bluuebunny/crossref_metadata_2025 huggingface dataset:
Influence of toileting behavior on the natural course of anterior vaginal wall prolapse
Authors: Kose Osman , Atik Yavuz Tarik , Gul Deniz , Uysal Burak , Cimen Haci Ibrahim , Bostanci Mehmet Suhha
Published: March 2022

Background

Many risk factors for pelvic organ prolapse (POP) have been proposed, and the cause is most likely multifactorial. This study aimed to investigate the effect of toileting behaviors on the natural course of anterior vaginal wall prolapse (AVWP).

Methods

Data on 75 women who underwent surgery for symptomatic AVWP were collected. Patients with grade ≥ II AVWP were included in this study and were divided into two groups according to their voiding and defecation position. The volunteers who voided and defecated in a sitting position comprised Group 1, and those who voided and defecated in a squatting position comprised Group 2. The Colorectal-Anal Impact Questionnaire (CRAIQ), Pelvic Floor Impact Questionnaire (PFIQ), Pelvic Organ Prolapse Impact Questionnaire (POPIQ), Urinary Impact Questionnaire (UIQ) and visual analog scale (VAS) pain scores were used to evaluate the patients’ symptoms.

Results

Forty-four patients were included in Group 1 (sitting position), and 31 patients were included in Group 2 (squatting position). The groups were similar in terms of BMI, parity, menopause duration, topical estrogen use, comorbidities, the presence of constipation and urinary incontinence, and the pad count for incontinence. The time from initial symptoms to surgery was shorter in Group 2 than in Group 1 12 (3–73) and 24 (2–182) months (p = 0.001), respectively. The PFIQ, POPIQ and POP-related VAS scores were significantly higher in patients who voided and defecated in a squatting position.

Conclusion

In patients with symptomatic POP, increased IAP while performing the squat position during defecation and voiding may increase the severity of patients' symptoms related to prolapse more than that of sitting position. Therefore, questioning the toileting position of patients with AVWP may help inform management decisions, with changing to a sitting position encouraged.
Distress financing in coping with out-of-pocket expenditure for maternity care in India
Authors: Balla Shalem , Sk Md Illias Kanchan , Ambade Mayanka , Hossain Babul
Published: March 2022

Background

The cost of maternity care is seen as the barrier in utilizing maternity care, resulting in high maternal deaths. This study focuses on the distress financing and its coping mechanisms associated with maternity care expenditure in India so that corrective measures can be taken to reduce the burden of maternity care.

Methods

This study used the National Sample Survey (NSS) data conducted in 20,014–15 (71st round of NSS) and 2017–18(75th round of NSS). We define distress financing as use of formal borrowing, borrowing from friends or family or sale of asser to finance maternity care. Percentage of pregnant/delivered females using distress financing were calculated.. The present study also used multinomial logistic regression with 95% to understand the impact of socio-economic variables on distress financing and concentration index to measure the inequality in maternity care expenditure.

Results

This study found that the maternity care expenditure has decreased from the INR. 9379 in 2014–15 to INR. 7835 in 2017–18. The percentage of households using distress financing is higher among the poorest (13.2%). Almost 14% of the SC households experience distress financing. Among EAG + A states, particularly in Madhya Pradesh and Uttarakhand, the percentage of households are which experience a high level of distress financing increased from 8.9 to 18.3 and 0.7 to 8.1 from 2014–15 to 2017–18 respectively. The study finds that more urban households (37%) utilized insurance than rural households (26%). Among EAG + A states, 67.9 percent of households were dependent upon household savings, and it was 63.6 percent in the non-EAG states. The households with a high burden of maternity care expenditure were at higher risk of borrowing money to finance the cost of maternity as compared to use of savings/income for the same (relative risk (RR) (R: 2.59; P < 0.01; 95% CI: 2.15–3.13). Mothers belonging to the SC caste were at significantly higher risk (RR: 1.43; P < 0.1; 95% CI: 1.07–1.91). of using borrowings as compared to the use of income/savings. Mothers with college education were 50% more likely to use health insurance as compared to those with primary education.

Conclusions

The study found that even though many programs for maternity care services are there, the maternity care expenditure, particularly the delivery care expenses, is very high in many states. The study recommends that India should increase subsidized maternity care facilities to decrease catastrophic maternity expenditure among households.
The role of feedback in emergency ambulance services: a qualitative interview study
Authors: Wilson Caitlin , Howell Anne-Marie , Janes Gillian , Benn Jonathan
Published: March 2022

Background

Several international studies suggest that the feedback that emergency ambulance service (EMS) personnel receive on the care they have delivered lacks structure, relevance, credibility and routine implementation. Feedback in this context can relate to performance or patient outcomes, can come from a variety of sources and can be sought or imposed. Evidence from health services research and implementation science, suggests that feedback can change professional behavior, improve clinical outcomes and positively influence staff mental health. The current study aimed to explore the experience of EMS professionals regarding current feedback provision and their views on how feedback impacts on patient care, patient safety and staff wellbeing.

Methods

This qualitative study was conducted as part of a wider study of work-related wellbeing in EMS professionals. We used purposive sampling to select 24 frontline EMS professionals from one ambulance service in the United Kingdom and conducted semi-structured interviews. The data was analyzed in iterative cycles of inductive and deductive reasoning using Abductive Thematic Network Analysis. The analysis was informed by psychological theory, as well as models from the wider feedback effectiveness and feedback-seeking behavior literature.

Results

Participants viewed current feedback provision as inadequate and consistently expressed a desire for increased feedback. Reported types of prehospital feedback included patient outcome feedback, patient-experience feedback, peer-to-peer feedback, performance feedback, feedforward: on-scene advice, debriefing and investigations and coroners’ reports. Participants raised concerns that inadequate feedback could negatively impact on patient safety by preventing learning from mistakes. Enhancing feedback provision was thought to improve patient care and staff wellbeing by supporting personal and professional development.

Conclusions

In line with previous research in this area, this study highlights EMS professionals’ strong desire for feedback. The study advances the literature by suggesting a typology of prehospital feedback and presenting a unique insight into the motives for feedback-seeking using psychological theory. A logic model for prehospital feedback interventions was developed to inform future research and development into prehospital feedback.
Strategies to overcome the main challenges of the use of CRISPR/Cas9 as a replacement for cancer therapy
Authors: Rasul Mohammed Fatih , Hussen Bashdar Mahmud , Salihi Abbas , Ismael Bnar Saleh , Jalal Paywast Jamal , Zanichelli Anna , Jamali Elena , Baniahmad Aria , Ghafouri-Fard Soudeh , Basiri Abbas , Taheri Mohammad
Published: March 2022

CRISPR/Cas9 (clustered regularly interspaced short palindromic repeats-associated protein 9) shows the opportunity to treat a diverse array of untreated various genetic and complicated disorders. Therapeutic genome editing processes that target disease-causing genes or mutant genes have been greatly accelerated in recent years as a consequence of improvements in sequence-specific nuclease technology. However, the therapeutic promise of genome editing has yet to be explored entirely, many challenges persist that increase the risk of further mutations. Here, we highlighted the main challenges facing CRISPR/Cas9-based treatments and proposed strategies to overcome these limitations, for further enhancing this revolutionary novel therapeutics to improve long-term treatment outcome human health.
Activation of miR-500a-3p/CDK6 axis suppresses aerobic glycolysis and colorectal cancer progression
Authors: Liu Yu , Tang Wentao , Ren Li , Liu Tianyu , Yang Meng , Wei Ye , Chen Yijiao , Ji Meiling , Chen Guosong , Chang Wenju , Xu Jianmin
Published: March 2022

Background

Colorectal cancer (CRC) is one of the lethal cancers with a high mortality rate worldwide and understanding the mechanisms behind its progression is critical for improving patients’ prognosis and developing therapeutics. MiR-500a-3p has been demonstrated to be involved in the progression of several human cancers but its role in CRC remains unclear. The aim of this study is to uncover the expression pattern and mechanisms of action of miR-500a-3p during the CRC progression.

Methods

The expression of miR-500a-3p and Cyclin-dependent kinases 6 (CDK6) in 134 CRC tissues were tested by quantitative PCR (qPCR) and immunohistochemistry staining (IHC), respectively. The effect of miR-500a-3p on cell proliferation was explored in vitro and in vivo. The glycolysis of CRC cells was determined by Mass Spectrometry and Seahorse XF 96 Extracellular Flux Analyzer. A dual-luciferase reporter assay was performed to validate the relationship between miR-500a-3p and CDK6.

Results

miR-500a-3p was abnormally downregulated in CRC tissues and cell lines and was negatively associated with a worse prognosis. miR-500a-3p mimics impeded CRC cell proliferation in vitro and in vivo. miR-500a-3p inhibited glucose consumption, lactate and ATP production, and down-regulated the expression of hexokinase2 (HK2). In silico prediction combined with western blot and luciferase assay confirmed that CDK6 is a direct target of miR-500a-3p. Overexpression of CDK6 phenotypically rescued the inhibitory effect of miR-500a-3p on the proliferation and glycolysis of CRC cells.

Conclusions

Our study revealed a potential tumor-suppressive role of miR-500a-3p in CRC, specifically targeting CDK6 and inhibiting cancer cell proliferation and aerobic glycolysis, which may provide new insights into novel prognostic biomarkers and therapeutic targets for CRC.
MiR-25 overexpression inhibits titanium particle-induced osteoclast differentiation via down-regulation of mitochondrial calcium uniporter in vitro
Authors: Hu Weifan , Yu Yongbo , Sun Yang , Yuan Feng , Zhao Fengchao
Published: March 2022

Background

Mitochondrial calcium uniporter (MCU) is an important ion channel regulating calcium transport across the mitochondrial membrane. Calcium signaling, particularly via the Ca2+/NFATc1 pathway, has been identified as an important mediator of the osteoclast differentiation that leads to osteolysis around implants. The present study aimed to investigate whether down-regulation of MCU using microRNA-25 (miR-25) mimics could reduce osteoclast differentiation induced upon exposure to titanium (Ti) particles.

Methods

Ti particles were prepared. Osteoclast differentiation of RAW264.7 cells was induced by adding Ti particles and determined by TRAP staining. Calcium oscillation was determined using a dual-wavelength technique. After exposure of the cells in each group to Ti particles or control medium for 5 days, relative MCU and NFATc1 mRNA expression levels were determined by RT-qPCR. MCU and NFATc1 protein expression was determined by western blotting. NFATc1 activation was determined by immunofluorescence staining. Comparisons among multiple groups were conducted using one-way analysis of variance followed by Tukey test, and differences were considered significant if p < 0.05.

Results

MCU expression was reduced in response to miR-25 overexpression during the process of RAW 264.7 cell differentiation induced by Ti particles. Furthermore, osteoclast formation was inhibited, as evidenced by the low amplitude of calcium ion oscillation, reduced NFATc1 activation, and decreased mRNA and protein expression levels of nuclear factor-κB p65 and calmodulin kinases II/IV.

Conclusions

Regulation of MCU expression can impact osteoclast differentiation, and the underlying mechanism likely involves the Ca2+/NFATc1 signal pathway. Therefore, MCU may be a promising target in the development of new strategies to prevent and treat periprosthetic osteolysis.
Single-cell and spatially resolved analysis uncovers cell heterogeneity of breast cancer
Authors: Liu Si-Qing , Gao Zhi-Jie , Wu Juan , Zheng Hong-Mei , Li Bei , Sun Si , Meng Xiang-Yu , Wu Qi
Published: March 2022

The heterogeneity and the complex cellular architecture have a crucial effect on breast cancer progression and response to treatment. However, deciphering the neoplastic subtypes and their spatial organization is still challenging. Here, we combine single-nucleus RNA sequencing (snRNA-seq) with a microarray-based spatial transcriptomics (ST) to identify cell populations and their spatial distribution in breast cancer tissues. Malignant cells are clustered into distinct subpopulations. These cell clusters not only have diverse features, origins and functions, but also emerge to the crosstalk within subtypes. Furthermore, we find that these subclusters are mapped in distinct tissue regions, where discrepant enrichment of stromal cell types are observed. We also inferred the abundance of these tumorous subpopulations by deconvolution of large breast cancer RNA-seq cohorts, revealing differential association with patient survival and therapeutic response. Our study provides a novel insight for the cellular architecture of breast cancer and potential therapeutic strategies.
A serpiginous lesion of scrotum
Authors: Romano Sara , Dall’Amico Roberto , Declich Valentina , Barbi Egidio
Published: March 2022

Background

Median raphe cyst is usually benign and asymptomatic male genitalia lesions. Although uncommon, infection may be a complication.

Case presentation

We report the case of a 4-year-old child presented to the emergency department for a serpiginous and redness lesion extended from the basis of the penis until the perineum. An infected median raphe cyst was suspected, and the patient underwent surgical treatment and antibiotic therapy with complete resolution of symptoms. Liquid culture resulted positive for Serratia Marcescens.

Conclusion

Infection is a rare complication, especially in childhood. To prevent relapses and clinical symptoms, the majority of authors recommend surgical excision followed by primary closure. In case of infections caused by Serratia Marcescens, chronic granulomatous disease should always be rule out.
Randomized controlled trial: neostigmine for intra-abdominal hypertension in acute pancreatitis
Authors: He Wenhua , Chen Peng , Lei Yupeng , Xia Liang , Liu Pi , Zhu Yong , Zeng Hao , Wu Yao , Ke Huajing , Huang Xin , Cai Wenhao , Sun Xin , Huang Wei , Sutton Robert , Zhu Yin , Lu Nonghua
Published: March 2022

Background

Intra-abdominal hypertension (IAH) in acute pancreatitis (AP) is associated with deterioration in organ function. This trial aimed to assess the efficacy of neostigmine for IAH in patients with AP.

Methods

In this single-center, randomized trial, consenting patients with IAH within 2 weeks of AP onset received conventional treatment for 24 h. Patients with sustained intra-abdominal pressure (IAP) ≥ 12 mmHg were randomized to receive intramuscular neostigmine (1 mg every 12 h increased to every 8 h or every 6 h, depending on response) or continue conventional treatment for 7 days. The primary outcome was the percent change of IAP at 24 h after randomization.

Results

A total of 80 patients were recruited to neostigmine (n = 40) or conventional treatment (n = 40). There was no significant difference in baseline parameters. The rate of decrease in IAP was significantly faster in the neostigmine group compared to the conventional group by 24 h (median with 25th–75th percentile: −18.7% [− 28.4 to − 4.7%] vs. − 5.4% [− 18.0% to 0],P = 0.017). This effect was more pronounced in patients with baseline IAP ≥ 15 mmHg (P = 0.018). Per-protocol analysis confirmed these results (P = 0.03). Stool volume was consistently higher in the neostigmine group during the 7-day observational period (allP < 0.05). Other secondary outcomes were not significantly different between neostigmine and conventional treatment groups.

Conclusion

Neostigmine reduced IAP and promoted defecation in patients with AP and IAH. These results warrant a larger, placebo-controlled, double-blind phase III trial.

Trial registrationClinical Trial No:NCT02543658(registered August /27, 2015).
Distribution of delirium motor subtypes in the intensive care unit: a systematic scoping review
Authors: la Cour Kirstine N. , Andersen-Ranberg Nina C. , Weihe Sarah , Poulsen Lone M. , Mortensen Camilla B. , Kjer Cilia K. W. , Collet Marie O. , Estrup Stine , Mathiesen Ole
Published: March 2022

Background

Delirium is the most common cerebral dysfunction in the intensive care unit (ICU) and can be subdivided into a hypoactive, hyperactive, or mixed motor subtype based on the clinical manifestation. The aim of this review was to describe the distribution, pharmacological interventions, and outcomes of delirium motor subtypes in ICU patients.

Methods

This systematic scoping review was performed according to the PRISMA-ScR and Cochrane guidelines. We performed a systematic search in six major databases to identify relevant studies. A meta-regression analysis was performed where pooled estimates with 95% confidence intervals were computed by a random effect model.

Results

We included 131 studies comprising 13,902 delirious patients. There was a large between-study heterogeneity among studies, including differences in study design, setting, population, and outcome reporting. Hypoactive delirium was the most prevalent delirium motor subtype (50.3% [95% CI 46.0–54.7]), followed by mixed delirium (27.7% [95% CI 24.1–31.3]) and hyperactive delirium (22.7% [95% CI 19.0–26.5]). When comparing the delirium motor subtypes, patients with mixed delirium experienced the longest delirium duration, ICU and hospital length of stay, the highest ICU and hospital mortality, and more frequently received administration of specific agents (antipsychotics, α2-agonists, benzodiazepines, and propofol) during ICU stay. In studies with high average age for delirious patients (> 65 years), patients were more likely to experience hypoactive delirium.

Conclusions

Hypoactive delirium was the most prevalent motor subtype in critically ill patients. Mixed delirium had the worst outcomes in terms of delirium duration, length of stay, and mortality, and received more pharmacological interventions compared to other delirium motor subtypes. Few studies contributed to secondary outcomes; hence, these results should be interpreted with care. The large between-study heterogeneity suggests that a more standardized methodology in delirium research is warranted.
Endemicity and genetic diversity of Hepatitis delta virus among Pygmies in Cameroon, Central Africa
Authors: Foupouapouognigni Yacouba , Mfonkou Jacques Delors Toumansie , Boyomo Onana , Gessain Antoine , Njouom Richard
Published: March 2022

Objective

A single study conducted about three decades ago on hepatitis D virus (HDV) infection among Baka pygmies in Cameroon reported a very high anti-HDV antibodies prevalence of 46%, but HDV genetic diversity has not been studied in this population. The genetic diversity of strains from endemic ancient populations may help to understand the origin and evolutionary history of viruses. This study aimed to investigate the HDV seroprevalence and the genetic diversity in three remote Cameroonian Pygmies with chronic HBV infection.

Results

An unusually high 69% (36/52) level of HDV infection was found among HBsAg-positive pygmies in Cameroon. HDV RNA was detected and sequenced in 38.8% (14/36). The phylogenetic analysis revealed that 9/14 strains (64.3%) were identified and classified as genotype 1 (HDV-1) and 5/14 (35.6%) as genotype 7 (HDV-7), respectively with a bootstrap value of 100%. The further analysis showed the co-circulation of highly diverse HDV genotypes HDV-1 and HDV-7 in this population. These results highlight the endemicity of HDV infection in Central Africa. The highly diverse HDV-1 and HDV-7 in pygmies suggest an African origin of HDV. However, further studies are needed with larger sample size.
Catastrophic health expenditure due to hospitalisation for COVID-19 treatment in India: findings from a primary survey
Authors: Garg Samir , Bebarta Kirtti Kumar , Tripathi Narayan , Krishnendhu C.
Published: March 2022

Objective

The COVID-19 pandemic has caused widespread illness and a significant proportion of the infected required hospitalisation for treatment. People in developing countries like India were vulnerable to high hospitalisation costs. Despite its crucial importance, few primary studies are available on this aspect of the pandemic. This study was aimed at finding out the out of pocket expenditure (OOPE) and incidence of catastrophic expenditure on hospitalisation of persons infected with COVID-19. A primary survey of 492 randomly selected hospitalisations of individuals tested positive for COVID-19 in high-burden districts during August to November 2020 was carried out telephonically in Chhattisgarh state of India.

Results

Public hospitals accounted for 69% of the hospitalisations for COVID-19 treatment. Mean OOPE per hospitalisation was Indian Rupees (INR) 4871 in public hospitals and INR 169,504 in private hospitals. Around 3% of hospitalisations in public hospitals and 59% in private hospitals resulted in catastrophic expenditure, at a threshold of 40% of non-food annual household expenditure. Enrolment under publicly or privately funded health insurance was not effective in curtailing OOPE. Multivariate analysis showed that utilisation of private hospitals was a key determinant of incurring catastrophic expenditure.
Early infant feeding and allergic respiratory diseases in Ibb city, Yemen
Authors: Obaid Jamil M. A. S. , Ali Waheed A. M. , Al-badani Antar F. A. M. , Damag Zakaria M. , Aziz Tariq A. , Al-Ansi Yosef M. , Sadek Khawla A.
Published: March 2022

Background

Allergic respiratory diseases (ARD) are a highly prevalent health problem affecting infants and children in Yemen. Early infant feeding predisposition to the development of ARD has been a controversial question. The aim of this study is to investigate the association between early feeding before 6 months of age and the development of ARD among children attending Childhood and Maternity Public Hospital (CMPH), Ibb, Yemen Republic.

Subjects and methods

The study population included 151 child patients attending the pediatric clinic at CMPH. Upon clinical and laboratory examinations, 72 out of 151 patients had ARD, while the other 79 had diseases other than ARD; all of them were used in risk assessment. Fifteen blood samples from healthy volunteers were used in laboratory investigations as a control. Complete blood count and IgE level were investigated for all participants. Children's parents were requested to give an informed consent and fill questionnaire about demography and history details.

Results

Early infant feeding was a significant risk factor for the development of ARD with an odds ratio (OR) of 6.8 and 95% confidence interval (CI) 3.0 to 15.3. Artificial milk particularly was risk factor with an OR of 6.1 and 95% confidence interval 2.7 to 13.5. Artificial milk exhibited more wheezing and asthma attack than others (OR 4.3, 95% CI 1.9 to 9.4 and OR 7.6, 95% CI 3.5 to 16.3, respectively). The risk of wheezing and asthma attack also increase with early feeding generally (OR 3.0, 95% CI 1.3 to 7.2 and OR 4.8, 95% CI 2.2 to 8.1, respectively). The patients had a higher sensitization markers than the control, such as eosinophil count and total serum IgE. The highest levels of IgE ever reported existed among early fed patients with artificial milk.

Conclusions

Early infant feeding, particularly with artificial milk, is a risk factor predisposing infants to the development of allergic respiratory disease presented with more clinical features of wheezing and asthma attack.
Study on identification, assay and organoleptic quality of veterinary medicines in Ethiopia
Authors: Tefera Belachew , Bacha Belachew , Belew Sileshi , Ravinetto Raffaella , Andualem Tenaw , Abegaz Zerihun , Zelelew Ayalew , Uma Gudeta , Setegn Tadese , Hunduma Abdisa , Jemal Dinsefa , Daba Diriba , Belete Bizuayehu
Published: March 2022

Background

Medicines of poor quality are currently prevailing problems undermining the quality of health care services in veterinary and human medicine. In this study, physico-chemical quality of veterinary medicines was evaluated.

Methods

A total of 959 veterinary medicines samples were collected during routine regulatory activities, i.e. pre-registration, re-registration, consignment checking and post-marketing surveillance, in Ethiopia. The samples were transported to Animal Products, Veterinary Drug and Feed Quality Assessment Centre (APVD-FQAC), which is the quality control laboratory of the Veterinary Drug and Feed Administration and Control Authority (VDFACA) and stored until analysis. The samples were subjected to visual inspection and chemical analysis following the United States, European or British Pharmacopoeias, or manufacturer’s methods.

Results

The findings revealed that 12 (1.3%) of tested products showed defects in physical characteristics, packaging, or labelling information, while a total of 66 (6.9%) samples of the investigated products failed to comply with the Pharmacopoeias and supplier’s specification limit set for assay. Of these, 60 samples did not comply with the minimum assay specification limit.

Conclusion

Overall, 8.2% of the investigated veterinary medicine samples did not comply with the specification set for the investigated quality attributes and thus were categorized as of poor quality. This indicates the need for continued strengthening of regulatory functions.
Visualization formats of patient-reported outcome measures in clinical practice: a systematic review about preferences and interpretation accuracy
Authors: Albers Elaine A. C. , Fraterman Itske , Walraven Iris , Wilthagen Erica , Schagen Sanne B. , van der Ploeg Iris M. , Wouters Michel W. J. M. , van de Poll-Franse Lonneke V. , de Ligt Kelly M.
Published: March 2022

Purpose

The use of Patient-Reported Outcome Measures (PROMs) for individual patient management within clinical practice is becoming increasingly important. New evidence about graphic visualization formats for PROMs scores has become available. This systematic literature review evaluated evidence for graphic visualization formats of PROMs data in clinical practice for patients and clinicians, for both individual and group level PROMs data.

Methods

Studies published between 2000 and 2020 were extracted from CINAHL, PubMed, PsychInfo, and Medline. Studies included patients ≥ 18 years old in daily clinical practice. Papers not available in English, without full-text access, or that did not specifically describe visualization of PROMs data were excluded. Outcomes were: visualization preferences; interpretation accuracy; guidance for clinical interpretation.

Results

Twenty-five out of 789 papers were included for final analysis. Most frequently studied formats were: bar charts, line graphs, and pie charts. Patients preferred bar charts and line graphs as these were easy and quick for retrieving information about their PROMs scores over time. Clinicians’ interpretation accuracy and preferences were similar among graphic visualization formats. Scores were most often compared with patients’ own previous scores; to further guide clinical interpretation, scores were compared to norm population scores. Different ‘add-ons’ improved interpretability for patients and clinicians, e.g. using colors, descriptions of measurement scale directionality, descriptive labels, and brief definitions.

Conclusion

There was no predominant graphical visualization format approach in terms of preferences or interpretation accuracy for both patients and clinicians. Detailed clarification of graph content is essential.
Efficacy and tolerability of ketogenic diet therapy in 55 Chinese children with drug-resistant epilepsy in Northwest China
Authors: Dou Xiangjun , Wang Zhijing , Li Xia , Wang Yan , Jia Shanshan , Song Xixiao , Wang Dong
Published: March 2022

Background

Due to the tradition of carbohydrate-rich diet, challenges exist for ketogenic diet (KD) implementation in Northwest China. This study was aimed to investigate the efficacy and tolerability of KD therapy administered with gradual initiation protocols in Chinese children with pharmacoresistant epilepsy in Northwest China.

Methods

In this single-center study, 55 children with drug-resistant epilepsy were enrolled from June 2013 to June 2019. The efficacy of KD, reasons for discontinuation, duration of retention and rate of adverse events were evaluated.

Results

Fifty-five children aged from 2.2 months to 169.7 months were included, with a median age at KD initiation of 14.1 months, and 32 cases (58.2%) responded to the diet therapy at the last contact. The responder rates were 16.4% (9/55), 36.4% (20/55), 30.9% (17/55), 27.3% (15/55) at 1, 3, 6 and 12 months, respectively. Univariate analysis indicated that the duration of epilepsy and the duration of KD therapy were predictors for KD effectiveness. Poor compliance and lack of response were main reasons for discontinuation of KD. There are a few side effects of KD, most of which were minor.

Conclusions

The KD therapy with a gradual-initiation protocol is effective and tolerable for children with drug-resistant epilepsy in Northwest China. Early start of KD and KD duration of more than 6 months may be predictive factors for KD efficacy.
Atomistic-scale investigation of self-healing mechanism in Nano-silica modified asphalt through molecular dynamics simulation
Authors: Long Zhengwu , Tang Xianqiong , Guo Nanning , Ding Yanhuai , Ma Wenbo , You Lingyun , Xu Fu
Published: March 2022

As one of the most widely used nanomaterials in asphalt modification, the nano-silica (nano-SiO2) can significantly improve the self-healing behavior of asphalt eco-friendly. However, understanding of the self-healing mechanism of nano-SiO2in asphalt is still limited. The objective of the study is to reveal the self-healing mechanism of nano-SiO2in asphalt by using molecular dynamics (MD) simulations from the nanoscale. A 10 Å (Å) vacuum pad was added between the two same stable asphalt models to represent the micro-cracks inside the asphalt. The self-healing process of virgin asphalt, oxidation aging asphalt, and nano-SiO2modified asphalt was studied using density evolution, relative concentration, diffusion coefficient, activation energy, and pre-exponential factor. The simulation results conclude that nano-SiO2improves the self-healing ability of asphalt by increasing the diffusion rate of molecules with aromatic structures without alkyl side chains and molecules with structures with longer alkyl chains. The self-healing capability of asphalt may be principally determined by the diffusion of light components such as saturate, while nano-SiO2only plays an inducing role. The research findings could provide insights to understand the self-healing mechanism of nano-SiO2in asphalt for promoting the sustainability of bitumen pavements while increasing their durability.

Graphical abstract
Molecular docking prediction and in vitro studies elucidate anti-inflammatory effect of Garcinia extract against inducible nitric oxide synthase and cyclooxygenase-2 targets
Authors: Kalita Anuradha , Das Manas , Das Bhabajyoti , Baro Momita Rani
Published: March 2022

Background

Garcinia is a tropical plant that has been traditionally used in medicinal folklore for its potential antioxidant, antibacterial, anti-hyperlipidemic, anti-diabetic, hepatoprotective, etc. In this study, methanolic extract of Garcinia herbal supplement (GME) and its important phytoconstituents (Garcinol and hydroxycitric acid) were evaluated for their inhibitory action against important inflammatory markers iNOS and COX-2 in lipopolysaccharide-induced RAW 264.7 cells. iNOS and COX-2 play a major role in the process of inflammation, and inhibition of these molecules will help to alleviate the inflammatory process. The cells were pre-treated with two doses of GME (115 µg/ml and 230 µg/ml); Ggarcinol (6 µM and 12 µM); hydroxycitric acid (17.5 µg/ml and 35 µg/ml) followed by stimulation with 1 µg/ml of LPS for 24 h.

Results

The results of the study demonstrated that Garcinia and its active components Garcinol and HCA play an important role in suppressing LPS-induced relative mRNA expression of iNOS, COX-2, and subsequent reduction in the levels of total nitric oxide and prostaglandinE2. Molecular docking analysis of Ggarcinol and HCA with iNOS and COX-2 proteins showed potent interactions with negative binding energies.

Conclusions

This study suggests that Garcinia possess anti-inflammatory activity thus providing a possibility for drug designing as iNOS and COX-2 inhibitor.

Graphical Abstract
A call for open data to develop mental health digital biomarkers
Authors: Adler Daniel A. , Wang Fei , Mohr David C. , Estrin Deborah , Livesey Cecilia , Choudhury Tanzeem
Published: March 2022

Digital biomarkers of mental health, created using data extracted from everyday technologies including smartphones, wearable devices, social media and computer interactions, have the opportunity to revolutionise mental health diagnosis and treatment by providing near-continuous unobtrusive and remote measures of behaviours associated with mental health symptoms. Machine learning models process data traces from these technologies to identify digital biomarkers. In this editorial, we caution clinicians against using digital biomarkers in practice until models are assessed for equitable predictions (‘model equity’) across demographically diverse patients at scale, behaviours over time, and data types extracted from different devices and platforms. We posit that it will be difficult for any individual clinic or large-scale study to assess and ensure model equity and alternatively call for the creation of a repository of open de-identified data for digital biomarker development.
Gynecologic Survivorship Tool: Development, Implementation, and Symptom Outcomes
Authors: Carter Jeanne , Abu-Rustum Nadeem R. , Saban Sally , Chen Ling Y. , Vickers Andrew J. , Tin Amy L. , Billanti Gabriela , Connors Nicole A. , Broach Vance , Brown Carol L. , Chi Dennis S. , Gardner Ginger J. , Goldfrank Deborah J. , Jewell Elizabeth L. , Leitao Mario M. , Long Roche Kara C. , Mueller Jennifer J. , Sonoda Yukio , Zivanovic Oliver
Published: March 2022

PURPOSE

To describe the development and implementation of a new digital health clinical tool (Gynecologic Survivorship Tool [GST]) for symptom management of women surgically treated for gynecologic cancer; to assess its feasibility; and to conduct a retrospective review of the data.

MATERIALS AND METHODS

The GST was developed on the basis of a comprehensive review of the literature, multidisciplinary expert opinion, and feedback from women with a history of gynecologic cancer. It is composed of 17 questions addressing six main categories—gynecologic health (abnormal bleeding/pain), lymphedema, vaginal/vulvar dryness, sexual health, menopause (hot flushes/sleep difficulties), and bowel/urinary issues. An electronic version using the Memorial Sloan Kettering Cancer Center Engage platform was piloted in two clinics for patients with endometrial or cervical cancer. Health information was generated into clinical summaries and identified concerns for actionable response. Associations of symptom and survey time point were assessed by longitudinal models using generalized estimating equations.

RESULTS

From January 1, 2019, to February 29, 2020, 3,357 GST assessments were assigned to 1,405 patients, with a 71% completion rate (90% within 5 minutes). Sixty-eight percent were performed at home via a patient portal, 32% at follow-ups using a clinic iPad. The most common symptoms were bowel problems, swelling/fluid, pain during examination, vaginal or vulvar dryness, and vaginal bleeding. Implementation challenges included improving patient compliance and ensuring that reports were reviewed by all clinical teams. We developed screening e-mails detailing patients whose assessments were due, planned training sessions for multidisciplinary teams, and incorporated feedback on methods for reviewing symptoms reports.

CONCLUSION

The GST demonstrated feasibility, a high completion rate, and minimal time commitment. It was an effective electronic reporting mechanism for patients, enabling the medical team to develop specific strategies for alleviating bothersome symptoms during follow-up.
Neurodiverse Afro-Fabulations: Pauline Hopkins’s Counterintelligence
Authors: Knadler Stephen
Published: March 2022

“Neurodiverse Afro-Fabulations” focuses on the neglected cognitive biopolitics in post-Reconstruction debates over African American progress and full democratic citizenship, in order to trace an unmarked African American neurodiverse disability history, or the antiableist imagining of neurological, cognitive, and psychological variations that existed before and persisted alongside the emergence of modern evolutionary- and hereditary-based diagnostic categories of intelligence. At the same time, “Neurodiverse Afro-Fabulations” argues for the importance of an abjected Blackness in the critical genealogy of modern neurodiversity, which has largely been associated with recent movements to recognize people with autism or ADHD and has focused on the middle-class white child. Through an examination of Pauline Hopkins’s essay series for the Colored American Magazine, “Famous Women of the Negro Race” (1901–2), this essay first recovers Hopkins’s ambivalent relation to the compulsory neurotypicality of racial uplift politics. “Neurodiverse Afro-Fabulations” then turns to Hopkins’s novel Contending Forces (1900) to foreground how her fiction is interrupted by scenes of neurodiverse Afro-fabulation that do not simply refute claims of Black inferiority through a representational politics of counterfacts, but fabulate, exaggerate, and deliberately foreground eccentric, excessive, and “irrational” ways of knowing that have their roots in diasporic epistemologies. Ultimately, “Neurodiverse Afro-Fabulations” raises questions about the way an engagement with a history of Black neurodiversity affects how we think about the political, especially as antiblackness and cognitive disability have often served as overlapping technologies in the formation of a white liberal humanism.
Shouting Abuse, Harmless Jolly, and Promiscuous Flattery: Considering the Contours of Sexual Harassment at Macy's Department Store, 1910–1915
Authors: Keire Mara
Published: March 2022

As the white slavery scare peaked in the United States in the early 1910s, department stores consistently figured among the most menacing sites mentioned by muckrakers for corrupting women’s morals. Worried about the reputation of departments stores in general and Macy’s in particular, the Straus brothers commissioned an anti-vice association, the Committee of Fourteen, to investigate why shopgirls might “go wrong.” Three women went undercover at Macy’s and reported on their experiences as department store employees. Their collected reports exposed the micropolitics of power that made some departments difficult places for women to work. This article alternates between general discussions of department stores and their workplace culture and specific case studies detailing how two male managers abused their power and the limited ways in which women could respond.
Planetary Longings
Authors: Pratt Mary Louise
Published: March 2022

In Planetary Longings eminent cultural theorist Mary Louise Pratt posits that the last decade of the twentieth century and the first decades of the twenty-first mark a turning point in the human and planetary condition. Examining the forces of modernity, neoliberalism, coloniality, and indigeneity in their pre- and postmillennial forms, Pratt reflects on the crisis of futurity that accompanies the millennial turn in relation to environmental disaster and to the new forms of thinking it has catalyzed. She turns to 1990s Latin American vernacular culture, literary fiction, and social movements, which simultaneously registered neoliberalism’s devastating effects and pursued alternate ways of knowing and living. Tracing the workings of colonialism alongside the history of anticolonial struggles and Indigenous mobilizations in the Americas, Pratt analyzes indigeneity both as a key index of coloniality, neoliberal extraction, and ecological destruction, and as a source for alternative modes of thought and being. Ultimately, Pratt demonstrates that the changes on either side of the millennium have catalyzed new forms of world-making and knowledge-making in the face of an unknowable and catastrophic future.
Characterization of Electronic Properties of Titanium Atom in Heterogeneous Ziegler-Natta Catalyst Analyzed by Soft X-ray Emission Spectrometry (SXES)
Authors: Saito Masayoshi , Murata Masahide , Kataoka Takuo , Sakuda Yusuke , Takahashi Hideyuki
Published: March 2022

An advanced spectroscopic analysis by Soft X-ray Emission Spectrometry (SXES) was applied for the first time to the characterization of a heterogeneous Ziegler-Natta catalyst, which comprised TiCl4 and dibutylphthalate (DBP) supported on MgCl2. The high energy resolution capability of SXES made it possible to quantitatively detect outermost shell orbit signals of Lα at 452 eV and Lβ at 458 eV of Ti atom. These were assigned to Ti species interacting with DBP and MgCl2, respectively.

From the correlation between the signal intensity ratios and the catalytic performances, it was presumed that Ti species interacting with MgCl2 should work as active sites for propylene polymerization.
Transtornos de ansiedade: histórico, aspectos clínicos e classificações atuais
Authors: Frota Ilgner Justa , De Moura Fé Augusto Andrade Campos , De Paula Francisco Thiago Martins , De Moura Victor Elmo Gomes Santos , Campos Eugênio De Moura
Published: March 2022

Objetivos: contribuir para a compreensão do desenvolvimento histórico do conceito de ansiedade, das classificações dos transtornos ansiosos e suas manifestações clínicas, bem como para a atualização sobre o processo de avaliação diagnóstica. Métodos: todas as edições das classificações da Organização Mundial de Saúde (OMS) - CID e da Associação Psiquiátrica Americana (APA) - DSM foram examinadas, além de livros-texto de referência de psiquiatria clínica, de publicações sobre a história e a evolução desses diagnósticos e de publicações produzidas pelas equipes responsáveis pela revisão das classificações atuais. Resultados: entende-se por ansiedade um estado afetivo normal, como um sintoma ou um termo para nomear um grupo de transtornos mentais. Nas primeiras e subsequentes edições das classificações da OMS e da APA, entre 1948 e 1975, os quadros ansiosos faziam parte do grupo das psiconeurose/neuroses. A partir do DSM-III (1980), o grupo das neuroses foi fragmentado em diversos outros, entre os quais os transtornos de ansiedade, o que foi seguido pela CID-10 (1992), apesar de alguma distinção na composição dos subtipos. Para as últimas versões, houve um empenho de compatibilização entre as duas, contudo restaram diferenças: o DSM-5 (2013) adota critérios diagnósticos; a CID-11 (2019) utiliza descrições clínicas e diretrizes diagnósticas, além de abordagens dimensionais para alguns transtornos. Conclusão: ocorreram modificações nas classificações psiquiátricas atuais, no grupo dos transtornos de ansiedade, que precisam ser disseminadas e agregadas a estratégias de formação e qualificação profissionais, incrementando habilidades diagnósticas e permitindo uma comunicação mais uniforme e precisa na prática clínica.
Κλινική και εργομετρική αξιολόγηση της επιστροφής στην άθληση μετά από αποκατάσταση ρήξεως πρόσθιου χιαστού συνδέσμου σε ερασιτέχνες αθλητές
Authors: Αρίδα Χριστίνα
Published: March 2022

Εισαγωγή : Μέχρι και σήμερα, η σωστή επιλογή μοσχεύματος για την αποκατάσταση του πρόσθιου χιαστού συνδέσμου (ACL) παραμένει θέμα σύγκρουσης. Στόχος αυτής της μελέτης ήταν να συγκρίνουμε τα κλινικά και λειτουργικά αποτελέσματα των δύο πιο συχνά χρησιμοποιούμενων αυτομοσχευμάτων, του αυτομοσχεύματος του επιγονατιδικού τένοντα (BPTB, bone-patella-tendon-bone) και του αυτομοσχεύματος της τετραπλής δέσμης των οπίσθιων μηριαίων τενόντων (4-HT, four strand hamstring tendon) στους 6 και 12 μήνες μετά την επέμβαση.Μέθοδοι : Σε μια προοπτική, συγκριτική και τυχαιοποιημένη μελέτη, συμπεριλάβαμε συνολικά 60 ασθενείς που υποβλήθηκαν σε αποκατάσταση ΠΧΣ, 30 στην ομάδα BPTB και 30 στην ομάδα HT. Όλοι οι ασθενείς ήταν ερασιτέχνες αθλητές και αξιολογήθηκαν στους 6 και 12 μήνες μετά την επέμβαση για: (α) την μετεγχειρητική λειτουργικότητα του χειρουργημένου γόνατος, χρησιμοποιώντας τις κλίμακες βαθμολόγησης Tegner, Lysholm και International Knee Documentation Committee (IKDC), (β) τα μυϊκά ελλείματα της έκτασης και της κάμψης του χειρουργημένου γόνατος σε σύγκριση με το ετερόπλευρο υγιές με την χρήση του δυναμόμετρου Cybex και (γ) τη μετεγχειρητική σταθερότητα του γόνατος σε σύγκριση με το ετερόπλευρο υγιές με τη χρήση του αρθρόμετρου KT-1000. Αποτελέσματα : Οι ασθενείς στις δύο ομάδες δεν διέφεραν ως προς τα δημογραφικά στοιχεία και την κατάσταση λειτουργικότητας πριν από τον τραυματισμό. Σημαντικά περισσότεροι ασθενείς στην ομάδα HT (n=6) σε σύγκριση με την ομάδα BPTB (n=1) παρουσίασαν εκ νέου ρήξη ΠΧΣ και υποβλήθηκαν σε χειρουργική επέμβαση αναθεώρησης πριν από το τέλος της παρακολούθησης (p=0,044). Όλοι οι ασθενείς, ανεξαρτήτως μοσχεύματος, εμφάνισαν σημαντική βελτίωση σε όλες τις κλίμακες βαθμολόγησης :Tegner, Lysholm και IKDC καθώς και των μετρήσεων Cybex -με αύξηση της μέγιστης ροπής δύναμης της έκτασης στην γωνιακή ταχύτητα των 60°/s και των 180°/s και της μέγιστης ροπής δύναμης της κάμψης στην γωνιακή ταχύτητα των 60°/s και των 180°/s - στους 12 μήνες σε σύγκριση με τους 6 μήνες παρακολούθησης (p<0,05). Ωστόσο, δεν υπήρχε διαφορά μεταξύ των δύο ομάδων όσον αφορά τη βελτίωση της λειτουργικότητας του γόνατος ή τις μετρήσεις μέγιστης ροπής δύναμης της έκτασης και της κάμψης ούτε στους 6 ούτε στους 12 μήνες. Η μετεγχειρητική σταθερότητα ήταν παρόμοια μεταξύ των δύο ομάδων στους 12 μήνες (p=0,519).Συμπέρασμα : Τόσο τα αυτομοσχεύματα BPTB όσο και τα αυτομοσχεύματα HT παρουσιάζουν πλεονεκτήματα και μειονεκτήματα και παραμένουν βιώσιμες επιλογές αυτομοσχεύματων για την πρωτογενή ανακατασκεύη του ΠΧΣ, αν και τα αυτομοσχεύματα HT φαίνεται να είναι πιο επιρρεπή σε εκ νέου ρήξη. Η επιλογή του μοσχεύματος θα πρέπει να βασίζεται στις ανάγκες και τις δραστηριότητες κάθε ασθενούς.
Εξέλιξη των αναδασώσεων Pinus pinaster Aiton και Pinus radiata D.Don σε σχέση με τις εδαφικές τους συνθήκες στη Χαλκιδική
Authors: Καραμανώλη Αικατερίνη
Published: March 2022

Σκοπός της παρούσας διατριβής είναι η μελέτη της ανάπτυξης και των εδαφικών συνθηκών των αναδασώσεων θαλάσσιας πεύκης (Pinus pinaster Ait) και ακτινωτής πεύκης (Pinus radiata D.Don) στη Χαλκιδική. Η μελέτη αφορά δύο αξιόλογα, κατάλληλα για τις περιοχές της Μεσογείου ταχυαυξή κωνοφόρα. Εξετάσαμε τους πληθυσμούς θαλάσσιας και ακτινωτής πεύκης σε τέσσερις περιοχές της Χαλκιδικής. Επίσης, αναλύσαμε τα εδαφικά χαρακτηριστικά και υπολογίσαμε την οργανική ουσία και τα θρεπτικά στοιχεία του εδάφους. Στη συνέχεια παρουσιάσαμε τις ποσότητες της οργανικής ουσίας και των θρεπτικών στοιχείων για τον δασικό τάπητα και το ανόργανο έδαφος και αναφέραμε τις διαφορές αναμεσά στα δασικά είδη και ανάμεσα στις περιοχές. Ασχοληθήκαμε επιπλέον με την παρουσία και την ανάπτυξη των δασικών αυτών ειδών ύστερα από πέντε δεκαετίες. Επίσης εξετάσαμε την προοπτική διατήρησης αυτών των κωνοφόρων στο μέλλον.