bluuebunny/crossref_metadata_2025 huggingface dataset:
Template copy number and the sensitivity of quantitative PCR for Plasmodium falciparum in asymptomatic individuals
Authors: Thompson Trevor A. , Touré Mahamoudou B. , Sanogo Daouda , Shaffer Jeffrey G. , Doumbia Seydou O. , Krogstad Donald J.
Published: August 2020

Background

The identification of asymptomatic individuals with Plasmodium falciparum infection is difficult because they do not seek medical treatment and often have too few asexual parasites detectable using microscopy or rapid diagnostic tests (≤ 200 parasites per μl). Quantitative PCR (qPCR) may provide greater sensitivity and permits estimation of the initial template DNA concentration. This study examined the hypothesis that qPCR assays using templates with higher copy numbers may be more sensitive for P. falciparum than assays based on templates with lower copy numbers.

Methods

To test this hypothesis, ten qPCR assays for DNA sequences with template copy numbers from 1 to 160 were compared using parasite DNA standards (n = 2) and smear-positive filter paper blots from asymptomatic smear-positive subjects (n = 96).

Results

Based on the testing of P. falciparum parasite DNA standards and filter paper blots, cycle threshold values decreased as the concentrations of template DNA and template copy numbers increased (p < 0.001). Likewise, the analytical and clinical sensitivities of qPCR assays for P. falciparum DNA (based on DNA standards and filter paper blots, respectively) increased with template copy number. Despite the gains in clinical sensitivity from increased template copy numbers, qPCR assays failed to detect more than half of the filter paper blots with low parasite densities (≤ 200 asexual parasites per μl).

Conclusions

These results confirm the hypothesis that the sensitivity of qPCR for P. falciparum in the blood of individuals with asymptomatic infection increases with template copy number. However, because even the most sensitive qPCR assays (with template copy numbers from 32 to 160) detected fewer than 50% of infections with ≤ 200 asexual parasites per μl, the sensitivity of qPCR must be increased further to identify all smear-positive, asymptomatic individuals in order to interrupt transmission.
A new postural stability-indicator to predict the level of fear of falling in Parkinson’s disease patients
Authors: Pourghayoomi Ehsan , Behzadipour Saeed , Ramezani Mehdi , Joghataei Mohammad Taghi , Shahidi Gholam Ali
Published: August 2020

Background

Fear of falling (FoF) is defined as a lasting concern about falling that causes a person to limit or even stop the daily activities that he/she is capable of. Seventy percent of Parkinson’s disease (PD) patients report activity limitations due to FoF. Timely identification of FoF is critical to prevent its additional adverse effects on the quality of life. Self-report questionnaires are commonly used to evaluate the FoF, which may be prone to human error.

Objectives

In this study, we attempted to identify a new postural stability-indicator to objectively predict the intensity of FoF and its related behavior(s) in PD patients.

Methods

Thirty-eight PD patients participated in the study (mean age, 61.2 years), among whom 10 (26.32%) were identified with low FoF and the rest (73.68%) with high FoF, based on Falls Efficacy Scale-International (FES-I). We used a limit of stability task calibrated to each individual and investigated the postural strategies to predict the intensity of FoF. New parameters (FTRis; functional time ratio) were extracted based on the center of pressure presence pattern in different rectangular areas (i = 1, 2, and 3). The task was performed on two heights to investigate FoF-related behavior(s).

Results

FTR1/2(the ratio between FTR1 and FTR2) was strongly correlated with the FES-I (r = − 0.63, p < 0.001), Pull test (r = − 0.65, p < 0.001), Timed Up and Go test (r = − 0.57,p < 0.001), and Berg Balance Scale (r = 0.62, p < 0.001). The model ofFTR1/2was identified as a best-fitting model to predicting the intensity of FoF in PD participants (sensitivity = 96.43%, specificity = 80%), using a threshold level of ≤ 2.83.

Conclusions

Using the proposed assessment technique, we can accurately predict the intensity of FoF in PD patients. Also, theFTR1/2index can be potentially considered as a mechanical biomarker to sense the FoF-related postural instability in PD patients.
Health-related quality of life (EQ-5D + C) among people living in artisanal and small-scale gold mining areas in Zimbabwe: a cross-sectional study
Authors: Butscher Friederike-Marie , Rakete Stefan , Tobollik Myriam , Mambrey Viola , Moyo Dingani , Shoko Dennis , Muteti-Fana Shamiso , Steckling-Muschack Nadine , Bose-O’Reilly Stephan
Published: August 2020

Background

In Zimbabwe, an estimated 500,000 people work in the sector of artisanal and small-scale gold mining (ASGM). Two million Zimbabweans are dependent on this sector. Using mercury is common to extract gold from ore. Long term exposure to mercury can cause various adverse health conditions including chronic mercury intoxication. The influence of these adverse health effects on the health-related quality of life (HRQoL) is still unknown. The aim of this study is to assess the HRQoL of people who identify themselves as miners, and to analyze potential influencing factors, such as age, years of working with mercury and health conditions caused by mercury exposure.

Methods

This cross-sectional study assessed the HRQoL using the standardized EQ-5D + C (3 L) questionnaire and collected human specimens (blood, urine) of people living and possibly working in ASGM areas in Zimbabwe. Factors such as age, years of working with mercury and adverse health conditions possibly caused by mercury exposure were analyzed with regards to their influence on the HRQoL.

Results

The 207 participants (82% male, mean age 38 years) reported 40 different health states. Of the study participants 42.5% reported to be in complete good health while 57.5% reported being unwell in different ways. Nine participants (4.3%) were identified with chronic mercury intoxication, whereas 92 participants (33.3%) had mercury levels above the “Alert” threshold in at least one specimen. Having chronic mercury intoxication has a significant negative influence on the HRQoL, when taking into account age, gender and years of working with mercury. Cognitive problems were the most reported in the questionnaire, however, the association between this domain separately and the HRQoL was not verified.

Conclusion

This study shows that adverse health effects caused by chronic exposure to mercury, have a negative influence on the HRQoL among people living in ASGM areas.
Does Sars-Cov-2 threaten our dreams? Effect of quarantine on sleep quality and body mass index
Authors: Barrea Luigi , Pugliese Gabriella , Framondi Lydia , Di Matteo Rossana , Laudisio Daniela , Savastano Silvia , Colao Annamaria , Muscogiuri Giovanna
Published: August 2020

Background

COVID 19-related quarantine led to a sudden and radical lifestyle changes, in particular in eating habits. Objectives of the study were to investigate the effect of quarantine on sleep quality (SQ) and body mass index (BMI), and if change in SQ was related to working modalities.

Materials

We enrolled 121 adults (age 44.9 ± 13.3 years and 35.5% males). Anthropometric parameters, working modalities and physical activity were studied. Sleep quality was evaluated by the Pittsburgh Sleep Quality Index (PSQI) questionnaire. At baseline, the enrolled subjects were assessed in outpatient clinic and after 40 days of quarantine/lockdown by phone interview.

Results

Overall, 49.6% of the subjects were good sleepers (PSQI < 5) at the baseline and significantly decreased after quarantine (p < 0.001). In detail, sleep onset latency (p < 0.001), sleep efficiency (p = 0.03), sleep disturbances (p < 0.001), and daytime dysfunction (p < 0.001) significantly worsened. There was also a significant increase in BMI values in normal weight (p = 0.023), in subjects grade I (p = 0.027) and II obesity (p = 0.020). In all cohort, physical activity was significantly decreased (p = 0.004). However, analyzing the data according gender difference, males significantly decreased physical activity as well as females in which there was only a trend without reaching statistical significance (53.5% vs 25.6%; p = 0.015 and 50.0% vs 35.9%, p = 0.106; in males and females, respectively). In addition, smart working activity resulted in a significant worsening of SQ, particularly in males (p < 0.001).

Conclusions

Quarantine was associated to a worsening of SQ, particularly in males doing smart working, and to an increase in BMI values.
Novel design for a dynamic ankle foot orthosis with motion feedback used for training in patients with hemiplegic gait: a pilot study
Authors: Hsu Chih-Chao , Huang Yin-Kai , Kang Jiunn-Horng , Ko Yi-Feng , Liu Chia-Wei , Jaw Fu-Shan , Chen Shih-Ching
Published: August 2020

Background

We designed a novel ankle foot orthosis (AFO), namely, ideal training AFO (IT-AFO), with motion feedback on the hemiparetic lower limb to improve ambulation in individuals with stroke-related hemiplegia. We, therefore sought to compare the kinematic parameters of gait between IT-AFO with and without dynamic control and conventional anterior-type AFO or no AFO.

Methods

Gait parameters were measured using the RehaWatch® system in seven individuals with hemiplegia (mean 51.14 years). The parameters were compared across four conditions: no AFO, conventional anterior AFO, IT-AFO without dynamic control, and IT-AFO with dynamic control, with three trials of a 10-m walk test for each.

Results

The dorsiflexion angle increased during the swing phase when the IT-AFO was worn, and it was larger with dynamic control. These data can confirm drop foot improvement; however, the difference between the parameters with- and without-AFO control conditions was not significant in the swing phase. The IT-AFO with or without dynamic control enhanced the loading response to a greater extent between the hemiparetic and unaffected lower limbs than conventional AFO or no AFO. The duration of the stance phase on the hemiparetic lower limb was also longer when using IT-AFO with and without dynamic control than that when using conventional AFO, which improved asymmetry. User comfort and satisfaction was greater with IT-AFO than with the other conditions.

Conclusions

The IT-AFO with dynamic control improved gait pattern and weight shifting to the hemiparetic lower limb, reducing gait asymmetry. The difference with and without dynamic control of IT-AFO is not statistically significant, and it is limited by sample size. However, this study shows the potential of IT-AFO in applying positive motion feedback with gait training.

Trial registration

Taipei Medical University-Joint Institutional Review Board. N201510010. Registered 12 February 2015. http://ohr.tmu.edu.tw/main.php.
Implementation outcome instruments for use in physical healthcare settings: a systematic review
Authors: Khadjesari Zarnie , Boufkhed Sabah , Vitoratou Silia , Schatte Laura , Ziemann Alexandra , Daskalopoulou Christina , Uglik-Marucha Eleonora , Sevdalis Nick , Hull Louise
Published: August 2020

Background

Implementation research aims to facilitate the timely and routine implementation and sustainment of evidence-based interventions and services. A glaring gap in this endeavour is the capability of researchers, healthcare practitioners and managers to quantitatively evaluate implementation efforts using psychometrically sound instruments. To encourage and support the use of precise and accurate implementation outcome measures, this systematic review aimed to identify and appraise studies that assess the measurement properties of quantitative implementation outcome instruments used in physical healthcare settings.

Method

The following data sources were searched from inception to March 2019, with no language restrictions: MEDLINE, EMBASE, PsycINFO, HMIC, CINAHL and the Cochrane library. Studies that evaluated the measurement properties of implementation outcome instruments in physical healthcare settings were eligible for inclusion. Proctor et al.’s taxonomy of implementation outcomes was used to guide the inclusion of implementation outcomes: acceptability, appropriateness, feasibility, adoption, penetration, implementation cost and sustainability. Methodological quality of the included studies was assessed using the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist. Psychometric quality of the included instruments was assessed using the Contemporary Psychometrics checklist (ConPsy). Usability was determined by number of items per instrument.

Results

Fifty-eight publications reporting on the measurement properties of 55 implementation outcome instruments (65 scales) were identified. The majority of instruments assessed acceptability (n= 33), followed by appropriateness (n= 7), adoption (n= 4), feasibility (n= 4), penetration (n= 4) and sustainability (n= 3) of evidence-based practice. The methodological quality of individual scales was low, with few studies rated as ‘excellent’ for reliability (6/62) and validity (7/63), and both studies that assessed responsiveness rated as ‘poor’ (2/2). The psychometric quality of the scales was also low, with 12/65 scales scoring 7 or more out of 22, indicating greater psychometric strength. Six scales (6/65) rated as ‘excellent’ for usability.

Conclusion

Investigators assessing implementation outcomes quantitatively should select instruments based on their methodological and psychometric quality to promote consistent and comparable implementation evaluations. Rather than developing ad hoc instruments, we encourage further psychometric testing of instruments with promising methodological and psychometric evidence.

Systematic review registration

PROSPERO 2017CRD42017065348
Trauma system developments reduce mortality in hospitalized trauma patients in Al-Ain City, United Arab Emirates, despite increased severity of injury
Authors: Alao David O. , Cevik Arif Alper , Eid Hani O. , Jummani Zia , Abu-Zidan Fikri M.
Published: August 2020

Background

Trauma is a leading cause of death in the United Arab Emirates (UAE). There have been major developments in the trauma system in Al-Ain City during the last two decades. We aimed to study the effects of these developments on the trauma pattern, severity, and clinical outcome of hospitalized trauma patients in Al-Ain City, United Arab Emirates.

Methods

This is a retrospective analysis of two separate sets of prospectively collected trauma registry data of Al-Ain Hospital. Data were collected over two periods: from March 2003 to March 2006 and from January 2014 to December 2017. Demography, injury mechanism, injury location, and clinical outcomes of 2573 trauma patients in the first period were compared with 3519 patients in the second period.

Results

Trauma incidence decreased by 38.2% in Al-Ain City over the last 10 years. Trauma to females, UAE nationals, and the geriatric population significantly increased over time (p< 0.0001, Fisher’s exact test for each). Falls on the same level significantly increased over time, while road traffic collisions and falls from height significantly decreased over time (p< 0.0001, Fisher’s exact test for each). Mortality significantly decreased over time (2.3% compared with 1%,p< 0.0001, Fisher’s exact test).

Conclusions

Developments in the trauma system of our city have reduced mortality in hospitalized trauma patients by 56% despite an increased severity of injury. Furthermore, the injury incidence in our city decreased by 38.2% over the last decade. This was mainly in road traffic collisions and work-related injuries. Nevertheless, falls on the same level in the geriatric population continue to be a significant problem that needs to be addressed.
Clouds over IMD? Perspectives for inherited metabolic diseases in adults from a retrospective cohort study in two Swiss adult metabolic clinics
Authors: Gariani Karim , Nascimento Marina , Superti-Furga Andrea , Tran Christel
Published: August 2020

Background

Inherited metabolic diseases (IMD) are complex medical conditions. Thanks to improvements in diagnosis and treatment, a growing number of pediatric IMD patients reach adulthood. Thus, clinical care of adults with IMD has emerged as a new and challenging reality. This purpose of this study of adults with IMD in an adult metabolic clinic at two academic hospitals (Lausanne and Geneva) was to help inform decisions on the future organization of health care for this group of patients.

Methods

All adult patients with a biochemical and/or genetic diagnosis of IMD followed at the clinics were included in the study. Electronic patient records were reviewed for clinical features, diagnostic studies, treatment and long-term outcome. Data of undiagnosed patients referred for suspected IMD were analyzed separately.

Results

126 patients were included in the study. The most prevalent group of diseases was small molecules disorders with 82 (65%) patients, followed by energy defects disorders with 29 (23%) patients and complex molecules disorders with 15 (12%) patients. Overall, 64% of patients were diagnosed before, and 36% after the age 16 years. Among the 126 cases, 51% suffered from medical complications. 79% of the patients were receiving a specific treatment for their disease. Among the 138 undiagnosed patients referred for suspicion of IMD, investigations lead to a genetic diagnosis in 24 (17%) patients. 19 had confirmation of an IMD, 5 were found to have another genetic condition.

Conclusions

This retrospective study reveals significant features of adult IMD cohort. The disorders are heterogeneous, and there is no one-size-fits-all approach – treatment must be tailored to fit each specific disorder in each individual patient. Even patients who are followed at the dedicated clinic are not protected from metabolic decompensations and/or chronic organ-specific complications. While it is commonly assumed that patients with IMD are more stable once they become adults, our data show that the diseases continue to exact a lifelong toll. A coordinated monitoring of target organs by a multidisciplinary team is needed. To ensure that the success in diagnosis and treatment of individuals with IMD is sustained, there is a clear requirement for adequately staffed adult IMD clinics.
Pediatric hypophosphatasia: lessons learned from a retrospective single-center chart review of 50 children
Authors: Vogt Marius , Girschick Hermann , Schweitzer Tilmann , Benoit Clemens , Holl-Wieden Annette , Seefried Lothar , Jakob Franz , Hofmann Christine
Published: August 2020

Background

Hypophosphatasia (HPP) is a rare, inherited metabolic disorder caused by loss-of-function mutations in the ALPL gene that encodes the tissue-nonspecific alkaline phosphatase TNAP (ORPHA 436). Its clinical presentation is highly heterogeneous with a remarkably wide-ranging severity. HPP affects patients of all ages. In children HPP-related musculoskeletal symptoms may mimic rheumatologic conditions and diagnosis is often difficult and delayed. To improve the understanding of HPP in children and in order to shorten the diagnostic time span in the future we studied the natural history of the disease in our large cohort of pediatric patients.

This single centre retrospective chart review included longitudinal data from 50 patients with HPP diagnosed and followed at the University Children’s Hospital Wuerzburg, Germany over the last 25 years.

Results

The cohort comprises 4 (8%) perinatal, 17 (34%) infantile and 29 (58%) childhood onset HPP patients. Two patients were deceased at the time of data collection. Diagnosis was based on available characteristic clinical symptoms (in 88%), low alkaline phosphatase (AP) activity (in 96%), accumulating substrates of AP (in 58%) and X-ray findings (in 48%). Genetic analysis was performed in 48 patients (31 compound heterozygous, 15 heterozygous, 2 homozygous mutations per patient), allowing investigations on genotype-phenotype correlations. Based on anamnestic data, median age at first clinical symptoms was 3.5 months (min. 0, max. 107), while median time to diagnosis was 13 months (min. 0, max. 103). Common symptoms included: impairment of motor skills (78%), impairment of mineralization (72%), premature loss of teeth (64%), musculoskeletal pain and craniosynostosis (each 64%) and failure to thrive (62%). Up to now 20 patients started medical treatment with Asfotase alfa.

Conclusions

Reported findings support the clinical perception of HPP being a chronic multi-systemic disease with often delayed diagnosis. Our natural history information provides detailed insights into the prevalence of different symptoms, which can help to improve and shorten diagnostics and thereby lead to an optimised medical care, especially with promising therapeutic options such as enzyme-replacement-therapy with Asfotase alfa in mind.
Increased phototoxic burn tolerance time and quality of life in patients with erythropoietic protoporphyria treated with afamelanotide – a three years observational study
Authors: Barman-Aksözen Jasmin , Nydegger Michèle , Schneider-Yin Xiaoye , Minder Anna-Elisabeth
Published: August 2020

Background

Erythropoietic protoporphyria (EPP) is an ultra-rare genetic disorder (prevalence 1:150`000) characterized by instant painful phototoxic burn reactions in skin exposed to visible light. Afamelanotide is the first clinically tested therapy effectively increasing the time EPP patients can spend in direct sunlight without developing symptoms and reducing the number and severity of phototoxic reactions.

Objectives

We report our data on real-world effectiveness of afamelanotide treatment in EPP and its phototoxic burn protection factor (PBPF).

Methods

We analysed clinical data collected between 2016 and 2018 in the Swiss EPP cohort (n = 39) on maximum phototoxic burn tolerance time (PBTT), i.e., maximum time spent in sunlight without phototoxic reaction, severity of phototoxic reactions as assessed by an 11-point Likert-type visual analogue scale (VAS), with 0 being no pain and 10 being the worst possible pain, and Quality of Life (QoL), as assessed with an EPP-specific instrument.

Results

Before treatment, the PBTT was median 10 min (IQR 5–20). Under treatment, PBTT increased to median 180 min (IQR 120–240). Individual PBPF increased 1.8- to 180-fold (full range, median 15). The pain severity of the worst phototoxic reaction before treatment was median 10 and under treatment median 6 (IQR 3–7). QoL at the end of the observation period in 2018 (with all the assessed patients under treatment) was 81.4% (IQR 69.4–93.4, n = 34). A 97.4% treatment adherence rate was observed.

Conclusion

Treatment of EPP patients with afamelanotide is highly effective under real-world conditions. We suggest PBTT as a clinical meaningful endpoint in further clinical trials.
Aspartate β-hydroxylase as a target for cancer therapy
Authors: Kanwal Madiha , Smahel Michal , Olsen Mark , Smahelova Jana , Tachezy Ruth
Published: August 2020

As metastasis is a major cause of death in cancer patients, new anti-metastatic strategies are needed to improve cancer therapy outcomes. Numerous pathways have been shown to contribute to migration and invasion of malignant tumors. Aspartate β-hydroxylase (ASPH) is a key player in the malignant transformation of solid tumors by enhancing cell proliferation, migration, and invasion. ASPH also promotes tumor growth by stimulation of angiogenesis and immunosuppression. These effects are mainly achieved via the activation of Notch and SRC signaling pathways. ASPH expression is upregulated by growth factors and hypoxia in different human tumors and its inactivation may have broad clinical impact. Therefore, small molecule inhibitors of ASPH enzymatic activity have been developed and their anti-metastatic effect confirmed in preclinical mouse models. ASPH can also be targeted by monoclonal antibodies and has also been used as a tumor-associated antigen to induce both cluster of differentiation (CD) 8+ and CD4+ T cells in mice. The PAN-301-1 vaccine against ASPH has already been tested in a phase 1 clinical trial in patients with prostate cancer. In summary, ASPH is a promising target for anti-tumor and anti-metastatic therapy based on inactivation of catalytic activity and/or immunotherapy.
Validation of a point-of-care capillary lactate measuring device (Lactate Pro 2)
Authors: Raa Anette , Sunde Geir Arne , Bolann Bjørn , Kvåle Reidar , Bjerkvig Christopher , Eliassen Håkon S. , Wentzel-Larsen Tore , Heltne Jon-Kenneth
Published: August 2020

Background

The measurement of lactate in emergency medical services has the potential for earlier detection of shock and can be performed with a point-of-care handheld device. Validation of a point-of-care handheld device is required for prehospital implementation.

Aim

The primary aim was to validate the accuracy of Lactate Pro 2 in healthy volunteers and in haemodynamically compromised intensive care patients. The secondary aim was to evaluate which sample site, fingertip or earlobe, is most accurate compared to arterial lactate.

Methods

Arterial, venous and capillary blood samples from fingertips and earlobes were collected from intensive care patients and healthy volunteers. Arterial and venous blood lactate samples were analysed on a stationary hospital blood gas analyser (ABL800 Flex) as the reference device and compared to the Lactate Pro 2. We used the Bland-Altman method to calculate the limits of agreement and used mixed effect models to compare instruments and sample sites. A total of 49 intensive care patients with elevated lactate and 11 healthy volunteers with elevated lactate were included.

Results

There was no significant difference in measured lactate between Lactate Pro 2 and the reference method using arterial blood in either the healthy volunteers or the intensive care patients. Capillary lactate measurement in the fingertip and earlobe of intensive care patients was 47% (95% CI (29 to 68%), p < 0.001) and 27% (95% CI (11 to 45%), p < 0.001) higher, respectively, than the corresponding arterial blood lactate. In the healthy volunteers, we found that capillary blood lactate in the fingertip was 14% higher than arterial blood lactate (95% CI (4 to 24%), p = 0.003) and no significant difference between capillary blood lactate in the earlobe and arterial blood lactate.

Conclusion

Our results showed that the handheld Lactate Pro 2 had good agreement with the reference method using arterial blood in both intensive care patients and healthy volunteers. However, we found that the agreement was poorer using venous blood in both groups. Furthermore, the earlobe may be a better sample site than the fingertip in intensive care patients.
Elevated admission lactate levels in the emergency department are associated with increased 30-day mortality in non-trauma critically ill patients
Authors: Bernhard Michael , Döll Stephanie , Kramer Andre , Weidhase Lorenz , Hartwig Thomas , Petros Sirak , Gries André
Published: August 2020

Background

Elevated blood lactate levels were reported as useful predictors of clinical outcome and mortality in critically ill patients. To identify higher-risk patients, this investigation evaluated the relationship between patient mortality and admission lactate levels during the management of non-trauma critically ill patients in the emergency department (ED).

Methods

In this prospective, single centre observational study in a German university ED, all adult patients who were admitted to the ED resuscitation room were evaluated between September 1, 2014 and August 31, 2015. Blood samples for blood gas analysis, including lactate levels, were obtained immediately at admission. Study endpoint was 30-day mortality.

Results

During the study period, 532 patients were admitted to the resuscitation room of the ED. The data of 523 patients (98.3%) were available. The overall 30-day mortality was 34.2%. Patients presenting to the resuscitation room with admission lactate levels < 2.0 mmol/l had a 30-day mortality of 22.7%, while admission lactate levels above 8.0 mmol/l were associated with higher mortality (8.0–9.9 mmol/l: OR: 2.83, 95%CI: 1.13–7.11, p = 0.03, and ≥ 10 mmol/l: OR: 7.56, 95%CI: 4.18–13.77, p < 0.001).

Conclusion

High lactate levels at admission are associated with an increased 24-h and 30-day mortality. These measurements may be used not only to predict mortality, but to help identify patients at risk for becoming critically ill. The breakpoint for mortality may be an ALL ≥8.0 mmol/l.
SIRT1-modified human umbilical cord mesenchymal stem cells ameliorate experimental peritoneal fibrosis by inhibiting the TGF-β/Smad3 pathway
Authors: Guo Yanhong , Wang Liuwei , Gou Rong , Wang Yulin , Shi Xiujie , Pang Xinxin , Tang Lin
Published: August 2020

Introduction

Peritoneal fibrosis is a serious complication of long-term peritoneal dialysis (PD). Combination therapies are emerging as a promising treatment for tissue damage. Here, we investigated the therapeutic potential of SIRT1-modified human umbilical cord mesenchymal stem cells (hUCMSCs) for peritoneal fibrosis.

Methods

SIRT1 was overexpressed in hUCMSCs to establish SIRT1-modified hUCMSCs. Co-culture and transplantation experiments were performed in TGF-β-stimulated Met-5A cells and peritoneal damage rodent model to assess the therapeutic potential of SIRT1-modified hUCMSCs for peritoneal fibrosis through qPCR, Western blot, and peritoneal function analyses.

Results

SIRT1-modified hUCMSC administration had more potent anti-fibrosis ability than hUCMSCs, which significantly inhibited the expression of fibrotic genes and suppressed EMT process, increased ultrafiltration volume, and restored homeostasis of bioincompatible factors in dialysis solution. Mechanistically, SIRT1-modified hUCMSCs attenuated peritoneal fibrosis through reducing peritoneal inflammation and inhibiting the TGF-β/Smad3 pathway in peritoneal omentum tissues.

Conclusion

SIRT1-modified hUCMSCs might work as a promising therapeutic strategy for the treatment of peritoneal dialysis-induced peritoneal damage and fibrosis.
Efficient ammonia production from food by-products by engineered Escherichia coli
Authors: Tatemichi Yuki , Kuroda Kouichi , Nakahara Takeharu , Ueda Mitsuyoshi
Published: August 2020

Ammonia is used as a fertilizer for agriculture, chemical raw material, and carrier for transporting hydrogen, and with economic development, the demand for ammonia has increased. The Haber–Bosch process, which is the main method for producing ammonia, can produce ammonia with high efficiency. However, since it consumes a large amount of fossil energy, it is necessary to develop an alternative method for producing ammonia with less environmental impact. Ammonia production from food by-products is an appealing production process owing to unused resource usage, including waste, and mild reaction conditions. However, when food by-products and biomass are used as feedstocks, impurities often reduce productivity. Using metabolic profiling, glucose was identified as a potential inhibitor of ammonia production from impure food by-products. We constructed the recombinant Escherichia coli, in which glucose uptake was reduced by ptsG gene disruption and amino acid catabolism was promoted by glnA gene disruption. Ammonia production efficiency from okara, a food by-product, was improved in this strain; 35.4 mM ammonia was produced (47% yield). This study might provide a strategy for efficient ammonia production from food by-products.
Existence of solutions for tripled system of fractional differential equations involving cyclic permutation boundary conditions
Authors: Matar Mohammed M. , Amra Iman Abo , Alzabut Jehad
Published: August 2020

In this paper, we introduce and study a tripled system of three associated fractional differential equations. Prior to proceeding to the main results, the proposed system is converted into an equivalent integral form by the help of fractional calculus. Our approach is based on using the addressed tripled system with cyclic permutation boundary conditions. The existence and uniqueness of solutions are investigated. We employ the Banach and Krasnoselskii fixed point theorems to prove our main results. Illustrative examples are presented to explain the theoretical results.
Construction of the type 2 poly-Frobenius–Genocchi polynomials with their certain applications
Authors: Duran Ugur , Acikgoz Mehmet , Araci Serkan
Published: August 2020

Kim and Kim (Russ. J. Math. Phys. 26(1):40–49, 2019) have studied the type 2 poly-Bernoulli polynomials. Inspired by their work, we consider a new class of the Frobenius–Genocchi polynomials, which is called the type 2 poly-Frobenius–Genocchi polynomials, by means of the polyexponential function. We also derive some new relations and properties including the Stirling numbers of the first and second kinds. In a special case, we give a relation between the type 2 poly-Frobenius–Genocchi polynomials and Bernoulli polynomials of order k. Moreover, motivated by the definition of the unipoly-Bernoulli polynomials given in (Kim and Kim in Russ. J. Math. Phys. 26(1):40–49, 2019), we introduce the unipoly-Frobenius–Genocchi polynomials via a unipoly function and give multifarious properties including derivative and integral properties. Furthermore, we provide a correlation between the unipoly-Frobenius–Genocchi polynomials and the classical Frobenius–Genocchi polynomials.
Pulse rate variability: a new biomarker, not a surrogate for heart rate variability
Authors: Yuda Emi , Shibata Muneichi , Ogata Yuki , Ueda Norihiro , Yambe Tomoyuki , Yoshizawa Makoto , Hayano Junichiro
Published: August 2020

With the popularization of pulse wave signals by the spread of wearable watch devices incorporating photoplethysmography (PPG) sensors, many studies are reporting the accuracy of pulse rate variability (PRV) as a surrogate of heart rate variability (HRV). However, the authors are concerned about their research paradigm based on the assumption that PRV is a biomarker that reflects the same biological properties as HRV. Because PPG pulse wave and ECG R wave both reflect the periodic beating of the heart, pulse rate and heart rate should be equal, but it does not guarantee that the respective variabilities are also the same. The process from ECG R wave to PPG pulse wave involves several transformation steps of physical properties, such as those of electromechanical coupling and conversions from force to volume, volume to pressure, pressure impulse to wave, pressure wave to volume, and volume to light intensity. In fact, there is concreate evidence that shows discrepancy between PRV and HRV, such as that demonstrating the presence of PRV in the absence of HRV, differences in PRV with measurement sites, and differing effects of body posture and exercise between them. Our observations in adult patients with an implanted cardiac pacemaker also indicate that fluctuations in R-R intervals, pulse transit time, and pulse intervals are modulated differently by autonomic functions, respiration, and other factors. The authors suggest that it is more appropriate to recognize PRV as a different biomarker than HRV. Although HRV is a major determinant of PRV, PRV is caused by many other sources of variability, which could contain useful biomedical information that is neither error nor noise.
The anti-apoptotic, antioxidant and anti-inflammatory effects of curcumin on acrylamide-induced neurotoxicity in rats
Authors: Guo Jie , Cao Xiaolu , Hu Xianmin , Li Shulan , Wang Jun
Published: August 2020

Background

Acrylamide (ACR) formed during heating of tobacco and carbohydrate-rich food as well as widely applied in industries has been known as a well-established neurotoxic pollutant. Although the precise mechanism is unclear, enhanced apoptosis, oxidative stress and inflammation have been demonstrated to contribute to the ACR-induced neurotoxicity. In this study, we assessed the possible anti-apoptotic, antioxidant and anti-inflammatory effects of curcumin, the most active component in a popular spice known as turmeric, on the neurotoxicity caused by ACR in rats.

Methods

Curcumin at the dose of 50 and 100 mg/kg was orally given to ACR- intoxicated Sprague-Dawley rats exposed by ACR at 40 mg/kg for 4 weeks. All rats were subjected to behavioral analysis. The HE staining and terminal deoxynucleotidyl transferase mediated dUTP nick end labelling (TUNEL) staining were used to detect histopathological changes and apoptotic cells, respectively. The mRNA and protein expressions of apoptosis-related molecule telomerase reverse transcriptase (TERT) were detected using real-time PCR and immunohistochemistry, respectively. The contents of malondialdehyde (MDA) and glutathione (GSH) as well as the activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) were measured as the indicators for evaluating the level of oxidative stress in brain. The levels of pro-inflammatory cytokinestumor necrosis factor-α (TNF-α) and interleukin-1β (IL-1β) in the cerebral homogenates were detected using ELISA assay.

Results

ACR-induced weigh loss, deficits in motor function as well as pathological alterations in brains were significantly improved in rats administrated with 50 and 100 mg/kg curcumin. TUNEL-positive apoptotic cells in curcumin-treated ACR intoxicated brains were less than those in the ACR model group. Curcumin administration especially at the dose of 100 mg/kg upregulated the TERT mRNA expression and enhanced the number of TERT-positive cells in ACR-intoxicated cortex tissues. Moreover, curcumin treatment reduced the concentrations of TNF-α, IL-1β and MDA, while increased the GSH contents as well as the SOD and GSH-Px activities in the cerebral homogenates, in comparison to ACR control group.

Conclusions

These data suggested the anti-apoptotic, antioxidant and anti-inflammatory effects of curcumin on ACR-induced neurotoxicity in rats. Maintaining TERT-related anti-apoptotic function might be one mechanism underlying the protective effect of curcumin on ACR-intoxicated brains.
Prediction of microvascular invasion of hepatocellular carcinoma: value of volumetric iodine quantification using preoperative dual-energy computed tomography
Authors: Kim Taek Min , Lee Jeong Min , Yoon Jeong Hee , Joo Ijin , Park Sae-Jin , Jeon Sun Kyung , Schmidt Bernhard , Martin Sedlmair
Published: August 2020

Background

To investigate the potential value of volumetric iodine quantification using preoperative dual-energy computed tomography (DECT) for predicting microvascular invasion (MVI) of hepatocellular carcinoma (HCC).

Methods

This retrospective study included patients with single HCC treated through surgical resection who underwent preoperative DECT. Quantitative DECT features, including normalized iodine concentration (NIC) to the aorta and mixed-energy CT attenuation value in the arterial phase, were three-dimensionally measured for peritumoral and intratumoral regions: (i) layer-by-layer analysis for peritumoral layers (outer layers 1 and 2; numbered in close order from the tumor boundary) and intratumoral layers (inner layers 1 and 2) with 2-mm layer thickness and (ii) volume of interest (VOI)-based analysis with different volume coverage (tumor itself; VOIO1, tumor plus outer layer 1; VOIO2, tumor plus outer layers 1 and 2; VOII1, tumor minus inner layer 1; VOII2, tumor minus inner layers 1 and 2). In addition, qualitative CT features, including peritumoral enhancement and tumor margin, were assessed. Qualitative and quantitative CT features were compared between HCC patients with and without MVI. Diagnostic performance of DECT parameters of layers and VOIs was assessed using receiver operating characteristic curve analysis.

Results

A total of 36 patients (24 men, mean age 59.9 ± 8.5 years) with MVI (n = 14) and without MVI (n = 22) were included. HCCs with MVI showed significantly higher NICs of outer layer 1, outer layer 2, VOIO1, and VOIO2 than those without MVI (P = 0.01, 0.04, 0.02, 0.02, respectively). Among the NICs of layers and VOIs, the highest area under the curve was obtained in outer layer 1 (0.747). Qualitative features, including peritumoral enhancement and tumor margin, and the mean CT attenuation of each layer and each VOI were not significantly different between HCCs with and without MVI (both P >  0.05).

Conclusions

Volumetric iodine quantification of peritumoral and intratumoral regions in arterial phase using DECT may help predict the MVI of HCC.
An interferometric ex vivo study of corneal biomechanics under physiologically representative loading, highlighting the role of the limbus in pressure compensation
Authors: Wilson Abby , Jones John , Tyrer John R. , Marshall John
Published: August 2020

Background

The mechanical properties of the cornea are complex and regionally variable. This paper uses an original method to investigate the biomechanics of the cornea in response to hydrostatic loading over the typical physiological range of intra-ocular pressure (IOP) fluctuations thereby increasing understanding of clinically relevant corneal biomechanical properties and their contributions to the refractive properties of the cornea.

Methods

Displacement speckle pattern interferometry (DSPI) was used to measure the total surface displacement of 40 porcine and 6 human corneal-scleral specimens in response to pressure variations up to 1 mmHg from a baseline of 16.5 mmHg. All specimens were mounted in a modified artificial anterior chamber (AAC) and loaded hydrostatically. Areas of high strain in response to loading were identified by comparing the displacements across different regions.

Results

The nature of the response of the corneal surface to loading demonstrated high regional topographic variation. Mechanical properties were shown to be asymmetrical, and deformation of the limbal and pre-limbal regions dominated these responses respectively with over 90% (N-T) and 60% (S-I) of the total maximum displacement occurring in these regions indicating high-strain. In contrast, the curvature of the central cornea remained relatively unchanged merely translating in position.

Conclusions

The limbal and pre-limbal regions of the cornea appear to be fundamental to the absorption of small pressure fluctuations facilitating the curvature of the central cornea to remain relatively unchanged. The differential mechanical properties of this region could have important implications for the application of corneal surgery and corneal crosslinking, warranting further investigation.
Correction to: Best MRI sequences for identifying axillary lymph node markers in patients with metastatic breast cancer: an inter-reader observational study
Authors: Samreen Naziya , Bhatt Asha A. , Adler Kalie , Zingula Shannon , Glazebrook Katrina N.
Published: August 2020

An amendment to this paper has been published and can be accessed via the original article.
Two efficient methods for solving fractional Lane–Emden equations with conformable fractional derivative
Authors: Malik Adyan M. , Mohammed Osama H.
Published: August 2020

In this paper, we introduce two reliable efficient approximate methods for solving a class of fractional Lane–Emden equations with conformable fractional derivative (CL-M) which are the so-called conformable Homotopy–Adomian decomposition method (CH-A) and conformable residual power series method (CRP). Furthermore, the proposed methods express the solutions of the non-linear cases of the CL-M in terms of fractional convergent series in which its components can be computed in an easy manner. Finally, the results are given by graphs for each case of the CL-M at different values of α in order to demonstrate its accuracy, applicability, and efficiency.
B-mode ultrasound, color Doppler, and sonoelastography in differentiation between benign and malignant cervical lymph nodes with special emphasis on sonoelastography
Authors: Abdelgawad Ehab Ali , Abu-samra Manal F. , Abdelhay Nasr Mohammed , Abdel-Azeem Hoda Mokhtar
Published: August 2020

Background

Enlarged cervical lymph nodes are the most commonly encountered neck lumps. Ultrasonography is the most extensively used tool for classification of superficial lymph nodes due to its availability and low cost. Ultrasound (US) elastography refers to a non-invasive imaging technique that can describe tissue displacement (i.e., strain) or stiffness in response to a given force.

The aim of this study is to compare between B-mode sonography, color Doppler, and sonoelastography in assessment of enlarged deep cervical lymph nodes.

Results

The prevalence of benign lymph nodes was 26 out of 84 (31%). Lymphomatous lymph nodes were 22/84 (26.2%), while metastatic lymph nodes were 36/84 (42.8%). Color Doppler evaluation of nodal vascular pattern was of high sensitivity (91.7%), specificity (80.8%), and accuracy (88.6%) for differentiating metastatic and benign nodes (P value was < 0.001). There was a significant difference between elasticity scores of benign and malignant lymph nodes (P < 0.001). The most frequent score in the malignant group was 3 (21/27) (77.8%) while the most frequent score in the benign group was 2 (5/11) (45.5%). The mean strain ratio (strain index) for malignant lymph nodes (mean 3.2 ± 0.8) was significantly greater than that for benign lymph nodes (mean 1.1 ± 0.8).

Conclusion

Ultrasound elastography with its high sensitivity and specificity is a helpful improvement in US for the assessment of cervical lymph nodes, in which biopsies should be performed.
Prenatal diagnosis of congenital anomalies of genito-urinary system on fetal magnetic resonance imaging
Authors: Gupta Saryu , Mohi Jaswinder Kaur , Gambhir Puneet , Mohi Manjit Kaur
Published: August 2020

Background

The aim of this study is to elucidate the spectrum of commonly encountered anomalies affecting fetal genito-urinary system (GUS) on fetal MRI and examine its utility in providing better morphological information resulting in improved diagnostic accuracy and in detecting additional malformations. The study also aims to highlight the promising role of fetal MRI in the detection and characterization of renal fusion anomalies like the horseshoe kidney or developmental abnormalities such as renal agenesis/ectopia.

Results

The mean age of study participants was 29 years ± 3 years. The gestation age of pregnant mothers ranged from 18 weeks and 1 day to 39 weeks and 0 day. Amniotic fluid was reduced or absent in 41% (N = 13) and normal in 59% (N = 18) of participating mothers. Overall, urinary obstruction was the commonest anomaly encountered (29%) followed by the multicystic dysplastic kidney (MCDK) (22%). Bilateral renal disease was seen in all mothers having features of anhydramnios {B/L MCDK (N = 3), autosomal recessive polycystic kidney disease (ARPKD) (N = 2), posterior urethral valves (PUV) (N = 2), B/L renal agenesis (N = 3), and megacystis (N = 1)}. Fusion anomalies (horseshoe kidney) and rotation anomaly (malrotation) were detected in one case each. Additional extrarenal findings were seen on fetal MRI in 35% (N = 11) cases.

Conclusions

Fetal MRI improves diagnostic accuracy in anomalies affecting the fetal kidney and genito-urinary systems by better morphological delineation. It has the ability to detect additional extra-renal malformations and perform a more accurate assessment of associated pulmonary hypoplasia. The diffusion-weighted sequence is particularly useful in confirming the diagnosis of renal agenesis/ectopia.