bluuebunny/crossref_metadata_2025 huggingface dataset:
Translational Medicine: What Orthopaedic Perspectives and Challenges Does the Mapping Technology?
Authors: Shi Guang , Liu Wei , Su Xiuyun , Cai Xiyu
Published: May 2021

Background Translational medicine (TM) is a bridge between basic science and clinical medicine by translating new knowledge, mechanisms and technologies generated by basic science research into new ways of preventing, diagnosing and treating disease. The purpose of this study is to systematically review the literature concerning the two-dimensional and three-dimensional mapping technology (MT) for fractures in orthopedics, to clarify what perspectives MT offers and the current challenges in TM. Methods A systematic review was conducted according to PRISMA guidelines. We systematically searched the PubMed, Scopus, IEEE Digital Library, Web of Science database and references of relevant studies, from the establishment of the database through December 2020, for any and all data regarding the application of fracture MT in orthopedics, (including upper limbs, lower limbs, spine, and pelvis). We then made a systematic summary of these research results. Results A total of 2777 articles were retrieved, and 28 articles met the inclusion criteria: 26 were retrospective studies of using fracture MT and 2 were prospective studies using of fracture MT. The application of fracture MT in orthopaedics was as follows: upper limbs (n=10, 35.71%), lower limbs (n=17, 60.71%), thoracolumbar spine (n=1, 3.58%). Article subjects included: how fracture mapping guided preoperative planning (n = 12, 42.86%); illustration of how the characteristics of fracture line distribution helped surgeons identify specific types of fractures (n=9, 32.14%); and how fracture MT illustrated fracture morphology and guided clinical treatment (n=7, 25.00%). Conclusion Today, we need a new generation of researchers: 'translational scientists' who are able to transfer ideas from basic research to clinical science. MT is a better technology to describe the morphological classifications of fractures compared to traditional methods, but its clinical application is still limited. Thus, much further research is needed to determine the potential advantages of this new technique in clinical application or practice. If possible, guidelines are needed to facilitate the development of MT with regard to the additional costs and time constraints required for the developing this technic.
Diagnostic Accuracy of First and Early Second Trimester Multiple Biomarkers for Prediction of Gestational Diabetes Mellitus: A Multivariate Longitudinal Approach
Authors: Eidgahi Elham Shaarbaf , Nasiri Malihe , Kariman Nourossadat , Ardebili Nastaran Safavi , Salehi Masoud , Kazemi Maryam , Zayeri Farid
Published: May 2021

Background

Gestational Diabetes Mellitus (GDM) is an underlying cause of maternal and newborn morbidity and mortality all around the world. Timely diagnosis of GDM plays an important role in reducing its adverse consequences and burden. This study aimed to determine diagnostic accuracy of multiple indicators in complete blood count (CBC) test for early prediction of GDM.
Methods

In this prospective cohort study, the data from 600 pregnant women was analyzed. In the study sample, the two-step approach was utilized for the diagnosis of GDM at 24–28 weeks of gestation. We also used the repeated measures of hemoglobin (Hb), hematocrit (Hct), fasting blood sugar (FBS) and red blood cell count (RBC) in the first and early second trimesters of pregnancy as the longitudinal multiple indicators for early diagnosis of GDM. The classification of pregnant women to GDM and non-GDM groups was performed using a statistical technique based on the random-effects modeling framework.
Results

Among the sample, 49 women (8.2%) were diagnosed with GDM. In the first and early second trimester of pregnancy, the mean HcT, Hb and FBS of women with GDM was significantly higher than non-GDMs (P < 0.001). The concurrent use of multiple longitudinal data from HcT, Hb, RBC and FBS in the first and early second trimester of pregnancy resulted in a sensitivity, specificity and area under the curve (AUC) of 87%, 70% and 83%, respectively, for early prediction of GDM.
Conclusions

In general, our findings showed that the concurrent use of repeated measures data on Hct, Hb, FBS and RBC in the first and early second trimester of pregnancy might be utilized as an acceptable tool to predict GDM in the earlier stages.
Yet another lockdown? A large-scale study on people's unwillingness to be confined during the first 5 months of the COVID-19 pandemic in Spain
Authors: Martinez-Garcia Marina , Rabasa Alejandro , Barber Xavier , Polotskaya Kristina , Roomp Kristof , Oliver Nuria
Published: May 2021

Population confinements have been one of the most widely adopted non-pharmaceutical interventions (NPIs) implemented by governments across the globe to help contain the spread of the SARS-CoV-2 virus. While confinement measures have been proven to be effective to reduce the number of infections, they entail significant economic and social costs. Thus, different policy makers and social groups have exhibited varying levels of acceptance of this type of measures. In this context, understanding the factors that determine the willingness of individuals to be confined during a pandemic is of paramount importance, particularly, to policy and decision-makers. In this paper, we study the factors that influence the unwillingness to be confined during the COVID-19 pandemic by means of a large-scale, online population survey deployed in Spain. We apply both quantitative (logistic regression) and qualitative (automatic pattern discovery) methods and consider socio-demographic, economic and psychological factors, together with the 14-day cumulative incidence per 100,000 inhabitants. Our analysis of 109,515 answers to the survey covers data spanning over a 5-month time period to shed light on the impact of the passage of time. We find evidence of pandemic fatigue as the percentage of those who report an unwillingness to be in confinement increases over time; we identify significant gender differences, with women being generally less likely than men to be able to sustain long-term confinement of at least 6 months; we uncover that the psychological impact was the most important factor to determine the willingness to be in confinement at the beginning of the pandemic, to be replaced by the economic impact as the most important variable towards the end of our period of study. Our results highlight the need to design gender and age specific public policies, to implement psychological and economic support programs and to address the evident pandemic fatigue as the success of potential future confinements will depend on the population's willingness to comply with them.
Population Pharmacokinetics and Dose Optimization of Piperacillin/tazobactam in Critically Ill Patients During Extracorporeal Membrane Oxygenation (ECMO) and Weaned from ECMO
Authors: Hahn Jongsung , Min Kyoung Lok , Kang Soyoung , Yang Seungwon , Jin Byung Hak , Kim Dasohm , Park Min Soo , Wi Jin , Chang Min Jung
Published: May 2021

Background: Piperacillin/tazobactam is commonly used for empirical or directed treatment of infections during extracorporeal membrane oxygenation therapy (ECMO). Critical illness and extracorporeal circulation, such as ECMO and continuous renal replacement therapy may alter the pharmacokinetic parameters. We aimed to develop a population pharmacokinetic model of piperacillin/tazobactam in ECMO patients and investigate the optimal dosage regimen to achieve a pharmacodynamics target.Methods: This was a prospective observational study of 26 ECMO patients who received piperacillin/tazobactam. A population PK model was developed using non-linear mixed-effects models and simulations were performed to evaluate patient variables, MIC levels, and dosage regimens in relation to the probability of target attainment (PTA). The acceptable piperacillin PTA was set at ≥90% for 50%ƒT >16 mg/L.Results: A total of 244 samples were collected (163 during ECMO and 81 weaned from ECMO). Thirteen patients (50%) underwent continuous venovenous hemodiafiltration (CVVHDF). In a 2-compartment model, clearance increased by 10.1% when patients weaned from ECMO. Because patients on CVVHDF had a significant residual renal function, CVVHDF was found non-relevant to clearance. Instead, volume overload which was main cause of CVVHDF and membrane adsorption might contribute to the increased volume of distribution. Creatinine clearance (CrCL) calculated by Cockcroft-Gault equation had a significant impact on clearance. Simulation demonstrated that extended infusion should be considered in ECMO patients with CrCL >60 mL/min. Our proposed regimen was extended infusion of 2/0.25 g q8h, 2/0.25 g 6h, 3/0.375 g q 6h, and 4/0.5g q6h for CrCL ≤40, 40–60, 60–130, and >130 mL/min, respectively. Furthermore, even a higher dose would be required when patients did not receive CVVHDF after weaning from ECMO, which was 4/0.5g q6h for CrCL >110 mL/minConclusions: Piperacillin/tazobactam PK changes observed in ECMO patients were associated with critical illness rather than ECMO itself. A recent guideline dose may result in underexposure against P.aeruginosa when ECMO patients have CrCL > 110 mL/min; therefore, close monitoring of renal clearance is crucial in ECMO patients who received piperacillin/tazobactam regardless of CVVHDF use to provide effective treatment of infections and promote recovery. Overall, this study provides preliminary insights into the incremental effects of critical illness, ECMO and CVVHDF on piperacillin/tazobactam PK.Trial Registration: Clinicaltrials.gov NCT02581280, December 1st, 2014.
Review and screening of key genes in esophageal squamous cell carcinoma
Authors: Sun Xizi
Published: May 2021

Esophageal squamous cell carcinoma (ESCC) is the most common type of human esophageal cancer with high mortality due to late stage diagnosis. Efforts have been made to figure out the genetic events underlying its carcinogenesis and progression, but the molecular mechanisms of these processes remain elusive. To identify the candidate genes involved in ESCC, literature about significantly mutated genes (SMGs) was extensively reviewed and gene expression profiles of GSE161533, GSE20347 and GSE77861 were downloaded from the Gene Expression Omnibus (GEO) database. Following the identification of 230 differentially expressed genes (DEGs), hub gene identification was performed by the plug-in MCODE in Cytoscape software. 14 hub genes were identified which were enriched in cell cycle, DNA replication and p53 signaling pathway. In summary, genes mentioned in this study may provide potential targets for treatment and diagnosis of ESCC and help us better understand the pathogenesis and progression of ESCC from genetic perspective.
Disorders of Major Inflammatory Factors and Histopathological Lesions in Excess-iron-fed Sheep Liver
Authors: Zhang LiangYu , Lu Jing , Sun FengJiao , Lv XiaoPing , Liu ChaoNan , Gao XueLi
Published: May 2021

Background: Iron plays a key role in biological metabolism as an essential microelement. Excess iron may cause pathological damage to the body. The purpose of this work is to explore the disorders of major inflammatory factors and histopathological lesions in the liver of excess-iron-fed sheep. Twenty German Mutton Merino sheep were randomly divided into 4 groups, control group (CON), iron-excess group one (IronE1), iron-excess group two (IronE2) and iron-excess group three (IronE3), respectively. Each group was fed with basal diets supplemented with 50 (CON), 500 (IronE1), 1000 (IronE2), and 1500 (IronE3) mg/kg as ferrous sulfate monohydrate (FeSO4 ·H2O). After 75 days, the liver was removed and collected. A variety of methods were utilized to detect indicators of sheep liver. Results: The histopathological damage of liver in sheep was rather severe with the excess of iron. Hemosiderin deposits were also obviously discovered. The results also showed that the expression of both protein and mRNA of IL-1β, TNF-α and IFN-γ reduced, but the factors of IL-2, IL-6, NF-κB and TGF-β1 obviously increased in the liver of each iron excess group. Corresponding changes were also discovered with the addition of iron dosage. The content of inflammatory factors above showed a significant change with an addition of 1500 mg/kg iron into the basic diet, which indicated that excess iron inhibited the release of IL-1β, TNF-α and IFN-γ in the sheep liver. The inflammation caused by excess iron extenuated by reducing the content of these three pro-inflammatory factors. The expression of IL-2, IL-6, NF-κB and TGF-β1 increased. As pro-inflammatory factors induced inflammation, anti-inflammatory factors also increased to protect the body from tissue damage. Conclusions: It can be concluded that excess iron can change the expression of main inflammatory factors in sheep liver, which will be an instructive significance to the development of medical prospect for sheep breeding and disease diagnosis.
A Novel LDMOS with Ultralow Specific on-Resistance and Improved Switching Performance
Authors: Wu Lijuan , Wu Haifeng , Zeng Jinsheng , Chen Xing , Su Shaolian
Published: May 2021

A stepped split triple-gate SOI LDMOS with P/N strip (P/N SSTG SOI LDMOS) is proposed, which has ultralow specific on-resistance (Ron,sp) and low switching losses. The proposed device has a triple-gate (TG) and stepped split gates (SSGs). P strip, N-drift and oxide trench are alternately arranged in the Z direction. Meanwhile, the SSGs are located in the oxide trench of the N-drift region and are distributed in steps. Firstly, the TG increases the channel width (Wch) and has the effect of modulating current distribution, resulting in lower Ron,sp and higher transconductance (gm). Secondly, the SSGs serve as the field plate to assist the depletion of the N-drift region, increasing the optimal doping concentration of the N-drift region (Nd-opt) and further reducing the Ron,sp. Moreover, the SSGs also have the effect of modulating the electric field distribution to maintain a high breakdown voltage (BV). Meanwhile, gate-drain charge (QGD) and switching losses are reduced on account of the introduction of the SSGs. Thirdly, in the off-state, the P strip and SSGs multidimensional assisted depletion of the N-drift region, which greatly increases the Nd-opt. The highly doped N-drift region provides a low-resistance path for the current, which also further reduces Ron,sp. Compared with triple-gate (TG) SOI LDMOS with almost equal breakdown voltage, the Ron,sp and QGD of P/N SSTG SOI LDMOS are reduced by 62% and 63%, respectively.
The impact of an audience response system on evaluation results in medical lectures, a controlled study.
Authors: Wegner Mathis , Michaelis Thorben , Alkatout Ibrahim , Lippross Sebastian
Published: May 2021

Background: Audience Response Systems (ARS) are well perceived by students and lecturers and represent a valuable instrument of quality assurance and student participation in academic teaching. Our controlled study investigated whether ARS in evaluation of medical lectures has an impact on evaluation results, enhances student learning and motivation. Methods: The study was conducted at the University medical center of Schleswig-Holstein, Campus Kiel, over the course of one year. 198 students who participated voluntarily were included. In alternating lectures a paper questionnaire and ARS were offered as an evaluation tool to the audience. In both processes two items concerning teacher’s behavior, three items concerning lecture’s design and two items concerning lecture’s content were investigated by using a seven-item questionnaire with a five-point Likert scale, two multiple-choice questions were posed at the end of each evaluation to assess knowledge transfer. Results: 128 students took part using the traditional paper and pencil format, 70 students agreed to use ARS. Participants not using ARS rated the quality of teaching in both items and the structure of the lecture in one item superior to participants using ARS (p < 0.001, p < 0.003, p < 0.001). The screening for participation in the additionally asked MC- questions showed a higher rate of participation in students using ARS. Conclusion: The results of our study show significant differences in lectures’ evaluation using ARS. Students’ motivation to evaluate lectures might increase by using an audience response device.
A novel PI3K/AKT Signaling Pathway-Associated Prognostic Signature Correlated With Immune Infiltration in Hepatocellular Carcinoma
Authors: Wang Zhihuai , Xiong Chen , Chen Shuai , Sun Li , Gao Peng , Gao Yuan , Zhu Chunfu , Qin Xihu
Published: May 2021

Hepatocellular carcinoma (HCC) has become the third leading cause of death from cancer worldwide, and PI3K/AKT signaling pathway acts as the most common oncogenic pathway in HCC. But few studies have reported the prognostic value of PI3K/AKT associated genes (PAGs) and their association with immune infiltration. Hence, we downloaded the mRNA sequencing data and clinical information from The Cancer Genome Atlas (TCGA), GSE14520 dataset of Gene Expression Omnibus (GEO) and International Cancer Genome Consortium (ICGC) database. The 105 PAGs gene sets were from the Gene set enrichment analysis (GSEA) website. The biological processes of differently expressed PAGs were explored by Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis. Then 4 prognostic PAGs (SFN, PRKAA2, PITX2 and CDK1) were identified through univariate and multivariate analyses. A prognostic signature was built base on the four PAGs. Afterward, the high-risk group had shorter survival time in Kaplan-Meier (KM) curves. Receiver operating characteristic (ROC) curves showed a better prognostic value of risk score (ROC=0.736) compared with other clinicopathological characteristics (AUC ≤ 0.511). The consistent results were obtained in the testing groups involving the GSE14520 dataset and ICGC database. The nomogram predicted the 1-year, 3-year, and 5-year overall survival rates in HCC. The correlation among risk score and immune infiltration of monocytes and M0 macrophages were determined, the expression levels of immune checkpoints (PDCD1, CTLA4, TIM3 and TIGIT) were also related to risk score in HCC. The study provided novel insight into the new targets for immunotherapy in HCC.
Clinical Characteristics of 60 Adult Cancer Patients Experience Covid-19: A Descriptive-Analytical Study
Authors: Aznab Mozaffar , Eskandari-Roozbahani Narges , Moazen Homa
Published: May 2021

Background

This study aimed to describe the clinical symptoms, the severity of the disease, and survival status of COVID-19 cancer patients, and comparing the results in the different cancer subtypes and stages among various ages/sexes and techniques of treatment.
Method:

In a descriptive-analytical study, the clinical status of 60 cancer patients with a history of Covid-19 over the past year from the covid-19 pandemic in Iran (Jan. 2020-Dec.2020) was assessed.
Results

Most of the patients (68%) were in the solid tumor categories. The mean age of the men was 52 ± 13 years, and women were 47 ± 13 years (P < 0.05). Most cases of COVID-19 positive in solid tumor were breast cancer (24.4%), colon cancer (22%), gastric cancer (9.8%), and in hematologic malignancy, lymphoma (31.6%), chronic lymphocytic leukemia (CLL) (31.6%), and acute leukemia (21.1%). There was a statistically significant difference between two categories of cancer in the clinical manifestations; the stage of cancer and survival status (P < 0.05).
Conclusion

Based on our results risk factors for Covid-19 disease progression, severe pulmonary involvement, and fatal complications in patients with malignancy require further evaluation based on tumor type, stage, age, sex, and treatment options.
Exposure to Long-Term Air Pollution and Incidence of Peripheral Arterial Disease in the General Population: A National Population-Based Retrospective Cohort Study
Authors: Gwon Jun Gyo , Park Ji Hun , Kim Joung Soo , Seo Hyun-Min
Published: May 2021

Objective

This study aimed to evaluate the causal relationship between long-term outdoor air pollutants and incidence of peripheral arterial disease (PAD) using the National Health Insurance Service–National Sample Cohort (NHIS-NSC) database.
Methods

This study is retrospective study. We included 292,091 subjects from the general population who had previously not been diagnosed with PAD by the NHIS-NSC between 2008 and 2014. Hourly air pollutant data (particulate and gaseous) and climate data were collected. Correlation analysis of the collected data confirmed the relationship between air pollution and PAD incidence.
Results

For 1,836,965.4 person-years, incident cases of PAD were observed in 5,243 subjects (285.4/100,000 person-years). In the Cox proportional hazard analysis, there was a significant association between the incidence of PAD and long-term average concentration of SO2 (hazard ratio [HR], 1.686; 95% confidence interval [CI], 1.108–2.565) and NO2 (HR, 1.200; 95% CI, 1.077–1.336) after the adjustment for variables.
Conclusions

This study demonstrated that SO2 and NO2 exposure are independent risk factors for PAD. On the other hand, new-onset PAD was not affected by exposure to particulate matter such as PM2.5 and PM10.
Invasive Stratified Mucin-Producing Carcinoma (ISMC) of The Uterine Cervix: A Clinicopathological Study of 8 Cases
Authors: Li Tingting , Xie Sixia , Qiu Yichao , Yuan Shuang , Wang Wei , Wang Hongjing
Published: May 2021

Invasive stratified mucin-producing carcinoma (ISMC) is a rare gynecologic malignancy. Previous studies suggested that ISMC was a morphologic variant of invasive cervical adenocarcinoma. The clinicopathologic features and prognosis of eight cases of ISMC are presented. Clinical symptoms and imaging were atypical. Four cases were pure ISMCs, and four cases were ISMCs mixed with usual-type endocervical adenocarcinomas. The depths of stromal invasion were more than half (5/8), with approximate full-thickness in one case, and there was vascular invasion (5/8), neutral invasion (3/8), uterine segment involvement (3/8), and parametrial involvement (1/8). One of the patients underwent vaginal cuff surgery. Lymph node metastasis was seen in two patients (2/8). All cases were diffusely positive for p16 and high Ki67 expression. These cases had high-risk HPV16,18, 58 infection. All patients were alive after surgery and adjuvant therapy during the 8- to 21-month follow-up, and only one developed vaginal wall recurrence at 15 months. The present data and those obtained from the literature suggest that ISMC is an invasive endocervical adenocarcinoma with high-risk HPV infection, mainly HPV18, and has a risk of recurrence and metastasis.
Gelatin, a protective agent against iron gall ink corrosion?
Authors: Gimat Alice , Michelin Anne , Massiani Pascale , Rouchon Véronique
Published: May 2021

Iron gall Inks are known to promote paper degradation, thus jeopardizing the conservation of written Heritage. This phenomenon, also called iron gall ink corrosion, is not only governed by chemical reactions occurring between ink constituents and cellulose (the main constituent of paper) but also by the penetration of ink components inside the paper. This penetration depends on the ability of water and ink soluble components to migrate inside the sheet. This latter is composed of hydrophilic cellulosic fibers (of diameter approx. 10 µm) embedded in a size that lowers water affinity and thus makes it suitable for writing. This work aims to better understand the impact of gelatin size on iron gall ink corrosion by investigating the distribution of gelatin and ink components at the scale of individual paper fibers. STXM, a nano-scale mapping technique (resolution of 30 nm) that also allows NEXAFS analysis was used for this purpose. Fe L-edge measurements enabled to map iron distribution and to locate iron(II) and iron(III) rich areas. N K-edge measurement made it possible to map gelatin distribution. C K-edge measurements allowed mapping and discrimination of cellulose, gallic acid, iron gall ink precipitate and gelatin. Three fibers were studied: an inked fiber with no size, a sized fiber that was afterwards inked and an inked fiber sprayed with gelatin (to model the impact of conservation treatments that use gelatin as a re-sizing agent). Analysis of gelatin and ink ingredients distribution inside and outside the cellulosic fiber gave some clues to account for the limiting impact of gelatin on iron gall ink corrosion.
Delayed Skin Reaction After mRNA-1273 Vaccine Against SARS-CoV-2
Authors:   Norman-Philipp Hoff1, Freise Noemi , Schmidt Albrecht G. , Firouzi-Memarpuri Parnian , Reifenberger Julia , Lüdde Tom , Boelke Edwin , Meller Stephan , Homey Bernhard , Feldt Torsten , Jensen Björn Erik Ole , Keitel Verena , Schmidt Livia , Maas Kitti , Haussmann Jan , Tamaskovics Balint , Budach Wilfried , Fischer Johannes C. , Buhren Bettina Alexandra , Knoefel Wolfram Trudo , Schneider Marion , Gerber Peter Arne , Pedotoa Alessia , Häussinger Dieter , Grebe Olaf , Griensven Martijn van , Braun Stephan A. , Salzmann Stefan , Rezazadeh Amir , Matuschek Christiane
Published: May 2021

The coronavirus disease 2019 (COVID‐19) is associated with a wide clinical spectrum of skin manifestations, including chilblain‐like, urticarial, vesicular and vasculitic lesions. Recently, delayed skin reactions following mRNA vaccination against SARS-CoV-2 have been reported. The exact pathomechanisms underlying these skin lesions remain unknown. Here, we describe eleven cases of delayed skin reactions after SARS-CoV-2 vaccination with the mRNA-1273 vaccine, discuss their transient and benign clinical courses and consider their potential pathomechanisms based on histopathological analyses. We conclude that further investigations to characterize the precise molecular and cellular mechanisms underlying this rare phenomenon are warranted.
Recovery of biologically active compounds from stinging nettle leaves part I: supercritical fluid extraction
Authors: Đurović Saša , Šorgić Saša , Popov Saša , Pezo Lato , Mašković Pavle , Blagojević Stevan , Zeković Zoran
Published: May 2021

Stinging nettle (Urtica dioica L.) is annual plant from Urticaceae family growing wild all over the world. Throughout the history, this plant found its place as a both food and medicine. Due to the nonsufficient study, this work aimed to isolate the bioactive compounds from the stinging nettle leaves by supercritical fluid extraction. Extracts were analyzed and assessed for antioxidant and cytotoxic activities. Main fatty acids were α-linolenic, palmitic, and linoleic acids in all six samples. Beside fatty acids, chlorophylls and carotenoids were also found in all samples. Four empirical kinetic equations were effectively utilized for kinetic modeling of supercritical fluid extraction of stinging nettle leaves oil. As per proper statistical features, empirical models show good concurrence with experimental data. The numerical modeling of a process is gainful to foresee the process conduct and furthermore extend the methodology from laboratory to industrial scales. The principal component analysis was used to visualize the fatty acids profile and antioxidant capacity and cytotoxic activity of extract obtained from stinging nettle leaves. It was found that both composition and activity were strongly dependent on the parameters of the extraction process.
Status of Antimicrobial Stewardship Implementation in Some Egyptian Hospitals, a Cross-sectional Study
Authors: Hamdy Noha Alaa , Kandil Nahla Hesham , Amer Ahmed Noby
Published: May 2021

Background: Antimicrobial stewardship (ASP) aims to stopping or slowing emergence of antimicrobial resistant strains. After initiation of National action plan on antimicrobial resistance (AMR) in Egypt, there were several initiatives by hospitals to implement ASP but no formal assessment was performed.Objective & setting: This study attempts to assess the extent of ASP application in different Egyptian hospitals; stewardship knowledge & implementation in selected hospitals. Method: A cross-sectional study was conducted to assess stewardship knowledge & implementation in selected hospitals in Egypt. Main outcome measure: Core elements of the survey included Hospital Description, ASP committee, ASP Activities (including training, restriction methods and outcome measurement), reporting antibiotic use, antibiogram, information technology (IT) support, ASP restriction methods and ASP Future ApplicationResults: The study included many aspects regarding hospital description; all types of hospitals were involved. Most of hospitals (61.8%) implemented an ASP program while 38.2% did not; 71.4 % of the later are planning for future Antimicrobial stewardship application. 22 hospitals (48.5%) reported having facility-specific antibiogram on regular basis. 13 hospitals (37.1%) reported receiving antimicrobial reports on regular basis. 15 hospitals (42.9%) reported having one or more computer programs already in use. The monitoring activities included resistance patterns, infection rates, length of stay, mortality rate & reported adverse drug reactions. Only 20% of the hospitals included in this study reported having an ASP training program. Conclusion: Egyptian hospitals have a fairly good implementation, improvements need to include IT support programs, healthcare members cooperation, monitoring outcomes & infectious disease (ID) consultations.
Effects of Partitioning Time and Temperature on the Microstructure and Mechanical Properties of a High Strength Microalloyed Steel
Authors: almasi ali , kianvash abbas , tutunchi abolfazl
Published: May 2021

In the present study, in a quenching-partitioning (Q-P) process, the effects of partitioning time (Pt) and partitioning temperature (PT) on the mechanical and microstructural properties of a microalloyed Fe-0.21C-1.5Si-2.2Mn-0.054Al-0.08Ti steel were studied. The XRD and SEM results confirmed increases in retained austenite (γR) volume fraction (VγR) and (γR)carbon concentration by increasing Pt and PT. XRD patterns confirmed reduction in (VγR)by further increasing the Pt and PT over 500 sec and 390°C, respectively, due to super-saturation of austenite (γ) with carbon. PT of 390°C and Pt of 500 sec were recorded as the optimum values for PTs and Pts, which allowed the present steel to obtain higher formability and higher fracture strain characteristics, while retaining higher hardness and strength. The highest yield and tensile strength, hardness and fracture elongation were obtained for the sample partitioned at 390°C for about 500 sec, which were about 741MPa, 1366 MPa, 424 HV and 25.2 %, respectively.
Impaired visuospatial but not verbal working memory in adult patients with neurofibromatosis type 1
Authors: Tang Hanlu , Wu Qiong , Li Shiwei , Fang Yehong , Yang Zhijun , Wang Bo , Wang XingChao , Liu Pinan
Published: May 2021

Purpose

Cognitive dysfunction is one of the main symptoms of neurofibromatosis type 1 (NF1). As an important advanced cognitive function, working memory (WM) has rarely been systematically analyzed in NF1 by isolating the particular domain of WM, and existing data involving WM in adults with NF1 are controversial. This study aimed to clarify the characteristics of WM in NF1 from the perspective of the adult population.
Methods

We comprehensively analyzed WM in both verbal and visuospatial WM domains by using the N-back task (including the verbal N-back task and the visuospatial N-back task) in 31 adults with NF1 and 34 healthy controls (HCs) matched for age, gender, education levels and general cognitive status. The accuracy and reaction times (RTs) in the N-back task were entered into repeated-measure ANOVAs.
Results

Compared with HCs, adults with NF1 presented significantly lower mean accuracy (F(1,62) = 4.60, p = 0.036) and longer RTs (F(1,62) = 4.91, p = 0.03) in the visuospatial N-back task, and the gap became more obvious as the difficulty levels increased. However, no significant difference was found in the verbal N-back task (accuracy: F(1,62) = 2.41, p = 0.13; RTs: F(1,62) < 1).
Conclusions

Our study found that adults with NF1 had selective deficits in WM (impaired visuospatial but not verbal WM), and visuospatial WM dysfunction became obvious as memory load increased. Our findings supplement and refine the existing data on WM in NF1 disorder and demonstrate functional independence between verbal and visuospatial WM.
Contraceptive Utilization and Unmet Need for Contraception Among Women Undergoing Treatment for Tuberculosis in Addis Ababa, Ethiopia; a Cross-sectional Study.
Authors: Alemayehu Semaria Solomon , Yitayew Berhanu , Kebede Abebaw , Getahun Haileyesus
Published: May 2021

Introduction: Pregnancy can pose a risk to women on tuberculosis (TB) treatment with a threat to the mother, fetus, and family at large. Contraceptive counseling and provision should be an integral part of TB clinics. Physiological and stress-related effects result when pregnancy occurs on TB illness and while treatment. Hence, this study aimed to assess contraceptive utilization, unmet need among women on TB treatment, and integration of family planning (FP) services with TB clinics in Addis Ababa, Ethiopia.Methods: A facility-based cross-sectional study was conducted using an interviewer-administered questionnaire. A total of 316 women aged 18-49 who were on TB treatment were recruited from one TB referral hospital and five randomly selected health centers in Addis Ababa with a response rate of 100%. The contraceptive utilization rate, unmet need, and integration of FP and TB services were determined. Logistic regression models were conducted to identify factors associated with contraceptive utilization.Result: Among women on TB treatment 49 (41.9%) were using contraceptives. Out of contraceptive users, 10 (34.5%) used contraceptive to limit and 18 (62.1%) used to space. In multiple logistic regression only parity had a significant association with contraceptive utilization. Women who had 1-3 children had 0.351 odds of having used contraception than those who had no children (AOR=0.351, 95% CI 0.152, 0.815, p=0.001). Among women who were married or sexually active, 12 (18.9%) had an unmetneed. Of the study participants, 144 (45.6% )have been informed about FP services at the TB clinics.Conclusion: The contraceptive utilization rate of women in the current study is slightly higher than the national prevalence yet it is still very low. Furthermore, the unmet need was lower than the national report for the general population However, more attention should be given to raise awareness of utilization in this group. Educating women about the risk of getting pregnant while visiting the health facility for TB medication will help improve their chances of better recovery, avoid medication side effects on the fetus, and improve their quality of life. TB guidelines can consider providing FP couselings when initiating treatment to provide women with the power of information to make deliberate decisions.
Modeling Incidence Rate by Region: Analysis of Asthma and Other Chronic Obstructive Lung Diseases
Authors: Wesonga Ronald , Abdelbasit Khidir
Published: May 2021

This study aimed to examine regional differences for asthma and other chronic obstructive lung diseases. The study was based on data collected from annual reports produced by the Ministry of Health over a ten-year period beginning from 2010 to 2019. Incidence rates for eleven regions in the Sultanate of Oman were analyzed using statistical tools including; analysis of variance and binary logistic regression model to determine the effect of region on asthma and other chronic obstructive lung diseases. The incident rates were found to be significantly different by region (F-value=27.07, p=0.00). There was no significant variation by year (F-value=1.05, p>0.407). Overall over the ten-year period the incidence rates stagnated between 250 and 300 per 10000 of the population, but showed a reducing trend between 2016 and 2019. The logistic regression model shows that compared to the Muscat region, all the other regions had significant increased odd ratios. There is a significant evidence of regional variation in the incidence of asthma and other chronic obstructive lung diseases. This implies probable characteristics in geographical regions that are associated with asthma and other chronic obstructive lung diseases’ exacerbation. Five asthma-region classifications were identified from our analysis. Findings of this study may be used to guide decision making towards the management and control of asthma and chronic obstructive lung diseases.
New Chalcone Derivatives as Effective Anti-SARS-CoV-2 Agents
Authors: Duran Nizami , Polat M. Fatih , Aktas Derya Anil , Alagoz M. Abdullah , Ay Emrah , Cimen Funda , Tek Erhan , Anil Baris , Burmaoglu Serdar , Algul Oztekin
Published: May 2021

Flavonoids and related compounds, such as quercetin-based antiviral drug Gene-Eden-VIR/Novirin, inhibit the protease of severe acute respiratory syndrome coronavirus (SARS-CoV-2). The alkylated chalcones isolated from Angelica keiskei inhibit SARS-CoV proteases. Hydroxychloroquine and Favipiravir have been used in many countries since the beginning of the pandemic with the thought that they may have antiviral activity against SARS CoV-2. In this study, we aimed to compare the anti-SARS CoV-2 activities of both newly synthesized chalcone derivatives and these two drugs.The current study aimed to determine the potent antiviral activity of newly synthesized chalcone derivatives against SARS-CoV-2 by calculating the RT-PCR cycling threshold (Ct) values. Antiviral activities of the compounds varied due to being dose dependent. Compound 6, 7, 9 and 16 were highly effective against SARS-CoV-2 at concentrations of 1.60 µg/mL. Structure-based virtual screening was carried out against the most important druggable SARS-CoV-2 targets, viral RNA-dependent RNA polymerase (RdRp), to identify putative inhibitors that could facilitate the development of potential anti-COVID-19 drug candidates. Computational analyses identified eight compounds inhibiting each target, with binding affinity scores ranging from − 4,370 to -2,748 kcal/mol along with their toxicological, ADME, and drug-like properties.
Pinocembrin ameliorates post-infarct heart failure through activation of Nrf2/HO-1 signaling pathway
Authors: Chen Xiuhuan , Wan Weiguo , Guo Yan , Ye Tianxin , Fo Yuhong , Sun Yazhou , Qu Chuan , Yang Bo , Zhang Cui
Published: May 2021

Background

Oxidative stress is an important factor involved in the progress of heart failure. The current study was performed to investigate whether pinocembrin was able to ameliorate post-infarct heart failure (PIHF) and the underlying mechanisms.
Methods

Rats were carried out left anterior descending artery ligation to induce myocardial infarction and subsequently raised for 6 weeks to produce chronic heart failure. Then pinocembrin was administrated every other day for 2 weeks. The effects were evaluated by echocardiography, western blot, Masson’s staining, biochemical examinations, immunohistochemistry, and fluorescence. In vitro we also cultured H9c2 myocytes to further testify the mechanisms.
Results

We found that PIHF-induced deteriorations of cardiac functions were significantly ameliorated by administrating pinocembrin. In addition, the pinocembrin treatment also attenuated collagen deposition and augmented vascular endothelial growth factor receptor 2 in infarct border zone along with an attenuated apoptosis, which were related to an amelioration of oxidative stress evidenced by reduction of reactive oxygen species (ROS) in heart tissue and malondialdehyde (MDA) in serum, and increase of superoxide dismutase (SOD). This were accompanied by upregulation of nuclear factor erythroid 2-related factor 2 (Nrf2)/ heme oxygenase-1 (HO-1) pathway. In vitro experiments we found that non-specific Nrf2 inhibitor significantly reversed the effects resulted from pinocembrin including antioxidant, anti-apoptosis, anti-fibrosis and neovascularization, which further indicated the amelioration of PIHF by pinocembrin was in a Nrf2/HO-1 pathway-dependent manner.
Conclusion

Pinocembrin ameliorated cardiac functions and remodeling resulted from PIHF by ROS scavenging and Nrf2/HO-1 pathway activation which further attenuated collagen fibers deposition and apoptosis, and facilitated angiogenesis.
Best Practices Learned from Online Problem-based Learning Help Prepare Students for Global Health Care Challenges of the Future
Authors: O'Donoghue Orla , Kasselman Lora , Ayala Gladys , Shelov Steven P. , Ragolia Louis
Published: May 2021

Background

Problem-based learning (PBL) offers a unique model of remote learning that resembles important facets of students’ future medical careers. The purpose of this study was to determine if online PBL was successful and to identify creative innovations and best practices of online learning in order to better prepare medical students for health care careers in the future.
Methods

The impact of implementing virtually delivered PBL sessions on student experience and performance in comparison to in-person PBL sessions was evaluated. A 4-point Likert scale question was used to investigate the effect of the transition to online PBL on the students’ PBL process experience. Student PBL process grades were measured on a scale of 5–10, where 5 is “needs substantial improvement” and 10 is “meets expectations”. PBL session grades were compared in one session before and one session after the transition to online PBL using a paired t-test. Data are presented as number of responses per category (percentage), or as a mean +/- standard deviation.
Results

Based on our experiences, we identified a successful transition to online PBL with no meaningful impact on students’ performance. We also identified several challenges to online PBL and how students demonstrated creative solutions to overcome these challenges. As a result of our experience, we identified several key factors as best practices of implementing online PBL to ensure a smooth transition from in-person sessions for both faculty and students, including extensive preparation, participation of support staff, availability of adequate internet services and equipment, and input from instructional technology and design personnel.
Conclusion

Successful student performance and experience, along with best practices learned from implementing virtual PBL, provide valuable tools for improving teaching and critical insight into the challenges faced, when preparing students for global health care changes in the future.
CD33 as a Leukocyte-Associated Marker Expressed on Human Spermatozoa
Authors: Sereshki Nasrin , Rafiee Mitra , Alipour Razieh , Navkhasi Sasan , Ahmadipanah Vahid , wilkinson david
Published: May 2021

Background
Sialic acid-binding immunoglobulin-type lectins (Siglecs) are commonly present on immune cells and often mediate cell-to-cell interactions and signaling. Studies have shown the presence of Siglecs 1, 2, 5, 6, 10 and 14 on human spermatozoa. To the best of our knowledge, the expression of CD33 on spermatozoa has not yet been studied.
Methods
Semen samples were collected from 25 healthy men with normal semen status. CD33 expression on purified spermatozoa was evaluated by flow cytometry methods.
Results
The results demonstrate the expression of CD33 on the surface of purified spermatozoa. The mean (± SD) of MFI (mean fluorescence intensity) was 12.85 (± 1.33) and the mean percentage of spermatozoa that express CD33 was 73.75 (± 3.75).
Conclusion
Results were obtained showing that spermatozoa express CD33 (or Siglec-3) on their surface. The physiological role of these molecules on spermatozoa remains to be determined. It is recommended that further research should be undertaken regarding the role of Siglecs (such as CD33) on spermatozoa apoptosis.
Survey for Online Tourist Guide
Authors: Garkal Satyaki , Ghodse Swapnil , Khare Rutuj , Jadho Shilpa
Published: May 2021

This paper presents survey related to existing systems used in e-tourism and the development of a location based online tourist guide application. This paper provides a summary of innovations that have happened in the field of e-tourism and addresses some of these limitations of these existing systems. It also provides certain recommendations which can be used to betterment of existing systems. The main motive behind this survey is to compare all the applications used for e-tourism and introduce a system which will help tourist to retrieve all information about place in absence of local information or tourist guide.
Chiral 1,2-Subnaphthalocyanines
Authors: Shimizu Soji , Miura Akito , Nyokong Tebello , Khene Samson , Kobayashi Nagao
Published: May 2021

Following the first suggestion of inherent
molecular chirality in asymmetrically substituted subphthalocyanines by Torres
and co-workers in 2000, elucidation of the relationship between structure and
chirality has become an important issue. However, separation of the enantiomers
has been prevented by the low solubility of the molecules synthesized to date,
and it has not been possible to link the CD signs and intensities to their
absolute structures. Recently, we observed that 1,2-subnaphthalocyanines possess
two diastereomers with respect to the arrangement of the naphthalene moieties
and that these novel chiral molecules exhibit moderate solubility in common
organic solvents. This has enabled us to separate all of the diastereomers and
enantiomers. The two diastereomers have been completely characterized by NMR
spectroscopy and X-ray diffraction analysis. The absorption and magnetic
circular dichroism spectra, together with theoretical calculation, reveal a
small variation in the frontier molecular orbitals of the
1,2-subnaphthalocyanines compared with conventional subphthalocyanines, except
for destabilization of the HOMO–3, which results in a characteristic absorption
in the Soret band region. The chirality of 1,2-subnaphthalcyanines, including
the CD signs and intensities, is discussed in detail for the first time with
enantiomerically pure molecules whose absolute structures have been
elucidated by single-crystal X-ray diffraction analysis.
Possibilities of combined therapy in patients with functional biliary sphincter of Oddi disorder
Authors: Mekhtiev S. N. , Mekhtieva O. A. , Ibragimova Z. M. , Ukhova M. V. , Volnukhin A. V.
Published: May 2021

Introduction. The prevalence of functional biliary disorders continues to increase with insufficient effectiveness of existing treatment approaches. Among them, functional biliary disorders of sphincter of Oddi account for at least 50%.

Objective. To study efficacy, safety and tolerability of a fixed combination of glycyrrhizic acid and ursodeoxycholic acid (Fosfogliv Urso) in capsule form in patients with functional biliary disorders of sphincter of Oddi.

Materials and Methods. The study included 32 patients diagnosed with functional biliary sphincter of Oddi disorders established according to the Rome Criteria IV revision (2016). Patients received Fosfogliv Urso (250 mg ursodeoxycholic acid and 35 mg glycyrrhizic acid) 1 capsule 3 times a day for 8 weeks. Prior to treatment, all study participants underwent a standard set of laboratory and instrumental examinations.

Results. Against the background of Fosfogliv Urso treatment, statistically significant decrease of biliary pain prevalence up to 48.3% (p < 0.001); intense biliary pain up to 11.4% (p < 0.0001); intensity of pain syndrome on visual analogue scale down to 1.7 ± 0.9 cm was registered (p < 0.0001). Alanine aminotransferase activity significantly decreased to 34.0 ± 4.0 U/L (p < 0.001). There was a tendency of choledochal diameter decrease to 0.57 ± 0.01 cm. Treatment efficacy was rated by patients as very good and good in 83.4% of cases. The safety profile was assessed as favorable and tolerability as satisfactory.

Discussion. The results obtained were superior to those previously obtained for ursodeoxycholic acid monotherapy and confirmed the data of the previously conducted phase III study. The rationality of the combination is due to the mutual complementation and possible synergism of the pharmacological effects of glycyrrhizinic and ursodeoxycholic acids.

Conclusion. The results obtained allow to recommend the prescription of Fosfogliv Urso in the complex scheme of treatment and prophylaxis of functional biliary disorders of sphincter of Oddi.