bluuebunny/crossref_metadata_2025 huggingface dataset:
Casca da manga como fonte de matéria prima lignocelulósica para obtenção do bioetanol
Authors: Eduardo Carlos Breno , Estrela Egídio Karina , Nascimento de Morais Oliveira Marcelo , Rogério Cruz de Souza Cláwsio , Kelly Santos Carmo Shirlene
Published: October 2020

O uso de combustíveis fósseis tem intensificado cada vez mais a emissão de gases poluentes à atmosfera, dessa forma, o etanol de segunda geração, obtido por matéria prima lignocelulósica surge como alternativa por ser considerado uma energia limpa. O biocombustível pode ser produzido a partir de resíduos gerados da fruticultura, como exemplo, a casca da manga, a qual possui uma composição satisfatória à produção do bioetanol. Este trabalho teve por objetivo, a produção de açúcares fermentescíveis, a partir desta matéria prima, para isso, foi realizado um planejamento fatorial acerca das principais variáveis de interesse no processo, e empregado a técnica da hidrólise ácida. Pôde-se observar, um aumento de 25,49% na formação de açúcares fermentescíveis comparados a composição in natura da matéria em estudo.
Editorial
Authors: Franco Vásquez José Gabriel
Published: October 2020

Para el segundo semestre de 2020, Medicina UPB trae cuatro artículos originales, tres revisiones narrativas y dos reportes de caso. Entre los artículos originales destaca una revisión sistemática sobre las tendencias en investigación sobre síntomas y trastornos mentales en relación con la COVID-19. Sin duda, el estrés psicosocial que implican el peligro de contagio, las medidas de salud pública y los cuidados de seguridad biológica, y los efectos de la infección viral sobre el sistema nervioso central, hacen que la salud mental sea uno de los aspectos fundamentales por tener en cuenta durante la pandemia. Además, los estudios de tendencias son importantes para entender cuáles son las preocupaciones de la comunidad científica y qué orientación tendrán las decisiones políticas en salud.
Mastitis granulomatosa
Authors: Bonilla Sepúlveda Óscar Alejandro , Calvo Herrera Daniel Eduardo
Published: October 2020

La mastitis granulomatosa es una enfermedad rara, de etiología desconocida y de diag­nóstico de exclusión luego de descartar otras causas de mastitis, como las asociadas a infecciones bacterianas y a gérmenes atípicos como hongos y tuberculosis. La incidencia ha sido difícil de determinar, pero varia del 0.3% al 1.8%. Más frecuente en mujeres en edad reproductiva, la presentación clínica más común de este tipo de mastitis es una masa mamaria de consistencia dura, unilateral, asociada a dolor, eritema, calor e hinchazón, sin fiebre. Tiende a formar abscesos únicos o múltiples con fistulización, lo que hace que se confunda con carcinoma inflamatorio o localmente avanzado. Además, tiende a ser recurrente. El diagnóstico solo puede confirmarse por histopatología, en la que se evidencian granulomas no caseificantes concentrados en lobulillos mamarios, con infiltrado linfocitario crónico, necrosis y, con frecuencia, ectasia ductal. El tratamiento es controvertido, con opciones que van desde la observación, antibióticoterapia, terapia con corticosteroides, medicamentos inmunosupresores como el metotrexato, a la cirugía con escisión local amplia.
Una aproximación a la descolonización de los estudios de paz: la experiencia intercultural y de abajo del pueblo Nasa Wes´x Tolima, Colombia
Authors: Sandoval Forero Eduardo Andrés , Capera Figueroa José Javier
Published: October 2020

El objetivo del artículo consiste en discutir teórica y conceptualmente el paradigma tradicional de la investigación moderno/colonial desde una perspectiva de paz descolonizadora a partir de la experiencia intercultural del pueblo Nasa Wes´x Tolima (Colombia), con respecto al conflicto entre los actores legales e ilegales inmersos en sus territorios. Laoriginalidad consiste en abordar la problemática desde la ruptura epistémica de la interculturalidad para la paz. El métodoutilizado fue el de la investigación fundamentada a partir de análisis de texto y de discursos de los indígenas, concluyendoque la experiencia de paz del pueblo Nasa Wes’x se articula con la perspectiva descolonizadora e intercultural de la paz, al enjuiciar los esquemas tradicionales de pacificación promovidos desde los intereses y dinámicas del Estado hegemónico; por el contrario, apela a la autonomía y liberación de la madre tierra, siendo el reflejo del sentipensar desde los territorios en el marco de la construcción de paces como la motivación de sus propias luchas por otra realidad posible en el ámbito comunitario.
ANÁLISE DE TÉCNICAS DE SEGMENTAÇÃO PARA MELHORIA NA OBTENÇÃO DE DADOS GEOMORFOMÉTRICOS COM BASE EM FERRAMENTAS OPEN SOURCE
Authors: De Oliveira Olavo Amancio , Bias Edilson de Souza , Steinke Valdir Adilson , De Sousa Rogerio Baptista , Passo Denílson Pereira , Baptista Gustavo Macedo de Mello , Filho Waterloo Pereira
Published: October 2020

O objetivo da pesquisa é demonstrar a viabilidade do uso de segmentação de imagens na obtenção de dados geomorfométricos para gestão de bacias hidrográficas. O estudo foi desenvolvido na bacia do Córrego Bandeirinha (BHCB), situada no estado de Goiás, no município de Formosa-GO. Para aplicação do estudo, utilizou-se o Shuttle Radar Topography Mission (SRTM), com dados de 1” x 1” (um segundo de arco) ou 30 m de resolução espacial. Para a segmentação do SRTM, com intuito de efetuar a separação de classes para identificação dos alvos que subsidiaram a pesquisa, foi utilizado o algoritmo ODR_Obia, adaptado do algoritmo de segmentação TA Baatz Segmenter, via plataforma do sistema open source QGIS, cujo resultado da segmentação e extração dos índices pré-definidos, resultou-se em nova imagem raster segmentada. Para a obtenção dos dados geomorfométricos, utilizou-se modelo ODR_Hidro, acessado via plataforma do QGIS, desenvolvido em linguagem Python. As formulações matemáticas foram compiladas dentro do modelo ODR_Hidro, assim como sua adaptação, por intermédio de outros algoritmos hidrológicos que são utilizados por software como o QGIS, GrassGIS e SagaGIS, subsidiando a extração dos índices geomorfométricos, a delineação da bacia e a extração dos canais da rede de drenagem. Os resultados foram avaliados a partir da aplicação do teste de hipóteses utilizando a estatística do Teste Mann-Whitney, para verificar se as médias das discrepâncias das coordenadas encontradas para os eixos E e N dos pontos de bifurcações são iguais ou similares àquelas que foram produzidas pelo modelo ODR_Hidro, tanto na imagem SRTM segmentada quanto na do SRTM original. O Teste de Mann-Whitney foi aplicado em seis conjuntos de amostras, sendo que em quatro, as hipóteses foram aceitas e apenas em dois conjuntos de amostras as hipóteses foram rejeitadas. Através dos resultados obtidos, infere-se que a aplicação do modelo ODR_Hidro para caraterização e definição de índices geomorfométricos utilizando a imagem do SRTM segmentado, ser bastante eficiente, haja visto que a validação de campo demonstrou a eficiência do modelo ao comprovar a existência das drenagens de 1ª ordem não mapeada na carta da DSG. Assim, é possível concluir que a segmentação de imagens, visando à caracterização geomorfométrica de bacias hidrográficas, poderá contribuir de forma eficiente para o fornecimento de dados morfométricos.
Factors Related to Malondialdehyde (MDA) Levels in Metal Casting Industry Workers
Authors: Suwondo Ari , Mohan Ahmad , Widyawati Melyana Nurul , Mardiyono Mardiyono
Published: October 2020

MDA, as a sign of oxidative stress, was increasing as a factor that changes the toxicity of responses in the workplace and causes male infertility etiology. This study aims to measure the MDA levels of workers in the casting industry metal. This type of research was analytical explanatory research with a cross-sectional design. This study's variables include the variables taken are MDA levels while the independent variables were age, years of service, type of work, IMT, marital status, and smoking habits. A saturated sampling technique took the research sample of 34 workers. Data analysis used univariate and bivariate methods. The results determined that respondents had MDA hormone levels below the average of 24 or 70.6%, while respondents who had MDA levels above an average of 10 or 29.4%. MDA levels relating to the length of work and marital status, while the type of work, IMT, and smoking habits are not associated with MDA levels in metal casting industry workers in the CV. Bonjor Jaya Klaten.
Effect of nitrogen management and seedling raising methods on the productivity of Aus rice under tidal ecosystem of Bangladesh
Authors: Sarker Antara , Samanta Swadesh Chandra , Saha Gopal
Published: October 2020

The low productivity of Aus rice in the tidal ecosystem of Bangladesh is mainly due to the difficulties in nitrogen (N) management under high tidal water along with unavailability of irrigation water during the onset of rice cultivation. Our present study demonstrated how the productivity of Aus rice could be improved using appropriate seedling raising methods and N management practices. The study was laid out in split plot design consisting two factors viz., seedling raising methods (wet seed bed and dry seed bed) and N management practices (six N treatments) in three replications. Results indicated that both the seedling raising methods and N management practices had significant effect on all the yield contributing characters of transplanted Aus rice under tidal condition. Specifically, the combination of seedlings raised in wet seed bed and fertilized with urea super granule (USG) at 10 days after transplanting (DAT) i.e., N3W showed the best values for plant height (110.33cm), number of effective tillers hill-1 (14.60), days required 50% flowering (53.00 DAT), days to maturity (84.33 DAT), panicle length (23.37 cm), number of filled grain panicle-1 (88.13), 1000-grain weight (43.17 g), grain yield (4.62 tha-1), straw yield (6.07 tha-1), biological yield (10.67 tha-1), and harvest index (43.17%). However, in considering the productivity/ grain yield, besides N3W, the whole urea application at land preparation along with wet seed bed (N1W) and USG application along with dry seed bed (N3D) also produced statistically similar results (p<0.01) and thus all these three combinations may be practiced for improving productivity and ensuring horizontal expansion of Aus rice in the tidal ecosystem of Bangladesh.
Effect of water stress and AM fungi on the growth performance of pea
Authors: Thakur Jaya , Shinde Bharat
Published: October 2020

The study was conducted to determine the effect of arbuscular mycorrhizal (AM) fungi inoculation on growth of pea grown under water stressed pot culture conditions. Water stress was given to the pea plants after 30 days at the interval of 4, 8 and 12 days. The data was collected at an interval of 15 days. Three replicates of each set were maintained. . The mixture of AM fungi used for current experiment included the species of Acaulospora denticulata, A. gerdemannii, Glomus macrocarpum, G. maculosum, G. fasciculatum and Scutellospora minuta. The mycorrhizal plants have shown more shoot and root length as compared to the control plants. The height of shoot and root was significantly decreased with the increase in drought stress. Mycorrhizal plants with low water stress showed enhanced shoot and root length than high water stress. The mycorrhizal plants have shown more number of leaves than control plants during drought stress. The number of leaves significantly reduced with the increase in drought stress. The leaves produced by the control plants were comparatively smaller than those of mycorrhizal plants. The dry weight of root and shoot of both control and mycorrhizal plants decreased with the increase in water stress. Mycorrhizal plants showed more dry weight of shoot and root as compared to control plants.  Plants inoculated with AM fungi produce more dry weight than the control plants. The fresh weight of both control and mycorrhizal plants has been decreased with the increase in water stress interval and also the fresh weight of root and shoot was observed higher in mycorrhizal plants as compared to those of control plants.
Evolution of human diseases
Authors: Smail Harem othman
Published: October 2020

The main aims of this review were to understand the roles of evolutionary process in human disease. The suffering of human from disease may be millions years ago and until now are continuing and the human disease can be classified into many types based on their sources such as bacterial, Genetics and viral. For the past sixty years the scientist carried out high number of experiment to understand   and the decision of the evolutionary process impact of the human disease. the main example of effect of evolution on the human health are using overuse of antibiotics against bacterial infection   and the results to the speedy evolution of bacteria that are resistant to multiple antibiotics such that even vancomycin. The process of natural selection which is proposed by Charles Darwin play vital roles in Biological and medical process and also helps to predict and find the relationship between natural selection process of evolution and phenotypical traits. Understanding the developmental and genetic underpinnings of unique evolutionary changes have been hindered by way of insufficient databases of evolutionary anatomy and through the lack of a computational method to become aware of underlying candidate genes and regulators to the developing o the process of the evolution with helps of other branches of modern sciences such as genetics, Bioinformatics, epidemiology, ecology, microbiology, molecular biology and biochemistry.
WNK1 Antagonist Decreased Sevoflurane-induced Neurotoxicity in HT22 Hippocampal Neurons via the WNK1/NKCC1 Signalling Pathway
Authors: Bai Ya-Fan , Li Wen-Jing , Zhang Li , Li Jun-Fa , An Li-Xin
Published: October 2020

Background: The GABAAR plays an important role in the neurotoxicity caused by sevoflurane, but the mechanism of its regulation in this context is unknown. The present study aimed to reveal the WNK1/NKCC1 pathway as a regulator of the neurotoxicity caused by sevoflurane on the HT22 hippocampal neuron cell line. Methods: HT22 cultured hippocampal neurons were divided into three groups: control group, 4.1% sevoflurane treatment group for 6h, WNK-463 (specific antagonist of WNK1, 1µmol) + sevoflurane treatment group. Cell viability and the optimum concentration of WNK-463 were measured by MTS method. Cell apoptosis was detected by Tunel method, and the content of cleaved caspase-3 protein apoptosis factor was detected by Western blot. Pathway protein detection including the expression of WNK1, NKCC1 were detected. Calcium imaging measures intracellular calcium ion concentration and verifies downstream targets.Results: The neurotoxic effects of sevoflurane on hippocampal neurons were observed. As setting the results of control group is “1”, compared with sevoflurane group, WNK-463 downregulated the protein expression of cleaved caspase-3 (1.96±0.49 vs 1.29±0.38), increased cell viability (0.68 vs 0.96) and decreased apoptosis (13.31±4.67/vision vs 7.05±3.82/vision, ***P < 0.001). Compared with the control group, sevoflurane treatment increased the expression of WNK1 kinase and NKCC1 protein, whereas WNK-463 reversed this increase without affecting the control HT22 cells (*P < 0.05). Compared with the control group, sevoflurane exposure in HT22 cells increased intracellular Ca2+ concentrations, while WNK-463 reversed this change (1.0 vs 2.08±1.36 vs 1.26±0.77, **P < 0.01). Conclusion: This study demonstrated a neuroprotective role of the WNK1 antagonist WNK-463 in sevoflurane-induced neurotoxicity. WNK-463 promoted hippocampal neuron viability and reduced the apoptosis and intracellular calcium overload caused by sevoflurane on HT22 hippocampal neurons, possibly via the modulation of the WNK1/NKCC1 pathway.
miR-129-5p inhibits clear cell renal cell carcinoma cell proliferation, migration and invasion by targeting SPN
Authors: Gao Bin , Wang Lijuan , Zhang Yubo , Zhang Na , Han Miaomiao , Liu Huancai , Sun Dongli , Wu Xiaotang , Xiao Xiaolong , Liu Yifei
Published: October 2020

Objective: Our study aims to investigate the mechanism of the miR-129-5p/SPN axis in clear cell renal cell carcinoma (ccRCC), providing a novel direction for the targeted therapy of ccRCC. Methods: Bioinformatics methods were implemented to find the differentially expressed genes (DEGs) associated with ccRCC from TCGA database. qRT-PCR was performed to detect miR-129-5p and SPN mRNA expression, while western bot was carried out for the detection of protein expression of SPN. Bioinformatics analysis was used to predict the binding sites of miR-129-5p on SPN 3’UTR, while dual-luciferase assay was conducted to verify their binding relationship. CCK-8 assay, colony formation assay, wound healing assay and Transwell assay were employed to measure ccRCC cell proliferative ability, cell formation ability, cell migratory and invasive abilities. Results: miR-129-5p exhibited a significantly down-regulated expression level in ccRCC, while SPN showed a remarkably up-regulated expression level. Overexpressed miR-129-5p inhibited ccRCC cell proliferative, invasive and migratory capacities. Dual-luciferase assay confirmed that there was a binding relationship between miR-129-5p and SPN. Additionally, overexpressing miR-129-5p markedly reduced SPN expression in tumor cells, and attenuated the promoting effect of SPN on cell proliferation, migration and invasion. Conclusion: Our study proves the regulatory effect of the miR-129-5p/SPN axis in ccRCC, and provides a novel potential target for precise treatment of patients with ccRCC.
Behavioral and Psychosocial Factors of Quality of Life Among Adult People Living With HIV on Highly Active Antiretroviral Therapy, in Public Hospitals of South West Ethiopia, 2018: a Case Control Study
Authors: Gesese Abreha Addis , Desta Yitages Getachew , Behire Endale zenebe
Published: October 2020

Background: Despite of the availability of Highly Active Antiretroviral Therapy, people living with HIV/AIDS suffer from socioeconomic, behavioral and psychosocial related factors affecting their quality of life. Previous studies assessed the magnitude of quality of life but the present one will identify behavioral and psychosocial factors associated with poor quality of live among adult PLWHIV on Antiretroviral therapy in the study setting.Objective: To identify behavioral and psychosocial determinants of Quality of life among Adult PLWHIV on HARRT, in Public Hospitals of Jimma Zone, South West, Ethiopia 2018.Method: Institution based unmatched case control study was employed. Simple random sampling technique was used to select cases and controls using screening criteria. Interviewer administered data collection method was used. Data were entered into Epi-Data and analyzed using SPSS version 20. Bivariate and multivariate logistic regressions were performed. The study was conducted from March 10-April 10- 2018.Results: A total of 75(25%) cases and 225(75%) of controls included in the study. Finally, the odds of poor quality of life among underweight (BMI kg/m2) 2.7 times [AOR 2.7 95%CI (1.0, 7.1)] more likely than normal /obese respondents, khat chewing 1-4 times/weak/month about 4.5 times [AOR 4.5 95%CI (1.85, 10.9)] and at daily intervals 4.7 times more [AOR 4.7 95% CI (1.18, 18.8)] likely than who never chew respectively. Being dissatisfied from support AOR 9.8 95% CI (1.9, 50), Stigmatized patients 8 times more likely than non-stigmatized AOR 8.0 95%CI (3.6, 18.1). Moreover, the odds of poor quality of life among severely depressed patients were 4 times AOR 4.0 95% CI (1.67, 9.83) more likely than mild depressed patients.Conclusion: Being underweight (BMI kg/m2), khat chewing 1-4 times/weak/month, khat chewing at daily interval, being dissatisfied from support, stigma and depression were independently associated. This may inform possible interventions to reduce comorbidities and disease exacerbation by improving on dietary and nutritional programs and support, reducing behavioral factors, improving social support, reducing stigma and depression by appropriate counseling and strengthening currently existing Information Education Communication to help develop life skills.
Plasma purification is associated with reduced inflammation factors and down-regulation of lipid metabolic and ER stress proteins in patients with hyperlipidemia
Authors: Zhang Xiao Meng , Deng Hao , Xu Zheng Quan , Zhong Ze Yuan , Jin Hui Min , Yang Xiu Hong
Published: October 2020

Background Hyperlipidaemia is a strong risk factor for arteriosclerosis and cardiovascular disease (CVD). Therapy with lipid-lowering drugs often results in many side effects. The aim of our study was to investigate the potential effects of non-drug therapy with double-filtration plasmapheresis (DFPP) on lipid metabolism-, endoplasmic reticulum (ER) stress- and apoptosis-related proteins in peripheral blood mononuclear cells (PBMCs) before and after lipid clearance in patients with hyperlipidaemia.Methods Thirty-five patients with hyperlipidaemia were selected for this study. Proteins related to lipid metabolism [CD36, proprotein convertase subtilisin/kexin type 9 (PCSK9) and LDL receptor], ER stress (GRP78, CHOP, ATF4, EIF2a) and apoptosis (Bcl-2, BAX, and Caspase-3) were assayed by western blot, reactive oxygen species (ROS) were measured by flow cytometry (FCM), and serum inflammatory factors were detected by ELISA.Results Compared with their pre-DFPP values, the values of most lipid metabolic parameters, such as cholesterol, triglycerides, LDL, lipoprotein a [Lp(a)] and small dense LDL cholesterol (sdLDL), were reduced after DFPP. DFPP was associated with the downregulation of proteins related to lipid metabolism, ER stress and apoptosis, which also resulted in decreased ROS and serum inflammatory factor release.Conclusion DFPP has lipid-lowering activity and can also regulate lipid metabolism-, ER stress- and apoptosis-related proteins in PBMCs and reduce the levels of inflammatory factors in patients with hyperlipidaemia (ClinicalTrials.gov number: NCT03491956).
Achromatic diffractive lens limits
Authors: Engelberg Jacob , Levy Uriel
Published: October 2020

Over the recent years, there have been many reports of achromatic metalenses and diffractive lenses. However, very few (if any) practical applications of such achromatic flat lenses have been demonstrated, which raises questions about the potential of these lenses to provide solutions for real world cases which involve broadband illumination. A recent paper placed limits on the performance of achromatic metalenses. However, is this limit also valid for a diffractive lens? Not necessarily so. In this paper we derive the limits on the performance of achromatic diffractive lenses. In particular, we show that achromatic diffractive lenses can cover a wide spectral range, limited only by loss of efficiency caused by manufacturing limitations related to feature depth and size. On the other hand, we show that achromatic diffractive lenses can provide near diffraction limited performance only at very low Fresnel numbers, i.e. they cannot provide large focusing power and broadband response simultaneously. We then go on to compare the limits of achromatic metalenses and diffractive lenses, in attempt to understand the potential of different types of flat lenses. Our findings may set the ground for better evaluation of flat lens performance, understanding of their capabilities and limitations, and for exploring novel design concepts and applications.
Unlocking of time reversal, space-time inversion and rotation invariants in magnetic materials
Authors: Yang Jian , Liu Zheng-Xin , Fang Chen
Published: October 2020

Time reversal (T ) and space inversion are symmetries of our universe in the low-energy limit. Fundamental theorems relate their corresponding quantum numbers to the spin for elementary particles: Tˆ2 = (PˆTˆ)2 = −1 for half-odd-integer spins and Tˆ2 = (PˆTˆ)2 = +1 for integer spins. Here we show that for elementary excitations in magnetic materials, this “locking” between quantum numbers is lifted: Tˆ2 and (PˆTˆ)2 take all four combinations of +1 and −1 regardless of the value of the spin, where T now represents the composite symmetry of time reversal and lattice translation. Unlocked quantum numbers lead to new forms of minimal coupling between these excitations and external ﬁelds, enabling novel physical phenomena such as the “cross-Lamor precession”, indirectly observable in a proposed light-absorption experiment. We list the magnetic space groups with certain high-symmetry momenta where such excitations may be found.
A randomized controlled trial comparing peginterferon-α-2a versus observation after stopping tyrosine kinase inhibitor in chronic myeloid leukemia patients with deep molecular response for at least two years
Authors: Kuan Jew Win , Chang Kian Meng , Phan Chin Lee , Wong Shu Ping , Lim Soo Min , Toh See Guan , Loh Weng Khean , Begum Habiba Nazeera , Hon Siong Leng , Ng Si Yuan , Chiang Su Kien , Chai Alvin Jung Mau , Yong Kar Ying , Teo Hock Gin , Tang Andy Sing Ong , Wilfred Gilbert , Guan Yong Khee , Wong Lily Lee Lee , Ko Ching Tiong
Published: October 2020

Background: Interferon (IFN) is a logical possibility to increase treatment free remission (TFR) rate in chronic myeloid leukemia (CML). We conducted the first randomized controlled trial comparing the use of pegIFN versus observation in CML patients attempting TFR. Methods: Adult CML patients with stable deep molecular response for ≥ 2 years with ≥2 readings of MR4.5 were randomized into two arms -- subcutaneous pegIFN-α-2a starting at 180µg weekly for a year, followed by observation, or observation. Results: A total of 30 patients were recruited (pegIFN n=15, observation n=15). Median follow-up was 38.1 months (range 15.9-49.4) and 23.8 (1.5-51.0) in pegIFN and observation arm, respectively. A total of 11 patients relapsed (pegIFN n=4, observation n=7). The median time of relapse was 13.1 months (range 9.2 to 25.5) and 4.4 (1.2 to 13.6) in pegIFN and observation arm, respectively. Only 8 out of 15 (53%) patients completed 52 doses of pegIFN with mean dose of 43 out of 52 doses (range 20 to 52). Dose of tolerable pegIFN was age dependent. Conclusion: PegIFN is a potential consolidative therapy to increase TFR. Trial registration:(1) Malaysia National Medical Research Register (NMRR): NMRR-13-1186-15491. Approved 23rd September 2014, https://www.nmrr.gov.my/fwbLoginPage.jsp(2) ClinicalTrials.gov: NCT02381379. Registered on 24th Feb 2015, https://clinicaltrials.gov/ct2/results?cond=&term=NCT02381379&cntry=&state=&city=&dist=
Serum IL-8 acts as a novel biomarker in the diagnosis of patients with laryngeal cancer
Authors: Wang Lili , Song Hongguang , Yang Shiming
Published: October 2020

Background: Cytokines has the capacity to serve as biomarkers and therapy targets in a number of cancers. The aim of this study was to estimate the diagnostic potential of serum IL-8 in laryngeal cancer.Methods: Serum levels of IL-8 in 126 laryngeal cancer patients and 112 healthy controls were detected using enzyme-linked immunosorbent assay (ELISA) analysis. The association of IL-8 with clinicopathological characteristics was analyzed via χ2 test. Additionally, the receiver operating characteristic (ROC) curve was plotted to evaluate the diagnostic value of serum IL-8 in laryngeal cancer by calculating the area under ROC curve (AUC).Results: Serum IL-8 was significantly increased in laryngeal cancer patients, and its increased expression was positively associated with T classification (P=0.031), clinical stage (P=0.021) and lymph node metastasis (P=0.023). ROC curve suggested that serum IL-8 had a high value in differentiating laryngeal cancer patients from healthy individuals with a AUC value of 0.859 (95%CI: 0.812-0.906) combing with a sensitivity of 86.5% and a specificity of 72.3%.Conclusion: Serum IL-8 was significantly upregulated in laryngeal cancer which may serve as a biomarker for early diagnosis of laryngeal cancer.
Treatment of Primary Intra-Articular Pigmented Villonodular Synovitis of the Knee by Using Complete Arthroscopic Synovectomy and Postoperative Low-Dose Radiotherapy
Authors: Tie Kai , Wang Hua , Chen Biao , Yang Xu , Chen Liaobin
Published: October 2020

BackgroundPigmented villonodular synovitis (PVNS) is a locally aggressive, proliferative synovial tissue disorder, the optimal treatment regimen for diffuse PVNS is still undefined. The aim of this study was to evaluate the long-term clinical outcome of the treatment of complete arthroscopic synovectomy combined with low-dose external radiotherapy in the knee affected by primary intra-articular diffuse PVNS.MethodsA series of 18 patients diagnosed with primary diffuse PVNS by clinical and pathological examination were enrolled in this study from May 2009 to January 2016. All patients underwent complete arthroscopic synovectomy and postoperative local low-dose (20 Gy) external radiotherapy, and were evaluated before treatment and final follow-up using the criteria of Ogilvie-Harris and International Knee Documentation Committee (IKDC) score.ResultsThe patients were followed-up for a mean of 68 months (35 to 120 months). No recurrence was found. No surgical and radiation-related complications were observed. The mean score according to Ogilvie-Harris criteria was 3.19 which rated as poor, and the IKDC function score was 37.1±3.8 before treatment. At the final follow-up, the mean score of Ogilvie-Harris was 8.79 which rated as good, and the IKDC score was 83.9±11.3 (p<0.05).ConclusionTreatment for primary intra-articular diffuse PVNS in the knee with complete arthroscopic synovectomy and postoperative low-dose external radiotherapy had good clinical outcome with no complication and recurrence.
Protocol: How Has Sustainable Development Goals Declaration Influenced Health Financing Reform Processes for Universal Health Coverage at the Country Level? A Systematic Review of Literature
Authors: Odoch Walter Denis , Senkubuge Flavia , Hongoro Charles
Published: October 2020

BackgroundAchieving universal health coverage (UHC) is necessitating reforms in the way countries finance health systems. However, health financing reforms (HFR) are inherently political and SDGs declaration is a political one. Therefore, the terrain where efforts for reforming health financing occurs is likely being influenced by the SDGs declaration. However, how the SDGs have influenced health financing reform processes at the national level, the outcomes of these processes and how stakeholders especially ministries of health are using SDGs to influence reforms towards UHC have not been explored. This review is proposed to provide information and lessons on how SDGs have influence health financing reforms for UHC at national level and identify methodological and empirical gaps in studies exploring the relationship between SDGs and health financing reforms for UHC. MethodsWe propose a systematic review of literature and shall adhere to preferred reporting items for systematic review and meta-analysis (PRISMA) guidelines. We shall search 5 databases (Ovid Medline, PubMed, EBSCO, Scopus and Web of Science) and grey literature. Boolean operators “OR” and “AND” will be used to combine the concepts of sustainable development goals and health financing. The literature to be reviewed will be those on health financing reforms (population), one of the factors influencing the reform is SDGs declaration (exposure/intervention), and there is change in a health financing function (outcome). Identification and selection of studies shall be done in duplicate using a predefined tool, the overall process shall be depicted in a PRISMA flow chart. Quality assessment will be conducted using Joanna Biggs Institute checklist. Data shall be managed in NVIVo, where a thematic synthesis of data will be conducted. The results will be presented narratively. DiscussionWe shall share our finding with relevant stakeholders through workshop and publications. The SDGs declaration is relatively new, how it is influencing health financing reforms towards UHC at national level needs to be documented and shared for cross-country learning by stakeholders involved in this area. In addition, the review is anticipated to provide information on the methodological and/or empirical gaps in studies exploring the linkage between SDGs declaration and health systems reforms.
Impact of Chronic Obstructive Pulmonary Disease on In-hospital Mortality in Patients with Aneurysmal Subarachnoid Hemorrhage: An Observational Cohort Study with Propensity Score Matching
Authors: Zhang Yu , Li Linjie , Yao Wei , Wang Xing , Peng Liyuan , Di Yuanyuan , Wang Peng , Deng Haidong , Fan Huaqian , Li Ying , Cheng Xin , Chen Younian , Chong Weelic , Hai Yang , You Chao , Fang Fang
Published: October 2020

Objective: Chronic obstructive pulmonary disease (COPD) has been associated with several complications and mortality in acutely ill patients. For patients with aneurysmal subarachnoid hemorrhage (aSAH), the association between COPD and clinical outcomes remains unclear. Methods: In this retrospective cohort study, we analyzed consecutive aSAH patients admitted to the West China Hospital between 2009 and 2019. Propensity score matching was performed to obtain the adjusted odds ratios (ORs) with 95% CI. The primary outcome was in hospital mortality.Results: Using a ten-year clinical database from a large university medical center, 5643 patients with aSAH were identified, of whom 377 (7.9%) also had COPD. After matching, 289 patients were included in COPD group and 1156 in non-COPD groups. COPD was associated with increased in-hospital mortality (OR 1.63, 95% CI 1.02-2.62) and poor functional outcome at discharge (OR 1.37, 95% CI 1.04-1.80). Similarly, patients with COPD had significantly longer length of hospital stay, higher odds of seizure (OR 2.05, 95% CI 1.04-4.04), pneumonia (OR 3.10, 95% CI 2.38-4.04), intracranial infection (OR 1.62, 95% CI 1.14-2.29), urinary tract infection (OR 1.59, 95% CI 1.16-2.20) and bloodstream infection(OR 3.27, 95% CI 1.74-6.15). Conclusions: Among aSAH patients, COPD is associated with increased mortality. COPD represents a significant risk factor for pneumonia and seizure.
The application analysis of 8F ultrafine chest drainage tube in thoracoscopic lobectomy for lung cancer
Authors: Song Yongbin , Zheng Chong , Zhou Shaohui , Cui Hongshang , Wang Jincong , Wang Jianxun , Wang Wenhao , Liu Lijun , Liu Junfeng
Published: October 2020

Background：Currently, thoracoscopic lobectomy is widely used in clinical practice, and postoperative placing of ultrafine drainage tube has advantages in reducing postoperative pain and accelerating postoperative recovery of patients.This study aim to investigate the feasibility and safety of placing 8F ultrafine chest drainage tube after thoracoscopic lobectomy and its superiority over traditional 24F chest drainage tube.Methods: A retrospective data analysis was undertaken on 134 patients who placed 8F ultrafine chest drainage tube or 24F chest drainage tube with thoracoscopic lobectomy for lung cancer from January 2018 to December 2019 by our surgical team.Patients divided into Group A（n=67）with 8F ultrafine chest drainage tube and Group B（n=67）with 24F chest drainage tube.The drainage time, the total drainage volume,postoperative hospital stay,postoperative pain score and postoperative complication of both groups were compared.Results: Compared to B group,the A group had lower pain scores on postoperative days 1,2 and 3(3.72±0.65point vs 3.94±0.67point,P=0.027 ;2.72±0.93point vs 3.13±1.04point,P=0.016;1.87±0.65point vs 2.39±1.22point,P=0.005),shorter drainage time(4.25±1.79d vs 6.04±1.96d,P=0.000),fewer drainage volume(1100.42±701.57ml vs 1369.39±624.25ml,P=0.021);shorter postoperative hospital stay(8.46±2.48d vs 9.37±1.70d,P=0.014).Postoperative complication such as subcutaneous emphysema,pulmonary infection,atelectasis,chest tube reinsertion and intrathoracic hemorrhage displayed no difference between both group as well(P >0.05).Conclusion:Compared with 24F chest drainage tube, the application of 8F ultrafine chest drainage tube after thoracoscopic lobectomy can significantly shorten the drainage time,reduce the total drainage volume,reduce the postoperative pain degree,shorten the hospital day,and effectively detect postoperative intrathoracic hemorrhage. It is an effective, safe and reliable drainage method.
Components of the Required Scholarly Project for U.S. Allopathic Medical Schools
Authors: Wypiszynski Sarah , Hartnett Erin , Kaur Pareena , McEchron Matthew
Published: October 2020

Background: The medical student scholarly project (SP) promotes self-directed independent learning and engenders critical thinking skills. The SP also allows medical students to understand scientific methods and promotes life-long learning practices. More medical schools have adopted aspects of the SP into their curricula, and notably the SP approaches have varied widely from one school to the next. Several studies have carefully documented the SP options for specific medical schools, but no study to date has compared the curricular components of the various medical schools with required SPs. Methods: This study queried 156 allopathic medical schools based in the U. S. to identify the curricular components of the various SPs. Each SP was analyzed to determine: (1) if it was required or optional, (2) its duration and placement within the four-year curriculum, (3) the capstone requirement (e.g., thesis, manuscript, and/or poster), (4) if the research required a data-driven research question and hypothesis, (5) if there was a formal curriculum dedicated to the SP, and (6) a list of the program objectives.Results: Our research shows that of the 156 medical schools examined, 108 schools (69%) have an SP included in their curricula, and 62 of the 156 (39.7%) require an SP for graduation. Only 24 (15.4%) of the 156 medical schools queried have a required SP that must have a data-driven research question. Of the 24, we found that six medical schools have a required SP spanning all four years of medical school, with a research question/hypothesis-driven project and completion of a final written thesis or journal article style manuscript. Conclusion: Numerous studies have described successful models of the medical student SP. We summarize the curricular components of the six medical schools that have a required, spanning all four years of medical school with a research question/hypothesis driven project and completion of a final written thesis or journal article style manuscript. We also describe two additional schools with comparable SP requirements, however, one of these example schools does not require a final written product and the other school concentrates the SP in a five-month period toward the end of the medical school curriculum.
The Economic Impact of Innovative Therapies for Rare Diseases on Healthcare Providers and the Healthcare System in Germany – The Example of Spinal Muscular Atrophy
Authors: Brennenstuhl Heiko , Green Kim , Störzinger Dominic , Hoppe-Tichy Torsten , Burgard Peter , Klein Ulrike , Kölker Stefan , Neitemeier Sandra , Schoch Goentje-Gesine , Steimle Tim , Baas Jens , Hoffmann Georg F. , Autenrieth Ingo B. , Ziegler Andreas
Published: October 2020

Background: Despite a constant number of prescriptions, the expenditures of the statutory health insurance funds for pharmaceuticals are rising sharply. This is due to high prices for orphan drugs and advanced therapy medicinal products (ATMPs). Despite attempts by policymakers to intervene, such as the 2011 German Pharmaceutical Market Restructuring Act (Arzneimittelmarktneuordnungsgesetz, AMNOG), the use of these therapies poses numerous challenges for the healthcare system, especially insurance companies and healthcare providers.Results: Using data from the University Hospital Heidelberg, we found that the division of pediatric neurology is experiencing a disproportionate increase in drug costs, caused by two drugs for the treatment of spinal muscular atrophy (SMA), Nusinersen and Onasemnogen Abeparvovec. A survey of 41 German SMA treatment centers revealed a lack of human and infrastructural resources to manage therapy and follow-up care, which currently is insufficiently reimbursed. Disease-independent registers that comply with the rules of the European Union for medication surveillance and which are not tied to the pharmaceutical industry are necessary.Conclusion: Innovative forms of therapy require a critical discussion and regulation of application, aftercare and reimbursement as well as (inter)national industry independent registry work. Based on the model of evidence-based dynamic pricing by the Techniker Krankenkasse, we propose a concept which offers an internationally scalable solution to combat these challenges.
Combining F-Scan and GAITRite® for use in Clinical Gait Analysis: A Validation Study.
Authors: Speight Stephanie , Reidy Selina , Stephenson John , Reel Sarah
Published: October 2020

BackgroundClinical gait analysis is widely used to aid the assessment and diagnosis of symptomatic pathologies. Equipment based analysis provides clinicians with a more comprehensive assessment using pressure systems such as F-scan, or analysis of the spatial-temporal parameters of gait using GAITRite. There are systems however such as Strideway™ that can measure these parameters simultaneously, but can be expensive. This study aimed to determine whether standalone systems can be used collectively while still providing quality data, as a cost-effective alternative.MethodsTwenty-six participants walked on a standard floor and a GAITRite walkway, three times wearing the F-Scan system. Mid gait protocols were utilised by analysing the contact pressure of the 2 nd metatarsophalangeal joint of the third, fifth and seventh step from each walk. The Bland-Altman method was used to determine a level of agreement between the two surfaces, using mean values from all walks of all participants who successfully completed all required walks. The intraclass correlation coefficient and Lin’s concordance correlation coefficient were calculated as indices of reliability.ResultsThe intraclass correlation coefficient was calculated to be 0.991 and Lin’s concordance correlation coefficient for the data was calculated to be 0.956, indicating very good reproducibility.ConclusionsThe level of agreement in plantar pressures observed on the two surfaces was very high, suggesting that it is feasible to use F-Scan and GAITRite® together in a clinical setting, as an alternative to other less cost-effective standalone systems.
Association of Exposure to Hydrocarbons Air Pollution with Incidence of Atopic Dermatitis in Children
Authors: Wang Chieh , Tsai Jeng-Dau , Wan Lei , Lin Cheng-Li , Wei Chang-Ching
Published: October 2020

Background:There is growing evidence that air pollution may act as an important environmental risk factor in the development and aggravation of childhood atopic dermatitis (AD). Methods:We collected data from the Taiwan National Health Insurance research database and linked the data to the Taiwan Air Quality-Monitoring Database. Children younger than 18 years old between January 1st, 2000 and until the diagnosis of AD was made, or December 31st, 2012, were selected from the database. We measured the incidence rate and hazard ratios for AD, and stratified by quartiles (Q1-Q4) of air pollutant concentration. Multivariable Cox proportional hazards models were also applied by adjusting for age, sex, monthly income, and level of urbanization. Results:Compared with those exposed to the concentrations in the Q1 quartile, the adjusted hazard ratio (HR) for AD increased, and total hydrocarbon (THC), non-methane hydrocarbon (NMHC), and methane (CH4) exposure concentrations ranged from 1.65 to 10.6, from 1.14 to 2.47, and from 1.70 to 11.9, respectively. Patients exposed to higher levels of THC, NMHC, and CH4 had greater accumulative incidence rates of childhood AD. Conclusions:The current study demonstrated that exposure to higher concentrations of THC, NMHC, and CH4 were associated with an increased risk of childhood AD.
Biomechanics of Subcutaneous Locked Plating vs Burke Plate and External Fixator for Comminuted Distal Radius Fractures
Authors: Pytiak Andrew , Jin Xin , Cizmic Zlatan , Washington Austen , Vaidya Rahul
Published: October 2020

Background: External fixators that span the wrist have been the historical norm in treating distal radius fractures. We have modified a dorsal distraction approach by using a subcutaneously applied locked bridge plate through 2 small incisions superficial to the extensor tendons and outside the extensor compartment. The purpose of this study was to biomechanically evaluate this modified method of fixation for comminuted distal radius fractures in comparison with two established constructs. Methods: Matched cadaver specimens were used to model an AO Type 23-C3 distal radius fracture. Biochemical testing for stiffness during axial compressive loading was done on three constructs: a conventional Burke distraction plate, the subcutaneous internal fixation plating technique and an external fixator. All specimens were cyclically loaded for 3000 cycles and then retested. Results: The modified construct was found to be stiffer than the external fixator (p=0.013). When compared to the Burke plate, the modified construct was significantly less stiff before axial cycling (p=0.025). However, the difference was not maintained after cycling and the post-axial loading stiffness difference was non-significant (p=0.456).Conclusion: Our data demonstrate the biomechanical integrity of the subcutaneous plating technique for the fixation of comminuted distal radius fractures. It is stiffer than an external fixator and has the theoretical advantage of avoiding pin-tract infections. In addition, it is subcutaneous, and not a cumbersome external construct. Our construct is minimally invasive and does not violate the dorsal extensor compartments allowing movement of the fingers while the construct is in place.
Are Routine Postoperative Laboratory Tests Really Necessary After High Tibial Osteotomy Surgery?
Authors: Lan Min , Nie Si
Published: October 2020

Background: The purpose of this study was to assess the necessity and cost-effectiveness of routine postoperative laboratory tests for patients undergoing high tibial osteotomy (HTO) surgery.Methods: A prospective study was conducted and 513 patients with symptomatic isolated medial compartment osteoarthritis received HTO surgery from January 2015 to May 2020 were included in this study. The associations between different clinical factors and postoperative clinical treatment were analyzed. Finally, A logistic regression analysis was performed to detect independent risk factors for patients requiring postoperative clinical treatment. Results: In this study, 482 patients had completed the full set of postoperative laboratory studies within 3 days after surgery were included in the present study. However, only a small proportion of the patients with anemia (3.9%), hypoalbuminemia (4.1%), and abnormal serum potassium levels (3.5%) required clinical intervention after surgery. Binary logistic regression model analysis showed that body mass index (BMI), preoperative hemoglobin level, estimated blood loss and operative time were the independent risk factors correlated with postoperative blood transfusion in patients with HTO surgery. Female gender and preoperative albumin level were independent risk factors for patients who had requiring albumin supplementation after HTO surgery. Finally, preoperative potassium was the independent risk factors for patients required potassium supplementation postoperatively.Conclusions: based on the analysis, we conclude that routinely ordering postoperative laboratory texts after HTO surgery are both unnecessary and cost inefficient for most of the patients. However, for patients with identified risk factors, routine postoperative laboratory tests are still needed.