bluuebunny/crossref_metadata_2025 huggingface dataset:
BOOKLET KONSELING TERHADAP PENINGKATAN PENGETAHUAN SELF CARE MANAGEMENT PADA PASIEN GAGAL GINJAL KRONIK (GGK) DENGAN HEMODIALISA
Authors: Barus Sadaukur Br , Zainaro M. Arifki
Published: August 2022

Background: Counseling is an individual approach method to help patients deal with, overcome problems and make efforts that can be done on their own, especially in patients undergoing dialysis. Self care is one of the basic human abilities in meeting their needs to maintain life, health and well-being. Self care management in HD patients includes fluid restrictions, diet regulation, treatment and treatment of vascular access.Purpose: To analyze the effect of information booklets in self-management knowledge and self-care behavior among patient with patients with chronic renal failure undergoing dialysis at Dustira Hospital, Cimahi.Methods: Quasi experiment with pre test and post test control group design used in this study.Results:  shows that the patient’s compliance on self care management is increase after counseling at intervention group with p value 0.000. family support confounding variable is the variable that affect patient’s compliance (with dialysis) on self care management. The recommendation for nurses is to continue the patient's health teaching using counseling, cooperate with the family to increase their compliance on self care management especially for the patient with dialysis.Keywords: Dialysis, Self Care Management, Booklet Pendahuluan: Konseling merupakan metode pendekatan individual untuk membantu pasien menghadapi, mengatasi masalah serta melakukan upaya yang dapat dilakukan dengan usaha sendiri khususnya pada pasien yang menjalani hemodialisa. Self care merupakan salah satu kemampuan dasar manusia dalam memenuhi kebutuhannya guna mempertahankan kehidupan, kesehatan dan kesejahteraan. Self care management pada pasien HD meliputi pembatasan cairan, pengaturan diet, pengobatan dan perawatan akses vaskuler.Tujuan: Penelitian ini bertujuan untuk menganalisis pengaruh booklet terhadap pengetahuan self care manajement pada pasien gagal ginjal kronik dengan hemodialisa di Rumah Sakit Dustira Kota Cimahi.Metode : Desain penelitian Quasi Eksperiment dengan Pre Test And Post Test With Control Group Desain, dengan jumlah sampel 56 responden yang dibagi menjadi kelompok intervensi dan kontrol.Hasil penelitian:  menunjukan pengetahuan self care management pada pasien yang dengan hemodialisa meningkat setelah diberi konseling 10-15 menit pada kelompok intervensi dengan P value 0.000.Simpulan: untuk perawat pelaksana diruang hemodialisa  dalam memberikan pendidikan kesehatan dengan metode konseling secara rutin dalam meningkatkan pengetahuan pasien menjalani terapi hemodialisa.
The development of media learning using plotagon software on circle material
Authors: Saputra Eri , Marhami M , B Raduan , Mursalin M , Azmi Nur
Published: August 2022

The challenges in learning mathematics at schools could be worrying because the delivery is usually less interesting which makes students feel bored with the lesson. Mathematics from the student’s perspective is considered a scary subject because it is very difficult to understand. This study aims to determine the feasibility level of learning media using Plotagon software in Mathematics Subjects at SMA Negeri 1 Terangun. This type of study is research and development (RD). The model used in this study is the Analyze, Design, Development, Implementation, Evaluation (ADDIE) model. The subjects of this study were students of class XI IPA I SMA Negeri 1 Terangun. Data collection techniques were carried out by questionnaires and observations. The instrument used is a questionnaire using a Likert scale. The results of the study obtained were Plotagon Learning Media in the Mathematics Subject Circle material received an assessment with average score 3,36 from material experts, 3,45 from media experts, 3,80 from small group students and 3,83 from large group students. So it can be concluded that the Plotagon software learning media in the Mathematics subject matter Circle is suitable for learning at SMA Negeri 1 Terangun.
Mathematics communication as an alternative to overcome the obstacles of undergraduate students in mathematical proof
Authors: Risalah Dewi , Hodiyanto H
Published: August 2022

Experiences at the educational personnel education institution, Department of Mathematics Education Institute of Teacher Training and Education Pontianak (IKIP) shows that students often had difficulty in proving propositions (theorems in mathe-matics). The alternative offered through this study was to develop students' abilities in proof through mathematical communication. The study method used in this study was qualitive research, case study. The subjects used in this study consisted of two un-dergraduate students who had been taught real analysis introductions and. The data collection tool used was tests and interview. Data analysis techniques used was de-scriptions: data reduction, data display and conclusion. Based on the results of re-search, study of theory and discussion, it could be concluded in this study that the student obstacles in answering mathematical proof questions are the students have difficulty in writing mathematical symbolic and inability in mathematical proof. But after being given didactic anticipation by mathematical communication, the ability of students to answer mathematical proof questions has increased. Thus, mathematical communication can be used as an alternative to overcome obstacles or difficulties for students in solving mathematical proof problems.
All I See Is White: The Colonial Problem in Finland
Authors: Kuokkanen Rauna
Published: August 2022

The question of whiteness is inextricably linked to colonialism. This chapter considers common misconceptions of colonialism in Finland through a lens of the “Sámi problem.” These misbeliefs include: colonialism is (mostly) about the past and, thus, we can only talk about “coloniality” or legacies of colonialism; colonialism is only about colonies; and the concept of colonialism is confusing, difficult or too broad to have analytical value. All of these views are frequently applied both in general terms and specifically with regard to the Sámi people. The chapter examines the ways in which the “Sámi question” is a part and parcel of bona fide colonialism, not a “separate chapter” as is frequently suggested in the Finnish discourse of colonialism. The problem of colonialism vis-à-vis the Sámi is commonly framed in terms of “internal colonialism” and thus assumed and presented (if discussed at all) as distinct from other colonial and colonization processes. This chapter suggests that a more correct understanding could be arrived at through the concept and analysis of settler colonialism, which emphasizes structural injustice and the ongoing character of colonialism. In conclusion, the chapter discusses white privilege and considers the key ways in which it plays out in Finland vis-à-vis the Sámi.
Imperial Complicity: Finns and Tatars in the Political Hierarchy of Races
Authors: Elmgren Ainur
Published: August 2022

Finnish and Tatar intellectuals shared a position of subordination and relative privilege in the Russian Empire from the early 19th century onward. They did not simply accept or reject Western racial knowledge production, which was increasingly used to justify colonialism and imperialism toward the end of the 19th century; they appropriated it and created a localized version of racial hierarchy, subverting derogatory racial stereotypes to sources of vitality. Within that framework, the heritage of another empire that had managed to menace the white West, the Mongol Empire, had an undeniable attraction to Finns and Tatars, who shared the experience of middle-men minorities providing experts and services to a multi-national empire, while aspiring for empires and colonies of their own.
Doing Whiteness and Masculinities at School: Finnish 12- to 15-Year-Olds’ Narratives on Multiethnicity
Authors: Peltola Marja , Phoenix Ann
Published: August 2022

As Finland becomes increasingly multiethnic, there is a growing need to understand how young, white Finnish people position themselves and others in relation to norms of Finnishness and whiteness, and in relation to racism and (in)equalities. In popular narratives, assumptions of increasing “tolerance” and decreasing racism and inequalities are sometimes particularly attributed to young people, a perspective that enables most of the population to continue to evade issues of racism and perpetuate “white innocence” (Wekker 2016) and the color blindness (Bonilla-Silva 2003) of imagined Finnishness. In this chapter, we draw on a study of masculinities in 12- to 15-year-olds in Helsinki to examine these issues by focusing on the white Finnish participants’ narratives on multiethnicity. Our theoretical starting point is to understand the intersections of Finnishness, whiteness, and masculinities. We argue that while the interviewees widely embraced egalitarianism and multicultural ideologies in the interviews, the norm of whiteness was unquestioned and the contradictions characteristic of white innocence largely prevailed. The combination of white Finnishness, male gender and egalitarian ideas allowed the white Finnish boys to occupy an unquestioned position of “ordinary boys.” They were able to construct themselves as tolerant and to see multiethnicity and racism as phenomena that were largely irrelevant to them, while benefiting from a privileged white position.
Some Characterizations on Actions of Generalized Derivations AsHomomorphisms And Anti-Homomorphisms In SemiprimeGamma Rings
Authors: Chakraborty Sujoy , Paul Akhil Chandra
Published: August 2022

Let I be a non-zero left ideal of a r-ring M satisfying the condition alpha alpha b beta c= a beta b alpha c for all a,b,c, e M and alpha, beta e r. We show that M contains a non-trivial central ideal if M is semiprime which admits an appropriate non-zero derivations on I, and also that M is commutative if M is prime admitting a non-zero centralizing derivation on I. We next give some characterizations when non-zero generalized derivations act as homomorphisms and as anti-homomorphisms on some non-zero left or two-sided ideals of semiprime gamma rings, somewhere of prime gamma rings also, satisfying the above condition.GANIT J. Bangladesh Math. Soc. 42.1 (2022) 025- 034
Study on Flow Behavior in Terminal Bronchus of Human Lung for Porous Medium
Authors: Akhtera Sadiya , Ahmmed MU
Published: August 2022

Flow simulation along human lung channel is one of the interests of investigation in fluid dynamics. We have studied flow phenomena of 11th generation of human lung as porous medium. The governing equations of porous medium have been solved numerically using finite difference scheme. The effect of different flow parameters are illustrated graphically. It is observed that the flow rate increases for increasing the value of pressure gradient, the porosity effect, effective viscosity and the dimensionless parameter . The numerical experiment for non-porous medium is also studied. It is found that the flow rate increases in porous medium compared with non-porous medium.
GANIT J. Bangladesh Math. Soc. 42.1 (2022) 069- 080
Perceived Stress Levels and Associated Factors in Adult Patients with Primary Open-angle Glaucoma: A Prospective Survey Study
Authors: Ji Man , Kim Jin-Soo , Baek Sung Uk , Kim Young Kook , Nam Ki Tae , Lee Jong Young , Lee Hye Jin , Jeong Jinho , Ha Ahnul
Published: August 2022

Purpose: To investigate adult primary open-angle glaucoma (POAG) patients’ perceived stress levels and to examine the associations with their clinical characteristics.Methods: Sixty-seven POAG patients, excluding those meeting the exclusion criteria (retinal or neurological disease diagnoses) comprised the study population. A validated questionnaire, namely Perceived Stress Scale-10 (PSS-10), was used to assess stress level. Additional data on glaucoma surgery history, medical benefit receipt, comorbidities, and daily antiglaucoma medication number were collected. The clinical characteristics of high (PSS-10 ≥15) and low stress (PSS-10 <15) patients and the risk factors associated with high stress level were subjected to a multivariable logistic regression analysis.Results: The patients were 56.8 ± 12.6 years of age on average, and 29 (43.3%) were female. The mean PSS-10 level was 13.5 ± 5.3 (range, 1–27) for the entire patient group; 31 patients (46.3%) were in the high stress group. In the high stress group relative to the low stress group, best-corrected visual acuity in the better eye was lower (p = 0.044) and the visual field defects, in both eyes, were more severe (better eye, p = 0.005; worse eye, p = 0.026). A logistic regression analysis indicated that severe visual field defect in the better eye (odds ratio, 1.159; 95% confidence interval, 1.016–1.323; p = 0.028) and lower best-corrected visual acuity in the better eye (odds ratio, 4.707; 95% confidence interval, 0.580–6.189; p = 0.072) were both likely to associated with high stress level in patients with POAG.Conclusions: These findings suggest an association between severe visual function loss and higher mental stress level in POAG patients. Stress level, therefore, might be an important consideration in POAG patient management.
Comparison of Netarsudil/Latanoprost Therapy with Latanoprost Monotherapy for Lowering Intraocular Pressure: A Systematic Review and Meta-analysis
Authors: Lee Jong-Wook , Ahn Hyeon-Soo , Chang Jinho , Kang Hye-Young , Chang Dong-Jin , Suh Jae Kyung , Lee Hankil
Published: August 2022

Purpose: Netarsudil is a Rho kinase inhibitor and the first new class of clinically useful ocular hypotensive agents. In this study, we conducted a systematic literature review and meta-analysis to summarize and synthesize the available evidence on the efficacy and safety of fixed-dose combination (FDC) therapy with netarsudil/latanoprost in patients with glaucoma.Methods: We identified relevant studies in PubMed, Ovid Medline, Embase, and Cochrane Central until April 2021. The quality of the studies and the level of evidence were assessed using the Risk of Bias tool. Efficacy was measured as the mean difference in reducing intraocular pressure (IOP), and safety was assessed by the risk of conjunctival hyperemia (CH) due to FDC therapy, netarsudil monotherapy, or latanoprost monotherapy.Results: Four studies met the predefined eligibility criteria and were included in the meta-analysis. The mean difference in the reduction in IOP after 2 weeks and 4 to 6 weeks of drug administration was -2.41 mmHg (95% confidence interval [CI], -2.95 to -1.87) and -1.77 mmHg (95% CI, -2.31 to -1.87), respectively, in patients receiving FDC therapy versus those receiving latanoprost monotherapy. On the other hand, latanoprost monotherapy had a greater effect in reducing IOP than netarsudil monotherapy after 4 to 6 weeks of administration (mean difference, 0.95 mmHg; 95% CI, 0.43 to 1.47). The risk of CH was significantly higher with both FDC therapy and netarsudil monotherapy compared to latanoprost monotherapy in week 12, where the relative ratio was 3.01 (95% CI, 1.95 to 4.66) and 2.33 (95% CI, 1.54 to 3.54), each.Conclusions: Netarsudil/latanoprost FDC therapy has a significantly greater effect on reducing IOP than latanoprost alone. The symptoms of CH were mostly mild, and only a few glaucoma patients discontinued the medication owing to CH in earlier clinical trials. Therefore, it would be beneficial to consider the administration of netarsudil/latanoprost FDC therapy in patients with glaucoma.
Incidence of Acute Endophthalmitis after Intravitreal Antivascular Endothelial Growth Factor Injection in Age-related Macular Degeneration
Authors: Seong Hyo Jin , Park Young Min , Kim Jiwon , Son Kang Ju , Chung Eun Jee
Published: August 2022

Purpose: Antivascular endothelial growth factor (anti-VEGF) agents are routinely intravitreously injected to treat neovascular age-related macular degeneration (AMD). Postoperative endophthalmitis, a side effect after intravitreal anti-VEGF injection, has been reported to have a low incidence but may threaten vision. In this study, we aimed to analyze the incidence of acute endophthalmitis after intravitreal anti-VEGF injection and associated risk factors in patients with neovascular AMD in South Korea.Methods: Using the health claims data recorded in the Korean National Health Insurance System database, we identified newly developed neovascular AMD cases from 2010 through 2019. Acute endophthalmitis was defined as a case of invasive treatment for accompanying symptoms. All statistical analyses were performed with a significance level p < 0.05. To find risk factors, we used univariate and multivariable Poisson regression.Results: The overall incidence of acute endophthalmitis was 0.019% (p = 0.21) during the 10-year period: 0.025% for aflibercept injection and 0.014% for ranibizumab injection. The incidence was higher in metropolitan city residents than in Seoul (incidence rate ratio [IRR], 1.96; 95% confidence interval [CI], 1.02–3.79; p = 0.04) and was higher for aflibercept injections than for ranibizumab injections (IRR, 1.82; 95% CI, 1.17–2.82; p = 0.01). However, in multivariate analysis, only aflibercept injections showed a significant effect on the incidence of acute endophthalmitis (IRR, 1.80; 95% CI, 1.16–2.79; p = 0.01).Conclusions: The incidence of acute endophthalmitis after intravitreal anti-VEGF injections was generally low, and aflibercept was revealed as a significant risk factor.
Gynecological surgical interventions (conservative and non-conservative): Clinical psychological variables and symptomatology pertaining to perioperative period
Authors: C Pruneti , S Mortilla , G Masellis , S Guidotti , C Caramuscio
Published: August 2022

Objective: After considering great inter-individual variability of subjective experience and clinical course in reference to conservative and non-conservative gynecological surgical interventions, an attempt was made to evaluate potential role of several clinical and psychological variables with respect to perioperative symptomatology course and illness behaviour. Materials and methods: The sample consists of 58 women (mean age 41.4 ± 8.7) undergoing gynecological surgical interventions (conservative and non-conservative ones) for benign pathologies. The anamnestic and clinical data (psychological anamnesis, clinical history, indications, methods and typology of the intervention) were collected using a specifically designed summary form. For the evaluation of pre-and post-operative symptomatology course and illness behaviour, the following psychological tests were respectively used: The Symptom Questionnaire (SQ), with 3 planned administrations (respectively 15 days before the intervention, a day before the intervention and at discharge) and the Illness Behavior Questionnaire (IBQ), completed before discharge. Non-parametric tests (Mann-Whitney and Kruskal-Wallis) were used to compare performances on independent samples. Results: Results show that perioperative course and illness behaviour in the cases of gynecological surgical interventions for benign pathologies depend on clinical variables, that is, typology and methods of the intervention, clinical history, psychopathological anamnesis. Conclusion: Findings suggest the importance of clinical-anamnestic inquiry oriented towards the evaluation of variables that emerged as risk factors, with the goal of planning personalized support interventions for preventing and/or reducing distress and impact on psychophysical wellbeing arising after gynaecological surgical interventions.
The Value of Serum Follicle-Stimulating Hormone in Predicting Successful Surgical Sperm Retrieval in Cases of Male Infertility: A Literature Review
Authors: Ramcharn Meera , Hampshire Tom , Tatarov Oleg , Abdu Shahana , Knaggs Paul , D’Angelo Arianna
Published: August 2022

Azoospermia is a common cause of male infertility; however, surgical sperm retrieval (SSR) and subsequent intracytoplasmic sperm injection offers couples the chance to have a biological child. SSR success is highly variable and dependent on a number of factors. One such factor is male follicle-stimulating hormone (FSH), which has been researched extensively. The aim of this literature review is to ascertain if there is a ‘cut off’ FSH value that correlates with successful SSR, whether this value differs depending on method of SSR, and if there is a correlation between male FSH level and obstetric outcomes. Thirty-five articles were identified and reviewed, with 10 papers suggesting FSH cut off values. These ranged from <8.5 to <25.0 IU/L, with a mean value of 14.0 IU/L. Generally the results suggested that lower FSH values were associated with increased SSR success. Few papers considered pregnancy and birth outcomes following intracytoplasmic sperm injection with surgically retrieved sperm, and there was no clear correlation with male FSH levels. Clinical implications include considering FSH results when counselling patients about both SSR and intracytoplasmic sperm injection. Suggested future research implications are to further investigate the predictive role of FSH in combination with other clinical and endocrinological markers.
Local Consistency of Smoothed Particle Hydrodynamics (SPH) in the Context of Measure Theory
Authors: Rendón Otto , Avendaño Gilberto D. , Klapp Jaime , Sigalotti Leonardo Di G. , Vargas Carlos A.
Published: August 2022

The local consistency of the method of Smoothed Particle Hydrodynamics (SPH) is proved for a multidimensional continuous mechanical system in the context of measure theory. The Wasserstein distance of the corresponding measure-valued evolutions is used to show that full convergence is achieved in the joint limit N → ∞ and h → 0, where N is the total number of particles that discretize the computational domain and h is the smoothing length. Using an initial local discrete measure given by μ0N=∑b=1Nm(xb,h)δ0,xb(0), where mb = m(xb, h) is the mass of particle with label b at position xb(t) and δ0,xb(t) is the xb(t)-centered Dirac delta distribution, full consistency of the SPH method is demonstrated in the above joint limit if the additional limit N → ∞ is also ensured, where N is the number of neighbors per particle within the compact support of the interpolating kernel.
A rapid and standardized workflow for functional assessment of bacterial biosensors in fecal samples
Authors: Zúñiga Ana , Muñoz-Guamuro Geisler , Boivineau Lucile , Mayonove Pauline , Conejero Ismael , Pageaux Georges-Philippe , Altwegg Romain , Bonnet Jerome
Published: August 2022

Gut metabolites are pivotal mediators of host-microbiome interactions and provide an important window on human physiology and disease. However, current methods to monitor gut metabolites rely on heavy and expensive technologies such as liquid chromatography-mass spectrometry (LC-MS). In that context, robust, fast, field-deployable, and cost-effective strategies for monitoring fecal metabolites would support large-scale functional studies and routine monitoring of metabolites biomarkers associated with pathological conditions. Living cells are an attractive option to engineer biosensors due to their ability to detect and process many environmental signals and their self-replicating nature. Here we optimized a workflow for feces processing that supports metabolite detection using bacterial biosensors. We show that simple centrifugation and filtration steps remove host microbes and support reproducible preparation of a physiological-derived media retaining important characteristics of human feces, such as matrix effects and endogenous metabolites. We measure the performance of bacterial biosensors for benzoate, lactate, anhydrotetracycline, and bile acids, and find that they are highly sensitive to fecal matrices. However, encapsulating the bacteria in hydrogel helps reduce this inhibitory effect. Sensitivity to matrix effects is biosensor-dependent but also varies between individuals, highlighting the need for case-by-case optimization for biosensors’ operation in feces. Finally, by detecting endogenous bile acids, we demonstrate that bacterial biosensors could be used for future metabolite monitoring in feces. This work lays the foundation for the optimization and use of bacterial biosensors for fecal metabolites monitoring. In the future, our method could also allow rapid pre-prototyping of engineered bacteria designed to operate in the gut, with applications to in situ diagnostics and therapeutics.
The potential of caproate (hexanoate) production using Clostridium kluyveri syntrophic cocultures with Clostridium acetobutylicum or Clostridium saccharolyticum
Authors: Otten Jonathan K. , Zou Yin , Papoutsakis Eleftherios T.
Published: August 2022

Caproate (hexanoate) and other medium-chain fatty acids are valuable platform chemicals produced by processes utilizing petroleum or plant oil. Clostridium kluyveri, growing on short chain alcohols (notably ethanol) and carboxylic acids (such as acetate) is noted for its ability to perform chain elongation to produce 4- to 8-carbon carboxylates. C. kluyveri has been studied in monoculture and coculture conditions, which lead to relatively modest carboxylate titers after long fermentation times. To assess the biosynthetic potential of C. kluyveri for caproate production from sugars through coculture fermentations, in the absence of monoculture data in the literature suitable for our coculture experiments, we first explored C. kluyveri monocultures. Some monocultures achieved caproate titers of 150 to over 200 mM in 40–50 h with a production rate of 7.9 mM/h. Based on that data, we then explored two novel, syntrophic coculture partners for producing caproate from sugars: Clostridium acetobutylicum and Clostridium saccharolyticum. Neither species has been cocultured with C. kluyveri before, and both demonstrate promising results. Our experiments of C. kluyveri monocultures and C. kluyveri—C. saccharolyticum cocultures demonstrate exceptionally high caproate titers (145–200 mM), fast production rates (3.25–8.1 mM/h), and short fermentation times (18–45 h). These results represent the most caproate produced by a C. kluyveri coculture in the shortest known fermentation time. We also explored the possibility of heterologous cell fusion between the coculture pairs similar to the results seen previously in our group with C. acetobutylicum and Clostridium ljungdahlii. Fusion events were observed only in the C. acetobutylicum—C. kluyveri coculture pair, and we offer an explanation for the lack of fusion between C. saccharolyticum and C. kluyveri. This work supports the promise of coculture biotechnology for sustainable production of caproate and other platform chemicals.
Identification of two rate-limiting steps in the degradation of partially folded immunoglobulin light chains
Authors: Mann Melissa J. , Flory Ashley R. , Oikonomou Christina , Hayes Candace A. , Melendez-Suchi Chris , Hendershot Linda M.
Published: August 2022

Antibody monomers are produced from two immunoglobulin heavy chains and two light chains that are folded and assembled in the endoplasmic reticulum This process is assisted and monitored by components of the endoplasmic reticulum quality control machinery; an outcome made more fraught by the unusual genetic machinations employed to produce a seemingly unlimited antibody repertoire. Proper functioning of the adaptive immune system is as dependent on the success of this operation, as it is on the ability to identify and degrade those molecules that fail to reach their native state. In this study, two rate-limiting steps were identified in the degradation of a non-secreted κ light chain. Both focus on the constant domain (CL), which has evolved to fold rapidly and very stably to serve as a catalyst for the folding of the heavy chain CH1 domain. The first hurdle is the reduction of the disulfide bond in the CLdomain, which is required for retrotranslocation to the cytosol. In spite of being reduced, the CLdomain retains structure, giving rise to the second rate-limiting step, the unfolding of this domain at the proteasome, which results in a stalled degradation intermediate.
Nicotinamide-riboside shifts the differentiation of human primary white adipocytes to beige adipocytes impacting substrate preference and uncoupling respiration through SIRT1 activation and mitochondria-derived reactive species production
Authors: Nagy Lilla , Rauch Boglárka , Szerafin Tamás , Uray Karen , Tóth Attila , Bai Péter
Published: August 2022

Beige adipocytes play key roles in organismal energy and metabolic balance. In this study, we assessed whether the supplementation of human white adipocytes, differentiated from human adipose tissue-derived stem cells, with nicotinamide riboside (NR), a potent NAD + precursor, can shift differentiation to beige adipocytes (beiging). NR induced mitochondrial biogenesis and the expression of beige markers (TBX1 and UCP1) in white adipocytes demonstrating that NR can declutch beiging. NR did not induce PARP activity but supported SIRT1 induction, which plays a key role in beiging. NR induced etomoxir-resistant respiration, suggesting increases in the oxidation of carbohydrates, carbohydrate breakdown products, or amino acids. Furthermore, NR boosted oligomycin-resistant respiration corresponding to uncoupled respiration. Enhanced etomoxir and oligomycin-resistant respiration were dependent on mitochondrial reactive-species production. Taken together, NR supplementation can induce beiging and uncoupled respiration, which are beneficial for combatting metabolic diseases.
Total glycosides contribute to the anti-diarrheal effects of Qiwei Baizhu Powder via regulating gut microbiota and bile acids
Authors: Xie Guozhen , Deng Na , Zheng Tao , Peng Xinxin , Zhang Shuihan , Tan Zhoujin
Published: August 2022

Qiwei Baizhu Powder (QWBZP) is a traditional Chinese medicine formula for treating diarrhea induced by various causes. It elicits an anti-diarrheal effect by regulating the gut microbiota (diversity, structure, and abundance). However, the contribution of different components in the QWBZP decoction to this effect remains unclear. In this study, we used the QWBZP decoction as a reference standard to investigate the effects of total glycosides (TGs) extracted from QWBZP decoction on the gut microbiota and bile acid metabolism in mice with antibiotic-associated diarrhea (AAD). The results of 16S rRNA gene sequencing and liquid chromatography-mass spectrometry (LC-MS) analysis showed that the effect of total glycosides of Qiwei Baizhu Powder (QWBZP-TG) on specific intestinal bacteria and bile acids was similar to that of the QWBZP decoction, but the intensity of this effect was more significant in the case of QWBZP-TG. The QWBZP decoction and QWBZP-TG promoted the proliferation of Lactobacillus and inhibited the growth of Proteus, Clostridium, Eubacterium, Facklamia, and Escherichia in AAD mice. They also increased the levels of deoxycholic acid and beta-muricholic acid and decreased those of taurocholate acid, tauro-alpha-muricholic acid, and tauro-beta-muricholic acid in AAD mice. Lactobacillus was the key bacterial genus responding to QWBZP-TG. Thus, this study provides novel insights into the bioactive components of QWBZP and their contribution to its effects.
Central carbon metabolism remodeling as a mechanism to develop drug tolerance and drug resistance in Mycobacterium tuberculosis
Authors: Eoh Hyungjin , Liu Rachel , Lim Juhyeon , Lee Jae Jin , Sell Philip
Published: August 2022

Suboptimal efficacy of the current antibiotic regimens and frequent emergence of antibiotic-resistant Mycobacterium tuberculosis (Mtb), an etiological agent of tuberculosis (TB), render TB the world’s deadliest infectious disease before the COVID-19 outbreak. Our outdated TB treatment method is designed to eradicate actively replicating populations of Mtb. Unfortunately, accumulating evidence suggests that a small population of Mtb can survive antimycobacterial pressure of antibiotics by entering a “persister” state (slowly replicating or non-replicating and lacking a stably heritable antibiotic resistance, termed drug tolerance). The formation of drug-tolerant Mtb persisters is associated with TB treatment failure and is thought to be an adaptive strategy for eventual development of permanent genetic mutation-mediated drug resistance. Thus, the molecular mechanisms behind persister formation and drug tolerance acquisition are a source of new antibiotic targets to eradicate both Mtb persisters and drug-resistant Mtb. As Mtb persisters are genetically identical to antibiotic susceptible populations, metabolomics has emerged as a vital biochemical tool to differentiate these populations by determining phenotypic shifts and metabolic reprogramming. Metabolomics, which provides detailed insights into the molecular basis of drug tolerance and resistance in Mtb, has unique advantages over other techniques by its ability to identify specific metabolic differences between the two genetically identical populations. This review summarizes the recent advances in our understanding of the metabolic adaptations used by Mtb persisters to achieve intrinsic drug tolerance and facilitate the emergence of drug resistance. These findings present metabolomics as a powerful tool to identify previously unexplored antibiotic targets and improved combinations of drug regimens against drug-resistant TB infection.
Budding pouches and associated bubbles: 3D visualization of exo-membrane structures in plasmodium falciparum gametocytes
Authors: Hayakawa Eri Saki H. , Wayama Marina , Tokumasu Fuyuki , Ohno Nobuhiko , Matsumoto Mami , Usukura Jiro
Published: August 2022

Plasmodium falciparum gametocytes have unique morphology, metabolism, and protein expression profiles in their asexual stages of development. In addition to the striking changes in their appearance, a wide variety of “exo-membrane structures” are newly formed in the gametocyte stage. Little is known about their function, localization, or three-dimensional structural information, and only some structural data, typically two-dimensional, have been reported using conventional electron microscopy or fluorescence microscopy. For better visualization of intracellular organelle and exo-membrane structures, we previously established an unroofing technique to directly observe Maurer’s clefts (MCs) in asexual parasitized erythrocytes by removing the top part of the cell’s membrane followed by transmission electron microscopy. We found that MCs have numerous tethers connecting themselves to the host erythrocyte membrane skeletons. In this study, we investigated the intracellular structures of gametocytes using unroofing-TEM, Serial Block Face scanning electron microscopy, and fluorescence microscopy to unveil the exo-membrane structures in gametocytes. Our data showed “balloon/pouch”-like objects budding from the parasitophorous vacuole membrane (PVM) in gametocytes, and some balloons included multiple layers of other balloons. Furthermore, numerous bubbles appeared on the inner surface of the erythrocyte membrane or PVM; these were similar to MC-like membranes but were smaller than asexual MCs. Our study demonstrated P. falciparum reforms exo-membranes in erythrocytes to meet stage-specific biological activities during their sexual development.
The short-term efficacy of adventitial inversion with graft eversion anastomosis for the reconstruction of the aortic sinus in the root treatment of aortic dissection
Authors: Gao Feng , Shi Zepeng , He Xuezhi , Gao Yang , Zhuang Xijing , Shi Lei , Wang Wenjun , Liu Wei
Published: August 2022

Background

The surgical approaches for a mildly affected aortic sinus (AS) are varied and controversial. Here, the AS was reconstructed using the extended adventitial inversion with graft eversion anastomosis technique before its perioperative and short-term efficacy was compared with that of the vascular grafts that wrap the aortic wall and the right atrial shunt technique, providing a new basis for surgical management strategies.

Method

A total of 101 patients with mildly affected AS were enrolled in the clinical trial. The extended adventitial inversion suture and the graft eversion anastomosis technique was performed in group A. Aorta wrapping and the right atrial shunt technique were performed in group B. The primary endpoints were reoperation-related events and fatal events related to the aorta, while the secondary endpoints were the duration of surgery and structural changes in the aortic root. Cardiac ultrasound and aortic computed tomography angiography examinations were performed before surgery, 2 weeks after surgery, and 1 year after surgery.

Results

Compared to group B (n = 56), group A (n = 36) had a significantly shorter duration of surgery (the time from skin incision to skin closure) and a reduced time from shutdown to skin closure (P < 0.05). Cardiovascular ultrasound examinations performed at follow-up 12 months after surgery and 2 weeks after surgery revealed a significant increase in the diameter of the aortic sinotubular junction (STJ) of group B (n = 50) (P < 0.05). The extended adventitial inversion suture and the graft eversion anastomosis technique (n = 33) performed better than Aorta wrapping and the right atrial shunt technique in terms of persistence of the false lumen closure effect, anastomotic leakage, and reduction in aortic valve (P < 0.05), and there was a significant difference between the two groups in terms of the incidence of events related to reoperation (P < 0.05).

Conclusion

Compared with the aorta wrapping and the right atrial shunt technique, the extended adventitial inversion suture and the graft eversion anastomosis technique allow shortening of the operation time and preventing near-term dilation of the STJ, with improved safety and an improved short-term surgical effect.
Comparison between endovascular aneurysm repair-selected and endovascular aneurysm repair-only strategies for the management of ruptured abdominal aortic aneurysms: An 11-year experience at a Chinese tertiary hospital
Authors: Fang Gang , Yue Jianing , Shuai Tao , Yuan Tong , Ren Bichen , Fang Yuan , Pan Tianyue , Liu Zhenjie , Dong Zhihui , Fu Weiguo
Published: August 2022

Objectives

The aim of this study was to review our management experience of ruptured abdominal aortic aneurysms (RAAAs) using an endovascular aneurysm repair (EVAR)-only strategy, and discuss the feasibility of this strategy.

Materials and methods

A retrospective analysis of clinical data was performed in patients with RAAAs from January 2009 to October 2020. Our strategy toward operative treatment for RAAAs evolved from an EVAR-selected (from January 2009 to April 2014) to an EVAR-only (from May 2014 to October 2020) strategy. Baseline characteristics, thirty-day mortality, perioperative complications, and long-term outcomes of patients were compared between the two periods.

Results

A total of 93 patients undergoing emergent RAAA repair were eventually included. The overall operation rate in RAAAs at our centre was 70.5% (93/132). In the EVAR-only period, all 53 patients underwent ruptured endovascular aneurysm repair (rEVAR). However, only 47.5% (19/40) of patients in the EVAR-selected period underwent rEVAR, and the remaining 21 patients underwent emergent open surgery. Thirty-day mortality in the EVAR-only group was 22.6% (12/53) compared with 25.0% (10/40) for the EVAR-selected group (P= 0.79). Systolic blood pressure ≤70 mmHg [adjusted odds ratio (OR) 4.99, 95% confidence interval (CI), 1.13–22.08,P= 0.03] and abdominal compartment syndrome (adjusted OR 3.72, 95% CI, 1.12–12.32,P= 0.03) were identified as independent risk factors responsible for 30-day mortality. After 5 years, 47.5% (95% CI, 32.0–63.0%) of patients in the EVAR-selected group were still alive versus 49.1% (95% CI, 32.3–65.9%) of patients in the EVAR-only group (P= 0.29).

Conclusion

The EVAR-only strategy has allowed rEVAR to be used in nearly all the RAAAs with similar mortality comparing with the EVAR-selected strategy. Due to the avoidance of operative modality selection, the EVAR-only strategy was associated with a more simplified algorithm, less influence on haemodynamics, and a shorter operation and recovery time.
CYP2C19 polymorphisms and lipoproteins associated with clopidogrel resistance in children with Kawasaki disease in China: A prospective study
Authors: Zhang Mingming , Meng Li , Chen Yeshi , Li Xiaohui , Shi Lin
Published: August 2022

Background

CYP2C19 genetic variation and clinical factors have been proved to be related with clopidogrel resistance (CR) in adults, while the presence of CR in children with Kawasaki disease (KD) was seldom reported. Our objective was to evaluate KD patients’ response to clopidogrel treatment and determine whether CYP2C19 gene polymorphisms and laboratory indicators are associated with CR in this population.

Methods

This was a prospective and single-center study. We recruited children with KD hospitalized in the cardiology department at the Children’s Hospital Capital Institute of Pediatrics between January 2019 and October 2021, and the distribution of the CYP2C19 gene polymorphisms was assessed. According to the light transmission aggregometry (LTA) test results, KD patients who were treated with clopidogrel were divided into CR group and non-CR (NCR) group. We also analyzed the influence of CYP2C19 gene polymorphisms and laboratory indicators on CR in children with KD.

Results

(1) A total of 346 children with KD were evaluated for the genotypic and phenotypic distributions of CYP2C19. Loss-of-function (LOF) mutated allele was included in 56.9% of CYP2C19 genotypes, and their corresponding phenotypes were intermediate metabolizers (46.2%) and poor metabolizers (10.7%). (2) The incidence of CR in this study population was 31.4%. The multivariate logistic regression showed that carrying CYP2C19 LOF allele (OR, 3.922; 95%CI, 1.504–10.282; P = 0.005) and high levels of low-density lipoprotein (OR, 1.675; 95%CI, 1.069–2.623; P = 0.024) were independent risk factor for CR, while low levels of high-density lipoprotein (OR, 0.120; 95%CI, 0.020, 0.734; P = 0.022) was an independent protective factor for CR. The area under the receiver operator characteristic curve of the multivariate logistic regression model (including high-density lipoprotein, low-density lipoprotein, and CYP2C19 LOF allele carriers) for predicting CR was 0.769 (95% CI, 0.674–0.863; P < 0.001). The sensitivity and specificity were 70.3 and 74.0%, respectively.

Conclusion

Carrying CYP2C19 LOF allele, low levels of high-density lipoprotein, and high levels of low-density lipoprotein were independent risk factors for CR in children with KD in China. This may benefit pediatricians in choosing appropriate individualized antiplatelet therapy.
A case report of long-term successful stereotactic arrhythmia radioablation in a cardiac contractility modulation device carrier with giant left atrium, including a detailed dosimetric analysis
Authors: Levis Mario , Dusi Veronica , Magnano Massimo , Cerrato Marzia , Gallio Elena , Depaoli Alessandro , Ferraris Federico , De Ferrari Gaetano Maria , Ricardi Umberto , Anselmino Matteo
Published: August 2022

Introduction

Catheter ablation (CA) is the current standard of care for patients suffering drug-refractory monomorphic ventricular tachycardias (MMVTs). Yet, despite significant technological improvements, recurrences remain common, leading to increased morbidity and mortality. Stereotactic arrhythmia radioablation (STAR) is increasingly being adopted to overcome the limitations of conventional CA, but its safety and efficacy are still under evaluation.

Case presentation

We hereby present the case of a 73-year-old patient implanted with a mitral valve prosthesis, a cardiac resynchronization therapy-defibrillator, and a cardiac contractility modulation device, who was successfully treated with STAR for recurrent drug and CA-resistant MMVT in the setting of advanced heart failure and a giant left atrium. We report a 2-year follow-up and a detailed dosimetric analysis.

Conclusion

Our case report supports the early as well as the long-term efficacy of 25 Gy single-session STAR. Despite the concomitant severe heart failure, with an overall heart minus planned target volume mean dosage below 5 Gy, no major detrimental cardiac side effects were detected. To the best of our knowledge, our dosimetric analysis is the most accurate reported so far in the setting of STAR, particularly for what concerns cardiac substructures and coronary arteries. A shared dosimetric planning among centers performing STAR will be crucial in the next future to fully disclose its safety profile.
One-hour plasma glucose as a long-term predictor of cardiovascular events and all-cause mortality in a Chinese older male population without diabetes: A 20-year retrospective and prospective study
Authors: Rong Lingjun , Cheng Xiaoling , Yang Zaigang , Gong Yanping , Li Chunlin , Yan Shuangtong , Sun Banruo
Published: August 2022

Introduction

Elevated one-hour plasma glucose (1 h-PG) during oral glucose tolerance test predicts the development of type 2 diabetes mellitus and its complications. However, to date, there have been no studies investigating the predictive values of 1 h-PG for the risk of cardiovascular diseases (CVDs) and all-cause mortality in the elderly population in China. This study aimed to evaluate and compare the effectiveness of 1 h-PG and two-hour plasma glucose (2 h-PG) to predict the risk of CVD and all-cause mortality in the Chinese elderly population.

Materials and methods

This retrospective and prospective cohort study was conducted using data obtained from the Chinese People’s Liberation Army General Hospital. All the non-diabetic elderly participants, who had plasma glucose measured at 0, 1, and 2 h during an OGTT (75 g glucose), were followed for 20 years. The primary outcomes were all-cause mortality, myocardial infarction, unstable angina, and stroke. Multivariate-adjusted Cox proportional hazard regression models were performed to examine the association between risk factors and outcomes and to estimate the risk of CVD and all-cause mortality based on 1 h-PG levels.

Results

A total of 862 non-diabetic male individuals were included. The median age was 74.0 (25th–75th percentile: 68.0–79.0) years. There were 480 CVD events and 191 deaths during 15,527 person-years of follow-up. The adjusted hazard ratio (HR) of 1 h-PG as a continuous variable was 1.097 (95% CI 1.027–1.172; P = 0.006) for CVD events and 1.196 (95% CI 1.115–1.281; P < 0.001) for higher risk of mortality. When compared with the lowest 1 h-PG tertile, the other tertiles were associated with CVD events (HR 1.464, 95% CI 1.031–2.080; P = 0.033 and HR 1.538, 95% CI 1.092–2.166; P = 0.014, for tertile 2 and tertile 3 compared with tertile 1, respectively), and the highest 1 h-PG tertile had a significantly higher risk of mortality (HR 2.384, 95% CI 1.631–3.485; P < 0.001) after full adjustment. Compared with 1 h-PG, 2 h-PG had similar abilities to predict all-cause mortality. However, 2 h-PG was less closely associated with CVD when examined in the fully adjusted model, neither as a continuous variable nor as a categorical variable. Conversely, 1 h-PG remained an independent predictor of CVD and all-cause mortality after adjusting for various traditional risk factors.

Conclusion

Patients with higher 1 h-PG had a significantly increased risk of CVD and all-cause mortality regardless of prediabetes status or development of diabetes at follow-up. The 1 h-PG level might be a better predictor of cardiovascular risk than the 2 h-PG level for the Chinese elderly population.