bluuebunny/crossref_metadata_2025 huggingface dataset:
Diabetes Medication Use and Cancer Risk: Protocol for a Systematic Review
Authors: Chen Yixian , Mushashi Fidela , Son Surim , Murphy Rachel A
Published: April 2021

Background: Cancer is a growing public health challenge. Innovative approaches to prevent the future burden of cancer are needed. Diabetes medications may help to decrease the risk of cancers, however, a better understanding of relationships by cancer site and diabetes medication class are essential to guide future clinical trials. However, there is not adequate knowledge synthesis on different types of diabetes medications and cancer types. We aim to provide an integrated view of diabetes medications’ role and site-specific cancers.Methods: This systematic review will include observational studies (cohort, nested case-control, case-cohort, and case-control) and randomized controlled trials in human adults in which the effect of diabetes medication use on breast, lung, colorectal, prostate, liver, and pancreatic cancers was evaluated. The former four are among the most common cancer types, while liver and pancreatic cancer are of interest due to the biological roles of the liver and pancreas in blood glucose regulation. MEDLINE, Embase, Web of Science Core Collection, and Cochrane CENTRAL will be searched using a comprehensive and sensitive search strategy. The reference list of identified studies and relevant systematic reviews will be manually screened. Two reviewers will independently screen studies, extract data, and assess quality. Random-effect models will be employed to obtain overall pooled estimates of associations and corresponding 95% confidence intervals (CIs). This systematic review and meta-analyses will be reported following the Meta-analysis of Observational Studies in Epidemiology (MOOSE) guidelines. Results will be reported as specified by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement.Discussion: Findings of this review will help to clarify relationships between diabetes medication and cancer, which is critical for future efforts to improve cancer prevention. Further, challenges and limitations identified in this review will foster opportunities to refine design and analysis procedures in future studies. Systematic review registration: The systematic review protocol was registered on Open Science Framework (https://osf.io/frg5z) and on PROSPERO (registration number CRD42021239348).
Genome-wide identification and expression analysis of the AT-hook Motif Nuclear Localized gene family in soybean
Authors: Wang Min , Chen Bowei , Zhou Wei , Xie Linan , Wang Lishan , Zhang Yonglan , Zhang Qingzhu
Published: April 2021

Background: Soybean is an important legume crop and has significant agricultural and economic value. Previous research has shown that the AT-Hook Motif Nuclear Localized (AHL) gene family is highly conserved in land plants, playing a crucial role in plant growth and development. To date, however, the AHL gene family has not been studied in soybean. Results: To investigate the roles played by the AHL gene family in soybean, genome-wide identification, expression patterns and gene structures were performed to analyze. We identified a total of 63 AT-hook motif genes, which were characterized by the presence of the AT-hook motif and PPC domain in soybean. The AT-hook motif genes were distributed on 18 chromosomes and formed two distinct clades (A and B), as shown by phylogenetic analysis. All the AHL proteins were further classified into three types (I,II and III) based on the AT-hook motif. Type-I was belonged to Clade-A, while Type-II and Type-III were belonged to Clade-B. Our results also showed that the main type of duplication in the soybean AHL gene family was segmented duplication event. To discern whether the AHL gene family was involved in stress response in soybean, we performed cis-acting elements analysis and found that AHL genes were associated with light responsiveness, anaerobic induction, MYB and gibberellin-responsiveness elements. This suggest that AHL genes may participate in plant development and mediate stress response. Moreover, a co-expression network analysis showed that the AHL genes were also involved in energy transduction, and the associated with the gibberellin pathway and nuclear entry signal pathways in soybean. Transcription analysis revealed that AHL genes in Jack and Williams82 have a common expression pattern and are mostly expressed in roots, showing greater sensitivity under drought and submergence stress. Hence, the AHL gene family mainly reacts on mediating stress responses in the roots and provide comprehensive information for further understanding of the AT-hook motif gene family-mediated stress response in soybean.Conclusion: 63 AT-hook motif genes were identified in the soybean genome. These genes formed into two distinct phylogenetic clades and belonged to three different types. Cis-acting elements and co-expression network analyses suggested that AHL genes participated in significant biological processes. This work provides important theoretical basis for the understanding of AHL biological functions in soybean.
TLR4 knock out alleviate both lung and liver inflammation caused by short-time exposure to PM2.5
Authors: Jiang Bijie , Lu Jianguo , Liu Yang , Li Congmin , An Zhen , Bai Yichun , Zheng Xinmei , Wu Weidong
Published: April 2021

Background: Ambient particulate matter (PM), a principal component of air pollutant, is harmful to human health in many ways. Toll-like receptors (TLRs) are non-catalytic transmembrane protein that can identify conservative molecules from microorganisms. However, the regulatory mechanism of TLR4 and its effects on lung and liver inflammation induced by PM are unknown presently. Method: Wild type mice and TLR4-/- mice (C57BL/10JNju, mixed gender, 8-10 weeks old,), both were randomly divided into two groups. The mice were intratracheally instilled with saline or PM2.5 (4 mg/kg) every other day and continued for 10 days. Result: PM2.5 increased the BCA and Lactate Dehydrogenase (LDH) level and TLR4 KO mice showed lower BCA compared to wild type mice(P=0.08). PM2.5 treatment increased the expression of inflammatory cytokines (HMGB1, TNFα, MCP-1/CCL2, CCR2) significantly compared to the saline treatment (P<0.05) and there is a trend that this could be attenuated in TLR4 knock out mice. HE staining showed that PM2.5 induced severe inflammatory damage, and TLR4 KO could alleviate the process of inflammation. As to the liver, LDH and Alkaline Phosphatase (AKP) significantly increased in PM2.5 treatment only in wild type mice. Similar to the lung tissue, PM2.5 stimulation resulted in robust induction of proinflammatory genes expression levels, and TLR4 KO could alleviate the progression of liver inflammation. Conclusion: Our findings suggest that, TLR4 plays an important role in regulating lung and liver inﬂammatory response caused by PM2.5.
Observations on the Use of Different Modes of Cisatracurium Administration in Hyperthermic Intraperitoneal Chemotherapy
Authors: Zhang Jing , Gao Danyang , Liu Pengfei , Li Tianzuo
Published: April 2021

Objective: To investigate the residual effects of cis-atracurium with different administrations in patients with hyperthermic intraperitoneal chemotherapy.Methods: 60 patients undergoing hyperthermic intraperitoneal chemotherapy were randomly divided into two groups with 30 cases in each group. All patients were induced with sufentanil 0.4ug/kg, propofol 2.0mg/kg and cis atracurium 0.2mg/kg. During the operation, sevoflurane and remifentanil were used to maintain anesthesia. BIS value was 45-55. The control group intermittently received cis-atracurium injection with 0.1mg/kg/h. The experimental group received continuous injection of cis-atracurium at a rate of 1.5ug/kg/min. Cis-atracurium was discontinued 30min before the end of the operation, sevoflurane inhalation was stopped 20min before the end of the surgery and remifentanil was discontinued 10min before the end. At the end of the operation, no muscle relaxant antagonism were applied. General information of patients was recorded. Mean arterial pressure (MAP), heart rate (HR), tidal volume (VT), respiratory rate (F), and blood oxygen saturation (SpO2) were recorded before anesthesia (T1) , at the time of tracheal catheter extraction (T2).Besides, the total amount of cis-atracurium, the time of recovery of spontaneous tidal volume to 6ml/kg (t1), the time of continuous lifting of the head for 5 s (t2), and the time from the withdrawal of muscle relaxant to the removal of the tracheal catheter (t3) were recorded. Blood gas analysis was also performed to record PaO2 and PaCO2 before anesthesia, when leaving the operating room and SICU. Moreover, relevant adverse reactions were recorded.Results: 1) general situation: there was no difference in body weight, operation time, ASA classification and other indicators between the two groups (P>0.05). 2) comparison of residual effects of muscle relaxants: the values of t1, t2 and t3 in the experimental group were significantly shorter than those in the control group (P<0.05). There was no significant difference between the two groups in PaO2 and PaCO2 before anaesthesia, when out of the operating room and when out of SICU (P>0.05). 3) hemodynamic comparison: there were no statistically significant differences in mean arterial pressure, heart rate, tidal volume, respiratory rate and blood oxygen saturation between the two groups at time points T1 and T2 (P>0.05). 4) comparison of adverse events: no adverse events occurred in either group.Conclusion: Compared with intermittent infusion, continuous infusion of cis-atracurium did not result in significant residual muscle relaxation and no significant histamine release. Therefore, continuous infusion is more suitable for long-term surgery.
Impaired Mitochondrial functions and Energy Metabolism in MPTP-induced Model of Parkinson’s Disease in Mice: Comparison of Strains and Dose Regimens
Authors: Pathania Anjana , Garg Priyanka , Sandhir Rajat
Published: April 2021

Parkinson’s disease is a multiplexed disease involving diverse symptoms and progression rate. Heterogenous diseases need an efficient animal model to enhance the understanding of the underlying mechanism. MPTP (1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine), a neurotoxin, has been widely used to replicate the pathophysiology of PD in rodents, but its effect on energy metabolic perturbation is limited. Moreover, susceptibility to different dosage regime of MPTP varies among mice strains. Thus, herein the present study compares the effect of acute and sub-acute MPTP dosage regimes on mitochondrial functions in terms of mitochondrial respiratory chain enzymes, mitochondrial swelling and membrane potential in C57BL/6 and Balb/c mice. In addition, activities of enzymes involved in energy metabolic pathways were also studied along with behaviour and neurochemical alterations. The results showed that acute dose of MPTP in C57BL/6 mice had more profound effect on the enzyme activities of electron transport chain complexes. Further, the activity of MAO-A and MAO-B was increased following acute and sub-acute MPTP administration in C57BL/6 mice. However, no significant change was observed in Balb/c strain. Acute MPTP treatment resulted in decreased mitochondrial membrane potential along with swelling of mitochondria in C57BL/6 mice. In addition, perturbations were observed in hexokinase and pyruvate dehydrogenase of glycolysis pathway and citrate synthase, aconitase, isocitrate dehydrogenase and fumarase of TCA cycle. Moreover, acute MPTP led to pronounced depletion in neostriatal dopamine levels in C57BL/6 than in Balb/c mice. Behavioral tests such as open field, Narrow beam walk test and footprint test showed that locomotor activity was drastically reduced as an acute effect of MPTP in C57BL/6 mice strain. Therefore, these results consistently showed that acute MPTP treatment in C57BL/6 strain had severe mitochondrial dysfunctions, perturbed energy metabolic pathways, altered neurotransmission and motor defects as compared to Balb/c strain. Thus, the findings suggest that the dose and strain of mice need to consider for pre-clinical studies targeting mitochondrial dysfunctions in MPTP-induced Parkinson’s disease model.
Child self-report and child-parent agreement regarding health-related quality of life under COVID-19 lockdown in the French Grand Est area
Authors: Bourion-Bedes Stephanie , Rousseau Hélène , Batt Martine , Tarquinio Pascale , Lebreuilly Romain , Sorsana Christine , Legrand Karine , Tarquinio Cyril , Baumann Cedric
Published: April 2021

Purpose: Billions of children worldwide were sent under lockdown due to the coronavirus disease. This study aimed to investigate child-reported and parent-rated health-related quality of life among 8- to 18-year-olds and the agreement between the children’s assessments and those of their parents during lockdown.Methods: A cross-sectional study was conducted among French children living in the Grand Est area. An online survey was used to collect data on the children’s sociodemographics, living environments, education and HRQoL. The latter was assessed with KIDSCREEN-27, which consists of five domains. Sex and age differences in parent ratings and child-reported data were analyzed using Kruskal-Wallis tests. Child-parent agreement was analyzed using the intraclass correlation coefficient (ICC).Results: In total, 471 child-parent pairs from 341 households were included. Compared to European norms, children scored lower on all dimensions during the first lockdown: physical well-being (45.9/49.94 EU), psychological well-being (48.8/49.77 EU), parent relations and autonomy (47.7/49.99 EU), social support and peers (36.4/49.94) and school (48.2/50). Significant child-reported sex and age differences were identified for both psychological and physical well-being dimensions. Moderate to good agreement existed between children’s and parents’ ratings on all KIDSCREEN dimensions (ICC ranged from 0.60 to 0.76).Conclusion: The study suggests the need to focus on children’s social support and peers during epidemics and to consider the children’s self-reported HRQoL. Additional research should be conducted to identify ways of minimizing the gap between mental health needs and the services available and to help more children maintain their physical and mental health during the current crisis.
Detecting and Learning from Unknown by Extremely Weak Supervision: eXploratory Classifier (xClass)
Authors: Angelov Plamen , Soares Eduardo
Published: April 2021

In this paper, we break with the traditional approach to classification, which is regarded as a form of supervised learning. We offer a method and algorithm, which make possible fully autonomous (unsupervised) detection of new classes, and learning following a very parsimonious training priming (few labeled data samples only). Moreover, new unknown classes may appear at a later stage and the proposed xClass method and algorithm are able to successfully discover this and learn from the data autonomously. Furthermore, the features (inputs to the classifier) are automatically sub-selected by the algorithm based on the accumulated data density per feature per class. In addition, the automatically generated model is easy to interpret, is locally generative and based on prototypes which define the modes of the data distribution. As a result, a highly efficient, lean, human-understandable, autonomously self-learning model (which only needs an extremely parsimonious priming) emerges from the data. To validate our proposal we approbated it on four challenging problems, including imbalanced Faces-1999 data base, Caltech-101 data set, vehicles dataset, and iRoads dataset, which is a dataset of images of autonomous driving scenarios. Not only we achieved higher precision (in one of the problems outperforming by 25% all other methods), but, more significantly, we only used a single class beforehand, while other methods used all the available classes) and we generated interpretable models with smaller number of features used, through extremely weak and weak supervision. We demonstrated the ability to detect and learn new classes for both, images and numerical examples.
Peripheral Nerve Pulsed Radiofrequency For Trigeminal Neuralgia Treatment: Is It An Effective Method?
Authors: Tanyel Tuba , Bilir Ayten , Gulec Sacit
Published: April 2021

ObjectiveTrigeminal neuralgia is a paroxysmal and shock-like pain in the trigeminal nerve area. Various treatment options have been used for trigeminal neuralgia such as medical treatment, interventional procedures and surgical operations. Pulsed radiofrequency (PRF) is a minimally invasive percutaneous technique which seems to be safer and easier to perform.This retrospective study aims to evaluate the analgesic effect, duration of efficacy and side effects of PRF procedures in the peripheral branches of the trigeminal nerve.Methods and MaterialThe data of the patients with trigeminal neuralgia who were followed up in our hospital's algology clinic from 2016 to 2018 were reviewed retrospectively. Patients aged between 18-70 who didn’t respond to medical treatment or couldn’t use medication due to side effects, were treated with PRF procedure for peripheral branches of trigeminal nerve were selected for this study. Demographic profile, clicinal presentation, pain intensity, duration of efficacy and complications were evaluated from their files.Results21 patients who underwent ultrasonography (USG) guided PRF procedures were included the study.Mean visual analog scale (VAS) value of the patients was found to have decreased from 9.25 ± 0.63 to 1.55 ± 0.88 at the end of the first month (p<0.001). The painless period for the patients lasted up to 12 (9-21) months and no complications occurred.ConclusionPRF procedure seems to be an effective and safe method in patients who respond to block of the peripheral branches of the trigeminal nerve.Key message: The use of pulsed radiofrequency method for the treatment of trigeminal neuralgia seems to be an effective and safe method. In addition, being easily applicable and repeatable is another advantage of the method.
Wnt5a Regulates Odontoblast Inflammation by Promoting CCL2 Expression
Authors: Zhang Ronghua , Ge Wei , Huang Ruixue , Meng Zhao , Xu Xiaojie , Liu Xuesheng , Zhao Yuan
Published: April 2021

Objective Wnt5a is involved inflammation, including pulpitis, by upregulating cytokine/chemokine expression. Odontoblasts are the first layer cells in dental pulp and respond to inflammatory stimuli. However, whether Wnt5a is involved in odontoblast inflammation is unclear. This study aimed to investigate the role of Wnt5a in odontoblast inflammation. Methods We measured and compared Wnt5a- or TNF-α-induced cytokine/chemokine expression in mouse odontoblast-like (17IIA11) cells by real-time PCR and Western blotting. Transwell assays were used to examine the effect of Wnt5a on RAW264.7 macrophage migration. We examined whether the nuclear factor-kappa B (NF-κB) and mitogen-activated protein kinase (MAPK) pathways were involved in the molecular mechanism of TNF-α or Wnt5a in 17IIA11 cells by Western blotting. Results TNF-α upregulated Wnt5a in odontoblasts. Wnt5a upregulated CCL2 expression in odontoblasts and enhanced RAW264.7 cell migration. We also found that TNF-α-induced Wnt5a expression was abrogated by inhibiting the MAPK pathway or NF-κB activity and that inhibiting MAPK activity could lead to decreased NF-κB activity. Conclusions Wnt5a is involved in the TNF-α-induced inflammatory response in odontoblasts. TNF-α upregulates Wnt5a expression via MAPK-dependent NF-κB activation in odontoblasts. Wnt5a upregulates CCL2 expression in odontoblasts and enhances RAW264.7 macrophage migration.
Training Needs Of Research Ethics Committee Members In Cameroon Regarding Research Participant Protection
Authors: Douanla Ingrid Marcelle Koutio , Ntsekendio Paul Nyibio , Dieumo Frank Forex Kiadjieu , Naah Felicité Tabala , Lekpa Fernando Kemta , Bekolo Cavin Epie , Nighie Ketina Hirma Tchio , Dongmo Rogacien Kana , Goura André Pascal , Nangue Charlette , Bisseck Anne-Cécile Zoung Kanyi , Ateudjieu Jérôme
Published: April 2021

Background The capacity of the Research Ethic Committee (REC) members to review research protocol is one of the frequently raised problems. The purpose of this study was to assess training needs of members of research ethics committee in Cameroon regarding research participant protection.Methods It was a cross-sectional descriptive study conducted in all the regions of Cameroon during the last quarter of the year 2020, assessing training needs of REC members’ ethical evaluation of health research protocols. Data were collected from all eligible REC members by trained and supervised surveyors using a well designed questionnaire integrated in smartphones via ODK-collect. The data were analyzed by estimating proportions with 95% Confidence Interval using the EpiInfo software version 7.2.2.6.Findings Out of the 79 ethics committee members reached, 64 (81.01%) accepted to participate including 28 (43.75) female. The result showed that,21 (32.81%) of ethics committee members were not trained in research ethics evaluation including 68.75% not exposed to training on research participants protection during clinical trials. A given fraction of respondent was not aware of the existence of key national regulations (25%) and international guidelines like the Helsinki Declaration (32.81%). Participants identified and ranked their priorities in terms of training needs in research participant’s protection, national text regulating research in Cameroon, evaluations’ procedures of research protocol, organization of research in Cameroon, and protection of participants in research involving the transfer of biological materials. The workshop and e-learning courses were seen to be the main accessible source of training.Conclusion Not all ethics committee members received training on ethical principles regarding research ethics review, review process and monitoring of research protocols, and on ethical issues associated to each study design including clinical trials. These gaps and the needs perceived by participants are to be taken into account when setting up a training program for RECs members on ethical evaluation in Cameroon.
Identification of Markers that Distinguish Adipose Tissue and Glucose and Insulin Metabolism using a Multi-Modal Machine Learning Approach
Authors: Henninger Josefin , Eliasson Björn , Smith Ulf , Rawshani Aidin
Published: April 2021

Background The study of metabolomics has improved our knowledge of the biology behind type 2 diabetes and its related metabolic dysregulations. We aimed to investigate markers of adipose tissue morphology dysfunction and insulin and glucose metabolism dysfunction in 53 non-obese male individuals.Methods The participants underwent extensive clinical, biochemical and magnetic resonance imaging phenotyping, and we also investigated non-targeted serum metabolites. We used a multi-modal machine learning approach to evaluate which serum metabolomic compounds predicted markers of glucose and insulin metabolism, adipose tissue morphology and distribution.Results Fasting glucose was associated with metabolites of intracellular insulin action and beta cell dysfunction, namely cysteine-s-sulphate and n-acetylgarginine. Fasting insulin was predicted by eugenol, a metabolite of beta-oxidation of fatty acids. OGTT glucose levels at 30 minutes were predicted by 7-Hoca and taurochenodeoxycholate, microbiota derived metabolites, as well as, fatty acid chains. Both insulin clamp and HOMA-IR were predicted by metabolites involved in beta-oxidation of fatty acids and biodegradation of triacylglycerol, namely tartrate and 3-phosphoglycerate, as well as pyruvate. OGTT glucose area under curve (AUC) was associated with bile acid metabolites and OGTT insulin AUC was predicted by subcutaneous adipocyte size as well as a metabolite of sphingolipid metabolism. Finally, subcutaneous adipocyte size was associated with several long chain fatty acids, metabolites involved in fatty acid biosynthesis, markers of beta-oxidation of fatty acids, as well as markers of sphingolipid metabolism. Lipid oxidation metabolites also predicted liver lipid accumulation, and cardiac lipid storage was predicted by a metabolite of branched chain amino acid (BCAA) turnover. Only adipocyte cell size, age and alpha-tocopherol were associated with visceral fat.Conclusions We identified several biomarkers associated with markers of dysfunction in adipose tissue and insulin and glucose metabolism using a multi-modal machine learning approach. Our approach demonstrated the relative importance of serum metabolites and they outperformed traditional clinical and biochemical variables for most endpoints.
Loss of Monoacylglycerol O Acyltransferase 2 Can Be Compensated for by Diacylglycerol O Acyltransferases 1 and 2 in High Fat Diet Induced Obesity and Mammary Cancer Development
Authors: Mei Yan , Wang Jing , Lu Jia-Bin , Lu Guan-Ming , Peng Li-Xia , Lang Yan-Hong , Zheng Li-Sheng , Huang Bi-Jun , Shi Yan-Xia , Qian Chao-Nan
Published: April 2021

Background: Dietary fat absorption involves the re esterification of digested triacylglycerol in the enterocytes, it is a biological process catalyzed by monoacylglycerol O acyltransferase 2 (MOGAT2, aka MGAT2), which is highly expressed in the small intestine. A previous study showed that the loss of the Mogat2 gene can prevent high fat diet induced obesity in mice. Obesity is associated with an increased risk of several types of cancer including postmenopausal breast cancer.Methods: We collected 147 patients with triple negative breast adenocarcinoma to explore the relationship between the expression of MOGAT2 and patient overall survival. And we generated a Mogat2 deficient mouse mammary tumor model by crossing Mogat2 deficient mice with MMTV PyMT mice to examine the effect of losing MOGAT2 in vivo. Results: Our founding suggest that obesity was induced by a relatively high fat diet (37% of calories from fat) in the mice with or without Mogat2 knockout. Mammary tumor development was deteriorated by a relatively high fat diet regardless of Mogat2 deficiency. As a compensation mechanism, upregulation of diacylglycerol O acyltransferases 1 and 2 (Dgat1 and Dgat2) in the Mogat2 deficient mice was found. Conclusions: Elevated expression of MOGAT2 in triple negative breast adenocarcinoma predicts poorer patient overall survival. With the compensation of Dgat1 and Dgat2, Mogat2 deficiency alone cannot prevent fat diet induced obesity, nor prevent mammary tumor development in a mouse model.
Excellent response to high-dose intravenous immunoglobulin in anti-PF4 positive cerebral thrombosis following Ofxord-AstraZeneca AZD1222 vaccine
Authors: Zanferrari Carla , Fanucchi Simona , Liberato Nicola L. , Lauria Giuseppe , Persico Alessandra , Cavallini Anna
Published: April 2021

One week after Oxford-AstraZeneca COVID-19 vaccine (AZD1222), a 40-year-old woman who did not report previous SARS-Cov2 infection developed headache resistant to analgesics, then nausea and vomiting. On admission, the neurological examination was negative and haematological exams showed thrombocytopenia (48x10 9 /L; range 130-400), increased d-dimer (27,546 ng/ml; normal value <500), and normal partial thromboplastin time (PTT; 24.9; range 24-38). Brain computed tomography (CT) and magnetic resonance imaging (MRI) identified an extended thrombosis involving left sigmoidal and transversal sinuses, rectus and inferior longitudinal sinuses without parenchymal damages. Serum anti-platelet factor 4 (PF4) IgG antibodies tested strongly positive (2.59 optical density; normal <0.4) confirming the hypothesis of a mechanisms mimicking heparin-induced thrombocytopenia. Enoxaparin 8,000 units were administered twice in 24 hours, then changed with fondaparinux. Four days later the clinical picture worsened with drowsiness, aphasia and right-side hemiparesis. Brain CT and MRI disclosed left-side temporal-occipital hypodensity with haemorrhagic infarctions. Platelet count remained low (range 37 to 45x10 9 /L) while PTT decreased below the lower normal value. Intravenous immunoglobulin (2 g/kg) was started. Over the following 5 days, the platelet count rapidly increased from 27x10 9 /L to 318x10 9 /L, while PTT normalized. The clinical picture significantly improved.Anti-PF4 antibody assay and high-dose IVIG therapy should be immediately considered in patients with vaccine-induced prothrombotic immune thrombocytopenia (VIPIT) and thrombosis to avoid life-threatening complications.
The Associations Between Socio-economic Status and Metabolic Syndrome Among General Population in Nanjing, China: a Cross-sectional Study
Authors: Ye Qing , Li Chao , Pan Tianxin , Wang Zhiyong , Yang Huafeng , Qi Shengxiang , Wang Chenchen , Zhou Hairong , Qin Zhenzhen , Wang Weiwei , Hong Xin
Published: April 2021

BackgroundWe aim to investigate the association between socioeconomic status (SES) and metabolic syndrome (MetS) among general population in Nanjing, China.MethodsA cross-sectional study was conducted in 2017 among adults aged 18 years or older in Nanjing, China. Participants were selected using multistage sampling approach. Diagnosed MetS was the outcome variable. Education and monthly family average income (FAI) was used to separately indicate SES. Mixed-effects models were used to calculate the association between SES and MetS.ResultsThe prevalence of MetS was 19.7% (95%CI=19.0%, 20.4%) among overall sample population. After controlling for covariates, educational attainment was negatively associated with MetS prevalence in women. As for men, the most well-educated subjects were at the lowest risk (OR=0.72, 95%CI=0.57, 0.92) of having MetS compared to the least educated subjects. Relative to those who from lower FAI sub-group, participants from upper tertile were less likely to have MetS for both genders (OR=0.73, 95%CI=0.617, 0.87; OR=0.85, 95%CI=0.73, 0.99). Among all participants, higher education level predicted lower waist circumference, triglycerides, systolic and diastolic blood pressure, and fasting glucose concentration. Higher FAI was associated with lower waist circumference and systolic and diastolic blood pressure in women, and with lower systolic and diastolic blood pressure in men.ConclusionsEducation and family average income each was inversely related to MetS and its components prevalence in Nanjing, China in 2017. It has important public health implications that the tailored prevention strategies should be implemented for people with different socioeconomic status.
The Proximal Left Anterior Descending Coronary Artery Tortuosity and Angle Associated with Severe Proximal Left Anterior Descending Coronary Artery Stenosis
Authors: Moon Seong Ho , Kim Jong Woo , Yang Jun Ho , Kang Dong Hoon , Kim Sung Hwan , Jung Jae Jun , Ahn Jong Hwa , Park Sung Eun , Jeon Kyung Nyeo , Byun Joung Hun
Published: April 2021

We aimed to describe two factors (coronary artery tortuosity and bifurcation angle) as one descriptor for the evaluation of proximal left anterior descending coronary artery (LAD) disease. We reviewed the medical records of 133 consecutive patients who underwent computed tomography angiography (CTA) for angina symptoms in November 2019 and January 2020. The patients were divided into two groups according to the presence of significant LAD stenosis on CTA (defined as LAD stenosis > 50%). The straight length of the vessel was measured using the central luminal line of the flow path, and, calculated using proprietary algorithms in TeraRecon software. We used three-dimensional volume rendering and two-dimensional axial images to measure the left main coronary artery (LM)-LAD angles. In the univariate analysis, there were significant differences in the linear distance between the endpoints of the 20mm actual curve of the LAD (d20), cosine value for LM-LAD angle (cosθ) < 0.8, age, presence of hypertension or diabetes, and number of pack years. However, in the multivariate analysis, the cosθ multiplied by the d20 (d20*cosθ) < 15.5, presence of hypertension and number of pack years were predictors of significant proximal LAD stenosis. In conclusion, d20*cosθ might be useful as a predictor of proximal LAD stenosis.
Prevalence of antibiotic use and household water-sanitation risk factors of acute watery diarrhea among children <5 years: retrospective analysis of multicounty health survey data, 2006-2018
Authors: Ahmed Md. Shakil
Published: April 2021

A total 12,69,944 under five year Childs were included in this study among them 1,80,067 Childs were acute watery diarrhea (AWD) and 19,502 Childs were bloody diarrhea respectively. Among them 47,755 Childs were taken antibiotic treatment for AWD. The overall prevalence of acute watery diarrhea ~ 14% (prevalence = 0.142; 95% CI = 0.141, 0.142). On the other hand the prevalence of bloody diarrhea ~ 2% (prevalence = 0.015; 95% CI = 0.015, 0.016). The prevalence of antibiotic treatment for AWD was ~ 27% (prevalence = 0.27, 95% CI = 0.26, 0.27) among the under five years old children in DH survey regions in the world. The prevalence of acute watery diarrhea was higher ~ 17% (prevalence = 0.17, 95% CI = 0.16, 0.17) in the Latin America DHS survey region. The minimum prevalence of AWD was almost equal between South East Asia and Central Asia DHS survey regions ~ 12% (prevalence = 0.12, 95% CI = 0.11, 0.12) and ~ 12% (prevalence = 0.12, 95% CI = 0.10, 0.13) respectively. On the other hand the prevalence of AWD between Europe and West North and Central Africa DHS survey regions ~ 16% (prevalence = 0.16, 95% CI = 0.15, 0.16) and ~ 15% (prevalence = 0.15, 95% CI = 0.14, 0.15) correspondingly. In the central Asia of 15,089 under five Childs were included in the survey. Among them 1,748 Childs were AWD and 967 Childs had taken antibiotic treatment for AWD. The highest prevalence of antibiotic use for AWD in Central Asia ~ 55% (prevalence=(967/1748) = 0.55, 95% CI = 0.52, 0.59) and Europe DH survey region ~ 44% (prevalence=(5483/12502) = 0.44, 95% CI = 0.43, 0.45). The lowest prevalence of antibiotic use for under five Child AWD was ~ 23% (prevalence=(11918/51328) = 0.23, 95% CI = 0.22, 0.24) in the DH survey region South East Asia. On the other hand the DH survey region Latin America and West North and Central Africa region the prevalence of antibiotic use for AWD were ~ 30% (prevalence=(7887/26396) = 0.30, 95% CI = 0.29, 0.31) and ~ 24% (prevalence=(21500/88093) = 0.24, 95% CI = 0.23, 0.24). The South East Asia DH survey region countries DHS 2007 (Bangladesh), DHS 2014 and 2010 (Cambodia), DHS 2017 and 2012 (Indonesia), DHS 2009 (Maldives), DHS 2015–2016 (Myanmar), DHS 2012–2013 (Pakistan), DHS 2017 and 2013 (Philippines), and DHS 2009–2010 (Timor-Leste) were higher risk of AWD for drinking unimproved water sources. The prevalence of antibiotic use for u5c AWD was shown highest prevalence in DHS 2007 (~ 44%), DHS 2012 (~ 49%), DHS 2016 (~ 40%), and DHS 2017 (~ 65%) from DH survey 2006 to 2018 in South East & Central Asia. The linear trend analysis showed that upward trend for using antibiotic of AWD in the South East & Central Asia DH survey region.
Translation and Validation of Adolescents’ Self-Concept Short Scale
Authors: Namood-e-Sahar  , Nadeem Hamid Ali
Published: April 2021

Adolescents’ Self-Concept Short Scale (Veiga& Leite, 2016) was devised to measure self-concept among adolescents. Present study was aimed to translate the scale into Urdu language and validate the underlying factors among adolescents of Pakistan. It comprised of three main phases. Phase-I underlies the translation through forward-back translation method, followed by the cross-language validation study. The translated and the original version were administered on bilingual secondary school students (N=100) and reliability was estimated that ranges from .39 to .71 for translated version. Phase-II aimed to establish the construct validity by using Exploratory Factor Analysis on adolescent students (N=150) with age range of 13 to 16 years (M=14.53; SD=1.02). Results showed four main factors, instead of six factors of original scale. Finally, Phase-III of the research aimed to confirm the factorial validity through Confirmatory Factor Analysis (CFA) on sample of secondary school adolescent students (N=300) age ranges from 13 to 18 years (M= 15.46; SD=1.23). Findings thus suggested that Adolescents’ Self-Concept Short Scale - Urdu version can be utilized as a valid and reliable measure for the assessment of self-concept among adolescent students with understandability of Urdu language.
Emesis in Pregnancy – a qualitative study on trial recruitment failure
Authors: Lie Mabel Leng Sim , McParlin Catherine , McColl Elaine , Graham Ruth Harriet , Robson Stephen Courtenay
Published: April 2021

BackgroundAs part of the internal pilot of the EMPOWER trial investigating second line antiemetic therapies in severe emesis in pregnancy (https://www.isrctn.com/ISRCTN16924692), a qualitative study of women’s views was carried out, to improve our understanding of why women did, or did not, consent to participation in the trial. Because of poor recruitment rates, interviews were extended to include site research staff, to broaden our understanding and explore other factors affecting recruitment.MethodsThe sample comprised women who accepted or declined trial participation (n = 21) and site research staff (n = 22). To reduce the burden on women, a structured topic guide was used, in four email interviews and 17 telephone interviews. Following slow trial recruitment, semi-structured telephone interviews were carried out with staff. All transcripts were checked for accuracy, anonymised, and entered into NVIVO12 for indexing and retrieval. Data was analysed using a generative thematic approach.ResultsOf the women interviewed, seven were decliners, and of the site research staff interviewed, 16 were research midwives/research nurses and six were principal investigators. In total, 72 codes were generated from the thematic analysis, 36 from each sample group. The themes focused on in this paper were: (a) The diversity of recruitment pathways and boundaries of care, (b) the impact of trial complexity on recruitment and staff morale and (c) the ethics of caring for a patient with emesis. To address these themes, staff perspectives are given more prominence.ConclusionsThe main reasons the trial did not progress were the patient population and their ineligibility due to prior treatment with study drug(s). We describe how staff had to manage the diversity of referral pathways, boundaries of care and the complexity of the trial and protocol. Ethical issues discussed included the use of double dummy and the time to treat women, particularly those suffering severely from the effects of nausea and vomiting. Qualitative work in feasibility and pilot stages of a clinical trial is recommended.Trial registrationTrial registration number ISRCTN16924692. Date of registration: 08/01/2018
Severe SARS-CoV-2 infection in a cat with hypertrophic cardiomyopathy 
Authors: Carvallo Francisco R. , Martins Mathias , Joshi Lok R. , Caserta Leonardo C. , Mitchell Patrick K. , Cecere Thomas , Hancock Sandy , Goodrich Erin L. , Murphy Julia , Diel Diego G.
Published: April 2021

Coronavirus disease 19 (COVID-19), has claimed millions of human lives worldwide since the emergence of the zoonotic severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China in December 2019. Notably, most severe and fatal SARS-CoV-2 infections in humans have been associated with underlying clinical conditions, including diabetes, hypertension, and heart diseases. Here we describe a case of severe SARS-CoV-2 infection in a domestic cat (Felis catus) that presented with hypertrophic cardiomyopathy (HCM), a chronic heart condition that has been described as a comorbidity of COVID-19 in humans and that is prevalent in domestic cats. The lung and heart of the affected cat presented clear evidence of SARS-CoV-2 replication, with histological lesions similar to those observed in humans with COVID-19 with high infectious viral loads being recovered from these organs. The study highlights the potential impact of comorbidities on the outcome of SARS-CoV-2 infection in animals and provides important information that may contribute to the development of a feline model with the potential to recapitulate the clinical outcomes of severe COVID-19 in humans.
Impacts of COVID-19 interventions: Health, economics, and inequality
Authors: Meng X. Flora , Jones Dalton , Rigobon Roberto , Dahleh Munther
Published: April 2021

Coronavirus disease 2019 (COVID-19) is exacerbating inequalities in the US. We build an agent-based model to elucidate the differential causal effects of nonpharmaceutical interventions on different communities and validate the results with US data. We simulate viral transmission and the consequent deterioration of economic conditions on socioeconomically disadvantaged and privileged populations. As found in data, our model shows that the trade-off between COVID-19 deaths and deaths of despair, dependent on the lockdown level, only exists in the socioeconomically disadvantaged population. Moreover, household overcrowding is a strong predictor of the infection rate. The model also yields new insights that fill in the gaps of our data analysis. While subsidisation narrows the socioeconomic gap in deaths of despair, the combination of testing and contact tracing alone is effective at reducing disparities in both types of death. Our results contribute to policy modelling and evaluation for reducing inequality during a pandemic.
Design of silicon waveguides with integrated graphene oxide films for nonlinear optics
Authors: Zhang Yuning , Wu Jiayang , Qu Yang , Jia Linnan , Jia Baohua , Moss David
Published: April 2021

The Kerr nonlinear optical performance of silicon nanowire waveguides integrated with 2D layered graphene oxide (GO) films is theoretically studied and optimized based on experimentally measured linear and nonlinear optical parameters of the GO films. The strong mode overlap between the silicon nanowires and highly nonlinear GO films yields a significantly enhanced Kerr nonlinearity for the hybrid waveguides. A detailed analysis for the influence of waveguide geometry and GO film thickness on the propagation loss, nonlinear parameter, and nonlinear figure of merit (FOM) is performed. The results show that the effective nonlinear parameter and nonlinear FOM can be increased by up to ~ 52 and ~ 79 times relative to bare silicon nanowires, respectively. Self-phase modulation (SPM)-induced spectral broadening of optical pulses is used as a benchmark to evaluate the nonlinear performance, examining the trade-off between enhancing Kerr nonlinearity and minimizing loss. By optimizing the device parameters to balance this, a high spectral broadening factor of 27.8 can be achieved ‒ more than 6 times that achieved in previous experiments. Finally, the influence of pulse chirp, material anisotropy, and the interplay between saturable absorption and SPM is also discussed, together with the comparison between the spectral broadening after going through GO-coated and graphene-coated silicon waveguides. These results provide useful guidance for optimizing the Kerr nonlinear optical performance of silicon waveguides integrated with 2D layered GO films.
Theoretical Proof that Entangled Polarized Photons Allow Superluminal Communication
Authors: Ritzmann Vinicius
Published: April 2021

In Quantum Mechanics, two particles are entangled if their physical states depend on one another's so that if we find one of them in state A, for example, we will be sure that the other is in state B. However, until the state of a quantum particle is measured, it will be in a superposition of states, being in neither one nor the other until then, so when an entangled particle is measured, its pair also assumes a state instantly and regardless of how far away it is from the other particle at that time. As promising as it could be to use this fact for instantaneous communication, Quantum Mechanics seems to claim this is impossible, as no method ever invented to do this has worked until today. What we demonstrate here theoretically is that with a protocol and simple optical devices, two people who share polarized entangled pairs of photons can send information to each other faster than light. If this model of communication proves to be experimentally functional, we will have a contradiction to Einstein's theories of relativity, and otherwise, we will have Quantum Mechanics predicting something that does not happen in real life. This result, therefore, shows there is something fundamental about the universe we do not know yet. One of these theories must be mistaken and both deal with fundamental aspects of reality, such as the dynamics of space and time, and the particles that almost all matter around us are made of. Besides, this result is of great relevance also because it has immediate applications in several areas if the model works experimentally, as in space exploration and security, since it will allow the creation of non-interceptable instantaneous communication technologies.
Lutein encapsulated oleic - linoleic acid nanoemulsion boosts oral bioavailability of retinal protective carotenoid lutein in rat model
Authors: Toragall Veeresh B , Godhwani Twinkle , Baskaran V , Jayapala Naveen
Published: April 2021

There is excessive interest in emerging colloidal delivery systems to enhance the water solubility and oral bioavailability of lutein, which is a hydrophobic carotenoid claimed to possess health benefits. The present study aimed to design lutein-enriched nanoemulsions with improved physicochemical properties and to achieve various health benefits of lutein. The prepared lutein nanoemulsion was characterized, and its bioavailability was examined in vitro (simulated gastrointestinal digestion) and in vivo. The mean size, PDI and zeta potential of the lutein nanoemulsion were 110 ± 8 nm, 0.271 and 36 ± 2 mV, respectively. Furthermore, TEM examination revealed that the particles are nanosized and spherical in shape. Notably, the aqueous solubility of the nanoemulsion was 726-fold higher than that of free lutein. The composite nanoemulsion also showed exceptionally higher (87.4%) in vitro bioaccessibility than that of nonencapsulated or free lutein (15%). The in vivo bioavailability of lutein nanoemulsion (112.6 ng/mL) was much higher than that of nonencapsulated lutein (48.6 ng/ml) and mixed micelles (68.5 ng/mL), and the tissue distribution pattern of lutein nanoemulsion showed higher lutein accumulation in the liver (2.80- and 1.70-fold) and eye (1.91- and 1.48-fold) compared to free lutein and mixed micelle-fed groups. These results suggested that oleic acid-linoleic acid composite nanoemulsions may be a promising delivery system for lutein and may help enhance the solubility, oral bioavailability and bioefficacy of lutein and could be used as an ingredient for the formulation of beverages or functional foods.
Análise das técnicas argumentativas nos textos dissertativo-argumentativos dos alunos do curso de redação PROENEM (UNILAB)
Authors: FERREIRA Leonardo , JÚNIOR José Olavo da Silva Garantizado
Published: April 2021

O presente trabalho tem o objetivo de analisar como os estudantes pré-universitários do Curso de Redação Gratuito ProEnem, promovido pelo Projeto Palestras Interdisciplinares e Oficinas de Produção Textual para o Enem (PROENEM), usam as estratégias argumentativas em redações dissertativo-argumentativas. Para darmos conta desse objetivo, a nossa base teórica está nos postulados de Perelman e Tyteca (1996), sobre as técnicas argumentativas, Fiorin (2018), em sua investigação sobre a argumentação, e Garantizado Júnior (2015), em seu modelo de análise e descrição do fenômeno argumentativo sob uma perspectiva textual e retórica. Para este trabalho, analisamos 25 redações produzidas por 25 estudantes pré-universitários da Turma 1 do primeiro módulo do Curso de Redação. Nossos resultados apontam que, após intervenção didática do ProEnem, as estratégias argumentativas de comparação, exemplificação, vínculo causal, e referência à autoridade foram mais adequadamente utilizadas nos textos produzidos pelos pré-universitários com os quais realizamos a pesquisa.