bluuebunny/crossref_metadata_2025 huggingface dataset:
Hereditary dehydrated stomatocytosis with new missense mutations in PIEZO1 through the use of next-generation sequencing panel
Authors: Koker Sultan Aydin , Karapınar Tuba , Bianchi Paola , Oymak Yesim , Fermo Elisa , Vergin Canan
Published: January 2024

Dehydrated hereditary stomatocytosis (DHS) is characterized by
alterations of ionic flux with increased cation permeability. Although
the clinical presentation of DHS is commonly variable, all of them
present hemolysis and anemia, which may range from mild to severe. Like
all hemolytic anemias, jaundice, pallor, fatigue, splenomegaly, and
gallstones are the key signs. The causative genes have been identified
on ABCG5, ABCG8, PIEZO1, SLC2A1, ABCB6, KCNN4, and RHAG. In this case
study, we report an 11-year-old male patient who had jaundice,
hepatosplenomegaly, and chronic mild congenital non-autoimmune hemolytic
anemia. In our patient, a novel homozygous missense mutation in the
PIEZO1 gene was detected using a gene-targeted Next-Generation
Sequencing panel: c.3364G>A (p.Glu1122Lys), confirming the
diagnosis of hereditary dehydrated stomatocytosis. The reason we want to
report this case is the detection of a new mutation due to hereditary
stomatocytosis, which is a rare disease. Also, due to the limited number
of research centers in developing countries and lack of financial
resources, it is late to be diagnosed with rare diseases.
Successful spermatogonial stem cells transplantation within Pleuronectiformes: first breakthrough at inter-family level in marine fish
Authors: Zhou Li , Wang Xueying , Liu Qinghua , Yang Jingkun , Xu Shihong , Wu Zhihao , Wang Yanfeng , You Feng , Song Zongcheng , Li Jun
Published: January 2024

As a promising biotechnology, fish germ cell transplantation shows
potentials in conservation germplasm resource, propagation of elite
species, and generation of transgenic individuals. In this study, we
successfully transplanted the Japanese flounder (P. olivaceus), summer
flounder (P. dentatus), and turbot (S. maximus) spermatogonia into
triploid Japanese flounder larvae, and achieved high transplantation
efficiency of 100%, 75-95% and 33-50% by fluorescence tracking and
molecular analysis, respectively. Eventually, donor-derived spermatozoa
produced offspring by artificial insemination. We only found male and
intersex chimeras in inter-family transplantations, while male and
female chimeras in both intra-species and intra-genus transplantations.
Moreover, the intersex chimeras could mature and produce turbot
functional spermatozoa. We firstly realized inter-family transplantation
in marine fish species. These results demonstrated successful
spermatogonial stem cells transplantation within Pleuronectiformes,
suggesting the germ cells migration, incorporation and maturation within
order were conserved across a wide range of teleost species.
On Various Types of Cone Metric Spaces and Some Applications in Fixed Point Theory
Authors: Bakr Sahar Mohamed Ali Abou
Published: January 2024

This paper gives a study of various types of cone metric spaces and its
topological characterizations, and considers some generalized
contraction type of mappings on θ-complete cone metric like spaces, then
generalizes some previous coupled fixed point theorems in this setting.
Higher than recommended lesion size index target values for pulmonary vein isolation result in better clinical outcomes in paroxysmal atrial fibrillation patients- a single center experience
Authors: Katić Josip , Anic Ante , Breskovic Toni , Jurisic Zrinka
Published: January 2024

Introduction: Catheter ablation is a cornerstone of the therapy for the
paroxysmal atrial fibrillation. The importance of effective lesion size
formation during pulmonary vein isolation is gauged through conduction
recovery and recurrence of arrhythmia. Therefore, lesion size index
(LSI) It is designed to utilize traditional intraprocedural parameters
and predict the procedural success. The impact of the optimal LSI index
and the respective segments of the pulmonary veins has not been commonly
evaluated. We aimed to assess whether higher and targeted LSI on the
different segments of pulmonary veins could actually leads to better
clinical outcomes of paroxysmal atrial fibrillation ablation. Methods:
Retrospective analyses of drug-refractory paroxysmal atrial fibrillation
patients who underwent first catheter ablation were conducted. Targeted
LSI of 6.5 at the anterior wall and 5.2 at the posterior wall, roof and
floor of pulmonary vein was applied. The primary endpoint was defined as
arrhythmias recurrence assessed by routine electrocardiograms and 24
hours ambulatory electrocardiographic monitoring at 3, 6, and 12 months
postablation. Results: Among the included 39 patients, the
single-procedure 12-months freedom from arrhythmias was reached in
92.3% patients. Interestingly, there was no tendency towards a
increased number of adverse effects using higher LSI index. Conclusion:
Atrial fibrillation ablation guided by targeted LSI value showed
efficiency on the freedom from arrhythmias during 1-year follow up
period without harmful effects.
Caveolin-3: a molecular insight into diseases of the heart
Authors: He Miaomiao , Qiu Jie , Wang Yan , Bai Yang , Chen Guangzhi
Published: January 2024

Caveolin-3 is protein on the membrane of cardiac myocytes correlated
with a variety of cardiovascular diseases. The functional significance
of the Cav-3 has been proved by the fact that Cav-3 overexpression or
knockdown results in the occurrence and development of cardiovascular
disease. Mutations in the gene encoding Cav-3 cause a broad spectrum of
clinical phenotypes, ranging from isolated hyperCKemia to most
cardiomyopathy and the effect of cav-3 mutations on current density
parallels the effect on channel trafficking. Mutations in the Cav-3
gene, such as F97C and S141R, promote ventricular arrhythmogenesis in
LQT9 by combined decrease in loss of IK1 and gain of Ina-L. Major
changes in the T-tubule system by Cav-3 mutation, which contribute to
the regulation of Ca2+ channels, result Cardiac hypertrophy.
Furthermore, Cav-3 knockdown (KO) could induce apoptosis initiated by
myocardial ischemia/reperfusion injury and many materials, such as
volatile anesthetic gas, facilitate cardioprotection by involving
AMP-activated protein kinase (AMPK) and cav-3 dependent cyclooxygenase-2
inhibition. This review highlights the overviews that the roles of Cav-3
play in cardiovascular disease, particularly on the arrhythmias and
cardiomyopathy.
Analysis of miRNAs in Rheumatoid arthritis: Correlation with Disease Activity
Authors: Abo-El-Atta Amira , elakhras basima , Bassyouni Iman , talaat Roba
Published: January 2024

Rheumatoid arthritis (RA) is a chronic, severe inflammatory disease,
characterized by progressive bone, cartilage, and joint
destruction.miRNAs are epigenetic regulatory mechanisms that
participated in broad and long-term changes in gene expression and
involved in various pathophysiological pathways related to several
autoimmune diseases such as RA. The regulated expression of miRNAs in
synovia, T cells, or Peripheral blood mononuclear cells (PBMCs) from RA
patients is associated with inflammation, angiogenesis,
osteoclastogenesis, innate immunity, and cartilage synthesis. This work
is designed to analyze the expression of certain miRNAs in PBMCs of 30
RA patients compared to 20 healthy controls using quantitative real-time
polymerase chain reaction (qRT-PCR). Selected miRNAs were categorized
into 3 main groups: miRNA participating in the inflammatory response
(miR-16, miR-146a, and miR-155), miRNA participating in the angiogenesis
process (miR-17 - miR-221 and miR-222) and muscle-specific myomiR
(miR-133b and miR-206). The data showed significant elevation in the
fold change expression levels of all studied miRNAs in PBMCs of RA
patients as compared with those in healthy controls. The receiver
operator characteristic curve (ROC) curve analysis of miR-206 showed the
best sensitivity and specificity value among studied miRNAs (70%
sensitivity and 85% specificity). Our results suggest that the elevated
expression of tested miRNAs might be involved in RA pathology including
inflammation, angiogenesis, and bone affection leading to joint
destruction and bone deformity. A better understanding of the role of
these miRNAs will enable a new advanced strategy to ameliorate disease
progression in RA.
Effect of Angiotensin-(1-7) on nAChR and mGluR1 in Amygdala and Hippocampus and 8-arm Maze Performance of Rats in Aβ40-Induced Memory Impairment model
Authors: Erolan Asli , Altunay Zeynep , Doğan Muhammed , HATIP Funda BÖLÜKBAŞI , Hatip-Al-Khatib Izzettin
Published: January 2024

Background and Purpose Alzheimer’s disease (AD) is characterized by
deposition of Amyloid-β-peptide (Aβ) plaques, memory impairment and
dysfunction of renin-angiotensin system: the regulator arm is decreased
whereas the classic Ang-II/III arm is elevated. This study aimed to
investigate effect of Ang-(-7) on Aβ40-impaired memory and change of
nAChR and mGluR1 sub units in amygdala(AMG) and hippocampus (HC).
Experimental Approach In this study, AD model was induced by bilateral
intra-amygdaloid injection of 3 nmol/3 µL amyloid beta peptide (Aβ40).
Angiotensin (Ang)-(1-7) was injected ICV at 11.1 nmol/0.25 µL/h for 7
days. Memory was evaluated by measuring latency, correct (CC) and error
choice (EC) in 8-arm radial maze (RAM) test. The expression of α7, α4
and β2 subunits of the nicotinic receptor (nAChR) and the metabotropic
glutamate receptors (mGluR1) group subunits (mGluR1 and mGluR5) in AMG)
and HC were analyzed by Western-blotting method. Key Results Aβ40 and
Ang-(1-7) displayed differential effects on nAChR, mGluR1 and mGluR5 and
RAM. Aβ40 decreased CC, increased EC and prolonged the latency.
Ang-(1-7) only decreased Aβ40-induced EC. In AMG, Aβ40 decreased α7,
α4nAChR and mGluR5, but increased mGluR1. Ang-(1-7) decreased α7nAChR
and mGluR5, but increased mGluR1, an effect increased by Aβ40. In HC,
only Ang-(1-7) increased β2 nAChR, an effect decreased by Aβ40.
Conclusion and Implications Aβ40 impaired RAM performance and decreased
nAChR and mGluR5 especially in AMG but increased mGluR1 in both AMG and
HC. Ang-(1-7) improved Aβ40-induced EC, increased β2 nAChR in HC,
reversed the Aβ40-reduced α4 nAChR, and furthered Aβ40-increased mGluR1
in AMG.
The use of platelet rich plasma (PRP) as a novel nonsurgical treatment of the female stress urinary incontinence: a prospective pilot study.
Authors: Athanasiou Stavros , KALANTZIS CHRISTOS , Zacharakis Dimitris , Kathopoulis Nikolaos , Pontikaki Artemis , Grigoriadis Themistoklis
Published: January 2024

Objective: To evaluate efficacy and safety of platelet rich plasma (PRP)
for stress urinary incontinence (SUI) treatment. Design: Prospective
observational pilot study. Setting: Tertiary referral urogynecology unit
in Greece. Sample: Adult women with urodynamically confirmed SUI.
Methods: Twenty women met the inclusion criteria and attended
follow-ups. All participants underwent 2 PRP injections into the lower
one-third of the anterior vaginal wall at 4-6 week intervals. At
baseline they underwent urodynamic studies, a 1-hr pad test and
completed the ICIQ-FLUTS and KHQ questionnaires. At follow up visits
(1,3 and 6 months) patients underwent the 1hr-pad test and completed the
KHQ, ICIQ-FLUTS and PGI-I. Primary outcome was to evaluate
post-treatment SUI. Secondary outcomes included assessment of patient
reported questionnaires, assessment of urine loss (1hr-pad test) and the
level of discomfort during injections (VAS score). Statistical analysis
was performed before PRP and 1,3 and 6 months after the last treatment.
Results: A significant improvement of SUI symptoms was observed 3 months
after treatment with a further improvement at 6 months. A mean reduction
of 50.2% of urine loss was observed in the 1hr-pad test. At 6-month
follow-up 80.0% of women reported to be at least improved. No adverse
effects were observed. Conclusions: PRP injections were both effective
and safe in the short term and could be offered as an alternative
outpatient procedure for the treatment of SUI. However, these
encouraging findings warrant further investigation with randomized
controlled trials. Funding: No funding to declare. Keywords: PRP; Stress
urinary incontinence; Minimally invasive treatment, Female Incontinec
Application of Caputo factional derivative in nonlinear programming problems
Authors: Behera P , Pattnaik A , Padhan S.
Published: January 2024

Convexity with respect to Caputo factional derivative is introduced and
applied in general nonlinear programming problems. The KKT conditions
are developed and proved the sufficient optimality conditions. Several
consequences of the new findings are discussed. Many counterexamples are
presented to justify the present investigation.
Bioprosthesis in aortic valve replacement. Long-term inflammatory response and functionality.
Authors: Saucedo-Orozco Huitzilihuitl , Vargas-Barron Jesus , Márquez-Velasco Ricardo , Martinez-Zavala Karla Susana , Jimenez-Rojas Valentin , Críales-Vera Sergio Andres , Arias-Godinez José Antonio , Guarner-Lans Veronica , Perez-Torres Israel , Melendez-Ramirez Gabriela , Sanchez-Perez Efrain , Soto Maria Elena
Published: January 2024

Abstract Background. The evaluation of long-term inflammatory response
and function in postoperative patients with aortic valve replacement
(AVR) deserves special analysis because it is important to try to
prevent reoperation and improve durability and functionality of the
prostheses. Methods In this study we included a cohort of patients with
aortic valve damage treated by AVR with mechanical prosthesis,
bioprosthesis and we included a control group. Results. We found that
IL-4 and OPN levels were higher in patients with mechanical vs.
biological prostheses (p = 0.01 and p = 0.04 respectively), OPG levels
were decreased (p = 0.01), women had lower levels of ET-1 and IL-6, (p =
0.02) (p = 0.04) respectively. Patients older than 60 years had
decreased levels of IL-1ß p <0.001) and a higher concentration
of IL-4 p < 0.05). IL-1ß, OPG and TNFα were higher in patients
with less than 5 years of evolution versus more than 10 years (p =
0.004, p = 0.02 and p = 0.03 respectively). Factors such as age, gender,
prosthetic, and elevated IL-1B and ET-1 levels are associated with valve
dysfunction prosthetic. These results indicate that the inflammatory
involvement present prior to valve replacement may be perpetuated by
various factors in the long term. Conclusions The findings provide us
with the opportunity to effectively treat patients with AVR in the
postoperative period, which could prolong the functionality of the
bioprostheses.
Factorizations of idempotent operator as products of two idempotents
Authors: Luo Wei
Published: January 2024

For two commutative idempotents Π1 and Π2, Π1+Π2−Π1Π2 is clearly
idempotent. By studying the characterisation of two idempotents
generated from factorizations of idempotent operator, we give a
necessary and sufficient condition for when there is no another
idempotent operator Π3 which has the same range with Π1Π2 such that Π1+
Π2− Π3is idempotent
Formation of Heterosteroid Type Skeletons: Mechanistic Elucidation of the Diels-Alder/(3 + 2) Cycloadditions in the Design and Synthesis of Novel Azasteroids
Authors: Donkor Benedicta , Opoku Ernest
Published: January 2024

The potential of azasteroids as novel drug candidates has prompted
numerous studies towards the syntheses of heterosteroidal skeletons.
Preparation of novel azasteroidal compounds and the modification of
substituents on their steroidal skeletons might provide excellent
congeners with useful biological properties. We present herein, a
computational investigations on the Diels-Alder/(3 + 2) tandem
sequential cycloaddition reaction of 21 distinctive derivatives of
furylcinnamate with phenyl azides. First, we performed the computational
study on the originally reported reaction of ester-substituted
furylcinnamate derivatives 1a and 1b with phenyl azide (3) under the
experimental conditions. We extended the scope of this tandem
cycloaddition reactions by studying several variants of 1a, 1b and 1c
and their reactivity towards 3. In all instances of tandem reactions
considered in this study, the Diels-Alder cycloaddition step is the rate
determining step (rds). Electron withdrawing-substituted 1a, 1b, and 1c
decreases the rds whiles electron donating substituents substantially
increase the rds. The parent reaction (1a) selectively proceeds via
transition states T5Exa to give tandem adduct 5Exa, the experimentally
observed tandem product. In the case of 1b and 1c, the reaction is
competitively favored via T4Ex and T5Ex to give corresponding 4Ex and
5Ex (the experimentally observed tandem adducts). The various
substituents studied demonstrate that the tandem adduct obtained is
highly dependent on the substituents on the Diels-Alder intermediate.
Whereas electron withdrawing groups substantially decrease the rds, the
direct opposite is true for electron donating groups. A plot of
electrophilicity indices and chemical hardness against activation
energies gives a good correlation.
EVALUATION OF HEALTH LITERACY, BEHAVIORAL AND PSYCHOSOCIAL CHARACTERISTICS IN CORONARY ARTERY PATIENTS: A HOSPITAL BASED STUDY IN TURKEY
Authors: AHCIOGLU Asuman , YILMAZEL GÜLAY
Published: January 2024

Background: This study was aimed to investigate evaluation of health
literacy, behavioural and psychosocial characteristics in coronary
artery patients. Methods: This study was carried out between March 2019
and March 2020 with 275 coronary artery patients aged ≥50 years in
Kastamonu State Hospital. Clinical, behavioural characteristics, Turkish
Health Literacy Scale-32 and Beck Depression Inventory were used to
collect the data. Results: General health literacy index score was 31.7
and the prevalence of limited health literacy was 59.3%. Depressive
symptom was found to be 33.4% in moderate/severe level. Limited health
literacy was 58.3% among ≥65 years old, while it was 41.7% in the
50-64 age group (p<0.05). Adequate health literacy was 62.5%
in males and 37.5% in females (p<0.05). Adequate health
literacy was 2.8 fold higher among 50-64 age group, 3.1 fold higher
among men, 3.4 fold higher among married and 5.3 fold higher among those
who believe in the necessity of individual protective practices have
more adequate health literacy levels (p<0.05). Health
check-up, utilizing health service, cigarette and alcohol use, exercise
and nutrition were the significant behavioural factors for health
literacy levels (p<0.05). Mild level of depressive symptoms
was more common among limited health literate patients. Conclusion:
Health literacy was poor among coronary artery patients and behavioural
and psychosocial variables were differed with health literacy levels. In
order to develop cardiovascular health among these patients, health
literacy-based interventions should be adopted to in coronary artery
clinics especially for risky groups. Keywords: Coronary disease,
coronary artery disease, health literacy, risk factors, life style,
depression, patients
Gender differences in Medical Students experience of Obstetrics and Gynaecology clinical education, in countries where Islam is the state religion compared to ‘Westernised’ countries: A systematic review.
Authors: Wahid Rachael , Woodman Jacqueline , Hooper Robert
Published: January 2024

Competence in intimate examinations is expected of all graduating
doctors, regardless of gender. These examinations are challenging to
teach and learn, with medico-legal and ethical issues surrounding
patient consent. Religion, culture, and societal expectations may also
impact this. Objectives: to determine if male medical students in
countries where Islam is the state religion are disadvantaged during
their O&G clinical education. A systematic literature review was
performed by searching ‘MEDLIINE’, ‘Web of science’, and ‘Science
Direct’. References were manually searched. Studies relating to gender
differences in undergraduate O&G clinical education were included.
Studies outside of the years 2000-2020 were excluded. Data was extracted
and critically appraised. A narrative synthesis method was employed.
Nine out of ten studies reported that female students performed more
vaginal exams than males during their O&G placement – four studies
reported statistical significance, with three being from countries where
Islam is the state religion. Five studies reported that females
performed more speculum examinations. Six studies reported significance
in the number of males who had experienced declined consent to perform
intimate examinations. The paper from Malaysia reported a figure higher
(93.3%) than any from ‘Westernised’ countries. Four studies reported
significance regarding the perception of gender bias from male students.
Gender bias is present in O&G undergraduate clinical education. In
addition to lower participation and higher refusal rates, male students
also perceive gender bias. Religion and culture put male medical
students training in countries where Islam is the state religion, at an
additional disadvantage to those in ‘Westernised’ countries.
A high-quality assembly reveals genomic characteristics, phylogenetic status and causal genes for white feather of Indian peafowl
Authors: Liu Shaojuan , Chen Hao , Ouyang Jing , Huang Min , Zhang Hui , Zheng Sumei , Xi Suwang , Tang Hongbo , Gao Yuren , Xiong Yanpeng , Cheng Di , Chen Kaifeng , Liu Bingbing , Li Wanbo , Yan Xueming , Mao Huirong , Ren Jun
Published: January 2024

Indian peafowl (Pavo cristatus) attracts people’s attention because of
the exclusively dazzling phenotypic characteristics. However, little is
known about the phenotypic evolution and phylogeny of Indian peafowl at
the whole-genome level. So far, there has been no report on the genetic
mechanism of the formation of white feather in white feather peafowl.
This study assembled a draft genome of Indian peafowl with a genome size
of 1.05 Gb (the sequencing depth is 362×), and N50 of the contig and
scaffold was up to 6.2 Mb and 11.4 Mb, respectively. Compared with other
birds, Indian peafowl changed in terms of metabolism, immunity, skeletal
development and feather development, which provided a novel insight into
the phenotypic evolution of peafowl, such as the large body size and
feather morphologies. It was confirmed that the phylogeny of Indian
peafowl was closer to that of turkey than that of chicken. Specially, it
was identified that PMEL was a causal gene leading to the formation of
white plumage in blue and white feather peafowl. This study provides a
peafowl genome with high-quality as well as a novel understanding in the
phenotypic evolution and phylogeny of peafowl among other birds. The
results contribute a valuable reference genome to the study of the avian
genome evolution. In addition, the discovery of the genetic mechanism of
white plumage not only is a breakthrough in the exploration of peafowl
plumage, but also provides clues and new ideas for further
investigations of the avian plumage coloration and artificial breeding
in peafowl.
Some new Hermite-Hadamard type inequalities for generalized harmonically convex functions involving local fractional integrals
Authors: Sun Wenbing , Xu Rui
Published: January 2024

In this paper, we establish a local fractional integral identity on
Yang’s fractal sets. Using this integral identity, some generalized
Hermite-Hadamard type inequalities for generalized harmonically convex
function on Yang’s fractal sets are obtained. Some applications of these
inequalities to special means are given.
Oxycodone/naloxone versus Tapentadol in real-world chronic non-cancer pain management: a prospective controlled and pharmacogenetic study
Authors: Barrachina Jordi , Margarit Cesar , Muriel Javier , López-Gil Santiago , López-Gil Vicente , Vara-González Amaya , Planelles Beatriz , Inda Maria del Mar , Morales Domingo , Peiró Ana
Published: January 2024

Background and purpose: Tapentadol (TAP) and oxycodone/naloxone (OXN)
are available formulations that potentially offer improved
gastrointestinal tolerability. However, real-world studies in chronic
non-cancer pain (CNCP) remain scarce. The aim is to analyse their
benefit/risk profiles and the influence of pharmacogenetic markers in
daily pain practice. Experimental approach: A prospective, controlled
study was developed with ambulatory CNCP patients. Cases were treated
with TAP (n=204) or OXN (n=180) prescription, and controls other opioids
(n=216). Pain intensity and relief, quality of life, morphine equivalent
daily doses (MEDD), adverse events (AEs) and hospital admissions were
registered. OPRM1 (rs1799971, A118G) and COMT (rs4680, G472A) gene
variants were also analysed. Key Results: Cases evidenced a
significantly higher pain relief than control did in real-world
management. Here, pain intensity and quality of life were predictive
values of relief (R2=0.3). OXN achieved greater pain relief under higher
28% MEDD, 15% pregabalin and 8% duloxetine than TAP. Additionally,
OXN needed 15-23% more prescription changes. What´s more, OXN presented
the highest rate of AEs at 6 (3-9) per person, including a 68%
prevalence of constipation and 24% of erythema. COMT-AA showed higher
rates of erythema and vomiting, especially in females. Conclusions and
Implications: OXN and TAP exhibited optimal benefit/risk profiles for
improving pain relief in real-world CNCP. However, increased OXN pain
relief conditioned patients for higher MEDDs, constipation side-effects
and drug prescription changes than TAP. Further research is necessary to
clarify a potential sex-bias in and genetic influence on side-effects.
Chronic ozone exposure preferentially modifies root rather than foliar metabolism of date palm (Phoenix dactylifera) saplings
Authors: Arab Leila , Hoshika Yasutomo , Müller Heike , Cotrozzi Lorenzo , Nali Cristina , Tonelli Mariagrazia , Ache Peter , Paoletti Elena , Alfarraj Saleh , Albasher Gadah , Hedrich Rainer , Rennenberg Heinz
Published: January 2024

In their natural environment, date palms are exposed to chronic
atmospheric ozone (O3) concentrations from local and remote sources. In
order to elucidate the consequences of this exposure, date palm saplings
were treated with ambient, 1.5 and 2.0 times ambient O3 for three months
in a free-air controlled exposure facility. Chronic O3 exposure reduced
carbohydrate contents in leaves and roots, but this effect was much
stronger in roots. Still, sucrose contents of both organs were
maintained at elevated O3, though at different steady states. Reduced
availability of carbohydrate for the TCA cycle may be responsible for
the observed reduced foliar contents of several amino acids, whereas
malic acid accumulation in the roots indicates a reduced use of TCA
cycle intermediates. Carbohydrate deficiency in roots, but not in leaves
caused oxidative stress upon chronic O3 exposure, as indicated by
enhanced malonedialdehyde, H2O2 and oxidized glutathione contents
despite elevated glutathione reductase activity. Reduced levels of
phenolics and flavonoids in the roots resulted from decreased production
and, therefore, do not indicate oxidative stress compensation by
secondary compounds. These results show that roots of date palms are
highly susceptible to chronic O3 exposure as a consequence of
carbohydrate deficiency.
Clinical characteristics of patients with dental malocclusion: an otolaryngologic perspective
Authors: Yoo Shin Hyuk , Mo Ji-Hun , Chung Young-Jun
Published: January 2024

Abstract Objectives: To investigate the relationship between allergic
rhinitis (AR) and dental malocclusion from an otolaryngologic
perspective. Design: Retrospective study. Setting: Single tertiary
medical center. Participants: Patients (n=217) referred to the
otolaryngology department before initiating orthodontic treatment were
recruited. Main outcome measures: The frequency and severity of AR
symptoms, sinonasal outcome test (SNOT-22) scores, physical examination
findings, acoustic rhinometry results, and treatment modalities were
retrospectively assessed. Patients with positive skin prick test
findings (SPT) (n=173; orthodontic group) were compared with age- and
sex-matched patients being treated for AR (AR group). Results: Total
76.5% of the enrolled patients had subjective nasal symptoms, and
93.1% patients showed abnormal physical examination findings: inferior
turbinate hypertrophy (82.0%), adenotonsillar hypertrophy (31.8%) or
deviated nasal septum (7.4%). The 173 (79.7%) patients with positive
SPT results exhibited a significantly higher incidence of rhinorrhoea,
sneezing, and inferior turbinate hypertrophy compared to those with
negative SPT results. The proportion of patients who underwent
pharmacological or surgical treatments was significantly higher among
patients with nasal obstruction (92.0%) than among patients without
nasal obstruction (36.9%). The frequency and mean visual analogue
symptom scores for nasal obstruction, rhinorrhoea, and sneezing, as well
as all SNOT-22 domain scores were significantly higher in the AR group
than in the orthodontic group. The minimal cross-sectional area measured
with acoustic rhinometry showed no significant difference between
groups. Conclusion: Patients with dental malocclusion had a high SPT (+)
rate and a high prevalence of structural abnormalities of the upper
airway. Early intervention may prevent further progression of
malocclusion.
Esmolol For Intractable Ventricular Arrhythmias in Major Amitriptyline Toxicity
Authors: Garrett Peter , klupfel steven
Published: January 2024

A massive tricyclic overdose of up to 10 grams of amitriptyline resulted
in cardiovascular collapse with multiple episodes of VT and VF despite
aggressive attention to current recommended therapy. 1600 mmols of
sodium bicarbonate and 1000 mmols of hypertonic saline, as well as
second-line anti-arrhythmic therapies failed to reduce the recurrent
deteriorations to malignant ventricular rhythms. Progression to
extracorporeal support was avoided by the use of an esmolol infusion. We
had a physiological rationale by which esmolol prevented tachyarrhythmia
and fibrillation in this severe amitriptyline toxicity.
Coumel law was confirmed in 3-month-old infant's transesophageal cardiac electrophysiological examination
Authors: Zhao Liang , Yan Song , Wang Tao , Hua Yimin , Zhou Kaiyu
Published: January 2024

Introduction: It is very rare that wide QRS complex tachycardia
automatically changes to narrow QRS complex tachycardia, and it is more
difficult to clarify the mechanism. Case report：A 3-month-old infant
with recurrent paroxysmal supraventricular tachycardia underwent
transesophageal cardiac electrophysiological examination. The wide QRS
complex tachycardia was induced by atrial RS2 stimulation, and it soon
changed into narrow QRS tachycardia automatically. By the accurate
measurement of esophageal lead, it was found that the electrocardiogram
changes completely conform to Coumel law. Conclusion: Transesophageal
cardiac electrophysiological examination can reveal certain special
electrophysiological phenomena, especially suitable for infants.
Ejection Fraction improvement in Left Ventricular only pacing vs Bi-Ventricular pacing in patients with heart failure.
Authors: Tabbah Randa , Francis Jamil , Skouri Hadi , Khoury Maurice , Abi-Saleh Bernard
Published: January 2024

Background: Left ventricular (LV) pacing with resynchronization therapy
improves ventricular synchrony in patients with decreased LV function
and Left Bundle Branch Bock (LBBB). Objective: The goal of this study is
to show that LV pacing is superior to BiVentricular (BiV) pacing in
patients with ventricular dysfunction and LBBB. Methods: This is a
retrospective study from 2 hospitals’ registries in Lebanon. 121
patients with LVEF ≤ 35%, a QRS ≥130msec and a LBBB pattern on full
medical therapy were included in 2 groups: LV pacing and BiV pacing. All
patients had echocardiograms before and after device implantation. The
primary endpoint was the change in ejection fraction and the secondary
endpoints were decrease in pulmonary artery pressure (PAPs), in LV end
diastolic diameter (LVDD) and in LV end systolic diameter (LVSD).
Statistical analysis was done with SPSS. Results: The study population
was mostly males (69.4%) with ischemic cardiomyopathy 74 (61.2%) & a
mean age of 67 years old. Fifty (41,3%) patients were programmed as LV
pacing. A statistically significant improvement in EF was seen in the LV
only 9.2% compared to BiV pacing 5.5%. Similarly, we noticed a
significant decrease in the LVDD and LVSD in the LV pacing compared to
the second group. There was a trend in favor of more PAPs improvement in
the LV pacing that did not reach significance. Conclusion: This study
demonstrates that LV pacing significantly improves EF and LV size
compared to BiV pacing. A large multicenter trial is needed to confirm
our findings.
A large bleeding mass on the scalp of an elderly male: A quick excision of a delayed case
Authors: Aktaş Habibullah , Akıncı Cevat , Demirkol Hikmet , Basar Merve , Erol Harun
Published: January 2024

Sebaceous nevus is a congenital hemartoma. It is a known condition that
benign or malignant skin tumors can develop on the sebaceous nevus
especially after puberty.. In this article, we present a 61-year-old
male patient with sebaceous nevus in which an ulcerated basal cell
carcinoma developed on a 61 years duration of sebaceous nevus.
Chaotic Time Series Prediction of Echo State Network Based on Memristor
Authors: Mu Xiaohui , Li Lixiang , Peng Haipeng , Pan Shuang , Li Shuai
Published: January 2024

In this paper, we proposed a new echo state network (ESN) model, namely
echo state network based on memristor (memristor-ESN). It improve the
memory function of the reservoir and the prediction performance of the
ESN. In the memristor-ESN, memristor is used to replace the synapses
between neurons in the reservoir of echo state network. In the
prediction of chaotic time series, we compare the classical echo state
network with the echo state network based on memristor. Simulations are
conducted to verify the prediction accuracy and prediction performance
of the memristor-ESN.
Investigating determinants for woman's choice to accept an epidural for labour analgesia at the delivery unit of the Tamale Teaching Hospital.
Authors: Anabah Thomas , Kampo Sylvanus , Falagán Aglais
Published: January 2024

Abstract Objective: This study aimed to assess factors that influence
epidural labour analgesia acceptance or refusal at the maternity unit of
the Tamale Teaching Hospital. Design: Prospective cross-sectional
survey, Setting: This study was carried out at the maternity unit of the
Tamale Teaching Hospital Population or Sampling: We recruited 540
parturients at the maternity unit of the Tamale Teaching Hospital.
Methods: A structured questionnaire was administered to each recruited
parturients after childbirth. Main Outcome Measures: The primary
outcomes measured were awareness and factors that affected epidural
labour analgesia acceptance at the delivery unit of the Tamale Teaching
Hospital Results: The data showed that 525 (97.2 %) of the participants
were aware of epidural labour analgesia, out of which 503 (93.1 %)
refused to accept the epidural for labour analgesia. Age, educational
background, cultural or religious beliefs, attitudes of midwives and the
cost of the epidural labour analgesia service were observed to be some
determinants of the epidural labour analgesia use at the delivery unit
of the Tamale Teaching Hospital.
Glycinebetaine enhances photosynthesis of albino tea under low temperature by regulating related gene methylation
Authors: Huang Shan , Zheng Xin , Yao Longren , Zuo Ting , Hou Qiong , Ni Wuzhong
Published: January 2024

As low temperature is a crucial contributing factor to the albino
peculiarity of young leaves of White Leaf No.1 (WL-1), the chilling
tolerance of its functional leaves should be considered simultaneously.
Alteration of DNA methylation (an epigenetic regulator) due to chilling
has been often observed in plants, but little is known about whether
glycinebetaine (GB, a potential methyl donor) is linked to gene
methylation priming responses of plants to low temperature. Herein, we
provided evidence for the regulation of gene methylation by GB, which in
turn affects the apparent characteristics of WL-1 functional leaves
under low temperature condition. Results showed that the transpiration
efficiency and chlorophyll levels of WL-1 functional leaves were
significantly increased by GB application under low temperature
condition. GB affected WL-1 response to low temperature by increasing
the methylation level of most of the methytransferase and demethylase
genes, PSⅡ structure genes, and some of the chlorophyll synthesis genes,
which were further proved by multivariate analyses. Additionally, the
number of methylated gene sites was increased by GB under low
temperature. Present study suggests important roles of GB in enhancing
photosynthesis of albino tea functional leaves under low temperature
condition by regulating related gene methylation.
Reducing severe cutaneous adverse and type B adverse drug reactions using pre-stored HLA genotypes
Authors: Lee Kye Hwa , Kang Dong Yoon , Kim Hyun Hwa , Kim Yi-Jun , Kim Hyo Jung , Kim Ju-Han , Young Song Eun , Yun James , Kang Hye-Ryun
Published: January 2024

Background: Several type B adverse drug reactions (ADRs), especially
severe cutaneous adverse reactions (SCARs), are associated with
particular human leukocyte antigen (HLA) genotypes. However, pre-stored
HLA information obtained from other clinical workups has not been used
to prevent ADRs. We aimed to simulate the preemptive use of pre-stored
HLA information in electronic medical records to evaluate whether this
information can prevent ADRs. Methods: We analyzed the incidence and the
risk of ADRs for selected HLA alleles (HLA-B*57:01, HLA-B*58:01,
HLA-A*31:01, HLA-B*15:02, HLA-B*15:11, HLA-B*13:01, HLA-B*59:01, and
HLA-A*32:01) and seven drugs (abacavir, allopurinol, carbamazepine,
oxcarbazepine, dapsone, methazolamide, and vancomycin) using pre-stored
HLA information of transplant patients based on the Pharmacogenomics
Knowledge Base guidelines and experts’ consensus. Results: Among 11,988
HLA-tested transplant patients, 4,092 (34.1%) had high-risk HLA
alleles, 4,583 (38.2%) were prescribed risk drugs, and 580 (4.8%)
experienced type B ADRs. Patients with HLA-B*58:01 had a significantly
higher incidence of type B ADR and SCARs associated with allopurinol use
than that of patients without HLA-B*58:01 (17.2% vs. 11.9%, odds ratio
(OR) 1.53 [95% confidence interval (CI) 1.09–2.13], P = 0.001,
2.3% vs. 0.3%, OR 7.13 [95% CI 2.19–22.69], P <
0.001). Higher risks of type B ADR and SCARs were observed in patients
taking carbamazepine or oxcarbazepine if they had one of HLA-A*31:01,
HLA-B*15:02, or HLA-B*15:11 alleles. Vancomycin and dapsone use in
HLA-A*32:01 and HLA-B*13:01 carriers, respectively, showed trends toward
increased risk of type B ADRs. Conclusion: Utilization of pre-stored HLA
data can prevent type B ADRs including SCARs by screening high-risk
patients.
Lipoprotein X hyperlipidemia in patients with liver graft-versus-host disease post-hematopoietic stem cell transplantation in Chinese children
Authors: Chan Wilson , Law Eric , Ling Tsz-Ki , Wong Felix , Cheuk Daniel Ka Leung , Tung Joanna
Published: January 2024

Severe hypercholesterolemia mediated by graft-versus-host disease of
liver in patients underwent allogeneic hematopoietic stem cell
transplantation is a recognized yet overlooked phenomenon. Reports in
literature is limited in both adult and pediatric population and none
had been reported in Chinese children to date. As lipoprotein X
hypercholesterolemia is due to regurgitation of cholesterol and bile
salts into systemic circulation rather than overproduction by
hepatocytes, usage of statins to downregulate cholesterol synthesis is
not effective. Here we report 2 local cases to increase awareness of
transplant physicians and endocrinologists of this association and avoid
unnecessary and ineffective usage of statins.
FACTORS INFLUENCING INITIATION AND DISCONTINUATION OF VITAMIN D SUPPLEMENTATION AMONG INFANTS
Authors: Közler Selen Hürmüzlü , Şaylı Tülin
Published: January 2024

Objectives: To determine vitamin D supplementation frequency among
infants, factors that influence adherence, and reasons for
discontinuation of initiated vitamin D. Methods: This cross-sectional
study was conducted using a questionnaire administered to the mothers
via face-to-face interview of 560 infants aged from 1 to 24 months
admitted to outpatient clinics from June to December 2017. Results: A
total of 351 infants were administered vitamin D, and the rate of
supplementation in the first year of life was 83%, while it was only
28% between 13 and 24 months. The rate of vitamin D supplementation was
higher among exclusively formula-fed infants (p<.05). When the
data were analyzed using logistic regression analysis, only visit family
physicians statistically significant independent variable in increasing
supplementation (p<.05). Compared with family refusal, the
rate of discontinuation of vitamin D by the healthcare providers was
higher after the first year of life (p<.05). The rate of
vitamin D discontinuation by healthcare providers, especially by nurses
who considered the duration of supplementation adequate, was
statistically significantly higher when compared with the fontanel
closure and other independent variables (p<0.05). Conclusions:
The rate of vitamin D supplementation was higher among families who
visited family physicians, which suggests the importance of well-baby
visits. Since vitamin D supplementation was less common among
exclusively breastfed infants, mothers should be educated. Healthcare
professionals need further education about the importance of vitamin D
supplementation and indications for discontinuation.
Diagnosis and Management of Childhood Obesity in a Canadian Academic Family Medicine Teaching Unit
Authors: Paquette Jean-Sebastien , Théoret Laurence , Veilleux Laurence , Graham Johann , Paradis Marie-Pier , Chamberland Nathalie , Lanctot Gabrielle , Breault Pascale , Pelletier Mathieu , Boudreault Samuel
Published: January 2024

Rationale: The aim of this study was to use the clinical practice
guidelines issued by the Quebec provincial government to assess the
diagnosis and management of childhood obesity in a Canadian academic
family medicine teaching unit (FMTU). Methods: We performed an audit of
diagnosis and care of childhood obesity in a FMTU in the province of
Quebec. We used the clinical practice guidelines established by the
Quebec government’s Institut national d’excellence en santé et en
services sociaux (INESSS) which include use of the World Health
Organization (WHO) growth chart for diagnosing childhood obesity. We
analyzed the electronic medical records of every child from 5 to 12
years old who had a medical appointment at the FMTU in 2017 (n=618). We
audited whether childhood obesity had been correctly diagnosed according
to the WHO growth chart and if the medical care that followed was
adequate according to INESSS guidelines. Results: We identified 71
children as obese according to the WHO chart, of whom 40 (56%) had been
diagnosed as such by clinic health professionals. Of these 40, (33) 83%
received nutritional counseling, (33) 83% received physical activity
counseling, (13) 33% had parent’s involvement counselling, (19) 48%
were referred to another health professional (e.g., dietician,
psychologist, kinesiologist) and (12) 31% were followed up within six
months. Only 7 (18%) patients received all INESSS’s recommendations.
Conclusions: Our study shows that childhood obesity remains
under-diagnosed in Canadian primary care, even in an academic teaching
environment. This affects the quality of care delivered to these
patients. Moreover, even if childhood obesity had been correctly
diagnosed, management of this clinical condition is still incomplete.
Understanding barriers and facilitators to diagnosing and managing
childhood obesity is necessary to improve the quality of care on a
larger scale.
Impact of physician' and pharmacy staff supporting activities in usual care on patients' statin adherence.
Authors: Huiskes Victor , Vriezekolk Johanna , Ende Cornelia van den , Dijk Liset van , Bemt Bart van den
Published: January 2024

Aims: Little is known about usual care by physicians and pharmacy teams
to support adherence to statins and whether the extent of this care is
associated with adherence to statins. Objective of the study was to
examine the relationship between the extent of adherence supporting
activities of HCPs and patients’ adherence to statins. Methods:
Cross-sectional study in 48 pharmacies and affiliated physicians’
practices, between September 3, 2014 and March 20, 2015. Patients
visiting the pharmacy with a statin prescription from participating
prescribers were invited to participate. Usual care to support adherence
was assessed among HCPs with the Quality of Standard Care questionnaire
about usual care activities to support adherence. Adherence to statins
was assessed among patients with the MARS-5 questionnaire. The
association between the extent of HCPs’ adherence supporting activities
and patients’ adherence was examined by means of multilevel regression
analysis. Results: 1,504 patients and 692 HCPs (209 physicians, 118
pharmacists and 365 pharmacy technicians) participated. No association
was found between the extent of physicians’ adherence supporting
activities and patients’ adherence to statins. The extent of adherence
supporting activities by pharmacy teams in usual care was negatively
associated with patients’ adherence to statins (B coefficient -0.057
(95%CI: 0.112-0.002). Conclusions: This study suggests that there is no
positive relationship between the extent of HCPs’ adherence supporting
activities in usual care and patients’ adherence to statins. Other
methods than questionnaires (e.g. electronic monitors (to assess
adherence) and observations (to assess usual care) should be applied to
confirm the results of this study
Evaluation of fractal dimension and panoramic radiomorphometric indices in children and adolescents with type 1 diabetes mellitus: A retrospective study
Authors: Alkis Humeyra Tercanli , Yagmur Burcu , Parlak Mesut , Karayilmaz Huseyin
Published: January 2024

Objective: The aim of this retrospective study is to evaluate the
cortical and trabecular mandibular bone morphology of children and
adolescents who have type 1 diabetes mellitus (DM) and controls by using
fractal dimension (FD) analysis and different panoramic
radiomorphometric indices through digital panoramic radiographic images
(DPRIs). Methods: The study included total 114 patients(57 type 1 DM-57
control). The type 1 DM group was divided into well-controlled(6,59.0)
groups, according to HbA1c. The mandibular cortical width (MCW) and
panoramic mandibular index (PMI) were measured, the mandibular cortical
index (MCI) and simple visual estimation (SVE) were evaluated, and FD
analysis of three areas of interest (IAs) was obtained in all of the
DPRI. Results: There were no statistically significant differences found
in any parameters when all the DM groups were compared with controls. In
all the groups, significant correlation was observed between the MCW-FD
values, PMI-FD values, and MCW-IA 1 FD values. Conclusions: This study
revealed no cortical and trabecular bone changes in mandibula in
children and adolescents with type 1 DM compared to the control group.
These findings did not support the hypothesis that children and
adolescents with type 1 DM may have different bone structure.