bluuebunny/crossref_metadata_2025 huggingface dataset:
Postmortem Diagnosis of Pulmonary Tumor Thrombotic Microangiopathy with Rapid Exacerbation in a Patient with Gastric Cancer: A Case Report
Authors: Kamidani Ryo , Kumada Keisuke , Okada Hideshi , Yoshimura Genki , Kanayama Tomohiro , Tomita Hiroyuki , Miura Tomotaka , Oiwa Hideaki , Mizuno Yosuke , Kitagawa Yuichiro , Yasuda Ryu , Fukuta Tetsuya , Miyake Takahito , Doi Tomoaki , Yoshida Takahiro , Yoshida Shozo , Hara Akira , Ogura Shinji
Published: August 2021

Background: Pulmonary tumor thrombotic microangiopathy (PTTM) is a condition that involves the development of pulmonary hypertension due to the presence of microscopic tumor emboli of the peripheral pulmonary arteries. Here, we report a case of rapidly exacerbating PTTM associated with gastric cancer that was identified postmortem through pathological autopsy.Case presentation: A 52-year-old Asian woman who experienced anterior chest pain while coughing visited the orthopedic department of the Gifu University Hospital. She was diagnosed as having multiple osteolytic bone metastases throughout her body and was subsequently scheduled to undergo combined positron emission tomography and computed tomography (CT) to search for a primary lesion. However, 4 days after her visit to the orthopedic department, she was unable to stand up and thus visited the emergency department. At the time of admission, physical examination results revealed that she had a percutaneous oxygen saturation level of 90% (on room air) and cyanosis, and that she was in a state of hemodynamic shock. Laboratory test results revealed elevated levels of fibrin degradation products and D-dimer in her blood. Chest CT results were normal. She was admitted to the hospital’s general ward for follow-up but soon entered a gradually worsening state of shock and respiratory failure. Electrocardiography revealed findings associated with right heart strain; however, contrast-enhanced CT did not reveal the presence of pulmonary embolism. She was admitted to the intensive care unit and was treated for pulmonary hypertension; however, 45 h after her arrival at the hospital, she died of respiratory failure. A pathological autopsy revealed the presence of gastric cancer, tumor microemboli, and fibrous intimal thickening of the peripheral arteries of both lungs; thus, a diagnosis of PTTM was made. Conclusions: In patients with carcinoma of unknown primary site and pulmonary hypertension with pulmonary embolism ruled out by CT, emergency physicians and intensivists must consider the possibility of PTTM, which represents an oncologic emergency, and initiate chemotherapy administration as soon as possible.
Safety Assessment of Oral 5-aminolevulinic Acid and Ferrous iron in Healthy Human Subjects: A Non-randomized, Open-label, Non-placebo-controlled Trial
Authors: Ito Hidenori , Tanaka Tohru
Published: August 2021

The combination of 5-aminolevulinic acid (5-ALA) phosphate and sodium ferrous citrate (SFC) has been approved as an ingredient of food supplement in several countries because of its wide applicability to healthcare areas. We aimed to assess the safety of 5-ALA phosphate and SFC in healthy adult subjects at the dose several times higher than that available on market. This was an open, non-randomized, non-placebo-controlled trial that included 11 men and 11 women. Doses of 250 mg 5-ALA phosphate and 143.4 mg SFC (15 mg as Fe) per day were orally administered for 28 days. Blood and urine analyses and interviews were conducted to assess the safety. No test compound-related adverse events or abnormal values were observed, except for elevated serum iron levels, which were mild to moderate and transient. Combined administration of 5-ALA phosphate and SFC to healthy adults is well-tolerated and safe at the dose and duration investigated in this study.
Heavy Thallium Based Fluoroperovskite TlAF3 (A = Ge, Sn and Pb) Compounds: A Computational Investigation
Authors: Zaman Shams U , Mehmood Nasir , Khan Sajid , Ahmad Rashid , Sultan Nadia , Ullah Farhat , Rahman Altaf Ur , Kim H. J.
Published: August 2021

Combination of heavy elements in forming a stable system leads to enhancement in effective atomic number making it desirable in many applications such as detection and shielding of radiation. We present our theoretical investigations on new Thallium based heavy fluoroperovskites TlAF3 (A = Ge, Sn and Pb). The study is carried out to explore the structural, elastic, electronic, and optical properties through the Density Functional Theory (DFT) using the Full-Potential Linearized Augmented Plane Wave (FP-LAPW) method implemented in WIEN2k. Generalized Gradient Approximation with consideration of electronic correlation effects (GGA+U) was employed for calculations. The lattice constants deduced from the optimization curves were found to be in the range of 4.00 Å to 4.85 Å. Elastic properties were obtained from the calculated elastic constants. From band structure calculations, it is evident that the bandgaps range from 0.84 to 1.89 eV. All the studied compounds exhibit indirect bandgap nature. Fluorine atom contributes significant number of electronic states in valence and conduction bands of all studied compounds. The optical response in terms of refractive index, extinction coefficient, optical conductivity, reflectivity, and absorption coefficients are calculated and discussed in the energy range of (0-20) eV. The properties of compounds in this study are being reported for the first time.
Association Between High Immune Activity and Worse Prognosis in Uveal Melanoma and Low-Grade Glioma in TCGA Transcriptomic Data
Authors: Matsuo Hitoshi , Kamatani Takashi , Hamba Yu , Boroevich Keith A. , Tsunoda Tatsuhiko
Published: August 2021

Background: Immune status in the tumor microenvironment is an important determinant of cancer progression and patient prognosis. Although a higher immune activity is often associated with a better prognosis, this trend is not absolute and differs across cancer types. We aimed to give insights into why some cancers do not show better survival despite higher immunity by assessing the relationship between different biological factors, including cytotoxicity, and patient prognosis in various cancer types using RNA-seq data collected by The Cancer Genome Atlas.Results: Results showed that a higher immune activity was associated with worse prognosis in patients with uveal melanoma and low-grade glioma, which are cancers of immune-privileged sites. In these cancers, epithelial or endothelial mesenchymal transition and inflammatory state as well as immune activation had notably negative correlation with patient prognosis. Further analysis using additional single-cell data of uveal melanoma and glioma revealed that epithelial or endothelial mesenchymal transition was mainly induced in retinal pigment cells or endothelial cells that comprise the blood-retinal and blood-brain barriers, which are unique structures of the eye and central nervous system, respectively. Inflammation was mainly promoted by macrophages, and their infiltration increased significantly in response to immune activation. Furthermore, we found the expression of CCL5 was strongly correlated with immune activity and associated with bad prognosis, particularly in these cancers, suggesting that CCL5 is a potential molecular target for therapeutics.Conclusions: Epithelial or endothelial mesenchymal transition is associated with a bad prognosis. This suggests that inflammation loosens the structures of the blood barrier and causes further infiltration of immune cells, which may result in a feedback loop of additional inflammatory effects leading to runaway conditions.
Performance Analysis and Simulation of Millimeter Wave Cell-Free mMIMO Networks
Authors: Shalaby Mohamed Saeid , Hussein Hussein Mohamed , Shokair Mona Mohamed Sabry , Benaya Ahmed Mohamed
Published: August 2021

5G networks and beyond can provide high data rate for the served users. Small cells, massive multiple input multiple outputs (mMIMO) as well as working in millimeter wave bands are emerging tools toward empowering 5G and beyond networks. The cellular mMIMO networks can provide high data rate for users, however their performance is not satisfied for the cell-edge users and shadowed users. Fortunately, the cell-Free mMIMO network can provide a satisfied performance for all users even if they are in shadowed areas or at cell edges. The distributed access points (APs) through the coverage area can allow users to get benefit of the best serving AP. Furthermore, the users can have services anywhere due to the existence of one AP at least. The cell-Free mMIMO networks can provide a high throughput when they are operated in the millimeter wave bands due to the high available bandwidth. The operation in millimeter wave bands can let the 5G networks and beyond have a high data rate. Therefore, this paper gives a great attention to the millimeter wave bands. In this paper, the performance of the cell-Free mMIMO network, operating in the millimeter wave bands, is mathematically evaluated and simulated. The performance can include the spectral efficiency (SE), bit error rate (BER), and energy efficiency (EE). It is observed that the centralized cooperation among the APs, level 4, can provide a high SE and EE even if the maximal ratio combining (MRC) is applied. Moreover, the cell-Free four cooperation levels can perform better than cellular mMIMO when the millimeter wave non-line-of-sight (NLOS) models are applied.
An Assessment on Performance Characteristics of Diesel Engine Using Lemongrass-Diesel Oil Fuel Blends
Authors: Rana Naveen , Nagwan Harikrishna , Manickam Kannan
Published: August 2021

Indeed, the development of alternative fuels for use in internal combustion engines has become an essential requirement to meet the energy demand and to deal with the different problems related to fuel. The research in this domain leads to the identification of adverse fuel properties and for their solution standard limits are being defined. This paper outlines an investigation of performance and combustion characteristics of a 4-stroke diesel engine using different cymbopogon (lemongrass) - diesel fuel blends. 10% to 40% cymbopogon is mixed with diesel fuel and tested for performance characteristics like brake specific fuel consumption and brake thermal efficiency. To obtain emission characteristics smoke density in the terms of HSU has been measured. In result, it has observed that there is an increase of 5% in brake thermal efficiency and 16.33% decrease in brake specific fuel consumption. Regarding emission characteristics, a 12.9% decrease in smoke emission has been found.
Stormwater Monitoring Using On-line UV-Vis Spectroscopy for Surrogate Measurements of Chemical Contaminants and Compared With Microbiological Data
Authors: Huang Jianyin , Chow Christopher W.K. , Shi Zhining , Fabris Rolando , Mussared Amanda , Hallas Gary , Monis Paul , Jin Bo , Saint Christopher P.
Published: August 2021

Stormwater runoff contains a myriad of pollutants, including faecal microbes, and can pose a threat to urban water supplies, impacting both economic development and public health. Therefore, it is a necessity to implement a real-time hazard detection system that can collect a substantial amount of data, assisting water authorities to develop preventive strategies to ensure the control of hazards entering drinking water sources. An on-line UV-Vis spectrophotometer was applied in the field to collect real-time continuous data for various water quality parameters (nitrate, DOC, turbidity and total suspended solids) during three storm events in Mannum, Adelaide, Australia. This study demonstrated that the trends for on-line and comparative laboratory analysed samples were complimentary through the events. Nitrate and DOC showed a negative correlation with water level while turbidity and total suspended solids indicated a positive correlation with water level during the high rainfall intensity. The correlations among nitrate, DOC, turbidity, total suspended solids, and water level are the opposite during the low rainfall intensity. Nitrate, one of the main pollutants in stormwater, was investigated and used as a surrogate parameter for microbial detection. However, the microbiological data (E.coli) from captured storm events showed poor correlations to nitrate and other typical on-line parameters in this study, possibly explained by the nature of the stormwater catchment outside of rain events, where the sources of bacteria and nutrients may be physically separate until mixed during surface runoff as a result of rainfall. In addition, the poor correlations among the microbiological data and on-line parameters can be due to the different sources of bacteria and nutrients that end up into the stormwater drain.
The Intrapersonal and Interpersonal Processes of Fear of Recurrence Among Cervical Cancer Survivors - A Qualitative Research.
Authors: Hamama-Raz Yaira , Shinan-Altman Shiri , Levkovich Inbar
Published: August 2021

Objective: Cervical cancer often takes an emotional and mental toll on the affected woman. Fear of cancer recurrence was identified as one of the most prominent unmet needs in patients and survivors. The present study sought to explore meaning of fear of cancer recurrence among cervical cancer survivors owing to the paucity of studies regarding this population. Methods: In this qualitative research, semi structured interviews conducted with 15 cervical cancer survivors. Interviewees' mean age was 41.33 years (range 34-47 years) and time since diagnosis ranged from six months to seven years (mean - 3.1 years). Results: Three central themes emerged that represent intrapersonal and interpersonal processes that begin with relief from fears of cancer recurrence, alongside acknowledgement of being no longer resilient, representing the intrapersonal level. Next, an interpersonal level that included mutual fears shared by the interviewee and her partner, reflected either by coping together or coping alone. Finally, fear of recurrence became a combination of intrapersonal and interpersonal processes manifested by the greatest fear - death, expressed by both the interviewee and her family members. Conclusions: The present findings revealed that the meaning of fear of cancer recurrence represents intrapersonal and interpersonal processes encompassing three factors – uncertainty, social-cognitive processing and death anxiety. Accordingly, potential psycho-social treatment options could be tailored specific to the dominance of these factors for cervical cancer survivor.
Vagus-Preserving Proximal Gastrectomy with Double- Flap Technique for Gastrointestinal Stromal Tumor involving the Esophagogastric Junction：A Case Report
Authors: Peng Wei , Huang Yi-Kai , Wu Yong-You , Gong Wei , Chen Zheng-Rong , Chen Qiang , Su Wen-Zhao , Cheng Ming
Published: August 2021

Background: Gastrointestinal stromal tumor (GIST) involving the esophagogastric junction (EGJ) is a relatively rare but thorny problem. It represents a dilemma between complete resection and impairment of quality of life (QOL) for loss of cardiac sphincter or even the whole stomach. Thus, emergence of function preserving gastrectomy is necessary and may provide partial solution to this hot potato. Here, we would like to introduce a method which successfully settle this matter through a clinical case. Case presentation: A 46-year-old male complaining of a progressive dysphagia. A huge GIST with 120mm in diameter was diagnosed by enhanced CT scan and pathological exam. Imatinib mesylate (IM) was initially prescribed, the tumor was shrank to a large extent while drug resistance emerged 6 months after therapy, leaving a mass approximately 90mm in diameter. We applied a method of vagus preserving proximal gastrectomy (VP-PG) and esophagogastrostomy with double-flap technique (DFT) for the patient. The operation was smooth and postoperative courses within a 12-months follow-up were uneventful. The patient had no digestive symptoms but slight leucopenia due to IM toxicity during this medication period. Conclusion: We consider that the application of VP-PG and DFT subsequent to neoadjuvant therapy with IM is likely to be an effective and feasible option for GISTs with EGJ involvement.
Negative-Pressure Wound Therapy is Effective for Peritoneal Dialysis Catheter Exit-Site Management in The Early Postoperative Period
Authors: Fukuzaki Haruna , Nakata Junichiro , Nojiri Shuko , Shimizu Yuki , Kano Toshiki , Shirotani Yuka , Maeda Takuya , Nohara Nao , Io Hiroaki , Suzuki Yusuke
Published: August 2021

Peritoneal dialysis (PD) catheter exit-site care is critically important for the prevention of catheter-related infections (CRIs) and subsequent peritonitis. The postoperative management of the site is particularly essential due to its susceptibility to slow healing and infection. Despite the recent use of negative-pressure wound therapy (NPWT) for a wide variety of wounds, few studies have investigated the effectiveness of NPWT for PD catheter exit sites. In this study, 30 patients with end-stage renal disease who underwent simultaneous PD catheter insertion and exit-site formation were randomly assigned to receive NPWT (NPWT group) or conventional dressing (non-NPWT group) for the first seven postoperative days. The exit-site scores on the seventh postoperative day and over 180 days were lower in the NPWT group than in the non-NPWT group (p = 0.0049 and p = 0.007, respectively). There were no statistically significant differences between the time to first CRI and PD-related peritonitis between the two groups. There was one case of CRI with relapsing peritonitis and catheter loss in the non-NPWT group. These findings demonstrate the association between NPWT and low exit-site score. NPWT can be recommended for the management of PD catheter exit sites in the early postoperative period.
RNA Sequencing Reveals Novel LncRNAs/mRNAs Network Associated with Puerarin-mediated Inhibition of Cardiac Hypertrophy in Mice
Authors: Ye Shan , Chen Wei-Yang , Ou Caiwen , Chen Min-Sheng
Published: August 2021

Background: Evidence has demonstrated that puerarin is a potential drug for the treatment of cardiac hypertrophy. However, the precise underlying molecular mechanisms of the protective effect of puerarin are still unclear. Here, we aimed to explore the regulatory mechanisms of lncRNAs/mRNAs in a cardiac hypertrophy mouse model after puerarin treatment.Methods: A mouse model of cardiac hypertrophy was established by transverse aortic constriction (TAC). The echocardiography, tissue staining and western blot were used to examine the protective effect of puerarin. Then RNA sequencing (RNA-seq) was carried out to systematically analyze global gene expression. The target lncRNAs were confirmed using qRT-PCR. Moreover, a coding/non-coding gene co-expression (CNC) network was established to find the interaction of lncRNAs and mRNAs. The molecular functions, biological processes, molecular components and pathways of different expression mRNAs targeted by lncRNA were explored using Gene Ontology (GO) analysis and Kyto Encyclopedia of Genes and Genomes (KEGG) pathways analysis.Results: Puerarin exhibited obvious inhibitory effect in cardiac hypertrophy in TAC model. RNA-seq analysis was performed to investigate the lncRNAs and mRNAs expression patterns of cardiomyocytes in sham and TAC groups treated with or without puerarin. RNA-seq identified that TAC upregulated 19 lncRNAs and downregulated 18 lncRNAs, which could be revised by puerarin treatment (Fold change ≥ 3 and P< 0.05). Expression alterations of selected lncRNAs ENSMUST00000125726, ENSMUST00000143044 and ENSMUST00000212795 were confirmed by qRT-PCR. Pearson’s correlation coefficients of co-expression levels suggested that there was interactive relationship between those 3 validated altered lncRNAs and 5,500 mRNAs (r > 0.95 or r < −0.95). Those co-expressed mRNAs were enriched in some important biological processes such as vesicle-mediated transport, sin 3 complex, and translation initiation factor activity. KEGG analyses suggested that those lncRNA-interacted mRNAs were enriched in RNA transport, ribosome biogenesis in eukaryotes and proteasome signaling pathway. Conclusion: Puerarin may exert beneficial effects on cardiac hypertrophy through regulating the ENSMUST00000125726 /ENSMUST00000143044 / ENSMUST00000212795 -mRNAs network.
Plant-Soil Interactions of an Invasive Plant Species in its Native Range Help to Explain its Invasion Success Elsewhere
Authors: Aldorfová Anna , Hanzelková Věra , Drtinová Lucie , Pánková Hana , Cajthaml Tomáš , Münzbergová Zuzana
Published: August 2021

Purpose: To compare plant-soil feedback (PSF) of invasive Cirsium vulgare and non-invasive C. oleraceum in their native range to test a hypothesis that the invasive species is more limited by specialized pathogens in the native range and/or able to benefit more from generalist mutualists, and thus may benefit more from loss of specialized soil biota in a secondary range.Methods: We assessed changes in soil nutrients and biota following soil conditioning by each species and compared performance of plants grown in self-conditioned and control soil, from which all, some or no biota was excluded. Results: The invasive species depleted more nutrients than the non-invasive species and coped better with altered nutrient levels. The invasive species had higher seedling emergence which benefited from presence of non-specific microbes. The invasive species biomass responded less positively to specialized (self-conditioned) microbiota and more negatively to specialized larger-sized biota compared to the non-specialized control biota, suggesting the species may benefit more from enemy release and suffer less from loss of specialized mutualists when introduced to a secondary range. The invasive species showed greater ability to decrease its root-shoot ratio in presence of harmful biota and thus reduce their negative effects on its performance.Conclusions: Our study highlights the utility of detailed PSF research in the native range of species for understanding the factors that regulate performance of invasive and non-invasive species in their native range, and for pinpointing the types of biota involved in their regulation and how this changes across the plants life cycle.
Prediction of Hospital Discharge Outcome From Changes in Albumin Quotient and Cerebrospinal Fluid Lactate Dehydrogenase in Patients With Cryptococcal Meningitis
Authors: Huang Yue , Zou Jun , Zhang Ke-ming , Li Hang , Hu Dong-ying , Liao Wan-qing , Zhang Lei , Pan Wei-hua
Published: August 2021

BackgroundCryptococcal meningitis (CM) is a life-threatening infection of the central nervous system that occurs in healthy individuals and immunocompromised patients, and reliable prognostic parameters are needed urgently. This study analyzed the clinical characteristics and laboratory findings of CM patients from two tertiary care hospitals in China between 2015 and 2019, aiming to provide reliable prognostic factors for patients with CM.MethodsClinical characteristics and laboratory findings of CM patients were retrospectively reviewed. The unfavorable outcome was defined as no improvement or worsening symptoms and signs or persistent positive results for CSF culture or death after starting treatment. The significant differences in clinical characteristics and symptoms between the patients with favorable and unfavorable outcomes were descriptively analyzed. For comparison of mean values of laboratory results between the patients with favorable and unfavorable outcomes, the t test was performed.Results63 patients with CM were enrolled in this study and 67% were men. 38/63 patients were confirmed to be HIV serology positive. The mean onset age of all patients was 49±15 (20– 77) years. For clinical characteristics, headache, nausea and/or vomiting, and fever were the most common symptoms. Older age and disturbance of consciousness tended to poor prognosis. Changes in serum antioxidant parameters were significantly associated with clinical outcome. For CSF parameters, there were significant correlations between changes in leukocyte count, lactate dehydrogenase and chloride, and outcomes in different groups. For HIV-infected patients, increased CD4+ T cell counts suggested good prognosis. Increased CSF/serum albumin quotient (Qalb) was indicative of unfavorable outcome in HIV-negative patients.ConclusionsIn summary, CSF lactate dehydrogenase and albumin quotient may improve prediction of outcome in patients with CM. We recommend incorporation of Qalb value analysis and pay attention to change of CSF LDH during hospitalization.
Evaluation of Traits Associated With Seed Characteristics in Arkansas Restorer Lines
Authors: Azapoglu Ozgur , Srivast Vibha , Sha Xueyan , Shakiba Ehsan
Published: August 2021

Rice Grain dimension and weight are two critical factors for marketing and increasing yield capacity. Seed shape is measured by its length, width, thickness, and ratio of length-width. In this study, an experiment was conducted in a controlled condition from fall 2017 to 2020 to identify QTL and candidate genes associated with seed dimension and weight using a bi-parental population resulting from two University of Arkansas developed genotypes: a restorer line 367R and an advanced breeding line RU1501139, in Stuttgart, Arkansas. Five seed dimension traits, including seed length, seed width, seed thickness, seed length-width ratio, and 100-seeds weight, were obtained for QTL detection. The study detected a total of 17 QTL. Four QTL associated with seed length were identified, in which two were positioned on chr. 3, one on chr. 7, and one on chr. 11. Two QTL related to seed length-width ratio were detected on chr. 3 and 7. Whereas a total of three QTL were identified for seed thickness, one each on chr. 5, 6, and 8. Eight QTL associated with seed weight were found, of which four QTL were detected on chr. 12, two each on chr. 1 and 10, and one on chr. 3. Of 17 QTL, four QTL originated from RU1501139, while the origin of the other 13 QTL was 367R. Since multiple genes could control the yield and seed physical characteristics, the detected QTL can play a role in introducing superior parental lines for developing conventional and hybrid rice production.
The Prognostic Value of an autophagy-related lncRNA Signature in Esophageal Cancer
Authors: Zhang Zhiyong , Bi Weiyun , Zhao Yan , Ren Mudan , Li Yarui , Li Hongtao , Zhu Cailin
Published: August 2021

Esophageal cancer is a clinically challenging disease, seriously affecting the quality of life and prognosis of patients. Autophagy is a basic intracellular event that can maintain cell homeostasis by degrading damaged or degenerate proteins and organelles. Long noncoding RNAs (lncRNAs) are a class of RNA transcripts with a length greater than 200 nucleotides that participate in fundamental biological processes and tumor progression. However, whether autophagy-related lncRNAs can be used to predict the survival of patients with esophageal cancer still needs in-depth research. The Human Autophagy Database19 (HADb) and The Cancer Genome Atlas (TCGA) database were used to identify autophagy-related lncRNAs. Univariate and multivariate COX analyses were performed to establish a prognostic risk score model. Kaplan–Meier curves and ROC curves were carried out to evaluate the prognostic value of the autophagy-related lncRNAs signature. 1757 autophagy-related lncRNAs in esophageal cancer were identified based on specific screening criteria and four key lncRNAs (ZFAS1, AC092687.3, AC083799.1, AL080317.1) were selected to construct a novel prognostic model. Particularly, the risk score for each patient could be calculated based on the expression levels of these four lncRNAs, and a high risk score was positively associated with shorter survival time and poor prognosis of esophageal cancer patients. The autophagy-related lncRNAs signature constructed in this study can be used as a novel risk score model to predict the survival and prognosis of patients with esophageal cancer.
Assessment of Pharmacological Properties of Hydroethanolic Extract of Bixa orellana (Bixaceae) Leaves on Acetic Acid-induced Colitis in Rat
Authors: Tagne Michel Archange Fokam , Kom Blaise , Fondjo Angèle Foyet , Noubissi Paul Aimé , Gaffo Estelle Flora , Fankem Gaëtan Olivier , Wambe Henri , Mukam Joseph Ngakou , Kamgang René , Oyono Jean-Louis Essame
Published: August 2021

Ulcerative colitis is one of the inflammatory bowel diseases that is increasing in incidence worldwide. The objective of this work was to evaluate the activities of the hydroethanolic extract of the leaves of Bixa orellana on colitis in rats. Thirty-six rats were anesthetized with ether after 18 hours of fasting and ulcerative colitis was induced by intrarectal administration of 1 mL of acetic acid (5%) in all animals except the normal control group which received instead distilled water (1 mL). 48 hours after induction, the normal control and the negative control received distilled water (10 mL/kg), the positive control received loperamide (5 mg/kg) and three test groups received hydroethanolic extract Bixa orellana leaves at 100, 200 and 400 mg/kg per day for seven days. Administration of the extract significantly (P <0.01) reduced the number of diarrheal stools, nitric oxide and malonedialdheide levels, anemia and the number of colon lesions. The extract significantly (P <0.01) improved body weight loss as well as antioxidant parameters (superoxide dismutase, catalase, gluthation). These results would justify the use of Bixa orellana in the treatment of inflammatory bowel disease.
Policy Spotlight Effect In Critical Time-Sensitive Diseases
Authors: Lin Chih-Yuan , Chang Li-Chuan , Lee Yue-Chune
Published: August 2021

Background: Categorization of hospital emergency capability (CHEC) is a policy implemented worldwide to regionalize critical emergent care. The CHEC policy mainly uses time-based indicators as emergency care quality measurements.Objectives: We aimed to explore the CHEC policy spotlight effect on critical time-sensitive diseases with and without the influence of time-based surveillance indicators and guidelines. Research Design: We conducted a nationwide retrospective cohort study between 2005–2011. Regarding critical time-sensitive diseases, our study targeted acute ischemic stroke (AIS), ST-segment elevation myocardial infarction (STEMI), septic shock, and major trauma. We selected diagnosis and treatment guideline adherence as process quality measures and defined medical utilization, upward transfer rate, and short-term mortality rate as outcome indicators. Subjects: The Taiwan National Health Insurance 2005 Longitudinal Health Insurance Database contains one million random cases, including medical records and hospital information. Results: During this 7-year study AIS, STEMI, septic shock, and major trauma, respectively. AIS and STEMI cohorts had significantly higher rates of guideline adherence and better process quality than those of septic shock and major trauma cohorts. Furthermore, AIS and STEMI cohorts had a significant increase in diagnosis costs. Conclusion: The CHEC policy spotlight effect exists in critical time-sensitive diseases with time-based quality indicators. Importantly, disease entities without these indicators may experience decreases in diagnosis and treatment guideline adherence, indirectly jeopardizing their outcomes.
Development of A Recombinant Murine Luteinizing Hormone Binding Protein As A Selective Hormone Inhibitor
Authors: Yamaguchi Yusuke , Sato Yorino , Kawamura Kazuhiro
Published: August 2021

Physiological levels of luteinizing hormone (LH), in concert with follicle stimulating hormone (FSH), promote ovarian follicular development and ovulation. However, high LH levels associated with ovarian dysfunction have been shown to inhibit these processes. Thus, developing a selective LH inhibitor could be potentially useful for treating ovarian dysfunction. Here, we developed a mouse LH-binding protein (mLBP) composed of the extracellular domain of LH receptors as a selective inhibitor of mouse LH. After transient introduction of mLBP expressing vectors into Expi293F cells, mLBP was obtained as a soluble protein via a cleavage reaction with thrombin. The binding ability of mLBP for mouse LH was confirmed using sera containing high LH and FSH collected from ovariectomized (OVX) mice. The bioactivity of mLBP was demonstrated by inhibition of cAMP and testosterone productions induced by OVXmouse serum in mouse Leydig MLTC-1 cells expressing LH receptors. In contrast, mLBP did not bind mouse FSH and inhibit cAMP production induced by OVX-mouse serum in 293 cells expressing mouse FSH receptors. The mLBP also showed binding affinity to human LH (hLH), and inhibited hLH-induced cAMP production in MLTC-1 cells. Thus, the mLBP selectively suppresses the action of LH and is a potential therapeutic agent for ovarian dysfunction.
Disorders of Tetrahydrobiopterin Metabolism: Experience from South India
Authors: Ray Somdattaa , Padmanabha Hansashree , Gowda Vykuntaraju K , Mahale Rohan , Christopher Rita , Sreedha Shruthy , Dhar Debjyoti , Kamate Mahesh , Nagappa Madhu , Bhat Maya D , Anjanappa Rammurthy , Arunachal Gautham , Mailankody Pooja , Mathuranath Pavagada S , Chandra Sadanandavalli R
Published: August 2021

Background: Disorders of tetrahydrobiopterin metabolism represent a rare group of inherited neurotransmitter disorders which manifest mainly in infancy or childhood with developmental delay, neuroregression, epilepsy, movement disorders and autonomic symptoms. Methodology: A retrospective review of genetically confirmed cases of disorders of tetrahydrobiopterin metabolism over a period of three years (Jan 2018 to Jan 2021) was performed across two paediatric neurology centres from South India.Results: A total of nine patients(M:F=4:5) fulfilled the eligibility criteria. The genetic variants detected include homozygous mutations in the QDPR(n=6), GCH1(n=2) and PTS(n=1) genes. The median age at onset of symptoms was 6-months(range 3-78 months), while that at diagnosis was 15-months (8-120 months) resulting in a median delay in diagnosis of 9-months. The main clinical manifestations included neuroregression (89%), developmental delay(78%), dystonia(78%) and seizures(55%). Management strategies included phenylalanine restricted diet, levodopa/carbidopa, 5-Hydroxytryphtophan, and folinic acid. Only, Patient-2 afforded and received BH4 supplementation at a sub-optimal dose later in the disease course. We had a median duration of follow up of 15 months (range 2-48 months). Though biochemical response has been marked, except for patients with GTPCH deficiency, only mild clinical improvement was noted with regards to developmental milestones, seizures or dystonia in others. Conclusion: Tetrahydrobiopterin deficiencies represent an rare yet potentially treatable cause for non-phenylketonuria hyperphenylalaninemia when diagnosed and treated early in life. Screening for disorders of biopterin metabolism in patients with hyperphenylalaninemia prevents delayed diagnosis. This study expands the genotype phenotype spectrum of patients with disorders of tetrahydrobiopterin metabolism from South India.
The Effect of Corona Epidemic on Hospital Services and Revenues: A Case Study of Fars Province / Iran
Authors: Kharazmi Erfan , Bordbar Shima , Jafari Abdosaleh
Published: August 2021

Background: The economic impact of corona virus (COVID-19) disease on hospital performance in Iran is unknown. The aim of this study was to examine the effect of corona epidemic on hospital services and revenues: a case study of Fars province / Iran.Methods: The study was cross-sectional and descriptive. The information recorded in the hospital information system (HIS) of hospitals affiliated with Shiraz University of Medical Sciences, Iran from March to August 2019 and 2020 was used to identify the number of services provided. Revenues from services were derived from HIS and accrual accounting systems.Results: The results showed that the total number of services provided from March to August 2019 and 2020 were 75,415,652 and 59,436,379, respectively, indicating that the total number of services in 2020 has decreased by 21% compared to 2019. The finding also indicated that the total revenue of services provided from March to August 2019 and 2020 is $ 166,929,626, and $ 146530916, respectively, indicating that the total revenue of services provided in 2020 decreased by 12% compared to 2019.Conclusions: Corona epidemic could accelerate the redesign of the health care system to make it more efficient, active, sustainable and patient-centered. Some strategies to measure and control costs and revenues and improve clinical outcomes as well as changes in reimbursement systems that maintain the structure of the health system are vital to reaching this redesign and the desired results.
Prediction of Second Wave of COVID-19 in India using the Modified SEIR Model
Authors: Sun Changqing , Zhao Mingyang , Tian Zhuoyang , Zhang Wensen , Zhang Hengzhen , He Wenqian , Wang Rongrong , Wu Ke , Wang Biyao , Sun Nan , Zhang Weihong , Zhang Qiang
Published: August 2021

Background: The second wave of the coronavirus disease 2019 (COVID-19) epidemic in India was caused by the COVID-19 Delta variant. However, the epidemiological characteristics and transmission mechanism of the Delta variant remain unclear. To explore whether the epidemic trend will change after effective isolation measures were taken and what is the minimum number of individuals who need to be vaccinated to end the epidemic.Methods: We used actual data from March 5 to April 15, 2021, of daily updates confirmed cases and deaths, to estimate the parameters of the model and predict the severity of possible infection in the coming months. The classical Susceptible-Exposed-Infected-Removed (SEIR) model and extended models [Susceptible-Exposed-Infected-Removed-Quarantine (SERIQ) model and Susceptible-Exposed-Infected-Removed- medicine (SERIM) model] were developed to simulate the development of epidemic under the circumstances of without any measures, after effective isolation measures were taken and after being fully vaccinated.Results: The result demonstrated good accuracy of the classic model. The SEIRQ model showed that after isolation measures were taken, the infections will decrease by 99.61% compared to the actual number of infections by April 15. And the SEIRQ model demonstrated that if the vaccine efficative rate was 90%, when the vaccination rate was 100%, the number of existing cases would reach a peak of 529,723 cases on the 52nd day.Conclusion: Effective quarantine measures and COVID-19 vaccination from official are critical prevention measures to help end the COVID-19 pandemic.
Effect of Neutrophil CD64 Index in Elderly Patient with Community-acquired Pneumonia
Authors: Cao Jie , LI YAN , Suhang-Wang  , Jing-Zhang
Published: August 2021

Background: Elderly patient with community-acquired pneumonia is the leading infectious cause of death. During the clinical diagnosis and treatment, some elderly patients do not have typical clinical symptoms .Therefore establishment of safe and effective diagnosis, prognostic assessment systems is important for clinicians. Objective: To evaluate the diagnostic and prognostic value of the neutrophil CD64(nCD64) in elderly patients with community-acquired pneumonia. Methods: One hundred and twenty-eight elderly patients(≥65year) diagnosed with community-acquired pneumonia from December 2018 to December 2020. All patients were further subdivided into two groups: Non severe community-acquired pneumonia(N-SCAP) group and severe community-acquired pneumonia (SCAP)group. nCD64 index, procalcitonin (PCT) level, C-reactive protein (CRP) level, White blood cell (WBC) counts and Neutrophil (NEUT) absolute counts were obtained and CURB-65 scores were calculated for each patient. Results: The nCD64, CRP ,PCT, WBC,NEUT levels,CURB-65 score were higher in severe community-acquired pneumonia group patients. The nCD64, CRP, PCT levels ,CURB-65 score were higher in non-survivors. The receiver operating characteristic (ROC) curve of nCD64 was higher than those of CRP, PCT, WBC, NEUT levels for diagnosing infection. The AUC of nCD64 for predicting 28-day mortality in community-acquired pneumonia was significantly higher than those of CRP ,PCT, WBC and NEUT. The AUC of nCD64 combined with CURB-65 score was significantly higher than that of CRP, PCT, WBC and NEUT parameter combined with CURB-65 score for predicting 28-day mortality. Conclusions: The neutrophil CD64 index is a valuable biomarker for diagnosis of infection and prognostic evaluation in elderly patients (≥65 year) with community-acquired pneumonia.
Analysis of Cytokines in the Aqueous Humor During Intravitreal Treatment With Ranibizumab in Diabetic Macular Edema
Authors: Freitas Luiz Guilherme Azevedo , Isaac David Leonardo Cruvinel , Abud Murilo Batista , Segundo Alexandre Dantas Soares Quintas , Barros Mariana Larissa Alvino , Albuquerque Gabriela Caroline Monteiro , Guimarães Bruna Dantas Aires , Morais Clarice Neuenschwander Lins , Ávila Marcos Pereira
Published: August 2021

Purpose: This study aimed to analyze the concentrations, in aqueous humor, of VEGF, b-FGF, TNF, and interleukins 1, 6, 8, 10, and 12 in patients with diabetic macular edema, with and without peripheral retinal ischemia, and to analyze the variation of the levels of these molecules, during the treatment with ranibizumab.Methods: A therapeutic, prospective, randomized interventional study was carried out. Twenty-four eyes from 24 patients were studied, divided into 3 groups. Group 1, (9 eyes), patients with EMD without peripheral ischemia. Group 2 (10 eyes), patients with EMD with peripheral ischemia. Group 3, (5 eyes), control group, formed by patients without systemic and/or eye diseases. Patients in groups 1 and 2 were treated with 3 intravitreal injections of 2 mg/0.05 ml of ranibizumab, with intervals of approximately 30 days. Before performing the injections, the aqueous humor was collected. In the control group, the material was collected before the facectomy procedure. Results: During treatment, the medians of IL-6 concentrations showed a statistically significant increase, in group 1 and group 2, there was a slight decrease, not statistically significant. Interleukin 8 showed statistically significant variations in groups 1 and 2, at the end of treatment. TNF, IL-1, IL-10, and IL-12 had their concentrations practically unchanged, in both groups. VEGF showed a statistically significant reduction in groups 1 and 2 at the end of the study. B-FGF was not detected in most of the studied patients, and in those that were found, they did not present statistically significant numbers. Conclusion: There were statistically significant variations in the increase of their median levels in interleukin 6, in the group without ischemia and a decrease in VEGF in both groups. The cytokines TNF, IL-1, IL-10, and IL-12 did not show statistically significant variations.
Participation and Dropout of Hockey New South Wales Participants in 2017 and 2018: A Longitudinal Study
Authors: Owen Katherine B , Foley Bridget C , Eime Rochelle , Rose Catriona , Reece Lindsey J
Published: August 2021

Background

Sports have a focus on increasing participation, which contributes to increasing population levels of physical activity, social cohesion and longevity of the sport. The primary aim of this study was to examine reasons for drop-out of a popular team sport in Australia, Field Hockey and identify opportunities to increase participation.
Methods

This longitudinal study obtained routinely collected registered player data from Hockey New South Wales over two consecutive years, and survey data from registered players who dropped out. Logistic regression models identified demographic subgroups who were more likely to drop out of sport, and the reasons for dropping out.
Results

In 2018, 8,463 (31%) of hockey players did not return to play hockey after the previous season and 805 (10%) of these completed a survey. Specific groups who were more likely to stop playing included 5–6 years (OR: 2.1, 95% CIs 1.8, 2.6; reference: 12–17 years), females (OR: 1.1, 95% CIs 1.3, 1.2; reference: males), Indigenous (OR: 1.2, 95% CIs 1.1, 1.4; reference: non-indigenous), most disadvantaged (OR: 1.1, 95% CIs 1.0, 1.2; reference: least disadvantaged) or regional and remote (1.1, 95% CIs 1.0, 1.2; reference: major cities). Top reasons for drop out were; medical/age (17%), change in circumstances (16%) and high cost (13%), lack of time (13%) and lack of enjoyment (7%).
Conclusions

This research makes recommendations to sport on how to reduce dropout and specifically amongst 5–6 year olds, females, Indigenous, disadvantaged and regional or remote areas through enjoyable flexible, modifiable versions of the game.
Lessons Learnt Implementing a Cardiovascular Disease Quality Improvement Intervention in Australian Primary Care: A Mixed Method Evaluation
Authors: Hespe Charlotte , Giskes Katrina , Harris Mark , Peiris David
Published: August 2021

Background There are discrepancies between evidence-based guidelines for screening and management of cardiovascular disease (CVD) and implementation in Australian general practice. Quality-improvement (QI) initiatives aim to reduce these gaps. This study evaluated a QI intervention (QPulse) that focussed on CVD assessment and management. MethodsThis mixed-methods study explored the implementation of guidelines and adoption of QI processes in 34 general practices. CVD screening and management were measured pre- and post-intervention. Qualitative analyses examined participants’ Plan-Do-Study-Act (PDSA) goals and in-depth interviews with practice stakeholders focussed on barriers and enablers to implementation and were analysed thematically using Normalisation Process Theory (NPT). ResultsPre- and post-intervention data were available from 15 practices (n=19562 and n=20249, respectively) and in-depth interviews from seven practices. At baseline, 45.0% of patients had their BMI measured and 15.6% had their waist circumference recorded in the past 2 years and blood pressure, lipids and smoking status were measured in 72.5%, 61.5% and 65.3% of patients, respectively. Most high-risk patients (57.5%) were not prescribed risk-reducing medications. After the intervention there were no changes in the documentation and prevalence of risk factors, attainment of BP and lipid targets or prescription of CVD risk-reducing medications. However, there was variation in performance across practices with some showing isolated improvements, such as recording waist circumference (0.7-32.2% pre-intervention to 18.5%-69.8% post-intervention), BMI and smoking assessment. Challenges to implementation included: lack of time, need for technical support, a perceived lack of value for quality improvement work, difficulty disseminating knowledge across the practice team, tensions between the team and clinical staff and a part-time workforce. ConclusionThe implementation barriers associated with this QI program was considerable in Australian GP practices. Findings highlighted they were not able to effectively operationalise the intervention due to numerous factors, ranging from lack of internal capacity and leadership to competing demands and insufficient external support. Trial registrationAustralian New Zealand Clinical Trials Reference Number (ACTRN12615000108516), registered 06/02/2015. Trial protocol can be accessed at: https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?ACTRN=12615000108516