bluuebunny/crossref_metadata_2025 huggingface dataset:
Postoperative Outcome in Children aged between 6 and 10 years in Major Abdominal Surgery, Neurosurgery and Orthopedic Surgery
Authors: Kumba Claudine
Published: September 2021

BackgroundAnticipating postoperative evolution in surgical patients is an important issue in our daily practice.We demonstrated in a previous study that there were multiple predictors of postoperative outcome, including American Society of Anesthesiologists status (ASA), transfusion, emergency, surgery and age. A detailed description of postoperative outcome was undertaken in children aged between 6 and 10 years old included in the initial study.ObjectiveTo describe postoperative outcomes in children aged between 6 and 10 years old included in the initial cohort in abdominal surgery, neurosurgery and orthopedics.MethodsThe secondary analysis of postoperative outcomes in children aged between 6 and 10 years old was retrospectively included in the initial study of 594 patients. The study was approved by the Ethics Committee.ResultsThere were 88 patients with a mean age of 98.7±13.8 months.The most common surgical interventions were scoliosis in 23 patients (26.1%), limb tumor resection in 8 patients (9.1%), femoral osteotomy in 6 patients (6.8%), intracerebral tumor resection in 6 patients (6.8%), intestinal resection in 5 patients (5.6%), Chiari’s malformation in 4 patients (4.5%), pelvic osteotomy in 4 patients (4.5%) and renal transplantation in 4 patients (4.5%).Most patients (45%) were American Society of Anesthesiologists grade 3 (ASA 3), and 13 (14.8%) were ASA grade 4.Twenty-two (25%) patients had intraoperative and/or postoperative complications (organ dysfunction or sepsis). Two patients (2.3%) had intraoperative hemorrhage, 1 patient (1.1%) had intraoperative difficult intubation, and 1 patient experienced intraoperative anaphylaxis. Nine patients (10.2%) had postoperative neurologic failure, and 2 (2.3%) had postoperative cardio-circulatory failure. Three patients (3.4%) had postoperative septicemia, 2 patients (2.3%) had postoperative pulmonary and urinary sepsis, and 1 patient (1.1%) had postoperative abdominal sepsis. 3 patients (3.4%) had re-operations. 42(47.7%) patients had intra-operative transfusion.There was 1 in-hospital death (1.1%). The median total length of hospital stay was 9 days [5-16].ConclusionTwenty-five percent of the patients had intraoperative and/or postoperative complications, and most of them were ASA grade ³3. Integrating goal-directed therapies to optimize intraoperative management in these patients is necessary to improve postoperative outcomes in surgical pediatric patients.
Relapsing Time to Severe Acute Malnutrition and Hazards Among Children Treated in the Health Posts.
Authors: Lambebo Abera , Temiru Desselegn , Belachew Tefera
Published: September 2021

Background: Malnutrition has many unpleasant results on child health during illness and after discharge. However, in Ethiopia there is luck of study that address either time to relapse or post discharge statusObjective: To identify time of relapse and associated factors among children discharged after undergoing treatment for SAM in South, Ethiopia Methods: An institution Retrospective cohort study was done among children admitted to health posts for treatment of SAM from 2014/2015-2019/2020 under-five children after discharge. After checking all the assumptions finally multivariable Cox regression has been used. All tests were two sided and P values <0.05 were used to declare statistical significance. Results: The mean time for relapse of severe acute malnutrition among under five children was determined us 22 at 95% CI, (20.69-24.82) week from discharge to relapse time.On multivariable negative binomial regression model, after adjusting for background variables time for relapse of severe acute undernutrition was significantly associated with edema during admission (AHR,2.02 ,95%, CI: 1.17-3.50), age group of 6-11 months (AHR 5.2,95%, CI:1.95-13.87), less discharge MUAC for first admission increase hazard of relapse (AHR 12,95%, CI: 7.90-19.52). Conclusion: The mean time was 22 week and edema, Age and MUAC was associated time to relapse.
Semi-Quantitative Chest Computed tomography Score in Novel Coronavirus (SARS-Cov-2) Patients: Its Correlation with Oxygen Saturation (SpO2) and Role in Predicting Oxygen Therapy Requirement.
Authors: Komatlapalli Ramamurthy S. , Arora Abhishek Jagdishchander , Thakur Rajani
Published: September 2021

Context: Quantitative and semi-quantitative indicators of lung involvement in COVID-19 could help to stratify the patients and thus help in triaging and speeding up the entire workflow in hospitals as patients with higher severity scores require early therapeutic intervention and critical care.Objective: To calculate Computed Tomography (CT) severity score for COVID-19 infection based on lobar involvement of the disease and correlate the score with oxygen saturation levels (SpO2) of the patient and further predict oxygen therapy requirement.Settings and Design: Prospective study.Methods and Material: This is a prospective study of 154 proven novel coronavirus (SARS-CoV-2) infected (COVID-19) patients. SpO2 values of all the patients were obtained within 6 hours of scan. All the scans were reviewed and semi-quantitative CT score was calculated based on the extent of lobar involvement Statistical analysis used: Scatter plot correlation and ROC curve analysis were performed. Results: CT score and SpO2 values of patients were plotted in scatter plot chart and Pearson correlation co-efficient (r) was calculated, which was -0.836 suggesting a strong negative correlation. Forty-six patients were given oxygen therapy and they had oxygen saturation value ≤ 94% with CT score ranging from 10-22. ROC curve analysis was performed to determine and reach an optimum cut off value of 11 for oxygen therapy requirement with sensitivity and specificity of 95.83% and 95.58% respectively. Conclusions: CT score in COVID-19 patients has strong negative correlation with oxygen saturation and it definitely helped to predict the requirement of the oxygen therapy in our study.
Phyto-Cleaning of Particulate Matter from Polluted Air by Woody Plant Species in the Near-Desert City of Jodhpur (India) and the Role of Heme Oxygenase in Their Response to PM Stress Conditions
Authors: Popek Robert , Mahawar Lovely , Shekhawat Gyan Singh , Przybysz Arkadiusz
Published: September 2021

Particulate matter (PM) is one of the most dangerous pollutants in the air. Urban vegetation, especially trees and shrubs, accumulate PM and reduce its concentration in ambient air. The aim of this study was to examine 10 tree and shrub species common for the Indian city of Jodhpur (Rajasthan) located on the edge of the Thar Desert and determine: (1) the accumulation of surface and in-wax PM (both in three different size fractions), (2) the amount of epicuticular waxes on foliage, (3) the concentrations of heavy metals (Cd and Cu) on/in the leaves of the examined species, and (4) the level of heme oxygenase enzyme in leaves that accumulate PM and heavy metals. Among the investigated species, F. religiosa and C. myxa accumulated the greatest amount of total PM. F. religiosa is a tall tree with a lush, large crown and leaves with wavy edge, convex veins and long petioles, while C. myxa have hairy leaves with convex veins. The lowest PM accumulation was recorded for drought resistant S. persica and A. indica, which is probably due to their adaptation to growing conditions. Heavy metals (Cu and Cd) were found in the leaves of almost every examined species. The accumulation of heavy metals (especially Cu) was positively correlated with the amount of PM deposited on the foliage. A new finding of this study indicated a potentially important role of HO in the plants’ response to PM-induced stress. The correlation between HO and PM was stronger than that between HO and HMs. The results obtained in this study emphasise the role of plants in cleaning polluted air in conditions where there are very high concentrations of PM.
Sexual Quality of Life Assessment in Young Women with Breast Cancer During Adjuvant Endocrine Therapy and Patient-Reported Supportive Measures
Authors: Bobrie Angelique , Jarlier Marta , Moussion Aurore , Jacot William , D'Hondt Veronique
Published: September 2021

Purpose: sexual quality of life (QoL) is affected during and after breast cancer (BC) treatment. The purpose was to investigate sexual and global QoL and patient-reported measures to address this issue in young women (< 51 years) with BC after the acute treatment phase, during adjuvant endocrine therapy. Methods: three EORTC questionnaires and an additional specific questionnaire, developed for the study, were used to assess sexual and global QoL and patient-reported supportive measures in BC patients who had received their endocrine therapy for at least 24 months.Results: We showed a deterioration of the sexual QoL and a poor communication with healthcare professionals. Most patients (88.9%) declared important that sexuality should be discussed with caregivers and that the partner should also be involved. Most patients (60%) had taken at least one action to overcome their sexual problems. Most of these interventions (63%) originated from the patient herself. Conclusions: sexual QoL is a major issue in young BC patients and is poorly addressed by healthcare professionals. Most of the supportive methods used by the patients to overcome these side effects were at their own initiative. Communication and counseling on sexuality from healthcare professionals needs to be improved during BC treatment. Patients suggested supportive measures they would find useful and appropriate to develop in clinic. The final goal being to improve sexual QoL of BC patients with the appropriate intervention and support.NCT 04200001
Optimization of Coagulation-flocculation Process for Pre-treatment of Artisanal Tannery Wastewater Using Response Surface Methodology
Authors: Appiah-Brempong Miriam , Essandoh Helen Michelle Korkor , Asiedu Nana Yaw , Dadzie Samuel Kwame , Momade Francis Yao
Published: September 2021

There is a dearth in knowledge on artisanal tannery wastewater treatment as most studies are focused on treatment of wastewater generated from modern-day leather manufacturing industries. The extensive use of plant materials in artisanal tanneries introduces high loads of polyphenolic compounds in the wastewater rendering biological treatment of the wastewater ineffective. This study, therefore, employed coagulation-flocculation process to pre-treat artisanal tannery wastewater with the aim of applying the central composite design, a statistical approach in Response Surface Methodology (RSM) to model and optimize the removal of Chemical Oxygen Demand (COD), Total Suspended Solids (TSS) and turbidity and to minimize Sludge Volume Index (SVI). Optimization process focused on the two most important influencing parameters: dosage of aluminium sulphate and initial pH of wastewater. Results revealed that optimal pH and aluminium sulphate dosage of 6.09 and 11.6g/L respectively could yield maximum removal efficiencies of 38.51% of COD, 76.05% of TSS and 79.64% of turbidity from the wastewater with a minimum SVI of 29.57mL/g. Further experiments conducted to validate these results showed a good agreement between the experimental and predicted results signifying the suitability of RSM for optimization of the coagulation treatment process. This is the first reported study on optimization of coagulation-flocculation treatment of artisanal tannery wastewater. Results of this study can be used practically for efficient pre-treatment of artisanal tannery wastewater.
Early Ambulation Training as Impairment-Driven Rehabilitation in Cancer Patients with Cervical Spine Metastases After Palliative Spine Surgery
Authors: Ishida Yukako , Shigematsu Hideki , Tsukamoto Shinji , Morimoto Yasuhiko , Iwata Eiichiro , Okuda Akinori , Kishi Shingo , Fujii Hiromasa , Honoki Kanya , Tanaka Yasuhito , Kido Akira
Published: September 2021

Background

Cervical spine metastasis worsens the quality of life (QOL) of patients with cancer. While the beneficial effects of surgery have been reported, the detailed course of functional recovery remains unclear, especially in the acute phase of rehabilitation. We previously reported on impairment-driven rehabilitation in patients with thoracic or lumbar level metastases. The present study assessed the effects of an impairment-driven strategy on the early recovery of ambulatory function in patients with cervical spine metastasis.
Methods

We retrospectively reviewed 13 consecutive patients with cervical neoplastic spinal compression. The patients were those whose primary impairment with spinal instability identified by a multidisciplinary tumor board who underwent palliative spine surgery. In addition, we examined neurological deficits; ambulation status; pathological fracture, collapse, and postoperative implant failure progress; and Barthel Index (BI).
Results

The average duration of ambulation was 3.75 ± 3.92 days after surgery. One case showed collapse and two showed progressions of paralysis. However, all patients had early ambulation after surgery, except for one patient who developed postoperative cerebral infarction. The BI scores showed an improving tendency; however, the difference before and after rehabilitation was not statistically significant.
Conclusions

We reviewed the recovery course of ambulation in patients with cervical spine metastases who underwent impairment-driven rehabilitation. Combined with surgery and early mobilization, this strategy may improve the QOL of patients with cancer and cervical spine metastasis.
Correlation Between Physical Activity Level and Functional Status of Subjects with High Spinal Cord Injury
Authors: Szeliga Ewa , Borys Renata , Brzozowska-Magoń Agnieszka , Wolan-Nieroda Andżelina , Magoń Grzegorz , Walicka-Cupryś Katarzyna
Published: September 2021

Background. Spinal cord injuries are one of the main causes of disability in Poland and in the world. Quadriparesis, limitations in activities of daily living, lack of full autonomy and psycho-social problems are consequences of cervical spinal cord injury. Due to the consequences, especially motor paralysis and sedentary lifestyle resulting from spinal injuries, much attention is drawn to physical activity in subjects with this type of injuries. Objective. The aim of the study is to assess the effect of regular physical activity on functional fitness and independent existence of subjects after high spinal cord injury.Methods. 80 subjects with transverse injury of cervical spinal cord were enrolled in the study. The study group included men aged 20-50, in which group 40 (50%) of the subjects were qualified to the physically active group – subjects doing wheelchair sport, and 40 (50%) of the subjects were qualified to the physically inactive group – subjects taking no physical activity. The physically active men were qualified on the basis of their participation in organised activities - wheelchair rugby. Minimum participation was 90 minutes a day twice a week. Subjects from the physically inactive group had a passive lifestyle and participated in no sports activities. Results. Highly significant differences were observed during the study between the physically active and inactive men with regard to the functionality status. The study subjects taking regular physical exercise had better results in all assessed activities. The biggest differences were observed in the field of toilet and dressing up. Conclusions. The study confirmed that regular physical activity is correlated with better fitness. The study also showed that the subjects playing wheelchair rugby are more independent, which results in their better functional status in everyday life.
LncRNA MIR4435-2HG Promotes Proliferation, Migration, Invasion and EMT Via Targeting miR-22- 3p/TMEM9B in Breast Cancer
Authors: Ke Jing , Wang Quhui , Zhang Wei , Mei Haijun
Published: September 2021

Background: Breast cancer, as the malignancy with the highest incidence rate and mortality rate in women, seriously threatens human life and health. Pieces of evidence have suggested that long non-coding RNAs (lncRNAs) possess important effects on regulating the occurrence and development of breast cancer.Results: In the present study, MIR4435-2HG was highly expressed in breast cancer tissues and cells. Down-regulation of MIR4435-2HG inhibited the viability, proliferation, migration, invasion and epithelial-mesenchymal transition (EMT) of breast cancer cell lines by Cell Counting Kit-8 (CCK-8), colony formation, transwell migration and invasion, immunofluorescence and western blot assays. Dual-luciferase reporter assay and RNA pull-down analysis confirmed that miR-22-3p was a target of MIR4435-2HG. Over-expression of MicroRNA-22-3p (miR-22-3p) obviously inhibited the viability, proliferation, migration, invasion and EMT of breast cancer cell lines. Transmembrane protein 9 domain family member B (TMEM9B) was up-regulated in breast cancer tissues and cell lines. Dual-luciferase reporter assay confirmed that TMEM9B was a target of miR-22-3p. TMEM9B inhibition partially restored the effects of MIR4435-2HG/miR-22-3p on the viability, proliferation, migration, invasion and EMT of breast cancer cell lines.Conclusions: MIR4435-2HG potentially played a tumor-promoting role in the occurrence and development of breast cancer, which might be achieved by regulating the miR-22-3p/TMEM9B axis.
Glibenclamide Reduces Excitatory Postsynaptic Currents In CA1 Hippocampal Neurons In A Mouse Model of Multiple Sclerosis
Authors: Fearey Brenna C. , Binkle Lars , Mensching Daniel , Schulze Christian , Lohr Christian , Friese Manuel A. , Oertner Thomas G. , Gee Christine E.
Published: September 2021

The transient receptor potential melastatin 4 (TRPM4) channel contributes to disease severity in the murine experimental autoimmune encephalomyelitis (EAE) model of multiple sclerosis and to neuronal cell death in models of excitotoxicity and traumatic brain injury. As TRPM4 is activated by intracellular calcium and conducts monovalent cations, we hypothesized that TRPM4 may contribute to and boost excitatory synaptic transmission in CA1 pyramidal neurons of the hippocampus. Using single-spine calcium imaging and electrophysiology, we found no effect of the TRPM4 antagonists 9-phenanthrol and glibenclamide on synaptic transmission in hippocampal slices from healthy mice. In contrast, glibenclamide but not 9-phenanthrol reduced excitatory synaptic potentials in slices from EAE mice, an effect that was absent in slices from EAE mice lacking TRPM4. We conclude that TRPM4 plays little role in basal hippocampal synaptic transmission but a glibenclamide-sensitive TRPM4-mediated contribution to excitatory postsynaptic responses is upregulated at the acute phase of EAE.
Patient Satisfaction, Needs and Preferences Concerning Information Dispensation at the Emergency Department; A Cross-Sectional Observational Study
Authors: de Steenwinkel Marank , Haagsma Juanita A , Berkel Esther C.M. van , Rozema Lotte , Rood Pleunie P.M. , Bouwhuis Marna G
Published: September 2021

Background Patient satisfaction is an important indicator of emergency care quality and has been associated with information dispensation at the Emergency Department (ED). Optimal information dispensation could improve patient experience and expectations. Knowing what kind of information patients want to receive and the preferred way of information dispensation are essential to optimize information delivery at the ED. The purpose of this cross-sectional observational study was to evaluate patient satisfaction concerning information dispensation (including general, medical and practical information), the need for additional information and preferences with regards to the way of information dispensation at the ED of a teaching hospital in the Netherlands. Results423 patients (patients ≥18 years with Glasgow Coma Scale 15) were enrolled (response rate 79%). The median patient satisfaction score concerning the overall information dispensation at the ED was 7.5 on a rating scale 0-10. Shorter length of ED stay was associated with higher patient satisfaction in multivariate analysis (P<0.001). The majority of respondents was satisfied regarding medical (N=328; 78%) and general information (N =233; 55%). Patients were less satisfied regarding practical information (N =180; 43%). Respondents who indicated that they received general, medical and practical information were significantly more often satisfied compared to patients who did not receive this information (P<0.001). Two thirds (N=260; 62%) requested more general information. Half of the respondents (N=202; 48%) requested more practical information and a third (N=152; 36%) requested more medical information. The preferred way for receiving information was orally (N=189; 44.7%) or by leaflets (N=108; 25.5%).ConclusionThe majority of respondents were satisfied concerning information dispensation at the ED, especially regarding medical information. Respondents requested more general and practical information and preferred to receive the information orally or by leaflets.
Population Attributable Fractions of Caffeine and Water Pipe on low birth weight: The Bandar-Abbas Population-based Cohort in suburban areas
Authors: Nematollahi Shahrzad , Mansournia Mohammad Ali , Rahimi-Foroushani Abbas , Mouseli Ali , Shabkhiz Hossein , Holakouie-Naieni Koroush
Published: September 2021

Background: Low Birth Weight (LBW) poses a major health challenge in low-resource suburban communities. Despite relatively commonality, there is little evidence on the effects of water pipe and dietary caffeine on reproductive outcomes in the Middle-East region. The Bandar Abbas Pregnancy Cohort (BAPC), as a population-based prospective study, has been investigating the effects of lifestyle and environmental factors on maternal wellbeing and child growth and development in suburban communities in the south of Iran. This study used the BAPC data to estimate the attribution of LBW incidence to fully or partially removal of dietary caffeine intake and water pipe smoking during pregnancy.Methods: ‎The present study used data on 861 live singleton pregnancies in the first two BAPC visits (response rate= 95.42%). Water pipe smoking (yes/no) was measured during pregnancy using a structured checklist recommended by the World Health Organization (WHO). Dietary caffeine intake was measured during pregnancy using a structured checklist and categorized into low for 0-99 mg/day, and high for>100 mg/day. LBW (yes/no) was determined using recorded birth weight in infant`s vaccination card. Exposure relative risks were calculated using Modified Poisson regression models. Population Attributable Fractions (PAFs) and Generalized Impact Fractions (GIFs) were calculated on relative risk scale. The prevalence of counter fact was set as 3% for water pipe smokers and 14.9% for intake of >100 mg/day caffeine.Results: The cumulative incidence of LBW was 16.1%. An estimated 19% (95%CI: 6, 30%) and 11% (95%CI: 8, 14%) of LBW were attributed to high intake of dietary caffeine and water pipe smoking, respectively. Reducing the intake of caffeine to less than 100 mg/day or prevalence of water pipe to 3% would prevent 10.7% (95%CI: 6.6, 25.3%) and 5.7% ‎‎(95%CI: ‎5.0, 6.8%) of LBW incidence, respectively. ‎Conclusions: Our findings have provided evidence on quantitative contributions of caffeine and water pipe on LBW using real-world data. Integration of this information into practical action plans to prevent LBW is the next step in our cohort project. Furthermore, to get an overarching picture and in-depth understanding of reproductive effects of caffeine and water pipe, exercising this study`s analytic approach in other contexts is encouraged. ‎
Sites of Blood Collection and Topical Disinfectants Associated with Contaminated Cultures: An Ambidirectional Cohort Study
Authors: Ota Koshi , Nishioka Daisuke , Ito Yuri , Hamada Emi , Ota Kanna , Shibata Yuriko , Takasu Akira
Published: September 2021

Background: We aimed to determine whether puncture sites for blood sampling and topical disinfectants are associated with rates of contaminated blood cultures in the emergency department (ED) of a single institution.Methods: This single-center, ambidirectional cohort study of 548 consecutive patients ≥ 20 years old was performed in the ED of a university hospital in Japan over a 13-month period. Pairs of blood samples were collected for aerobic and anaerobic cultures from patients in the ED. Physicians selected puncture sites and topical disinfectants according to their personal preference.Results: Potential contamination was identified in 110 of the 548 patients (20.1%). One hundred fourteen (20.8%) patients showed true-positive results for bacteremia and 324 (59.1%) patients showed true-negative results. Multivariate analysis revealed more frequent contamination when puncture sites were disinfected with povidone-iodine (PVI) than with alcohol/chlorhexidine (ACHX) (adjusted risk difference, 19.1%; 95% confidence interval [CI]), 15.7–22.6; P < 0.001). In terms of blood collection sites, femoral and central venous (CV) catheter with PVI disinfection showed more frequent contamination than venous sites with ACHX (adjusted risk differences: 26.6%, 95%CI 21.3–31.9, P < 0.001 and 41.1%, 95%CI 22.2–59.9, P < 0.001, respectively).Conclusions: Rates of contaminated blood cultures were significantly higher when blood was collected from CV catheter or femoral sites with PVI as the topical disinfectant.
Snail-Regulated Exosomal MicroRNA-21 Suppresses NLRP3 Inflammasome Activity to Enhance Chemoresistance
Authors: Cheng Han-Ying , Hsieh Chia-Hsin , Tai Shyh-Kuan , Chu Pen-Yuan , Lin Po-Han , Chen Yu-Tung , Hsu Dennis Shin-Shian , Yang Muh-Hwa
Published: September 2021

Compared to the precise targeting of drug-resistant mutant cancer cells, strategies for eliminating non-genetic adaptation-mediated resistance are limited. The pros and cons of the existence of inflammasomes in cancer have been reported. Nevertheless, the dynamic response of inflammasomes to therapies should be addressed. Here, we have demonstrated that in cancer cells undergoing Snail-induced epithelial-mesenchymal transition (EMT), tumor cells suppress NLRP3 inflammasome activities of tumor-associated macrophages (TAMs) in response to chemotherapy through the delivery of exosomal microRNA (miR)-21. Mechanistically, miR-21 represses PTEN and BRCC3 to facilitate NLRP3 phosphorylation and lysine-63 ubiquitination, inhibiting NLRP3 inflammasome assembly. Furthermore, the Snail-miR-21 axis shapes the post-chemotherapy tumor microenvironment (TME) by repopulating TAMs and by activating CD8+ T cells. In head and neck cancer patients, the Snail-high cases lacked post-chemotherapy IL-1β surge and were correlated with a worse response. This finding reveals the mechanism of EMT-mediated resistance beyond cancer stemness through modulation of post-treatment inflammasome activity. It also highlights the dynamic remodeling of the TME throughout metastatic evolution.
“Even Though They Insult Us, the Delivery They Give Us is the Greatest Thing”: A Qualitative Study Contextualizing Women’s Satisfaction with Facility-Based Maternal Health Care in Ethiopia
Authors: Hagaman Ashley , Rodriguez Humberto Gonzalez , Barrington Clare , Singh Kavita , Estifanos Abiy Seifu , Keraga Dorka Woldesenbet , Alemayehu Abiyou Kiflie , Magge Hema , Bitewulign Befikadu , Abate Mehiret , Barker Pierre
Published: September 2021

Background: Globally, amidst increased utilization of facility-based maternal care services, there is continued need to better understand women’s experience of care in places of birth. Quantitative surveys may not sufficiently characterize satisfaction with maternal healthcare (MHC) in local context, limiting their interpretation and applicability. The purpose of this study is to untangle how contextual and cultural expectations shape women’s care experience and what women mean by satisfaction in two Ethiopian regions. Methods: Health center and hospital childbirth care registries were used to identify and interview 41 women who had delivered a live newborn within a six-month period. We used a semi-structured interview guide informed by the Donabedian framework to elicit women’s experiences with MHC and delivery, any prior delivery experiences, and recommendations to improve MHC. We used an inductive analytical approach to compare and contrast MHC processes, experiences, and satisfaction. Results: Maternal and newborn survival and safety were central to women’s descriptions of their MHC experiences. Women nearly exclusively described healthy and safe deliveries with healthy outcomes as ‘satisfactory’. The texture behind this ‘satisfaction’, however, was shaped by what mothers bring to their delivery experiences, creating expectations from events including past births, experiences with antenatal care, and social and community influences. Secondary to the absence of adverse outcomes, health provider’s interpersonal behaviors (e.g., supportive communication and behavioral demonstrations of commitment to their births) and the facility’s amenities (e.g., bathing, cleaning, water, coffee, etc) enhanced women’s experiences. Finally, at the social and community levels, we found that family support and material resources may significantly buffer against negative experiences and facilitate women’s overall satisfaction, even in the context of poor-quality facilities and limited resources. Conclusion: Our findings highlight the importance of understanding contextual factors including past experiences, expectations, and social support that influence perceived quality of MHC and the agency a woman has to negotiate her care experience. Our finding that newborn and maternal survival primarily drove women’s satisfaction suggests that quantitative assessments conducted shortly following delivery may be overly influenced by these outcomes and not fully capture the complexity of women’s care experience.
Latissimus Dorsi Muscle Flap Transfer Through Endoscopic Approach Combined With the Implant After Tissue Expansion for Breast Reconstruction of Mastectomy Patients
Authors: Ma Jian-Xun , Li Bi , Xia You-Chen , You Wei-Tao , Zhang Jie , Sun Yi-Mou , Chang Xu , Lang Yue
Published: September 2021

Background: The increasing demand for breast reconstruction and good outcomes lead plastic surgeons to look for a new method to obtain more natural and aesthetically pleasing appearance of the reconstructed breasts.Methods: A retrospective review of thirty-one patients undergoing tissue expander (TE)/implant two-stage breast reconstruction with latissimus dorsi muscle flap (LDMF) transfer through endoscopic approach in Peking University Third Hospital from April 2016 to August 2020 was performed. The LDMF harvest time, drain time, and complications were reviewed. The 3D volume was obtained to assess the symmetry of bilateral breasts.Results: The mean endoscopic LDMF harvest time was 90.4 minutes (70.0~120.0 min). The average drain time after the final reconstruction was 10.1 days (6~19 days). In the mean follow-up of 11.2 months (6~28 months), there were no postoperative complications noted. The average post–reconstruction breasts asymmetry was 4.8%±2.4%, the reconstructed side achieved good volume symmetry to the contralateral side (P=0.256).Conclusions: The novel type of two-stage breast reconstruction protocol, which includes tissue expansion followed by implant insertion with endoscopy-assisted LDMF transfer, could effectively reduce visible scars, avoid the patch effect, shorten the LDMF harvest time and reduce the incidence of complications. It is a promising method for breast reconstruction because it achieves good outcomes in the mastectomy patients.
Comparison of Nitrogen Removal Efficiencies and Microbial Communities of Full-Scale Anaerobic, Anoxic and Aerobic Processes in Municipal Wastewater Treatment Plants having Low and High COD/TN Ratios
Authors: Phanwilai Supaporn , Noophan Pongsak , Li Chi-Wang , Choo Kwang-Ho
Published: September 2021

Full-scale anaerobic, anoxic and aerobic (A2O) process is used worldwide for biological nutrient removal (BNR). However, operation parameters for nitrogen removals and information of microbial communities related to nitrogen removal in full-scale A2O wastewater treatment plants (WWTPs) having low and high COD/TN ratios are not available. Based on the analysis of four full-scale A2O WWTPs, it is suggested that maintaining longer SRT of ≥ 30 day and DO of ≥ 0.9±0.2 mg-O2 L-1 is needed to improve nitrogen removal efficiency under low COD/TN ratio (≤ 3.7). On other hand, at high COD/TN ratio (≥ 4.2), DO level of ≥ 2.6 mg-O2 /L and typical SRT of 19‒ 25 days would be suggested. It was confirmed that phosphorus removal efficiency significantly improved under BOD/TP ratio of > 20 for A2O process in these full-scale WWTP. Microbial distribution analysis showed that ammonia-oxidizing archaea (AOA) was abundant under conditions of low DO level, longer SRT, high temperature and low COD/TN ratio (≤ 3.7). Nitrosomonas sp. are mostly found in aerobic tank of full-scale A2O WWTPs. However, abundances of Nitrosomonas sp. are proportional to DO and NH4+ concentrations for WWTPs with high COD/TN ratio. Nitrosospira sp. are only found under operating condition of longer SRT for WWTPs with low COD/TN ratio. Abundances of Nitrobacter sp. are proportional to DO concentration and temperature rather than abundance of Nitrospira sp. Predominance of nosZ-type denitrifiers were found at low COD/TN ratio. Abundance of denitrifiers by using nirS genes was over abundance of denitrifiers by using nirK genes at high COD/TN ratios WWTPs.
Long Non-Coding RNA SNHG12 Contributes to Cisplatin Resistance by Mediating WEE1 via miR-503-5p in Cervical Cancer
Authors: Dong Jing , Cong Qing , Xie Feng , Zhang Xiaojin
Published: September 2021

Background: Emerging evidences have indicated that the aberrant expression of long noncoding RNAs (lncRNAs) was responsible for drug resistance, which represents a major obstacle for chemotherapy failure. Our previous study has showed that small nuclear RNA host gene 12 (SNHG12) was increased and contributed to cell growth and invasion in cervical cancer. In the present study, we aimed to investigate the role of the lncRNA SNHG12 in cisplatin (DDP) resistance and elucidate its underlying mechanisms in cervical cancer.Methods: The expression and prognosis of SNHG12 in cervical cancer tissues were evaluated based on bioinformatics. MTT, colony formation assay and flow cytometer were performed to detect cell viability. Further, Molecular relationships among CTD-3252C9.4, IRF1 and IFI6 were investigated via luciferase reporter assay, western blot, and qRT-PCR. Finally, subcutaneous xenograft model was established to verify our findings.Results: In the present study, we evaluated the cell apoptosis and half maximal inhibitory concentration (IC50) of cervical cancer upon DDP treatment. Mechanically, we found that SNHG12 upregulated WEE1 expression to regulate cell and DDP resistance via sponging miR-503-5p. Moreover, SNHG12 silencing inhibited the growth of DDP-resistant cervical cancer tumors in vivo. Conclusions: Taken together, our findings suggested that a SNHG12/miR-503-5p/ WEE1 axis which modulated the chemoresistance of cervical cancer cell to DDP, and provided promising targets for dealing with the chemoresistance of cervical cancer.
Surgical Outcomes of Unilateral Lateral Rectus Recession Versus Recess-resect in Children With Small-to-medium Angle Convergence Insufficiency-type Intermittent Exotropia
Authors: Jang Yoon Kyung , Bae Seok Hyun , Choi Dong Gyu
Published: September 2021

To determine the efficacy of unilateral lateral rectus recession (ULR) for convergence insufficiency-type intermittent exotropia (CI-type IXT), we compared surgical outcomes following ULR and recess‒resect (RR) procedures for CI-type IXT. In this retrospective study, medical records of 57 children who underwent ULR (n = 30) or RR (n = 27) for CI-type IXT of less than 25 PD at distance with a postoperative follow-up of 6 months or more were reviewed. Surgical success was defined as an alignment between 10 PD exodeviation and 5 PD esodeviation at distance and near fixation. The postoperative exodeviation showed no significant difference between the two groups at the last follow-up. A significant reduction in the mean near-distance difference was achieved postoperatively in both groups: from 5.4 PD preoperatively to 2.5 at last follow-up after ULR, and from 8.2 to 2.4 after RR (both p = 0.001). However, this difference between ULR and RR was not statistically significant (p > 0.05). The success rate at the last follow-up was 63.3% for ULR and 70.4% for RR (p = 0.574). ULR was found to be an effective treatment for CI-type IXT, with similar surgical outcomes to RR.
Percutaneous Coronary Intervention Compared to Coronary Artery Bypass Grafting in Patients with Non-ST-Elevation Acute Coronary Syndrome – A Systematic Review and Meta-Analysis
Authors: Kirov Hristo , Caldonazo Tulio , Rahouma Mohamed , Robinson Bryce , Demetres Michelle , Serruys Patrick , Biondi-Zoccai Giuseppe , Gaudino Mario , Doenst Torsten
Published: September 2021

Objectives: Non-ST-elevation acute coronary syndrome (NSTE-ACS) affects millions of patients. Although an invasive strategy can improve survival, the optimal treatment (i.e., percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG]) is not clear. We performed a meta-analysis of studies reporting outcomes between PCI and CABG in patients with NSTE-ACS.Methods: MEDLINE, EMBASE and Cochrane Library were assessed. The primary outcome was long-term mortality. Inverse variance method and random model were performed.Results: We identified 13 observational studies (48,891 patients). No significant difference was found in the primary endpoint (CABG vs. PCI, incidence rate ratio [IRR]= 0.93, 95% confidence interval [CI] 0.70; 1.23). CABG was associated with lower long-term major adverse cardiovascular events (MACE) (IRR= 0.64, 95% CI 0.54; 0.76) and lower long-term re-revascularization (IRR= 0.37, 95% CI 0.30; 0.47). There was no significant difference in long-term myocardial infarction (CABG vs. PCI, IRR= 0.96, 95% CI 0.50; 1.84) and peri-operative mortality (CABG vs. PCI, odds ratio [OR]= 1.36, 95% CI 0.94; 1.95).Conclusion: For the treatment of NSTE-ACS, CABG and PCI are associated with similar rates of long-term mortality and myocardial infarction. CABG is associated with lower rates of long-term MACE and re-revascularization. Randomized comparisons in this setting are necessary.
Evaluation of CMIP6 Models Toward Dynamical Downscaling Over Eight CORDEX Domains
Authors: Zhang Meng-Zhuo , Xu Zhongfeng , Han Ying , Guo Weidong
Published: September 2021

Both reliability and independence of global climate model (GCM) simulation are essential for model selection to generate a reasonable uncertainty range of dynamical downscaling simulations. In this study, we evaluate the performance and interdependency of 37 GCMs from the Coupled Model Intercomparison Project Phase 6 (CMIP6) in terms of seven key large-scale driving fields over eight CORDEX domains. A multivariable integrated evaluation method is used to evaluate and rank the models’ ability to simulate multiple variables in terms of their climatological mean and interannual variability. The results suggest that the model performance varies considerably with seasons, domains, and variables evaluated, and no model outperforms in all aspects. However, the multi-model ensemble mean performs much better than any individual model. Among 37 CMIP6 models, the MPI-ESM1-2-HR, FIO-ESM-2-0, and MPI-ESM1-2-LR rank top three due to their overall good performance across all domains. To measure the model interdependency in terms of multiple fields, we define the similarity of multivariate error fields between pairwise models. Our results indicate that the dependence exists between most of the CMIP6 models, and the models sharing the same idea or/and concept generally show less independence. Furthermore, we hierarchically cluster the top 15 models based on the similarity of multivariate error fields to facilitate the model selection. Our evaluation can provide useful guidance on the selection of CMIP6 models based on their performance and relative independence, which helps to generate a more reliable ensemble of dynamical downscaling simulations with reasonable inter-model spread.
A Study on Design, Development, Implementation, and Evaluation of Severe Drug-Drug Interaction Alert System in ICU
Authors: Karajizadeh mehrdad , Zand Farid , Sharifian Roxana , Vazin Afsaneh , Bayati Najmeh
Published: September 2021

Background and objective:
The overridden rate of Drug-Drug Interaction Alerts (DDIAs) in the Intensive Care Unit (ICU) is very high. Therefore, this study aimed to design, develop, implement, and evaluate a severe Drug-Drug Alert System (DDIAS) in ICU and measure the override rate of DDIAs.
Methods
This is a cross-sectional study for the design, development, implementation, and evaluation of severe DDIAs into a Computerized Provider Order Entry(CPOE) system in the ICUs of Nemazee general teaching hospitals in 2021. The patients exposed to the volume of DDIAs, acceptance and overridden of DDIAs, and usability of DDIAS have been collected.
Results
The knowledge base of DDIAS contains 9,809 severe DDIs. A total of 2672 medications were prescribed in the population study. The volume and acceptance rate for severe DDIAs were 81 and 97.5%, respectively. However, the override rate was 2.5%. The mean System Usability Scale (SUS) score of the DDIAS was 75.
Conclusion
This study demonstrated that the implementation of high-risk DDIAs at point of prescribing in ICU improved adherence to alerts. In addition, the usability of DDIAS was reasonable. Further studies are need to investigate the establishment of severe DDIAS and measure the physician's response to DDIAS on a larger scale.
Incidence and Risk Factors for Chronic Postsurgical Pain Following Video-assisted Thoracoscopic Surgery: a Retrospective Study
Authors: Zhang Yingying , Zhou Rong , Hou Bailing , Tang Suhong , Hao Jing , Gu Xiaoping , Ma Zhengliang , Zhang Juan
Published: September 2021

Backgroud: Video-assisted thoracoscopic surgery (VATS) has been widely used as an alternative for thoracotomy, but the reported incidence of chronic postsurgical pain (CPSP) following VATS varied widely. The purpose of this study was to investigate the incidence and risk factors for CPSP after VATS. Methods: We retrospectively collected preoperative demographic, anesthesiology, and surgical factors in a cohort of patients undergoing VATS between January 2018 and October 2020. Patients were interviewed via phone survey for pain intensity, and related medical treatment 3 months after VATS. Univariate and multivariate analysis were used to explore independent risk factors associated with CPSP.Results: 2,348 patients were included in our study. The incidence of CPSP after VATS were 43.99% (n = 1,033 of 2,348). Within those suffering CPSP, 14.71% (n = 152 of 1,033) patients reported moderate or severe chronic pain. Only 15.23% (n = 23 of 152) patients with moderate to severe chronic pain sought active analgesic therapies. According to multivariable analysis, age ＜ 65 years (OR 1.278, 95% CI 1.057-1.546, P = 0.011), female (OR 1.597, 95% CI 1.344-1.898, P < 0.001), education level less than junior school (OR 1.295, 95% CI 1.090-1.538, P = 0.003), preoperative pain (OR 2.564, 95% CI 1.696-3.877, P < 0.001), consumption of rescue analgesia postoperative (OR 1.248, 95% CI 1.047-1.486, P = 0.013), consumption of sedative hypnotic postoperative (OR 2.035, 95% CI 1.159-3.574, P = 0.013), subcutaneous emphysema of chest wall postoperative (OR 1.255, 95% CI 1.000-1.575, P = 0.050), and history of postoperative wound infection (OR 5.949, 95% CI 1.344-1.898, P < 0.001) were independent risk factors for CPSP development.Conclusions: CPSP remains a challenge in clinic because half of patients may develop CPSP after VATS. Trial registration: Chinese Clinical Trial Registry (ChiCTR2100045765), 2021/04/24
Micro-Fourier-Transform Infrared Reflectance Spectroscopy as Tool for Probing IgG Glycosylation in COVID-19 Patients
Authors: Bandeira Carla , Madureira Karen , Rossi Meire , Gallo Juliana , Silva Ana Paula da , Torres Vilanilse , de Lima Vinicius , Júnior Norival Kesper , Almeida Janete , Zerbinati Rodrigo , Braz-Silva Paulo , Lindoso Jose Angelo Lauletta , Martinho Herculano
Published: September 2021

It has been reported that patients diagnosed with COVID-19 become critically ill primarily around the time of activation of the adaptive immune response. However the role of antibodies in the worsening of disease is not obvious. Higher titers of anti-spike immunoglobulin IgG1 associated to low fucosylation of the antibody Fc tail have been associated to excessive inflammatory response. In contrast it has been also reported in literature that NP-, S-, RBD- specific IgA, IgG, IgM are not associated with SARS-CoV-2 viral load, indicating that there is no obvious correlation between antibody response and viral antigen detection. In the present work the micro-Fourier-Transform Infrared reflectance spectroscopy (micro-FTIR) was employed to investigate blood serum samples of healthy and COVID-19 (mild or oligosynthomatic) individuals (82 healthcare workers volunteers in “Instituto de Infectologia Emilio Ribas”, São Paulo, Brazil). The molecular-level-sensitive, multiplexing quantitative and qualitative FTIR data probed on 1 mL of dryed biofluidwas compared to Signal-to-Cutoff index of chemiluminescent immunoassays CLIA and ELISA (IgG antibodies against SARS-CoV-2). Our main result indicated that 1702-1785 cm-1 spectral window (carbonyl C=O vibration) appeared to be a spectral marker of the degree of IgG glycosylation, allowing to probe distinctive subpopulations of COVID-19 patients, depending on their degree of severity. The specificity was 87.5 % while the detection rate of true positive was 100%. The computed area under the receiver operating curve was equivalent to CLIA, ELISA and other ATR-FTIR methods (> 0.85). In summary, overall discrimination of healthy and COVID-19 individuals and severity prediction as well could also be potentially implemented using micro-FTIR reflectance spectroscopy on blood serum samples. Considering the minimal and reagent-free sample preparation procedures combined to fast (few minutes) outcome of FTIR we can state that this technology is very suitable for fast screening of immune response of individuals with COVID-19. It would be an important tool in prospective studies, helping investigate the physiology of the asymptomatic, oligosymptomatic, or severe individuals and measure the extension of infection dissemination in patients.
Enhanced functional properties of biodegradable Polyvinyl alcohol /carboxymethyl cellulose (PVA/CMC) composite films reinforced with L-alanine surface modified CuO nanorods
Authors: Amaregouda Yamanappagouda , Kamanna Kantharaju , Gasti Tilak , Kumbar Vijay
Published: September 2021

Herein, we described novel biogenic preparation of the CuO nanorods and its surface modification with L-alanine amino acid accelerated by microwave irradiation. The effect of surface functionalized CuO nanorods on the polyvinyl alcohol/carboxymethyl cellulose film physico-mechanical properties were investigated through various characterization techniques. The tensile strength was improved from 28.58 ± 0.73 MPa to 43.40 ± 0.93 MPa, UV shielding ability and barrier to the water vapors were highly enhanced when PVA/CMC matrices filled with 8 wt% of CuO-L-alanine. In addition, the prepared films exhibited acceptable overall migration limit and readily undergoes soil burial degradation. Nevertheless, CuO-L-alanine incorporated films showed potent antioxidant activity against DPPH radicals and had high antibacterial activity against Staphylococcus aureus and Escherichia coli, and antifungal activity against Candida albicans and Candida tropicalis. Furthermore, the nanocomposite films showed negligible cytotoxic effect on HEK293 and Caco-2 cell lines. In these contexts, the developed nanocomposite films can be implementing as an active food packaging material.