bluuebunny/crossref_metadata_2025 huggingface dataset:
Group hypnosis for stress reduction and improved stress coping: a multicenter randomized controlled trial
Authors: Fisch Silvia , Trivaković-Thiel Suzana , Roll Stephanie , Keller Theresa , Binting Sylvia , Cree Margit , Brinkhaus Benno , Teut Michael
Published: November 2020

Background

The aim of the trial was to investigate the effect of a hypnotherapeutic group program in healthy persons with increased levels of perceived stress.

Methods

In a randomized controlled multicenter trial participants with a self-assessed subjective stress level ≥ 40 mm on a visual analogue scale (0–100 mm; VAS) for the previous week and a stable state of health were randomized to either 5 weekly sessions of 120-min duration of a hypnotherapeutic group program for stress reduction and improved stress coping plus 5 hypnosis audiorecords for individual practice at home plus an educational booklet for stress coping (hypnosis group) versus an educational booklet only (control group). The primary outcome parameter was the VAS stress level for the previous week after 5 weeks. Secondary outcome parameters included the VAS stress level after 12 weeks, perceived stress (CPSS), depression (ADS-K), self efficacy (SWE) and quality of life (SF 36) after 5 weeks and 12 weeks. Analysis of covariance with a significance level of 5% using the full analysis set was used for analysis; the model included treatment (fixed effect), VAS baseline value (fixed covariate), and center (random effect).

Results

A total of 95 participants were randomized; 47 (40 female, 45 ± 13.4 years of age) were allocated to the hypnosis group, and 48 (41 female, 46.9 ± 14.3 years) were allocated to the control group. Regarding VAS stress level after 5 weeks, the adjusted VAS mean in the hypnosis group was 41.8 mm [95% confidence interval (CI): 35.2; 48.4] compared to 62.9 mm [56.2; 69.7] in the control group, and the group difference was − 21.2 mm [− 30.1; − 12.2] (P < 0.001). After 12 weeks, the stress intensity on the VAS showed a between-group difference of − 14.7 mm [− 25.1; − 4.4] (P = 0.006), and the adjusted means were 41.1 mm [33.4; 48.8] in the hypnosis group and 55.9 mm [48.4; 63.5] in the control group. Improvements were also reported for CPSS, SF-36, SWE and ADS-K after 5 and 12 weeks.

Conclusion

Compared to the control group, the hypnosis group showed reduced perceived stress after 5 and 12 weeks.

Trial registration

ClinicalTrials.govNCT03525093; date of registration: May 15, 2018.
Limited predictive value of admission time in clinical psychiatry
Authors: Kreuzer Peter M. , Günther Stefan , Simoes Jorge , Ziereis Michael , Langguth Berthold
Published: November 2020

Background

A large proportion of admissions to psychiatric hospitals happen as emergency admissions and many of them occur out of core working hours (during the weekends, on public holidays and during night time). However, very little is known about what determines admission times and whether the information of admission time bears any relevance for the clinical course of the patients. In other words, do admission times correlate with diagnostic groups? Can accumulations of crises be detected regarding circadian or weekly rhythms? Can any differences between workdays and weekends/public holidays be detected? May it even be possible to use information on admission times as a predictor for clinical relevance and severity of the presented condition measured by the length of stay?

Methods

In the present manuscript we analyzed data derived from 37′705 admissions to the Psychiatric District Hospital of Regensburg located in the Southern part of Germany covering the years 2013 to 2018 with regard to ICD-10 diagnostic groups and admission times. The hospital provides 475 beds for in-patient treatment in all fields of clinical psychiatry including geriatrics and addiction medicine.

Results

Several core questions could be answered based on our analysis: 1st Our analysis confirms that there is a high percentage of unheralded admissions out of core time showing broad variation. 2nd In contrary to many psychiatrists’ misconceptions the time of admission has no relevant impact on the length of stay in the hospital. 3rd The predictive value of admission time regarding the allocation to ICD-10 diagnostic groups is low explaining only 1% of variability.

Conclusions

Taken together, our data reveal the enormous variation of admission times of psychiatric patients accounting for the need of adequate and consistent provision of personnel and spatial resources.
Potential role of polycyclic aromatic hydrocarbons in air pollution-induced non-malignant respiratory diseases
Authors: Låg Marit , Øvrevik Johan , Refsnes Magne , Holme Jørn A.
Published: November 2020

Epidemiological studies have found strong associations between air pollution and respiratory effects including development and/or exacerbation of asthma and chronic obstructive pulmonary disease (COPD) as well as increased occurrence of respiratory infections and lung cancer. It has become increasingly clear that also polycyclic aromatic hydrocarbons (PAHs) may affect processes linked to non-malignant diseases in the airways. The aim of the present paper was to review epidemiological studies on associations between gas phase and particle-bound PAHs in ambient air and non-malignant respiratory diseases or closely related physiological processes, to assess whether PAH-exposure may explain some of the effects associated with air pollution. Based on experimental in vivo and in vitro studies, we also explore possible mechanisms for how different PAHs may contribute to such events. Epidemiological studies show strongest evidence for an association between PAHs and asthma development and respiratory function in children. This is supported by studies on prenatal and postnatal exposure. Exposure to PAHs in adults seems to be linked to respiratory functions, exacerbation of asthma and increased morbidity/mortality of obstructive lung diseases. However, available studies are few and weak. Notably, the PAHs measured in plasma/urine also represent other exposure routes than inhalation. Furthermore, the role of PAHs measured in air is difficult to disentangle from that of other air pollution components originating from combustion processes. Experimental studies show that PAHs may trigger various processes linked to non-malignant respiratory diseases. Physiological- and pathological responses include redox imbalance, oxidative stress, inflammation both from the innate and adaptive immune systems, smooth muscle constriction, epithelial- and endothelial dysfunction and dysregulated lung development. Such biological responses may at the molecular level be initiated by PAH-binding to the aryl hydrocarbon receptor (AhR), but possibly also through interactions with beta-adrenergic receptors. In addition, reactive PAH metabolites or reactive oxygen species (ROS) may interfere directly with ion transporters and enzymes involved in signal transduction. Overall, the reviewed literature shows that respiratory effects of PAH-exposure in ambient air may extend beyond lung cancer. The relative importance of the specific PAHs ability to induce disease may differ between the biological endpoint in question.
microRNA-365 inhibits YAP through TLR4-mediated IRF3 phosphorylation and thereby alleviates gastric precancerous lesions
Authors: Zhang Tianqi , Zhang Kunpeng , Ji Kaiyue , Zhang Cuiping , Jiang Yueping , Zhang Qi , Tian Zibin , Wang Xinyu , Zhang Mengyuan , Li Xiaoyu
Published: November 2020

Background

Gastric carcinoma (GC) is currently one of the most common malignant tumors of the digestive system, and gastric precancerous lesions play a vital role in studying the mechanism of GC. Multiple microRNAs (miRNAs) have been documented to be potential biomarkers to indicate progression of gastric precancerous lesions. In this study, we explained the anti-cancer effect of miR-365 in gastric precancerous lesions via regulation of the TLR4/IRF3/YAP/CDX2 axis.

Methods

miR-365, TLR4, CDX2 and IPF3 expression was determined in GC and atrophic gastritis tissues and cells. After transfection of shRNA and overexpression plasmids, in vitro experiments detected the alteration of cell viability, apoptosis and inflammatory factors. Bioinformatics analysis, Co-IP and dual luciferase reporter gene assay were conducted to evaluate the binding between miR-365 and TLR4 as well as IRF3 and YAP. Rat models were established to explore the effect of the miR-365 and TLR4 on gastric precancerous lesions.

Results

miR-365 was poorly expressed in GC and atrophic gastritis tissues and GC cell lines, while TLR4, CDX2 and IRF3 were overexpressed. Of note, miR-365 was indicated to target TLR4 and thereby suppressed cancer progression and increased hemoglobin content. Interestingly, silencing of TLR4 was accompanied by decreased IRF3 phosphorylation and reduced expression with less binding between CDX2 and IRF3. Downregulation of YAP resulted in declined CDX2 expression in cancer cells. Moreover, the inhibitory role of miR-365 was further confirmed in animal models.

Conclusion

Taken together, miR-365-mediated TLR4 inhibition reduces IRF3 phosphorylation and YAP-mediated CDX2 transcription to impede progression of gastric precancerous lesions.
An unusual postural headache: a case report
Authors: Pollard Henry , Pollard Rachel
Published: November 2020

Background

This paper presents a case of an evolving unusual thunderclap headache that presented to a chiropractor.

Case presentation

The intense “migraine-like” headache was aggravated by standing up and relieved substantially when lying down. This low pressure, orthostatic headache was diagnosed as a spontaneous intracranial hypotension (SIH) secondary to a spontaneous tear of the dura. It was referred to the local hospital for management with autogolous blood injection to form an epidural blood patch of the defect. It resolved substantially within 3 days.

Conclusions

The significance of key features in the history and examination and how if not recognised and subsequently treated with manual therapy, the dural tear could be attributed to the treatment of the chiropractor, a treatment that would typically involve cervical manipulation. Discussion is provided of the implications of a missed diagnosis and possible subsequent chiropractic management with the evolving SIH being attributed to the chiropractic intervention rather than its true “spontaneous” nature.
Quarantine at home may not enough!-from the epidemiological data in Shaanxi Province of China
Authors: Shi Lei , Li Qian , Li Kang , Zheng Jie , He Yingli , Zhang Xi , Gong Xianfeng , Wang Wei , Zhang Qing , Dai Chao , Zhao Wenxuan , Meng Xuefei , Du Feng , Fan Pei , Li Chunyan , Gao Chunyan , Yang Yuan , Liu Xiaojing , Chen Yunru , Liu Jinfeng , Li Jianzhou , Yang Nan , Niu Yinghua , Chen Hongmei , Zhang Guoyu , Yan Taotao , Zhu Li , Han Qunying , Fan Wanhu , Ye Feng , Liu Zhengwen , Lin Shumei , Zhao Yingren , Chen Tianyan
Published: November 2020

Objectives

A pneumonia associated with 2019 novel coronavirus (2019-nCoV, subsequently named SARS-CoV2) emerged worldwide since December, 2019. We aimed to describe the epidemiological characteristics of 2019 coronavirus disease (COVID-19) in Shaanxi province of China.

Results

1. Among the 245 patients, 132 (53.9%) were males and 113 (46.1%) were females. The average age was 46.15 ± 16.43 years, ranging from 3 to 89 years. 2. For the clinical type, 1.63% (4/245) patients were mild type, 84.90% (208/245) were moderate type, 7.76% (19/245) were severe type, 5.31% (13/245) were critical type and only 0.41% (1/245) was asymptomatic. 3. Of the 245 patients, 116 (47.35%) were input case, 114 (46.53%) were non-input case, and 15 (6.12%) were unknown exposure. 4. 48.57% (119/245) cases were family cluster, involving 42 families. The most common pattern of COVID-19 family cluster was between husband and wife or between parents and children.
Longitudinal analysis of Socioecological obesogenic factors in a National Sample of U.S. children
Authors: Kim TaeEung , Kwon Junhye , Lee Chung Gun , Jang Chang-Yong
Published: November 2020

Background

Childhood obesity is a serious public health threat. Although many researchers conducted research on socioecological determinants of childhood obesity, their longitudinal effects remain inconclusive especially among young children. This study examined socioecological factors and associated transitions of children’s body mass index (BMI) status throughout children’s kindergarten to elementary school years, using data from a national longitudinal sample.

Methods

The baseline sample of this study included 1264 children (weighted N = 379,297) extracted from the Early Childhood Longitudinal Study (baseline mean age: 5.24 years). The socioecological framework guided selection of socioecological obesogenic variables (e.g., family activity and parental involvement). Longitudinal ordered logistic regressions were performed to determine the associations between socioecological obesogenic variables and unhealthy/healthy changes in BMI status that captured transitions between healthy and unhealthy weight status (i.e., overweight, obesity, and severe obesity).

Results

Children with Hispanic ethnicity and nonwhite, less socioeconomic and environmental support, and living in households with fewer family members were more likely than their counterparts to have unhealthy BMI status changes over time (all ps < 0.05). Over the study period, girls were less likely than boys to experience transitions to unhealthy BMI status (all ps < 0.05).

Conclusion

As hypothesized a priori, the findings of the current affirmed multiple dimensions of how sociological obesogenic factors may influence children’s BMI status changes in a longitudinal setting. In order to maintain children’s long-term healthy weight, more attention should be paid to socioeconomic obesogenic factors surrounding children as well as individual determinants of obesity (e.g., being physically active and having well-balanced nutrition).
All-cause mortality supports the COVID-19 mortality in Belgium and comparison with major fatal events of the last century
Authors: Bustos Sierra Natalia , Bossuyt Nathalie , Braeye Toon , Leroy Mathias , Moyersoen Isabelle , Peeters Ilse , Scohy Aline , Van der Heyden Johan , Van Oyen Herman , Renard Françoise
Published: November 2020

Background

The COVID-19 mortality rate in Belgium has been ranked among the highest in the world. To assess the appropriateness of the country’s COVID-19 mortality surveillance, that includes long-term care facilities deaths and deaths in possible cases, the number of COVID-19 deaths was compared with the number of deaths from all-cause mortality. Mortality during the COVID-19 pandemic was also compared with historical mortality rates from the last century including those of the Spanish influenza pandemic.

Methods

Excess mortality predictions and COVID-19 mortality data were analysed for the period March 10th to June 21st 2020. The number of COVID-19 deaths and the COVID-19 mortality rate per million were calculated for hospitals, nursing homes and other places of death, according to diagnostic status (confirmed/possible infection). To evaluate historical mortality, monthly mortality rates were calculated from January 1900 to June 2020.

Results

Nine thousand five hundred ninety-one COVID-19 deaths and 39,076 deaths from all-causes were recorded, with a correlation of 94% (Spearman’s rho, p < 0,01). During the period with statistically significant excess mortality (March 20th to April 28th; total excess mortality 64.7%), 7917 excess deaths were observed among the 20,159 deaths from all-causes. In the same period, 7576 COVID-19 deaths were notified, indicating that 96% of the excess mortality were likely attributable to COVID-19. The inclusion of deaths in nursing homes doubled the COVID-19 mortality rate, while adding deaths in possible cases increased it by 27%. Deaths in laboratory-confirmed cases accounted for 69% of total COVID-19-related deaths and 43% of in-hospital deaths. Although the number of deaths was historically high, the monthly mortality rate was lower in April 2020 compared to the major fatal events of the last century.

Conclusions

Trends in all-cause mortality during the first wave of the epidemic was a key indicator to validate the Belgium’s high COVID-19 mortality figures. A COVID-19 mortality surveillance limited to deaths from hospitalised and selected laboratory-confirmed cases would have underestimated the magnitude of the epidemic. Excess mortality, daily and monthly number of deaths in Belgium were historically high classifying undeniably the first wave of the COVID-19 epidemic as a fatal event.
Design and performance evaluation of thin-film actuators based on flexible Ni-Co substrates
Authors: Kim Suhwan , Kim Woojin , Kim Yongdae
Published: November 2020

This paper proposes a new design of bimorph-type electrothermal actuators based on flexible Ni-Co substrates and describes the results of the finite element method (FEM) simulation and performance evaluation of the actuators. In the design of the actuators, a multilayer structure consisting of an adhesion layer, two insulation layers, and a Pt (platinum) heater layer was formed on the Ni-Co flexible substrate that was patterned in an individual shape. The thin-film actuators proposed in this study could be detached from a Si carrier wafer and adhered to other micro or macrostructural elements. To investigate the temperature distribution and mechanical behavior of the actuators, multiphysics FEM simulations combining electrothermal and static structural analyses were carried out. The actuators were fabricated using conventional microfabrication and electroplating technologies on Si carrier wafer; then, the actuators were peeled off from the carrier wafer using the release process proposed in this paper. After fabricating the actuators, the deflection of their tips was evaluated and compared with that obtained from the FEM simulations.
Comparative matched-pair cohort analysis of the short-term clinical outcomes of mesenchymal stem cells versus hyaluronic acid treatments through intra-articular injections for knee osteoarthritis
Authors: Kim Yong Sang , Suh Dong Suk , Tak Dae Hyun , Chung Pill Ku , Kwon Yoo Beom , Kim Tae Yong , Koh Yong Gon
Published: November 2020

Purpose

Intra-articular injection of hyaluronic acid (HA) has shown promises in reducing pain and improving physical function in knee osteoarthritis (OA). Recently, cell-based therapies using mesenchymal stem cells (MSCs) have emerged as potential treatments. However, few studies have compared the treatment outcomes between MSCs and HA. This study aimed to compare the clinical and radiological outcomes of intra-articular injections of MSCs versus HA in patients with knee OA.

Methods

A cohort of 209 patients with knee OA were retrospectively screened for those who underwent intra-articular injections using MSCs or HA. Thirty MSC-treated patients (MSC group) were pair-matched with thirty HA-treated patients (HA group) based on gender and age. Clinical outcomes were evaluated using the visual analog scale (VAS), International Knee Documentation Committee (IKDC) rating system, and Lysholm scoring system. Radiological evaluation was assessed using the Kellgren-Lawrence (K-L) grading system.

Results

MSC treatment yielded consistent significant improvements in VAS, IKDC and Lysholm scores. In the HA group, VAS scores significantly decreased at 1 month, slightly increased at 3 months, and increased significantly from 3 months to 1 year after injection. The IKDC and Lysholm scores improved significantly until 3 months, but gradually worsened thereafter. Significantly greater improvements in VAS (P = 0.041), IKDC (P = 0.014), and Lysholm (P = 0.020) scores were observed in the MSC group compared to those in the HA group at 1-year post-treatment. The K-L grade worsened in a few patients, especially those in the HA group, albeit no significant difference.

Conclusions

MSC group showed better VAS, IKDC, and Lysholm scores at 1-year post-treatment, compared to the HA group, although earlier clinical improvements were superior in the HA group for the initial 3 months.

Level of Evidence

Therapeutic study, Level III.
Model improvement and future projection of permafrost processes in a global land surface model
Authors: Yokohata Tokuta , Saito Kazuyuki , Takata Kumiko , Nitta Tomoko , Satoh Yusuke , Hajima Tomohiro , Sueyoshi Tetsuo , Iwahana Go
Published: November 2020

To date, the treatment of permafrost in global climate models has been simplified due to the prevailing uncertainties in the processes involving frozen ground. In this study, we improved the modeling of permafrost processes in a state-of-the-art climate model by taking into account some of the relevant physical properties of soil such as changes in the thermophysical properties due to soil freezing. As a result, the improved version of the global land surface model was able to reproduce a more realistic permafrost distribution at the southern limit of the permafrost area by increasing the freezing of soil moisture in winter. The improved modeling of permafrost processes also had a significant effect on future projections. Using the conventional formulation, the predicted cumulative reduction of the permafrost area by year 2100 was approximately 60% (40–80% range of uncertainty from a multi-model ensemble) in the RCP8.5 scenario, while with the improved formulation, the reduction was approximately 35% (20–50%). Our results indicate that the improved treatment of permafrost processes in global climate models is important to ensuring more reliable future projections.
Halo artifacts of indwelling urinary catheter by inaccurate scatter correction in 18F-FDG PET/CT imaging: incidence, mechanism, and solutions
Authors: Magota Keiichi , Numata Naoto , Shinyama Daiki , Katahata Junya , Munakata Yamato , Maniawski Piotr J. , Kobayashi Kentaro , Manabe Osamu , Hirata Kenji , Tateishi Ukihide , Kudo Kohsuke , Shiga Tohru
Published: November 2020

Background

Halo artifacts from urinary catheters can occur due to inaccurate scatter correction, and the artifacts affect the tumor visibility in 18F-FDG PET/CT images. We investigated the incidence rate and the mechanisms of halo-artifact generation and explored several scatter correction techniques to prevent artifacts.

Methods

We conducted patient and phantom studies. (1) We retrospectively reviewed the cases of patients who had undergone 18F-FDG PET/CT scans. To determine the frequency of halo-artifact generation, we used the patients’ PET images with a standard scatter correction based on a tail-fitted single-scatter simulation (TF-SSS) using 4-mm voxel μ-maps (TFS 4-mm). (2) We performed phantom studies to evaluate the effects of a urine catheter and two scatter correction techniques, i.e., TF-SSS with 2-mm voxel μ-maps (TFS 2-mm) and a Monte Carlo-based single-scatter simulation (MC-SSS) using 4-mm voxel μ-maps (MCS 4-mm). The average standardized uptake values (SUVs) were measured for axial PET images. (3) Using the patients’ data, we investigated whether TFS 2-mm and MCS 4-mm can eliminate the artifacts in the clinical images.

Results

(1) There were 61 patients with urinary catheters; in five (8.2%), halo artifacts were observed in the TFS 4-mm PET images. (2) The phantom study clearly reproduced the halo artifacts in the TFS 4-mm PET images. The halo artifacts were generated when urine moved in the interval between the CT and PET imaging, and when the urinary catheter was placed in a circular shape. The SUVs for the TFS 4-mm and TFS-2mm PET images were underestimated at the halo-artifact regions, whereas the SUVs for the MCS 4-mm PET images were close to the true values. (3) The halo artifacts disappeared in the TFS 2-mm PET images in 4/5 patients but not 1/5 patient, whereas the halo artifacts were completely absent in the MCS 4-mm PET images in 5/5 patients.

Conclusions

These data suggest that halo artifacts are caused if the PET images do not correspond to the physical material in the μ-maps, which induces the scatter correction error. With the MC-SSS, it was possible to accurately estimate the scatter without generating halo artifacts.
Malignant solitary fibrous tumor of the pancreas: a case report
Authors: Taguchi Yuka , Hara Takanobu , Tamura Hiroaki , Ogiku Masahito , Watahiki Mana , Takagi Toru , Harada Takashi , Miyazaki Shinichiro , Hayashi Tadataka , Kanai Toshikazu , Mori Hiroki , Ozawa Takachika , Nishiwaki Yoshiro
Published: November 2020

Background

Solitary fibrous tumors (SFTs) are rare tumors, mostly derived from connective tissue mesenchymal cells that arise from the pleura. There are very few reports of primary pancreatic SFT. Preoperative diagnosis is difficult owing to the lack of distinctive radiological findings. We report a case of pancreatic SFT with particularly rare malignant findings.

Case presentation

A 60-year-old man was referred to the hospital because of a right upper quadrant mass and abnormal liver function test results. Contrast-enhanced computed tomography (CT) showed a well-defined enhanced tumor measuring approximately 8 cm in the pancreatic head. Magnetic resonance imaging (MRI) showed T1WI hypointensity, T2WI hyperintensity, and DWI hyperintensity. The main pancreatic duct and common bile duct were dilated owing to obstruction by the tumor. The following tumor markers were mildly elevated: carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), SPan-1, and DUPAN-2. The histological diagnosis obtained by endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) was negative for pancreatic ductal carcinoma, malignant lymphoma and neuroendocrine tumor, suggesting the possibility of mesenchymal tumor, but the diagnosis was not confirmed. The patient was judged suitable for surgery and underwent subtotal stomach-preserving pancreatoduodenectomy with D2 lymph node dissection. On histopathological examination of the resected specimen, infiltrating spindle-shaped cells had proliferated, containing numerous mitotic figures, with necrotic findings inside the tumor. Immunostaining was positive for cluster of differentiation-34 (CD34), B cell CLL/lymphoma-2 (Bcl-2), and signal transducer and activator of transcription (STAT6). On the basis of these findings, a diagnosis of malignant pancreatic SFT was made. The patient remains free of recurrent disease after 12 months of follow-up without adjuvant therapy and he is being carefully followed up as an outpatient.

Conclusions

We experienced a case of malignant pancreatic head SFT. Immunohistochemical staining of the extracted specimens was useful for diagnosis.
Evaluation of Andira inermis stem bark extract for hypoglycaemic and antioxidant effects’
Authors: Egua Maxwell Osaronowen , Nwinyi Florence Chimezie , Okwoche Ode Julius , Monday Onakpa Micheal , Ganiyat Akande Motunrayo , Okwudili Onoja Samuel , Garba Mikail Hudu , Dezi Akumka David , Mohammed Adamu
Published: November 2020

Background

The aqueous methanolic extract of Andira inermis(A. inermis) stem bark was screened for phytochemical constituents, antioxidant activity, acute oral toxicity, and preliminary prophylactic normoglycaemic test and effect on Oral Glucose Tolerance in albino rats.

Methods

Andira inermis was double macerated and extracted with 80% methanol. Phytochemical analysis and acute toxicity were performed using standard methods. The extract was screened for in vitro antioxidant activity using Ferric Reducing/Antioxidant Power (FRAP) and 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging spectrophotometric assays. Prophylactic control of glucose was evaluated in normoglycaemic and glucose-challenged albino rats. Graded test doses (100–400 mg/kg body weight) of the extract were used in the investigation. The effects observed were compared with that of glibenclamide (0.2 mg/kg) and distilled water control groups.

Results

The stem bark extract of A. inermis was found to contain saponins, terpenes, tannins, steroids, flavanoids, anthraquinones, carbohydrates and alkaloids. The extract was found to have a significant in vitro antioxidant activity in both methods. The oral acute toxicity study showed the extract had LD50 greater than 5000 mg/kg. The extract significantly (p ≤ 0.05) reduced blood glucose levels in normoglycaemic animal model (the control group seen to have − 5.6(− 8.7%) poor glucose handling; and the glibenclamide& extract treatment group (100 mg/kg) to positively reduce blood glucose 14.8(26.8%) & 16.4(25.9%) respectively). The glucose challenged test, from the 1st hour, showed − 57.4(− 89.4%),-26.8(− 33.8%),-23.8(− 26.3%),-12.8(− 13.9%) and − 9.8(− 10.4%) for the vehicle control, glibenclamide (positive control), and the 100, 200 & 400 mg/kg extract treatment groups respectively. The extract showed mild hypoglycemic effect in the results recorded, up to the 4th hour.

Conclusion

The results of this study elucidated that the aqueous methanolic extract of Andira inermis stem bark possessed potent antioxidant phyto-constituents with potential hypoglycaemic effects that could be explored for therapeutic use worldwide following isolation and characterization of the bioactive principles. And the results also authenticate the folklore use of the plant.
S&P BSE Sensex and S&P BSE IT return forecasting using ARIMA
Authors: Challa Madhavi Latha , Malepati Venkataramanaiah , Kolusu Siva Nageswara Rao
Published: November 2020

This study forecasts the return and volatility dynamics of S&P BSE Sensex and S&P BSE IT indices of the Bombay Stock Exchange. To achieve the objectives, the study uses descriptive statistics; tests including variance ratio, Augmented Dickey-Fuller, Phillips-Perron, and Kwiatkowski Phillips Schmidt and Shin; and Autoregressive Integrated Moving Average (ARIMA). The analysis forecasts daily stock returns for the S&P BSE Sensex and S&P BSE IT time series, using the ARIMA model. The results reveal that the mean returns of both indices are positive but near zero. This is indicative of a regressive tendency in the long-term. The forecasted values of S&P BSE Sensex and S&P BSE IT are almost equal to their actual values, with few deviations. Hence, the ARIMA model is capable of predicting medium- or long-term horizons using historical values of S&P BSE Sensex and S&P BSE IT.
Bartonella hanselae retinitis patient evaluated with multimodal retinal exams
Authors: Rosa Paulo Alberto Cervi , Nakayama Luis Filipe , Bergamo Vinicius Campos , Kuroiwa Dante Akira Kondo , de Moraes Nilva Simeren Bueno
Published: November 2020

Background

Cat scratch disease is a systemic infectious illness caused by the bacterium Bartonella henselae. The most common ophthalmological involvement due to infection by Bartonella is Parinaud oculoglandular syndrome, whereas the most common posterior segment findings are neuroretinitis and subsequent late macular star. Moreover, other findings, such as retinal or subretinal lesions, intermediate uveitis and angiomatous lesions, may be present.

Case presentation

A 37-year-old female patient with retinal findings and serological confirmation of Bartonella infection was evaluated via multimodal retinal exams. The patient received treatment with doxycycline 100 mg twice daily for 2 weeks. One month after treatment, complete improvement of her visual scotoma symptoms was confirmed. A swept-source optical coherence tomography exam also showed decreases in the size and intraretinal extension of the lesion. Improvement of light perception at the affected area was confirmed by microperimetry.

Conclusions

Bartonella henselae infection, particularly retinitis, can present a variable spectrum of clinical and ophthalmological findings. Multimodal retinal exams can clearly identify lesion characteristics, thus providing important information for diagnosis and the evaluation of lesion improvement after antibiotic treatment.
A practical guide to optical coherence tomography angiography interpretation
Authors: Greig Eugenia Custo , Duker Jay S. , Waheed Nadia K.
Published: November 2020

Background

Optical coherence tomography angiography (OCTA) can image the retinal vasculature in vivo, without the need for contrast dye. This technology has been commercially available since 2014, however, much of its use has been limited to the research setting. Over time, more clinical practices have adopted OCTA imaging. While countless publications detail OCTA’s use for the study of retinal microvasculature, few studies outline OCTA’s clinical utility.

Body

This review provides an overview of OCTA imaging and details tips for successful interpretation. The review begins with a summary of OCTA technology and artifacts that arise from image acquisition. New methods and best practices to prevent image artifacts are discussed. OCTA has the unique ability among retinovascular imaging modalities to individually visualize each retinal plexus. Slabs offered in standard OCTA devices are reviewed, and clinical uses for each slab are outlined. Lastly, the use of OCTA for the clinical interpretation of retinal pathology, such as diabetic retinopathy and age-related macular degeneration, is discussed.

Conclusion

OCTA is evolving from a scientific tool to a clinical imaging device. This review provides a toolkit for successful image interpretation in a clinical setting.
Nutritional values and acceptability of syrups produced after blending carrots, sweet potatoes, and tomatoes
Authors: Ibrahim Ibrahim Mahmoud Ahmed , Khashaba Hamed Mohamed Hassanin
Published: November 2020

Background

The artificial syrups on the market are known with many harmful health effects for using unnatural colors and flavors. This study evaluated the effect of different compositions of syrups and storage on the quality and nutritional value of syrups produced from three types of high nutritional vegetables such as carrot, sweet potato, and tomato, at weighting ratios T1 (6:2:2), T2 (5:3:2), T3 (4:4:2), T4 (3:5:2), and T5 (2:6:2). Pasteurization was performed at 85 °C/25 s for concentrated syrup at 65°Brix. Physicochemical analyses were applied to the recovered drink at 14°Brix every 2 months for 6 months.

Results

Ascorbic acid, carotenoids, lycopene, color values, total phenols, and antioxidant activity gradually decreased in all treatments during storage, while acidity and browning increased. Increasing sweet potatoes about 4% or decreasing under 3% harmed the overall acceptability of the syrups.

Conclusion

Finally, the findings revealed that T2 and T3 were the most suitable samples on storage. Therefore, our data recommended producing syrups from carrot, sweet potato, and tomato with the same composition of T2 and T3, which give a more attractive taste and flavor similar to apricot juice.
Growth and chemical profile of clary sage (Salvia sclarea L.) in response to algae and banana peel extracts
Authors: El-Gohary Ahmed E. , Amer Heba M. , Salama Adel B. , Wahba Hend E. , Khalid Khalid A.
Published: November 2020

Background

Clary sage (Salvia sclarea L.) has anti-inflammatory and anti-microbial properties; its seeds were imported from Germany for cultivation and acclimatization under the Egyptian environmental conditions as a new source of natural products. Solutions of alga and banana peel waste considered as a source of plant nutrition; it contains some bio-regulators and minerals. This research paper aimed to evaluate growth (fresh and dry weights) and chemical composition (free radical-scavenging activity, carbohydrates, flavonoids, phenols and phenolic compounds) under foliar spray of algae solution (ALS) and the extract of banana peel waste (BPW).

Results

The highest values of fresh and dry weights were detected with the treatment of 1.5 g/l (BPW) × 1.5 g/l (ALS). The maximum inhibition of free radical -cavenging activity was recorded at 1 g/l (ALS) × 0.5 g/l (BPW). 2 g/l (ALS) without BPW treatment resulted in the greatest amounts of total carbohydrates. The greatest accumulation of total flavonoids was obtained from the plants treated with 0.5 g/l (BPW) × 1 g/l (ALS). Plants exposed to 1.5 g/l (BPW) with 2 g/l (ALS) gave the greatest accumulation of total phenols. Phenolic compounds that were detected by HPLC analysis were changed due to ALS, BPW, and their interactions.

Conclusion

Different variations were observed in growth characters and various chemical constituents of Clary sage under the application of ALS and/or BPW. This research will help farmers to produce medicinal and aromatic plants by using cheap and environmentally friendly methods.
Characterizing the cirri and gut microbiomes of the intertidal barnacle Semibalanus balanoides
Authors: Brown Bianca R. P. , Nunez Joaquin C. B. , Rand David M.
Published: November 2020

Background

Natural populations inhabiting the rocky intertidal experience multiple ecological stressors and provide an opportunity to investigate how environmental differences influence microbiomes over small geographical scales. However, very few microbiome studies focus on animals that inhabit the intertidal. In this study, we investigate the microbiome of the intertidal barnacle Semibalanus balanoides. We first describe the microbiome of two body tissues: the feeding appendages, or cirri, and the gut. Next, we examine whether there are differences between the microbiome of each body tissue of barnacles collected from the thermally extreme microhabitats of the rocky shores’ upper and lower tidal zones.

Results

Overall, the microbiome of S. balanoides consisted of 18 phyla from 408 genera. Our results showed that although cirri and gut microbiomes shared a portion of their amplicon sequence variants (ASVs), the microbiome of each body tissue was distinct. Over 80% of the ASVs found in the cirri were also found in the gut, and 44% of the ASVs found in the gut were also found in the cirri. Notably, the gut microbiome was not a subset of the cirri microbiome. Additionally, we identified that the cirri microbiome was responsive to microhabitat differences.

Conclusion

Results from this study indicate that S. balanoides maintains distinct microbiomes in its cirri and gut tissues, and that the gut microbiome is more stable than the cirri microbiome between the extremes of the intertidal.
Root causes of deaths by suicide among patients under the care of a mental health trust: thematic analysis
Authors: Odejimi Opeyemi , Webb Kerry , Bagchi Dhruba , Tadros George
Published: November 2020

Aims and method

This study explored the root causes of deaths by suicide among patients under the care of a mental health trust. Thematic analysis was carried out to identify themes from the serious incident reports for patients between 1 January 2017 and 31 July 2018.

Results

In total, 48 cases were reviewed. Three main themes emerged from this study: patient-, professional- and organisation-related factors. The majority of the deaths were caused by patient-related factors, particularly exacerbation of the patient's mental health condition.

Clinical implications

This study provides insight into perceived causes of death by suicide among mental health patients. It is hoped that this will, in turn, influence the manner in which decisions, policies and resource allocation are carried out to further prevent and reduce the incidence of suicide, particularly among mental health patients.
Clinical Trial Metrics: The Complexity of Conducting Clinical Trials in North American Cancer Centers
Authors: Lee Carrie , Werner Theresa L. , Deal Allison M. , Krise-Confair Cassandra J. , Bentz Tricia Adrales , Cummings Theresa M. , Grant Stefan C. , Lee Ashley Baker , Moehle Jessica , Moffett Kristie , Peck Helen , Williamson Stephen , Zafirovski Aleksandar , Shaw Kate , Hofacker Janie K.
Published: November 2020

PURPOSE:

Cancer clinical trials offices (CTOs) support the investigation of cancer prevention, early detection, and treatment at cancer centers across North America. CTOs are a centralized resource for clinical trial conduct and typically use research staff with expertise in four functional areas of clinical research: finance, regulatory, clinical, and data operations. To our knowledge, there are no publicly available benchmark data sets that characterize the size, cost, volume, and efficiency of these offices, nor whether the metrics differ by National Cancer Institute (NCI) designation. The Association of American Cancer Institutes (AACI) Clinical Research Innovation (CRI) steering committee developed a survey to address this knowledge gap.

METHODS:

An 11-question survey that addressed CTO budget, accrual and trial volume, full-time equivalents (FTEs), staff turnover, and activation timelines was developed by the AACI CRI steering committee and sent to 92 academic cancer research centers in North America (n = 90 in the United States; n = 2 in Canada), with 79 respondents completing the survey (86% completion rate).

RESULTS:

The number of FTE employees working in the CTOs ranged from 4.5 to 811 (median, 104). The median number of analytic cases (ie, newly diagnosed or received first course of treatment) reported by the main center was 3,856. Annual CTO budgets ranged from $250,000 to $23,900,000 (median, $8.2 million). The median trial activation time, based on 61 centers, was 167 days. The median number of accruals per center was 480 (range, 5-6,271) and median number of trials per center was 282 (range, 31-1,833). Budget and FTE ranges varied by NCI designation.

CONCLUSION:

The response rate to the survey was high. These data will allow cancer centers to evaluate their CTO infrastructure, funding, portfolio, and/or accrual goals as compared with peers. A wide range in each of the outcomes was noted, in keeping with the wide variation in size and scope of cancer center CTOs across the United States and Canada. These variations may warrant additional investigation.
Perioperative Renoprotection: General Mechanisms and Treatment Approaches
Authors: Molinari Luca , Sakhuja Ankit , Kellum John A.
Published: November 2020

In the perioperative setting, acute kidney injury (AKI) is a frequent complication, and AKI itself is associated with adverse outcomes such as higher risk of chronic kidney disease and mortality. Various risk factors are associated with perioperative AKI, and identifying them is crucial to early interventions addressing modifiable risk and increasing monitoring for nonmodifiable risk. Different mechanisms are involved in the development of postoperative AKI, frequently picturing a multifactorial etiology. For these reasons, no single renoprotective strategy will be effective for all surgical patients, and efforts have been attempted to prevent kidney injury in different ways. Some renoprotective strategies and treatments have proven to be useful, some are no longer recommended because they are ineffective or even harmful, and some strategies are still under investigation to identify the best timing, setting, and patients for whom they could be beneficial. With this review, we aim to provide an overview of recent findings from studies examining epidemiology, risk factors, and mechanisms of perioperative AKI, as well as different renoprotective strategies and treatments presented in the literature.
Perioperative Lung Protection: Clinical Implications
Authors: Hol Liselotte , Nijbroek Sunny G. L. H. , Schultz Marcus J.
Published: November 2020

In the past, it was common practice to use a high tidal volume (VT) during intraoperative ventilation, because this reduced the need for high oxygen fractions to compensate for the ventilation-perfusion mismatches due to atelectasis in a time when it was uncommon to use positive end-expiratory pressure (PEEP) in the operating room. Convincing and increasing evidence for harm induced by ventilation with a high VT has emerged over recent decades, also in the operating room, and by now intraoperative ventilation with a low VT is a well-adopted approach. There is less certainty about the level of PEEP during intraoperative ventilation. Evidence for benefit and harm of higher PEEP during intraoperative ventilation is at least contradicting. While some PEEP may prevent lung injury through reduction of atelectasis, higher PEEP is undeniably associated with an increased risk of intraoperative hypotension that frequently requires administration of vasoactive drugs. The optimal level of inspired oxygen fraction (Fio
2) during surgery is even more uncertain. The suggestion that hyperoxemia prevents against surgical site infections has not been confirmed in recent research. In addition, gas absorption-induced atelectasis and its association with adverse outcomes like postoperative pulmonary complications actually makes use of a high Fio
2 less attractive. Based on the available evidence, we recommend the use of a low VT of 6–8 mL/kg predicted body weight in all surgery patients, and to restrict use of a high PEEP and high Fio
2 during intraoperative ventilation to cases in which hypoxemia develops. Here, we prefer to first increase Fio
2 before using high PEEP.
Perioperative Cardioprotection: Clinical Implications
Authors: Roth Sebastian , Torregroza Carolin , Huhn Ragnar , Hollmann Markus W. , Preckel Benedikt
Published: November 2020

Perioperative cardioprotection aims to minimize the consequences of myocardial ischemia–reperfusion injury. In isolated tissue and animal experiments, several treatments have been identified providing cardioprotection. Some of these strategies have been confirmed in clinical proof-of-concept studies. However, the final translation of cardioprotective strategies to really improve clinical outcome has been disappointing: large randomized controlled clinical trials mostly revealed inconclusive, neutral, or negative results. This review provides an overview of the currently available evidence regarding clinical implications of perioperative cardioprotective therapies from an anesthesiological perspective, highlighting nonpharmacological as well as pharmacological strategies. We discuss reasons why translation of promising experimental results into clinical practice and outcome improvement is hampered by potential confounders and suggest future perspectives to overcome these limitations.
Perioperative Cardioprotection: General Mechanisms and Pharmacological Approaches
Authors: Torregroza Carolin , Raupach Annika , Feige Katharina , Weber Nina C. , Hollmann Markus W. , Huhn Ragnar
Published: November 2020

Cardioprotection encompasses a variety of strategies protecting the heart against myocardial injury that occurs during and after inadequate blood supply to the heart during myocardial infarction. While restoring reperfusion is crucial for salvaging myocardium from further damage, paradoxically, it itself accounts for additional cell death—a phenomenon named ischemia/reperfusion injury. Therefore, therapeutic strategies are necessary to render the heart protected against myocardial infarction. Ischemic pre- and postconditioning, by short periods of sublethal cardiac ischemia and reperfusion, are still the strongest mechanisms to achieve cardioprotection. However, it is highly impractical and far too invasive for clinical use. Fortunately, it can be mimicked pharmacologically, for example, by volatile anesthetics, noble gases, opioids, propofol, dexmedetomidine, and phosphodiesterase inhibitors. These substances are all routinely used in the clinical setting and seem promising candidates for successful translation of cardioprotection from experimental protocols to clinical trials. This review presents the fundamental mechanisms of conditioning strategies and provides an overview of the most recent and relevant findings on different concepts achieving cardioprotection in the experimental setting, specifically emphasizing pharmacological approaches in the perioperative context.