bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of the Value of SOFA and Pitt Bacteremia Scores in the Prognostic Evaluation of Patients With Hospital-acquired Klebsiella Pneumoniae Bloodstream Infection
Authors: Guo Jun , Fan Shuaihua , Lin Jinlan , Wu Sheng
Published: October 2021

This clinical research studied the value of SOFA score and Pitt bacteremia score in the prognosis assessment of patients with hospital-acquired Klebsiella pneumonia bloodstream infection. We conducted a retrospective analysis of 40 patients with hospital-acquired Klebsiella pneumoniae bloodstream infection in a tertiary hospital from January 2016 to December 2020. For these patients, the SOFA score and Pitt bacteremia score were used to evaluate the prognosis. Logistic regression was performed with the known prognosis results to obtain the best cut-off value, sensitivity, and specificity. Pitt bacteremia score [3 (3-4) points to 6 (5.5-7) points] and SOFA score [7 (6-10) points to 17 (13-17.5) points] in the survival group were lower than those in the death group (P<0.05). The SOFA score predicts the death of hospital-acquired Klebsiella pneumoniae bloodstream infection patients with a sensitivity of 80%, a specificity of 84%, and the area under curve(AUC) of SOFA score is 0.8960 (95% CI 0.7951-0.9969); Pitt bacteremia score predicts the hospital-acquired Klebsiella pneumoniae blood infection with a sensitivity of 86.67%, a specificity of 80%, and AUC of Pitt bacteremia score is 0.9413 (95% CI 0.8700- 1.000). Both the SOFA score and the Pitt bacteremia score have predictive value for the prognosis of patients with HAI (hospital acquired infection) Klebsiella pneumonia blood infection. However, the difference shows that the SOFA score has obvious accuracy and specificity in the prognosis of patients with HAI Klebsiella pneumoniae bloodstream infection, it is better than the Pitt bacteremia score and has greater application prospects in prognostic evaluation.
Nos2 -/- Mice Infected With M. Tuberculosis Develop Neurobehavioral Changes and Immunopathology Mimicking Human Central Nervous System Tuberculosis
Authors: Poh Xuan Ying , Hong Jia Mei , Bai Chen , Miow Qing Hao , Thong Pei Ming , Wang Yu , Rajarethinam Ravisankar , Ding Cristine S.L. , Ong Catherine W.M.
Published: October 2021

BackgroundUnderstanding the pathophysiology of central nervous system tuberculosis (CNS-TB) is hampered by the lack of a good pre-clinical model that mirrors the human CNS-TB infection. We developed a murine CNS-TB model that demonstrates neurobehavioral changes with similar immunopathology with human CNS-TB. MethodsWe injected two Mycobacterium tuberculosis ( M.tb ) strains, H37Rv and CDC1551, respectively, into two mouse strains, C3HeB/FeJ and Nos2 -/- mice, either into the third ventricle or intravenous. We compared the neurological symptoms, histopathological changes and levels of adhesion molecules, chemokines, and inflammatory cytokines in the brain induced by the infections through different routes in different strains. ResultsIntra-cerebroventricular infection of Nos2 -/- mice with M.tb led to development of neurological signs and more severe brain granulomas compared to C3HeB/FeJ mice. Compared with CDC1551 M.tb , H37Rv M.tb infection resulted in a higher neurobehavioral score and earlier mortality. Intra-cerebroventricular infection caused necrotic neutrophil-dominated pyogranulomas in the brain relative to intravenous infection which resulted in disseminated granulomas and mycobacteraemia. Histologically, intra-cerebroventricular infection of Nos2 -/- mice with M.tb resembled human CNS-TB brain biopsy specimens. H37Rv intra-cerebroventricular infected mice demonstrated higher brain concentrations of inflammatory cytokines, chemokines and adhesion molecule ICAM-1 than H37Rv intravenous-infected mice. ConclusionsIntra-cerebroventricular infection of Nos2 -/- mice with H37Rv creates a murine CNS-TB model that resembled human CNS-TB immunopathology, exhibiting the worst neurobehavioral score and with a high and early mortality reflecting disease severity and its associated neurological morbidity. Our murine CNS-TB model serves as a pre-clinical platform to dissect host-pathogen interactions and evaluate therapeutic agents for CNS-TB.
Association of Alcohol Drinking With Incident Type 2 Diabetes and Pre-diabetes: the Guangzhou Biobank Cohort Study
Authors: Li Mei Jiao , Ren Jing , Zhang Wei Sen , Jiang Chao Qiang , Jin Ya Li , Lam Tai Hing , Cheng Kar Keung , Thomas G Neil , Xu Lin
Published: October 2021

Background To examine associations of baseline alcohol drinking with incident type 2 diabetes or impaired fasting glucose, and explore whether the associations were modified by genetic polymorphisms of aldehyde dehydrogenase-2 (ALDH2) and alcohol dehydrogenase-1B (ADH1B).Methods Information of alcohol consumption was collected at baseline from 2003 to 2008. Incident type 2 diabetes was defined as fasting glucose ≥7.0 mmol/l or post-load glucose ≥11.1 mmol/l at follow-up examination (2008-2012), self-reported type 2 diabetes and/or initiation of hypoglycemia medication or insulin during follow-up. Impaired fasting glucose was defined as fasting glucose ≥5.6 mmol/l and <7 mmol/l. Results Of 15,716 participants without diabetes and 11,232 participants without diabetes and impaired fasting glucose at baseline, 1,624 (10.33%) developed incident type 2 diabetes, and 1,004 (8.94%) developed incident impaired fasting glucose during average 4 years of follow-up. After adjusting for sex, age, education, occupation, personal annual income, smoking, physical activity, body mass index, waist/hip ratio, health status, family history of diabetes, compared with never drinking, occasional or moderate alcohol drinking was not associated with risk of incident type 2 diabetes+impaired fasting glucose (odds ratio (OR) 1.08, 95% confidence interval (CI) 0.94-1.25, and 0.89 (0.68-1.16), respectively), but heavy alcohol drinking was associated with a higher risk of incident type 2 diabetes+impaired fasting glucose (1.83, 1.25-2.69). No interactions of sex, overweight/obesity and genetic polymorphisms of ADH1B or ALDH2 genes with alcohol drinking on incident type 2 diabetes and/or impaired fasting glucose were found (p for interaction from 0.12 to 0.81). Conclusions Our results support a detrimental effect of heavy alcohol use on impaired fasting glucose and type 2 diabetes. No protective effect was found for those carrying lower risk alleles for ADH1B and ALDH2 genes.
Thoracic Endovascular Aortic Repair With a Right Thoracotomy Approach: a Case Report
Authors: Tanioka Hideki , Shibukawa Takanori , Iwata Keiji
Published: October 2021

Background: The common femoral artery is usually the preferred access route for thoracic endovascular aortic repair (TEVAR). However, if access from the common femoral artery is challenging, other routes must be considered. We report a case of TEVAR performed by approaching the descending thoracic aorta with a right thoracotomy and using the descending thoracic aorta as an access route. Case presentation: A 70-year-old female was diagnosed with a descending thoracic aortic aneurysm (65 mm in diameter), a thoracoabdominal aneurysm (54 mm in diameter), and an abdominal aortic aneurysm (49 mm in diameter). Since the patient had severe chronic obstructive pulmonary disease, one-stage replacement of the thoracoabdominal aortic aneurysm was contraindicated and TEVAR on the descending aorta was selected. A strong tortuous section of the aorta—from the descending aorta to the abdominal aorta—hampered endovascular access to the site from the common femoral artery. A TEVAR approach from the abdominal aorta was also considered; however, an abdominal aortic aneurysm and a transverse colon loop stoma from an earlier surgery presented challenges to this technique. We chose to access the descending thoracic aorta with a thoracotomy from the right 6th intercostal space for TEVAR, because the access route that is not affected by the meandering of the aorta is considered to be the descending aorta with a right thoracotomy. The patient’s postoperative course was uneventful after the stent graft was placed. No complications were detected with postoperative contrast-enhanced computed tomography (CT). Conclusions: Our findings suggest that TEVAR can be performed by approaching the descending aorta from a right thoracotomy, if variations of vascular anatomy interfere with the more commonly used femoral artery approach.
Method Related Attributes and Contraceptive Discontinuation: Results from A Prospective Study from Nairobi and Homa Bay Counties in Kenya.
Authors: Wado Yohannes Dibaba , Mutua Martin K. , Odwe George , Obare Francis , Machiyama Kazuyo , Casterline John B. , Cleland John
Published: October 2021

Background: Rates of contraceptive discontinuation are high in many low and middle countries contributing to unmet need for contraception and other adverse reproductive health outcomes. Few studies have investigated how method specific beliefs and strength of fertility preferences affect discontinuation rates. This study examines this question using primary data collected in Nairobi and Homa Bay counties in Kenya.Methods: We used data from two rounds of a longitudinal study of married women ages 15-39 years (2812 and 2424 women from Nairobi and Homa Bay respectively at round 1) from two communities in Kenya. Information on fertility preferences, past and current contraceptive behavior, and method-related beliefs about six modern contraceptive methods were collected, along with a monthly calendar of contraceptive use between the two interviews. The analysis focused on discontinuation of the two most commonly used methods in both sites, injectable and implants. We carry out competing risk survival analysis to identify which method related beliefs predict discontinuation among women using at the first round. Results: The percentages of episodes discontinued in the 12 months between the two rounds was 36%, with a higher rate of discontinuation in Homa Bay (43%) than in the Nairobi slums (32%) and higher for injectables than implants. Method related concerns and beliefs were the major self-reported reasons for discontinuation in both sites. The competing risk survival analysis showed that the probability of method related discontinuation of implants and injectables was significantly lower among respondents who believed that the methods do not cause serious health problems (SHR=0.78, 95% CI 0.62-0.98), do not interfere with regular menses (SHR=0.76, 95% CI 0.61 - 0.95) and do not cause unpleasant side effects (SHR=0.72, 95% CI 0.56-0.89). By contrast, there were no net effects of three method related beliefs that are commonly cited as obstacles to contraceptive use in African societies: safety for long-term use, ability to have children after stopping the method, and the approval of the husband.Conclusion: This study is unique in its examination of the effect of method specific beliefs on subsequent discontinuation for a method-related reason, using a longitudinal design. The single most important result is that concerns about serious health problems, which are largely unjustified and only moderately associated with beliefs about side effects, are a significant influence on discontinuation. The negative results for other beliefs show that the determinants of discontinuation differ from the determinants of method adoption and method choice.
Elevated STIL predicts poor prognosis in patients with hepatocellular carcinoma
Authors: Song Huangqin , Zhao Haichao , Chen Changzhou , Zhang Donglin , Wang Xiaoxiao , he jiefeng
Published: October 2021

Background

Overexpression of STIL centriolar assembly protein (STIL) has been observed in a variety of cancers. However, the functional significance of STIL in hepatocellular carcinoma remains unknow.
Results

STIL expression were abnormal in HCC tissues, and HCC patients with increased STIL expression had poor prognosis. In addition, increased STIL expression was correlated with T stage, pathologic stage, histologic grade, AFP, age, tumor status. STIL was an independent predictor of poor prognosis in HCC patients, as verified with a nomogram based on a Cox regression model. STIL was involved in HCC progression by modulating the cell cycle, DNA replication, oocyte meiosis, etc. Correlation analysis indicated TUBG1 mRNA expression was correlated with immune infiltrates.
Conclusion

STIL plays a vital role in HCC progression and prognosis; it may, therefore, serve as an effective biomarker for the prediction of patient survival.
Experimental Study on Single Factor, Orthogonal and Characteristics of SRB Particles Fixed by Biologically Activated Lignite
Authors: Di Junzhen , Jiang Yangyang , Wang Mingjia , Dong Yanrong
Published: October 2021

Aiming at the problems of insufficient supply of carbon source and toxic effect of heavy metal ions in the treatment of acid mine wastewater (AMD) by sulfate reducing bacteria (SRB), immobilized particles were prepared with Rhodopseudomonas spheroides, SRB and lignite as the main raw materials, and the optimal ratio of immobilized particles was determined based on single factor test and orthogonal test. The adsorption experiment of immobilized particles was carried out under the optimal ratio, the reaction kinetic process and adsorption capacity of immobilized particles for different ions were analyzed, and the action mechanism was studied. The results show that lignite not only has good adsorption performance, but also can be used as the carbon source of SRB after degradation by Rhodopseudomonas spheroides, so as to solve the problems of low removal efficiency of AMD by SRB and insufficient supply of carbon source. When the dosage of lignite, Rhodopseudomonas spheroides and SRB is 3%, 10% and 10% respectively, and the particle size of lignite is 200 mesh, the overall treatment effect is the best. The removal rates of SO42-, Zn2+ and Cu2+ are 83.21%, 99.59% and 99.93% respectively, the pH is increased to 7.43, the release of COD is 523 mg/L, and the ORP number is -134 mV. The reduction process of SO42- by immobilized particles conforms to the pseudo first-order kinetics, the isothermal adsorption of Zn2+ more conforms to the Freundlich isothermal adsorption equation, and the adsorption kinetics of Zn2+ more conforms to the pseudo second-order kinetic model.
Pulmonary Sclerosing Pneumocytoma and Mortality Risk
Authors: Kim So Jeong , Kang Hye-Rin , Lee Chun Geun , Choi Seung Ho , Kim Yeon Wook , Lee Hyun Woo , Lee Chang-Hoon
Published: October 2021

Background: Surgical resection is recommended in all patients with pulmonary sclerosing pneumocytoma (PSP). However, no comparative study has demonstrated that surgical resection leads to improved outcomes. We aimed to compare all-cause mortality between patients with PSP who underwent surgery or did not and those without PSP.Methods: Participants aged ≥18 years who had pathologically diagnosed PSP between 2001 to 2018, at 3 hospitals were included. Randomly selected (up to 1:5) age-, sex-, and smoking status-matched controls were included. Mortality was compared using Kaplan–Meier estimates and Cox proportional hazards regression models. Literature review of studies reporting PSP was also conducted.Results: This study included 107 patients with PSP (surgery:non-surgery, 80:27) and 520 matched controls. There were no cases of lymph node or distant metastasis, recurrence, or mortality from PSP. No significant difference in all-cause mortality risk was observed between the PSP surgery, PSP non-surgery, and non-PSP groups (log rank test P=0.78) (PSP surgery vs. non-PSP: adjusted hazards ratio [aHR], 1.80; 95% confidence interval [CI], 0.22-14.6; PSP non-surgery vs. non-PSP: aHR, 0.77; 95% CI, 0.15-3.86; PSP surgery vs. PSP non-surgery: aHR, 2.35; 95% CI, 0.20-28.2). In the literature review, we identified 3,469 patients with PSP from 355 studies. Only 1.33% of these patients reported metastasis, recurrence, or death.Conclusion: All-cause mortality did not differ between patients with PSP and those without, irrespective of undergoing surgery. Our study and the literature review suggest that PSP has less impact on increased mortality risk.
Glycosylated Hemoglobin Levels Among Non-Diabetic Children With Sickle Cell Anemia At Muhimbili National Hospital. A Case For Establishing Normal Values
Authors: Mugyabuso Nancy M , Muze Kandi , Manji Karim
Published: October 2021

BackgroundImprovement in the management of children with SCA, has led to increase in their lifespan. However, the increased lifespan, has been accompanied with emergence of various endocrinopathies such as Diabetes mellitus (DM).Glycosylated Hemoglobin (HbA1c) levels have been found to be lower in children with SCA compared to children without SCA in various studies. This can lead to missed children with DM hence delaying their treatment. There is a need to establish normal ranges of HbA1c levels corresponding to children with SCA.ObjectiveTo determine normal range of HbA1c levels among non-diabetic children with SCA attending clinics at Muhimbili National Hospital in Dar-es-salaamMethodologyThis was a hospital-based cross sectional study conducted at Paediatric clinics in Muhimbili National Hospital involving children from 9 months to 14 years. The study was approved by Institutional review Board of MUHAS. A written informed consent was obtained.120 children with SCA and 40 children without SCA were recruited. Data was reported as median and IQR or as mean ± standard deviation. Chi-square was used for categorical data while independent t-test and Mann Whitney test were used for continuous data. ResultsThe reference range of HbA1c levels in children with SCA was from 3.4% to 5.2%. Median HbA1c level in children with SCA was 4.2% with IQR of (4.1% - 4.6%) while for children without SCA median HbA1c levels was 5.3% with IQR of (4.9% - 5.5%). The median HbA1c level was significantly lower in children with SCA than children without SCA.Conclusion and RecommendationThe reference range of HbA1c levels in children with SCA was from 3.4% to 5.2%. Children with SCA had lower levels of HbA1c compared to children without SCA. Health personnel are advised to use HbA1c reference ranges obtained from this study when screening for Diabetes mellitus in children with SCA.
Clinical Classifiers to Identify Ascending Aortic Dilatation in Patients With Bicuspid Versus Tricuspid Aortic Valves
Authors: Gaye Bamba , Vignac Maxime , Gådin Jesper R. , Ladouceur Magalie , Caidahl Kenneth , Olsson Christian , Franco-Cereceda Anders , Eriksson Per , Björck Hanna M
Published: October 2021

Objective: We aimed to develop clinical classifiers to identify prevalent ascending aortic dilatation in patients with BAV and tricuspid aortic valve (TAV). Methods: This study included BAV (n=543) and TAV (n=491) patients with aortic valve disease and/or ascending aortic dilatation but devoid of coronary artery disease undergoing cardiothoracic surgery. We applied machine learning algorithms and classic logistic regression models, using multiple variable selection methodologies to identify predictors of high risk of ascending aortic dilatation (ascending aorta with a diameter above 40 mm). Analyses included comprehensive multidimensional data (i.e., valve morphology, clinical data, family history of cardiovascular diseases, prevalent diseases, demographic, lifestyle and medication). Results: BAV patients were younger (60.4±12.4 years) than TAV patients (70.4±9.1 years), and had a higher frequency of aortic dilatation (45.3% vs. 28.9% for BAV and TAV, respectively. P<0.001). The aneurysm prediction models showed mean AUC values above 0.8 for TAV patients, with the absence of aortic stenosis being the main predictor, followed by diabetes and high sensitivity C-Reactive Protein. Using the same clinical measures in BAV patients our prediction model resulted in AUC values between 0.5-0.55, not useful for prediction of aortic dilatation. The classification results were consistent for all machine learning algorithms and classic logistic regression models. Conclusions: Cardiovascular risk profiles appear to be more predictive of aortopathy in TAV patients than in patients with BAV. This adds evidence to the fact that BAV- and TAV-associated aortopathy involve different pathways to aneurysm formation and highlights the need for specific aneurysm preventions in these patients. Further, our results highlight that machine learning approaches do not outperform classical prediction methods in addressing complex interactions and non-linear relations between variables.
Integrating Depth of Invasion in T Classification Improves the Prognostic Performance of the American Joint Committee on Cancer Staging System for Laryngeal Squamous Cell Carcinoma: a Retrospective Multicenter Study
Authors: wang xueying , cao kui , guo erliang , mao xionghui , an changming , guo lunhua , zhang cong , yang xiangguang , sun ji , yang weiwei , li xiaomei , Miao Susheng
Published: October 2021

Background: It has been recognized that depth of invasion (DOI) is closely associated with patient survival for all types of cancer. The purpose of this study was to determine the optimal threshold and prognostic value in laryngeal squamous carcinoma (LSCC). Most importantly, we evaluated the prognostic performance of five candidate modified T-classification models in patients with LSCC. Methods: LSCC patients from Harbin Medical University Cancer Hospital and Chinese Academy of Medical Sciences Cancer Hospital were divided into training group (n=412) and validation group (n=147). The primary outcomes were overall survival (OS) and relapse-free survival (RFS), and the effect of DOI on prognosis was analyzed using a multivariable regression model. We identified the optimal model based on its simplicity, goodness of fit and Harrell's consistency index. Further independent testing was performed on the external validation queue. The nomograms was constructed to predict an individual's OS rate at one, three, and five years.Results: In multivariate analysis, we found significant associations between DOI and OS (Depth of Medium-risk invasion HR, 2.631; P <0.001. Depth of high-risk invasion: HR, 5.287; P <0.001) and RFS(Depth of high-risk invasion: HR, 1.937; P =0.016). Model 5 outperformed the American Joint Committee on Cancer (AJCC) staging system based on a low Akaike information criterion score, improvement in the concordance index, and Kaplan-Meier curves.Conclusions: Inclusion of DOI in the current AJCC staging system can improve the differentiation of T classification in LSCC patients.
Sarcopenia and Associated Factors According to the EWGSOP2 Criteria in Older People Living in Nursing Homes: A Cross-Sectional Study
Authors: Escribà-Salvans Anna , Jerez-Roig Javier , Molas-Tuneu Miriam , Farrés-Godayol Pau , Moreno-Martin Pau , Goutan-Roura Ester , Güell-Masramon Helena , Amblàs-Novellas Jordi , de Souza Dyego Leandro Bezerra , Skelton Dawn A , Torres-Moreno Miriam , Minobes-Molina Eduard
Published: October 2021

Background: In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. To our knowledge, this is the first study considering it for the diagnosis of sarcopenia in older people living in Nursing Homes.Aim: Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes from Central Catalonia (Spain).Design: A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia.Results: Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8), and 84.6% women), 85 (81.7%) (95% confidence interval [CI], 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) confirmed sarcopenia and 7 (6.7%) severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition was positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associate factor: OR=0.13 (0.03 - 0.57), p=0.007 and OR=0.14 (0.03 - 0.60), p=0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence. For confirmed sarcopenia, obesity also represented a negative associate factor OR=0.06 (0.01 - 0.99), p=0.049 and the total time in sedentary behavior a positive associate factor OR=1.10 (1.00- 1.20), p=0.040. Conclusions: According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7% to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia whilst obesity represented a protective factor in this population.
Robot-Assisted versus Open Pancreatoduodenectomy: Identifying Perioperative Anesthetic Factors associated with Postoperative Morbidity. A retrospective cohort study.
Authors: Enden Antoon van den , Vereen Maya , Koerkamp Bas Groot , Klimek Markus
Published: October 2021

BackgroundRobot-assisted pancreatoduodenectomy (RAPD) poses several challenges concerning perioperative anesthetic guidance compared to open pancreatoduodenectomy (OPD), e.g. combined pneumoperiotoneum with reversed-Trendelenburg positioning. The primary objective of this observational study is to specify these anesthetic differences of RAPD versus OPD and secondly to identify independent anesthetic factors associated with patient morbidity following RAPD.MethodsAll consecutive patients who underwent either RAPD or OPD between 2017 and 2018 were included for analysis. Patient records were screened for intraoperative vasopressor and fluid administration as well as for results of perioperative arterial blood gas analysis. Variables were compared for the groups RAPD versus OPD, major morbidity following RAPD versus non-major morbidity following RAPD (resp. Clavien-Dindo score ≥ III vs. < III) and high versus low intraoperative blood loss during RAPD. Perioperative factors associated with major postoperative morbidity (Clavien-Dindo ≥ III ) were identified using a logistic regression model.ResultsN=64 RAPD and n=62 OPD patients were included for retrospective analysis. RAPD was associated with higher administration of intraoperative norepinephrine (9.5% of operative time vs. 0% in OPD, p=0.005) and a higher net intraoperative fluid balance (2497.6 vs. 1572.3 ml, p<0.001). During OPD, patients received more frequent and higher doses of colloid fluids compared to RAPD (79.0% vs. 51.6%, p<0.001, median 1000.0 vs. 500.0 ml, p<0.001). Colloid administration during surgery and hyperlactatemia 12 hours postoperatively were associated with major morbidity after RAPD (OR 5.06, 95% CI 1.49-17.20, p=0.009 and OR 3.18, 95% CI 1.01-9.91, p=0.047, respectively).ConclusionsRAPD is a challenging procedure for the anesthesiologist, e.g. considering a higher demand for vasopressors. Inotropic/vasopressor administration as well as the intraoperative fluid balance are associated with (major) morbidity following RAPD. However, it remains unclear whether and in which direction a causal relationship exists.Trial registration: Not applicable.
Privacy Preservation, Trust, and Security in Intelligent Embedded Systems
Authors: Yadav Kusum , Alharbi Yasser
Published: October 2021

An embedded system is a software and hardware system that is based on a microcontroller or microprocessor designed to accomplish the dedicated functions within a massive electrical or mechanical system. An intelligent embedded system (IES) is a generation or promising evolution of an embedded system (ES). IES has the ability of reasoning about their external atmosphere and acclimates their nature accordingly. The capacity of IES is characterized by the ability of process, service, or product to expose the performance of the environment to enrich the lifetime, quality, and satisfaction of the individual. IES facilitates the processing of information gathered from the embedded sensors. IES rely on numerous multidisciplinary methods for the successive operation.IES is widely employed in consumer electronics, industrial machines, agriculture, medical equipment, and other automated applications. It is programmable and necessary functionalities can be achieved effectively. In this article diversified utilities of embedded intelligence, challenges, issues, privacy, and security metrics of IES are discussed.
Analysis of Strawberry Metabolic Profiling in Interaction with Bacillus Spp. Strain DM12 using Gas Chromatography-Mass Spectrometry and Determination of Its Antifungal Activity
Authors: Alijani Zahra , Amini Jahanshir , Mozafari Ali akbar
Published: October 2021

An endophytic bacterial strain, isolated from Fragaria × ananassa, and antifungal properties against Colletotrichum nymphaeae was assayed under in vitro, in vivo, and greenhouse experiments. Bacterial strain was identified as Bacillus spp. DM12 (MH161581) using phenotypic, biochemical and molecular phylogenetic analysis of the 16S rDNA gene. DM12 strain inhibited mycelial growth of fungal pathogen (64.03%) using dual-culture test. The cell-free culture compounds produced by DM12 prevented mycelial growth and conidial germination of C. nymphaeae by 32.86% and 73.98%, respectively but, inhibition percentage of mycelial growth of pathogen by volatile compounds was less (9.82%). As well as, protease, chitinase, pectinase, siderophore, IAA, gibberellin, and phosphate solubilization tests for this strain were positive. Anthracnose disease at post-harvest on fruit suppressed by the strain DM12 (90.87%). Also, biocontrol efficacy on strawberry plants by drenching soil and spraying methods were 72.22% and 94.44%, respectively, 60 days after inoculation. PCR amplification represented the presence of genes of surfactin. In addition, metabolite profile of strawberry was changed on presence of bacterial strain that a number of metabolites in control treatment with maximum area percent were Acetoglyceride (19.418%), Acetic acid, butyl ester (4.734%) and Ribitol (4.349%), in treatment inoculated with DM12 strain alone were Tetramethyl-2-hexadecen (21.350%), Ethylene glycol monoisobutyl ether (18.688%) and Myrtenol (8.75%), in treatment inoculated with fungal pathogen alone were Acetoglyceride (18.089%) and Acetic acid, monoglyceride (17.96%) and in treatment inoculated with C. nymphaeae and DM12 strain together were tert-Butanethiol (36.153%), Ethoxytriethylsilane (14.126%), 5-(Methylamino)-1,2,3,4-thiatriazole (9.53%) and 2,3-Butanediol (7.795%).
Sustaining 99.99% Reliability for US Electric Grid by using Renewable Energy Systems Complexity as a Benefit
Authors: Mechtenberg Abigail , Francois Henri , Stratman Anne , Stiller Robert , McLaughlin Brady , Frink-Larca Desere ́e , Brown Janaya
Published: October 2021

Renewable energy system designers in status-quo and high-income countries (HICs) work to improve the environmental and societal impacts of energy systems by using increasingly complex technologies to predict the future. However, low-to-middle-income countries (LMICs) focus on innovative solutions by turning complexity into an asset. This paper presents the results from four optimization objectives, presented as scenarios with data from EIA utility regions, and with powerloads scaled using population data, solar radiance, wind speed, and wastewater treatment plant (WWTP) capabilities for biogas turbines. This allowed for the complexity of renewable energy systems to be used as a benefit instead of a deficit. For many US cities, an emerging LMIC-based optimization pathway can make possible energy system designs that increase reliability by including backup biogas generators. Here we show that the HIC-based approach is optimal for some cities; for others the status-quo pathway; for many, surprisingly, the LMIC approach is optimal.
Cheminformatics and Pharmacological Network Analysis for the Prediction of Molecular Mechanism of Herbal Drug Ligands
Authors: Singh Lalit Raj
Published: October 2021

The global demand for safer and more therapeutically effective medications is surging, providing medicinal plants a boost as suppliers of lead particles. The focus of current research is on an in silico comparison of one major bioactive principle and curatively designed new small drug-like molecule (scaffold analog). The recent study confirmed that the plant belongs to the Cyperaceae family and that it is Cyperus rotundus L. in taxonomy. The study's purpose was to uncover the mechanism of action of ligands/ scaffold analog by revealing genomic relationships, cellular signaling, and the top ten diseases/ illnesses that they were linked to. The scaffold analog showed promising drug-like potential as compared with cyperene. These investigations could broaden the reach of herbal medications, provide new formulations for current diseases or disorders, and pave the door for drug repurposing.
Crocodile tear syndrome post microvascular decompression of the trigeminal nerve: a case report and literature review
Authors: Abul Mohammad H
Published: October 2021

Background Crocodile tear syndrome (CTS) is a condition characterised by excessive tear secretion in response to eating, drinking, or smelling foods. Traditionally, acquired cases are most commonly reported following facial nerve trauma or paralysis, or in slow-growing facial nerve tumours. More recently, it has been reported following vestibular Schwannoma surgery. We report the first case of crocodile tear syndrome following microvascular decompression of the trigeminal nerve. Case presentation A 61-year-old lady presented with excessive lacrimation and clear rhinorrhoea one month post-operatively from a re-do trigeminal microvascular decompression surgery. The patient experienced similar symptoms following her initial surgery two years prior, which had resolved spontaneously. CT and MRI head, and comprehensive clinical examination showed no evidence of CSF rhinorrhoea or cause of her symptoms. An ENT opinion was sought, and the patient was diagnosed with post-operative crocodile tear syndrome.Literature review revealed no reported cases of CTS following microvascular decompression of the trigeminal nerve. Surgical technique and relevant imaging were reviewed for any possible explanation for the condition. Considering the accepted pathogenesis of CTS, we discuss the aetio-pathogenesis for the development of the condition following this procedure. Conclusions We conclude CTS should be considered in patients presenting with rhinorrhoea following microvascular decompression of the trigeminal nerve. In patients presenting with post-operative rhinorrhoea after MVD, after excluding CSF leak, CTS should be considered as a potential differential diagnosis. Treatment for CTS in this context may pose a challenge. The patient has undergone botulinum toxin injection of the lacrimal gland and will need long term follow up. This is the first documented case of CTS post microvascular decompression of the trigeminal nerve.
Interoperable System for COVID-19
Authors: Chaudhari Yash , Sachdeva Shelly , Aggarwal Lakshita
Published: October 2021

In the year 2020, the world halted due to the spread of COVID-19 or SARS-CoV2 which was first identified in Wuhan, China. Since then, it has caused a plethora of problems around the globe such as the loss of millions of lives. India was one of the countries which were majorly affected by this pandemic. Thousands lost their lives and millions had to be hospitalized and taken into medical care. Due to this, there is an abundance of unorganized and redundant medical data in the Health Information Technology sector. Many hospitals contain various mismatched health records of a single person. We attempt to develop an Interoperable System specifically for COVID-19 using the openEHR standard to organize health records in digital form by creating Electronic Health Records. These records can be accessed and shared by multiple hospitals and clinics to reduce the redundancy of health records. This would establish effective communications between different hospitals and greatly make data sharing, efficient and low cost. Standardization can hugely affect medical errors. Interoperability provides hospitals to share across many channels and help Health care workers to detect discrepancies easily. Lives that are lost due to human error in the health care system can be minimized or even completely avoided. The number of hospitals using interoperable standards is still low and we hope that this paper will help make a change towards following the standard.
Analysis of structural differences of Ag Nanoparticles generated using Thermal and E-beam process based on SEM image
Authors: Saha Mainak , Singh Simrat , Acharjee Suvojit , Kandagatla Chandrasekhar , Chakrabartty Shubhro
Published: October 2021

The variation in applications of nanoparticles (NPs) comes from differences in their microstructures. This may be observed in the terms of variation in size, area fraction and even the morphology of the particles. It is mainly the size and topography of these particles which govern the mechanical, and optoelectronic properties and have a huge impact in Bio-medical engineering.
Situated Withnessing in/as Intervention
Authors: Bieler Patrick
Published: October 2021

Im Rahmen meiner Forschung über die Zusammenhänge von psychischer Gesundheit und städtischen Umwelten in Berlin, Deutschland, beobachtete und arbeitete ich in und mit einem Projekt zur Verbesserung der Lebensbedingungen für Menschen mit schweren psychischen Problemen unter den Bedingungen eines angespannten Wohnungsmarktes. Im Laufe des Projekts wurde ich über ‚lediglich‘ teilnehmendes Beobachten hinausgehend ein aktiv mitarbeitendes Projektmitglied. Diese Art des Engagements basiert nicht auf einer ethischen Verpflichtung gegenüber den moralischen und politischen Zielen der Forschungspartner*innen, sondern stellt vielmehr eine Methode zur Generierung von situiertem empirischem Wissen und Konzepten dar. Die Arbeit mit dem Projekt ermöglichte es, Situationen des kritischen Dialogs und der Konfrontation zu schaffen, wodurch sich über einen zeitlichen Verlauf hinweg analytische Ideen herauskristallisierten. So verschwimmt die Trennung zwischen beobachteten und beobachtenden Subjekten ebenso wie die zwischen Beobachten, Intervenieren und Analysieren. Darüber hinaus argumentiere ich, dass die aktive Teilnahme an einer Intervention als ethnografische Langzeitintervention dienen kann, die auf die Produktion neuartiger Forschungsfragen und methodischer Erkenntnisse abzielt, die weitere Forschungszusammenhänge informieren können. Das Ziel der Intervention liegt also abseits von und geht über die lokal beobachteten Probleme hinaus. Ich werde dieses Argument kurz erläutern, indem ich meinen Beitrag zu den interdisziplinären Interessen der Urban Mental Health Forschung diskutiere.
Death and morality: perspectives on the moral function of death among the basoga of Uganda
Authors: Isiko Alexander Paul , Serugo Paulous
Published: October 2021

Numerous studies on death in African societies with no doubt have been successfully conducted though their preoccupation has been with the religious and spirituality perspectives. There has been a great deal of theologizing about the spiritual connection between the life here and life after death. Most studies in the humanities have zeroed on burial rituals and rites as means of transition to the spiritual world. Others have concentrated on how different societies cope with the misfortune of death; through grieving, mourning, choosing an heir or heiress and the succession disputes that are always part and parcel of such a culturally acknowledged process. Death is largely constructed as a challenge and misfortune, and many a scholar in the humanities are concerned with how different societies define, perceive, handle and cope with this catastrophe. Most scholarly works have paid a deaf ear to the social value that comes with the demise of an individual. One such social value is the definition and shaping of moral order in society, in which death occurs. Busoga traditional society of Uganda is used as the case study. Busoga is both a geographical reality and cultural entity, found in the eastern part of Uganda. The authors argue that rather than militating life, death promotes and perpetuates moral values on one hand and discourages vices that destabilize society on the other.
Assessing the homogeneity of Actimask® acetaminophen and N-acetyl glucosamine mixture to predict further steps in the development of orodispersible tablets
Authors: Zupanets Ihor , Ruban Оlena , Kolisnyk Tetiana , Stolper Yurij
Published: October 2021

One of the main problems in the production of tablets, which has significant negative consequences, is the segregation of the tablet mixture leading to inhomogeneity of dosage units, material losses in the manufacturing process and improperness of the specified pharmaceutical technical characteristics of the mixture.

The aim of the research. This work aims at the pharmaceutical technical study of the substances N-acetyl-D-glucosamine and Actimask® Acetaminophen and determination the uniformity of the powder mixture of active pharmaceutical ingredients (APIs) to predict the optimal technology for obtaining a pharmaceutical formulation with the acceptable properties.

Materials and methods. N-acetyl-D-glucosamine (Zhejiang Candorly Pharmaceutical, China) and Actimask® Acetaminophen (SpiPharma, USA) were used.

Scanning probe microscope Solver P47N-PRO ("NT-MDT", Russia), optical microscope, flowability tester VP-12A, laser diffraction particle size analyzer SALD-2201 ("Shimadzu", Japan), liquid chromatograph Agilent 1260 Infinity II with Diode Array Detector (Agilent Technologies, USA), spectrophotometers Shimadzu UV-1800 ("Shimadzu", Japan) were used.

The study of API pharmaceutical technical properties (microscopic characteristics, moisture absorption capacity, flowability, bulk volume and tapped volume, particle size distribution by sieve analysis and laser diffraction), as well as vibration simulation and following chromatographic study were carried out in this work.

Results and discussion. The shape of the particles N-acetyl-D-glucosamine and Actimask® Acetaminophen, which was determined by microscopic analysis, demonstrated the possibility of N-acetyl-D-glucosamine particles to stick to Actimask® Acetaminophen ones. The experimental study allowed to reveal the hygroscopicity of both APIs; poor flowability, unsatisfactory Hausner ratio, and Carr index for N-acetyl-D-glucosamine; excellent flowability, Hausner ratio, and Carr index for Actimask®. Vibration caused segregation of the powder mixture. It was found that all layers do not meet the requirements and an excessive content of Actimask® is registered, which indicates the stratification of the powder mixture.

Conclusions. The physical properties of the substances were determined and found to have significant differences in their particle size distribution. Segregation of the mixture after vibration was confirmed by laser diffraction and assay analysis. In order to solve the segregation problem, the granulation of N-acetyl-D-glucosamine may be proposed.
Female patients with androgenetic alopecia: immunohistochemical picture of scalp biopsies
Authors: Salyenkova Olena
Published: October 2021

The aim of the research. To expand the knowledge about immunohistochemical changes in female patients with androgenetic alopecia (AGA) focusing on non-androgenic co-factors of pathogenesis of the disease, as this may serve as a basis for improving therapeutic regimens.

Materials and methods. Scalp biopsies of female patients with androgenetic alopecia were examined by immunohistochemical method. The study included two groups: the main group of 30 female patients aged 22 to 40 years, average age 32,13±5,03 years, and the control group that included 20 skin samples from women aged 25–40 years (average age 34,75±4,19 years) who underwent autopsies.

Results. It was found that AGA in women is characterized by a number of immunomorphological manifestations: the inflammatory infiltrate that consists of immunocompetent T-lymphocytes CD3+, CD4+ and CD8+, macrophages (CD68+); imbalance of growth polypeptides VEGF, TGF-β1, EGFR; accumulation of oxidative stress enzymes eNOS and iNOS; accumulation of pathological fraction of Collagen IV.

Conclusions. The data obtained by this study helps to improve the concept of morphogenesis of AGA, and also can become a base to improve the standards of treatment of the disease. The pathological triade “oxidative stress-microinflammation- fibrosis” should be considered as a possible treatment target, as well as the imbalance of growth peptides.
Screening and monitoring of watermelon source material by components of the vegetation period in the conditions of the forest-steppe of Ukraine
Authors: Linnik Zahar , Sergienko Oksana , Harbovska Tetiana
Published: October 2021

Relevant in the selection of each crop, including watermelon is a comprehensive study of the source material to identify sources of valuable traits and include them in the selection process in order to expand the genetic diversity of the culture. According to the results of research, to create a new source material for heterosis selection of watermelon, screening and monitoring of the vegetation period duration (number of days from germination to ripening) and its components 118 (101 varieties, 17 hybrids) genotypes of watermelon in the forest-steppe of Ukraine have been conducted. Research methods are generally accepted: field experiment, observation, accounting, analysis, statistical. According to the results of determining the duration of the components of the vegetation period, the samples were divided into five groups of ripeness: early (65–80 days) – 80 (68 %), medium-early (81–85 days) – 14 (12 %), medium (86–95 days) – 18 (15 %), medium-late (96–105 days) – 4 (3 %) and late (106 days) – 2 (2 %). Variety-samples, selected by morphological and economically valuable characteristics, belong mainly (80 %) to early and medium-early. Only 6 % of genotypes belong to the medium-late and late-ripening groups. 52 samples with the smallest separate interphase periods were isolated. According to the results of the research, 8 sources with the high early ripeness were identified, the vegetation period of which was 66–70 days: Yellow early 108105 (66 days), Karapuz 108109, Surprise 108121 (67 days), Gift of the sun 108109, Lezheboka honey 108116, Thailand №1 108153 ( 69 days), Sweet Diamond 107874, Northern Lights 108127 (70 days). Sources are involved in the selection process