bluuebunny/crossref_metadata_2025 huggingface dataset:
Ultrasound Assessment of Entheses and Correlations Between Disease Activity and Ultrasound Scores in Ankylosing Spondylitis: A Cross Sectional Study
Authors: XIE HAIQIN , ZHOU GENGMIN , WEN BO , LUO HAIYU , ZHANG YUSEN , DONG QIAN , ZHONG JIANQIU , LV JIYANG , ZHANG WEIWEI , LV HENG , SUN DESHENG , Wang Qingwen , LI LIU
Published: October 2020

Background: An increasing number of studies have applied ultrasound (US) to evaluate enthesitis in spondyloarthritis. However, there is no clear agreement on which sites should be evaluated for enthesitis. Furthermore, there are different opinions on whether US can monitor disease activity. The objectives of this study were to evaluate the common involvement of entheses and correlations between disease activity and US scores in ankylosing spondylitis (AS).Methods: A cross-sectional, monocentric, and controlled study was performed. US was used to scan 34 entheses per person and the Madrid sonography enthesitis index (MASEI) score was used. US scores were used to evaluate the elemental lesions of hypoechogenicity, thickness, erosion, calcification, bursitis, and Doppler signal. Disease activity was assessed by Disease Activity Score–C reactive protein (ASDAS-CRP) and Bath Ankylosing Spondylitis Disease Activity Index (BASDAI).Results: 104 patients with AS and 50 control subjects were included. A total of 5236 entheses were assessed. Compared with the control subjects, only three entheses – the Achilles tendon (AT), sternoclavicular joint (SCJ), and costochondral joint (CCJ) – showed significant differences in the AS group (p < 0.05). Patients with high disease activity (ASDAS-CRP ≥ 2.1) had higher scores than patients with low activity (ASDAS-CRP < 2.1) in erosion (p = 0.02). Patients who were categorized in very high disease activity (ASDAS-CRP ≥ 3.5) had a higher score in erosion (p = 0.02). The erosion score was moderately associated with ASDAS-CRP and BASDAI (r = 0.44, r = 0.21).Conclusions: The commonly involved entheses were the AT, SCJ, and CCJ in AS. Erosion occurred more often in patients with disease activity or high activity. Erosion would be more useful for monitoring disease activity in AS.
Vancomycin resistant enterococci gut Colonization and its associated factors among HIV infected patients on anti-Retro viral therapy in Ethiopia
Authors: Regasa Belayneh , Solomon Zerihun , Tesfaye Mheret
Published: October 2020

BackgroundThe emergence of vancomycin resistant Enterococci (VRE) has alarmed the global infectious diseases community due to its tendency for colonization of the gastrointestinal tract. Human Immunodeficiency Virus (HIV) patients are colonized by vancomycin resistant Enterococci than other groups. The aim of this study was to determine the prevalence of vancomycin resistant Enterococci gut colonization and its associated factors among HIV infected patients on Anti-Retroviral Therapy (ART).MethodsInstitution based cross sectional study was conducted among HIV infected patients on ART at from June 1 to August 30, 2020. Socio-demographic and clinical data were collected by pre-tested structured questionnaire. Stool sample was collected and processed by standard microbiological techniques. Kirby Bauer Disc diffusion method was used to perform antimicrobial susceptibility testing. Data were entered by Epi data version 4.6.0.2 and analyzed by SPSS version 25. P-value <0.05 was considered as significant.ResultsAmong a total of 200 study participants, colonization of Enterococci spp was isolated on 123 (61.50%) respondents. Among these isolates, the prevalence of vancomycin resistant Enterococci colonization was 11.4% [95% CI: (6.0-17.0)]. Enterococci isolates tested against commonly prescribed antibiotics showed highest rate of resistance to ampicillin (69.9%). Multidrug resistances were observed in 49.59% of Enterococci isolates. Study participants who had prior antibiotic exposure for more than two weeks [AOR=7.35; 95% CI: (1.2144.64)] and hospitalization in the last six months [AOR=5.68; 95% CI: (1.09 29.74)] were significantly associated with vancomycin resistant Enterococci gut colonization.ConclusionHigh prevalence of vancomycin resistant Enterococci gut colonization was found. Previous exposure to antibiotics for more than two weeks and previous hospitalization for more than six months were significant factors for vancomycin resistant Enterococci colonization. The isolated Enterococci had variable degrees of resistance to commonly prescribed antibiotics. Therefore, periodic surveillance on antimicrobial resistance pattern, adhering to rational use of antibiotics and implementing infection prevention protocols may reduce colonization by VRE.
SARS-CoV-2 Identification in Saliva: Are We Interpreting the Results Correctly?
Authors: Ramirez-Hinojosa Juan Pablo , Rodriguez-Sanchez Yunuen , Romero-Gonzalez Angel Kaleb , Chavez-Gutierrez Marisol , Gonzalez-Arenas Nelly Raquel , Ibarra-Arce Aurora , Arroyo-Escalante Sara , Zavaleta-Villa Beatriz , Monteros-Perez Luz Elena Espinosa de los , Olivo-Diaz Angelica , Hernandez-Castro Rigoberto , Suarez-Roa Lourdes , Prado-Calleros Hector , Sierra-Martinez Octavio , Avila-Ramirez Guillermina , Flisser Ana , Maravilla Pablo , Romero-Valdovinos Mirza
Published: October 2020

BackgroundIn the present study, we obtained cycle threshold (Ct) values by qRT-PCR and compared them with clinical and laboratory data from saliva specimens of inpatients with COVID-19 and asymptomatic health workers (AHW).MethodsSaliva specimens from inpatients with COVID-19 and AHW were studied by qRT-PCR using three sets of primers for the N (N1, N2, and N3) gene of SARS-CoV-2. The Ct values obtained were compared with the clinical and laboratory data.ResultsData from 58 inpatients (37 critically ill patients and 21 patients with severe disease) and 105 AHW were analysed. In our system, the limit of viral detection corresponded to a Ct =46.5; therefore, our analysis focused on comparing the positivity rate obtained when using Ct <40 as the cut-off with that obtained using Ct <46 as the cut-off. The positivity rate was increased when the Ct cut-off of 46 was used as the criterion, yielding a sensitivity of 87.9% for patients and a sensitivity of 43% for AHW. The bivariate analysis revealed an association between Ct <40 for N2 and mechanical ventilation assistance among patients (p=0.013). In addition, the serological values of alanine transaminase (ALT), aspartate-transaminase (AST), lactate dehydrogenase (LDH), ferritin and creatine kinase–MB (CK-MB) showed significant correlations with the Ct values of N1 and N3.ConclusionDue to the intrinsic characteristics of the qRT-PCR process, obtaining amplification curves implies the presence of an active viral replication process, while Ct values may correlate with some clinical data. Our results support the claim that physicians should be informed of the Ct values obtained during the amplification of viral markers, as well as the Ct values that correspond to the limit of detection for viral RNA, which vary according to the characteristics of each system and amplification protocol used.
Development and Validation of an Immune Microenvironment Based Prognostic Signature and Signal Pathways in Prostate Cancer
Authors: Zhao Qi , Cheng Yingying , Ren Yujie , Li Xianfa , Xiong Ying
Published: October 2020

Background: The study of the PCa immune microenvironment has brought new opportunities for the clinical diagnosis and treatment of PCa, but the current study has failed to obtain satisfactory results. We aim to develop a generalized, individualized immune prognostic signature that can improve the survival rate of patients.Methods: We collected a total of 591 sample data from the TCGA and GEO cohorts, and evaluated the abundance and distribution of immune cell members in the mixed cell population in the gene expression matrix by CIBERSORT, ESTIMATE, ssGSEA, and other methods. Calculate the TMB value of the mutant gene to evaluate the reliability of PCa for immunotherapy. Besides, the genes related to the immune microenvironment and mutation load of PCa are obtained, and the target genes are obtained by the intersection with the immune-related genes in the ImmPort database. And perform pan-cancer analysis of the target gene to evaluate the immunological commonality and biological pathways in a variety of cancers. Finally, a Western blot experiment was used to explore the mechanism of the target gene in PCa immune microenvironment.Results: We found that M0, M2, and Mast cell sresting differed significantly between prostate cancer and normal tissue and that patients with low plasma cell abundance were more likely to develop lymph node metastasis. LTF, as a core gene, is closely related to changes in the immune microenvironment of PCa, and its low expression in tumors promotes primary immune deficiency, cancer development, and enrichment in the JAK/STAT signaling pathway. Cell experiments found that LTF overexpression reduces tumor-derived GM-CSF secretion by inhibiting JAK/STAT pathway, achieving the purpose of regulating tumor immune microenvironment and inhibiting PCa cell proliferation and migration.Conclusions: The proposed clinical-immune signature and core gene is the most promising biomarkers for improving the overall survival rate of PCa. It has been verified that overexpression of LTF reduces the secretion of tumor-derived GM-CSF by inhibiting the JAK/STAT pathway.
Methylprednisolone Protects SAP and Pancreatitis-Associated ALI in Mice by Inhibiting NLRP3 Inflammasome Through NF-κB
Authors: Liu Chuan-jiang , Fu Qiang , Zhou Wenjing , Zhang Xu , Chen Rui , Zhai Zhen-sheng , Wang Yu-zhu , Qin Tao , Zhang Hongwei
Published: October 2020

Background: Methylprednisolone (MP) is a synthetic corticosteroid with potent anti-inflammatory and antioxidant properties used as therapy for a variety of diseases. The underlying mechanism of MP to reduce acute pancreatitis still needs to be elucidated.Methods: Twenty-four male C57BL/6 mice (6-8 weeks) were used to establish SAP mouse model by administering an intraperitoneal injection of Cae and LPS. Amylase expression levels of serum and PLF were measured with an amylase assay kit. The concentrations of IL-1β and TNF-α in the serum and PLF were detected by ELISA. The level of pancreatic and lung tissue damage and inflammation was assessed by H&E staining and immunofluorescence staining. Western blot and qPCR were used to detect the expression levels of NLRP3, IL-1β and TNF-αin vivo and in vitro.Results: In this study, we found MP, used in the early phase of SAP, decreased the levels of IL-1β and TNF-α in serum and peritoneal lavage fluids (PLF), reduced the level of serum amylase and the expression of MPO in lung tissue, attenuated the pathological injury of the pancreas and lungs in a dose-dependent manner. The expression of NLRP3 and IL-1β in pancreas and lungs was down-regulated significantly depending on the MP concentration. In vitro, MP reduced the levels of IL-1β and TNF-α by down-regulating the expression of NLRP3, IL-1β and p-NF-κB in isolated peritoneal macrophages. Conclusion: MP can attenuate the injury of pancreas and lungs, and the inflammatory response in SAP mice by down-regulating the activation of NF-κB and the NLRP3 inflammasome.
Accounting for Context: Using Qualitative Methods to Model the Effects of Adaptations to Family Planning Services During COVID-19
Authors: Hamon Jessie K. , Hoyt Jenna , Krishnaratne Shari , Kambanje Misozi , Demissie Shiferaw Dechasa , Ariko Angela Barbra , Mbembe Miriam , Moseti Easterlina , Gnintoungbe Marius , Curry Dora , Webster Jayne
Published: October 2020

Background – During the first six months of the global response to Coronavirus Disease-2019 (COVID-19), multiple service delivery adaptations were suggested to maintain access to modern contraceptive methods (MCMs) and family planning (FP) services. Though these adaptations may help maintain services during COVID-19, they may also trigger mechanisms capable of fundamentally shifting MCM use and community perceptions of FP long after routine services are restored if they fail to take into account the contexts in which they are implemented. This study aimed to model the context-specific effects of suggested adaptations to FP service delivery. Methods – A multi-step approach to modelling using qualitative methods was employed. Methods involved a targeted review of relevant literature on adaptations to FP service delivery, the development of context categories using empirical findings from five countries, and the construction of a model based on realist concepts to predict the mechanisms and outcomes likely to be triggered by adaptations to FP service delivery in specific contexts. Results – Eleven key adaptations to FP service delivery were identified, and 19 mechanisms and their associated outcomes were predicted. The model revealed 8 negative and 11 positive effects of suggested adaptations when implemented in contexts where women’s decisions around MCM use are influenced by: 1) stigma surrounding FP; 2) male control of reproductive decisions; 3) covert use of MCMs; 4) fear of MCM side effects; and 5) concerns about long-acting reversible contraceptives. These effects were predicted to drive changes in MCM use, community perceptions of FP, and women’s trust in health services. The model also demonstrated that suggested adaptations are likely to have important long-term effects and result in changes to the prevailing contexts.Conclusions – Though adaptations to FP service delivery are needed in response to COVID-19, the contexts in which these are implemented should be carefully considered by national and sub-national decision-makers to minimise unwanted outcomes. The model constructed in this study can be leveraged as a theorising tool to facilitate this process in different settings.
Experimental and theoretical insights into the effects of pH on catalysis of bond-cleavage by the lignin peroxidase isozyme H8 from Phanerochaete chrysosporium
Authors: Pham Le Thanh Mai , Deng Kai , Northen Trent R , Singer Steven W , Adams Paul D , Simmons Blake A , Sale Kenneth L
Published: October 2020

Background: Lignin peroxidases catalyze a variety of reactions, including cleavage of both β-aryl ether bonds and C–C bonds in lignin, both of which are essential for depolymerizing lignin into fragments amendable to biological or chemical upgrading to valuable products. Studies of the specificity of lignin peroxidases to catalyze these various reactions and the role reaction conditions such as pH play have been limited by the lack of assays that allow quantification of specific bond-breaking events. The subsequent theoretical understanding of the underlying mechanisms by which pH modulates the activity of lignin peroxidases remains nascent. Here, we report on combined experimental and theoretical studies of the effect of pH on the enzyme-catalyzed cleavage of β-aryl ether bonds and of C–C bonds by a lignin peroxidase isozyme H8 from Phanerochaete chrysosporium and an acid stabilized variant of the same enzyme. Results: Using a nanostructure initiator mass spectrometry assay that provides quantification of bond cleavages in a phenolic model lignin dimer we found that degradation of the lignin dimer was greatly enhanced at lower pH, and the acid-stable lignin peroxidase isozyme H8 increased the degradation of the lignin dimer to products from 38.4 % at pH 5 to 92.5% at pH 2.6. At pH 2.6, the observed product distribution resulted from 65.5% b -aryl ether bond cleavage, 27.0% C a -aryl carbon bond cleavage and 3.6% C a -oxidation as by-product . Using ab initio molecular dynamic simulations and climbing-image Nudge Elastic Band based transition state searches, we suggest the effect of lower pH is via hydration of hydronium cation on aliphatic and phenolic hydroxyl groups under, which extremely acidic conditions resulted in lower energetic barriers for bond-cleavages, especially β-ether bonds. Conclusion: These coupled experimental results and theoretical explanations suggest pH is a key driving force for selective and efficient lignin peroxidase isozyme H8 catalyzed depolymerization of lignin and further suggest that lignin peroxidase isozyme H8 engineering efforts include targeting stability at low pH.
Clinical and Economic Consequences of Switching From Omalizumab to Mepolizumab in Uncontrolled Severe Eosinophilic Asthma: an Observational Retrospective Study
Authors: Carpagnano Giovanna Elisiana , Resta Emanuela , Povero Massimiliano , Pelaia Corrado , D'Amato Mariella , Crimi Nunzio , Scichilone Nicola , Scioscia Giulia , Resta Onofrio , Calabrese Cecilia , Pelaia Girolamo , Barbero Maria Pia Foschino
Published: October 2020

Background: Severe asthma is burdened by frequent exacerbations and use of oral corticosteroids, which worsen patients’ health and increase healthcare spending. The aim of this study was to assess the clinical and economic impact of switching from omalizumab to mepolizumab in patients eligible for both biologics, but not optimally controlled by omalizumab.Methods: We retrospectively enrolled uncontrolled severe asthmatic patients, referred to seven asthma clinics in Italy, who switched from omalizumab to mepolizumab during the last two years. Clinical, functional, and laboratory information included blood eosinophil count, asthma control test, spirometry, serum IgE, fractional exhaled nitric oxide, oral corticosteroids intake, use of controller and rescue drugs, exacerbations/hospitalizations, visits and diagnostic exams. Within the perspective of Italian National Health System, a pre- and post-mepolizumab 12-month standardized total cost per patient was calculated.Results: 33 patients were enrolled: 5 males and 28 females, mean age 57 years, mean disease onset 24 years. At omalizumab discontinuation, 88% were oral corticosteroids-dependent with annual mean rate of 4.0 clinically significant exacerbations, 0.30 exacerbations needing emergency room visits or hospitalization; absenteeism due to disease was 10.4 days per patient. Switch to mepolizumab improved all clinical outcomes, reducing total exacerbation rate (RR = 0.06, 95% CI 0.03 to 0.14), oral corticosteroids -dependent patients (OR = 0.02, 95% CI 0.005 to 0.08), and the number of lost working days because of uncontrolled disease (Δ = -7.9, 95% CI -11.2 to -4.6). Pulmonary function improved, as well as serum IgE, fractional exhaled nitric oxide and eosinophils decreased. Mean annual costs were € 12,239 for omalizumab and € 12,639 for mepolizumab (Δ = € 400, 95% CI -1,588 to 2,389); the increment due to drug therapy (+ € 1,581) was almost offset by savings regarding all other cost items (- € 1,181). Conclusions: Patients with severe eosinophilic asthma, not controlled by omalizumab, experienced comprehensive benefits in asthma control by switching to mepolizumab. These relevant improvements were burdened by only very slight increases in economic costs.
Development and testing of a composite index to monitor the continuum of maternal health service delivery at provincial and district level in South Africa
Authors: Mothupi Mamothena Carol , Man Jeroen De , Tabana Hanani , Knight Lucia
Published: October 2020

Introduction: The continuum of care is a recommended framework for comprehensive health service delivery for maternal health, and it integrates health system and social determinants of health. There is a current lack of knowledge on a measurement approach to monitor performance on the framework. In this study we aim to develop and test a composite index for assessing the maternal health continuum in South Africa. Materials and Methods: The composite index was computed as a geometric mean of four dimensions of adequacy of the continuum of care. Data was sourced from the district health information system, household surveys and the census. The index formula was tested for robustness when alternative inputs for indicators and standardization methods were used. The index was used to assess performance in service delivery in the North West province of South Africa, as well as its four districts over a five-year period (2013-2017). The index was validated by assessing associations with maternal health and other outcomes. And factor analysis was used to assess the statistical dimensions of the index. Results: The provincial level index score increased from 62.3 in 2013 to 74 in 2017, showing general improvement in service delivery over time. The district level scores also improved over time, and our analysis identified areas for performance improvement. These include social determinants of health in some districts, and access and linkages to care in others. The provincial index was correlated with institutional maternal mortality rates (rs=-0.90, 90% CI = (-1.00, -0.25)) and the Human Development Index (r=0.97, 95% CI = (0.63, 0.99). It was robust to alternative approaches including z-score standardization of indicators. Factor analysis showed three groupings of indicators for the health system and social determinants of health. Conclusions: This study demonstrated the development and testing of a composite index to monitor and assess service delivery on the continuum of care for maternal health. The index was shown to be robust and valid, and identified potential areas for service improvement. A contextualised version can be tested in other settings within and outside of South Africa.
Development of high sensitive real-time PCR to detect mustard and other allergens of the family Brassicaceae in food samples
Authors: Kurbakov K. A. , Zhulinkova V. N. , Minaev M. Yu.
Published: October 2020

Mustard is a commonly used condiment including in production of other food products. As mustard is an allergen, it is necessary to control its presence. The development of PCR test-systems for its detection is complicated by the fact that this condiment can be made from seeds of various plant species (Brassica juncea, Brassica nigra, Sinapis alba) of the family Brassicaceae that are not closely related. This family includes other plant species such as white cabbage (Brassica oleracea) and rapeseed (Brassica napus), which can cause the allergic reaction, although seldom. In this connection, many authors use primers specific to many species of this family, including to allergens, to detect mustard. In this work, we used the similar strategy. To increase sensitivity, primers for the mitochondrial COX gene were selected. To increase PCR stability in analysis of deeply processed products, primers were selected for a region with a length of 61 base pair. In the work, the specificity and sensitivity of the developed PCR method was confirmed. Analyses of different products, including those that underwent deep technological processing, were carried out with these primers. Also, primers were selected to detect white mustard (S. alba). When analyzing products on the presence of white mustard, charac‑ teristic regional preferences were demonstrated: this species is used in manufacturing products mainly in the UK and USA.
Moralna odgovornost i znanstvena slika svijeta
Authors: Mijić Jelena
Published: October 2020

Predmet su rada rasprave o odnosu determinizma i slobode volje (tj. problem kompatibilnosti), odnosno implikacije koje imaju po moralnu odgovornost. Problemu se pristupa iz naturalističke perspektive iako se ne nudi odgovor na pitanje istine kauzalnog determinizma. Međutim, s ciljem da se ispita perspektiva za moralnu odgovornost, pretpostavlja se da je kauzalni determinizam potkrijepljen znanošću. Razmatra se pojam kauzalnog determinizma, a potom se ispituju izazovi koje argument konzekvenci postavlja pred slobodu volje shvaćenu kao mogućnost da se učini drugačije. Cilj je rada pokazati da su u osnovi svakodnevne upotrebe pojma moralne odgovornosti slabiji uvjeti od slobode shvaćene kao mogućnosti da se učini drugačije. Na tim temeljima branimo zaključak da je moralna odgovornost kompatibilna s kauzalnim determinizmom.
Ljudska priroda ili ljudske prirode
Authors: Finci Predrag
Published: October 2020

Može li ljudska priroda biti definirana? Autor se zalaže za opisivanje ljudske prirode, u čemu vidi mogućnost ukazivanja na njena bitna svojstva i svu različitost, ali i istost. Već samo postavljanje pitanja o ljudskoj prirodi govori o nužnosti filozofskog promišljanja svega što pripada i može pripadati ljudskom biću. Zato je pitanje o ljudskoj prirodi trajno otvoreno pitanje.
Marine Natural Products as a Source of Drug Leads against Respiratory Viruses: Structural and Bioactive Diversity
Authors: Sun Tian-Tian , Zhu Hua-Jie , Cao Fei
Published: October 2020

Respiratory viruses, including influenza virus, respiratory syncytial virus, coronavirus,
etc., have seriously threatened the human health. For example, the outbreak of severe
acute respiratory syndrome coronavirus, SARS, affected a large number of countries
around the world. Marine organisms, which could produce secondary metabolites with
novel structures and abundant biological activities, are an important source for seeking effective
drugs against respiratory viruses. This report reviews marine natural products
with activities against respiratory viruses, the emphasis of which was put on structures
and antiviral activities of these natural products. This review has described 167 marinederived
secondary metabolites with activities against respiratory viruses published from
1981 to 2019. Altogether 102 references are cited in this review article.
Prevalence, Incidence, Risk and Protective Factors of Amnestic Mild Cognitive Impairment in the Elderly in Shanghai
Authors: Wang Tao , Xiao Shifu , Chen Kewei , Yang Cece , Dong Shuhui , Cheng Yan , Li Xia , Wang Jinghua , Zhu Minjie , Yang Fuzhong , Li Guanjun , Su Ning , Liu Yuanyuan , Dai Jing , Zhang Mingyuan
Published: October 2020

Background:

Amnestic MCI (aMCI) has notably increased in Shanghai, China.

Objective:

The study was designed to estimate the prevalence and incidence rates of aMCI and to determine
the risk and protective factors for aMCI among persons ≥ 60 years-old and ≥ 70 years-old in Shanghai communities,
respectively.

Method:

We carried out this 1-year longitudinal study to survey a random sample of 1,302 individuals ≥ 60
years-old, to collect baseline and follow-up data about lifestyle through self-reports, and vascular and comorbid
conditions from medical records and a physical examination. We also analyzed a subgroup of individuals ≥
70 years-old.

Results:

The prevalence rate of aMCI in persons ≥ 60 years-old was 22.3%, and the incidence rate (per 1,000
person-years) was 96.9. Being female was a risk factor for aMCI; protective factors included smoking, drinking
tea, engaging in intellectual work before retirement, social activities and hobbies, regular reading habits,
and surfing the internet. The prevalence rate of aMCI in persons ≥ 70 years was 30.3%, and the incidence rate
was 145.6. Smoking, drinking tea, and surfing the internet were not protective factors for this age group (≥ 70
years).

Conclusion:

The present study indicates that aMCI is a considerable health problem in Shanghai. Preventive
strategies for aMCI are needed to enhance lifestyle factors that promote brain activity.
Plants as a Promising Reservoir of Tyrosinase Inhibitors
Authors: Riaz Rabia , Batool Salma , Zucca Paolo , Rescigno Antonio , Peddio Stefania , Saleem Rahman Shah Zaib
Published: October 2020

The process of melanogenesis that takes place in the melanocytes of the epidermis, leads to
hyperpigmentation. The biosynthetic pathway for the production of melanin involves the enzyme tyrosinase
that has been an attractive target for cosmaceutical research. Numerous synthetic, semisynthetic
and natural, especially plant-based, inhibitors of tyrosinase have been reported in the literature. In
plants, the secondary metabolites like flavonoids, chalcones, stilbenes, tannins, hydroquinone and kojic
acid, etc., have been shown to possess anti-tyrosinase activity. In the current review, we have covered
the progress in this sphere that would be useful for not only further mechanistic investigations but also
for the optimization of the structure of the metabolites for improved activity and selectivity. Thus, the
review presents a comprehensive report on tyrosinase inhibitors of plant origin reported in the extract
form or as isolated compounds. A huge gap has been found between research and industry due to inconsistent
pursual of potent plant-based extracts. There is a need to completely evaluate the extracts for
structure optimization using molecular docking and evaluation of the safety in order to benefit the industry
with non-toxic biological friendly products through in vivo and ex vivo optimization.
Gender Disparity in the Medical Speciality of Obstetrics and Gynecology
Authors: Kaliberdenko Vitalii B. , Kulanthaivel Shanmugaraj , Popova-Petrosyan Elena V. , Kosolapova Natalya V. , Balasundaram Keerthanaa
Published: October 2020

Background::

The actual question on the health care system all over the world is gender inequity in some
specialties. In spite of different influencing factors for choosing their specialty by medical students and residents, the
recent research studies show that gender is significantly influencing on their specialty. Especially gender disparity or
inequity is mostly seen in the field of Obstetrics and gynecology.

Aim :

The purpose of our study is to understand the actual problems for male specialists in the field of
obstetrics and gynecology in health care system and to understand how it affects the nation’s health care system and to
analyze the possible solutions.

Materials and Methods::

The research consists of 815 respondents, which includes medical students, obstetricians and
gynecologists and ObsGyn patients. Average age of the respondents were 20 - 50 years. They were divided into three
groups. Questionnaire consists of 15 different questions for each group of people in different languages.

Results::

The significant difference about the future plan towards choosing of specialty of ObsGyn were less among male
respondents with 4%, whereas female respondents accounts for 69% (P<0.001). The main reason for women to choose
ObsGyn specialty were comfortability on field with 43%. On the other hand, male respondents didn’t choose ObsGyn
specialty because of its less scope for male specialists in this field with 37% and they weren’t sure about the availability of
patients with 51%. There is a direct proportion between patients age and wish to visit the male consultants. And indirect
proportion between patients age and wish to visit the female consultants.

Conclusion::

Less number of male specialists in the obstetrics and gynecology field, doesn’t mean that the male students
and residents have no interests on obstetrics and gynecology, but they are thinking and doubting on employment, patient’s
availability and scope in the field. By including male and female specialists equally in this field we can improve the
quality in preservation of reproductive health, women’s health and significant changes in crude and specific demographic
indices. Making proper awareness and explaining about the current reality could be the best possible solution for this
issue. The interpersonal style and communication skills should be the most important traits in physicians rather than
gender.
Review of Prelabor Rupture of the Membranes: Pathophysiologic Concepts and Novel Therapeutic Strategies
Authors: Ghafoor Saadia
Published: October 2020

Background::

Prelabor rupture of membrane (PROM) refers to the breakage of fetal
membranes before the onset of labor, resulting in the leakage of amniotic fluid. PROM affects approximately
3% and 8% of preterm and term pregnancies, respectively. Because of associated high
maternal and perinatal mortality, correct and timely diagnosis together with effective management
is highly recommended to prevent adverse fetal and maternal outcomes.

Objective::

To provide an overview of the novel concepts in the understanding of PROM including etiology, pathophysiology, risk factors, complications, assessment, diagnostic modalities, and contemporary management strategies for PROM at preterm and term.

Methodology::

This narrative literature review was conducted through a literature search using the Cochrane library and electronic databases including PubMed, Web of Science, Medline, Scopus, Crossref, Google Scholar, Wiley online library, ScienceDirect with specific search terms in scientific publications published from March 1980 to March 2020.

Main Body::

Preterm PROM has the potential to cause prenatal morbidity and mortality. It is imperative
to monitor the signs and symptoms of an impending infection due to the risk of infectious morbidity
with PROM at preterm and preterm. PROM at preterm and term requires prompt diagnosis followed
by an appropriate management strategy.

Conclusion::

The correct and timely diagnosis of PROM is essential for efficacious management. Furthermore, it can reduce avoidable emergent health care visits and related costs in a clinical setting subjected to pregnancy with suspected PROM. Further studies are needed to fill the gaps in identifying better diagnostic predictive tools in high- risk pregnancies.
Clinical Characteristics, Comorbidities, and Prognosis in Patients with Heart Failure with Unknown Ejection Fraction
Authors: Lavine Steven J. , Murtaza Ghulam , Rahman Zia Ur , Kelvas Danielle , Paul Timir K
Published: October 2020

Background:

Heart Failure (HF) is a frequent cause of mortality and recurrent hospitalization. Although HF databases are assembled based on left ventricular (LV) ejection fraction, patients without LV ejection fraction determination are not further analyzed.

Objective:

The purpose of this study is to characterize patient attributes and outcomes in this group-HF with unknown Ejection Fraction (HFunEF).

Methods:

We queried the electronic medical record from a community-based university practice for patients with a HF diagnosis. We included patients with >60 days follow-up and had interpretable Doppler-echocardiograms. We recorded demographic, Doppler-echocardiographic, and outcome variables (up to 2083 days).

Results:

There were 820 patients: 269 with HF with preserved Ejection Fraction (HFpEF), 364 with HF with reduced Ejection Fraction (HFrEF), of which 231 had a LV ejection fraction=40-49% and 133 had a LV ejection fraction<40%, and 187 with HFunEF. As compared to patients with HFunEF, HFpEF patients were younger, had a higher coronary disease and hyperlipidemia prevalence. Patients with HFrEF had more prevalent coronary disease, myocardial infarction, and hyperlipidemia. Patients with HFunEF were more likely to be seen by non-cardiology providers. All-cause mortality (ACM) was greater in HFunEF patients than patients with HFpEF (Hazard Ratio (HR)=1.60 (1.16-2.29), p=0.004). Furthermore, HF readmission rates were lower in HFunEF as compared to HFpEF (HR=0.33 (0.27-0.54), p<0.0001) and HFrEF (HR=0.30 (0.028-0.50), p<0.0001).

Conclusion:

Patients with HFunEF have greater ACM and lower HF re-admission than other HF phenotypes. Adherence to core measures, including LV ejection fraction assessment, may improve outcomes in this cohort of patients.
Resilience, Psychological Characteristics, and Resting-state Brain Cortical Activity in Athletes and Non-athletes
Authors: Cevada Thais , Moreira Alexandre , Vilete Liliane Maria Pereira , Oertel-Knöchel Viola , Deslandes Andrea Camaz
Published: October 2020

Background:

Athletes might build long-term resilience due to their need to adapt constantly to stressful situations. Further, physical activity is a powerful tool for stress-release, and controlling anxiety and depressive symptoms which might induce resilience by enhancing coping skills.

Objective:

This study aimed to compare the resilience, psychological characteristics, and the resting-state brain cortical activity of athletes and non-athletes. The secondary goal was to identify which variables could predict the resilience score.

Methods:

Ninety participants were divided into three groups, athlete (n=30), physically active (n=30) and sedentary (n=30), and asked to fill out the international physical activity questionnaire – short version (IPAQ), the resilience scale, the Beck depression inventory (BDI) and the trait and state anxiety inventory (STAI). Moreover, resting-state brain cortical activity was recorded by using an EEG to compute the standardized low-resolution brain electromagnetic tomography (sLORETA) analyses.

Results:

Significant differences between groups were observed in terms of resilience (X2=8.52; p=0.014) and physical activity level (X 2=76.07; p<0.001), with the athletes presenting higher values. Lower anxiety and depression, and higher physical activity levels were associated with higher resilience scores (R2=0.45; p=0.02). The results of sLORETA showed higher activity for sedentary individuals compared to athletes in frontal areas (Broadmann Area-BA 6, BA 8, BA 9), as well as when compared to physically active individuals in the superior frontal gyrus (BA 9). Additionally, physically active individuals presented less activity than athletes in the inferior occipital gyrus (BA 18).

Conclusion:

The results suggest that the physically active and athlete groups may have built a more resilient profile (compared to sedentary), have similar anxiety and depressive symptoms, and present a divergent resting-state brain cortical activity from the sedentary group, mainly in prefrontal areas. These findings suggest that regular physical activity and sports should be encouraged to aid in enhancing resilience and resting-state brain cortical function, and consequently, improving mental health.
Plant Oil-based Nanoemulsions: Preparation and Efficacy for Hair Treatment
Authors: Rodrigues Lívia Gonçalves Ferreira , Alves de Carvalho Juliana Falcão , dos Santos Cerqueira Pinto Cristal , Santos Elisabete Pereira , Mansur Claudia Regina Elias
Published: October 2020

Background::

The use of polymers in hair care products is widespread, and silicones in particular, are extensively used in cosmetic formulations. In addition, plant oils can also be used for hair treatment.

Objective:

n the present work, oil-in-water (O/W) nanoemulsions were prepared to repair chemical damage to human hair samples, to investigate the combined use of a silicone polyether copolymer (surfactant) that has a branch composed of poly(ethylene oxide) in its chains, and two types of plant oils: coconut and ojon oil.

Materials and Methods::

Surfactant-oil-water formulations were obtained by ultrasonic processing. The nanoemulsions were then applied to human hair strands previously damaged with sodium hydroxide, to compare the treated strands with untreated ones. The efficacy of the formulations was investigated by scanning electron microscopy, thermogravimetric analysis and mechanical tests.

Results and Discussion::

Stables nanoemulsions were obtained with average size of the dispersed droplets up to 400 nm. The micrographs suggest that the action mechanism of the nanoemulsions depends not only on the type of plant oil used and on size of the droplets dispersed in the system, but also on the type of hair that receives the treatment. The thermal analysis showed that the use of nanoemulsion changed the temperature of keratin interconversion to higher values, which can make hair fibers more resistant to heat. Hair resistance was improved when comparing virgin samples to the damaged ones.

Conclusion::

The nanoemulsions were efficient in the treatment of the hair samples, which showed a significant improvement in their mechanical properties.
Hepatoprotective Evidence of Hydroxytyrosol Against Non-Alcoholic Fatty Liver in Animal Models
Authors: Quetglas-Llabrés Maria M. , Reynés-Capó Clara , Monserrat-Mesquida Margalida , Sureda Antoni
Published: October 2020

Background:

Non-alcoholic fatty liver (NAFLD) is a metabolic disorder characterized by an excessive accumulation of fat in hepatocytes. It is a condition directly related to being overweight and is considered as a manifestation of metabolic syndrome. The progressive increase in its incidence due to the global increase in obesity, together with the absence of effective pharmacological treatment, makes it necessary to find new strategies to reduce or reverse its development and progression. In this sense, natural compounds can be potential targets for their remarkable biological activity and low toxicity. Hydroxytyrosol (HT) is a phenolic compound mainly found in olive oil and in olive leaves with antioxidant, anti-inflammatory and cardiovascular properties, among others.

Objective:

This document analyses the available information on the potential beneficial effects of the administration of HT against NAFLD.

Results:

Studies with animal models have shown promising results by reducing the degree of steatosis, oxidative stress, inflammation, and improving liver function. The effects of HT derive from its direct antioxidant and anti-inflammatory activity, but also from regulating the activity of various signalling pathways.

Conclusion:

The consumption of HT, preferably associated with virgin olive oil, combined with an adequate diet and a healthy lifestyle, may be a strategy to consider preventing or reversing liver steatosis. However, well-designed clinical trials are still necessary to determine their real usefulness in human patients.
COVID-19 Pandemic: Care for Indian Cancer Patients
Authors: Kumar Sandeep
Published: October 2020

Background:

Current COVID-19 pandemic poses a significant health crisis caused by SARSCoV-
2 coronavirus around the globe, including India. Patients with cancer, especially those who underwent
treatment, may have a higher risk of getting sicker with COVID-19 disease. Medical care facilities
aim to provide proper treatment to cancer patients while minimizing the possibilities of COVID-19
transmission.

Objective:

The perspective article summarizes practical recommendations and perspective answers to all difficulties so that
we can better treat and care for cancer patients.

Method:

The literature search includes recent publications and guidelines/recommendation of the central institutes of India.

Results:

Social distancing, guidelines, rescheduling the treatment of stable patients, nutritional care and telecommunication
are some of the containment measures that can be applied in clinical practice in cancer management in COVID-19
pandemic.

Conclusion:

With these interventions discussed above, we can reduce the impact of this pandemic and deliver the best care
to cancer patients.
Aspiration Pneumonia and the Traditional Chinese Medicine Banxia Houpu Tang
Authors: Iwasaki Koh ,   Natori Kumanodoh Hospital, Natori, J apan
Published: October 2020

Aspiration pneumonia is one of the most common reasons for death in stroke patients. Recently, a traditional herbal medicine banxia houpu tang is remarked to prevent the aspiration pneumonia. This review tells the history of study of banxia houpu tang for prevent aspiration pneumonia.
Data Object Exchange (DOEx) as a Method to Facilitate Intraorganizational Collaboration by Managed Data Sharing: Viewpoint (Preprint)
Authors: Hauser Ronald G , Bhargava Ankur , Talmage Ronald , Aslan Mihaela , Concato John
Published: October 2020

BACKGROUND

To help reduce expenses, shorten timelines, and improve the quality of final deliverables, the Veterans Health Administration (VA) and other health care systems promote sharing of expertise among informatics user groups. Traditional barriers to time-efficient sharing of expertise include difficulties in finding potential collaborators and availability of a mechanism to share expertise.

OBJECTIVE

We aim to describe how the VA shares expertise among its informatics groups by describing a custom-built tool, the Data Object Exchange (DOEx), along with statistics on its usage.

METHODS

A centrally managed web application was developed in the VA to share informatics expertise using database objects. Visitors to the site can view a catalog of objects published by other informatics user groups. Requests for subscription and publication made through the site are routed to database administrators, who then actualize the resource requests through modifications of database object permissions.

RESULTS

As of April 2019, the DOEx enabled the publication of 707 database objects to 1202 VA subscribers from 758 workgroups. Overall, over 10,000 requests are made each year regarding permissions on these shared database objects, involving diverse information. Common “flavors” of shared data include disease-specific study populations (eg, patients with asthma), common data definitions (eg, hemoglobin laboratory results), and results of complex analyses (eg, models of anticipated resource utilization). Shared database objects also enable construction of community-built data pipelines.

CONCLUSIONS

To increase the efficiency of informatics user groups, a method was developed to facilitate intraorganizational collaboration by managed data sharing. The advantages of this system include (1) reduced duplication of work (thereby reducing expenses and shortening timelines) and (2) higher quality of work based on simplifying the adoption of specialized knowledge among groups.
Statistics decrypted - a comprehensive review for non-mathematicians (Preprint)
Authors: Guglielmetti Laura Chiara , Strange Fabio , Fink Lukas , Vuille-Dit-Bille Raphael N.
Published: October 2020

BACKGROUND

Statistic scripts are often made by mathematicians and cryptic for clinicians or non-mathematician scientists. Nevertheless, almost all research projects necessitate the application of some statistical tests or at least an understanding thereof.

OBJECTIVE

The present review aims on decrypting basic statistics for scientists and clinicians.

METHODS

First, different types of bias are discussed. Then different types of variables and measurements to describe a data set with means of descriptive statistics are introduced.

RESULTS

The basic thoughts and tools of interferential statistics are presented and in the final paragraph the most commonly used statistical tests and the respective applications are described.

CONCLUSIONS

The present article should help scientists to understand the most frequently used statistical expressions and to perform the most commonly used statistical tests independently.