bluuebunny/crossref_metadata_2025 huggingface dataset:
One Pot and Facile Preparation of Pure ZnO and Cudoped Au-ZnO Nano-particles : Photocatalytic Properties
Authors: FKIRI Anis , Saidani Mohamed Ali , Smiri Leila Samia
Published: June 2021

In this present work, a new synthesis process, named hydrothermal method, of hybrid Au-ZnO nanoparticles (Au-Zn1-xCuxO; where 0<x<1%) was presented and discussed in detail. Nanocrystals of copper doped zinc oxide in the presence of diethylene glycol (DEG) as solvent were synthesized using the One Pot and Facile new proposed synthesis process. The photocatalytic activities of the synthesized nanoparticles were tested and analyzed for the degradation of methylene blue (MB) under white light illumination. The performances of the synthesized Au-ZnO nanoparticles showed a pronounced enhancement compared to either pure ZnO nanoparticles or to undoped Au-ZnO nanocomposites. Various key parameters such a photocatalyst loading, the MB concentration, and type current gas have been systematically investigated on the catalytic activities of the as-prepared.
Perioperative Myocardial Injury After Elective Neurosurgery: Incidence, Risk Factors and Effects on Mortality.
Authors: saka esra , Abdullah Taner , Canbaz Mert , DINC Tugce , Polat Ozlem , Sabanci Pulat Akin , Akıncı İbrahim Özkan , Tugrul Kamil Mehmet , ali achmet
Published: June 2021

BackgroundPerioperative myocardial injury is an important reason of mortality and morbidity after neurosurgery. It usually is missed due to asymptomatic character. In the present study, we investigated myocardial injury after noncardiac surgery (MINS) incidence, the risk factor for MINS and association of MINS with 30-day mortality in neurosurgery patients.MethodsPatients with cardiac risk who underwent elective neurosurgery were enrolled to the study. The patients’ demographics, comorbidities, medications used, medical history, and type of operation were recorded. The high-sensitivity cardiac troponin (hs-cTn) levels of the patients were measured 12, 24, and 48 hours after surgery. The patients were considered as MINS-positive if at least one of their postoperative hs-cTn measurement values was ≥14 ng/l. All the patients were followed up for 30 days after surgery for evaluation of their outcomes, including total mortality, mortality due to cardiovascular cause, and major cardiac events.ResultsTotal 312 patients completed the study and 64 (20.5%) of them was MINS positive. Long antiplatelet or anticoagulant drug cessation time (OR: 4.9, 95%CI: 2.1-9.4) was found the most prominent risk factor for MINS occurrence. Total mortality rate was 2.4% and 6.2% in patients MINS negative and positive respectively (p = 0.112). The mortality rate due to cardiovascular reasons (0.8% for without MINS, 4.7for with MINS, and p=0.026) and incidence of the major cardiac event (4% for without MINS, 10.9 for with MINS, and p=0.026) were significantly higher in patients with MINS.ConclusionsMINS is a common problem after neurosurgery and, high postoperative hs-cTn level is associated with mortality and morbidity.
"Qualitative Development and Content Validation of the "SPART" Model; a Focused Ethnography Study of Observable Diagnostic and Therapeutic Activities in the Emergency Medical Services Care Process"
Authors: Dercksen Bert , Struys Michel M.R.F. , Cnossen Fokie , Paans Wolter
Published: June 2021

BackgroundClinical reasoning is a crucial task within the Emergency Medical Services (EMS) care process. Both contextual and cognitive factors make the task susceptible to errors. Understanding the EMS care process’ structure could help identify and address issues that interfere with clinical reasoning. The EMS care process is complex and only basically described. AimIn this research, we aimed to define the different phases of the process and develop an overarching model that can help detect and correct potential error sources, improve clinical reasoning and optimize patient care.MethodsWe conducted a focused ethnography study utilizing nonparticipant video observations of real-life EMS deployments combined with thematic analysis of peer interviews.After an initial qualitative analysis of 7 video observations, we formulated a tentative conceptual model of the EMS care process. To test and refine this model, we carried out a qualitative, thematic analysis of 28 video-recorded cases. We validated the resulting model by evaluating its recognizability with a peer content analysis utilizing semi-structured interviews.ResultsBased on real-life observations, we defined and validated a model covering the distinct phases of an EMS deployment. We have introduced the acronym “SPART” to describe ten different phases: Start, Situation, Prologue, Presentation, Anamnesis, Assessment, Reasoning, Resolution, Treatment, and Transfer.ConclusionThe “SPART” model describes the EMS care process and helps to understand it. We expect it to facilitate identifying and addressing factors that influence both the care process and the clinical reasoning task embedded in this process.
Characteristics of Pores in Coals Samples Exposedto Acid Mine Drainage
Authors: Tang Hao , LUO Jin-zhi , ZHENG Li-wei , LIU Chi-yang , LI huahua , WU Guan-nan , Zeng Meng-li , Bai Xue-song
Published: June 2021

Acid mine drainage commonly occupies some pore space after underground coal mining, and this severely depreciates coal pillars, thereby posing a significant risk to mine stability. Considering that such depreciation is reflected in the microstructures of these pillars, in the present study, we propose a static immersion method suitable for coal seam samples immersion in the laboratory. We immersed the No. 2-2 coal seam samples from the Ningtiao Tower Coal Mine in Yulin, Shaanxi Province, in different acid mine drainage solutions and monitored the pH, oxidation–reduction potential (ORP), electrical conductivity (EC), total dissolved solids (TDS) among other water quality parameters for 300 h. After the immersion tests, samples were examined using scanning electron microscopy (SEM). The pH, ORP, EC, and TDS of the prepared acid mine drainage solutions increased significantly as the immersion time increased. Changes in water quality parameters are attributed to the absorption of hydrogen ions by insoluble clay minerals in the coal, which reduced the acidity, increased the pH value, and enhanced the electrical conductivity of the acid mine drainage solutions. SEM analysis reveals differences in the pore characteristics of (pore throat size and orientation) of the coal samples, and these are caused by erosive effects of the acid mine drainage solutions. Pores with throat sizes greater than 10 µm increased by 95% as the pH of the acid mine drainage solutions decreased, while the dominant pore orientation (60–90°) decreased to the 0–30° or increased to the 150–180° range, thereby increasing their randomness.
The Association of an Early Net Ultrafiltration Rate and 28-day Mortality in Patients Receiving Continuous Kidney Replacement Therapy: a Cohort Study
Authors: Wu Buyun , Shen Yining , Peng Yudie , Xing Changying , Mao Huijuan
Published: June 2021

Background: An early net ultrafiltration (NUF) rate may be associated with prognosis in patients receiving continuous kidney replacement therapy (CKRT). In this study, we tested whether high or low early NUF rates in patients treated with CKRT were associated with increased mortality.Methods: We conducted a retrospective, observational study among all patients in the Medical Information Mart for Intensive Care IV database who received CKRT for more than 24 hours within 14 days after intensive care unit admission. We defined the early (initial 48 hours) NUF rate as the amount of fluid removal per hour adjusted by the patients’ weight and took it as a classified variable (low rate: < 1.6, moderate rate: 1.6–3.1 and high rate: > 3.1 mL/kg/h). The association between 28-day mortality and the NUF rate was analyzed by logistic regression and mediation analyses. Results: A total of 911 patients were included in our study. The median NUF rate was 2.71 (interquartile range 1.90–3.86) mL/kg/h and the 28-day mortality was 40.1%. Compared with the moderate NUF rate, the low NUF rate (adjusted odds ratio 1.56, 95% CI 1.04–2.35, p = 0.032) and high NUF rate (adjusted odds ratio 1.43, 95% CI 1.02–2.01, p = 0.040) were associated with higher 28-day mortality. The putative effect of a low or high NUF rate on 28-day mortality was possibly direct [adjusted average direct effects (ADE) 1.03, p = 0.096 for a low NUF rate; adjusted ADE 0.92, p = 0.064 for a high NUF rate], and also mediated by effects of the NUF rate on fluid balance during the same period [adjusted average causal mediation effects (ACME) 0.96, p = 0.010 for a low NUF rate; adjusted ACME 0.99, p = 0.042 for a high NUF rate]. Moreover, we found an increase trend in the NUF rate corresponding to the lowest mortality when fluid input increased. Conclusion: Compared with NUF rates between 1.6–3.1 mL/kg/h in the first 48 hours of CKRT, NUF rates > 3.1 mL/kg/h and < 1.6 mL/kg/h were associated with higher mortality.
Electromagnetic Transparency of Composites of Unsaturated Polyester and Nanolignin: Morphological and Surface Energy Considerations
Authors: Suzuki Mayu , Kondor Annet , Sakuraba Yuma , Rojas Orlando J. , Ago Mariko
Published: June 2021

We introduce a simple spray drying method for the scaleup production of spherical organic (lignin) microparticles with controlled size distribution (0.85 to 1.57 mm). We assess the surface energy of the lignin particles by inverse gas chromatography and determine its role in nanocomposites synthesized from unsaturated polyester. Such nanocomposites are shown to be irradiation transparent (millimeter frequency region). The permittivity and tan d of the composite material reached values between 0.01 and 3.1 (28 GHz) with 10 per hundred resin filler content. Vinyl groups were introduced on the surface of the particles to achieve enhanced interfacial adhesion, and resulted in a reduced relative permittivity (2.75). Together with wave interactions, the mechanical and thermal properties of the composites are placed in perspective, opening new opportunities in next generation bio-based devices for 5G high-speed communication.
Different Recurrence and Growth Pattern of Gliomatous Foci after Mesenchymal Stem Cell Harbouring the Herpes Simplex Thymidine Kinase Gene Transplantation in Multifocal Glioblastoma Multiform: A Clinical Case Report
Authors: Yazdani Saeed Oraee , Akhlaghpasand Mohammadhosein , Golmohammadi Maryam , Rostami Fatemeh , Shokri Gelareh , Hafizi Maryam , Oraee-Yazdani Maryam , Zali Ali-Reza , Soleimani Masoud
Published: June 2021

Background: Glioblastoma multiform (GBM) as a malignant brain tumor has poor prognosis despite the current therapies. Suicide gene therapy is one of the most widespread cancer gene therapies which requires mRNA encoding a pro-drug activating enzyme transduced into the vector such as Mesenchymal Stem Cells (MSCs) that injects into the tumor tissue and leads to tumor suppression. Case presentation: In this case report, the authors describe a 37-year-old man with two obvious foci of glioblastoma multiform at left frontal and left parietal lobes. After the resection of the foci, the patient received stem cell-mediated herpes simplex virus thymidine kinase (HSV-TK) gene at frontal focus of tumor besides ganciclovir as prodrug for 14 days after injection. Then he was followed up with regular magnetic resonance imaging (MRI). The growth and recurrence pattern of foci was assessed. After the injection on Feb 09, 2019, the patient’s follow-up revealed recurrence of parietal focus on Dec 19, 2019; however, frontal focus had a slight and unremarkable enhancement. Until our last radiological follow-up (on Mar 18, 2020) left frontal focus had no prominent recurrence and the size of the left parietal focus increased and extended to the contralateral hemisphere through the corpus callosum. Eventually patient has passed away on July 16, 2020 (PFS=293 days, OS=657 days).Conclusions: It seems that the gliomatous focus that undergone administration of bone marrow MSC containing the HSV-TK gene, had a different pattern of growth and recurrence compared to a non-treated one.
Seroprevalence Canine Survey for Selected Vector-Borne Pathogens of and Its Relationship with Poverty in Metropolitan Pereira, Colombia, 2020
Authors: Bonilla-Aldana D. Katterine , Gutiérrez-Grajales Erwin J. , Martínez-Arboleda J. Paola , Reina-Mora María Angelica , Trejos-Mendoza Adrián E. , Pérez-Vargas Soffia , Valencia-Mejía Lorenzo , Marín-Arboleda Luisa F. , Osorio-Navia Daniela , Chacón-Peña Mariana , González-Colonia Luz Victoria , Cardona-Ospina Jaime A. , Jiménez-Posada Erika Vanessa , Diaz Andrés , Salazar Jean Carlos , Sierra Manuel , Muñoz Fausto , Zambrano Lysien I. , Ramírez-Vallejo Eduardo , Álvarez Juan Camilo , Jaramillo-Delgado Ingrid Lorena , Pecho-Silva Samuel , Paniz-Mondolfi Alberto , Faccini-Martínez Álvaro A. , Rodriguez-Morales Alfonso J.
Published: June 2021

Background: Tick-borne diseases (TBD) and dirofilariasis are currently not under surveillance in most Latin American countries, and there is a significant lack of studies describing the current situation in most endemic areas, including Colombia. Seroprevalence studies are crucial for understanding the epidemiology of these vector-borne diseases.Methods: A serosurvey for TBD and dirofilariasis amongst 100 dogs was carried out in the municipality of Pereira, located in the Coffee-Triangle region, Colombia. Samples were tested using a rapid assay test system (SNAP® 4Dx®); based on an enzyme immunoassay technique‚ screening for antibodies to Anaplasma phagocytophilum/platys (sensitivity 99.1%)‚ Borrelia burgdorferi s.l. (98.8%), and Ehrlichia canis/ewingii (96.2%) by using specific antigens, and checking for Dirofilaria immitis antigen based on specific antibodies (99.2%). Bivariate analyses were performed on Stata®14, significant p<0.05. Results: Global seroprevalence to the selected vector-borne pathogens was 74% (95%CI 65-83%). The highest seroprevalence was found for Ehrlichia canis/ewingii (74%), followed by Anaplasma phagocytophilum/platys (16%). Seropositivity for Borrelia spp. and Dirofilaria spp. was 0%. All Anaplasma spp. seropositive dogs showed co-detection of Ehrlichia spp. (16%). Seroprevalence was significantly higher among dogs from families of lower socioeconomic status / level (I, 86%), followed by level II (74%), and III (36%) (p=0.001); no seropositive dogs were found in for levels IV and V (higher socioeconomic status). All dogs exhibiting anorexia (12%) were invariably seropositive (100%) (p=0.029). Seroprevalence was higher amongst those showing mucocutaneous paleness (95%) compared to those without paleness (68%) (p=0.013) (OR=9.3; 95%CI 1.18-72.9). There was high variability in seroprevalence through the studied areas, ranging from 0% (La Libertad Park) up to Combia, Cesar Nader, Las Brisas and Saturno localities (100%) (p=0.033). Conclusions: Given the high seroprevalence obtained in an area with documented presence of ticks, there is a potential risk for zoonotic transmission to humans. Further seroprevalence studies in humans are needed to assess the prevalence of infections. Poverty is highly associated with these tick-borne pathogens in Pereira, as shown in the present study.
Supplementation with Human-Origin Probiotic Lactobacillus plantarum PL-02 Could Effectively Improve Muscle Mass and Exercise Performance, and Have an Anti-Fatigue Effect
Authors: Lee Mon-Chien , Hsu Yi-Ju , Ho Hsieh‐Hsun , Kuo Yi‐Wei , Lin Wen-Yang , Tsai Shin-Yu , Chen Wei-Ling , Lin Che-Li , Huang Chi-Chang
Published: June 2021

Gut microbiota are very important for energy metabolism and regulation, which in turn affect the health and physiological functions of the host. The most direct way to change the gut microbiota is to supplement with probiotics. In this study, we screened Lactobacillus plantarum (PL-02), a probiotic of human-origin, from the intestines of Olympic gold medalists and explored the role of PL-02 in improved exercise endurance performance, reduced fatigue biochemical parameters, and changes in body composition. Male Institute of Cancer Research (ICR) mice were assigned to 0 CFU/kg (vehicle), 2.05 × 109 CFU/kg (PL-02-1X), 4.10 × 109 CFU/kg (PL-02-2X), and 1.03 × 1010 CFU/kg (PL-02-5X) groups and were fed by oral gavage once daily for 4 weeks to assess exercise performance, fatigue parameters, and body composition. The results showed that 4 weeks of PL-02 supplementation could significantly increase muscle mass, improve muscle strength and endurance performance, and increase hepatic and muscular glycogen storage. Furthermore, PL-02 could significantly decrease fatigue biochemical parameters, such as lactate, blood urea nitrogen (BUN), ammonia, and creatine kinase (CK) levels, after exercise. We believe that PL-02 can be used as a supplement to improve exercise performance and for its anti-fatigue effect.
Pregnancy Outcomes and Associated Factors for Uterine Rupture: An 8 Years Population-based Retrospective Study
Authors: Wan Sheng , Yang Mengnan , Pei Jindan , Zhao Xiaobo , Zhou Chenchen , Wu Yuelin , Sun Qianqian , Wu Guizhu , Hua Xiaolin
Published: June 2021

Background: Uterine rupture is an obstetrical emergency with serious undesired complications for laboring mothers resulting in fatal maternal and neonatal outcomes. The aim of this study was to assess the incidence of uterine rupture, its association with previous uterine surgery and vaginal birth after caesarean section (VBAC), and the maternal and perinatal implications. Methods: This is a population-based retrospective study. All pregnant women treated for ruptured uterus in one center between 2013 and 2020 were included. Their information retrieved from the medical records department were retrospectively reviewed.Results: A total of 209,112 deliveries were included and 41 cases of uterine rupture were identified. The incidence of uterine rupture was 1.96/10 000 births. 16 (39.0%) had maternal and fetal complications. There were no maternal deaths secondary to uterine rupture, while perinatal fatality related to uterine rupture was 7.3%. Among all case, 38 (92.7%) were scarred uterus and 3 (7.3%) were unscarred uterus. The most common cause of uterine rupture was previous cesarean section, while cases with a history of laparoscopic myomectomy were more likely to have serious adverse outcome. 24 (59%) of the ruptures occurred in anterior lower uterine segment. Fetal heart rate monitoring changes were the most reliable signs for rupture.Conclusions: Incidence of uterine rupture in the study area was consistent with developed countries. Further improvement in obstetric care and strong collaboration with referring health facilities was needed to ensure maternal and perinatal safety.
Implementation of Evidence-based Guidance for Dementia Palliative Care using Participatory Action Research: Examining Implementation Through the Consolidated Framework for Implementation Research (CFIR)
Authors: Coffey Alice , Hartigan Irene , Timmons Suzanne , Buckley Catherine , Lehane Elaine , O'Loughlin Christina , O'Connell Selena , Cornally Nicola
Published: June 2021

Background: The importance of providing evidence-based palliative care for people with dementia is increasingly acknowledged. In Ireland, evidence-based guidance has been developed in order to address key features of dementia palliative care, including the management of pain, medications and hydration and nutrition. The aim of this study was to identify and explore the factors affecting the implementation of evidence-based guidance on dementia palliative care.Methods: The Consolidated Framework for Implementation (CFIR) guided a mixed-method pre-post study. One guidance document pertaining to the management of pain, medication or hydration and nutrition was implemented in three long-term care facilities. Participatory Action Research in the form of work-based learning groups was used to implement the guidance, drawing on a situational analysis (pre-implementation). Staff questionnaires and audits were conducted pre and post-implementation while champion interviews were also conducted post-implementation. Results: Features of the guidance (innovation), the inner setting, and the process of implementation were most frequently identified as impacting implementation. Components of the outer setting and individual characteristics featured less commonly. The guidance was perceived as advantageous or complimentary to previous care provided. Within the inner setting, leadership and support from other colleagues facilitated implementation. However, limited availability of other healthcare professionals to assist with carrying out guidance actions presented a barrier in some facilities. The external facilitators of the work-based learning groups (WBLGs) were perceived as experienced and encouraged active participation and reflection on practices. Despite the challenge of releasing staff to attend the WBLGs, a trend toward reduced staff de-motivation among those who did attend was noted post-implementation. Conclusions: A situational analysis informed by the CFIR framework in conjunction with a participatory action research approach helped to advance implementation of the guidance. The progress of implementation depended on the extent to which evidence-based care was previously being implemented at each site. Post-implementation analysis using CFIR, identified challenges to address in future projects such as staff cover on the ward and timing of training to facilitate attendance for staff with different working hours. Facilitators included multidisciplinary engagement with the intervention and champions at each site to support the implementation process.
Epidemiological Traceability Investigation of a New Wave of COVID-19 Outbreaks in Beijing
Authors: Chen Dongwan , ZHEN Guo Xin , Chao HE , Chang LV Jin , Peng GAO , LIU Xiu Feng
Published: June 2021

Background: To investigate a new wave of COVID-19 outbreaks in Beijing at the end of 2020, and to analyze the infection situation and transmission chain of each generation.Methods: Using a unified questionnaire, through the combination of field investigation and telephone survey, and with the help of trajectory big data technology to track the infected persons and close contacts for clues and case investigation. All nasal/pharyngeal swabs were collected and detected by real-time fluorescence quantitative RT-PCR method. The propagation relationship was analyzed by using the schematic diagram of transmission chain.Results: The outbreak involved 21 infected persons (15 confirmed cases and 6 asymptomatic). The first case was only an index case rather than the source of infection. The infected persons were spread through family exposure, workplace exposure, public premises exposure, vehicle exposure, diet exposure and so on. The average incubation period was 4 days, and those who had contact during both the virus incubation period and the symptom period had a higher risk of infection (c2=30.688, P<0.001). Unprotected family exposure, diet exposure, and exposure to small spaces, such as within transport, presented a higher risk of infection (c2=33.461, P<0.001). Conclusion: Against the background of global integration, the COVID-19 situation is still grim, still can not relax. While speeding up the recovery of the economy, "external defense input and internal defense rebound" is still the top priority in China's epidemic prevention and control work.
Examining Phosphorus Use Efficiency Across Different Lettuce (Lactuca sativa L.) Genotypes
Authors: Kreutz Gustavo F. , Bhadha Jehangir H. , Sandoya Germán
Published: June 2021

Most agricultural soils worldwide present limited availability of phosphorus (P) and crops require supplemental application of P fertilizers. Due to the economic and environmental concerns derived from the use of P fertilizers, identifying and breeding P-efficient lettuce (Lactuca sativa L.) cultivars is imperative for the reduction of production costs and implementation of more sustainable practices. Phosphorus use efficiency (PUE) remains unexplored in lettuce. In this research, 66 lettuce genotypes of six morphological types were evaluated between standard recommended P rate (202 kg·ha–1 of P2O5) and half-P rate (101 kg·ha–1 of P2O5). Lettuce genotypes were tested in two field experiments conducted during the 2017-2018 and 2019-2020 growing seasons in the organic soils (Histosols) within the Everglades Agricultural Area of South Florida. Head weight, marketability, tissue P concentration, soil total-P concentration, and soil extractable P were measured. Genetic variation was detected for PUE within romaine, crisphead, butterhead, Latin, and loose leaf. Eight genotypes were found to produce similar or higher head weight and good marketability when grown in the half-P rate compared to the standard P rate. No correlations were detected between head weight and tissue P concentration, indicating possible variation in P uptake and utilization on the tested lettuce genotypes. A significant, positive correlation was observed for soil total-P and soil extractable P, indicating that the increase in total P concentration of Histosols resulted in higher availability of P to plants. Lettuce genetic variation for PUE may allow further development of P-efficient cultivars for conventional and alternative production systems. More comprehensive investigations must be conducted to elucidate the genetic mechanisms controlling PUE in lettuce.
Macroautophagy Involved in Testosterone Synthesis in Leydig Cells of Male Dairy Goats (Capra Hircus)
Authors: Chen Hong , Chen Kexin , Zhao Fange , Guo Yihan , Liang Yue , Wang Zhengrong , Liu Tengfei , Chen Shulin
Published: June 2021

Background
Testosterone is an important steroid hormone that is indispensable for male sexual development and the reproductive system. Leydig cells (LCs), where autophagy extremely active, reside in the testicular interstitium and are the major sites of testosterone production. However, the ultrastructural characteristics and the functional role of autophagy in LCs of livestock remain unknown. This study was to investigate the role of autophagy in LCs testosterone synthesis of dairy goats at juvenile, pubertal, and adult stages.
Results
In the present study, morphological results showed that the steroidogenic activity and ultrastructure of the LCs were altered with increasing age. Serum luteinizing hormone and testosterone levels were significantly elevated with sexual maturation. Organelles involved in testosterone synthesis, e.g., smooth endoplasmic reticulum, mitochondria, and lipid droplets, were abundantly distributed within the cytoplasm of LCs in adult testes. However, further studies demonstrated that selective autophagy (including lipophagy and mitophagy) did not participate in the synthesis of testosterone in LCs. In contrast, the autophagy activity was enhanced in the testes at puberty and adulthood compared to that at the juvenile stage. Moreover, a number of different autophagosomes, including phagophores and autolysosomes, were observed within the cytoplasm of LCs.
Conclusions
Together, our results reveal that macroautophagy is involved in testosterone synthesis mainly through degrading mitochondria and endoplasmic reticulum in the LCs of dairy goats.
Season of Birth and Vulnerability to the Pathology of Alzheimer’s Disease: an in Vivo Positron Emission Tomography Study
Authors: Yasuno Fumihiko , Minami Hiroyuki
Published: June 2021

This study used positron emission tomography to examine whether the seasonal birth effect as an exogenic indicator of early life environmental factors influenced vulnerability to Alzheimer’s disease (AD) pathology in the elderly. We analyzed datasets from the Alzheimer’s Disease Neuroimaging Initiative, which included the data for 234 cognitively normal individuals and patients with mild cognitive impairment (n = 115) and AD dementia (n = 38). As an index of amyloid β (Aβ)/tau accumulation, the AV-45/AV-1451-standardized uptake value ratios (SUVRs) were compared between groups of spring-to-summer births and fall-to-winter births by analysis of covariance. Seasonal birth difference was a good predictor of AV-1451 SUVR. We found that participants with a fall-to-winter birth showed lower AV-1451 SUVRs than those with a spring-to-summer birth, after accounting for the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS) score and other factors that could possibly affect tau accumulation. Our findings showed a vulnerability to tau pathology in participants with a fall-to-winter birth, which may be caused by perinatal or postnatal brain damage due to the risk factors associated with the cold season.
Combined Thalidomide and Recombinant Human Interferon-α-1b and Interleukin-2 for Acute Myeloid Leukemia of Various Disease Status: A Multi-Center Prospective Study
Authors: Mi Ruihua , Chen Lin , Wang Xiaojiao , Yin Qingsong , Wang Zhanfang , Ma Xiaomiao , Xu Yulin , Chen Shuxia , Wang Genjie , Yang Haiping , Li Zhichun , Wang Huirui , Zhao Hongmiao , Guo Shuli , Song Qinglin , Li Weiyong , Li Jingdong , Song Yongping , Wei Xudong
Published: June 2021

Objectives: This study investigated the therapeutic effects of combined recombinant human interferon-α-1b (IFN-α1b), thalidomide, and recombinant interleukin-2 (IL-2) in treating acute myeloid leukemia (AML) in patients of various disease status and vulnerabilities. Methods: Patients with AML (n = 166) were treated with combined recombinant IFN-α1b, thalidomide, and recombinant IL-2 (ITI regimen). The rates of partial and complete remission, minimal residual disease (MRD) status, quality of life, and long-term survival were compared among 3 patient groups. Lymphocyte profiles and relevant cytokine levels determined from peripheral blood samples of patients (pre- and post-treatment) and healthy individuals were compared. (Registration number: ChiCTR-ONC-14004688; Registered 23 May 2014, www.chictr.org.cn)Results: Sixty patients with primary AML who were unable to receive chemotherapy, or with relapsed/refractory AML, showed a total response rate of 30% after undergoing the ITI regime, and maintained a good quality of life. Eighteen patients with morphologically complete remission and consistently positive MRD achieved a response rate of 72.2%: the MRD converted to negative or was mitigated in 9 and 4 patients, respectively; 5 patients did not respond. For 88 patients with initial complete remission and negative MRD, 11 failed to maintain the negative MRD, and the relapse rate was 12.5%. The ITI regime was associated with substantial anti-leukemic changes in peripheral blood lymphocyte profiles and cytokine levels. Conclusions: The ITI regimen may be an effective and affordable option for patients with AML who cannot tolerate conventional chemotherapy, including those with relapsed/refractory disease, or complete remission status but MRD-positive, or after initial complete remission.
Gestational Weight Gain During the Second and Third Trimesters and Adverse Pregnancy Outcomes, Results From a Prospective Pregnancy Cohort in Urban Tanzania
Authors: Yang Jiaxi , Wang Molin , Tobias Deirdre K. , Rich-Edwards Janet W. , Darling Anne Marie , Abioye Ajibola I. , Pembe Andrea B. , Madzorera Isabel , Fawzi Wafaie W.
Published: June 2021

Background Appropriate gestational weight gain (GWG) is important for optimal pregnancy outcomes. This study prospectively evaluated the associations between GWG during the second and third trimesters of pregnancy and adverse pregnancy outcomes in an urban Tanzanian pregnancy cohort. Methods We used data from a randomized clinical trial conducted among pregnant women recruited by 27 weeks of gestation in Dar es Salaam, Tanzania (N = 1,230). Women’s gestational weight was measured at baseline and at monthly antenatal visits. Weekly GWG rate during the second and third trimesters was calculated and characterized as inadequate, adequate, or excessive, in conjunction with measured or imputed early-pregnancy BMI status according to the 2009 Institute of Medicine (IOM) GWG guidelines. We used multivariable Poisson regression with a sandwich variance estimator to calculate risk ratios (RR) for associations of GWG with low birth weight, preterm birth, small for gestational age (SGA), and large for gestational age (LGA). Degree of appropriate GWG defined using additional metrics (i.e., percentage of adequacy, z-score) and potential effect modification by maternal BMI were additionally evaluated. Results According to the IOM guidelines, 517 (42.0%), 270 (22.0%), and 443 (36.0%) women were characterized as having inadequate, adequate, and excessive GWG, respectively. Overall, compared to women with adequate GWG, women with inadequate GWG had a lower risk of LGA births (RR=0.54, 95% CI: 0.36 - 0.80) and a higher risk of SGA births (RR=1.32, 95% CI: 0.95 - 1.81). ­­Women with inadequate GWG as defined by percentage of GWG adequacy had a higher risk of LBW (OR=1.93, 95% CI: 1.03 - 3.63). In stratified analyses by early-pregnancy BMI, excessive GWG among women with normal BMI was associated with a higher risk of preterm birth (RR=1.59, 95% CI: 1.03 - 2.44). Conclusions A comparatively high percentage of excessive GWG was observed among healthy pregnant women in Tanzania. Both inadequate and excessive GWGs were associated with elevated risks of poor pregnancy outcomes. Future studies among diverse SSA populations are warranted to confirm our findings, and clinical recommendations on optimal GWG should be developed to promote healthy GWG in SSA settings. Trial registration This trial was registered as “Prenatal Iron Supplements: Safety and Efficacy in Tanzania” (NCT01119612; http://clinicaltrials.gov/show/NCT01119612).
Hierarchy of Scientific Evidence and Thematic Analysis of African Neurosurgery Research – a Scoping Review
Authors: Kanmounye Ulrick Sidney , Nguembu Stéphane , Zolo Yvan , Sichimba Dawin , Rolle Myron L. , Ammar Adam , Bankole Nourou Dine Adeniran , Kabulo Kantenga DM , Cheserem Beverly , Park Kee B. , Karekezi Claire , Esene Ignatius
Published: June 2021

BackgroundAfrican neurosurgical practice is faced with numerous challenges. Although there have been improvements in recent years, some problems persist. Research can help identify these problems and propose solutions for the growth of African neurosurgery. In this study, we decided to evaluate the landscape of African research.MethodsPubMed, Embase, and Web of Science were searched from inception to April 24, 2020. Duplicate articles were excluded, and at least two authors reviewed non-duplicate articles on Rayyan. After data had been extracted, they were analyzed to generate descriptive statistics (number of articles and articles per local neurosurgeon). The Kruskal Wallis test and Spearman's correlation were used for bivariate data analyses.ResultsThe authors reviewed 667 articles on neurosurgery in 34 (63%, n=54) African countries. Malawi (4.50), South Africa (3.33), and Benin (2.33) had the highest number of articles per local neurosurgeon (after excluding articles by foreign researchers). Foreign researchers published 1.0 (IQR=2.5) articles per country. Articles were published in World Neurosurgery (120, 18.0%), South African Medical Journal (44, 6.6%), and Journal of Neurosurgery Pediatrics (34, 5.1%). The articles were on pediatric neurosurgery (167, 25.0%) and neurotrauma (129, 19.3%). Also, the majority (411, 61.6%) of studies were cross-sectional.ConclusionAfrican neurosurgeons produce a median of 0.4 articles and publish in well-established journals. Collaboration with foreign researchers significantly increases local research output. In the future, we should assess the impact of this research.
Rational Route of Delivery Mesenchymal Stem Cell Therapy for Acute Myocardial Infarction (AMI) and Chronic Ischemic Cardiomyopathy (ICM): a Systematic Review and Meta-analysis
Authors: ting Huang Yan , Weizhao Lin , Xiangbin Yang , Shuqing Chen , Kai Gao , Yiwan Su , Zhishan Lin , Meiling Xu , Zhi Li
Published: June 2021

Background: Recent studies suggest that mesenchymal stem cells (MSCs) may have therapeutic potential for both acute myocardial infarction (AMI) and chronic ischemic cardiomyopathy (ICM). However, the rational route of delivery MSC therapy has not reached consensus. We performed a systematic review of clinical trials evaluating the rational route of delivery MSCs for AMI or ICM.Methods: Databases including Embase, PubMed, and Cochrane Central Register of Controlled Trials were searched from inception to February 2021. Studies that examined the use of MSCs in adults with AMI or ICM were eligible. Bias of included studies were assessed by the Cochrane risk of bias tool. The primary outcome was cardiac function assessed by left ventricular ejection fraction (LVEF) and the secondary outcome was cardiac remodeling which was assessed by left ventricular end-systolic volume (LVESV) and left ventricular end-diastolic volume (LVEDV), we also explored the safety between different routes. Results: 18 studies fulfilled eligibility criteria, which consist of 11 studies evaluated AMI and 7 studies evaluated ICM. In AMI group, only when patients received intracoronary infusion(IC) can improve LVEF (SMD 0.88, 95% CI 0.64-1.12), and there was a decrease in LVEDV&LVESV when administered IC or intravenous infusion (IV). While in ICM group, no significant difference in LVEF was noted no matter administered which route, and transendocardial stem cell injection(TESI) seems to be effective in decreasing LVEDV&LVESV. Safety appeared no difference between different routes. Conclusions: Results from our systematic review suggest that intracoronary infusion seems more effective for MSC’s delivery in AMI group, while in ICM group, TESI better.
Understanding Low-value Care and Associated De-implementation Processes: A Qualitative Study of Choosing Wisely Interventions Across Canadian Hospitals
Authors: Parker Gillian , Kastner Monika , Born Karen , Shahid Nida , Berta Whitney
Published: June 2021

Background:Choosing Wisely (CW) is an international movement comprised of national campaigns in more than 20 countries to reduce low-value care (LVC). Hospitals and healthcare providers are examining existing practices and putting interventions in place to reduce practices that offer little to no benefit to patients or may cause them harm. De-implementation, the reduction or removal of a healthcare practice is an emerging field of research. Little is known about the factors which (i) sustain LVC; and (ii) the magnitude of the problem of LVC. In addition, little is known about the processes of de-implementation, and if and how these processes differ from implementation endeavours. The objective of this study was to explicate the myriad factors which impact the processes and outcomes of de-implementation initiatives that are designed to address national Choosing Wisely campaign recommendations.Methods:Semi-structured interviews were conducted with individuals implementing Choosing Wisely Canada recommendations in healthcare settings in four provinces. The interview guide was developed using concepts from the literature and the Implementation Process Model (IPM) as a framework. All interviews were conducted virtually, recorded, and transcribed verbatim. Data were analysed using thematic analysis.Results:Seventeen Choosing Wisely team members were interviewed. Participants identified numerous provider factors, most notably habit, which sustain LVC. Contrary to reporting in recent studies, the majority of LVC in the sample was not ‘patient facing’; therefore, patients were not a significant driver for the LVC, nor a barrier to reducing it. Participants detailed aspects of the magnitude of the problems of LVC, specifically the impact of harm and resources. Unique factors influencing the processes of de-implementation reported were: influence of Choosing Wisely campaigns, availability of data, lack of targets and hard-coded interventions.Conclusions: This study explicates factors ranging from those which impact the maintenance of LVC to factors that impact the success of de-implementation interventions intended to reduce them. The findings draw attention to the significance of unintentional factors, highlight the importance of understanding the impact of harm and resources to reduce LVC and illuminate the overstated impact of patients in de-implementation literature. These findings illustrate the complexities of de-implementation.
A Portfolio of Geographically Distinct Laboratory-adapted Plasmodium Falciparum Clones With Consistent Infection Rates in Anopheles Mosquitoes
Authors: de Vegte-Bolmer Marga van , Graumans Wouter , Stoter Rianne , Gemert Geert-Jan van , Sauerwein Robert , Collins Katharine , Bousema Teun
Published: June 2021

BackgroundThe ability to culture P. falciparum continuously in vitro has enabled stable access to asexual and sexual parasites for malaria research. The portfolio of isolates has remained limited and research is still largely based on NF54 and its derived clone 3D7. Since 1978, isolates were collected and cryopreserved at Radboudumc from patients presenting at the hospital. Here, procedures are described for culture adaptation of asexual parasites, cloning and production of sexual stage parasites responsible for transmission (gametocytes) and production of oocysts in Anopheles mosquitoes. This study aimed to identify new culture adapted transmissible P. falciparum isolates, originating from distinct geographical locations.ResultsOut of a collection of 121 P. falciparum isolates stored in liquid nitrogen, 21 from different geographical origin were selected for initial testing. Isolates were evaluated for their ability to be asexually cultured in vitro, their gametocyte production capacity, and consistent generation of oocysts. Out of 21 isolates tested, twelve were excluded from further analysis due to lack of mature gametocyte production (n = 1) or generation of satisfactory numbers of oocysts in mosquitoes (n = 11). Nine isolates fulfilled selection criteria and were cloned by limiting dilution and retested. After cloning, one isolate was excluded for not showing transmission. The remaining eight isolates transmitted to A. stephensi or A. coluzzii mosquitoes and were categorized into two groups with a reproducible mean oocyst infection intensity above (n = 5) or below five (n = 3). ConclusionsThese new P. falciparum culture adapted isolates with reproducible transmission to Anopheles mosquitoes are a valuable addition to the malaria research tool box. They can aid in the development of malaria interventions and will be particularly useful for those studying malaria transmission.
A Systematic Review of the Literature for Suicide Prevention Interventions Initiated in Emergency Departments in the United States
Authors: Costello Scott , Li Jinjin
Published: June 2021

Objective: Suicide is a leading cause of death around the world. In the United States, the suicide rate continues to increase with US Emergency Departments seeing over 500,000 suicide-related visits each year. Authors conducted a systematic literature review to determine the range of interventions administered in the ED. Methods: This is the first systematic literature review of this topic. The review is limited to studies conducted in Emergency Departments located in the United States with interventions that were initiated in the ED setting. Results: Of the 2,735 titles and abstracts identified, eight studies met the inclusion criteria. A narrow range of suicide prevention interventions are administered in the ED. Conclusions: Opportunities exist for additional types of suicide prevention interventions in the ED.
A Beneficial Role of Computer-aided Diagnosis System for Less Experienced Physicians in the Diagnosis of Thyroid Nodule on Ultrasound
Authors: Kang Sunyoung , Lee Eunjung , Chung Chae Won , Jang Han Na , Moon Joon Ho , Shin Yujin , Kim Kyuho , Li Ying , Shin Soo Myoung , Kim Yoo Hyung , Kwon Seul Ki , Ahn Chang Ho , Jung Kyong Yeun , Hong A Ram , Park Young Joo , Park Do Joon , Kwak Jin Young , Cho Sun Wook
Published: June 2021

Ultrasonography is the primary diagnostic tool for thyroid nodules, while the accuracy is highly operator-dependent. The aim of this study was to investigate whether ultrasonography with computer-aided diagnosis (CAD) has assisting roles to physicians in the diagnosis of thyroid nodules. 451 thyroid nodules (³ 1 cm) evaluated by fine-needle aspiration cytology following surgery were included. 300 (66.5%) of them were diagnosed as malignancy. Thirteen physicians who had 0 months (E0, n=8), 1 year (E1, n=2), or more than 5 years (E5, n=3) of experience in ultrasonography reviewed the prepared ultrasound images of thyroid nodules before and after CAD assistance. The diagnostic performance of CAD was comparable to that of the E5 group, and better than those of the E0 and E1 groups. The AUC of the CAD for conventional PTC was higher than that for FTC and follicular variant PTC (0.925 vs. 0.499), independent of tumor size. CAD assistance significantly improved diagnostic performance in E0 group, but not in the E1 and E5 groups. In conclusion, the CAD system showed good performance in the diagnosis of conventional PTC. CAD assistance improved the diagnostic performance of physicians with less experience in ultrasonography, especially in the diagnosis of conventional PTC.
Aldosterone, Dexamethasone and Triamcinolone Activate African Lungfish Mineralocorticoid Receptor: Increased Activation After Removal of the Amino-Terminal Domain
Authors: Katsu Yoshinao , Oana Shin , Lin Xiaozhi , Hyodo Susumu , Baker Michael E.
Published: June 2021

A distinct mineralocorticoid receptor (MR) ortholog first appears in cartilaginous fishes, such as sharks, skates, rays and chimaeras. Although aldosterone, the main physiological mineralocorticoid in humans and other terrestrial vertebrates, is a transcriptional activator of skate MR and elephant shark MR, aldosterone is not synthesized by cartilaginous fishes. Aldosterone, first appears in lungfish, which are lobe-finned fish that are forerunners of terrestrial vertebrates. Aldosterone activation of the MR regulates internal homeostasis of water, sodium and potassium, which was critical in the conquest of land by vertebrates. We studied transcriptional activation of the slender African lungfish (Protopterus dolloi) MR by aldosterone, other corticosteroids and progesterone and find that aldosterone, 11-deoxycorticosterone, 11-deoxycortisol and progesterone have half-maximal responses (EC50s) below 1 nM and are potential physiological mineralocorticoids. In contrast, EC50s for corticosterone and cortisol were 23 nM and 66 nM, respectively. Unexpectedly, truncated lungfish MR, consisting of the DNA-binding domain, hinge domain and steroid-binding domain, had a stronger response to aldosterone, other corticosteroids and progesterone than did full-length lungfish MR, indicating that an allosteric action of the N-terminal domain represses steroid activation of lungfish MR. This contrasts to human MR in which the N-terminal domain contains an activation function. BLAST searches of GenBank did not retrieve a GR ortholog, leading us to test dexamethasone and triamcinolone for activation of lungfish MR. At 10 nM, both synthetic glucocorticoids are about 4-fold stronger than 10 nM aldosterone in activating full-length lungfish MR, leading us to propose that lungfish MR also functions as a GR.