bluuebunny/crossref_metadata_2025 huggingface dataset:
Focusing characteristics of high voltage electron gun under variable electromagnetic and beam source parameters
Authors: SHENGBO LI , YUFAN QIU , SHENGPING FU , DENIS SHUTIN , YE SONG , JIAWEI CHANG , FENGMIN BAI
Published: May 2022

The focusing characteristics of electron guns sufficiently affect the quality of electron beam welding. At present, no systematic theoretical method calculates the beam waist and beam spot parameters that reflect the focusing characteristics of electron gun. Aiming at this problem, this paper contains a theoretical analysis of the relationship among the potential on the electron gun axis, the diameter of beam waist, and the trajectory of charged particles that pass through the focusing coil. A simulation model based on a F19-01 high-voltage electron gun for this study is developed using the CST simulation platform. The model simulates the variation of electron beam waist and beam spot diameter under different electrostatic focusing and magnetic focusing parameters. Results of a single-parameter study show that an increase in the cathode-to-anode distance leads to the increment in the beam spot diameter, whereas an increase in the bias cup aperture, as well as increases in anode aperture and focusing current, cause its decrease. An orthogonal test confirms that the aspect ratio of the electron beam welding seam under the same power can be improved effectively by selecting the cathode-to-anode distance of 28.4 mm, the bias cup aperture of 6 mm, and the anode aperture of 10 mm. Thus, the experimental data prove the correctness of the theoretical and simulation analyses.
The Utility of the CADISS® System in the Dissection of Epidural Fibrosis in Revision Lumbar Spine Surgery
Authors: Collard Xavier , De Witte Olivier , Lubansu Alphonse
Published: May 2022

Background: Spine surgery and spinal fusion surgery are rising. Revision rates following initial surgery are between 8 and 45%. Epidural fibrosis is a common response to spine surgery for most patients and increases complications in revision surgery. Previous research suggests using MESNA (Sodium 2-mercaptoethane sulfonate) in combination with mechanical blunt dissection safely reduces surgical complications. MESNA is a mucolytic agent which selectively cleaves disulphide bonds involved in the adherence and strength of fibrosis, meaning cutting instruments are not needed. The Chemically Assisted DISSection (CADISS®) System is an optimised non-cutting surgical device, consisting of a reconstitution cartridge for MESNA preparation, irrigated surgical instruments, and a footswitch to control MESNA release. This is the first study to investigate the use of the CADISS® System in revision spine surgery. Methods: This was a prospective, open label, observational case study. We enrolled 21 patients for revision spine surgery with the CADISS® System at two Belgium sites. The primary assessment was the number of successful removals of epidural fibrosis without cutting. The amount of MESNA used, total dissection and procedure time were recorded. For secondary criterion, the surgeons assessed global satisfaction, facilitation of dissection, quickness of action, usability, bleeding reduction and visualisation of the cleavage plane using an 11-point Likert scale (0-10). Due to the exploratory nature, no formal statistical analysis was planned. We calculated the percentage and confidence interval of successful procedures, the medians and corresponding interquartile range of the Likert criterion, and the mean (±SD) of the amount of MESNA used, CADISS® dissection time and total procedure time. Results: 24 fibrosis dissections were performed in 19 patients and 23 were successful (95.8%, CI: 78.9%; 99.9%). The mean amount of MESNA used, mean dissection time and procedure time were 16 ml (± 4.94), 16.5 minutes (±16.1) and 86.3 minutes (±25.1), respectively. No dural tears were reported. The mean global satisfaction score was 9.0 (8.0-9.0). All other Likert criterion had scores of 8.0 or 9.0, excluding quickness of action, which scored 7.0 (6.0-9.0).Conclusions: The CADISS® System in revision spine surgery has potential to effectively reduce dissection complications. Trial Registration: ClinicalTrials.gov Identifier: NCT05016739 - first registration: 23/08/2021 https://clinicaltrials.gov/ct2/show/NCT05016739
High-normal versus low-normal mean arterial pressure thresholds in critically ill patients: A systematic review and meta-analysis of randomized trials
Authors: Rikhraj Kiran J K , Ronsley Claire , Sekhon Mypinder S , Mitra Anish R , Griesdale Donald E G
Published: May 2022

Targeted blood pressure thresholds remain unclear in critically ill patients. Two prior systematic reviews have not demonstrated differences in mortality with a high mean arterial pressure (MAP) threshold but they only included patients with septic shock. Thus, we conducted an updated systematic review and meta-analysis of randomized controlled trials (RCTs) that compared the effect of a high-normal versus low-normal MAP on mortality in all pertinent disease states for critically ill patients. We searched six databases from inception until September 5th 2021 for RCTs of critically ill patients targeted to either a high-normal (≥ 65 mm Hg) versus a low-normal (≥ 60 mm Hg) MAP threshold for at least 24-hours. We assessed study quality using the RoB-2 tool and the risk ratio (RR) was used as the summary measure of association. We included 7 RCTs with 3772 patients. Three trials were conducted in patients following out-of-hospital cardiac arrest, two in distributive shock, one in septic shock, and one in hepatorenal syndrome. The pooled RR for mortality was 1.06 (95%CI 0.98 to 1.17). There was no significant between-study heterogeneity (I2 = 0%, 95%CI: 0 to 47%). Furthermore, there was no difference in the rates of favourable neurologic outcome or renal replacement therapy between the high-normal versus low-normal MAP groups. This systematic review and meta-analysis demonstrates that there is no difference in mortality amongst critically ill patients targeted to a high-normal versus low-normal MAP target.
Our Voice in a Rural Community: Empowering Colombian Rural Adolescents to Advocate for Community Well-being through Citizen Science
Authors: Montes Felipe , Guerra Ana María , Higuera-Mendieta Diana , Vega-Taboada Eduardo , King Abby C. , Banchoff Ann , Maturana Augusto César Rodríguez , Sarmiento Olga L.
Published: May 2022

Backround: Santa Ana is home to an Afro-descendant rural population of the island of Barú in Cartagena, Colombia. While a popular area for tourism, Santa Ana’s population is affected by multidimensional poverty, precarious work conditions, homelessness, broken streets and sewer systems, limited quality education, and lack of recreation and sport spaces. While Santa Ana’s Community Action Board aims to unify efforts and resources to solve these problems, the state’s capacity to meet the requirements of the Board is limited. Methods: We evaluated the relationship between healthy lifestyles and characteristics of Santa Ana’s school using the Our Voice Citizen Science Research Method. This systemic approach combines information and communication technologies with group facilitation to empower adolescents to: 1) collect and discuss data about factors in their local environments that facilitate or hinder well-being within their school community; 2) identify relevant local stakeholders who could help to address the issues identified; and 3) advocate collectively for local improvements to support increased well-being at a community level. Results: Eleven citizen scientists ages 13 to 17 years from the science club of Institución Educativa Santa Ana were recruited and together conducted 11 walks within the school to collect data about the facilitators and barriers to student well-being. They identified barriers to well-being related to school infrastructure, furniture, bathrooms, and sense of belonging. They then advocated with school stakeholders and reached agreements on concrete actions to address identified barriers, including fostering a culture among students of caring for school property, and presenting their findings to the community action board. This methodology allowed the community to realize how students can become agents of change and take collective action when motivated by practice-focused methodologies such as Our Voice. Project ripple effects, including greater empowerment and participation in collective actions by students, also were observed. Conclusions: This study underscores the importance of the school’s built environment in the well-being of students in rural areas. The Our Voice method provided the opportunity to inform school-based interventions, and promoted ripple effects that expanded productive dialogue to the community level and generated systemic actions involving actors outside of the school community.
Selected Coffee (Coffea arabica L.) Extracts Inhibit Intestinal α-Glucosidases Activities in- vitro and Postprandial Hyperglycemia in SD Rats
Authors: Mitiku Haimanot , Kim Tae Yang , Kang Hanna , Apostolidis Emmanouil , Lee Jung-Yun , Kwon Young-In
Published: May 2022

One of the therapeutic approaches for decreasing postprandial hyperglycemia is to retard absorption of glucose by the inhibition of carbohydrate hydrolyzing enzymes, α-amylase, and α-glucosidases, in the digestive organs. Coffee consumption has been reported to beneficial effects for controlling calorie and cardiovascular diseases, however, the clear efficacy and mode of action are yet to be proved well. Therefore, in this study we evaluated in- vitro rat intestinal α-glucosidases and porcine α-amylase inhibitory activities as well as in vivo (Sprague-Dawley rat model) blood glucose lowering effects of selected coffee extracts. The water extracted Sumatra coffee (SWE) showed strong α-glucosidase inhibitory activity (IC50, 4.39 mg/mL) in a dose-dependent manner followed by Ethiopian water extract (EWE) (IC50, 4.97) and Guatemala water extract (GWE) (IC50, 5.19). Excepted for GWE all the coffee types significantly reduced the plasma glucose level at 0.5 hour after oral intake (0.5 g/kg-body weight) in sucrose and starch-loaded SD rats. In sucrose loading test SWE (p < 0.001) and EWE (p < 0.05) had significantly postprandial blood glucose reduction effect, when compared to control. The maximum blood glucose levels (Cmax) of EWE administration group were decreased by about 18% (from 222.3 ± 16.0 to 182.5 ± 15.4, p < 0.01) and 19% (from 236.2 ± 25.1 to 191.3 ± 13.2 hr·mg/dL, p < 0.01) in sucrose and starch loading tests, respectively. These results indicate that selected coffee extract may improve exaggerated postprandial spikes in blood glucose via inhibition of intestinal sucrase and thus delays carbohydrate absorption. These in vitro and in vivo studies therefore could provide the biochemical rationale for the benefit of coffee-based dietary supplement and the basis for further clinical study.
Seed Morphological and Anatomical Structures as Taxonomy Tool for Turkish Hyacinthella Schur (Asparagaceae) Taxa
Authors: EROĞLU Hüseyin , KARAİSMAİLOĞLU Mehmet Cengiz , FİDAN Mehmet , PINAR Süleyman Mesut
Published: May 2022

This paper offers the first taxonomic assessment of the morphological and anatomical characters of the seeds of 11 Hyacinthella taxa from Turkey, 10 of them are endemic, with the cluster analysis and principal component analysis. Macro-morphologically, the outcomes display that the species are different from each other as per seed shape and size. The studied seeds are separated into 5 shapes; triangularis, circularis, ellipticus, ellipticus-late and ovatus. Seed sizes range from 1.51 mm to 3.06 mm in length, from 1.06 mm to 2.04 mm in width. Micro-morphologically, seed surface ornamentation is grouped into 7 types: rugose, reticulate-pusticulate, verrucate, tuberculate, ruminate, reticulate-foveate and alveolate. The most common type is verrucate, as rugose (in H. acutiloba), reticulate-pusticulate (in H. campanulata), ruminate (in H. hispida) and reticulate-foveate (in H. lineata) ornamentation types are taxon specific. Anatomically, testa structures of the studied seeds are usually consisted of 1 layer, the epidermis, formed in the sclerenchymatous tissue. The epidermis layer demonstrates significant differences in cell form, comprising of crushed, flat or polygonal cells, in 1–7 layers, and has surged or straight wall form. Also, the subepidermis layer is found in some of the studied taxa (H. glabrescens, H. heldreichii and H. siirtensis). The thickness of testa layers varies between 15.77 µm (in H. micrantha) and 49.76 µm (in H. campanulata). In the systematics of the genus Hyacinthella, the seed morphological and anatomical characters are very important characteristics that reveal inter-specific relationships among the studied species. Also, a dichotomous key is provided for the identification of the examined species based on seed characters.
Molecular Epidemiology of Enteroviruses Associated with Hand, Foot and Mouth Disease in South India during 2015 to 2017
Authors: Ramachandran Sanjay Erathodi , Joseph Josmi , Sasidharanpillai Sarita , Sheik Shahin , J Michael C , Sasidharanpillai Sabeena , S Aswathyraj , Karunakaran Kavitha , Cheerngod Shilpa , Varamballi Prasada , Jayaram Anup , Govindakaranavar Arunkumar
Published: May 2022

Hand, foot and mouth disease (HFMD) is a common childhood infection caused by human enteroviruses and clinically characterised by fever with vesicular rash on hand, foot or mouth. While Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CVA16) were the major aetiologies of HFMD in India earlier, there were sparse data on recently circulating enteroviruses associated with HFMD. Here we describe the molecular epidemiology of enteroviruses associated with HFMD in South India from 2015 to 2017. We used archived enterovirus real-time reverse transcriptase (RT) PCR positive vesicle swab and or throat swab specimens from clinically suspected HFMD cases collected from four secondary care hospitals in South India between July 2015 to December 2017. PCR amplification and sequencing were done based on 5’VP1, 3’VP1, VP2 or 5´NCR regions to identify enterovirus types. Genetic diversity among enteroviruses was inferred by phylogenetic analysis. Of the 107 enterovirus RNA real-time RT-PCR positive HFMD cases, 69 (64%) were typed as CVA6, 16 (15%) were CVA16, and 1 (1%) was CVA10. Whereas 21 (20%) cases were not typable by any of the methods used in the study. The majority of HFMD cases (89, 83%) were children below five years, while 11 (10.3%) were adults. 5’VP1 yielded the maximum number of enteroviruses genotyped and the phylogenetic analysis showed the CVA6 strains belongs to the subclade D3 while the subclades of CVA16 and CVA10 were B1c and D, respectively. The predominant etiology of HFMD in South India during 2015-2017 period was CVA6 followed by CVA16 and CVA10.
Distribution according to the European Society of Cardiology risk categories and associated risk of all-cause mortality in individuals with type 2 diabetes: A prospective cohort study
Authors: Orsi Emanuela , Solini Anna , Bonora Enzo , Vitale Martina , Garofolo Monia , Fondelli Cecilia , Trevisan Roberto , Vedovato Monica , Cavalot Franco , Laviola Luigi , Morano Susanna , Pugliese Giuseppe
Published: May 2022

Background.
Atherosclerotic cardiovascular disease (ASCVD) is the main cause for the excess mortality in type 2 diabetes. In 2019, the European Society of Cardiology (ESC) identified three risk categories, with the very high-risk category including individuals with established ASCVD and/or target organ damage (TOD) and/or ≥ 3 additional ASCVD risk factors. This classification was revised in 2021 manly by excluding the latter group from the very high-risk category. This analysis assessed the distribution according to the two ESC classifications and the associated risk of all-cause mortality in patients with type 2 diabetes from the Renal Insufficiency And Cardiovascular Events Italian Multicentre Study.
Methods.
This observational, prospective study enrolled 15,773 patients in 19 Diabetes Clinics throughout Italy in 2006–2008. Participants were stratified based on the presence of established ASCVD, TOD (renal ± retinal), and ASCVD risk factors at baseline. Vital status was retrieved on 31 October 2015 for 15,656 patients (99.3%).
Results.
Less than 1% of participants fell in the moderate-risk category with both classifications; moreover, approximately one third fell in the high-risk and two thirds in the very high-risk category according to the 2019 classification, whereas the opposite was observed with the 2021 classification. Mortality risk (adjusted hazard ratio [95% confidence interval]) was increased in high-risk (2.805 [0.903–8.719], P = 0.075, and 2.757 [1.311–5.795], P = 0.007) and very high-risk (6.529 [2.105–20.254], P = 0.001, and 6.865 [3.266–14.432], P < 0.0001) versus moderate-risk category according to the 2019 and 2021 classification, respectively. Among patients at very high-risk, risk of death was much lower in those with ≥ 3 additional ASCVD risk factors and almost equal in those with TOD and ASCVD ± TOD, using the 2019 classification, whereas it was much higher in those with ASCVD + TOD and, to a lesser extent, TOD only than in those with ASCVD only, using the 2021 classification.
Conclusions.
Only a few patients with type 2 diabetes fall in the moderate-risk category, suggesting an overestimation of ASCVD risk. Downgrading those with ≥ 3 additional ASCVD risk factors to the high-risk category is consistent with all-cause mortality data. Risk of death is very high in the presence of TOD (namely microangiopathy), possibly due to the association with subclinical ASCVD.
Trial registration.
ClinicalTrials.gov, NCT00715481, 15 July, 2008.
A retrospective study on solitary deaths (kodoku-shi) from the aspects of forensic and social medine
Authors: Hashizume Yumiko , Ishigami Akiko , Ishida Yuko , Nosaka Mizuho , Kuninaka Yumi , Yamamoto Hiroki , Hata Satoshi , Matsuki Jumpei , Yasuda Haruki , Takayasu Tatsunori , Furukawa Fukumi , Kimura Akihiko , Kondo Toshikazu
Published: May 2022

This retrospective study evaluated 637 forensic autopsy cases of solitary death (kodoku-shi in Japanese) and clarified the present situation of solitary death from the viewpoints of forensic medicine. Of 637 cases who had solitary death, 471 were male and 166 were female, indicating that solitary death predominantly occurred in men. This tendency increased from the age of 40 years in men and 60 years in women. Among the cases, 349 and 199 were natural death and external death, respectively. Ischemic heart disease- and fire-related fatalities were most common in natural death and external death cases, respectively. Suicidal death was more frequent in women than in men. We found two peaks of postmortem interval until finding (PMI-f): < 1 d (182 cases, 28.6%) and 7 days to < 1 month (164 cases, 25.7%). The PMI-f in female cases was significantly shorter than that in male cases. The PMI-f of external death cases was significantly shorter than that of natural death cases. Kushimoto and Shingu, located in the southern part (Kinan region), had a high solitary death rate in forensic autopsy cases because of their small population and high aging rate. Few cases were welfare recipients in solitary death cases in Kinan region (non-urban area), and 23 of 36 welfare recipients lived in Wakayama City, indicating that the economic state would contribute more to the occurrence of solitary death in Wakayama City (urban area). We identified several risk factors and regional characteristics for solitary death cases, and our observations could contribute to administrative welfare measures for the prevention of solitary deaths.
Hyperlactatemia is a predictor of mortality in patients undergoing continuous renal replacement therapy for acute kidney injury
Authors: Kim Seong Geun , Lee Jinwoo , Yun Donghwan , Kang Min Woo , Kim Yong Chul , Kim Dong Ki , Oh Kook-Hwan , Joo Kwon Wook , Kim Yon Su , Han Seung Seok
Published: May 2022

Background
Hyperlactatemia occurs frequently in critically ill patients, and this pathologic condition leads to worse outcomes in several disease subsets. Herein, we addressed whether hyperlactatemia is associated with the risk of mortality in patients undergoing continuous renal replacement therapy (CRRT) due to acute kidney injury.
Methods
A total of 1,661 patients who underwent CRRT for severe acute kidney injury were retrospectively reviewed between 2010 and 2020. The patients were categorized according to their serum lactate levels, such as high (≥ 7.6 mmol/l), moderate (2.1–7.5 mmol/l) and low (≤ 2 mmol/l), at the time of CRRT initiation. The hazard ratios (HRs) for the risk of in-hospital mortality were calculated with adjustment of multiple variables. The increase in the area under the receiver operating characteristic curve (AUROC) for the mortality risk was evaluated after adding serum lactate levels to the Sequential Organ Failure Assessment (SOFA) and the Acute Physiology and Chronic Health Evaluation (APACHE) II score-based models.
Results
A total of 802 (48.3%) and 542 (32.6%) patients had moderate and high lactate levels, respectively. The moderate and high lactate groups had a higher risk of mortality than the low lactate group, with HRs of 1.64 (1.22–2.20) and 4.18 (2.99–5.85), respectively. The lactate-enhanced models had higher AUROCs than the models without lactates (0.764 vs. 0.702 for SOFA score; 0.737 vs. 0.678 for APACHE II score).
Conclusions
Hyperlactatemia is associated with mortality outcomes in patients undergoing CRRT for acute kidney injury. Serum lactate levels may need to be monitored in this patient subset.
Liposomal silymarin anti-oxidative and anti-apoptotic features in lung cells: An implication in cadmium toxicity
Authors: Gheybi Fatemeh , Rajabian Fatemeh , Tayarani-Najaran Zahra , Adibi Amir Reza , Alavizadeh Seyedeh Hoda
Published: May 2022

Heavy metals are serious toxicants, and environmental pollution increase the risk of their exposure to human. This study compared the role of silymarin nanoliposomes (SL-L) against cadmium (Cd) toxicity in normal MRC-5 and A 549 cancer cells. For this, MRC-5 and A 549 cells exposed to Cd at 25 and 0.25 µM respectively, were treated with various non-toxic SL-L concentrations (2.5, 5, 10 µM) and the cells viability, reactive oxygen species (ROS) generation, apoptosis and the levels of cleaved PARP and caspase-3 proteins were determined following incubation. Results indicated that Cd exposure significantly increased apoptosis due to ROS generation, and showed greater toxicity on cancer cells compared to the normal cells. While SL-L at higher concentrations (25 µM and higher) exhibits pro-apoptotic features, lower concentrations (10 and 2.5 µM for MRC-5 and A 549 cancer cells, respectively) played a protective and anti-oxidant role in Cd induced toxicity in both cells. Further, lower SL-L was required to protect cancer cells against Cd toxicity. In general, treatment with SL-L significantly improved the cell survival by decreasing ROS levels, cleaved PARP and caspase-3 in both MRC-5 and A 549 cells compared to free silymarin. Results demonstrated that SL-L potential in protecting against Cd-induced toxicity depends on concentration-dependent antioxidant and anti-apoptotic balance.
Scheduled simple production method of pseudopregnant female mice for embryo transfer using the luteinizing hormone-releasing hormone agonist
Authors: Sari Gema Puspa , Yuri Shunsuke , Honda Arata , Isotani Ayako
Published: May 2022

The use of mice as experimental animal models has been a practice since the development of genetically engineered mouse models (GEMMs) in the early 1980s. New technologies, including genome editing, have helped in the time- and cost-efficient generation of GEMMs. However, methods for preparing pseudopregnant females, essential for the generation of GEMMs, remain less advanced. This study proposes a new method to achieve simple production of pseudopregnant female mice using a luteinizing hormone-releasing hormone agonist (LHRHa). A 20 µg LHRHa/mouse was identified as the best dose for inducing estrus synchronization. However, the frequency of copulation was 40% on a single injection. With sequential injections of 20 µg LHRHa/mouse on Days-1 and − 2, followed by pairing on Day-5, 78% of LHRHa-treated females copulated with male mice. Moreover, LHRHa treatment did not affect fetal development and offspring viability. Eventually, successful generation of offspring via embryo transfer was attained using LHRHa-treated pseudopregnant females. LHRHa administration method is efficient in producing pseudopregnant female mice for the generation of GEMMs, and we expect that it will contribute towards advancing the clinical research.
Restoration and Renewal of Ecological Spatial Network in Mining Cities for the Purpose of Enhancing Carbon Sinks: The Case of Xuzhou，China
Authors: Qiu Shi , Yu Qiang , Niu Teng , Fang Minzhe , Guo Hongqiong , Liu Hongjun , Li Song
Published: May 2022

Context
The original ecosystems of mining cities are constantly being destroyed. Therefore, it becomes crucial to restore and enhance the ecological environment of mining cities and improve the carbon sink capacity of vegetation. However, there is a lack of relevant strategies to optimize.
Objectives
We explored the optimization strategies to enhance the ecological functionality and carbon sink of the city and verified the optimization effects.
Methods
We extracted the ecological spatial network of Xuzhou City, calculated the ecological functionality, carbon sink and topological indicators of the sources, and correlated the topological indicators with the carbon sink. We proposed an optimization strategy according to the results. Finally, we determine the effect of optimization by the change of robustness and carbon sink.
Results
We abstracted the sources as nodes and found that the ecospatial network was divided into different communities and nodes of the same community were adjacent to each other in geographic space. We also found that the three types of node carbon sinks have a significant positive correlation with the betweenness centrality of nodes. By adding ecological corridors and stepping stones, the robustness of the network and the ecological recovery ability can be improved. At the same time, the optimized carbon sink increased by 377.6 tons.
Conclusions
By restoring and renewing ecological space, the carbon sink of mining cities can be effectively enhanced, which provides theoretical and measure references for future ecological engineering of mining cities. In addition, it is a remote sensing application to promote urban development and sustainability.
Cause of stillbirth and pathophysiological pathways in mothers with overweight and obesity
Authors: Nijkamp Janna Willemina Willemina , KORTEWEG Fleurisca J. , GROEN Henk , TIMMER Albertus , ERWICH Jan Jaap H.M.
Published: May 2022

Purpose
Obesity is independently associated with stillbirth, especially in early gestation and late-term gestation. Underlying pathophysiological mechanism causing fetal death is yet not clear. The purpose of this study was to determine the association between maternal body mass index and stillbirth and its importance in potential pathophysiological mechanisms of fetal death.
Methods
In a multicenter prospective cohort study from 2002 to 2008, 1.025 women with a fetal death > 20 weeks of gestation were studied. An extensive diagnostic workup was performed including maternal blood tests, coagulation tests, autopsy and placental examination. Cause of death was classified by a multidisciplinary panel. Odds ratios for each outcome stratified by gestational age were estimated for different maternal BMI classes (underweight BMI < 18.5; overweight BMI 25.0-29.9; obesity BMI > 30.0) compared with normal weight women (BMI 18.5–24.9) by using logistic regression and cause of death was studied.
Results
We analysed 793 women. Obese women significantly more often had pre-existing hypertension, pregnancy induced hypertension or gestational diabetes. Early fetal death (< 37 weeks) in obese women is more often caused by placental bed pathology (OR 4.10, 95% CI 1.79–9.40, P 0.001), and term fetal death by developmental placental pathology (OR 1.93, 95% CI 1.01–3.71, P 0.05).
Conclusion
In obese women there are at least 2 distinct underlying pathophysiological pathways causing fetal death. The underlying mechanisms of these pathways are uncertain and should be investigated in future.
Functional outcomes of transanal versus transabdominal restorative proctectomy with ileal pouch- anal anastomosis in Ulcerative Colitis. A comparative study
Authors: Bislenghi Gabriele , Denolf Melvin , Fieuws Steffen , Wolthuis Albert , D’Hoore André
Published: May 2022

Background Ileal pouch-anal anastomosis (IPAA) ensures satisfactory gastro-intestinal function and quality of life (QoL) in patients with refractory ulcerative colitis (UC). The transanal approach to proctectomy and IPAA (Ta-IPAA) has been developed to address the technical shortfalls of the traditional transabdominal approach (Tabd-IPAA). In previous studies, Ta-IPAA has proven to be safe but there is lack of reported functional outcomes. Aim of this study is to compare functional outcomes and QoL after Ta- or Tabd-IPAA for UC.MethodsThis is a retrospective study of consecutive UC patients who underwent IPAA between 2011 and 2017. Only patients who underwent a modified-2 or 3 stage approach were included in the analysis. Close rectal dissection was performed in Ta-IPAA as opposed to total mesorectal excision in Tabd-IPAA. A propensity score weighting was performed. Functional outcomes were assessed using two functional scoring systems: the Pouch Functional Score (PFS) and the Öresland score (OS). The global quality of life scale (GQOL) was used for patients’ overall perspective on QoL. Follow-up was scheduled at 1, 3, 6, and 12 months, postoperatively.ResultsOne hundred and eight patients were included. Thirty eight patients had Ta-IPAA. At 12 months follow-up, mean OS and PFS were 4.6 (CI 3.2-6.0) vs 6.2 (CI 5.0-7.3), p=0.025 and 6.1 (CI 3.5-8.8) vs 7.4 (CI 5.4-9.5), p=0.32, for Ta and Tabd-IPAA, respectively. Mean GQOL score for Ta-IPAA was 82.5 (CI 74.8-90.1) vs 75.5 (69.4-81.7) for Tabd-IPAA (p=0.045).ConclusionsAt 12 months postoperatively, Ta-IPAA seems to provide a superior pouch function and QoL.
De Novo Metastatic Invasive Lobular Breast Cancer with Synchronous Gastric and Colonic Spread: a case report
Authors: Antar Ahmad , AlHajjar Ahmad , AlQatari Mahfood , El-Majzoub Nadim
Published: May 2022

Gastrointestinal metastasis from invasive lobular breast cancer (ILC) is relatively rare. Simultaneous gastric and colonic metastases are extremely rare. Its presentation is typically vague; therefore, early recognition using clinical, radiological, endoscopic and histopathologic investigations is critical to distinguish it from primary gastric carcinoma. We report a 62-year-old woman who presented initially with atypical gastrointestinal symptoms and was diagnosed with de novo metastatic ILC with synchronous gastric and colonic involvement. She had excellent clinical response after 4 weeks of medical treatment. To our best knowledge, this is the first case of synchronous spread to stomach and colon as the first presentation of de novo metastatic breast cancer.
Short sleep duration increases the risk of diseases in older adults exercise practitioners
Authors: Fank Felipe , Werlich Matheus Godinho , Pereira Franciele Silva , Mazo Giovana Zarpellon
Published: May 2022

Background: Aging causes changes in sleep and thus can increase the risk of developing diverse diseases. However, little is still known about the impact of sleep duration in some conditions of older adults who exercise regularly. Aim: To evaluate the association between diseases and short sleep duration in older adults who are practitioners of physical exercise. Methods: This is a cross-sectional observational study. Two hundred and sixteen older adults (70.2±6.81 years) were investigated. Sociodemographic and health characteristics were collected by interview using questionnaires. The Pittsburgh Sleep Quality Index (PSQI) was applied to assess sleep quality and sleep duration. Sleep duration was classified as short when the older adults slept less than seven hours per night. A Poisson regression model was used, adopting a 5% significance level. Results: The prevalence of poor sleep quality in the sample was 47.7% (95%CI: 44.4-50.9). In addition, 43.1% (95%CI: 36.5-49.6) of the older adults had short sleep duration. Older adults with arthrosis (p=0.008), depression (p=0.043), diabetes (p=0.005), heart disease (p=0.008), fibromyalgia (p<0.001), and urinary incontinence (p=0.004) had a higher PSQI score than those without these diseases. In regression analysis, hypothyroidism (PR=1.63; 95%CI: 1.19-2.23) and fibromyalgia (PR=1.68; 95%CI: 1.07-2.62) were associated with short sleep duration. Conclusions: Older adults with hypothyroidism and fibromyalgia are more likely to sleep less than seven hours per night compared to those without these diseases. Multidisciplinary interventions are important to improve sleep and the quality of life of older adults.
“I wish she would explain the medication in a way I could understand.” A Mixed Methods Study of Chin Burmese Refugee-Pharmacist Relationships
Authors: Ryder Priscilla Tankersley , Chinpar Biak , Kercood Suneeta
Published: May 2022

Background: Because they face persecution in their native Myanmar, many members of the Chin ethnic group have come to the United States as refugees, where they face language and cultural barriers. Little is known about their perceptions of Western medications or relationships with pharmacists. Aim: To explore, from the refugees’ perspectives, the meanings that Western medications hold, how they prefer to communicate with healthcare providers and pharmacists, and the strategies they use to take medication properly. Method: This mixed-methods study used a survey, an assessment of health literacy, and in-depth semi-structured interviews.Results: The 21 respondents were born in Myanmar, had a median age of 64 years, little formal education, and low health literacy. Respondents reported positive attitudes toward Western medications and high adherence to prescribers’ instruction. Although they usually obtained medication at community pharmacies, respondents reported communication barriers and refugees’ knowledge of services available to them there was limited.Conclusion: Community pharmacists need to be aware of the needs of their Chin patients and consider strategies to accommodate them.
Large-scale heavy precipitation over the Czech Republic and its link to atmospheric circulation in CORDEX regional climate models
Authors: Beranová Romana , Kyselý Jan
Published: May 2022

The study evaluates ability of regional climate models (RCMs) to reproduce relationships between large-scale heavy precipitation events (LHPEs) over the Czech Republic and atmospheric circulation. We use an ensemble of 32 RCM simulations with the 0.11° resolution from the Euro-CORDEX project, and compare the historical simulations (1951–2005) against observations from the E-OBS data set. A novel selection criterion for LHPEs is proposed, defining these as days with at least 70% of all grid boxes over a given area with precipitation amounts exceeding the 90th grid-specific percentile of the seasonal distribution of daily amounts. The association with atmospheric circulation is investigated through circulation types derived from sea level pressure using airflow indices (direction, strength and vorticity). The majority of the RCMs capture that the frequency of days with LHPEs is higher in winter than summer, but almost all underestimate the occurrence of LHPEs in both seasons. In winter, the observed LHPEs are connected mainly with cyclonic types and westerly supertype; the role of nonwesterly and cyclonic-nonwesterly supertypes is significant only in the eastern part, where the Atlantic influence is weaker. In summer, the importance of cyclonic and nonwesterly types in producing LHPEs increases compared to winter. The RCMs reasonably well reproduce these links, including differences between seasons and regions, if their ensemble mean is evaluated, but large variations occur among individual simulations mainly in summer. The importance of cyclonic vorticity is overestimated in the RCMs, while westerly advection of moist air plays a smaller role in models than in observations.
Spatial Distribution of the Trends in Potential Evapotranspiration and its Influencing Climatic Factors in Iraq
Authors: Al-Hasani Alaa Adel Jasim , Shahid Shamsuddin
Published: May 2022

Understanding the spatial variations in Potential Evapotranspiration (PET) and its influencing climatic variables is essential for sustainable agriculture and water resources management. However, little published research has investigated the alternation of PET due to climate change in the case of Iraq. The objective of the present study was to analyze the spatial trends in annual and seasonal PET in Iraq. Accordingly, the latest global ERA5-Land dataset of the European Centre for Medium-Range Weather Forecasts for 1981‒2021 was employed. The PET was estimated using the FAO-Penman-Monteith method. The modified Mann-Kendall statistical test was applied to evaluate the significance of the trends in PET, which can separate unidirectional trends caused by climate change from the natural variability of climate. The obtained results indicate that: (1) Over the past four decades, the annual and seasonal PET witnessed a significant increasing trend in almost all of Iraq, except over the alluvial plain located in the eastern and southeastern parts. (2) The increasing trend in PET confirmed the patterns of the trend significance, with the highest increase of 0.28‒0.65 mm/decade in southwest Iraq. (3) Summer had the highest increasing trend of 0.35‒0.65 mm/decade, followed by spring, autumn, and winter. (4) The air temperature was the predominant driving factor of rising PET, showing a strong correlation ranging from 0.77 to 0.88 and a contribution of 26 to 94%, mainly in the south, central, and northwest regions. The reverse contribution of wind speed and surface pressure to PET, particularly in the southeast and southwest, remains offset by the influence of air temperature and net solar radiation. Overall, the PET has risen drastically due to global climate change, indicating the potential for increased atmospheric water demand in the region.
TSGA10, a new player in regulating autophagy and apoptosis
Authors: Rezazadeh Davood , Ranjbarnejad Fatemeh , Mansouri Kamran , Mostafaie Ali , Barzegari Ebrahim , Modarressi Mohammad Hossein
Published: May 2022

Testis specific gene antigen 10 (TSGA10) overexpression could inhibit angiogenesis and tumor cell proliferation, migration and invasion through inhibiting HIF-1α. The exact role of TSGA10 in autophagy and apoptosis is not clear. Present study was conducted to investigate the potential effects of TSGA10 overexpression on regulation of autophagy and apoptosis. To do so, TSGA10-containing vector (pcDNA3.1-TSGA10 vector) was designed for stable and transient transfections in HeLa cells, and clonal selection was applied. Expression of autophagy and apoptosis-related genes was assessed by real-time RT-PCR in TSGA10-overexpressing cells compared with HeLa cells transfected by empty vector. Rate of autophagy and cell viability were assessed by acridine orange and MTT assays, respectively. Our findings showed that overexpression of TSGA10 would induce autophagy under normoxic and hypoxic conditions in the presence or absence of autophagy inducers. Expression levels of autophagy and apoptosis-related genes increased significantly in TSGA10-overexpressing cells compared with control cells. In addition, HeLa cells overexpressing TSGA-10 exhibited lower expression of BCL-2 and survival rates in comparison with control cells. Molecular docking results showed that interaction between TSGA10 and BCL-2 could inhibit anti-apoptotic activity of BCL-2. According to our findings, TSGA10 overexpression has a main role in regulating autophagy and apoptosis through inhibition of BCL-2. Therefore, TSGA10 could be considered as a new regulator of autophagy and apoptosis in future studies.
Pathogenicity of Streptococcus pyogenes and its correlation with hematological alterations in infected Nile tilapia (Oreochromis niloticus) fingerlings
Authors: Nasr-Eldahan Sameh , Nabil-Adam Asmaa , Shreadah Mohamed Attia , Ali Tamer El-Sayed , Maher Adham
Published: May 2022

This study was realized to investigate the lethal dose fifty (LD50) of Streptococcus pyogenes on Nile tilapia and to determine the effect of every dose on hematological parameters as indicator of infection. In this study, a total number of 100 healthy Nile tilapia (Oreochromis niloticus) fingerlings (15 ± 0.5 g) were infected with Streptococcus pyogenes. These fish were randomly divided into five groups, each with 20 fingerlings. Five concentrations of Streptococcus pyogenes (0, 106, 107, 108, and 109 CFU/ml) were used to realize the objective of this study. Group 1 was injected inter-perennial with 0.2 ml sterilized saline solution and it was considered as a control group. The other 4 groups were injected inter-perennial at a rate of 1ml per 10 g of inoculum. All experimental groups were examined for infection signs, mortality rate and hematological parameters. The results revealed that the LD50 of Streptococcus pyogenes was 1×107 CFU/ml with ten days of tilapia infection. Also, it affected significantly on the hematological parameters and this concentration showed moderate value of infection and mortality rate compared with 1×108 CFU/ml which showed high value led to 100% immediate death of the fish. On the other hand, the concentration 1×106 CFU/ml presented normal value with control which led to weak infection. The concentration 1×109 CFU/ml was violent and fish body can’t resist it
The pan-cancer landscape of crosstalk between chemokines and the tumor immune microenvironment
Authors: Wuguo Tian , Lingli Wang , Jianjie Zhao , Donglin Luo
Published: May 2022

Background: Chemokines are a subfamily of cytokines known for their ability to promote cell migration, particularly that of immune cells. Chemokines are necessary for immune system function and have attracted considerable attention on account of their roles in regulation of the tumor immune microenvironment.Methods: Chemokine genes were obtained from the TISIDB database, and we examined the correlation, gene alteration, differential expression, and prognostic value of these genes in 33 tumor types based on Cancer Genome Atlas and Genotype-Tissue Expression data. The chemokine score of each sample was calculated using the “ssGSEA” function of the R package “GSVA.” We also evaluated the correlation between chemokine scores and a tumor immune microenvironment index and assessed the influence of chemokine scores on the response of cancer patients to immune checkpoint inhibitor therapy.Results: We found that tumor samples with high chemokine scores were immune-activated, and further analysis using three immunotherapy cohorts revealed that patients with high chemokine scores were sensitive to anti-PD-1 therapy.Conclusions: Our results indicate that chemokines are closely associated with the tumor microenvironment, and consequently, patients with high chemokine scores may be suitable for treatment using immune checkpoint inhibitors.
Dynamic Peripheral Blood Lymphocyte Subsets as Predictive Biomarkers for Langerhans Cell Histiocytosis in Children
Authors: Feng Yuhua , Wang Leyuan , Yu Yan , Yang Liangchun
Published: May 2022

Background: Langerhans cell histiocytosis (LCH) is an inflammatory myeloid neoplasm, immune system dysfunction may attribute to the cause of LCH. There is no standard prognosis evaluation system for LCH in children. We investigated the prognosis predictive value of peripheral lymphocyte subsets in childhood LCH patients.Methods: A cohort of 79 childhood LCH patients was retrospectively studied. The prognosis predictive significance of CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, NK cells, B cells and CD4/CD8 ratio were analyzed.Results: After 6-week induction therapy, the percentage of CD3+ T cells, CD3+CD4+ T cells and CD4/CD8 ratio were significantly increased, while CD3+CD8+ T cells and B cells were decreased. CD3+CD8+ T cells and B cells were closely related to BRAF V600E and MAP2K1 mutation. ∆CD3+ T cells, ∆CD3+CD4+ T cells, ∆CD3+CD8+ T cells, ∆NK cells and ∆B cells were related to treatment efficacy. As for organ involvements, ∆CD3+ T cells and ∆CD3+CD8+ T cells were related to liver involvement, ∆CD4/CD8 ratio was related to CNS involvement ∆CD3+ T cells and ∆B cells were related to BRAF V600E mutation, while ∆CD3+CD4+ T cells was related to MAP2K1 mutation. Furthermore, increased ∆CD3+ T cells, decreased ∆CD3+CD4+ T cells, decreased ∆CD3+CD8+ T cells, decreased ∆NK cells and increased ∆B cells were predictors for superior PFS, while increased ∆CD3+ T cells, decreased ∆CD3+CD8+ T cells and decreased ∆NK cells were predictors for superior OS. In addition, multivariate Cox regression analysis showed that ∆CD3+ T cells and ∆CD3+CD8+ T cells were independent prognostic factors for PFS.Conclusions: The peripheral lymphocyte subsets including CD3+ T cells, CD3+CD4+ T cells, CD3+CD8+ T cells, NK cells and B cells might be promising predictive indicators for LCH in children.
The Relationship Between Dental Caries, Food Intake and Body Composition in School-Age Children
Authors: Özel İrem Çağla , Ayhan Nurcan Yabancı , Ünverdi Gizem Erbaş
Published: May 2022

Purpose: The aim of this study is to evaluate the relationship between dental caries, food intake and body composition in school-age children. Methods: The study was conducted on 210 children, 105 boys and 105 girls, aged 6-12 years, without mental and / or physical disorders. Oral examinations of the children were performed by pediatric dentists and DMFT –DMFS and dmft-dmfs values were recorded. A detailed food frequency questionnaire was applied to determine consumption frequency of dairy products and sugar‐added foods. Children's height, waist and hip circumference measurements were taken by the researcher; body weight and body composition were evaluated with Tanita BC-601F body analyzer. Results: DMFT values were found to be lower in children who consumed milk, buttermilk and white cheese daily, but this differences were not statistically significant (p>0.05).Body weight and waist circumference are found to be positively correlated with DMFT and negatively correlated with dmft. BMI was found to be positively correlated with DMFT; negatively correlated with dmft (p<0.05).Conclusions: In this study, dental caries was found to be associated with food consumption and body mass index. In children, consumption of sugary foods should be reduced and consumption of milk and dairy products should be increased.