bluuebunny/crossref_metadata_2025 huggingface dataset:
Antimicrobial susceptibility of gram-positive and gram-negative bacteria: a 5-year retrospective analysis at a multi-hospital healthcare system in Saudi Arabia
Authors: Alhumaid Saad , Al Mutair Abbas , Al Alawi Zainab , Alzahrani Ahmad J. , Tobaiqy Mansour , Alresasi Ahmed M. , Bu-Shehab Ibrahim , Al-Hadary Issa , Alhmeed Naif , Alismail Mossa , Aldera Ahmed H. , AlHbabi Fadhil , Al-Shammari Haifa , Rabaan Ali A. , Al-Omari Awad
Published: June 2021

Background

Studying time-related changes in susceptible pathogens causing healthcare-associated infections (HAIs) is vital in improving local antimicrobial and infection control practices.

Objectives

Describe susceptibility patterns to several antimicrobials in gram-positive and gram-negative pathogens isolated from patients causing HAIs at three private tertiary care hospitals in Saudi Arabia over a 5-year period.

Methods

Data on trends of antimicrobial susceptibility among bacteria causing HAIs events in children and adults at three tertiary private hospitals located in Riyadh and Qassim, Saudi Arabia, were collected retrospectively between 2015 and 2019 using the surveillance data datasets.

Results

Over a 5-year period, 38,624 pathogens caused 17,539 HAI events in 17,566 patients. About 9450 (53.8%) of patients who suffered HAIs were females and the average age was 41.7 ± 14.3 years (78.1% were adults and 21.9% were children). Gram-negative pathogens were 2.3-times more likely to cause HAIs compared to gram-positive bacteria (71.9% vs. 28.1%). The ranking of causative pathogens in decreasing order was: Escherichia coli (38%), Klebsiella species (15.1%), and Staphylococcus aureus (12.6%). Gram-positive isolates were mostly susceptible to linezolid (91.8%) whereas they were resistant to ampicillin (52.6%), cefoxitin (54.2%), and doxycycline (55.9%). Gram-negative isolates were mostly sensitive to tigecycline (95%) whereas they were resistant to cefotaxime (49.5%) and cefixime (59.6%). During the 5 years, there were relatively stable susceptibility patterns to all tested antimicrobials, except for cefotaxime which shown a susceptibility reduction by 41.4%, among Escherichia coli and Klebsiella species. An increase in the susceptibility of Acinetobacter and Enterobacter and Citrobacter species to all studied antimicrobials was observed except for colistin that had a slight sensitivity reduction in 2019 by 4.3% against Acinetobacter species. However, we noted reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin.

Conclusion

The observed increase in susceptibility of gram-positive and gram-negative bacteria to studied antimicrobials is important; however, reduced sensitivity of MRSA, CoNS and Enterococcus species to gentamicin; and increased resistance of MRSA to linezolid and vancomycin is a serious threat and calls for effective antimicrobial stewardship programs.
Single-cell RNA sequencing reveals the mechanism of sonodynamic therapy combined with a RAS inhibitor in the setting of hepatocellular carcinoma
Authors: Wu Bolin , Yuan Yanchi , Liu Jiayin , Shang Haitao , Dong Jing , Liang Xitian , Wang Dongxu , Chen Yichi , Wang Chunyue , Zhou Yang , Jing Hui , Cheng Wen
Published: June 2021

Background

Ras activation is a frequent event in hepatocellular carcinoma (HCC). Combining a RAS inhibitor with traditional clinical therapeutics might be hampered by a variety of side effects, thus hindering further clinical translation. Herein, we report on integrating an IR820 nanocapsule-augmented sonodynamic therapy (SDT) with the RAS inhibitor farnesyl-thiosalicylic acid (FTS). Using cellular and tumor models, we demonstrate that combined nanocapsule-augmented SDT with FTS induces an anti-tumor effect, which not only inhibits tumor progression, and enables fluorescence imaging. To dissect the mechanism of a combined tumoricidal therapeutic strategy, we investigated the scRNA-seq transcriptional profiles of an HCC xenograft following treatment.

Results

Integrative single-cell analysis identified several clusters that defined many corresponding differentially expressed genes, which provided a global view of cellular heterogeneity in HCC after combined SDT/FTS treatment. We conclude that the combination treatment suppressed HCC, and did so by inhibiting endothelial cells and a modulated immunity. Moreover, hepatic stellate secretes hepatocyte growth factor, which plays a key role in treating SDT combined FTS. By contrast, enrichment analysis estimated the functional roles of differentially expressed genes. The Gene Ontology terms “cadherin binding” and “cell adhesion molecule binding” and KEGG pathway “pathway in cancer” were significantly enriched by differentially expressed genes after combined SDT/FTS therapy.

Conclusions

Thus, some undefined mechanisms were revealed by scRNA-seq analysis. This report provides a novel proof-of-concept for combinatorial HCC-targeted therapeutics that is based on a non-invasive anti-tumor therapeutic strategy and a RAS inhibitor.
Post SARS-CoV-2 infection reactive arthritis: a brief report of two pediatric cases
Authors: Sinaei Reza , Pezeshki Sara , Parvaresh Saeedeh , Sinaei Roya , Shiari Reza , Hassas Yeganeh Mehrnoush , Bazargn Nasrin , Gharaei Nava
Published: June 2021

Background

Although, preliminary reports of Severe Acute Respiratory Syndrome (SARS)-CoV-2 infection suggest that the infection causes a less severe illness in children, there is now growing evidence of other rare or even serious complications of disease.

Case presentation

During the recent COVID-19 pandemic in Kerman, Iran, two children (an 8 year-old boy and a 6 year-old girl) were referred to outpatient Clinic of Pediatric Rheumatology with complaints of limping. Both children had experienced fever and mild respiratory tract infection. At the beginning of the second week of infection, they developed joint effusion. They both tested positive for coronavirus infection and were therefore diagnosed with post Coronavirus reactive arthritis. Both children were treated successfully with rest and Non-Steroidal Anti-Inflammatory Drugs (NSAID). They did not have any medical problems in the two months fallow up.

Conclusions

These two cases suggest that COVID-19 may be rheumatogenic. Highlighting the need for awareness of physicians, especially pediatricians, regarding the pathogenesis margins of this virus, as late presentations are of great importance.
Myositis autoantibodies in a racially diverse population of children with idiopathic inflammatory myopathies
Authors: Perron Megan Mariko , Vasquez-Canizares Natalia , Tarshish Gabriel , Wahezi Dawn M.
Published: June 2021

Background

Juvenile idiopathic inflammatory myopathies (JIIMs) is a group of autoimmune disorders, including juvenile dermatomyositis (JDM), juvenile polymyositis (JPM) and overlap myositis, that are characterized by proximal muscle weakness, elevated levels of serum muscle enzymes, and pathognomonic skin findings. While the exact etiology of JIIMs is unclear, the presence of myositis specific autoantibodies (MSAs) have been associated with certain clinical phenotypes, organ involvement and disease prognosis. To date, there have been few studies of the associations between MSA presence and patient ethnicity. It is important to understand the extent to which ethnicity impacts disease manifestations, organ involvement and clinical outcomes. The goal of our study is to determine MSA and myositis associated autoantibody (MAA) presence, clinical phenotype, and disease course in a racially diverse population of pediatric patients with JIIMs.

Methods

Patients age 2–21 years with a prior diagnosis of JDM, JPM or overlap myositis, who had been tested for MSA/MAA, were eligible for study inclusion. Clinical and laboratory data were collected retrospectively via manual chart review in this single-center study. Descriptive statistics were performed to summarize each variable. Given the small sample size, non-parametric testing was performed using Fischer’s exact test, Wilcoxon rank sum test and Kruskal-Wallis test.

Results

Thirty one patients were included in the analysis. Race and ethnicity were self-reported as Hispanic (48.4%), white (25.8%), and Black (25.8%). The most prevalent MSAs were anti-MDA5 (25.8%), anti-p155/140 (22.6%) and anti-MJ (19.4%). Presence of autoantibodies (p = 0.04) and pulmonary disease (p = 0.03) were significantly higher in patients of Black or Hispanic descent compared with white descent. Anti-MDA5 antibodies, cutaneous ulceration, cardiopulmonary involvement, hospitalizations and one death were only reported in patients with Black or Hispanic descent. Patients with anti-MDA5 antibodies were more likely to be male (p = 0.04) and to have cutaneous ulceration (p = 0.02).

Conclusions

This study describes the prevalence of MSA/MAA in a racially diverse group of patients with JIIM and further delineates clinical phenotype and disease complications in these groups. We found a relatively high proportion of children with anti-MDA5 antibodies and described potentially worse clinical courses in children of Black or Hispanic descent. Further investigation is warranted to examine these findings.
Realising sexual and reproductive health and rights of adolescent girls and young women living in slums in Uganda: a qualitative study
Authors: McGranahan Majel , Bruno-McClung Elizabeth , Nakyeyune Joselyn , Nsibirwa Derrick Aaron , Baguma Christopher , Ogwang Christopher , Serunjogi Francis , Nakalembe Judith , Kayaga Marianna , Sekalala Sharifah , Oyebode Oyinlola
Published: June 2021

Background

Sexual and reproductive health and rights are critical entitlements best supported through human rights-based approaches empowering rights-holders to claim their rights and duty bearers to fulfil their obligations. Implementing these requires information on the current needs and challenges faced by those seeking to claim their sexual and reproductive health and rights. We aimed to identify the underlying factors influencing the realisation of sexual and reproductive health and rights for adolescent girls and young women living Ugandan slums by: (1) exploring the role of relevant service providers and stakeholders; and (2) uncovering knowledge and gaps in protecting adolescent girls’ and young women’s sexual and reproductive health and rights.

Methods

Qualitative data were collected through focus groups and interviews focused on current knowledge, behaviours and attitudes towards sexual and reproductive health and rights among adolescent girls and young women, service providers and stakeholders. Data were analysed thematically using NVivo software. Ten in-depth interviews were conducted with key informants; two focus groups were held with adolescent girls and young women living in two slums in Uganda (21 participants in total); and three focus groups were held with community leaders, service providers, teachers and parents (30 participants in total).

Results

Adolescent girls and young women lacked information regarding their sexual health, services available, and redress mechanisms for rights violations. Formal sources of information were frequently inaccessible. Family members were sometimes the source of rights violations, and informal methods of redressing rights were often sought. Stigma and fear were common features both in healthcare and in the pursuit of formal justice, with duty-bearers habitually breaking confidentiality. Education and training were the predominant suggestions offered for change.

Conclusions

Adolescent girls and young women continue to face obstacles in achieving their full sexual and reproductive health and rights. Targeted interventions for the realisation of adolescent girls’ and young women’s sexual and reproductive health and rights can address underlying causes and positively shift attitudes to promote health.
Effect of the lysosomotropic agent chloroquine on mTORC1 activation and protein synthesis in human skeletal muscle
Authors: Borack Michael S. , Dickinson Jared M. , Fry Christopher S. , Reidy Paul T. , Markofski Melissa M. , Deer Rachel R. , Jennings Kristofer , Volpi Elena , Rasmussen Blake B.
Published: June 2021

Background

Previous work in HEK-293 cells demonstrated the importance of amino acid-induced mTORC1 translocation to the lysosomal surface for stimulating mTORC1 kinase activity and protein synthesis. This study tested the conservation of this amino acid sensing mechanism in human skeletal muscle by treating subjects with chloroquine—a lysosomotropic agent that induces in vitro and in vivo lysosome dysfunction.

Methods

mTORC1 signaling and muscle protein synthesis (MPS) were determined in vivo in a randomized controlled trial of 14 subjects (10 M, 4 F; 26 ± 4 year) that ingested 10 g of essential amino acids (EAA) after receiving 750 mg of chloroquine (CHQ, n = 7) or serving as controls (CON, n = 7; no chloroquine). Additionally, differentiated C2C12 cells were used to assess mTORC1 signaling and myotube protein synthesis (MyPS) in the presence and absence of leucine and the lysosomotropic agent chloroquine.

Results

mTORC1, S6K1, 4E-BP1 and rpS6 phosphorylation increased in both CON and CHQ 1 h post EAA ingestion (P < 0.05). MPS increased similarly in both groups (CON, P = 0.06; CHQ, P < 0.05). In contrast, in C2C12 cells, 1 mM leucine increased mTORC1 and S6K1 phosphorylation (P < 0.05), which was inhibited by 2 mg/ml chloroquine. Chloroquine (2 mg/ml) was sufficient to disrupt mTORC1 signaling, and MyPS.

Conclusions

Chloroquine did not inhibit amino acid-induced activation of mTORC1 signaling and skeletal MPS in humans as it does in C2C12 muscle cells. Therefore, different in vivo experimental approaches are required for confirming the precise role of the lysosome and amino acid sensing in human skeletal muscle.

Trial registration NCT00891696. Registered 29 April 2009.
Development of clinical application program for radiotherapy induced cancer risk calculation using Monte Carlo engine in volumetric-modulated arc therapy
Authors: Kang Dong-Jin , Shin Young-Joo , Jeong Seonghoon , Jung Jae-Yong , Lee Hakjae , Lee Boram
Published: June 2021

Background

The purpose of this study is to develop a clinical application program that automatically calculates the effect for secondary cancer risk (SCR) of individual patient. The program was designed based on accurate dose calculations using patient computed tomography (CT) data and Monte Carlo engine. Automated patient-specific evaluation program was configured to calculate SCR.

Methods

The application program is designed to re-calculate the beam sequence of treatment plan using the Monte Carlo engine and patient CT data, so it is possible to accurately calculate and evaluate scatter and leakage radiation, difficult to calculate in TPS. The Monte Carlo dose calculation system was performed through stoichiometric calibration using patient CT data. The automatic SCR evaluation program in application program created with a MATLAB was set to analyze the results to calculate SCR. The SCR for organ of patient was calculated based on Biological Effects of Ionizing Radiation (BEIR) VII models. The program is designed to sequentially calculate organ equivalent dose (OED), excess absolute risk (EAR), excess relative risk (ERR), and the lifetime attributable risk (LAR) in consideration of 3D dose distribution analysis. In order to confirm the usefulness of the developed clinical application program, the result values from clinical application program were compared with the manual calculation method used in the previous study.

Results

The OED values calculated in program were calculated to be at most approximately 13.3% higher than results in TPS. The SCR result calculated by the developed clinical application program showed a maximum difference of 1.24% compared to the result of the conventional manual calculation method. And it was confirmed that EAR, ERR and LAR values can be easily calculated by changing the biological parameters.

Conclusions

We have developed a patient-specific SCR evaluation program that can be used conveniently in the clinic. The program consists of a Monte Carlo dose calculation system for accurate calculation of scatter and leakage radiation and a patient-specific automatic SCR evaluation program using 3D dose distribution. The clinical application program that improved the disadvantages of the existing process can be used as an index for evaluating a patient treatment plan.
Organ motion in linac-based SBRT for glottic cancer
Authors: Perillo Annarita , Landoni Valeria , Farneti Alessia , Sanguineti Giuseppe
Published: June 2021

Purpose

The purpose of this study is to evaluate inter- and intra-fraction organ motion as well as to quantify clinical target volume (CTV) to planning target volume (PTV) margins to be adopted in the stereotactic treatment of early stage glottic cancer.

Methods and materials

Stereotactic body radiotherapy (SBRT) to 36 Gy in 3 fractions was administered to 23 patients with early glottic cancer T1N0M0. Patients were irradiated with a volumetric intensity modulated arc technique delivered with 6 MV FFF energy. Each patient underwent a pre-treatment cone beam computed tomography (CBCT) to correct the setup based on the thyroid cartilage position. Imaging was repeated if displacement exceeded 2 mm in any direction. CBCT imaging was also performed after each treatment arc as well as at the end of the delivery. Swallowing was allowed only during the beam-off time between arcs. CBCT images were reviewed to evaluate inter- and intra-fraction organ motion. The relationships between selected treatment characteristics, both beam-on and delivery times as well as organ motion were investigated.

Results

For the population systematic (Ʃ) and random (σ) inter-fraction errors were 0.9, 1.3 and 0.6 mm and 1.1, 1.3 and 0.7 mm in the left-right (X), cranio-caudal (Y) and antero-posterior (Z) directions, respectively. From the analysis of CBCT images acquired after treatment, systematic (Ʃ) and random (σ) intra-fraction errors resulted 0.7, 1.6 and 0.7 mm and 1.0, 1.5 and 0.6 mm in the X, Y and Z directions, respectively. Margins calculated from the intra-fraction errors were 2.4, 5.1 and 2.2 mm in the X, Y and Z directions respectively. A statistically significant difference was found for the displacement in the Z direction between patients irradiated with > 2 arcs versus ≤ 2 arcs, (MW test, p = 0.038). When analyzing mean data from CBCT images for the whole treatment, a significant correlation was found between the time of delivery and the three dimensional displacement vector (r = 0.489, p = 0.055), the displacement in the Y direction (r = 0.553, p = 0.026) and the subsequent margins to be adopted (r = 0.626, p = 0.009). Finally, displacements and the subsequent margins to be adopted in Y direction were significantly greater for treatments with more than 2 arcs (MW test p = 0.037 and p = 0.019, respectively).

Conclusions

In the setting of controlled swallowing during treatment delivery, intra-fraction motion still needs to be taken into account when planning with estimated CTV to PTV margins of 3, 5 and 3 mm in the X, Y and Z directions, respectively. Selected treatments may require additional margins.
Frequency of detection and load of amastigotes in the pancreas of Leishmania infantum-seropositive dogs: clinical signs and histological changes
Authors: Kost William de Oliveira , Pereira Sandro Antonio , Figueiredo Fabiano Borges , Mendes Junior Artur Augusto Velho , Madeira Maria de Fátima , Miranda Luciana de Freitas Campos , de Oliveira Raquel de Vasconcellos Carvalhaes , Ferreira Luiz Cláudio , Morgado Fernanda Nazaré , Menezes Rodrigo Caldas
Published: June 2021

Background

Zoonotic visceral leishmaniasis is caused by the protozoanLeishmania infantumand is highly lethal in humans and dogs if left untreated. The frequency of this parasite and associated histological changes in the pancreas of dogs are poorly studied. Therefore, the objectives of this study were to evaluate the frequency of detection and load of amastigotes in the pancreas ofL. infantum-seropositive dogs and to identify the clinical signs and histological changes associated with parasitism of this organ.

Methods

One hundred forty-three dogs from an endemic area in Brazil that tested seropositive forL. infantumwere studied. The dogs were clinically examined, killed, and necropsied between 2013 and 2014. One fragment of the pancreas was randomly collected for histopathology and immunohistochemistry, and spleen and bone marrow were collected for culture.

Results

Leishmaniaamastigotes were detected in the pancreas of 22 dogs (15.4%) by immunohistochemistry, all exhibitingL. infantumparasitism in the spleen and/or bone marrow. Poor body condition and cachexia were only associated with infection of the pancreas withLeishmaniaspp. (p = 0.021) and were found in 40.9% of dogs with pancreatic infection. Anorexia, vomiting, and/or diarrhea were observed in 9.2% of dogs with pancreatitis. The median parasite load in the pancreas was 1.4 infected macrophages/mm2. Pancreatic histological changes and their frequencies were: granulomatous pancreatitis (28.0%), lymphoplasmacytic pancreatitis (23.8%), acinar cell degeneration (6.3%), fibrosis (5.6%), hemorrhage (2.1%), eosinophilic pancreatitis (0.7%), suppurative pancreatitis (0.7%), and necrosis (0.7%).

Conclusions

The present results demonstrate thatL. infantumis one of the etiological agents of chronic pancreatitis in dogs; however, the frequency of detection and parasite load are low in this organ. The lack of an association of poor body condition and cachexia with pancreatitis and the low frequency of clinical signs commonly associated with pancreatitis suggest that a significant portion of the organ is not affected by this parasite. On the other hand, the association of poor body condition and cachexia with concomitant infection of the pancreas, spleen, and/or bone marrow with this parasite suggests that these manifestations are the result of a more advanced stage of canine visceral leishmaniasis.

Graphic abstract
Severe COVID-19 in Alzheimer’s disease: APOE4’s fault again?
Authors: Xiong Nian , Schiller Martin R. , Li Jingwen , Chen Xiaowu , Lin Zhicheng
Published: June 2021

Challenges have been recognized in healthcare of patients with Alzheimer’s disease (AD) in the COVID-19 pandemic, given a high infection and mortality rate of COVID-19 in these patients. This situation urges the identification of underlying risks and preferably biomarkers for evidence-based, more effective healthcare. Towards this goal, current literature review and network analysis synthesize available information on the AD-related gene APOE into four lines of mechanistic evidence. At a cellular level, the risk isoform APOE4 confers high infectivity by the underlying coronavirus SARS-CoV-2; at a genetic level, APOE4 is associated with severe COVID-19; at a pathway level, networking connects APOE with COVID-19 risk factors such as ACE2, TMPRSS2, NRP1, and LZTFL1; at a behavioral level, APOE4-associated dementia may increase the exposure to coronavirus infection which causes COVID-19. Thus, APOE4 could exert multiple actions for high infection and mortality rates of the patients, or generally, with COVID-19.
Stroke associated with Mycoplasma hominis infection: a case report
Authors: Tsolaki Anthoula C. , Konstantinidis Galaktion , Koukou Stavroula , Michali Fotini , Georgiadou Despina , Tegos Thomas , Michalis Nikolaos D.
Published: June 2021

Background

Mycoplasmas are the smallest prokaryotic microorganisms in nature. Many cases of stroke post-Mycoplasma pneumoniae infection have been reported, particularly in the pediatric population. However, Mycoplasma hominis infection has not previously been associated with stroke.

Case presentation

We report the case of a 36-year-old Greek woman who presented with an extensive stroke with an unspecified cause. She had a concurrent genital infection with Mycoplasma hominis for an unknown duration.

Conclusion

An association may exist between stroke and the immune response to Mycoplasma hominis infection.
On the performance of physical layer security in virtual full-duplex non-orthogonal multiple access system
Authors: Guo Weidong , Liu Yuxi
Published: June 2021

This paper investigates physical layer security analysis of cooperative non-orthogonal multiple access (NOMA) communication system. A virtual full-duplex (VFD) relaying scheme with an untrusted amplify-and-forward (AF) half-duplex (HD) relay and a trusted decode-and-forward (DF) HD relay is used in this system to improve the spectral efficiency. In order to prevent the untrusted relay from eavesdropping, a simple and practical cooperative jamming scheme is designed to confuse the untrusted relay. The exact expressions of effective secrecy throughput (EST) for NOMA users and approximate expression of EST for non-NOMA user are derived. All theoretical results are validated by numerical simulations which demonstrate that the proposed VFD-NOMA scheme is superior to existing HD-NOMA scheme in cooperative system and jamming plays an important role for obtaining acceptable EST. In addition, simulation results shows that the best secrecy performance highly depends on the system parameters such as transmit powers and jamming signal power.
Sharp bounds for a ratio of the q-gamma function in terms of the q-digamma function
Authors: Alzahrani Faris , Salem Ahmed , El-Shahed Moustafa
Published: June 2021

In the present paper, we introduce sharp upper and lower bounds to the ratio of two q-gamma functions ${\Gamma }_{q}(x+1)/{\Gamma }_{q}(x+s)$

Γ
q

(
x
+
1
)
/

Γ
q

(
x
+
s
)
for all real number s and $0< q\neq1$
0
<
q
≠
1
in terms of the q-digamma function. Our results refine the results of Ismail and Muldoon (Internat. Ser. Numer. Math., vol. 119, pp. 309–323, 1994) and give the answer to the open problem posed by Alzer (Math. Nachr. 222(1):5–14, 2001). Also, for the classical gamma function, our results give a Kershaw inequality for all $0< s<1$
0
<
s
<
1
when letting $q\to 1$
q
→
1
and a new inequality for all $s>1$
s
>
1
.
Transmission dynamics model of Tuberculosis with optimal control strategies in Haramaya district, Ethiopia
Authors: Kereyu Doyo , Demie Seleshi
Published: June 2021

In this study, we use a compartmental nonlinear deterministic mathematical model to investigate the effect of different optimal control strategies in controlling Tuberculosis (TB) disease transmission in the community. We employ stability theory of differential equations to investigate the qualitative behavior of the model by obtaining the basic reproduction number and determining the local stability conditions for the disease-free and endemic equilibria. We consider three control strategies representing distancing, case finding, and treatment efforts and numerically compare the levels of exposed and infectious populations with and without control strategies. The results suggest that combination of all controls is the best strategy to eradicate TB disease from the community at an optimal level with minimum cost of interventions.
Diarrhoea Management using Over-the-counter Nutraceuticals in Daily practice (DIAMOND): a feasibility RCT on alternative therapy to reduce antibiotic use
Authors: Hu Yanhong Jessika , Zhou Xudong , Wang Shanjuan , Willcox Merlin , Garner Colin , Brown David , Becque Taeko , Stuart Beth , Han Zongru , Chang Qin , Moore Michael , Little Paul
Published: June 2021

Background

Although rarely indicated, antibiotics are commonly used for acute diarrhoea in China. We conducted a randomised, double blind exploratory clinical trial of loperamide, berberine and turmeric for treatment of acute diarrhoea.

Methods

Adults with acute uncomplicated diarrhoea aged 18 to 70 were randomised to 4 groups: (A) loperamide; (B) loperamide and berberine; (C) loperamide and turmeric; (D) loperamide, berberine and turmeric. All participants were given rescue ciprofloxacin for use after 48 h if symptoms worsened or were unimproved. Primary endpoints were feasibility and ciprofloxacin use during the 2-week follow-up period. Semi-structured interviews were conducted following recruitment and were analysed thematically. Recruiting doctors, delivery pharmacists and research assistants were blinded to treatment allocation.

Results

Only 21.5% (278/1295) of patients screened were deemed eligible, and 49% (136/278) of these consented and were entered into the final analysis. Most participants had mild symptoms, because most patients with moderate or severe symptoms wanted to be given antibiotics. Follow-up was good (94% at 2 weeks). Only three participants used rescue antibiotics compared to 67% of acute diarrhoea patients in the hospital during the recruitment period. The median symptom duration was 14 h in group B (interquartile range (IQR) 10-22), 16 h in group D (IQR 10-22), 18 h in group A (IQR 10-33) and 20 h in group C (IQR 16-54). Re-consultation rates were low. There were no serious treatment-related adverse events. Most interviewed participants said that although they had believed antibiotics to be effective for diarrhoea, they were surprised by their quick recovery without antibiotics in this trial.

Conclusion

Although recruitment was challenging because of widespread expectations for antibiotics, patients with mild diarrhoea accepted trying an alternative. The three nutraceuticals therapy require further evaluation in a fully powered, randomised controlled trial among a broader sample.

Trial registration

ChiCTR-IPR-17014107
GMP production of 6-[18F]Fluoro-l-DOPA for PET/CT imaging by different synthetic routes: a three center experience
Authors: Andersen Valdemar L. , Soerensen Mikkel A. , Dam Johan Hygum , Langkjaer Niels , Petersen Henrik , Bender Dirk Andreas , Fugloe Dan , Huynh Tri Hien Viet
Published: June 2021

Background

The radiofluorinated levodopa analogue 6-[18F]F-l-DOPA (3,4-dihydroxy-6-18F-l-phenylalanine) is a commonly employed radiotracer for PET/CT imaging of multiple oncological and neurological indications. An unusually large number of different radiosyntheses have been published to the point where two different Ph. Eur. monographs exist depending on whether the chemistry relies on electrophilic or nucleophilic radiosubstitution of appropriate chemical precursors. For new PET imaging sites wishing to adopt [18F]FDOPA into clinical practice, selecting the appropriate production process may be difficult and dependent on the clinical needs of the site.

Methods

Data from four years of [18F]FDOPA production at three different clinical sites are collected and compared. These three sites, Aarhus University Hospital (AUH), Odense University Hospital (OUH), and Herlev University Hospital (HUH), produce the radiotracer by different radiosynthetic routes with AUH adopting an electrophilic strategy, while OUH and HUH employ two different nucleophilic approaches. Production failure rates, radiochemical yields, and molar activities are compared across sites and time. Additionally, the clinical use of the radiotracer over the time period considered at the different sites are presented and discussed.

Results

The electrophilic substitution route suffers from being demanding in terms of cyclotron operation and maintenance. This challenge, however, was found to be compensated by a production failure rate significantly below that of both nucleophilic approaches; a result of simpler chemistry. The five-step nucleophilic approach employed at HUH produces superior radiochemical yields compared to the three-step approach adopted at OUH but suffers from the need for more comprehensive synthesis equipment given the multi-step nature of the procedure, including HPLC purification. While the procedure at OUH furnishes the lowest radiochemical yield of the synthetic routes considered, it produces the highest molar activity. This is of importance across the clinical applications of the tracer discussed here, including dopamine synthesis in striatum of subjects with schizophrenia and congenital hyperinsulinism in infants.

Conclusion

For most sites either of the two nucleophilic substitution strategies should be favored. However, which of the two will depend on whether a given site wishes to optimize the radiochemical yield or the ease of the use.
Bayesian full-waveform inversion with realistic priors
Authors: Zhang Xin , Curtis Andrew
Published: June 2021

Seismic full-waveform inversion (FWI) uses full seismic records to estimate the subsurface velocity structure. This requires a highly nonlinear and nonunique inverse problem to be solved; therefore, Bayesian methods have been used to quantify uncertainties in the solution. Variational Bayesian inference uses optimization to efficiently provide solutions. However, previously the method has only been applied to a transmission FWI problem and with strong prior information imposed on the velocity such as is never available in practice. We have found that the method works well in a seismic reflection setting and with realistically weak prior information, representing the type of problem that occurs in reality. We conclude that the method can produce high-resolution images and reliable uncertainties using data from standard reflection seismic acquisition geometry, realistic nonlinearity, and practically achievable prior information.
C/Can City Engagement Process: An Implementation Framework for Strengthening Cancer Care in Cities in Low- and Middle-Income Countries
Authors: Frech Silvina , Morton Doherty Rebecca , Lesmes Duque Maria Cristina , Ramirez Oscar , Pomata Alicia , Samudio Angelica , Antwi Osei A. , Htun Yin Yin , Mra Rai , Htoon Pe Thet , Osei-Bonsu Ernest Baawuah , Dal Molin Rafaela Komorowski , Mebonia Nana , Mestres Isabel , Soe Aung Naing , Bussmann-Kemdjo Sophie , Navarro Maria Fernanda , Henshall Susan , Camacho Rolando
Published: June 2021

The effective implementation of locally adapted cancer care solutions in low- and middle-income countries continues to be a challenge in the face of fragmented and inadequately resourced health systems. Consequently, the translation of global cancer care targets to local action for patients has been severely constrained. City Cancer Challenge (C/Can) is leveraging the unique value of cities as enablers in a health systems response to cancer that prioritizes the needs of end users (patients, their caregivers and families, and health care providers). C/Can’s City Engagement Process is an implementation framework whereby local stakeholders lead a staged city-wide process over a 2- to 3-year period to assess, plan, and execute locally adapted cancer care solutions. Herein, the development and implementation of the City Engagement Process Framework (CEPF) is presented, specifying the activities, outputs, processes, and indicators across the process life cycle. Lessons learned on the application of the framework in the first so-called Key Learning cities are shared, focusing on the early outputs from Cali, Colombia, the first city to join C/Can in 2017. Creating lasting change requires the creation of a high-trust environment to engage the right stakeholders as well as adapting to local context, leveraging local expertise, and fostering a sustainability mindset from the outset. In the short term, these early learnings inform the refinement of the approach in new cities. Over time, the implementation of this framework is expected to validate the proof-of-concept and contribute to a global evidence base for effective complex interventions to improve cancer care in low- and middle-income countries.
New Horizons: Is Obesity a Disorder of Neurotransmission?
Authors: Caron Alexandre , Jane Michael Natalie
Published: June 2021

Obesity is a disease of the nervous system. While some will view this statement as provocative, others will take it as obvious. Whatever our side is, the pharmacology tells us that targeting the nervous system works for promoting weight loss. It works, but at what cost? Is the nervous system a safe target for sustainable treatment of obesity? What have we learned—and unlearned—about the central control of energy balance in the last few years? Herein we provide a thought-provoking exploration of obesity as a disorder of neurotransmission. We discuss the state of knowledge on the brain pathways regulating energy homeostasis that are commonly targeted in anti-obesity therapy and explore how medications affecting neurotransmission such as atypical antipsychotics, antidepressants, and antihistamines relate to body weight. Our goal is to provide the endocrine community with a conceptual framework that will help expending our understanding of the pathophysiology of obesity, a disease of the nervous system.
Expert Consensus Statement on the Perioperative Management of Adult Patients Undergoing Head and Neck Surgery and Free Tissue Reconstruction From the Society for Head and Neck Anesthesia
Authors: Healy David W. , Cloyd Benjamin H. , Straker Tracey , Brenner Michael J. , Damrose Edward J. , Spector Matthew E. , Saxena Amit , Atkins Joshua H. , Ramamurthi Radhamangalam J. , Mehta Arpan , Aziz Michael F. , Cattano Davide , Levine Adam I. , Schechtman Samuel A. , Cavallone Laura F. , Abdelmalak Basem B.
Published: June 2021

The perioperative care of adult patients undergoing free tissue transfer during head and neck surgical (microvascular) reconstruction is inconsistent across practitioners and institutions. The executive board of the Society for Head and Neck Anesthesia (SHANA) nominated specialized anesthesiologists and head and neck surgeons to an expert group, to develop expert consensus statements. The group conducted an extensive review of the literature to identify evidence and gaps and to prioritize quality improvement opportunities. This report of expert consensus statements aims to improve and standardize perioperative care in this setting. The Modified Delphi method was used to evaluate the degree of agreement with draft consensus statements. Additional discussion and collaboration was performed via video conference and electronic communication to refine expert opinions and to achieve consensus on key statements. Thirty-one statements were initially formulated, 14 statements met criteria for consensus, 9 were near consensus, and 8 did not reach criteria for consensus. The expert statements reaching consensus described considerations for preoperative assessment and optimization, airway management, perioperative monitoring, fluid management, blood management, tracheal extubation, and postoperative care. This group also examined the role for vasopressors, communication, and other quality improvement efforts. This report provides the priorities and perspectives of a group of clinical experts to help guide perioperative care and provides actionable guidance for and opportunities for improvement in the care of patients undergoing free tissue transfer for head and neck reconstruction. The lack of consensus for some areas likely reflects differing clinical experiences and a limited available evidence base.
Σύνολα Birkhoff-James ε-ορθογωνιότητας και Birkhoff-James συνημίτονο
Authors: Παναγάκου Βασιλική
Published: June 2021

Στην παρούσα Διδακτορική Διατριβή μελετάμε το σύνολο Birkhoff-James ε-ορθογωνιότητας του διανύσματος χ ως προς το διάνυσμα ψ, σε ένα μιγαδικό γραμμικό χώρο με νόρμα. Το σύνολο αυτό αποτελεί γενίκευση του γνωστού αριθμητικού πεδίου πινάκων και τελεστών. Αρχικά, αποδεικνύεται ένας ισοδύναμος εναλλακτικός ορισμός με χρήση γραμμικών συναρτησιακών και ερευνάται η πλούσια δομή του ως άνω συνόλου. Ο νέος αυτός ορισμός οδηγεί σε βασικές ιδιότητες, μεταξύ των οποίων και η υποπροσθετικότητα του συνόλου Birkhoff-James ε-ορθογωνιότητας ως προς το διάνυσμα χ.Επίσης, εισάγουμε και διερευνούμε το Birkhoff-James συνημίτονο της κυρτής γωνίας, που σχηματίζεται από δύο μη μηδενικά διανύσματα ενός μιγαδικού γραμμικού χώρου με νόρμα, το οποίο βρίσκεται σε άμεση σύνδεση με το σύνολο Birkhoff-James ε-ορθογωνιότητας. Το συνημίτονο αυτό μελετάται και για φραγμένους γραμμικούς τελεστές, ενώ παρουσιάζονται κάποιοι χαρακτηρισμοί των φραγμένων γραμμικών τελεστών για την Birkhoff-James ε-ορθογωνιότητα, στην προσπάθεια επέκτασης του γνωστού Θεωρήματος Bhatia-Semrl σε απειροδιάστατους μιγαδικούς γραμμικούς χώρους με νόρμα.Τέλος, εισάγουμε το σύνολο Birkhoff-James ε-ορθογωνιότητας για διανυσματικά πολυώνυμα μιας μιγαδικής μεταβλητής και διερευνούμε τις γεωμετρικές και τοπολογικές ιδιότητες του συνόλου αυτού στο μιγαδικό επίπεδο. Επιπλέον, μελετάμε το πλήθος των συνεκτικών συνιστωσών του συνόλου, χαρακτηρίζουμε το σύνορό του και διερευνούμε την τοπική διάσταση των σημείων του.
The Scientific and Religious Exploration of the World in the Name of God. Jesuit Missionaries as Anthropologists and Natural Scientists in the New World. With a Focus on the Swiss Jesuit Philipp Segesser
Authors: Classen Albrecht
Published: June 2021

In jüngster Zeit hat sich viel Interesse an der Arbeit jesuitischer Missionare in der Neuen Welt des 17. und 18. Jahrhunderts geregt, weil deren Leistungen in praktischer und theoretischer Hinsicht unübersehbar gewesen sind, ganz gleich was die sogenannte ‘Schwarze Legende’ über sie zu verbreiten versuchte. Viele dieser Missionare, von denen erstaunlich viele aus der deutschen Provinz kamen, hinterließen z.T. sehr umfangreiche wissenschaftliche Werke, manche sogar enzyklopädischer Natur. Dazu besitzen wir viele Korrespondenzen. Aus kulturhistorischer Sicht können wir darin einen recht beachtlichen Beitrag zur wissenschaftlichen Erforschung der jeweiligen Missionsgebiete erkennen, auch wenn die Missionare stark durch ihre westliche und vor allem christliche Sicht geprägt waren. Neuere transkulturelle Perspektiven in der Germanistik haben dazu geführt, in diesen Schriften der Jesuiten wichtige schriftliche Zeugenaussagen und Selbstreflexionen zu erkennen. Hier aber geht es darum, das wissenschaftliche Interesse der Missionare in den Blick zu nehmen, wozu besonders die Briefe und ein größerer Bericht des Schweizer Jesuiten Philipp Segesser (1689-1762) dienlich sind. Die ersteren werden demnächst in englischer Übersetzung erscheinen, und der gegenwärtige Aufsatz vermittelt wichtige Erkenntnisse darüber, welche wissenschaftlichen Studien dieser Missionar durchführte
Intercambio lingüístico español—neerlandés: Período bajo la Corona Española (1496-1714) de los Países Bajos Históricos
Authors: Sánchez Romero Francisco
Published: June 2021

Los primeros contactos políticos entre España y los Países Bajos históricos comienzan con el matrimonio entre Felipe el Hermoso y Juana la Loca (1496). En el año 1648 los Países Bajos históricos del norte (lo que actualmente son los Países Bajos) se independizan de la Corona española. Sin embargo, el sur (Flandes) se mantiene bajo influencia española hasta el año 1714. En este marco histórico, el español peninsular y el neerlandés intercambian préstamos lingüísticos. Clasificaré los préstamos en los diferentes campos semánticos para llegar a la conclusión de cuál es el campo semántico que más ha influido en ambas lenguas en este período. A partir de esta ordenación semántica se podrá reconstruir en líneas generales el grado de contacto en diferentes ámbitos del neerlandés con la lengua española. No hay que olvidar que en este período analizado España se asienta en el continente americano, lo que hará que el español de América también influya directamente con préstamos en la lengua neerlandesa. Por lo tanto, también se recogerán en el presente estudio.
Empatía y extrañamiento en el concepto de aura de Walter Benjamin.
Authors: Ibarlucía Ricardo
Published: June 2021

El articulo propone una reconsideración de la concepción del aura en Walter Benjamin, a la luz de un recorrido teórico que lleva desde los “Protocolos de ensayos con las drogas” y consideraciones sobre la mímesis hasta “La obra de arte en la época de su reproductibilidad técnica” y sus estudios sobre Charles Baudelaire. La tesis central es que es el concepto de aura de Benjamin implica una dialéctica de empatía y extrañamiento que está profundamente arraigada en la historia de la percepción humana. La caracterización de la experiencia de lo bello de la naturaleza y del arte como aurática consiste, en último análisis, en una derivación de la relación interpersonal que constituye la base del mundo social o, más precisamente, en la transferencia de un proceso perceptivo originario en segunda persona a la actitud que los seres humanos manifiestan frente a entes y hechos experimentados en tercera.
La herencia kantiana en la estética de Jean Marie Schaeffer: autoteleología, despragmatización y consecuencias para la acción.
Authors: Omar Scheck Daniel
Published: June 2021

En este trabajo se desarrolla un enfoque del hecho estético entendido como un proceso experiencial y relacional, no centrado en las producciones artísticas, ni en los objetos materiales en general. En ese marco, se intenta mostrar la conexión y el parentesco entre ciertos elementos de la teoría de la experiencia estética de Schaeffer y la concepción del juicio estético de Kant. Se establece un paralelo entre la concepción de la experiencia estética como un proceso autoteleológico y despragmatizado, sostenido como tal por una interacción particular entre cognición, emociones y placer, propuesto por Schaeffer; y las tesis kantianas sobre el juego libre y desinteresado de las facultades que postula el principio trascendental de la facultad de juzgar. Hacia el final, se sugiere que debería contemplarse la injerencia de un componente moral en el complejo entramado del hecho estético. Palabras clave: hecho estético, proceso relacional, bucle homeodinámico, subrepción y desinterés, afectividad y moralidad
La promesa de un cuerpo. Relaciones prácticas con la corporalidad en elaboraciones de Heidegger de 1959-1969.
Authors: Butierrez Luis Fernando
Published: June 2021

En el siguiente trabajo analizaremos la cuestión de las relaciones prácticas con la corporalidad, tal y como Heidegger lo articula en sus consideraciones relativas al cuerpo propio y la labor médico-terapéutica relativa al cuerpo del otro en los Zollikoner Seminare. En el marco de estas elaboraciones buscaremos distinguir un compromiso no suficientemente tematizado con la perspectiva tradicional del cuerpo físico. Junto a ello, nos proponemos clarificar el estatuto de la acción y la injerencia práctica en esta perspectiva, para cotejar en qué medida es posible plantear transiciones o desplazamientos en las modalidades epocales de relación con la corporalidad
La cárcel como metáfora de la experiencia de lo trágico en el cine de Lars von Trier.
Authors: Díaz Lucena Antonio
Published: June 2021

En este artículo explicaremos la conexión que encontramos entre la angustia protestante —definida por Lutero y Kierkegaard— y la experiencia de lo trágico desde una perspectiva moderna. Con este fin, llevaremos a cabo un análisis textual de algunas de las secuencias de la Trilogía Hipnótica (1984-1991) del cineasta danés Lars von Trier. Su elección obedece principalmente a la crítica a la sociedad occidental que contienen sus films liberando lo trágico a través del dolor y de aquello a lo director denomina la estética de “lo feo”. Bajo estas premisas reflexionaremos sobre la oportunidad que tenemos en la experiencia trágica como uno de los elementos que nos permiten una reconciliación con lo pretérito y por lo tanto con nosotros mismos.