bluuebunny/crossref_metadata_2025 huggingface dataset:
A influência da incontinência urinária na qualidade de vida de mulheres jovens: uma revisão de literatura
Authors: Souza Bruna Ribeiro de , Dantas Isabely dos Santos , Souza Janglea Sousa de , Alencar Indiara de
Published: October 2021

A incontinência urinária (IU) está entre uma das situações que diminuem a qualidade de vida das mulheres, devido ao comprometimento em várias áreas da vida, o que deixa a mulher vulnerável a vários problemas por conta das restrições que as limitam. A incontinência urinária não é uma patologia específica de mulheres idosas, visto que o número de mulheres jovens com essa disfunção tem se tornado relevante afetando as mulheres em diversas fases do ciclo vital. A IU está entre uma das situações que diminuem a qualidade de vida das mulheres, devido ao comprometimento em várias áreas da vida, como físico, social e principalmente psicológico, o que leva a limitação de atividades sociais e familiares. Devido a falta de informação, muitas mulheres acham que não existe tratamento e imaginam que é normal esse escape de urina. Como metodologia do estudo buscou-se reunir artigos que apresentaram importância no campo científico sobre o tema proposto. Apesar de serem poucos o número de estudos encontrados, podemos concluir que a incontinência urinária afeta de forma negativa a qualidade de vida das mulheres, principalmente no que diz respeito ao âmbito psicológico, incapacitando-as de realizar de forma adequada suas atividades de vida diária.
The health of children and adolescents in foster care: a scoping review
Authors: Vasconcelos Gabriela Brito , Costa Nataly Pereira da , Barreira Alice Kelly , Colares Viviane
Published: October 2021

Providing healthcare to foster minors is challenging, given the family and institutional risk factors. This scoping review aimed to identify characteristics of articles on these minors’ health, published in PubMed from 2010 to 2020, following the Joanna Briggs model. The research question was developed with the PCC acronym. Half of the 252 articles were from the United States; most were from the Health Sciences, then multidisciplinary ones, and from the Human Sciences. Under Health, Medicine published the most, then Dentistry, Public Health, Nursing, Nutrition, and Pharmacy. Psychology represented the Human Sciences. In Medicine, there were studies from Pediatrics, Psychiatry, Endocrinology, and Parasitology. The participation of Pediatrics, Psychology/Psychiatry, and Dentistry increased over time. The types of care (of which, foster care and child welfare system were the most prevalent) associated with continents, reflecting a deinstitutionalization in America, Europe, and Oceania. The most approached health topics were mental, physical, and oral health, and the need for health services. The increased number of health publications, predominantly in developed countries and addressing various problems, confirms this group’s vulnerability, evidencing the need for public policies.
O papel do enfermeiro na prevenção do câncer no colo de útero
Authors: Souza Daniele Andrade de , Costa Marli de Oliveira
Published: October 2021

O presente trabalho tem por objetivo dispor sobre o papel do enfermeiro na prevenção do câncer no colo do útero, desde os exames de prevenção, rastreamento precoce e tratamento. Assim, se faz necessário uma explanação sobre a patologia, bem como sua incidência nas mulheres atualmente, para que o enfermeiro possa estar atualizado a fim de promover um tratamento digno à paciente. Insta ressaltar que o enfermeiro é a peça chave para obter um bom resultado no desenvolvimento do tratamento, apoiando emocionalmente a mulher com a patologia, auxiliando nos exames pertinentes e oferecendo suporte profissional. A metodologia utilizada para apresentar o tema foi a revisão bibliográfica, onde foram pesquisados livros, dissertações, artigos científicos, teses e revistas, através da busca junto ao Google acadêmico, Biblioteca Virtual em Saúde (BVS) e na SciELO, relacionados ao câncer de colo de útero, suas causas, patogenia, possíveis tratamentos e atuação da enfermagem, publicados de 2008 até 2021, sendo utilizado o método dedutivo. O estudo foi dividido em dois capítulos, de modo a ser explicado sobre a importância do enfermeiro em relação ao câncer de colo de útero desde sua prevenção, rastreamento precoce e tratamento, passando pelas necessidades de acolhimento das mulheres acometidas e, por fim, dispondo sobre a ligação da saúde da mulher a prevenção da patologia.
Análise do número de casos e perfil das gestantes com sífilis no estado do Paraná, Brasil durante os anos de 2007 a 2017
Authors: Cortez Milena Passarelli , Silva Daniel Augusto da , Melo Emiliana Cristina
Published: October 2021

Objetivo: Conhecer a prevalência da sífilis gestacional no estado do Paraná, Brasil em um período de 10 anos (2007-2017) e o perfil epidemiológico das gestantes. Métodos: Estudo transversal e descritivo, quantitativo, no qual foi analisado os dados da sífilis gestacional no estado do Paraná, em um período de 10 anos. Foram utilizados os dados disponíveis no Departamento de Informática do Sistema Único de Saúde (DATASUS), a partir do Sistema de Informação de Agravos e Notificação (SINAN). Posteriormente, os dados foram tabulados no software Microsoft Excel® 7.0. Para o banco de dados foram selecionados os 399 municípios do estado e as variáveis ano de notificação, regional de saúde, infecção por zona de residência, faixa etária, escolaridade, raça/cor e classificação clínica. Resultados: Foi possível observar um aumento no número de casos nas 22 Regionais de Saúde, totalizando 11.450 casos em 10 anos. Quanto ao perfil das gestantes, em 18 Regionais de Saúde o perfil era de mulheres da zona urbana, com ensino fundamental incompleto, de raça/cor e branca, com faixa etária d20 a 39 anos e classificação clinica primária. Em 2 Regionais, o perfil foi de mulheres da zona urbana, com ensino fundamental incompleto, de raça/cor branca, com faixa etária de 20 a 39 anos e classificação clínica latente. Nas 2 Regionais restantes, o perfil foi de mulheres da zona urbana, com ensino fundamental incompleto, de raça/cor não branca, com faixa etária de 20 a 39 anos e classificação clínica primária. Considerações finais: Pode-se afirmar que a sífilis gestacional é uma infecção sexual transmissível que vem aumentando significativamente no estado como um todo. Foi possível observar que o perfil da maioria das gestantes infectadas era de mulheres da zona urbana, com ensino fundamental incompleto, de raça/cor branca, com faixa etária de 20 a 39 anos e com a classificação clinica primária.
Reflexões sobre a materialidade escolar do Instituto Gentil Bittencourt em Belém do Pará: história, artefatos e arquitetura escolar
Authors: Sousa Marlucy do Socorro Aragão de , Lima Maria do Socorro Pereira
Published: October 2021

Este estudo discorre sobre a materialidade circulante no Instituto Gentil Bittencourt, em Belém do Pará, no início do século XX, período em que a cidade experimentou grandes transformações e conflitos promovidos pelos anseios de um projeto civilizatório de uma sociedade que utilizou a educação como ferramenta ideológica em suas dimensões prática, científica e política. Desta forma, nos empenhamos em investigar a educação no estado do Pará analisando os objetos e artefatos no campo da cultura material escolar a partir das instalações do Instituto Gentil Bittencourt. Objetivamos, portanto, analisar a presença dos objetos, artefatos, arquitetura e as práticas contidas na organização do cotidiano escolar no referido instituto, considerando a época de sua inauguração, em 1906 na cidade de Belém do Pará. Metodologicamente utilizamos dois momentos: primeiramente, a realização de um estudo exploratório permitindo identificar as fontes no Museu do Instituto Gentil Bittencourt, assim como na sua biblioteca; posteriormente, apresentamos breve articulação teórica. Assim, tomando como objeto de investigação a materialidade escolar do Instituto Gentil Bitencourt, temos a seguinte problemática: como a cultura material escolar se configura no espaço escolar com suas práticas e artefatos escolares? As análises realizadas para o desenvolvimento deste objeto, permiti-nos perceber como o desenvolvimento histórico, cultural e social do estado do Pará interferiu na materialidade do cenário educacional. Constatamos, ainda, que a utilização e disposição dos objetos e artefatos expostos na estrutura do edifício escolar analisado, bem como a as práticas escolares, revelam a organização das aulas e a formação moral, cívica e científica, voltadas para os preceitos pedagógicos estabelecidos nos regulamentos da instrução pública do Pará, em meados do século XX.
Educação permanente em central de regulação: nota prévia
Authors: Campos Carina Corrêa Bonates , Cortez Elaine Antunes
Published: October 2021

Este estudo tem por objetivo informar sobre a execução de um estudo que investiga como a implementação da Educação Permanente na equipe multiprofissional atuante em Central de Regulação pode contribuir para o processo regulatório do SUS, em um município do Rio de Janeiro. Propõe assim, a construção coletiva de estratégias educativas com a finalidade de reorganizar o processo de trabalho deste setor. A pesquisa terá como método de estudo descritivo e exploratório, com abordagem qualitativa, do tipo de pesquisa Convergente Assistencial, buscando articular conhecimento prático e acadêmico. A coleta de dados será dividida em duas etapas: a primeira será desenvolvida através de um questionário semiestruturado com a finalidade de estimular a reflexão e discussão do tema e gerar a problematização necessária para a realização da segunda etapa que consistirá na realização de encontros com a equipe multiprofissional através de rodas de conversa, seguidas de oficinas, utilizando-se de metodologias ativas. A análise dos dados ocorrerá através da análise de conteúdo de Bardin nos questionários e posteriormente terão as rodas de conversa e oficinas analisadas baseando-se no Arco de Maguerez, ambos em consonância com a Política Nacional de Educação Permanente e por inspiração ao teórico Paulo Freire, considerando a problematização advinda do cotidiano e a relação do sujeito com o trabalho educativo. Vislumbra-se que os profissionais atuantes em Central de Regulação consigam apreender o seu protagonismo como autores na busca por processos de mudanças e melhorias da realidade vivenciada, proporcionando a efetividade do acesso dos usuários aos serviços de saúde do SUS.
O treinamento de resistência variável reduz os níveis de glicemia em idosas octogenárias
Authors: Barbosa Alexandre Medeiros de Quadros
Published: October 2021

Introdução: O uso de treinamento resistido com resistência variável (TRRV) sobre fatores biodinâmicos tem sido explorado na literatura científica, entretanto informações sobre o uso TRRV em idosos longevos diabéticos ainda são inconclusivas na literatura. Objetivo: Analisar o efeito agudo do treinamento de resistência variável com faixas elásticas sobre os níveis de glicemia de mulheres idosas octogenárias. Método: Sete idosas octogenárias (81,4 ± 1,61 anos de idade) diagnosticadas com diabetes Mellitus tipo dois participaram do estudo. A glicemia de repouso foi aferida 10 minutos antes e 10 minutos após uma sessão de exercícios resistidos com resistência variável utilizando faixas elásticas. Resultados: Após o TRRV os níveis de glicemia (tamanho do efeito: 2,49; p<0,001) reduziram de forma significativa. Conclusão: O treinamento resistido utilizando resistência variável com faixas elásticas, promoveu redução significante da glicemia de repouso em idosas octogenárias acometidas por Diabetes Mellitus tipo dois.
A importância do profissional da nutrição na orientação adequada dos praticantes do vegetarianismo
Authors: Vasconcelos Bruna Karine Bastos de , Farias Monique dos Santos , Silva Daize Milena Costa da , Freitas Francisca Marta Nascimento de Oliveira
Published: October 2021

Introdução: No ramo da alimentação vegetariana pode-se identificar várias diferenças dessa prática. O termo vegetarianismo em si remete a uma dieta isenta de carne animal. Objetivo Geral: O presente artigo é parte de uma pesquisa que tem como objetivo mostrar os diferentes aspectos da prática do veganismo e vegetarianismo, seu impacto na saúde, e a influência do nutricionista nessa prática.  Assim como descrever os nutrientes na composição alimentar e recomendação na dieta vegetariana. Metodologia:  O trabalho foi desenvolvido com coleta de dados a parti de fontes segundarias, por meio de levantamento bibliográfico e baseado no estudo de autores e suas pesquisas sobre o vegetarianismo e o impacto na saúde humana. Resultado e discussão: Para realização desse estudo foi desenvolvido com base nos artigos o impacto deste tipo de dieta na vida adulta. Estas pesquisas foram realizadas em base de artigos científicos, publicações acadêmicas e periódicos científicos, em maioria dos últimos 10 anos. Também foram utilizados livros acadêmicos e científicos como material de consulta. Conclusão: Conclui-se com realização desse projeto orientar os indivíduos vegetarianos sobre a importância do nutricionista ao iniciar esse tipo de alimentação, pontuando os riscos da falta de informação que pode causar inúmeras desordens alimentares, como as deficiências nutricionais que podem ser supridas tanto pela dieta, adequando os nutrientes e respeitando as recomendações quanto, e se preciso, fazer o uso da suplementação.
Perfil epidemiológico dos idosos brasileiros que buscam tratamento fisioterapêutico: uma revisão de literatura
Authors: Costa Adiele Sousa da , Santos Ana Carolina Branches dos , Souza Gabriela Carolina Marcião Seixas de , Alencar Indiara de
Published: October 2021

O processo de envelhecimento ocorre durante a vida afetando todos os organismos, sendo considerada de forma progressiva causando diversas alterações dos padrões fisiológicos do indivíduo, envolvendo fatores sociais, culturais, biológicos e psicológicos. A fisioterapia pode ser necessária em qualquer fase da vida, porém para a população idosa ela é indispensável não só relacionado ao tratamento, mas preventiva, contribuindo para melhor qualidade de vida. Desta forma, é extremamente importante identificar o perfil dos pacientes atendidos numa dada população, conhecer os usuários do serviço de fisioterapia, entender a demanda do serviço, e patologias mais frequentes. Trata-se de uma revisão de literatura exploratória descritiva, método pelo qual se narra detalhadamente um tema estudado em pesquisas anteriores, com o intuito de abranger mais sobre determinado assunto. A pesquisa foi realizada nos seguintes bancos de dados da área da saúde: Google Acadêmico, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS) e Scientific Eletronic Library Online (SciELO). Nesta pesquisa foi possível observar uma crescente busca por atendimento fisioterapêutico em diversas áreas de atuação, sendo que, a predominância dos pacientes atendidos era do sexo feminino com idade superior a 60 anos. Outro dado importante observado na pesquisa foi o fato que os pacientes não possuíam apenas um diagnóstico, mais várias comorbidades diminuindo a capacidade funcional do idoso causando efeitos deletérios na sua qualidade de vida, vale ressaltar que a necessidade de atendimentos mais frequentes pelos fisioterapeutas fora provocada por distúrbios musculares representando 83% dos casos e distúrbios neurológicos com 61,1% de buscas por atendimentos.
Como os indicadores sociais e ambientais influenciam as taxas de suicídio - uma análise estatística
Authors: Ferreira Maurielle de Casto , Silva Maguylene Rosa da , Fernandes Daniela Aparecida Araujo , Jaconi Angélica , Rambo Magale Karine
Published: October 2021

Uma análise multivariada de dados, avaliando os parâmetros sociais e ambientais do estado do Tocantins, mais especificamente da capital, Palmas, foi utilizada como forma de entender as causas das violências autoprovocadas - os suicídios.  Os resultados estatísticos apresentaram forte relação entre as variáveis faixa etária, ocupação e sexo, enquanto que a variável escolaridade não apresentou grande influência. Já as variáveis ocupação e faixa etária, com 20,7% da variância, estão altamente correlacionadas. As variáveis escolaridade, raça/cor, tipo de óbito e local da ocorrência não apresentaram distinção entre as amostras. É importante destacar, que para mudança da realidade de saúde se faz necessário fortalecer as Políticas de Redução da Morbimortalidade por Acidentes e Violências e de Promoção de Saúde a fim de promover equidade e a melhoria das condições dos modos de viver, potencializando a saúde e reduzindo vulnerabilidades e riscos decorrentes dos determinantes sociais, econômicos, políticos e ambientais.
Vitamina D em pacientes com COVID-19: atuais perspectivas
Authors: Albuquerque Ana Beatriz Bessa de , Fernandes Alan Lins , Reis Bruna Zavarize
Published: October 2021

A busca por recursos terapêuticos adjacentes à vacina capazes de prevenir e/ou tratar a COVID-19 sugere a vitamina D como um possível aliada. Sabe-se que a vitamina D desempenha diversos papéis extra esqueléticos no organismo, dentre os quais destaca-se no sistema imunológico. A presente revisão narrativa tem por objetivo enunciar as atribuições e perspectivas atuais de utilização da vitamina D em pacientes diagnosticados com COVID-19. A busca foi realizada utilizando a base de dados Medline (PubMed), entre os meses de maio e julho de 2021, no que tange os papéis fisiológicos e imunológicos da vitamina D nas infecções respiratórias, bem como seus mecanismos de ação, concernentes à COVID-19. Os resultados sugerem uma possível associação entre as concentrações séricas de 25(OH)D e o quadro clínico da COVID-19 (i.e., mortalidade, inflamação, gravidade da doença, necessidade de ventilação mecânica ou admissão em UTI), embora, estes estudos diferem quanto ao delineamento, tamanho amostral e os desfechos avaliados, impossibilitando estabelecer análise comparativa mais acurada. Portanto, faz-se necessário novos estudos em que pese um delineamento claro e objetivo no tocante ao papel da vitamina D na prevenção e/ou tratamento da COVID-19.
Qualidade em serviços de Unidade Alimentação e Nutrição - UAN em tempos de Covid-19
Authors: Encarnação Gleicimara Aquino da , Reis João Paulo Dutra dos , Ferreira Vanusa Lima de Oliveira , Ferreira José Carlos de Sales , Figueiredo Rebeca Sakamoto
Published: October 2021

Introdução: Com a disseminação do vírus da Sars-CoV-2 e o mundo em estado de pandemia, o setor de alimentação precisou se reinventar e adotar novas formas de atender os clientes e consumidores. As Unidades de alimentação e nutrição (UANs) que atendem comensais não tiveram suas atividades suspensas por se tratarem de um serviço essencial outrossim tiveram que se adequar ao novo cenário e realizar mudanças internas, teóricas e ambientais. Objetivo geral: Com base em estudo bibliográfico, esse artigo tem o propósito de discorrer sobre a importância da adoção das normas de Boas Práticas e aspectos importantes envolvidos na gestão de uma boa qualidade em alimentação e nutrição, assim também, como estas influenciam em todo o processo mesmo em período de pandemia, pois evitam contaminações e reduzem riscos de doenças transmitidas por alimentos (DTAs). Resultado e Discussão: O exercício das boas práticas eleva a qualidade das comidas e a segurança nutricional dos consumidores, juntamente diminui gastos, aumenta a organização e a geração de produtos, motiva os colaboradores e fortalece o laço cliente e empresa. Conclusão: O presente trabalho também enfatiza o quanto é indispensável a função do nutricionista para o êxito das atividades em UANs além de vantagens estruturais, sanitárias e econômicas e sintetiza as novas recomendações atribuídas ao nutricionista, justificadas pela necessidade do enfrentamento à pandemia, em um contexto de isolamento e distanciamento social.
Mesoporous Silica Nanoparticles for Potential Immunotherapy of Hepatocellular Carcinoma
Authors: Wu Han , Xu Xin-Fei , Zhu Jia-Qi , Wang Ming-Da , Li Chao , Liang Lei , Xing Hao , Wu Meng-Chao , Shen Feng , Huang Dong-Sheng , Yang Tian
Published: October 2021

Hepatocellular carcinoma (HCC) remains a leading cause of cancer-related death worldwide, which lacks effective inhibition of progression and metastasis in the advanced clinical stage. Mesoporous silica nanoparticle (MSN)–based cytotoxic or immunoregulatory drug–loading strategies have attracted widespread attention in the recent years. As a representative of mesoporous biomaterials, MSNs have good biological characteristics and immune activation potential and can cooperate with adjuvants against HCC. This review summarizes the possible future development of the field from the perspective of tumor immunity and aims to stimulate the exploration of the immune mechanism of MSN-based therapy. Through this point of view, we hope to develop new clinical immune drugs that can be applied to HCC clinical management in the future.
Qualitative and Quantitative Assessments of Blood Flow on Tears in Type B Aortic Dissection With Different Morphologies
Authors: Saitta Simone , Guo Baolei , Pirola Selene , Menichini Claudia , Guo Daqiao , Shan Yan , Dong Zhihui , Xu Xiao Yun , Fu Weiguo
Published: October 2021

Objective: The interactions between aortic morphology and hemodynamics play a key role in determining type B aortic dissection (TBAD) progression and remodeling. The study aimed to provide qualitative and quantitative hemodynamic assessment in four different TBAD morphologies based on 4D flow MRI analysis.

Materials and Methods: Four patients with different TBAD morphologies underwent CT and 4D flow MRI scans. Qualitative blood flow evaluation was performed by visualizing velocity streamlines and flow directionality near the tears. Quantitative analysis included flow rate, velocity and reverse flow index (RFI) measurements. Statistical analysis was performed to evaluate hemodynamic differences between the true lumen (TL) and false lumen (FL) of patients.

Results: Qualitative analysis revealed blood flow splitting near the primary entry tears (PETs), often causing the formation of vortices in the FL. All patients exhibited clear hemodynamic differences between TL and FL, with the TL generally showing higher velocities and flow rates, and lower RFIs. Average velocity magnitude measurements were significantly different for Patient 1 (t = 5.61, p = 0.001), Patient 2 (t = 3.09, p = 0.02) and Patient 4 (t = 2.81, p = 0.03). At follow-up, Patient three suffered from left renal ischemia because of FL collapse. This patient presented a complex morphology with two FLs and marked flow differences between TL and FLs. In Patient 4, left renal artery malperfusion was observed at the 32-months follow-up, due to FL thrombosis growing after PET repair.

Conclusion: The study demonstrates the clinical feasibility of using 4D flow MRI in the context of TBAD. Detailed patient-specific hemodynamics assessment before treatment may provide useful insights to better understand this pathology in the future.
Quantifying the Impact of Ultraviolet Subtype C in Reducing Airborne Pathogen Transmission and Improving Energy Efficiency in Healthy Buildings: A Kahn–Mariita Equivalent Ventilation Model
Authors: Kahn Kevin , Mariita Richard M.
Published: October 2021

There is growing evidence that viruses responsible for pandemics, such as Middle East respiratory syndrome and severe acute respiratory syndrome, are mainly spread through aerosols. Recommendations have been introduced to reduce the transmission risks of virulent airborne viral particles by increasing ventilation rates, expressed in air changes per hour (ACHs), effectively improving the dilution of pathogens via mechanical ventilation. However, infrastructural and operational costs associated with upgrades of building heating, ventilation, and air conditioning systems make these solutions expensive. It is well documented that Ultraviolet Subtype C (UVC) disinfection can help lower exposure risks by inactivating viruses and the performance of such solutions can translate into equivalent ventilation. Here, we present the first framework to extract the optimal UVC requirements to improve facility management yet ensuring compliance with ventilation guidelines at lower energy costs. The Kahn–Mariita (KM) model considers the air quality of shared enclosed spaces over time by supplementing the existing mechanical ventilation with localized UVC air treatment and includes variables such as room size, occupancy, existing ventilation, and target equivalent ACH. For example, the model applied to a conference room shows that a UVC chamber with recirculation rates of 160 m3/h increases ventilation from an ACH 3 to 7.9 and reduces the room’s reset time from 46 to <10 min with as little as 1 W. Recirculation rates of 30 m3/h however offer no benefits beyond 200 mW, with an eACH of 3.9 and reset time of 31 min. The first finding is that single-pass disinfection is not an appropriate metric of performance, i.e., low recirculation rates increase single-pass disinfection, and, however, only treats a portion of the space volume within a given time, limiting the overall performance. Conversely, higher recirculation rates decrease single-pass disinfection but treat larger portions of air, potentially multiple times, and are therefore expected to lower the transmission risk faster. The second result is that for fixed amounts of recirculating air flow, increasing UVC power helps with diminishing return, while for a fixed UVC power, increasing the recirculating air flow will always help. This dynamic is particularly important toward optimizing solutions, given the constraints system engineers must work with, and particularly to design for end-user benefits such as increased occupancy, in-dwelling time, or reduction of shared-space reset time.
Programmed Cell Death Not as Sledgehammer but as Chisel: Apoptosis in Normal and Abnormal Craniofacial Patterning and Development
Authors: Compagnucci Claudia , Martinus Kira , Griffin John , Depew Michael J.
Published: October 2021

Coordination of craniofacial development involves an complex, intricate, genetically controlled and tightly regulated spatiotemporal series of reciprocal inductive and responsive interactions among the embryonic cephalic epithelia (both endodermal and ectodermal) and the cephalic mesenchyme — particularly the cranial neural crest (CNC). The coordinated regulation of these interactions is critical both ontogenetically and evolutionarily, and the clinical importance and mechanistic sensitivity to perturbation of this developmental system is reflected by the fact that one-third of all human congenital malformations affect the head and face. Here, we focus on one element of this elaborate process, apoptotic cell death, and its role in normal and abnormal craniofacial development. We highlight four themes in the temporospatial elaboration of craniofacial apoptosis during development, namely its occurrence at (1) positions of epithelial-epithelial apposition, (2) within intra-epithelial morphogenesis, (3) during epithelial compartmentalization, and (4) with CNC metameric organization. Using the genetic perturbation ofSatb2,Pbx1/2,Fgf8, andFoxg1as exemplars, we examine the role of apoptosis in the elaboration of jaw modules, the evolution and elaboration of the lambdoidal junction, the developmental integration at the mandibular arch hinge, and the control of upper jaw identity, patterning and development. Lastly, we posit that apoptosis uniquely acts during craniofacial development to control patterning cues emanating from core organizing centres.
DNA Damage-Induced Inflammatory Microenvironment and Adult Stem Cell Response
Authors: Cinat Davide , Coppes Robert P. , Barazzuol Lara
Published: October 2021

Adult stem cells ensure tissue homeostasis and regeneration after injury. Due to their longevity and functional requirements, throughout their life stem cells are subject to a significant amount of DNA damage. Genotoxic stress has recently been shown to trigger a cascade of cell- and non-cell autonomous inflammatory signaling pathways, leading to the release of pro-inflammatory factors and an increase in the amount of infiltrating immune cells. In this review, we discuss recent evidence of how DNA damage by affecting the microenvironment of stem cells present in adult tissues and neoplasms can affect their maintenance and long-term function. We first focus on the importance of self-DNA sensing in immunity activation, inflammation and secretion of pro-inflammatory factors mediated by activation of the cGAS-STING pathway, the ZBP1 pathogen sensor, the AIM2 and NLRP3 inflammasomes. Alongside cytosolic DNA, the emerging roles of cytosolic double-stranded RNA and mitochondrial DNA are discussed. The DNA damage response can also initiate mechanisms to limit division of damaged stem/progenitor cells by inducing a permanent state of cell cycle arrest, known as senescence. Persistent DNA damage triggers senescent cells to secrete senescence-associated secretory phenotype (SASP) factors, which can act as strong immune modulators. Altogether these DNA damage-mediated immunomodulatory responses have been shown to affect the homeostasis of tissue-specific stem cells leading to degenerative conditions. Conversely, the release of specific cytokines can also positively impact tissue-specific stem cell plasticity and regeneration in addition to enhancing the activity of cancer stem cells thereby driving tumor progression. Further mechanistic understanding of the DNA damage-induced immunomodulatory response on the stem cell microenvironment might shed light on age-related diseases and cancer, and potentially inform novel treatment strategies.
Auditory Neuropathy as the Initial Phenotype for Patients With ATP1A3 c.2452 G > A: Genotype–Phenotype Study and CI Management
Authors: Wang Wenjia , Li Jin , Lan Lan , Xie Linyi , Xiong Fen , Guan Jing , Wang Hongyang , Wang Qiuju
Published: October 2021

Objective: The objective of this study is to analyze the genotype–phenotype correlation of patients with auditory neuropathy (AN), which is a clinical condition featuring normal cochlear responses and abnormal neural responses, and ATP1A3 c.2452 G > A (p.E818K), which has been generally recognized as a genetic cause of cerebellar ataxia, areflexia, pes cavus, optic atrophy, and sensorineural hearing loss (CAPOS) syndrome.

Methods: Four patients diagnosed as AN by clinical evaluation and otoacoustic emission and auditory brainstem responses were recruited and analyzed by next-generation sequencing to identify candidate disease-causing variants. Sanger sequencing was performed on the patients and their parents to verify the results, and short tandem repeat-based testing was conducted to confirm the biological relationship between the parents and the patients. Furthermore, cochlear implantation (CI) was performed in one AN patient to reconstruct hearing.

Results: Four subjects with AN were identified to share a de novo variant, p.E818K in the ATP1A3 gene. Except for the AN phenotype, patients 1 and 2 exhibited varying degrees of neurological symptoms, implying that they can be diagnosed as CAPOS syndrome. During the 15 years follow-up of patient 1, we observed delayed neurological events and progressive bilateral sensorineural hearing loss in pure tone threshold (pure tone audiometry, PTA). Patient 2 underwent CI on his left ear, and the result was poor. The other two patients (patient 3 and patient 4, who were 8 and 6 years old, respectively) denied any neurological symptoms.

Conclusion:ATP1A3 p.E818K has rarely been documented in the Chinese AN population. Our study confirms that p.E818K in the ATP1A3 gene is a multiethnic cause of AN in Chinese individuals. Our study further demonstrates the significance of genetic testing for this specific mutation for identifying the special subtype of AN with somewhat favorable CI outcome and offers a more accurate genetic counseling about the specific de novo mutation.
Fast and Accurate Electric Field Gradient Calculations in Molecular Solids With Density Functional Theory
Authors: Hartman Joshua D. , Mathews Amanda , Harper James K.
Published: October 2021

Modern approaches for calculating electric field gradient (EFF) tensors in molecular solids rely upon plane-wave calculations employing periodic boundary conditions (PBC). In practice, models employing PBCs are limited to generalized gradient approximation (GGA) density functionals. Hybrid density functionals applied in the context of gauge-including atomic orbital (GIAO) calculations have been shown to substantially improve the accuracy of predicted NMR parameters. Here we propose an efficient method that effectively combines the benefits of both periodic calculations and single-molecule techniques for predicting electric field gradient tensors in molecular solids. Periodic calculations using plane-wave basis sets were used to model the crystalline environment. We then introduce a molecular correction to the periodic result obtained from a single-molecule calculation performed with a hybrid density functional. Single-molecule calculations performed using hybrid density functionals were found to significantly improve the agreement of predicted 17O quadrupolar coupling constants (Cq) with experiment. We demonstrate a 31% reduction in the RMS error for the predicted 17O Cq values relative to standard plane-wave methods using a carefully constructed test set comprised of 22 oxygen-containing molecular crystals. We show comparable improvements in accuracy using five different hybrid density functionals and find predicted Cq values to be relatively insensitive to the choice of basis set used in the single molecule calculation. Finally, the utility of high-accuracy 17O Cq predictions is demonstrated by examining the disordered 4-Nitrobenzaldehyde crystal structure.
Alleviation Effects of GQD, a Traditional Chinese Medicine Formula, on Diabetes Rats Linked to Modulation of the Gut Microbiome
Authors: Tian Jiaxing , Bai Bingbing , Gao Zezheng , Yang Yingying , Wu Haoran , Wang Xinmiao , Wang Jun , Li Min , Tong Xiaolin
Published: October 2021

Gegen Qinlian Decoction (GQD) is a Chinese herbal medicine that has been reported to significantly decrease blood glucose levels, which is suggested to be related to interactions with the gut microbiota. However, the protective effect of GQD on intestinal barrier function with regard to its influence on the gut microbiota has not been explored to date. In this study, we investigated the role of the gut microbiota in mediating the hypoglycemic mechanism of GQD in type 2 diabetes mellitus (T2DM) rats induced by a single intraperitoneal injection of streptozotocin after 4 weeks of high-fat diet feeding. The T2DM rats were randomly allocated to receive GQD, metformin (Met), or saline for 12 consecutive weeks, and changes in metabolic parameters, intestinal barrier function, and inflammation were investigated. Gut microbiota was analyzed using 16S rRNA gene sequencing from fecal samples, and statistical analyses were performed to correlate microbiota composition with phenotypes of the T2DM rats. GQD administration decreased the levels of blood glucose and inflammatory cytokines, and increased the levels of tight junction proteins. Besides, GQD had a protective effect on islet function, restoring intestinal permeability, and inhibiting inflammation, as evidenced by increases in the levels of serum C-peptide, occludin, and claudin-1 in the colon, and also improved the expression of serum inflammatory factors. In addition, GQD regulated the structure of the gut microbiota by increasing the proportions of short-chain fatty acids-producing and anti-inflammatory bacteria, and decreasing the proportions of conditioned pathogenic bacteria associated with the diabetic phenotype. Overall, these findings suggest that GQD could ameliorate hyperglycemia and protect islet function by regulating the structure of the gut microbiota, thereby restoring intestinal permeability and inhibiting inflammation in T2DM rats. Our study thus suggests that the hypoglycemic mechanism of GQD is mediated by its modulation of the gut microbiota.
Roles of TLR7 in Schistosoma japonicum Infection-Induced Hepatic Pathological Changes in C57BL/6 Mice
Authors: Feng Yuanfa , Xie Hongyan , Shi Feihu , Chen Dianhui , Xie Anqi , Li Jiajie , Fang Chao , Wei Haixia , Huang He , Pan Xingfei , Tang Xiaoping , Huang Jun
Published: October 2021

S. japonicum infection can induce granulomatous inflammation in the liver of the host. Granulomatous inflammation limits the spread of infection and plays a role in host protection. Toll-like receptor 7 (TLR7) is an endosomal TLR that recognizes single-stranded RNA (ssRNA). In this study, the role of TLR7 in S. japonicum infection-induced hepatitis was investigated in both normal and TLR7 knockout (KO) C57BL/6 mice. The results indicated that TLR7 KO could aggravate S. japonicum infection-induced damage in the body, with less granuloma formation in the tissue, lower WBCs in blood, and decreased ALT and AST in the serum. Then, the expression of TLR7 was detected in isolated hepatic lymphocytes. The results indicated that the percentage of TLR7+ cells was increased in the infected mice. Hepatic macrophages, DCs, and B cells could express TLR7, and most of the TLR7-expressing cells in the liver of infected mice were macrophages. The percentage of TLR7-expressing macrophages was also increased after infection. Moreover, macrophages, T cells, and B cells showed significant changes in the counts, activation-associated molecule expression, and cytokine secretion between S. japonicum-infected WT and TLR7 KO mice. Altogether, this study indicated that TLR7 could delay the progression of S. japonicum infection-induced hepatitis mainly through macrophages. DCs, B cells, and T cells were involved in the TLR7-mediated immune response.
Bacterial Subversion of Autophagy in Cystic Fibrosis
Authors: Flores-Vega Verónica Roxana , Vargas-Roldán Silvia Yalid , Lezana-Fernández José Luis , Lascurain Ricardo , Santos-Preciado José Ignacio , Rosales-Reyes Roberto
Published: October 2021

Cystic fibrosis (CF) is a genetic disease affecting more than 70,000 people worldwide. It is caused by a mutation in the cftr gene, a chloride ion transporter localized in the plasma membrane of lung epithelial cells and other organs. The loss of CFTR function alters chloride, bicarbonate, and water transport through the plasma membrane, promoting the production of a thick and sticky mucus in which bacteria including Pseudomonas aeruginosa and Burkholderia cenocepacia can produce chronic infections that eventually decrease the lung function and increase the risk of mortality. Autophagy is a well-conserved lysosomal degradation pathway that mediates pathogen clearance and plays an important role in the control of bacterial infections. In this mini-review, we describe the principal strategies used by P. aeruginosa and B. cenocepacia to survive and avoid microbicidal mechanisms within the autophagic pathway leading to the establishment of chronic inflammatory immune responses that gradually compromise the lung function and the life of CF patients.
Mechanisms of Action of MiRNAs and LncRNAs in Extracellular Vesicle in Atherosclerosis
Authors: Xu Hui , Ni Yu-Qing , Liu You-Shuo
Published: October 2021

Atherosclerosis, a complex chronic inflammatory disease, involves multiple alterations of diverse cells, including endothelial cells (ECs), vascular smooth muscle cells (VSMCs), monocytes, macrophages, dendritic cells (DCs), platelets, and even mesenchymal stem cells (MSCs). Globally, it is a common cause of morbidity as well as mortality. It leads to myocardial infarctions, stroke and disabling peripheral artery disease. Extracellular vesicles (EVs) are a heterogeneous group of cell-derived membranous structures that secreted by multiple cell types and play a central role in cell-to-cell communication by delivering various bioactive cargos, especially microRNAs (miRNAs) and long non-coding RNAs (lncRNAs). Emerging evidence demonstrated that miRNAs and lncRNAs in EVs are tightly associated with the initiation and development of atherosclerosis. In this review, we will outline and compile the cumulative roles of miRNAs and lncRNAs encapsulated in EVs derived from diverse cells in the progression of atherosclerosis. We also discuss intercellular communications via EVs. In addition, we focused on clinical applications and evaluation of miRNAs and lncRNAs in EVs as potential diagnostic biomarkers and therapeutic targets for atherosclerosis.
Lipoprotein Glomerulopathy-Like Lesions in Atherosclerotic Mice Defected With HDL Receptor SR-B1
Authors: Liao Jiawei , Bai Jie , An Xiangbo , Liu Yang , Wang Yuhui , Liu George , Huang Wei , Xia Yunlong
Published: October 2021

High-density lipoprotein (HDL) homeostasis is important in maintaining both cardiovascular and renal health. Scavenger receptor class B type 1 (SR-B1), the major HDL receptor in mammals, plays a crucial role in reverse cholesterol transport and HDL metabolism. Evidence from mouse study has well demonstrated that HDL disorders caused by Srb1 inactivation accelerate atherosclerosis and even induce lethal cardiovascular diseases. However, the renal consequences of Srb1 dysfunction are still unknown. Here we explored this issue in both Srb1 knockout (Srb1-/-) mice and atherosclerotic low-density lipoprotein receptor knockout (Ldlr-/-) mice with Srb1 deletion. Our data showed that no apparent renal damage was observed in 5-month-old Srb1-/- mice fed on standard rodent chow diet as well as Srb1-/- mice fed on a high-fat diet (HFD) for 12 weeks. However, 5-month-old Srb1/Ldlr-/- mice fed on rodent chow had increased urinary albumin excretion and developed spontaneous intraglomerular Oil-red O (ORO)-positive lipoprotein deposition that is similar to lesions observed in human lipoprotein glomerulopathy (LPG). HFD feeding accelerated LPG-like lesions in Srb1/Ldlr-/- mice, inducing severe proteinuria and significantly promoting intraglomerular ORO-positive lipoprotein deposition. Interestingly, probucol reversed HFD-induced HDL disorders and almost fully abrogated LPG-like lesions in Srb1/Ldlr-/- mice. In conclusion, the present study demonstrates that SR-B1 dysfunction leads to LPG-like lesions in atherosclerotic mice, which could be rescued by probucol. SR-B1 loss-of-function mutant carriers therefore might be susceptible to developing metabolic nephropathy in addition to cardiovascular diseases, and probucol might be a potential therapeutics.
Develop and Apply Electrocardiography-Based Risk Score to Identify Community-Based Elderly Individuals at High-Risk of Mortality
Authors: Lu Tzu-Pin , Chattopadhyay Amrita , Lu Kuan-Chen , Chuang Jing-Yuan , Yeh Shih-Fan Sherri , Chang I-Shou , Chen Ching-Yu Julius , Wu I-Chien , Hsu Chih-Cheng , Chen Tzu-Yu , Tseng Wei-Ting , Hsiung Chao Agnes , Juang Jyh-Ming Jimmy
Published: October 2021

With an aging world population, risk stratification of community-based, elderly population is required for primary prevention. This study proposes a combined score developed using electrocardiographic (ECG) parameters and determines its long-term prognostic value for predicting risk of cardiovascular mortality. A cohort-study, conducted from December 2008 to April 2019, enrolled 5,380 subjects in Taiwan, who were examined, using three-serial-12-lead ECGs, and their health/demographic information were recorded. To understand the predictive effects of ECG parameters on overall-survival, Cox hazard regression analysis were performed. The mean age at enrollment was 69.04 ± 8.14 years, and 47.4% were males. ECG abnormalities, LVH [hazard ratio (HR) = 1.39, 95% confidence intervals (CI) = (1.16–1.67), P = 0.0003], QTc [HR = 1.31, CI = (1.07–1.61), P = 0.007] and PR interval [HR = 1.40, CI = (1.01–1.95), P = 0.04], were significantly associated with primary outcome all-cause death. Furthermore, LVH [HR = 2.37, CI = (1.48–3.79), P = 0.0003] was significantly associated with cardiovascular death, while PR interval [HR = 2.63, CI = (1.24– 5.57), P = 0.01] with unexplained death. ECG abnormality (EA) score was defined based on the number of abnormal ECG parameters for each patient, which was used to divide all patients into sub-groups. Competing risk survival analysis using EA score were performed by using the Gray's test, which reported that high-risk EA groups showed significantly higher cumulative incidence for all three outcomes. Prognostic models using the EA score as predictor were developed and a 10-fold cross validation design was adopted to conduct calibration and discrimination analysis, to establish the efficacy of the proposed models. Overall, ECG model could successfully predict people, susceptible to all three death outcomes (P < 0.05), with high efficacy. Statistically significant (P < 0.001) improvement of the c-indices further demonstrated the robustness of the prediction model with ECG parameters, as opposed to a traditional model with no EA predictor. The EA score is highly associated with increased risk of mortality in elderly population and may be successfully used in clinical practice.
Hypoglycemia Among Type 1 Diabetes Patients After Insulin Use in Southwest Ethiopia
Authors: Yosef Tewodros
Published: October 2021

Introduction

Glycemic control is a valuable goal for people with diabetes; however, the greatest challenge to achieving tight glycemic control is hypoglycemia. Hypoglycemic events are probably common in type 1 diabetes; however, little is known about hypoglycemia in Ethiopia. Therefore, this study aimed to assess the prevalence and the associated factors of hypoglycemia among type 1 diabetes (T1D) patients after insulin use at Metu Karl Referral Hospital in southwest Ethiopia.

Materials and Methods

A hospital-based cross-sectional study was conducted among 242 T1D patients at Metu Karl Referral Hospital in southwest Ethiopia. The prevalence of hypoglycemia was assessed by a structured questionnaire through a face-to-face interview in which all the possible symptoms of hypoglycemia were included. If the patients reported that they had experienced the symptoms at least two times in a month and the symptoms were relieved upon consuming sugar/candy/honey, such cases were considered to have had a hypoglycemic episode. Binary logistic regression analysis was done to identify the factors associated with the occurrence of hypoglycemia.

Results

Out of 242 T1D patients interviewed, 114 (47.1%) had self-reported hypoglycemia. The most reported symptom of hypoglycemia was sweating (91.7%), followed by dizziness and hunger and nausea with a prevalence of 24.8 and 14.5%, respectively. The study also found that educational level with reading and writing skills up to primary level [adjusted odds ratio, AOR = 0.41; 95% confidence interval, CI (0.19–0.88)] and secondary level and above [AOR = 0.32, 95% CI (0.14–0.70)], poor knowledge of diabetes [AOR = 2.26, 95% CI (1.06–4.84)], good knowledge of insulin self-administration [AOR = 0.54, 95% CI (0.30–0.99)], and duration of insulin use ≥5 years [AOR = 3.93, 95% CI (1.44–10.7)] were factors associated with hypoglycemia.

Conclusions

The prevalence of hypoglycemia was found remarkable. We can conclude that hypoglycemia is of public health importance among T1D patients. Since the study assesses hypoglycemia after insulin injection, this prevalence may be due to the poor practice of insulin injection. Therefore, imparting education on the proper technique of insulin administration should be considered at each follow-up visit.