bluuebunny/crossref_metadata_2025 huggingface dataset:
Impaired oxygenation and hemodynamic instability are independent predictors of long-term mortality in a regional cohort needing urgent fixed-wing intensive care transport to tertiary care
Authors: Sundbom Marcus Fredriksson , Sangfelt Amalia , Lindgren Emma , Nyström Helena , Johansson Göran , Brändström Helge , Haney Michael
Published: November 2020

Background We aimed to test if impaired oxygenation or major hemodynamic instability at the time of emergency intensive care transport between hospitals are predictors of long-term mortality.Methods From a regional hospital intensive care transport research database, the study cohort was identified as those emergency intensive care cases transported in fixed-wing air ambulance from outlying hospitals to a regional tertiary care center during 2000–2016 for adults (16 years old or older). Impaired oxygenation was defined as oxyhemoglobin % - inspired oxygen fraction ratio (S/F ratio) < 100. Major hemodynamic instability was defined as need for treatment with noradrenaline infusion to sustain mean arterial pressure (MAP) at or above 60 mmHg or having a mean MAP < 60. All-cause mortality at 3 months after transport was the primary outcome, and secondary outcomes were all-cause mortality at 6 and 12 months. Multivariate cumulative survival and hazard analysis was performed for intervals 3, 6 and 12 months.Results There were 2142 patients included in the analysis. The S/F ratio < 100 was associated with increased mortality risk compared to S/F > 300 at all time-points, with hazard ratio (HR) 2.9 (1.9–4.4 95% CI, p < 0.001) at 12 months. Major hemodynamic instability during ICU transport was associated with increased HR of all-cause mortality up to one year with hazard ratio 1.9 (1.5–2.5, p < 0.001).Conclusion Major impairment of oxygenation and/or major hemodynamic instability at the time of ICU transport to get to urgent tertiary intervention is strongly associated with reduced survival at least up to one year after the transport, in this cohort. These findings support the conclusion that these conditions are markers for many fold increase in risk for death notable already at 3 months after transport for patients with these conditions. How much this risk is modifiable is not assessable in this analysis.
SARS-CoV-2-specific T cell immunity in mild hypertensive patients with COVID-19 in China
Authors: Zeng Qiang , Huang Gang , Li Yong-Zhe , Li Yirong , Dong Shenyong , Xu Guoqiang , Xu Yang
Published: November 2020

Background: Coronavirus disease 2019 (COVID-19) pandemic leads to severe illness, life-threatening complications, and death, especially in high-risk groups such as elderly people and individuals with hypertension or diabetes. It has been shown that SARS-CoV-2-specific T cell immunity is important for the patient recovery from COVID-19. However, there are no reports about SARS-CoV-2-specific T cell immunity in hypertensive patients with COVID-19.Results: In this work, through the study of a cohort of 76 mild cases of hypertensive patients with COVID-19 and 572 hypertensive patients without COVID-19, we discovered that SARS-CoV-2 infection in hypertensive patients is characterized by T lymphopenia during the acute phase and the high frequency of CD4+CD25+, CD4+CD45RO+, and CD8+CD28+ T cells in the recovery phase. We also showed that strong SARS-CoV-2-specific CD4+IFNg+ T cell responses are associated with high SARS-CoV-2-specific antibody titers in hypertensive patients with COVID-19.Conclusions: The subsets of T cells including CD4+CD25+, CD4+CD45RO+, and CD8+CD28+ could be valuable biomarkers for the estimation of the progression of hypertensive patients with COVID-19. The hypertensive patients with COVID-19 exhibits T lymphopenia during the acute phase and have proper immune function during the recovery phase. This study may provide valuable insights for the monitoring and treatment of hypertensive patients with COVID-19.
“Having more women humanitarian leaders will help transform the humanitarian system”: Challenges and Opportunities for Women Leaders in Conflict and Humanitarian Health
Authors: Patel Preeti , Meagher Kristen , Achi Nassim El , Ekzayez Abdulkarim , Sullivan Richard , Bowsher Gemma
Published: November 2020

Background: It is estimated that over 40 percent of the half a million humanitarian workers who provide frontline care during emergencies, wars and disasters, are women. Women are at the forefront of improving health for conflict-affected populations through service delivery, education and capacity strengthening, advocacy and research. Women are also disproportionately affected by conflict and humanitarian emergencies. The growing evidence base demonstrating excess female morbidity and mortality reflects the necessity of evaluating the role of women in leadership driving health research, policy and programmatic interventions in conflict-related humanitarian contexts. Despite global commitments to improving gender equality, the issue of women leaders in conflict and humanitarian health has been given little or no attention. The aim of this paper focuses on three domains: importance, barriers and opportunities for women leaders in conflict and humanitarian health. Following thematic analysis of the material collected, we discuss the following themes: barriers of women’s leadership domain at societal level, and organisational level, which is subcategorized into culture and strategy. Building on the available opportunities and initiatives and on inspirational experiences of the limited number of women leaders in this field, recommendations for empowering and supporting women’s leadership in conflict health are presented. Methods: A desk-based literature review of academic and grey sources was conducted followed by thematic analysis.Results: There is very limited evidence on women leaders in conflict and humanitarian health. Some data shows that women have leadership skills that help to support more inclusive solutions which are incredibly important in this sector. However, deeply imbedded discrimination against women at the organisational, cultural, social, financial and political levels is exacerbated in conflict which makes it more challenging for women to progress in such settings.Conclusion: Advocating for women leaders in conflict and health in the humanitarian sector, governmental bodies, academia and the global health community is crucial to increasing effective interventions that adequately address the complexity and diversity of humanitarian crises.
Topical application of adipose tissue derived mesenchymal stem cells (ADMSCs) reduced cerebral edema in experimental traumatic brain injury (TBI)- a preliminary study
Authors: MA Hui , Cui Lian Xu , Lam Ping Kuen , Tong Cindy SW , Lo Kin KY , Wong George KC , Poon Wai Sang
Published: November 2020

Background:Our previous studies showed that topical application of mesenchymal stem cells (MSCs) improved functional recovery in rat traumatic brain injury (TBI) model, and hypoxic precondition further enhanced the therapeutic effects of MSCs. There was no previous study on the attenuation of cerebral edema by MSCs.Objective:We investigated whether topical application of normoxic and hypoxic MSCs could reduce cerebral edema in an experimental TBI model.Methods:2 million normoxic (N=24) and hypoxic (N=24) MSCs were applied topically to exposed cerebral cortex in a controlled cortical impact (CCI) model. The MSCs were fixed in position with fibrin glue. No treatment was given to control animals (TBI only: n=24). After surgery, four animals in each group were sacrificed daily (day 1 to day 6) for edema evaluation. Normal animals without TBI were used as reference (n=4). The expressions of GFAP, AQP4 and MMP9 were also investigated by immunofluorescence staining and RT-PCR at day 3. Results:The edema peaked within 3 days after TBI. Compared with the control, hypoxic MSCs reduced brain water content significantly (p<0.05). Both hypoxic and normoxic MSCs downregulated the expression of MMP9 and normalized AQP4 distribution to astrocytes end feet.Conclusion:Our preliminary study showed that topical application of hypoxic MSCs suppressed both vasogenic and cytotoxic edema formation.
Analysis of the heterogeneity of the BCR H-CDR3 repertoire in the bone marrow and spleen of 3-, 12-, and 20-month old mice 
Authors: Ma Lina , Yao Xinsheng , Xinxin Tao , Xiaoyan He , Peng Wang , Long Ma , Bin Shi
Published: November 2020

The number of central and peripheral B cells and their responsiveness are decreased in aged mice. The diversity of mouse central and peripheral B cell repertoires with increasing age has not been elucidated. In this study, we demonstrated that there were significant differences in the usage of some V, D, and J genes in the BCR H-CDR3 repertoire of bone marrow B cells, spleen B cells and spleen memory B cells in 3-, 12-, and 20-month-old mice. In the productive, pseudogene, and out-of-frame sequences, bone marrow B cells had significant differences in 5′J trimming with age; peripheral spleen B cells and memory B cells had significant differences in N1 insertion, N2 insertion, P5'D insertion, and 5'D trimming with age. The BCR H-CDR3 repertoire diversity of mouse bone marrow B cells, spleen B cells and spleen memory B cells decreased with increasing age. The proportion of overlap in bone marrow and spleen B cells, but not spleen memory B cells, of mice at different ages was lower at 3 months than at 12 and 20 months. This study is the first to report the homogeneity and heterogeneity of the CDR3 repertoire of central and peripheral B cells change as mice age, to further investigation of the decline and response of B cell immunity in young/middle/old-aged mice.
Everything Counts -- A Method to Determine Viral Suppression Among People Living With Hiv Using Longitudinal Data for the Hiv Care Continuum. - Results of two large, German, multi-center real-life cohort studies over 20 years (1999-2018)
Authors: Schmidt Daniel , Kollan Christian , Stoll Matthias , Hamouda Osamah , Bremer Viviane , Kurth Tobias , Bartmeyer Barbara
Published: November 2020

BackgroundThe aim of this study was to develop a standardized method to reconstruct persons' individual VL courses to determine viral suppression and duration of viremia for the HIV care continuum in Germany using longitudinal cohort data.MethodsWe analyzed data from two large, multi-center German cohort studies under the direction of the Robert Koch Institute. We included data from 1999-2018 of all diagnosed people and of people who initiated antiretroviral treatment (ART). We developed a model generating virtual VL values and an individual VL course corresponding to real VL measurements with a maximum distance of 180 days, considering ART status and VL dynamics. If the distance between VL measurements was >180 days, the time between was defined as gap time. Additionally, we considered blips, which we defined as a single detectable VL <1,000 copies/ml within 180 days.ResultsA total of 22,120 people (164,691 person-years, PY) after ART initiation were included in the analyses. The proportion of people with viral suppression (VL <50 copies/ml) increased from 34% in 1999 to 93% in 2018. The proportion of people with VL <200 copies/ml increased from 47% in 1999 to 96% in 2018. The proportion of people with viremia >1,000 copies/ml decreased from 37% in 1999 to 3% in 2018. The proportion of people with gap time fluctuated and ranged between 18% and 28%. An analysis of the first VL after gap time showed that 90% showed viral suppression, 5% VL between 50-<1,000 copies/ml and 5% VL >1,000 copies/ml.ConclusionWe provide a method for estimating viral suppression and duration of viremia using longitudinal VL data. We observed a continuous and remarkable increase of viral suppression. Furthermore, a notable proportion of those with viremia showed low-level viremia and were therefore unlikely to transmit HIV. Individual health risks and HIV drug resistance among those with low-level viremia are problematic, and viral suppression remains the goal. In 2018, 93% and 96% of people after ART initiation showed VL <50 copies/ml and VL <200 copies/ml, respectively. Therefore, using the threshold of VL <200 copies/ml, Germany reached the UNAIDS 95 target of viral suppression since 2017.
Financial burden impact quality of life among Lymphatic Filariasis Patients
Authors: Asiedu Samuel Opoku , Kwarteng Alexander , Amewu Emmanuel Kobla Atsu , Kini Priscilla , Aglomasa Bill Clinton , Forkuor John Boulard
Published: November 2020

Background: Human lymphatic filarial pathology is the main cause of disability and poverty among people living with the infection. The second goal of the Global Programme to Eliminate Lymphatic Filariasis (GPELF) is to manage the morbidity associated with the disease with the purpose of improving the quality of life of the patients. Consequently, the current study assessed the overall quality of life of lymphatic filariasis (LF) pathology patients in some selected endemic communities in rural Ghana. Method: In the present study, the Lymphatic Filariasis Quality of Life Questionnaire (LFSQQ) was used to evaluate the effect of lymphatic filariasis on the quality of life of people, with the disease in nine (9) communities in the Ahanta West District of the Western Region of Ghana where mass drug administration is being implemented for the past twenty years. Pearson’s correlation, linear regression and one-way analysis of variance (ANOVA) analyses were used to assess the associations between the domains of LFSQQ instrument. Results: Of the 155 study participants recruited, 115 (74.19%) were females and 40 (25.81%) males. A greater proportion of the study participants (40, 25.8%) were presented with stage two (2) lymphedema while only 2 patients had stage seven (7) lymphedema. The average of the overall quality of life scores of study participants was 68.24. There was a negative Pearson correlation (r = -0.504, p-value < 0.001) between the stage of lymphedema (severity of the disease) and the quality of life of the LF patients. In addition, a clear pattern of positive correlation (r = 0.71, p-value < 0.001) was observed between the disease burden and pain/discomfort domains of the study participants. Whereas the highest domain specific score (85.03) was observed in the domain of self-care, we noted that the environmental domain, which consists of the financial status was the lowest (45.94) among the study participants. Conclusion: Our findings support previous works on the reduced quality of life among lymphatic filariasis patients with pathology. In this study, our results reveal a depressing financial condition among people presenting with late stages of LF pathologies, which eventually reduces their wellbeing.
Human fetal liver MSCs are more effective than adult bone marrow MSCs for their immunosuppressive, immunomodulatory and Foxp3+ T regs induction capacity
Authors: Yu Yi , Valderrama Alejandra Vargas , Han Zhongchao , Uzan Georges , Naserian Sina , Oberlin Estelle
Published: November 2020

Background: Mesenchymal stem cells (MSCs) display active capacities of suppressing or modulating harmful immune responses through diverse molecular mechanisms. These cells are under extensive translational efforts as cell therapies for immune-mediated diseases and transplantations. A wide range of preclinical studies and limited number of clinical trials using MSCs have not only shown promising safety and efficacy profiles but have also revealed changes in regulatory T cell (T reg) frequency and function. However, the mechanisms underlying this important observation are not well understood. Cell-to-cell contact, production of soluble factors, reprogramming of antigen presenting cells to tolerogenic phenotypes have emerged as possible mechanisms by which MSCs produce an immunomodulatory environment for T reg expansion. We and others demonstrated that adult bone-marrow (BM)-MSCs suppress adaptive immune responses directly by inhibiting the proliferation of CD4+ (“helper”) and CD8+ (“cytotoxic”) T cells but also indirectly through induction of Tregs. In parallel we demonstrated that fetal liver (FL)-MSCs displays much longer-lasting immunomodulatory properties compared to BM-MSCs, by inhibiting directly the proliferation and activation of CD4+ and CD8+ T cells. Therefore, we investigated if FL-MSCs exert their strong immunosuppressive effect also indirectly through induction of T regs.Methods: MSCs were obtained from FL and adult BM and characterized according to their surface antigen expression, their multilineage differentiation and their proliferation potential. Using different in-vitro combinations, we performed co-cultures of FL or BM-MSCs and murine CD3+CD25-T cells to investigate immunosuppressive effects of MSCs on T cells and to quantify their capacity to induce functional T regs. Results: We demonstrated that although both types of MSC exhibit similar phenotypic profile and differentiation capacity, FL-MSCs have significantly higher proliferative capacity and ability to suppress both CD4+ and CD8+ murine T cell proliferation and to modulate them towards less active phenotypes than adult BM-MSCs. Moreover, their substantial suppressive effect was associated with an outstanding increase of functional CD4+CD25+Foxp3+ T regs compared to BM-MSCs.Conclusions: These results highlight the immunosuppressive activity of FL-MSCs on T cells and show for the first time that one of the main immunoregulatory mechanisms of FL-MSCs passes through active and functional T reg induction.
Microbial fuel cell assisted utilization of glycerol for succinate production by mutant of Actinobacillus succinogenes
Authors: Zheng Tianwen , Xu Bin , Ji Yaliang , Zhang Wenming , Xin Fengxue , Dong Weiliang , Wei Ping , ma jiangfeng , Jiang Min
Published: November 2020

Background: The global production of glycerol is increasing year by year since the demands of biodiesel is rising. It is benefit for high-yield succinate synthesis due to its high reducing property. A. succinogenes, a succinate-producing candidate, cannot grow on glycerol anaerobically, as it needs a terminal electron acceptor to maintain the balance of intracellular NADH and NAD+. Microbial fuel cell (MFC) has been widely used to release extra intracellular electrons. However, A. succinogenes is a non-electroactive strain which need the support of electron shuttle in MFC, and pervious research showed that acid tolerant A. succinogenes has higher content of unsaturated fatty acids, which may be beneficial for the transmembrane transport of lipophilic electron shuttle.Results: MFC assisted succinate production was evaluated using neutral red as an electron shuttle to recover the glycerol utilization. Firstly, an acid tolerant mutant JF1315 was selected by atmospheric and room temperature plasma (ARTP) mutagenesis aiming to improve transmembrane transport of neutral red (NR). Additionally, MFC was established to increase the ratio of oxidized NR to reduced NR. By combining these two strategies, ability of JF1315 for glycerol utilization was significantly enhanced, and 23.92 g/L succinate was accumulated with a yield of 0.88 g/g from around 30 g/L initial glycerol, along with an output voltage above 300 mV.Conclusions: A novel MFC-assisted system was established to improve glycerol utilization by A. succinogenes for succinate and electricity production, making this system as a platform for chemicals production and electrical supply simultaneously.
Interpersonal Relationships and Drug Use Over Time Among Homeless People: A Qualitative Study
Authors: de Espíndola Marília Ignácio , Bedendo André , Silva Eroy Aparecida da , Noto Ana Regina
Published: November 2020

BACKGROUND: Homelessness is one of the most severe forms of social exclusion and is an important public health issue. It is characterized by processes of weakening of interpersonal bonds. The objective of this study was, therefore, to elucidate how interpersonal relationships change over the life cycle of homeless drug and alcohol users. METHOD: We used a qualitative methodology. The participants were adults who had a history of homelessness and use of alcohol and other drugs. The interviews were semi structured and used a timeline instrument. All interview were audio recorded, transcribed, and submitted to thematic analysis.RESULTS: Twenty individuals participated in the study. Reports on social exclusion over time stood out in respect of four main themes and their respective subthemes: Theme 1 – Childhood: instability upbringing, abuse, violence, and an absent or not very present father figure; Theme 2 – Adolescence: school dropout and failure; acceptance of gender and sexual orientation; birth of first child, living with a partner or getting married: Theme 3 – Adulthood: estrangement or conflicting relationship with family; health problems; drug trafficking and prostitution; Theme 4 – Cross-cutting factors: death of relatives and substance use. CONCLUSION: The results suggest that interpersonal relationships are permeated by successive breakups, conflicts and other events that start in childhood and can have a cumulative effect in later stages of life, and cross the subsequent phases. Substance abuse and dependence are mentioned as cross-cutting factors that intensify social exclusion in all stages of life.
Sex Differences and Psychological Stress: Responses to the COVID-19 Pandemic in China
Authors: Yan Shiyan , Xu Rui , Stratton Terry D. , Kavcic Voyko , Luo Dan , Hou Fengsu , Bi Fengying , Jiao Rong , Song Kangxing , Jiang Yang
Published: November 2020

Background About 83,000 COVID-19 patients were confirmed in China up to May 2020. Amid the well-documented threats to physical health, the effects of this public health crisis - and the varied efforts to contain its spread - have altered individuals’ “normal” daily functioning. These impacts on social, psychological, and emotional well-being remain relatively unexplored – in particular, the ways in which Chinese men and women experience and respond to potential behavioral stressors. Our study investigated sex differences in psychological stress, emotional reactions, and behavioral responses to COVID-19 and related threats among Chinese residents. Methods In late February (2020), an anonymous online questionnaire was disseminated via WeChat, a popular social media platform in China. The cross-sectional study utilized a non-probabilistic “snowball” or convenience sampling of residents from various provinces and regions of China. Basic demographic characteristics (e.g., age and gender) – along with residential living arrangements and conditions – were measured along with psychological stress and emotional responses to the COVID-19 pandemic.Results 3,088 questionnaires were returned: 1,749 females (56.6%) and 1,339 males (43.4%). The mean stress level,as measured by a visual analog scale, was 3.4 (SD=2.4) - but differed significantly by sex. Besides sex, factors positively associated with stress included: age (<45 years), employment (unsteady income, unemployed), risk of infection (exposureto COVID-19，completed medical observation), difficulties encountered (diseases, work/study, financial, mental), and related behaviors (higher desire for COVID-19 knowledge, more time concerning on the COVID-19 outbreak). “Protective” factors included frequent contact with colleagues, calmness of mood comparing with the pre-pandemic, and psychological resilience. Males and females also differed significantly in adapting to current living/working, conditions, responding to run a fever, and needing psychological support services. Conclusions The self-reported stress of Chinese residents related to the COVID-19 pandemic was significantly related to sex, age, employment, resilience and coping styles. Future responses to such public health threats may wish to provide sex- and/or age-appropriate supports for psychological health and emotional well-being to those at greatest risk of experiencing stress.
Effect of docosahexaenoic acid plus insulin on atherosclerotic human endothelial cells
Authors: Abriz Aysan Eslami , Rahbarghazi Reza , Nourazarian Alireza , Avci Çıgır Biray , Mahboob Soltan Ali , Rahnema Maryam , Araghi Atefeh , Heidarzadeh Morteza
Published: November 2020

Background: Atherosclerosis is touted as one of the most critical consequences of diabetes mellitus indicated by local inflammation of endothelial cells. The Effect of Omega 3 fatty acids, mainly docosahexaenoic acid (DHA), has been investigated in cells after exposure to high doses of lipids. The current experiment aimed to address the modulatory effects of docosahexaenoic acid and insulin in palmitic-treated human endothelial cells. Methods: Human umbilical vein endothelial cells were treated with 1mM palmitic acid, 50μM insulin, 50μM docosahexaenoic acid, and their combination for 48 hours. Cell survival rate and apoptosis were measured using MTT and flow cytometry assays. The Griess assay detected NO levels. Protein levels of TNF-α, IL-6, and NF-κB were studied using ELISA and immunofluorescence imaging. The expression of genes participating in atherosclerosis was monitored using PCR array analysis. Results: Oil Red O staining showed the inhibitory effect of DHA and insulin to reduce the intracellular accumulation of palmitic acid. Both DHA and Insulin blunted palmitic acid detrimental effects on HUVECs indicated by an increased survival rate (p<0.05). The percent of apoptotic cells was decreased in palmitic-treated cells received insulin and DHA compared to palmitic-treated group (p<0.05). Based on our data, DHA and Insulin diminished the production of all inflammatory cytokines, TNF-α, IL-6, and NF-κB, in palmitic-treated cells (p<0.05). Similar to these data, NO production was also decreased in all groups treated with insulin and DHA compared to the palmitic-treated cells (p<0.05). PCR array analysis revealed the modulatory effect of DHA and insulin on the expression of atherosclerosis-related genes pre-treated with palmitic acid compared to the control group (p<0.05). Conclusion: DHA and Insulin could alter the dynamic growth and dysfunctional activity of human endothelial cells after treatment with palmitic acid. Taken together, Omega 3 fatty acids, along with insulin, could dictate specific cell behavior in endothelial cells in vitro
Consolidated bioprocessing of cellulose to itaconic acid by a co-culture of Trichoderma reesei and Ustilago maydis.
Authors: Schlembach Ivan , Tehrani Hamed , Blank Lars Mathias , Büchs Jochen , Wierckx Nick , Regestein Lars , Rosenbaum Miriam
Published: November 2020

Background: Itaconic acid is a bio-derived platform chemical with uses ranging from polymer synthesis to biofuel production. The efficient conversion of cellulosic waste streams into itaconic acid could thus enable the sustainable production of a variety of substitutes for fossil oil based products. However, the realization of such a process is currently hindered by an expensive conversion of cellulose into fermentable sugars. Here, we present the stepwise development of a fully consolidated bioprocess (CBP), which is capable to directly convert recalcitrant cellulose into itaconic acid without the need for separate cellulose hydrolysis including the application of commercial cellulases. The process is based on a synthetic microbial consortium of the cellulase producer Trichoderma reesei and the itaconic acid producing yeast Ustilago maydis. A method for process monitoring was developed to estimate cellulose consumption, itaconic acid formation as well as the actual itaconic acid production yield online during co-cultivation.Results: The efficiency of the process was compared to a simultaneous hydrolysis and fermentation setup (SSF). Because of the additional substrate consumption of T. reesei in the CBP, the itaconic acid yield was significantly lower in the CBP than in the SSF. In order to increase yield and productivity of itaconic acid in the CBP, the population dynamics was manipulated by varying the inoculation delay between T. reesei and U. maydis. Surprisingly, neither inoculation delay nor inoculation density significantly affected the population development or the CBP performance. Instead, the substrate availability was the most important parameter. U. maydis was only able to grow and to produce itaconic acid when the cellulose concentration and thus, the sugar supply rate, was high. Finally, the metabolic processes during fed-batch CBP were analyzed in depth by online respiration measurements. Thereby, substrate availability was again identified as key factor also controlling itaconic acid yield. In summary, an itaconic acid titer of 34 g/L with a total productivity of up to 0.07 g/L/h and a yield of 0.16 g/g could be reached during fed-batch cultivation. Conclusion: This study demonstrates the feasibility of consortium based CBP for itaconic acid production and also lays the fundament for the development and improvement of similar microbial consortia for cellulose based organic acid production.
Evaluation of Cardiovascular Risk Factors in Patients With Familial Hypercholesterolemia From the North-eastern Area of Romania
Authors: Vlad Cristiana-Elena , Foia Liliana , Florea Laura , Costache Irina-Iuliana , Covic Andreea , Popescu Roxana , Reurean-Pintilei Delia , Covic Adrian
Published: November 2020

Background. Familial hypercholesterolemia(FH) is one of the most frequent and important monogenic cholesterol pathologies. Traditional and nontraditional cardiovascular risk factors increase the prevalence of atherosclerotic cardiovascular disease(ASCVD) in this population. The aims of the study were: (a)to identify FH patients in the North-Eastern part of Romania and to analyze demographic, clinical and paraclinical data (b)to evaluate the risk of new cardiovascular events at follow-up in FH patients stratified by lipid-lowering agents.Methods. This first prospective study in the North-Eastern part of Romania was carried out between October 2017 and October 2019; out of 980 patients with dyslipidemia evaluated with the Dutch Lipid Network(DLCN) and Simon Broome(SM) scores, 61 patients with DLCN score above 3 and possible/probable FH (SM score) were included.Results. The 61 subjects with clinical diagnosis of FH (6.2% of all patients examined) recorded a mean age of 48.5±12.5 years, with more female patients than male patients. Hypertension was the main cardiovascular risk factor for both genders, followed by physical inactivity and obesity for the female group and active smoking for the male group. The measured DLCN score recorded: “possible” FH identified in 39.4%, “probable” FH in 45.9% and “definite” FH in 14.7%. As far as treatment was concerned, the effective lipid-lowering drugs were statin alone and statin in association with fenofibrate, which improved both the lipid profile values and the subclinical atherosclerosis markers (ankle-brachial index, carotid intima-media thickness and high-sensitivity C-reactive protein). New ASCVDs that emerged during the study were most commonly represented by coronary heart disease and stroke. At the same time, the new CV events were delayed in patients receiving the lipid-lowering drugs, without significant differences between them.Conclusions. In patients with suspected FH, the lipid-lowering agents during the follow-up delayed the new cardiovascular events, yet failed to reach the goals proposed by the guidelines.
COVID-19-related mental health burden and reduced awareness of mental healthcare services in low income earners of Western Uganda 
Authors: Lemuel Ann Monima , Usman Ibe Michael , Kasozi Kenneth Iceland , Aigbogun Eric . Osamudiamwen , Bassey Victor Archibong , Ifie Josiah , Ssebuufu Robinson , Afodun Adam Moyosore , Terkimbi Swase Dominic , Mbiydzenyuy Ngala Elvis , Adeoye Azeez , Aruwa Joshua Ojodale , Saidi Odoma , Ssempijja Fred , Ayuba John Tabakwot , Onohuean Hope , Kembabazi Stellamaris , Pius Theophilus , Nankya Viola , Matama Kevin , Henry Rachael , Yusuf Helen , Welburn Susan Christina
Published: November 2020

Background: The imposed COVID-19 lockdown is taking a toll on mental health individuals, with low-income earners considered most affected, as the imposed lockdown was accompanied with partial or complete loss of livelihood among low income earners. The study aimed to investigate level of education and relationship status on awareness of mental healthcare and explore how these factors influence mental health among low income earners in Western Uganda.Methods: A cross sectional descriptive study was undertaken among low-income earners in South Western Uganda. Data were collected from two hundred and fifty-three (253) participants using a structured closed ended questionnaire. Anxiety, anger and depression were assessed using a modified generalized anxiety disorder (GAD-7), Spielberger’s State-Trait Anger Expression Inventory-2 (STAXI-2) and Beck Depression Inventory (BDI) item tools respectively.Result: Most respondents were single male individuals with secondary level of education. Respondents with tertiary level of education and those with partners had higher score (71.7% and 70.28% respectively) for awareness on mental healthcare. Respondents with primary education level and individuals that were single had higher score (46.98% and 43.72% respectively) for anxiety. Respondents with primary education level and those living with partners had higher mean score (56.44% and 56.21% respectively) for anger. Respondents with no formal education and those who had lost partners had higher mean score (32.11% and 30.50% respectively) for depression. Individuals without formal educational and primary education were observed to have a negative correlation (r2 = 47.4 and 6.4% respectively) with awareness on mental healthcare, and the no formal group had positive correlation with anger and depression (r2 =1.9 and 0.3% respectively), while other groups were negatively correlated (r2 =10.1%). The group of single individuals had a negative correlation with awareness on mental healthcare, anger and depression (r2 =1.9, 0.8 and 0.3% respectively), and a positive correlation with anxiety (r2 =3.9%).Conclusion: It is evident that education and relationship status influence awareness on mental healthcare and mental health state among low income earners in Western Uganda. Therefore, we suggest policy maker pay more attention to social transformation, through proper engagement of low income earners.
Ist die Standardabkommen-Praxis Geschichte?
Authors: Gebistorf Louis
Published: November 2020

Nach Inkrafttreten der Neuregelung des fakultativen Staatsvertragsreferendums im Jahr 2003 haben Bundesrat und Bundesversammlung begonnen, nach der sogenannten «Standardabkommen-Praxis» vorzugehen. Dies hatte zur Konsequenz, dass standardisierte völkerrechtliche Verträge grundsätzlich nicht dem fakultativen Referendum unterstellt wurden. Trotz teils deutlicher Kritik aus der Rechtswissenschaft an der Verfassungsmässigkeit dieser Praxis wurde über Jahre an der Praxis festgehalten und zudem mehrfach versucht, diese zu kodifizieren. Dieser Beitrag untersucht die Entwicklung der Referendumsunterstellung von standardisierten völkerrechtlichen Verträgen von 2003 bis heute. Dabei werden Inkonsistenzen im Handeln der Behörden dargelegt. Die Zulässigkeit einer Kodifizierung der Standardabkommen-Praxis wird geprüft und verneint. Die Untersuchung ergibt, dass vieles darauf hindeutet, dass die Standardabkommen-Praxis ein definitives Ende gefunden hat.
Detecting In-Vitro Colistin Resistance- A Comparative Study Between Broth Microdilution Versus Vitek-2 For Colistin Susceptibility Testing
Authors: Butta Hena , Mendiratta Leena , Sardana Raman , Gilotra Kirti , Hasan Sana , Kansal Sudha , Chatterjee Suranjit
Published: November 2020

Background: Susceptibility testing for polymyxins is a great challenge for a Clinical Microbiology laboratory. There are several methodological issues associated with MIC (Minimum Inhibitory Concentration) determination of colistin.

Methods: In our study, we have compared the results of colistin susceptibility testing by Automated system (Vitek-2, Biomerieux, France) with the reference Broth Microdilution method (BMD) to identify the type of discrepancies by Vitek-2 method and thus develop a practical and accurate approach for colistin susceptibility testing in a Clinical Microbiology laboratory. A total of 730 strains of Gram negative bacteria [Escherichia coli (325), Klebsiella sp.(346), Acinetobacter baumanii complex (37) and Pseudomonas aeruginosa (22)] from 485 patents were tested simultaneously by BMD and Vitek-2 method for colistin susceptibility testing.

Results: The Essential agreement (EA), Categorical agreement (CA), Very major error (VME) and Major error (ME) rates for Klebsiella sp. were 87.3%, 89.3%, 8% and 2.3% respectively, for Escherichia coli were 88.3%, 89.5%, 9.2% and 1.2%  respectively, for Acinetobacter baumannii complex were 89.1%, 91.8%, 8.1% and 0% respectively, for Pseudomonas aeruginosa were 68.1%, 72.7%, 0% and 27.2% respectively.

Conclusions: Colistin susceptibility testing by Vitek-2 method is an easily adoptable method and the results of Vitek-2 with reference to BMD are acceptable to a great extent in Klebsiella sp., Escherichia coli and Acinetobacter baumanii complex. So, we believe that Vitek-2 method may be used for colistin susceptibility testing in low risk patients. However, BMD should be used in high risk immunosupressed and immunocompromised patients who are admitted in critical care units. For Pseudomonas aeruginosa, BMD should be routinely used.
Study of Various Vesiculobullous Lesions Using Tzanck Smear
Authors: Singhal Sanchit , M Hemalata
Published: November 2020

Background: The vesiculobullous reaction pattern is characterized by the presence of vesicles or bullae within the epidermis or at the dermoepidermal junction. Despite some having characteristic presentations, it’s difficult to make a definite diagnosis clinically. Hence, cytological evaluation is required for reliable and early diagnosis. Objectives of the study are to determine the incidence of various vesiculobullous lesions and evaluate cytology as a tool for early diagnosis of vesiculobullous lesions.

Methods: For Tzanck smears fresh vesicle or bulla was selected and incised with scalpel, reflecting the roof of bulla. Base of the blister scraped gently and material spread on a glass slide. These smears were stained with MGG (air dried), Pap and H&E stains (fixed).Skin punch biopsies from the bullae were subjected to routine fixation, processing, sectioning and staining.

Results: A total of 62 Tzanck smears were done for vesiculobullous lesions of skin of which 29 had histopathological correlation. Herpes constituted the most common vesiculobullous disorder (42%) followed by bullous pemphigoid (27.4%) and pemphigus vulgaris (19.3%). Most patients were in the age group 61- 70 years. The M:F ratio of 1:1.38 showing female preponderance. Tzanck smears showed acantholytic cells in pemphigus group, eosinophils in bullous pemphigoid and multinucleate giant cells in viral blisters. Histopathology showed intraepidermal acantholysis in pemphigus vulgaris, subcorneal blister in pemphigus foliaceus and subepidermal in bullous pemphigoid.

Conclusion: Cytohistopathological correlation showed an overall sensitivity of 79%. Tzanck smear showed 96% sensitivity for viral infections. Tzanck smear is a quick, non-invasive method for the early diagnosis of vesiculobullous disorders.
A Study of Histopathological Spectrum of Ovarian Neoplastic and Non-Neoplastic Lesions at Teaching Hospital, Ahmedabad
Authors: Patel Piyush Ashokbhai , Patel Deval Narendrakumar , Patel Mona Manubhai , Bhalodia Jignasa Nathalal
Published: November 2020

Background: Ovarian carcinoma is one of the most common gynecologic cancers that ranks third after cervical and uterine cancer. ovarian lesions are neoplastic and non neoplastic and many neoplastic lesions are asymptomatic and possess great challenge to the gynecological oncologist.

Aims & Objectives: To analyze frequency, age distribution and histopathological spectrum of ovarian lesions at teaching hospital, Ahmedabad.

Materials & Method: This study was undertaken between period of 1st January 2018 to 29th February 2020 at Department of Pathology, GMERS Medical college, sola, Ahmedabad. H and E stained slides were examined by light microscopy and histopathological type of lesions were classified according to World Health Organization (WHO) classification -2014.

Results: There were total 182 cases of ovarian lesions. 56(30.76%) cases are neoplastic, among them only 6(10.71%) were malignant. Surface epithelial tumor (n=27 cases, 48.21%) were most common neoplastic lesion while sex cord stromal tumor (n=8 cases,14.29%) were least common. Most common age group affected for neoplastic lesions was 31-40 years.

Conclusion: We found that ovarian lesions affect wide variation of age starting from 11 years young patient to 65 years old patients. Non neoplastic lesions were almost double in prevalence than neoplastic lesions. Histopathological analysis according to WHO classification reveal that surface epithelial tumors and germ cell tumors were forms the majority of neoplastic lesions.
Plexiform Schwannoma Masquerading as Giant Cell Tumor of Tendon Sheath- A Case Report
Authors: Singh Sharanjit , Pendkur Ganesh , Baveja Puneet , Roy Nilanjan
Published: November 2020

Plexiform schwannoma is a rare benign variant of Schwann cell tumor characterised by multinodular plexiform growth pattern. Usual location of this tumor includes trunk, head, neck and upper extremities but it may rarely be found in lower extremities. It generally affects young adults with no sex predilection. We report a case of 37 years old male who presented with gradually progressive swelling of right little finger of 28years duration that was diagnosed as giant cell tumor of tendon sheath clinically, radiologically and intraoperatively. Authors wish to discuss the case due to its clinical rarity and diagnostic difficulties due to many common histological mimickers at that site.
RECENTES APLICAÇÕES DO ORGANOFOTOCATALISADOR 1,2,3,5-TETRAQUIS(CARBAZOL-9-IL)-4,6- DICIANOBENZENO EM TRANSFORMAÇÕES QUÍMICAS
Authors: Pugnal Lucas , Pissinati Emanuele , Quaglio Karina , Paixão Márcio
Published: November 2020

RECENT APPLICATIONS OF THE ORGANIC PHOTOCATALYST 1,2,3,5-TETRAKIS(CARBAZOL-9-YL)- 4,6-DICIANOBENZENE IN CHEMICAL TRANSFORMATIONS. Ruthenium and iridium polypyridine complexes are among the most employed photocatalysts described in literature. The broad applicability is due to the redox potentials and long half-life times of the excited state which these molecules presented. The pursuit for metal-free alternatives has been intensified in the last few years, therefore, many organic fluorophores were successfully employed as photocatalysts. Among them, 1,2,3,5-tetrakis(carbazol-9-yl)- 4,6-dicianobenzene (4CzIPN) recently drawn attention of the community, and it’s been widely employed by distinguished research groups. Recent studies have shown that this catalyst do not only present similar properties to transition metal complexes, but also, its synthesis can be accomplished more easily and less expensive when compared with the metallic photocatalysts above mentioned. Therefore, 4CzIPN constitutes a metal-free alternative to replace transition metal complexes in conventional photochemical protocols. Moreover, it’s as a powerful ally in the development of new photochemical approaches. In this work, we aim to summarize recent applications of 4CzIPN as catalyst in the emerging field of redox photocatalysis.
A mathematical approach to improving the representation of surface water–groundwater exchange in the hyporheic zone
Authors: He Bowen , Guan Qun
Published: November 2020

It is well known that land surface topography governs surface–groundwater interactions under some circumstances and can be separated in a Fourier-series spectrum that provides an exact analytical solution of both the surface and the underlying three-dimensional groundwater flows. We evaluate the performance of the current Fourier fitting process by testing on different scenarios of synthetic surfaces. We identify a technical gap and propose a new version of the approach which incorporates the spectral analysis method to help identify the statistically significant frequencies of the surface to guide the refinement and mesh. Our results show that spectral analysis is the method that can help improve the accuracy of representing the surface, thus further improving the accuracy of predicting the bedform-driven hyporheic exchange flows.
Field-scale anaerobic baffled reactor for domestic wastewater treatment: effect of dynamic operating conditions
Authors: Yenji S. S. , Munavalli G. R. , Koli M. M.
Published: November 2020

A 45 m3/d field-scale anaerobic baffled reactor (ABR) was studied for its performance to remove carbonaceous organic content and suspended solids under a dynamic hydraulic loading rate (HLR) and organic loading rate (OLR). Sludge granulation effect was also assessed with and without sand as a bio-carrier aided with poly aluminium chloride. ABR was subjected to a significant variation in HLR (0.26 to 7.72 m3/m2.d) and OLR (0.03 to 8 kg COD/m3.d). Tracer study showed flow-through time was 50% of theoretical hydraulic retention time. The initial compartments of ABR were more effective for the removal of organic carbon. An overall CODTotal removal of 60 to 90% was possible for OLR in the range 1 to 8 kg COD/m3.d irrespective of low/high HLR. OLR dominated the performance of ABR compared to HLR. The compartmentalized nature of ABR was visualized through a two-phase system of anaerobic digestion as alkalinity increased while VFA decreased from the first to last compartment even under dynamic conditions. Sludge granulation with sand and PAC increased the size of granule from 629 to 1,471 μm, decreased sludge depth by 20% and enhanced CODTotal removal within a month. ABR is sturdy to sustain low/high HLR with low/high OLR conditions without impairing CODTotal removal efficiency significantly.
Türkiye’de Fındık İhracatının Box-Jenkins Yöntemiyle Modellenmesi ve İhracat Öngörüsü
Authors: Kılıç Tuğçe Meryem
Published: November 2020

Ülkemiz fındık üretim ve ihracatında Dünya’da ilk sırada yer alarak fındık pazarında söz sahibi ülke durumundadır. Bu nedenle fındık piyasasının şekillenmesinde önemli rolü vardır. Bu çalışmanın amacı Türkiye’de 1961-2018 yıllarına ait fındık ihracatının zaman serileri ile modellenerek 2023 yılına kadar olan fındık ihracat öngörüsünü yapmaktır. Fındık ihracatı veri tabanına FAO’dan ulaşılmıştır ve 2019-2023 yıllarını tahminlemek için ARIMA modeli kullanılmıştır. Yapılan analizler sonucu en uygun modelin ARIMA(1,1,11) olduğu tespit edilmiştir. Sonuçlara göre 2019 yılında Türkiye’nin fındık ihracatının 162 bin ton, 2023 yılına gelindiğinde ise 176 bin ton olacağı tahmin edilmiştir.
Recent Topics in Organohalogen Reagents and Compounds
Authors: Dohi Toshifumi
Published: November 2020

This Special Issue covers the hot topics on recent synthetic interest in halogen and related
chemistry as well as the unique characteristics of halogen compounds. The excellent reviews by the
experts and eminent researchers engaged in the recent advances, i.e., preparations, reactions, and
mechanistic studies of unique organohalogen compounds, halogen bond interaction as the catalysis,
and halogen-controlled unique reactions for synthesizing useful organic molecules, such as
pharmaceutical compounds and organic materials, are provided in this Special Issue.
Como Prever a Substituição de Administradores Uma Solução para o Problema
Authors: Pollock Ross
Published: November 2020

Lamento imensamente vê-lo aposentar-se, pois temos necessidade de alguém com a sua experiência entre nós”, disse um dia ao seu chefe um jovem e dedicado funcionário. O chefe sorriu e respondeu: “Sinto-me feliz ouvindo-o dizer isso, mas não há o que lamentar; quando eu me for, você e outros nove serão, provavelmente, promovidos”. Como mostra a história, muitas vezes a aposentadoria de um administrador traz a um só tempo benefícios e malefícios. Quando um administrador incapaz se aposenta, a administração é com isso beneficiada; perde, ao contrário, ao afastar-se um de valor. Mas, mesmo assim, há lucros que parcialmente compensam a perda: uma oportunidade de renovar a organização, modificar lhe ou alterar lhe o rumo, e experimentar, nos altos postos, os mais jovens, com ideias talvez mais novas e melhores.