bluuebunny/crossref_metadata_2025 huggingface dataset:
The Impact of Lockdown during COVID-19 Pandemic on Hip Fracture Cases in Austria
Authors: Oliver Malle , Wolfgang Brozek , Michael Szivak , Dimai Hans Peter
Published: August 2021

Mini AbstractSocial lockdowns may have an impact on fracture cases. During the first lockdown in Austria (March 16th to May 31st 2020), hip fracture cases did not significantly change, except a decreased rate in female patients aged 50-69 years.IntroductionSocial lockdown has been repeatedly imposed worldwide due to the coronavirus disease 2019 (COVID-19). Resultant isolation with less physical activity and restricted health care access may have an impact on fracture incidences. The aim of this analysis was to assess the effect of a social lockdown on hip fracture cases in Austria.MethodsThis analysis is based on the data of the Austrian Workers' Compensation Board (AUVA), which is the social insurance for the majority in Austria. Hip fracture cases in the time period March 16th to May 31st, 2020 (first lockdown period in Austria) were compared with those in the same period of previous years (2016-2019). Further analysis included stratification by gender, age and weekly intervals using repeated measures analysis of variance (ANOVA), while a p-value of less than 0.05 was considered statistically significant.ResultsIn the time period March 16th to May 31st 2020 the fracture cases of 445 lied within the standard deviation (SD) of years before (438 ± 20.1). The mean cases of weekly separated intervals in 2016-2019 did not differ significantly from those in 2020. In patients aged 50 to 69 years, the fracture cases in 2020 was below the SD of those in years before (64 vs. 77 ± 10). Stratified by weekly intervals and age group, mean fracture cases of years before were comparable with those of 2020, except 2018, which had significant lower rates in patients aged 50-69 years (p<0.05). Separated by gender, this difference was only seen in women.ConclusionHip fracture cases did not significantly change during first social lockdown (March 16th to May 31st 2020) in Austria, except a decreased fracture rate in female patients aged 50-69 years.
Preoperative Anemia Is A Predictor of Cacoethic Postoperative Outcomes Following Open Pancreatoduodenectomy – A Propensity Score-Based Analysis
Authors: Xu Jing-Yong , Tian Xiao-Dong , Yang Yin-Mo , Song Jinghai , Wei Jun-Min
Published: August 2021

Background: Preoperative anaemia is a common clinical situation that was proved to be associated with severe outcomes in major surgery but not pancreatic surgery alone. We aimed to study the impact of preoperative anaemia on morbidity and mortality in patients undergoing open pancreaticoduodenectomy by using propensity score matching (PSM) to balance the basal data and reduce bias. Methods: Consecutive patients undergoing open pancreaticoduodenectomy with complete record of preoperative haemoglobin at two pancreatic centers in China between 2015 to 2019 were analysed. Haemoglobin less than 12g/dl for male and 11g/dl for female were defined as anaemia in Chinese population. Clinical and economic outcomes were compared before and after propensity score matching (PSM). Logistic regression analysis was used to assess correlation between variables and anaemia. Results: The unmatched initial cohort consist of 517 patients. 148 cases (28.6%) were diagnosed as anaemia at admission, and no case received preoperative blood transfusion or anti-anaemia therapy. After PSM, 126 cases were in each group. The rate of severe postoperative complications was significantly higher in anaemia group than in normal group (43.7% versus 27.0%, P=0.006), among which prevalence of clinically relevant postoperative pancreatic fistula (31.0% versus 15.9%, P=0.005) and cardiac and cerebrovascular events (4.0% versus 0.0%, P=0.024) were most significant. It costed more in the anaemia group (26958.2±21671.9 versus 20987.7±10237.9 USD, P=0.013). Among all patients, multivariate analysis showed that preoperative obstructive jaundice [OR 1.813, 95%CI (1.206-2.725), P=0.004] and pancreatic ductal adenocarcinoma [OR 1.861, 95%CI (1.178-2.939), P=0.008] were predictors of anaemia. Among paired patients, preoperative anaemia [OR 2.593, 95%CI (1.481-5.541), P=0.001] and malignant pathology [OR 4.266, 95%CI (1.597-11.395), P=0.004] were predictors of postoperative severe complications.Conclusions: Preoperative anaemia is a predictor of cacoethic postoperative outcomes following open pancreatoduodenectomy and needs identified and treated.
Relationship Between The Appropriateness of Antibiotic Treatment and Clinical Outcomes of Patients With Community-Acquired Acute Pyelonephritis: A Multicenter Prospective Cohort Study
Authors: Yoon Choseok , Park Se Yoon , Kim Bongyoung , Kwon Ki Tae , Ryu Seong-yeol , Wie Seong-Heon , Jo Hyun-uk , Kim Jieun , Hong Kyung-Wook , Kim Hye In , Kim Hyun ah , Kim Mi-Hee , Bae Mi-Hyun , Sohn Yong-Hak , Kim Jieun , Lee Yangsoon , Pai Hyunjoo
Published: August 2021

Background

Inappropriate use of antibiotics not only increases antibiotic resistance as collateral damage but also increases clinical failure rates and medical costs. The purpose of this study was to determine the relationship between the appropriateness of antibiotic prescription and clinical outcomes of community-acquired acute pyelonephritis (CA-APN).
Methods

A multicenter prospective cohort study was conducted at eight hospitals in Korea between September 2017 and August 2018. All hospitalized patients aged ≥ 19 years who were diagnosed with CA-APN on admission were recruited. The appropriateness of empirical and definitive antibiotics, as well as the appropriateness of antibiotic treatment duration and route of administration, was evaluated. Clinical outcomes were compared between patients who were administered antibiotics ‘appropriately’ and ‘inappropriately.’
Results

A total of 397 and 318 patients were eligible for the analysis of the appropriateness of empirical and definitive antibiotics, respectively. Of them, 10 (2.5%) and 18 (5.7%) were administered ‘inappropriately’ empirical and definitive antibiotics, respectively. Of the 119 patients whose use of both empirical and definitive antibiotics was classified as ‘optimal,’ 57 (47.9%) received antibiotics over a longer duration than that recommended; 67 (56.3%) did not change to oral antibiotics on day 7 of hospitalization, even after stabilization of the clinical symptoms. Patients who were administered empirical antibiotics ‘appropriately’ had shorter hospitalization days (9 vs. 12.5 days, P = 0.014) and lower medical costs (2,332.7 vs. 4,531.2 USD, P = 0.007) than those who were administered them ‘inappropriately.’ Similar findings were observed for patients administered both empirical and definitive antibiotics ‘appropriately’ and those administered either empirical or definitive antibiotics ‘inappropriately’
Conclusions

Appropriate use of antibiotics leads to better clinical outcomes, including reduced hospitalization duration and medical costs.
Impact of the COVID19 pandemic on the implementation of Health Information Technologies (HIT): a case study in Maternity Hospital of Lubango-Angola
Authors: Sanjuluca Tomas Hambili Paulo , Cruz-Correia Ricardo , Almeida Anabela Antunes
Published: August 2021

Background

COVID19 pandemic has shown the importance of data to manage health crises. Therefore, countries that were more mature regarding using Information Systems (IS) were better prepared to respond to their population needs. Unfortunately, in Angola, such Health Information Systems (HIS) maturity is very low, so new Health Information Technology (HIT) projects must change this scenario.
Objective

Describe the impact of COVID19 on a new health information technology project called "ObsCare Lubango" to collect essential data on deliveries and births at the Maternity Hospital in Lubango-Angola.
Methods

Retrieve data from the notes, communication events of the project management. Also, the collected data regarding obstetrics (pregnancies and childbirth) was from Jan 2019 to Apr 2021 (14 months before COVID19 and 14 months after the beginning of COVID19). The data analyzed were collected from the utilization audit trail that stores the sessions and clicks in the application logs. These logs are then presented in aggregated and anonymized form in a web interface.
Results

The start of COVID19 in Maternity halted the evolution of the health information project implementation. At the beginning of 2020, the usage of ObsCare Lubango was growing steadily (5.9%, 7.5%, 9.4% in the first three months), but rapidly dropped to 0% in the following months after the first of COVID arrived in late March.
Conclusion

COVID19 had a significant impact on the evolution of ObsCare Lubango and heavily impacted the quality of the data collected in the paper. COVID19 will probably increase the digital divide in health care between nations.
Cocktail Treatment by GnRH-Antagonist, Letrozole, and Mifepristone for the Prevention of Ovarian Hyperstimulation Syndrome: A Prospective Randomized Trial
Authors: Qi Qianrong , Xia Yi , Luo Jin , Wang Yaqin , Xie Qingzhen
Published: August 2021

Ovarian hyperstimulation syndrome (OHSS) is a major complication of controlled ovarian hyperstimulation. This study is aimed to determine the efficacy of a cocktail style treatment by combining GnRH-antagonist, letrozole, and mifepristone on the prevention of ovarian hyperstimulation syndrome (OHSS) in high-risk women. This prospective, randomized controlled clinical trial included 170 women who identified as high risk of OHSS during the ovarian hyperstimulation and underwent cryopreservation of whole embryos. On the day of oocyte retrieval, the combination group (89 cases) received 0.25 mg Cetrorelix for three days, 5 mg letrozole for five days, and 50 mg mifepristone for three days, the mifepristone group (80 cases) received 50 mg mifepristone for three days. 156 cases were included in final analysis. The combination group showed significantly decreased incidence of moderate and severe OHSS than mifepristone group (20.5% vs. 42.3%), with remarkably reduced serum estradiol level on hCG+3 and +5 day, decreased ovarian diameter, and shortened luteal phase. Oocyte retrieval number, levels of estradiol on hCG+0 and VEGF, and ovarian diameter on hCG+5 were associated with the severity of the symptoms. In Conclusion, the combination treatment effectively reduce the incidence of moderate/severe OHSS in high-risk women. Clinical trial registration information:Date of registration: 12-27-2017Date of initial participant enrollment: 01-01-2018Clinical trial identification number: ChiCTR-INR-17014174 URL of the registration site: www.chictr.org.cn
Inappropriate Use of Antibiotics and Their Predictors in Pediatric Patients Admitted at the Hospital Central De Nampula, Mozambique
Authors: Xavier Sancho Pedro , Victor Audêncio , Cumaquela Graciano , Vasco Melsequisete Daniel , Rodrigues Osiyallê , Cobre Alexandre de Fátima
Published: August 2021

Background

Antibiotics are synthetic or natural substances used to treat diseases of infectious origin. When used incorrectly, they can be a factor in the development of antimicrobial resistance, increased treatment time, costs, and mortality. The present study aimed to assess the pattern inappropriate use of antibiotics and their predictors in pediatric patients admitted to the Hospital Central de Nampula, Mozambique
Methods

A cross-sectional, retrospective study with a quantitative approach was conducted between January and July 2019. The population consisted of children aged 0 to 10 years hospitalized in the pediatric ward I. Binary logistic regression was used to determine risk factors for inappropriate use of antibiotics with 95% CI.
Results

The prevalence of antibiotic use among pediatric patients was 97.5%. Of the 464 antibiotics prescribed, 39.9% were for patients suffering from gastroenteritis, 21.8% and 9.1% Affected with pneumonia and malaria. Most antibiotics were for systemic use (95.9%, 445/464). Most (36.5%) of prescriptions had errors. Duration of treatment (74.6%) and dosage (25.4%) were the most frequent errors. Binary logistic regression analysis revealed that patients were prescribed with ≥ 3 antibiotics (OR = 2.920, 95% CI = 1.283–6.646, p–value = 0.011) and with a short hospitalization time (OR = 1.726, 95% CI = 1.040–2.864, p–value = 0.035) were more likely to experience some inappropriate use of antibiotics.
Conclusion

The study showed a higher prevalence of antibiotic use, however, a greater number of prescriptions contained errors. Errors related to dose and duration of treatment were the most common among pediatric patients. These results reveal a concern, since inappropriate and excessive use of antibiotics is a major factor for the development of antibiotic resistant microorganisms. Therefore, strategies concerning the use of antibiotics in order to reduce their inappropriate and excessive use are necessary.
Paraneoplastic Cerebellar Degeneration Associated with Anti-CV2/CRMP5 Antibodies in Ovarian Cancer: Case Report and Review of Literature.
Authors: Whaley Juan Jose Juarez-Vignon , Carrera-Muiños Aurelio , Hernandez-Gutierrez Karol Gema , Rodriguez-Cid Jerónimo Rafael , Otero-Cerdeira Maria Elisa , Garcia-Montes Vanessa
Published: August 2021

BackgroundParaneoplastic neurological syndromes are rare presentations of an underlying oncological disease and even more unusual they can present during an oncological disease. These syndromes more likely present in small cell lung carcinomas and thymomas, but in less than 1% of the cases gynecological neoplasms have shown this paraneoplastic presentation, such as the case presented. Even though not completely understood yet, acknowledging the pathophysiology is essential for management, relate other types of neoplasms and explain its clinical presentation. We present a patient with an underlying gynecological cancer, that during her disease developed a paraneoplastic neurological syndrome with an unusual autoantibody (anti-CV2/CRMP5) mediating the disease.Case PresentationA 62-yo female diagnosed with ovarian cancer who in the course of her disease develops neurological symptoms associated with cerebellar degeneration. After ruling out differential diagnoses such as metastases, a neurological paraneoplastic syndrome was suspected and studied, in which anti-CV2/CRMP5 were positive. Putting together her clinical presentation, radiological features, auto-antibody positivity on CSF related with paraneoplastic neurological syndromes and an underlying oncological disease, cerebellar degeneration as a paraneoplastic syndrome was diagnosed.ConclusionThe pathophysiology of neurological paraneoplastic syndromes is not fully understood; therefore, its diagnosis and management are complex. Diagnosis is based on clinical presentation and specific antibodies associated. Unfortunately, patients have a bad prognosis and diminished quality of life, therefore its management needs a multidisciplinary approach. It is important to mention that the presentation of paraneoplastic neurological syndromes do not mandatory appear before the diagnosis of cancer, multiple cases have been reported in which patients with an underlying oncological disease develop these syndromes. As medical oncologists and neurologists we must consider and study these syndromes as a possible etiology in cases with an underlying cancer who develop neurological symptoms in the course of their disease after ruling out differential diagnoses such as brain metastases.
Factors influencing sternal healing and comparison of different sternal closure methods: a retrospective analysis
Authors: Long Xuanren , Mei Kun , Qian Yongxiang , Zhang Xiaoyin , Wang Min , Wang Bin , Di Dongmei
Published: August 2021

Background

We determined the factors affecting sternum healing after a median sternotomy based on a retrospective analysis; additionally, we compared the stability of different sternal closure techniques.
Methods

We collected information involving patients who underwent a median sternotomy in Changzhou First People's Hospital from 2014–2019 and who had chest CT examinations at 1–24 months post-operation. The main outcome included the average sternal healing score at the five specific anatomic levels and adverse events of transverse displacement of the sternum.
Results

In the short-term healing group, the sternal score was only correlated with postoperative time (HR = 0.18, 95% CI: 0.135–0.225, p < 0.001). In the long-term healing group, older people had a higher risk of poor sternal healing than young people (age, HR=-0.028, 95% CI: -0.05–0.006, p = 0.013). Patients with left internal mammary artery dissociation (LIMA-d) had a high risk of poor sternal healing (HR=-0.444, 95% CI: -0.869-0.019, p = 0.045). The binary logistic regression showed that steel wire fixation was a favorable factor for preventing transverse displacement of the sternum (HR = 0.122, 95% CI: 0.007–0.651, p = 0.047).
Conclusion

In summary, advanced age and internal mammary artery interception are risk factors that affect sternal healing, based on the imaging findings. This new method of sternal closure provides an effective way of ensuring sternal stability of both sternal plates and reduces the risk for complications after cardiac surgery in high-risk patients.
Determining The Age Priority in Universal Vaccination Using Economic Evidence: Case From US Based On Dynamic Transmission Model
Authors: Zhou Dachuang , Shao Taihang , Liu Zeyao , Pan Xingming , Zhang Xueke , Zhou Chengchao , Tang Wenxi
Published: August 2021

Background: Currently, increasing regions have realized that universal vaccination are necessary to prevent COVID-19. However many of them are facing problems associated with insufficient supply or chaotic allocation of vaccines. This study selected the United States population as an example and explored prioritization strategies of COVID-19 vaccination for different age groups to achieve the highest economic efficiency.Methods: We built a dynamic transmission model to predict the incidence of SARS-CoV-2 infections under the prioritization strategies of vaccination for different ages within a 180-day simulation period. Quality-adjusted life year (QALY) was selected as the outcome. Medical costs included direct medical cost and vaccine cost based on a healthcare system perspective. Data on SARS-CoV-2 epidemiology, vaccine efficacy, and medical costs were derived from publicly available databases and previously published literature. Different COVID-19 vaccines were included in scenario analysis. The robustness of the study results was evaluated by one-way sensitivity analysis and probabilistic sensitivity analysis.Results: COVID-19 vaccination is economical compared with no vaccination. Priority vaccination for adults aged 25–59 years saves $31,664.2 million and that for adults over 60 years old saves $30,082.9 million in medical costs compared with no vaccine intervention. Additionally, priority vaccination for adults aged 25–59 years vs. over 60 years old saves $1,581.3 million. In contrast, priority vaccination for adults aged over 60 years vs. 25–59 years old gains 0.001 QALYs and costs $4.7 per capita, with an incremental cost-effectiveness ratio of $4,829.3/QALY, and it is economical when taking gross domestic product per capita of the United States in 2020 as the willingness-to-pay threshold. The results of sensitivity analysis indicate that the base-case results are robust.Conclusions: From a healthcare system perspective, it is most economical to prioritize adults aged over 60 years for COVID-19 vaccination in the United States, thereby achieving effective resource allocation and saving the government costs.
A Dual-Emitting Two-Dimensional Nickel-Based Metal-Organic Framework Nanosheets: Eu3+/Ag+ Functionalization Synthesis and Ratiometric Sensing in Aqueous Solution
Authors: Shu Yun , Dai Tao , Ye Qiuyu , Jin Dangqin , Xu Qin , Hu Xiaoya
Published: August 2021

Using two-dimensional (2D) nickel-based metal organic framework (Ni-MOF) nanosheets as a matrix, Eu3+ and Ag+ were incorporated to synthesize Ag/Eu@Ni-MOF with double luminescence centers of Eu3+ ion (615 nm) and organic ligand (524 nm). And a ratiometric luminescence sensor is constructed based on Ag/Eu@Ni-MOF for sensitive detection of biothiols in aqueous solutions. The dual-emissive fluorescence properties can be tuned by changing the amounts of Ag+ ions doping. The results of temperature and pH effects on the fluorescence of Ag/Eu@Ni-MOF indicates that the Ag/Eu@Ni-MOF is a temperature-sensitive material and the fluorescence of Ag/Eu@Ni-MOF can keep stable over a wide pH range. Due to the binding of -SH in Cys and GSH with Ag+, the ligand luminescence was significantly inhibited by weakening the Ag+ influence on the energy transfer process in the MOFs. Therefore, ratiometric fluorescent sensing of biomolecular thiols was realized based on the dual-emission Ag/Eu@Ni-MOF. More importantly, the fluorescence color change can be observed with naked eyes to realize visual detection. The ratiometric fluorescent sensor exhibits high performance for Cys and GSH detection with a wide linear range of 5-250 μM and a relatively low detection limit of 0.20 μM and 0.17 μM, respectively. Furthermore, the biothiols content in human serum was determined with satisfactory results. It proves the Ni-MOF nanosheets can be used as a stable matrix for construction luminescent MOFs for the first time, and validate the great potential of Ag/Eu@Ni-MOF as a ratiometric fluorescent probe for point-of-care testing (POCT) in disease diagnosis.
Short-term Effect of Monosodium glutamate on serum hormonal level and histological changes of uterus during estrus phase in rat
Authors: Abdulghani Mahfoudh Almuslai Mohammed
Published: August 2021

Background

Monosodium glutamate (MSG) is commonly used in the Middle East and worldwide as a flavour enhancer in food. MSG is called Chinese salt and is commonly used by the food processing industry, restaurants, and institutional services. The current study was conducted to investigate the effects of monosodium glutamate on the uterine tissue of adult female Sprague Dawley rats with a regular estrus cycle.
Results

The mean relative values of progesterone and estrogen to the control in the MSG-treated animal group significantly affect (P < 0.05) compared with the control group. The means of the relative lumen area (um2) showed smaller than the control group.
Conclusions

MSG may cause disturbance in serum progesterone and estrogen levels in young female rats. So, a precautionary utilised for this compound, especially for females under risk factor of hormonal abnormality, is recommended. Further study should be conducted to evaluate the effect of MSG on corpus lutea function.
Sargassum Horneri (Turner) C. Agardh Regulates Neuroinflammation via Inhibition of LPS-stimulated Microglia Activation in Vitro and in Vivo
Authors: Lee Jun Sik , Cho Jun Hwi , Kim Mi Eun
Published: August 2021

Previously we reported that Sargassum horneri (Turner) C. Agardh (S. horneri) is a brown algae species that exerts anti-inflammatory activity toward murine macrophages. However, the anti-neuroinflammatory effects and the mechanism of S. horneri on microglia cells are still unknown. We investigated the anti-neuroinflammatory effects of S. horneri extract on microglia in vitro and in vivo. In present study, we found that S. horneri was not cytotoxic to BV-2 microglia cells, and it significantly decreased lipopolysaccharide (LPS)-induced NO production. Moreover, S. horneri also diminished the protein expression of iNOS, COX-2, and cytokines production including IL-1b, TNF-a, and IL-6 on LPS-stimulated microglia activation. S. horneri elicited anti-neuroinflammatory effects by inhibiting phosphorylation of p38 MAPK and NF-kB. In addition, S. horneri inhibited astrocytes and microglia activation in LPS-challenged mice brain. Therefore, these results suggested that S. horneri exerted anti-neuroinflammatory effects on LPS-stimulated microglia cells activation by inhibiting MAPK phosphorylation and NF-kB signaling.
Applying Low-Cost Air-Pollution Sensors’ Information to Explore PM2.5 Concentration With an Emphasis on Spatial and Temporal Analysis: A Case in Chiayi City
Authors: Tseng Chao-Heng , Chen Ling Ling , Tseng Guan-Hua
Published: August 2021

Low-cost air-pollution sensors are attracting increasing attention. They offer air-pollution monitoring at a cost lower than that of conventional methods, theoretically facilitating air-pollution monitoring in several locations and immediate application of acquired information. We establish a particulate matter (PM2.5) map based on low-cost air-pollution sensor information developed using internet of things at Taiwan’s Environmental Protection Agency. We synergize data from one monitoring station with 287 low-cost air-pollution-pollution sensors (data entries = ∼50 million) to estimate PM2.5 concentrations from September 1, 2018 to August 31, 2019. We investigate Chiayi City because it has the second-highest PM2.5 concentration in Taiwan. By analyzing Geographic Information System data, we map Chiayi City’s spatial and temporal distributions, identify PM2.5, and recognize the characteristics of Chiayi City’s hotspots. Our main discoveries are as follows: Chiayi City’s spatial distribution reveals PM2.5 concentrated in its industrial area, which increasingly reduces from the industrial area to the city center. Hot spots are identified by two types of space units: northwest industrial and central and western agricultural zone. Concentrated PM2.5 occurs mainly in winter, with the highest rate in January, occurring most frequently and less frequently from 7 to 10 a.m. and 3 to 5 p.m., respectively. Although this study focuses on Chiayi City, the proposed approach has general applicability to wide-ranging environment-monitoring studies and air-pollution interventions and will substantially assist in validating PM2.5 transport models and enhance exposure estimation accuracy in further research.
New Insights Into the Regulation of TGF-β/Smad and MPK Signaling Pathway Gene Expression by Nasal Allergen and Methacholine Challenge Test in Asthma.
Authors: Panek Michał , Karbownik Michał Seweryn , Górski Karol Maksymilian , Koćwin Marcelina , Kardas Grzegorz , Marynowski Mateusz , Kuna Piotr
Published: August 2021

BackgroundAsthma is a heterogeneous chronic inflammatory disease of the bronchi, the course of which is significantly influenced by specific and non-specific extrinsic factors. The aim of this study was to evaluate the effect of these factors on changes in the mRNA expression of genes encoding the TGF-β (TGF-β1 and TGF-β3) - Smad (MPK1/3, Smad1/3/6/7) signaling pathway in asthmatic patients. Methods and ResultsSeventy-five subjects were included in the study, of whom 27 (nine men and 18 women) received an intranasal allergen provocation (specific factors) and 48 (17 men and 31 women) were administered a methacholine provocation (non-specific factors). ConclusionBoth examined types of challenges were found to contribute to changes in the relative expression of genes of the TGF-β (TGF-β1 and TGF-β3) - Smad (MPK1/3, Smad1/3/6/7) signaling pathway in asthmatic patients. A decrease was noted for the MAPK1, MAPK3, Smad3, Smad6 and Smad7 genes, while an increase of up to 2.5 times was observed for the TGF-β1 gene. Our findings suggest that intranasal allergen or bronchial methacholine challenge influences the mRNA expression of the TGF-β1- MPK1/3 and Smad3/6/7 genes.
The Effectiveness of Felt in Reducing Peak Plantar Pressures at the 1st Metatarsophalangeal Joint: In a Healthy Population
Authors: Connell Lauren , MacGilchrist Claire
Published: August 2021

Semi-compressed felt is frequently used in clinical podiatric practice to offload areas of high pressure, particularly in patients with chronic ulceration. The study aimed to assess the effectiveness of semi-compressed felt, on plantar pressures, in offloading the 1st metatarsophalangeal joint, whilst assessing pressure encountered at the peripheries. Elevated plantar pressures are a strong predictor of ulceration in patients with diabetic foot disease, where undetected mechanical trauma can rapidly become ulcerative. In this study, plantar pressure was assessed using the Foot Work Pro plate (AM CUBE, Inc., France, www.amcube.net), in three conditions: barefoot; 5mm thickness and 10mm thickness conditions. This study was of a cross sectional design, where participants were conveniently sampled within the Podiatric Medicine student population within the National University of Ireland, Galway. 33 participants (28 females; 5 males) with a mean age of 23 years (Interquartile Range, 18-44). Plantar pressures at the 1st metatarsophalangeal joint decreased (P<0.01; P<0.01), when semi-compressed felt was applied to offload the 1st metatarsophalangeal joint. Whereas, plantar pressures were found to be increased at both the 3rd metatarsophalangeal joint (P= 0.04; P= 0.01) and the 5th metatarsophalangeal joint (P=0.82; P=0.40), as a result of applying felt to the 1st metatarsophalangeal joint. Evidently, offloading one joint subjected other joints to greater mechanical load allowing insight into the mechanical redistribution associated with the use of felt in offloading, which must be accounted for in the high risk diabetic foot.
An Updated Checklist of The Alien Flora In a Mediterranean Region of Europe: The Case of Calabria (Southern Italy)
Authors: Spampinato Giovanni , Laface Valentina Lucia Astrid , Posillipo Giandomenico , Ortiz Ana Cano , Canas Ricardo Quinto , Musarella Carmelo Maria
Published: August 2021

An updated checklist of the Calabrian alien vascular flora is presented. The alien flora of the Calabria region (Southern Italy) representing almost 12% of the regional flora and comprises 381 alien taxa, among which there are 370 angiosperms, 9 gymnosperms and 2 ferns. In relation to the state of spread, 35 invasive alien species (IAS) have been identified (4 of these are included in the list of Union Concern, sensu Regulation (EU) no. 1143/2014) which represent 9% of the Calabrian alien flora.In the last years the alien flora in Calabria has increased: in particular, alien species have increased over a decade from 190 to the current 381 taxa. If on the one hand this is due to new introductions, resulting from the globalization that relentlessly affects the whole planet, on the other hand it is to be linked to awareness of the problem of alien species and the increasing intensity of research in recent decades. This study would provide a baseline for further advanced studies on the management of invasive species and on the invasion ecology.
Hurdles for Adopting Mobile Learning Devices at the Outset of Clinical Courses
Authors: Folger Daniel , Merenmies Jussi , Sjöberg Lena , Pyörälä Eeva
Published: August 2021

Background: Mobile devices provide medical students with easy access to medical information and educational resources. Since 2013, we have followed the study use of iPads among medical students. In 2016, we observed a notable drop in the mobile device usage in the first cohort of medical students entering their clinical courses. Methods: The aim of the study was to identify the hurdles for adopting mobile devices at the beginning of the clinical courses. We examined how students evaluated their own and the clinical teachers’ ability to use the iPad, how the study assignments fit into digital learning, and how students used the mobile device with patients. The data were collected with online surveys among three consecutive student cohorts and the distributions of closed-ended questions analyzed. Results: Response rates ranged from 67.5% to 90.8%. Students evaluated their own ability to use the iPad as good or excellent and teachers' skills as relatively poor and wanted more digitally tailored assignments. They reported negative attitudes towards mobile device use in the clinical setting and were hesitant to use them in patient contact. Teachers seldom communicated suitable quality medical applications to students. Conclusions: Clinical teachers need support and training to implement a learning environment and assignments appropriate for mobile devices. Both students and teachers were concerned about using these devices with patients. To achieve the full potential of digitalisation in clinical courses, their use should be developed collectively with students.
Unsupervised Spammer Detection in Social Networks based on User Information Interests
Authors: Koggalahewa Darshika , Xu Yue , Foo Ernest
Published: August 2021

Online Social Networks (OSNs) are a popular platform for communication and collaboration. Spammers are highly active in OSNs. Uncovering spammers has become one of the most challenging problems in OSNs. Classification-based supervised approaches are the most commonly used method for detecting spammers. The classification-based systems suffer from limitations of “data labelling”, “spam drift”, “imbalanced datasets” and “data fabrication”. These limitations effect the accuracy of a classifier’s detection. We present a pure unsupervised approach for spammer detection based on peer acceptance of a user in a social network to distinguish spammers from genuine users. The peer acceptance of a user to another user is calculated based on common shared interests over multiple shared topics between the two users. The main contribution of this paper is the introduction of a pure unsupervised spammer detection approach based on users’ peer acceptance. Our approach does not require labelled training datasets. While it does not better the accuracy of supervised classification-based approaches, our approach has become a successful alternative for traditional classifiers for spam detection by achieving an accuracy of 96.9%.
The Autism Risk Factor CHD8 Is a Chromatin Activator in Human Neurons and Functionally Dependent on the ERK-MAPK Pathway Effector ELK1
Authors: Derafshi Bahareh Haddad , Danko Tamas , Chanda Soham , Batista Pedro , Litzenburger Ulrike , Lee Qian Yi , Ng Yi Han , Sebin Anu , Chang Howard Y. , Südhof Thomas C. , Wernig Marius
Published: August 2021

The chromodomain helicase DNA-binding protein CHD8 is among the most frequently found de-novo mutations in autism spectrum disorder (ASD)1-4. Despite its prominent disease involvement, little is known about its molecular function in the human brain. CHD8 is believed to be a chromatin regulator, but mechanisms for its genomic targeting is also unclear. To elucidate the role of CHD8 in human neurons, we generated conditional loss-of-function alleles in pluripotent stem cells. Chromatin accessibility and transcriptional profiling showed that CHD8 is a potent chromatin opener and transcriptional activator of its direct neuronal targets, including a distinct group of ASD genes. We found the chromatin targeting of CHD8 to be highly context dependent. In human neurons, CHD8 was preferentially bound at promoter sequences which were significantly enriched in ETS motifs. Indeed, the chromatin state of ETS motif-containing promoters was preferentially affected upon loss of CHD8. Among the many ETS transcription factors, we found ELK1 to be the best correlated with CHD8 expression in primary human fetal and adult cortical neurons and most highly expressed in our ES cell-derived neurons. Remarkably, ELK1 was necessary to recruit CHD8 specifically to ETS motif-containing sites. These findings imply the functional cooperativity between ELK1, a key downstream factor of the MAPK/ERK pathway, and CHD8 on chromatin involvement in human neurons. THEREFORE, the MAPK/ERK/ELK1 axis may also play a role in the pathogenesis caused by CHD8 mutations5 .
Genome Analysis of The Salt-Resistant Paludifilum Halophilum DSM 102817T Reveals Genes Involved In Flux-Tuning of Ectoines And Unexplored Bioactive Secondary Metabolites
Authors: Frikha-Dammak Donyez , Ayadi Houda , Rekik Imen Hakim , Belbahri Lassaad , Maalej Sami
Published: August 2021

Paludifilum halophilum is the first member of the genus Paludifilum in the Thermoactinomycetaceae family. The thermohalophilic bacterium was isoated from the solar saltern of Sfax, in Tunisia and was shown to be able to produce ectoines in relatively high-yield and cope with salt stress conditions. In this study, the whole genome of P. halophilum was sequenced and analysed. Analysis revealed 3,789,765 base pairs with average GC % content of 51.5%. A total of 3,775 genes were predicted of which 3616 were protein-coding genes and 73 were RNA genes. The genes encoding key enzymes for ectoines synthesis were identified from the bacterial genome next to a gene cluster (ehuABCD) encoding a binding-protein-dependent ABC transport system responsible for ectoines mobility through the cell membrane. With the aid of KEGG analysis, we found that the central catabolic network of P. halophilum comprises the pathways of glycolysis, tricarboxylic acid (TCA) cycle, and pentose phosphate pathway (PPP). In addition, anaplerotic pathways replenishing oxaloacetate and glutamate synthesis from central metabolism, both needed for high ectoines biosynthetic fluxes were identified through several key enzymes. Furthermore, a total of 18 antiSMASH-predicted putative biosynthetic gene clusters (BGCs) for secondary metabolites with high novelty and diversity were identified in P. halophilum genome, including biosynthesis of Colabomycine-A, Fusaricidin-E, Zwittermycin A, Streptomycin, Mycosubtilin and Meilingmycin. Based on these data, P. halophilum emerged as a promising source for ectoines and antimicrobials with the potential to be scaled up for industrial production, which could benefit the pharmaceutical and cosmetic industries.
Dynamic regulation of mitochondrial pyruvate metabolism Is necessary for orthotopic pancreatic tumor growth
Authors: Ruiz Nancy P Echeverri , Mohan Vijay , Wu Jinghai , Scott Sabina , Kreamer McKenzie , Benej Martin , Papandreou Ioanna , Denko Nicholas
Published: August 2021

BackgroundPyruvate dehydrogenase complex (PDC) plays a central role in carbohydrate metabolism, linking cytoplasmic glycolysis to the mitochondrial tricarboxylic acid (TCA) cycle. PDC is a conserved E1-E2-E3 dehydrogenase with a PDHA1 and PDHB heterotetramer functioning as the E1 subunit. PDHA1 contains three serine residues that can be reversibly phosphorylated by a dedicated family of four inhibitory pyruvate dehydrogenase kinases (PDHK1-4) and two reactivating phosphatases (PDP1,2). Hypoxia induces the expression of PDHK1 and PDHK3 and hyperphosphorylates PDHA1. The role of PDC in metabolic reprogramming and tumor progression appears to be for the integration of oncogenic and environmental signals which supports tumor growth. MethodsTo isolate the function of the serine-dependent regulation pf PDC, we engineered MiaPaca2 cells to express PDHA1 protein with either intact serines at positions 232, 293 and 300, or all the combinations of non-phosphorylatable alanine substitution mutations. These lines were compared in vitro for biochemical response to hypoxia by western blot, metabolic activity by biochemical assay and Seahorse XF flux analysis, and growth in media with reduced exogenous metabolites. The lines were also tested for growth in vivo after orthotopic injection into the pancreata of immune-deficient mice. ResultsIn this family of cells with non-phosphorylatable PDHA1 we found reduced hypoxic phosphorylation of PDHA1, decreased PDH enzymatic activity in normoxia and hypoxia, decreased mitochondrial function by Seahorse flux assay, reduced in vitro growth of cells in media depleted of lipids, and reduced growth of tumors after orthotopic transplantation of cells into the pancreata of immune-deficient mice. ConclusionsWe found that any substitution of alanine for serine at regulatory sites generated a hypomorphic PDC. However, the reduced PDC activity was insensitive to further reduction in hypoxia. These cells had very modest reduction of growth in vitro, but were significantly compromised in their growth as tumors, indicating that dynamic PDC adaptation to microenvironmental conditions is necessary for optimal pancreatic cancer growth in vivo.
Ginseng Polysaccharides and its Effective Subfraction Protects Against Dextran Sodium Sulfate-Induced Colitis via Regulating NF-κB Signaling Pathway, Recovering Intestinal Barrier and Adjusting Gut Microbiota
Authors: Li Shanshan , Qi Yuli , Ren Duoduo , Zhang Yue , Sun Yinshi
Published: August 2021

Background: Polysaccharides from Panax ginseng is a natural carbohydrates with multiple activities. Our previous work found that ginseng polysaccharide could recover the gut microbiota dysbiosis caused by antibiotic. However, it was little known about its functions on colitis. In this study, we aim to investigate the protective effects of ginseng polysaccharide (WGP), its neutral fraction (WGPN) and acidic fraction (WGPA) on dextran sodium sulfate (DSS) induced colitis and the potential mechanisms with pharmacological experiments.Methods: Animal model of DSS-induced colitis was constructed by male Wistar rats. Disease activity index (DAI) scores, weight increment, colon weights, and colon length were recorded. Physiological and histological parameters, tight junctions proteins, inflammatory factors, gut microbiota, short-chain fatty acids (SCFAs) and NF-kB signalling pathway related proteins were compared among the five experimental groups, which were treated with a normal diet (Con group), DSS (DSS group), WGP (WGP group), WGPN (WGPN group), and WGPA (WGPA group), respectively. Results: Both WGP and WGPA alleviated the colitis symptoms and colon structure changes of colitis rats. They can decreased the DAIs and improved colon health; reduced colon damage and recovered intestinal barrier via regulating the tight-junction related proteins (ZO-1 and Occludin); downregulated inflammatory cytokines (IL-1β, IL-2, IL-6, and IL-17) and inhibited the TLR4/MyD88/NF-kB signalling pathway in the colon; regulated the diversity and composition of gut microbiota, especially the relative abundance of Ruminococcus; enhanced the production of SCFAs. Conclusions: WGP exerted had a protective effect against colitis through regulating NF-kB signaling pathway, recovering intestinal barrier and adjusting gut microbiota, with its acidic fraction (WGPA) primarily contributing to this activity. The results support to the utilization and investigation of ginseng polysaccharides as potential intervention strategy for the prevention of colitis.
Combining Blood Glucose and SpO 2 /FiO 2 Ratio Facilitates Prediction of Imminent Ventilatory Needs in Emergency Room COVID-19 patients
Authors: Sakai Kazuya , Okoda Kai , Nishii Mototsugu , Saji Ryo , Ogawa Fumihiro , Abe Takeru , Takeuchi Ichiro
Published: August 2021

The increasing requirement of mechanical ventilation (MV) due to the novel coronavirus disease (COVID-19) is still a global threat. The aim of this study is to identify markers that can easily stratify the impending use of MV in the emergency room (ER). A total of 106 patients with COVID-19 requiring oxygen support were enrolled. Fifty-nine patients were provided MV 0.5 hours (interquartile range: 0.3 to 1.4) post-admission. Clinical and laboratory data before intubation were collected. Using a multivariate logistic regression model, we identified four markers associated with the impending use of MV, including the ratio of peripheral blood oxygen saturation to fraction of inspired oxygen (SpO2/FiO2 ratio), alanine aminotransferase, blood glucose (BG), and lymphocyte counts. Among these markers, the combination of SpO2/FiO2 ratio and BG, which can be measured easily and immediately, showed higher accuracy in its prediction (AUC: 0.88) compared to SpO2/FiO2 ratio alone (AUC: 0.84). Moreover, even in patients without severe respiratory failure (SpO2/FiO2 ratio > 300), BG (> 138 mg/dL) was predictive of MV use. Measuring BG and SpO2/FiO2 ratio may be a simple and versatile new strategy to accurately identify ER patients with COVID-19 at high risk for the imminent need of MV.
GD2-specific Chimeric Antigen Receptor-modified T Cells for the treatment of Refractory and/or Recurrent Neuroblastoma in Pediatric Patients
Authors: Yu Lihua , Huang Lulu , Lin Danna , Lai Xiaorong , Wu Li , Liao Xu , Liu Jiale , Zeng Yinghua , Liang Lichan , Zhang Guanmei , Wang Bin , Wu Zhu , Tao Shaohua , Liu Yuchen , Jiao Cheng , Chang Lung-Ji , Yang Lihua
Published: August 2021

PurposeThis study aimed to evaluate the safety and efficacy of the fourth-generation chimeric antigen receptor (CAR) disialoganglioside 2 (GD2)-specific (4SCAR-GD2) T cells for treatment of refractory and/or recurrent neuroblastoma (NB) in pediatric patients. Experimental DesignA phase I clinical study using 4SCAR-GD2 T cells for the treatment of NB in pediatric patients was conducted. This study was registered at www.clinicaltrials.gov (NCT02765243). A lentiviral CAR with the signaling domains of CD28/4-1BB /CD3ζ-iCasp9 was transduced into activated T-cells. The response to 4SCAR-GD2 T cell treatment, and 4SCARGD2 T cell expansion and persistence in patients were evaluated. Toxicities were determined based on the National Cancer Institute Common Terminology Criteria for Adverse Events (CTCAE) v4.03. ResultsTwelve patients were enrolled and finally ten ptients were included in this clinical trial which occurred from January 1, 2016, to August 1, 2017. These patients had progressive disease (PD) before CAR T cell infusion. After 4SCAR-GD2 T cell treatment, 6 (6/10) had stable disease (SD) at 6 months, and 4(4/10) remained SD at 1 year and alive after 3-4 years of follow up. Six patients died due to disease progression by the end of July 1, 2020. The median overall survival (OS) time was 25 months (95% CI, 0.00 to 59.43), and the median progression-free survival (PFS) time was 8 months (95% CI, 0.25 to 15.75). Grade 3 or 4 hematological toxicities were the common adverse events frequently occurred after fludarabine and cyclophosphamide (Flu/cy) chemotherapy. Grade 1-2 toxicities like cytokine release syndrome and neuropathic pain were common, transient and mild. ConclusionsThe 4SCAR-GD2 T cell therapy demonstrated antitumor effect and manageable toxicities, indicating its potential to benefit children with refractory and/or recurrent NB.
Purification and Characterization of Polyphenol Oxidase Enzyme from Damson Plum (Prunus insititia) by Spectrophotometrically
Authors: Yıldız Selinnur , Bilen Çiğdem , Karakuş Emine
Published: August 2021

Polyphenol oxidase enzyme, performing browning reactions in fruits and vegetables, was purificated from damson plum (Prunus insititia) which has a high antioxidant activity. Firstly, partially purified polyphenol oxidase was treated by 0-80% ammonium sulfate precipitation and dialysis, respectively. Characterization studies were carried out by using catechol, 4-methyl catechol, pyrogallol and caffeic acid as 0.05M/ pH:7.2/ 25°C; 0.2M/ pH:4.5/ 10°C; 0.01M/ pH:6.8/ 5°C and 0.2M/ pH:8.5/ 10°C, respectively. The kinetic constants of Vmax and KM were calculated for the same substrates as 17219.97 U/(mL*min) and 11.67mM; 7309.72 U/(mL*min) and 5mM; 12580.12 U/(mL*min) and 3.74mM; 12100.41 U/(mL*min) and 6.25 mM, respectively. Catechol gave the highest Vmax value when compared to others. In the second step, purification was performed by using Sepharose 4B-L-Tyrosine-p-amino benzoic acid and Sepharose 6B-L-Tyrosine-p-amino benzoic acid affinity gels. A single band of approximately as 50-55 kDa was observed in SDS-PAGE and Native-PAGE. 90 and 10.2 purification folds were obtained for Prunus insititia PPO by the reference Sepharose-4B-L-Tyrosine-p-aminobenzoic acid and original Sepharose-6B-L-Tyrosine-p-aminobenzoic acid gels, respectively. PPO enzyme purification from Prunus insititia by affinity chromatography has not been investigated in literature yet.