bluuebunny/crossref_metadata_2025 huggingface dataset:
DISENTANGLING THE LINK BETWEEN LEAF PHOTOSYNTHESIS AND TURGOR ON FRUIT GROWTH
Authors: Hernandez-Santana Virginia , Perez-Arcoiza Adrián , Gomez-Jimenez M. Carmen , Diaz-Espejo Antonio
Published: January 2024

Despite the importance of understanding plant growth, the mechanisms
underlying how plant and fruit growth declines, during drought remains
poorly understood. Specifically, it remains unresolved whether carbon or
water factors are responsible for limiting growth as drought progresses.
We examine questions regarding the relative importance of water and
carbon to fruit growth depending on the water deficit level and the
fruit growth stage, by measuring in olive fruit diameter, leaf
photosynthesis, a proxy of cell turgor and flow cytometry to determine
the fruit cell division stage. We found that photosynthesis and turgor
were related to fruit growth; specifically, the relative importance of
photosynthesis was higher during periods of more intense cell division,
while turgor had higher importance in periods where cell division comes
close to ceasing, and fruit growth is dependent mainly on cell
expansion. This pattern was found regardless of the water deficit level,
although, turgor and growth ceased at more similar values of leaf water
potential than photosynthesis. We conclude that carbon and water
processes are able to explain fruit growth, with importance placed on
the combination of cell division and expansion. However, the major
limitation to growth is turgor, which adds evidence to the sink
limitation hypothesis.
Mathematical analysis of Heat and mass transfer for Williamson nanofluid flow over an exponentially stretching surface subject to the exponential order surface temperature and heat flux
Authors: Badshah Zeeshan , Ali Rashid , Khan Muhammad Riaz
Published: January 2024

This article investigates the features of heat and mass transfer for the
steady two-dimensional Williamson nanofluid flow across an exponentially
stretched surface depending on suction/injection. The boundary
conditions incorporate the impacts of the Brownian motion and
thermophoresis boundary. The analysis of heat transfer is carried out
for the two cases of prescribed exponential order surface temperature
(PEST) and prescribed exponential order heat flux (PEHF). The ongoing
flow problem is mathematically modeled under the basic laws of motion
and heat transfer. The similarity variables are allowed to transmute the
governing equations of the problem into a similarity ordinary
differential equation (ODEs). The solution of this reduced non-linear
system of ODEs is supported by the Homotopy analysis method (HAM). The
combination of HAM arrangements is acquired by plotting the h-curve. In
order to evaluate the influence of several emergent parameters, the
outcomes are presented numerically and are plotted diagrammatically as a
consequence of velocity, temperature, and concentration proles.
Self-reported experience of tinnitus patients for different outpatient modes
Authors: Xiang Tao , Xu Tao , Ren Jing , Pu Junmei , Liu Lu , Xiao Yan , Lai Dan
Published: January 2024

Objective: To explore self-reported experience for different outpatient
modes in tinnitus patients. Methods: A observational study design was
adopted. Tinnitus outpatients from the otological medicine and routine
otolaryngology of our hospital fulfilling the study criteria were
enrolled between October 2018 and January 2020. They were examined by
semi-structured interview questionnaire. Groups were formed according to
the different outpatient modes. The data were analyzed with SPSS 23.0.
Results: 193 questionnaires were included; 118 questionnaires of
otological medicine outpatients, 75 questionnaires of otolaryngology
outpatients. Nearly half of the otological medicine patients (48.3%)
said that they communicated for 5–10 minutes with their doctor and a
routine otolaryngology outpatient service usually takes 3–5 minutes
(61.3%). However, most patients expected a longer time. Patient
satisfaction and return visit rate of otological medicine (95.5% and
43.9%) were better than routine otolaryngology (77.3% and 7.1%). The
main factors of efficacy considered physician interpretation and
guidance (66.7%). Conclusion: Both outpatient models can give patients
a more satisfactory experience in the real world. Specialized outpatient
service can better fit the shared decision making model, conducive to
the rehabilitation and management of tinnitus. However, the long-term
follow-up and management of patients still need to be scrutinized and
improved continuously.
Autochthonous, zoonotic Onchocerca lupi in a South Texas dog, United States
Authors: Verocai Guilherme , Sobotyk Caroline , Lamison Allegra , Borst Mindy , Edwards Erin
Published: January 2024

Onchocerca lupi is an emerging, zoonotic filarioid nematode
associated with ocular disease in companion animals. We report the first
autochthonous case of O. lupi in a dog from Hidalgo County,
southern Texas, USA. An 11-year-old, castrated male, Pitbull dog from
McAllen, Hidalgo County, southern Texas with no travel history, was
diagnosed with a perforating corneal ulceration of the right eye.
Enucleation was performed, and tissues submitted for histopathology.
Sections of two filarioid nematodes were observed. Parasite
identification relied on morphological features seen on histopathology
and molecular confirmation by PCR of the cox1 gene of the mitochondrial
DNA, followed by sequencing and phylogenetic analysis. Our finding
suggests Texas as an additional endemic state for this zoonotic
nematode. Further investigations are required to understand the
epidemiology of this parasite along the United States/Mexico border.
Development and content validity of a rating scale for the Pain and Disability Drivers Management Model.
Authors: Naye Florian , Décary Simon , TOUSIGNANT-LAFLAMME YANNICK
Published: January 2024

Rationale, aims and objectives Establishing the biopsychosocial profile
of patients with low back pain is essential to personalize care. The
Pain and Disability Drivers Management model (PDDM) has been suggested
as a useful framework to help clinicians establish the profile. Yet,
there is no tool to facilitate its integration into clinical practice.
Thus, the aim of this study is to develop and validate a rating scale,
in order to rapidly establish the patient’s profile based on the domains
of the PDDM. Method The tool was developed in accordance with the
principles of COSMIN methodology. We conducted 3 steps: 1) item
generation from a comprehensive review, 2) refinement of the scale with
clinicians’ feedback, and 3) statistical analyses to assess the content
validity. To validate the item assessing with Likert scales, we
performed Item level-Content Validity Index (I-CVI) analyses on three
criteria with an a priori threshold of >0.78. We conducted
Average-Content Validity Index (Ave-CVI) analyses to validate the
overall scale with a threshold of >0.9. Results Coherent
with the PDDM, we developed a 5-item rating scale with 4 score options.
We selected clinical instruments to screen the presence or absence of
the categories of each domain. 42 participants provided feedback to
refine the clarity, presentation and clinical applicability of the
scale. The statistical analysis of the latest version presented I-CVI
above the threshold for each item (between 0.94 and 1). The analysis of
the overall scale supported its validation (Ave-CVI=0.95
[0.94;0.97]). Conclusion From the 51 biopsychosocial elements
contained within the 5 domains of the PDDM, we developed a rating scale
that allows to rapidly screen for problematic issues for categories
within each domain. The involvement of clinicians in the process allowed
us to validate the content of the first scale to establish the patient’s
biopsychosocial profile for people with LBP
Patient outcomes after the implementation of a decolonisation protocol in patients undergoing hip or knee replacement
Authors: García Miguel Ángel Amor , Ribed Almudena , Sanz-Ruiz Pablo , Melgarejo-Ortuño Alejandra , RODRIGUEZ-GONZALEZ CARMEN , Sanchez-Somolinos Mar , Matas-Díaz José Antonio , HERRANZ-ALONSO ANA , SANJURJO-SAEZ MARIA
Published: January 2024

Rationale, aims and objectives Surgical-site infections (SSI) are
associated with increases in hospital length of stay and hospitalization
costs and patient’s poor quality of life. Eradication of S. aureus with
nasal mupirocin could decrease the incidence of SSI by this pathogen.
The primary purpose of our study was to evaluate the incidence of SSI
before and after the implementation of a decolonisation program in
orthopaedic patients. Methods A pre-post intervention study was
conducted. A multidisciplinary group elaborated and implemented a
standard procedure for nasal decolonisation, including a pharmacy visit.
The proportion of patients who had a SSI and those infected by S. aureus
were the primary outcome variables. The proportion of pre-screened
patients, nasal carriers, and adequate prophylaxis (3 mupirocin
applications) and decolonisation (5 applications) were recorded to
analyse program implementation. Mupirocin resistance or adverse effect
were also registered. Results 1,192 patients were included in the study
(599 pre- and 593 post-intervention group) SSI were recorded in 2.5% vs
2.0% of patients (pre vs post-intervention), showing a relative risk
(RR) of 0.81 (p=0.58). S. aureus infections were recorded in 0.7% vs
0.3% (p=0.420, RR=0.51). 59.2% vs 3.5% of patients were pre-screened
(p<0.001). 63 patients (17.9%) were nasal carriers of S.
aureus, of which 58 (92.1%) received an adequate prophylaxis and 32
(50.8%) an adequate decolonisation. No infection was reported regarding
patients who received adequate nasal prophylaxis. Conclusions The nasal
prophylaxis and decolonisation protocol were implemented in the
orthopaedic patient flow. Eradication of S. aureus with nasal mupirocin
seem to decrease the incidence of S. aureus infections.
Heisenberg's Uncertainty Principle from Gravity
Authors: Roy Shibdas
Published: January 2024

We propose that Heisenberg’s uncertainty principle is a consequence of
gravity. While quantum mechanics and gravity are widely considered
incompatible, we show that Heisenberg’s uncertainty principle, which is
a central tenet in quantum mechanics, in fact, arises from
non-diminishing finite gravity between a particle and another identical
particle. We observe that it is impossible to know the position or
momentum of the particle with unlimited precision, unless the gravity is
infinite or zero, respectively, between the particles. We derive upper
and lower bounds on the uncertainties in position and momentum of the
particle, based on the uncertainty principle emerging from gravity.
Accordingly, the quantum-classical boundary is identified, beyond which
gravity behaves classically.
Chest wall tuberculosis in an infant : a rare case report.
Authors: Fakiri Karima EL , Draiss Ghizlane , Bouskraoui Mohammed , Kamili El Aouni
Published: January 2024

Background : Tuberculosis is still an important world health problem.
The parietal chest wall site in children is a extremely rare form of
tuberculosis. Its diagnosis is often so difficult requiring a surgical
biopsy. Case presentation : We report the case of 1.5-year-old infant,
with no family history of active tuberculosis, who had a swelling of the
anterior chest wall for two months. Physical examination found a
swelling measuring 1.5 cm by 1 cm in relation to the second parasternal
intercostal space, fluctuating in its center, with an inflammatory skin
which fistulized giving a bud-like appearance with a purulent exudate.
Chest X-ray was normal. The thoracic computed tomography showed a
sternal mass responsible for a bone lysis with an infiltration.
Pathology examination of biopsies of the parietal mass confirmed the
diagnosis of caseo-follicular tuberculosis with lesion of tuberculosis
osteitis. Human immunodeficiency virus serology was negative, early
morning gastric aspirates performed on two consecutive days were
negative for acid-fast bacilli, and quantiferon TB Gold in tube test
resulted was also negative. Antitubercular therapy was started with
prolonged regimens for 12 months. She has allowed a favorable outcome
with healing of the thoracic parietal lesion after 6 months. Conclusions
: Diagnosis of chest well tuberculosis is still challenging even if we
are in endemic area and it must be conducted early, his management is
based on both surgey and antitubercular therapy for having a complete
recovery. Prompt diagnosis and treatment are important to prevent
serious complications.
Evaluating the physiological metabolism of the ovaries with [18F]-FDG and [68Ga]Ga-DOTA-FAPI-04 PET/CT
Authors: Wang Qixin , Liu Hanxiang , Yang Songsong , Tang Wenxin , Peng Dengsai , Liu Lin , Chen Yue
Published: January 2024

Objective: The purpose of this study was to investigate the role of
[68Ga]Ga-DOTA-FAPI-04 PET/CT in evaluating ovarian physiological FDG
uptake. We also prospect future research. Design: Retrospective study.
Setting: Nuclear Medicine Department of the Affiliated Hospital of
Southwest Medical University. Sample: female patients who underwent
simultaneous [18F]-FDG PET/CT and [68Ga]Ga-DOTA-FAPI-04 PET/CT
examinations in the Affiliated Hospital of Southwest Medical University
from September of 2020 to January of 2021. Methods: We reviewed the data
of 78 female patients who underwent [18F]-FDG and
[68Ga]Ga-DOTA-FAPI-04 PET/CT scanning within 3 days and selected
those whose ovaries showed abnormal FDG activity. Patients with ovarian
lesions confirmed by pathological biopsy or clinical follow-up were
excluded, and the uptake of imaging agents was semi-quantitatively
analyzed. Main outcome measures: Characteristics of ovarian imaging
agent uptake on 18F-FDG and 68Ga-DOTA-FAPI-04 PET/CT images,
pathological data, and clinical follow-up evidence. Results: This study
included 14 patients who were diagnosed with physiological ovarian FDG
uptake by pathology or at least 6 months follow-up. The average age was
38.6 years old (range, 19-52). Physiological ovarian uptake of FDG was
more common in unilateral cases, with a median SUVmax of 4.8±1.8 (range,
2.7-8.2). There was no ovarian uptake of the imaging agent on FAPI
imaging. Conclusion: Our study showed that FDG, but not FAPI, uptake
increased in normal ovaries due to the influence of the menstrual cycle.
[68Ga]Ga-DOTA-FAPI-04 PET/CT has a unique advantage in
differentiating the ovarian physiological [18F]-FDG uptake and can
better identify ovarian lesions.
A vegetation on the surface of left ventricular muscle and subvalvular tissue just below the anterolateral commissure of the mitral valve without exposure to regurgitation or shunt jet
Authors: masada kenji , Ueda Hironori , Ozawa Masamichi , Mitsui Norimasa , utsunomiya hiroto , Takahashi Shinya
Published: January 2024

Bacteria can adhere to cardiac endothelium damaged by regurgitation or
shunt jet; however, healthy cardiac endothelium is supposedly resistant
to bacterial adhesion. Bacterial vegetations are most common on cardiac
valves, but are rarely observed at other sites. We report a case of a
vegetation on the surface of left ventricular muscle/subvalvular tissue
without regurgitation or shunt jet. Transthoracic echocardiography did
not detect the vegetation because of its unique location; however,
transesophageal echocardiography (TEE) did detect. In conclusion,
vegetations can form without exposure to regurgitation or shunt jet, and
TEE is highly sensitive for detecting the vegetation in unusual
locations.
Outcomes of complete hydatidiform mole coexistent with live fetus following assisted reproductive technologies: A retrospective study
Authors: WANG XIA , Wang Yang , Li Rong
Published: January 2024

Objective To investigate the etiology of complete hydatidiform mole
coexistent with live fetus (CHMCF) following assisted reproductive
technologies (ART). Design Retrospective study. Setting Peking
University Third Hospital and tertiary reference. Population Total of 47
patients conceived via ART and diagnosed with CHMCF, including 5 cases
from our hospital and 42 cases from literature. Methods Retrospective
analysis of risk factors associated with neonatal outcome and the
progression of gestational trophoblastic neoplasia (GTN). Main Outcome
Measures Pregnancy complications. Results Vaginal bleeding presented as
the most common complication (75%). The average gestational age
confirming diagnosis by ultrasound was 15.9±4.7 weeks. 40.4% of the
patients progressed to GTN. 41.5% of those who chose to continue
pregnancy had a favorable fetal outcome. Hyperemesis gravidarum and
abdominal pain had a 33.3% and 25% occurrence rate in not surviving
baby group, respectively, but not presented in surviving baby group.
Hypertension emerged in a significantly earlier gestational week in not
surviving baby group than the other (17.0±2.4 vs 25.3±2.3, p=0.003) .
Patients who progressed to GTN had a statistically higher rate of
abdominal pain (26.3% vs 3.6%, p=0.033) compared to those who did not.
Conclusions For CHMCF patients via ART, the surviving baby rate is
41.5% and the GTN progression rate is 40.4%, and appearance of
hyperemesis gravidarum, abdominal pain and early emerge of hypertension
predicted an adverse pregnancy outcome. Occurrence of abdominal pain and
early presentation of vaginal bleeding indicated a poor prognosis in GTN
progression.
Does Merged three-dimensional mapping Improve Contact foRce and long-term procedure Outcome in Atrial Fibrillation ablation? (MICRO-AF study): A prospective randomized controlled study
Authors: Shin Dong Geum , Roh Seung-Young , Ahn Jinhee , Park Sang-Weon , Kim Dong-Hyeok , Han Sang-Jin , Lim Hong Euy
Published: January 2024

Introduction: Integration of electroanatomical map (EAM) with
preacquired three-dimensional (3D) cardiac images provides detailed
appreciation of the complex anatomy of the left atrium (LA) and
pulmonary vein (PV). High-density (HD) multi-electrode mapping catheters
have enabled creating more accurate EAM reflecting real-time
volume-rendered LA-PV geometry during atrial fibrillation (AF) ablation.
However, no study has compared the outcomes of AF ablation using HD-EAM
versus 3D-merged map. We aimed to investigate the procedural and
clinical outcomes of AF ablation with HD-EAM (HD-EAM group) versus
3D-merged map (Merge group). Methods: One hundred patients
(59.5±11.5years, 53% with paroxysmal AF [PAF]) were randomly
assigned (1:1) to HD-EAM or Merged group. HD multi-electrode mapping and
contact force (CF)-sensing catheters were used to create virtual LA-PV
chamber and to perform wide antral circumferential ablation (WACA),
respectively. Results: The two groups showed no significant differences
in baseline characteristics and procedural data including ablation time,
fluoroscopy time, LA voltage, and CF. PV isolation with a single WACA
line was achieved in 21 (42%) and 27 (54%) patients in the Merge and
HD-EAM groups, respectively (P=NS). CF was significantly lower in
lesions with gap than lesions without gap after a single WACA (7.3±7.3 g
vs. 16.0±8.3, respectively, P<0.001). During the 12-month
follow-up, no significant difference in AF recurrence was observed
between two groups, irrespective of AF type. In multivariate analysis,
non-PAF was an independent risk factor for AF recurrence. Conclusion:
Integration of 3D cardiac imaging did not improve procedural and
clinical outcomes. HD-EAM provides an accurate real-time LA geometry.
Evaluation of Index of Cardio-Electrophysiological Balance in Patients with Coronary Slow Flow
Authors: Askin Lutfu , Tanriverdi Okan
Published: January 2024

Objectives: Coronary slow flow (CSF) is defined as the late progression
of applied contrast through coronary arteries. The cardiac
electrophysiological balance index (iCEB) reflects the balance between
ventricular depolarization and repolarization and provides more
information about ventricular arrhythmogenesis (VA) than other
electrocardiography (ECG) parameters (QT, corrected QT (QTc), etc.). We
aimed to evaluate iCEB in patients with CSF. Material and Methods: We
divided the study population into two groups as CSF and control. The CSF
group consisted of 100 patients (33 female, 67 male, mean age 52.2 ±
2.6), while the control group consisted of the same number of age and
sex-matched patients (35 female, 65 male, mean age 51.7 ± 1.4). ECG
parameters of the study population (QRS duration, QT, T wave peak-to-end
(Tp-e) intervals, iCEB (QT / QRS), and iCEBc (heart rate corrected QT
(QTc) / QRS) rates were calculated and compared between CSF and control
groups. Results: Intervals (QT, and QTc intervals) and Tp-e/QTc ratio
were greater in the CSF group compared with controls [422.1 ± 12.8 bpm
vs 349.4 ± 14.3 bpm, respectively, p< 0.001; 457.0 ± 12.2 bpm
vs 378.1 ± 12.3 bpm, respectively, p< 0.001, and 0.19 vs 0.12,
respectively, p< 0.001]. ICEB and iCEBc were significantly
greater than controls [(4.9 ± 0.4 vs 4.2 ± 0.4, respectively,
p< 0.001), (5.7 ± 0.3 vs 4.4 ± 0.3, respectively, p<
0.001)]. Conclusions: ICEB and iCEBc were significantly increased in
patients with CSF. This may suggest that CSF may predispose to malign
arrhythmias.
Efficiency of Curcumin in Preventing Ischemia-Reperfusion Damage in Aortic Vascular Endothelial Cells
Authors: Aydin Mehmet , Sönmez Sakine , Kankilic Nazim , Korkmaz Ezhar , Koyuncu İsmail
Published: January 2024

Backgrounds: Turmeric (Curcuma longa, Turmeric, Indian saffron) is a
widely used herb in China and India. Curcumin, the most active
ingredient in this plant, has been shown to have protective effects
against ischemia-reperfusion damage. In our study, the effects of
Curcumin on vascular endothelium in ischemia-reperfusion injury in the
abdominal aorta were investigated. Methods: Fifteen Wistar-albino rats
were divided into three groups as sham, control and treatment (Curcumin
group). Abdominal aortic ischemia was applied to the control and
Curcumin groups for 60 minutes. Curcumin was administered
intraperitoneally at a dose of 200 mg / kg to the Curcumin group 5
minutes before reperfusion. Afterwards, a 60-minute reperfusion period
was applied to both groups. Total antioxidant capacity (TAC), total
oxidant status (TOS) and oxidative stress index (OSI) in blood serum
were measured. Aortic endothelial tissue was examined in a
histopathological way and endothelial damage was scored and compared.
Results: It was observed that TAC, TOS and OSI activities in blood
samples were significantly decreased in sham and curcumin groups
compared to the control group (p <0.05). There was no
difference in vascular endothelial damage scores in Sham, curcumin and
control groups (p> 0.05). Histopathological examination
revealed no lesions in the curcumin and control groups. Curcumin
administration reduces oxidative stress in ischemia-reperfusion injury.
Conclusion: It was thought that the aortic tissue was more resistant to
I / R damage due to possible perfusion differences. In future studies,
the effects of Curcumin on vascular endothelium in ischemia-reperfusion
injury will be understood more.
High Dose Vitamin C Improves Inflammatory Markers and Clinical Outcome of Patients with Acute Respiratory Distress Syndrome
Authors: Farrag Nada , Wakeel Lamia El , Abdelhafeez Ahmed , Schaalan mona
Published: January 2024

Objectives: To assess the efficacy, tolerability and clinical outcome of
high dose IV Vitamin C administration in patients with Acute respiratory
distress syndrome (ARDS). Design: A prospective, randomized, controlled,
open-label study. Setting: Intensive Care Unit of Embaba-Chest Hospital,
Cairo, Egypt. Patients: Forty clinically and radiologically diagnosed
cases of eligible ARDS patients were randomized to either, Group 1
(Control); 20 patients received conventional ARDS management, or Group 2
(Test); 20 ARDS patients received IV Vitamin C 10 g on two divided
doses, both for 10 days. Interventions: Vitamin C, Interleukin 8 (IL8)
and nuclear factor erythroid 2–related factor 2 (NRf2) levels together
with PaO2/FiO2 were all measured for both groups at baseline and after
10 days. Main Results: Groups were comparable at baseline. After 10 days
of Vitamin C administration, a significant increase (P<0.001)
in levels of Vitamin C, NRf2 and PaO2/FiO2 together with a significant
decrease (P<0.001) in IL8 was noted in test versus control
group. Number of patients weaned off mechanical ventilation MV was
significantly higher in test versus control groups (15 versus 6,
p=0.004, respectively). Survival and occurrence of side effects were
comparable between groups. Conclusions: Administration of 10 g IV
Vitamin C in 2 divided doses daily for 10 days in ARDS patients improved
lung functions, pulmonary oxygenation, oxidative stress and inflammatory
markers and weaning off MV and reduced IL8 levels. Vitamin C was
tolerable with no significant side effects or drug interactions reported
throughout the 10 days-treatment. (Clinicaltrials.gov Registration
number: NCT03780933)
Association of School Instructional Mode with Community COVID-19 Incidence During August -- December 2020 in Cuyahoga County, Ohio
Authors: Terebuh Pauline , Albert Jeffrey , Curtis Jacqueline , Stange Kurt , Hrusch Suzanne , Brennan Kevin , Miracle Jill , Yar Wail , Ganesh Prakash , Gullett Heidi , Rose Johnie
Published: January 2024

Remote and hybrid modes of instruction have been employed as
alternatives to in-person instruction as part of mitigation efforts in
response to the COVID-19 pandemic. Little is known about whether
instructional mode in a given school district may impact transmission in
the surrounding community. Utilizing weekly case counts by zip code from
August – December 2020, we employed a generalized estimating equations
approach to estimate the association between instructional mode of the
public school district and emergent COVID-19 cases in Cuyahoga County,
Ohio. Of 51 zip codes, 37 are contained largely within a single
district; of the 20 included school districts, 7 employed only remote
instruction (RI) and 13 used some non-remote instruction (NRI) (2-15
weeks). Districts attempting NRI had lower average Social Vulnerability
Index (SVI) (0.32 versus 0.73). Weekly incidence increased in all zip
codes from August to peaks in late November to early December before
declining. The zip code cumulative incidence within school districts
that employed some NRI was higher than in those offering only RI (risk
ratio = 1.12; risk difference = 519 per 100,000), a contrast to
relatively lower pre-study incidence in NRI zip codes (incidence rate
ratio of study: pre-study period = 6.12 (NRI) versus 3.59 (RI)). The
mean effect (incidence rate ratio) for NRI on emergent cases 2 weeks
after mode exposure, controlling for SVI was significant only for high
SVI zip codes 1.30 (p<0.001). NRI may be associated with
increased community COVID-19 incidence. Vulnerable communities may need
more resources to open schools safely.
Effect of early physical therapy on schoolchildren with hematological cancer: a quasi-randomized controlled pilot study
Authors: Sonoda Yuma , Tobita Ryo , Ikeda Yuhachi , Kigawa Takashi , Taga Takashi
Published: January 2024

Background: Although the treatment for childhood hematological cancers
such as acute lymphoblastic leukemia (ALL) has improved, there are
problems involving a decrease in motor functional capacity and
health-related quality of life (HRQOL) during and after cancer
treatment. Physical therapy (PT) is expected to positively impact motor
functional capacity and HRQOL in patients, but the optimal time for
intervention is unknown. Procedure: This study evaluated the effect of
inpatient PT intervention in pediatric patients with hematological
cancer undergoing treatment at a single tertiary hospital. Participants
were assigned to two groups that started PT before or after initial
treatment (early PT or late PT, respectively). We evaluated the exercise
tolerance of participants using the six-minute walking distance (6MWD)
and differences in the HRQOL of participants and their mothers using the
Pediatric Quality of Life Inventory (PesdsQL) questionnaire at (1)
admission, (2) the end of initial treatment, and (3) discharge. Results:
Thirteen pediatric patients (61.5% ALL, aged 7–13 years) included.
Significant improvements were observed in PedsQL in the early PT cohort
but declined in the 6MWD and PedsQL in the late PT (all
p<0.025). The changes in PedsQL scores for the patients and
their mothers were similar. No adverse events related to PT during
treatment were identified. Conclusion: Early PT intervention is an
effective alternative to intensive rehabilitation care. Data suggest
that early rather than late-PT participation can result in significant
functional gains in locomotion and HRQOL in pediatric patients with
hematologic and oncologic conditions during hospitalization.
Transatrial management of inadvertent puncture of the posterior wall during transseptal access for atrial fibrillation ablation -- Case report
Authors: Chokr Muhieddine , Sousa Ítalo , Andere Tamer El , Filho Luiz Fernando de Gouvea , Scanavacca Mauricio Ibrahim
Published: January 2024

Transseptal puncture for atrial fibrillation ablation is a safe and
common procedure, however, complications, such as cardiac tamponade, are
possibly fatal if not recognized and treated. Our goal is to report a
case in which management of an inadvertent puncture of the posterior
wall of the left atrium was accomplished using an unusual technique,
followed by successful pulmonary vein isolation, and without the need of
subsequent subxiphoid puncture.
CRAMBESCIN C1 ACTS AS A SUBSTRATE OF iNOS and eNOS INCREASING NITRIC OXIDE PRODUCTION WITH AN IN VIVO HYPOTENSIVE EFFECT
Authors: Rubiolo Juan , Lence Emilio , González-Belo Concepción , Roel María , Gil-Longo José , Campos-Toimil Manuel , Thomas Olivier , González-Cantalapiedra Antonio , López-Alonso Henar , Vieytes Mercedes , Ternon Eva , Botana Luis
Published: January 2024

1. Crambescins are guanidine alkaloids from the sponge Crambe crambe.
Crambescine C induces metallothionein genes and nitric oxide is one of
the triggers. We assayed in silico, in vitro and, in vivo the effect in
comparison with two analogs: crambescine A, and homo-crambescine C 2.
HepG2 gene expression was analyzed using microarrays and additionally
assays used isolated rat aortic rings. The targets of crambescines were
studied in silico. In vivo vasodilation in rats was done by direct
measurement. 3. Crambescines C and homo-crambescine C, but not
crambescine A, induced metallothioneins transcripts. HepG2 cells with
crambescine C increased nitric oxide production. Vasodilation was
observed in aortic ring and in vivo after injection in rats. In silico
analysis points to eNOS and iNOS as targets of crambescin C and source
of nitric oxide increment. 4. Crambescin C effect is mediated through
crambescing binding to the active site of eNOS and iNOS. In isolated rat
aortic rings CC and HCC induced an endothelium-dependent relaxation
related to eNOS activation and an endothelium-independent relaxation
related to iNOS activation, hence both compounds increase NO and reduce
vascular tone. 5. Crambescin C1 docking studies in iNOS and eNOS active
site revealed hydrogen bonding of the hydroxylated chain with residues
Glu377 and Glu361, involved in the substrate recognition, and explains
its higher binding affinity than Crambescin A1. The later interaction
and the extra polar contacts with its pyrimidine moiety, absent in the
endogenous substrate, explain its role as exogenous substrate of NOSs
and NO production.
Subscapular Retrocardiac View in Bilateral Atriomegaly: An Amazing Window to the Heart
Authors: Allievi Luca , Conconi Barbara , Bongarzoni Amedeo , Carugo Stefano
Published: January 2024

We report a case in which bilateral atriomegaly allowed the assessment
of a mitral bioprosthesis and other cardiac structures through a
subscapular retrocardiac view, rarely used in clinical practice.
Baseline predictors of hospital length of stay in children with respiratory syncytial virus infection: A retrospective analysis of three prospective observational studies
Authors: Makariadou Elli , Keyaerts Els , Proesmans Marijke , Rector Annabel , Kirman Joanna , Ingham Tristram , Jones Bernadette , Miyairi Isao , Shinjoh Masayoshi , Tetsuka Noriyuki , Ispas Gabriela , Fleischhackl Roman
Published: January 2024

Background: Respiratory syncytial virus (RSV) is a common cause of
hospitalisation in infants and children. This study aimed to identify
common patient characteristics and baseline predictors of hospital
length of stay (LOS) among infants diagnosed with RSV infection.
Methods: This is a descriptive analysis of data from three separate
prospective observational paediatric studies in Belgium, Japan, and New
Zealand. Hospitalised children ≤5 years of age with a
laboratory-confirmed diagnosis of RSV infection and an onset of symptoms
≤5 days prior to hospitalisation were considered for inclusion. We
collected demographic and clinical information and the hospital LOS for
each patient. LOS was assessed by age, presence of comorbidity, presence
of prematurity, duration of symptoms and by country. Results: Overall,
181 patients were included in the analysis. The majority of patients
(84%; 152/181) were otherwise healthy; only 16% (29/181) had
comorbidity. Median hospital LOS was longer in Belgium and Japan than in
New Zealand (5, 7, and 3 days, respectively). Presence of comorbidity
prolonged hospital stay, with the effect on hospital LOS varying by
country. Age, duration of symptoms prior to hospitalisation, and
premature birth were not predictive of hospital LOS. Conclusion: In this
cohort of children ≤5 years old hospitalised for RSV infection, medical
practice varied greatly between countries. Although overall, comorbidity
was associated with longer LOS, while other predictive factors were of
little value in estimating LOS.
Quality Evaluation of Clinical Practice Guidelines and the Recommendations for Esophageal Cancer
Authors: Ni Peizan , Zhang Ruiyun , Wang Xiaohui , Wu Xuan , Ge Hong
Published: January 2024

Background: In the process of diagnosis and treatment of esophageal
cancer, the clinical guidelines is of great significance for the medical
behavior of clinicians and application of new research results. However,
a non-standard formulation of the guidelines may mislead clinicians and
bring unnecessary financial burden to patients. This study is to
evaluate the quality of the guidelines. Methods: We identified the
clinical practice guidelines or recommendations published in the English
database since 2018 that guide for the diagnosis or treatment of
esophageal cancer. Two reviewers used RIGHT checklist to evaluate the
quality of eligible guidelines independently. Results: A total of 15
guidelines and recommendations meet the inclusion criteria. Six of them
are from China, four from the United States, three from Japan, and the
remaining two are from Canada and Germany. Among them, there are 4 in
Chinese and 11 in English. The evaluation of these guidelines and
recommendations showed that the reporting proportion of 4 articles was
less than 50%. The average reporting proportion of 15 articles is
60.00%. Of the seven domains covered by RIGHT checklist, “basic
information” has the highest reporting proportion (78.89%) and the
lowest is “review and quality assurance” (13.33%). Of all sub-items,
3 are 100% reported, 13 (37.14%) sub-items are less than 50%. There
is no difference between the Chinese guide and the English guide (P=
0.442). Conclusions: The reporting quality of the esophageal cancer
guidelines published in the past three years is moderate, but there are
some deficiencies in the domains of “review and quality assurance”,
“funding and declaration and management of interests” and “other
information”. Guideline developers should strictly follow the standard
to improve the quality.
The impact of the CervicalCheck controversy on provision of colposcopy services in Ireland: a cohort study
Authors: Cheung Maria , Fitzpatrick M.
Published: January 2024

Objective: In 2018, an inquiry into the Irish cervical cancer screening
programme attracted widespread media coverage, resulting in anxiety
about the quality of the screening programme. We investigated whether
the controversy led to an increase in referrals based on clinical
suspicion and the impact on waiting times for abnormal cytology. Design:
A retrospective cross-sectional analysis was performed. Setting:
Department of Colposcopy, National Maternity Hospital, Dublin, Ireland.
Population or Sample: All colposcopy referrals before (March 2016 -
2018) and after (March 2018 - 2020) the media coverage. Methods:
Chi-squared (χ2) and independent one-tailed t-tests were used to perform
between-group analyses. Main Outcome Measures: Suspicious-appearing
cervix referrals, colposcopic impression and histological diagnosis of
these referrals, waiting time for abnormal cytology referrals. Results:
Post-controversy, suspicious cervix referrals increased (10.1% to
14.2%; p=0.037x10-27), as did colposcopic impression of CIN
(p=0.000000016). While an increase in CIN1 histology (18.5% to 30.3%)
was diagnosed, a decrease in high-risk CIN2 (10% to 8.6%), CIN3 (6.2%
to 2.9%), AIS (1.2% to 0.3%) and invasive cancer (2.8% to 1.2%;
p=0.0058 x 10-9) were diagnosed. Across all grades of cytological
abnormality, significantly fewer patients were reviewed in the
recommended waiting time post-controversy. Half of delayed abnormal
cytology referrals had high-grade changes. Conclusions: Heightened
anxiety and increased surveillance does not necessarily lead to better
clinical outcomes for patients but can result in unnecessary distress
for low-risk patients and delays to diagnosis for high-risk patients
with concerning abnormalities. Funding: None Keywords: cervical cancer
screening, CervicalCheck, scandal, controversy, media, colposcopy.
Interactions of anti-COVID-19 drug candidates with hepatic transporters may cause liver toxicity and affect drug metabolism
Authors: Temesszentandrási-Ambrus Csilla , Bakos Éva , Sarkadi Balázs , Özvegy-Laczka Csilla , Telbisz Ágnes
Published: January 2024

Background: Transporters in the human liver play a major role in the
metabolism of endo- and xenobiotics, as well as of pharmaceutical
agents. Drugs and metabolites are extruded into the bile through the
apical, canalicular membrane of the hepatocytes, while transporters in
the basolateral membrane either promote the uptake or perform an
extrusion of various compounds into the venous blood stream.
Experimental Approach: In the present work we have examined the in vitro
interactions of some key repurposed drugs advocated to treat COVID-19
(lopinavir, ritonavir, ivermectin, remdesivir and favipiravir), with the
relevant key transporters in the hepatocytes. These transporters
included the ABCB11/BSEP, ABCC2/MRP2, and MATE1 in the canalicular
membrane, as well as ABCC3/MRP3, ABCC4/MRP4, OCT1, OATP1B1, OATP1B3, and
NTCP, residing in the basolateral membrane. Key Results: Lopinavir and
ritonavir in low micromolar concentrations inhibited the ABCB11/BSEP and
MATE1 exporters, as well as the OATP1B1/1B3 uptake transporters.
Ritonavir had a similar inhibitory pattern, also inhibiting OCT1.
Remdesivir strongly inhibited ABCC4/MRP4, OATP1B1/1B3, MATE1 and OCT1.
Thus, these agents may cause severe drug-drug interactions and
drug-induced liver injury. Favipiravir had no significant effect on any
of the transporters examined. Conclusion and Implications: Since both
general drug metabolism and drug-induced liver toxicity are strongly
dependent on the functioning of these transporters, the variable
interactions reported here may have important clinical relevance in the
drug treatment of this viral disease and the existing co-morbidities.
Another new application of heparin in COVID-19: more than anticoagulation and antiviral
Authors: Yu Xianqiang
Published: January 2024

Heparin is used as a classic anticoagulant in clinic. In addition, with
the ongoing pandemic and unknown challenges, the mechanism of action of
heparin in antiviral and anti-inflammatory aspects has been constantly
discovered and clarified. This also provides effective support for the
treatment of COVID-19 in specific contexts. Most importantly, heparin
may act as a multi-drug.
Production and application of mouse monoclonal antibodies targeting linear epitopes in pB602L of African Swine Fever Virus
Authors: Wang Pengfei , Liu Chunguo , Wang Shida , Wen Lili , Shi Zhibin , Chi Yue , Wang Ming , Liu Zaisi , Sun Zhenzhao , Wei Lili , Yang Dechen , He Xijun , Wang Jingfei
Published: January 2024

African swine fever (ASF) is an acute hemorrhagic disease of domestic
pigs. The causative agent of ASF, ASF virus (ASFV), is a double-stranded
DNA virus, the sole member in the family Asfarviridae. The
non-structural protein pB602L of ASFV is a molecular chaperone of the
major capsid protein p72 and plays a key role in the icosahedral capsid
assembly. This protein has good antigenicity and is also a target for
developing diagnostic tools for ASF. To understand the molecular basis
for the antigenicity of pB602L, a procaryoticly expressed recombinant
pB602L protein was produced and applied to immunize mice for producing
monoclonal antibodies (mAbs). A total of eight mouse mAbs were obtained
and their binding epitopes were screened by Western blot against
overlapped polypeptides of pB602L. Three linear epitopes were identified
and designated Epitope 1 (366ANRERYNY373), Epitope 2 (415GPDAPGLSI423),
and Epitope 3 (498EMLNVPDD505). Based on their recognizing epitopes, the
eight mAbs were placed to three groups: Group 1 (B2A1, B2F1 and B2D10),
Group 2 (B2H10, B2B2, B2D8, and B2A3), and Group 3 (B2E12), accordingly.
mAbs B2A1, B2H10 and B2E12 were applied to detect pB602L in ASFV
infected porcine alveolar macrophages (PAM) and pig tissues by indirect
florescence assay (IFA), immunohistochemical staining, and immunogold
labeling for electron microscopy, respectively. The results showed that
pB602L was well detected with all the three mAbs by immunohistochemical
staining and immunoelectron microscopy; but only B2H10 was suitable for
detecting the protein in ASFV infected PAM cells by IFA. Taken together,
we developed eight anti-pB602L mouse mAbs recognizing three linear
epitopes in the protein, which provide biological materials and
molecular basis for the basic and applied researches on ASFV.
Clinical Assessment Service (CAS) – a novel approach to expand access to secondary care in gynaecology during the COVID-19 pandemic: a single-institution intervention study
Authors: Rahman Rumana , Flynn Lauren , Verghese Tina , Naeem Tahira , Tumula Sree , Taylor Caroline , Adil Md Tanveer
Published: January 2024

Background-The COVID-19 pandemic called for significant restructuring of
healthcare system in the United Kingdom to overcome the burden on
emergency services and restore elective activities.This study aims to
discuss the development of a new triage system of reviewing gynaecology
e-referrals to secondary care and analyse the sustainability of this
service beyond the pandemic.The streamlining of primary care referrals
was conceptualised on the framework of Clinical Assessment Service (CAS)
as recommended by NHS Long-Term Plan. Method-CAS was implemented in our
gynaecology department as a response to COVID-19 pandemic.E-referrals
triaged using CAS in phase 1 were reviewed and areas of improvement
identified. A second review was carried out in phase 2 after
implementing changes to ensure improved services.The outcomes of
interest were appropriateness of referrals,destination appointments and
percentage of virtual appointments. Results-185 e-referrals in phase 1
and 85 e-referrals in phase 2 were analysed.Training and education of
relevant stakeholders and a more efficient CAS in phase 2 resulted in
significant reduction in inappropriate referrals from 14% to 3%
[RR-0.17 (95% CI - 0.04-0.72); p=0.02].For every 9 e-referral
reviewed in CAS,1 inappropriate referral was avoided.The number of
virtual appointments increased by 16% (45% in Group 1, 61% in Group
2). Conclusion-CAS framework provides a sustainable strategy to overcome
disruptions in the provision of elective outpatient services caused by
COVID-19 pandemic.It reduces inappropriate secondary care
e-referrals,allows management of eligible patients digitally,shortens
patient care pathway and creates a dynamic link between the primary care
providers and specialist care.
Synthesis, crystal structure and DFT study of a new compound N-(4-((6-bromopyrido[2,3-d]pyrimidin-4-yl)oxy)phenyl)morpholine-4-carboxamide
Authors: Deng liyuan , Sun Hong , Hu weiyin , Liao Wanpeng , Liao Weike , Zhou Zhixu , Pan Hongyan
Published: January 2024

N-(4-((6-bromopyrido[2,3-d]pyrimidin-4-yl)oxy)phenyl)morpholine-4-carboxamide
is a derivative of pyrido[2,3-d]pyrimidine with anti-tumor,
antibacterial, anti-inflammatory and anti-microbial effects. Using
2-aminonicotinic acid as the starting material, the title compound was
prepared through esterification, bromo ring and chlorine reactions. 1H
NMR, 13C NMR and HRMS confirmed the structure of the target compound.
The precise structure of the compound
N-(4-((6-bromopyrido[2,3-d]pyrimidin-4-yl)oxy)phenyl)morpholine-4-carboxamide
was analyzed by single-crystal X-ray diffraction. The molecular
structure was further calculated using density functional theory (DFT),
compared with the X-ray diffraction value. The molecular electrostatic
potential and frontier molecular orbitals of the title compound were
further investigated using DFT.
The impact of testosterone on the QT interval: A Systematic review
Authors: Gutierrez Gilmar , Wamboldt Rachel , Baranchuk Adrian
Published: January 2024

Background: Humans and mammals have sex-specific differences in cardiac
electrophysiology, linked to the action of sex hormones in the cardiac
muscle. These hormones can either increase or decrease the expression of
ionic channels modulating the cardiac cycle through genomic and
non-genomic interactions. Methods: Systematic search in PubMed, Medline
and EMBASE including keywords pertaining to testosterone and QT
interval. Included experimental studies, observation studies and case
reports presenting the results of testosterone administration, excess or
deficiency in humans and animals. Results: Testosterone has been shown
to shorten the action potential duration, by enhancing the expression of
K+ channels and downregulating ICaL increasing the repolarization
reserve of the cardiac muscle. This increased repolarization reserve
also protects the heart against the effects of QT prolonging drugs and
arrhythmogenesis. This effect has been observed in both genders and
animals. Conclusions: Testosterone deficient states can promote
arrhythmogenesis. The evidence in this paper may be used to guide
clinical consideration relating to testosterone levels and QT prolonging
states and medications, such as increased clinical surveillance of
patients in testosterone deficient states using ECG.
Right atrial papillary fibroelastoma arising from the Chiari network detected by echocardiography: a case report.
Authors: Hu Nana , Shen Wenqian , Cai Guohua , Zhang Qinghua , Zhang Yanmei , Du Guo-Qing
Published: January 2024

Right atrial papillary fibroelastomas (PFE) originated from the Chiari
network (CN) are exceedingly rare. Only 2 cases have been reported in
the worldwide literature. We present a case of PFE arising from the
right atrial CN detected by transesophageal echocardiography (TEE) with
a previous vertebral aneurysm history and underwent a complete surgical
removal. In this report, we describe our clinical observations to
improve our understanding of the tumor and provide evidence for its
treatment and prognosis.