bluuebunny/crossref_metadata_2025 huggingface dataset:
Aging and Social Security Policies: A Systematic Review Protocol
Authors: Teixeira Laíze Marina de Oliveira , Uribe Fabio Alexis Rincón , Moreira Hélio Luiz Fonseca , Junior Leandro Passarinho Reis , Pedroso Janari da Silva
Published: April 2021

Background: Aging is a process of changes dictated by the concurrent action of the biopsychosocial determinants. Population aging is a phenomenon that occurs on a global scale in heterogeneous ways, representing the growth of elderly at a greater rate than the number of newborn. Previous empirical evidence suggests that population aging has become a concern for several sectors of society. Among these, the social security policies that play a fundamental role in supporting the elderly. Given the rise of research on aging and its importance in the various health and social outcomes, it is necessary to initiate processes of compilation and synthesis of this evidence to facilitate the understanding of the importance of this variable into social security policies for public health, especially, for the elderly's health.Methods: The included studies will be qualitative and quantitative original research articles. This systematic review protocol will be conducted following the Cochrane Manual and will follow the statement of PRISMA-P. Searches will run from April 2021 to July 2021, and will be carried out from the following electronic databases: Embase, Web of Science, Scopus, PubMed Central, CINAHL, ASSIA and APA PsycNet. Two reviewers will obtain the eligible articles, published from 1979 to 2020, to assess the quality of each study and extract the data. A narrative and qualitative synthesis will be used to analyze the primary outcomes. If data are pertinent for quantitative analysis, a meta-analytic approach will be held.Discussion: The findings of this review will contribute to a better understanding of the impact of aging in social security policies and will help to establish causality in terms of the effects of this public policy on elderly’s health and their access to the healthcare system. This information can be used to identify effective interventions that could be implemented to improve the management of public health and social security policies at old age.Ethics and dissemination: The approval of an ethics committee is not required for a systematic review protocol. The results will be will be published in a peer-reviewed social or health science journal. Systematic Review Registration: PROSPERO CRD42021225820
P38 MAPK Inhibits Autophagy and Promotes Hepatic Stellate Cells Inflammatory Responses via Atg13 During Acute-On-Chronic Liver Failure
Authors: Tian Zhen , Yao Naijuan , Wu Yuchao , Wang Fei , Zhao Yingren
Published: April 2021

Inflammation plays a critical role in disease pathogenesis of acute-on-chronic liver failure (ACLF). Atg13 is a vital regulatory component of ULK1 complex, which plays an essential role in initiation of autophagy, and autophagy has been connected to hepatic inflammation. The aim of this study is to evaluate how autophagy regulates hepatic stellate cells (HSCs) inflammatory responses via Atg13 during ACLF. Clinical data were collected from ACLF patients, and surgical resected paraffin embedded human ACLF liver tissues specimens were collected. Inflammation and autophagy were investigated by immunoblot analysis in HSCs treated with lipopolysaccharide (LPS). Co-immunoprecipitation were used to investigate interaction of Atg13 and ULK1. Our data exhibit that serum LPS is positively associated with disease severity in ACLF patients, and p38 MAPK is overexpressed in ACLF liver tissues. Inflammatory factors are up-regulated via the activation of p38 MAPK and the inhibition of the autophagy in LX-2 cells. Furthermore, we illuminate in the vitro study that LPS triggers p38 MAPK activity, resulting in phosphorylation of Atg13, inhibition of Atg13-ULK1 interaction and autophagy. This study highlights a molecular mechanism that LPS promotes inflammation through inhibition of autophagy in HSCs via Atg13, and provides a new understanding into the mechanistic of inflammatory process of severe hepatitis and a novel strategy for ACLF treatment.
COVID-19-related acute kidney injury; temporal changes in incidence rate and outcomes in a large UK cohort
Authors: Jewell Paul D. , Bramham Kate , Galloway James , Post Frank , Norton Sam , Teo James , Fisher Richard , Saha Rohit , Hutchings Sam , Hopkins Phil , Smith Priscilla , Joslin Jennifer , Jayawardene Satish , Mackie Sarah , Mudhaffer Ali , Holloway Amelia , Kibble Henry , Akter Mosammat , Zuckerman Benjamin , Palmer Kieran , Murphy Ciara , Iatropoulou Domniki , Sharpe Claire C. , Lioudaki Eirini
Published: April 2021

Background: Acute kidney injury (AKI) is common among patients hospitalised with COVID-19, and associated with worse prognosis. The aim of this study was to investigate the epidemiology, risk factors and outcomes of AKI in patients with COVID-19 in a large UK tertiary centre. Methods: We analysed data of consecutive adults admitted with a laboratory-confirmed diagnosis of COVID-19 across two sites of a hospital in London, UK, from 1st January to 13th May 2020. Results: Of the 1248 inpatients included, 487 (39%) experienced AKI (51% stage 1, 13% stage 2,and 36% stage 3). The weekly AKI incidence rate gradually increased to peak at week 5 (3.12 cases/100 patient-days), before reducing to its nadir (0.83 cases/100 patient-days) at the end the study period (week 10). Among AKI survivors, 84.0% had recovered renal function to pre-admission levels before discharge and none required on-going renal replacement therapy (RRT). Pre-existing renal impairment [odds ratio (OR) 3.05, 95%CI 2.24-4,18; p<0.0001], and inpatient diuretic use (OR 1.79, 95%CI 1.27-2.53; p<0.005) were independently associated with a higher risk for AKI. AKI was a strong predictor of 30-day mortality with an increasing risk across AKI stages [adjusted hazard ratio (HR) 1.59 (95%CI 1.19-2.13) for stage 1; p<0.005, 2.71(95%CI 1.82-4.05); p<0.001for stage 2 and 2.99 (95%CI 2.17-4.11); p<0.001for stage 3]. One third of AKI3 survivors (30.7%), had newly established renal impairment at 3 to 6 months. Conclusions: This large UK cohort demonstrated a high AKI incidence with a changing pattern over time and was associated with increased mortality even at stage 1. Inpatient diuretic use was linked to a higher AKI risk. One third of survivors with AKI3 exhibited newly established renal impairment already at 3-6 months.
Organization and Expression Analysis of 5S and 45S Ribosomal DNA Clusters in Autotetraploid Fish Derived From Carassius Auratus Red Var. (♀) × Megalobrama Amblycephala (♂)
Authors: Zhao Chun , Zhang Yuxin , Qin Huan , Wang Chongqing , Huang Xu , Yang Li , Yu Tingting , Xu Xidan , Luo Xiang , Qin Qinbo , Liu Shaojun
Published: April 2021

Background: Autotetraploid fish (4n = 200, RRRR) (abbreviated as 4nRR) are derived from whole genome duplication of red crucian carp (2n = 100, RR) (abbreviated as RCC). rDNA is often used to study molecular evolution of repeated sequences because it has high copy rate and special conserved coding regions in genomes. In this study, we determined the sequences (5S, ITS1-5.8S-ITS2 region), structure, methylation level (NTS and IGS), and expression level (5S and 18S) of 5S and 45S rRNA genes in 4nRR and RCC in order to elucidate the effects of autotetraploidization on ribosomal DNA (rDNA) in fish. Results: Results showed that there was high sequence similarity of 5S, 5.8S and ITS1 region between 4nRR and RCC. This study also identified two different types of ITS2 region in 4nRR and predicted the secondary structure. It turns out that both secondary structures are functional. Compared with the diploid ancestor of RCC, there was no significant difference in NTS (5S) methylation level, but the expression level of 5S rRNA was lower in 4nRR, indicating that methylation had little effect on the expression level in 4nRR. IGS (45S) was hypermethylated in 4nRR compared to RCC, but the expression of 18S gene were no significantly different from that in RCC, indicating that methylation regulation affected gene expression in 4nRR. Conclusion: These results demonstrate the effects of related structure and expression of autotetraploidization on rDNA. In addition, this study provides reference for studying the effect of autopolyploid on the evolution of species.
The successful implementation of the ERAS program among Caesarean deliveries to reduce the postoperative length of hospital stay
Authors: Tamang Tshering , Wangchuk Tashi , Zangmo Choning , Wangmo Tshering , Tshomo Karma
Published: April 2021

Background: Enhanced Recovery After Surgery (ERAS) is a multidisciplinary perioperative care program to optimize and enhance postoperative recovery. It has a beneficial role in decreasing the length of hospital stay and improving the quality of care. This study aims to observe the successful implementation of ERAS in reducing the length of hospital stay (LOS) among Caesarean deliveries. Methods: A pre-and post-implementation study of ERAS protocol was conducted, among cohort of women who underwent Caesarean deliveries from January to December 2020 in the department of Obstetrics and Gynaecology, Mongar Regional Referral hospital. Data collected retrospectively and analyzed in SPSS (IBM SPSS trial version); and comparison of length of hospital stay between the two groups were tested by t-test. Results: 171 patients were included in the study: 87 in the pre-ERAS and 84 in the post-ERAS cohort. Post implementation, LOS decreased by an average of 21.0 (CI 16.11-24.64; p-value <0.001) hours in the postoperative period. A greater proportion of patients were discharged on day-2 (2.3% in pre-ERAS and 81% in ERAS; p-value <0.001). Conclusion: Implementation of ERAS protocol can significantly decrease the postoperative length of hospital stay without increasing the complications and readmission rates.
Geotechnical Modelling of The Climate Change Impact on World Heritage Properties in Alexandria, Egypt
Authors: Hemeda Sayed
Published: April 2021

Alexandria is one of the Mediterranean UNESCO World Heritage sites at risk from coastal flooding and erosion due to sea-level rise.The city’s position on the Mediterranean coast means it is especially vulnerable to rising sea levels. Alexandria is one of UNESCO sites in Egypt at risk from flooding. All the archaeological sites in the northern coast of Egypt are also said to be at risk from coastal erosion. The flood risk in Alexandria is expected to reach a tipping point by 2050.This research presents the numerical analysis of geotechnical and structural damage mechanism of Catacombs of Kom El-Shoqafa and El-Shatbi Necropolis, the sites have the lowest topography in Alexandria induced by the sea level rise and heavy rain due to the Climate Change, based on Finite Element PLAXIS Code. The purpose of the study was to investigate the behavior fully-saturated soft rock/ hard soil subjected to ground water intrusions. The main objective of this study is to very accurately record and analyze geotechnical problems and induced structural failure mechanisms that have been observed and accounted for in field, experimental and Numerical studies. The land area is also vulnerable to coastal flooding. It is widely expected that the numerical analysis of such geotechnical problems will contribute to the preservation of cultural heritage. The present research presents an attempt and experimental study to design a PLAXIS 2D FE model to simulate hard soil/hard rock problems, distortion and stress analysis of the complex structure of the catacombs. Plastic modeling or Mohr - Coulomb model was used in advanced soils during various stages of numerical analysis. Results are recorded and discussed regarding stress and volumetric behavior of soil / rocks. Groundwater infiltration into pores or fissures of rock and soil has a great influence on the engineering mechanical properties of rocks and soils.
(-)-Epigallocatechin Gallate Attenuates Spinal Motoneuron Death Induced by Brachial Plexus Root Avulsion in Rats
Authors: Lu Fatai , Zhang Guodong , Zhu Yingkang , Liu Zunpeng
Published: April 2021

BackgroundRecent studies have indicated that epigallocatechin gallate (EGCG) benefits a variety of neurological insults. This study was performed to investigate the neuroprotective effect of EGCG after brachial plexus root avulsion in rats. Methods One hundred twenty rats were randomized into the following three groups: an EGCG group, an Avulsion group, and a Sham group. EGCG (100 mg/kg, i.p.) or normal saline was administered to rats immediately following the injuries. The treatment was continued from day 1 to day 7, and the animals were sacrificed on days 3, 7, 14 and 28 for Nissl staining, immunohistochemistry and western blot analysis.Results We determined that EGCG significantly increased the survival ratio of motoneurons and inhibited the cell apoptosis. The level of phospho-c-jun was reduced at 3d and 7d after the injury.Conclusions Our results indicated that motoneurons were protected by EGCG against the cell death induced by brachial plexus root avulsion,and this effect was correlated with inhibiting c-jun phosphorylation.
Resolution-enhanced OCT and expanded framework of information capacity and resolution in coherent imaging
Authors: Leartprapun Nichaluk , Adie Steven
Published: April 2021

Spatial resolution in optical microscopy has traditionally been treated as a fixed parameter of the optical system. Here, we present an approach to enhance transverse resolution in beam-scanned optical coherence tomography (OCT) beyond its aberration-free resolution limit, without any modification to the optical system. Based on the theorem of invariance of information capacity, resolution-enhanced (RE)-OCT navigates the exchange of information between resolution and signal-to-noise ratio (SNR) by exploiting efficient noise suppression via coherent averaging and a simple computational bandwidth expansion procedure. We demonstrate a resolution enhancement of 1.5× relative to the aberration-free limit while maintaining comparable SNR in silicone phantom. We show that RE-OCT can significantly enhance the visualization of fine microstructural features in collagen gel and ex vivo mouse brain. Beyond RE-OCT, our analysis in the spatial-frequency domain leads to an expanded framework of information capacity and resolution in coherent imaging that contributes new implications to the theory of coherent imaging. RE-OCT can be readily implemented on most OCT systems worldwide, immediately unlocking information that is beyond their current imaging capabilities, and so has the potential for widespread impact in the numerous areas in which OCT is utilized, including the basic sciences and translational medicine.
Genome-Wide Characterization of CDPK Gene Family in Apple (Malus Domestica) and Its Transcriptional Expression During Apple Fruit Development
Authors: Dai Yu , Zhang Xinxin , Tian Juan , Zhu Liufang , Li Dahui
Published: April 2021

Background: Calcium-dependent protein kinases (CDPKs) play important roles both in developments and response to stresses, via mediating Ca2+ signal transduction in plants. To characterize the CDPKs in apple (Malus domestica), the apple CDPK gene family, together with those from pear (Pyrus bretschneideri), peach (Prunus persica), strawberry (Fragaria vesca), and and Arabidopsis thaliana, were analyzed at the genome-wide level in the present study.Results: A total of 116 CDPKs, consisting of 24 MdCDPKs, 28 PbCDPKs, 16 PpCDPKs, 14 FvCDPKs, and 34 AtCDPKs, was identified from apple, pear, peach, strawberry, and Arabidopsis, respectively. An integrated analysis of these CDPKs was performed on their chromosomal distribution, phylogenetic and collinearity relationships, characteristics of gene structures and conserved motifs. As a result, the CDPK gene family members were showed to be highly conserved both at their kinase and EF-hand domains. Among 209 gene-pairs with interspecies collinearity, there existed 22, 36, 21, and 25 ones between MdCDPKs and other CDPKs in Arabidopsis, pear, strawberry, and peach, respectively. And the evaluated Ka/Ks ratios were less than 1 between the CDPK gene pairs with collinearity relationships. Transcriptomic analysis demonstrated that among 24 members of the apple CDPK gene family, two up-regulatory ones (HF05266 and HF09216) and two down-regulatory ones (HF05471 and HF15429), were differentially expressed with significance between the apple fruit developmental stage S4 (mature) and other stages (early growing-S1, mid growing-S2, and late growing-S3), respectively.Conclusions: The whole genome duplication and subsequent purifying selection, might have played an important role in the CDPK gene expansion, leading to structural and functional novelty during evolution of the species lineages. In many cases, the MdCDPK genes within a phylogenetic group could show the different expression patterns at the transcriptional level, suggesting that these MdCDPKs have undergone genetic variant events and potential functional diversification. Some of MdCDPKs with significantly differential expression, were indicated their particular functions at the specific stages of apple fruit development.
Mortality Risk Factors in the China Dialysis Outcomes and Practice Patterns Study (DOPPS)
Authors: Zhao Xinju , Niu Qingyu , Ni Zhaohui , Chen Xiaonong , Chen Yuqing , Hou Fan Fan , Liang Xinling , Zhao Junhui , Bieber Brian , Robinson Bruce , Gan Liangying , Zuo Li
Published: April 2021

Background Mortality risk for hemodialysis (HD) patients varies by country and ethnicity. Here, mortality rate and its related risk factors in Chinese HD patients from the Dialysis Outcomes and Practice Patterns Study (DOPPS) were investigated.Methods Data from China DOPPS phase 5 (2012–2015) were used. Patients’ demographics, assigned primary causes of end stage Kidney disease (ESKD), comorbidities, dialysis prescription, laboratory values, date and cause for death were analyzed. Cox proportional hazards models were used to assess the association of patient characteristics and treatments with mortality.Results 1427 HD patients were enrolled. The mean age was 59.4 ± 14.9 years. The median follow-up time was 1.9 (1.1–2.1) years. There was total 205 deaths with at least 103 from cardiovascular disease (50.2%). The overall mortality rate was 8.8 per 100 patient-years. In the multivariate COX model, older, serum albumin (Alb < 4g/dl, blood platelets < 100*109/L, pulse pressure (PP) > 63mmHg, and congestive heart failure history were independent risk factors for all-cause mortality.Conclusions Attention should be paid to patients who were older, with lower Alb and blood platelets level, higher PP and congestive heart failure history. Our results highlighted that there might be some modifiable risk factors for patients’ survival, such as Hgb, Alb, blood platelets, and blood pressure management.
One-year follow-up of the nutritional status of celiac people on a gluten-free diet
Authors: Perez-Junkera Gesala , Vazquez-Polo Maialen , Eizagirre Francisco Jose , Benjumea Laura , Tutau Carlos , Esteban Blanca , Larretxi Idoia , Navarro Virginia , Churruca Itziar , Lasa Arrate
Published: April 2021

Background

The gluten-free diet (GFD), the only effective treatment for celiac disease, is usually nutritionally imbalanced. The present work aimed to analyze the evolution of the nutritional status, dietary profile, and symptoms present among celiac people over one year on a GFD while receiving individualized dietary advice.
Methods

Twenty-seven adults and thirty-one celiac children/adolescents participated in the cohort study. They were followed by 3 visits, at diagnosis (vt0) and after 3 and 12 months (vt3;vt12). Participants filled out dietary and gastrointestinal symptoms questionnaires and received a personalized form from dietitians containing dietary advice and anthropometric and biochemical data evolution.
Results

Most patients presented normal BMI, fat and muscle mass, and biochemical parameters at diagnosis and vt12. By contrast, all participants consumed protein and lipids in excess and carbohydrates in defect, in both vt0 and vt12. Low intakes of cereals, fruits and vegetables and high of meat were observed, these also remain-ing unchanged after dietary counseling. Symptoms present decreased after vt3 but rebounded in vt12.
Conclusions

Few changes in dietary pattern and symptom elimination suggested that the intervention was not effective enough. More research is necessary to evaluate whether closer follow up and face-to-face dietary advice improve dietary habits of celiac people.
Trial registration:

Code PI2016069, Ethical Comitee of the Clinical Investigation of the Basque Country. Registered on 15 July 2016.
Glycation Markers in the Geriatrics Patients
Authors: Kuzan Aleksandra , Królewicz Emilia , Kustrzeba-Wójcicka Irena , Lindner Karolina , Sobieszczańska Małgorzata
Published: April 2021

Background: Medical care for geriatric patients is a great challenge, mainly due to overlapping various deficits relevant to physiologic ageing with numerous coexisting diseases, of which the most common are diabetes mellitus and atherosclerosis. In case of diabetes, glycation process is intensified, which accelerates atherosclerosis development and diabetic complications. Our goal was to investigate the relationship between the classical biochemical parameters of diabetes and atherosclerosis (fasting glucose, glycated hemoglobin (HbA1c), low and high density lipoproteins (LDL, HDL), triglycerides, etc.), as well as parameters which may indicate a nephropathy (creatinine, glomerular filtration rate – GFR), and the parameters strictly related to glycation. Methods: We analyzed the patients' serum concentration of fluorescent glycation products, concentration of soluble receptor for advanced glycation products (sRAGE), lipoprotein receptor-1 (LOX-1), galectin 3 (GAL3), scavenger receptor class A (SR-A) and scavenger receptor class B (SR-BI), as well as the level of lipid peroxidation and free amine content. Results: Among the identified correlations, the most interesting are the following : sRAGE with triglycerides (r = 0.47); sRAGE with SR-BI (r=0.47); SR-BI with LOX-1 (r=0.31), and SR-BI with HDL (r=-0.30). It has been shown that pentosidine and fluorescent AGEs as well as reactive free amine contents are significantly higher in elderly patients with ischemic heart disease. Fluorescent AGEs and pentosidine are also significantly higher in patients with arterial hypertension. The influence of diabetes therapy on parameters related to peroxidation and glycation was also analyzed. Malondialdehyde turned to be higher in patients with diabetes mellitus type 2 not treated with insulin or metformin than in those treated with both medications (p=0.052). GAL3 was found to be lower both in persons without diabetes and in diabetics treated with metformin (p=0.005). LOX1 was higher in diabetic patients not treated with metformin or insulin, and lowest in diabetics treated with both insulin and metformin, with the effect of metformin reducing LOX1 levels (p=0.039). Conclusions: Our results were the basis for a discussion about the diagnostic value in clinial practice of LOX-1 and GAL3 in geriatric patients with diabetes and also provide grounds for inferring the therapeutic benefits of insulin and metformin treatment.
Optimal clustering algorithm for wireless sensor networks using combined turbid ant swarm and improved myopic algorithm for maximizing life of sensors
Authors: S Muthukumar , Rajesh D. Hevin
Published: April 2021

Wireless sensor network (WSNs) consistsof a variety of sensor nodes to sense the environmentalparameters and communicate to the sink knot. The control factor is that controlling the power of the sensor nodes and charging or replacing the battery is an expensive and complicated process, which affects the sensor node lifetime as well as network lifetime. Clustering is one of the schemes that save energy by reducing the amount of intra-cluster communication cost. In this paper, an optimal clustering (OC) algorithm proposed to maximizes the network lifetime at data transmission without compromising energy expenditure. In OC algorithm, first we propose the turbid ant swarm(TAS) algorithm to form the clusters, which reduces much amount of energy consumption. Then, an improved myopic (IM) algorithm proposed to determines the cluster head (CH) of cluster, which minimizes re-clustering frequency and intra-communication charge. The proposed OC-TAS-IM algorithm is concentrate to get better the energy efficiency and extend the network life span. Moreover, the planned algorithm is practical to the low-energy adaptive clustering hierarchy (LEACH) to perform the entire routing. The completion and imitation experiment with Network Simulator (NS2) are obtainable in order to authenticate our planned OC-TAS-IM algorithm. Imitation outcome illustrate that OC-TAS-IM algorithm is stable in terms of energy consumption and network lifetime because of optimal clustering.
Development and Characterization of Microsatellite Markers for Rhododendron Purdomii Using Next-Generation Sequencing
Authors: Zhang Ningning , Qin Mengyun , Zhu Shixin , Huang Ziyang , Dong Hao , Yang Yang , Yang Lili , Lu Yang
Published: April 2021

Rhododendron purdomii, an endangered ornamental species endemic to the Qinling Mountains, is an important component of montane ecosystem in central China. Due to the impact of climate change and human disturbance, management and conservation of this species are in urgent needs. In this study, we developed 13 novel microsatellite markers for R. purdomii based on next-generation sequencing data, and tested these markers’ utility in congeneric species R. concinnum. For the 13 microsatellite markers in three R. purdomii populations, number of alleles ranged from two to 12, number of effective alleles was from 1.000 to 8.892, Shannon’s information index was from 0.000 to 2.320, and the observed and expected heterozygosity were from 0.000 to 1.000 and from 0.000 to 0.888, respectively. Cross-species amplification for R. concinnum indicated eight microsatellite loci were successfully amplified and polymorphic. The microsatellite markers developed in this study will provide opportunities for examining the genetic diversity and population structure of R. purdomii and contribute to the effective conservation of this species.
The Effect of Surgical Technique, Age and Trisomy 21 on Early Outcome of Surgical Management of Complete Atrioventricular Canal Defect
Authors: Azzab Sherief , Samy Ahmed , Singab Hamdy , Zeinah Mohamed , Musollari Gledisa , Axiaq Ariana , Harky Amer , Tarek Ahmed , Ghanam Mohamed EL
Published: April 2021

Background: The optimal timing, surgical technique and the influence of Trisomy 21 on outcome of surgical repair of Complete Atrio-Ventricular Canal Defect (CAVC) remain uncertain. We reviewed our experience in repair of CAVC to identify the influence of these factors on operative outcome. Methods: A prospective study included 70 patients who underwent repair of CAVC at our institute between July 2016 to October 2019. Primary endpoint was mortality and secondary endpoint was degree of left atrio‐ventricular valve (LAVV) regurgitation.Results: No significant difference noted between patients operated on, at the first 6 months of age versus later, regarding mortality or LAVV regurgitation. Surgical repair by modified single patch technique showed significant reduction in bypass time (71.13 ± 13.507 min vs 99.19 ± 27.092 min, P value =0.001). Comparison to closure of cleft only, posterior annuloplasty used for repair of LAVV resulted in significant reduction in the occurrence of post-operative valve regurgitation during the early period (LAVV 2+ 43 % vs 7 %, P value=0.03) and at 6 months of follow up (LAVV 2+ 35.4 % vs 0 %, P value=0.01) respectively.Conclusion: Early intervention, in the first 6 months in patients with CAVC by surgical repair gives comparable acceptable results to later repair; Trisomy 21 was not found to be a risk factor for early intervention. Repair of common AV valve by cleft closure with posterior LAVV annuloplasty showed better results with significant decrease in postoperative LAVV regurgitation and early mortality in comparison to closure of cleft only.
Incorporating Interactive Workshops into Bedside Teaching: Completion of a Multi- Modal Rheumatology Rotation Significantly Increases Internal Medicine Residents’ Competency and Comfort with Comprehensive Knee Examinations
Authors: Kwiatkowski Alysia , Shakoor Najia , Manadan Augustine , Block Joel A. , Khandelwal Sonali
Published: April 2021

Background: Studies have elucidated the lack of competency in musculoskeletal (MSK) examination skills amongst trainees. Various modalities have been studied, however, there remains a dearth of literature regarding the effectiveness of bedside teaching versus dedicated workshops. Our aim was to determine if incorporating a workshop into a rheumatology rotation would be effective in increasing medicine residents’ competency and comfort with knee examinations when compared to the rotation alone.Methods: Over 16 months, rotators were randomized to workshop plus rotation versus rotation alone. Participants were tested on their knee examination skills using an objective structured clinical examination (OSCE). Surveys were administered assessing to what degree the rotation was beneficial. Comfort and helpfulness were measured using a 5-point Likert scale. Paired and independent samples t-tests were used for comparisons. Results: Fifty-seven residents participated. For both groups, there were improvements between pre and post OSCE scores (workshop p < 0.001, no workshop p = 0.003), and levels of comfort with examination (workshop p < 0.001, no workshop p < 0.001). When comparing groups, there were differences favoring the workshop in post OSCE score (p = < 0.001), mean change in OSCE score (p < 0.001) and mean change in comfort with knee examination (p = 0.025).Conclusion: An elective in rheumatology augmented residents’ MSK competency and comfort. Incorporation of a workshop further increased knowledge, skills and comfort with diagnosis and treatment. Current educational research focuses on alternatives to traditional methods. This study provides evidence that a multi-modal approach, combining traditional bedside and interactive models, is of benefit.
Differences in Neuronal Numbers, Morphology and Developmental Apoptosis in Mice Nigra Provide Evidence of Ontogenic Origin of Vulnerability to Parkinson’s Disease
Authors: Vidyadhara D J , Yarreiphang Haorei , Raju Trichur R , Alladi Phalguni Anand
Published: April 2021

Parkinson’s disease (PD) prevalence varies by ethnicity. In an earlier study we replicated the reduced vulnerability to PD in an admixed population, using 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)-susceptible C57BL/6J, MPTP-resistant CD-1 and their F1 crossbreds. In the present study we investigated if the differences have a developmental origin. Substantia nigra was evaluated atpostnatal days 2 (P2), P6, P10, P14, P18, and P22. C57BL/6J mice had smaller nigra and fewer dopaminergic neurons than the CD-1 and crossbreds at P2, which persisted through development. A significant increase in numbers and nigral volume was observed across strains till P14. A drastic decline thereafter was specific to C57BL/6J. CD-1 and crossbreds retained their numbers from P14 to stabilize with supernumerary neurons at adulthood. The neuronal size increased gradually to attain adult morphology at P10 in the resistant strains, vis-à-vis at P22 in C57BL/6J. Accordingly, in comparison to C57BL/6J, the nigra of CD-1 and reciprocal crossbreds possessed cyto-morphological features of resilience, since birth. The considerably lesser dopaminergic neuronal loss in the CD-1 and crossbreds seen at P2, P14 and thereafter was complemented by attenuated developmental cell death. The differences in programmed cell death were confirmed by reduced TUNEL labelling, AIF and caspase-3 expression. GDNF expression aligned with the cell death pattern at P2 and P14 in both nigra and striatum. Earlier maturity of nigra and its neurons appear to be better features that reflect as MPTP-resistance at adulthood. Thus variable MPTP-vulnerability in mice and also differential susceptibility to PD in humans may arise early during nigral development.
The Fate of Methylmercury Through Formation of Bismethylmercury Sulfide as an Intermediate in Mice
Authors: Abiko Yumi , Katayama Yusuke , Zhao Wenyang , Horai Sawako , Sakurai Kenji , Kumagai Yoshito
Published: April 2021

A previous study of ours indicated that methylmercury (MeHg) is biotransformed to bismethylmercury sulfide [(MeHg)2S)] by interaction with reactive sulfur species (RSS) produced in the body. In the present study, we explored the transformation of MeHg to (MeHg)2S in the gut and the subsequent fate of (MeHg)2S in vitro and in vivo. An ex vivo experiment suggested the possibility of extracellular transformation of MeHg to (MeHg)2S in the distal colon, and accordingly, the sulfur adduct MeHg was detected in the intestinal content and feces of mice given MeHg, suggesting that (MeHg)2S is formed from reactions of MeHg with RSS in the gut. In a cell-free system, we found that (MeHg)2S spontaneously undergoes degradation in a time-dependent fashion, resulting in formation of mercury sulfide, as determined by X-ray diffraction, and dimethylmercury (DMeHg), as evaluated by gas chromatography/mass spectrometry. We also identified DMeHg in expiration after intraperitoneal administration of (MeHg)2S to mice. Our present study therefore identifies a new fate of MeHg through (MeHg)2S as an intermediate, which leads to conversion of volatile DMeHg in the body.
In vitro protective effects of Lactobacillus plantarum Lac16 on Clostridium perfringens infection-associated intestinal injury in IPEC-J2 cells
Authors: Zhou Yuanhao , Wang Baikui , Wang Qi , Tang Li , Zou Peng , Zeng Zihan , Zhang Huihua , Gong Li , Li Weifen
Published: April 2021

Background: Clostridium perfringens causes intestinal injury through overgrowth and secretion of multiple toxins, leading to diarrhea and necrotic enteritis in animals, such as pigs. Lactobacillus plantarum (L. plantarum) Lac16 has been reported to protect broilers against C. perfringens infection. This study aimed at investigating the protective effects of Lactobacillus plantarum Lac16 on C. perfringens infection-associated intestinal injury in intestinal porcine epithelial cell line (IPEC-J2). Results: The results showed that L. plantarum Lac16 significantly inhibit the growth and biofilm formation of C. perfringens (P < 0.001). In the co-culture system, L. plantarum Lac16 significantly suppressed colony forming units (CFU) of C. perfringens (P < 0.05), which was accompanied by a decrease in pH levels (P < 0.01). Moreover, L. plantarum Lac16 significantly elevated the mRNA expression levels of host defense peptides (HDPs) in IPEC-J2 cells (P < 0.05), decreased C. perfringens-induced cellular cytotoxicity (P < 0.01) and adhesion to cells (P < 0.05). At the same time, L. plantarum Lac16 significantly attenuated C. perfringens-induced damage to intestinal barrier integrity and the decrease in claudin-1 (P < 0.01) as well as zona occludens 1 (ZO-1) expressions. Preincubation with L. plantarum Lac16 significantly suppressed mRNA expression levels of pattern recognition receptors (PRRs) (Toll-like receptor (TLR) 1, TLR2, nucleotide-binding oligomerization domain (NOD) 1) in C. perfringens-challenged IPEC-J2 cells (P < 0.01). C. perfringens significantly elevated the phosphorylation of p38 mitogen-activated protein kinase (MAPK), JNK, and p65 nuclear factor-κB (NF-κB) (P < 0.05) while L. plantarum Lac16 pre-incubation effectively inhibited phosphorylation of p65 (P < 0.001). Furthermore, L. plantarum Lac16 significantly suppressed C. perfringens induced gene expressions of proinflammatory cytokines (interleukin (IL)-1β, IL-6, IL-8, tumor necrosis factor-α (TNF-α)) (P < 0.05). Conclusions: Collectively, probiotic L. plantarum Lac16 exerts protective effects against C. perfringens infection-associated intestinal injury in IPEC-J2 cells.
A Rhombencephalitis Revealing HIV Virorachia
Authors: MAGNEROU Annick Melanie , NIDA Martine , GAMS Daniel MASSI , ZANGA Hugues Martial , HALIMA Fidelie Scolastique NGOUNGOURE , MAPOURE Yacouba NJANKOUO
Published: April 2021

One of the possible causes of persistent inflammation of the brain parenchyma in the age of antiretrovirals is residual HIV replication, despite effective viral suppression in the bloodstream with Antiretroviral treatment (ART). The central nervous system (CNS) is infected early during primary HIV infection and is one of the reservoirs of this virus during chronic infection. Inadequate penetration of certain ART into the CNS could promote some degree of intrathecal HIV replication.We describe the case of an HIV-infected patient compliant to ART with an undetectable viral load in the blood but present in the cerebrospinal fluid (CSF). The patient presented with subacute rhombencephalitis due to HIV which was fatal to him.An HIV-infected and treated patient, well controlled on ART, with new neurological disorders, should be promptly investigated by brain MRI and CSF analysis for exhaustive detection of viruses including that of HIV itself.
High efficacy of microbial larvicides for malaria vectors control in the city of Yaounde Cameroon: a cluster randomised study
Authors: Antonio-Nkondjio Christophe , Doumbe-Belisse Patricia , Djamouko-Djonkam Landre , Ngadjeu Carmene Sandra , Talipouo Abdou , Kopya Edmond , Bamou Roland , Mayi Marie Paul Audrey , Sonhafouo-Chiana Nadege , Nkahe Diane Leslie , Tabue Raymond , Fosah Dorothy Achu , Bigoga Jude D , Awono-Ambene Parfait , Wondji Charles S.
Published: April 2021

The rapid expansion of insecticide resistance and outdoor malaria transmission are affecting the efficacy of current malaria control measures. In urban settings, where malaria transmission is focal and breeding habitats are few, fix and findable, the addition of anti-larval control measures could be efficient for malaria vector control. But field evidences for this approach remains scarce. Here we provide findings of a randomized-control larviciding trial conducted in the city of Yaoundé that support the efficacy of this approach. A two arms random control trial design including 26 clusters of 2 to 4 km2 each (13 clusters in the intervention area and 13 in the non-intervention area) was used to assess larviciding efficacy. The microbial larvicide VectoMax®G combining Bacillus thuringiensis var israelensis (Bti) and Bacillus sphaericus in a single granule was applied twice per month in all standing water collection points. The biting anopheline density collected using CDC light traps was used as the primary outcome, secondary outcomes included the entomological inoculation rate, breeding habitats with anopheline larvae, and larval density. Baseline entomological data collection was conducted for 17 months from March 2017 to July 2018 and the intervention lasted 26 months from September 2018 to November 2020. The intervention was associated with a reduction of over 85% of habitats with anopheline larvae. The application of the larvicide also resulted in a reduction of 68% of adult anopheline biting density and of 79% of the entomological inoculation rate (OR 0.21; 95% CI 0.14–0.30, P < 0.0001). A reduction of 68.27% was recorded for indoor biting anophelines and 57.74% for outdoor biting anophelines. No impact on the composition of anopheline species was recorded. A reduction of over 35% of adult Culex biting densities was recorded. The study also assessed the impact of the microbial larvicide on non-target organisms and registered no significant impact of the larvicide VectoMax on the aquatic microfauna diversity. The study indicated high efficacy of larviciding for reducing malaria transmission intensity in the city of Yaoundé. Larviciding could be part of an integrated control approach for controlling malaria vectors and other mosquito species in the urban environment.
Impact of Multimodal Cognitive Training on Cognitive Traits of Children: A Multicentric Interventional Study
Authors: R Manjunatha , Pankajakshan Praveen , Joseph Alphonsa , Kashyap Gyan , Manjunath Usha , Jayanna Krishnamurthy
Published: April 2021

In this article, we evaluate the hypothesis that a multimodal cognitive training (MCT) program, the Brighter Minds, can enhance certain inherent traits of a child and thus bring changes in the external behavior. For the study, 186 children (randomized to 93 each in intervention and control group) aged 10-15 years were enrolled from three different locations. Psychometric tests, parental/caregiver interviews and EEG (electroencephalography) tests were conducted before and after the program. Intervention group showed strong statistical significance for improvements in Mini Mental Status Examination (MMSE) (P<0.01) but no significance for Raven’s Standard Progrssive Matrices (SPM) or Susan Harter’s test. The parental/caregiver reported satistically significant improvements in focus (P<0.05), empathy (P<0.05), intuition (P<0.05), comprehension (P<0.05) and understanding of abstract concepts (P<0.05) for the intervention group. For the control, Power Spectral Density (PSD) of the baseline eyes-closed (EC) EEG recording, the spectrum below 20Hz exhibited the characteristic “1/f” spectral scaling of the power-law. This signature matches prior reported evidence in literature of those in wakeful state with EC. The intervention group EC PSD, however, exhibited a signature similar to those in a slow sleep state; reflective of the possible transfer effect of the training on other skills like relaxation. We used unsupervised learning methods with dice distance, on the psychometric and interview data, to show the effect of location and the exposure of a few control children to the program.
Left Atrial Appendage Orifice Area and Morphology is Closely Associated with Flow Velocity in Patients with Nonvalvular Atrial Fibrillation
Authors: Chen Lei , Xu Changjiang , Chen Wensu , Zhang Chaoqun
Published: April 2021

Background Thromboembolic events are the most serious complication of atrial fibrillation (AF), and the left atrial appendage (LAA) is the most important site of thrombosis in patients with atrial fibrillation. During the period of COVID-19, a non-invasive left atrial appendage detection method is particularly important in order to reduce the exposure of the virus. This study used CT three-dimensional reconstruction methods to explore the relationship between LAA morphology, LAA orifice area and its mechanical function in patients with non-valvular atrial fibrillation(NVAF).Methods A total of 81 consecutive patients with NVAF (36 cases of paroxysmal atrial fibrillation and 45 cases of persistent atrial fibrillation) who were planned to undergo catheter radiofrequency ablation were enrolled. All patients were examined by transthoracic echocardiography (TTE), TEE, and computed tomography angiography (CTA) before surgery. The LAA orifice area was obtained according to the images of CTA. According to the left atrial appendage morphology, it was divided into chicken wing type and non-chicken wing type. At the same time, TEE was performed to determine left atrial appendage flow velocity (LAAFV), and the relationship between the left atrial appendage orifice area and LAAFV was analyzed.Results The LAAFV in Non-chicken wing group was lower than that in Chicken wing group (36.2±15.0cm/s vs. 49.1±22.0 cm/s, P<0.05). In the subgroup analysis, the LAAFV in Non-chicken wing group was lower than that in Chicken wing group in the paroxysmal AF (44.0±14.3cm/s vs. 60.2±22.8cm/s, P<0.05); In the persistent AF, similar results were observed (29.7±12.4 cm/s vs. 40.8±17.7 cm/s, P<0.05). The LAAFV in persistent AF group was lower than that in paroxysmal AF group (34.6±15.8 cm/s vs. 49.9±20.0 cm/s, P<0.001). The LAAFV was negatively correlated with left atrial dimension (R=-0.451, P<0.001) and LAA orifice area (R=-0.438, P<0.001), while it was positively correlated with LVEF (R=0.271, P<0.001). Multiple linear regression analysis showed that LAA morphology (β=-0.319, P<0.001), LAA orifice area (β=-0.219, P=0.030), AF type ( β=-0.283, P=0.003) and left atrial diameter (LAD) (β=-0.241, P=0.018) were independent predictors of LAAFV.Conclusion The LAA orifice area is closely related to the mechanical function of the LAA in patients with NVAF. The larger LAA orifice area and LAD, Non-chicken wing LAA and persistent AF are independent predictors of decreased mechanical function of the left atrial appendage.
Genomic Analysis of Citrobacter Portucalensis Sb-2 Identifies a Phage Predation Driven Metalloid Resistance
Authors: Yu Yanshuang , Xie Zhenchen , Yang Jigang , Liang Jinxuan , Li YuanPing , Zhu Yong Guan , Yang Qiue , Alwathnani Hend , Feng Renwei , Rensing Christopher , Herzberg Martin
Published: April 2021

Bacterial adaptation to extreme environments is often mediated by horizontal gene transfer (HGT). At the same time, phage mediated HGT for conferring bacterial arsenite and antimonite resistance has not been documented before. In this study, a highly arsenite and antimonite resistant bacterium, C. portucalensis strain Sb-2, was isolated and subsequent genome analysis showed that putative arsenite and antimonite resistance determinants were flanked or embedded by prophages. We predict these phage-mediated resistances play a significant role in maintaining genetic diversity within the genus of Citrobacter and are responsible for endowing the corresponding resistances to C. portucalensis strain Sb-2.
Adsorption and Diffusion of Magnesium on Nitrogen Doped Mo2C Monolayer
Authors: Ni Jiangfeng , Fan Kaimin , Tang Jing
Published: April 2021

The Mg adsorption and diffusion behaviors on nitrogen doped (N-doped) Mo2C monolayer have been systematically investigated by the first principles based on density functional theory (DFT). The adsorption energies of Mg on pristine Mo2C and Mo2C1 − xNx (x = 0.0625, 0.125, 0.1875 and 0.25) have been studied. The adsorption energies of Mg on N-doped Mo2C are lower than that of pristine Mo2C. Especially, the adsorption energies of Mg are − 1.639 eV and − 1.625 eV on TC1 and H2 sites for Mo2C0.875N0.125, which have decreased by 16.49% and 18.43%. Furthermore, the Mg diffuses along H3-B-H4 and H-B-H with the barriers of 0.021 eV and 0.028 eV, which indicate that Mo2C0.875N0.125 exhibits fast diffusion properties. Additionally, the partial density of states (PDOS) reveals the interaction between Mg and Mo2C0.875N0.125. The PDOS results indicate that nitrogen doping causes the PDOS peaks transfer to a lower energy level, which is benefit for the bonding between Mg and MoC0.875N0.125. These results suggest that the adsorption and diffusion behaviors of Mg are enhanced by nitrogen doping.