bluuebunny/crossref_metadata_2025 huggingface dataset:
Zinc Oxide Nanoparticles Foliar Application Effectively Enhanced Zinc and Aroma Content in Rice (Oryza sativa L.) Grains
Authors: Wang Rui , Mi Kailiang , Yuan Xijun , Chen Jie , Pu Jialing , Shi Xinyan , Yang Yanju , Zhang Hongcheng , Zhang Haipeng
Published: August 2023

The search for an effective zinc fertilizer and its application method to effectively increase zinc content and enhance aroma in rice grains is a crucial objective. In this study, a 2-year field plot experiment was conducted to investigate the influence of ZnO NPs foliar spraying on rice quality, grain zinc and aroma content, along with exploring the physiological mechanisms underlying these effects. Our results demonstrated that the rice breakdown value and taste value of foliar spraying zinc oxide nanoparticles were improved by 31.0–41.7% and 8.2–13.0% compared with CK (control treatment involved spraying water), improving the tasting and steaming quality of rice. While Fe and Cu content in grains decreased for the application of zinc oxide nanoparticles, zinc oxide nanoparticles foliar spraying significantly increased the zinc content and accumulation of grains by 33.6–65.1% and 37.8–74.7%, respectively. Further analysis showed that the sprayed zinc oxide nanoparticles achieved effective enrichment of zinc in edible parts and increased the final bioavailability of Zn. In addition, foliar spraying of zinc oxide nanoparticles significantly increased activities of nitrate reductase and glutamine synthetase in leaves, which elevated nitrogen content in leaves and grains, and ultimately enhanced 2-acetyl-1-pyrroline (2-AP) content in grains at maturity by 6.1–21.4% compared to CK. Our findings indicated that zinc oxide nanoparticles can be practically applied as a foliar fertilizer at the gestation for quality improvement, zinc enrichment and aroma enhancement of rice grains.
The effect of luteinizing hormone changes in GnRH antagonist protocol on the outcome of controlled ovarian hyperstimulation and embryo transfer
Authors: Zhou Jing-Shuang , Chen Jian-Hong , Tang Fei-Fei , Ou Jian-Ping , Tao Xin , Cai Liu-Hong
Published: August 2023

Backgroud

To investigate the effect of Luteinizing hormone (LH) level changes on the outcomes of controlled ovarian hyperstimulation (COH) and embryo transfer (ET) in gonadotropin-releasing hormone antagonist (GnRH-ant) protocol.

Methods

A total of 721 patients undergoing GnRH-ant protocol COH for the first IVF/ICSI cycles were retrospectively analyzed. COH process were divided into 2 stages, before (stage 1) and after (stage 2) the GnRH-ant initiation, and each with 5 groups basing on LH levels: LH decreased more than 50% (groups A1, A2), decreased 25-50% (groups B1, B2), change less than 25% (groups C1, C2), increased 25-50% (groups D1, D2), and increased more than 50% (groups E1, E2).

Results

There were no significant differences among groups of stage1 regarding COH and ET outcomes. For stage 2, the more obvious the decrease of LH level, the more the number of oocytes retrieved, mature oocytes, fertilized oocytes, embryos cleavaged and the numbers of embryo available (P < 0.05), but without significant differences regarding ET outcomes. We also found the freeze-all rate in Group A2 was higher (P < 0.001).

Conclusion

LH level changes before GnRH-ant addition were not related to COH and ET outcomes. LH level changes after the addition of GnRH-ant were related to the outcome of COH, and no significant differences were found relating to ET outcomes.
Deep learning-based postoperative visual acuity prediction in idiopathic epiretinal membrane
Authors: Wen Dejia , Yu Zihao , Yang Zhengwei , Zheng Chuanzhen , Ren Xinjun , Shao Yan , Li Xiaorong
Published: August 2023

Background

To develop a deep learning (DL) model based on preoperative optical coherence tomography (OCT) training to automatically predict the 6-month postoperative visual outcomes in patients with idiopathic epiretinal membrane (iERM).

Methods

In this retrospective cohort study, a total of 442 eyes (5304 images in total) were enrolled for the development of the DL and multimodal deep fusion network (MDFN) models. All eyes were randomized into a training dataset with 265 eyes (60.0%), a validation dataset with 89 eyes (20.1%), and an internal testing dataset with the remaining 88 eyes (19.9%). The input variables for prediction consisted of macular OCT images and diverse clinical data. Inception-Resnet-v2 network was utilized to estimate the 6-month postoperative best-corrected visual acuity (BCVA). Concurrently, a regression model was developed using the clinical data and OCT parameters in the training data set for predicting postoperative BCVA. The reliability of the models was subsequently evaluated using the testing dataset.

Results

The prediction DL algorithm exhibited a mean absolute error (MAE) of 0.070 logMAR and root mean square error (RMSE) of 0.11 logMAR in the testing dataset. The DL model demonstrated a robust promising performance with R2 = 0.80, notably superior to R2 = 0.49 of the regression model. The percentages of BCVA prediction errors within ± 0.20 logMAR amounted to 94.32% in the testing dataset.

Conclusions

The OCT-based DL model demonstrated sensitivity and accuracy in predicting postoperative BCVA in iERM patients. This innovative DL model exhibits substantial potential for integration into surgical planning protocols.
Implementing shared decision-making interventions in breast cancer clinical practice: a scoping review
Authors: Oprea Natalia , Ardito Vittoria , Ciani Oriana
Published: August 2023

Background

Shared decision-making (SDM) is a collaborative process whereby patients and clinicians jointly deliberate on the best treatment option that takes into account patients’ preferences and values. In breast cancer care, different treatment options have become available to patients in the last decade. Various interventions, including patient decision aids (PtDAs), have been designed to promote SDM in this disease area. This study aimed at investigating the factors that influence the successful adoption and implementation of SDM interventions in real-world healthcare delivery settings.

Methods

A scoping review of scientific and grey literature was conducted for the period 2006–2021 to analyse the support for SDM interventions and their adoption in breast cancer clinical practice. The interpretation of findings was based on the Practical, Robust Implementation and Sustainability Model (PRISM) for integrating research findings into practice.

Results

Overall, 19 studies were included for data synthesis, with more than 70% published since 2017. The availability of SDM tools does not automatically translate into their actual use in clinical settings. Factors related to users’ co-creation, the clinical team’s attitude and knowledge, organisational support and regulatory provisions facilitate the adoption of SDM interventions. However, overlooking aspects such as the re-organisation of care pathways, patient characteristics, and assigning of resources (human, financial, and facilities) can hinder implementation efforts.

Conclusions

Compared to the mounting evidence on the efficacy of SDM interventions, knowledge to support their sustained implementation in daily care is still limited, albeit results show an increasing interest in strategies that facilitate their uptake in breast cancer care over time. These findings highlight different strategies that can be used to embed SDM interventions in clinical practice. Future work should investigate which approaches are more effective in light of organisational conditions and external factors, including an evaluation of costs and healthcare system settings.
Altered insulin secretion dynamics relate to oxidative stress and inflammasome activation in children with obesity and insulin resistance
Authors: González-Domínguez Álvaro , Belmonte Thalía , Domínguez-Riscart Jesús , Ruiz-Ocaña Pablo , Muela-Zarzuela Inés , Saez-Benito Ana , Montañez-Martínez Raúl , Mateos Rosa M. , Lechuga-Sancho Alfonso M.
Published: August 2023

Background

Insulin resistance (IR) is considered the main driver of obesity related metabolic complications, and is related to oxidative stress and inflammation, which in turn promote each other. There is currently no specific definition of IR in children, rather, that for adult population is used by pediatric endocrinologists instead. Altered insulin secretion dynamics are associated with worse metabolic profiles and type 2 diabetes mellitus development, thus we aimed to test whether insulin response relates to oxidative stress and inflammation in children.

Methods

We conducted a case–control study, including 132 children classified as follows: 33 children without obesity (Lean); 42 with obesity but no IR according to the American Diabetes Association criteria for adults (OBIR-); 25 with obesity and IR and an early insulin response to an oral glucose tolerance test (OGTT) (EP-OBIR +); 32 with obesity, IR, and a late insulin peak (LP-OBIR +); and studied variables associated with lipid and carbohydrate metabolism, oxidative stress, inflammation and inflammasome activation.

Results

The measured parameters of children with obesity, IR, and an early insulin response were similar to those of children with obesity but without IR. It was late responders who presented an impaired antioxidant system and elevated oxidative damage in erythrocytes and plasma, and inflammasome activation at their white blood cells, despite lower classical inflammation markers. Increased uric acid levels seems to be one of the underlying mechanisms for inflammasome activation.

Conclusions

It is insulin response to an OGTT that identifies children with obesity suffering oxidative stress and inflammasome activation more specifically. Uric acid could be mediating this pathological inflammatory response by activating NLRP3 in peripheral blood mononuclear cells.

Graphical Abstract
Dual-screw versus single-screw cephalomedullary nails for intertrochanteric femoral fractures: a systematic review and meta-analysis
Authors: Yang Fan , Li Xiafei , Zhao Lei , Yang Qi
Published: August 2023

Background

Internal fixation with cephalomedullary nails has been widely used in the treatment of intertrochanteric femoral fractures (IFF). Yet, the difference in efficacy and safety between the commonly used integrated dual-screw cephalomedullary nail (InterTAN) and single-screw cephalomedullary nail remains inconclusive. Thus we performed the present systematic review and meta-analysis.

Methods

Randomized controlled trials (RCTs) or observational studies comparing InterTAN with proximal femoral nail anti-rotation (PFNA), the Asian PFNA (PFNA-II), or the Gamma3 nail in treating IFF were searched on PubMed, EMBASE, Web of Science and Cochrane Library from inception to April 30, 2023. The differences in perioperative parameters and clinical and radiological outcomes were evaluated by mean difference (MD) with 95% confidence interval (95%CI). The risks of various complications and mortality were assessed by risk ratio (RR) with 95%CI.

Results

Twenty-three studies comprising 3566 patients were included. Compared with single-screw cephalomedullary nails (PFNA/PFNA-II, Gamma3), InterTAN conferred significantly reduced risk of implant failures (RR = 0.37, 95%CI 0.26 to 0.51, P < 0.001), hip and thigh pain (RR = 0.70, 95%CI 0.55 to 0.90, P = 0.006) and all-cause revision/reoperation (RR = 0.38, 95%CI 0.26 to 0.57, P < 0.001). Moreover, patients treated with InterTAN had significantly higher 1-year Harris Hip Score (MD = 0.82, 95%CI 0.20–1.44, P = 0.010) and shorter time to union/healing (MD = − 0.66 days, 95%CI  − 1.16 to  − 0.16, P = 0.009). Femoral neck shortening, time to full bearing, and incidences of non-union, infection, deep venous thrombosis, and mortality were comparable between both groups.

Conclusions

The integrated dual-screw InterTAN construct has superior performance in reducing risks of complications and improving clinical and functional outcomes in the treatment of IFF. More well-designed, high-quality RCTs are warranted to confirm these findings.
Effects of a remotely supervised physical training program combined with cognitive training for older individuals at increased risk of clinical-functional vulnerability: study protocol for a randomized clinical trial
Authors: Berní Franciele Costa , Kanitz Ana Carolina , Miranda Camila , de Oliveira Dener Budziarek , Bergamin Marco , Bullo Valentina , Schaun Gustavo Zaccaria , Alberton Cristine Lima
Published: August 2023

Background

Despite the robust body of evidence for the benefits of home-based physical exercise, there is still a paucity of data on the benefits of home-based cognitive training for older adults, especially in those at increased risk of clinical-functional vulnerability. As such, the present study aims to compare the chronic effects of a telehealth-delivered physical training intervention alone or combined with a cognitive training program in older adults at increased clinical-functional vulnerability risk.

Methods

A randomized clinical trial will be conducted including 62 sedentary older individuals classified as at increased risk of clinical-functional vulnerability based on their Clinical-Functional Vulnerability Index score. Participants will be randomly allocated in a 1:1 ratio to one of two groups, an intervention group including physical training combined with cognitive training, or an active control group including physical training alone. Both groups will receive home-based supervised training remotely for 12 weeks and will be assessed for the primary and secondary outcomes of the study before and after the training period. Primary outcomes include cognitive function and dynamic balance with a dual task. Secondary outcomes encompass physical, cognitive, and occupational performance, functional capacity, quality of life, and anxiety and depression symptoms, as well as hemodynamic measures. Data analysis will be performed by intention-to-treat and per protocol using mixed linear models and Bonferroni’s post hoc (α = 0.05).

Discussion

Our conceptual hypothesis is that both groups will show improvements in the primary and secondary outcomes. Nevertheless, we expect physical combined with cognitive training to improve cognitive function, dual task, and occupational performance to a greater degree as compared to physical training alone.

Trial registration

NCT05309278. Registered on April 4, 2022.
Antibiotic utilisation and resistance over the first decade of nationally funded antimicrobial stewardship programmes in Singapore acute-care hospitals
Authors: Ng Tat Ming , Ang Li Wei , Heng Shi Thong , Kwa Andrea Lay-Hoon , Wu Jia En , Seah Xue Fen Valerie , Lee Siok Ying , Seah Jonathan , Choo Robin , Lim Poh Lian , Thoon Koh Cheng , Chlebicki Maciej Piotr , Somani Jyoti , Lee Tau Hong , Lye David C.
Published: August 2023

Objective

The aim of this study was to describe the time series of broad-spectrum antibiotic utilisation and incidence of antibiotic-resistant organisms during the implementation of antimicrobial stewardship programmes (ASP) in Singapore.

Methods

An observational study was conducted using data from 2011 to 2020 in seven acute-care public hospitals. We applied joinpoint regressions to investigate changes in antibiotic utilisation rate and incidence density of antibiotic-resistant organisms.

Results

Across the seven hospitals, quarterly broad-spectrum antibiotic utilisation rate remained stable. Half-yearly incidence density of antibiotic-resistant organisms with two joinpoints at first half (H1) of 2012 and second half (H2) of 2014 decreased significantly in the second and third period with a half-yearly percentage change (HPC) of -2.9% and − 0.5%, respectively. Across the five hospitals with complete data, half-yearly broad-spectrum antibiotic utilisation rate with one joinpoint decreased significantly from H1 of 2011 to H2 of 2018 (HPC − 4.0%) and H2 of 2018 to H2 2020 (HPC − 0.5%). Incidence density of antibiotic-resistant organisms decreased significantly in the two joinpoint periods from H1 of 2012 to H2 of 2014 (HPC − 2.7%) and H2 of 2014 to H2 of 2020 (HPC − 1.0%). Ceftriaxone with one joinpoint decreased significantly from H1 of 2011 to H1 of 2014 (HPC − 6.0%) and H1 of 2014 to H2 of 2020 (HPC − 1.8%) and ceftriaxone-resistant E. coli and K. pneumoniae decreased significantly in later periods, from H2 of 2016 to H2 of 2020 (HPC − 2.5%) and H1 of 2012 to H2 of 2015 (HPC − 4.6%) respectively. Anti-pseudomonal antibiotics with one joinpoint decreased significantly from H1 of 2011 to H2 of 2014 (HPC − 4.5%) and H2 of 2014 to H2 of 2020 (HPC − 0.8%) and that of quinolones with one joinpoint at H1 of 2015 decreased significantly in the first period. C. difficile with one joinpoint increased significantly from H1 of 2011 to H1 of 2015 (HPC 3.9%) and decreased significantly from H1 of 2015 to H2 of 2020 (HPC − 4.9%).

Conclusions

In the five hospitals with complete data, decrease in broad-spectrum antibiotic utilisation rate was followed by decrease in incidence density of antibiotic-resistant organisms. ASP should continue to be nationally funded as a key measure to combat antimicrobial resistance in acute care hospitals.
Structural, functional, nutritional composition and analytical profiling of Triticum aestivum L.
Authors: Ammar Mai K. , Hanafi Rasha S. , Choucry Mouchira A. , Handoussa Heba
Published: August 2023

Wheat is considered as the most important cereal grain globally. It has a vast economic importance as it is used in producing bread, pastries, and household flour and serving as food for livestock among other uses. Different biological activities of wheat were correlated with the presence of polyphenols due to their antioxidant activities and other preventative capabilities. Wheat can also be used as an antidiabetic, anti-inflammatory, anticancer, antimicrobial, and antiaging agent. Omics has established itself during the past 20 years as a crucial tool for comprehending the internal systems of various plant systems including wheat using LC–MS, GC–MS, and UV spectrophotometry as analytical techniques. The current review represents in depth search regarding wheat cultivation, botanical description, economic significance, quantitative phytochemical characterization, and biological importance. Additionally, a critical assessment of the cited omics research on wheat was conducted with an emphasis on the analytical instrument, methods of analysis and results interpretation.
Laboratory Investigation on Preplaced Ballast Aggregate Concrete Deterioration over Freezing–Thawing Cycles
Authors: Esmaeili Morteza , Behnajad Sajad , Hossein Esfahani Milad
Published: August 2023

One of the major gaps in previous research on the mechanical behavior of ballasted railway tracks converted into slab tracks using the preplaced aggregate concrete technique is its durability against freezing and thawing cycles. The present study pioneers at investigating the Preplaced Ballast Aggregate Concrete (PBAC) deterioration during freezing–thawing cycles, in which several freeze–thaw tests were carried out to measure the weight loss of PBAC samples during various freezing–thawing cycles, as well as the reduction in both compressive/tensile strengths and the relative dynamic modulus of elasticity. Moreover, the image acquisition of the PBAC samples was performed using a digital microscope and subsequently, an image processing technique was utilized to find a relation between the surface defect area at each imposed cycle and the number of cycles as a lifetime representative. As a result, an equation was developed to predict the defect frequency versus imposed cycles and the defect area generated to find the serviceability lifetime of PBAC in aggressive weather conditions. It was concluded that such PBAC can tolerate 6.16 years in the regions with full freezing–thawing weather conditions.
Assessment of urbanization impact on cultural heritage based on a risk-based cumulative impact assessment method
Authors: Fu Li , Zhang Qingping , Tang Yizhou , Pan Jie , Li Qun
Published: August 2023

Urbanization is inevitable in both developing and developed countries. However, this growth and transformation of the urban area can pose a significant threat to urban cultural heritage, which is a sensitive component of the urban environment. As cities modernize and change, a risk of irreparable loss of cultural heritage exists. Therefore, taking steps to protect and preserve these sites for posterity is crucial. To better protect urban cultural heritage, decision-makers must rapidly assess the impact of urbanization on cultural heritage while maintaining a balance between cultural heritage preservation and urban growth. This study developed a risk-based cumulative impact assessment (CIA) method that integrates a set of quantifiable indicators to address these issues. This method generates standardized assessment results based on game theory and set pair analysis theory. In contrast to other CIA methods, this risk-based approach effectively manages scientific complexity and uncertainties, thus enhancing the quality of the assessment results. This method was applied to 21 classical gardens in Suzhou, China. The results show that Suzhou classical gardens are impacted by urbanization. This study confirmed that adopting a risk-based CIA method that considers the impact of adverse urbanization on cultural heritage sites is an efficient approach. Successful implementation of the proposed method can provide decision-making support for different types of cultural heritage in other areas.
Effect of norepinephrine on the vascular waterfall and tissue perfusion in vasoplegic hypotensive patients: a prospective, observational, applied physiology study in cardiac surgery
Authors: Andrei Stefan , Bar Stéphane , Nguyen Maxime , Bouhemad Bélaid , Guinot Pierre-Grégoire
Published: August 2023

Background

Norepinephrine is a commonly used drug for treating vasoplegic acute circulatory failure in ICU. The prediction of norepinephrine macro- and micro-circulatory response is complicated by its uneven receptors’ distribution between the arterial and the venous structures, and by the presence of a physiological vascular waterfall (VW) that disconnects the arterial and the venous circulation in two pressure systems. The objectives of this study were to describe the VW in patients with arterial hypotension due to vasodilatory circulatory shock, and its behavior according to its response to norepinephrine infusion.

Methods

A prospective, observational, bi-centric study has included adult patients, for whom the physician decided to initiate norepinephrine during the six first hours following admission to the ICU after cardiac surgery, and unresponsive to a fluid challenge. The mean systemic pressure (MSP) and the critical closing pressure (CCP) were measured at inclusion and after norepinephrine infusion.

Results

Thirty patients were included. Norepinephrine increased arterial pressure and total peripheral resistances in all cohort. The cohort was dichotomized as VW responders (patients with a change of VW over the least significant change (≥ 93% increase in VW)), and as VW non-responders. In 19 (63%) of the 30 patients, VW increased from 3.47 [− 14.43;7.71] mmHg to 43.6 [25.8;48.1] mmHg, p < 0.001) with norepinephrine infusion, being classified as VW responders. The VW responders improved cardiac index (from 1.8 (0.6) L min−1 m−2 to 2.2 (0.5) L min−1 m−2, p = 0.002), capillary refill time (from to 4.2 (1.1) s to 3.1 (1) s, p = 0.006), and pCO2 gap (from 9 [7;10] mmHg to 6 [4;8] mmHg, p = 0.04). No baseline parameters were able to predict the VW response to norepinephrine. In comparison, VW non-responders did not significantly change the VW (from 5 [-5;16] mmHg to -2 [-12;15] mmHg, p = 0.17), cardiac index (from 1.6 (0.3) L min−1 m−2 to 1.8 (0.4) L min−1 m−2, p = 0.09) and capillary refill time (from 4.1 (1) s to 3.7 (1.4), p = 0.44).

Conclusions

In post-cardiac surgery patients with vasoplegic arterial hypotension, the vascular waterfall is low. Norepinephrine did not systematically restore the vascular waterfall. Increase of the vascular waterfall was associated with an improvement of laboratory and clinical parameters of tissue perfusion.
Effect of coupling primary sedimentation tank (PST) and microscreen (MS) to remove particulate organic carbon (POC): a study to mitigate energy demand in municipal wastewater treatment plants
Authors: Lasaki Behnam Askari , Maurer Peter , Schönberger Harald
Published: August 2023

Particulate Chemical Oxygen Demand (COD) removal is one of the first and foremost steps in a wastewater treatment plant (WWTP). It is a highly essential step that supports subsequent biological steps to achieve discharge limits. However, the energy demand for subsequent biological steps is significant due to the requirement of physical processes such as aeration. As a part of the project: WWTP of the future, it was expected that by coupling primary sedimentation tank (PST) and microscreen (MS) as advanced primary treatment (APT), around 60 to 70% removal of total COD and more than 90% of total suspended solids could be achieved which can replace such energy-intensive steps. To achieve this, a pilot plant set up including two different types of rotatory drum sieves (8 and 20 μm) was coupled with a PST in the WWTP Büsnau, Stuttgart, Germany, and the efficiency of APT was undergone for deeper investigations. The results showed that applying APT processes is an innovative and robust approach for removing more solids in municipal WWTPs so that retrofitting treatment plants comes true with a marginal footprint. However, the long-term performance of the APT system demonstrated that the system’s ability to remove solids is highly limited by MS capacity and strength of produced flocs/filter-cakes inside the MS against shear forces, which makes it easier for flocs to be detained by MS. Therefore, additional auxiliary steps like flocculation are recommended to be synchronized with APT system to enhance its efficiency. Additionally, applying a middle mesh size sieve, for instance, a 15 μm, along with changing the backwashing regime, could be considered the next alternative.
Predicting missed delirium diagnosis in a tertiary care center: the Consultation-Liaison at the American University of Beirut (CLAUB) analysis
Authors: Bizri Maya , Zalzale Hussein , Khalil Elissa , Kassir Ghida , El Hayek Rawad , El Hayek Samer , Ibrahim Nour
Published: August 2023

Background

Delirium is a very common occurrence in hospital settings and is frequently missed by the primary care team. It remains, however, poorly studied in the Middle East despite abundant global reports. In this study, we aimed to estimate the prevalence of missed delirium diagnosis in a tertiary care center in Lebanon and investigate potential predictors of this missed diagnosis. This was a retrospective study of adult patients admitted to the American University of Beirut Medical Center between March 2019 and December 2019 and assessed by the consultation-liaison psychiatry (CLP) team. The primary endpoint was the rate of missed delirium diagnosis among CLP consultations. Relevant statistical tests were performed to assess the association between the missed diagnosis of delirium and characteristics of patients.

Results

Five hundred fifty-three patients were included with a mean age of 69.19 ± 14.79 years. 86.13% of the patients received a delirium diagnosis by the CLP team that had been missed prior to the CLP referral. A missed delirium diagnosis was more likely to be found in patients with a history of depression (OR = 24, p < 0.01) and a longer hospital stay [in days] (OR = 1.04, p = 0.04).

Conclusion

The alarmingly high prevalence of missed delirium diagnosis is the first evidence of its kind in the Middle East. This urges the implementation of educational interventions to increase the detection of delirium among healthcare providers and ultimately improve patient outcomes.
Sedation in pediatric intensive care unit and its impact on outcomes of ventilated children: a prospective observational study
Authors: Shajan Nidhie , Sharma Monika , Kaur Gurmeet
Published: August 2023

Background

Sedation is an integral part in the management of critical patients in the pediatric intensive care unit (PICU). Optimum sedation is when the child is asleep but easily arousable. The patient should be able to breathe synergistically with the ventilator and should tolerate or be compliant with other therapeutic procedures. Undersedation can make the children hypertensive, tachycardic, and agitated. Conversely, oversedation can cause increased tolerance and prolonged ventilation. Both undersedation and oversedation have negative impacts on patient outcomes such as prolonged mechanical ventilation and ICU stay and increased risk of contracting ventilator-associated pneumonia, thus contributing to significant morbidity and mortality. This study aims to assess sedation levels in ventilated children using RASS in the first 48hrs of ventilation and study their correlation with patient outcomes.

Results

Of the 111 children enrolled in the study, 2 were excluded because the sedation was discontinued before 48 h, and 9 were excluded because they were ventilated for more than 7 days. Majority of the children receiving ventilation in PICU were oversedated (40%). Adequately sedated children were observed to have significantly lesser duration of mechanical ventilation (p-value: 0.022) and PICU stay (p-value: 0.01). Undersedated children were noted to have significantly higher incidence of self extubation (p-value: < 0.001), reintubation (p-value: < 0.001), and higher requirement of restraints (p-value: < 0.001). Oversedated had a higher incidence of VAP and mortality (p-value: < 0.001).

Conclusion

The findings of this study highlight the importance of achieving adequate sedation in PICU which is associated with better outcomes with respect to duration of ventilation, PICU stay, hospital stay, and mortality. This study also reflects the impact of absence of sedation protocols and emphasizes the need for monitoring of sedation and having protocols to guide clinical practice in order to improve patient outcome.
Phytocompounds, antioxidant potential, and inhibitory actions of ethanolic leaf fraction of Sida linifolia Linn. (Malvaceae) on enzymes linked to inflammation, diabetes, and neurological disorders
Authors: Ezeako Emmanuel Chimeh , Nworah Florence Nkechi , Osuji Dionysius Obinna
Published: August 2023

Background

Sida linifolia L. is a weed ubiquitously found in Africa with several folkloric applications. Traditional healers in the Southeastern part of Nigeria employ the alcoholic concoction of S. linifolia leaves as antidepressants, anti-malaria, antihypertensive, anti-abortifacients, and for managing painful whitlow; however, these claims lack scientific validation. The present study was aimed to explore the phytochemical profile of the plant, S. linifolia with special emphasis to its antioxidant and inhibitory actions on enzymes linked to inflammation, diabetes, and neurological disorders. Phytochemical profiling and in vitro antioxidant and enzyme inhibition assays were employed to assess the pharmacological profile of S. linifolia ethanolic leaf fraction (SLELF).

Results

Preliminary phytochemical screening of SLELF revealed appreciable amounts of total phenolics (91.64 ± 7.61 mg GAE/g), total tannins (62.44 ± 3.86 mg TAE/g), and total flavonoids (27.35 ± 1.48 mg QE/g) present in SLELF. Results of HPLC analysis of SLELF revealed rich composition in bioactive compounds such as ellagic acid, quercetin, ferulic acid, 3,4-dimethoxy benzoic acid, gallic acid, 4-methoxy cinnamic acid, sinapic acid, vanillic acid, and chlorogenic acid. Enzymatic antioxidants (catalase and superoxide dismutase), non-enzymatic antioxidants (reduced glutathione (GSH), Vit A, C, and E), elemental minerals (Cu, Mn, Zn, Cr, Fe, and Ca), and γ-aminobutyric acid (GABA) were present in SLELF in appreciable levels. At various concentrations (0.2–1.0 mg/ml), SLELF exhibited potent and concentration-dependent hydrogen peroxide (H2O2) and 2,2′-azinobis-(3-ethylbenzothiazoline-6-sulfonic) acid (ABTS) radical scavenging activities and exerted moderate inhibitory actions on enzymes associated with inflammation (cyclooxogenase-2 (COX-2) and lipoxygenases (LOXs), diabetes (α-amylase, α-glucosidase), and neurological disorders (butyrylcholinesterase (BChE) and γ-aminobutyric acid transaminase (GABA-T), compared to respective standards (ascorbic acid, acarbose, indomethacin, galanthamine, and vigabatrin). Perhaps, the observed potent pharmacological activities of SLELF could be anchored to its phytoconstituents. Furthermore, the slightly higher ranges of IC50 values (0.57–0.87 mg/ml) of SLELF compared to standards (0.44–0.68 mg/ml) suggest moderation in enzyme inhibition that may preclude adverse side effects.

Conclusion

This study lends credence to the folklore claims of S. linifolia leaves and revealed its potential as possible source of bioactive compounds for medicinal and pharmaceutical exploration.
The Essential Network (TEN): engagement and mental health insights from a digital mental health assessment tool for Australian health professionals during COVID-19
Authors: Coleshill M. J. , Alagirisamy D. , Patki S. , Ronksley M. , Black M. J. , Yu S. , Phillips M. , Newby J. M. , Cockayne N. , Tennant J. , Harvey S. B. , Christensen H. , Baldwin P. A.
Published: August 2023

Background

Health professionals are at risk of poor mental health outcomes due to the COVID-19 pandemic. The Essential Network (TEN) is a blended care mental health support service for Australian health professionals, funded by the Australian Federal Department of Health. TEN comprises both digital and face-to-face components. We examined completed digital mental health assessments (Digital Mental Health Check-Up) to understand usage of TEN and the demographics and mental health of users.

Methods

A total of 9889 completed assessments from a community sample of help-seeking health professionals who engaged with the Digital Mental Health Check-Up between May 2020 and December 2021 were examined. Users had the option to complete the Distress Questionnaire (DQ-5), Patient Health Questionnaire (PHQ-9), Generalised Anxiety Disorder (GAD-7), Oldenburg Burnout Inventory (OLBI-16), Work and Social Adjustment Scale (WSAS), Post-traumatic Stress Disorder Checklist (PCL-5), as well as provide demographic information on their gender, age, and profession.

Results

Users were mostly women (85.7%) aged between 25 and 54 (73.7%). Nursing was the most reported profession (32.6%), followed by allied health (27.5%) and doctors (21.9%). Notably, 8.1% of users reported being in medical administration roles. Mental health measures were poor across all measures and professions and worse than would be expected from the general population. Disengagement (92.5%) from burnout and impaired social and occupational functioning (75%) were also notably high. Use of the DQ-5 as a screening tool in the Digital Mental Health Check-Up was confirmed through correlation with clinically significance scoring on all other measures and increased likelihood of opting to complete other optional measures following clinically significant scoring on the DQ-5.

Conclusions

The present study indicates good usage of the TEN digital components among Australian health professionals, with use across all professional categories. While self-selection bias is inherent in the sample, mental health measures were notably poor – particularly for burnout. Such findings highlight the continued need to provide mental health support to health professionals both during and after the eventual resolution of the COVID-19 pandemic, as well as to develop better support for health professionals experiencing burnout.
Making Islam (Coherent): Academic Discourse and the Politics of Language
Authors: Rafii Raha
Published: August 2023

Despite the Islamophobic insistence on “Islam” as an alien and hermetically sealed phenomenon in popular and political Anglophone cultures, the field of Islamic and Near Eastern studies—historically subsumed under Oriental studies—has long been studied alongside a multiplicity of pre-Islamic Southwest Asian cultures. Yet the European Orientalist tradition still needed to create a “coherence” out of Islamic history in order to place it within a hierarchy of so-called civilizations. This essay discusses the issues regarding the Orientalist legacy of the terms Middle Ages and medieval in academic Islamic discourse, and how such usage, made to “familiarize” non-European cultures to Anglophone, non-Muslim audiences, served to reinforce Orientalist notions of lack of progress and backwardness in Muslim-majority societies.
Molecular markers of VEGF, TNF-α and TNF-β IN bladder cancer patients at stage T3N0M0 and their relationship with the degree of tumor neoplasia
Authors: Fedevych O. , Fedevych V. , Pasichnyk S.
Published: August 2023

17 bladder cancer patients, stage T3N0M0 (main group), were included in the study. There were 10 men (mean age 58.2 ± 6.2 years) and 7 women (mean age 59.5 ± 2.4 years). Clinical data of 12 healthy individuals were used as a control. According to statistic data, the average level of VEGF in bladder cancer patients urine was 246.55± 6.90 pg/ml which significantly exceeded this indicator in the control group (129.21± 7.60 pg/ml), the difference was statistically significant At bladder cancer diagnosis the sensitivity and specificity of the urinary level of TNF-α was low and amounted to 30% and 20%, respectively, and the level of TNF-β was even lower - 25% and 20%, respectively, which is not representative for the pathology under study.
Dynamic changes of striatal neurotransmitter systems activity cause changes in behavioral non-convulsive disorders of depressive nature in the course of chronic seizure activity formation in kindling model of epileptogenesis
Authors: Ostapenko I.
Published: August 2023

Epilepsy is a chronic neurological disease characterized by recurrent behavioral seizures and affects approximately 1% of the global population. Epilepsy causes recurrent behavioral seizures, which are temporary behavioral changes caused by disordered, synchronized, and rhythmic activations of specific populations of neurons in the brain. Depressive disorders are one of the most common comorbid behavioral disorders in patients with epilepsy, yet they remain undiagnosed and untreated. The aim of the study is to investigate the severity of non-convulsive swimming and emotional behavior and mnemonic processes in rats with a kindling model of epilepsy under conditions of modulation of neurotransmitter systems of the caudate nuclei. It was found that in the dynamics of picrotoxin-induced kindling in rats, impaired swimming behavior, learning and memory abilities, as well as emotional dysfunctions, which are correlates of non-convulsive behavior, are recorded. It has been proven that the detected disorders of non-convulsive behaviors progressed in the dynamics of the formation of the kindling model of epilepsy and were maximal at the stages of completed kindling and postkindling. The obtained data demonstrate the key role of the striatum in the formation of non-convulsive behavioral disorders. On the 18th day, the pro-convulsive role of striatum is noted, which is confirmed by the enhancement of GABAergic and inhibition of dopaminergic neurotransmission of striatum along with the inhibition of its cholinergic mediation. The completion of the formation of kindling is confirmed by the enhancement of cholinergic and dopaminergic neurotransmission of striatum along with the inhibition of GABAergic mechanisms. In the postkindling stage, activation of cholinergic and dopaminergic neurotransmission of striatum and inhibition of its GABAergic activity are observed. The author considers the data obtained to be an experimental basis for the feasibility of testing clinical diagnostic effects in terms of dynamic monitoring of the behavior of patients with epilepsy during interictal periods, as well as possible corrective pharmacological effects in the case of modulation of the activity of certain neurotransmitter systems and intrastriatal neurotransmission.
Cognitive function restoration in rats with chronic brain ischemia using Semax and hopantenic acid comprehensive administration
Authors: Kirchev V.
Published: August 2023

The relevance and importance of treating patients with ischemic brain lesions are indisputable. Chronic ischemic processes in the brain occur much more frequently than acute cerebral circulation disorders, leading to prolonged disability and being the main contributors to a significant number of strokes. Cognitive dysfunctions prevail in the dynamics of the post-ischemic period and are often the primary determinants of the severity of residual organic and subsequent functional impairments of the brain. The aim of the study is to investigate the effectiveness of separate and combined administration of Semax and hopantenic acid in the pharmacological correction of cognitive disorders in rats with experimental chronic brain ischemia. It has been established that rats with chronic brain ischemia exhibit cognitive impairments from the 1st day, manifested in worsened learning processes, short-term and long-term memory functioning in the context of conditioned active avoidance and conditioned feeding reflexes. It has been shown that separate and combined application of Semax and hopantenic acid contributes to the restoration of the learning process and improvement of mnestic functions in rats with chronic brain ischemia. The most pronounced nootropic effect in rats with chronic brain ischemia was registered under the conditions of combined administration of Semax and hopantenic acid, starting from the 3rd day of the study. Subsequently, in terms of anti-ischemic efficacy, the effect of Semax follows, which was realized starting from the 3rd day of the study. The least pronounced neuroprotective effect belongs to hopantenic acid, starting from the 7th day of the study. The author considers the obtained data as experimental groundwork for the feasibility of clinically testing the nootropic effects of the combined administration of Semax and hopantenic acid in cases of chronic brain ischemia. The comprehensive pharmacological correction of cognitive disorders in chronic brain ischemia is pathogenetically justified and aimed at activating sanogenetic mechanisms.
Leucodystrophies at children
Authors: Sielwanowska Wiktoria , Syzdoł Bartłomiej , Rzewuska Anna , Żybowska Monika , Chrościńska-Krawczyk Magdalena
Published: August 2023

Introduction  
Leukodystrophies involve a diverse group of rare hereditary disorders mostly affecting the white matter of the central nervous system, which straddleses nerves and glial cells. Unfortunately, these conditions are often undervalued by doctors from various specialties. The aim of the article was to present the most common leukodystrophies occurring in children 
Material and methods 
A review of the most common leukodystrophies based on the available literature. We conducted a systematic literature review. We searched the PubMed and Google Scholar databases from 1997 to 2023. 
Conclusions 
Leukodystrophies are rare genetic diseases that often present with non-specific symptoms, which can pose diagnostic challenges. Ocular abnormalities and psychomotor delay in the early stages of life should raise suspicion. A combination of symptoms may suggest a pyramidal-extrapyramidal form of cerebral palsy. Therefore, it is crucial to include a head MRI examination in the diagnostic workup and carefully evaluate the findings, as subtle imaging changes can indicate the presence of leukodystrophies. Currently, no causal treatment for leukodystrophies has been developed. Hence, further research is needed to enable the introduction of gene therapies.
Knowledge about Cognitive Behavioral Therapy for Insomnia (CBTI) as the most effective treatment for insomnia
Authors: Rosa Lidia , Kister Klaudia , Laskowski Jakub , Szabrańska Anna , Bronst Paulina , Czechowska Julia , Zach-Źródlak Monika , Małolepsza Aleksandra , Rektor Natalia , Mazur Magdalena
Published: August 2023

Introduction: Insomnia is becoming increasingly prevalent in society. According to research, cognitive behavioral therapy for insomnia (CBTI) is the most effective and safest treatment for insomnia, now also available in digital form (dCBTI). It is recommended as the gold standard for insomnia treatment by the European Standards of Insomnia Treatment and the Polish Society for Sleep Research.
Aim of study: This study aimed to assess the knowledge in society regarding effective methods for treating insomnia.
Materials and methods: The study was conducted using a proprietary online questionnaire. The survey consisted of 12 multiple-choice questions and 1 single-choice question. The study took place in the Łódź Voivodeship from May to June 2023. A total of 114 participants took part in the study. The participants were adults, informed consent was obtained from all individuals participating in the study.
Results: 78,9% of the participants experienced sleep problems. 54,4% of the participants identified CBTI as the most effective method for treating insomnia, but only 16,7% knew to what extent it was effective. 28.1% had knowledge of the approximate duration of CBTI. Only 28.1% of the respondents were aware of the existence of applications based on CBTI principles (dCBTI). 14% of the respondents correctly answered the question regarding the method of sleep restriction in CBTI.
Conclusions: 1. Difficulties falling asleep, middle-of-the-night awakenings, and poor sleep quality are widespread problems in society. 2. Chronic insomnia leads to numerous health and psychological consequences. 3. Knowledge about factors that perpetuate insomnia, such as daytime napping or extending time spent in bed, is low. 4. Awareness-raising actions about CBTI and dCBTI are necessary for both patients and healthcare professionals.
Analysis and assessment of the knowledge regarding to exploitation of electrical installations, risks and due to electric shock
Authors: Rektor Natalia , Bronst Paulina , Szabrańska Anna , Mazur Magdalena , Małolepsza Aleksandra , Zach-Źródlak Monika , Rosa Lidia , Czechowska Julia , Laskowski Jakub , Kister Klaudia
Published: August 2023

INTRODUCTION
This study presents the dangers due caused by electric shock and how they affect the human body. This is an important issue, because each of the recipients of this study is a user of electrical installations and the number of devices that may carry an unwanted threat is constantly increasing in every household. 
AIM OF STUDY
The main purpose of the study is to analyze the knowledge of studied population about low-voltage electrical installations in the places of their residence, as well as the danger and consequences of electrical shock.
MATERIALS AND METHODS
In order to verify the level of awareness of household electrical installations users, a survey was conducted, in which participants were given the opportunity to answer questions forming three main research problems.
CONCLUSION
A significant part of the collected results leads to the conclusion that, on average, every second person surveyed has significant shortcomings in basic training in the safe use of electrical installations, as well as its operation and, most importantly, in providing first aid to victims. A relatively large number of respondents are not aware of the need to perform maintenance work, technical inspections and basic activities ensuring safety for them and other household members. Introduction of mandatory prevention and cyclical training, e. g. during periodic building inspections, could be one of the steps to reduce the still high rate of fatal accidents due to electric shock in Poland.