bluuebunny/crossref_metadata_2025 huggingface dataset:
Surgical treatment for antiplatelet intracerebral hemorrhage (SAP-ICH): protocol for a prospective cohort study of emergency surgery for severe spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet treatment
Authors: Wu Jun , Sun Xinguo , Liu Qingyuan , Li Maogui , Chen Shanwen , Wang Jiantao , Wang Youquan , Guo Peng , Li Xiong , Peng Lei , Jiang Pengjun , Wang Nuochuan , Guo Rui , Yang Shuzhe , Cao Yong , Ning Bo , Liu Cang , Zhang Fuzheng , Li Jingping , Zhang Yanan , Wang Shuo
Published: January 2021

Background

Despite the capability of emergency surgery to reduce the mortality of severe spontaneous intracranial hemorrhage (SSICH) patients, the effect and safety of surgical treatment for severe spontaneous intracranial hemorrhage (SSICH) patients receiving long-term oral antiplatelet treatment (LOAPT) remains unclear. In consideration of this, the cohort study is aimed at figuring out the effect and safety of emergency surgery for SSICH patients on LOAPT.

Methods

As a multicenter and prospective cohort study, it will be conducted across 7 representative clinical centers. Starting in September 2019, the observation is scheduled to be completed by December 2022, with a total of 450 SSICH patients recruited. The information on clinical, radiological, and laboratory practices will be recorded objectively. All of the patients will be monitored until death or 6 months after the occurrence of primary hemorrhage.

Results

In this study, two comparative cohorts and an observational cohort will be set up. The primary outcome is the effect of emergency surgery, which is subject to assessment using the total mortality and comparison in the survival rate of SSICH patients on LOAPT between surgical treatment and conservative treatment. The second outcome is the safety of surgery, with the postoperative hemorrhagic complication which is compared between the operated SSICH patients on and not on LOAPT. Based on the observation of the characteristics and outcome of SSICH patients on LOAPT, the ischemic events after discontinuing LOAPT will be further addressed, and the coagulation function assessment system for operated SSICH patients on LOAPT will be established.

Conclusions

In this study, we will investigate the effect and safety of emergency surgery for SSICH patients on LOAPT, which will provide an evidence for management in the future.

Ethics and dissemination

The research protocol and informed consent in this study were approved by the Institutional Review Board of Beijing Tiantan Hospital (KY2019-096-02). The results of this study are expected to be disseminated in peer-reviewed journals in 2023.

Trial registration

Name: Effect and safety of surgical intervention for severe spontaneous intracerebral hemorrhage patients on long-term oral antiplatelet treatment.

ChiCTR1900024406. Date of registration is July 10, 2019.
The comparing of infant mortality rate in different World Health Organization regions during 1990–2017
Authors: Esmaeilzadeh Firooz , Alimohamadi Yousef , Sepandi Mojtaba , Khodamoradi Farzad , Jalali Parisa
Published: January 2021

Background

Infant mortality rate is an important index of community health status and mortality rate. It is also one of the most prominent indexes showing the development of various societies. Regarding the importance of infant mortality rate (IMR), the purpose of current study was to compare and trend analysis of IMR in different areas of the WHO during 1990–2017. In current ecological study, IMR per 1000 live births in different WHO regions from 1990 to 2017 data were derived from the WHO website. The required information included the data about IMR per 1000 live births in different WHO regions from 1990 to 2017. The analysis was performed by using descriptive and analytical methods.

Results

The IMR during the study period had a significant decreasing trend in all the regions (p < 0.001) but the slope of decrease was greater in Africa than in other regions. The African and European regions had the highest (55.7%) and lowest (17.2%) annual decrease in the infant mortality rate (from 106.3 cases in 1990 to 50.6 in 2017, and from 24.9 in 1990 to 7.7 in 2017), respectively.

Conclusion

Our results showed that the trend of IMR had a decreasing trend in all WHO regions. It can be due to improving the public health situation in different areas. But the identification of effective factors on IMR needs individuals based studies.
What’s the “secret sauce”? How implementation variation affects the success of colorectal cancer screening outreach
Authors: Coury Jennifer , Miech Edward J. , Styer Patricia , Petrik Amanda F. , Coates Kelly E. , Green Beverly B. , Baldwin Laura-Mae , Shapiro Jean A. , Coronado Gloria D.
Published: January 2021

Background

Mailed fecal immunochemical testing (FIT) programs can improve colorectal cancer (CRC) screening rates, but health systems vary how they implement (i.e., adapt) these programs for their organizations. A health insurance plan implemented a mailed FIT program (named BeneFIT), and participating health systems could adapt the program. This multi-method study explored which program adaptations might have resulted in higher screening rates.

Methods

First, we conducted a descriptive analysis of CRC screening rates by key health system characteristics and program adaptations. Second, we generated an overall model by fitting a weighted regression line to our data. Third, we applied Configurational Comparative Methods (CCMs) to determine how combinations of conditions were linked to higher screening rates. The main outcome measure was CRC screening rates.

Results

Seventeen health systems took part in at least 1 year of BeneFIT. The overall screening completion rate was 20% (4–28%) in year 1 and 25% (12–35%) in year 2 of the program. Health systems that used two or more adaptations had higher screening rates, and no single adaptation clearly led to higher screening rates. In year 1, small systems, with just one clinic, that used phone reminders (n= 2) met the implementation success threshold (≥ 19% screening rate) while systems with > 1 clinic were successful when offering a patient incentive (n= 4), scrubbing mailing lists (n= 4), or allowing mailed FIT returns with no other adaptations (n= 1). In year 2, larger systems with 2–4 clinics were successful with a phone reminder (n= 4) or a patient incentive (n= 3). Of the 10 systems that implemented BeneFIT in both years, seven improved their CRC screening rates in year 2.

Conclusions

Health systems can choose among many adaptations and successfully implement a health plan’s mailed FIT program. Different combinations of adaptations led to success with health system size emerging as an important contextual factor.
Using behavioral insights to design implementation strategies in public mental health settings: a qualitative study of clinical decision-making
Authors: Last Briana S. , Schriger Simone H. , Timon Carter E. , Frank Hannah E. , Buttenheim Alison M. , Rudd Brittany N. , Fernandez-Marcote Sara , Comeau Carrie , Shoyinka Sosunmolu , Beidas Rinad S.
Published: January 2021

Background

Trauma-focused cognitive behavioral therapy (TF-CBT) is an evidence-based intervention for youth with posttraumatic stress disorder. An important component of TF-CBT is the trauma narrative (TN), a phase in the intervention in which youth are guided to process the memories, thoughts, and feelings associated with their traumatic experience(s). Previous work has shown that TF-CBT clinicians complete TNs with only half of their clients, yet little is known about what determines TF-CBT clinicians’ use of TNs. The behavioral insights literature—an interdisciplinary field studying judgment and decision-making—offers theoretical and empirical tools to conceptualize what drives complex human behaviors and decisions. Drawing from the behavioral insights literature, the present study seeks to understand what determines clinician use of TNs and to generate strategies that target these determinants.

Methods

Through semi-structured qualitative interviews, we sought the perspectives of trained TF-CBT clinicians working in public mental health settings across the city of Philadelphia (N= 17) to understand their decisions to use TNs with clients. We analyzed the qualitative data using a coding approach informed by the behavioral insights literature. We used an iterative process of structured hypothesis generation, aided by a behavioral insights guide, and rapid validation informed by behavioral insights to uncover the determinants of TN use. We then generated implementation strategies that targeted these determinants using the “Easy Attractive Social Timely” framework, a behavioral insights design approach.

Results

We generated and validated three broad themes about what determines clinician implementation of TNs: decision complexity, clinician affective experience, and agency norms. We hypothesized behavioral insights that underlie these implementation determinants and designed a list of nine corresponding behavioral insights strategies that may facilitate TN implementation.

Conclusions

Our study investigated why an effective component of an evidence-based intervention is difficult to implement. We leveraged robust scientific theories and empirical regularities from the behavioral insights literature to understand clinician perspectives on TN implementation. These factors were theoretically linked to implementation strategies. Our work revealed the potential for using behavioral insights in the diagnosis of evidence-based intervention determinants and the design of implementation strategies.
Pathogenic Germline Variants in Cancer Susceptibility Genes in Children and Young Adults With Rhabdomyosarcoma
Authors: Kim Jung , Light Nicholas , Subasri Vallijah , Young Erin L. , Wegman-Ostrosky Talia , Barkauskas Donald A. , Hall David , Lupo Philip J. , Patidar Rajesh , Maese Luke D. , Jones Kristine , Wang Mingyi , Genome Research Laboratory Cancer , Tavtigian Sean V. , Wu Dongjing , Shlien Adam , Telfer Frank , Goldenberg Anna , Skapek Stephen X. , Wei Jun S. , Wen Xinyu , Catchpoole Daniel , Hawkins Douglas S. , Schiffman Joshua D. , Khan Javed , Malkin David , Stewart Douglas R.
Published: January 2021

PURPOSE

Rhabdomyosarcoma (RMS) is the most common pediatric soft-tissue sarcoma and accounts for 3% of all pediatric cancer. In this study, we investigated germline sequence and structural variation in a broad set of genes in two large, independent RMS cohorts.

MATERIALS AND METHODS

Genome sequencing of the discovery cohort (n = 273) and exome sequencing of the secondary cohort (n = 121) were conducted on germline DNA. Analyses were performed on 130 cancer susceptibility genes (CSG). Pathogenic or likely pathogenic (P/LP) variants were predicted using the American College of Medical Genetics and Genomics (ACMG) criteria. Structural variation and survival analyses were performed on the discovery cohort.

RESULTS

We found that 6.6%-7.7% of patients with RMS harbored P/LP variants in dominant-acting CSG. An additional approximately 1% have structural variants ( ATM, CDKN1C) in CSGs. CSG variants did not influence survival, although there was a significant correlation with an earlier age of tumor onset. There was a nonsignificant excess of P/LP variants in dominant inheritance genes in the patients with FOXO1 fusion–negative RMS patients versus the patients with FOXO1 fusion–positive RMS. We identified pathogenic germline variants in CSGs previously ( TP53, NF1, DICER1, mismatch repair genes), rarely ( BRCA2, CBL, CHEK2, SMARCA4), or never ( FGFR4) reported in RMS. Numerous genes ( TP53, BRCA2, mismatch repair) were on the ACMG Secondary Findings 2.0 list.

CONCLUSION

In two cohorts of patients with RMS, we identified pathogenic germline variants for which gene-specific therapies and surveillance guidelines may be beneficial. In families with a proband with an RMS-risk P/LP variant, genetic counseling and cascade testing should be considered, especially for ACMG Secondary Findings genes and/or with gene-specific surveillance guidelines.
Smoking flies: testing the effect of tobacco cigarettes on heart function ofDrosophila melanogaster
Authors: Santalla Manuela , Pagola Lucía , Gómez Ivana , Balcazar Darío , Valverde Carlos A. , Ferrero Paola
Published: January 2021

Studies about the relationship between substances consumed by humans and their impact on health, in animal models, have been a challenge due to differences between species in the animal kingdom. However, the homology of certain genes has allowed extrapolation of certain knowledge obtained in animals. Drosophila melanogaster, studied for decades, has been widely used as model for human diseases as well as to study responses associated with the consumption of several substances. In the present work we explore the impact of tobacco consumption on a model of ‘smoking flies’. Throughout these experiments, we aim to provide information about the effects of tobacco consumption on cardiac physiology. We assessed intracellular calcium handling, a phenomenon underlying cardiac contraction and relaxation. Flies chronically exposed to tobacco smoke exhibited an increased heart rate and alterations in the dynamics of the transient increase of intracellular calcium in myocardial cells. These effects were also evident under acute exposure to nicotine of the heart, in a semi-intact preparation. Moreover, the alpha 1 and 7 subunits of the nicotinic receptors are involved in the heart response to tobacco and nicotine under chronic (in the intact fly) as well as acute exposure (in the semi-intact preparation). The present data elucidate the implication of the intracellular cardiac pathways affected by nicotine on the heart tissue. Based on the probed genetic and physiological similarity between the fly and human heart, cardiac effects exerted by tobacco smoke in Drosophila advances our understanding of the impact of it in the human heart. Additionally, it may also provide information on how nicotine-like substances, e.g. neonicotinoids used as insecticides, affect cardiac function.

This article has an associated First Person interview with the first author of the paper.
What machine learning can do for developmental biology
Authors: Villoutreix Paul
Published: January 2021

Developmental biology has grown into a data intensive science with the development of high-throughput imaging and multi-omics approaches. Machine learning is a versatile set of techniques that can help make sense of these large datasets with minimal human intervention, through tasks such as image segmentation, super-resolution microscopy and cell clustering. In this Spotlight, I introduce the key concepts, advantages and limitations of machine learning, and discuss how these methods are being applied to problems in developmental biology. Specifically, I focus on how machine learning is improving microscopy and single-cell ‘omics’ techniques and data analysis. Finally, I provide an outlook for the futures of these fields and suggest ways to foster new interdisciplinary developments.
Inducible expression of human C9ORF72 36× G4C2 hexanucleotide repeats is sufficient to cause RAN translation and rapid muscular atrophy in mice
Authors: Riemslagh Fréderike W. , van der Toorn Esmay C. , Verhagen Rob F. M. , Maas Alex , Bosman Laurens W. J. , Hukema Renate K. , Willemsen Rob
Published: January 2021

The hexanucleotide G4C2 repeat expansion in the first intron of the C9ORF72 gene accounts for the majority of frontotemporal dementia (FTD) and amyotrophic lateral sclerosis (ALS) cases. Numerous studies have indicated the toxicity of dipeptide repeats (DPRs), which are produced via repeat-associated non-AUG (RAN) translation from the repeat expansion, and accumulate in the brain of C9FTD/ALS patients. Mouse models expressing the human C9ORF72 repeat and/or DPRs show variable pathological, functional and behavioral characteristics of FTD and ALS. Here, we report a new Tet-on inducible mouse model that expresses 36× pure G4C2 repeats with 100-bp upstream and downstream human flanking regions. Brain-specific expression causes the formation of sporadic sense DPRs aggregates upon 6 months of dox induction, but no apparent neurodegeneration. Expression in the rest of the body evokes abundant sense DPRs in multiple organs, leading to weight loss, neuromuscular junction disruption, myopathy and a locomotor phenotype within the time frame of 4 weeks. We did not observe any RNA foci or pTDP-43 pathology. Accumulation of DPRs and the myopathy phenotype could be prevented when 36× G4C2 repeat expression was stopped after 1 week. After 2 weeks of expression, the phenotype could not be reversed, even though DPR levels were reduced. In conclusion, expression of 36× pure G4C2 repeats including 100-bp human flanking regions is sufficient for RAN translation of sense DPRs, and evokes a functional locomotor phenotype. Our inducible mouse model suggests that early diagnosis and treatment are important for C9FTD/ALS patients.

This article has an associated First Person interview with the first author of the paper.
Neural crest-specific loss ofBmp7leads to midfacial hypoplasia, nasal airway obstruction and disordered breathing, modeling obstructive sleep apnea
Authors: Baddam Pranidhi , Biancardi Vivian , Roth Daniela M. , Eaton Farah , Thereza-Bussolaro Claudine , Mandal Rupasri , Wishart David S. , Barr Amy , MacLean Joanna , Flores-Mir Carlos , Pagliardini Silvia , Graf Daniel
Published: January 2021

Pediatric obstructive sleep apnea (OSA), a relatively common sleep-related breathing disorder affecting ∼1-5% of children, is often caused by anatomical obstruction and/or collapse of the nasal and/or pharyngeal airways. The resulting sleep disruption and intermittent hypoxia lead to various systemic morbidities. Predicting the development of OSA from craniofacial features alone is currently not possible, and controversy remains as to whether upper-airway obstruction facilitates reduced midfacial growth or vice versa. Currently, there is no rodent model that recapitulates both the development of craniofacial abnormalities and upper-airway obstruction to address these questions. Here, we describe that mice with a neural crest-specific deletion of Bmp7 (Bmp7ncko) present with a shorter, more acute-angled cranial base, midfacial hypoplasia, nasal septum deviation, turbinate swelling and branching defects, and nasal airway obstruction. Interestingly, several of these craniofacial features develop after birth during periods of rapid midfacial growth and precede the development of an upper-airway obstruction. We identified that, in this rodent model, no single feature appeared to predict upper-airway obstruction, but the sum of those features resulted in reduced breathing frequency, apneas and overall reduced oxygen consumption. Metabolomics analysis of serum from peripheral blood identified increased levels of hydroxyproline, a metabolite upregulated under hypoxic conditions. As this model recapitulates many features observed in OSA, it offers unique opportunities for studying how upper-airway obstruction affects breathing physiology and leads to systemic morbidities.

This article has an associated First Person interview with the first author of the paper.
Long-term segmentation-free assessment of head–flagellum movement and intracellular calcium in swimming human sperm
Authors: Corkidi Gabriel , Hernández-Herrera Paul , Montoya Fernando , Gadêlha Hermes , Darszon Alberto
Published: January 2021

Human spermatozoa are the archetype of long-term self-organizing transport in nature and are critical for reproductive success. They utilize coordinated head and flagellar movements to swim long distances within the female reproductive tract in order to find and fertilize the egg. However, to date, long-term analysis of the sperm head–flagellar movements, or indeed those of other flagellated microorganisms, remains elusive due to limitations in microscopy and flagellar-tracking techniques. Here, we present a novel methodology based on local orientation and isotropy of bio-images to obtain long-term kinematic and physiological parameters of individual free-swimming spermatozoa without requiring image segmentation (thresholding). This computer-assisted segmentation-free method evaluates, for the first time, characteristics of the head movement and flagellar beating for up to 9.2 min. We demonstrate its powerful use by showing how releasing Ca2+ from internal stores significantly alters long-term sperm behavior. The method allows for straightforward generalization to other bio-imaging applications, such as studies of bull sperm and Trypanosoma, or indeed of other flagellated microorganisms – appealing to communities other than those investigating sperm biology.
Symbiont regulation in Stylophora pistillata during cold stress: an acclimation mechanism against oxidative stress and severe bleaching
Authors: Marangoni Laura Fernandes de Barros , Rottier Cecile , Ferrier-Pagès Christine
Published: January 2021

Widespread coral bleaching and mortality, leading to coral reef decline, have been mainly associated with climate-change-driven increases in sea surface temperature. However, bleaching and mortality events have also been related to decreases in sea surface temperature, with cold stress events (e.g. La Niña events) being expected to increase in frequency or intensity as a result of a changing climate. Cold stress creates physiological symptoms in symbiotic reef-building corals similar to those observed when they are heat stressed, and the biochemical mechanisms underpinning cold stress in corals have been suggested to be related to an oxidative stress condition. However, up to now, this hypothesis had not been tested. This study assessed how short and long cold excursions in seawater temperature affect the physiology and biochemical processes related to oxidative stress in the reef-building coral Stylophora pistillata. We provide, for the first time, direct evidence that the mechanisms underpinning cold stress and bleaching are related to the production of reactive oxygen species, and that rapid expulsion of a significant proportion of the symbiont population by the host during cooling conditions is an acclimation mechanism to avoid oxidative stress and, ultimately, severe bleaching. Furthermore, this study is one of the first to show that upwelling conditions (short-term cold stress+nutrient enrichment) can provoke a more severe oxidative stress condition in corals than cold stress alone.
Shackling the Poor, or Effective Altruism: A Critique of the Philosophical Foundation of Effective Altruism
Authors: Ioannidis Iraklis
Published: January 2021

Effective Altruism (EA) is both a philosophy and a movement. The main criticism on EA is that by donating to charities EA leaves fundamental moral issues such as global poverty and injustice intact. EA arguably does not promote radical institutional change which could lead to an ultimate eradication of the problems that may endanger people’s lives in the first place. In this article this critique is reinforced from a different point of view. The criticism on EA has been mainly on the performative or the empirical aspect of the movement. That is, criticism on EA focuses on evaluating the practical realisation of its mandates with little, if any, evaluation on its philosophical foundation. My aim in this paper is to extend the critique but from a different angle, that is, by going back to its philosophical underpinnings. By exploring the philosophical foundation of EA, I would like to show how EA is not authentic altruism as it is founded on the sacrifice of the Other whom is supposed to be saved.
Is it Possible to be Better Off Dead? An Epicurean Analysis of Physician-Assisted Suicide
Authors: Pavelich Andrew
Published: January 2021

Epicurus wrote that death cannot be bad for a person who dies, since when someone dies they no longer exist to be the subject of harm. But his conclusion also applies in the converse: Death cannot be good for someone, since after their death they will not exist to be the subject of benefit. This conclusion is troubling when it is brought to bear on the question of physician assisted suicide. If Epicurus is right, as I think he is, then it means that even when someone is dying of a long and painful illness, we cannot say that they would be better off dead. I defend this conclusion by first presenting Epicurus’s argument, and defending it against some of its more important contemporary critics. I then re-examine the conclusion that someone cannot be better off dead by looking at the issue of mercy killing and euthanasia. Drawing on the work of philosophers who examine the ethics of animal euthanasia, I argue that killing someone who is suffering severe agony can be good, but it cannot be good for the person who suffers – it is just good in itself. This, I think, is why we have the intuitions that we do around physician assisted suicide: we are mistaken about the idea that someone can be better off dead, but we can be correct in thinking that sometimes someone’s death is good.
3-D Dynamic UAV Base Station Location Problem
Authors: Cicek Cihan Tugrul , Shen Zuo-Jun Max , Gultekin Hakan , Tavli Bulent
Published: January 2021

We address a dynamic covering location problem of an unmanned aerial vehicle base station (UAV-BS), in which the location sequence of a single UAV-BS in a wireless communication network is determined to satisfy data demand arising from ground users. This problem is especially relevant in the context of smart grid and disaster relief. The vertical movement ability of the UAV-BS and nonconvex covering functions in wireless communication restrict utilizing classical planar covering location approaches. Therefore, we develop new formulations to this emerging problem for a finite time horizon to maximize the total coverage. In particular, we develop a mixed-integer nonlinear programming formulation that is nonconvex in nature and propose a Lagrangean decomposition algorithm (LDA) to solve this formulation. Because of the high complexity of the problem, the LDA is still unable to find good local solutions to large-scale problems. Therefore, we develop a continuum approximation (CA) model and show that CA would be a promising approach in terms of both computational time and solution accuracy. Our numerical study also shows that the CA model can be a remedy to build efficient initial solutions for exact solution algorithms.

Summary of Contribution: This paper addresses a facet of mixed integer nonlinear programming formulations. Dynamic facility location problems (DFLPs) arise in a wide range of applications. However, classical DFLPs typically focus on the two-dimensional spaces. Emerging technologies in wireless communication and some other promising application areas, such as smart grids, have brought new location problems that cannot be solved with classical approaches. For practical reasons, many research attempts to solve this new problem, especially by researchers whose primary research area is not OR, have seemed far from analyzing the characteristics of the formulations. Rather, solution-oriented greedy heuristics have been proposed. This paper has two main objectives: (i) to close the gap between practical and theoretical sides of this new problem with the help of current knowledge that OR possesses to solve facility location problems and (ii) to support the findings with an exhaustive computational study to show how these findings can be applied to practice.
Design of Blessing Ball Throwing Techniques for KRAI 2018 Robot
Authors: Diantoro Rochmat , Aji Wahyu Sapto
Published: January 2021

Abu Robocon 2018 which was held in Vietnam with the theme "nem con" which means throwing a berkah ball. The Indonesia Abu Robot Contest 2018 made a throwing robot design with different pole height. The parameter that must be achieved is the optimization of the throwing mechanical drive. The thrower mechanics in the KRAI robot can use pneumatically by determining the angle of the robotic thrower. The mechanical tilt angle determines the throwing distance of the berkah ball. To find out the height of this research berkah ball will use python to display the parabolic motion. Based on the results of the study obtained the first test results with a throwing angle of 0 ˚-115 ˚ get an average value of a distance of 7.37 m, height 273.4 Cm, time 1.42 s and speed of 5.152 m / s. The results of the two test with a throwing angle of 0 ˚-95˚ obtained an average distance of 8.78 m, height 352.4 Cm, time 1.63 s and speed 5.381 m / s. It can be concluded that the mechanical tilt angle is leaned forward, the pitching results will be lower. When the angle of inclination is tilted backwards the berkah ball will soar more.
Should lidocaine routinely be used to prevent pain on propofol injection during induction of general anaesthesia or sedation?
Authors: Ratanshi Nadir A , Mandour Yasser
Published: January 2021

Anaesthetists commonly debate whether lidocaine should be added to propofol for anaesthetic induction. The benefits include pain relief and improved patient satisfaction, but disadvantages include the effect on the emulsion itself, the efficacy of propofol once it has been mixed, and the effect on growth of bacteria in the syringe.
Concordance and non-compliance: a psychological perspective
Authors: Allen Lloyd
Published: January 2021

Promoting concordance is a key element of all non-medical prescribing practise. However, more than half of medications prescribed are not taken properly or not taken at all. The reasons for a patient's non-compliance with prescribed medication is complex but the factors that promote compliance are becoming more clearly understood. This article considers what is now understood about the psychological impact prescribing medication has on patients and emphasising the need for prescribers to think about the role they adopt when prescribing. It recommends key communication skills that support the patient's psychological adjustment to change and acknowledges that the prescribing process often forms part of a larger process in which patients are adapting to significant life events. Concordance therefore hinges on skills like empathy and ensuring a prescribers approach to prescribing is truly person centred.
Remote asthma consultations in primary care
Authors: Henry Heather
Published: January 2021

The COVID-19 pandemic has accelerated the move towards remote clinical consultations. Heather Henry explains how remote asthma consultations can be conducted effectively

The COVID-19 pandemic has lead to a rapid increase in remote clinical consultations. Telephone, text messaging and video-based consultations reduce the need for face-to-face consultations that might increase the risk of infection. Appropriate triage is key to the safety of remote consultations. The evidence so far is that, with careful triage, remote consultations are as effective as traditional face-to-face consultations and could be more resource and time effective both for nurses and patients. There are pros and cons to each method of remote consultation. This article will look at the technique for conducting a successful video consultation.
Management of Children with Optic Gliomas and Neurofibromatosis Type 1
Authors: Attina Giorgio , Maurizi Palma , Triarico Silvia , Capozza Michele Antonio , Romano Alberto , Mastrangelo Stefano , Ruggiero Antonio
Published: January 2021

Optic pathway gliomas (OPG) are a common cancer in children with neurofibromatosis type 1. OPGs can cause clinical symptoms such as reduction of visual acuity, alterations of the visual field, pallor of the optical papilla, strabismus, endocrinological alterations up to diencephalic syndrome.The current guidelines provide for wait and see as the main approach if the tumor is not causing visual deterioration and adopting treatment only in the event of significant impairment of the visual function. Therefore, it is essential to early detect the visual deterioration changes as well as the identification of children eligible for treatment.
Effect of Prunus Dulcis & Álpha-Tocopherol in Ethanol Induced Dyslipidemia In Wistar Rats
Authors: Doss Samuel Sundar , Vijayakumar J. , Sukumar E. , Rekha K.
Published: January 2021

The study is aimed at assessing the effect of Prunus dulcis and alpha-tocopherol treatment against ethanol induced dyslipidemia in Wistar rats. 30 albino Wistar rats were selected based on the selection criteria and equally distributed into 5 groups – Control, ethanol, Prunus dulcis, alpha-tocopherol and combination of alpha-tocopherol + Prunus dulcis treated for 40 days. After the treatment for 40 days, all the animals were euthanized and a retro-orbital puncture was made to collect the blood samples for biochemical investigations. Obtained results were statistically analysed using ANOVA. Compared to ethanol group alpha tocopherol, Prunus dulcis and alpha tocopherol + Prunus dulcis treatment significantly decreased total cholesterol and triglycerides levels with p value <0.001. High density lipoprotein (66.31%) levels in the ethanol group were decreased compared to the control group and were significantly increased in other groups. Low density lipoprotein and Very low density lipoprotein levels were higher in the ethanol group compared with the control group and were significantly reduced in other groups with p value <0.001. Results suggest that ethanol has an ill effect on the lipid profile. Treatment with Prunus dulcius and alpha-tocopherol both solely or in combination has produced beneficial effects against dyslipidemia.
Optimization of Physiological Processes in Conditions Staged Activation of Motor Activity in Cardiac Patients
Authors: Zavalishina Svetlana Yu. , Karpov Vladimir Yu. , Eremin Maxim V. , Bakulina Elena D. , Boldov Alexander S. , Dorontsev Alexander V.
Published: January 2021

The development of coronary atherosclerosis leads to the formation of coronary heart disease, which threatens early death or disability. Such patients need a shunt operation to restore blood flow in the vessels of the heart. After this operation, patients need complex rehabilitation, which has strict stages. To expand the physical activity of patients after coronary bypass grafting, a system of motor activity consisting of 7 steps is used, modified for use in Russian clinical conditions for the rehabilitation of patients after shunting of blood vessels supplying the myocardium. This technique involves the use of seven stages of motor activation of patients, through the use of complexes of medical-physical culture with a gradual strengthening of gymnastic exercises, through the use of training using exercise bikes and dosed walking in open areas, built on the principle of "from simple to more complex." The first two stages of motor activation are applicable to patients immediately after coronary artery bypass grafting at the stationary stage; 3-5 stages of motor activation are physiologically justified for in-patient rehabilitation; the 6-7 steps of motor activation are applicable to patients on outpatient rehabilitation.
Investigation into the Phytochemical profile, Antioxidant and Antibacterial potentials of Combretum Molle and Acacia Mearnsii leaf parts
Authors: Ntshanka Nokhanyo M. , Ejidike Ikechukwu P. , Mthunzi Fanyana M. , Moloto Makwena J. , Mubiayi Kalenga P.
Published: January 2021

The use of herbal plants in recent years have increased tremendously owing to their user-friendliness, accessibility, and affordability. In this study, the plant species Combretum molle and Acacia mearnsii were phytochemical screened for the existence of active organic compounds, the content of total phenols, flavonoids and antioxidants using different solvents were investigated. The functional groups existing in the plants extracts were identified using FT-IR. The total phenol contents varied from 53.74 ± 5 – 97.29 ± 3 GAE mg/g and 53.74 ± 7 – 98.58 ± 2 GAE mg/g in the extraction powders for C. molle and A. mearnsii. In C. molle, the content of total flavonoids ranged from 76.90 ± 2 – 114.54 ± 0.18 QE mg/g, while 89.40 ± 3 – 105.45 ± 0.15 QE mg/g was found in A. mearnsii. The radical scavenging activities of the solvent extracts against DPPH and the controls revealed that acetone extract of C. molle displayed 99.64% DPPH inhibition, while A. mearnsii showed a maximum activity of 85.53% at 5 µg/ml. The antimicrobial activity of the two plant species was evaluated using diffusion disk and broth dilution methods. The activity by broth dilution of ethanol, methanol and acetone extracts of C. molle exhibited MIC values (39.06 and 78.13 mg/µL) against P. aeruginosa and E. coli strains respectively, while ethanol and chloroform extracts of A. mearnsii showed (39.06 and 78.13 mg/µL) against P. aeruginosa and E. faecalis respectively. Results from this study showed that the leave extracts constitute healthy supplements with antioxidant and antibacterial potentials that could be useful in traditional medicine for the treatment of numerous infectious ailments.
The Diurnal Variation of Thyroid Hormones in Individuals Attending Tertiary Care Hospital, Kanchipuram District
Authors: Viswan Santhosh , Gurusamy Gurulakshmi , Altaff Khadeja Bi , Subbarayalu Suganya , Surendran Gomathi
Published: January 2021

Free thyroxin hormones FT4 and FT3 are unbounded thyroid hormone are biologically active and involves in regulation of metabolism. Measuring the concentrations of free thyroid hormones is of great diagnostic value. A cross sectional study was carried out during the March 2019 to September 2019 in patients between 18 years to 60 years. A total of 60 samples were collected from 30 patients attending Karpaga Vinayaga Institute of Medical Sciences at morning (6am-8am) and 2nd sampling at night (8pm-9pm). FT4, FT3 and TSH were measured by Enzyme linked immunosorbent assay, using Avantor kit.In our study 36.67% participants were males, 63.3% participants were females. The mean FT3, FT4 and TSH in day are 2.43±0.56, 1.14±0.44 and 2.74±3.16 respectively. The mean night FT3, FT4 and TSH are 2.66±0.55, 1.3±0.61 and 3.21±3.18 respectively. The one sample t test shows difference of FT3, t 4.489 and p value 0.000, FT4, t value 3.092 and p value 0.004 and TSH t value 3.394 and p value 0.002. The time of blood sampling has an important role in the interpretation of TSH levels. However fluctuations in diurnal variations in thyroid hormone levels are less. In our study although statistically significant, all the values are within the normal biological reference interval Further studies in larger cohorts is essential to desire important conclusions.
Role of Th2 type Cytokines and IgE in Asthmatic Children
Authors: Abo-Shanab Assem Metwally , Elnady Hala , Helwa Iman , Abdelkawy Rania Fawzy Mahmoud , Atta Hanan , Salah Dina A , Raouf Haiam Abdel
Published: January 2021

Bronchial asthma (BA) is usually persistent through allergic sensitization, which is likely to result in bronchial hyper-responsiveness and acute bronchoconstriction due to reactions to specific and non-specific trigger stimuli. Many research focused on the role of T cells; particularly, T helper 2 (Th2) cells which linked to controlling immunoglobulin E (IgE) production due to their role in producing different cytokines, like Interleukin-13 (IL-13), in addition to influencing the function of eosinophils through the actions of IL-5. From this perspective, we decided to study the role of IgE, IL-13, and IL-5 in asthmatic children. IL-5, IL-13, and total IgE have been measured by ELISA technique in the serum of 57 children with bronchial asthma and compared to that of 20 healthy controls. Our results reported that 38/57 (66.67%) of the patient group had a family history for allergy, and parental consanguinity was found in 4/57 families (0.07%). IgE levels showed high statistical significance in asthmatic patients in comparison to controls (p = 0.00001), while IL-13 and IL-5 levels were not significantly different in patients versus control groups (P= 0.96, P = 0.81). Moreover, IgE was found significantly increased in both groups with/without family history for allergy (p = 0.009), whereas IL-13 was significantly elevated only in the group of patients with family history for allergy (0.01). This study demonstrates that asthma is strongly related to the family history of allergy, where IgE, as well as IL-13 levels, were found high in these asthmatic patients suggesting their association with underlying symptoms. Unexpectedly IL-5 was found insignificantly decreased.
Status of Novel Coronavirus Disease and Analysis of Mortality in Mexico, Until June 30th, 2020: An Ecological Study
Authors: Raygoza Nicolas Padilla , Salazar Cuauhtémoc Sandoval , Ramírez-Gómez Xóchitl Sofía , Navarro-Olivos Efraín , Gallardo-Luna María de Jesus , Magos-Vazquez Francisco J. , Diaz-Martinez Daniel Alberto
Published: January 2021

Introduction.Mexico has high number of new cases of Coronavirus Infectious Disease-19 and high rates of diabetes, hypertension, obesity, smoking, that can increase the mortality. The aim was to analyze the evolution of the disease until June 30th, 2020; to know the Cause-SpecificMortality Rate by each state from Mexico and the effect of co-morbidities on mortality for Coronavirus Infectious Disease-19. Methods. An ecological study was designed with public data of National Epidemiological Surveillance System to compare the hospital infrastructure (beds) and Cause-Specific Mortality Rate in each state from Mexico and analyze the effect of co-morbidities in mortality by Coronavirus Infectious Disease.19. It was used t-Student test, Z for two proportions, P-values, and OR, CI95%, and logistic regression .Results. From 509,539 registries, 226,089 (44.37%) were confirmed cases and 27,769 deaths were reported (12.28%). The states with higher mortality were Morelos, Baja California, Chihuahua, Guerrero. There was a lineal relationship between number of beds and cause-specific mortality rate (P<,05). Diabetes, chronic obstructive pulmonary disease, immunosuppression, hypertension, cardiovascular disease, chronic kidney disease and obesity shown a stronger effect on mortality by coronavirus disease (OR higher than 2). Asthma shown a protective effect on mortality from coronavirus disease in Mexican population. Conclusion.The spread on coronavirus disease is active in Mexico. The comorbidities had a stronger effect on mortality of Coronavirus disease.
Formulating Strategies to Tackle COVID-19 Pandemic by Understanding its Molecular Mechanisms: A Review
Authors: Ariyanto Eko Fuji , Bashari Muhammad Hasan
Published: January 2021

Coronavirus disease 2019 (COVID-19) is the current biggest health problem that has caused pandemic in hundreds of countries worldwide. Important efforts for COVID-19 prevention and management have been implemented by WHO and many countries; however, the number of new cases is still increasing. The objective of this review is to formulate appropriate strategies to tackle COVID-19 pandemic using molecular mechanisms-based approach. COVID-19 preventive measures aim to avoid virus entry to human cells by applying physical distancing, hand washing and personal protective equipment, maintaining good immune system by balanced nutrition and physical exercise, developing vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) based on comprehensive analysis on SARS-CoV-2 antigen presentation and subsequent immunological cascades, considering the patients’ clinical condition including biomolecular parameters, and developing drugs by designing inhibitors for SARS-CoV-2 proteins responsible for virus replication and transcription.
Testosterone or Dehydroepiandrosterone Sulfate as a Biomarker for Hirsutism in Women with Polycystic Ovary Syndrome
Authors: Imran Husam Jihad , Dhaher Samer Abdulameer , Mansour Abbas Ali
Published: January 2021

Background:Hirsutism is a distressing medical problem for women. Most of hirsutism in women is associated with excess androgen, and most cases have PCOS as an underlying cause.Which androgen to be used to evaluate clinical or biochemical hyperandrogenism in women with PCOS is still debated.There are a small number of studies that evaluated androgens in women with PCOS having hirsutism with conflicting results. The Objective of this study was to determine which androgen predict hirsutism in women with polycystic ovary syndrome (PCOS). Patients and Methods:A case-control study was done in Faiha Specialized Diabetes, Endocrine, and Metabolism Center (FDEMC), Basrah, Iraq. A total of 130 women with PCOS (based on Rotterdam criteria) and 70 healthy controls of comparable age (16-40 years) were investigated for androgens (total testosterone, free testosterone, DHEA-S) using Electrochemiluminescence technology assay; excess hair was examined according to the modified Ferriman-Gallwey (mFG) score and a cut-off value of 8 defined hirsutism. Results: In the three groups of women, the first (n=100) included PCOS with hirsutism, the second (n=30) PCOS without hirsutism, and the third (n=70) women without PCOS or hirsutism as healthy control, hirsutism was seen in about 77 % of PCOS women mostly of moderate severity; High TT, FT, DHEA-S, and overall androgens were seen in 69%, 76%, 37%, and 99% respectively of our PCOS women with hirsutism. No correlation was found between TT, FT, and DHEA-S and the mFG score. Conclusions: This study provides evidence that presence of hirsutism in women with PCOS was associated with a higher level of biochemical hyperandrogenism than seen in PCOS without hirsutism; however, there was no correlation between the studied androgens and mFG score.
Immuno informatics Approach in Designing a Novel Vaccine Using Epitopes from All the Structural Proteins of SARS-CoV-2
Authors: Herrera Leana Rich M.
Published: January 2021

The rapid transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has resulted to the death of hundreds of thousands of people worldwide. With the devastating effects on the economy and healthcare system of many countries, it is crucial to acceleratevaccine development against SARS-CoV-2. Thus, thisworkutilizedimmunoinformaticsto efficiently design a novel multi-epitope vaccine that can potentially induce immune response through the immunogenic, and abundantly expressed structural proteins in SARS-CoV-2. Epitopes were screened and evaluated using various immunoinformatics tools and databases. Antigenicity, allergenicity, and population coverage were assessed. Epitopes were adjoined to form a single vaccine construct (Covax),linked with 50S ribosomal protein as an adjuvant. Physicochemical properties, cross-reactivity, antigenicity,andallergenicityof Covax were evaluated. The tertiary structure of Covax was modeled, refined and validated for docking with toll-like receptor 4 (TLR4). Binding affinity of Covax-TLR4 was estimated and compared with TLR4-adjuvant as control. Lastly,the immune response with Covax was simulated and compared withadjuvant alone. Total of 33 epitopes from S (21), E (3), M (5),and N (4)proteins were merged in Covax. These include epitopes on thereceptor-binding motif (RBM) of S protein known to beessential in the viral attachment. In silico evaluations classified Covax as stable, antigenic, and non-allergenic. Epitopes were estimated to have large worldwide population coverage, especially in areas with high infection rates, indicating broad potential efficacy of Covax as a vaccine for the most affected populations.Results in this work showed that Covax can bind to TLR4 whichindicates potential immunogenicity and superior properties necessary for a successful vaccine. Overall, this work efficiently minimized time, effort and cost in designing a candidate vaccine against SARS-CoV-2. In vitro and in vivo studies on Covax are anticipated.