bluuebunny/crossref_metadata_2025 huggingface dataset:
Process Intensification of The Ionosolv Pretreatment: Effects Of Biomass Loading, Particle Size And 100-Fold Scale-Up
Authors: Chambon Clementine L. , Verdía Pedro , Fennell Paul S. , Hallett Jason
Published: January 2021

Background: The ionoSolv process is one of the most promising technologies for biomass pretreatment in a biorefinery context. In order to evaluate the transition of the ionoSolv pretreatment of biomass from bench-scale experiments to biorefinery scale, there is a need to get better insight in process intensification. In this work, the effects of biomass loading, particle size, pulp washing protocols and 100-fold scale up for the pretreatment of the grassy biomass Miscanthus giganteus with the IL triethylammonium hydrogen sulfate, [TEA][HSO4], are presented. Results: At the bench scale, increasing biomass loading from 10 wt% to 50 wt% reduced glucose yields from 68% to 23% due to re-precipitation of lignin onto the pulp surface. Omitting the pulp air-drying step maintained saccharification yields at 66% at 50 wt% loading due to reduced fiber hornification. 100-fold scale-up (from 10 mL to 1 L) improved the efficacy of ionoSolv pretreatment and increasing loadings from 10 wt% to 20 wt% reduced lignin reprecipitation and led to higher glucose yields due to the improved heat and mass transfer caused by efficient slurry mixing in the reactor. Pretreatment of particle sizes of 1–3 mm was more effective than fine powders (0.18–0.85 mm) giving higher glucose yields due to reduced surface area available for lignin re-precipitation while reducing grinding energy needs.Conclusion: Stirred ionoSolv pretreatment showed great potential for industrialization and further process intensification after optimization of the pretreatment conditions (temperature, residence time, stirring speed), particle size and biomass loading. Pulp washing protocols need further improvement to reduce the incidence of lignin precipitation and the water requirements of lignin washing.
Impact of Sociodemographic Factors on The Consumption of Tubers in Brazil
Authors: Horodyska Justyna , Pigat Sandrine , Wonik Jasmin , Bompola Foteini , Cai David , Rehm Colin Davis , Gonzalez Tanhia Denys
Published: January 2021

BackgroundAlthough tubers play a significant role in Brazilian agriculture, very little is known about the intake of tubers among the Brazilian population. The objective of this study was to characterize the intake of tubers across Brazil. The types of tubers consumed were quantified, and the impact of geographic and sociodemographic factors was assessed. MethodsThis cross-sectional study is based on dietary intake data of 33,504 subjects obtained from the Brazilian National Dietary Survey. All tuber containing foods were identified, and the contribution of different tubers to overall tuber consumption in Brazil was quantified. Descriptive analyses assessed the impact of macroregion and sociodemographic characteristics on tuber consumption, and differences in intake were assessed using statistical tests. Lastly, the dietary intakes of tuber consumers and non-consumers were compared after adjusting for energy and covariates to determine if there were any major differences in dietary intakes between the two groups. ResultsFifty-five percent of the Brazilian population consumed tubers, which differed by macroregion. The intake of tubers among consumers also differed between macroregions. Overall, rural areas reported significantly higher mean daily intakes of tubers (127 g/day) among tuber consumers than urban areas (96 g/day). Mandioca and potato were the most commonly consumed tubers (59 and 43% prevalence, respectively, on any of the two days), while the highest daily intakes amongst tuber consumers across Brazil were noted for sweet potato (156 g/day) and potato (95 g/day). On a macroregion level, among tuber consumers, mandioca had the highest prevalence of consumption in the North (94%), Northeast (83%), and Central-West (68%), while consumption of potatoes was most prevalent in the Southeast (63%) and South (62%). Compared to women, small but significantly higher tuber intakes were noted for males (108 vs. 85 g/day). Amongst tuber consumers, children aged 10 to 12 consumed fewer tubers than the individuals aged 19 onwards. The highest mean daily intakes were noted amongst tuber consumers in the first income quintile (low earners) and lowest in the fifth quintile (high earners) (P<0.001). After adjusting for energy and other covariates, nutrient intakes between tuber and non-tuber consumers were not meaningfully different, with the exception of sodium (+6.0% comparing non-tuber to tuber consumers), iron (+6.1%), zinc (+5.7%), vitamin C (+8.3%), riboflavin (+9.0%), and folate (+7.9%).ConclusionsTuber consumption is influenced by regional and sociodemographic characteristics of the Brazilian population. When looking at energy-adjusted nutrient intakes, diets of tuber consumers have resulted in somewhat lower intakes of some micronutrients, namely riboflavin, folate, vitamin C, iron, sodium, and zinc
Short-Term Outcome Analysis of Temporary Ostomy in Low Anterior Resection for Rectal Cancer-A Retrospective Study
Authors: Zhao Chuanduo , Zhou Sicheng , Su Hao , Liang Jianwei , Zhou Zhixiang
Published: January 2021

Background Temporary ostomy has proved to be an effective method to reduce anastomotic leakage in low anterior resection. However, the injury of additional reversal surgery and ostomy-related complications require more evaluation regarding its necessity and feasibility. In this study, we analyzed the outcomes of temporary ostomy in low anterior resection to provide more evidence for surgeons to make clinical decisions.Methods A total of 279 consecutive patients with rectal cancer with temporary ostomy were matched 1:1 to contemporaneous 279 controls without temporary ostomy at our institution to compare the perioperative clinical situation. The matching criteria included age, body mass index (BMI), American Society of Anesthesiology (ASA) score, and tumor stage. The one-year follow-up data was collected to evaluate ostomy-related outcomes.Results The non-ostomy group had a higher proportion of chemoradiotherapy (39.4% vs 10.0%, P < 0.001) and a lower site of anastomosis (6.0 cm vs. 9.0 cm, P < 0.001) than the ostomy group. The ostomy group had a lower rate of anastomotic leakage (0.4% vs 3.6%, P = 0.039), reduced reoperation rate (0.4% vs 2.9%, P = 0.044), longer operating time (214.9 min vs. 151.4 min, P = 0.009) and shorter time to first flatus (3.4 days vs. 4.1 days, P = 0.005) than the non-ostomy group. The safety of reversal surgery is acceptable; however, 21.1% of ostomates did not complete the reversal operation for various reasons within 1 year after the first operation. Age (P = 0.029) and AJCC stage (P = 0.043) may be important factors affecting the closure of ostomy.Conclusions Although time-consuming, temporary ostomy is a good option for high-risk patients to reduce the rates of anastomotic leakage and reoperation in low anterior resection. Considering the ostomy-related inconveniences in daily living, other related complications and rather high proportion of non-reversal, the scope of application should be more for patients with low anastomosis and neoadjuvant treatment.
The Provider's Checklist to Improve Pregnant Women Coverage by Intermittent Preventive Malaria Treatment in Mali. A Pilot Implementation Study
Authors: Doumbia Issa , Fomba Seydou , KONE Diakalia , Bennis Issam
Published: January 2021

Background: Intermittent Preventive Treatment of Malaria in Pregnancy (IPTp) is a comprehensive treatment protocol of antimalarial drugs administered to pregnant women to prevent Malaria, started at the fourth pregnancy month, with at least three doses of Sulfadoxine-pyrimethamine (SP), taken as directly observed treatment (DOT) every 30 days as interval until childbirth, in combination with other preventive measures. This paper introduces feasibility and adoption concepts as implementation research outcomes (IRO), allowing, after a defined intervention, to assess the coverage improvement by intermittent preventive malaria treatment for pregnant women attending a reference District hospital in Mali. Specifically, the purpose is to evaluate the feasibility of a reminder tool (provider checklist) to enhance pregnant women's adoption of information about IPTp-SP as immediate and sustained women practices.Methods: The implementation strategy was based on using a reminder checklist about malaria knowledge and the recommended preventive tools. Then, the checklist feasibility was assessed during routine practices with the adoption-level about pregnant women' knowledge. Quantitative data were collected through a questionnaire distributed to a non-probability purposive sampling targeting 200 pregnant women divided into two groups before and after the checklist intervention. In contrast, the qualitative data were based on in-depth face to face gynaecologists interviews. Results: Both the implementation research outcomes (feasibility and adoption) were satisfactory. The gynaecologists agreed of the easy use of this checklist during the routine practice with a recommendation to generalise it to other health providers. After the gynaecologist visit, a significant increase of the adoption-level about the prior knowledge and preventive tools was noticed. A total of 83% of participants were not knowledgeable about malaria disease before checklist use vs 15% after. Similarly, women's coverage to SP DOT increased from 0% to 59% after introducing the checklist and the SP intake after the visit time was highly significative in the second group. The latter reached 95% of the pregnant woman with four and eight months as gestational age, who were the most respectful of all SP future visits as theoretically scheduled.Conclusions: We recommend generalising such a checklist reminder to improve women's knowledge about malaria prevention.
Association of Window-side bed Admission with Delirium Suppression in General wards: A Cohort Study of Older Inpatients
Authors: Aomura Daiki , Yamada Yosuke , Harada Makoto , Hashimoto Koji , Kamijo Yuji
Published: January 2021

Delirium is a serious problem among older inpatients. Windows in intensive care unit wards may reportedly suppress delirium, with some guidelines recommending the assignment of delirious inpatients to window-side beds. However, whether window-side bed placement suppresses delirium in general wards remains unknown. We therefore performed a retrospective cohort study of 1556 patients who were: 1) admitted to internal medicine departments in Shinshu University Hospital, Japan, between 2009 and 2018, 2) older than 75 years, 3) admitted to a multi-patient room in a general ward, and 4) admitted unexpectedly. We compared 495 patients assigned to a window-side bed (window group) with 1061 patients assigned to a non-window-side bed (non-window group). The main outcome was delirium with event (e.g. use of anti-delirium medication or physical restraint) within 14 days after admission, which was recorded in 11.1 and 12.1 patients per thousand person-days in the window and non-window group, respectively. Multivariate analysis adjusting for potential confounders including the severity of patient’s illness with Cox regression modeling revealed no remarkable association for the window group with outcome development (adjusted hazard ratio 0.90, 95% confidence interval: 0.61–1.34). Thus, admission to a window-side bed may not prevent delirium in older patients admitted to a general ward.
Oral Probiotic Activities and Biosafety of Lactobacillus gasseri HHuMIN D
Authors: Mann Soyon , Park Myeong Soo , Johnston Tony V. , Ji Geun Eog , Hwang Keum Taek , Ku Seockmo
Published: January 2021

Background
Specific probiotic bacteria may have inhibitory effects against oral pathogens. Lactobacillus spp. have been researched worldwide and are used in probiotics, but due to difficulties with laboratory cultivation of and experimentation on oral microorganisms, there are few reports of Lactobacillus spp. being isolated from the oral cavity and tested against oral pathogens. This research aimed to determine the safety and inhibitory impacts of L. gasseri HHuMIN D as a potential oral probiotic with biotherapeutic capabilities against oral pathogens.
Results
The microbial and genetic characteristics of L. gasseri HHuMIN D were evaluated in this research. A 5% dilution of L. gasseri HHuMIN D culture supernatant exhibited 88.8% inhibition against halitosis-producing anaerobic microorganisms and L. gasseri HHuMIN D exhibited powerful inhibitory effects on the growth of every harmful oral bacterium tested. Unfortunately, other oral bacteria affected the growth of L. gasseri HHuMIN D, suggesting a poor proliferative response to most co-cultures. Hydrogen peroxide production by L. gasseri HHuMIN D reached 802 µmol/L after 12 hours and gradually diminished until 24 hours. It efficiently aggregated with P. catoniae and S. sanguinis, and completely supressed S. mutans-manufactured artificial dental plaque. L. gasseri HHuMIN D’s KB cell adhesion capacity was 4.41 cells per cell, and the cell adhesion of F. nucleatum and S. mutans diminished strongly in protection and displacement assays. L. gasseri HHuMIN D was evaluated for safety using ammonia and biogenic amine development, hemolytic property and mucin degradation testing, antibiotic susceptibility, and whole genome sequencing (WGS).
Conclusion
Our results suggest that L. gasseri HHuMIN D may be a safe, bioactive, lactobacterial food ingredient, starter culture, and/or probiotic microorganism for human oral health.
Prebiotic Properties of Bacillus Coagulans MA 13: Production of Galactoside Hydrolyzing Enzymes and Characterization of the Transglycosylation Properties of a GH42 β-Galactosidase
Authors: Aulitto Martina , Andrea Strazzulli , Sansone Ferdinando , Cozzolino Flora , Monti Maria , Moracci Marco , Limauro Danila , Fiorentino Gabriella , Bartolucci Simonetta , Contursi Patrizia
Published: January 2021

BackgroundThe spore-forming lactic acid bacterium Bacillus coagulans MA-13 has been isolated from canned beans manufacturing and successfully employed for the sustainable production of lactic acid from lignocellulosic biomass. Among lactic acid bacteria, B. coagulans strains are generally recognized as safe (GRAS) for human consumption. Low-cost microbial production of industrially valuable products such as lactic acid and various enzymes devoted to the hydrolysis of oligosaccharides and lactose, is of great importance to the food industry. Specifically, α- and β-galactosidases are attractive for their ability to hydrolyze not-digestible galactosides present in the food matrix as well as in the human gastrointestinal tract.ResultsIn this work we have explored the potential of B. coagulans MA-13 as a source of metabolites and enzymes to improve the digestibility and the nutritional value of food. A combination of mass spectrometry analysis with conventional biochemical approaches has been employed to unveil the intra- and extra- cellular glycosyl hydrolase (GH) repertoire of B. coagulans MA-13 under diverse growth conditions. The highest enzymatic activity was detected on β-1,4 and α-1,6-glycosidic linkages and the enzymes responsible for these activities were unambiguously identified as a β-galactosidase (GH42) and α-galactosidase (GH36), respectively. Whilst the former has been found only in the cytosol, the latter is localized also extracellularly. The export of this enzyme may occur through a not yet identified secretion mechanism, since a typical signal peptide is missing in the α-galactosidase sequence. A full biochemical characterization of the recombinant β-galactosidase has been carried out and the ability of this enzyme to perform homo- and hetero-condensation reactions to produce galacto-oligosaccharides, has been demonstrated. ConclusionsProbiotics which are safe for human use and are capable of producing high levels of both α-galactosidase and β-galactosidase are of great importance to the food industry. In this work we have proven the ability of B. coagulans MA-13 to over-produce these two enzymes that are commonly used for treatment of gastrointestinal diseases. Moreover, B. coagulans MA-13 can be employed for an eco-friendly production of prebiotics from dairy food waste because of the ability of β-galactosidase to synthesize galacto-oligosaccharides from lactose.
Development and Psychometric Attributes of a Theory-Based Physical Activity Assessment Questionnaire for the Pregnant Women (PA2Q-PW)
Authors: Kianfard Leila , SHokravi Farkhonde Amin , Rakhshanderou Sakineh , Niknami Shamsaddin
Published: January 2021

Background This study's goal was to design and validate questionnaires for using to distinguish PEN-3 cultural model determinant factors of exercise in pregnant women. A questionnaire of physical activity theory-based was performed in 400 pregnant women with the first pregnancy. The validation of questionnaire design was used to develop the measures, including validity, reliability, and factor analysis by correlating scores to be an exercise of pregnant women during pregnancy. MethodsThe perception scale contained two factors: Knowledge and attitudes The Nurtures scale contained one element: Support was sought. The Enabling level included one element: barriers. Coefficients of reliability ranged from within 0.99. Among the four scores, significant correlations were achieved in this study. Four scales to measure PEN-3 cultural model determinants factors of being active during pregnancy were reformed for utilization with country, mostly Tehran-Iran, pregnant women, and shown to be validity and reliability. ResultsFactor analysis resulted in interpretable subclass that may be used as variables. These preliminary results provide support; for using the scales to measure the influences on pregnant women's physical activity. ConclusionsThe Physical Activity Questionnaire for pregnant women Patients (PA2Q-PW) is the first instrument that uses the PEN-3 cultural model within its constructs. The results indicated that PA2Q-PW is a valid and reliable instrument for assessing physical activity perceptions and is now existing and can be used in future studies.
Short Trends and Associated Factors of Cognitive Impairment in a Population at High Cardiovascular Risk 
Authors: yang li , hu shiyun , xu xiaoling , huang yanying , xuan cheng , yu caiyan , zheng pinpin , yan jing
Published: January 2021

Background: It has been proposed that some risk factors of cardiovascular disease (CVD) are associated with and contribute to the development of all cause of dementia. Our aim was to examine the short trends and associated factors of cognitive impairment among a eastern Chinese population at high risk of CVD. Methods: We used a convenience sampling strategy to select 7 subdistricts in Zhejiang province, which was a part of China Patient-Centered Evaluative Assessment of Cardiac Events (PEACE) project. Participants in 2018 (n=3089) and in 2020 (n=3082) at high risk of CVD in Zhejiang province with registry for the PEACE Project. Participants completed 3+ neuropsychological evaluations including of Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA) and Hospital Anxiety and Depression Scale (HAD) tests. Age-, gender- standardized prevalence rates were calculated based on the sixth population census for population of China. Cox proportional hazards regression models to estimate hazard ratios (HR) for the associations between the risk for all-cause dementia. Trial registration number was NCT02536456.Results: There was an increase prevalence of dementia and MCI among the individuals at high risk of CVD between 2018 and 2020. It showed that older age, lower education levels, having a medical history of hypertension, stroke and diabetes, having the family history of hypertension, heavy drinking, depression, and obesity were associated with dementia, while female might be a protective factor for dementia.Conclusion: More population-based strategies should be focusing on modifiable risk factors of dementia, such as CVD risk factors.
Protocol for a Systematic Review of Outcomes From Microsurgical Free Tissue Transfer Performed on Short-term Surgical Missions in Low-income and Middle-income Countries
Authors: Berker Henry Tobias de , Čebron Urška , Bradley Daniel , Patel Vinod , Berhane Meklit , Almas Fernando , Walton Gary , Eshete Mekonen , McGurk Mark , Martin Dominique , Honeyman Calum
Published: January 2021

Background: In many units around the world, microsurgical free tissue transfer represents the gold standard for reconstruction of significant soft tissue defects following cancer, trauma or infection. However, many reconstructive units in low-income and middle-income countries (LMICs) do not yet have access to the resources, infrastructure or training required to perform any microsurgical procedures. Long-term international collaborations have been formed with annual short-term reconstructive missions conducting microsurgery. In the first instance, these provide reconstructive surgery to those who need it. In the longer-term, they offer an opportunity for teaching and the development of sustainable local services.Methods: A PRISMA-compliant systematic review and meta-analysis will be performed. A comprehensive, predetermined search strategy will be applied to the MEDLINE and Embase electronic databases from inception to December 2020. All clinical studies presenting sufficient data on free tissue transfer performed on short-term surgical missions (STSMs) in LMICs will be eligible for inclusion. The primary outcomes are rate of free flap failure, rate of emergency return to theatre for free flap salvage and successful salvage rate. The secondary outcomes include postoperative complications and any functional or patient reported outcome measures. Screening of studies, data extraction and assessments of study quality and bias will be conducted by two authors. Individual study quality will be assessed according to the Oxford Evidence-based Medicine Scales of Evidence 2, and risk of bias using either the ‘Revised Cochrane risk of bias tool for randomized trials’ (Rob2), or the ‘Risk of bias in non-randomized studies of interventions’ (ROBINS-I) tools. Overall strength of evidence will be assessed according to the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) approach.Discussion: To-date the outcomes of microsurgical procedures performed on STSMs to LMICs are largely unknown. Improved education, funding and allocation of resources are needed to support surgeons in LMICs to perform free tissue transfer. STSMs provide a vehicle for sustainable collaboration and training. Disseminating microsurgical skills could improve the care received by patients living with reconstructive pathology in LMICs, but this is poorly established. This study sets out a robust protocol for a systematic review designed to critically analyse outcomes. Systematic review registration: Submitted to PROSPERO (15/12/20 ID: 225613)
Systematic Review and Meta-analysis of Surgery for Hilar Cholangiocarcinoma With Arterial Resection 
Authors: Rebelo Artur , Ukkat Jörg , Klose Johannes , Ronellenfitsch Ulrich , Kleeff Jörg
Published: January 2021

Objective: With the advances in multimodality treatment in the recent years, an analysis of the outcome of vascular resections in surgery of hilar cholangiocarcinoma is lacking. The aim of this meta-analysis was to summarize the currently available evidence on outcomes of patients undergoing arterial resection for the treatment of hilar cholangiocarcinoma.Methods: A systematic literature search from PubMed/Medline, Cochrane Library, Cinahl, ClinicalTrials.gov (clinical trials registry) and WHO ICTRP (clinical trials registry,) databases will be carried out. PRISMA guidelines will be followed. Pre-defined outcomes are mortality (100-day and in-hospital), morbidity (Clavien-Dindo classification, any type of complication, surgical and medical), vascular complications (thrombosis of the portal vein or hepatic artery, stenosis of these vessels, and pseudoaneurysms), liver failure, postoperative bleeding, duration of surgery, reoperation rate, length of hospital stay, survival time, actuarial survival (2-, 3- and 5-year survival), R0/R1/R2 resection rates, proportion of patients with no resection during surgery, rate of histologic arterial invasion and lymph node positivity (number of positive lymph nodes and lymph node ratio). Discussion: Our findings will enable us to present the current evidence on feasibility, safety and oncological effectiveness of surgery for hilar cholangiocarcinoma with arterial resection. These data will support healthcare professionals in their clinical decision-making.Systematic review registration: PROSPERO ID 223396
Biotransformation of Pharmaceuticals by Comamonas and Aeromonas Species
Authors: Sajid Atika , Yahya Saira
Published: January 2021

Background: Contamination of natural niches with pharmaceutical residues has emerged out as a serious concern. Disposal of untreated effluents from the pharmaceutical, hospital, and domestic settings has been identified as a significant source of such a massive spread of antibiotics. The unnecessary persistence of pharmaceutical residues including antibiotics has been related to the increased risk of resistance selection among pathogenic and non-pathogenic microorganisms. To date, several methods have been devised to eliminate such pollutants from wastewater, but their implication on larger scales is not feasible due to complexities and high costs of the processes, especially in developing and underdeveloped countries. This study aimed to isolate and characterize bacterial strains from domestic and pharmaceutical effluents having biotransformation potential towards most persistent antibiotics. Results: Antibiotic resistance screening and MIC determination experiments indicated highest resistivity of three bacterial isolates against two antibiotics Erythromycin and Sulfamethoxazole-trimethoprim, evincing extensive usage of these antibiotics in our healthcare settings. These isolates were identified as Comamonas jiangduensis, Aeromonas caviae and Aeromonas hydrophila by 16S rDNA sequencing. Growth conditions including incubation temperature, initial pH and inoculum size were optimized for these strains. Successful biotransformation of Erythromycin and Sulfamethoxazole-trimethoprim was achieved within 92 h under optimum growth conditions. Conclusions: Aeromonas and Comononas species were found to be potent degraders of antibiotics tested, presenting these strains as potential candidates to be utilized in the remediation processes.
Challenges of Clinical Practice Guidelines Adaptation in Iran: Lesson Learned for Developing Countries
Authors: Sayarifard Azadeh , Nazari Maryam , Bahmanziari Najmeh , Ghadirian Laleh , Mehrdad Neda
Published: January 2021

The authors have requested that this preprint be removed from Research Square.
Detection of Begomovirus in Chilli and Tomato Plants Using Functionalized Gold Nanoparticles Authors: Lavanya. R and Arun. V
Authors: Ramesh Lavanya , Viswanathan Arun
Published: January 2021

Begomoviruses are a major class of Geminiviruses that affects most dicotyledonous plants and causes heavy economic losses to farmers. Early detection of begomovirus is essential to control the spread of the disease and prevent loss. Many available detection methods like ELISA, immunosorbent electron microscopy, PCR or qPCR require expertise in handling sophisticated instruments, complex data interpretation and costlier chemicals, enzymes or antibodies. Hence there is a need for a simpler detection method, here we report the development of a visual detection method based on functionalized gold nanoparticles (AuNP probe assay). The assay was able to detect upto 500 ag/𝜇l of begomoviral DNA (pTZCCPp3, a clone carrying partial coat protein gene) suspended in MilliQ water. Screening of chilli plants for begomoviral infection by PCR (Deng primers) and AuNP assay showed that AuNP assay (77.7%) was better than PCR (49.4%). The AuNP assay with clccpi1 probe was able to detect begomoviral infection in chilli, tomato, common bean, green gram and black gram plants which proved the utility and versatility of the AuNP assay. The specificity of the assay was demonstrated by testing with total DNA from different plants that are not affected by begomoviruses.
Comparison of Digital Subtraction Angiography Combined Arterial Thrombectomy Versus Simple Arterial Thrombectomy in the Treatment of Acute Lower Limb Ischemia
Authors: Ge Hongwei , Song Bin , Wang Xin , Zhu Yunfeng , Huang Yiming , Huang Weibin , Zhu Yongbin
Published: January 2021

Background: This study aimed to compare the clinical efficacy of digital subtraction angiography (DSA) combined arterial thrombectomy versus simple arterial thrombectomy in the treatment of acute lower limb ischemia (ALI). Methods: This retrospective cohort study collected the clinical data from 125 patients (129 affected lower limbs) with ALI who underwent emergency surgery from March 2010 to November 2019. Patients were consecutively divided into Group A and Group B. Patients in Group A underwent simple arterial thrombectomy via the Fogarty catheterization. Patients in Group B underwent arterial thrombectomy, and the DSA was performed during the surgery. The differences in the success rate of primary surgery, the second intervention rate, and the amputation/mortality rate within 30-d after surgery were compared. Results: In Group A, 4 of 70 limbs (5.7%) were amputated, 54 of 70 limbs (77.1%) had improved blood flow, 14 of 70 limbs (20.0%) received a second intervention, and 3 of 68 patients (4.4%) died within 30 d. In Group B, 1 of 59 limbs (1.7%) was amputated, 56 of 59 limbs (94.9%) had improved blood flow, 3 of 59 limbs (5.1%) received a second intervention, and 2 of 57 patients (3.5%) died within 30-d. The success rate of primary surgery, the second intervention rate, and the amputation rate of Group B were significantly lower than Group A (P<0.05). Conclusion: Arterial thrombectomy combined with DSA may effectively improve the clinical efficacy of patients with ALI.
Critical Appraisal on the Selection Criteria for Evidence-based Healthcare
Authors: Mayer Paulo Cesar Morales , Gonçalves Caroline Amélia , Porzsolt Franz
Published: January 2021

Background: Evidence-Based healthcare deals basically with published clinical trials to guide the decision making on what treatment to use for any specific conditions.Aims: The present paper assessed the inclusion and exclusion criteria used in clinical trials of cervical cancer aiming at establishing a clear distinction between each criterion.Methods: We performed a bibliographical search in pubmed with the terms cervical cancer and treatment or therapy filtered for clinical trials with human subjects for the last ten years. A total of 30 papers were used extracting and classifying the inclusion and exclusion category according to the characteristic they described. Results: We found no clear parameter to establish which criteria could exclusively serve as inclusion or exclusion across the papers, about 56% of the categories identified were found either listed as inclusion or exclusion criteria or even as both in some cases.Conclusions: The key issue of selection criteria is not in its form but in its function, the first point to consider is if the trial is experimental (focused on efficacy and proof of principle) or observational (pragmatic trials, focused on effectiveness and real world conditions). We suggest, inclusion criteria should be broad, focused on the investigated condition; exclusion criteria should apply only to the subset of this “included” population, and do not take part in observational studies. These conclusions do not serve only for researchers but should affect practitioners and policy makers to correctly compare the results of investigated treatment.
A Fundamental Mechanism of Solar Eruption Initiation
Authors: Jiang Chaowei , Feng Xueshang , Liu Rui , Yan Xiaoli , Hu Qiang , Moore Ronald , Duan Aiying , Cui Jun , Zuo Pingbing , Wang Yi , Wei Fengsi
Published: January 2021

Solar eruptions are spectacular magnetic explosions in the Sun's corona and how they are initiated remains unclear. Prevailing theories often rely on special magnetic topologies which, however, may not generally exist in the pre-eruption source region of corona. Here using fully three-dimensional magnetohydrodynamic simulations with high accuracy, we show that solar eruption can be initiated in a single bipolar configuration with no additional special topology. Through photospheric shearing motion alone, an electric current sheet forms in the highly sheared core field of the magnetic arcade during its quasi-static evolution. Once magnetic reconnection sets in, the whole arcade is expelled impulsively, forming a fast-expanding twisted flux rope with a highly turbulent reconnecting region underneath. The simplicity and efficacy of this scenario argue strongly for its fundamental importance in the initiation of solar eruptions.
W246G Mutant ELOVL4 Impairs Synaptic Plasticity in Parallel and Climbing Fibers and Causes Motor Defects in a Rat Model of SCA34
Authors: Nagaraja Raghavendra Y , Sherry David M , Fessler Jennifer L. , Stiles Megan A. , Li Feng , Multani Karanpreet , Orock Albert , Ahmad Mohiuddin , Brush Richard , Anderson Robert E , Agbaga Martin-Paul , Deak Ferenc
Published: January 2021

Background: Spinocerebellar ataxias (SCA) are a group of neurodegenerative disorders characterized by neuronal degeneration leading to loss of motor coordination. A number of different mutations gives rise to different types of SCA with characteristic ages of onset, symptomatology, and rates of progression. SCA type 34 (SCA34) is an age-related cerebellar neurodegenerative disorder caused by mutations in the fatty acid elongase-4 (ELOVL4). The ELOVL4 is an essential enzyme that mediates biosynthesis of Very Long Chain Saturated and Polyunsaturated Fatty Acids (VLC-SFA and VLC-PUFA, resp., ≥28 carbons) that are critical for the normal function of brain, skin, retina, Meibomian glands, and testes in which ELOVL4 is expressed. Global deletion or homozygous expression of truncated mutant ELOVL4 that lack VLC-SFA and VLC-PUFA biosynthesis cause severe skin disorders, seizures and neonatal mortality in rodents and humans. Methods: To understand role of ELOVL4 and its products in neuronal function and to evaluate the consequences of ELOVL4 mutations in pathogenesis of age-related SCA34, we generated a rat model of SCA34 by knock-in of the SCA34-causing 736T>G (p.W246G) ELOVL4 mutation. We performed biochemical, neuroanatomical and behavioral analyses by rotorod to measure motor function. We used electrophysiological recordings from cerebellar slices to determine the impact of the W246G mutation on neuronal function. Results were analyzed using GraphPad Prism Statistical software. Results: Heterozygous and homozygous rats carrying the W246G mutation developed impaired motor deficits by two months of age. To understand the mechanism of these motor deficits, we performed electrophysiological studies using cerebellar slices from rats homozygous for W246G mutant ELOVL4 and found marked reduction of long-term potentiation at parallel fiber synapses and long-term depression at climbing fiber synapses onto Purkinje cells. Neuroanatomical analysis of the cerebellum up 6 months of age showed normal cytoarchitectural organization despite the early-onset motor deficits and defects in synaptic plasticity. Conclusions: Our results point to ELOVL4 and its products being essential for motor function and cerebellar synaptic plasticity. The results further suggest that in SCA34 patients, ataxia arises from primary impairment of synaptic plasticity and cerebellar network desynchronization that precedes cerebellar degeneration and loss of motor coordination with aging.
Relationship between enlarged perivascular space in hippocampus and P300 event-related potential in patients with acute lacunar stroke
Authors: Huang Shan , Zhang Zhixiang , Mei Yuqing , Huang Kuankuan , Feng Yiping , Gu Xia , Zhang Qiaoyang , Zhang Min , Yun Wenwei
Published: January 2021

Background

This study aimed to investigate the relationship between enlarged perivascular space in hippocampus (H-EPVS) and P300 event-related potential (ERP) in patients with acute lacunar stroke.
Methods

Patients with acute lacunar stroke hospitalized in Changzhou No.2 people's Hospital from February 2019 to July 2020 were collected. All the patients performed the P300 auditory oddball task and a full set of cognitive function tests. We recorded P300 latency and amplitude by EMG evoked potential instrument. H-EPVS showed round, oval and linear structures on MRI T2-weighted images of hippocampus, with clear boundaries and consistency in the direction of the perforating arterioles. Dividing the total number of H-EPVS ≥ 7 into extensive H-EPVS group (n = 61) and non-extensive H-EPVS group (n = 53). ROC curve was used to analyze the relationship between P300 ERP and cognitive function of extensive H-EPVS in patients with acute lacunar stroke.
Results

A total of 114 patients with acute lacunar stroke were included, and 61 (53.5%) patients were found to have extensive H-EPVS. The P300 latency in patients with extensive H-EPVS( mean and SD, 393.61 ± 30.36) was significantly higher than in non-extensive H-EPVS (mean and SD, 356.4 ± 19.59 ms, t = -7.870, P < 0.01). There was no significant difference in P300 amplitude between the two groups (P > 0.05). In addition, The cognitive function (the field of verbal fluency) in patients with extensive H-EPVS (mean and SD, -0.41 ± 0.50) was significantly lower than in non-extensive H-EPVS (mean and SD, 0.47 ± 0.54, t = 9.017, P < 0.01). Further analysis shows that in patients with acute lacunar stroke, P300 latency was positively associated with H-EPVS counts (r = 0.726, P = 0.000). H-EPVS counts was negatively associated with cognitive function score (the field of verbal fluency) (r=-0.705, P = 0.000). ROC curve analysis showed that the index of cognitive impairment diagnosed by P300 in patients with acute lacunar stoke was 0.796.
Conclusion

Extensive H-EPVS has a high incidence in patients with acute lacunar stroke. The P300 latency may be used as an early indicator to evaluate the verbal fluency function of extensive H-EPVS patients with acute lacunar stroke.
Association Between Community Environment and Dependency Among the Elderly From a Service Provision Perspective
Authors: Pan YiYang , Chen Yuan , Cui PingYu , WaiLi Nuremaguli , Li Ying
Published: January 2021

Background: The prevalence of dependency is high among the elderly worldwide and increases with increasing life expectancy. The objective of this study was to explore from the perspective of resource demand the association between community environmental resources and dependency among the elderly. Methods: The study was designed as a population-based cross-sectional study. A total of 950 participants aged ≥ 60 years from 22 locations in China were selected using a complex multistage sampling design. All data were collected using questionnaires and face-to-face interviews. The dependency was assessed using the Chinese version of the Minnesota Multiphasic Personality Inventory-II. The community environment was assessed using 43 items. Logistic regression analysis was used to evaluate the association between the community environment and dependency. Cluster analysis was used and demonstrated that dependency was mainly associated with community primary preventive care service resources. Results: In the analysis result, both age-specific and social support levels-stratified results showed that the dependency associated with community environmental resources differed among the elderly by age group and level of social support. Conclusions: The levels of dependency were significantly associated with community environment resources. Our results suggest that the dependent on local environment resources may consider as the resource needs among elderly.
Perioperative Use of Serum Creatinine and Postoperative Acute Kidney Injury: a Single Centre, Observational Retrospective Study to Explore Physicians’ Perception and Practice.
Authors: Villa Gianluca , De Rosa Silvia , Calabrisotto Caterina Scirè , Nerini Alessandro , Saitta Thomas , Innocenti Dario Degl , Paparella Laura , Bocciero Vittorio , Allinovi Marco , De Gaudio Angelo R. , Ostermann Marlies , Romagnoli Stefano
Published: January 2021

Background. Postoperative acute kidney injury (PO-AKI) is a leading cause of short- and long-term morbidity and mortality, as well as progression to chronic kidney disease (CKD). The aim of this study was to explore the physicians’ attitude toward use of serum creatinine (sCr) for identification of patients at risk for PO-AKI and patients who should be reassessed in the long-term for progression toward CKD. We also evaluated the incidence and risk factors associated with PO-AKI and renal function deterioration in patients undergoing major surgery for malignant disease.Methods. Adult oncological patients who underwent major abdominal surgery from November 2016 to February 2017 were considered for this single centre, observational retrospective study. Routinely available sCr values were used to define AKI in the first three postoperative days. Long-term kidney dysfunction (LT-KDys) was defined as a reduction in the estimated glomerular filtration rate by more than 10 ml/min/m2 at 12 months postoperatively. A questionnaire was administered to 125 physicians caring for the enrolled patients to collect information on local attitudes regarding use of sCr perioperatively and its relationship with PO-AKI.Results. A total of 423 patients were observed. sCr was not available in 59 patients (13.9%); the remaining 364 (86.1%) had at least one sCr value measured to allow for detection of postoperative kidney impairment. Among these, PO-AKI was diagnosed in 8.2% of cases. Of the 334 patients who had a sCr result available at 12-month follow up, 56 (16.8%) developed LT-KDys. Data on long-term kidney function were not available for 21% of patients. Interestingly, 33 of 423 patients (7.8%) did not have a sCr result available in the immediate postoperative period or long-term. All the physicians who participated in the survey (83 out of 125) recognised that postoperative assessment of sCr is required after major oncological abdominal surgery, particularly in those patients at high-risk for PO-AKI and LT-KDys.Conclusion. PO-AKI after major surgery for malignant disease is common but clinical practice of measuring sCr is variable. As a result, the exact incidence of PO-AKI and long-term renal prognosis are unclear, including in high-risk patients.Trial registration. Retrospectively registered in Clinicaltrialgov NCT04341974
PROLIFERATE: An Adaptable Framework to Evaluate Participatory Research Products
Authors: Plaza Maria Alejandra Pinero De , Archibald Mandy , Lawless Michael , Ambagtsheer Rachel , Mudd Alexandra , McMillan Penelope , Kitson Alison
Published: January 2021

BackgroundParticipatory research (PR) – the practice of involving stakeholders in research processes – is growing in prominence in health research because it can enhance the impact of research and the translation of research-based knowledge. Yet, the literature indicates that the products of PR studies are rarely evaluated empirically to track, demonstrate, and expand their claimed effectiveness and impact. This lack of measurement tools and frameworks can limit the effectiveness of knowledge translation (KT). MethodsWe introduce a framework for evaluating the products of PR called PROLIFERATE. We use an inductive combination of formative and summative evaluation methods to pilot test the framework on a Frailty PR communication product (a video) to determine the methods’ functionality.ResultsPROLIFERATE demonstrates adeptness for evaluating barriers and enablers of PR product uptake, effectiveness, and impact. It can identify ways to address barriers by assessing knowledge user perspectives on the comprehensibility of the product, emotional resonance, motivation to change, and future accessibility. ConclusionsPROLIFERATE can enable longitudinal and cross-sectional measurement of PR products in implementation and integrated KT efforts. It can evaluate and track the effectiveness and impact of different types of PR products in a situational responsive manner which compares users, platforms, and other factors in a replicable way.
Significantly Decreased Islet β Cell Function and Increased Fasting Plasma Glucose in Patients With Chronic Hepatitis B: a Cross-sectional Study
Authors: Liu Dafeng , Zhou Lingyun , Zhang Xinyi , Zeng Yilan , Bai Lang , Wu Dongbo , Tang Hong
Published: January 2021

Background: The contributing factors of abnormal glucose metabolism and the characteristics of the homeostasis model assessment of β cell function (HOMA-β) value in chronic hepatitis B (CHB) patients are unclear and worth studying.Method: This cross-sectional study recruited 110 CHB patients (CHB group) and 110 patients without hepatitis B virus (non-HBV group); the groups were matched according to sex, age, and body mass index. The contributing factors of abnormal glucose metabolism and the characteristics and differences in glucose metabolism parameters between the two groups were analyzed.Results: The abnormal glucose metabolism rate was higher in CHB patients with liver cirrhosis (LC) and patients with hepatitis B envelope antigen (HBeAg) (-) status. In addition, under the same glucose metabolism conditions, the fasting plasma glucose (FPG) levels of the CHB group was higher than that of the non-HBV group, especially in those with LC that had higher FPG levels (all p=0.000), while the HOMA-β values was significantly lower in the CHB group than in the non-HBV group, especially under normal glucose tolerance conditions (all p=0.000). Further analyses revealed that the main contributing factors of abnormal glucose metabolism were HBeAg (-) status and hepatitis B envelope antibody levels, but HBV serological and virological indicators had no direct effect on the HOMA-β value.Conclusion: These findings provide a reference that will allow clinicians to monitor abnormal glucose metabolism in CHB patients, especially those with LC or HBeAg (-) status, focus on the protection of islet β-cell function, and avoid the application of insulin secretagogues in CHB patients with abnormal glucose metabolism.
Se Alleviated Oxidative Stress-Mediated Complex Poisoning Mechanism in Pb-Treated Chicken Kidneys: Inflammation, Heat Shock Response, and Autophagy
Authors: Miao Zhiying , Yu Weikang , Wang Yueyang , Gu Xianhong , Teng Xiaohua
Published: January 2021

Background: Lead (Pb) is a toxic environmental pollutant and can exerts toxicity in kidneys. It is known that selenium (Se) has an antagonistic effect on Pb poisoning. However, biological events during the process were not well understood in chicken kidneys.Methods: One hundred and eighty male Hyline chickens (7-day-old) were randomly divided into the control group (offering standard diet and potable water), the Se group (offering Na2SeO3-added standard diet and potable water), the Pb group (offering standard diet and (CH3OO)2Pb-added potable water), and the Pb+Se group (offering Na2SeO3-added standard diet and (CH3OO)2Pb-added potable water). On 30th, 60th, and 90th days, kidneys were removed to perform the studies of histological structure, oxidative stress indicators, cytokines, heat shock proteins, and autophagy in the chicken kidneys.Results: The experimental results indicated that Pb poisoning changed renal histological structure; decreased catalase, glutathione-s-transferase, and total antioxidative capacity activities; increased hydrogen peroxide content; induced mRNA and protein expression of heat shock proteins; inhibited interleukin (IL)-2 mRNA expression, and induced IL-4 and IL-12β mRNA expression; inhibited mammalian target of rapamycin mRNA and protein expression, and induced autophagy-related gene mRNA and protein expression in the chicken kidneys. Supplement of Se mitigated the above changes caused by Pb.Conclusion: Our research strengthens the evidence that Pb induced oxidative stress, inflammation, heat shock response, and autophagy and Se administration alleviated Pb poisoning through mitigating oxidative stress in the chicken kidneys.