bluuebunny/crossref_metadata_2025 huggingface dataset:
Efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing in treating grade III/IV hemorrhoids: a retrospective study
Authors: Yu Qiuxiang , Zhi Congcong , Jia Lansi , Li Hui
Published: May 2021

Background

Hemorrhoids are common. Hemorrhoidectomy should typically be offered to patients whose symptoms result from external hemorrhoids or combined internal and external hemorrhoids with prolapse (grades III/IV). However, none of the currently used surgical methods could be considered an ideal surgical option that is effective, safe, and painless. We hypothesized that a combination of Ruiyun procedure for hemorrhoids (RPH) and simplified Milligan–Morgan hemorrhoidectomy (sMMH) will increase the safety and effectiveness of surgical treatment hemorrhoids. This study aimed to evaluate the efficacy of Ruiyun procedure for hemorrhoids combined simplified Milligan–Morgan hemorrhoidectomy with dentate line-sparing (RPH + sMMH) to treat grade III/IV hemorrhoid.

Methods

Total 452 patients with hemorrhoids of grade III/IV were retrospectively reviewed in China-Japan Friendship Hospital, 244 cases were assigned to RPH + sMMH group, and 208 cases in MMH group. The primary efficacy outcome was rate of curative at 3 month after operation, and the recurrence rate within 12 months post operation. Secondary efficacy outcomes included wound healing time, time required to resume normal work, constipation symptom, quality of life, and pain post operation was also evaluated. The safety outcome included postoperative complications.

Results

There were no differences between the two groups in demographic characteristics. There was no statistically significant difference between the two groups in the curative rate. The recurrence rate after 12 months post operation in the RPH + sMMH (3.0%) was significantly lower than the sMMH group (7.8%) (P = 0.032). The wound healing time was significantly shorter in RPH + sMMH group than that in MMH group (P < 0.001). The time required to resume normal work in the RPH + sMMH group was significantly shorter than MMH group (P < 0.001). Compared with the MMH group, the RPH + sMMH therapy preserve better life quality and lower constipation symptom (all P < 0.05). Patients who underwent RPH + sMMH had significantly less postoperative pain than MMH therapy. The total rate of patients with postoperative complications in the RPH + sMMH group (8.6%) was significant lower than the MMH group (16.3%) (P = 0.012).

Conclusion

RPH + sMMH may more effective in treating patients with III/IV hemorrhoids, which indicated lower recurrence rate, lower postoperative complications and pain, shorter recovery and return to normal life.
Development and psychometric properties of surveys to assess provider perspectives on the barriers and facilitators of effective care transitions
Authors: Johnson Maurice C. , Liu Helen , Sorra Joann , Brock Jane , Gass Brianna , Li Jing , Clouser Jessica Miller , Hirschman Karen , Carpenter Deborah , Nguyen Huong Q. , Williams Mark V.
Published: May 2021

Background

The quality of the discharge process and effective care transitions between settings of care are critical to minimize gaps in patient care and reduce hospital readmissions. Few studies have explored which care transition components and strategies are most valuable to patients and providers. This study describes the development, pilot testing, and psychometric analysis of surveys designed to gain providers’ perspectives on current practices in delivering transitional care services.

Methods

We underwent a comprehensive process to develop items measuring unique aspects of care transitions from the perspectives of the three types of providers (downstream, ambulatory, and hospital providers). The process involved 1) an environmental scan, 2) provider interviews, 3) survey cognitive testing, 4) pilot testing, 5) a Stakeholder Advisory Group, 6) a Scientific Advisory Council, and 7) a collaborative Project ACHIEVE (Achieving Patient-Centered Care and Optimized Health in Care Transitions by Evaluating the Value of Evidence) research team. Three surveys were developed and fielded to providers affiliated with 43 hospitals participating in Project ACHIEVE. Web-based survey administration resulted in 948 provider respondents. We assessed response variability and response missingness. To evaluate the composites’ psychometric properties, we examined intercorrelations of survey items, item factor loadings, model fit indices, internal consistency reliability, and intercorrelations between the composite measures and overall rating items.

Results

Results from psychometric analyses of the three surveys provided support for five composite measures: 1) Effort in Coordinating Patient Care, 2) Quality of Patient Information Received, 3) Organizational Support for Transitional Care, 4) Access to Community Resources, and 5) Strength of Relationships Among Community Providers. All factor loadings and reliability estimates were acceptable (loadings ≥ 0.40, α ≥ 0.70), and the fit indices showed a good model fit. All composite measures positively and significantly correlated with the overall ratings (0.13 ≤ r ≤ 0.71).

Conclusions

We determined that the items and composite measures assessing the barriers and facilitators to care transitions within this survey are reliable and demonstrate satisfactory psychometric properties. The instruments may be useful to healthcare organizations and researchers to assess the quality of care transitions and target areas of improvement across different provider settings.
Synergies and fragmentation in country level policy and program agenda setting, formulation and implementation for Global Health agendas: a case study of health security, universal health coverage, and health promotion in Ghana and Sierra Leone
Authors: Agyepong Irene Akua , M’Cormack-Hale Fredline A. O. , Brown Amoakoh Hannah , Derkyi-Kwarteng Abigail N. C. , Darkwa Theresa Ethel , Odiko-Ollennu Wallace
Published: May 2021

Background

Global health agendas have in common the goal of contributing to population health outcome improvement. In theory therefore, whenever possible, country level policy and program agenda setting, formulation and implementation towards their attainment should be synergistic such that efforts towards one agenda promote efforts towards the other agendas. Observation suggests that this is not what happens in practice. Potential synergies are often unrealized and fragmentation is not uncommon. In this paper we present findings from an exploration of how and why synergies and fragmentation occur in country level policy and program agenda setting, formulation and implementation for the global health agendas of Universal Health Coverage (UHC), Health Security (HS) and Health Promotion (HP) in Ghana and Sierra Leone. Our study design was a two country case study. Data collection involved document reviews and Key Informant interviews with national and sub-national level decision makers in both countries between July and December 2019. Additionally, in Ghana a stakeholder workshop in December 2019 was used to validate the draft analysis and conclusions.

Results

National and global context, country health systems leadership and structure including resources were drivers of synergies and fragmentation. How global as well as country level actors mobilized power and exercised agency in policy and program agenda setting and implementation processes within country were also important drivers.

Conclusions

There is potential in both countries to pull towards synergies and push against fragmentation in agenda setting, formulation and implementation of global health agendas despite the resource and other structural constraints. It however requires political and bureaucratic prioritization of synergies, as well as skilled leadership. It also requires considerable mobilization of country level actor exercise of agency to counter sometimes daunting contextual, systems and structural constraints.
Barriers and facilitators to implementing the CURE stop smoking project: a qualitative study
Authors: Wearn Angela , Haste Anna , Haighton Catherine , Mallion Verity , Rodrigues Angela M.
Published: May 2021

Background

The Conversation, Understand, Replace, Experts and evidence-based treatment (CURE) project aims to provide a comprehensive offer of both pharmacotherapy and specialist support for tobacco dependence to all smokers admitted to hospital and after discharge. CURE was recently piloted within a single trust in Greater Manchester, with preliminary evidence suggesting this intervention may be successful in improving patient outcomes. Plans are currently underway to pilot a model based upon CURE in other sites across England. To inform implementation, we conducted a qualitative study, which aimed to identify factors influencing healthcare professionals’ implementation behaviour within the pilot site.

Methods

Individual, semi-structured telephone interviews were conducted with 10 purposively sampled health professionals involved in the delivery and implementation of the CURE project pilot. Topic guides were informed by the Theoretical Domains Framework (TDF). Transcripts were analysed in line with the framework method, with data coded to TDF domains to highlight important areas of influence and then mapped to the COM-B to support future intervention development.

Results

Eight TDF domains were identified as important areas influencing CURE implementation; ‘environmental context and resources’ (physical opportunity), ‘social influence’ (social opportunity), ‘goals’, ‘professional role and identity’ and ‘beliefs about consequences’ (reflective motivation), ‘reinforcement’ (automatic motivation), ‘skills’ and ‘knowledge’ (psychological capability). Most domains had the potential to both hinder and/or facilitate implementation, with the exception of ‘beliefs about consequences’ and ‘knowledge’, which were highlighted as facilitators of CURE. Participants suggested that ‘environmental context and resources’ was the most important factor influencing implementation; with barriers most often related to challenges integrating into the wider healthcare context.

Conclusions

This qualitative study identified multi-level barriers and facilitators to CURE implementation. The use of theoretical frameworks allowed for the identification of domains known to influence behaviour change, and thus can be taken forward to develop targeted interventions to support future service implementation. Future work should focus on discussing these findings with a broad range of stakeholders, to ensure resultant intervention strategies are feasible and practicable within a healthcare context. These findings complement wider evaluative work to support nationwide roll out of NHS funded tobacco dependence treatment services in acute care trusts.
The modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo, China
Authors: Zhang Rui , Meng Yujie , Song Hejia , Niu Ran , Wang Yu , Li Yonghong , Wang Songwang
Published: May 2021

Background

Although exposure to air pollution has been linked to many health issues, few studies have quantified the modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo, China.

Methods

The data of daily incidence of influenza and the relevant meteorological data and air pollution data in Ningbo from 2014 to 2017 were retrieved. Low, medium and high temperature layers were stratified by the daily mean temperature with 25th and 75th percentiles. The potential modification effect of temperature on the relationship between air pollutants and daily incidence of influenza in Ningbo was investigated through analyzing the effects of air pollutants stratified by temperature stratum using distributed lag non-linear model (DLNM). Stratified analysis by sex and age were also conducted.

Results

Overall, a 10 μg/m3 increment of O3, PM2.5, PM10 and NO2 could increase the incidence risk of influenza with the cumulative relative risk of 1.028 (95% CI 1.007, 1.050), 1.061 (95% CI 1.004, 1.122), 1.043 (95% CI 1.003, 1.085), and 1.118 (95% CI 1.028, 1.216), respectively. Male and aged 7–17 years were more sensitive to air pollutants. Through the temperature stratification analysis, we found that temperature could modify the impacts of air pollution on daily incidence of influenza with high temperature exacerbating the impact of air pollutants. At high temperature layer, male and the groups aged 0–6 years and 18–64 years were more sensitive to air pollution.

Conclusion

Temperature modified the relationship between air pollution and daily incidence of influenza and high temperature would exacerbate the effects of air pollutants in Ningbo.
Bioinformatics analysis and identification of genes and molecular pathways in steroid-induced osteonecrosis of the femoral head
Authors: Lin Tianye , Chen Weijian , Yang Peng , Li Ziqi , Wei Qiushi , Liang Du , Wang Haibin , He Wei , Zhang Qingwen
Published: May 2021

Background

Steroid-induced osteonecrosis of the femoral head (ONFH) is a common hip joint disease and is difficult to be diagnosed early. At present, the pathogenesis of steroid-induced ONFH remains unclear, and recognized and effective diagnostic biomarkers are deficient. The present study aimed to identify potentially important genes and signaling pathways involved in steroid-induced ONFH and investigate their molecular mechanisms.

Methods

Microarray data sets GSE123568 (peripheral blood) and GSE74089 (cartilage) were obtained from the Gene Expression Omnibus database, including 34 ONFH samples and 14 control samples. Morpheus software and Venn diagram were used to identify DEGs and co-expressed DEGs, respectively. Besides, we conducted Kyoto Encyclopedia of Genome (KEGG) and gene ontology (GO) pathway enrichment analysis. We construct a protein-protein interaction (PPI) network through GEO2R and used cytoHubba to divide the PPI network into multiple sub-networks. Additionally, quantitative real-time polymerase chain reaction (qRT-PCR) was performed to verify the bioinformatics analysis results.

Results

A total of 118 intersecting DEGs were obtained between the peripheral blood and cartilage samples, including 40 upregulated genes and 78 downregulated genes. Then, GO and KEGG pathway enrichment analysis revealed that upregulated DEGs focused on the signaling pathways related to staphylococcus aureus infection, leishmaniasis, antigen processing, and presentation, as well as asthma and graft-versus-host disease. Downregulated genes were concentrated in the FoxO signaling pathway, AMPK signaling pathway, signaling pathway regulating stem cell pluripotency, and mTOR signaling pathway. Some hub genes with high interactions such as CXCR1, FPR1, MAPK1, FOXO3, FPR2, CXCR2, and TYROBP were identified in the PPI network. The results of qRT-PCR demonstrated that CXCR1, FPR1, and TYROBP were upregulated while MAPK1 was downregulated in peripheral blood of steroid-induced ONFH patients. This was consistent with the bioinformatics analysis.

Conclusions

The present study would provide novel insight into the genes and associated pathways involved in steroid-induced ONFH. CXCR1, FPR1, TYROBP, and MAPK1 may be used as potential drug targets and biomarkers for the diagnosis and prognosis of steroid-induced ONFH.
Mental health and sleep habits/problems in children aged 3–4 years: a population study
Authors: Horiuchi Fumie , Kawabe Kentaro , Oka Yasunori , Nakachi Kiwamu , Hosokawa Rie , Ueno Shu-ichi
Published: May 2021

Background

Sleep is essential for mental health at all ages, but few studies have investigated the importance of sleep for mental health in early childhood. Therefore, this study examined the association between mental health and sleep habits/problems in children aged 3–4 years.

Methods

Children aged 3 to 4 years who were living in the community (n = 415; 211/204 boys/girls) were recruited for this study. Their mental health was assessed using the Strengths and Difficulties Questionnaire (SDQ), and their sleep habits/problems were evaluated using the Child and Adolescent Sleep Checklist.

Results

Based on the total difficulties score of the SDQ, the children were divided into two groups: a poor mental health group (n = 76) and a control group (n = 339). In terms of sleep habits, which included total sleep time, bedtime, wake time, and nap conditions, there were no differences between the two groups. Regarding sleep-related problems, however, anxiety before going to sleep (p = 0.026), circadian rhythm abnormalities (p = 0.014), and sleepiness during classes outside of naptimes (p = 0.031) were significantly higher in the poor mental health group than in the control group. Multiple regression analysis showed that poor mental health status was significantly associated with sleepiness and snoring (p = 0.017 andp = 0.018, respectively).

Conclusions

The mental health status of 3–4-year-old children was associated with sleep-related problems, namely sleepiness and snoring. Healthcare providers should pay attention to children’s irregular sleep-wake patterns; moreover, interventions for appropriate sleep hygiene will reduce the psychological burden on both children and their families.
Technical and tactical diagnosis model of table tennis matches based on BP neural network
Authors: Huang Wenwen , Lu Miaomiao , Zeng Yuxuan , Hu Mengyue , Xiao Yi
Published: May 2021

Background

The technical and tactical diagnosis of table tennis is extremely important in the preparation for competition which is complicated by an apparent nonlinear relationship between athletes’ performance and their sports quality. The neural network model provides a high nonlinear dynamic processing ability and fitting accuracy that may assist in the diagnosis of table tennis players’ technical and tactical skill. The main purpose of this study was to establish a technical and tactical diagnosis model of table tennis matches based on a neural network to analyze the influence of athletes’ techniques and tactics on the competition results.

Methods

A three-layer Back Propagation (BP) neural network model for table tennis match diagnosis were established. A Double Three-Phase evaluation method produced 30 indices that were closely related to winning table tennis matches. A data sample of 100 table tennis matches was used to establish the diagnostic model (n = 70) and evaluate the predictive ability of the model (n = 30).

Results

The technical and tactical diagnosis model of table tennis matches based on BP neural network had a high-level of prediction accuracy (up to 99.997%) and highly efficient in fitting (R2 = 0.99). Specifically, the technical and tactical diagnosis results indicated that the scoring rate of the fourth stroke of Harimoto had the greatest influence on the winning probability.

Conclusion

The technical and tactical diagnosis model of table tennis matches based on BP neural network was highly accurate and efficiently fit. It appears that the use of the model can calculate athletes’ technical and tactical indices and their influence on the probability of winning table tennis matches. This, in turn, can provide a valuable tool for formulating player’s targeted training plans.
Role of CD44 in increasing the potency of mesenchymal stem cell extracellular vesicles by hyaluronic acid in severe pneumonia
Authors: Zhou Li , Hao Qi , Sugita Shinji , Naito Yoshifumi , He Hongli , Yeh Che-chung , Lee Jae-Woo
Published: May 2021

Background

Although promising, clinical translation of human mesenchymal stem or stromal cell-derived extracellular vesicles (MSC EV) for acute lung injury is potentially limited by significant production costs. The current study was performed to determine whether pretreatment of MSC EV with high molecular weight hyaluronic acid (HMW HA) would increase the therapeutic potency of MSC EV in severe bacterial pneumonia.

Methods

In vitro experiments were performed to determine the binding affinity of HMW HA to MSC EV and its uptake by human monocytes, and whether HMW HA primed MSC EV would increase bacterial phagocytosis by the monocytes. In addition, the role of CD44 receptor on MSC EV in the therapeutic effects of HMW HA primed MSC EV were investigated. InPseudomonas aeruginosa(PA) pneumonia in mice, MSC EV primed with or without HMW HA were instilled intravenously 4 h after injury. After 24 h, the bronchoalveolar lavage fluid, blood, and lungs were analyzed for levels of bacteria, inflammation, MSC EV trafficking, and lung pathology.

Results

MSC EV bound preferentially to HMW HA at a molecular weight of 1.0 MDa compared with HA with a molecular weight of 40 KDa or 1.5 MDa. HMW HA primed MSC EV further increased MSC EV uptake and bacterial phagocytosis by monocytes compared to treatment with MSC EV alone. In PA pneumonia in mice, instillation of HMW HA primed MSC EV further reduced inflammation and decreased the bacterial load by enhancing the trafficking of MSC EV to the injured alveolus. CD44 siRNA pretreatment of MSC EV prior to incubation with HMW HA eliminated its trafficking to the alveolus and therapeutic effects.

Conclusions

HMW HA primed MSC EV significantly increased the potency of MSC EV in PA pneumonia in part by enhancing the trafficking of MSC EV to the sites of inflammation via the CD44 receptor on MSC EV which was associated with increased antimicrobial activity.
Conditioned medium from induced pluripotent stem cell-derived mesenchymal stem cells accelerates cutaneous wound healing through enhanced angiogenesis
Authors: Liang Xiaoting , Lin Fang , Ding Yue , Zhang Yuelin , Li Mimi , Zhou Xiaohui , Meng Qingshu , Ma Xiaoxue , Wei Lu , Fan Huimin , Liu Zhongmin
Published: May 2021

Background

Mesenchymal stem cells (MSCs) can improve cutaneous wound healing via the secretion of growth factors. However, the therapeutic efficacy of MSCs varies depending upon their source. Induced pluripotent stem cells are emerging as a promising source of MSCs with the potential to overcome several limitations of adult MSCs. This study compared the effectiveness of conditioned medium of MSCs derived from induced pluripotent stem cells (iMSC-CdM) with that derived from umbilical cord MSCs (uMSC-CdM) in a mouse cutaneous wound healing model. We also investigated the mechanisms of protection.

Methods

The iMSC-CdM or uMSC-CdM were topically applied to mice cutaneous wound model. The recovery rate, scar formation, inflammation and angiogenesis were measured. We compared angiogenesis cytokine expression between iMSC-CdM and uMSC-CdM and their protective effects on human umbilical vein endothelial cells (HUVECs) under H2O2-induced injury. The effects of iMSC-CdM on energy metabolism, mitochondria fragmentation and apoptosis were measured.

Results

Topical application of iMSC-CdM was superior to the uMSC-CdM in accelerating wound closure and enhancing angiogenesis. Expression levels of angiogenetic cytokines were higher in iMSC-CdM than they were in uMSC-CdM. The iMSC-CdM protected HUVECs from H2O2 induced injury more effectively than uMSC-CdM did. Administration of iMSC-CdM stimulated HUVEC proliferation, tube formation and energy metabolism via the ERK pathway. Mechanistically, iMSC-CdM inhibited H2O2-induced mitochondrial fragmentation and apoptosis of HUVECs.

Conclusion

Collectively, these findings indicate that iMSC-CdM is more effective than uMSC-CdM in treating cutaneous wounds, and in this way, iMSC-CdM may serve as a more constant and sustainable source for cell-free therapeutic approach.

Graphical abstract
Gut microbiome variation modulates the effects of dietary fiber on host metabolism
Authors: Murga-Garrido Sofia M. , Hong Qilin , Cross Tzu-Wen L. , Hutchison Evan R. , Han Jessica , Thomas Sydney P. , Vivas Eugenio I. , Denu John , Ceschin Danilo G. , Tang Zheng-Zheng , Rey Federico E.
Published: May 2021

Background

There is general consensus that consumption of dietary fermentable fiber improves cardiometabolic health, in part by promoting mutualistic microbes and by increasing production of beneficial metabolites in the distal gut. However, human studies have reported variations in the observed benefits among individuals consuming the same fiber. Several factors likely contribute to this variation, including host genetic and gut microbial differences. We hypothesized that gut microbial metabolism of dietary fiber represents an important and differential factor that modulates how dietary fiber impacts the host.

Results

We examined genetically identical gnotobiotic mice harboring two distinct complex gut microbial communities and exposed to four isocaloric diets, each containing different fibers: (i) cellulose, (ii) inulin, (iii) pectin, (iv) a mix of 5 fermentable fibers (assorted fiber). Gut microbiome analysis showed that each transplanted community preserved a core of common taxa across diets that differentiated it from the other community, but there were variations in richness and bacterial taxa abundance within each community among the different diet treatments. Host epigenetic, transcriptional, and metabolomic analyses revealed diet-directed differences between animals colonized with the two communities, including variation in amino acids and lipid pathways that were associated with divergent health outcomes.

Conclusion

This study demonstrates that interindividual variation in the gut microbiome is causally linked to differential effects of dietary fiber on host metabolic phenotypes and suggests that a one-fits-all fiber supplementation approach to promote health is unlikely to elicit consistent effects across individuals. Overall, the presented results underscore the importance of microbe-diet interactions on host metabolism and suggest that gut microbes modulate dietary fiber efficacy.
Comparative egg attendance patterns of incubating polar petrels
Authors: Shaffer Scott A. , Blévin Pierre , Barbraud Christophe , Chastel Olivier , Weimerskirch Henri
Published: May 2021

Background

The internal environment of eggs in most birds is regulated by transferring heat energy through contact incubation, maintaining nest microclimate, and frequent egg turning by the incubating parent on its nest. However, we lack information about egg attendance patterns in birds that breed in polar environments where variations in life history are expected to influence incubation behavior. Moreover, crevice/burrow nesting petrels in high-latitude regions are known for periodically leaving their egg unattended (hereafter ‘egg neglect’), but there is little reporting on the internal condition of unattended eggs. At Dumont d’Urville Station, Antarctica, we studied the incubation behavior of 24 snow (Pagodroma nivea) and 15 Cape (Daption capense) petrel pairs using egg loggers that recorded egg turning rates, orientation changes, and temperatures at 1 Hz for durations of 3–6 days.

Results

Egg turning frequency (1.31 ± 0.33 vs. 1.38 ± 0.39 turns h−1), angle change per turn (43.1 ± 43.2 vs. 48.6 ± 43.7° turn−1), and egg temperature (34.1 ± 2.3 vs. 34.1 ± 2.0 °C) were nearly identical for snow and Cape petrels, respectively. However, egg neglect was only observed in snow petrel nests (based on egg temperature changes) where loggers recorded mean durations of 1.34 ± 1.15 days (maximum duration of 3.63 days). During periods of neglect, eggs cooled to 5.5 ± 1.8 °C over an average of 91 min, but were rewarmed by parents in only 76 min at a rate of 0.33 °C min−1.

Conclusions

Egg temperatures of both species during regular incubation were within 1–2 °C of other high-latitude petrel species, but neglected snow petrel eggs remained several degrees above freezing, which was likely attributed to crevice nesting where neglected eggs are buffered by environmental conditions. Using egg rewarming rates, thermal capacity of eggs, and published metabolic rates, we estimate egg rewarming costs in snow petrels to be 1.5 to 1.9 × BMR. Excluding egg neglect periods, turning rates for both petrel species were lower than other seabirds studied using biologging devices, which may be associated with the prolonged incubation periods that are characteristic of procellariiform seabirds.
Immunological and genetic kinetics from diagnosis to clinical progression in chronic lymphocytic leukemia
Authors: Jiménez Isabel , Tazón-Vega Bárbara , Abrisqueta Pau , Nieto Juan C. , Bobillo Sabela , Palacio-García Carles , Carabia Júlia , Valdés-Mas Rafael , Munuera Magdalena , Puigdefàbregas Lluís , Parra Genís , Esteve-Codina Anna , Franco-Jarava Clara , Iacoboni Gloria , Terol María José , García-Marco José Antonio , Crespo Marta , Bosch Francesc
Published: May 2021

Background

Mechanisms driving the progression of chronic lymphocytic leukemia (CLL) from its early stages are not fully understood. The acquisition of molecular changes at the time of progression has been observed in a small fraction of patients, suggesting that CLL progression is not mainly driven by dynamic clonal evolution. In order to shed light on mechanisms that lead to CLL progression, we investigated longitudinal changes in both the genetic and immunological scenarios.

Methods

We performed genetic and immunological longitudinal analysis using paired primary samples from untreated CLL patients that underwent clinical progression (sampling at diagnosis and progression) and from patients with stable disease (sampling at diagnosis and at long-term asymptomatic follow-up).

Results

Molecular analysis showed limited and non-recurrent molecular changes at progression, indicating that clonal evolution is not the main driver of clinical progression. Our analysis of the immune kinetics found an increasingly dysfunctional CD8+T cell compartment in progressing patients that was not observed in those patients that remained asymptomatic. Specifically, terminally exhausted effector CD8+T cells (T-betdim/−EomeshiPD1hi) accumulated, while the the co-expression of inhibitory receptors (PD1, CD244 and CD160) increased, along with an altered gene expression profile in T cells only in those patients that progressed. In addition, malignant cells from patients at clinical progression showed enhanced capacity to induce exhaustion-related markers in CD8+T cells ex vivo mainly through a mechanism dependent on soluble factors including IL-10.

Conclusions

Altogether, we demonstrate that the interaction with the immune microenvironment plays a key role in clinical progression in CLL, thereby providing a rationale for the use of early immunotherapeutic intervention.
Thoracic esophageal injury due to a neck stab wound: a case report
Authors: Honda Masaki , Tanioka Toshiro , Haruki Shigeo , Kamata Yuko , Hoshi Hiromasa , Ryu Kyoko , Yagi Kenta , Ueno Kodai , Matsui Satoshi , Ohata Yoshiteru , Hasegawa Fumi , Kaito Akio , Arita Kaida , Ito Koji , Takiguchi Noriaki
Published: May 2021

Background

Traumatic esophageal injury leads to severe complications such as mediastinitis, pyothorax, and tracheoesophageal fistula. Although prompt diagnosis and treatment are required, there are no established protocols to guide diagnosis or treatment. In particular, thoracic esophageal injury tends to be diagnosed later than cervical esophageal injury because it has few specific symptoms. We report a case of thoracic esophageal injury caused by a cervical stab wound; the patient was stabbed with a sharp blade.

Case presentation

A 74-year-old woman was attacked with a knife while sleeping at home. The patient was taken to the emergency room with an injury localized to the left section of her neck. She was suspected of a left jugular vein and recurrent laryngeal nerve injury from cervical hematoma and hoarseness. On the day following the injury, computed tomography revealed a thoracic esophageal injury. Emergency surgery was performed for an esophageal perforation and mediastinal abscesses. Although delayed diagnosis resulted in suture failure, the patient was able to resume oral intake of food a month later following enteral feeding with a gastrostomy. Esophageal injuries due to sharp trauma are rare, and most are cervical esophageal injuries. There are very few reports on thoracic esophageal injuries.

Conclusions

The possibility of thoracic esophageal injury should always be considered when dealing with neck stab wounds, particularly those caused by an attack.
Did imports of sweetened beverages to Pacific Island countries increase between 2000 and 2015?
Authors: Lo Veronica Yueh Torng , Sacks Gary , Gearon Emma , Bell Colin
Published: May 2021

Background

Nutrition-related chronic diseases are the major cause of illness and death in Pacific Island countries. Imports of sweetened beverages (SBs) are likely to be contributing but there is limited analysis of the quantities imported or the source countries of such beverages. The purpose of this study was to describe trends in the amount and types of SBs imported to Pacific Island countries and the impact of SB taxes on imports in Fiji and Tonga.

Methods

A repository of official international trade statistics was used to collect data on the volume, dollar value and source countries of SBs exported to Pacific Island countries from 2000 to 2015. Corresponding population data was sourced from the Secretariat of the Pacific Community for per capita analyses. We also explored which countries earned the most from exporting SBs to the Pacific. Descriptive and regression analyses were used to describe trends over time for each country and for the region as a whole.

Results

Imports of SBs to Pacific Island Countries from 2000 to 2015 increased by an average of 0.30 kg per person per year (p < 0.001). New Zealand and the USA were the largest income earners from SB exports to the Pacific over this period. The introduction of a tax did not impact the volume of SBs imported to Fiji. More data is needed to assess the impact of SBs tax on imports in Tonga.

Conclusions

Exports of SBs to Pacific Island countries are increasing. Both importing and exporting countries should consider the health implications of trade in these products.
Evaluation of different point-of-care tests to characterize the vaginal discharge of sows after parturition and parameters’ correlation with subsequent reproductive performance
Authors: Grahofer A. , Mäder T. , Nathues H.
Published: May 2021

The lochia is the physiological uterine discharge post-partum, whereas abnormal fluids are often indicators of puerperal disorders in sows, which negatively influence the further reproductive performance. The aim of the study was to characterize the vaginal discharge in sows employing simple and feasible tests and to correlate the evaluated parameters with the subsequent reproductive performance of these sows. The birth process of 48 clinically healthy free farrowing sows was monitored and several parameters characterizing the vaginal discharge such as total amount, colour, amount of cells (somatic cell count) and cell characteristics (cytology) were collected daily from first to fifth day after parturition. Finally, the reproductive performance of the following gestation was evaluated and compared to the characteristics of the lochia. The amount of vaginal discharge was significantly increased on the second (p < 0.01), third (p = 0.019) and fourth (p = 0.011) day post-partum compared to day one. Furthermore, a decrease in the percentage of neutrophilic granulocytes from day one to three (p = 0.038), four (p = 0.038) and five (p = 0.048) post-partum was observed. The percentage of neutrophilic granulocytes in the yellowish vaginal discharge was increased compared to whitish (p = 0.02) or clear (p = 0.027) vaginal discharge. In addition, obstetrics (p = 0.003) and an increased farrowing duration (p = 0.017) significantly increased the amount of vaginal discharge. Sows with a high amount of vaginal discharge had a significant higher body temperature than sows with no (p = 0.014) or low amount (p < 0.01) of vaginal discharge. No correlation was detected between the evaluated parameters of the lochia and the subsequent reproductive performance. It is hypothesised that the amount of vaginal discharge alone is not a predictor for the performance of sows during their next gestation. However, it might serve as indicator for acute endometritis. In summary, the different parameters of the vaginal discharge determined by means of point-of-care tests might be useful to strengthen a presumptive diagnose of endometritis in sows during the first five days after parturition.
Infodemic: the effect of death-related thoughts on news-sharing
Authors: Lim Amy J. , Tan Edison , Lim Tania
Published: May 2021

Research on the sharing of fake news has primarily focused on the manner in which fake news spreads and the literary style of fake news. These studies, however, do not explain how characteristics of fake news could affect people’s inclination toward sharing these news articles. Drawing on the Terror Management Theory, we proposed that fake news is more likely to elicit death-related thoughts than real news. Consequently, to manage the existential anxiety that had been produced, people share the news articles to feel connected to close others as a way of resolving the existential anxiety. Across three experimental studies (totalN = 416), we found that it was not news type per se (i.e., real versus fake news) that influenced news-sharing intentions; instead, it was the increased accessibility to death-related thoughts elicited from the content of news articles that motivated news-sharing. The findings support the Terror Management framework and contribute to the existing literature by providing an empirical examination of the underlying psychological motive behind fake news-sharing tendencies.
Sexual dimorphism, metabolic, and oxidative stress markers of African catfish (Clarias garepinus and Heterobranchus longifilis) broodstock in Southwest Nigeria
Authors: Jimoh Olatunji Abubakar , Raimi Christie Oluwatosin , Adebayo Ebenezer Temitope , Oyeyemi Bolaji Fatai , Odedele Matthew Ayobami
Published: May 2021

Background

Sexual dimorphism in metabolic and oxidative stress markers of Clarias gariepinus and Heterobranchus longifilis found in southwest Nigeria was investigated. C. garepinus and H. longifilis broodstock weighing 2.54 ± 0.12 and 2.11 ± 0.15 kg consisting of 20 males and females each per species were sourced from southwest Nigeria. Fishes conditioned conditioning for breeding, blood samples were collected, and serum obtained to assess metabolic and oxidative stress indices using standard procedures.

Results

The results obtained show that serum albumin, triglyceride, low-density lipoprotein, alanine aminotransferase, and total antioxidant activity of Clarias garepinus were significantly (p < 0.05) higher than Heterobranchus longifilis. Superoxide dismutase of males was significantly (p < 0.05) superior to females in both species. The total antioxidant activity of males was significantly (p < 0.05) superior to females in Heterobranchus longifilis. Serum catalase, glutathione peroxidase and lipid peroxidation were not affected by sex and species differences. Superoxide dismutase activity and some non-enzyme antioxidants could account for superior total antioxidant activity in males despite similar lipid peroxidation.

Conclusion

Catfish broodstocks of Heterobranchus longifilis possess superior total antioxidant activity than Clarias gariepinus owing to its superior non-enzyme antioxidants fraction. In both clariid species, males have better antioxidant defence than females.
Review on the “Biological Applications of Okra Polysaccharides and Prospective Research”
Authors: Al-Shawi Ali A. A. , Hameed Mustafa F. , Hussein Kawkab A. , Thawini Haneen K.
Published: May 2021

Background

Vegetables with edible parts like flowers, fruits, stems, leaves, fibers, roots, and seeds are rich sources of essential vitamins, minerals, and trace elements with various medical functions. Many diseases such as osteoporosis, diabetes, high cholesterol, obesity, heart diseases, and stroke are caused by poor, healthy lifestyle or nutrition. Therefore, generation of new biological functions from vegetables will increase the interests of scientific research and applications.

Main body

Okra is an edible vegetable which contains vitamins, fiber, carbohydrates, protein, and minerals. The bioactive compounds of okra possess various biological activities such as anti-inflammation, antibacterial, anticancer, and antifungal. Polysaccharides from vegetables or medicinal plants are important large molecules with various biological applications. In this review, we will focus on the biological properties and nanoparticle uses of polysaccharides isolated from okra and the extraction methods of polysaccharides.

Conclusion

This review will enhance the scientific research findings of okra polysaccharides and recommend future prospective of polysaccharides for biological uses.
Current perspectives in herbal and conventional drug interactions based on clinical manifestations
Authors: Surana Ajaykumar Rikhabchand , Agrawal Shivam Puranmal , Kumbhare Manoj Ramesh , Gaikwad Snehal Balu
Published: May 2021

Background

Herbs are an important source of pharmaceuticals. Herbs are traditionally used by millions of peoples for medicine, food and drink in developed and developing nations considering that they are safe. But, interaction of herbs with other medicines may cause serious adverse effects or reduces their efficacy. The demand for “alternative” medicines has been increased significantly, which include medicine derived from plant or herbal origin. The objective of this review article mainly focuses on drug interactions of commonly used herbs along with possible mechanisms. The method adopted for this review is searching of herb-drug interactions in online database.

Main text

Herb-drug interaction leads to pharmacological modification. The drug use along with herbs may show pharmacodynamic and pharmacokinetic interactions. Pharmacokinetic interaction causes alteration in absorption, distribution, metabolism and elimination. Similarly, pharmacodynamic interaction causes additive or synergistic or antagonist effect on the drugs or vice versa. Researchers had demonstrated that herbs show the toxicities and drug interactions like other pharmacologically active compounds. There is lack of knowledge amongst physician, pharmacist and consumers related to pharmacological action and mechanism of herb-drug interaction. This review article focuses on the herb-drug interaction of danshen (Salvia miltiorrhiza), Echinacea (Echinacea purpurea), garlic (Allium sativum), ginkgo (Ginkgo biloba), goldenseal (Hydrastis canadensis), green tea (Camellia sinensis), kava (Piper methysticum), liquorice (Glycyrrhiza glabra), milk thistle (Silybum marianum) and St. John’s wort (Hypericum perforatum) along with probable mechanisms and clinical manifestation based on case studies reported in literature.

Conclusion

Herb-drug interactions may lead to serious side effects. Physician, pharmacist and patients must be more cautious while prescribing and or consuming these herbs.
Specific language impairment: speech perception in relation to noise
Authors: Elmahallawi Trandil H. , Gabr Takwa A. , Darwish Mohamad E. , Seleem Fatma M.
Published: May 2021

Background

Children with specific language impairment (SLI) fail to develop age-appropriate language despite being apparently normal in other respects. Those children usually have abnormal speech perception in noise. This work is designed to investigate speech perception in background noise in those children. It included two groups of children: control group (15 children with normal typical language development) and study group (25 children diagnosed with SLI). All children were submitted to intelligence scale, language assessment, full audiological evaluation, and Arabic Pediatric Speech Intelligibility in noise test (PSI).

Results

Results showed no statically significant difference in total and verbal IQ, while non-verbal IQ was significantly lower in the study group. As regard results of speech audiometry, the control group had better SRT and higher WD% than the study group. Expressive, receptive, and total language scores were lower in the study group. Arabic Pediatric Speech Intelligibility in noise test showed significantly increased PSI scores with increasing the SNR from 0 to +8dB in both groups. The comparison between both groups showed a significant higher score in the control group at different S/N recording conditions.

Conclusions

Children with SLI have difficulty in speech perception when compared to typically developed language children. This difficulty is more apparent in the presence of background noise.
Association of Gut Microbiota during Early Pregnancy with Risk of Incident Gestational Diabetes Mellitus
Authors: Hu Ping , Chen Xiuyi , Chu Xufeng , Fan Mengran , Ye Yi , Wang Yi , Han Maozhen , Yang Xue , Yuan Jiaying , Zha Li , Zhao Bin , Yang Chun-Xia , Qi Xiao-Rong , Ning Kang , Debelius Justin , Ye Weimin , Xiong Bo , Pan Xiong-Fei , Pan An
Published: May 2021

Aims

We aimed to assess the association between gut bacterial biomarkers during early pregnancy and subsequent risk of gestational diabetes mellitus (GDM) in Chinese pregnant women.

Methods

Within the Tongji-Shuangliu Birth Cohort study, we conducted a nested case-control study among 201 incident GDM cases and 201 matched controls. Fecal samples were collected during early pregnancy (at 6-15 weeks), and GDM was diagnosed at 24 to 28 weeks of pregnancy. Community DNA isolated from fecal samples and V3-V4 region of 16S rRNA gene amplicon libraries were sequenced.

Results

In GDM cases versus controls, Rothia, Actinomyces, Bifidobacterium, Adlercreutzia, and Coriobacteriaceae and Lachnospiraceae spp. were significantly reduced, while Enterobacteriaceae, Ruminococcaceae spp., and Veillonellaceae were overrepresented. In addition, the abundance of Staphylococcus relative to Clostridium, Roseburia, and Coriobacteriaceae as reference microorganisms were positively correlated with fasting blood glucose, 1-hour and 2-hour postprandial glucose levels. Adding microbial taxa to the base GDM prediction model with conventional risk factors increased the C-statistic significantly (P < 0.001) from 0.69 to 0.75.

Conclusions

Gut microbiota during early pregnancy was associated with subsequent risk of GDM. Several beneficial and commensal gut microorganisms showed inverse relations with incident GDM, while opportunistic pathogenic members were related to higher risk of incident GDM and positively correlated with glucose levels on OGTT.
Loss of p21-activated kinase Mbt/PAK4 causes Parkinson-like phenotypes inDrosophila
Authors: Pütz Stephanie M. , Kram Jette , Rauh Elisa , Kaiser Sophie , Toews Romy , Lueningschroer-Wang Yi , Rieger Dirk , Raabe Thomas
Published: May 2021

Parkinson's disease (PD) provokes bradykinesia, resting tremor, rigidity and postural instability, and also non-motor symptoms such as depression, anxiety, sleep and cognitive impairments. Similar phenotypes can be induced in Drosophila melanogaster through modification of PD-relevant genes or the administration of PD-inducing toxins. Recent studies correlated deregulation of human p21-activated kinase 4 (PAK4) with PD, leaving open the question of a causative relationship of mutations in this gene for manifestation of PD symptoms. To determine whether flies lacking the PAK4 homolog Mushroom bodies tiny (Mbt) show PD-like phenotypes, we tested for a variety of PD criteria. Here, we demonstrate that mbt mutant flies show PD-like phenotypes including age-dependent movement deficits, reduced life expectancy and fragmented sleep. They also react to a stressful situation with higher immobility, indicating an influence of Mbt on emotional behavior. Loss of Mbt function has a negative effect on the number of dopaminergic protocerebral anterior medial (PAM) neurons, most likely caused by a proliferation defect of neural progenitors. The age-dependent movement deficits are not accompanied by a corresponding further loss of PAM neurons. Previous studies highlighted the importance of a small PAM subgroup for age-dependent PD motor impairments. We show that impaired motor skills are caused by a lack of Mbt in this PAM subgroup. In addition, a broader re-expression of Mbt in PAM neurons improves life expectancy. Conversely, selective Mbt knockout in the same cells shortens lifespan. We conclude that mutations in Mbt/PAK4 can play a causative role in the development of PD phenotypes.