bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Physical Activity/Exercise Interventions on Immune Parameters, and Inflammatory Markers for Proxy Conditions Among Adults Prone to COVID-19: A Systematic Review Protocol
Authors: Anieto Ebuka Miracle , Ogbodo Veronica Ebere , Nwadilibe Ijeoma Blessing , Adu Omotoyosi Johnson , Smits-Engelsman Bouwien C.M. , Mohammed Jaleel , Kalu Michael Ebe
Published: August 2020

BackgroundOlder individuals (over 60 years) with hypertension, diabetes, cardiovascular disease, chronic respiratory disease, and cancer are at the highest risk of contracting and dying from Coronavirus (COVID-19). Compromised immunity (both innate and adaptive) and increased inflammatory response (cytokine-storm syndrome) are predictors for high mortality among this population group. Exercise/physical activity seems to be a plausible way to decrease both the risk of transmission and mortality, and improve health outcomes among this population since there is no available treatment for COVID-19. The study will investigate the effectiveness of physical activity/exercise in improving the immune parameters and reducing the inflammatory biomarkers in proxy conditions that make individuals susceptible to COVID-19.MethodsThe Preferred Reporting Items for systematic reviews and Meta-Analyses Protocol (PRISMA-P) 2015 will guide this review. We will search ten databases (until August 2020) to include randomized control trials articles that explored the effectiveness of physical activity/exercise in improving immune parameters and reducing inflammatory biomarkers in proxy conditions (hypertension, diabetes, cardiovascular disease, chronic respiratory disease and cancer). Two review authors will independently screen citations (title and abstract), extract data (using standardized forms), assess the risk of bias (using Cochrane risks of bias) and quality of data (using GRADE). Homogenous studies will be analyzed using the fixed-effect model of meta-analysis, while a narrative synthesis will be conducted for heterogeneous studies.DiscussionThere are no specific physical activity/exercise parameters (frequency, intensity, type of exercise and time- FITT) for interventionists to use when developing high-quality RCT for individuals vulnerable to COVID-19. Therefore, it is important to review the literature to identify and highlight the exercise FITT parameters that increase the immune outcomes and reduce inflammatory biomarkers for proxy conditions that make individuals susceptible to COVID-19. It is also important to identify the specific exercise regimen suitable and beneficial for each proxy group.Systematic review registrationPROSPERO CRD42020196907
Altered Lipid Profile is a Risk Factor for the Progression Andrecurrenceof COVID-19: From Two Retrospective Cohorts
Authors: Jin Hui , He Junji , Dong Chuan , Cao Luhong , Qi Xing , Huang Tiande , Ma Zhiyue , Gu Qingjia , He Gang , Fan Jiangang , Li Bin , Zhao Xiao long
Published: August 2020

Background The COVID-19 pandemic has spread worldwide. However, the impact of lipid profile and lipid-lowering treatment on clinical endpoints in COVID-19 have not previously been investigated. Methods In this retrospective, multicenter cohort study, we consecutively enrolled 430 adult COVID-19 patients from two Chinese hospitals (one each in Chengdu and Wuhan) admitted during February 2020 and followed-up until April 30. Demographic, metabolic profile, laboratory, treatment and clinical endpoint data including in-hospital death and recurrence of COVID-19, were collected. Results In Chengdu patients, univariable and multivariable Cox regression showed that the low-density lipoprotein cholesterol (LDL-C) dyslipidemia on admission was associated with the recurrence of COVID-19 during the follow-up period. In Wuhan cohort, the patients with triglycerides hyperlipemia had an increased risk of in-hospital death. However, in both cohorts, statin therapy during COVID-19 course did not affect these clinical endpoints. Compared to the Chengdu cohort, the Wuhan patients tended to have more severe COVID-19 but, unexpectedly, had lower levels of serum lipid. It is of interesting to notice that the relationship between the observed biomarkers of inflammation and lipid do not match the relationship between the organ function measures and this lipid. Conclusions The baseline dyslipidemia should be considered as a risk factor for poor prognosis and recurrence of COVID-19. The lipid level may be altered during COVID-19 course, since lipidology may be distinctly affected by both inflammation and organic damage for SARS-CoV-2. Further investigation is needed on the role of use of lipid-lowering therapy among patients with COVID-19 infections.
Short- and Medium-Term Outcomes After Uniportal and Multiportal Video-Assisted Thoracic Surgery Lobectomy in Elderly Patients with Non-Small Cell Lung Cancer
Authors: Zhong Dian , Lin Qing , Zhang Jinqiang , Liu Yujuan , Zhan Zhiqiang
Published: August 2020

Objective: To investigate the short- and medium-term outcomes following treatment with uniportal video-assisted thoracic surgery lobectomy (uniportal VATS) in elderly patients with non-small cell lung cancer (NSCLC). Methods: We conducted a retrospective analysis on the clinical and follow-up data of 74 elderly patients with NSCLC who underwent uniportal VATS between January 2015 and January 2020. One-to-one propensity score matching (PSM) was employed to select 71 elderly patients with NSCLC who underwent multiportal video-assisted thoracoscopic lobectomy (multiportal VATS) during the same period. Results: The baseline characteristics of the two patient groups were comparable, with no statistically significant differences in postoperative complications, operation time, conversion to thoracotomy, or lymph node dissection. The amount of intraoperative blood loss and postoperative pain were lower in the uniportal VATS group than in the multiportal VATS group. The 3-year overall survival and disease-free survival of the two groups were similar. Conclusions: Uniportal VATS achieved similar short- and medium-term outcomes as Multiportal VATS in elderly patients with NSCLC.
Comparative Analysis of Bacterial and Archaeal Population Structure by Illumina Sequencing of 16S rRNA Genes in Three Municipal Anaerobic Sludge Digesters
Authors: Khan Munawwar Ali , Khan Shams Tabrez , Sequeira Milred Cedric , Faheem Sultan Mohammad
Published: August 2020

Understanding the microbial communities in anaerobic digesters is important for better regulation, operation, and sustainable management of the sludge produced at various stages of wastewater treatment processes. Microbial communities in the anaerobic digester of the gulf region where the climatic conditions and other factors may impact the incoming feed have not been documented. Archaeal and Bacterial communities of three full-scale anaerobic digesters, namely AD1, AD3 and AD5 were analyzed by Illumina sequencing of 16S rRNA genes. Among bacteria, the most abundant genus was fermentative bacteria Acetobacteroides (Blvii28). Other predominant bacterial genera in the digesters included thermophilic bacteria (Fervidobacterium and Coprothermobacter) and halophilic bacteria like Haloterrigena and Sediminibacter. This can be correlated with the climatic condition in Dubai, where the bacteria in the original feed may be thermophilic or halophilic as much of the water used in the country is desalinated seawater. Propionic acid-producing bacteria like Paludibacter and propionate oxidizing bacteria like W5 were also dominating group and were found in all the digesters. The predominant Archaea include mainly the members of phylum Euryarchaeota and Crenarchaeota belonging to genus Methanocorpusculum, Metallosphaera, Methanocella, and Methanococcus. The highest population of Methanocorpusculum (more than 50% of total Archaea) hydrogenotrophic archaea matches with the high population of Acetobacteroides (Blvii28) and Fervidobacterium bacteria which ferments the organic substrates to acetate and H2. Coprothermobacter, which is known to improve protein degradation by establishing a syntrophy with hydrogenotrophic archaea, was also one of the dominant genera in the digesters. This study, for the first time, contributes to an in-depth understanding of the phylogenetic diversity of a microbial community of three full-scale anaerobic digesters of a municipal wastewater treatment plant in Dubai, UAE.
Prevalence and correlates of pre-diabetes and diabetes among a national population based sample of adults in Zambia: Results of the first national STEPS survey in 2017
Authors: Peltzer Karl , Pengpid Supa
Published: August 2020

Background: This investigation aimed to estimate the prevalence and its correlates of pre-diabetes and diabetes among 18-69 year-old persons in Zambia.Method: Nationally representative cross-sectional data were analysed from 3,608 18-69 year old persons (31 years median age) that participated in the “2017 Zambia STEPS survey,” with complete blood glucose measurement.Results: Results indicate that 8.8% of 18-69 year-olds had pre-diabetes and 7.2% diabetes. In adjusted multinomial logistic regression analysis, older age, rural residence, central obesity (or overweight or obesity), hypertension, raised total cholesterol and physical inactivity were associated with pre-diabetes and/or diabetes. In addition, in unadjusted analysis, female sex, lower education, alcohol family problem and alcohol dependence were associated with pre-diabetes and/or diabetes. Only 8.4% of the study sample reported that they ever had their blood glucose examined by a health care professional. Having had blood glucose measured was higher among women (9.6%) than men (7.2%) but not significantly (P=0.08). Residents in urban areas (11.8%) had significantly more often ever their blood glucose measured than residents in rural areas (5.4%) (P<0.001). Among study participants with diabetes, 22.3% were aware, 9.4% were currently taking treatment and 17.1% had controlled their diabetes (<7.0 mmol/L).Conclusion: Almost one in ten participants had pre-diabetes and diabetes and several associated variables were detected which can aid in designing intervention strategies.
Disability-Adjusted Life Years (DALYs) and Mortality Rate Attributed to Unsafe Sex and Drug Use for AIDS in the Middle East and North Africa Countries
Authors: Najafi Farid , Khosravi Fatemeh , Ghalandari Mojtaba , Darbandi Mitra
Published: August 2020

Background: To reduce the burden of HIV/AIDS, it is important to identify and estimate the attributable burden of risk factors associated with HIV/AIDS. The present study aimed to estimate the attributable burden of unsafe sex and drug use in AIDS in the Middle East and North Africa (MENA) countries. Methods: We used the data in Global Burden of Disease (GBD) 2017 to estimate the attributable burden of unsafe sex and drug use in AIDS in the MENA (22 countries) from 1990 to 2017 by sex and age. We estimated the attributable mortality and disability-adjusted life-years (DALYs) for the mentioned risk factors.Results: The rate of DALYs/100,000 attributed to drug use for AIDS increased 1.10 (95% CI: 0.75-1.71) to 13.39 (95% CI: 9.98- 18.17) in women of MENA countries from 1990 to 2017, and there is an increasing trend in DALY attributable to drug use for AIDS in men. The rate of DALYs/100,000 attributed to unsafe sex for AIDS increased in women of MENA countries, 5.15 (95% CI: 3.34-8.07) to 53.44 (95% CI: 38.79-75.89); and 10.06 (95% CI: 6.61-16.18) to 46.16 (95% CI: 31.30-72.66) in men. Age-standardized mortality rate attributed to drug use and unsafe sex for AIDS increased from 1990 to 2017 in both sex in MENA.Conclusion: The rate of DALYs/100,000 and age-standardized mortality rate attributed to unsafe sex and drug use increased in MENA from 1990 to 2017. While most of such countries have traditional cultures with religious believes, such increase need to be addressed in more depth by all policy makers.
A Modified Minimally Invasive Osteotomy for Hallux Valgus Allows Reduction of Malpositioned Sesamoid Bones
Authors: Palmanovich Ezequiel , Ohana Nissim , Slevin Omer , Feldman Viktor , Brin Yaron , Nyska Meir , Segal David
Published: August 2020

Background: Current minimally invasive distal metatarsal osteotomy for hallux valgus (HV) is V-shaped, which prevents correcting the rotational metatarsal head deformity and reduction of sesamoid bones. Methods: We retrospectively reviewed the records of 53 patients that underwent HV surgery by a single surgeon from 2017 to 2019 to compare outcomes of three techniques: open chevron osteotomy (n=19), minimally invasive V-shaped osteotomy (n=18), and a modified, straight minimally invasive osteotomy (n=16). Sesamoid position was graded using the Hardy and Clapham method based on standing radiographs. Results: Postoperative sesamoid position scores were significantly lower (better) following the modified osteotomy, compared with the two other techniques (1.44±0.81 vs 3.74±1.48 and 4.61±1.09, P<0.001), and mean change in score was greater (P<0.001). The modified technique yielded the largest improvements in inter-metatarsal and HV angles (P<0.05).Conclusion: The modified minimally invasive osteotomy was superior in the correction of HV deformity in all planes, including sesamoid reduction.Level of Evidence: IV
Changes in PCSK 9 and Apolipoprotein B100 in Niemann-Pick Disease After Enzyme Replacement Therapy with Olipudase Alfa
Authors: Kwok See , Garside Bethanie , Ho Jan Hoong , Liu Yifen , Dhage Shaishav , Donn Rachelle , Iqbal Zohaib , Jones Simon A. , Soran Handrean
Published: August 2020

Background: Enzyme replacement therapy (ERT) with olipudase alfa, a recombinant human acid sphingomyelinase (rhASM), is being developed to treat patients with ASM deficiency (ASMD), commonly known as Niemann-Pick Disease (NPD) types A or B. This study assessed the effect of ERT on lipid parameters and inflammatory markers.Methods: Serum and plasma samples from five adults with NPD type B (NPD-B) who received olipudase alfa ERT for 26 weeks were analysed. We also collected fasting blood samples from fifteen age- and sex-matched participants as reference and comparison group.We measured fasting lipid profile, apolipoproteins B48 and B100 (apoB48 and apoB100), apolipoprotein A1 (apoA1), proprotein convertase subtilisin/klexin type 9 (PCSK9) mass, oxidised low-density lipoprotein (oxLDL), small dense low-density lipoprotein cholesterol (sdLDL-C) and tumour necrosis factor α (TNF-α).Results: Patients with NPD-B, compared with age and sex matched reference group, had higher triglycerides, PCSK9, apoB48, oxLDL and TNF-α and lower high density lipoprotein cholesterol (HDL-C) and apoA1. Treatment with ERT was associated with improved lipid parameters including total cholesterol, triglycerides, low density lipoprotein cholesterol (LDL-C), sdLDL-C, oxLDL and apoB100. Though there was an increase in apoA1, HDL-C was slightly reduced. TNF-α showed a reduction. ApoB100 decreased in parallel with a decrease in total serum PCSK9 mass after ERT.Conclusion: This study demonstrated that patients with NPD-B had a proatherogenic lipid profile and higher circulating TNF-α compared to reference group. There was an improvement in dyslipidaemia after olipudase alfa. It was possible that reductions in LDL-C and apoB100 were driven by reductions in TNF-α and PCSK9 following ERT.
Tumor-Asociated Microbiota in Esophageal Squamous Cell Carcinoma
Authors: Yang Weixiong , Chen Chang-Han , Jia Minghan , Xing Xiangbin , Gao Lu , Tsai Hsin-Ting , Zhang Zhanfei , Liu Zhenguo , Zeng Bo , Yeung Sai-Ching Jim , Lee Mong-Hong , Cheng Chao
Published: August 2020

Background: Human intestinal tract microbiome dysbiosis plays an emerging pivotal role in tumorigenesis of gastrointestinal tract cancers. For esophageal squamous cell carcinoma (ESCC), the esophageal microbiota plays a critical role during the pathogenesis. The microbiome of esophageal can impact its host decades before the onset of ESCC, and can interact with the host’s physiological situation, which are affected by lifestyle factors, including diet, obesity, alcohol and tobacco use, and oral hygiene.Our objective is to analyze the composition of the ESCC-associated microbiota and characterize its contribution to the development of ESCC. The esophageal microbiota was prospectively investigated in 18 patients with ESCC and 11 patients with physiological normal (PN) esophagus by 16S rRNA gene profiling, using next-generation sequencing. Results: The microbiota composition in tumor tissues of ESCC patients is significantly different from that of patients with PN tissues. The ESCC microbiota was characterized by reduced microbial diversity, by decreased abundance of Bacteroidetes, Fusobacteria and Spirochactes. Employing these taxa into a microbial dysbiosis index demonstrated that dysbiosis microbiota had good capacity to discriminate between ESCC and PN esophagus. Functional analysis of the microbiota characterized that ESCC microbiota had altered nitrate reductase and nitrite reductase functions when compared with PN group. The observations were confirmed in other validation cohorts.Conclusions: Detailed analysis of the microbiota of the ESCC patients revealed that tumor exhibit a dysbiotic microbial community when compared with PN groups. We characterized microbial compositional changes, and further identified significant enrichments of Treponema amylovorum, Streptococcus infantis, Prevotella nigrescens, Porphyromonas endodontalis, Veillonella dispar, Aggregatibacter segnis, Prevotella melaninogenica, Prevotella intermedia, Prevotella tannerae, Prevotella nanceiensis and Streptococcus anginosus in ESCC oncogenic progression.Trial registration number: This study was registered at the Chinese Clinical Trial Registry (ChiCTR1800018897). http://www.chictr.org.cn/.
Gastric Adenocarcinoma of the Fundic Gland Type: Clinicopathological Features of Eight Patients Treated With Endoscopic Submucosal Dissection
Authors: Li Chengfang , Wu Xinglong , Yang Shuang , Yang Xiaorong , Yao Jin , Zheng Hong
Published: August 2020

BACKGROUNDGastric adenocarcinoma of the fundic gland type (GA-FG) has been added to the 2019 edition of the World Health Organization’s list of digestive system-associated cancers. This lesion differentiates toward the fundic gland and mostly involves chief cell-predominant differentiation with low-grade cytology. Clinicians and pathologists are still unaware of this rare disease; consequently, some cases are incorrectly diagnosed. This study aimed to investigate the clinicopathological features of GA-FG using retrospective analyses of endoscopic and pathological findings. CASE SUMMARYEight cases of endoscopic submucosal dissection (ESD) were obtained from our institution. Patient age ranged from 4880 years (mean, 65 years). Some patients were on acid-suppressing medication. Most lesions were located in the upper third (n = 7) and one was in the middle third of the stomach. Six lesions were of the superficial flat type, while two were of the superficial elevated type. Narrow-band imaging using magnifying endoscopy showed irregular microvascular patterns (MVPs) in four cases and regular MVPs in the remaining cases. All lesions were primarily solitary and ~6 mm in diameter (largest, 12 mm). All tumors were localized in the mucosal layer with six cases of invasion into the submucosal layer. Well-formed glands of chief cells were predominant. Tumor cells were positive for pepsinogen-I, MUC6, SYN, and CD56. Lymphatic and vascular infiltration and metastatic and recurrent disease were not observed in any case.CONCLUSIONGA-FG, a well-differentiated adenocarcinoma with mild atypia, can be completely removed using ESD, with a favorable prognosis in patients.
Characteristics of Gut Microbiome and Prediction of Infection in Neutropenic Children with Acute Leukemia
Authors: Wang Hongwu , Li Bixin , Li Aijia , Ni Ping , Lin Limin , Zhong Yong , Ma Lian
Published: August 2020

Background: Neutropenia in children with acute leukemia have a high incidence of infection and mortality. To identify and classify the potentially infected pathogens, this study compared the structural characteristics of gut microbiome in neutropenic and non-neutropenic children with acute leukemia. Results: The results showed that 6033 OUTs were observed in total, and the sequence coverage index was more than 0.97. In the analysis of alpha diversity, the colony richness index (Chao1 index) of Group A1 was significantly lower than that of Group A0 (P = 0.035). The fecal bacterial communities were dominated by the phylum Firmicutes, Proteobacteria, and Bacteroidetes in both groups, with no significant difference. Higher relative abundance of genera Enterococcus (P = 0.0076), Streptococcus (P = 0.014) and species Bacteroides fragilis (P = 0.034) were observed in Group A1, but class Clostridia (P = 0.038), genera Blautia (P = 0.021) and Roseburia (P = 0.011) were more prevalent in Group A0. The relatively high abundance of Bacteroides fragilis in neutropenia with childhood acute leukemia was an independent risk factor for infection (P=0.028, 95% CI 1.024-1.241).Conclusions: The increase of Enterococcus, Streptococcus and Bacteroides fragilis, and the decrease of Clostridium, Blautia, and Roseburia may be the characteristics of intestinal flora in patients with acute leukemia. The relatively high abundance of Bacteroides fragilis in neutropenia with childhood acute leukemia may predict the occurrence of infection.
Curtailing COVID-19 spread in drain pipelines: Using interfacial hydrodynamics for removing Bacterial and Viral Biofilms
Authors: Shahabaz P P , Murallidha Janani Srree
Published: August 2020

Drainage systems contains biological contaminants like bacteria and viruses flowing through them. Additionally, these pipelines also have organic matter known as biofilms growing on their walls. These biofilms infact act as incubation zones for further growth of bacteria and coronaviruses. Standard water treatment routines with traditional cleaning agents are known to be not be able to clean or sterilize microbes located in the inner layers of the biofilm. A recent study has identified specialised fluids which are effective in removing biofilms but these need to be used prudently. The present study proposes to use ‘ interfacial hydrodynamics’ to ensure that the cleaner-fluid (CF) is transported effectively to the location of the biofilms at the pipe walls, and allowed to be in contact with the biofilms for a sufficient amount of time so as to ensure its effective removal. The present study has used CFD technique of Multi-fluid VOF and has demonstrated that relative superficial velocities of cleaner- fluids and sewage water can be controlled, so as to achieve flow regimes that ensure delivery of cleaner fluid to the periphery of the tube walls. Our simulations indicate that most effective cleaning can be achieved by using a cleaner-fluid with a high viscosity ( ~5000 cP)). In such cases, a low- medium velocity (~0.05-0.3 m/s) of CF and water would ensure that the cleaner fluids are in constant contact with the pipe walls. Other suitable viscosity and velocity combinations have also been proposed. Flow parameters that can be used to monitor and cross-verify expected flow patterns on-site have also been proposed.
Artificial Intelligence Based Model to Predict Labour Productivity for Small & Medium Scale Bus Body Building Society in Present and Post Pandemic Situation
Authors: Nagarajan Bagathsingh , Annamalai Sivakumar , D Arulkirubakaran , P Praveen Vijaya Raj
Published: August 2020

In the recession, the lack of potential labour was the most important concern for the small- and medium-scale bus body fabrication industries. In the pandemic covid-19 situation, the productivity of these fabrication industries was turndown due to deprivation of labour productivity, postponement of work and cost overshoot, which may pilot to argue. In India, Central Tamil Nadu fabrication industries are buttress by immense labour intensity. In this panic situation, these industries are struggling to obtain better productivity. Diversity of earlier works on the detection of the factors with the intention of impacting labour productivity in structural industries and manufacturing sectors has been carried out by research in many countries. Nevertheless, those attempt characteristics are restricted to credentials and implemented in subjective techniques for analysis in declining bus body fabrication sectors. Ambition of this particular research is to recommend an artificial intelligence-based model to predict the “uncertainty factors” influencing labour productivity and safety performance of bus body fabrication industries related to small and medium scale in the pandemic and post pandemic situation.
Food Insecurity and Its Predictors among Lactating Mothers in North Shoa Zone, Central Ethiopia
Authors: Getacher Lemma , Egata Gudina , Aynalem Yared Asmare , Molla Abebaw , Tesfaye Adane , Abebe Haimanot , Alebachew Wubet , Derbie Samuel
Published: August 2020

Background: Ending food insecurity is one of the goals of Sustainable Development Goals (SDGs). It is also one of the serious problems of Ethiopia. However, there is a dearth of studies that show the status of food insecurity among lactating mother in Ethiopia including the study area. Therefore, the objective of this study is to assess the predictors of food insecurity among lactating mothers in Ataye District, North Shoa, and Central Ethiopia. Methods: A community-based cross-sectional study design was used among 612 lactating mothers aged 15-49 years. The food insecurity was determined by computing nine standards Household Food Insecurity Access Scale (HFIAS) questions. A structured interviewer-administered questionnaire was used to collect the data. Data were entered into EpiData version 4.2 and exported to SPSS (Statistical Package for Social Science) version 24 for analysis. Odds ratio with 95% confidence interval was used for the predictors of food insecurity using bivariate and multivariate logistic regression analysis. Results: The prevalence of food insecurity among lactating mothers was 36.8%. No formal education [(AOR=1.82, 95% CL: (1.13, 2.92)], no income-generating activities [(AOR=3.39, 95% CI: ((2.05, 5.64))], no home gardening practices [(AOR=5.65, 95% CI: (3.51, 9.08)], alcohol use by husbands [(AOR=2.02, 95% CI: (1.25, 3.24)], low minimum dietary diversity scores [(AOR=2.94, 95% CI: (1.88, 4.57)], less than three frequencies of meals [(AOR=3.97, 95% CI: (1.65, 9.54)] and three meals only per day [(AOR= 1.86, 95% CI: (1.08, 3.17)] were significant predictors of food insecurity of mothers. Conclusion: The prevalence of food insecurity was high in the study area. No formal education, no income-generating activities, no home gardening practice, alcohol use by husbands, low minimum dietary diversity score, fewer than three frequencies of meals and three meals only per day were independent predictors of food insecurity. Therefore, increasing home gardening, decreasing alcohol intake, increasing dietary diversity, and performing income-generating activities are highly recommended to reduce food insecurity.
Resuscitation Refresher Training in the Wake of the COVID-19 Pandemic – Instructor-led Training Outperforms Self-directed Learning.
Authors: O’Donnell Alice , Pawar Aniela , Hardy Emma , Percival Harriet , Coffin Nicholas , Hulme Jonathan , Owen Andrew , Alderman Joseph
Published: August 2020

Background

survival following out-of-hospital cardiac arrest is worse in the United Kingdom than in many other developed countries, possibly due to below average delivery of early bystander cardiopulmonary resuscitation (CPR). Training laypeople how to perform CPR is vital, but skill decays quickly. Most methods of training require face-to-face contact which is challenging during the Covid-19 pandemic. The optimal method of delivering CPR refresher training is not yet known. Our aim was to understand how basic life support (BLS) performance decays over time, and how best to deliver refresher training in terms of timeframe and training method – are methods with limited instructor / student contact effective?
Methods

this quasi-randomised trial allocated participants to receive refresher training one, two, or three years after their initial BLS training. Participants’ baseline BLS performance was assessed by a trained instructor, and then they were randomly allocated to receive refresher training via one of three methods: one-to-one instructor led training, video assisted learning with self-directed practice, or a written information guide alone. BLS performance was assessed again following refresher training.
Results

42 participants were recruited - all completed all study stages. Baseline BLS performance was poor – only 21% of participants passed a formative assessment. Students who had received BLS training most recently showed better BLS performance than those where greater time had elapsed. one-to-one training was the most effective refresher training modality, and video assisted training did not lead to significant improvement in BLS performance.
Conclusion

one-to-one BLS refresher training outperforms self-directed methods with more limited instructor contact, though it requires greater resource and planning. It may be impractical to deliver instructor-led BLS refresher training during the Covid-19 pandemic. The video we chose to use for our training was not interactive, though such tools exist. Alternative video-led approaches (with or without instructor guidance) should be explored to investigate if they are more effective than the tool we used in this study.
Using 3D Printing Technology for Corrective Biplanar Chevron Osteotomy with Customized Osteotomy Guide and Patient-Matched Monoblock Crosslink Plate in Treatment of Cubitus Varus Deformity: A Case Report and Technical Note
Authors: Sri-utenc Nithid , Pengrung Nachapan , SrikonK Korakod , Puncreobutr Chedtha , Lohwongwatana Boonrat , Sa-ngasoongsong Paphon
Published: August 2020

Background

Cubitus varus deformity (CVD), a common complication after a supracondylar fracture of the distal humerus, is usually treated with corrective osteotomy. However, due to the complex anatomy of the distal humerus, conventional osteotomy techniques are sometimes unreliable and can result in an inaccurate correction, residual deformity, and lateral condyle prominence. Recently, medial three-dimensional (3D) printing technology has demonstrated potential benefits for the treatment of CVD by improving the accuracy of the osteotomy through the use of an osteotomy guide with or without a patient-mated plate. This study aimed to present an interesting CVD case involving a patient who was treated with corrective biplanar Chevron osteotomy using an innovative customized osteotomy guide and a newly designed patient-matched monoblock crosslink plate created with 3D printing technology.
Methods

A computer simulation was processed using images from computerized tomography(CT) scans of both upper extremities. The biplanar Chevron osteotomy was designed to create identical anatomy between the mirror image of the contralateral distal humerus and the osteotomized distal humerus. Next, the customized osteotomy guide and patient-matched monoblock crosslink plate were designed and printed. A simulation osteotomy for the real-sized bone model was created.
Results

The operation was performed using the posterior paratricipital approach and the k-wire position from the customized osteotomy guide as a predrilled hole for screw fixation to achieve immediate control of the reduction after osteotomy. Our method helped successfully treat the CVD in the case study patient and significantly improved her radiographic and clinical outcomes with a satisfactory result.
Conclusion

This study showed that the treatment of CVD using 3D printing technology to create an innovative customized osteotomy guide and a patient-matched monoblock crosslink plate can help accurately assess and control the CVD correction. To the best of our knowledge, this case report introduces a new insight for the clinical application of 3D printing technology in the treatment of CVD.
Number of type 2 diabetes patients achieving HbA1c goal and Related Factors in Brazil: A real world evidence study
Authors: Harder Lillian , Andrade Tarik K , Serra Fernando B , Pinho Felipe M , Pinzon Adolfo , Orengo Juan Carlos
Published: August 2020

Background

Despite the clinical advances in the management of type 2 diabetes mellitus (T2DM) over the past decades, in the US, nearly 48% of patients do not achieve the ADA recommended glycemic goal of glycated hemoglobin (HbA1c) below 7.0%1. The Brazilian Guidelines for the Treatment of T2DM has established the same goal of HbA1c below 7.0%2, but the data for the rate of glycemic goal achievement in Brazil is lacking. The aim of this study was to determine the rate of HbA1c goal achievement among Brazilian patients receiving antidiabetic therapy and investigate its relation to other clinical and demographic covariates.
Methods

Using a cross-sectional database analysis from a group of private clinics in São Paulo, Brazil, this Real Word Evidence study evaluated 1034 patients with T2DM, which were being treated with at least one antidiabetic agent for a minimum of three months and had a basal level of Glycated Hemoglobin (HbA1c) above 7.0%. The number of patients that did not achieve the therapeutic target of HbA1c below 7% was calculated. Demographic and clinical characteristics were collected and a correlation analysis with the treatment target achievement was performed.
Results

The average age of the population was 60.5 years and gender were equally distributed. A total of 60.3% of the patients did not achieve the target of HbA1c below 7% after a minimum of three months treatment with one or more antidiabetic agents. The average time between HbA1c basal to final was 9.9 months. The average basal level of HbA1c was 9.9% ± 2.2 and the final level was 7.8% ± 1.9. In the univariate analysis a statistically significant difference was observed in the following clinical variables: age, total cholesterol level, LDL level, basal and final HbA1c, time to HbA1c final measure, treatment time, and number of antidiabetic agents.
Conclusion

In this retrospective real-world study, only 40% of patients achieved the glycemic target of HbA1c below 7% after at least 3 months of treatment with one or more antidiabetic agent. The average initial HbA1c was 9.9% and the final level was 7.8%. Patients not at goal were older and had more comorbidities, which highlight the challenge that represents the management of diabetes in Brazil. This study confirms previous published data that T2DM glycemic targets are difficult to achieve and the reasons for this are complex and multifactorial
Best Practice Guidelines in Managing the Craniofacial Aspects of Skeletal Dysplasia
Authors: Savarirayan Ravi , Tunkel David E. , Sterni Laura M. , Bober Michael B. , Cho Tae-Joon , Goldberg Michael J , Hoover-Fong Julie , Irving Melita , Kamps Shawn E. , Mackenzie William G. , Raggio Cathleen , Spencer Samantha A. , Bompadre Viviana , White Klane
Published: August 2020

Background
Recognition and appropriate management of the craniofacial manifestations of patients with skeletal dysplasia are challenging, due to the rarity of these conditions, and dearth of literature to support evidence-based clinical decision making.
Methods
Using the Delphi method, an international, multi-disciplinary group of individuals, with significant experience in the care of patients with skeletal dysplasia, convened to develop multi-disciplinary, best practice guidelines in the management of craniofacial aspects of these patients.
Results
After a comprehensive literature review, 23 initial statements were generated and critically discussed, with subsequent development of a list of 22 best practice guidelines after a second round voting.
Conclusions
The guidelines are presented and discussed to provide context and assistance for clinicians in their decision making in this important and challenging component of care for patients with skeletal dysplasia, in order standardize care and improve outcomes.
Characterization of the metasomatizing agent in the upper mantle beneath the northern Pannonian Basin based on Raman imaging, FIB-SEM, and LA-ICP-MS analyses of silicate melt inclusions in spinel peridotite
Authors: Liptai Nóra , Berkesi Márta , Patkó Levente , Bodnar Robert J. , O’Reilly Suzanne Y. , Griffin William L. , Szabó Csaba
Published: August 2020

Silicate melt inclusions (SMI) containing several daughter minerals, residual glass, and a CO2 bubble were analyzed to constrain the composition and evolution of the metasomatic melt present in the upper mantle beneath the Nógrád-Gömör Volcanic Field (NGVF), northern Hungary to southern Slovakia. The SMI were analyzed with a combination of Raman spectroscopy, FIB-SEM, and LA-ICP-MS to identify phases and obtain their volume proportions and major- and trace-element geochemistry. Slicing through the entire volume of the inclusions and collecting geochemical information at each slice with FIB-SEM allowed us to model the 3D appearance of the phases within the SMI and to use this information to calculate bulk major-element compositions.

The partially crystallized SMI are hosted in clinopyroxene in a lherzolite xenolith that shows evidence of a metasomatic event that altered the lherzolites to produce wehrlites. Based on bulk compositions, the SMI trapped the metasomatic melt linked to wehrlite formation in the NGVF. The melt is enriched in Fe and has an OIB-like trace-element pattern, which suggests an intraplate mafic melt similar to the host basalt, but with slightly different chemistry. Pre-entrapment evolution and reaction with the lherzolite wall rock produced an intermediate melt composition. Petrogenetic modeling indicates that the melt was generated as a result of a very small degree of partial melting of a garnet lherzolite source. Following entrapment, a volatile bubble exsolved from the residual melt during ascent to shallow depths as suggested by consistent densities of CO2 in vapor bubbles. Small crystals, including sulfates and mica, that formed at the boundary of the bubble and the glass indicate that the exsolved fluid originally contained S and H2O, in addition to CO2.
Titanium diffusion profiles and melt inclusion chemistry and morphology in quartz from the Tshirege Member of the Bandelier Tuff
Authors: Boro Joseph R. , Wolff John A. , Neill Owen K. , Steiner Arron R. , Ramos Frank C.
Published: August 2020

Many rhyolites contain quartz crystals with relatively Ti-rich rims and Ti-poor cores, with a sharp interface between zones, attributed to partial dissolution followed by overgrowth following a heating event due to mafic recharge of the system. Quartz crystals in the compositionally zoned, high-silica rhyolite Tshirege Member of the Bandelier Tuff erupted at 1.26 Ma from the Valles caldera, New Mexico, show a range in zoning styles with Ti-rich rims becoming more abundant upward in the ignimbrite sheet among progressively less evolved magma compositions. Here we compare times between quartz overgrowth and eruption obtained by applying Ti diffusion coefficients to Ti concentration profiles in Tshirege Member quartz crystals with those from cathodoluminescence (CL) brightness profiles and show that panchromatic CL provides only a crude proxy for Ti in quartz in this unit. Titanium concentrations are measured to detection limits of ~1.2 ppm with small analytical errors (<5%) using MAN backgrounds, blank corrections, and oblique corrected transects to resolve diffusion-relaxed zone boundaries as thin as ~10 μm. Timescales derived from Ti profiles using the widely applied Tiin-quartz diffusion coefficients of Cherniak et al. (2007) range from 60 to 10 000 years, suggesting heating and mobilization events at different times prior to the eruption. However, the use of the newer Ti diffusivities reported by Jollands et al. (2020) yields timescales up to three orders of magnitude longer, including results that are geologically unreasonable for the Bandelier system. We suggest that assumptions commonly made in diffusion modeling, specifically about the form of the Ti zoning profile prior to diffusive relaxation, may be invalid.

Melt inclusions in the Ti-poor cores of late-erupted quartz are chemically akin to early erupted melt compositions, while adhering and groundmass glasses more closely reflect the composition of the host pumice. Heating and mobilization events identified from quartz Ti zoning are thus linked to overall compositional zoning of the tuff, which may have been produced by repeated episodes of melting of a crystal cumulate cognate to the early-erupted, evolved rhyolite. Quartz-hosted melt inclusion faceting suggests the development of a crystal mush over a minimum time frame of 1000–10 000 years prior to the recharge events that produced the erupted Tshirege magma at 1.26 Ma.
Effect of cationic substitution on the pressure-induced phase transitions in calcium carbonate
Authors: Martirosyan Naira S. , Efthimiopoulos Ilias , Pennacchioni Lea , Wirth Richard , Jahn Sandro , Koch-Müller Monika
Published: August 2020

The high-pressure CaCO3 phase diagram has been the most extensively studied within the carbonates group. However, both the diverse mineralogy of carbonates and the abundance of solid solutions in natural samples require the investigation of multi-component systems at high pressures (P) and temperatures (T). Here we studied a member of the CaCO3–SrCO3 solid-solution series and revealed the effect of cationic substitution on the pressure-induced phase transitions in calcium carbonate.

A synthetic solid solution Ca0.82Sr0.18CO3 was studied in situ by Raman spectroscopy in a diamond-anvil cell (DAC) up to 55 GPa and 800 K. The results of this work show significant differences in the high-pressure structural and vibrational behavior of the (Ca,Sr)CO3 solid solution compared to that of pure CaCO3. The monoclinic CaCO3-II-type structure (Sr-calcite-II) was observed already at ambient conditions instead of the “expected” rhombohedral calcite. The stress-induced phase transition to a new high-pressure modification, termed here as Sr-calcite-IIIc, was detected at 7 GPa. Sr-calcite-VII formed already at 16 GPa and room T, which is 14 GPa lower compared to CaCO3-VII. Finally, crystallization of Sr-aragonite was detected at 540 K and 9 GPa, at 200 K lower T than pure aragonite. Our results indicate that substitution of Ca2+ by bigger cations, such as Sr2+, in CaCO3 structures can stabilize phases with larger cation coordination sites (e.g., aragonite, CaCO3-VII, and post-aragonite) at lower P-T conditions compared to pure CaCO3. The present study shows that the role of cationic composition in the phase behavior of carbonates at high pressures should be carefully considered when modeling the deep carbon cycle and mantle processes involving carbonates, such as metasomatism, deep mantle melting, and diamond formation.
ADVANCE DIAGNOSTICS TO RESOLVE INTRICATE AND NEGLECTED HEALTH PROBLEMS IN INDONESIA
Authors: Perdamaian Teguh Kristian
Published: August 2020

We are proud to present the first full English edition of BIKDW starting from this fifth volume in 2020. In this issue, we present articles on the utilisation of medical technology for daily clinical practice, and research on preventive medicine
Drug Repositioning for the Treatment of Hematologic Disease: Limits, Challenges and Future Perspectives
Authors: Allegra Alessandro , Imbesi Chiara , Bitto Alessandra , Ettari Roberta
Published: August 2020

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Drug repositioning is a strategy to identify new uses for approved or investigational
drugs that are used off-label outside the scope of the original medical indication.

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In this review, we report the most relevant studies about drug repositioning in hematology,
reporting the signalling pathways and molecular targets of these drugs, and describing the biological
mechanisms which are responsible for their anticancer effects.

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Although the majority of studies on drug repositioning in hematology concern acute myeloid
leukemia and multiple myeloma, numerous studies are present in the literature on the possibility
of using these drugs also in other hematological diseases, such as acute lymphoblastic leukemia,
chronic myeloid leukemia, and lymphomas. Numerous anti-infectious drugs and
chemical entities used for the therapy of neurological or endocrine diseases, oral antidiabetics,
statins and medications used to treat high blood pressure and heart failure, bisphosphonate
and natural substance such as artemisin and curcumin, have found a place in the treatment of
hematological diseases. Moreover, several molecules drastically reversed the resistance of the
tumor cells to the chemotherapeutic drugs both in vitro and in vivo.
Drug Repurposing in Oncology, an Attractive Opportunity for Novel Combinatorial Regimens
Authors: Falvo Paolo , Orecchioni Stefania , Roma Stefania , Raveane Alessandro , Bertolini Francesco
Published: August 2020

The costs of developing, validating and buying new drugs are dramatically increasing.
On the other hand, sobering economies have difficulties in sustaining their healthcare systems,
particularly in countries with an elderly population requiring increasing welfare. This
conundrum requires immediate action, and a possible option is to study the large, already present
arsenal of drugs approved and to use them for innovative therapies. This possibility is
particularly interesting in oncology, where the complexity of the cancer genome dictates in
most patients a multistep therapeutic approach. In this review, we discuss a) Computational
approaches; b) preclinical models; c) currently ongoing or already published clinical trials in
the drug repurposing field in oncology; and d) drug repurposing to overcome resistance to
previous therapies.
An Overview of the Activities of Cefiderocol Against Sensitive and Multidrug- Resistant (MDR) Bacteria
Authors: AlMatar Manaf , Albarri Osman , Makky Essam A. , Var Işıl , Köksal Fatih
Published: August 2020

The need for new therapeutics and drug delivery systems has become necessary owing to
the public health concern associated with the emergence of multidrug-resistant microorganisms.
Among the newly discovered therapeutic agents is cefiderocol, which was discovered by Shionogi
Company, Japan as an injectable siderophore cephalosporin. Just like the other β-lactam antibiotics,
cefiderocol exhibits antibacterial activity via cell wall synthesis inhibition, especially in Gram negative
bacteria (GNB); it binds to the penicillin-binding proteins, but its unique attribute is that it crosses the
periplasmic space of bacteria owing to its siderophore-like attribute; it also resists the activity of
β-lactamases. Among all the synthesized compounds with the modified C-7 side chain, cefiderocol (3)
presented the best and well-balanced activity against multi-drug resistant (MDR) Gram negative bacteria,
including those that are resistant to carbapenem. İn this article, an overview of the recent studies on
cefiderocol was presented.
Naphthoquinone Derivatives Isolated from Plants: Recent Advances in Biological Activity
Authors: Ahmadi Esmaeil Sheikh , Tajbakhsh Amir , Iranshahy Milad , Asili Javad , Kretschmer Nadine , Shakeri Abolfazl , Sahebkar Amirhossein
Published: August 2020

Naturally occurring naphthoquinones (NQs) comprising highly reactive small molecules are the subject of increasing attention due to their promising biological activities such as antioxidant, antimicrobial, apoptosis-inducing activities, and especially anticancer activity. Lapachol, lapachone, and napabucasin belong to the NQs and are in phase II clinical trials for the treatment of many cancers. This review aims to provide a comprehensive and updated overview on the biological activities of several new NQs isolated from different species of plants reported from January 2013 to January 2020, their potential therapeutic applications and their clinical significance.