bluuebunny/crossref_metadata_2025 huggingface dataset:
Case Report: Mini-endoscopic combined intrarenal surgery in an en-bloc kidney transplant
Authors: Santillán Diego , Scherñuk Schroh Jordan Ceferino , Gutierrez Patricia Andrea , Thomas Franco , Tirapegui Federico Ignacio , Moldes Juan , Cristallo Christian , González Mariano Sebastian
Published: October 2021

Background

Overall incidence of stones in kidney transplant recipients is 1%. En-bloc kidney transplant is a rare anatomical condition in which kidney stones treatment can be extremely difficult to treat. As far as we know, no cases of staghorn calculi in en-bloc kidney transplant have been published so far.

Case presentation

A 27-year-old woman presented to the Emergency Department because of asthenia, adynamia and weight loss associated with lower urinary tract symptoms and subfebrile temperature. Ten years before, she had undergone an en-bloc kidney transplant because of end-stage renal disease secondary to perinatal asphyxia syndrome. One kidney was implanted capo-volta in the right iliac fossa and the other one in the right flank. NCCT scan showed incomplete staghorn calculi in the iliac fossa transplanted kidney. Besides, severe dilation of the native and the right flank transplanted kidney, due to two ureteral stones of 6 and 7 mm impacted in the uretero-ureteral anastomosis, was found. After hospital admission and under ceftriaxone prophylaxis, an attempt to perform primary RIRS following our COVID protocol was carried out. Nevertheless, we ended up placing a JJ stent because once the guidewire passed through the ureteral stones, purulent material came out from the ureteral orifice. She stayed 9 days in-hospital for management of postobstructive polyuria and was discharged with oral antibiotics. Three weeks afterward, we removed the stent and performed flexible ureteroscopy and holmium laser lithotripsy of the ureteral stones. In the same procedure, we performed Mini-ECIRS (21 French) previous ultrasound-guided upper pole puncture. Postoperative NCCT scan showed neither residual fragments nor operative complications.

Conclusion

This is the first clinical case reporting Mini-ECIRS in a patient with an en-bloc kidney transplant. This endourological approach seems to be a feasible, safe and effective approach to treat stones in this anatomically challenging condition.
Whole genome sequencing and comparative genomic analyses of Planococcus alpniumensis MSAK28401T, a new species isolated from Antarctic krill
Authors: Wang Yuanyuan , Ma Lingbo , He Jian , Liu Zixuan , Weng Shaoping , Wang Lumin , He Jianguo , Guo Changjun
Published: October 2021

Background

Extremophiles have attracted much attention in the last few decades, as they possess different properties by producing certain useful metabolites. However, the secondary metabolism of the extremophiles of Antarctic krill has received little attention.

Results

In this study, a new bacterial strain MSAK28401T from Antarctic krill was isolated and identified. The results of analysis on phenotypic, chemotaxonomic, and genomic characteristics showed that the strain MSAK28401T belongs to the genus Planococcus. Cells of this strain were coccoid (0.89–1.05 μm) and aerobic. The majority of the fatty acid content was C15:0 anteiso (37.67 ± 0.90%) followed by C16:1 ω7c alcohol (10.37 ± 1.22%) and C16:0 iso (9.36 ± 0.71%). The calculated average nucleotide identity and DNA–DNA hybridization values between the strain MSAK28401T and type strains P. citreus DSM 20549T and P. rifietoensis M8T were lower than 91 and 70%, respectively. The strain MSAK28401T (=KCTC 43283T and MCCC 1k05448T) represented a new member of the genus Planococcus and was named P. alpniumensis sp. nov. Moreover, genes involved in the degradation of aromatic compounds (e.g., salicylate, gentisate, and quinate) were found in the genome, implying that strain MSAK28401T has an aromatic compound as its potential metabolite. This work will help us understand the genomic characteristics and potential metabolic pathway of Planococcus from Antarctic krill.

Conclusions

This study reported the genomic information and phenotypic characteristics of the new strain P. alpniumensis MSAK28401T isolated from Antarctic krill, and provided the genome information of Planococcus strains for further studying the function roles in aromatic compound metabolism.
Factors contributing to delay intensive care unit admission of critically ill patients from the adult emergency Department in Tikur Anbessa Specialized Hospital
Authors: Teklie Helen , Engida Hywet , Melaku Birhanu , Workina Abdata
Published: October 2021

Background

The transfer time for critically ill patients from the emergency department (ED) to the Intensive care unit (ICU) must be minimal; however, some factors prolong the transfer time, which may delay intensive care treatment and adversely affect the patient’s outcome.

Purpose

To identify factors affecting intensive care unit admission of critically ill patients from the emergency department.

Patients and methods

A cross-sectional study design was conducted from January 13 to April 12, 2020, at the emergency department of Tikur Anbesa Specialized Hospital. All critically ill patients who need intensive care unit admission during the study period were included in the study. A pretested structured questionnaire was adapted from similar studies. The data were collected by chart review and observation. Then checked data were entered into Epi-data version 4.1 and cleaned data was exported to SPSS Version 25 for analysis. Descriptive statistics, bivariate and multivariate logistic regression were used to analyze the data.

Result

From the total of 102 critically ill patients who need ICU admission 84.3% of them had prolonged lengths of ED stay. The median length of ED stay was 13.5 h with an IQR of 7–25.5 h. The most common reasons for delayed ICU admission were shortage of ICU beds 56 (65.1%) and delays in radiological examination results 13(15.1%). On multivariate logistic regression p < 0.05 male gender (AOR = 0.175, 95% CI: (0.044, 0.693)) and shortage of ICU bed (AOR = 0.022, 95% CI: (0.002, 0.201)) were found to have a significant association with delayed intensive care unit admission.

Conclusion

there was a delay in ICU admission of critically ill patients from the ED. Shortage of ICU bed and delay in radiological investigation results were the reasons for the prolonged ED stay.
Future projections of the prevalence of dementia in Japan: results from the Toyama Dementia Survey
Authors: Nakahori Nobue , Sekine Michikazu , Yamada Masaaki , Tatsuse Takashi , Kido Hideki , Suzuki Michio
Published: October 2021

Background

This study aimed to make future projections of the nationwide prevalence of dementia in Japan using the prevalence of dementia from the Toyama Dementia Survey and population projections.

Methods

We performed linear regression analysis using the prevalence of dementia by sex and age in 1985, 1990, 1996, 2001, and 2014 from the Toyama Dementia Survey to calculate the estimated future prevalence by sex and age. The estimated prevalence was then multiplied by the estimated future population of people aged 65 years and older by sex and age in each of the 47 prefectures from 2020 to 2045 and added together to calculate the total number of people with dementia. The estimated future prevalence of dementia was calculated by dividing the calculated number of people with dementia by the estimated future population of people aged 65 years and older in each of the 47 prefectures. In addition, the estimated future prevalence of dementia in each of the 47 prefectures from 2020 to 2045 was presented on a map of Japan and grayscale-coded in four levels.

Results

In 2020, the estimated future prevalence of dementia did not exceed 20% in any prefecture, but in 2025, five prefectures, mainly rural prefectures, had projected rates exceeding 20%. In 2030, the prevalence rate is projected to exceed 20% nationwide, and by 2035, the rate will exceed 25% in 42 prefectures. In 2045, all prefectures excluding Tokyo are projected to have a dementia prevalence rate exceeding 25%, and the rate will exceed 30% in 12 of 47 prefectures.

Conclusions

Over the next 25 years, the prevalence of dementia in people older than 65 years is projected to exceed 25% nationwide, including metropolitan areas.
Multidimensional geriatric evaluation in acromegaly: a comparative cross-sectional study
Authors: Gagliardi Irene , Chiloiro Sabrina , Vallillo Maria , Bondanelli Marta , Volpato Stefano , Giampietro Antonella , Bianchi Antonio , De Marinis Laura , Zatelli Maria Chiara , Ambrosio Maria Rosaria
Published: October 2021

Background

Improvement in acromegaly management increased disease survival and prevalence. Evidence regarding acromegaly in older adults are sparse. We aim to explore acromegaly impact on aging process quality.

Methods

Multicenter case-control study conducted on 42 older adults (≥ 65 years) acromegaly patients (ACRO) compared to an age- and gender-matched control group (CTR). Each participant underwent a multidimensional geriatric evaluation.

Results

Mean age in both groups was 73 ± 6 years and female gender was most represented (69%). All comorbidities were more frequent in ACRO than CTR. Thirteen ACRO were in remission and 29 had active disease controlled by medical therapy except for one patient. ACRO showed worse physical performance and mobility skills worsening with age as compared to CTR. ACRO performed poorly in functional status assessment, and age negatively correlated with instrumental and basic daily activities execution. Cognitive evaluation scores were significantly lower in ACRO vs. CTR, worsening with age. No difference was found concerning nutritional and psychological status. Musculoskeletal and bone diseases were more frequent in ACRO than in CTR (52% vs. 12%; 64% vs. 10%; P < 0.05) and independently associated with geriatric outcomes in ACRO. ACRO reported a less satisfactory quality of life concerning physical activity and pain, general health, vitality, social activities.

Conclusions

Our study demonstrates increased frailty of older acromegaly patients as compared to non-acromegaly patients with a consequent negative impact on their quality of life. Therefore, it seems advisable to include physical, functional, cognitive, nutritional, and psychological status assessments in routine clinical practice. Further studies are needed to identify the most appropriate geriatric tools.
Educational behaviors of pregnant women in the Bronx during Zika’s International emerging epidemic: “First mom … and then I’d Google. And then my doctor”
Authors: Rodriguez Miguel , Danvers Antoinette A. , Sanabia Carolina , Dolan Siobhan M.
Published: October 2021

Background

The objective of the study was to understand how pregnant women learned about Zika infection and to identify what sources of information were likely to influence them during their pregnancy.

Methods

We conducted 13 semi-structed interviews in English and Spanish with women receiving prenatal care who were tested for Zika virus infection. We analyzed the qualitative data using descriptive approach.

Results

Pregnant women in the Bronx learned about Zika from family, television, the internet and their doctor. Informational sources played different roles. Television, specifically Spanish language networks, was often the initial source of information. Women searched the internet for additional information about Zika. Later, they engaged in further discussions with their healthcare providers.

Conclusions

Television played an important role in providing awareness about Zika to pregnant women in the Bronx, but that information was incomplete. The internet and healthcare providers were sources of more complete information and are likely the most influential. Efforts to educate pregnant women about emerging infectious diseases will benefit from using a variety of approaches including television messages that promote public awareness followed up by reliable information via the internet and healthcare providers.
Characteristics of gastric precancerous conditions and Helicobacter pylori infection among dyspeptic patients in north-eastern Iran: is endoscopic biopsy and histopathological assessment necessary?
Authors: Esmaeilzadeh Abbas , Goshayeshi Ladan , Bergquist Robert , Jarahi Lida , Khooei Alireza , Fazeli Alireza , Mosannen Mozaffari Hooman , Bahari Ali , Oghazian Mohammad Bagher , Hoseini Benyamin
Published: October 2021

Background

Early detection and appropriate treatment of precancerous, mucosal changes could significantly decrease the prevalence of life-threatening gastric cancer. Biopsy of the normal-appearing mucosa to detect Helicobacter pylori and these conditions is not routinely obtained. This study assesses the prevalence and characteristics of H. pylori infection and precancerous conditions in a group of patients suffering from chronic dyspepsia who were subjected to gastric endoscopy and biopsy mapping.

Methods

This cross-sectional study included dyspeptic patients, not previously treated for H. pylori, undergoing esophagogastroduodenoscopy (EGD) with their gastric endoscopic biopsies obtained for examination for evidence of H. pylori infection and precancerous conditions. Demographic and clinical data on the gender, smoking, opium addiction, alcohol consumption, medication with aspirin, corticosteroids and non-steroidal anti-inflammatory drugs (NSAIDs) and family history of cancer were collected by interviewing the patients and evaluating their health records. The cohort examined consisted of 585 patients with a mean (SD) age of 48.0 (14.46) years, 397 (67.9%) of whom were women.

Results

H. pylori infection was identified in 469 patients (80.2%) with the highest prevalence (84.2%) in those aged 40–60 years. Opium addiction correlated with a higher a H. pylori infection rate, while alcohol consumption was associated with a lower rate by Odds Ratio 1.98 (95% CI 1.11–3.52) and 0.49 (95% CI 0.26–0.92), respectively. The prevalence of intestinal metaplasia, gastric atrophy and gastric dysplasia was 15.2, 12.6 and 7.9%, respectively. Increased age, positive H. pylori infection, endoscopic abnormal findings and opium addiction showed a statistically significant association with all precancerous conditions, while NSAID consumption was negatively associated with precancerous conditions. For 121 patients (20.7% of all), the EGD examination revealed normal gastric mucosa, however, for more than half (68/121, 56.2%) of these patients, the histological evaluation showed H. pylori infection, and also signs of atrophic mucosa, intestinal metaplasia and dysplasia in 1.7, 4.1 and 1.7%, respectively.

Conclusion

EGD with gastric biopsy mapping should be performed even in the presence of normal-appearing mucosa, especially in dyspeptic patients older than 40 years with opium addiction in north-eastern Iran. Owing to the high prevalence of precancerous conditions and H. pylori infection among patients with dyspepsia in parts of Iran, large-scale national screening in this country should be beneficial.
Exploring low grade inflammation by soluble urokinase plasminogen activator receptor levels in schizophrenia: a sex-dependent association with depressive symptoms
Authors: Bigseth Therese Torgersen , Engh John Abel , Egeland Jens , Andersen Eivind , Andreassen Ole Andreas , Bang-Kittilsen Gry , Falk Ragnhild Sørum , Holmen Tom Langerud , Lindberg Morten , Mordal Jon , Nielsen Jimmi , Steen Nils Eiel , Ueland Thor , Vang Torkel , Fredriksen Mats
Published: October 2021

Background

There is evidence of increased low grade inflammation (LGI) in schizophrenia patients. However, the inter-individual variation is large and the association with demographic, somatic and psychiatric factors remains unclear. Our aim was to explore whether levels of the novel LGI marker soluble urokinase plasminogen activator receptor (suPAR) were associated with clinical factors in schizophrenia and if such associations were sex-dependent.

Method

In this observational study a total of 187 participants with schizophrenia (108 males, 79 females) underwent physical examination and assessment with clinical interviews (Positive and Negative Syndrome Scale (PANSS), Calgary Depression Scale for Schizophrenia (CDSS), Alcohol Use Disorder Identification Test (AUDIT), and Drug Use Disorder Identification Test (DUDIT)). Blood levels of suPAR, glucose, lipids, and high sensitivity C-reactive protein (hsCRP) were determined and body mass index (BMI) calculated. Multivariable linear regression analyses were used adjusting for confounders, and sex interaction tested in significant variables.

Results

Adjusting for sex, age, current tobacco smoking and BMI, we found that levels of hsCRP and depressive symptoms (CDSS) were positively associated with levels of suPAR (p < 0.001). The association between suPAR and CDSS score was significant in females (p < 0.001) but not in males. Immune activation measured by hsCRP was not associated with depressive symptoms after adjusting for BMI.

Conclusion

Our findings indicate that increased suPAR levels are associated with depressive symptoms in females with schizophrenia, suggesting aberrant immune activation in this subgroup. Our results warrant further studies, including longitudinal follow-up of suPAR levels in schizophrenia and experimental studies of mechanisms.
Metabolically healthy obesity and unhealthy normal weight rural adults in Xinjiang: prevalence and the associated factors
Authors: Wang Wen-qiang , Wei Bin , Song Yan-peng , Guo Heng , Zhang Xiang-hui , Wang Xin-ping , Yan Yi-zhong , Ma Jiao-long , Wang Kui , Keerman Mulatibieke , Zhang Jing-yu , Ma Ru-lin , Guo Shu-xia , He Jia
Published: October 2021

Background

This study aimed to describe the prevalence of metabolically healthy obesity (MHO) and metabolically unhealthy normal weight (MUNW) rural adults in Xinjiang and to explore their influencing factors.

Methods

We selected 13,525 Uyghur, Kazakh and Han participants in Kashi, Yili and Shihezi areas in Xinjiang from 2009 to 2010. Weight status was classified according to body mass index. Metabolic phenotype was further defined based on the National Cholesterol Education Program Adult Treatment Panel III criteria.

Results

The prevalence of normal weight, overweight, and obesity were 51.6, 30.2, and 14.4%, respectively. The mean age of the population was 45.04 years. The prevalence of MHO was 5.5% overall and was 38.5% among obese participants. The prevalence of MUNW was 15.5% overall and was 30.1% among normal weight participants. A metabolically healthy phenotype among obese individuals was positively associated with females and vegetable consumption ≥4 plates per week. However, this was inversely associated with higher age, red meat consumption ≥2 kg per week, and larger waist circumference (WC). Conversely, a metabolically unhealthy phenotype among normal-weight individuals was positively associated with higher age, red meat consumption ≥2 kg per week, and larger WC; this was however inversely associated with vegetable consumption ≥4 plates per week.

Conclusions

The prevalence of MHO among obese adults in Xinjiang is higher than that of Han adults, while the prevalence of MUNW among normal weight adults is lower than that among Han adults. In obese and normal weight participants, higher age, more red meat consumption, and larger WC increase the risk of metabolic abnormality, and more vegetable consumption reduces the risk of metabolic abnormality.
Prevalence of vaccine and non-vaccine human papillomavirus types among women in Accra and Kumasi, Ghana: a cross-sectional study
Authors: Debrah Oksana , Agyemang-Yeboah Francis , Donkoh Emmanuel Timmy , Asmah Richard Harry
Published: October 2021

Background

Human Papillomavirus (HPV) infection is the main etiological factor for pre-invasive and invasive cervical cancer. HPV type-specific vaccination is being widely recommended to control the burden of disease, but the genotype-specific distribution of HPV may vary in different countries. The aim of the study was to determine the prevalence and distribution of HPV genotypes among women attending reproductive health services in Ghana, their associated risk factors, and to assess the potential coverage of identified HPV genotypes by three licensed vaccines among these women.

Method

Women presenting for reproductive health services in two regional hospitals in Accra and Kumasi from October 2014 to March 2015 were conveniently recruited into the study (n = 317). HPV-DNA detection and genotype identification were carried out by a nested multiplex PCR assay that combines degenerate E6/E7 consensus primers and type-specific primers for the detection and typing of eighteen HPV genotypes. Cytology was performed to screen women for cervical cancer lesions. Risk factors for HPV infection were analyzed by logistic regression. Statistical significance was accepted for p < 0.05.

Results

The age of study participants ranged from 21 to 76 years. Among women positive for HPV, 35.0% were infected with high-risk HPV, 14.5% with probable high-risk HPV, and 17.0% with low-risk HPV. The prevalence of HPV 16/18 was 8.2%, HPV 6/11/16/18 was 9.1% and HPV 6/11/16/18/31/33/45/52/58 was 28.4%. The most prevalent among HR-HPV were types 52 (18.3%) and 58 (8.8%). HPV positivity may be associated with educational background (p < 0.001), age at first pregnancy (p = 0.028), and age at coitarche (p = 0.016).

Conclusions

Our study revealed a high prevalence of HR-HPV infection among women. The high prevalence of HR HPV indicates that multivalent vaccines will be useful for controlling HPV burden in general population contexts. The distribution of HPVs in this population suggests that of the three currently available vaccines the nonavalent vaccine, which protects against seven HPV types in addition to HPV 16 and 18, has the highest coverage of HPV infections among Ghanaian women. Healthcare officials planning to reduce the transmission of HPV and cervical cancer must consider the coverage of the nonavalent vaccine as an advantage.
Effects of modified BOPPPS-based SPOC and Flipped class on 5th-year undergraduate oral histopathology learning in China during COVID-19
Authors: Wang Shan , Xu Xin , Li Fang , Fan Haixia , Zhao Eryang , Bai Jie
Published: October 2021

Background

Colleges and universities in China have offered courses based on online teaching platforms as required by the Ministry of Education since the beginning of the COVID-19 pandemic. This emergency action was not an expedient measure, but a powerful impetus to improve extant education and implement teaching reform. Oral histopathology is a basic subject in oral medicine education, which combines theory with practice. The course aims to improve the ability of students to observe, think, analyze and identify oral diseases.

Method

We adjusted and modified the original Bridge-In, Outcomes, Pre-assessment, Participatory Learning, Post-assessment, and Summary (BOPPPS) teaching method to fit the characteristics and needs of oral histopathology. We then combined the characteristics of Small Private Online Courses (SPOCs) and a Flipped class to complete teaching material online, and assessed the effects of such teaching using a questionnaire and interviews. Fifty 5th-year undergraduates in stomatology at the School of Stomatology of Harbin Medical University of China participated in online classes. All were in the junior second half of the semester at the beginning of 2020. Teachers investigated from various medical colleges were responsible for delivering courses associated with stomatology or ophthalmology.

Result & conclusion

The results showed that the modified BOPPPS combined with SPOC and the Flipped class improved teaching satisfaction. Modified BOPPPS combined with SPOC and the Flipped class is a useful complement to offline teaching on 5th-year undergraduate oral histopathology learning in China during COVID-19, and it can meet the multiple needs of students participating in the course.
Is bouldering-psychotherapy a cost-effective way to treat depression when compared to group cognitive behavioral therapy – results from a randomized controlled trial
Authors: Schwarzkopf Larissa , Dorscht Lisa , Kraus Ludwig , Luttenberger Katharina
Published: October 2021

Background

Bouldering-Psychotherapy (BPT) has proven to effectively reduce depressive symptoms, but evidence on its cost-effectiveness is lacking. Corresponding information is paramount to support health policy decision making on a potential implementation of BPT in routine care.

Methods

Using data from the German KuS trial BPT was compared with group Cognitive Behavioral Therapy (CBT). Severity of depression symptoms at end of the intervention was operationalized via Montgomery-Asberg Depression Rating Scale (MADRS) and Patient Health Questionnaire (PHQ-9). Adopting a societal perspective, direct medical costs and productivity loss were calculated based on standardized unit costs. To determine incremental cost-effectiveness ratios (ICER) and cost-effectiveness-acceptance curves (CEAC), adjusted mean differences (AMD) in costs (gamma-distributed model) and both effect parameters (Gaussian-distributed model) were obtained from 1000 simultaneous bootstrap replications.

Results

BPT was related to improved effects (AMDs: MADRS -2.58; PHQ-9: − 1.35) at higher costs (AMD: +€ 754). No AMD was significant. ICERs amounted to €288 per MADRS-point and €550 per PHQ-9-point. For both effect parameters about 20% of bootstrap replications indicated dominance of BPT, and about 75% larger effects at higher costs. At hypothetical willingness to pay (WTP) thresholds of €241 (MADRS) and €615 (PHQ-9) per unit of change BPT had a 50% probability of being cost-effective.

Conclusion

BPT is a promising alternate treatment strategy which – in absence of established WTP thresholds for improving symptoms of depression – cannot unambiguously be claimed cost-effective. Further studies defining subgroups that particularly benefit from BPT appear paramount to delineate recommendations for an efficient prospective roll-out to routine care.
High expression levels and the C3435T SNP of the ABCB1 gene are associated with lower survival in adult patients with acute myeloblastic leukemia in Mexico City
Authors: Olarte Carrillo Irma , García Laguna Anel Irais , De la Cruz Rosas Adrián , Ramos Peñafiel Christian Omar , Collazo Jaloma Juan , Martínez Tovar Adolfo
Published: October 2021

Background

Acute myeloid leukemia (AML) is a heterogeneous hematologic malignancy characterized by different genetic alterations that cause changes in the normal mechanisms of differentiation, which are associated with chemoresistance. The ABCB1 gene is part of a family of ATP-binding cassette (ABC) transporter genes involved in the progression of various types of cancer. The following work aimed to evaluate the expression levels of the ABCB1 gene and the C3435T SNP with the response to first-line treatment and survival in patients with AML.

Methods

In total 135 samples were taken to isolate total RNA and DNA at the beginning of the treatment. Expression analysis by RT-qPCR and SNP C3435T assessment method were performed for real-time Polymerase chain reaction (qPCR).

Results

The expression levels impact on the survival of patients with AML compared to low or absent levels; the CC genotype was found in 22.9%, the CT genotype was found in 47.4%, and the TT genotype was found in 29.6%, the presence of the C3435T SNP, the TT genotype also impacts with a lower survival compared to CT and CC genotypes. In addition, it was shown that the dominant model significantly impacts survival.

Conclusion

In conclusion, we have found that the overexpression of the ABCB1 gene, as well as the presence of the TT genotype of the C3435T SNP, contributes to a worse prognosis in AML.
Diabetes mellitus exacerbates experimental autoimmune myasthenia gravis via modulating both adaptive and innate immunity
Authors: Zhang Peng , Yang Chun-Lin , Du Tong , Liu Yu-Dong , Ge Meng-Ru , Li Heng , Liu Ru-Tao , Wang Cong-Cong , Dou Ying-Chun , Duan Rui-Sheng
Published: October 2021

Background

Diabetes mellitus (DM) is a common concomitant disease of late-onset myasthenia gravis (MG). However, the impacts of DM on the progression of late-onset MG were unclear.

Methods

In this study, we examined the immune response in experimental autoimmune myasthenia gravis (EAMG) rats with DM or not. The phenotype and function of the spleen and lymph nodes were determined by flow cytometry. The serum antibodies, Tfh cells, and germinal center B cells were determined by ELISA and flow cytometry. The roles of advanced glycation end products (AGEs) in regulating Tfh cells were further explored in vitro by co-culture assays.

Results

Our results indicated clinical scores of EAMG rats were worse in diabetes rats compared to control, which was due to the increased production of anti-R97–116 antibody and antibody-secreting cells. Furthermore, diabetes induced a significant upregulation of Tfh cells and the subtypes of Tfh1 and Tfh17 cells to provide assistance for antibody production. The total percentages of B cells were increased with an activated statue of improved expression of costimulatory molecules CD80 and CD86. We found CD4+ T-cell differentiation was shifted from Treg cells towards Th1/Th17 in the DM+EAMG group compared to the EAMG group. In addition, in innate immunity, diabetic EAMG rats displayed more CXCR5 expression on NK cells. However, the expression of CXCR5 on NKT cells was down-regulated with the increased percentages of NKT cells in the DM+EAMG group. Ex vivo studies further indicated that Tfh cells were upregulated by AGEs instead of hyperglycemia. The upregulation was mediated by the existence of B cells, the mechanism of which might be attributed the elevated molecule CD40 on B cells.

Conclusions

Diabetes promoted both adaptive and innate immunity and exacerbated clinical symptoms in EAMG rats. Considering the effect of diabetes, therapy in reducing blood glucose levels in MG patients might improve clinical efficacy through suppressing the both innate and adaptive immune responses. Additional studies are needed to confirm the effect of glucose or AGEs reduction to seek treatment for MG.
Supplementation of quinoa regulates glycolipid metabolism and endoplasmic reticulum stress in the high-fat diet-induced female obese mice
Authors: An Tian , Liu Jia-Xian , Yang Xiu-yan , Lv Bo-han , Wu Yan-xiang , Jiang Guang-jian
Published: October 2021

Objective

To explore the effects of the quinoa diet on glycolipid metabolism and endoplasmic reticulum (ER) stress in an obese mouse model.

Methods

Six-week-old C57BL/6J female mice have received a high-fat diet (HFD) to induce obesity and subsequently were treated with a quinoa diet for 12 weeks. During this period, fasting blood glucose, body fat and insulin resistance were measured regularly. At the end of the experiment, mouse serum and liver tissue were collected. The differences in glucose and lipid metabolism were analyzed, and liver tissue pathological morphology, liver endoplasmic reticulum stress-related mRNA and protein levels, and serum oxidative stress levels were measured.

Results

Quinoa diet could significantly reduce the level of blood glucose, triglyceride, cholesterol, low-density lipoprotein, improve glucose tolerance, as well as improve histological changes of liver tissues in obese mice (P < 0.05 or < 0.01). Besides, quinoa could improve oxidative stress indicators such as GSH, and MDA (P < 0.05 or < 0.01). Furthermore, quinoa can down-regulate mRNA expression of ER stress markers eIF2α, GRP78, and CHOP in the liver of obese mice (P < 0.05 or < 0.01).

Conclusions

Quinoa supplementation can improve glycolipid metabolism, regulate ER stress, and alleviate obesity in HFD-induced mice.
Female Urgency, Trial of Urodynamics as Routine Evaluation (FUTURE study): a superiority randomised clinical trial to evaluate the effectiveness and cost-effectiveness of invasive urodynamic investigations in management of women with refractory overactive bladder symptoms
Authors: Abdel-fattah M. , Chapple C. , Guerrero K. , Dixon S. , Cotterill N. , Ward K. , Hashim H. , Monga A. , Brown K. , Drake M. J. , Gammie A. , Mostafa A. , Bladder Health U. K. , Breeman S. , Cooper D. , MacLennan G. , Norrie J.
Published: October 2021

Background

Overactive bladder (OAB) syndrome is a symptom complex affecting 12–14% of the UK adult female population. Symptoms include urinary urgency, with or without urgency incontinence, increased daytime urinary frequency and nocturia. OAB has a negative impact on women’s social, physical, and psychological wellbeing. Initial treatment includes lifestyle modifications, bladder retraining, pelvic floor exercises and pharmacological therapy. However, these measures are unsuccessful in 25–40% of women (refractory OAB). Before considering invasive treatments, such as Botulinum toxin injection or sacral neuromodulation, most guidelines recommend urodynamics to confirm diagnosis of detrusor overactivity (DO). However, urodynamics may fail to show evidence of DO in up to 45% of cases, hence the need to evaluate its effectiveness and cost-effectiveness. FUTURE (Female Urgency, Trial of Urodynamics as Routine Evaluation) aims to test the hypothesis that, in women with refractory OAB, urodynamics and comprehensive clinical assessment is associated with superior patient-reported outcomes following treatment and is more cost-effective, compared to comprehensive clinical assessment only.

Methods

FUTURE is a pragmatic, multi-centre, superiority randomised controlled trial. Women aged ≥ 18 years with refractory OAB or urgency predominant mixed urinary incontinence, and who have failed/not tolerated conservative and medical treatment, are considered for trial entry. We aim to recruit 1096 women from approximately 60 secondary/tertiary care hospitals across the UK. All consenting women will complete questionnaires at baseline, 3 months, 6 months and 15 months post-randomisation. The primary outcome is participant-reported success at 15 months post-randomisation measured using the Patient Global Impression of Improvement. The primary economic outcome is incremental cost per quality-adjusted life year gained at 15 months. The secondary outcomes include adverse events, impact on other urinary symptoms and health-related quality of life. Qualitative interviews with participants and clinicians and a health economic evaluation will also be conducted. The statistical analysis of the primary outcome will be by intention-to-treat. Results will be presented as estimates and 95% CIs.

Discussion

The FUTURE study will inform patients, clinicians and policy makers whether routine urodynamics improves treatment outcomes in women with refractory OAB and whether it is cost-effective.

Trial registration

ISRCTN63268739. Registered on 14 September 2017.
Effect of alkalized urine on renal calculi in patients with gout: a protocol for a placebo-controlled, double-blinded randomized controlled trial
Authors: Jia Ertao , Zhu Haiqiong , Geng Hongling , Wang Yadong , Zhong Li , Liu Shangwen , Lin Feng , Zhang Jianyong
Published: October 2021

Background

The prevalence of renal calculi in patients with gout is high. Alkalized urine has been recommended by the 2020 European Association of Urology (EAU) guidelines to promote calculus dissolution. However, randomized controlled trials are lacking.

Methods

In the protocol of this randomized, placebo-controlled, double-blinded trial, patients with gout combined with renal calculi are randomized (1:1) to the placebo and sodium bicarbonate groups. The intervention would be performed for 24 weeks, the 1–12 weeks are double-blinded, and the 13–24 weeks are open-labeled. Sodium bicarbonate (1 g tid) will be performed for 24 weeks in the sodium bicarbonate group. The placebo will be performed for 12 weeks and not be performed from 13 weeks to 24 weeks in the placebo group. All subjects will be administered febuxostat (40 mg/day) for 24 weeks and receive concomitant anti-inflammatory prophylaxis therapy for 12 weeks. The primary outcome is the proportion of patients whose renal calculus volume will be reduced after 12 weeks of treatment. The secondary outcomes include the volume changes of renal calculi, uric acid changes, the proportion of patients with serum uric acid (sUA) levels < 360 μmol/L, the changes in estimated glomerular filtration rate (eGFR), the pH value of urine, and the incidence of adverse events after treatment for 12 and 24 weeks.

Discussion

This study will evaluate the efficacy and safety of sodium bicarbonate-alkalized urine on renal calculi in patients with gout.

Trial registration

ClinicalTrials.gov ChiCTR2100045183. Registered on April 7, 2021, with ChiCTR.
Time in range, especially overnight time in range, is associated with sudomotor dysfunction in patients with type 1 diabetes
Authors: Feng Zhou-qin , Guo Qing-yu , Wang Wei , Yuan Yan-yu , Jin Xu-guang , Zhou Hui , Liu Jun , Lei Hai-yan , Yang Xin-yi , Liu Jun , Lu Bin , Shao Jia-qing , Gu Ping
Published: October 2021

Background

Time in range (TIR) is advocated as key metric of glycemic control and is reported to be associated with microvascular complications of diabetes. Sudomotor dysfunction is among the earliest detectable diabetic peripheral neuropathy (DPN). We set about to research the relationship between TIR including overnight TIR and sudomotor function detected by SUDOSCAN with the intention of exploring the correlation of TIR including overnight TIR and early DPN in type 1 diabetes (T1D).

Methods

95 patients with T1D were enrolled. TIR including nocturnal TIR of 3.9–10.0 mmol/L was evaluated with CGM. SUDOSCAN measured feet electrochemical skin conductance (FESC) and sudomotor dysfunction was defined as average FESC < 60µS. Logistic regressions were applied to examine the independent association of TIR and overnight TIR with sudomotor function.

Results

The overall prevalence of sudomotor dysfunction was 28.42%. Patients with sudomotor dysfunction had significantly lower TIR for the whole recorded phase and for nighttime. The sudomotor dysfunction prevalence progressively declined with the ascending tertiles of TIR and nocturnal TIR (P for trend < 0.05). Correlation analysis showed that the relationship between nocturnal TIR and FESC was stronger than that between TIR and FESC with correlation coefficients were respectively 0.362 and 0.356 (P < 0.001). Finally, logistic regression analysis indicated the independently negative relation between TIR and nocturnal TIR and sudomotor dysfunction (P < 0.05), and the correlation between nocturnal TIR and sudomotor dysfunction was more statistically significant.

Conclusions

TIR is negatively correlated with sudomotor dysfunction in T1D independent of HbA1c. Furthermore, decreased nocturnal TIR is more closely related to the impaired function of sudomotor nerves in sweat glands.
An approach to convivial urban spaces: a comparison between users’ and experts’ perception of convivial urban spaces
Authors: Shedid Mona Y. , Hefnawy Noha H.
Published: October 2021

Convivial urban spaces are a process as well as a philosophy. They revolve around observing users in specific urban spaces to comprehend their various needs, especially their social needs. Designing urban spaces for people to promote social connections is the foundation of creating convivial urban spaces. This means that this form of urban space has been interpreted as a daily social activity and as social pleasure expressed in the physical and psychological context of people's urban space. To provide a convivial environment for all users, effective convivial urban spaces should fulfill certain important aspects. From this point of view, the paper aims to identify the main aspects of creating convivial urban spaces through their repletion in the different theories. Then, the paper will evaluate and arrange the importance of the different aspects that form convivial urban spaces from the users and experts (urban designer and architects) point of view to reach the main objective of the paper which is to create a prospected framework for the urban designer and architects to help them in future decisions in designing convivial urban spaces that fulfill users’ needs.
Thermoelectric properties of a diamond ribbon subjected to a transverse magnetic field
Authors: Chakraborty Suvendu , Ganguly Sudin , Maiti Santanu K.
Published: October 2021

To manufacture an efficient thermoelectric device at the nanoscale and to get its controlled performance, we suggest a finite-width diamond ribbon in the presence of a perpendicular magnetic field. Contemplating the asymmetry in transmission function in a narrow conducting channel, the possibility of a gap around the energy band center in the presence of a magnetic field is discussed here. The eigenvalue spectrum and band structures show several interesting features. The different thermoelectric quantities are evaluated following the Landauer prescription. We show that the gap is tunable by controlling the strength of the magnetic field. Near the edge of the gap, our results exhibit a favorable thermoelectric response. We believe that our analysis of the proposed model can be experimentally tested in the laboratory and hope our study helps to construct an efficient thermoelectric device at the mesoscopic level.
What Kind of Freedom Is Academic Freedom?
Authors: Scott Joan W.
Published: October 2021

This essay argues for a definition of academic freedom that does not confuse it with what is considered to be a human right—the individual right to free speech. This is a freedom granted in principle by the state to scholars (usually within educational institutions: schools, colleges, and universities) because their critical activity has been considered vital to the public good and because it is a self-regulated activity committed to processes of relentless questioning that require disciplined forms of reading and reasoning. Neoliberal practices have undermined the basis for this classic definition of academic freedom. The essay explores the alternatives to state-ensured academic freedom that have emerged both within and outside the university, focusing particular attention on Turkey's Solidarity Academies. It concludes by insisting that the critical function of producing knowledge for the common good must be protected by nonstate actors if the state has broken the covenant upon which academic freedom once rested.
Just What the Doctor Ordered
Authors: Schlicht Jeffrey A. , Inskip Michael , Fiatarone Singh Maria
Published: October 2021

Apply It!

• Screening for frailty, cognitive impairment, depression, malnutrition, inappropriate medications, and falls risk provides important information for your client’s portfolio.

• Proper exercise modalities and progression are key to creating a safe and effective exercise prescription.

• High-intensity strength training is safe and should be prescribed to even the most frail older adults.
Autism spectrum disorder in architecture perspective: a review of the literature and bibliometric assessment of research indexed in Web of Science
Authors: Moniem Ali Reham , Al-Saleh Deema Faisal , Ansari Khadeeja M N , El-Wakeel Hala A. , Shukri Mai Ibrahim
Published: October 2021

Purpose:

The primary objective of this research paper was to explore the current state-of-the-art research on autism spectrum disorder from a designer's perspective. An increasing number of scholarly publications in this discipline have urged researcher interest in this topic; however, there is still a lack of quantitative analysis. Therefore, this paper aims to analyze global research output on autism spectrum disorder from a designer's perspective during 1992–2021.

Methodology:

A bibliometric method was employed to analyze the published literature from 1992–2021. 812 papers were downloaded from the Web of Science core collection for analysis focused on annual growth of literature, prolific authors, authorship pattern, productive organizations, countries, international collaboration, literature trends by keyword analysis, and identifying the funding agencies. Various bibliometrics and scientometrics software were used to analyze the data, namely Bibexcel, Biblioshiny, and VOS viewer.

Results:

There were 812 research papers published in 405 sources during 1992–2021. 2019 was noted as the most productive year (NP=101), and 2014 received the highest number of citations (TC=6634). Researchers preferred to publish as journal articles (NP=538; TC=24922). The University of Toronto, Canada, was identified as a productive institution with 42 publications and 5358 citations. The USA was the leading producing country with 433 publications, and most of the researchers publish their work in the journal "Scientific Reports" (NP=16). The word "autism" (NP=257) and "architecture" (NP=165) were the most frequently used keywords in autism research.
An Interference Assessment between New Unlicensed Wireless Connectivity and Outside Broadcasting Service in the 6 GHz Band
Authors:   Department of Electrical, Electronics & Control Engineering, Kongju National University, Cheonan 31080, Korea, Kim Seung-Nam , Lee Il-Kyoo , Kang Bub-Joo
Published: October 2021

New innovative technology such as unlicensed wireless connectivity has become essential to provide more beneficial and advanced services. Therefore, it is necessary to study the use of broadband available and potentials of spectrum harmonization for massive unlicensed applications, equally Wireless Fidelity (Wi-Fi) with higher frequency and wider bandwidth. This paper presents an interference assessment between unlicensed Wi-Fi service and an incumbent service such as Outside Broadcasting (OB) system in the 6 GHz band. It also includes several radio interference scenarios to analyse coexistence by Minimum Coupling Loss (MCL) and Monte Carlo (MC) methods. Consequently, this study suggests protection distance as a possible approach for the coexistence of the unlicensed Wi-Fi service and OB system in the 6 GHz band.
АКТУАЛИЗАЦИЯ ПРОФЕССИОНАЛЬНЫХ КОМПЕТЕНЦИЙ ИННОВАЦИОННОЙ ИНЖЕНЕРНОЙ ДЕЯТЕЛЬНОСТИ
Authors: Levitskaya Irina A.
Published: October 2021

Цель. Статья посвящена актуализации в условиях цифровизации профессиональных компетенций, связанных с принятием инженерных решений исследовательского характера и внедрению инноваций, а также поиском инновационных творческих решений в инженерной деятельности.

Метод или методология проведения работы. Методология инженерно-технического творчества является одним из эффективных методов креативного инжиниринга. Основу исследования образуют аналитико-синтетические методы работы с научными источниками.

Результаты. Установлено, что инженерно-техническое творчество в условиях цифровой экономики представляет собой инновационную инженерную деятельность, направленную на разработку принципиально новых технических решений на основании известных закономерностей.

Область применения результатов. Результаты исследования могут быть применены в сфере педагогического проектирования и прогнозирования деятельности инженеров цифровой экономике.
ПОДХОДЫ К ИЗУЧЕНИЮ РЕЧИ БИЛИНГВОВ (НА ОСНОВЕ АНАЛИЗА ПСИХОЛИНГВИСТИЧЕСКИХ ИССЛЕДОВАНИЙ ЗАРУБЕЖНЫХ АВТОРОВ)
Authors: Ravi Ranjan
Published: October 2021

Цель. В статье представлен теоретический обзор подходов зарубежных авторов, изучающих проблему становления и развития речи билингвов. Теоретический анализ зарубежных исследований, с точки зрения психологических аспектов, позволит глубже понять особенности когнитивного развития двуязычных детей (в частности, особенностей их речевого развития).

Метод или методология проведения работы. Основу работы образуют теоретические методы исследования в психологии: метод индукции, сравнения и обобщения.

Результаты работы. В статье проанализированы психолингвистические теории с упором на анализ функционирования именно психических процессов (в частности, речи). Обобщение материалов зарубежных практиков позволит усилить содержание коррекционных и развивающих программ для детей-билингвов, усовершенствовать педагогические технологии обучения иностранному языку, отточить техники развития и формирования познавательных процессов с опорой на психологические основы обучения с использованием методик психологической практики.

Область применения результатов. Результаты исследования могут быть применены в сфере образования и педагогической деятельности, а также в сфере прикладной психологии.