bluuebunny/crossref_metadata_2025 huggingface dataset:
Extracts from Argentinian native plants reverse fluconazole resistance in Candida species by inhibiting the efflux transporters Mdr1 and Cdr1
Authors: Gil Florimar , Laiolo Jerónimo , Bayona-Pacheco Brayan , Cannon Richard D. , Ferreira-Pereira Antonio , Carpinella María Cecilia
Published: October 2022

Background

The development of multidrug resistance (MDR) associated with the overexpression of the efflux transporters Mdr1 and Cdr1 in Candida species impedes antifungal therapies. The urgent need for novel agents able to inhibit the function of both pumps, led us to evaluate this property in 137 extracts obtained from Argentinian plants.

Methods

The ability of the extracts to reverse efflux pump-mediated MDR was determined with an agar chemosensitization assay using fluconazole (FCZ) resistant Mdr1- and Cdr1-overexpressing clinical isolates of Candida albicans and Candida glabrata as well as Saccharomyces cerevisiae strains selectively expressing Mdr1 (AD/CaMDR1) or Cdr1 (AD/CaCDR1). The resistance-reversing activity of the most potent extracts was further confirmed using a Nile Red accumulation assay.

Results

Fifteen plant extracts overcame the FCZ resistance of Candida albicans 1114, which overexpresses CaMdr1 and CaCdr1, and AD/CaMDR1, with those from Acalypha communis and Solanum atriplicifolium being the most effective showing 4- to 16-fold reversal of resistance at concentrations ≥ 25 µg/mL. Both extracts, and to a lesser extent that from Pterocaulon alopecuroides, also restored FCZ sensitivity in CgCdr1-overexpressing C. glabrata 109 and in AD/CaCDR1 with fold reversal values ranging from 4 to 32 and therefore demonstrating a dual effect against Mdr1 and Cdr1. Both, A. communis and S. atriplicifolium extracts at concentrations ≥ 12.5 and ≥ 25 µg/mL, respectively, increased the intracellular Nile Red accumulation in all yeast strains overexpressing efflux pumps.

Conclusions

The non-toxic and highly active extracts from A. communis and S. atripicifolium, provide promising sources of compounds for potentiating the antifungal effect of FCZ by blocking the efflux function of Mdr1 and Cdr1 transporters.
Identification of risk factors for incident cervical insufficiency in nulliparous and parous women: a population-based case-control study
Authors: Meng Lili , Öberg Sara , Sandström Anna , Wang Chen , Reilly Marie
Published: October 2022

Background

Cervical insufficiency is one of the underlying causes of late miscarriage and preterm birth. Although many risk factors have been identified, the relative magnitude of their association with risk in nulliparous versus parous women has not been well demonstrated, especially for incident cervical insufficiency (ICI). The aim of this study was to investigate and compare the magnitude of the association of ICI with predictive factors in nulliparous and parous women, and to further investigate various aspects of obstetric history for parous women.

Methods

Pregnant women with a first diagnosis of cervical insufficiency were compared to a random sample of control pregnancies from women with no diagnosis by using Swedish national health registers. Demographic, reproductive, and pregnancy-specific factors were compared in case and control pregnancies, and relative risks presented as odds ratios (OR), stratified by nulliparous/parous. Independent associations with ICI were estimated from multivariable logistic regression. Associations with obstetric history were further estimated for multiparous women.

Results

A total of 759 nulliparous ICI cases and 1498 parous cases were identified during the study period. Multifetal gestation had a strong positive association with ICI in both groups, but of much larger magnitude for nulliparous women. The number of previous miscarriages was also a much stronger predictor of risk in nulliparous women, especially for multifetal pregnancies. History of preterm delivery (<37 weeks’ gestation) was an independent predictor for parous women, and for those whose most recent delivery was preterm, the association with ICI increased with each additional week of prematurity. A previous delivery with prolonged second stage of labor or delivery of a very large infant were both inversely associated with risk of ICI in the current pregnancy.

Conclusions

The differences in importance of predictive risk factors for incident cervical insufficiency in nulliparous and parous women can help resolve some of the inconsistencies in the literature to date regarding factors that are useful for risk prediction. Stratifying on parity can inform more targeted surveillance of at-risk pregnancies, enable the two groups of women to be better informed of their risks, and eventually inform screening and intervention efforts.
BMSC exosome-enriched acellular fish scale scaffolds promote bone regeneration
Authors: Wang Yangyufan , Kong Bin , Chen Xiang , Liu Rui , Zhao Yuanjin , Gu Zhuxiao , Jiang Qing
Published: October 2022

Tissue engineering scaffolds are essential for repairing bone defects. The use of biomimetic scaffolds for bone tissue engineering has been investigated for decades. To date, the trend in this area has been moved toward the construction of biomimetic acellular scaffolds with effective modification to enhance the osteogenic differentiation efficiency of bone marrow mesenchymal stem cells (BMSCs). The exosomes derived from BMSCs have been shown as a potential therapeutic tool for repairing bone defects. In this study, we demonstrated the pro-osteogenic effects of exosomes derived form osteogenic differentiated BMSCs (OBMSC) and presented a novel exosmes-functionalized decellularized fish scale (DE-FS) scaffold for promoting bone regeneration in vivo. The DE-FS scaffolds were obtained through decellularization and decalcification processes, which exhibited high biocompatibility and low immunological rejection. The intrinsic anisotropic structures of DE-FS could enhance the adhesion and proliferation ability of BMSCs in vitro. In addition, we demonstrated that the porous structure of DE-FS endowed them with the capacity to load and release exosomes to BMSCs, resulting in the enhanced osteogenic differentiation of BMSCs. Concerning these pro-osteogenic effects, it was further proved that OBMSC exosome-modified DE-FS scaffolds could effectively promote bone regeneration in the mouse calvarial defect models. In conclusion, our work provided a new insight to design exosome-riched biomimetic scaffolds for bone tissue engineering and clinical applications.
Effects of electromagnetic waves on pathogenic viruses and relevant mechanisms: a review
Authors: Xiao Yi , Zhao Li , Peng Ruiyun
Published: October 2022

Pathogenic viral infections have become a serious public health issue worldwide. Viruses can infect all cell-based organisms and cause varying injuries and damage, resulting in diseases or even death. With the prevalence of highly pathogenic viruses, such as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), it is urgent to develop efficient and safe approaches to inactivate pathogenic viruses. Traditional methods of inactivating pathogenic viruses are practical but have several limitations. Electromagnetic waves, with high penetration capacity, physical resonance, and non-contamination, have emerged as a potential strategy to inactivate pathogenic viruses and have attracted increasing attention. This paper reviews the recent literature on the effects of electromagnetic waves on pathogenic viruses and their mechanisms, as well as promising applications of electromagnetic waves to inactivate pathogenic viruses, to provide new ideas and methods for this inactivation.
High-coverage targeted lipidomics could reveal lipid alterations and evaluate therapeutic efficacy of membranous nephropathy
Authors: Lu Zhenzhen , Liu Conghui , Wu Qingqing , Deng Yueyi
Published: October 2022

Background

Membrane nephropathy (MN) often presents as nephrotic syndrome with characteristic lipid metabolism that could not be explained by lipid indicators commonly used in clinical practice. Studies have shown that invigorating spleen and qi, activating blood and detoxication in the treatment of MN is an effective method proved by randomized controlled clinical trial. However, the alterations of lipid profile before and after traditional Chinese medicine (TCM) treatment and the related lipid markers that affect the therapeutic effect have not been fully clarified.

Methods

We analyzed plasma lipid profiles of 92 patients with MN before and after TCM treatment by high-coverage targeted lipidomics.

Results

675 lipids were identified, of which 368 stably expressed lipids (coefficient of variation less than 30% and deletion value less than 10%) were eventually included for statistical analysis. 105 lipids were altered mainly including spingolipids, glycerides, glycerophosholipid, fatty acyl and steroids, among which, the abundance of ceramides (Cers), sphingomyelins (SMs), diacylglycerols (DGs), phosphatidylcholines (PCs) were lower than those before treatment with statistically significant difference. The WGCNA network to analyze the correlation between the collective effect and the therapeutic effect showed that the triglyceride (TG) molecules were most relevant to the therapeutic effect. Analysis of 162 triglyceride molecules showed that 11 TGs were significantly down-regulated in the effective group which were concentrated in carbon atom number of 52–56 and double bond number of 0–4. TGs molecules including TG56:2-FA20:0, TG56:2-FA20:1, TG56:3-FA20:0 and TG56:5-FA20:2 were most closely related to the therapeutic effect of TCM after adjusting the influence of clinical factors. ROC curve analysis showed that these four lipids could further improve the predictive efficacy of treatment based on clinical indicators.

Conclusion

Our work demonstrated that the therapeutic effect of invigorating spleen and qi, activating blood and detoxication in the treatment of MN may be exerted by regulating lipid metabolism. High-coverage targeted lipidomics provided a non-invasive tool for discovery of lipid markers to improve the predictive efficacy of TCM therapy.
Sustainable thresholds, health outcomes, health expenditures and education nexus in selected African countries: quadratic and moderation modelling
Authors: Adegoke Yetunde Oluranti , George Gavin , Mbonigaba Josue
Published: October 2022

Background

This study aligns with Sustainable Development Goal 3 which borders on “good health and well-being for people by ensuring healthy lives and promoting well-being for all at all ages”. It contributes to the health literature by evaluating the roles of health expenditures and educational quality on three health outcomes (infant mortality, maternal mortality and life expectancy at birth).

Methods

The study uses the panel spatial correlation consistent (PSCC) approach on balanced panel data on 25 selected sub-Saharan African countries from 2000 to 2020 to interrogate the nexus.

Results

The following findings are documented. First, health expenditures reveal significant asymmetric quadratic effects on health outcomes. Second, the interactions between health expenditures and educational quality reduce infant and maternal mortalities while enhancing life expectancy. Third, the threshold points from the interaction effects indicate that enhancing educational quality beyond some critical thresholds of 1.51 and 1.49 can induce a drop in maternal and child mortalities while a point beyond 1.84 exerts an improvement in life expectancy.

Conclusions

Hence, policy makers should ensure that both health expenditures and educational quality exceed the established thresholds for sustainable health outcomes.
SPECT/CT imaging features of cystic degeneration of the talus and their relation to pathological findings
Authors: Song Qitao , Zeng Xiantie , Huang Haijing , Long Lei , Xu Jin , Cui Shuangshuang , Li Zhonghai , Ma Xinlong
Published: October 2022

Background

Osteochondral lesions of the talus (OLTs) are a common orthopedic condition. The image presentation is very similar to that of ischemic necrosis of the talus complicated by a talar neck fracture, but the two are very different lesions. When abnormalities in bone density (or signal) of the talar body (apex of the fornix) with concomitant bone defects and cystic changes are found on X-ray, computed tomography (CT), or magnetic resonance imaging, it is important to accurately determine the nature of the lesion and make a correct diagnosis for the treatment and prognosis of the patient. The purpose of this study was to explore the imaging features of three-phase single-photon emission computed tomography (SPECT)/CT images of cystic lesions of the talus.

Methods

A total of 189 patients with chronic pain in the ankle joint suspected to be caused by cystic degeneration of the talus were enrolled. All patients underwent 99mTc-methyl diphosphonate (99mTc-MDP) three-phase SPECT/CT bone imaging and delayed scans in our hospital. The location, range of involvement, classification, CT value, and radioactivity uptake of the sclerotic areas of cystic lesions on the talus, and the continuity of the articular surface, were recorded. All recorded parameters were analyzed in comparison with pathological results.

Results

Eighty-three percent (157/189) of the talar cysts were located on the medial fornix, largely involving the anterior middle part (43.27%), with larger cysts involving the posterior part (9.6%). Sixty-three percent (119/189) of the patients had type I lesions and 37% (70/189) had type II lesions. The articular surface of the medial dome of the talus was intact in all patients, but the subchondral bony articular surface was rough in 88% (166/189) of patients. The coincidence rate for the location, type, and range of involvement of cystic lesions with the pathological results was 87.83% (166/189). The mean CT value of the cystic lesions was 45 ± 15 HU (30–60 HU). The percentages of pathological chondrogenesis in high CT value ≥ 50 HU (19/70) and low CT value < 50 HU (51/70) groups were 89.47% (17/19) and 29.14% (15/51) (χ2 = 20.12, p < 0.001), respectively. The target/background ratio (T/B ratio) of the radioactivity-uptake area of the talus vault was 2.0 ± 0.5 (1.5–2.5). The percentages of pathological new trabecular bone in those with a T/B ratio ≥ 2.0 (157/189) and T/B ratio < 2.0 (32/189) were 82.80% (130/157) and 25.00% (8/32; χ2 = 45.08, p < 0.001), respectively.

Conclusions

Three-phase bone imaging could identify damage of the talus caused by cystic degeneration, while delayed SPECT/CT images showed advantages for displaying bone microstructure, blood supplement, and bone metabolism when examining the location, range of involvement, classification, and repair of cystic lesions of the talus.
Metabolic recycling of storage lipids promotes squalene biosynthesis in yeast
Authors: Son So-Hee , Kim Jae-Eung , Moon Soo Young , Jang In-Seung , Yu Byung Jo , Lee Ju Young
Published: October 2022

Background

Metabolic rewiring in microbes is an economical and sustainable strategy for synthesizing valuable natural terpenes. Terpenes are the largest class of nature-derived specialized metabolites, and many have valuable pharmaceutical or biological activity. Squalene, a medicinal terpene, is used as a vaccine adjuvant to improve the efficacy of vaccines, including pandemic coronavirus disease 2019 (COVID-19) vaccines, and plays diverse biological roles as an antioxidant and anticancer agent. However, metabolic rewiring interferes with inherent metabolic pathways, often in a way that impairs the cellular growth and fitness of the microbial host. In particular, as the key starting molecule for producing various compounds including squalene, acetyl-CoA is involved in numerous biological processes with tight regulation to maintain metabolic homeostasis, which limits redirection of metabolic fluxes toward desired products.

Results

In this study, focusing on the recycling of surplus metabolic energy stored in lipid droplets, we show that the metabolic recycling of the surplus energy to acetyl-CoA can increase squalene production in yeast, concomitant with minimizing the metabolic interferences in inherent pathways. Moreover, by integrating multiple copies of the rate-limiting enzyme and implementing N-degron-dependent protein degradation to downregulate the competing pathway, we systematically rewired the metabolic flux toward squalene, enabling remarkable squalene production (1024.88 mg/L in a shake flask). Ultimately, further optimization of the fed-batch fermentation process enabled remarkable squalene production of 6.53 g/L.

Conclusions

Our demonstration of squalene production via engineered yeast suggests that plant- or animal-based supplies of medicinal squalene can potentially be complemented or replaced by industrial fermentation. This approach will also provide a universal strategy for the more stable and sustainable production of high-value terpenes.
Correlation between insulin-based and C-peptide based homeostatic model assessment of insulin resistance in adults without diabetes in a sub-Saharan African setting: a cross-sectional study
Authors: Tekoh Blessing N. , Mbono-Samba Esther Astrid E. , Etoa-Etoga Martine Claude , Eko Manuela Audrey , Amazia Falmata , Agoons Batakeh Ba , Nansseu Jobert Richie , Bigna Jean Joel , Ama-Moor Vicky Jocelyne
Published: October 2022

Objective

To assess the correlation between the insulin-based and C-peptide based HOMA-IR in the general population without diabetes in sub-Saharan Africa as well as to identify factors associated with IR.

Results

This was a cross-sectional study in urban settings in Yaoundé, Cameroon. We included 84 people with a body mass index (BMI) ≥ 18.5 Kg/m² and without diabetes (females: 72.6%; mean age: 37 years). IR was assessed using the following formulae: HOMA-IRINS = fasting insulin (mU/ml) x fasting plasma glucose (FPG) (mmol/L)/ 22.5; HOMA-IRCP1 = fasting C-peptide (mU/ml) x FPG (mmol/L)/ 22.5; and HOMA-IRCP2 = 1.5 + (FPG (mg/dl) x fasting C-peptide (ng/ml))/ 2800. Correlation (rho) between HOMA-IRINS and C-peptide based HOMA-IR was investigated using the Spearman rank test. The median (25th -75th percentiles) HOMA-IRINS, HOMA-IRCP1, and HOMA-IRCP2 were: 1.94 (1.36–3.50), 0.18 (0.11–0.27) and 9.91 (6.81–14.52), respectively. There was no correlation between the insulin-based and C-peptide-based HOMA-IR indices: rho = 0.043, p = 0.697. IR (HOMA-IRINS ≥ 2.8) was associated with obesity: A BMI ≥ 30 Kg/m² (adjusted odds ratio (aOR): 16.9, 95% confidence intervals (CI): 3.1–92.5) and being a student (aOR: 8.9, 95%CI: 2.1–38.2) were associated with IR.
DAR-PCR: a new tool for efficient retrieval of unknown flanking genomic DNA
Authors: Sun Tianyi , Jia Mengya , Wang Lingqin , Li Zhaoqin , Lin Zhiyu , Wei Cheng , Pei Jinfeng , Li Haixing
Published: October 2022

Various PCR-based genome-walking methods have been developed to acquire unknown flanking DNA sequences. However, the specificity and efficacy levels, and the operational processes, of the available methods are unsatisfactory. This work proposes a novel walking approach, termed differential annealing-mediated racket PCR (DAR-PCR). The key to DAR-PCR is the use of primer-mediated intra-strand annealing (ISA). An ISA primer consists of a 5’ root homologous to the known sequence and a heterologous 3’ bud. In the single low-stringency cycle, the ISA primer anneals to a site on an unknown region and extends towards the sequence-specific primer (SSP) 1 site, thereby forming a target single-stranded DNA bound by the SSP1 complement and the ISA primer. In the subsequent more stringent cycles, its complementary strand is accumulated, owing to the differential annealing between the moderate-stringency ISA primer and the high-stringency SSP1. The accumulation of this strand provides an opportunity for ISA mediated by the ISA primer root. A loop-back extension subsequent to ISA occurs, creating a racket-like DNA with the known region positioned at both ends of the unknown sequence. This DNA is exponentially amplified during the secondary PCR driven by an SSP pair inner to SSP1. DAR-PCR was validated as an efficient walking method by determining unknown flanking sequences in Lactobacillus brevis and Oryza sativa.
An enhanced encryption-based security framework in the CPS Cloud
Authors: Priyadarshini R. , Quadir Md Abdul , Rajendran N. , Neelanarayanan V. , Sabireen H.
Published: October 2022

The rapid advancement of computation techniques and cloud computing has led to substantial advancements in Cyber-Physical Systems (CPS), particularly in the field of health care. There are a variety of ways in which CPS is used in healthcare today, including delivering intelligent feedback systems, automatically updating patient data digitally, monitoring patients passively with biosensors, etc. In recent years, cyber-physical systems have become capable of making lifesaving decisions as they are becoming more connected to the cloud. However, healthcare has become one of the most critical issues for many. A CPS network uses the Internet of Medical Things (IoMT) to continuously monitor patients’ health metrics such as body temperature, heart rate, etc. Due to physical connectivity restrictions, networks are more susceptible to security threats. In spite of the fact that the data is stored in the cloud, it is necessary to provide security regardless of device security and network security. Several cyber-security vulnerabilities have been identified in cloud-based healthcare systems in particular. To give patients a reliable healthcare experience, security concerns with CPSs need to be addressed carefully. In this context, this paper proposes a Cross-Breed Blowfish and MD5 (CBM) approach to improve the security of health data in the CPS cloud. The proposed model uses the wireless sensor network, in which data acquired by the network is transmitted via the transmitting node. Using the fuzzified effective trust-based routing protocol (FET-RP), the most efficient path for data travel is selected. The best route is determined using Butter-Ant Optimization (BAO) algorithm. The proposed method conveys data throughput encryption and decryption in a decoded format. The encrypted data is then stored in the cloud database for security reasons. The route finding algorithm is the one which is sending the data from one end to other end. The data is encrypted based on the source and destination. We compare the performance metrics of our recommended technique to those of other existing techniques, such as RSA, Two fish, ICC, and FHEA, in order to ensure that it performs optimally. The values of Cross Breed Blowfish and MD5 and FET-RP with regard to the performance metrics in terms of encryption (60 ms), decryption (55 ms), latency (60 s), throughput (97 mbps), security level (98%), and execution time (57 ms) which outperforms the conventional methods by 10–15%. Also the proposed encryption shows the considerable improvement in the level of security making our model a real world solution.
Managing type 2 diabetes or prediabetes and binge eating disorder: a qualitative study of patients’ perceptions and lived experiences
Authors: Salvia Meg G. , Ritholz Marilyn D. , Craigen Katherine L.E. , Quatromoni Paula A.
Published: October 2022

Background

The overlap in prevalence between type 2 diabetes and binge eating disorder is substantial, with adverse physical and mental health consequences. Little is known about patients’ efforts at managing these two conditions simultaneously. The research objective was to explore patients’ experiences managing co-existing type 2 diabetes or prediabetes and binge eating disorder.

Methods

This is a qualitative descriptive study using semi-structured interviews. Participants included 21 women with type 2 diabetes or prediabetes (90% non-Hispanic White; mean age 49 ± 14.8 years, mean BMI 43.8 ± 8.4; 48% with type 2 diabetes and mean HbA1c was 8.4%). Interviews were analyzed using thematic analysis and NVivo software.

Results

Qualitative analysis revealed that participants reported binge episodes frequently started in childhood or adolescence and went undiagnosed for decades; notably, they recalled that diabetes diagnosis preceded the binge eating disorder diagnosis. They also described trying to lose weight throughout their lives and how feelings of deprivation, shame, and failure exacerbated binge eating. Participants further reported how binge eating made diabetes self-care and outcomes worse. Finally, participants observed that when binge eating disorder treatment and diabetes management were synergistically integrated, they experienced improvements in both binge eating and glycemic outcomes. This integration included reframing negative thoughts surrounding binge eating disorder and diabetes self-management and increasing their understanding of how the two disorders were inter-related.

Conclusion

Findings highlight the importance of increasing healthcare providers’ awareness of and screening for binge eating disorder in the treatment of diabetes and inform specific integrated interventions that address both diagnoses.

Plain ENGLISH summary

From this study where we interviewed 21 women with binge eating disorder (BED) and type 2 diabetes/prediabetes, we learned how binge eating impacted diabetes management and how diabetes impacted BED. Most participants reported receiving the diabetes diagnosis before being diagnosed with BED despite the earlier onset of binge eating, pointing to the need for BED screening. Participants described trying to lose weight throughout their lives and reported feelings of failure and shame, which made binge eating worse. Binge eating made diabetes management harder, but when diabetes and BED treatment were aligned, participants experienced improvements in binge symptoms and diabetes outcomes.
The Maximal Intensity Period: Rationalising its Use in Team Sports Practice
Authors: Weaving Dan , Young Damien , Riboli Andrea , Jones Ben , Coratella Giuseppe
Published: October 2022

Quantifying the highest intensity of competition (the maximal intensity period [MIP]) for varying durations in team sports has been used to identify training targets to inform the preparation of players. However, its usefulness has recently been questioned since it may still underestimate the training intensity required to produce specific physiological adaptations. Within this conceptual review, we aimed to: (i) describe the methods used to determine the MIP; (ii) compare the data obtained using MIP or whole-match analysis, considering the influence of different contextual factors; (iii) rationalise the use of the MIP in team sports practice and (iv) provide limitations and future directions in the area. Different methods are used to determine the MIP, with MIP values far greater than those derived from averaging across the whole match, although they could be affected by contextual factors that should be considered in practice. Additionally, while the MIP might be utilised during sport-specific drills, it is inappropriate to inform the intensity of interval-based, repeated sprint and linear speed training modes. Lastly, MIP does not consider any variable of internal load, a major limitation when informing training practice. In conclusion, practitioners should be aware of the potential use or misuse of the MIP.
Vertical distribution of microplastics in the sediment profiles of the Lake Taihu, eastern China
Authors: Huang Yinan , Fan Jiajia , Liu Huan , Lu Xiancai
Published: October 2022

Microplastics are ubiquitous in the freshwater environment, while its abundance in the sediment profiles has received little attention. The vertical microplastic distribution in the sediment of the North (NTH) and Southwest (SWTH) of Lake Taihu was identified and characterized in this study. Microplastics could be detected at all depths (0–50 cm) at the two sites, with the total abundance of 8100 and 5300 particles kg−1 dry weight sediment at NTH and SWTH, respectively. This indicates that the microplastic storage in the sediment of the Lake Taihu may be underestimated, if only the surface sediment is considered. Microplastics composed of various polymer types were identified in the sediment of the two sites, including polyamide (PA), acrylic acid, polyethylene terephthalate and cellulose acetate, while high density polyethylene and polypropylene were only detected at NTH. The main type of polymers detected at NTH (42%) and SWTH (43%) were PA. The major shape of microplastics was fibers, with a ratio of 76% and 78%, respectively at the site NTH and SWTH. The colors of microplastics were mainly white (accounted for 42 and 43% at NTH and SWTH, respectively), which may be caused by the long-term decomposition of dyestuff in the syngenesis of sediment and/or probably the degradation during sample treatments. The textile industry and fishery activities may provide the source. In summary, our findings in the Lake Taihu provide better understanding of the microplastic pollution and tackle microplastics challenges.
Modeling TSH Receptor Dimerization at the Transmembrane Domain
Authors: Mezei Mihaly , Latif Rauf , Davies Terry F
Published: October 2022

Biophysical studies have established that the thyrotropin (TSH) receptor (TSHR) undergoes posttranslational modifications including dimerization. Following our earlier simulation of a TSHR–transmembrane domain (TMD) monomer (called TSHR-TMD-TRIO) we have now proceeded with a molecular dynamics simulation (MD) of TSHR-TMD dimerization using this improved membrane-embedded model. The starting structure was the TMD protein with all extracellular and intracellular loops and internal waters, which was placed in the relative orientation of the model originally generated with Brownian dynamics. Furthermore, this model was embedded in a DPPC lipid bilayer further solvated with water and added salt. Data from the MD simulation studies showed that the dimeric subunits stayed in the same relative orientation and distance during the 1000 ns of study. Comparison of representative conformations of the individual monomers when dimerized with the conformations from the monomer simulation showed subtle differences as represented by the backbone root mean square deviations. Differences in the conformations of the ligand-binding sites, suggesting variable affinities for these “hot spots,” were also revealed by comparing the docking scores of 46 small-molecule ligands that included known TSHR agonists and antagonists as well as their derivatives. These data add further insight into the tendency of the TSHR-TMD to form dimeric and oligomeric structures and show that the differing conformations influence small-molecule binding sites within the TMD.
Investigating the Association Between a Risk-Directed Prophylaxis Protocol and Postoperative Nausea and Vomiting: Validation in a Low-Income Setting
Authors: Tuyishime Jean de Dieu H. , Niyitegeka Joseph , Olufolabi Adeyemi J. , Powers Samuel , Naik Bhiken I. , Tsang Siny , Durieux Marcel E. , Twagirumugabe Theogene
Published: October 2022

BACKGROUND:

The efficacy of postoperative nausea and vomiting (PONV) prevention protocols in low-income countries is not well known. Different surgical procedures, available medications, and co-occurring diseases imply that existing protocols may need validation in these settings. We assessed the association of a risk-directed PONV prevention protocol on the incidence of PONV and short-term surgical outcomes in a teaching hospital in Rwanda.

METHODS:

We compared the incidence of PONV during the first 48 hours postoperatively before (April 1, 2019–June 30, 2019; preintervention) and immediately after (July 1, 2019–September 30, 2019; postintervention) implementing an Apfel score-based PONV prevention strategy in 116 adult patients undergoing elective open abdominal surgery at Kigali University Teaching Hospital in Rwanda. Secondary outcomes included time to first oral intake, hospital length of stay, and rate of wound dehiscence. Interrupted time series analyses were performed to assess the associated temporal slopes of the outcome before and immediately after implementation of the risk-directed PONV prevention protocol.

RESULTS:

Compared to just before the intervention, there was no change in the odds of PONV at the beginning of the postintervention period (odds ratio [OR], 0.23; 95% confidence interval [CI], 0.05–1.01). There was a decreasing trend in the odds of nausea (OR, 0.60; 95% CI, 0.36–0.97) per month. However, there was no difference in the incidence of nausea immediately after implementation of the protocol (OR, 0.96; 95% CI, 0.25–3.72) or in the slope between preintervention and postintervention periods (OR, 1.48; 95% CI, 0.60–3.65). In contrast, there was no change in the odds of vomiting during the preintervention period (OR, 1.01; 95% CI, 0.61–1.67) per month. The odds of vomiting decreased at the beginning of the postintervention period compared to just before (OR, 0.10; 95% CI, 0.02–0.47; P = .004). Finally, there was a significant decrease in the average time to first oral intake (estimated 14 hours less; 95% CI, −25 to −3) when the protocol was first implemented, after adjusting for confounders; however, there was no difference in the slope of the average time to first oral intake between the 2 periods (P = .44).

CONCLUSIONS:

A risk-directed PONV prophylaxis protocol was associated with reduced vomiting and time to first oral intake after implementation. There was no substantial difference in the slopes of vomiting incidence and time to first oral intake before and after implementation.
Comparison of the pathogenesis of SARS-CoV-2 infection in K18-hACE2 mouse and Syrian golden hamster models
Authors: Jeong Haengdueng , Woo Lee Youn , Park In Ho , Noh Hyuna , Kim Sung-Hee , Kim Jiseon , Jeon Donghun , Jang Hui Jeong , Oh Jooyeon , On Dain , Uhm Chanyang , Cho Kyungrae , Oh Heeju , Yoon Suhyeon , Seo Jung Seon , Kim Jeong Jin , Seok Sang-Hyuk , Lee Yu Jin , Hong Seung-Min , An Se-Hee , Yeon Kim Seo , Kim Young Been , Hwang Ji-Yeon , Lee Hyo-Jung , Kim Hong Bin , Jeong Dae Gwin , Song Daesub , Song Manki , Park Man-Seong , Choi Kang-Seuk , Park Jun Won , Seo Jun-Young , Yun Jun-Won , Shin Jeon-Soo , Lee Ho-Young , Nam Ki Taek , Seong Je Kyung
Published: October 2022

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the etiological agent of COVID-19, causes life-threatening disease. This novel coronavirus enters host cells via the respiratory tract, promoting the formation of severe pulmonary lesions and systemic disease. Few animal models can simulate the clinical signs and pathology of COVID-19 patients. Diverse preclinical studies using K18-hACE2 mice and Syrian golden hamsters, which are highly permissive to SARS-CoV-2 in the respiratory tract, are emerging; however, the systemic pathogenesis and cellular tropism of these models remain obscure. We intranasally infected K18-hACE2 mice and Syrian golden hamsters with SARS-CoV-2, and compared the clinical features, pathogenesis, cellular tropism and infiltrated immune-cell subsets. In K18-hACE2 mice, SARS-CoV-2 persistently replicated in alveolar cells and caused pulmonary and extrapulmonary disease, resulting in fatal outcomes. Conversely, in Syrian golden hamsters, transient SARS-CoV-2 infection in bronchial cells caused reversible pulmonary disease, without mortality. Our findings provide comprehensive insights into the pathogenic spectrum of COVID-19 using preclinical models.
An update on uterine artery embolization for uterine leiomyomata and adenomyosis of the uterus
Authors: Kröncke Thomas
Published: October 2022

Uterine artery embolization (UAE) is an established technique to treat benign diseases of the uterus such as uterine leiomyomata (fibroids) and adenomyosis. This article reviews the use of UAE in these conditions and summarizes the evidence regarding safety and efficacy of the technique based on the current literature.
Safety of simultaneous bilateral intravitreal versus unilateral anti-vasculo-endothelial growth factors injection in an operating room setting
Authors: Jeeva Irfan Kabiruddin , Masud Sidra , Siddiqui M. A Rehman , Fahad Hadees Murad
Published: October 2022

Objectives: Chorioretinal diseases requiring the use of anti-vascular endothelial growth (anti-VEGF) injections often occur in both eyes simultaneously. This can necessitate injecting both eyes together rather than one eye at a time. The purpose of the study was to determine whether simultaneous bilateral intravitreal injections of anti-VEGF agents are safe when administered in an operation theatre setting.

Methods: Retrospective review of data was conducted. Single center study conducted in a tertiary care hospital in Karachi Pakistan. Approximately 30,000 eyes that received anti-VEGF injection during a 10-year study period were included (March 2008-February 2018). Patients who were lost to follow up prior to completion of treatment were excluded. Consecutive sampling technique was employed. The patients who received bilateral anti-VEGF injections were analysed separately from the ones who received unilateral injections. All injections were administered in operating theatre setting. The rate of endophthalmitis was measured in each group.

Results: A total of 30,258 injections were administered of which 15,338 were bilateral injections. Four cases (4/30,258, 0.013%) of endophthalmitis occurred during the study period. Only one case (1/15,338, 0.0065%) of endophthalmitis occurred after the administration of simultaneous bilateral anti-VEGF injections.

Conclusions: Administration of simultaneous bilateral anti-VEGF injections was safe in our population.

doi: https://doi.org/10.12669/pjms.38.8.5125

How to cite this:Jeeva IK, Masud S, Siddiqui MAR, Fahad HM. Safety of simultaneous bilateral intravitreal versus unilateral anti-vasculo-endothelial growth factors injection in an operating room setting. Pak J Med Sci. 2022;38(8):---------. doi: https://doi.org/10.12669/pjms.38.8.5125

This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Η προστασία και διαχείριση των ιστορικών κέντρων πόλεων στην Ελλάδα
Authors: Μπεριάτου Μαρία
Published: October 2022

Η παρούσα εργασία είναι το αποτέλεσμα της εκπόνησης της διδακτορικής διατριβής με τίτλο "Η προστασία και διαχείριση των ιστορικών κέντρων πόλεων στην Ελλάδα", στο πλαίσιο του Τομέα Πολεοδομίας - Χωροταξίας της Σχολής Αρχιτεκτόνων Μηχανικών του Εθνικού Μετσόβιου Πολυτεχνείου. Αντικείμενο της εργασίας είναι η διερεύνηση του πλαισίου (τρόπων, μέσων, μεθόδων, θεσμικών εργαλείων) προστασίας και διαχείρισης των ιστορικών κέντρων των πόλεων στην Ελλάδα, υπό την επίδραση των εξελίξεων των σχετικών θεωριών και πολιτικών των τελευταίων δεκαετιών. Η διερεύνηση επιχειρείται μέσω μιας ιστορικής προσέγγισης και μιας κριτικής εξέτασης των δράσεων βασικών παραγόντων (κεντρική διοίκηση, αυτοδιοίκηση, επιστημονική κοινότητα) που διαμορφώνουν τις πολιτικές και πρακτικές για την προστασία των ιστορικών κέντρων πόλεων. Η διερεύνηση περιλαμβάνει το σύνολο των αστικών κέντρων της χώρας, πλην των δύο μητροπολιτικών περιοχών Αθήνας και Θεσσαλονίκης. Αρχικά, γίνεται μια θεωρητική και εννοιολογική επισκόπηση σχετικά με την ιστορική εξέλιξη της πόλης και την εμφάνιση της έννοιας της κτισμένης κληρονομιάς και του ιστορικού κέντρου στον διεθνή και ευρωπαϊκό χώρο. Στη συνέχεια, παρουσιάζεται η ελληνική πόλη και η ανάδυση της προβληματικής και του επιστημονικού διαλόγου για την αρχιτεκτονική κληρονομιά, τα οικιστικά σύνολα και τα ιστορικά κέντρα στην Ελλάδα, μέσα από σχετικές πρωτοβουλίες και δράσεις (μελέτες, έρευνες, προγράμματα). Επίσης, παρουσιάζονται οι νομοθετικές και άλλες ρυθμίσεις, καθώς και οι αρμόδιοι δημόσιοι φορείς για την προστασία και ανάδειξη των ιστορικών κέντρων. Ακολουθεί το κύριο μέρος της έρευνας, το οποίο αφορά την οριζόντια και μεθοδική καταγραφή και διερεύνηση των ιστορικών κέντρων της χώρας, μέσα από ενδελεχή ανάλυση των θεσμοθετημένων μελετών των πρώτων Γενικών Πολεοδομικών Σχεδίων (Γ.Π.Σ.), καθώς και των ειδικών κανονιστικών ρυθμίσεων. Η διερεύνηση αυτή πλαισιώνεται από έρευνα πεδίου στις δημοτικές αρχές και υπηρεσίες των πόλεων στις οποίες υπάγονται τα ιστορικά κέντρα, με τη χρήση κατάλληλου ερωτηματολογίου, καθώς και μέσα από δομημένες συνεντεύξεις ειδικών επιστημόνων και εμπειρογνωμόνων (πανεπιστημιακών καθηγητών και άλλων) που εκφράζουν τις απόψεις τους απαντώντας σε σχετικά ερωτήματα. Κατόπιν αυτών, διατυπώνονται οι βασικές διαπιστώσεις και τα ειδικά και γενικά συμπεράσματα, από τα οποία συνάγονται ορισμένες συστάσεις και κατευθύνσεις σχεδιασμού των ιστορικών κέντρων, με στόχο αφενός την προώθηση περαιτέρω έρευνας και αφετέρου την υποστήριξη των σχετικών πολιτικών προστασίας και διαχείρισης. Στο τέλος, παρατίθενται ταξινομημένες οι διάφορες πηγές τεκμηρίωσης ανά κατηγορία (βιβλιογραφία, νομοθετήματα, διπλωματικές εργασίες, διδακτορικές διατριβές, άλλες ανέκδοτες πηγές) σε αλφαβητική, χρονική ή χωρική σειρά, ανάλογα με την κατηγορία.
Living in the european borderlands
Authors: Μαρκοδημητράκης Μιχαήλ-Χρυσοβαλάντης
Published: October 2022

Οι μεταναστευτικές ροές που κορυφώθηκαν κατά την περίοδο της «προσφυγικής κρίσης» του 2015-2016 έχουν ως αποτέλεσμα μακροχρόνιες συνέπειες στις χώρες του ευρωπαϊκού Νότου. Οι τελευταίες θεωρούνται ως συνοριοφύλακες της Ευρωπαϊκής Ένωσης, φιλτράροντας τους «ανεπιθύμητους» που θεωρούνται ως απειλή για τον ευρωπαϊκό Βορρά, και κατ’ επέκταση τον αποκαλούμενο «δυτικό τρόπο ζωής.» Η διατριβή εξετάζει τις συνθήκες ζωής των εκτοπισμένων και τα συστήματα υποστήριξης που υπάρχουν στην ευρωπαϊκή παραμεθόριο της Ελλάδας, με μελέτη περίπτωσης την Κρήτη. Ξεκινώντας από αρχειακή εθνογραφία και κειμενική ανάλυση της «κρίσης» σε ένα αποθετήριο ακαδημαϊκού ιδρύματος, η εθνογραφική έρευνα επικεντρώνεται στις εμπειρίες εργαζόμενων στον ανθρωπιστικό τομέα στην Ελλάδα, καθώς και εκτοπισμένων ανθρώπων στο νησί της Κρήτης, όπου διεξάγονται από το 2017 προγράμματα υποδοχής για αιτούντες άσυλο και πρόσφυγες. Μέσω εθνογραφικών, σε βάθος, συνεντεύξεων με έξι (6) εκτοπισμένα άτομα και είκοσι τέσσερις (24) εργαζόμενους στον ανθρωπιστικό τομέα, η διατριβή αναλύει τις απόψεις, εμπειρίες, και στρατηγικές που χρησιμοποιούνται από εργαζόμενους σε προγράμματα προστασίας και παροχής βοήθειας σε αιτούντες άσυλο και πρόσφυγες, η πλειοψηφία των οποίων λαμβάνει χώρα στα σύνορα της Ελλάδας και της Ευρώπης. Η διατριβή υπογραμμίζει επίσης ότι η διαρκής στόχευση από τις ελληνικές και τις ευρωπαϊκές αρχές στην κατηγοριοποίηση των αιτούντων και δικαιούχων διεθνούς προστασίας επηρεάζει κρατικές πολιτικές και την καθημερινότητα της εργασίας στο πεδίο, διαμορφώνοντας την οπτική των εκτοπισμένων για τον εαυτό τους, τη σχέση τους με τις αρχές, και την τοπική κοινωνία. Η παρούσα έρευνα επισημαίνει ότι στην Ελλάδα η φύση των παρεχόμενων υπηρεσιών είναι προσωρινή, χωρίς βιώσιμες πολιτικές για το μέλλον, παρά το ότι οι συμμετέχοντες στην έρευνα αναγνωρίζουν ότι τα μεταναστευτικά ρεύματα προς την Ευρώπη μέσω της Ελλάδας θα αυξηθούν στο μέλλον. Η έλλειψη πολιτικών ένταξης έχει ως αποτέλεσμα την περαιτέρω ενδυνάμωση του ρόλου της Ελλάδας ως χώρα-ενδιάμεσο σταθμό για τους εκτοπισμένους ανθρώπους που έρχονται προς την Ευρώπη, προσφέροντας ελάχιστα κίνητρα σε αυτούς για να μείνουν: στις επιτυχημένες περιπτώσεις ένταξης, οι κοινότητες που αναπτύσσονται σε επίπεδο γειτονιάς έχουν κρίσιμης σημασίας ρόλο στην αναπλήρωση συστημικών δυσλειτουργιών.
Prevalence of depression among medical students in River Nile State Universities 2021
Authors: Musa Tarteel , Yahia Alwathig
Published: October 2022

Studying  medicine is uphill and tiring requiring long hours of study and, continuous dealing with patients and death. A medical student in River Nile state suffers from a high rate of depression due to academic stress, expectations of parents, and comparisons with peers.  Medical education is stressful and exhausting for mental health and has a negative impact on academic, health, and social performance. It also affects the student’s future as a doctor and patient care. The aim of this study knowledge prevalence of depression and its relation to socio-demographic variables among medical students in River Nile State Universities. This cross-sectional study in River Nile State describes the prevalence of depression. We used random samples of students from the first to fifth years, including 335 questionnaires, the Hospital Anxiety, and Depression Scale (HADS) data tool, and an additional question regarding the demographic variable. We found a high prevalence of depression .77.9%(depression 38.8 and borderline depression 39.1%). There was no significant association between college and depression (p= 0.67) and no significant in depression scores among different academic year (p= 0.21), gender (p= 0.23), notionally (p=0.7), smoking (p=0.79), and showed associated drugs (p=0.5). There are some risk factors other than university and smoking that lead to depression The rate of depression is high among medical students. Students must be identified and assisted and taken seriously.
Branch-and-Price for Drone Delivery Service Planning in Urban Airspace
Authors: Levin Michael W. , Rey David
Published: October 2022

Unmanned aerial vehicles or drones are increasing in use both for commercial and casual purposes. Although drone traffic management is mostly absent, as drone use increases, aerial conflicts are likely to also increase. This paper studies the problem of planning drone delivery service through an urban air traffic network space. The urban air traffic network is assumed to mostly be the airspace above existing roads and is modeled as a transportation network with multiple flight levels. Drone flights are modeled as individual trip requests with origins, destinations, and time windows. We present a novel integer linear programming formulation for this drone delivery service planning problem. The main contribution of this paper is developing a branch-and-price algorithm to solve the formulation, as the number of decision variables grows quickly with the problem size. We investigate three variations of branch-and-price, including branching on trajectory assignment variables, branching rules related to served requests, and a primal heuristic to quickly find integer feasible solutions. Numerical results show the limits of the integer linear programming formulation and the benefits of the primal heuristic in finding a good feasible solution.

History: This paper has been accepted for the Transportation Science Special Issue on Emerging Topics in Transportation Science and Logistics.

Supplemental Material: The online appendix is available at https://doi.org/10.1287/trsc.2022.1175 .
Challenges in Managing Bilingual Schools: A Solution Through Higher Education for Prospective Leaders
Authors: Muniroh Siti , Febrianti Yusnita , Kusumaningrum Shirly Rizki , Rachmajanti Sri , Sobri Ahmad Yusuf
Published: October 2022

This qualitative study is part of a feasibility study conducted by State University of Malang (SUM), Indonesia, to determine stakeholder needs for a study program specializing in managing bilingual education. The study participants included one SUM lecturer who held a managerial position in the division of SUM laboratory schools and twelve teachers/leaders of bilingual schools in some cities in East Java and South Sulawesi. Data were collected using an online questionnaire and in-depth interviews with two selected participants. The results indicate issues related to teachers' English competencies, materials development, and integrating an internationally-oriented curriculum into the national curriculum. Teachers' low English competencies prevented them from conducting teaching and learning bilingually and developing instructional materials in appropriate English. In addition, the combination of national and international curricula was identified as the biggest challenge for bilingual schools. The teachers/leaders were never trained to manage the bilingual program. They learned based on their experiences, and it took years to figure out how to manage bilingual programs successfully. Therefore, the establishment of a new program of study is needed.