bluuebunny/crossref_metadata_2025 huggingface dataset:
Longitudinal Assessment of Balance Using Virtual Reality in Patients Receiving Potentially Neurotoxic Adjuvant Chemotherapy
Authors: Teng Christina , Chiarovano Elodie , Tighe David Gregory , Bui Kim Tam , Venkatesha Venkatesha , Blinman Prunella L , Macdougall Hamish Gavin , Vardy Janette L
Published: October 2021

PurposeChemotherapy-induced peripheral neuropathy (CIPN) commonly affects people treated for cancer, with functional consequences of impaired balance and falls. Virtual reality technology (VR) may be able to assess balance, identifying patients at increased risk of falls. We aimed to assess the impact of neurotoxic chemotherapy on balance and falls risk using VR, and explore whether changes in balance threshold were associated with falls or validated CIPN measures. MethodsWe conducted a prospective, longitudinal cohort study at two Australian oncology centres. Eligible participants were commencing adjuvant chemotherapy containing a taxane for breast cancer, or oxaliplatin for colon cancer. Excluded: insufficient English to complete assessments, VR intolerance, or pre-existing balance disorder. VR balance threshold was recorded at baseline, intervals during chemotherapy, and 3- and 6-months after chemotherapy completion. Additional measures: 1) clinician-graded peripheral sensory neuropathy (Common Terminology Criteria for Adverse Events), 2) Total Neuropathy Score-clinical, 3) patient-reported neuropathy, 4) ‘Timed Up-and-Go’ test, 5) participant-reported falls/near-falls. ResultsOf 34 participants consented, 24 (71%) had breast cancer and 10 (29%) had colon cancer. Compared to baseline, balance threshold worsened in 10/28 (36%) evaluable participants assessed at the end-of-chemotherapy; this persisted in 7/22 (32%) at 6 months. CIPN affected 86% at end of chemotherapy, and 73% at 6-months post-chemotherapy . Falls/near-falls were reported by 12/34 (35%), and associated with impaired balance (p = 0.002). ConclusionVR balance assessment warrants further investigation as a surrogate method to objectively identify patients at risk of falls from CIPN, however was no better at diagnosing CIPN than existing tools. Trial Registration: N/A
Psychological and Emotional Impact Of COVID-19 Pandemic on People Living with Chronic Disease: HIV and Cancer
Authors: Focà Emanuele , Fornari Chiara , Arsuffi Stefania , Vetrano Maria Chiara , Calza Stefano , Renzetti Stefano , Copeta Silvia , Berruti Alfredo , Castelli Francesco , Compostella Silvia , Quiros-Roldan Eugenia
Published: October 2021

People living with chronic disease (PLWCD) are the frailest category, both for the risk of severe COVID-19 illness and for the impact on the care continuum. Aim of this study was to analyze coping strategies and resilience in people living with HIV (PLWH) compared to people living with oncological diseases (PLWOD) during COVID-19 pandemic. We administrated an anonymous questionnaire, which explored the emotional experience, the demographic factors linked to a COVID-19-related stress syndrome, the patient’s perception about the adequacy of clinical undertaking from the hospital and the resilience. We analyzed 324 questionnaires. There were no significant differences in prevalence of psychological distress among the whole cohort; however, PLWOD were calmer, less troubled, and more serene than PLWH. Moreover, PLWH smoked more, ate more and gained more weight than PLWOD. Most patients didn’t feel lonely and continued to take pleasure from their activities. No differences in resilience were found between the groups. In the whole cohort lower levels of resilience were found in patients that were unemployed, with history of psychological disorders and in those who experienced more feelings of anger, anxiety and concern. PLWCD had high level of resilience, preserved their well-being, and activated adaptive coping during the pandemic.
Biochemical Profile of Human Infant Cerebrospinal Fluid in Intraventricular Hemorrhage and Post-hemorrhagic Hydrocephalus of Prematurity
Authors: Otun Ayodamola , Morales Diego , Garcia-Bonilla Maria , Goldberg Seth , Castaneyra-Ruiz Leandro , Yan Yan , Isaacs Albert , Strahle Jennifer M. , McAllister James P. , Limbrick David D.
Published: October 2021

BACKGROUND
Intraventricular hemorrhage (IVH) and post-hemorrhagic hydrocephalus (PHH) have complex pathophysiology involving inflammatory response, ventricular zone and cell-cell junction disruption, and choroid-plexus (ChP) hypersecretion. Increased cerebrospinal fluid (CSF) cytokines, extracellular matrix proteins, and blood metabolites have been noted in IVH/PHH, but osmolality and electrolyte disturbances have not been evaluated in human infants with these conditions. We hypothesized that CSF total protein, osmolality, electrolytes, and immune cells increase in PHH.
METHODS
CSF samples were obtained from lumbar punctures in control infants and infants with IVH prior to development of PHH and any neurosurgical intervention. Osmolality, total protein, and electrolytes were measured in 52 infants (18 controls, 10 low grade (LG) IVH, 13 high grade (HG) IVH, and 11 PHH). Serum electrolyte concentrations, and CSF and serum cell counts within 1-day of clinical sampling were obtained from clinical charts. Dunn or Tukey’s post-test ANOVA analysis were used for pair-wise comparisons.
RESULTS
CSF osmolality, sodium, potassium, and chloride were elevated in PHH compared to control (p=0.012 - <0.0001), LGIVH (p=0.023 - <0.0001), and HGIVH (p=0.015 - 0.0003), while magnesium and calcium levels were higher compared to control (p=0.031) and LGIVH (p=0.041). CSF total protein was higher in both HGIVH and PHH compared to control (p=0.0009 and 0.0006 respectively) and LGIVH (p=0.034 and 0.028 respectively). These differences were not reflected in serum electrolyte concentrations nor calculated osmolality across the groups. However, quantitatively, CSF sodium and chloride contributed 86% of CSF osmolality change between control and PHH; and CSF osmolality positively correlated with CSF sodium (r,p=0.55,0.0015), potassium (r,p=0.51,0.0041), chloride (r,p=0.60,0.0004), but not total protein across the entire patient cohort. CSF total cells (p=0.012), total nucleated cells (p=0.0005), and percent monocyte (p=0.016) were elevated in PHH compared to control. Serum white blood cell count increased in PHH compared to control (p=0.042) but there were no differences in serum cell differential across groups. CSF total nucleated cells also positively correlated with CSF osmolality, sodium, potassium, and total protein (p=0.025-0.0008) in the whole cohort.
CONCLUSIONS
CSF osmolality increased in PHH, largely driven by electrolyte changes rather than protein levels. However, serum electrolytes levels were unchanged across groups. CSF osmolality and electrolyte changes were correlated with CSF total nucleated cells which were also increased in PHH, further suggesting PHH is a neuro-inflammatory condition.
Risk Prediction Model of Postoperative Venous Thrombosis of Ovarian Cancer
Authors: Wang Xue , Wang Xiao-hui
Published: October 2021

Objective

To investigate the influencing factors of venous thromboembolism (VTE) after ovarian cancer surgery, and construct its prediction model.
Methods

A total of 67 patients with ovarian cancer who developed VTE after surgery were selected from October 2008 to June 2020 in the Department of Obstetrics and Gynecology, First Hospital of Lanzhou University, and conducted a retrospective study with 100 patients without VTE after the operation who were confirmed by imaging during the same period. The clinical data of two groups of patients were analyzed and compared, and the risk prediction model was established. The ROC curve was drawn to evaluate the prediction effect of the model.
Results

Univariate analysis showed that there were statistically significant differences in age, menopausal status, hypertension, neoadjuvant chemotherapy, FIGO staging, lymph node metastasis, operation time, preoperative plasma FIB and D-dimer between the thrombosis group and the non-thrombosis group;The results of multivariate analysis showed that old age, neoadjuvant chemotherapy, late FIGO staging, high levels of plasma FIB and D-dimer before surgery are independent risk factors for VTE after ovarian cancer surgery. Construct a prediction model based on the results of multivariate regression analysis: Logit(P) = 0.053 × age + 0.917 × neoadjuvant chemotherapy + 0.956 × tumor FIGO staging + 0.398 × preoperative plasma FIB + 0.531 × preoperative D-dimer -7.679 ( Neoadjuvant chemotherapy, yes=1, no=0; tumor FIGO stage Ⅰ+Ⅱ=1, Ⅲ+Ⅳ=2; age, preoperative plasma FIB and D-dimer are actual values). The ROC curve analysis shows that the AUC value of the model is 0.773, the sensitivity is 74.6%, the specificity is 71.0%, and the total prediction accuracy rate is (78+39)/167=0.701.
Conclusions

Age, neoadjuvant chemotherapy, tumor FIGO staging, preoperative plasma FIB and D-dimer can be used as reliable indicators to predict the occurrence of postoperative VTE in patients with ovarian cancer. The constructed prediction model has good risk prediction ability, It has certain clinical application value.
The Impact of Face Shields on the Quality of Colonoscopy During the COVID-19 Pandemic
Authors: Lee Jong Yoon , Kang Yeo Wool , Lee Jong Hoon
Published: October 2021

Background: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Healthcare workers are at a higher risk for exposure to COVID-19 infection than the general population. During the COVID-19 pandemic, endoscopists are recommended to wear personal protective equipment (PPE), including face shields, to prevent COVID-19 transmission. However, to the best of our knowledge, there are no reports on the impact of face shields on the quality of colonoscopy. This study aimed to determine whether the use of PPE, including face shields, affects the quality of colonoscopy during the COVID-19 pandemic.Methods: We retrospectively reviewed the medical records of patients who underwent screening or surveillance colonoscopy performed at Dong-A University Hospital between June 2020 and March 2021 during the COVID-19 pandemic. Endoscopists wore isolation gowns, disposable gloves, and KF94 masks from June 2020 to October 2020. From November 2020, endoscopists additionally wore face shields. Therefore, we compared the colonoscopy quality indicators during the 5 months without the use of face shields and the 5 months with the use of face shields. We calculated the overall adenoma detection rates (ADRs) of the group using face shields and the group not using face shields. Further, the polyp detection rate (PDR), sessile serrated lesion detection rate (SSLDR), advanced neoplasia detection rate (ANDR), polyp per colonoscopy, and adenoma per colonoscopy were calculated for each group.Results: In total, 1,359 patients were included in the study; the face shield and non-face shield groups comprised 679 and 680 patients, respectively. We found no statistically significant differences in the PDR (49.04 vs. 52.50%, p=0.202), ADR (38.59 vs. 38.97%, p=0.884) SSPDR (1.91 vs. 1.32%, p=0.388), and ANDR (3.98 vs. 3.97%, p=0.991) between the groups. In both the experienced endoscopist group and trainee endoscopist group, there was no difference in the colonoscopy quality indicators between the groups of patients examined by endoscopists with and without face shields.Conclusions: The quality indicators of colonoscopy were not affected by face shields during the COVID-19 pandemic.
The Study on the Regulation of Th Cells by MSCs Through the JAK-STAT Signaling Pathway to Protect Naturally Aged Sepsis Model Rats
Authors: Wang Lu , Deng Zihui , Sun Yan , Zhao Yan , Li Yun , Yang Mengmeng , Yuan Rui , Liu Yuyan , Qian Zhirong , Zhou Feihu , Kang Hongjun
Published: October 2021

Background: Sepsis is the leading cause of death among patients, especially elderly patients, in intensive care units worldwide. However, there is no effective treatment for sepsis in the aging population. Therefore, we designed such a study to confirm the protective effect of MSCs against sepsis in the elderly and to explore its mechanisms.Methods: In this study, we established a sepsis model using naturally aged SD rats and injected 5×106 umbilical cord-derived MSCs via the tail vein. Each group of rats was analyzed for survival, examined for biochemical parameters, stained for organ histology, and analyzed for the Th cell subpopulation ratio and inflammatory cytokine levels by flow cytometry. Western blotting was performed to detect the activity of the JAK-STAT signaling pathway. We designed in vitro experiments to confirm the regulatory role of MSCs, and verified the possible mechanism using JAK/STAT inhibitors. Results: The results revealed that the 72 h survival rate of sepsis rats treated with MSCs was significantly increased, organ damage and inflammatory infiltration were reduced, the levels of organ damage indicators were decreased, the ratios of Th1/Th2 and Th17/Treg in peripheral blood and spleen were significantly decreased, the levels of pro-inflammatory cytokines such as IL-6 were decreased, the levels of anti-inflammatory cytokines such as IL-10 were increased, and the levels of STAT1 and STAT3 phosphorylation were reduced. These results were validated in in vitro experiments. Conclusions: Therefore, this study confirms that MSCs can control the inflammatory response induced by sepsis by regulating Th cells and inflammatory factors, and that this leads to reduction of tissue damage, protection of organ functions and ultimately improvement of survival in aged sepsis model rats. Inhibition of the JAK-STAT signaling pathway may be an important mechanism for their action.
Molecular Detection of blaTEM, blaCTX-M and blaSHV Genes in Extended Spectrum β-Lactamase (ESBL) Escherichia Coli from Clinical Samples
Authors: Chaudhary Mahesh Kumar , Jadhav Indrani , Banjara Megha Raj
Published: October 2021

BackgroundExtended spectrum β-lactamases are the group of beta-lactamase enzymes which confer resistance to the oxyimino-cephalosporins and monobactams. Emergence of ESBL producing genes which possess a serious threat for the treatment of infections both in community and hospitals since it is found to be increasing trends of multidrug resistance. This study was focused to find out the ESBLs producing genes.MethodsThis was a cross-sectional study conducted over a period of 2 years (September 2018 to April 2020) at microbiology laboratory of Nepal Mediciti Hospital. Clinical samples were processed in microbiology laboratory and culture isolates were indetified and characterized by standard microbiological techniques. following standard procedures.Antibiotic susceptibility testing was performed by modified Kirby-Bauer disc diffusion method as recommended by Clinical and Laboratory Standard Institute. Extended spectrum beta-lactamases were phenotypically confirmed by combined disc method.ESBL producing genes i.e. blaTEM,blaCTX-M and blaSHV were confirmed by PCR.ResultsOf the 1449 total E.coli isolates, 323/1449(22.29%) isolates were multi -drug resistance.Among total MDR Escherichia coli isolates, 215/323(66.56%) isolates were ESBL producers. The maximum number of ESBL Escherichia coli was isolated from urine 194(90.23%), followed by sputum 12(5.58%), swab 5 (2.32%), pus 2 (0.93%) and blood 2 (0.93%).Antibiotic susceptibility pattern of ESBL E.coli producers showed highest sensitivity towards tigecycline (100%) followed by polymyxin b, colistin and meropenem.Out of 215 phenotypically confirmed ESBL E.coli,only 186(86.51%) isolates were found to positive by PCR.The last 29(13.49%) were negative for any of the resistant genes.Among the ESBL genotypes,most common was blaTEM 118(63.4%) followed by blaCTX-M 68(36.6%).ConclusionThe emergence of MDR and ESBL producing E.coli isolates with high antibiotic resistant rates to commonly used antibiotics and increased predominance of major gene types blaTEM is a serious concern to the clinicians as well as microbiologist. This study forwarded a real massage to all the clinicians for the emergence of XDR and PDR resistant bacteria and preservation of antibiotics for their proper use in near future, if past experience with MDR and ESBLs is any indicator.
Assessment of Evidence-Based Practice Knowledge, Utilization of Practice and Associated Factors on Nurses Working in the Adult Intensive Care Unit of Federal Public Hospital in Addis Ababa
Authors: Alene Zerihune , W/Hawariat Negat , Bogale Helina , Fikadu Ayele , Workina Abdata
Published: October 2021

Background

Critical care nurses face several challenges in providing safe, evidence-based care for critical patients. Evidence-based practices are important to improve the overall quality of patient care, enhance nursing practice, and increase confidence in evidence-based decision-making. Thus, this study was intended to assess evidence-based practice knowledge and utilization of the practice on nurses working in the adult intensive care units.
Methods

Institutional based cross-sectional study was employed on 135 randomly selected nurses working in adult intensive care units of federal public hospitals in Addis Ababa, Ethiopia, from April 3 to December 21, 2020. Data were collected using a structured questionnaire through face-to-face interviews. Then, it was entered into Epi data version 4.4.2.1, and exported to SPSS version 25 for analysis. In the bivariate logistic regression analysis, predictors variables with p< 0.25 were fitted to multivariate analysis. Then, the adjusted odds ratio with 95% CI was used to report the association at P< 0.05.
Results

Among the study participants, about 92(68.1%) and 115(85.2%) of them were found to have good knowledge and utilization of evidence-based practice, respectively. Predictors like difficulty to properly interpret research results (AOR=11.36; 95% CI: 1.86-69.39), and insufficient resources to implement changes in practice (AOR=4.44; 95% CI: 1.05-18.80) were associated with poor knowledge of evidence-based practice. Moreover, nurses who were not able to interpret research results, lack of nursing colleague support, and insufficient time were significantly associated with poor utilization (P<0.05).
Conclusion

The knowledge and utilization of evidence-based practice among nurses was found to be high compared to the findings of former studies. Inability to properly interpret research results, lack of confidence, insufficient time, and lack of nursing colleague support were independently associated with poor knowledge and utilization of evidence-based practices among nurses working in adult ICU nurses.
Pulmonary Involvement of ANCA-associated Vasculitis in Adult Chinese Patients.
Authors: Zhou Peining , Li Zhiying , Gao Li , Que Chengli , Li Haichao , Ma Jing , Wang Guangfa , Chen Min
Published: October 2021

Objective: The aim of this study was to clarify the clinical characteristics and long-term outcomes of ANCA-associated vasculitis (AAV) patients with pulmonary involvement from a single Chinese cohort. Methods: Newly diagnosed AAV patients with pulmonary involvement, as defined by CT, were recruited from January 2010 to June 2020. Clinical data and CT images were collected retrospectively. Baseline CTs were evaluated and re-classified into four categories: interstitial lung disease (ILD), airway involvement (AI), alveolar hemorrhage (AH), and pulmonary granuloma (PG). Results: A total of 719 patients were newly diagnosed with AAV, 366 (50.9%) of whom combined with pulmonary involvement at baseline. Among the AAV cases with pulmonary involvement, 55.7% (204/366) had ILD, 16.7% (61/366) had AI alone, 14.8% (54/366) had PG, and 12.8% (47/366) had AH alone. During follow-up of a median duration of 42.0 months, 66/366 (18.0%) patients died, mainly died from infections. Survival, relapse, and infection were all significantly different based on the radiological features. Specifically, the ILD group tends to have a poor long-term prognosis, the PG group is prone to relapse, and the AI group is apt to infection. The AH group has a high risk of both early infection and relapse, thus a poor short-term prognosis.Conclusion: AAV patients with diverse radiological features have different clinical characteristics and outcomes. Therefore, the intensity of immunosuppressive therapy must be carefully valued by considering the baseline CT findings among AAV patients with pulmonary involvement.
The Association between Serum Gamma Glutamyl transferase and Fasting Blood Glucose in Chinese People: A 6-Year Follow-up Study
Authors: Teng Fei , Lai Peng , Wang Liying , Liu Xuekui , Geng Houfa , Xu Wei , Ye Yan , Li Jiayi , Liang Jun
Published: October 2021

Objective The aim of this study was to identify the relationships between gamma−glutamyltransferase (GGT) and fasting blood glucose (FBG) during a 6-year follow-up of subjects, and to evaluate if GGT is an independent factor affecting FBG. Methods Total of 1369 individuals from health examination survey at the urban area of Xuzhou, central China, were followed up for 6 years. The patients were divided into four groups according to their baseline GGT levels (in quartiles). The one-way ANOVA method was used to compare the differences of variables with basic line. The relationship between GGT and FBG levels was examined using repeated measurements ANOVA. Results The grouping of baseline GGT levels influenced changes in blood glucose during 6-year follow-up. In GGT quartile subgroups, the annual mean increase of FBG level shows a positive relationship with baseline GGT level. And this trend was even more pronounced in the highest baseline GGT group. Time course, baseline FBG and GGT groups at different individuals, which together affected the change of FBG level during the follow-up. Considering that baseline FBG may affect subsequent FBG levels, repeated measures ANOVA was used to exclude the effect of this factor. Results showed that different baseline GGT groups were still significantly associated with increased FBG levels during follow-up. GGT is an independent factor affecting FBG level（p<0.001）. Conclusions The annual mean increase of FBG level shows a positive relationship with baseline GGT level. Higher baseline GGT levels resulted in a faster annual mean increase in FBG. GGT could be used for early detection of impaired fasting glucose regulation (IFG) patients in clinical field.
Experimental Evaluation of an Antimicrobial Protein from Bacillus Amyloliquefaciens MBL27 for Wound Healing Potential in Rats
Authors: K Vijayalakshmi , Rajakumar G. Suseela
Published: October 2021

Objective: This study was aimed at assessing the ability of the antimicrobial protein (AMP) produced by Bacillus amyloliquefaciens MBL27 as a potent wound healant. Methods: Rat models were used to study the efficacy of AMP and AMP incorporated chitosan sheet along with control groups.Results: AMP and AMP incorporated chitosan sheet significantly improved wound contraction when compared to controls. Rate of wound contraction (97.23%), decreased period of epithelialization (14 days) and the levels of biochemical markers such as hydroxyproline (collagen), hexosamine, uronic acid and total protein in the granulation tissue on various days of wound healing revealed the wound healing efficacy of the AMP. The histological examinations also correlated well with the biochemical findings, confirming the wound healing efficacy of the AMP. Conclusion: The results indicate the beneficial effects of AMP from B.amyloliquefaciens MBL27 and its potential to be developed into new therapeutic agent for dermal wound healing.
Frailty in the over 65’s undergoing elective surgery (FIT-65) – a three-day study examining the prevalence of frailty in patients presenting for elective surgery
Authors: Harrison Sarah , Harvie David Alexander , Matthews Lewis , Wensley Frances
Published: October 2021

Background

Frailty increases the risk of perioperative complications, length of stay, and the need for assisted-living after discharge. As the UK population ages the number of frail patients presenting for elective surgery in the UK is likely to grow. Despite the potential benefits of early diagnosis, frailty is not uniformly screened for in UK elective surgical patients and its prevalence remains unclear. The primary aim of this study was to assess the prevalence of frailty in patients aged over 65 years undergoing elective surgery.
Methods

We performed a prospective cross-sectional observational study in eight UK hospitals. Data were collected over three consecutive days with follow-up at 30 days. HRA approval was obtained (REC 20/SC/0121) and signed informed consent obtained. Participants were eligible for inclusion if they were 65 years or older and undergoing elective surgery. Pre-operative data were collected from hospital notes by anaesthetic trainees. A member of the research team blinded to the pre-operative dataset screened the participant for frailty pre-operatively using the Reported Edmonton Frail Scale (REFS). Post-operative data were collected from the notes on day of surgery and at 30 days. Participants were defined as “frail” if they scored 8 or more on the REFS.
Results

228 participants were recruited during the study period of whom 218 proceeded to surgery. There were 103 females and 115 males. Median age was 75 years (interquartile range 70-80). Thirty-seven participants (17.0%) were identified as frail. Frail patients were older, had a higher ASA score, were more likely to have carers and were more likely to be anaemic and present with ECG abnormalities. There were no differences in gender, BMI, place of residence or smoking status for patients identified as frail versus non-frail. There was no difference in length-of-stay between frail and non-frail patients, although those identified as frail were less likely to be discharged to their own home.
Conclusion

We found the prevalence of frailty in a mixed population of elective surgical patients aged 65 or over to be 17.0%. Furthermore, we found the REFS to be a practical tool for pre-operative frailty screening. Frail patients presented for elective surgery with modifiable co-morbidities which could have been optimised pre-operatively. Early screening could highlight frail patients, allowing time for pre-operative planning and evidence-based optimisations of comorbidities. We therefore encourage the adoption of frailty assessment as a routine part of pre-operative assessment.
Level of IL-6 in cerebrospinal fluid is a preoperative predictor of short - term outcome in acquired hydrocephalus
Authors: Wu Dengjun , Lv Yinghao , Guan Zhengyan , Xiao Linmin , Shen Junjun , Fan Xinlin , Li Donghai
Published: October 2021

Background: Acquired hydrocephalus (AH) is a common complication in patients with severe brain injury. Brain tissue injury has been proposed to induce a neuroinflammatory reaction reflected by cytokines release, particularly interleukin-6 (IL-6), which associates with early brain damage. The present study measured IL-6 in the cerebrospinal fluid (CSF) of AH patients and determined its relationship to functional outcome following shunt operation.Methods: The study included a total of 32 patients with a shunt operation due to hydrocephalus. CSF samples from 26 AH subjects and 6 iNPH patients were collected via lumbar puncture before surgery. IL-6 level was measured using the micro ELISA immunoassay method. AH subjects were dichotomized into good versus poor outcomes based on modified Rankin Scale (mRS) at 3 months after shunting.Results: CSF analysis demonstrated that IL-6 was significantly elevated in the CSF of the AH group compared to controls (p = 0.023). Within the AH group, eighteen (69.2%) had a good outcome while eight (30.8%) patients had a poor outcome. Mean IL-6 level in the good outcome group was approximately four-times higher than the poor outcome group (p = 0.004). Glasgow Coma Scale (GCS) on admission was significantly different between the two groups (p = 0.014). IL-6 level and admission GCS were significantly correlated with improvement of mRS score (r = 0.473, p = 0.015 and r = 0.691, p＜0.0001, respectively). Receiver operating characteristic curve analysis showed that both factors can accurately differentiate between patients with good versus poor functional outcome (AUC = 0.861, p = 0.0039 and AUC = 0.823, p = 0.0098, respectively). Conclusions: The CSF level of IL-6 is elevated in AH patients and higher levels correlate with improvement of post-shunt functional outcome. Therefore, IL-6 CSF level might serve as a complementary surrogate parameter for operative indication. A possible IL-6 threshold in clinical routine might be a 6.98-pg/ml cutoff value to rule out unresponsive and poor outcome AH patients that are under the 6.98-pg/ml threshold.
Mapping Transgene Insertion Sites Reveals the α-Cre Transgene Expression in Both Developing Retina and Olfactory Neurons
Authors: Fan Yimeng , Chen Wenyue , Wei Ran , Qiang Wei , Pearson Joel , Yu Tao , Bremner Rod , Chen Danian
Published: October 2021

The Tg(Pax6-cre,GFP)2Pgr (α-Cre) mouse (MGI:3052661) is a commonly used Cre line thought to be retinal-specific. Using targeted locus amplification (TLA), we mapped the insertion site of the transgene, and defined primers useful to deduce zygosity. Further analyses revealed four tandem copies of the transgene. The insertion site mapped to clusters of vomeronasal and olfactory receptor genes. Using R26R and Ai14 Cre reporter mice, we confirmed retinal Cre activity, but also detected expression in olfactory neurons, implicating the influence of neighbouring regulatory elements. RT-PCR and the buried food pellet (BFP) test did not detect any effects of the transgene on flanking genes in the nasal mucosa and retina. Together, these data precisely map α-Cre, show that it does not affect surrounding loci, but reveal previously unanticipated transgene expression in olfactory neurons. The α-Cre mouse can be a valuable tool in both retinal and olfactory research.
STS Protects Diabetic Glomerular Vascular Endothelial Barrier by Ameliorating EPC Dysfunction: Targeting RAGE-TXNIP-NLRP3 Inflammasome Pathway
Authors: Heng Yan-Yan , Zhang Xiao-Yan , Wang Fei-Fei , Zhang Peng-Fei , wei wei
Published: October 2021

Background: Glomerular endothelial cell (GEC) injury is one of the crucial causes of diabetic kidney disease (DKD). Endothelial progenitor cell (EPC) is the essential mechanism of vascular endothelial repair, which damages by diabetic pathology. Sodium Tanshinone Sulfonate ⅡA (STS) is known to protect endothelium, but the mechanism and the role in DKD need to be studied. Methods: EPC was treated with high glucose (HG), and thioredoxin interacting protein (TXNIP), NLR family pyrin domain containing 3 (NLRP3) inflammasome, DNA damage, proliferation, differentiation and senescence were detected; STS and EPC were intravenous injected into diabetic nude mice, the urine protein quantitation and urine protein/creatinine were detected; the Dil-labeled EPC was traced and the expression of TXNIP, caspase-1 (p20), p21, Ki67, CD31 were detected by fluorescence co-location in glomerulus.Results: We found that STS inhibited HG-induced TXNIP expression and NLRP3 inflammasome activation, catalase (CAT) inactivation, DNA damage, senescence； STS restored EPC proliferation and differentiation functions; advanced glycation end products (AGEs) produced in HG treated EPC supernatant, the receptor of AGE (RAGE) blocking inhibited TXNIP expression and NLRP3 inflammasome activation, which mimicked by STS. STS protected EPC functions in diabetic glomerular and enhanced EPC renal function amelioration. Conclusions: We concluded that STS watched CAT activity to prevent HG-induced EPC DNA damage, proliferation, differentiation dysfunction, accelerated senescence by inhibiting the RAGE-TXNIP-NLRP3 inflammasome-caspase-1 pathway.
A Spider Silk-derived Solubility Domain Inhibits Nuclear and Cytosolic Protein Aggregation in Human Cells
Authors: Schellhaus Katharina , Gierisch Maria , Vornberger Julia , Johansson Jan , Dantuma Nico
Published: October 2021

Due to the inherent toxicity of protein aggregates, the propensity of natural, functional amyloidogenic proteins to aggregate must be tightly controlled to avoid negative consequences on cellular viability. The importance of controlled aggregation in biological processes is illustrated by spidroins, which are functional amyloidogenic proteins that form the basis for spider silk. Premature aggregation of spidroins is prevented by the N-terminal NT domain. Here we explored the potential of the engineered, spidroin-based NT* domain in preventing protein aggregation in the intracellular environment of human cells. We show that the NT* domain increases the soluble pool of a reporter protein carrying a ligand-regulatable aggregation domain. Interestingly, the NT* domain prevents the formation of aggregates independent of its position in the aggregation-prone protein. The ability of the NT* domain to inhibit ligand-regulated aggregation was evident both in the cytosolic and nuclear compartments, which are both highly relevant for human disorders linked to non-physiological protein aggregation. We conclude that the spidroin-derived NT* domain has a generic anti-aggregation activity, independent of position or subcellular location, that is also active in human cells and propose that the NT* domain can potentially be exploited in controlling protein aggregation of disease-associated proteins.
Dynamic Analysis and Synchronization with Unidirectional Coupling Involving Energy of a HR Neuron Under Electric Field and Memristive Autapse
Authors: Qiao Shuai , Gao Chenghua , An Xinlei , He Xingyue , Wang Jingjing
Published: October 2021

Reliable neuron models play an important role in identifying the electrical activities, global bifurcation patterns, and dynamic mechanisms of neurons in complex electromagnetic environments. Considering the memristive autapse involving magnetic coupling has voltage-controlled, nonlinear, and memory, a 5-D HR neuron model containing magnetic field and electric field variables is established. Detailedly, the existence and stability conditions of the equilibrium point are determined by theoretical analysis, and the complex time-varying stability, saddle-node bifurcation, and Hopf bifurcation behaviors of the model are verified by numerical calculation. Interestingly, the system has a bistable structure consisting of quiescent state and period-1 and period-2 bursting modes near the subcritical Hopf bifurcation. It is noteworthy that the memristive autapse has a complex regulation mechanism for the bistable region so that three kinds of bistable coexisting structures and counterintuitive dynamic phenomena can be induced by appropriately adjusting the memristive autapse. Accordingly, the mechanism of positive feedback memristive autapse decreases its firing frequency, while negative feedback memristive autapse promotes its excitability was revealed by the fast-slow dynamic analysis. Extensive numerical results display that the system generally possesses period-adding bifurcation modes and comb-shaped chaotic structures. Furthermore, it is found that the firing modes and multistability regions of the system can be accurately predicted by analyzing the global dynamic behaviors of Hamilton energy. Importantly, it is verified that the unidirectional coupling controller involving energy is far more efficient and consumes less energy than electrical synaptic coupling in achieving complete synchronization with mismatched parameters.
Comparison of Different Sepsis Scoring Systems and Pathways: qSOFA, SIRS, Shapiro Criteria and CEC SEPSIS KILLS Pathway in Bacteraemic and Non-Bacteraemic Patients Presenting To The Emergency Department
Authors: Sparks Rebecca , Harada Arisa , Chavada Ruchir , Trethewy Christopher
Published: October 2021

Background
Bacteraemia is associated with high morbidity and mortality, with delayed antibiotic treatment associated with poorer outcomes. Early identification is challenging, but clinically important. Multiple scoring systems have been developed to identify individuals in the broader categories of sepsis. We designed this study to assess the performance of existing scoring systems and pathways - CEC SEPSIS KILLS pathway, quick sequential organ failure score (qSOFA), systemic inflammatory response syndrome (SIRS) and the Shapiro criteria.
Methods
This was a retrospective cohort study performed in two metropolitan hospitals in NSW, consisting of adult patients (>18 years) with positive blood cultures containing a true pathogen and patients matched by age without positive blood cultures. Performance (sensitivity, specificity, and mortality prediction) of recognised sepsis and bacteraemia criteria and pathways - qSOFA, SIRS, Shapiro criteria and CEC SEPSIS KILLS pathway in the first 4 hours following ED triage was assessed.
Results
There were 251 patients in each cohort. Sepsis-related mortality was higher in the bacteraemic group (OR 0.4, p=0.03). Of the criteria studied, the modified Shapiro criteria had the highest sensitivity (88%) with modest specificity (37.85%), and qSOFA had the highest specificity (83.67%) with poor sensitivity (19.82%). SIRS had reasonable sensitivity (82.07%), with poor sensitivity (20.72%). The CEC SEPSIS pathway sensitivity of 70.1% and specificity of 71.1%. The SEPSIS KILLS was activated on only 14% of bacteraemic patients.
Conclusion
The performance of all scoring systems and pathways was suboptimal in the identification of patients at risk of bacteraemia presenting to the emergency department.
CEREBROVASCULAR COMPLICATIONS OF COVID-19
Authors: Lychko Volodymyr , Burtyka Mykola
Published: October 2021

The systematic online search of articles utilizing the search terms ”Coronavirus, SARS-COV-2 and Neurological complications”, published between January 2019 and September 2021, was performed.
Neurological manifestations are prevalent during infection with the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is a clear association between cerebrovascular disease and coronavirus disease 2019 (COVID-19). But today, whether this association is causal or incidental is still unknown. This systemic review presents the possible pathophysiological mechanisms linking COVID-19 and cerebrovascular disease, describes the most often neurological complications and their prognosis, discusses several clinical and laboratory characteristics.
A systematic literature search was conducted, and relevant information was abstracted. Angiotensin-converting enzyme-2 receptor dysregulation, uncontrollable immune storm with inflammation, coagulopathy, complications due to critical illness and prolonged hospitalization can all contribute as potential etiological and pathogenic mechanisms leading to diverse cerebrovascular clinical manifestations.
Acute ischemic stroke, intracerebral haemorrhage, and cerebral venous sinus thrombosis have been described in case reports and cohorts of COVID-19 patients, with a prevalence ranging between 0.5 % and 5.0 %. SARS-CoV-2-positive stroke patients have higher mortality rates, worse functional outcomes at discharge and longer duration of hospitalization as compared with SARS-CoV-2-negative stroke patients. Understanding of the specific demographic, clinical, laboratory and radiological characteristics may be used as ‘red flags’ in recognizing COVID-19-related acute neurological complications.
Navigating the role of clinician-researcher: Insights from a Constructivist Grounded Theory study in traumatic brain injury
Authors: Kivunja Stephen , Pryor Julie , River Jo , Gullick Janice
Published: October 2021

Using the case of traumatic brain injury, this paper explores 1) challenges to academic and ethical integrity when in the role of clinician-researcher, and 2) potential strategies to enhance ethical qualitative research involving people with possible physical and/or emotional trauma and temporary or permanent cognitive disruption. When undertaking qualitative research with patients, families, and/ or health professionals, a researcher’s clinical background may stimulate insightful and relevant research questions, interviews, and/or field observations of care to inform meaningful and translatable practice improvements. However, there may be tension between clinician versus researcher values, and these priorities affect what the clinician sees and interprets in the field. A clinician’s ingrained values and professional socialisation can make it difficult to hold their professional assumptions about various phenomena at bay. The principles of human research merit and integrity, justice, beneficence, and respect, along with methodological clarity, can provide a rigorous foundation for discussion of ethical research in traumatic brain injury.

This paper discusses challenges and strategies through: 1) examining clinical assumptions; 2) determining capacity for consent; 3) considering dependent or unequal power relationships; 4) determining the scope for field observations; 5) responding to unprofessional practice; 6) discriminating between research interviews and clinical conversations; and 7) critically reflecting on research data. Implications for clinical research are evident: seeing past one’s own construct of understanding is challenging for clinician-researchers aiming to illuminate both patient and family experiences of care, and nuanced clinical skills. Careful ethical and methodological planning can protect participants while illuminating elements of specialist practice.
Bioplastic material based on ion-track wound coatings and chitosan nano-scaffold
Authors: Eremin P.S. , Poddubikov A.V. , Gilmutdinova I.R. , Nechaev A.N.
Published: October 2021

Abstract-A bioplastic material based on a titanium-metallized ion-track wound coating and a chitosan nano-scaffold has been created, which has high strength, elasticity, as well as water and gas permeability. Its strength characteristics were studied and its bacteriostaticity, bactericidal activity, cytotoxicity and biocompatibility were evaluated. This material is non-toxic and, after preclinical and clinical trials, can serve as a platform for a new generation of wound coatings in regenerative medicine.

Key words: bioplastic material, ion-track wound coatings, chitosan, nano-scaffold

The work was supported by a grant for JINR young researchers (no. 21-502-02).
Using GANs and MLP Artificial Neural Networks to support early diagnosis of Alzheimer’s disease: a study on the potential of artificial data expansion
Authors: Bandeira Jonathan , Valença Mêuser , Alencar Renan
Published: October 2021

The life expectancy of the population in the most developed countries is growing every day and, consequently, there is an increase in various age-related diseases. In Brazil, just over 1.1 million people have Alzheimer’s disease (AD). In 2019, according to the World Health Organization, Alzheimer’s disease and other dementias were the third leading cause of mortality in the Americas and Europe. Despite being a degenerative and irreversible disease, if diagnosed early, treatments can be performed to slow the progression of symptoms and ensure a better quality of life for the patient. Most papers that study Computational Intelligence solutions to support diagnosis follow an approach based on neuroimaging evidence. In addition to this, another approach that has been gaining prominence is biochemical and molecular analysis. Following this approach, Ray et al., Ravetti & Moscato and Dantas & Valença carried out studies with classifiers from statistics or Computational Intelligence to support the early diagnosis of the disease. The work was carried out from a dataset with values of 120 blood proteins. Through this, they were able to classify whether or not the patient could be diagnosed with AD. As a result, Ray et al., Ravetti & Moscato and Dantas & Valença obtained an average accuracy rate of 89%, 93% and 94.34%, respectively. Thus, this work aims to use a traditional approach with a proposed Multilayer Perceptron Artificial Neural Network model to perform the early diagnosis of a patient with or without AD and compare the results obtained with the results of the related works cited. In addition, this work has as main objective to evaluate the potential of using synthetic data generated using a Generative Adversarial Network in the training and tests of the proposed classification model.
Comparing the effect of tailwater replenishment at different time intervals on eutrophic surface freshwater: a mesocosm simulation study
Authors: Tang Haibin , Dai Yanran , Fan Yaocheng , Cun Deshou , Song Xiaoyong , Wang Feihua , Liang Wei
Published: October 2021

Tailwater is becoming the main water source supplied to surface freshwater worldwide. However, few studies have compared the effect of tailwater replenishment at different time intervals on eutrophic surface freshwater. In this study, we investigated the changes of water quality, sediment, and submerged macrophytes in eutrophic water in an outdoor mesocosm in response to different tailwater replenishment time intervals [every 7 days (TW7), 14 days (TW14) and 28 days (TW28)]. An 84-day simulation experiment demonstrated that there were only significant differences in the total nitrogen (TN) concentration of the overlying water, with the lowest mean value occurring in TW28. Nevertheless, the sediment TN was lowest in TW7 with a denitrification rate of 102.9 μmol/m2/h. Tailwater replenishment also increased the nitrogen content and total biomass of Vallisneria spiralis, and TW7 had the highest total biomass of 20.19 g. Additionally, tailwater replenishment also affected plant enzyme activity, causing an increase in superoxide dismutase, peroxidase, and catalase, coupled with a decrease in malondialdehyde concentration in leaves. Overall, TW28 can be adopted as a tailwater replenishment strategy to ensure water quality, whereas TW7 can be applied without a strict water quality requirement for TN.
Sustainable robust green synthesis of nanoparticles from waste aquatic plants and its application in environmental remediation
Authors: Balasubramanian Uma Maheswari , Vaiyazhipalayam Murugaiyan Sivakumar , Marimuthu Thirumarimurugan
Published: October 2021

Green synthesis of nanoparticles using natural materials is an emerging technique that fascinates the scientific community globally for the treatment of wastewater. In the present study, aquatic plants such as Piaropus crassipes (PC) and Lemna gibba (LG), were utilized to make low-cost nanoparticles, and its feasibility for the removal of Zn(II) ions was studied. The synthesized nano adsorbents were characterized by scanning electron microscopy, Fourier transform infrared spectroscopy, Brunauer–Emmett–Teller analysis, and zeta potential analysis. The optimal conditions were evaluated by batch adsorption studies, to investigate the parameters such as pH (2–7), adsorbent dosage (0.5–5 g/L), initial concentration (20–60 mg/L), and contact time (10–120 min) etc. The isotherm, and kinetic data results fit well with Langmuir, and pseudo-second order models. The anticipated monolayer adsorption capacity with respect to the PC, and LG was found to be 42.41 mg/g and 27.65 mg/g, respectively. Thermodynamic studies showed that the process is exothermic. The adsorption mechanism of PC/LG on Zn(II) exhibited surface complexation, ion exchange, and diffusion. Desorption studies were performed to analyze the recovery potential of Zn(II) ion. Hence, this article investigates the economic synthesis of green nanoparticles, and their potential utilization in heavy metal remediation.