bluuebunny/crossref_metadata_2025 huggingface dataset:
Appropriateness of Empirical Antibiotic Therapy in Bacterial Culture-Positive Inpatients: A Retrospective Cohort Study
Authors: Luo Yuting , Guo Zhaowang , Li Ying , Ouyang Hui , Huang Shanfeng , Chen Yuanli , Li Kenan , Ji Yuxin , Zhu Hongqiong , Luo Wentao , Xia Jinyu , Liu Xi
Published: March 2022

Objectives
We aimed to evaluate the prevalence, relative factors, and outcomes of different empirical antibiotic therapy (EAT) prescriptions in infected inpatients.
Methods
We performed a retrospective cohort analysis of inpatients a tertiary hospital in China between October 1, 2019 and September 30, 2020. Bacterial culture-positive patients received EAT were enrolled in this study. We initially assessed the prevalence of different EAT prescriptions by univariate analysis, and then used an enter multivariable logistic regression model to calculate adjusted odds ratios for assessing relative factors and outcomes of them.
Results
1,257 infected patients received EAT on the day of sampling culture. 31.7% (398/1257) received appropriate but unnecessarily broad-spectrum empirical antibiotic therapy (AUEAT), and 37.3% (469/1257) received inappropriate empirical antibiotic therapy (IEAT). Age was a correlated factor of receiving AUEAT and IEAT. The odds of receiving AUEAT and IEAT increased with age (adjusted OR 1.023 [95% CI, 1.013 ~ 1.032]; p < 0.001; 1.009 [95% CI, 1.001 ~ 1.018]; p = 0.033). Patients who received AUEAT and IEAT had higher rates of ICU care and increased hospital costs. AUEAT has a higher proportion of poor prognosis (29.4%, 117/398, p < 0.001). Respiratory tract was the most common infection site (418/1257, 33.3%). The common pathogens were Escherichia coli (315/1257, 25.1%), Klebsiella species (208/1257, 16.5%), Staphylococcus aureus (204/1257, 16.2%), and Pseudomonas species (167/1257, 13.3%). 45.3% (570/1257) patients were infected with multidrug-resistant organism (MDRO), of which 53.5% (305/570) received IEAT. Among 305 MDRO infected patients with IEAT, 71.5% (218/305) were infected with Gram-negative bacteria. The majority of Gram-negative bacteria was Enterobacteriaceae (178/218, 81.7%), among which E. coli (116/178, 65.2%) and Klebsiella (38/178, 21.3%) strains accounted for high proportions.
Conclusions
Inappropriate or unnecessarily broad-spectrum use of antibiotics is widely prevalent in hospital. AUEAT and IEAT were bound to increase antimicrobial resistance, rates of ICU care, and health care costs. AUEAT was associated with increased risk of poor prognosis. Near half of inpatients infected with MDRO, and these patients were more likely to receive IEAT. Early identification of infectious pathogens and resistance can provide the basis for rational use of antibiotics and improve the current situation of antibiotic abuse and antimicrobial resistance.
The mucin-like, secretory type-I transmembrane glycoprotein GP900 in the apicomplexan Cryptosporidium parvum is cleaved in the secretory pathway and likely plays a lubrication role
Authors: li Xiaohui , Yin Jigang , Wang Dongqiang , Gao Xin , Zhang Ying , Wu Mingbo , Zhu Guan
Published: March 2022

Background
Cryptosporidium parvum is a zoonotic parasite, a member of apicomplexans that possess unique secretory organelles including a rhoptry, micronemes and dense granules that discharge contents during the parasite invasion. The mucin-like glycoprotein GP900 with a single transmembrane domain is one of the immunodominant antigens and micronemal proteins. It was found to be relocated to the surface of excysted sporozoites and shed to form trails by gliding sporozoites, for which the biological process remained unclear. The major aim of this study was to verify whether GP900 was present as a transmembrane protein anchored to the plasma membrane on the surface of sporozoites and whether it was cleaved before being shed from the sporozoites.
Methods
Two anti-GP900 antibodies, a mouse monoclonal antibody (mAb) to the long N-terminal domain (GP900-N) and a rabbit polyclonal antibody (pAb) to the short C-terminal domain (GP900-C), were produced for the detection of intact and cleaved GP900 proteins in sporozoites and other parasite developmental stages by microscopic immunofluorescence assay (IFA) and discharged molecules by ELISA.
Results
Both antibodies recognized the apical region of unexcysted and excysted sporozoites. However, anti-GP900-N (but not anti-GP900-C) also stained the pellicles/surface of excysted sporozoites and trails of gliding sporozoites. Both antibodies stained the intracellularly developing and developed meronts, but not in the macro- and micro-gamonts. Additionally, the epitope recognized by anti-GP900-N (but not anti-GP900-C) was detected in the secretions of excysted sporozoites and intracellular parasites.
Conclusions
GP900 is present in sporozoites and intracellular meronts, but absent in sexual stages. It is stored in micronemes of sporozoites, but enters secretory pathway during excystation and invasion. The short cytoplasmic domain of GP900 is cleaved in the secretory pathway before it reaches to the extracellular space. The molecular features and behaviors imply that GP900 mainly plays a lubrication role.
The effect of phosphate application in Pb-contaminated soil on the oxidative stress of leaves, Pb accumulation in biomass of maize and Pb speciation in rhizosphere soil
Authors: He Yongjian , Jiang Ranran , Jiang Runhai , Zhu Chengqiang , Cao Yanru , Xia Tiyuan , Hou Xiuli
Published: March 2022

Reducing the bioavailability of Pb in soil is the key to alleviate the toxicity of Pb to plant. Maize were exposed to Pb 100 mg/kg of soil with three fertilizer levels of control (T1), nitrogen, phosphorus and potassium of 204 mg/kg (T2) and nitrogen, potassium of 204 mg/kg (T3). The phosphate supplement lead to the reduction by 24.92%, 29.73% and 25.31% respectively in activity of total superoxide dismutase (T-SOD), peroxidase (POD) and concentration of lipid peroxidation (MDA) in maize leaves, and reduced Pb accumulation in above- and below-ground biomass of maize by 39.20% and 37.58%. In T2 treatment group, the water soluble Pb, ionic fraction and carbonate fraction Pb in rhizosphere soil decreased by 37.57%, 36.36% and 43.24%, and organic fraction Pb and residual fraction Pb was the highest with the value of 11.67 and 18.57 mg/kg; the soil aluminum bound (Al-P) and iron bound phosphate (Fe-P) were the highest with 93.53 mg/kg and 230.32 mg/kg, indicating that the phosphate supplement increases the soil ionic P and transforms the chemically mobilized P (such as O-P, Ca-P) into the bioavailable P. Moreover, the soil organic fraction and residual fraction immobilized Pb was positively correlated with the bioavailable Al-P and Fe-P, indicating that the ionic fraction P (Al-P and Fe-P) react with Pb and produce residual P-Pb compounds. Therefore, phosphate supplement to Pb contaminated soil could transfer unstable fraction Pb into stable fraction Pb by P-induced Pb immobilization, reduce the bioavailability of Pb and alleviate the toxicity of heavy metal to plant.
Reduced HMGB1 expression contributed to lapatinib-induced cutaneous injury
Authors: Jiang Li Yu , Zeng Yan , Ai Lei Lei , Yan Hao , Yang Xiao Chun , Luo Pei Hua , Yang Bo , Xu Zhifei , He Qiao Jun
Published: March 2022

Lapatinib, a widely-used dual inhibitor of human epidermal growth factor receptor 1 (EGFR/ERBB1) and 2 (HER2/ERBB2), has been seriously limited due to cutaneous toxicity. However, the specific mechanism of lapatinib-induced cutaneous toxicity has not been clarified, leading to a lack of effective strategy to improve clinical safety. Here, we found that lapatinib could induce mitochondrial dysfunction, lead to DNA damage and finally cause apoptosis of keratinocytes. In addition, we found that lapatinib could induce aberrant immune response and promote the release of inflammatory factors in vitro and in vivo. Mechanistically, downregulated expression of DNA repair protein HMGB1 played a critical role in these toxic reaction processes. Overexpression of HMGB1 could inhibit keratinocyte apoptosis and inflammation reaction. Therefore, recovering the HMGB1 expression might be an effective remedy against lapatinib-induced cutaneous toxicity. Finally, we found that saikosaponin A could significantly rescue the reduced HMGB1 transcription, which could alleviate lapatinib-induced DNA damage, inhibit keratinocyte apoptosis and further prevent toxicity of lapatinib in mice. Collectively, our study might bring new hope to clinicians and tumor patients, and shed new light on the prevention of cutaneous adverse drug reactions induced by EGFR inhibitors.
GSDMD-dependent platelet pyroptosis exacerbates NET formation and inflammation in severe sepsis
Authors: Tang WaiHo , Su Meiling , Chen Chaofei , Li Shaoying , Li Musheng , Zeng Zhi , Zhang Yuan , Xia Luoxing , Li Xiuzhen , Zheng Dezhong , Lin Qiqi , Fan Xuejiao , Wen Ying , Liu Yingying , Chen Feiyan , Luo Wei , Bu Yun , Qin Jinhong , Guo Manli , Qiu Miaoyun , Sun Lei , Liu Renjing , Wang Ping , Hwa John
Published: March 2022

Dysregulated inflammation is closely associated with increased mortality in sepsis. Platelets have emerged as key inflammatory cells implicated in the pathology of sepsis, including the development of thrombosis, thrombocytopenia, and neutrophil extracellular traps (NETs). Platelet’s contributions to rapid clinical deterioration and dysregulated inflammation in sepsis have not been defined. In our cohort, the incidence of thrombocytopenia, thrombocytopathy and excessive inflammatory cytokines released in patients with severe sepsis were significantly increased. Platelet proteomic analysis revealed significant up-regulation of Gasdermin D (GSDMD). Using platelet-specific Gsdmd deficient mice, we demonstrated a requirement for GSDMD in triggering platelet pyroptosis in cecal ligation and puncture (CLP)-induced sepsis. We further demonstrated that GSDMD-dependent platelet pyroptosis was induced by high levels of S100A8/A9 targeting platelet toll-like receptor 4 (TLR4). Pyroptotic platelet-derived oxidized mitochondrial DNA (ox-mtDNA) potentially promoted NET formation, which in turn contributed to platelet pyroptosis via the release of S100A8/A9, forming a positive feedback loop that led to excessive inflammatory cytokines release. Both pharmacological inhibition using Paquinimod and genetic ablation of the S100A8/A9-TLR4 signaling axis suppressed GSDMD-dependent platelet pyroptosis, thereby alleviating NET-mediated inflammation and improving survival in CLP-induced sepsis mice. Taken together, these findings provide new insights into the proinflammatory role of platelet pyroptosis in severe sepsis.
PVR (CD155) Expression as a Potential Prognostic Marker in Multiple Myeloma
Authors: Lee Byung-Hyun , Kim Ji-Hea , Kang Ka-Won , Lee Se Ryeon , Park Yong , Sung Hwa Jung , Kim Byung Soo
Published: March 2022

Poliovirus receptor (PVR, CD155) is upregulated during tumor progression, and PVR expression is associated with poor prognosis in patients with cancer; however, prognostic implications for PVR in multiple myeloma (MM) have not been investigated. We assessed PVR expression in bone marrow samples of 125 patients via immunohistochemistry (IHC) and in those of 22 patients via enzyme-linked immunosorbent assay (ELISA) and quantitative polymerase chain reaction. Additionally, we evaluated TIGIT levels in bone marrow CD8+ T cells and natural killer cells in 14 patients using flow cytometry. Soluble PVR and TIGIT levels in 22 patients were measured using ELISA. PVR clinical and prognostic significance were assessed using a histoscore via IHC. PVR was highly expressed in patients with MM, and membrane PVR expression showed significant correlation with soluble PVR levels. Moreover, PVR expression was significantly associated with Revised-International Staging System stage, presence of extramedullary plasmacyoma and bone lesions, percentage of bone marrow plasma cells, and β2-microglobulin levels, suggesting a possible role in advanced stage and metastasis. Furthermore, we found that TIGIT expression was significantly correlated with the percentage of bone marrow plasma cells. Patients with high PVR expression had significantly shorter overall and progression-free survival, and PVR expression was identified as an independent prognostic factor for poor survival in MM. These findings indicated that PVR expression is associated with MM stage and poor prognosis, suggesting PVR expression as a potential prognostic marker for MM.
Chylothorax After Excision of the Right Broad Ligament Mass of the Uterus Was Diagnosed Lymphangiomyomatosis a Case Report and Literature Review
Authors: Dai Liwan , Chen Tao , Wu Jinxing
Published: March 2022

BackgroundLymphangioleiomyomatosis (LAM) is a rare disease frequently occurs in women of childbearing age. It is a multi-systemic disorder characterized by the proliferation, metastasis, and infiltration of smooth muscle cells in the lung and other tissues. The exact etiology of this disease is not known, but due to the gender-specific nature of this disease, the female reproductive system is currently considered as the source of this cell . We will report a case of a patient diagnosed with LAM who presented with chylothorax after b road ligament resection .This phenomenon has not been reported in our literature study, which would provide new evidence for the mechanism of the disease.Case presentationA woman who was found to be occupying the right broad ligament developed dyspnea after surgical treatment. Chest CT found bilateral pleural effusion and multiple cystic lesions in both lungs. The pleural fluid Chyle test was positive, subsequent postoperative pathology confirmed LAM. The patient was treated by Sirolimus with Ideal therapeutic effect. ConclusionsThe pathogenesis of LAM is not completely clear, but the clinical manifestations of this patient seem to confirm the hypothesis that LAM originates from the female reproductive system. LAM should be considered in the differential diagnosis of female reproductive system tumors, we suggested to improve chest CT before surgery to be vigilant against the possibility of LAM if multiple cystic changes occur in pulmonary.
Clinical features and prognostic analysis of diffuse large B-cell lymphoma coexisting with follicular lymphoma at initial diagnosis
Authors: shen jianzhen , lai guilan , Zhen Weili , Cui Guoxian , Chen Yachun
Published: March 2022

The clinicopathological information of patients with diffuse large B-cell lymphoma (DLBCL) along with concurrent follicular lymphoma (FL) at initial diagnosis (FL/DLBCL) is scarce. In this retrospective study, we aimed to elucidate the clinical characteristics and outcomes of patients with FL/DLBCL. The study involved all patients consecutively diagnosed with FL/DLBCL (n = 46) and those with pure FL (n = 131), de novo DLBCL (n = 365), or transformed FL (t-FL, n = 17) as controls. In patients with FL/DLBCL, 63.0% of the tumors were of GCB origin, 32.6% were non-GCB, and 4.4% were unclassified. The median proportion of DLBCL components was 50% (range: 15%–99%). The cell of origin and the proportion of DLBCL component did not affect the outcomes of FL/DLBCL. Seventy-one percent of patients with FL/DLBCL received immunochemotherapy, such as the R-CHOP regimen, and none received further intensive treatment. Complete and overall response rates were 60% and 87.5%, respectively, similar to those for DLBCL. Progression-free and overall survival of patients with FL/DLBCL were between those of patients with FL and DLBCL and significantly better than those of patients with t-FL. None of the independent risk factors affected FL/DLBCL prognosis in the multivariate analyses. In conclusion, patients with FL/DLBCL had the GCB subtype with outcomes similar to those of patients with DLBCL, and the treatments for these patients should be similar to those for patients with DLBCL. The outcome of patients with FL/DLBCL was significantly better than that of patients with t-FL, and these patients should not be considered to have “transformed lymphoma.”
Examining the Moderating Role of Technostress and Compatibility in EFL Learners’ Mobile Learning Adoption: A Perspective from the Theory of Planned Behaviour (TPB)
Authors: Wang Qiong , Zhao Guoqing , Cheng Zhuo
Published: March 2022

Mobile English learning has multiple advantages and brings enormous benefits to EFL learners. However, not everyone adopts it, and the determinants of learners’ adoption intention remain unclear. This study aimed to bridge this gap by employing the theory of planned behaviour (TPB) in conjunction with the influences of technostress and compatibility. Based on existing literature, a research model was proposed and verified with a sample of 409 undergraduates from a Chinese university. The results indicated that in the context of mobile English learning: (a) Individuals with higher adoption intention are more likely to engage in mobile English learning with higher frequency and longer duration; (b) Individuals’ attitude towards mobile English learning, perceived behavioural control, subjective norms, and compatibility are significantly positively associated with their adoption intention; (c) Compatibility is the strongest predictor of adoption intention and negatively moderates the effect of subjective norms on adoption intention; (d) The influence of technostress on the adoption intention of mobile English learning is not significant. Practical implications related to mobile English learning were discussed.
A comprehensive meta-analysis of human assortative mating in 22 complex traits
Authors: Horwitz Tanya , Keller Matthew
Published: March 2022

Assortative mating (AM) occurs when the correlation for a trait between mates is larger than would be expected by chance. AM can increase the genetic and environmental variation of traits, can increase the prevalence of disorders in a population, and can bias estimates in genetically informed designs. In this study, we conducted the largest set of meta-analyses on human AM published to date. Across 22 traits, meta-analyzed correlations ranged from r = .08 to r = .58, with social attitude, substance use, and cognitive traits showing the highest correlations and personality, disorder, and biometrical traits generally yielding smaller but still positive and nominally significant (p < .05) correlations. We observed high between-study heterogeneity for most traits, which could have been the result of phenotypic measurement differences between samples and/or differences in the degree of AM across time or cultures.
Meta-atom Microfluidic Sensor for Highly Sensitive Cell Detection
Authors: Bahrami Ali
Published: March 2022

A meta-atom microfluidic-based sensor (MAMS) for detecting, enumerating and differentiating cancer cells is proposed. A microfluidic constriction channel is placed between the gaps of a two-gap split ring resonator (SRR). This two-gap SRR is implemented in a way that is sensitive to the stiffness of the cell which is passing through the constriction channel. With passing a cell through the channel, geometrical features of the SRR changes, and these changes are reflected in the device output. In addition, dielectric properties of the cells passing through the constriction channel, changes the sensor output upon electromagnetic excitation of the SRR. As both stiffness and relative permittivity of the cell, which are biosignatures of a cell, determines the output characteristics of the sensor, this label-free assay can almost perfectly distinguish between different cancer cells and normal cells with high sensitivity. Sensor function is simulated and analyzed, as proof of concept, to show the effectiveness and high sensitivity of the device in differentiating of cells with different dielectric and stiffness properties.
Rethinking Teachers’ Continuing Professional Development for Improved Teaching and Learning of English Language in the 21st Century
Authors: Ossai Rosemary Chidimma , Oluikpe Professor Esther N. , Uloh-Bethels Annah C , Ibenegbu Christopher Ifeanyi
Published: March 2022

This study focused on rethinking teachers’ continuing professional development for improved teaching and learning of the English language in the 21st century. The study was carried out in Enugu East and Enugu North local government areas, Enugu State, Nigeria. The study adopted a descriptive survey research design. A total number of 158 English language teachers were used for the study. The instrument used for data collection was the Teachers’ Continuing Professional Development Questionnaire (TCPDQ). This instrument was validated by two specialists in Language Education and one specialist in Measurement and Evaluation, all from the University of Nigeria, Nsukka. Mean and standard deviations were used to analyze the data collected. The findings of the study revealed that the CPD provided for English language teachers does not equip them properly for English language teaching in the 21st century. Poor monitoring, lack of continuity and poor integration of ICT in the training programs were identified as the loopholes of teachers’ CPD; while focusing the CPD programs on technology literacy, collaboration among teachers during the training programs, and online CPD were found to be strategies for improving English language teachers’ CPD for improved teaching and learning of English language in the 21t century. Based on the findings of this study, it was recommended that professional bodies for teachers’ professional development should be organizing high-quality CPD programs to enable the English language teachers to develop leadership, collaborative, social, and technological skills that will enable them to teach English effectively in this century.
Communication skills training in advance care planning: a survey among medical students at the University of Antwerp
Authors: de Wiel Mick van , Bombeke Katrien , Janssens Annelies
Published: March 2022

Background
Palliative care (PC) medicine is a strongly emerging discipline worldwide. Despite efforts to integrate this important topic in the medical curriculum in Belgium, still little time is spent on PC and its implementation during theoretical and practical training.
Materials & Methods
To explore possible gaps in PC training and to evaluate students’ self-confidence regarding end-of-life-conversations, we had two cohorts of second master’s year MD students at the University of Antwerp complete a survey compromising a custom-built PC knowledge test and a self-confidence assessment of communicative skills used in end-of-life conversations before and after the PC training program. We also wished to know whether the PC classes enabled the students to adequately reflect on factors that might influence end-of-life conversations and added an open-end question about the potential implications of the COVID-19 pandemic on advance care planning (ACP) conversations. Finally, we compared the results of the respondents having enjoyed face-to-face training with those having received online training only.
Results
Although the respondents in both cohorts indicated that the overall curriculum did not pay enough attention to PC training, their theoretical knowledge about PC was good. Feeling confident about their communicative skills in general, they indicated to be less confident when it came to communications concerning PC and ACP in particular. The COVID-19 pandemic was initially equally deemed to impede and facilitate ACP and end-of-life conversations, but after the ACP training class more respondents saw the pandemic as an opportunity to broach end-of-life issues. Finally, we found no differences in scores between online and regular classroom teaching.
Conclusion
Students experience a lack of confidence in communication skills used in end-of-life conversations and ACP. To help improve skills and competencies in conducting end-of-life conversations, it is recommended to have medical students assess PC/ACP training programs regularly and to modify the curriculum and course content based on these outcomes and current developments.
Adoption of e-government by Indonesian state universities: An application of Technology Acceptance Model
Authors: Aswar Khoirul , Ermawati  , Juliyanto Wisnu , Andreas  , Wiguna Meilda
Published: March 2022

E-government is the use of internet platforms to deliver governmental services to citizens with the goal of improving government efficiency, transparency, and participation. This study aims to find out what factors determine the rate at which public university in Indonesians accept e-government services. This study uses the Technology Acceptance Model (TAM). TAM is a traditional model of technology diffusion that is an essential conceptual criterion. It drives acceptance consisting of perceived usefulness and perceived ease of use. The results of this paper back up the original TAM hypothesis. Based on the data collected and analyzed, the study concludes that three influencing factors, namely perceived usefulness (PU), perceived ease of use (PEU), and perceived risk (PR), are significantly related to the intention to use e-commerce government. However, trust and social influence do not significantly affect the intention to use e-government services. This paper has significant implications for policymakers and government officials who want to see the growth of e-government usage in Indonesia. When attempting to market a new online system from the perspective of human-computer interaction, it becomes evident that designers must consider how users perceive the risks.
Review and outlook of river morphology expression
Authors: Li Ziwei , Yan Chaode , Boota Muhammad Waseem
Published: March 2022

The morphological expression of rivers provides a primary medium for human understanding of river geomorphology and the transmission of geographical information. In an ever-changing environment, constantly updated river monitoring data and products offer considerable potential for an explicit expression of river morphological characteristics and associated processes. This paper reviewed the advances in river morphology expression and examines how the various approaches can be utilized to interpret changing geomorphic features of rivers. First, taking alluvial rivers as the research object, river morphology is classified into three types of expression data and four categories of expression models. Then, the limitations of current river morphology models, such as uncertainty, inconsistency, and poor joint application, are analyzed. Finally, four outlooks are offered for improving river morphology expression, including stimulating the expression of river morphology with big data of rivers, redefining different river types, promoting multidisciplinary and interdisciplinary integration, and serving scientific management and decision-making.
Suitability pre-assessment for decoupling in-sewer captured streams to support urban blue-green climate adaptation measures
Authors: Prenner F. , Müller H. , Stern P. , Holzer M. , Rauch H. P. , Kretschmer F.
Published: March 2022

The application of nature-based solutions for climate change adaptation in cities has increased in recent years. To improve microclimatic conditions and to preserve the natural components of related assets, water supply is necessary. As an alternative to drinking water, stream water might serve as a natural source for irrigation. However, due to continuous urbanisation, water courses have often been banned underground in pipes or integrated in the combined sewer network, both making them not directly available for further usage. This article focuses on the perspectives of decoupling captured streams from underground infrastructure to support nature-based urban climate adaptation measures. It introduces a method to identify suitable locations for practical implementation considering the hydrological potential of the stream and the urban microclimatic sensitivity of the concerned area. The approach was applied in a case study in the north-western part of Vienna, including 16 streams with a total length of about 39 km covering an area of approximately 95 km2 with about half a million inhabitants. This work proved the general practicality of the suggested method. It also revealed that about one-third of the investigated stream lengths appears high or medium suitable to support climate adaption measures, leading to notable cost savings for irrigation (for the substitution of drinking water) and wastewater treatment. Concluding, the decoupling of captured streams could contribute to a more sustainable and nature-based urban water management. The introduced method for suitability pre-assessment is applicable with rather easily available input data, which makes it transferable to other cities.
A DISPERSÃO INSTITUCIONAL DA AGENDA DE DESENVOLVIMENTO REGIONAL BRASILEIRA NOS MUNICÍPIOS DO RIO GRANDE DO NORTE
Authors: Da Costa Feitosa Luciana , Costa Rodrigues Lucas , Spinelli de Medeiros Vitor
Published: March 2022

O artigo tem por objetivo analisar o arranjo institucional que dá sustentação às políticas e programas de desenvolvimento regional oriundas da União nos municípios do Rio Grande do Norte (RN). A premissa da investigação considera que arranjos e mecanismos institucionais coesos são imprescindíveis para a promoção do desenvolvimento regional nas diferentes escalas do planejamento governamental. A metodologia de trabalho pautou-se no cruzamento das transferências de recursos dos programas de desenvolvimento regional feitas pelo Governo Federal com a estrutura organizacional dos municípios do RN. O trabalho identificou uma dispersão e sombreamento de competências institucionais relativas aos temas dos programas nas diversas secretarias dos municípios do RN e uma baixa capacidade de angariamento desses recursos pelos entes subnacionais.
PRÉ-TEXTUAIS
Authors: (es) Editor
Published: March 2022

Elementos Pré-textuais

Sociedade e Território

Volume 33 - Número 3
Contribuição ao entendimento dos processos naturais de dissolução de rochas carbonáticas na bacia sedimentar de Irecê, Bahia, NE do Brasil
Authors: Cunha Mônica , Gonçalves Manuel , Cruz Manoel
Published: March 2022

Este artigo apresenta os resultados das pesquisas engendradas da aplicação de modelos hidrogeoquímicos experimentais associados aos métodos estáticos, simulando os processos naturais de interação água/rocha. Os métodos buscam avaliar a evolução da água subterrânea em contato com rochas carbonáticas, mineralizadas em sulfatos e sulfetos e estimar a composição química do aquífero Salitre, pertencente à Bacia Sedimentar de Irecê. A oxidação dos sulfetos tende a aumentar a acidez das drenagens favorecendo a contaminação geogênica do aquífero. Para atingir os objetivos foram coletadas e analisadas rochas carbonáticas dos domínios da bacia sedimentar supracitada, mineralizadas em sulfatos e sulfetos, com teores variáveis. As amostras foram submetidas a processos de interação água/rocha, utilizando-se o método estáticos (pH e Equilíbrio Ácido-Base). Os resultados encontrados indicam que as drenagens geradas pelas rochas carbonáticas são alcalinas, onde os valores de pH encontrados variaram de 7,38 a 8,93, bem como o método ABA sugeriu que as lixiviações não seriam ácidas, embora, com base na amostra de São José, não se pode descartar uma drenagem ácida, mesmo que localizada. Nos sítios onde as rochas concentram maior existem também grandes variações do valor do pH, de forte tendência para pH ácido. Os resultados obtidos delineiam para estes terrenos cársticos, onde se constata a menor ou maior concentração de dolinas e cavernas podem ser relacionadas, além dos aspectos hidrogeológicos, com o processo de acidez e alcalinidade, reciprocamente, da água subterrânea circulante.
Intravenous Injection of SDF-1α-overexpressing Bone Marrow Mesenchymal Stem Cells has a Potential Protective Effect on Myocardial Ischemia in Mice
Authors: Wang Ruihua , Wei Wen , Rong Shuling , Wang Ting , Li Bao
Published: March 2022

Background:

Neutrophils are involved in the injury of myocytes during myocardial ischemia (MI). Stem cells migrate to the site of myocardial injury under homing signals and play a protective role, such as inhibiting inflammation. Chemokine SDF-1α and its related receptor CXCR4 are upregulated after myocardial infarction, which may play an important role in stem cell homing.

Objectives:

This study aimed to explore the potential therapeutic effect of SDF-1α-modified bone marrow mesenchymal stem cells on myocardial ischemia/reperfusion (I/R) injury.

Methods:

We explored the role of SDF-1α modified bone marrow mesenchymal stem cells in vivo and in vitro. SDF-1α and CXCR4 expression was detected under hypoxia/reoxygenation (H/R) condition. Cell migration was detected by the transwell method. The levels of SDF-1α and IL-1β, IL-6, IL-10, and TNF-α were detected in different groups.

Results:

In vitro, SDF-1α was mainly upregulated and secreted by cardiomyocytes, and cardiomyocytes recruited stem cells through the SDF-1/CXCR4 pathway to reduce the damage of polymorphic mononuclear neutrophils to cardiomyocytes under H/R. Upregulation of SDF-1α increased the migration ability of BMSC Stem Cells to H/R-induced cardiomyocytes. In vivo, intravenous injection of SDF-1α genemodified BMSC Stem Cells reduced inflammatory infiltration in the injured area as well as the level of systemic inflammatory factors.

Conclusions:

SDF-1α-overexpressing BMSC Stem Cells protected the heart function of mice and significantly reduced I/R-induced myocardial injury, which has a potential protective effect on MI.
Development and Evaluation of Exenatide Loaded PLGA Nanoparticles
for Intranasal Delivery in the Treatment of Obesity
Authors: Pandya Tosha , Bhatt Priyanka , Misra Ambikandan
Published: March 2022

Background:

Obesity, considered a complex condition, is the fastest-growing public health concern worldwide. Its treatment is limited due to the side effects of pharmacological options available, outweighing their benefits.

Aim:

The present study aims to formulate a novel biodegradable formulation of exenatide for direct brain delivery through the nasal route.

Methods:

To formulate exenatide loaded poly (lactide-co-glycolide) (PLGA) nanoparticles, a dou-ble emulsion (w/o/w) solvent evaporation method was employed. A full factorial (33) design of the experiment was used to optimize the formulation.

Results:

The entrapment efficiency and particle size of the optimized formulation were found to be 68% and 110 nm, respectively. The in-vitro drug release study indicated the sustained release of 48% drug in 5 days. The safety of drug-loaded PLGA nanoparticles for intranasal delivery was in-dicated by the sheep nasal toxicity study. The efficacy of the developed nanoparticles was demon-strated by an in-vivo pharmacodynamics study on Albino Wistar rats, showing a 6.2% weight reduc-tion after 30 days of treatment.

Conclusion:

Thus, exenatide is a novel peptide having significant weight loss benefits and no se-vere side effects. Long-term studies in at least two or more animal models followed by extensive clinical evaluation can safely result in a product for clinical use.
Phytochemical Analysis andIn vitroEvidence of Antimalarial, Antibacterial, Antifungal, Antioxidant and Anti-inflammatory Activities of Ethanol Extract ofEmblica officinalisFruit
Authors: Kaushik Jyoti , Yadav Monu , Sharma Nidhi , Jindal Deepak K. , Joshi Kajal , Dahiya Mini , Deep Aakash
Published: March 2022

Introduction:

The purpose of this study was to evaluate the antimalarial, antibacterial, antifungal, antioxidant, and anti-inflammatory properties of Emblica officinalis fruit ethanol extract.

Methods:

Emblica officinalis fruit extract was prepared using the Soxhlet apparatus at room temperature for 48 hours with 99% ethanol and 1% of double distilled water. GCMS was used to determine the phytoconstituent profile of an extract of Emblica officinalis fruit, and in-vitro assays were used to assess the biological activities.

Results:

Malic acid, pyrogallol, cinnamic acid, pidolic acid, L-glucose, palmitic acid, linoleic acid, gallic acid, ellagic acid, heneicosane, and levoglucosenone were identified in the extract by GCMS analysis. Ethanol extract of Emblica officinalis fruit showed antimalarial activity against Plasmodium falciparum with EC50=13.68 g/ml and antibacterial activity with MIC=6.25µg/ml and MIC=12.5 µg/ml on Staphylococcus aureus and Salmonella typhi respectively. Also, significant antifungal activity of the extract was observed with MIC=6.25µg/ml on Aspergillus niger.

Conclusion:

The extract showed excellent affinity to scavenge the free radicals and protection of protein denaturation, which indicates its antioxidant and anti-inflammatory effects respectively. These protective effects are possibly due to therapeutically active compounds available in Emblica officinalis fruit.
Increased ACE2, sRAGE, and Immune Activation, but Lowered Calcium
and Magnesium in COVID-19
Authors: Al-Hakeim Hussein Kadhem , Al-Jassas Hawraa Kadhem , Morris Gerwyn , Maes Michael
Published: March 2022

Background:

The characterization of new biomarkers that could help externally validate the diagnosis of COVID-19 and optimize treatments is extremely important. Many studies have es-tablished changes in immune-inflammatory and antibody levels, but few studies measured the soluble receptor for the advanced glycation end product (sRAGE), angiotensin-converting enzyme 2 (ACE2), calcium, and magnesium in COVID-19.

Objective:

To evaluate serum advanced glycation end-product receptor (sRAGE) and angiotensin converting enzyme (ACE)2 and peripheral oxygen saturation (SpO2) and chest CT scan abnormalities (CCTA) in COVID-19.

Methods:

sRAGE, ACE2, interleukin (IL)-6, IL-10, C-reactive protein (CRP), calcium, magnesium, and albumin were measured in 60 COVID-19 patients and 30 healthy controls.

Results:

COVID-19 is characterized by significantly increased IL-6, CRP, IL-10, sRAGE, ACE2, and lowered SpO2, albumin, magnesium, and calcium. COVID-19 with CCTAs showed lower SpO2 and albumin. SpO2 was significantly inversely correlated with IL-6, IL-10, CRP, sRAGE, and ACE2, and positively with albumin, magnesium, and calcium. Neural networks showed that a combination of calcium, IL-6, CRP, and sRAGE yielded an accuracy of 100% in detecting COVID-19 patients, with calcium being the most important predictor followed by IL-6 and CRP. Patients with positive IgG results showed a significant elevation in the serum level of IL-6, sRAGE, and ACE2 compared to the negatively IgG patient subgroup.

Conclusion:

The results show that immune-inflammatory and RAGE pathways biomarkers may be used as an external validating criterion for the diagnosis of COVID-19. Those pathways coupled with lowered SpO2, calcium, and magnesium are drug targets that may help reduce the consequences of COVID-19.
Demographic and Psychosocial Characteristics Associated With Use of a Prostate Cancer Survivorship Website: Implications From a Multisite Randomized Controlled Trial
Authors: Marziliano Allison , Diefenbach Michael A , Hudson Shawna V , Tagai Erin K , Handorf Elizabeth A , Bator Alicja , Miller Suzanne M
Published: March 2022

Background

Many prostate cancer (PC) survivors experience disease and treatment-related symptomatology in both the physical and psychosocial domains. Although the benefits and barriers to using web-based resources for cancer patients are well-documented, less research has focused on the personal characteristics important for efficient tailoring and targeting of information that are associated with usage.

Objective

We used the Cognitive-Social Health Information Processing (C-SHIP) framework to guide our exploration of personal characteristics associated with use of PROGRESS, an informational PC survivorship website that addresses physical, emotional, interpersonal, and practical concerns relevant for PC survivors.

Methods

PC survivors (N=217) were randomized to the intervention arm (PROGRESS) of a randomized controlled trial. Of those randomized to the intervention arm, 84 used PROGRESS, and 133 did not use PROGRESS. Multivariable analyses evaluated demographic and psychosocial characteristics (eg, style of coping, health literacy, self-efficacy, affective states of depression, anxiety, and fatigue) associated with website use.

Results

A larger proportion of non-Hispanic White (68/160, 42.5%), compared with non-Hispanic Black (9/40, 23%), participants used PROGRESS (P<.001). Further, PROGRESS users were older in age (P<.001), had a monitoring style of coping (P=.01), and were less depressed (P=.004), anxious (P=.02), and fatigued (P<.001) than nonusers. Education, income, health literacy, blunting style of coping, self-efficacy, and treatment type (radiation therapy or surgery) were not significantly related to use. On multivariable analyses, race (OR 0.28, P<.001), age (OR 1.05, P<.001), monitoring style of coping (OR 1.27, P=.02), and overall mood (OR 0.98, P<.001) remained significant.

Conclusions

A combination of monitoring and low levels of negative affect were associated with website use. Additionally, users were older, non-Hispanic White survivors. To ensure that important survivorship-relevant information reaches users, future efforts need to focus on enhancing patient engagement.

Trial Registration

ClinicalTrials.gov NCT02224482; https://clinicaltrials.gov/ct2/show/NCT02224482
Development of an Internet of Things Technology Platform (the NEX System) to Support Older Adults to Live Independently: Protocol for a Development and Usability Study
Authors: Timon Claire M , Heffernan Emma , Kilcullen Sophia M , Lee Hyowon , Hopper Louise , Quinn Joe , McDonald David , Gallagher Pamela , Smeaton Alan F , Moran Kieran , Hussey Pamela , Murphy Catriona
Published: March 2022

Background

In a rapidly aging population, new and efficient ways of providing health and social support to older adults are required that not only preserve independence but also maintain quality of life and safety.

Objective

The NEX project aims to develop an integrated Internet of Things system coupled with artificial intelligence to offer unobtrusive health and wellness monitoring to support older adults living independently in their home environment. The primary objective of this study is to develop and evaluate the technical performance and user acceptability of the NEX system. The secondary objective is to apply machine learning algorithms to the data collected via the NEX system to identify and eventually predict changes in the routines of older adults in their own home environment.

Methods

The NEX project commenced in December 2019 and is expected to be completed by August 2022. Mixed methods research (web-based surveys and focus groups) was conducted with 426 participants, including older adults (aged ≥60 years), family caregivers, health care professionals, and home care workers, to inform the development of the NEX system (phase 1). The primary outcome will be evaluated in 2 successive trials (the Friendly trial [phase 2] and the Action Research Cycle trial [phase 3]). The secondary objective will be explored in the Action Research Cycle trial (phase 3). For the Friendly trial, 7 older adult participants aged ≥60 years and living alone in their own homes for a 10-week period were enrolled. A total of 30 older adult participants aged ≥60 years and living alone in their own homes will be recruited for a 10-week data collection period (phase 3).

Results

Phase 1 of the project (n=426) was completed in December 2020, and phase 2 (n=7 participants for a 10-week pilot study) was completed in September 2021. The expected completion date for the third project phase (30 participants for the 10-week usability study) is June 2022.

Conclusions

The NEX project has considered the specific everyday needs of older adults and other stakeholders, which have contributed to the design of the integrated system. The innovation of the NEX system lies in the use of Internet of Things technologies and artificial intelligence to identify and predict changes in the routines of older adults. The findings of this project will contribute to the eHealth research agenda, focusing on the improvement of health care provision and patient support in home and community environments.

International Registered Report Identifier (IRRID)

DERR1-10.2196/35277
Digital Health Opportunities to Improve Primary Health Care in the Context of COVID-19: Scoping Review
Authors: Silva Cícera Renata Diniz Vieira , Lopes Rayssa Horácio , de Goes Bay Jr Osvaldo , Martiniano Claudia Santos , Fuentealba-Torres Miguel , Arcêncio Ricardo Alexandre , Lapão Luís Velez , Dias Sonia , Uchoa Severina Alice da Costa
Published: March 2022

Background

The COVID-19 pandemic brought social, economic, and health impacts, requiring fast adaptation of health systems. Although information and communication technologies were essential for achieving this objective, the extent to which health systems incorporated this technology is unknown.

Objective

The aim of this study was to map the use of digital health strategies in primary health care worldwide and their impact on quality of care during the COVID-19 pandemic.

Methods

We performed a scoping review based on the Joanna Briggs Institute manual and guided by the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-analyses) Extension for Scoping Reviews. A systematic and comprehensive three-step search was performed in June and July 2021 in multidisciplinary health science databases and the gray literature. Data extraction and eligibility were performed by two authors independently and interpreted using thematic analysis.

Results

A total of 44 studies were included and six thematic groups were identified: characterization and geographic distribution of studies; nomenclatures of digital strategies adopted; types of information and communication technologies; characteristics of digital strategies in primary health care; impacts on quality of care; and benefits, limitations, and challenges of digital strategies in primary health care. The impacts on organization of quality of care were investigated by the majority of studies, demonstrating the strengthening of (1) continuity of care; (2) economic, social, geographical, time, and cultural accessibility; (3) coordination of care; (4) access; (5) integrality of care; (6) optimization of appointment time; (7) and efficiency. Negative impacts were also observed in the same dimensions, such as reduced access to services and increased inequity and unequal use of services offered, digital exclusion of part of the population, lack of planning for defining the role of professionals, disarticulation of actions with real needs of the population, fragile articulation between remote and face-to-face modalities, and unpreparedness of professionals to meet demands using digital technologies.

Conclusions

The results showed the positive and negative impacts of remote strategies on quality of care in primary care and the inability to take advantage of the potential of technologies. This may demonstrate differences in the organization of fast and urgent implementation of digital strategies in primary health care worldwide. Primary health care must strengthen its response capacity, expand the use of information and communication technologies, and manage challenges using scientific evidence since digital health is important and must be integrated into public service.