bluuebunny/crossref_metadata_2025 huggingface dataset:
The Diachronic Evolution of Polysemous Motion Verbs in Chinese—A Case Study of Zǒu ‘Walk’
Authors: Qiu Lei
Published: December 2022

Based on the actual uses of the polysemous motion verb zǒu ‘walk’ in the corpora of Chinese texts from Old Chinese to Modern Chinese period, this paper argues that the directed motion sense of the manner verb mainly derives from pragmatic inference from the contexts and cognitive preference for the conceptualization of motion events. In addition, it is essential that favorable morphosyntactic constructions in the language promote the pragmatic sense to be lexicalized as the verb’s lexical meaning. That is, the specific direction encoded in the verb and its grammatical behaviors are not fully determined by the lexical semantics of the verb itself as the grammatical constructions available in the language also account for the evolution of its lexical semantics and grammatical behaviors.
The Philosophical Relationship Between the Origin of English and Chinese Affixes and Their Word Format
Authors: Tan Zhenghua , Guo Yanhua
Published: December 2022

Western scholars believe that the difference between Chinese and Western languages is a conceptual gap in their traditions, apply the Western phonetic-centered language philosophy theory to study Chinese and Chinese characters, and put forward a series of ideas and views on the comparison of Chinese characters and Western languages, believing that Chinese characters as a thinking tool are far inferior to languages with perfect grammatical forms, and that Chinese remains in the childhood stage of human language development. This paper aims to reveal how Western scholars based on phonetic centrism and logocentrism ignore the particularity of Chinese characters, and should not copy the western language philosophy theory when understanding the nature of Chinese characters, but should pay attention to the characteristics and advantages of Chinese characters in the process of historical development.
The Spread of English Language Elements During the COVID-19 Period
Authors: Balabekova Merey , Khan Nadezhda , Tuite Yeldos , Kenzhegaliev Sayan , Zuyntayeva Zamzagul , Kaliev Bektursun , Smagulov Zhandos
Published: December 2022

The global pandemic COVID-19 has made a large difference in our minds and lives. Changes related to COVID-19 have had a significant impact on the Kazakh linguistic community as well. This paper considers the emergence of new concepts associated with greetings, color, education and linguistic changes in Kazakh linguistic society during COVID-19. The main purpose of this study is to show that some concepts related to greeting, education and learning, and ways of using colors have new content and a new quality. The research findings revealed that new words related to greetings, colors, and education had come into the language by the calque (translation-loan) method, and the elements of the English language indicate the flexibility to update the language structure. The study showed the emergence of new calque phrases caused by COVID-19, such as shyntakpen amandasy, kyzyl aymak, sary aymak, zhasyl aymak, ZOOMga shygu, and ZOOMmen otkizu; some of them have new semantic characteristics.
Forensic medical analysis of the dynamics of death rates in suicides
Authors: Giyasov Zaynitdin A. , Makhsumkhonov Kulfiddinkhon A. , Bakhriev Ibrokhim I. , Islamov Shavkat E.
Published: December 2022

BACKGROUND: The increase in the number of completed suicides associated with multiple risk factors is a worldwide concern. The rates of completed suicide in both sexes, according to different researchers, differ significantly.
AIMS: To investigate the sex characteristics of death rates of completed suicide.
MATERIALS AND METHODS: Mortality rates using information from official reports on the activities of forensic medical institutions from 1992 to 2019 were analyzed retrospectively.
RESULTS: The results of the analysis of suicide mortality rates indicate that suicides have natural features of development, i.e., a cyclical change in the states of indicators, namely, rise, decline, wave-like flow, characterized by certain periodicity, and constancy (stability of the occurrence of the phenomenon on a national scale). During the study period, completed suicides accounted for 14.0% of the total number of examinations of corpses and 21.4% of all cases of violent death. An analysis of the absolute number of suicide-related deaths by sex revealed a clear predominance of suicides in men (n = 33,888) compared with women (n = 16,036), which counted for 67.9% and 32.1%, respectively. The ratio of the absolute number of completed suicide cases in the group of men and women was approximately 2:1. Suicide mortality rates make it possible to conclude about the nature of this phenomenon in the country as permanent and sustainable.
CONCLUSION: The results of the study of completed suicides in Uzbekistan for the period 19922019 allow us to assert that completed suicides as a phenomenon have their natural features of development, namely, the constancy of changes (stability of the occurrence of the phenomenon) and cyclicity (cyclic change of the states of indicators, i.e., rise, decline, wave-like flow, and certain periodicity).
Ensuring food safety in use antimicrobial veterinary drugs in agriculture
Authors: Orlova Diana A. , Kalyuzhnaya Tamara Vasilievna
Published: December 2022

Currently, the problem of antibiotic resistance is acute at the world level. As a result of unsystematic and uncontrolled intake of antimicrobial drugs into the human body, pathogenic and opportunistic microorganisms acquire resistance to the action of drugs, and therapy is ineffective. Antibiotic resistance develops as a result of non-compliance with the course of treatment, dosage of drugs, as well as when antibiotics enter the body, residual amounts of which circulate in the external environment and are found in food. The use of antimicrobial agents in agriculture is of great importance. In 2017, Decree of the Government of the Russian Federation No. 2045-r On approval of the Strategy for preventing the spread of antimicrobial resistance in the Russian Federation for the period up to 2030 and the action plan for its implementation came into force, in accordance with which the SCAMP program was developed - a system for monitoring antimicrobial drugs. This program is currently being implemented within the framework of voluntary certification and provides for the achievement of the therapeutic efficacy of antibiotic therapy; reduction in the use of antibiotics; rejection of unsystematic and uncontrolled use of antibiotics for prevention, stimulation of growth and productivity; obtaining raw materials of animal origin and products that do not contain residual amounts of antimicrobial drugs; ensuring food security. A high role in the control system of antimicrobial drugs is played by digitalization in the circulation of food products on the territory of the Russian Federation, which makes it possible to control the turnover from farm to table and to nullify the cases of circulation of unsafe counterfeit products, and the registration of manufacturers in electronic systems and the assignment of a unique digital labeling of products will oblige manufacturers to comply with the requirements of regulatory and technical documentation, including when using medicines.
"Evaluation of the effect of Cassia fistula L. extracts on the muscle contraction intensity using an ex vivo model"
Authors: Ranadive Kiran Ramchandra , Jagtap Neeta Vijayrao , Jagtap Pradnya Nilesh , Perelygin Vladimir V. , Zharikov Mikhail V. , Zmitrovich Ivan V. , Sanjay Gaikwad Dattatray
Published: December 2022

Cassia fistula L. is a peculiar Fabaceae representative that has long been used in traditional medicine. The purpose of this study is to evaluate the effect of Cassia fistula L. herbal extracts in the form of solutions of a certain concentration on the smooth muscles of the intestine. The design of the experiment involved the identification of raw materials, their drying, grinding, extraction of soluble fractions, purification of aqueous, ethereal (diethyl ether) and ethanol extracts and their testing on the tissues of the ileum of the domestic chicken (Gallus gallus domesticus L.) extracted ex vivo. It was shown that the ethereal, ethanol and aqueous extracts of Cassia fistula L. fruits showed a generally high relaxation activity in comparison with the control relaxation stimulants, leaf extracts showed a more modest relaxation activity, a similar situation was observed during testing of extracts of young shoots, and aqueous extracts showed more modest results, while the alcoholic and ethanol extracts of young shoots performed better than the corresponding leaf extracts, and the most modest results in terms of a dose sufficient for a physiological response were demonstrated by root extracts. The initial assessment of the activity of Cassia fistula L. extracts makes it possible to identify as the most promising for further chemical study the pools of substances concentrated in the ethanol extract of fruits, which exhibit the minimum effective dose, in the ether extracts of fruits and bark, which demonstrate the shortest reaction time, and in aqueous extracts of young shoots and cortex showing the highest percentage increase in activity in comparison with the control.
¿Puede aquello que comemos cambiar la expresión de nuestros genes?
Authors: Brito Jácome Calos , Crespo Vizcaino Estiven , García Rusca Alexander , Jacquin Serna Olga
Published: December 2022

Se ha denominado epigenética al estudio de procesos moleculares heredables y reversibles que regulan la expresión génica sin afectar directamente la secuencia del ADN. Estos procesos moleculares pueden estar sujetos a variaciones dependientes del ambiente como lo es la calidad de la dieta, lo que está siendo objeto de amplio estudio al reflejar mayor predisposición al desarrollo de enfermedades o la protección de las mismas ante el influjo de hábitos alimentarios específicos. A este respecto, algunos constituyentes de vitaminas, minerales y fitoquímicos se les empieza a denominar alimentos epigenéticos al tener la capacidad de modular la expresión de genes asociados a enfermedad, por lo que surge un novedoso concepto y alternativa terapéutica como lo es la nutrición de precisión. De esta manera, la programación de  sistemas fisiológicos podría intervenirse a través de hábitos dietarios beneficiosos que impacten sobre la descendencia de madres obesas hasta reprogramaciones epigenéticas beneficiosas  en pacientes malnutridos.
Aplicación Móvil para el “Control de Diabetes”
Authors: Beltrán Ramírez Jesús Raúl , Becerra González Xochitl Maritza , Jiménez Román Xochitl Citlalli , Orizaga Trejo José Antonio , Maciel Arellano Ma. Del Roció
Published: December 2022

El número de personas con diabetes ha aumentado considerablemente desde 2017 a 2021 con 537 millones de personas, con una prevalencia del 15% en adultos mayores de 20 años, siendo mayor en países con ingresos medianos y bajos, provocando 6.7 millones de muertes   en 2021. Así mismo más ciudades se van tornando en Smart Cities y con ello el incremento del uso de la salud electrónica (e-Health), dentro de está la telemedicina y la salud móvil (m- Health) por lo que desarrolló la aplicación móvil “Control Diabetes”, incluye información referente a los tipos de diabetes, un plan alimenticio para las personas con esta enfermedad, rutinas de ejercicio y ubicaciones de las clínicas que las atienden, por medio del uso de esta aplicación se espera que las personas conozcan más acerca de esta enfermedad, principalmente aquellas que lo padecen o son propensas a tenerla, y tengan información oportuna.

El número de personas con diabetes mellitus a nivel mundial ha aumentado considerablemente desde 2013 con una prevalencia de 382 millones, y en 2019 se presentaron 415 millones, la Federación Internacional de Diabetes (FID) estima que el 9.3% de adultos entre los 20 y 79 años sufren de esta enfermedad.
Aspectos clínicos de la enfermedad por almacenamiento de glucógeno: a propósito de un caso
Authors: Aragón-Palencia José , Romero-Vergara Sharon , Carrillo- Benítez Liliana , Muñoz-Otero Cristina
Published: December 2022

Las enfermedades por almacenamiento de glucógeno comprenden patologías hereditarias causadas por anomalías de las enzimas y transportadores en la síntesis y degradación de glucógeno. Los datos clínicos comprenden acidosis láctica en ayunas, hipoglicemia y hepatomegalia que pueden ayudar a orientar al diagnóstico. El diagnóstico se sospecha en función de la presentación clínica. Anteriormente el diagnóstico definitivo requería una biopsia de hígado para demostrar depósitos de glucógeno. Sin embargo, en la actualidad se realiza el análisis mutacionacional de genes como una forma no invasiva. Se presenta el caso de una paciente de 19 meses, multi-consultante a servicios de urgencias por episodios que inicialmente son considerados como crisis focales (hipertonía de miembros superiores e inferiores, chupeteo, mirada fija) asociado a hepatomegalia y talla baja. Valorada por varias especialidades, con múltiples manejos sin mejoría. Finalmente se  hizo diagnostico enfermedad por almacenamiento de glucógeno mediante una biopsia de hígado.
Embolización selectiva de arteria uterina en embarazo ectópico en cicatriz de cesárea: reporte de caso
Authors: Figueroa González Judeska , Fortich Arrieta Andy , Julio Mendoza Mario
Published: December 2022

Objetivo: Describir el caso cínico de una paciente con embarazo ectópico en cicatriz de cesárea (EECC), a quién se le realizó embolización selectiva de la arteria uterina izquierda para preservar su fertilidad, luego de usar metrotexate como manejo inicial. Materiales y Métodos: se presenta el caso clínico de una paciente con diagnóstico de embarazo ectópico en cicatriz de cesárea, atendida en una clínica privada en Barranquilla (Colombia), se realizó aplicación de metrotexate como opción de tratamiento y posteriormente embolización selectiva de la arteria uterina izquierda para preservación de su fertilidad. Conclusiones: El EECC incrementa la morbilidad materna, y depende del diagnóstico oportuno y el manejo preciso para evitar desenlaces graves. Se describe el manejo conservador con el uso de metrotexate y posteriormente la embolización de arterias uterinas, los que se hacen con el fin de preservar la fertilidad de la paciente.
Aprendizaje autorregulado y estrés académico universitario en tiempos de pandemia
Authors: Castro Porras Jheniffer Fabiola , Mayorga Rojas Jaime César
Published: December 2022

El objetivo del presente estudio fue determinar la relación entre el aprendizaje autorregulado y el estrés académico universitario en tiempos de pandemia. Tomando como puntos principales a desarrollar al aprendizaje autorregulado dentro de un marco educativo superior y sus dimensiones, el estrés académico enfocado en un entorno educativo universitario con sus fases o momentos y la relación de ambos en el actual contexto de pandemia a causa del COVID 19. Para llevar a cabo el presente estudio, se aplicaron los instrumentos adaptados Cuestionario de aprendizaje autorregulado e Inventario sobre estrés académico a 116 discentes pertenecientes a una universidad pública de Lima durante el tiempo de pandemia. El estudio se realizó bajo un enfoque cuantitativo y de diseño no experimental, como resultado entre la relación de ambas variables en el contexto de pandemia se obtuvo que existe una relación significativa e inversa entre el aprendizaje autorregulado y el estrés académico, ya que el coeficiente correlación Rho de Spearman arrojó como resultado -0.506 y un ρ = 0.000 (ρ < 0.05) Por lo tanto, se puede inferir mediante el presente estudio que a mayor aprendizaje autorregulado, menor fue la incidencia del estrés académico en los estudiantes universitarios en tiempos de pandemia.
Violencia conyugal y dependencia emocional en mujeres víctimas de maltrato en el Perú reportados en el primer trimestre del 2021
Authors: Radas Barbié Doris Luz , Araujo Robles Elizabeth Dany
Published: December 2022

El presente estudio tiene como finalidad identificar el maltrato que son víctimas las mujeres por parte de su pareja en el Perú de los reportados dentro del primer trimestre del 2021, realizado a través de una exploración de distintas investigaciones, logrando identificar, que la violencia ejercida sobre las mujer no se ha detenido, muy por el contrario los casos va en un nivel creciente y lastimosamente cada vez se identifican; a través de la información hallada se logra identificar que las víctimas en más de una vez han vuelto con su agresor a quien se identifica como su pareja.
Comparing the Risk of M. Tuberculosis Infection among Men and Women in an African City
Authors: Quach Trang , Zalwango Sarah , Kakaire Robert , Sekandi Juliet , Whalen Christopher , Kiwanuka Noah
Published: December 2022

Background: Despite the well-known male bias in tuberculosis disease, the underlying reasons remained elusive. We examined whether male predominance in tuberculosis disease is result of higher risk of tuberculosis infection or not. If so, whether it is due to higher likelihood of exposure or higher susceptibility to infection among men. Methods: A household contact study and a prospective cohort study conducted in Kampala, Uganda, from 2013 to 2017 were used to estimate and compare prevalence and annual risk of tuberculosis infection among men and women. In household contact study, index tuberculosis cases and healthy index controls were asked to list their household contacts and extra-household contacts. All contacts were tested with tuberculin skin test to detect tuberculosis infection. In prospective cohort study, individuals with tuberculin skin test (TST) < 5 mm were enrolled and retested with the skin test at one year to detect new infection. Poisson regression with robust standard errors was used to estimate prevalence ratio and relative risk of tuberculous infection between men and women. Results: In household contact study, 123 index tuberculosis cases and 124 index controls listed 382 household contacts of tuberculosis cases, 624 extra-household contacts of tuberculosis cases, and 1044 contacts of controls. Of 1681 enrolled participants in cohort study, 1213 (72%) were retested with TST at one year. There was no sex difference in prevalence of tuberculosis infection among household contacts of tuberculosis cases, but men had a higher prevalence of tuberculosis infection among extra-household contacts of tuberculosis cases (prevalence ratio 1.25, 95% CI 1.06 – 1.48) and contacts of controls (prevalence ratio 1.53, 95% CI 1.30 – 1.81). Similarly, in cohort study, there was no sex difference in annual risk of tuberculosis infection when participant reported knowing tuberculosis cases, but men had a higher annual risk of tuberculosis infection when participants no known contact with tuberculosis (relative risk 1.94, 95% CI: 1.34, 2.80). Conclusion: Men have higher risk of acquiring tuberculous infection than women. Men and women may have the same susceptibility to tuberculosis infection given known exposure to tuberculosis cases. The observed difference in rate of infection may be partially explained by higher rates of exposure to undetected, infectious tuberculosis cases among men.
Fertility and Pregnancy Outcomes in Systemic Lupus Erythematosus Patients: A Study Using Antimullerian Hormone
Authors: Kandil Iman
Published: December 2022

Background: Systemic lupus Erthymatosus (SLE) affects predominantly women of reproductive age, and can lead to both negative effect on their fertility and adverse pregnancy outcomes. Antimullerian hormone (AMH) serum levels have been found to be a reliable marker of ovarian reserve. Objectives: This research aimed to assess ovarian reserve by measuring AMH level in premenopausal SLE patients and to study different factors that can have an effect on it, and also to evaluate pregnancy outcomes in SLE patients. Methods: The study was performed on 60 subjects divided into 2 groups; (I): 30 SLE female patients and (II): control group which includes 30 healthy female subjects. Full history taking and examination were carried out including assessment of disease activity by Systemic Lupus Erythematosus Disease Activity Index (SLEDAI-2K) score and damage index by Systemic Lupus International Collaborating Clinics American College of Rheumatology Damage index (SLICC/ACR) on SLE patients, pregnancy questionnaire were used for taking history of the pregnancy outcomes. AMH levels were measured in both groups using AMH Gen II ELISA kits. Results: There was no statistically significant difference between both groups as regard to median AMH levels and there was no statistically significant correlation between AMH and disease duration, BMI, SLEDAI-2K activity score, damage index and the immunosuppressive drugs such as cyclophosphamide, mycophenolate mofetil and azathioprine. There was statistically significant difference between both groups as regards to occurrence of miscarriage (P<0.0166) and hypertension in pregnancy (P<0.04). Conclusion: From these results we can conclude that AMH values did not differ between SLE patients and healthy subjects, and the disease duration and/or activity did not affect its level. Moreover, the study reflected that immunosuppressive agents such as cyclophosphamide, azathioprine and mycophenolate mofetil did not affect the fertility in SLE patients. However, it was noted that adverse pregnancy outcomes were relatively more common in SLE patients, namely hypertension in pregnancy and miscarriages.
New oral anti coagulants – A guide for Plastic Surgeons
Authors: Gargya Vipul , Allam Omar , Ross Lance
Published: December 2022

With the advent of new oral anticoagulants (NOACs), it is a challenge for a plastic surgeon to stay updated with the myriad of new medications, and their associated mechanisms of action, laboratory monitoring, adverse events and potential reversal agents. The limitations of warfarin therapy include varying pharmacokinetic profiles, multitude of food and drug interactions, hypersensitivity, resistance, therapy failure and frequent laboratory monitoring)1. Hence there are an increasing number of patients who are presenting to their plastic surgeon on alterative antithrombotic agents. The aim of this paper is to educate Plastic Surgeons regarding NOAC's, and their management in the operative setting.
Comparative Evaluation of the Plaque and Gingivitis Reducing Efficacy of Chlorhexidine Diundecylinate (Salibact) and Triclosan Based Dentifrice: A Double Blind Randomized Controlled Trial
Authors: Sajjan Parappa , Rathnam Rakesh , koli Sahithi , irigineni kalyani , Chimmula Ruchika , sajjanar Mangala
Published: December 2022

Background: Microbial complexity of biofilm indicate that streptocouss mutans and candida species lives in symbiotic relationship. The combination of antiplaque agent with antifungal agent can significantly influence the dental plaque. There is a search for effective antimicrobial agent in dentifrice formulation. chlorhexidine diundecylinate((CHUA) is novel antimicrobial agent introduced by salicylates and chemicals pvt ltd, has shown extended antimicrobial properties and are comparable to triclosan Objectives: To evaluate and compare the plaque and gingivitis reducing efficacy of chlorhexidine Diundecylinate (salibact) and triclosan based dentifrice Material and methods: A double blind randomized controlled trial was conducted among 86 subjects who are randomly divided into two groups. Experimental group received dentifrice containing chlorhexidine Diundecylinate with antidiscoloration system (salibact 0.1%+ ADS) and control group received 0.3% triclosan containing dentifrice.Plaque and gingival index scores were compared between baseline and six weeks. Results: There is a significant difference between mean plaque index scores between salibact and triclosan containing dentifrice p(0.032)(0.015)<0.05 respectively. Mean plaque and gingivitis reduction was found to be better for salibact compared to triclosan Conclusion: The study results provide some evidence that CHUA (Salibact) has definite role in plaque reduction and has better efficacy compared to triclosan. The new ingredient chlorhexidine diundecylenate seems to be a better choice as an efficient antimicrobial agent for the oral care dentifrice formulations.
Ambiguous Loss and Coping Strategies in Couples Raising a Child With Down Syndrome: A Qualitative Directed Content Analysis Study
Authors: Bentley Gail , Thomas-Jackson Shera , Goff Briana , Piland Nicole
Published: December 2022

Despite years of research about developmental diversity, relatively little is known about the experience of couples raising a child with Down syndrome. Previous research has identified that Ambiguous Loss Theory can be helpful to understand the parents’ process of navigating the uncertainty, challenges, stressors, and demands of raising a child diagnosed with a neurodevelopmental disorder. Building on previous research and the framework of ambiguous loss, this study sought to provide insight into the lived experience of couples raising a child diagnosed with Down syndrome. Using a qualitative directed content analysis of the paired responses to open-ended questions from 16 couples, the current study provides insight into the couple’s experience of ambiguous loss and greater understanding about their coping strategies. Results indicated a process of dealing with ambiguous loss by most couples. Coping strategies reported by the couples included medical and educational advocacy, deepening and building connections, and gaining new perspectives on raising a child with Down syndrome. Implications for policy and practice are also included, based on the coping strategies, skills, and resources available to parents of children with Down syndrome or other neurodevelopmental disorders.
Management of Patients with Malignant Peritoneal Mesothelioma: The Evolving Role of Surgery and Immunotherapy
Authors: Gribkova Yelizaveta , Alexander Henry
Published: December 2022

Malignant peritoneal mesothelioma, a neoplastic process that arises from the peritoneal membranes and presents as a diffuse malignant process, has an incidence of approximately 400-600 new cases annually in the United States. Systemic chemotherapy regimens, like the combination of cisplatin and pemetrexed, have response rates of approximately 25% in peritoneal mesothelioma. Due to chemotherapy’s poor response rates, the first line approach to treating malignant peritoneal mesothelioma over the last 30 years has been surgical resection with regional intra-peritoneal chemotherapy in appropriately selected patients. Hyperthermic intraoperative intraperitoneal perfusion with chemotherapy with cisplatin or mitomycin c for 90 to 120 minutes is the most commonly reported type of regional chemotherapy that is administered during surgical cytoreduction. Favorable prognostic factors for patient outcomes after cytoreduction and hyperthermic intraperitoneal perfusion with chemotherapy tend to be favorable operative characteristics (lower peritoneal cancer index, better complete cytoreduction score), less aggressive tumor characteristics (epithelioid histology, low Ki-67, well-differentiated), and other patient characteristics (young, female, fewer comorbidities). Recently, there has been considerable interest in the utility of immune checkpoint inhibitors either alone or in combination with chemotherapy for patients with mesothelioma. Data demonstrate that programmed death-ligand 1 may be highly expressed in a large proportion of malignant peritoneal mesothelioma tumors and therefore the evaluation of checkpoint blockade in this patient population is a high clinical priority.
Refutation of the Identity of the Contemporary Official Description of Atherosclerosis with the Real Atherosclerotic Lesions in Humans and Animals
Authors: Rusanov Sergey
Published: December 2022

The "contemporary official" description of AS, according to the generally accepted theory, should completely coincide with vascular lesions in an animal and vascular lesions in humans. A study of AS in humans and animals has shown that humans have two separate types of lesions that are completely unrelated. Both species have their own characteristics (etiology, pathogenesis, appearance), which are completely different from each other. Lesions in humans also do not coincide with lesions in animals. The "contemporary" type of AS differs both from AS in animals and AS in humans, but at the same time creates the illusion of "identity" of these processes. In practice, the "contemporary" look cannot be found in the vessels of animals and humans. This article analyzes how the "contemporary" type of atherosclerotic lesion appeared, and how, for 100 years, the "contemporary" type could create an imitation of the "similarity" of completely different processes.
The Effects of Moral Injury: Invisible Wounds of Healthcare Workers and the Challenges of Mattering Post Pandemic
Authors: Fleur Richard
Published: December 2022

The COVID-19 pandemic has put extreme stress on the health care system globally, leading to workforce shortages as well as increased health care worker burnout, exhaustion, moral injury and many forms of traumas. These pandemic-related difficulties have taken place in the context of overwhelming pre-existing workforce challenges and inconsistencies, as well as in a workforce where burnout, stress, and mental health problems were already at high occurrences. Many health care workers experienced being furloughed or having their hours reduced, particularly early in the pandemic when nations were trying to implement mitigation protocols. Total employment in the healthcare industry declined during the early months of the pandemic but has gradually recovered since summer 2020. Federal, state, and local governments took significant action to address the need for prevention and treatment services that arose from COVID-19. This led to the disruptions in health care delivery and finances as a result of the pandemic through supplemental funding from federal relief legislation and easing many regulatory requirements. Even after the pandemic, many of the effects the pandemic has had on the health care workforce will likely persist. This paper takes a closer look at the power of mattering, the effects of moral injury as related to healthcare workers and the tools needed to begin the healing process. Keywords: Moral Injury, Healthcare workers, Mattering, Productivity, Healing, Pandemic
Pulmonary Hypertension in Hispanics: An Update on Treatment Options and Possible Causes
Authors: Miret Rafael , Martinez-Nunez Ana , Tesh Mari , Chauhan Zeeshan , Degregori Mauricio , Sanchez-Gonzalez Marcos , Ferrer Gustavo
Published: December 2022

Pulmonary arterial hypertension, a form of pulmonary hypertension (PH), is a rare but serious disease. This condition carries significantly increased risk of morbidity and mortality, associated with progressive elevations of pulmonary pressures and the subsequent development of right heart failure. PAH can also be very difficult to diagnose primarily because the initial symptom of shortness of breath can be very nonspecific and similar to other diseases. There are certain medications used to target obesity that have been associated with the development of pulmonary hypertension. Aminorex, commonly used in Europe in the 1960s, has been grossly tied with PAH. Additionally, Flenfluramine both on its own and used in combination with Phentermine, as appetite-suppressant medications, were associated with Primary Pulmonary Hypertension and valvulopathies. We believe the widespread use of weight loss medications in Latin America remains a risk factor for PH development in the Hispanic population. The NIH and the REVEAL registries in the United States provide the most information for different races/ethnicities in patients with the diagnosis of PAH. Both NIH and the REVEAL registries in the United States show a lower prevalence of PH than the expected prevalence of 11.5% in the Hispanic population. The underdiagnosis of PH in the Hispanic population can be explained by several causes such as lack of awareness of disease, access to healthcare, and tolerance to symptoms. Remarkable efforts in medicine have been made to better treat patients with this condition in the past few years, with the introduction of combination therapy in treatment-naive patients, which has changed the guidelines for treatment of PAH. Furthermore, recent clinical trials have shown promissory results with initiation of dual or even triple therapy instead of a step up approach in therapeutics. However, the majority of these therapies are indicated for PAH and PH related to connective tissue disease and come with a high financial burden to patients, especially minority patients such as Hispanics.
Life Expectancy and COVID-19 in Relation to Systemic Endotheliopathy (Systemic Endotheliopathy after COVID-19 as Life Expectancy Indicator: Development, Risk Factors, Prevention)
Authors: Kolesnikova Olena , Radchenko Anastasiia
Published: December 2022

Life expectancy is a key indicator for assessing the population health, as it includes an estimate of lifetime mortality rates from various causes. Since 2019, coronavirus disease 2019 (COVID-19) has become the main cause of increased mortality and decreased life expectancy. This is mainly due to unfavorable outcomes of COVID-19 in the acute period. Currently, more and more data is accumulating regarding the negative impact of an incurred COVID-19 on the aging rates and the development of cardiovascular complications, which persists for a long time after the pathogen is eliminated from the body. It is believed that the development of systemic endotheliopathy can be a key mechanism of such long-term outcomes. Despite the widespread distribution of this infection in the population and the large number of cases of prolonged COVID-19 syndrome, the results on the long-term impact of COVID-19 on the development and course of endotheliopathy are scattered and do not provide a comprehensive understanding of risk factors and possible methods of prevention of such endotheliopathies, that could be used for practical needs. Therefore, our review summarized data on the pathogenetic mechanism of development, course features and risk factors of endotheliopathies in relation to COVID-19. We also presented methods of prevention of systemic endotheliopathy in patients with a history of COVID-19 with an emphasis on the dietary component and included our own research results regarding this matter.
A Prospective Evaluation of Clinical Outcomes with Fast Track Protocols for Colorectal Surgery in an Eastern Caribbean Nation
Authors: Griffith Sahle , Cawich Shamir , Doyle Alex , Chase Coutenay , Hefeji Fatima , Whitehead R , Ramkissoon Solange , Padmore Greg
Published: December 2022

Background: Fast track protocols (FTPs) have triggered considerable improvements in patients’ perioperative care and are accepted as the standardised approach to patient management in developed countries globally. Although the benefits of FTPs have been illustrated for some time, they are not universally used in developing countries. In the Eastern Caribbean, FTPs are implemented in an ad-hoc manner based on the attending surgeons. Methods: We designed a comprehensive FTP modified for use in Barbados, an island nation in the Eastern Caribbean. After consensus, the FTPs were introduced into clinical practice at a tertiary referral public hospital. We prospectively evaluated clinical outcomes after introduction of FTP protocols for all patients undergoing colorectal operations from January 1, 2018 to February 1, 2019. The study population was divided into three groups: Group I: full adherence (>16 FTP steps completed), Group II: partial adherence (10-15 FTP steps completed), Group III: non-adherence to FTP protocols (<9 FTP steps observed). In each group, we compared morbidity, mortality, return of bowel function, length of post-operative hospital stay and hospital readmission using SPSS version 20 for statistical analyses.  Results: Over the study period, there were 27 colorectal operations performed. When the outcomes in group 1 and group 3 were compared, there was a statistically significant reduction in post-operative LOS (3 Vs 8.9 days; P<0.05) and overall morbidity (10% vs 50%; P 0.05) in the full FTP adherence groups. Conclusions: In this Caribbean healthcare system, FTP implementation resulted in significant improvements in post-operative duration of hospitalization and overall morbidity. The main challenge is to achieve universal buy-in from health care providers in the Caribbean. We believe that the way to achieve this is continued medical education and targeted research to acquire local practice data from the Caribbean. We advocate the incorporation of FTP into colorectal surgical practice for Caribbean hospitals.
A Contemporary Assessment of Osteosarcoma: Lessons from a Comparative Approach
Authors: Sarver Aaron , Makielski Kelly , Modiano Jaime
Published: December 2022

This review will describe more than two decades of comparative research on primary bone cancer (osteosarcoma). Osteosarcoma is a chaotic disease present in a complex and variable microenvironment composed of many different cell types which interact with each other and lead to high transcriptional heterogeneity. Despite this heterogeneity, common transcriptional patterns can be observed in the bulk transcriptomes of these tumors; additionally, these patterns are associated with outcome, indicating their importance to the molecular biology of the disease. Work from our group and others has led to our current understanding of osteosarcoma as a disease where multiple pathological processes appear to converge into a limited array of tissue organizations with distinct biology. Recurrent as well as distinct events can lead to these states of tissue organization, explaining the heterogeneity of osteosarcoma that is observed among and within species. Yet, despite their chaotic genomes, osteosarcomas seem to be (relatively) genetically stable, with persistent maintenance of essentially the same chromothriptic karyotype throughout the developmental lifetime of the tumor. Importantly, the transcriptional variance between tumors can highlight the underlying biology of the malignant cells themselves, as well as the composition of the osteosarcoma microenvironment and the host response, both of which are prognostically significant for this disease. Initial single cell RNA-seq reports provide further evidence of the importance of the osteosarcoma microenvironment for tumor characterization. Our data suggest that improving patient outcomes in immunologically barren or “cold” osteosarcomas, necessitates generating immune permissive or “warmer” microenvironments within the tumor. Furthermore, the aging bone microenvironment may create specific niches that predispose to cancer, and identification of the drivers that lead to these variable transcriptional patterns will be essential to identify personalized, effective genomic therapy for osteosarcoma.
Tetramethylpyrazine Stalls Lesional Progression via Inducing Senescence in Mouse with Induced Deep Endometriosis
Authors: Luo Min , Cai Xianjun , Liu Xishi , Yan Dingmin , Guo Sun-Wei
Published: December 2022

So far, the pressing need for the development of non-hormonal therapeutics for endometriosis has been unfulfilled. In light of the evidence that platelets play important roles in the development of endometriosis and that tetramethylpyrazine has therapeutic potential, we tested the hypothesis that tetramethylpyrazine can induce cellular senescence in endometriotic lesions, hindering fibrogenesis in mice with induced deep endometriosis and that the combined use of tetramethylpyrazine and sodium tanshinone IIA sulfonate may have a synergistic effect. We induced deep endometriosis in 32 female Balb/C mice, and then randomly divided mice into equal-sized four groups: low- and high-dose tetramethylpyrazine, low-dose tetramethylpyrazine plus low-dose tanshinone IIA sulfonate and inert vehicle control. After two weeks of treatment, their lesion tissues were removed and procured. All lesions were weighed, and lesion fibrosis was quantitated by Masson trichrome staining. In addition, cellular senescence in lesions was evaluated by senescence-associated β-galactosidase, along with immunohistochemistry analyses of p53, Salvador 1, cellular communication network factor 1, hyaluronan synthase 2, surviving and granulocyte-macrophage colony stimulating factor and other markers. We found that tetramethylpyrazine treatment significantly decreased lesion weight, arrested lesional progression and ameliorated pain behaviour ostensibly via inducing senescence by p53 activation, and induction of Salvador 1 and cellular communication network factor 1 while suppressing hyaluronan synthase 2, survivin and granulocyte-macrophage colony stimulating factor, resulting in increased apoptosis and reduced lesional infiltration of alternatively activated macrophages. Tetramethylpyrazine treatment also significantly reduced the plasma concentration of P-selectin and hyaluronic acid, possibly leading to reduced lesional platelet aggregation. Thus, we conclude that tetramethylpyrazine holds the promise as therapeutics for treating endometriosis, but the tetramethylpyrazine plus tanshinone IIA sulfonate did not further enhance the therapeutic effect. These results further underscore the notion that induced senescence may play an antifibrotic role in endometriosis, and activating the senescence pathway, through treatment with tetramethylpyrazine or other similar drugs, may be a novel avenue for treating endometriosis.
Colorectal Cancer Screening: Are we Missing an Opportunity in Trinidad & Tobago?
Authors: Cawich Shamir , Wharfe Gillian , Nimrod Marissa , Muddeen Alyssa , Mike Kellie , Ramesh Sashtri , Barrow Mikhail , Barrow Shaheeba
Published: December 2022

Objectives: Opportunistic (ad-hoc) screening for colorectal cancer is practiced in Trinidad & Tobago, but there is no data on the outcomes of opportunistic screening. We carried out this study to determine the proportion of persons with colorectal ancer who were screen-detected.  Methods: We retrospectively audited the records of all patients who underwent colectomies for colorectal cancer at a public hospital over a 10-year period from January 1, 2012 to January 30, 2022. We compared American Joint Committee on Cancer stage based on method of diagnosis (screening vs symptomatic). Descriptive statistical analyses were generated using SPSS version 21.0. Results: We analyzed 340 patients with colorectal cancer at a mean age of 63.3 years (SD +/- 13.4). There were 52 (15.3%) patients who had diagnoses made at screening and 283 (84.7%) had investigations after developing symptoms. Significantly more screen-detected lesions were early-stage colorectal cancer (73.1% vs 25%; P <0.001). Table 1 compares the cancer stage in both patient groups. Conclusions: Although significantly more patients with colorectal cancer are diagnosed at early stages by screening, the incidence screen-detected disease in Trinidad & Tobago is low. Most patients present with locally advanced (52%) or metastatic (15%) disease, when the opportunity for curative treatment is reduced. The time has come for policy makers to develop and institute a national screening programme for colorectal cancer in Trinidad & Tobago.
Alternative Ways to Improve Asthma Control in Obese Patients
Authors: Lahoda Daria
Published: December 2022

Diseases of the respiratory tract occupy one of the leading places among pathologies in people of working age in the world. According to the data of world studies, it can be considered that these two comorbidities are mutually aggravating, but scientists do not have a unanimous opinion about whether this is a simple coincidence or whether these pathologies are pathogenetically related. There is considerable evidence that asthma patients do not achieve adequate asthma control worldwide. Yes, according to Maria Sandra Magnoni et al. 77.8% of patients with asthma have an uncontrolled course of asthma, although 68.4% of them believe that they have sufficient asthma control, and their treatment does not require correction. Therefore, taking into account all of the above and taking into account the low level of asthma control in patients with comorbid pathology who often suffer from bacterial and viral diseases, we believe that a more detailed study of the immunological status of these individuals is necessary in order to optimize treatment and prevention measures. Aim: to investigate the effectiveness of alternative ways of asthma control in patients with bronchial asthma against the background of overweight or obesity. Materials and methods. At the I stage, 255 patients with BA were examined. According to the study design, patients were selected according to the "inclusion/exclusion" criteria at this stage. The study was randomized. Allocation of patients into groups was carried out by the method of simple randomization with elements of stratification. Groups are statistically significant. Statistical processing of the results was carried out using parametric and non-parametric analysis methods. Resalts. Overweight or obese patients had a more severe course of bronchial asthma than patients with a normal body mass index. Overweight or obese patients were found to have higher levels of systemic inflammation, namely eosinophilic cationic protein levels and erythrocyte sedimentation rate, than patients with a normal body mass index. In addition, a close direct correlation was established between the severity of the course of bronchial asthma and indicators of eosinophil cationic protein (r=0.97; p˂0.001). After pharmacological correction, there was an increase in asthma control in patients with different severity of the course (р˂0.001; p˂0.001; p˂0.001, respectively), a decrease in the frequency of exacerbations (p˂0.05), a reduction in the number of hospitalizations (p˂0, 05) and the number of acute respiratory diseases (p˂0.05) in patients with bronchial asthma against the background of excess body weight or obesity. The use of the developed treatment-prophylactic complex using the drug bacterial lysate and inosine pranobex together with training in the Asthma School and standard treatment contributes to increasing asthma control and compliance with the doctor, reducing the number of exacerbations and hospitalizations per year in patients with bronchial asthma against the background overweight or obesity.
Clinical Tier Grading of Cancer Stem Cells According to Clinical Characteristics for Immune Checkpoint Inhibitors Guided by mRNA stemness index
Authors: Hays Priya
Published: December 2022

Cancer stems cells are cells in tumors that have self-renewing capabilities and proliferation, and are partly responsible for tumor growth, metastasis and drug resistance, and have been associated with multidrug resistance and epithelial-mesenchymal transition. mRNA stemness index or mRNAsi is a machine learning tool that uses the application of algorithms to find associations between cancer stemness and tumor prognostic signatures. mRNAsi predicts gene mutation status and identifies tumor signaling pathways. Clinical tier grading is a common feature for stratifying the presenting features and symptoms of patients in several diseases. This study is a review article that summarizes studies in lung cancer, gastric cancer, hepatocellular carcinoma and glioblastoma that use mRNA stemness index machine learning tools to identify differentially expressed genes, characterize the tumor microenvironment and tumor mutational burden, and determine clinical endpoints. A prognostic signature is shown in this paper as determined by mRNAsi high and low values, and a clinical tier grading system is proposed that categorizes cancer stemness presenting characteristics. This clinical grading tier system demonstrates a relationship between cancer stemness and immune checkpoint inhibitor efficacy. This type of tiered system for cancer patients and the accompanying workflow proposed may prove useful to oncologists, and has not been performed before, and is unique in the literature.