bluuebunny/crossref_metadata_2025 huggingface dataset:
Effects of Exenatide on Blood Coagulation and Platelet Aggregation in Patients with Type 2 Diabetes
Authors: Zhang Yaqin , Chen Ruofei , Jia Yangyang , Shuai Zongwen , Chen Mingwei
Published: March 2021

Background: To explore the effect of glucagon-like peptide-1 receptor (GLP-1R) agonist exenatide on blood coagulation function and platelet aggregation function in patients with type 2 diabetes mellitus (T2DM).Method: Thirty patients with newly diagnosed T2DM were enrolled as the case group, and 30 healthy people with matching age and sex were selected as the control group. Patients in the case group received exenatide treatment for 8 weeks. Collect the general clinical data and biochemical indicators of the patients in the case group before and after 8 weeks of exenatide treatment and the control subjects, and detect their peripheral blood platelet count (×1012 g/L), plasma prothrombin time (PT, s), prothrombin time activity (PTA, %), activated partial thromboplastin time (APTT, s), international normalized ratio (INR), fibrinogen (FIB, g/L), plasma thrombin time (TT, s) , Fibrin degradation products (FDP, μg/mL), D-dimer (DD, μg/mL), nitric oxide (NO, μmol/L), CD62p (%), platelet activation complex-1 (PAC-1, %) and platelet aggregation induced by collagen, epinephrine, arachidonic acid (AA, %), and adenosine diphosphate (ADP, %).Results: There was no significant difference in platelet count, PLT, PT, PTA, APTT, TT, INR, FDP, DD between the case group and the control group; the FIB, CD62p, PAC-1, platelet aggregation rates of the case group (EPI 87.23±6.84 , ADP 87.51±9.21, AA 90.17±3.19) is higher than normal control group (EPI 82.15±5.37, ADP 82.38±6.42, AA 83.41±6.17, P＜0.05), NO level is lower than normal control group (68.1±14.7 vs. 79.4±11.2, P<0.05); After 8 weeks of exenatide treatment in the case group, CD62p, PAC-1, and platelet aggregation rates were lower than before (EPI: 81.62±9.02 vs. 87.23±6.84, AA: 84.62±7.12 vs. 90.17±3.19, P＜0.05), the level of NO was higher than before (89.6±15.8 vs. 68.1±14.7); Pearson correlation analysis showed that the changes in platelet aggregation rates (Δ EPI, ΔAA) of patients in the case group after 8 weeks of exenatide treatment were positively correlated with the changes in body mass index (BMI, kg/m2), waist circumference (cm), weight (kg), total cholesterol (TCH, mmol/L), triglycerides (TG, mmol/L), low-density lipoprotein (LDL-C, mmol/L), fasting plasma glucose (FPG, mmol/L), Hemoglobin A1c (HbA1c, %), CD62p, PAC-1 (P<0.05), and negatively correlated with the change of high density lipoprotein (HDL-C, mmol/L) and NO (P<0.05). Multiple linear regression analysis showed that the changes of NO, CD62p and PAC-1 were independent risk factors affecting the changes of platelet aggregation rates.Conclusions: The GLP-1R agonist exenatide can inhibit the activation state of platelets in patients with T2DM, reduce the platelet aggregation rate, and inhibit thrombosis, which is beneficial to reduce the risk of cardiovascular events.
Developing a Nomogram for Predicting Risk of Invasive Mechanical Ventilation in Children With Severe Adenovirus Associated Pneumonia
Authors: Zhang Yin , Lin Jilei , Fu Zhou , Dai Jihong
Published: March 2021

Background: The recognition of the development of poor outcomes in children with HAdV infection in early stage of the disease is vital because of high mortality rates. This study aimed to develop and validate a nomogram in predicting risk of IMV in children with SAdVP at the early stage of the disease.Methods: The retrospective study collected clinical data of hospitalized children with SAdVP in general wards of a 1900-bed teaching hospital in Chongqing, China (2015-2019). The nomogram was built by using the multivariate logistic regression analysis. The performance of the nomogram was assessed by discrimination, calibration and clinical utility. Results: Two hundred and seven children with SAdVP were included. Age, level of albumin, atelectasis and creatine kinase MB isoenzyme were identified as predictors in the nomogram. The area under the receiver operating characteristic curve of the nomogram was 0.85 (95% CI, 0.78-0.91) in the training set and 0.81 (95% CI, 0.69-0.94) in the validating set. A good consistency was observed between the predictions and the actual observations, and decision curve analysis showed that the nomogram was clinically useful. Conclusions: Nomogram to predict the risk of IMV in children with SAdVP in general wards was established and validated. It may be a valuable tool for clinicians to recognize the risk of IMV for children with SAdVP at the early stage of the disease.
Post Intensive Care Unit Follow-up General Health Survey: A Cross-Sectional Study in a Tertiary Academic Hospital
Authors: Aljuhani Ohoud , Tirkistani Albatool , Albeeshy Muna , Alnahdi Afnan
Published: March 2021

Background: Despite the tremendous efforts regarding post hospital discharge services, the literature regarding health status, social and medical support of ICU survivors in Saudi Arabia is very limited. This study aimed to involve pharmacists to conduct a general survey to assess health, medical and social status of ICU survivors. Methods: This was a cross- sectional study conducted at a tertiary academic center in Saudi Arabia. The phone survey has been conducted by the study investigators after getting a verbal consent for participation. Results: Majority of our participants have no issues in concentration and only small percentage reported that they experience one or more of anxiety, depression, despair, and blue mood. A larger percentage of our subjects were satisfied by the support they received from their relatives, social support, and access to medical services. Conclusion: ICU survivors discharged from one center in Saudi Arabia reported great general health and satisfied by social and medical support but functional and mental status and multidisciplinary team approach worth further investigations.
Cryogenic Treatment Analysis in WEDM of Al2024/Al2O3/W Composite
Authors: Raza Muhammad Huzaifa , Ali Muhammad Asad , Tahir Waseem , Zhong Ray Y. , Mufti Nadeem Ahmad , Ahmad Naveed
Published: March 2021

Increasing demand for aluminum matrix composites (AMCs) in the manufacturing sector leads to the development of squeeze casted hybrid AMCs bearing superior mechanical attributes. Excessive hardness due to squeeze pressure and the presence of reinforcement particles makes the machining of AMCs challenging and results in excessive tool wear and inadequate surface finish. Wire electric discharge machining (WEDM) process has been preferred over conventional manufacturing processes for the machining of squeeze casted Al2024/Al2O3/W hybrid composite. This study investigates the selection of the most pertinent wire electrode for the precise machining of Al2024/Al2O3/W. Simple zinc-coated (NT) and cryogenic treated (CT) brass wire electrodes have been selected for machining. Scanning electron microscope (SEM) analysis of CT wire shows that cryogenic treatment enhances the soundness and stability by reducing microcavities in its microstructure. To analyze the effects of cryogenic treatment, the machining performance of CT wire has been compared with NT wire. Besides wire type, the influence of key input variables has also been analyzed on the imperative response measures including cutting speed (CS), surface roughness (SR) and kerf width (KW) to make the machining process more effective. Microstructural analysis of NT wire depicts a high concentration of micro-voids, micro-cracks, and deep craters, while the surface of CT has been observed relatively fine after the machining. Comparative analysis of both wire electrodes has declared that CT wire yields 26.96% and 15.10% superior results for CS and SR respectively, and 6.92% deprived results for KW than NT wire.
Optic Nerve Head Microcirculation in Eyes With Vogt-Koyanagi-Harada Disease Accompanied by Anterior Ischemic Optic Neuropathy: a Case Report
Authors: Yamashita Yui , Hashimoto Yuki , Namba Kenichi , Mizuuchi Kazuomi , Ishida Susumu
Published: March 2021

Purpose: It has been reported that anterior ischemic optic neuropathy (AION) is an infrequent complication of Vogt-Koyanagi-Harada (VKH) disease; however, the physiological changes have not been understood. We quantitatively examined sequential changes in the morphology and circulation hemodynamics using an optical coherence tomography (OCT) C-scan and laser speckle flowgraphy (LSFG) in a patient with VKH disease accompanied by AION.Case presentation: A 65-year-old female complained of blurred vision in both of her eyes. She presented with optic disc swelling and remarkable choroidal thickening detected by OCT bilaterally. Indocyanine green angiography in the middle phase showed multiple hypofluorescent dark dots scattering around the fundus. With the use of Goldmann perimetry, bilateral visual field defects were detected; these were similar to those of inferior altitudinal hemianopsia. Pleocytosis was detected. The patient was diagnosed with VKH disease, suspected to be accompanied by AION in both eyes. She received methylprednisolone pulse therapy followed by oral prednisolone. With these treatments, optic disc swelling disappeared; however, optic disc atrophy with visual field defects remained in both eyes. An OCT C-scan showed the ganglion cell complex (GCC) and circumpapillary retinal nerve fiber layer (cpRNFL) thickness getting thinner below the normal range, and LSFG showed a decrease in optic nerve head tissue microcirculation during follow-up. These results supported the occurrence of AION in this patient with VKH disease.Conclusion: The analyses of GCC and cpRNFL thicknesses with an OCT C-scan and optic nerve head microcirculation with LSFG would be useful for supporting the occurrence of AION in cases of VKH disease.
Developing a Framework for Sustainable Urban Resilience During Disasters
Authors: Kamble Aakash , Desai Supriya , Lele Vishwanath
Published: March 2021

The fast-growing population in developing countries coupled with the migration of the huge mass of village inhabitants to the large cities to seek better opportunities and safety conditions have been substantially increased the pressure on the existing urban infrastructure. This, coupled with the increased frequency of the natural as well as man-made disasters, presses the need for modern societies in large cities to search for pathways towards prevention, preparedness and recovery of this infrastructure in an event of a disaster. Owing to this, urban resilience has gained importance in the scientific context so as to explore the capabilities of cities to face and withstand extreme disaster events. Cities are complex adaptive and reconciling systems with a prospect to cope with resilience towards sustainability by effective use of transformational processes. Our study analyses urban resilience in the context of natural and man-made disasters across developing countries. In particular, this research first identifies the key elements of resilience and further studies them with a focus on different cities in developing economies as well as various types of disasters. Moreover, we investigate the urban resilience from the perspective of a case on dust storms in New Delhi, India. The outcome of the research enabled in developing an urban resilience framework with respect to urban infrastructure in the case of disasters. In particular, this framework aims to ensure an adequate level of sustainability, centred on humans and society.
Misdiagnosis of Dengue Fever and Co-infection With Malaria and Typhoid Fevers in Rural Areas in Southwest Nigeria
Authors: Okoror Lawrence Ehis , Bankefa Emmanuel Olufemi , Ukhureigbe Oluchi Mariam , Ajayi Evelyn Olubunmi , Ojo Stephen Kayode , Ogeneh Bryan
Published: March 2021

BackgroundDengue and malaria have similar symptoms and arthropod vector and their mode of transmission coupled with differential diagnosis. Though typhoid fever differs from dengue and malaria by not having arthropod vector and different mode of transmission, it shares differential diagnosis with Dengue and Malaria which make misdiagnosis possible. This misdiagnosis of these three diseases has since been a major concern towards therapeutic administration because of their co-occurrence in many cases. MethodsThis study focused on the misdiagnosis of dengue fever for malaria or typhoid fever since the three have differential diagnosis and could co-occur. 741 samples were collected from malaria patient and 333 samples for typhoid fever outpatient at the health department facilities in rural communities of South West Nigeria. The samples were tested for dengue virus (DV) NS1 protein, anti DV IgM, anti DV IgG and RT-qPCR. ResultOf all the samples tested 315 (29.4%) were positive to DV NS1 while 50 (6.7%) and 13 (3.9%) of 714 malaria samples and 333 typhoid samples respectively had Dengue fever co-infection. Co-infection of the three types of fever occurred in 5 (0.5%). A total of 54 (5%) DV cases were wrongly diagnosed for malaria while 14 (1.3%) DV cases was wrongly diagnosed as typhoid. ConclusionConclusively, there was significant number of misdiagnosed cases of DV for either malaria or typhoid, hence it is recommended to include DV screening into routine hospital test especially in cases of malaria and typhoid negative by rapid diagnostic testing.
Initial Study on TMPRSS2 p.Val160Met Genetic Variant in COVID-19 patients
Authors: Wulandari Laksmi , Hamidah Berliana , Pakpahan Cennikon , Damayanti Nevy Shinta , Kurniati Neneng Dewi , Adiatmaja Christophorus Oetama , Wigianita Monica Rizky , Soedarsono Soedarsono , Husada Dominicus , Tinduh Damayanti , Prakoeswa Cita Rosita Sigit , Endaryanto Anang , Puspaningsih Ni Nyoman Tri , Lusida Maria Inge , Shimizu Kazufumi , Oceandy Delvac
Published: March 2021

BackgroundCoronavirus disease 2019 (COVID-19) is a global health problem that causes millions of deaths worldwide. The clinical manifestation of COVID-19 widely varies from asymptomatic infection to severe pneumonia and systemic inflammatory disease. It is thought that host genetic variability may affect the host's response to the virus infection and thus cause severity of the disease. The SARS-CoV-2 virus requires interaction with its receptor complex in the host cells before infection. The transmembrane protease serine 2 (TMPRSS2) has been identified as one of the key molecules involved in SARS-CoV-2 virus receptor binding and cell invasion. Therefore, in this study we investigated the correlation between a genetic variant within the human TMPRSS2 gene and COVID-19 severity and viral load.ResultsWe genotyped 95 patients with COVID-19 hospitalized in Dr Soetomo General Hospital and Indrapura Field Hospital (Surabaya, Indonesia) for the TMPRSS2 p.Val160Met polymorphism. Polymorphism was detected using a TaqMan assay. We then analysed the association between the presence of the genetic variant and disease severity and viral load. We did not observe any correlation between the presence of TMPRSS2 genetic variant with the severity of the disease. However, we identified significant association between the p.Val160Met polymorphism and the SARS-CoV-2 viral load, as estimated by the Ct value of the diagnostic nucleic acid amplification test. Furthermore, we observed a trend of association between the presence of the C allele and the mortality rate in patients with severe COVID-19. ConclusionOur data indicate a possible association between TMPRSS2 p.Val160Met polymorphism and SARS-CoV-2 infectivity and the outcome of Covid-19.
Supplier Selection in Sustainable Supply Chains: A Risk-Based Integrated Group Decision-Making Model
Authors: Wu Chong , Zou Haohui , Barnes David
Published: March 2021

With the recent emphasis on supply risk management in sustainable supply chains (SSCs), the evaluation and selection of appropriate suppliers are more important than ever. However, most existing research does not take all three sustainability perspectives of supply risk into account simultaneously and they rarely consider the correlation among supply risk factors in risk assessment. Therefore, considering the uncertain information decision-making environment, this research paper proposes a risk-based integrated group decision-making model for sustainable supplier selection (SSS). First, the weights of decision-makers (DMs) are taken as linguistic terms denoted by intuitionistic fuzzy numbers (IFNs). Second, after obtaining the aggregated intuitionistic fuzzy decision-making matrix considering the expert weights, this study uses the entropy weight method to calculate the criteria weights objectively. Then, the improved failure mode and effects analysis (FMEA) is adopted for the risk assessment to exclude high-risk suppliers. Finally, the extended alternative queuing method (AQM) is applied to rank the qualified suppliers in SSCs. This model can not only enable enterprises to reduce supply risk in SSS practices and identify and prevent the failure modes that lead to supply risk, but also reduce the uncertainty of decision-making, in order to make supplier selection more accurate. The feasibility and effectiveness of the proposed model are illustrated through application in a leading Chinese electrical appliance manufacturing company.
Prevention and Contrast of Child Abuse and Neglect in the Practice of European Paediatricians: a Multi-national Pilot Study
Authors: Pettoello-Mantovani Massimo , Paola Nigri , Giovanni Corsello , Luigi Nigri , Donjeta Bali , Giorgina Kuli-Lito , Plesca Doina , Lucian Pop Tudor , Angel Carrasco-Sanz , Leyla Namazova-Baranova , Julije Mestrovic , Mehmet Vural , Ida Giardino , Laszlo Losonczi , Eli Somekh , Teresa Balducci Maria , Pietro Ferrara
Published: March 2021

Background: Child abuse and neglect, or maltreatment, is a serious public health problem, which may cause long-term effects on children’s health and wellbeing and expose them to further adulthood vulnerabilities. Studies on child maltreatment performed in Europe are scarce, and the number of participants enrolled relatively small. The aim of this multi-national European pilot study, was to evaluate the level of understanding and perception of the concepts of child abuse and neglect by European paediatricians working in different medical settings, and the attitude toward these forms of maltreatment in their practice.Methods: The study was performed by a cross-sectional, descriptive, online survey, made available online to European paediatricians members of 50 national paediatric, who belonged to four different medical settings: hospital, family care, university centres and private practice. The questionnaire, designed as a multiple choice questions survey, with a single answer option consisted of 22 questions/statements. Frequency analyses were applied. Most of the data were described using univariate analysis and Chi-squared tests were used to compare the respondents and answers and a significance level of p ≤ 0.05 applied.Results: Findings show that European paediatricians consider the training on child maltreatment currently provided by medical school curricula and paediatric residency courses to be largely insufficient and continuing education courses were considered of great importance to cover educational gaps. Physical violence was recognized by paediatricians mostly during occasional visits with a significant correlation between detecting abuse during an occasional visit and being a primary care paediatrician. Results also showed a reluctance by paediatricians to report cases of maltreatment to the competent judicial authorities.Conclusions: Data of this study may provide useful contribution to the current limited knowledge about the familiarity of European paediatricians with child maltreatment and their skills to recognize, manage and contrast abusive childhood experiences in their practice. Finally, they could provide local legislators and health authorities with information useful to further improve public health approaches and rules able to effectively address shared risk and protective factors, which could prevent child abuse and neglect from ever occurring.
Prosocial Modeling Matters: The Association Between Parent and Faculty Involvement in Fighting COVID-19 With Medical Students’ Career Commitment
Authors: Wang Dan , Ye Xiaoyang , Wu Hongbin
Published: March 2021

Background: Role models play an important role in enhancing students’ intention to pursue medical careers. While, as the two most influential role models for medical students, there is limited research to explore the different impacts between faculty and parents. This study investigated the association of different role model’s prosocial behavior of joining the fight against novel coronavirus disease 2019 (COVID-19) on medical students’ career commitment. We examined whether there are different effects and how these effects differ among different medical students.Method: A national-scale survey was conducted with 118,030 undergraduate students majoring in clinical medicine in mainland China. Questions were asked to collect information of participants in the battle of COVID-19, medical students’ determination of practicing medicine after graduation, as well as students’ socio-demographic characteristics. Chi-square tests and hierarchical regressions were performed to examine the effects of parent and faculty involvement on students’ career commitment.Results: The results showed that prosocial modeling during the COVID-19 pandemic in China is associated with students’ intention to pursue medical careers. The effect of faculty was greater than that of parents on medical students. Gender was related to the effects. And those who already determined to be the doctor before the pandemic were much more likely to persist in the medical profession.Conclusions: Our study provides more definitive answers to the issue of who has a greater effect on medical students’ career commitment between parents and faculty. Encouraging faculty to act as positive role models could help medical students increase the intention to become doctors.
Impact of Early Corticosteroids on 60-day Mortality in Critically Ill Patients with COVID-19: A Multicenter Cohort Study of the OUTCOMEREA Network
Authors: Dupuis Claire , Montmollin Etienne de , Buetti Niccolò , Goldgran-Toledano Dany , Reignier Jean , Schwebel Carole , Domitile Julien , Neuville Mathilde , Ursino Moreno , Siami Shidasp , Ruckly Stéphane , Alberti Corinne , Mourvillier Bruno , Bailly Sebastien , Laurent Virginie , Gainnier Marc , Souweine Bertrand , Timsit Jean-François
Published: March 2021

ObjectivesIn severe COVID-19 pneumonia, the appropriate timing and dosing of corticosteroids(CS) is not known. Patient subgroups for which CS could be more beneficial also need appraisal. The aim of this study was to assess the effect of early CS in COVID-19 pneumonia patients admitted to the ICU on the occurrence of 60-day mortality, ICU-acquired-bloodstream infections(ICU-BSI), and hospital-acquired pneumonia and ventilator-associated pneumonia(HAP-VAP).MethodsWe included patients with COVID-19 pneumonia admitted to 11 ICUs belonging to the French OutcomeReaTM network from January to May 2020. We used survival models with ponderation with inverse probability of treatment weighting (IPTW). Inflammation was defined as Ferritin >1000 µg/l or D-Dimers >1000 µg/l or C-Reactive Protein >100 mg/dL.ResultsThe study population comprised 302 patients having a median age of 61.6(53-70) years of whom 78.8% were male and 58.6% had at least one comorbidity. The median SAPS II was 33(25-44). Invasive mechanical ventilation was required in 34.8% of the patients. Sixty-six (21.8%) patients were in the Early-CS-subgroup. Most of them (n=55, 83.3%) received high doses of steroids. Overall, 60-day mortality was 29.4%. The risks of 60-day mortality (IPTWHR =0.88;95% CI 0.55 to 1.39, p=0.58), ICU-BSI and HAP-VAP were similar in the two groups. Importantly, early CS treatment was associated with a lower mortality rate in patients aged 60 years or more (IPTWHR, 0.51;95% CI, 0.29 – 0.91; p=0.02). But, CS was associated with an increased risk of death for the patients younger than 60 years without inflammation on admission (IPTWHR =8.17;95% CI, 1.76, 37.85; p=0.01).ConclusionFor patients with COVID-19 pneumonia, early CS treatment was not associated with patient survival. Interestingly, inflammation and age can significantly influence the effect of CS.
WITHDRAWN: Understanding the Low Take-Up of Home-Based Dialysis Through Shared Decision-Making: A Qualitative Study
Authors: Dallimore David , Roberts Gareth W. , McLaughlin Leah , Renal Gail Williams Wales , Chess James , Noyes Jane
Published: March 2021

Background Despite home dialysis having many advantages, take-up by people with established renal failure is low in many countries. Previous studies highlight complex social, psychological, economic and health-system obstacles to patients choosing home dialysis. The study explored how people who are pre-dialysis, caregivers and health professionals together navigate common shared decision-making processes, and assesses how this impacts on choice of dialysis, conservative treatment or transplant. Methods This qualitative study took place in Wales, a country within the United Kingdom with a publicly-funded healthcare system. From 5 renal centres, education literature used in patient education was collected and content analysis applied. The theoretical framework was the MAGIC shared decision-model. From February 2019 until data saturation was reached in January 2020, semi-structured interviews with a purposive sample of 51 patients, 41 caregivers and 49 renal professionals were undertaken. Interview data were analysed using framework analysis. Patient and public representatives were involved throughout. Results Thematic findings are presented as: Prior knowledge, choice talk, options talk, decision talk. Gaps were found in both knowledge and understanding at every stage of the decision-making process and amongst all involved. Patients and caregivers came with varying levels of prior knowledge and understanding, which can result in misinformation and biases that contaminate the shared decision-making process. This is not always recognised by renal professionals. Presentation of treatment options through education programmes was often found to be inadequate, biased or poorly understood. Such deficiencies create partialities towards some treatments and, in particular, mitigate against the take-up of home therapies, even when they may be the most appropriate. A logic model and a road map to further evolving clinical practice was developed. Conclusions There are critical points in the process at where change could benefit patients. Patients need to be better prepared and their preconceived ideas and misconceptions gently challenged. Healthcare professionals need to update their knowledge in order to provide the best advice and guidance. Shared decision-making processes need to be individually-tailored so that there is more attention paid to the benefits of home based options, and on people who could chose a home therapy but select a different option.
Association Between Stress and Bilateral Symmetrical Alopecia in Free-Ranging Formosan Macaques (Macaca Cyclopis) in A High-Population-Density Area
Authors: Chen Chen-Chih , Chang Ai-Mei , Tsai Ming-Shan , Huang Yen-Hua , Pei Kurtis Jai-Chyi , Li Yi-Chia
Published: March 2021

Since 2013, a high incidence of bilateral symmetrical alopecia has been observed in free-ranging Formosan macaques (Macaca cyclopis) in Mt. Longevity, Taiwan. We hypothesized that stress induces alopecia in this population. To verify our hypothesis, we evaluated the histopathological characteristics of skin biopsy and used a validated enzyme immunoassay (EIA) for fecal glucocorticoid metabolite (FGM) analysis, which act as an indicator of stress experienced by the individual. Follicular densities were lower (2.1–3.0 mm2) in individuals with symmetrical alopecia than in those with normal hair conditions (4.7 mm2). Furthermore, anagen to catagen/telogen ratios were lower in individuals with alopecia (0–1.4) than in those with normal hair (4.0). The histopathological characteristics of alopecia were similar to those of telogen effluvium, which indicates that stress is one of the possible etiologies. On the basis of the analytical and biological validation of EIAs for FGM analysis, 11β-hydroxyetiocholanolone was considered suitable for monitoring adrenocortical activity in both sexes of Formosan macaques. The mean concentrations (standard error; sample size) of 11β-hydroxyetiocholanolone were 2.02 (0.17; n = 10) and 1.41 (0.10; n = 31) μg/g for individuals with and without alopecia, respectively. Furthermore, the results of logistic regression analysis show that 11β-hydroxyetiocholanolone (p = 0.012) concentration was positively associated with alopecia. Thus, stress was the most likely to trigger symmetrical alopecia in Formosan macaques in Mt. Longevity. Although stress can decrease the fitness of an individual, it should not impact the total population of Formosan macaque in Taiwan. Nonetheless, stress-induced immunosuppression might increase zoonosis risk due to frequent human–macaque contact in Mt. Longevity.
Arthroscopy-assisted First Rib Resection and Brachial Plexus Neurolysis for Thoracic Outlet Syndrome
Authors: Satake Hiroshi , Honma Ryusuke , Nito Toshiya , Naganuma Yasushi , Shibuya Junichiro , Maruyama Masahiro , Uno Tomohiro , Kazama Tomoyuki , Takagi Michiaki
Published: March 2021

The present study included 27 consecutive patients (30 limbs) undergoing arthroscopy-assisted transaxillary first rib resection and brachial plexus neurolysis for thoracic outlet syndrome (TOS). To improve visualization, we changed the intraoperative limb position in three stages. We assessed the intraoperative parameters, including the scalene interval width between the anterior and middle interscalene muscles (interscalene base), blood loss, operation time, preoperative and postoperative QuickDASH, patient satisfaction, and complications. The mean intraoperatively measured interscalene base width was 6.2 mm. Appropriate visualization could be obtained at zero-position in the late phase. Intraoperative blood loss and operation time were significantly less in the late phase (p < 0.001). The QuickDASH score was significantly improved (42 before surgery vs. 9 at final follow-up, p < 0.001), especially in athletes relative to non-athletes (0.2 vs 14, p < 0.001). The outcome was excellent in 43.3% of cases, good in 43.3%, fair in 13.3%, and poor in none. The present approach achieved complete relief in 43% of cases overall (91% in athletes and 16% in non-athletes). Pneumothorax was present at the early phase in 3.3%. There were no other complications and no recurrences. Arthroscopic surgery is useful for TOS, especially in athletes.
Ang-(1-7) Protects Skeletal Muscle Function in Aged Mice
Authors: Huang Xiaoli , Song Jiao , Jiang Yangyang , Yang Xue , Cao Li , Xiao Chun , Li Suli , Dong Birong , Li Ying
Published: March 2021

Background: The angiotensin-converting enzyme 2 (ACE2)/angiotensin 1-7 (Ang-(1-7)) axis has been shown to perform a protective task in the decline of the function of skeletal muscle correlated with the process of aging. In the present investigation, the protective effects of ACE2 in mitigating the age-associated decline of skeletal function and identified the potential underlying molecular mechanism mediating the process have been extensively evaluated.Methods: We measured the expression levels of Ang-(1-7) in C57BL/6J mice of different ages and correlated these levels with measures of skeletal muscle function. Also, we determine the expression of myocyte enhancer factor 2A (MEF2A) were detected in ACE2 knockout (ACE2KO) and correlated with muscle function. We then treated ACE2KO aged mice for 4 weeks with Ang-(1-7) and characterized the levels of MEF2A and skeletal muscle function before and after treatment. We assessed the impact of Ang-(1-7) on the growth and differentiation of C2C12 cells in vitro and assessed changes in the glucose transporter type 4 (Glut4) expression.Results: Aged mice showed reduced skeletal muscle function and levels of Ang-(1-7) expression in comparison to young and middle-aged mice. In ACE2KO mice, skeletal muscle function and MEF2A protein expression were significantly lower than in age-matched WT mice. After 1 month of the treatment of Ang-(1-7), the function of skeletal muscle related to the aged ACE2KO mice improved, however, the expression of MEF2A protein was similar to that in the untreated group. In C2C12 cells, Ang-(1-7) was shown to increased cell growth and differentiation characteristics along with the upregulated expression of Glut4.Conclusions: The axis of ACE2/ Ang-(1-7) has a protective task in skeletal muscle and the administration of exogenous Ang-(1-7) can delay the age-related decline in the functions of skeletal muscle.
Cancer Services During the COVID-19 Pandemic: Systematic Review of Patients’ and Caregivers’ Experiences
Authors: Dhada Symran , Stewart Derek , Cheema Ejaz , Hadi Muhammed Abdul , Paudyal Vibhu
Published: March 2021

Background Cancer patients have faced intersecting crises in the face of COVID-19 pandemic. This review aimed to examine patients’ and caregivers’ experiences of accessing cancer services during the COVID-19 pandemic and perceived impact of the pandemic on their psychological wellbeing.Methods A protocol-led (CRD42020214906) systematic review was conducted by searching six databases including EMBASE, MEDLINE and CINAHL for articles published in English-language between 1/2020-12/2020. Data were extracted using a pilot-tested, structured data extraction form. Thematic synthesis of data was undertaken and reported as per the PRISMA guideline. Results A total of 1110 articles were screened of which 19 studies met the inclusion criteria. Studies originated from 10 different countries including the US, UK, India and China. Several themes were identified which were categorised into seven categories. Postponement and delays in cancer screening and treatment, drug shortages and inadequate nursing care were commonly experienced by patients. Hospital closures, resource constraints, national lockdowns and patient reluctance to use health services because of infection worries contributed to the delay. Financial and social distress, isolation; and spiritual distress due to the uncertainty of rites as well as fulfilment of last wishes were also commonly reported. Caregivers felt anxious about infecting cancer patients with COVID-19. Conclusions Patients and caregivers experienced extensive impact of COVID-19 on cancer screening, treatment and care, and their own psychological wellbeing. Patient and caregiver views and preferences should be incorporated in ensuring resilient cancer services that can minimise the impact of ongoing and future pandemic on cancer care and mitigate patient fears. Protocol Registration Published protocol registered with Centre for Review and Dissemination CRD42020214906 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=214906)
Re-emergence of Porcine Epidemic Diarrhea Virus in a Piglet-producing Farm in Jiangxi Province in China in 2020
Authors: Gao Qi , Zheng Zezhong , Wang Heng , Zhang Guihong , Gong Lang
Published: March 2021

BackgroundOn October 30, 2020, piglets and sows in the farrowing house of a pig farm in Jiangxi showed clinical symptoms such as anorexia, watery diarrhea, and vomiting. Epidemiological test, clinical necropsy, and RT-PCR test were carried out on the pig farm for diagnosis. After comprehensive considerations, the disease was judged as porcine epidemic diarrhea virus infection. ResultsThereafter, a series of comprehensive prevention and control measures such as emergency vaccination with autogenous vaccines were adopted. Half a month after inoculation with autogenous vaccines for the farm, the mortality rate of newborn piglets in the farrowing house began to decline, and production gradually returned to being stable. The second-generation sequencing analysis and phylogenetic analysis showed that the porcine epidemic diarrhea virus (PEDV) sequence obtained from the stool and small intestine samples of the diseased pigs on the farm was 97.8% homologous to the vaccine strain. At the same time, antibody testing found that the vaccinated pigs on the pig farm had satisfactory immune response.ConclusionThis case indicating that the PEDV outbreak on the pig farm might aggravate owing to the strain being mutated and could escape the immune protection of the existing vaccine. This case has accumulated technical data for the clinical prevention and control of porcine epidemic diarrhea.
Three Dimensional Morphometric Differences of Resected Distal Femur and Proximal Tibia in Osteoarthritis and Normal Knees
Authors: Dong Xiang-hui , Huang Xiang-hui , Chen Ming , Chang Yan-hai , Ling Ming , Yang Bo
Published: March 2021

Background: There is a paucity of data concerning the morphological differences of resected distal femur and proximal tibias in osteoarthritis (OA) and normal knees. The objective of this study was to determine if morphometric differences exist in resected distal femur and proximal tibia surface between OA and normal knees in Chinese population. Methods: Ninety-eight OA knee and ninety-six normal ones, taken from Chinese population, were measured by computed tomography for femoral mediolateral (fML), medial anteroposterior (fMAP), lateral anteroposterior (fLAP), medial condylar width (fMCW), lateral condylar width (fLCW) and tibial mediolateral (tML), middle anteroposterior (tAP), medial anteroposterior (tMAP), lateral anteroposterior (tLAP) dimensions to determine the morphologic differences between OA and normal knees. Results: The average tMAP and fMCW dimensions were 50.2 ± 3.3 mm, 28.7±2.3 mm for OA, and 48.8 ± 3.8 mm, 27.1±2.2 mm for normal knees, respectively. There were signiﬁcant differences between OA and normal knees with regard to tMAP and fMCW dimensions (p<0.05). Conclusions: The study revealed the morphological differences of tMAP and fMCW between the OA and normal groups, which may provide guidelines for designing better knee implants that are more size-matching for OA knees.
Low Cerebrospinal Fluid Beta Amyloid1-42 in Patients with Tuberculous Meningitis
Authors: Stroffolini Giacomo , Guastamacchia Giulia , Audagnotto Sabrina , Atzori Cristiana , Trunfio Mattia , Nigra Marco , Stefano Alessandro Di , Perri Giovanni Di , Calcagno Andrea
Published: March 2021

BackgroundTuberculous meningitis (TBM) is an important disease leading to morbidity, disability and mortality that primarily affects children and immune-depressed patients. Specific neuromarkers predicting outcomes, severity and inflammatory response are still lacking. In recent years an increasing number of evidences show a possible role for infective agents in developing neurodegenerative diseases. MethodsWe retrospectively included 13 HIV-negative patients presenting with meningeal tuberculosis. Lumbar punctures were performed for clinical reasons and CSF biomarkers were routinely available: we analyzed blood brain barrier permeability (CSF to serum albumin ratio, “CSAR”), intrathecal IgG synthesis, (CSF to serum IgG ratio), inflammation (neopterin), amyloid deposition (Aβ1-42), neuronal damage (T-tau, P-tau, 14.3.3) and astrocytosis (S-100 β). ResultsPatients were 83% male and 67 % Caucasian with a median age of 51 years (24.5-63.5 IQR). Apart from altered CSAR (median value 18.4, 17.1-30.9 IQR), neopterin (14.3 ng/ml, 9.7-18.8) and IgG ratios (15.4, 7.9-24.9), patients showed very low levels of Aβ1-42 in their CSF (348.5 pg/mL,125-532.2). Protein 14.3.3. tested altered in 38.5% cases. T-tau, ptau and S100Beta were in the range of normality. Altered low level of Aβ1-42 correlated over time with classical TBm findings and altered neuromarkers.ConclusionsCSF Biomarkers from patients with TBM were compatible with inflammation, blood brain barrier damage and impairment in amyloid-beta metabolism. Amyloid-beta could be tested as a prognostic markers, backing the routine use of available neuromarkers. To our knowledge this is the first case showing such low levels of Aβ1-42 in TBM; its accumulation, drove by neuroinflammation related to infections, can be central in understanding neurodegenerative diseases.
The Relationship Between Bite Force, Morphology, and Diet in Southern African Agamids.
Authors: Tan Wei Cheng , Measey John , Vanhooydonck Bieke , Herrel Anthony
Published: March 2021

Background: Many animals display morphological and behavioural adaptations to the habitats in which they live and the resources they exploit. Bite force is an important whole-organism performance trait that allows an increase in dietary breadth, the inclusion of novel prey in the diet, territory and predatory defence, and is important during mating in many lizards. Methods: Here, we study six species of southern African agamid lizards from three habitat types (ground-dwelling, rock-dwelling, and arboreal) to investigate whether habitat use constrains head morphology and bite performance. We further tested whether bite force and head morphology evolve as adaptations to diet by analysing a subset of these species for which diet data were available. Results: Overall, both jaw length and its out-lever are excellent predictors of bite performance across all six species. Rock-dwelling species have a flatter head relative to their size than other species, possibly as an adaptation for crevice use. However, even when correcting for jaw length and jaw out-lever length, rock-dwelling species bite harder than ground-dwelling species. Diet analyses demonstrate that body and head size are not directly related to diet, although greater in-levers for jaw closing (positively related to bite force) are associated to an increase of hard prey in the diet. Ground-dwelling species consume more ants than other species. Conclusions: Our results illustrate the role of head morphology in driving bite force and demonstrate how habitat use impacts head morphology but not bite force in these agamids. Although diet is associated with variation in head morphology it is only partially responsible for the observed differences in morphology and performance.
Identification and Characterization of Wheat - Aegilops Comosa 7M/7A Disomic Substitution Lines with Stripe Rust Resistance
Authors: Zuo Yuanyuan , Dai Shoufen , Song Zhongping , Xiang Qin , Li Wenjia , Liu Gang , Li Jian , Xu Donghe , Yan Zehong
Published: March 2021

Aegilops comosa (MM, 2n = 2x = 14), an important diploid species belonging to wheat tertiary gene pools, contains many excellent genes/traits, including disease resistance for wheat breeding. In this study, three sister lines, NAL-32, NAL-33, and NAL-34, were identified from a wheat - Ae. comosa distant cross using fluorescence in situ hybridization (FISH) combined with single nucleotide polymorphism (SNP) microarray analysis. Genetically, NAL-32 contained neither an alien nor translocation chromosome, whereas NAL-33 and NAL-34 had disomic 7M/7A substitution chromosomes but differed in the absence (NAL-33) or presence (NAL-34) of 1BL/1RS translocation chromosomes. The substitution of 7M/7A in NAL-33 and NAL-34 was verified using wheat 55 K SNP arrays but 1BL/1RS translocation in NAL-34 was not. The two 7M/7A substitution lines, NAL-33 and NAL-34, had similar stripe rust resistance, and both showed higher stripe rust resistance than NAL-32 and their parents, suggesting that stripe rust resistance in NAL-33 and NAL-34 was derived from the 7M of Ae. comosa and that their resistance was likely irrelevant to 1BL/1RS translocation. Meanwhile, the three NAL lines also showed higher grain weights (grams per 50 grains) than one to three of their three wheat parents, and the two 7M/7A substitution lines, NAL-33 and NAL-34, had larger seed size-related traits than NAL-32, suggesting that both the 7M and 1BL/1RS chromosomes had positive effects on seed size-related traits. The results provide important bridge materials that can potentially be used for transferring stripe rust resistance, as well as seed size-related traits from Ae. comosa to wheat.
Novel CD44-Targeting and pH/redox Dual-Stimuli Responsive Core-Shell Nanoparticles Loading Triptolide to Combat Breast Cancer Growth and Lung Metastasis
Authors: Shi Jinfeng , Ren Yali , Ma Jiaqi , Luo Xi , Li Jiaxin , Wu Yihan , Gu Huan , Fu Chaomei , Cao Zhixing , Zhang Jinming
Published: March 2021

BackgroundThe toxicity and inefficient delivery of triptolide (TPL) in tumor therapy have greatly limited its clinical application. Therefore, we fabricated a CD44-targeting and tumor-microenvironment pH/redox sensitive nanosystem, composed by hyaluronic acid-Vitamin E succinate (HA-VE) and Poly (β-Amino Esters) (PBAEss) polymers, to enhance the suppression of breast cancer proliferation and lung metastasis of TPL. ResultsThe generated TPL/NPs had the high drug loading efficiency (94.93 ± 2.1%) and a desirable average size (191 nm). Mediated by PBAEss core, TPL/NPs displayed a pH/redox dual stimuli drug release profile in vitro. Based on HA coating, TPL/NPs exhibited selective tumor-cellular uptake and high tumor-tissue accumulation capacity via targeting CD44. As a consequence, TPL/NPs showed higher cell proliferation suppression, pro-apoptosis and cell cycle arrest activities, and stronger inhibitory effects on cell migration and invasion than free TPL in MCF-7 and MDA-MB-231 cells. Importantly, TPL/NPs also showed higher efficacy in shrinking tumor size and block lung metastasis in a 4T1 breast cancer mice model at equivalent or lower TPL dosage compared to free TPL, with the decreased systemic toxicity. Histological immunofluorescence and immunohistochemical analyses in tumor and lung tissue revealed that TPL/NPs induced a high level of apoptosis, suppressed expression of matrix metalloproteinases, which all these contributed to inhibit tumor growth and pulmonary metastasis. ConclusionCollectively, our results demonstrate that TPL/NPs, which integrates tumor active-targeting and pH/redox responsive drug release, pro-apoptosis, and anti-mobility, represent a promising candidate in halting breast cancer progression and metastasis while minimizing systemic toxicity.
Microstructure, Mechanical Behavior and Crystallographic Texture in a Hot Forged Dual Phase Stainless Steel.
Authors: Badji Riad , Cheniti Bellel , Kahloun Charlie , Chauveau Thierry , Hadji Mohammed , Bacroix brigitte
Published: March 2021

In this work, the hot forging behavior of a dual phase stainless steel in the temperature range of 850 – 1250 °C was investigated. The study revealed the occurrence of a significant cracking phenomenon for processing temperatures below 950 °C that was attributed to the combined effect of intermetallic precipitation and severe deformation. EBSD examination highlighted the occurrence of continuous dynamic recrystallization in both ferrite and austenite microstructures for processing temperatures above 1050 °C. Increasing the hot forging temperature to 1250 °C increased the low angle grain boundaries fraction and lowered the one of the high angle grain boundaries. This was accompanied by a gradual change in the crystallographic texture of the material. The mechanical behavior investigation showed that the steel plasticity, sharply dropped after forging at 850°, was gradually recovered after hot forging at temperatures above 1050°C. This was confirmed by nanoindentation measurements that revealed a remarkable increase of the hardness and young modulus of the steel after hot forging at 850°C and 950°C due to the dislocation nucleation and the s phase precipitation at g/δ interface. The enhancement of dislocation movement at the vicinity of the grain boundaries due to the absence of s phase as well as the dynamic recovery and recrystallization occurring in the temperature range of 1050°C - 1250 °C improved the global mechanical properties of the hot forged steel.