bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of biomarkers of endothelial dysfunction and microvascular endothelial function in patients with primary aldosteronism and essential hypertension
Authors: Sang Miaomiao , Fu Yu , Wei Chenmin , Yang Jing , Qiu Xueting , Ma Jingqing , Qin Chao , Wu Feiyan , Zhou Xueling , Yang Tao , Sun Min
Published: March 2021

Introduction:

Studies have shown that primary aldosteronism (PA) has a higher risk of cardiovascular events than essential hypertension (EH). Endothelial dysfunction is an independent predictor of cardiovascular events. Whether PA and EH differ in the endothelial dysfunction is uncertain. Our study was designed to investigate the levels of biomarkers of endothelial dysfunction (Asymmetric dimethylarginine, ADMA; E-selectin, and Plasminogen activator inhibitor-1, PAI-1) and assess the microvascular endothelial function in patients with PA and EH, respectively.

Methods:

The biomarkers of endothelial dysfunction were measured by enzyme-linked immunosorbent assay (ELISA). Microvascular endothelial function was evaluated by Pulse amplitude tonometry (PAT).

Results:

Thirty-one subjects with EH and 36 subjects with PA including 22 with aldosterone-producing adenoma (APA) and 14 with idiopathic hyperaldosteronism (IHA) were enrolled in our study. The ADMA levels among the three groups were different (APA 47.83 (27.50, 87.74) ng/ml vs EH 25.08 (22.44, 39.79) ng/ml vs IHA 26.00 (22.23, 33.75) ng/ml; p = 0.04), however, when the APA group was compared with EH and IHA group, there was no statistical significance (47.83 (27.50, 87.74) ng/ml vs 25.08 (22.44, 39.79) ng/ml for EH, p = 0.11; 47.83 (27.50, 87.74) ng/ml vs IHA 26.00 (33.75) ng/ml, p = 0.07). The results of ADMA levels are presented as Median (p25, p75). Whereas, levels of PAI-1 and E-selectin, microvascular endothelial function were not significantly different between PA and EH subjects.

Conclusions:

Our study shows no significant differences between PA and EH in terms of biomarkers of endothelial dysfunction and microvascular endothelial function. The microvascular endothelial function of PA and EH patients is comparable.
Flow-related posterior cerebral artery aneurysms with internal carotid artery occlusions: An institutional series
Authors: Butt Waleed , Malik Luqman , Dhillon Permesh Singh , McConachie Norman
Published: March 2021

Background

Aneurysm formation after internal carotid artery (ICA) occlusion has been described in animal models and human case series with alteration of cerebral blood flow dynamics considered an aetiological risk factor. Such de novo aneurysms have seldom been described in the posterior cerebral artery (PCA) with the majority observed in the anterior circulation collateral pathways.

Methods

We retrospectively reviewed our institutional database of posterior circulation aneurysms in patients with iatrogenic, atherosclerotic or congenital ICA occlusions. A comprehensive review of the online literature using the PubMed and Medline databases was performed to identify previous cases of PCA aneurysms that were considered ‘flow-related’.

Results

We present five patients with symptomatic or ruptured PCA aneurysms with ICA occlusions. Age at presentation ranged from 21-58 and aneurysm size from 3–12 mm. All cases had angiographic evidence of posterior-anterior flow via the ipsilateral posterior communicating artery (PComA). The clinical presentation, diagnostic imaging and management strategies are further discussed. A literature review identified only two previous reported cases.

Conclusion

To our knowledge this is the first single centre series of posterior circulation aneurysms in patients with ICA occlusions that are considered to be ‘flow-related.’ The natural history of these rare lesions is unclear and the best management and surveillance strategy requires a patient-tailored approach by an experienced neurovascular team.
Urogenital atrophy: The ‘unknown factors’ challenging current practice
Authors: Briggs Paula , Hapangama Dharani K
Published: March 2021

Urogenital atrophy occurs as a result of the effect of estrogen deficiency on the tissue quality in the vulva, vagina, urethra and bladder. It is a common consequence of the menopause, with possibly up to 80% of women experiencing symptoms. Despite a number of different diagnostic methods, there is no validated objective method by which to confirm the diagnosis in clinical practice and research settings. Education, for women and clinicians, is called for to support diagnosis and treatment. However, before this can be of global benefit, development of an accessible and reproducible diagnostic test is required. Current assessment methods include routine history and clinical examination, with the clinician’s opinion based on their subjective observations. A vaginal smear to assess the ratio of superficial to parabasal cells and measurement of the pH of the vaginal secretions is more commonly used in research settings. A number of formulae have been postulated to facilitate the diagnosis including the Vaginal Health Index, the Vulval Health Index, the Genitourinary Syndrome of the Menopause assessment tool, the Genital Health Clinical Evaluation and vaginal biopsy and assessment of the vaginal microbiome. However, none of these potential methods of assessment has been validated. This article focuses on what we do not know about urogenital atrophy including the prevalence, the most appropriate terminology, aetiology, pathogenesis and the most objective and reproducible method of assessment.
Activity of ceftolozane/tazobactam against Gram-negative isolates from patients with lower respiratory tract infections – SMART United States 2018–2019
Authors: Karlowsky James A. , Lob Sibylle H. , Young Katherine , Motyl Mary R. , Sahm Daniel F.
Published: March 2021

Background

Ceftolozane/tazobactam (C/T) is approved in 70 countries, including the United States, for the treatment of patients with hospital-acquired and ventilator-associated bacterial pneumonia caused by susceptible Gram-negative pathogens. C/T is of particular importance as an agent for the treatment of multidrug-resistant (MDR) Pseudomonas aeruginosa infections. The current study summarizes 2018–2019 data from the United States on lower respiratory tract isolates of Gram-negative bacilli from the SMART global surveillance program. The CLSI reference broth microdilution method was used to determine in vitro susceptibility of C/T and comparators against isolates of P. aeruginosa and Enterobacterales.

Results

C/T inhibited 96.0% of P. aeruginosa (n = 1237) at its susceptible MIC breakpoint (≤4 μg/ml), including > 85% of meropenem-nonsusceptible and piperacillin/tazobactam (P/T)-nonsusceptible isolates and 76.2% of MDR isolates. Comparator agents demonstrated lower activity than C/T against P. aeruginosa: meropenem (74.8% susceptible), cefepime (79.2%), ceftazidime (78.5%), P/T (74.4%), and levofloxacin (63.1%). C/T was equally active against ICU (96.0% susceptible) and non-ICU (96.7%) isolates of P. aeruginosa. C/T inhibited 91.8% of Enterobacterales (n = 1938) at its susceptible MIC breakpoint (≤2 μg/ml); 89.5% of isolates were susceptible to cefepime and 88.0% susceptible to P/T. 67.1 and 86.5% of extended-spectrum β-lactamase (ESBL) screen-positive isolates of Klebsiella pneumoniae (n = 85) and Escherichia coli (n = 74) and 49.6% of MDR Enterobacterales were susceptible to C/T. C/T was equally active against ICU (91.3% susceptible) and non-ICU (92.6%) Enterobacterales isolates.

Conclusion

Data from the current study support the use of C/T as an important treatment option for lower respiratory tract infections including those caused by MDR P. aeruginosa.
Antibiotic resistance in Pakistan: a systematic review of past decade
Authors: Bilal Hazrat , Khan Muhammad Nadeem , Rehman Tayyab , Hameed Muhammad Fazal , Yang Xingyuan
Published: March 2021

Background

During the last six decades, extensive use of antibiotics has selected resistant strains, increasing the rate of fatal infectious diseases, and exerting an economic burden on society. This situation is widely accepted as a global problem, yet its degree is not well elucidated in many regions of the world. Up till now, no systemic analysis of Antimicrobial resistance (AMR) in Pakistan has been published. The current study aims to describe the antibiotic-resistance scenario of Pakistan from human samples of the last 10 y, to find the gaps in surveillances and methodology and recommendations for researchers and prescribers founded on these outcomes.

Methods

Original research articles analyzed the pattern of Antibiotic resistance of any World Health Organization (WHO) enlisted priority pathogens in Pakistan (published onward 2009 till March 2020), were collected from PubMed, Google scholar, and PakMedi Net search engines. These articles were selected based on predefined inclusion and exclusion criteria. Data about the study characteristics and antibiotic-resistance for a given bacterium were excluded from literature. Antibiotic resistance to a particular bacterium was calculated as a median resistance with 95% Confidence Interval (CI).

Results

Studies published in the last 10 y showed that Urinary Tract Infection (UTI) is the most reported clinical diagnosis (16.1%) in Pakistan. E. coli were reported in 28 (30.11%) studies showing high resistance to antibiotics’ first line. Methicillin-resistant Staphylococcus aureus (MRSA) was found in 49% of S. aureus’ total reported cases. Phenotypic resistance pattern has mostly been evaluated by Disk Diffusion Method (DDM) (82.8%), taken Clinical Laboratory Standards Institute (CLSI) as a breakpoint reference guideline (in 79.6% studies). Only 28 (30.11%) studies have made molecular identification of the resistance gene. blaTEM (78.94% in Shigella spp) and blaNDM-1 (32.75% in Klebsiella spp) are the prominent reported resistant genes followed by VanA (45.53% in Enterococcus spp), mcr-1 (1.61% in Acinetobacter spp), and blaKPC-2 (31.67% in E. coli). Most of the studies were from Sindh (40.86%), followed by Punjab (35.48%), while Baluchistan’s AMR data was not available.

Conclusion

Outcomes of our study emphasize that most of the pathogens show high resistance to commonly used antibiotics; also, we find gaps in surveillances and breaches in methodological data. Based on these findings, we recommend the regularization of surveillance practice and precise actions to combat the region’s AMR.
A standardized approach for exact CT-based three-dimensional position analysis in the distal tibiofibular joint
Authors: Souleiman Firas , Heilemann Martin , Hennings Robert , Hennings Mareike , Klengel Alexis , Hepp Pierre , Osterhoff Georg , Ahrberg Annette B.
Published: March 2021

Background

Assessment of tibiofibular reduction presents an intra- and postoperative challenge. Numerous two-dimensional measurement methods have been described, most of them highly dependent on leg orientation and rater. Aim of the present work was to develop a standardized and orientation-independent 3D based method for the assessment of syndesmotic joint position.

Methods

In a retrospective single center study, 3D models of bilateral ankle joints, either after unilateral syndesmosis stabilization (operative group) or with no injury (native group) were superimposed (best fit matching) and aligned uniformly. Based on center of gravity calculations three orientation- and rater-independent parameters were determined: tibiofibular clears space (CS), vertical offset between both fibulae, and translation angle of the fibulae about tibia axis.

Results

Bilateral CT datasets of 57 native and 47 postoperative patients were analyzed. In the native group mean CS was 2.7 (SD, 0.8; range, 0.7–4.9) mm, mean CS side difference was 0.62 (SD, 0.45) mm and mean translation angle was 1.6 (SD, 1.4) degrees regarding absolute values. The operative group was found to show a significantly higher CS side difference of 0.88 (SD, 0.75) mm compared to native group (P = .046). Compared to the healthy contralateral side, operated fibulae showed mean proximal displacement of 0.56 (SD, 1.67) mm (P = .025), dorsal displacement of 1.5 (SD 4.1) degrees (P = .017).

Conclusion

By using 3D best fit matching, orientation- and rater-dependent errors can be minimized. Large interindividual and small intraindividual differences of uninjured couples support previous recommendations for bilateral imaging.

Trial registration: AZ 131/18-ek; AZ 361/19-ek

Level of evidence

Level III.
Imaging analysis of 13 rare cases of renal collecting (Bellini) duct carcinoma in northern China: a case series and literature review
Authors: Lyu Zhehao , Liu Lili , Li Huimin , Wang Haibo , Liu Qi , Chen Tingting , Xu Meiling , Tian Lin , Fu Peng
Published: March 2021

Background

Collecting (Bellini) duct carcinoma (CDC) is a highly malignant and rare kidney tumor. We report our 12-year experience with CDC and the results of a retrospective analysis of patients and tumor characteristics, clinical manifestations, and imaging features by computed tomography (CT), magnetic resonance imaging (MRI), and positron emission tomography (PET)/CT.

Methods

Retrospective examination of tumors between January 2007 and December 2019 identified 13 cases of CDC from three medical centers in northern China. All 13 patients underwent CT scan, among which eight underwent dynamic enhanced CT scan, two underwent PET/CT scan, and one underwent magnetic resonance cholangiopancreatography (MRCP) examination. The lesions were divided into nephritis type and mass type according to the morphology of the tumors.

Results

The study group included ten men and three women with an average age of 64.23 ± 10.74 years. The clinical manifestations were gross hematuria, flank pain, and waist discomfort. The mean tumor size was 8.48 ± 2.48 cm. Of the 13 cases, six (46.2%) were cortical-medullary involved type and seven (53.8%) were cortex–medullary–pelvis involved type. Eleven (84.6%) cases were nephritis type and two (15.4%) were mass type. The lesions appeared solid or complex solid and cystic on CT and MRI. The parenchymal area of the tumors showed isodensity or slightly higher density on unenhanced CT scan in the 13 cases. PET/CT in two cases showed increased radioactivity intake. Evidence of intra-abdominal metastatic disease was present on CT in nine (69.2%) cases.

Conclusions

The imaging characteristics of CDC differ from those of other renal cell carcinomas. In renal tumors located in the junction zone of the renal cortex and medulla that show unclear borders, slight enhancement, and metastases in the early stage, a diagnosis of CDC needs to be considered. PET/CT provides crucial information for the diagnosis of CDC, as well as for designing treatment strategies including surgery.
Determinants of completing recommended antenatal care utilization in sub-Saharan from 2006 to 2018: evidence from 36 countries using Demographic and Health Surveys
Authors: Tessema Zemenu Tadesse , Teshale Achamyeleh Birhanu , Tesema Getayeneh Antehunegn , Tamirat Koku Sisay
Published: March 2021

Background

Every day in 2017, approximately 810 women died from preventable causes related to pregnancy and childbirth, with 99% of these maternal deaths occurring in low and lower-middle-income countries. Sub-Saharan Africa (SSA) alone accounts for roughly 66%. If pregnant women gained recommended ANC (Antenatal Care), these maternal deaths could be prevented. Still, many women lack recommended ANC in sub-Saharan Africa. This study aimed at determining the pooled prevalence and determinants of recommended ANC utilization in SSA.

Methods

We used the most recent standard demographic and health survey data from the period of 2006 to 2018 for 36 SSA countries. A total of 260,572 women who had at least one live birth 5 years preceding the survey were included in this study. A meta-analysis of DHS data of the Sub-Saharan countries was conducted to generate pooled prevalence, and a forest plot was used to present it. A multilevel multivariable logistic regression model was fitted to identify determinants of recommended ANC utilization. The AOR (Adjusted Odds Ratio) with their 95% CI andp-value ≤0.05 was used to declare the recommended ANC utilization determinates.

Results

The pooled prevalence of recommended antenatal care utilization in sub-Saharan Africa countries were 58.53% [95% CI: 58.35, 58.71], with the highest recommended ANC utilization in the Southern Region of Africa (78.86%) and the low recommended ANC utilization in Eastern Regions of Africa (53.39%). In the multilevel multivariable logistic regression model region, residence, literacy level, maternal education, husband education, maternal occupation, women health care decision autonomy, wealth index, media exposure, accessing health care, wanted pregnancy, contraceptive use, and birth order were determinants of recommended ANC utilization in Sub-Saharan Africa.

Conclusion

The coverage of recommended ANC service utilization was with high disparities among the region. Being a rural residence, illiterate, low education level, had no occupation, low women autonomy, low socioeconomic status, not exposed to media, a big problem to access health care, unplanned pregnancy, not use of contraceptive were determinants of women that had no recommended ANC utilization in SSA. This study evidenced the existence of a wide gap between SSA regions and countries. Special attention is required to improve health accessibility, utilization, and quality of maternal health services.
The importance of evaluating specific myeloid malignancies in epidemiological studies of environmental carcinogens
Authors: Mundt K. A. , Dell L. D. , Boffetta P. , Beckett E. M. , Lynch H. N. , Desai V. J. , Lin C. K. , Thompson W. J.
Published: March 2021

Introduction

Although myelodysplastic syndrome (MDS), acute myeloid leukemia (AML), myeloproliferative neoplasms (MPN) – including chronic myeloid leukemia (CML) – and myelodysplastic/myeloproliferative neoplasms (MDS/MPN) are largely clinically distinct myeloid malignancies, epidemiological studies rarely examine them separately and often combine them with lymphoid malignancies, limiting possible etiological interpretations for specific myeloid malignancies.

Methods

We systematically evaluated the epidemiological literature on the four chemical agents (1,3-butadiene, formaldehyde, benzene, and tobacco smoking, excluding pharmaceutical, microbial and radioactive agents, and pesticides) classified by the International Agency for Research on Cancer as having sufficient epidemiological evidence to conclude that each causes “myeloid malignancies.” Literature searches of IARC Monographs and PubMed identified 85 studies that we critically assessed, and for appropriate subsets, summarized results using meta-analysis.

Results

Only two epidemiological studies on 1,3-butadiene were identified, but reported findings were inadequate to evaluate specific myeloid malignancies. Studies on formaldehyde reported results for AML and CML – and not for MDS or MPN – but reported no increased risks. For benzene, several specific myeloid malignancies were evaluated, with consistent associations reported with AML and MDS and mixed results for CML. Studies of tobacco smoking examined all major myeloid malignancies, demonstrating consistent relationships with AML, MDS and MPN, but not with CML.

Conclusions

Surprisingly few epidemiological studies present results for specific myeloid malignancies, and those identified were inconsistent across studies of the same exposure, as well as across chemical agents. This exercise illustrates that even for agents classified as having sufficient evidence of causing “myeloid malignancies,” the epidemiological evidence for specific myeloid malignancies is generally limited and inconsistent. Future epidemiological studies should report findings for the specific myeloid malignancies, as combining them post hoc – where appropriate – always remains possible, whereas disaggregation may not. Furthermore, combining results across possibly discrete diseases reduces the chances of identifying important malignancy-specific causal associations.
Screening is associated with lower mastectomy rates in eastern Switzerland beyond stage effects
Authors: Herrmann Christian , Morant Rudolf , Walser Esther , Mousavi Mohsen , Thürlimann Beat
Published: March 2021

Background

A recent study found an influence of organized mammography screening programmes (MSPs) on geographical and temporal variation of mastectomy rates. We aimed to quantify the effect on the example of one of the cantonal programmes in Switzerland.

Methods

We used incidence data for the years 2010–2017 from the cancer registry of Eastern Switzerland. We included women with invasive-non-metastatic breast cancer (BC) in the screening age group 50–69-year-olds in the canton of St.Gallen. We compared mastectomy rates among cancer patients detected through the organised screening programme (MSP) vs. otherwise detected by stage.

Results

MSP-detected patients in St.Gallen presented with lower stages. 95% of MSP-detected had stages I-II vs 76% of Non-MSP-detected. Within all non-metastatic stage, tumour size and nodal status groups, MSP-detected patients had lower mastectomy rates, overall 10% vs 24% in 50–69-year-old non-participants. Their odds of receiving a mastectomy are about half of the Non-MSP-detected (OR = 0.48, p = 0.002).

Conclusions

Our study showed that MSPs have a positive effect on lowering mastectomy rates. Screening participants are significantly less likely to receive a mastectomy compared to non-participants, which must be attributed to additional factors than just lower stages. Lower mastectomy rates lead to a higher quality of life for many patients.
Multizonal anogenital neoplasia in women: a cohort analysis
Authors: Albuquerque Andreia , Godfrey Michelle A. L. , Cappello Carmelina , Pesola Francesca , Bowring Julie , Cuming Tamzin , De Masi Anke , Rosenthal Adam N. , Sasieni Peter , Nathan Mayura
Published: March 2021

Background

There is currently a lack of information on full anogenital evaluation of women with a previous history of anogenital neoplasia.

Methods

Retrospective analysis of the Homerton Anogenital Neoplasia Service records from January 2012 to March 2017, to identify all new referrals of women with previous anogenital neoplasia, who had had at least one complete examination of all anogenital sites. Multizonal anogenital disease (MZD) was defined as the presence of high-grade squamous intraepithelial lesions (HSIL)/carcinoma concurrently at two or more of the following sites/zones: perianus, anal canal, vulva, vagina or cervix.

Results

253 women were included, mean age was 47 (SD=15) years and median duration of follow-up was 12 (IQR=21) months. Fifty-six women (22%) were diagnosed with MZD at first assessment and/or during follow-up. Current smokers (RR=1.84, 95% CI 1.21–2.79, p=0.004) and women on immunodulators/immunosuppressive drugs (RR=2.57, 95% CI 1.72-3.86, p<0.001) had an increased risk for MZD. The risk was lower for women without a previous history of anogenital high-grade lesions/cancer compared to those with this history (RR=0.06, 95% CI 0.01-0.45, p=0.006).

Conclusions

Multizonal assessment was important to diagnose occult areas of disease and should be especially considered in current smokers, pharmacologically immunocompromised and those with a previous history of anogenital HSIL/cancer.
The emerging clinical relevance of genomic profiling in neuroendocrine tumours
Authors: Burak Guney Isa , Ozge Sonmezler , Cem Mujde , Gulgun Buyukdereli , Zeynep Dogruca Yapar , Atil Bisgin
Published: March 2021

Background

Neuroendocrine tumours (NETs) arise from hormone-producing or nervous system cells and can develop from anywhere in the body. They have heterogeneous origins from skin to gastrointestinal track and a complicated histology. Thus, there is an inevitable need for genomic profiling to determine the exact genetics of each tumour for prognosis and treatment strategies to overcome the disease’s complexity. For this purpose, next-generation-sequencing (NGS) is the most reliable methodology for both germ-line and somatic studies to make a clinical diagnosis. In this study, we analyse liquid biopsies, formalin fixed paraffin embedded (FFPE) tissues, and peripheral blood samples for their ability to provide information for actionability.

Methods

A customized multi-gene panel comprised of Succinate Dehydrogenase Complex Iron Sulfur Subunit B (SDHB), Succinate Dehydrogenase Complex Subunit C (SDHC), Cell Division Cycle 73(CDC73), Calcium Sensing Receptor (CASR), Platelet Derived Growth Factor Receptor Alpha (PDGFRA), Succinate Dehydrogenase Complex Flavoprotein Subunit A (SDHA), Ret Proto-Oncogene (RET), Succinate Dehydrogenase Complex Assembly Factor 2(SDHAF2), Menin 1(MEN1), Succinate Dehydrogenase Complex Subunit D (SDHD), MYC Associated Factor X (MAX) and Protein Kinase CAMP-Dependent Type I Regulatory Subunit Alpha (PRKAR1A) genes was constructed to assess multiple specimen types including: 3 liquid biopsies, 6 FFPE tissues, and 26 peripheral blood samples from 35 unique NET patients. Quality-control and bioinformatics analyses were performed using QCI-Analyze and QCI-Interpret.

Results

The three liquid biopsies and the 6 FFPE tissue samples were evaluated for somatic mutations; while the 26 peripheral blood samples were analysed using the germ-line pipeline. Five (55.6%) of the nine patients that were studied for somatic changes carried actionable mutations related to therapy sensitivities. Through the germ-line studies, we observed a 50% positivity rate for disease predisposition with 16 variants classified according to ACMG (American College of Medical Genetics) Standards and Guidelines.

Conclusions

Genomic profiling medicine is an emerging area of clinical oncology and has become crucial for disease and patient management by providing a precision approach; this is especially true for rare diseases including rare cancers such as NETs. Notably, this study emphasized the relevance of multiple distinctive biological sample types for use in the genetic testing of cancers to help with the choice of therapy to maximize the likelihood of a positive clinical outcome.
Psychological and physiological stress and burnout among maternity providers in a rural county in Kenya: individual and situational predictors
Authors: Afulani Patience A. , Ongeri Linnet , Kinyua Joyceline , Temmerman Marleen , Mendes Wendy Berry , Weiss Sandra J.
Published: March 2021

Background

Stress and burnout among healthcare workers has been recognized as a global crisis needing urgent attention. Yet few studies have examined stress and burnout among healthcare providers in sub-Saharan Africa, and even fewer among maternity providers who work under very stressful conditions. To address these gaps, we examined self-reported stress and burnout levels as well as stress-related physiologic measures of these providers, along with their potential predictors.

Methods

Participants included 101 maternity providers (62 nurses/midwives, 16 clinical officers/doctors, and 23 support staff) in western Kenya. Respondents completed Cohen’s Perceived Stress Scale, the Shirom-Melamed Burnout scale, and other sociodemographic, health, and work-related items. We also collected data on heart rate variability (HRV) and hair cortisol levels to assess stress-related physiologic responses to acute and chronic stress respectively. Multilevel linear regression models were computed to examine individual and work-related factors associated with stress, burnout, HRV, and cortisol level.

Results

85% of providers reported moderate stress and 11.5% high stress. 65% experienced low burnout and 19.6% high burnout. Average HRV (measured as the root mean square of differences in intervals between successive heart beats: RMSSD) was 60.5 (SD = 33.0) and mean cortisol was mean cortisol was 44.2 pg/mg (SD = 60.88). Greater satisfaction with life accomplishments was associated with reduced stress (β = − 2.83; CI = -5.47; − 0.18), while motivation to work excessively (over commitment) was associated with both increased stress (β = 0.61 CI: 0.19, 1.03) and burnout (β = 2.05, CI = 0.91, 3.19). Female providers had higher burnout scores compared to male providers. Support staff had higher HRV than other providers and providers under 30 years of age had higher HRV than those 30 and above. Although no association between cortisol and any predictor was statistically significant, the direction of associations was consistent with those found for stress and burnout.

Conclusions

Most providers experienced moderate to high levels of stress and burnout. Individuals who were more driven to work excessively were particularly at risk for higher stress and burnout. Higher HRV of support staff and providers under age 30 suggest their more adaptive autonomic nervous system response to stress. Given its impact on provider wellbeing and quality of care, interventions to help providers manage stress are critical.
Health study of 11,800 workers under occupational noise in Xinjiang
Authors: Zhao Shiyu , He Dongkui , Zhang Hanwei , Hou Tingting , Yang Chengxin , Ding Wen , He Ping
Published: March 2021

Background

We investigated the health status of some workers exposed to occupational noise in Xinjiang, and explored the influencing factors of their health level. We aimed to determine the key protection groups of occupational noise hazards, which might provide the basis for the development of targeted noise prevention measures.

Methods

We used descriptive analysis to investigate a total of 11,800 participants who underwent occupational health examination in Xinjiang Occupational Disease Prevention Hospital.

Results

The hearing abnormality rate of noise exposure participants was 8.03%, which was higher in males than females (χ2 = 54.507, p < 0.05). The abnormal rate of high-frequency hearing threshold in Xinjiang minorities was lower than in Han nationality (χ2 = 11.780, p < 0.05), while the results of the electrocardiogram were reversed (χ2 = 9.128, p < 0.05). Differences in abnormal rates of blood pressure (χ2 = 149.734, p < 0.05), hearing (χ2 = 231.203, p < 0.05), and physical examination (χ2 = 360.609, p < 0.05) are statistically significant in different industries. The abnormal rates of blood pressure (χ2 = 67.416, p < 0.05) and hearing (χ2 = 49.535, p < 0.05) gradually decrease with the expansion of the enterprise scale. Logistic regression analysis showed that gender, nationality, age, enterprise size, and industry were closely related to pure tone audiometry examination abnormal rate.

Conclusion

Workers of male, elder, in mine and small/medium enterprises should be the key populations to prevent occupational noise hazard. It is necessary to standardize occupational health management in enterprises, which helps to improve workers’ self-protection awareness and quality of life.
Domestic violence and abuse related emergency room visits in Ontario, Canada
Authors: Singhal Sonica , Orr Sarah , Singh Harkirat , Shanmuganantha Menaka , Manson Heather
Published: March 2021

Background

Hospitals’ emergency rooms (ERs) are generally the first point of contact of domestic violence and abuse (DVA) victims to the health care system. For efficient management and resource allocation for ERs to manage DVA-related emergencies in Canada, it is important to quantify and assess the pattern of these visits.

Methods

Aggregate DVA-related ER visits data, using relevant ICD-10-CA codes, from 2012 to 2016 were retrieved from IntelliHealth Ontario. The 2011 ON-Marg (Ontario Marginalization) indices were linked at the Dissemination Area level to ER data. Descriptive analyses including total number and rate of visits per 100,000 people were calculated, stratified by age and sex. The Slope Index of Inequality (SII) and Relative Index of Inequality (RII) were also assessed.

Results

From 2012 to 2016, 10,935 (81.2% by females and 18.8% by males) DVA-related visits were made to ERs in Ontario. An annual average of 25.5 visits per 100,000 females and 6.1 visits per 100,000 males was observed. Residential instability and deprivation were significant predictors of DVA-related ER visits. No particular site of injury was indicated in 38.5% of visits, 24.7% presented with cranio-maxillofacial (CMF) trauma in isolation, 28.9% presented with non-CMF injuries, and 7.9% visits presented with both CMF and non-CMF injuries.

Conclusion

This study identified that the burden of DVA-related ER visits is large enough to warrant timely public health interventions, and observed that certain populations in Ontario experience more DVA and/or are more prone to its impact. Our findings have important implications for various stakeholders involved in planning and implementing relevant policies and programs.
Immunohistochemical analysis of ADAMTS-1, versican and pEGFR expressions in periapical granuloma and radicular cyst
Authors: Batista Nádia Marielly Gomes , de Moraes Antonia Taiane Lopes , Balbinot Karolyny Martins , de Souza Neto Osvaldo Rodrigues , da Silva Brandão Juliana Melo , da Silva kataoka Maria Sueli , de Melo Alves Júnior Sérgio , de Jesus Viana Pinheiro João
Published: March 2021

Background

ADAMTS expression can be associated with several inflammatory processes, and has been correlated with tumorigenesis of some neoplasms, but its participation in the development of periapical lesions has not been investigated. Therefore, our objective was to verify the expression of ADAMTS-1, versican and pEGFR in Periapical Granuloma (PG) and in the Radicular Cyst (RC) since they are the most common lesions of the periapex.

Methods

25 samples of RC and 10 of PG were used. As a control, 10 samples of inflammatory fibrous hyperplasia (IFH) and 10 of dental follicle (DF) were used. The expression of these proteins was investigated using immunohistochemistry.

Results

In the epithelium of RC, IFH and DF, the expression of ADAMTS-1 was greater in DF than in RC (p < .001). Versicano showed greater expression in IFH than in RC, DF than in RC (p < .001). pEGFR showed greater expression in IFH and RC than in DF (p < .01 and p < .05, respectively). In connective tissue, ADAMTS-1 expression was greater in PG and RC than in IFH and DF (p < .001). Versicano showed greater expression in PG, RC and IFH compared to DF (p < .001). In pEGFR there was a higher expression in PG when compared to RC, IFH and DF (p < .001). Greater immunostaining occurred in the RC than in the DF (p < .001).

Conclusions

Our results suggest that the studied proteins may participate in the pathogenesis of PG and RC, through the interaction of these proteins, in the remodeling of the ECM (versican) by ADAMTS-1, producing bioactive fragments, which could activate EGFR, contributing to the formation, growth and maintenance of injuries.
ApoE4 (Δ272–299) induces mitochondrial‐associated membrane formation and mitochondrial impairment by enhancing GRP75-modulated mitochondrial calcium overload in neuron
Authors: Liang Tao , Hang Weijian , Chen Jiehui , Wu Yue , Wen Bin , Xu Kai , Ding Bingbing , Chen Juan
Published: March 2021

Background

Apolipoprotein E4 (apoE4) is a major genetic risk factor of Alzheimer’s disease. Its C-terminal-truncated apoE4 (Δ272–299) has neurotoxicity by affecting mitochondrial respiratory function. However, the molecular mechanism(s) underlying the action of apoE4 (Δ272–299) in mitochondrial function remain poorly understood.

Methods

The impact of neuronal apoE4 (Δ272–299) expression on ER stress, mitochondrial-associated membrane (MAM) formation, GRP75, calcium transport and mitochondrial impairment was determined in vivo and in vitro. Furthermore, the importance of ER stress or GRP75 activity in the apoE4 (Δ272–299)-promoted mitochondrial dysfunction in neuron was investigated.

Results

Neuronal apoE4 (Δ272–299) expression induced mitochondrial impairment by inducing ER stress and mitochondrial-associated membrane (MAM) formation in vivo and in vitro. Furthermore, apoE4 (Δ272–299) expression promoted GRP75 expression, mitochondrial dysfunction and calcium transport into the mitochondria in neuron, which were significantly mitigated by treatment with PBA (an inhibitor of ER stress), MKT077 (a specific GRP75 inhibitor) or GRP75 silencing.

Conclusions

ApoE4 (Δ272–299) significantly impaired neuron mitochondrial function by triggering ER stress, up-regulating GRP75 expression to increase MAM formation, and mitochondrial calcium overload. Our findings may provide new insights into the neurotoxicity of apoE4 (Δ272–299) against mitochondrial function and uncover new therapeutic targets for the intervention of Alzheimer’s disease.
Comparison of age‐dependent alterations in thioredoxin 2 and thioredoxin reductase 2 expressions in hippocampi between mice and rats
Authors: Yoo Yeon Ho , Kim Dae Won , Chen Bai Hui , Sim Hyejin , Kim Bora , Lee Jae-Chul , Ahn Ji Hyeon , Park Yoonsoo , Cho Jun Hwi , Kang Il Jun , Won Moo-Ho , Lee Tae-Kyeong
Published: March 2021

Background

Aging is one of major causes triggering neurophysiological changes in many brain substructures, including the hippocampus, which has a major role in learning and memory. Thioredoxin (Trx) is a class of small redox proteins. Among the Trx family, Trx2 plays an important role in the regulation of mitochondrial membrane potential and is controlled by TrxR2. Hitherto, age-dependent alterations in Trx2 and TrxR2 in aged hippocampi have been poorly investigated. Therefore, the aim of this study was to examine changes in Trx2 and TrxR2 in mouse and rat hippocampi by age and to compare their differences between mice and rats.

Results

Trx2 and TrxR2 levels using Western blots in mice were the highest at young age and gradually reduced with time, showing that no significant differences in the levels were found between the two subfields. In rats, however, their expression levels were the lowest at young age and gradually increased with time. Nevertheless, there were no differences in cellular distribution and morphology in their hippocampi when it was observed by cresyl violet staining. In addition, both Trx2 and TrxR2 immunoreactivities in the CA1-3 fields were mainly shown in pyramidal cells (principal cells), showing that their immunoreactivities were altered like changes in their protein levels.

Conclusions

Our current findings suggest that Trx2 and TrxR2 expressions in the brain may be different according to brain regions, age and species. Therefore, further studies are needed to examine the reasons of the differences of Trx2 and TrxR2 expressions in the hippocampus between mice and rats.
The global race to develop a COVID-19 vaccine
Authors: Winter George
Published: March 2021

The COVID-19 pandemic has lead to researchers around the world working to find a safe and effective vaccine as quickly as possible. This monumental effort has found more than 300 COVID-19 candidate vaccines, of which around 40 are in clinical trials, with three currently approved for use in the UK. This article looks at the development of a vaccine for SARS-CoV-2, the virus responsible for the pandemic.
Lift Interference in Wind Tunnels with Perforated and Solid Walls
Authors: MANEA Mihaela , BURGHIU Adrian
Published: March 2021

In order to obtain accurate results in wind tunnel testing it is necessary to determine the effect of interaction between the flow around the model and the test section walls. In this paper, the classical theory for wind tunnel wall corrections assessment is used to evaluate the wall induced change in the circulation caused by the presence of the test article in the wind tunnel. This primary correction, also known as lift interference is based on the test section geometry and it is applied to the test article angle of attack. The computations performed in this paper employ the assumption of the potential linearized flow between the test section walls and the model. As well, the principle of superposition is a key element in this analysis.
Wildlife-pet markets in a one-health context
Authors: Warwick Clifford , Steedman Catrina
Published: March 2021

Background and Aim: Wildlife markets are centers of trade involving live animals and their derivatives from wild-caught and captive-bred non-domesticated animals, including for the culinary, fashion, traditional medicine, curio, and pet sectors. These markets occur in Southeast Asia, India, North America, Latin America, Europe, Africa, and elsewhere. This study aims to address a diversity of related issues that have a one-health bearing while focusing on wildlife markets in relation to the pet trade. Across relevant regions and countries, all major animal classes are traded at wildlife-pet markets. Wildlife markets, in general, are considered distinct from so-called "wet markets" at which domesticated animals, fish, and other "seafood" are offered only for consumption. Several aspects of wildlife markets have attracted scientific and popular scrutiny, including animal welfare concerns, species conservation threats, legality, ecological alteration, introduction of invasive alien species, presence of undescribed species, and public and agricultural animal health issues.

Materials and Methods: Onsite inspections were conducted for markets in the United States, Spain, Germany, The Netherlands, and the UK, as well as observational research of visual imagery of market conditions, and we compared these conditions with evidence-based standards for animal welfare and public health management.

Results: Wildlife markets globally shared common similar structures and practices including the presence of sick, injured, or stressed animals; mixing of animals of uncertain origin and health state; and no specific or any hygiene protocols, with issues of animal welfare, public health and safety, agricultural animal health, and other one-health concerns being inherently involved.

Conclusion: We conclude that wildlife markets are incompatible with responsible standards and practices, and we recommend that such events are banned globally to ameliorate inherent major problems.
Histopathological evaluation of Senecio rhizomatus Rusby in 7,12-dimethylbenz(α) anthracene-induced breast cancer in female rats
Authors: Arroyo-Acevedo Jorge Luis , Herrera-Calderon Oscar , Rojas-Armas Juan Pedro , Chávez-Asmat Roberto , Calva James , Behl Tapan
Published: March 2021

Background and Aim: Senecio rhizomatus Rusby (SrR) is a medicinal plant of the Asteraceae family and traditionally consumed as infusion in the Andean region from Peru for inflammatory disorders. This study aimed to determine the histopathological changes afforded by SrR in 7, 12-dimethylbenz[α]anthracene (DMBA)-induced breast cancer (BC) in rats.

Materials and Methods: An ethanolic extract of SrR aerial parts was prepared by maceration with 96% ethanol, and the chemical components were identified by gas chromatography coupled to mass spectrometry; the antioxidant activity was determined by 1,1-diphenyl-2-picril-hidrazil (DPPH) assay; and the acute toxicity was assessed according to the OCED 423 guidelines. In a pharmacological study, 30 female Holztman rats were distributed randomly into five groups, as follows. Group I: Negative control (physiological serum, 2 mL/kg); Group II. DMBA (80 mg/Kg body weight); and Groups III, IV, and V: DMBA + ethanol extract of SrR at doses of 10, 100, and 200 mg/kg, respectively.

Results: The antioxidant activity of the SrR extract against DPPH was 92.50% at 200 μg/mL. The oral administration of SrR at doses of 50, 300, 2000, and 5000 mg/kg did not show any clinical evidence of toxicity or occurrence of death. The groups that received SrR presented a lower frequency of tumors and a cumulative tumor volume compared with the DMBA group (p<0.05); the DMBA group exhibited a higher incidence of necrosis and moderate mitosis, up to 66.67% and 100.00%, respectively. Finally, infiltrating carcinoma with extensive tumor necrosis was evidenced.

Conclusion: In experimental conditions, the ethanolic extract of SrR had a protective effect in DMBA-induced BC in female rats. Furthermore, the antioxidant activity of its main phytochemicals could be responsible for the effect observed, and SrR seems to be a safe extract in the preclinical phase.
Efficient key distribution protocol for mobile devices in cloud environments
Authors: Su Jeong Yoon , Tae Kim Yong , Cheol Park Gil
Published: March 2021

Background/Objectives: Recently, as the fourth industrial revolution has emerged, cloud computing services have been attracting attention for efficient use of Internet-based computing resources. Among the cloud computing services, even if the data processed by the mobile device is encrypted after being stored in the server, the confidential information can be leaked. Therefore, there is a need for the key generation for data encryption and decryption.Methods/Statistical analysis: In this paper, we propose a key distribution protocol that enables mobile devices to securely encrypt and decrypt keys in an efficient manner in a cloud environment. The main purpose of the proposed protocol is to maximize the efficiency and cost reduction of key generation, which can securely transmit and receive data, in a situation where the size of data used in the cloud environment and the storage location are increasing. As a result of the performance evaluation, the proposed method improved the authentication processing time by 4.1% on average compared with the existing protocol, and the average throughput rate of the server per unit time was 6.5%. In addition, the communication delay time between the authentication server and the mobile device improved by 9.3% on average, and the authentication overhead of the server was 11.5% lower than that of the conventional method.Findings: In order to solve this problem, the proposed protocol can solve the security problem of the mobile device because it can receive the authentication through the one - way hash function and the XOR operation using the encrypted data using the session key.Improvements/Applications: In future studies, we will apply the proposed protocol to the actual environment based on the results of this study and compare it with the results obtained from the theoretical studies.
The satisfaction level of SMES with smart factory introduction using cluster analysis
Authors: Yoon Oh Jeong , Hyun Choi Sang , . .
Published: March 2021

Background/Objectives: It is necessary to confirm whether the introduction of smart factory is moving in the right direction for SMEs applying the basic stage of Smart Factory. We would like to investigate the characteristics of the company according to satisfaction levels of Smart Factory introduction.Methods/Statistical analysis: We collected the questionnaire of companies applying the basic level of Smart Factory and conducted a cluster analysis on the whole data. Four groups were classified into two groups with low satisfaction level and two groups with high satisfaction level. To investigate the characteristics of each group, we conducted a cluster analysis of each group to identify the difference according to satisfaction.Findings: The group with low satisfaction was divided into two clusters. One applied MES and the improvement of defect rate is as low as 8%, the other applied ERP and the expectation of quality improvement is high. The groups were divided into three groups. The first one is the group that wants to proceed to next stage regardless of the governmental support without staying at the basic stage. The second one is the group that applied MES and considers governmental support important when progressing with the intermediate 1st stage. And last one is the group that has the highest rate of Equipment linkage, productivity improvement, sales growth and improvement of defect rate.Improvements/Applications: This paper will help to benchmark companies that are introducing smart factories. However, it would be a better study if we carry out research that increases the number of data and predicts satisfaction.