on which their clinical uses differ from the traditional uses such as Borago officinalis, Calendula officinalis or Euphorbia peplus. When the frequency of traditional uses of herbs are compared, Plantago species, Plantago major and Plantago lanceolata are the most used taxa in Turkey, secondly, Hypericum perforatum comes. However, Plantago species are not of much interest in clinical trials. It is seen that most of the plants in the clinical research are tried for wound healing occuring due to different origins such as cancer, surgery and injury.

Side effects were observed only during the application of Allium cepa, Cydonia oblonga and H. perforatum.

Conclusions

When clinical trials are evaluated in terms of efficacy and overall results, significant differences and effective results are seen in treatment groups given herbs in comparison with placebo or control groups.
Sida acuta Burm.f. leaves ethanol extract ameliorates haematological and biochemical alterations induced by Plasmodium berghei ANKA-65 in mice
Authors: Enechi Osmond Chukwuma , Amah Christian Chijioke , Okagu Innocent Uzochukwu , Ononiwu Pamela Chidinma , Nweke Alice Chinwendu , Ugwuanyi Theophilus Chukwudi , Ajibo Emmanuel Arinzechukwu , Nweze Anthonia Chiamaka , Chukwurah Blessing Chiamaka
Published: October 2021

Background

Malaria has continued to be a threat to man and his wellbeing, especially Africans and Asians. New antimalarial drugs are urgently needed to mitigate malaria treatment failure due to resistant Plasmodium species. Medicinal plants used by indigenous Nigerians for treating fever and malaria such as Sida acuta Burm.f. (Malvaceae) could be a promising source of lead compounds for developing new generations of antimalarial drugs. The effects of ethanol extract of S. acuta leaves (EESAL) on malaria parasitemia, haematological and biochemical status of P. berghei-infected mice were investigated, using the 4-day curative test.

Methodology

EESAL was prepared by maceration method. The phyto-constituents and acute toxicity profile of the extract were evaluated using standard protocols. In addition, malaria parasitemia and chemo-suppression, and indicators of haematological and biochemical status of P. berghei-infected mice treated with EESAL were assessed.

Results

At 200, 400 and 600 mg/kg/d b.w., p.o doses for 4 consecutive days, EESAL significantly (p < 0.05) decreased parasitaemia and suppressed malaria parasite by 89.64%, 95.95% and 97.38%, respectively comparable to negative control. The reduction in percentage malaria parasitemia by EESAL is comparable to Artemether (140 mg/kg/d b.w., p.o) used as standard antimalarial drug in this study. The packed cell volume (PCV), haemoglobin (Hb) concentration, and red blood cell (RBC) and white blood cell (WBC) counts of negative control are significantly (p < 0.05) higher than normal control. However, parasitized-EESAL-treated mice have significantly (p < 0.05) higher PCV value, Hb concentration and RBC and WBC counts than negative control. Similarly, treatment of parasitized mice with EESAL restored some indicators of the antioxidant, lipid peroxidation, lipid profile and liver status altered by malaria. In addition, EESAL was tolerable up to 5000 mg/kg b.w., p.o.

Conclusion

These results indicate that the EESAL possesses antimalarial activity and normalizes alterations in haematological and biochemical status of malaria-infected mice.
Surgical management of chronic subdural hematomas through single-burr hole craniostomy: is it sufficient?
Authors: Ahmed Omar El Farouk , El Sawy Ahmad , El Molla Shafik
Published: October 2021

Background

Symptomatic chronic subdural hematomas (CSDH) remain one of the most encountered forms of intracranial hemorrhages particularly in the elder patients, yet fortunately implies a good surgical prognosis. Burr hole evacuation under general anesthesia is the most commonly used neurosurgical technique for the management of CSDH. Clinical disagreement between many studies regarding the number of burr holes required to achieve the optimal surgical and clinical outcome has long existed. The objective of this study is to evaluate the prognosis and clinical outcome following the use of single-burr hole craniostomy technique in the aim of surgical evacuation of CSDH.

Results

This is a retrospective study of 30 patients, with symptomatic unilateral or bilateral CSDH managed by the authors strictly by single-burr hole evacuation with closed-system drainage on the corresponding site of the hematoma. Clinical outcome was then assessed at 1, 7, and 30 days after surgery using the Glasgow Coma Scale (GCS) and by comparing the Markwalder grade scale before surgery to 1 month following surgery; the pre- and post-operative radiological data, clinical neurological progress and the possible incidence of complications postoperatively were also recorded. Study duration was from August 2019 to October 2020. Our study included 18 (60%) male patients and 12 (40%) female patients. The main presenting symptom was altered level of consciousness noted in 29 (96.7%) patients; a history of a relevant head trauma was recorded in 11 patients (36.7%). The GCS showed a statistically highly significant improvement comparing the preoperative to the postoperative values throughout the follow-up intervals (p = 0.001); similarly, the Markwalder score significantly improved 1 month after surgery, where 17 (63%) patients were Markwalder grade 0, 9(33.3%) patients were grade 1, a single patient (3.7%) was grade 2, and none were Markwalder grade 3.

Conclusion

Our study concluded that single-burr hole craniostomy with closed-system drainage for the management of symptomatic CSDH would be a sufficient approach to achieve a good surgical outcome with a low complication rate. Larger series and further studies would be yet considered with longer follow-up periods.
A call to action: molecular pathology in Brazil
Authors: da Cunha Isabela Werneck , de Almeida Coudry Renata , de Macedo Mariana Petaccia , de Assis Emilio Augusto Campos Pereira , Stefani Stephen , Soares Fernando Augusto
Published: October 2021

Background

Adoption of molecular pathology in Brazil is currently very limited. Of note, there are no programs for training new molecular pathologists in the country; thus, documents compiling nationally applicable information on molecular pathology are few.

Methods

A selected panel of Brazilian experts in fields related to molecular pathology were provided with a series of relevant questions to address prior to the multi-day conference. Within this conference, each narrative was discussed and edited by the entire group, through numerous drafts and rounds of discussion until a consensus was achieved.

Results

The panel proposes specific and realistic recommendations for implementing molecular pathology in cancer care in Brazil. In creating these recommendations, the authors strived to address all barriers to the widespread use and impediments to access mentioned previously within this manuscript.

Conclusion

This manuscript provides a review of molecular pathology principles as well as the current state of molecular pathology in Brazil. Additionally, the panel proposes practical and actionable recommendations for the implementation of molecular pathology throughout the country in order to increase awareness of the importance molecular pathology in Brazil.
Prevalence of iron deficiency anemia and beta thalassemia carriers among relatives of beta thalassemia patients in Nile Delta region, Egypt: a multicenter study
Authors: El-Shanshory Mohamed R. , Sherief Laila M. , Hassab Hoda M. , Ragab Seham M. , Yahia Sohier , Mansour Ahmed K. , Ahmed Adel S. , Abdou Said H. , Helmy Amal M. , Watany Mona M. , Gad ALllah Ahmed M. , Guindy Myriam A. , Mourad Zeinab I. , Soliman Mohamed A. , El-Farahaty Reham M. , El-Dahtory Faeza , Darwish Ahmad , Elmabood Suzy Abd , Kabbash Ibrahim A. , Saied Shimaa M.
Published: October 2021

Background

Screening of β thalassemia among close relatives is more feasible in highly prevalent countries with limited resources. The purpose of this study is to determine the prevalence of β thalassemia carriers and iron deficiency anemia among relatives of β thalassemia patients in Mid Delta, Egypt.

Methods

This is a cross-sectional multi-center study conducted on 2118 relatives of patients with β thalassemia from different Egyptian governorates in the Mid Delta region. They were subjected to history taking with precise determination of geographic location, general examination, and the following investigations: complete blood counts, serum ferritin for those who showed microcytic hypochromic anemia, and high-performance liquid chromatography for those who were not diagnosed as iron deficiency anemia.

Results

The total prevalence of iron deficiency anemia among close relatives of confirmed β thalassemia patients in the Nile Delta region was 17.19%. The highest prevalence of iron deficiency anemia (45.05%) was reported in Al-Gharbia Governorate, followed by Al-Menoufia Governorate (21.67%), and the lowest prevalence was that of Al-Sharkia Governorate (4.91%). The differences were highly statistically significant (p < 0.001). β thalassemia carrier prevalence rate in the studied relatives was 35.84%, with the highest prevalence detected in Al-Sharkia Governorate (51.32%), followed by Kafr-Alsheikh and Al-Dakahilia Governorates (41.78%, 37.13%) respectively, while Al-Menoufia Governorate had the lowest prevalence rate (25.00%). These differences were also highly statistically significant (p < 0.001).

Conclusion

More than one-third of relatives of patients with β thalassemia are carriers of the disease, while 17.19% suffer from iron deficiency anemia. This study demonstrates the importance of tracing the high number of beta thalassemia carriers among relatives of patients with β thalassemia in Egypt.
Oil palm in the 2020s and beyond: challenges and solutions
Authors: Murphy Denis J. , Goggin Kirstie , Paterson R. Russell M.
Published: October 2021

Background

Oil palm, Elaeis guineensis, is by far the most important global oil crop, supplying about 40% of all traded vegetable oil. Palm oils are key dietary components consumed daily by over three billion people, mostly in Asia, and also have a wide range of important non-food uses including in cleansing and sanitizing products.

Main body

Oil palm is a perennial crop with a > 25-year life cycle and an exceptionally low land footprint compared to annual oilseed crops. Oil palm crops globally produce an annual 81 million tonnes (Mt) of oil from about 19 million hectares (Mha). In contrast, the second and third largest vegetable oil crops, soybean and rapeseed, yield a combined 84 Mt oil but occupy over 163 Mha of increasingly scarce arable land. The oil palm crop system faces many challenges in the 2020s. These include increasing incidence of new and existing pests/diseases and a general lack of climatic resilience, especially relating to elevated temperatures and increasingly erratic rainfall patterns, plus downstream issues relating to supply chains and consumer sentiment. This review surveys the oil palm sector in the 2020s and beyond, its major challenges and options for future progress.

Conclusions

Oil palm crop production faces many future challenges, including emerging threats from climate change and pests and diseases. The inevitability of climate change requires more effective international collaboration for its reduction. New breeding and management approaches are providing the promise of improvements, such as much higher yielding varieties, improved oil profiles, enhanced disease resistance, and greater climatic resilience.
Pre-hospital, in-hospital and post-hospital factors associated with sleep quality among COVID-19 survivors 6 months after hospital discharge: cross-sectional survey in five cities in China
Authors: Fu Leiwen , Fang Yuan , Luo Dan , Wang Bingyi , Xiao Xin , Hu Yuqing , Ju Niu , Zheng Weiran , Xu Hui , Yang Xue , Chan Paul Shing Fong , Xu Zhijie , Chen Ping , He Jiaoling , Zhu Hongqiong , Tang Huiwen , Huang Dixi , Hong Zhongsi , Ma Xiaojun , Hao Yanrong , Cai Lianying , Yang Jianrong , Ye Shupei , Yuan Jianhui , Chen Yao-Qing , Xiao Fei , Wang Zixin , Zou Huachun
Published: October 2021

Background

Understanding factors associated with post-discharge sleep quality among COVID-19 survivors is important for intervention development.

Aims

This study investigated sleep quality and its correlates among COVID-19 patients 6 months after their most recent hospital discharge.

Method

Healthcare providers at hospitals located in five different Chinese cities contacted adult COVID-19 patients discharged between 1 February and 30 March 2020. A total of 199 eligible patients provided verbal informed consent and completed the interview. Using score on the single-item Sleep Quality Scale as the dependent variable, multiple linear regression models were fitted.

Results

Among all participants, 10.1% reported terrible or poor sleep quality, and 26.6% reported fair sleep quality, 26.1% reported worse sleep quality when comparing their current status with the time before COVID-19, and 33.7% were bothered by a sleeping disorder in the past 2 weeks. After adjusting for significant background characteristics, factors associated with sleep quality included witnessing the suffering (adjusted B = −1.15, 95% CI = −1.70, −0.33) or death (adjusted B = −1.55, 95% CI = −2.62, −0.49) of other COVID-19 patients during hospital stay, depressive symptoms (adjusted B = −0.26, 95% CI = −0.31, −0.20), anxiety symptoms (adjusted B = −0.25, 95% CI = −0.33, −0.17), post-traumatic stress disorders (adjusted B = −0.16, 95% CI = −0.22, −0.10) and social support (adjusted B = 0.07, 95% CI = 0.04, 0.10).

Conclusions

COVID-19 survivors reported poor sleep quality. Interventions and support services to improve sleep quality should be provided to COVID-19 survivors during their hospital stay and after hospital discharge.
Ketamine Alleviates Depressive Symptoms in Patients Undergoing Intracranial Tumor Resection: A Randomized Controlled Trial
Authors: Zhou Yang , Sun Wanchen , Zhang Guofu , Wang Anxin , Lin Song , Chan Matthew T. V. , Peng Yuming , Wang Gang , Han Ruquan
Published: October 2021

BACKGROUND:

Depressive symptoms occur in over 40% of neurosurgical patients during the perioperative period. However, no measure has been suggested to have a rapid effect on depressive surgical patients during increasingly shorter stays in the hospital. This study aimed to determine whether ketamine could improve depressive symptoms rapidly and safely during the hospital stay.

METHODS:

This was a randomized, placebo-controlled, and double-blinded trial. Patients with moderate-to-severe depressive symptoms undergoing elective supratentorial brain tumor resection were randomized to intravenously receive either (1) 0.5 mg·kg−1 ketamine for 40 minutes or (2) an identical volume of normal saline. The primary outcome was treatment response on postoperative day 3, defined as a ≥50% reduction from the baseline depressive score. The secondary outcomes included the rate of remission and safety outcomes. The Montgomery-Åsberg Depression Rating Scale was applied by trained psychiatrists to evaluate depressive symptoms.

RESULTS:

A total of 84 neurosurgical patients were enrolled in the trial. The response rate was increased by the administration of ketamine (41.5% [17/41] vs 16.3% [7/43]; relative risk [RR]: 2.51, 95% confidence interval [CI], 1.18–5.50) relative to the administration of placebo at 3 days. Furthermore, the remission rate at discharge (29.3% [12/41] vs 7.0% [3/43]; RR: 4.20, 95% CI, 1.28–13.80) was also improved by ketamine. No psychotic symptoms or adverse events were reported to be substantially higher in the ketamine group.

CONCLUSIONS:

The trial indicates that the intraoperative administration of ketamine could alleviate moderate-to-severe depressive symptoms in neurosurgical patients without worsening safety.
Statistics From A (Agreement) to Z (z Score): A Guide to Interpreting Common Measures of Association, Agreement, Diagnostic Accuracy, Effect Size, Heterogeneity, and Reliability in Medical Research
Authors: Schober Patrick , Mascha Edward J. , Vetter Thomas R.
Published: October 2021

Researchers reporting results of statistical analyses, as well as readers of manuscripts reporting original research, often seek guidance on how numeric results can be practically and meaningfully interpreted. With this article, we aim to provide benchmarks for cutoff or cut-point values and to suggest plain-language interpretations for a number of commonly used statistical measures of association, agreement, diagnostic accuracy, effect size, heterogeneity, and reliability in medical research. Specifically, we discuss correlation coefficients, Cronbach’s alpha, I
2, intraclass correlation (ICC), Cohen’s and Fleiss’ kappa statistics, the area under the receiver operating characteristic curve (AUROC, concordance statistic), standardized mean differences (Cohen’s d, Hedge’s g, Glass’ delta), and z scores. We base these cutoff values on what has been previously proposed by experts in the field in peer-reviewed literature and textbooks, as well as online statistical resources. We integrate, adapt, and/or expand previous suggestions in attempts to (a) achieve a compromise between divergent recommendations, and (b) propose cutoffs that we perceive sensible for the field of anesthesia and related specialties. While our suggestions provide guidance on how the results of statistical tests are typically interpreted, this does not mean that the results can universally be interpreted as suggested here. We discuss the well-known inherent limitations of using cutoff values to categorize continuous measures. We further emphasize that cutoff values may depend on the specific clinical or scientific context. Rule-of-the thumb approaches to the interpretation of statistical measures should therefore be used judiciously.
Αξιολόγηση απόδοσης νοσηλευτών κατά την εκπαίδευση στην ορθοσιγμοειδοσκόπηση με χρήση προσομοιωτή
Authors: Αλουντάτ Μούσσα
Published: October 2021

Σπανίζουν οι βιβλιογραφικές αναφορές που αξιολογούν την εκπαίδευση των νοσηλευτών στην ορθοσιγμοειδοσκόπηση με βάση την προσομοίωση. Σκοπός αυτής της προοπτικής μη τυχαιοποιημένης μελέτης ήταν η εκτίμηση της απόδοσης ατόμων με νοσηλευτική κατάρτιση στη βασιζόμενη σε προσομοίωση εκπαίδευση στην ορθοσιγμοειδοσκοπηση και την ανίχνευση τυχόν επίδρασης στην απόδοσή τους, της εργασιακής εμπειρίας σε ενδοσκοπική μονάδα, της γενικής επαγγελματικής εμπειρίας και των δεξιοτήτων σε δραστηριότητες που απαιτούν συντονισμένους χειρισμούς. Συμπεριλήφθηκαν 44 άτομα: 12 νοσηλευτές με (ομάδα Α) και 14 νοσηλευτές χωρίς εμπειρία ενδοσκοπικής μονάδας (ομάδα Β) καθώς και 18 τελειόφοιτοι φοιτητές νοσηλευτικής (ομάδα Γ). Όλοι εκπαιδεύτηκαν στην ορθοσιγμοειδοσκόπηση με χρήση προσομοιωτή. Οι συμμετέχοντες αξιολογήθηκαν σε σχέση με προκαθορισμένες πιστοποιημένες (validated) παραμέτρους. Οι δεξιότητες σε δραστηριότητες που απαιτούν συντονισμένους χειρισμούς αναλύθηκαν προκειμένου να εξαχθούν πιθανές συσχετίσεις με την απόδοσή τους. Ο συνολικός πληθυσμός χρειάστηκε διάμεσο αριθμό 5 προσπαθειών για την επίτευξη όλων των προκαθορισμένων στόχων. Οι ομάδες Α και Γ υπερείχαν της ομάδας Β όσον αφορά τον αριθμό των προσπαθειών που απαιτούνταν για την επίτευξη του προκαθορισμένου ποσοστού ενδοσκοπηθέντος βλεννογόνου (p = 0,017, p = 0,027, αντιστοίχως). Επιπλέον, η ομάδα Α υπερείχε της ομάδας Β σχετικά με την προκαθορισμένη διάρκεια της διαδικασίας (p = 0,046). Παρατηρήθηκε τάση για λιγότερες προσπάθειες για την επίτευξη της συνολικής επιτυχούς ενδοσκόπησης στις ομάδες Α και Γ συγκριτικά με την ομάδα Β. Η αυξημένη βαθμολογία (score) στην χρήση έγχορδων μουσικών οργάνων συσχετίστηκε με μειωμένο συνολικό χρόνο της διαδικασίας (rs = -0,34, p = 0,03) και με μειωμένο αριθμό συνολικών προσπαθειών επιτυχούς ενδοσκόπησης (rs = -0,31, p = 0,046).Από τη μελέτη αυτή προκύπτει ότι η εκπαίδευση νοσηλευτών και φοιτητών νοσηλευτικής στην ορθοσιγμοειδοσκόπηση με χρήση προσομοιωτή είναι εφικτή μέσω ενός κατάλληλου προγράμματος εκμάθησης. Η εμπειρία στην ενδοσκοπική μονάδα και οι δεξιοτήτες σε δραστηριότητες που απαιτούν συντονισμένους χειρισμούς έχουν θετικό αντίκτυπο στην εκπαίδευση.