bluuebunny/crossref_metadata_2025 huggingface dataset:
Toxicity and Genotoxicity of Imidacloprid in Tadpoles of Leptodactylus Latrans and Physalaemus Cuvieri (Anura: Leptodactylidae)
Authors: Samojeden Caroline Garcia , Pavan Felipe André , Rutkoski Camila Fátima , Folador Alexandre , Fré Silvia Pricila Da , Müller Caroline , Hartmann Paulo Afonso , Hartmann Marilia Teresinha
Published: May 2021

Imidacloprid is a neonicotinoid insecticide widely used worldwide, but which can cause adverse effects on non-target organisms, especially in aquatic environments. This study aimed to evaluate the chronic toxicity of an insecticide-based imidacloprid in amphibians, using Leptodactylus latrans and Physalaemus cuvieri tadpoles. The parameters of survival, swimming activity, body size, damage to body structures and genotoxicity for both species were analyzed; and the ecological risk of this insecticide calculated. Chronic short-term assay was carried out for 168 h (7 days) and five concentrations of imidacloprid, between 3 and 300 µg L-1, were tested. The insecticide did not affect the tadpoles survival tadpoles; however, both species tested showed smaller body size, damage to the mouth and intestine and the induction of micronuclei and other erythrocytes nuclear abnormalities after exposure to imidacloprid-based herbicide. Insecticide exposure affected the swimming activity in L. latrans, which contributes to the greater sensitivity of L. latrans to imidacloprid when compared to P. cuvieri. All parameters analyzed indicated that the insecticide presents an ecological risk for both species at concentrations greater than 3 µg L-1. This demonstrates the genotoxicity of the insecticide imadacloprid, which can contribute to the population decline of L. latrans and P. cuvieri species in natural systems.
Laparoscopic Resection Combined With Aspiration for Central Renal Angiomyolipoma：Preliminary Outcomes of a Novel Surgical Technique
Authors: zhang dong , cheng yue , jiang junhui , jiang zhaohu , zhou cheng , Yan Zejun
Published: May 2021

BackgroundThe purpose of this article was to explore the safety and efficacy of laparoscopic resection combined with aspiration in a selected cohort of 17 patients with central renal angiomyolipoma(RAML). Methods17 patients diagnosed with central RAML by the pathological report and CT/MRI were enrolled in our center from August 2015 to November 2019. The indication for surgery was tumor size more than 4cm or symptomatic tumor such as hemorrhage, backache or hematuria. The main endpoint included operative time, warm ischemia time(WIT), intraoperative blood loss, postoperative hospital time, complications and renal function.ResultsThe average age was 45.3±4.8 years, 12 patients were women, 5 patients were men. Of all cases，10 underwent peritoneal laparoscopic resection and 7 underwent retroperitoneal surgery. All operations were performed successfully without conversion to open surgery. One patient experienced collecting system injury managed by 3-0 barbed self-retaining suture. The average size of the tumors was (6.9±2.3)cm. The average operation time，blood loss, WIT, and postoperative hospital time were (105.3±19.5)min, (145.8±35.7)ml, (25.6±4.2)min and 5-7 days, respectively. No complications happened in the postoperative period, and there were no local recurrence and distant metastases at a 28.5 month follow-up period. Pre-operative and post-operative serum creatinine(SCr) were (67.6±15.8)μmol/L and (65.4±16.8)μmol/L, indicating no significant renal function drop was found. Similarly, no significant difference was found in terms of preoperative and postoperative diseased renal glomerular filtration rate（GFR）value. The main limitation included the sample size and short follow-up time.ConclusionsThe results of this study supported that laparoscopic resection combined with aspiration was a feasible, safe and effective procedure in the treatment of RAML, especially for the large central RAML which is closely related to the collection system and renal blood vessels.
Dark Stress to Improve Lipid Quantity and Quality in Acid-Tolerant Microalgae Exposed to Simulated (6% CO2) Flue Gas
Authors: Desjardins Sabrina Marie , Laamanen Corey Alfred , Muinonen Sari , Basiliko Nathan , Scott John Ashley
Published: May 2021

The use of CO2 rich industrial flue gases to support cultivation of microalgae to produce lipids for biofuel and other applications is an increasingly researched option. However, this approach presents a challenge, as whilst flue gasses typically contain 6-10% CO2, excessive medium acidification can be caused by the presence of NOx and SO2. The use of acidophilic or acid-tolerant species is a possible solution, but little is known about these microalgae. In this study we investigated the growth of a bioprospected acid-tolerant mixed photosynthetic green microalgae culture (91% dominated by a single Coccomyxa sp. taxon) at pH 2.5 and fed with a simulated flue gas containing 6% CO2 and 94% N2. At the end of the exponential growth phase, lipid accumulation and profiles, and the elemental composition of biomass were analysed over one week during which biomass was exposed to either continued light-dark cycle conditions or continual dark conditions. After three days of dark stress, the biomass consisted of approximately 28% of lipids, which was 42% higher than at the end of the exponential phase and 55% higher than the maximum lipid content achieved under light/dark conditions. Oleic acid (C18:1), pentadecanoic acid (C15:0), and palmitic acid (C16:0) were the dominant fatty acids at the end of the exponential phase, and light-dark and dark-treated biomass, respectively. Dark stress conditions favoured polyunsaturated fatty acid production and showed an increase in nitrogen content. This suggests that the use of dark stress to stimulate production of desirable lipids is a no-cost alternative to other commonly used stressors.
A LASSO Analysis of Maternal, Obstetric, and Perinatal Predictors of Autism
Authors: Ron Michal , Pohl Alexa , Aizenberg Dan , Simantov Tslil , Ruigrok Amber , Smith Paula , Lombardo Michael , Allison Carrie , Eran Alal , Baron-Cohen Simon , Uzefovsky Florina
Published: May 2021

Background. While genetics is clearly implicated in the etiology of autism, other biological factors may also increase the likelihood of an autism diagnosis. Many of these pertain to obstetric history and maternal medical conditions, but as they tend to co-occur it is difficult to ascertain which ones are most predictive of child's autism.Methods. Women reported regarding their medical history and the pregnancy history of their first-born (N=557, 34.5% of children diagnosed with autism) and second-born (N=374, 28.1% of children diagnosed with autism) children. In Study 1, the first-born and second-born data were analyzed separately using LASSO, which enables the selection of variables most associated with child's autism. In Study 2, obstetric course and perinatal factors were compared for siblings discordant for autism (N mothers= 132, 61.7% males), thus allowing to control for many genetic and environmental aspects. Results. Study 1 revealed maternal medical conditions, obstetric course factors, and perinatal factors predictive of child's autism (15 and 20 predictors for the first and second child analyses, respectively). Factors that replicated across the two pregnancies were among others, infertility, vaginal bleeding during pregnancy, and Type II diabetes. Study 2 revealed that maternal vaginal bleeding differentiated the pregnancy course of children later diagnosed with autism from neurotypical children.Limitations. The medical information analyzed in this study is based on participants' recollection. While this approach allows to collect information regarding medical symptoms that may not have been logged in official medical records, participants might have forgotten relevant information. Future studies would benefit from combining self-report and health-provider recorded data. Conclusions. This is one of few studies to analyze a large set of predictors, spanning maternal medical conditions, obstetric course, and perinatal factors. Analyzing these together, using machine-learning methods, allows us to disentangle the specific factors associated with child's autism. Study 2 enabled us to examine this within families, thus passively controlling for genetic and non-specific environmental effects. Our findings highlight the pregnancy course and maternal fertility factors which are of importance for predicting child's autism.
Surgical, Oncological and Obstetric Outcomes After Radical Abdominal Trachelectomy for Early-Stage Cervical Cancer at a Single Tertiary Center.
Authors: Kranawetter Marlene , Grimm Christoph , Obermair Helena M , Paspalj Valentina , Reinthaller Alexander , Langthaler Eva , Polterauer Stephan
Published: May 2021

Purpose

Radical trachelectomy is a viable option to preserve fertility for young patients with early cervical cancer. The aim of this study was to report surgical, oncological and obstetric outcomes of patients treated with radical abdominal trachelectomy at our institution.
Methods

A retrospective chart analysis and telephone survey for all patients with early stage cervical cancer treated with a radical abdominal trachelectomy and pelvic lymphadenectomy between 2007 and 2019 at the Department of Obstetrics and Gynaecology at the Medical University of Vienna, Austria was performed.
Results

Radical abdominal trachelectomy with pelvic lymph-node dissection was attempted for 22 patients. Four cases required conversion to radical hysterectomy due to positive resection margins and two cases required primary chemo-radiotherapy due to positive lymph nodes. Sixteen successfully abdominal radical trachelectomies preserving fertility were performed with two of these patients treated with neo-adjuvant chemotherapy. With a median follow-up time of 21.5 (6.5- 57.25) months, one patient (4.5%) had disease recurrence and subsequently died from cervical cancer. Six patients attempted to conceive, with a resulting four pregnancies with a live birth rate of 75%.
Conclusion

Abdominal radical trachelectomy is a safe procedure for women with early stage cervical cancer who desire fertility preservation. Surgery should be performed at a high volume gynaeco-oncological center.
Nomogram to Predict an Endometrial Thickness >7.5 mm in the Frozen Embryo Transfer Cycle for Thin Endometrial Women
Authors: Guo Zizhen , Chen Wei , Wang Yuqing , Chu Ran , Xu Xinxin , Zhang Lixia , Yan Lei , Ma Jinlong
Published: May 2021

Background A sufficient endometrial thickness (EMT) is essential for successful pregnancy. For patients with a thin endometrium (EMT ≤7.5 mm on human chorionic gonadotropin [HCG] trigger day) in IVF, some studies have suggested freezing all embryos and preparing the endometrium in the subsequent frozen-thawed cycle, but not all patients can obtain a thicker endometrium during endometrial preparation in the frozen embryo transfer cycle than on HCG trigger day in the fresh embryo transfer cycle. This study aimed to investigate which characteristics of patients with a thin endometrium suggest the possibility of EMT >7.5 mm in the subsequent frozen cycle, and build up a prediction nomogram.Methods Data were collected from the university-based reproductive medical center between January 2013 and September 2019. Multivariable logistic regression was used to generate the final prediction model and construct the nomogram. Model performances were quantified by discrimination and calibration.Results The predictive variables that entered the final model were: hysteroscopic adhesiolysis history, PCOS status, application of clomiphene in the ovarian stimulation process, the ovarian stimulation protocol, and the endometrial preparation protocol. The receiver operating characteristic curve for the final model and validation cohort was 0.76 (95% confidence interval [CI]: 0.722–0.797) and 0.71 (95% CI: 0.66–0.76), respectively. Discrimination performed well in both the modeling and validation cohorts.Conclusion We conclude that in women with a thin endometrium (EMT ≤7.5 mm on HCG trigger day), the absence of a hysteroscopic adhesiolysis history, and the presence of PCOS, the application of clomiphene in the ovarian stimulation process, the application of a GnRH agonist short protocol, mild stimulation protocol, natural cycle protocol, and natural cycle for endometrial preparation are prognostic for an increased possibility of EMT >7.5 mm in the subsequent frozen cycle.
Cellulolytic enzymes produced from ramie stalks feedstock and their synergistic effect on sacchariﬁcation of ramie stalks
Authors: Xie Chunliang , Cao Cha , Xu Chao , Gong Wenbing , Zhu Zuohua , Zhou Yingjun , Yan Li , Hu Zhenxiu , Peng Yuande
Published: May 2021

Background: The high cost of cellulase is one of the main obstacles hindering the large-scale biorefining of lignocellulosic biomass. Screening strains with high cellulase producing capability and improving enzymatic hydrolysis technology are important methods to reduce the cost of enzymes. A powerful strategy to lignocellulose as a feedback combined with different enzymes synergism can reduces the time of designing high-efficient enzyme mixtures and significantly improve saccharification of specific substrates.Results: After optimization, the maximum CMCase and FPA produced by Trichoderma reesei reached to 6.06 IU/mL and 0.085 IU/mL, respectively. The hydrolysis capability of Trichoderma reesei was induced at the presence of ramie stalk not wheat bran. Synergistic effect was observed as enzymes produced by Trichoderma reesei and Aspergillus niger were incubated together, and the highest reducing sugars yield was achieved when enzyme cocktail was prepared at the ratio of 1:1. In particular, reducing sugars yield reached to 417 mg/g dry substrate was achieved after hydrolyzing the substrate by prepared enzyme cocktail, which were 1.36 - 3.35 folds higher than different single enzymes.Conclusion: This study indicated that (1) the carbon source exhibited a directional induction effect on the types of cellulolytic enzymes secreted by microorganisms; (2) cellulolytic enzymes from different sources could synergistically strengthen the enzymatic hydrolysis of lignocellulosic materials, providing a clue for the preparation and compounding of cellulolytic enzymes.
Impact of Binary Triage System and Structural Reorganization of Emergency Department on Health Care Worker Exposed to Suspected Covid-19 Patients – A Single Centre Analysis
Authors: Safaai Sufian , Wahab Mahathar Abd , Saiboon Ismail Mohd
Published: May 2021

Background

A binary triage system based on infectivity and facilitated by departmental restructuring was developed to manage suspected COVID-19 patients with an aim to provide effective infection prevention and control among health care workers (HCWs) in the emergency department. This study analyses the effectiveness of the new triage system and structural reorganization in response to the COVID-19 pandemic.
Methods

Cross-sectional observational study conducted in the Emergency and Trauma Department in Kuala Lumpur Hospital (HKL). The implementation of a binary triage system separates patients with risk of COVID-19 who present with fever and respiratory symptoms from other patients. Data on exposed HCW to COVID-19 patients were captured pre-restructuring and post-restructuring of the emergency department and analysed using descriptive statistics.
Results

A total of 846 HCWs were involved in this study. Pre-restructuring reported 542 HCWs exposed to COVID-19 patients while post-restructuring reported 122. Using the four categorical exposure risks for HCWs which are no identifiable risk, low risk, medium risk, and high risk, the number of HCWs exposed during pre-restructuring were 15(1.8%), 504(59.6%), 15(1.8%), and 8(0.9%) respectively while post-restructuring the numbers were 122(14.4%), 8(0.9%), 109(12.9%), and 5(0.1%) respectively. There was a 77.5% reduction in the number of exposed HCW (542 vs 122).
Conclusion

A binary triage system based on severity and infectivity supported with structural reorganization can be effective in reducing HCWs COVID-19 exposure.
Delineation of Neck Node Levels for Patients with Locally Advanced Supraglottic Cancer Receiving Radical IMRT: A Cross-Sectional Study in Mainland China
Authors: Xu Yi , He Meilin , Liu Yang , Yi Jun-Lin , Zhang Ye
Published: May 2021

Background and purpose: In the era of IMRT for locally advanced supraglottic cancer (LA-SGC), the delineation of lymph node clinical target volumes (LN-CTV) remains controversial. We aim to survey the diversity of LN-CTV for LA-SGC patients undergoing radical radiotherapy in mainland China and to provide a basis for improving delineation consistency.Methods: Radiation oncologists from one provincial cancer hospital, one randomly chosen provincial general hospital and one randomly chosen municipal general hospital from each of the 30 provinces of mainland China participated. The study included four representative cases (T2N1, T3N2b, T4N0, T4N2c) of LA-SGC chosen from the following four different groups: non-T4, low nodal burden (T2-3N0-1); non-T4, high nodal burden (T2-3N2-3); T4, low nodal burden (T4N0-1); and T4, high nodal burden (T4N2-3). Respondents were asked which lymph node levels should be included in high-risk (HR) or low-risk (LR) CTV for nodal prophylactic irradiation. The impact of risk factors was also assessed.Results: Altogether, 164 chief or attending physicians completed valid questionnaires from all 82 hospitals in China. The criteria that HR-CTV included the node levels with positive lymph nodes and the next lower adjacent level (83.8%–90% agreement) were followed by most physicians (n=160, 97.6%). In the N0-1 stage (cases 1 and 3), ipsilateral levels II and III selected as HR-CTV and level IV as LR-CTV reached good agreement. Whether contralateral levels II and III should be included in HR- or LR-CTV remained controversial; more respondents were inclined to choose them as HR-CTV in case 3 (61.3%). Some respondents supported including contralateral level IVa in LR-CTV (61.9%-68.1%). In the N2 stage (cases 2 and 4), bilateral levels II–IVb other than HR-CTV regions were all included in LR-CTV was indicated in most respondents (75%–92.5%). Levels Ib and V were more likely included in CTV when there were multiple positive lymph nodes in the ipsilateral neck, and more respondents selected level V as HR-CTV in case 4. Nearly half of respondents selected ipsilateral level VIb as CTV when the subglottic region was involved (50.6%, 46.2% and 56.2% in cases 2 to 4, respectively). Tumours crossing the midline (141, 86%), extracapsular spread (132, 80.5%), T stage (142, 86.5%) and N stage (154, 93.9%) as risk factors influencing nodal level selection were shown to have good agreement (≥80%).Conclusion: Most physicians selected involved nodal levels and lower adjacent levels as HR-CTVs in mainland China. Whether bilateral levels II–IV are included in CTV reached relative consensus but poor agreement for HR- or LR-CTV. The selection conditions of levels Ib, Va/b and VIb as CTVs require further research.
The Challenge of Ovarian Tissue Culture: 2D Versus 3D Culture
Authors: Pais Ana Sofia , Reis Sandra , Laranjo Mafalda , Caramelo Francisco , Silva Fátima , Botelho Maria Filomena , Almeida-Santos Teresa
Published: May 2021

Background

Cryopreservation of ovarian tissue is a powerful technique for preserving female fertility, as it can restore fertility and endocrine function. To increase the longevity of the transplant and decrease the risk of reimplantation of neoplastic cells, several studies have been carried out with the culture of ovarian tissue. The aim of this study was to compare a conventional (2D) culture with an alginate matrix three-dimensional (3D) model for ovarian tissue culture.
Results

The ovarian tissue culture within the alginate matrix (3D) was similar to 2D culture, regarding follicular density, follicular cell proliferation and cell apoptosis in follicles and stroma. Stromal cells proliferation was kept stable in conventional culture but decreased in 3D culture (p = 0.001). At 24 hours of culture, cytotoxicity was lower in the 3D model (p = 0.006). As culture time increased, cytotoxicity seemed to be similar. Degradation of the tissue was suggested by the histological score analysis of tissue morphology during 72 hours of culture. Tissue injury was greater (p = 0.01) in 3D culture due to higher interstitial oedema (p = 0.017) and tissue necrosis (p = 0.035).
Conclusion

According to our results 3D culture of ovarian tissue has no advantage over 2D culture being more time consuming, difficult to perform and having worse reproducibility.
Inflammatory Cytokines are Associated to Lower Glomerular Filtration Rate in Patients with Hypertensive Emergency
Authors: de Andrade Days Oliveira , Aguiar Franciana Luísa , Mansor Ana Luiza Possebon , Valente Flavia Mariana , Souza Doroteia Rossi Silva , Lopes Valquiria da Silva , Fernandes Leticia Baruffi , de Godoy Moacir Fernandes , Yugar-Toledo Juan Carlos , Cosenso-Martin Luciana Neves , Vilela-Martin Jose Fernando
Published: May 2021

Introduction: Hypertension and kidney function are closely related. However, there are few studies on renal function during acute elevation of blood pressure (BP), denominated hypertensive crisis (HC). Objectives: To evaluate the relationship between renal function and inflammatory cytokines in HC, subdivided into hypertensive urgency (HUrg) and emergency (HEmerg). Methods: 74 normotensive subjects (NT), 74 controlled hypertensive (ContrHT), 50 patients with HUrg and 78 with HEmerg were studied. The glomerular filtration rate (eGFR) was estimated, and cytokine levels were measured. Statistical analysis was performed using the Kruskal-Wallis or Mann-Whitney test and Spearman's correlation, with significant differences p-value <0.05. Results: The eGFR was significantly lower in HEmerg group compared to the NT, ContrHT and HUrg groups. All cytokines were significantly elevated in patients with HC compared to the control groups (NT and ContrHT). In addition, the cytokines interleukin (IL)-1β, IL-6 and IL-10 were higher in the HEmerg group compared to the HUrg groups. There was a negative correlation between eGFR and the cytokines (IL-6, IL-8, IL-10 and TNF-α) in the HEmerg group. Conclusions: Elevated inflammatory cytokines are associated with reduced eGFR in individuals with HEmerg, indicating an involvement of the inflammatory process in the pathogenesis of acute elevations of BP.
Impact of simulation-based education on the performance assessment, knowledge retention and mentality of nursing students: A systematic reviews and meta-analysis
Authors: Xu Yun , Xu Yue , Wang Qing , Du Shizheng , Jiang Xing , Xu Guihua
Published: May 2021

Background: Simulation-based education is a new type of teaching method that is suitable for clinic-related majors. This article aims to determine its impact on clinical skill assessment, performance maintenance, and mentality of nursing students.Methods: After searching PubMed, Embase, Web of Science, The Cochrane Library, MEDLINE, and EBSCO database, we conducted a systematic collection of randomized controlled trials (RCTs) on the impact of simulation-based education on performance evaluation and mentality of nursing students. The retrieval time limit was from the establishment of the database to March 12, 2021. Meta-analysis was performed using RevMan5.4 software, and two researchers used ROB2.0 software to evaluate the risk of bias in the included literature. The quality evaluation of the outcome indicators was performed using GRADEpro. A standardized mean difference (SMD) with a 95% confidence interval (CI) was used in estimating the pooled effects of RCTs. Results: A total of 21 RCTs were performed, including 1683 nursing students. The results of meta-analysis showed that simulation-based education significantly improved the assessment scores of nursing students (SMD = 1.46, 95% CI = 1.02 to 1.90, P < 0.00001), self-confidence (SMD = 1.19, 95% CI = 0.48 to 1.90, P = 0.001), satisfaction (SMD = 0.86, 95% CI = 0.13 to 1.60, P = 0.02), and knowledge retention (SMD = 1.89, 95% CI = 0.76 to 2.87, P = 0.0008), and the difference was statistically significant. The results of subgroup analysis showed that long-term intervention (MD = 1.44, 95% CI = 0.62, 2.26, P = 0.0006) and short-term intervention (MD = 1.46, 95% CI = 0.95, 1.97, P < 0.00001) improved the performance assessment of nursing students, and the difference was statistically significant.Conclusions: Simulation-based education can significantly improve the assessment scores, self-confidence, and satisfaction of the nursing students, and the scores can be effectively retained for a period of time. Limited by the quality of the number of included studies, the above conclusions need to be verified by high-quality studies.
Effects of (Combined) Chinese Medicine on the Risk of Death From COVID-19: A Retrospective Data Analysis Based on 4567 Patients
Authors: Wang Qian , Liu Yuntao , Weng Heng , Yang Yuqi , Li Jun , Zeng Jing , Wang Jinzhong , Peng Zhe , Liangsheng Sun , Pan Zongqi , Yan Fang , Zhou Yuanshen , Ding Banghan , He Zehui , Tao Lanting , Huang Donghui , Liu Yuxiang , Chen Yahui , Zhu Wei , Li Kun , Zou Xu , Zhang Zhongde
Published: May 2021

Background

The coronavirus disease 2019 (COVID-19) epidemic is still ongoing, but the optimal treatment remains unclear. China adopted a series of measures, including widespread screening, strict quarantine and early treatment, combining western medicine with Chinese medicine, leading to rapid control of its spread. Nevertheless, the effects of ( combined ) Chinese medicine in reducing the toll of COVID-19 lack proof from statistics.
Objective

We conducted a retrospective data analysis to determine whether ( combined ) Chinese medicine is able to affect patient outcomes and to decrease the risk of death in COVID-19 patients.
Methods

The data were acquired by outputting the formatting information from the HIS system and then extracting and recording it in the database for complete cases. The demographics, disease onset, treatment, survival/death and all of the clinical classifications, groups and definitions were verified by specialists in the clinic, along with the research methodology and statistics, before conducting the statistical analysis. The characteristics of the cohort and the clinical symptoms and signs, prescriptions and outcomes were described and analyzed by the mean ± SD, median, interquartile range and composition ratio. Analysis of variance was used for comparisons between the measurement data sets; otherwise, the rank sum test was used. Counting data were compared between groups using the chi square test and Fisher’s exact test. Tendency matching was adopted to make the general data balance between groups. A Cox proportional hazard model was used to compare the risk of death among the different groups.
Results

Four centers were included in our study, and a total of 6,076 patients' clinical records were obtained after combining the data. We included 4567 cases for the descriptive statistics, and the crude case fatality rate was 3.0%. Compared with using only western medicine, (combined) Chinese medicine reduced the risk of death from COVID-19 after adjusting for other prognostic risk factors (HR = 0.135, 95% CI (0.088, 0.208)). Multivariate Cox regression also indicated that when applying the clinical classification of severe/critical, age ≥ 65 years old, coronary heart disease or chronic kidney disease and a time from onset to hospital admission of fewer than 14 days, all of these factors increased the risk of death.
Conclusion

(Combined) Chinese medicine can significantly reduce the risk of death from COVID-19, but the specific strategy/solution, effects and amount need further exploration in future studies.
Functionally significant polymorphisms of the MMP-9 gene are associated with peptic ulcer disease in the Caucasian population of Central Russia
Authors: Minyaylo Oksana , Ponomarenko Irina , Reshetnikov Evgeny , Dvornyk Volodymyr , Churnosov Mikhail
Published: May 2021

This study analyzed the association of functionally significant SNPs of matrix metalloproteinase (MMP) genes in the development of peptic ulcer disease (PUD) in Caucasians from Central Russia. Ten SNPs of the MMP-1, MMP-2, MMP-3, MMP-8, and MMP-9 genes were analyzed for association with PUD in a cohort of 798 patients with PUD (including 404 H. pylori-positive and 394 H. pylori-negative) and 347 H. pylori-negative controls using logistic regression and assuming the additive, recessive, and dominant genetic models. Allele G of the rs17576 MMP9 locus conferred a higher risk for PUD (ORadj = 1.31, pperm=0.016), haplotype AACG of loci rs17576-rs3787268-rs2250889-rs17577 of the MMP9 gene decreased risk for PUD (ORadj=0.17, pperm=0.003). Also, allele C of rs3918249, allele G of rs17576 and haplotype CG of rs3918249-rs17576 of the MMP9 gene increased risk for H. pylori-positive PUD (ORadj = 1.82, pperm=0.002; ORadj = 1.53–1.95 pperm=0.001–0.013 and ORadj = 1.49 pperm=0.009 respectively). The above loci and 50 linked to them possess significant regulatory effects and may affect the alternative splicing of four genes and the expression of 17 genes in various organs and tissues related to the PUD pathogenesis.
WITHDRAWN: Inhibitory Effect of ZnO-NPs and NF-CS-ZnO Nano-Hybrid Against Herpes Simplex Virus Type 1 Infection
Authors: Abbasi Mahya , Arab-Bafrani Zahra , Zabihi Erfan , Arabzadeh Ali Mohammad , Babaei Amir , Sedaghat Mohsen , Mousavi Elham
Published: May 2021

Background: Since the viruses are intracellular parasite and their replication depends on the host cells, to develop a medication against the viral infections, some substances should be provided having no damage on the host’s cells and tissue. Although the antiviral effects of zinc ion against the viral pathogens has been conspicuous, undesirably it shows a severe toxicity on the cells in cell culture and host tissues in animal models. Methods: To optimize, zinc oxide nanoparticles with antiviral property at the lowest cell toxicity, nano-fibrillar chitosan-ZnO nano-hybrid was synthesized and then, its inhibitory effect against the HSV replication was investigated in comparison to ZnO nanoparticles using plaque reduction and Real time PCR method. Results: Although the infectivity of HSV-1 was reduced in initial steps of virus entry, the significant reduction of viral titer was observed in post exposure of Nano particles on HSV-1 infected cells. In contrary, no changes of viral load were identified in pre-incubation experiment, co-incubation of virus and nanoparticles prior to virus inoculation. Conclusion: Nano-fibrillar CS could dramatically decrease the cell cytotoxicity of ZnO, even though the antiviral effect of ZnO nanoparticles did not change. Nano hybrids appears to penetrate into the host cells and intracellularly inhibits the virus multiplication.
An Empirical Analysis of the Stay-at-Home Behaviors During COVID-19 Pandemic of China
Authors: Liu Chao , Gao Weijun , Sun Limei , Jing Xiaotong , Tang Yuanze , Li Zhengru , Cai Gangwei , Wang Yan
Published: May 2021

Background

The spread of the Coronavirus Disease 2019(COVID-19) pandemic has a great impact on people's life, study, and work. People must stay at home and cannot go out for a long time, especially when the number of infected people increases rapidly. In order to explore the changes in the behavior of people at home during the COVID-19 pandemic in March, 2020, a national survey in China was conducted on people’s anxiety, sleep quality, study/work status, daily activities and family communication with the window opening and overlooking behavior.
Methods

The survey was carried out by online questionnaires of SMS service. A total of 3401 valid questionnaires were received. Chi-square analysis was used to establish the relationship model of the human behavior and activities during the stay-home of the COVID-19 pandemic.
Results

The survey results showed that due to the influence of the COVID-19, more than 74.92% participants had anxiety. Compared with the pre-outbreak period, the sleep quality of people become worse. There was a tendency for people to study/work less, exercise less, play more game, and watch the TV. On the other hand, the family communication has been increased, and people have tried to open windows and look outside through windows to alleviate the human anxiety.
Conclusions

This paper has revealed COVID-19 has had a great impact on people's behavior in all sorts of ways. The response of people affected by the pandemic should be constantly identified and monitored, to assist policy formulation for future short-term or long-term pandemic.
Olfactory Dysfunction in Alzheimer’s Disease: The Clinical Characteristics and Cortical Thickness Alterations
Authors: Yu Shu-yang , Zhu Wan-lin , Lian Teng-hong , Li Shao-wu , Liu Ya-ou , Guo Peng , Ding Du-yu , Li Dan-ning , Li Li-xia , Zhao Hui , Liu Li , Zuo Li-jun , Hu Yang , Yu Qiu-jin , Jin Zhao , Wang Rui-dan , Gao Jun-hua , Zhu Rong-yan , Wang Xiao-min , Zhang Wei
Published: May 2021

Background Olfactory dysfunction (OD) is reported as a useful predictor for Alzheimer’s disease (AD). There are three sub-domains of olfaction: olfactory threshold, discrimination and identification. In AD patients, whether the performance of three sub-domains has different influential factors or relates to specific brain magnetic resonance imaging (MRI) change is not clear. Methods We recruited 105 typical AD patients, assessed patients’ cognitive function, neuropsychiatric symptoms and activity of daily living by related scales, evaluated patients’ olfactory function by Sniffin’ Sticks test and measured patients’ cortical thicknesses by MRI. Results Olfactory threshold negatively correlated with AD patients’ age and positively related to cognitive function; olfactory discrimination positively related to patients’ cognitive function and cortical thickness of left lateral orbitofrontal gyrus; olfactory identification positively related to patients’ cognitive function and cortical thicknesses of left medial orbitofrontal gyrus, left middle temporal gyrus and bilateral superior temporal gyrus. Conclusions The three sub-domains of olfaction in AD patients have different influential factors: age influences olfactory threshold and cognitive function influences all three olfactory sub-domains. The performance of olfactory discrimination and identification in AD patients was associated with the cortical thickness of orbitofrontal gyrus and temporal lobe.
Inhibitors of PD-1/PD-L1 and ERK1/2 impede the proliferation of receptor positive and triple negative breast cancer cell lines
Authors: Bräutigam Karen , Kabore-Wolff Elodie , Hussain Ahmad Fawzi , Polack Stephan , Rody Achim , Hanker Lars , Köster Frank
Published: May 2021

Purpose: Triple negative breast cancer (TNBC) is characterized by an unfavorable prognosis and missing systemic therapeutic approaches beside chemotherapy. Targeting the immune checkpoint PD-1/PD-L1 showed promising results in breast cancer and especially in TNBC. The extracellular signal-regulated kinase 1/2 (ERK1/2) is an important driver of carcinogenesis. Here, the effect of combined PD-1/PD-L1 and ERK1/2 inhibitor treatment is investigated of cell growth and intracellular impact of breast cancer cell lines.Methods: The IC50 values of each inhibitor and the effect of combined treatment were determined in three TNBC cell lines of different subtypes and one non-TNBC cell line. Phospho-specific antibodies were used in western blot analyses to investigate an effect on ERK1/2 activation. Expression of immune modulatory and cell cycle associated genes were examined by quantitative reverse transcription PCR.Results: Both inhibitors PD-1/PD-L1 and ERK1/2 impeded the proliferation of TNBC to a higher extent than of non-TNBC. By combined treatment cell lines were inhibited either synergistically or additively. ERK1/2 and S6 phosphorylation were reduced and expression of c-Fos and FosL were diminished after ERK1/2 inhibitor as single and combined treatment. Between genes involved in immune modulation, IL-8 was upregulated in TNBC cells after combined treatment.Conclusion: In conclusion, combination of PD-1/PD-L1 and ERK1/2 inhibitors showed favorable effects for a new therapy strategy, with better results in TNBC cell lines than in non-TNBC. The effects have to be validated in models that can reflect the interaction between immune and tumor cells like the situation in the tumor micro environment.
High-flow nasal cannula therapy for hypoxemic respiratory failure in patients with COVID-19
Authors: Chavarria Adrian Palacios , Lezama Erika Salinas , Navarro Mauricio Gonzalez , Vazquez Rafael Ricardo Valdez , Bello Héctor Herrera , Gascon Julieta Lomelín , Juárez Linda Morales , Avendaño Mónica Arboleya , Gonzalez Luis Esteban Ramirez , Benavides Rodrigo Ville , Wyssmann Renate Victoria Álvarez , Ortiz Brenda Sandoval , Cerda Mariana Lizbeth Rodríguez de la , Castañeda Lidia Moreno , Martinez-Juarez Luis Alberto , Gallardo-Rincón Héctor , Tapia-Conyer Roberto
Published: May 2021

Purpose

High-flow nasal cannula (HFNC) therapy in patients with hypoxemic respiratory failure due to COVID-19 is poorly understood and remains controversial.
Methods

We designed a prospective observational study of a large cohort of patients with COVID-19-related hypoxaemic respiratory failure at the Temporary COVID-19 Hospital in Mexico City. The primary outcome was the success rate of HFNC to prevent the progression to invasive mechanical ventilation (IMV). We also evaluated the risk factors associated with HFNC success or failure.
Results

This study included 378 patients who were admitted to the Temporary COVID-19 Hospital with a confirmed diagnosis of COVID-19 and hypoxemic respiratory failure. HFNC therapy effectively prevented IMV in 71.4% of patients (n = 270; 95% confidence interval [CI] 66.6–75.8%). Factors that were significantly different between patients who were only treated with HFNC therapy and those who progressed to IMV included age, the presence of hypertension, and the Charlson comorbidity index. Predictors of therapy failure included the CALL score at admission (adjusted hazard ratio [HR] 1.27; 95% CI 1.09–1.47; p < 0.01), Rox index at 1 hour (adjusted HR 0.82; 95% CI 0.7–0.96; p = 0.02), and no prior treatment with steroids (adjusted HR 0.34; 95% CI 0.19–0.62; p < 0.0001). Overall, therapy was significantly associated with a lower intensive care unit admission rate (7.0% vs 96.3%) and length of hospital stay (15.0 vs 26.5 days).
Conclusions

Treating patients with HFNC therapy at admission was effective and prevented the worsening of symptoms in some patients with COVID-19.
Change in Levothyroxine Requirements After Bariatric Surgery in Patients With Hypothyroidism.
Authors: García-Moreno Rosa María , Blanco Ana Isabel Cos , Viñuela Isabel Calvo , Larrauri Miriam Zapatero , Morena Lucrecia Herranz de la
Published: May 2021

PurposeThis study aims to evaluate the need to modify the levothyroxine dose after surgery. Additional goals are to estimate the increase or decrease of total dose and weight-adjusted dose, assess the influence of weight loss on the levothyroxine requirements, and identify predictors.Material and methodsRetrospective study in patients with treated hypothyroidism that underwent bariatric surgery. The required levothyroxine dose was evaluated before the surgery and at 6, 12, and 24 months post-surgery. Dose modification during follow-up and its association with weight loss and other potential predictors were assessed. ResultsOf the 63 patients included, 82.54% needed an adjustment of dose during the follow-up. The total dose of levothyroxine decreased significantly at 6 months post-surgery (-49.1 µg/week; 95%CI= -93.7 to -4.5; p=0.031) and 12 months (-54.9 µg/week; 95%CI= -102 to -7.8; p=0.022), with no significant change at 24 months (p=0.114). The weight-adjusted dose increased at 6 months (1.37 µg/kg/week; 95%CI=0.91 to 1.83; p<0.001), 12 months (2.05 µg/kg/week; 95%CI=1.43 to 2.67; p<0.001), and 24 months (2.52 µg/kg/week; 95%CI=1.74 to 3.30; p<0.001). Weight loss showed significant association with weight-adjusted dose (OR=1.07; 95%CI=1.02 to 1.12; p=0.004) and did not with the total dose (p=0.320).Conclusions﻿It is expected that the levothyroxine requirements change in the firsts years after bariatric surgery. This study shows a significant decrease in the total dose during the first year of follow-up and an increase in the weight-adjusted dose over the two first years. No predictors for the modification in the total dose of levothyroxine have been identified.
Malaria Prevalence and Performance of Diagnostic Tests Among Hospitalized Fever Patients in Zanzibar
Authors: Onken Annette , Haanshuus Christel Gill , Miraji Mohammed , Marijani Msafiri , Kibwana Kibwana Omar , Abeid Khamis Ali , Mørch Kristine , Reimers Marianne , Langeland Nina , Müller Fredrik , Jenum Pål Arne , Blomberg Bjørn
Published: May 2021

Background: Control efforts in Zanzibar reduced the burden of malaria substantially from 2000 to 2015, but re-emergence of falciparum malaria has been observed the last years. This study evaluated the prevalence of malaria and performance of routine diagnostic tests among hospitalized fever patients in a 1.5 years period in 2015 and 2016. Methods: From March 2015 to October 2016, pediatric and adult patients hospitalized with acute undifferentiated fever at Mnazi Mmoja Hospital, Zanzibar were included. The malaria prevalence was assessed by polymerase chain reaction (PCR), rapid diagnostic test (RDT) and routine microscopy. Results: Malaria prevalence was 8% (67/820). All cases identified by PCR had Plasmodium falciparum infection, except for one P. ovale. Compared to PCR, the RDT had sensitivity of 64% (36/56), specificity 98% (561/575), positive predictive value (PPV) 72% (36/50) and negative predictive value (NPV) 97% (561/581). Microscopy had a sensitivity of 50% (18/36), specificity 99% (251/254), PPV 86% (18/21) and NPV 93% (251/269) compared to PCR. Conclusions: A high malaria prevalence was identified compared to previous studies in Zanzibar. Microscopy showed higher PPV than RDT in this study. Both RDT and microscopy had low sensitivity compared to PCR. However, low parasitemia identified only by PCR in a semi-immune individual could be coincidental and may not be the cause of the presenting symptoms. To achieve malaria elimination in Zanzibar, PCR-based surveillance is suitable to guide control and elimination efforts.
The Impact of Cervical Conization Size Followed by Cervical Length Changes on Preterm Birth Rates in Asymptomatic Singleton Pregnancies
Authors: Firichenko Sergei V. , Stark Michael , Mynbaev Ospan A.
Published: May 2021

The study aimed to explore the impact of the cervical conization size (CCS) followed by cervical length (CL) changes on preterm birth (PTB) rates in asymptomatic singleton pregnancies compared to pregnancy outcomes (POs) in women with an intact cervix, and to estimate the PTB prevention efficiency in patients with a short cervix (vaginal progesterone alone group (PAG) vs. progesterone-pessary group (PPG)). POs in populations with similar age, ethnicity, residency, education, and harmful habits who underwent cervical conization compared to the women with an intact cervix, and sub-populations with the sufficient CL vs. short cervix, and the PTB prevention efficiency of PAG and PPG were retrospectively analyzed. PTB risks depend on the CCS which is the key point, further, during pregnancy, the larger CCS is associated with the short cervix, and higher PTB risks, notably increased among nulliparous women, and the smaller CCS followed by the sufficient CL and lower PTB risks predominantly observed in women with the prior parity. The USCL assessment is the PTB risk predicting tool, and it can be supplemented with the CCS to increase its diagnostic value. There was no substantial impact on the POs associated with the PTB prevention modes, whereas, the CL changes during pregnancy depending on the CCS is more critical in POs.
Fatal Nodular Regenerating Hyperplasia Rupture in a Common-Variable-Immunodeficiency Patient With TACI Mutation
Authors: Sompornrattanaphan Mongkhon , Tongdee Ranista , Wongsa Chamard , Jitmuang Anupop , Thongngarm Torpong
Published: May 2021

BackgroundNodular regenerating hyperplasia (NRH) is considered the most common liver involvement in common variable immunodeficiency (CVID). Most patients are asymptomatic with gradually increasing alkaline phosphatase (ALP) and mildly elevated transaminase enzymes over years. We report the first case of fatal NRH rupture complication in a CVID patient.Case presentationA 24-year-old man was diagnosed CVID at the age of 1.25 years. Genetic testing revealed a transmembrane activator and calcium-modulator and cyclophilin-ligand interactor (TACI) mutation. He had been receiving intravenous immunoglobulin (IVIg) replacement therapy ever since then. The trough level of serum IgG ranged between 750-1200 mg/dL. However, he still had occasional episodes of lower respiratory tract infection until bronchiectasis developed. At 22 years old, computed tomograph (CT) chest and abdomen as an investigation for lung infection revealed incidental findings of numerous nodular arterial-enhancing lesions in the liver and mild splenomegaly suggestive of NRH with portal hypertension. Seven months later, he developed sudden hypotension and tense bloody ascites. Emergency CT angiography of the abdomen showed NRH with intrahepatic hemorrhage and hemoperitoneum. Despite successful gel foam embolization, the patient died from prolonged shock and multiple organ failure. ConclusionsAlthough CVID patients with NRH are generally asymptomatic, late complication including portal hypertension, hepatic failure, and hepatic rupture could occur. Therefore, an evaluation of liver function should be included in the regular follow-up of CVID patients.
A Novel Loss-of-function Pathogenic Missense Mutation in CASK Gene Causes Mental Retardation and Microcephaly with Pontine and Cerebellar Hypoplasia
Authors: Wu Sixian , Jiang Chuan , Li Jiaman , Zhang Guohui , Shen Ying , Wang Jing
Published: May 2021

Background: Mutations in the CASK gene result in a wide range of observed phenotypes in humans like FG Syndrome 4 and mental retardation. In this study, researchers investigated the case of an 11-month-old female diagnosed with mental retardation and microcephaly with pontine and cerebellar hypoplasia (MICPCH). These issues caused general developmental delays, microcephaly, and cerebellar hypoplasia. Results: Whole-exome sequencing (WES) was used to identify a novel pathogenic missense mutation (NM_003688.3: c.638T>G) in the CASK gene in this index. Researchers further confirmed the pathogenicity of the missense mutation by bioinformatics analysis. At the same time, researchers tested its protein expression level and mRNA expression level. Strikingly, the protein expression was down-regulation while the mRNA expression was not changed. By using protein structure prediction, this study found that amino acid mutation resulted in further changes in the stability of protein structures, which caused down-regulation of the protein expression and loss of the protein function. Conclusions: In this study, researchers first reported a novel causative mechanism of MICPCH: amino acid mutations led to changes in protein structure and down-regulation of stability, which caused protein was loss of function. This study can be helpful in the genetic diagnosis of this disease.