bluuebunny/crossref_metadata_2025 huggingface dataset:
Tim-3 downregulation by Toxoplasma gondii infection contributes to decidual dendritic cell dysfunction
Authors: Xie Hongbing , Li Zhidan , Zheng Guangmei , Yang Chunyan , Liu Xianbing , Xu Xiaoyan , Ren Yushan , Wang Chao , Hu Xuemei
Published: October 2022

Background

Women in early pregnancy infected by Toxoplasma gondii may have severe adverse pregnancy outcomes, such as spontaneous abortion and fetal malformation. The inhibitory molecule T cell immunoglobulin and mucin domain 3 (Tim-3) is highly expressed on decidual dendritic cells (dDCs) and plays an important role in maintaining immune tolerance. However, whether T. gondii infection can cause dDC dysfunction by influencing the expression of Tim-3 and further participate in adverse pregnancy outcomes is still unclear.

Methods

An abnormal pregnancy model in Tim-3-deficient mice and primary human dDCs treated with Tim-3 neutralizing antibodies were used to examine the effect of Tim-3 expression on dDC dysfunction after T. gondii infection.

Results

Following T. gondii infection, the expression of Tim-3 on dDCs was downregulated, those of the pro-inflammatory functional molecules CD80, CD86, MHC-II, tumor necrosis factor-α (TNF-α), and interleukin-12 (IL-12) were increased, while those of the tolerant molecules indoleamine 2,3-dioxygenase (IDO) and interleukin-10 (IL-10) were significantly reduced. Tim-3 downregulation by T. gondii infection was closely associated with an increase in proinflammatory molecules and a decrease in tolerant molecules, which further resulted in dDC dysfunction. Moreover, the changes in Tim-3 induced by T. gondii infection further reduced the secretion of the cytokine IL-10 via the SRC-signal transducer and activator of transcription 3 (STAT3) pathway, which ultimately contributed to abnormal pregnancy outcomes.

Conclusions

Toxoplasma gondii infection can significantly downregulate the expression of Tim-3 and cause the aberrant expression of functional molecules in dDCs. This leads to dDC dysfunction, which can ultimately contribute to abnormal pregnancy outcomes. Further, the expression of the anti-inflammatory molecule IL-10 was significantly decreased by Tim-3 downregulation, which was mediated by the SRC-STAT3 signaling pathway in dDCs after T. gondii infection.
Efficacy and safety of guselkumab and adalimumab for pustulotic arthro-osteitis and their impact on peripheral blood immunophenotypes
Authors: Ueno Masanobu , Miyagawa Ippei , Miyazaki Yusuke , Hanami Kentaro , Fukuyo Shunsuke , Kubo Satoshi , Nakayamada Shingo , Tanaka Yoshiya
Published: October 2022

Objectives

We compared the treatment effectiveness between guselkumab and adalimumab in patients with pustulotic arthro-osteitis (PAO). In addition, we performed peripheral blood immunophenotyping to elucidate the immunological background and analyzed the impact of therapeutic drugs to verify the validity of immunological phenotypes as therapeutic targets.

Methods

Patients were treated with guselkumab 100 mg (guselkumab group; n = 12) and adalimumab 40 mg (adalimumab group; n = 13). Arthritis disease activity, skin lesion activity, and patient-reported outcomes (PROs) were evaluated and compared between the two groups. The retention rate and adverse events were evaluated. Comprehensive phenotyping of peripheral immune cells was performed in both groups, and phenotypes were compared before and after treatment.

Results

At 6 months, both groups showed significant improvement in arthritis disease activity and PROs. In the guselkumab group, skin symptoms significantly improved. The 6-month continuation rates were 91.7% (11/12) and 69.2% (9/13) in the guselkumab and adalimumab groups, respectively. Adverse events occurred in 2/12 and 5/13 patients in the guselkumab (16.7%) and adalimumab (38.5%) groups, respectively. Peripheral blood immunophenotyping showed that the proportion of activated T helper (Th) 1 cells was significantly lower in patients with PAO than in healthy controls and that the proportion of activated Th17 cells was significantly higher in patients with PAO, which significantly decreased after treatment with guselkumab.

Conclusion

Although guselkumab and adalimumab have comparable efficacy for PAO, their impact on immunophenotypes varies.
Network meta-analysis on the efficacy and safety of finerenone versus SGLT2 inhibitors on reducing new-onset of atrial fibrillation in patients with type 2 diabetes mellitus and chronic kidney disease
Authors: Zhang Yaofu , Wang Junheng , Jiang Li , Wang Tongxin , Li Zhuang , Fu Xiaozhe , Huang Weijun , Xiao Yonghua , Wang Shidong , Zhao Jinxi
Published: October 2022

Objective

To evaluate the efficacy and safety of finerenone and sodium-glucose cotransporter-2 inhibitors (SGLT2i) on reducing new-onset of atrial fibrillation (AF) in patients with type 2 diabetes mellitus (T2DM) and chronic kidney disease (CKD).

Method

We searched the PubMed, Cochrane Library, Web of Science, Medline and Embase covering January 1, 2000 to April 30, 2022. Randomized control trials comparing finerenone or SGLT2i with placebo in patients with T2DM and CKD were selected. Results were reported as risk ratio (RR) with corresponding 95% confidence interval (CI).

Results

A total of 10 studies (35,841 patients) were included. Finerenone (RR 0.79, 95% CI 0.62–0.99) was associated with a decreased risk of AF compared with placebo, while SGLT2i were not. SGLT2i were associated with a decreased risk of hospitalization for heart failure (RR 0.78, 95% CI 0.63–0.98) compared with finerenone. They were comparable in AF(RR 0.84, 95% CI 0.48,1.46), major adverse cardiovascular events(MACE) (RR 0.93, 95% CI 0.81,1.06) and nonfatal stroke(RR 0.78, 95% CI 0.58,1.05). They both showed no significant risk of adverse events compared with placebo.

Conclusion

There was no significant difference in the reduction of new-onset of atrial fibrillation between Finerenone and SGLT2i based on the indirect comparisons of currently available clinical studies. The large-sampled head-to-head trials was needed for the more precise conclusion.
Obstructive sleep apnea risk and its associated factors among type 2 diabetes mellitus patients at wolkite university specialized hospital, Wolkite, Southern Ethiopia, 2021. A comparative cross-sectional study
Authors: Wondie Alemayehu , Taderegew Mitku Mammo , Girma Betemariam , Getawey Atsede , Tsega Daniel , Terefe Tamene Fetene , Mitiku Shimelis , Berhanu Hiwot
Published: October 2022

Background

Obstructive sleep apnea is a syndrome characterized by recurrent partial, or complete upper airway collapse during sleep. Although obstructive sleep apnea is common in type 2 diabetes mellitus, the majority of patients remain undiagnosed because of the prohibitive cost of the test and paucity of the sleep clinic, especially in developing nations. The study aimed to assess high-risk obstructive sleep apnea and its associated factors among type 2 diabetes mellitus patients at Wolkite University Specialized Hospital.

Methods

A Hospital-based comparative cross-sectional study was employed from October 15 to December 5, 2021, among 204 participants. Data collection was done by semi-structured interviewer-administered questionnaires. Data was entered into the Epi data version 4.6 and exported to SPSS version 25.0 for analysis. Independent t-test and chi-square test were used to compare continuous and categorical variables accordingly. Binary and multiple logistic regression analysis was used to assess factors associated with high-risk obstructive sleep apnea. Statistical significance was set at P-value < 0.05.

Results

A total of 204 participants with an equal proportion of the two groups were included with a 100% response rate. About 56.9% of the participants were males. The mean age of type 2 diabetes mellitus patients was 57.1 (± 12.0) years and the non-diabetic group was 55.3 (± 10.9) years. The prevalence of high-risk obstructive sleep apnea among type 2 diabetes mellitus was 42.2%, and that of non-diabetics was 13.7% (p < 0.001). Age (AOR: 1.13; 95%CI: 1.04, 1.22), neck grasp (AOR: 6.48; 95%CI: 1.56, 26.96), waist circumference (AOR: 4.44; 95%CI: 1.12, 17.61) and the presence of diabetes-related complications (AOR: 4.18; 95%CI: 1.13, 15.43) were independently associated with high-risk obstructive sleep apnea among type 2 diabetes mellitus patients.

Conclusion

The prevalence of high-risk obstructive sleep apnea among type 2 diabetes mellitus was higher with a significant difference from their comparison group. Age, neck grasp, waist circumference, and diabetes-related complications were significantly associated with high-risk obstructive sleep apnea among type 2 diabetes mellitus patients. Therefore, type 2 diabetes mellitus patients should be screened for obstructive sleep apnea in the early course of their follow-up to take preventive measures and early treatments.
Feature stability and setup minimization for EEG-EMG-enabled monitoring systems
Authors: Cisotto Giulia , Capuzzo Martina , Guglielmi Anna Valeria , Zanella Andrea
Published: October 2022

Delivering health care at home emerged as a key advancement to reduce healthcare costs and infection risks, as during the SARS-Cov2 pandemic. In particular, in motor training applications, wearable and portable devices can be employed for movement recognition and monitoring of the associated brain signals. This is one of the contexts where it is essential to minimize the monitoring setup and the amount of data to collect, process, and share. In this paper, we address this challenge for a monitoring system that includes high-dimensional EEG and EMG data for the classification of a specific type of hand movement. We fuse EEG and EMG into the magnitude squared coherence (MSC) signal, from which we extracted features using different algorithms (one from the authors) to solve binary classification problems. Finally, we propose amapping-and-aggregationstrategy to increase the interpretability of the machine learning results. The proposed approach provides very low mis-classification errors ($$<0.1$$<0.1), with very few and stable MSC features ($$<10\%$$<10%of the initial set of available features). Furthermore, we identified a common pattern across algorithms and classification problems, i.e., the activation of thecentro-parietalbrain areas andarm’s muscles in 8-80 Hz frequency band, in line with previous literature. Thus, this study represents a step forward to the minimization of a reliable EEG-EMG setup to enable gesture recognition.
An efficient quality of services based wireless sensor network for anomaly detection using soft computing approaches
Authors: Mittal Mohit , Kobielnik Martyna , Gupta Swadha , Cheng Xiaochun , Wozniak Marcin
Published: October 2022

Wireless sensor network (WSN) is widely acceptable communication network where human-intervention is less. Another prominent factors are cheap in cost and covers huge area of field for communication. WSN as name suggests sensor nodes are present which communicate to the neighboring node to form a network. These nodes are communicate via radio signals and equipped with battery which is one of most challenge in these networks. The battery consumption is depend on weather where sensors are deployed, routing protocols etc. To reduce the battery at routing level various quality of services (QoS) parameters are available to measure the performance of the network. To overcome this problem, many routing protocol has been proposed. In this paper, we considered two energy efficient protocols i.e. LEACH and Sub-cluster LEACH protocols. For provision of better performance of network Levenberg-Marquardt neural network (LMNN) and Moth-Flame optimisation both are implemented one by one. QoS parameters considered to measure the performance are energy efficiency, end-to-end delay, Throughput and Packet delivery ratio (PDR). After implementation, simulation results show that Sub-cluster LEACH with MFO is outperforms among other algorithms.Along with this, second part of paper considered to anomaly detection based on machine learning algorithms such as SVM, KNN and LR. NSLKDD dataset is considered and than proposed the anomaly detection method.Simulation results shows that proposed method with SVM provide better results among others.
Market outlet choices for African Indigenous Vegetables (AIVs): a socio-economic analysis of farmers in Zambia
Authors: Arumugam Surendran , Govindasamy Ramu , Simon James E. , Van Wyk Emil , Ozkan Burhan
Published: October 2022

Agricultural research institutes in Sub-Sahara Africa have focused on establishing farmer groups that facilitate the commercial production and marketing of African Indigenous Vegetables (AIVs) to address food and nutritional security. With the freedom of selecting the choices of market outlets, we explored the factors such as farmers’ characteristics, farm attributes, selling preferences, social relations, and other primary reasons that influence farmers' decision to choose a particular outlet to sell AIVs. A purposive random survey was conducted among the AIV farmers to understand the preferred market outlets for AIVs in Zambia. The results of the multinomial logit model indicate that male respondents are more likely to choose intermediary options to sell AIVs, particularly brokers and wholesalers. The rainfed farmers and those who receive primary income from farming activities are less likely to choose retailers and wholesalers to market their AIVs. Similarly, those who expect instant payment for their produce indicate that they are less likely to prefer retailers and brokers. Farmers who belong to the farmer's group exhibited a positive coefficient, meaning that they are more likely to choose intermediary options to sell their AIVs compared with the farmer-to-consumer direct sales option. However, good price, a positive momentum of AIVs price in the past, and processing activities were found to be insignificant determinants for market outlet choices when compared with farmer-to-consumer direct outlet option. Our findings could help to better cognize AIVs marketing channels and develop the intervention for new farmers to make an informed decision as to how best to market their AIVs.
Safe and effective treatment of venous Thromboembolism associated with Cancer: focus on direct Oral Anticoagulants in Asian patients
Authors: Lee Lai Heng , Danchaivijitr Pongwut , Uaprasert Noppacharn , Gill Harinder , Sacdalan Dennis Lee , Ho Gwo Fuang , Parakh Rajiv , Pai Paresh , Lee Jen-Kuang , Rey Nannette , Cohen Alexander T.
Published: October 2022

Cancer-associated thrombosis (CAT) poses a significant disease burden and the incidence in Asian populations is increasing. Anticoagulation is the cornerstone of treatment, but can be challenging due to the high bleeding risk in some cancers and the high risk of recurrent venous thromboembolism (VTE) in patients with malignancies. Direct oral anticoagulants (DOACs) are well established as first-choice treatments for VTE in non-cancer patients, offering a more convenient and less invasive treatment option than low-molecular-weight heparin (LMWH). Asian patients have exhibited comparable efficacy and safety outcomes with other races in trials of DOACs for VTE in the general population. Although no specific data are available in Asian patients with CAT, results from randomized controlled trials of apixaban, edoxaban, or rivaroxaban versus the LMWH, dalteparin, indicate that DOACs are a reasonable alternative to LMWH for anticoagulation in Asian patients with CAT. This is further supported by analyses of real-world data in Asian populations demonstrating the efficacy and safety of DOACs in Asian patients with CAT. Apixaban, edoxaban, or rivaroxaban are recommended in the most recently updated international guidelines as first-line therapy for CAT in patients without gastrointestinal or genitourinary cancers and at low risk of bleeding. An increased risk of major gastrointestinal bleeding was evident with edoxaban or rivaroxaban, but not apixaban, versus dalteparin in the clinical trials, suggesting that apixaban could be a safe alternative to LMWH in patients with gastrointestinal malignancies. Determining the optimal anticoagulant therapy for patients with CAT requires careful consideration of bleeding risk, tumor type, renal function, drug–drug interactions, financial costs, and patients’ needs and preferences.
Empowering engineering with data, machine learning and artificial intelligence: a short introductive review
Authors: Chinesta Francisco , Cueto Elias
Published: October 2022

Simulation-based engineering has been a major protagonist of the technology of the last century. However, models based on well established physics fail sometimes to describe the observed reality. They often exhibit noticeable differences between physics-based model predictions and measurements. This difference is due to several reasons: practical (uncertainty and variability of the parameters involved in the models) and epistemic (the models themselves are in many cases a crude approximation of a rich reality). On the other side, approaching the reality from experimental data represents a valuable approach because of its generality. However, this approach embraces many difficulties: model and experimental variability; the need of a large number of measurements to accurately represent rich solutions (extremely nonlinear or fluctuating), the associate cost and technical difficulties to perform them; and finally, the difficulty to explain and certify, both constituting key aspects in most engineering applications. This work overviews some of the most remarkable progress in the field in recent years.
Role of time perspectives and self-control on well-being and ill-being during the COVID-19 pandemic: A multiple mediation model
Authors: Zong Min , Dong Dan , Yang Zhizun , Feng Yi , Qiao Zhihong
Published: October 2022

Background

A growing body of evidence indicates that the outbreak of COVID-19 has had a significant influence on individuals’ cognition, emotion, and psychological health. This study aims to explore the effect of the association between time perspectives and self-control on the well-being and ill-being among college students in China during the COVID-19 pandemic.

Methods

We conducted an online survey involving 1,924 participants in mainland China during the outbreak of COVID-19. A series of self-rating questionnaires measuring the perceived impact of COVID-19, time perspectives, self-control, as well as the statuses of well-being and ill-being were administered. Multiple indirect effects of time perspectives and self-control on well-being and ill-being were analysed through structural equation modelling.

Results

The present-hedonistic time perspective (an orientation on immediate impulses of pleasure) meditated the effects of perceived impacts on both well-being and ill-being, and the future time perspective (considering the outcomes of actions and decisions) mediated the effects on well-being. Moreover, the mediating effects were further mediated by self-control. Specifically, the impact of the future time perspective on ill-being was fully mediated by self-control (β = 0.01, p < 0.01).

Conclusion

Based on the results, it is evident that the present-hedonistic time perspective, the future time perspective, and self-control are related to higher levels of well-being and lower levels of ill-being, thereby providing further insight into the theoretical framework of time perspectives during the COVID-19 pandemic. Additionally, our findings provide practical implications for psychological interventions during the on-going COVID-19 pandemic, focusing on the effects of time perspectives and self-control on the well-being and ill-being of different individuals.
Determining dimensions of job satisfaction in healthcare using factor analysis
Authors: Karaferis Dimitris , Aletras Vassilis , Niakas Dimitris
Published: October 2022

Background:

Job satisfaction in health care has a great impact as it affects quality, productivity, effectiveness, and healthcare costs. In fact, it is an indicator of the well-being and quality of life of the organization’s employees, as it has been variously linked with increased performance and negatively to absenteeism and turnover. Better knowledge of healthcare employees’ job satisfaction and performance can directly contribute to the quality of the services provided to patients and is critical for the success of organizations.

Methods:

The Cronbach’s alpha coefficient, split-half reliability, exploratory factor and confirmatory factor analysis were employed to assess the reliability and validity of JSS.

Results:

Six underlying dimensions were extracted (benefits and salary, management’s attitude, supervision, communication, nature of work, and colleagues’ support). Internal consistency reliability was satisfactory since Cronbach’s alpha for the overall scale was 0.81 and for the various dimensions ranged from 0.61 to 0.81, respectively. Exploratory factor analysis showed a KMO value of 0.912. The confirmatory factor analysis indicated good fit: SRMR = 0.050, RMSEA = 0.055, IFI = 0.906 and CFI = 0.906.

Conclusion:

Job satisfaction is a multidimensional construct that encompasses different facets of satisfaction. There is a lack of consensus as to which factors are more important and a researcher may find satisfaction with some factors while at the same time dissatisfaction with others. Our findings are significant for improving our understanding of the nature and assessment of job satisfaction in the Greek healthcare context, providing a more stable ground in a rapidly changing environment. A short JSS developed that could be much more widely used in the future.
Difficulties in facial emotion recognition: taking psychopathic and alexithymic traits into account
Authors: Kyranides Melina Nicole , Christofides Demetris , Çetin Melis
Published: October 2022

Background

Alexithymic and psychopathic traits are closely associated, but distinct constructs. Both have been associated with facial emotion processing deficits reflecting empathy deficits, however the underlying mechanism contributing to these deficits is not well-understood.

Methods

This study investigated facial emotion recognition performance in a non-clinical sample (N = 110) including both male and female participants, with varying levels of psychopathic and alexithymic traits. Facial emotion recognition was assessed using a computerized task, that presented different expressions depicting five emotional states (pain, fear, sadness, anger, happiness) and neutral expressions.

Results

Results suggest that the high psychopathic traits group reported lower accuracy compared to the low psychopathic traits group, indicating a more generalized deficit in facial affect recognition, across all emotions. The alexithymic groups (high vs. low) on the other hand did not differ in their performance on the task for any of the emotions presented.

Conclusion

These findings add to the current body of research regarding face processing categorization deficits in relation to psychopathic and alexithymic traits and can inform prevention and intervention efforts that aim to facilitate facial emotion recognition in individuals with these personality traits.
Test review: French examination of the College Scholastic Ability Test in Korea
Authors: Choi Yoonhee , Chun Jihye
Published: October 2022

This study reviews the French examination of the College Scholastic Ability Test (CSAT), the most influential and highest-stakes test in Korea. The CSAT score has considerable influence on university admissions, and admission to a highly ranked university is generally a prerequisite for socioeconomic success. From this perspective, the significance of the CSAT is enormous. In general, the assessment is influenced by the goals and content of the curriculum, and it also plays an important role in curriculum implementation. In Korea, the national curriculum has been recently reformed. The main goal of the reformed French curriculum is to promote communicative skills and cultural literacy. However, the examination has been criticized for not uniformly or adequately evaluating overall communicative skills. Considering the importance of the CSAT and the interdependence of assessment and curriculum, the CSAT French examination has to be reviewed from the perspective of test quality. Due to its limited assessment of communicative skills, the validity of the French examination is debatable. The problem of low reliability also arises due to the uncertainty of assessment criteria and guidelines. Authenticity and interactiveness could be improved by avoiding fragmentary knowledge and memorization-oriented assessment. The negative washback effect needs to be addressed to resolve the low relevance of the curriculum to the test and the relatively low applicability of the CSAT French score in university admission policy.
The light aging behavior of daylight fluorescent paints: a colorimetric, photographic, Raman spectroscopic and fluorescence spectroscopic study
Authors: Reiß Lukas , Prestel Thomas , Giering Sarah
Published: October 2022

Daylight fluorescent pigments with their intense color effects have attracted great interest among artists since their market launch in the mid-twentieth century. Since then they have been widely used in the visual arts. The pigments are mainly compositions of organic fluorescent dyes and optical brighteners diluted in an insoluble resin. Due to the susceptibility of the dyes to visible and UV radiation, their lightfastness is comparatively low. This paper presents a comprehensive study of the color and fluorescence changes of daylight fluorescent paints upon exposure in visible light and ultraviolet radiation conducted on mock-ups of commercial daylight fluorescent pigments. The different aging characteristics of the pigments depend on the color tone. They were recorded by means of photographic and colorimetric documentation. In addition, Raman spectroscopy was used to identify the main dyes of the various pigments, even in the complex system of paints, consisting of primer, binder, resin and dyes, and to determine their degradation during aging. Fluorescence spectroscopy revealed that the change in fluorescent color may not only be due to the decrease in dye concentration, but also to the transformation of the original dyes into other fluorescent compounds during light aging. Finally, this paper provides recommendations for the presentation of artworks containing daylight fluorescent pigments.
Dehydrocostus lactone ameliorates lipid accumulation, insulin resistance, and endoplasmic reticulum stress in palmitate-treated hepatocytes
Authors: Hong Yeonhee , Lee Minji , Kim Chanseul , Kim Gun-Hwa
Published: October 2022

Fatty liver disease is caused by lipid accumulation in the liver, insulin resistance (IR), reactive oxygen species (ROS), and endoplasmic reticulum (ER) stress. Dehydrocostus lactone (DHE) has anticancer, anti-inflammatory, and anti-ulcer effects. However, its effects on hepatic steatosis and IR remain unclear. In this study, we investigated whether DHE has antisteatotic effect on fatty liver in vitro. Hepatocytes HepG2 and SNU-449 cells were exposed to 0.25 mM palmitate (PA), and then antisteatotic effect was evaluated by treatment with 10 μM DHE. DHE treatment reduced lipid accumulation and lipogenesis factor protein levels, compared with PA-treated hepatocytes. DHE treatment also decreased gluconeogenesis marker expression and recovered IR in PA-treated hepatocytes, and promoted glucose uptake in PA-treated HepG2 cells. Additionally, the levels of ROS and ER stress factors in PA-treated HepG2 cells were reduced by DHE treatment, compared with PA-treated HepG2 cells. Overall, DHE decreased lipid accumulation and lipogenesis factors as well as recovered IR, gluconeogenesis, and glucose uptake by reducing ER stress and ROS levels in PA-treated hepatocytes. Thus, DHE is a potential antisteatotic agent.
Prevalence and associated factors of medication-related problems among epileptic patients at ambulatory clinic of Mettu Karl Comprehensive Specialized Hospital: a cross-sectional study
Authors: Bekele Firomsa , Mamo Tadele , Fekadu Ginenus
Published: October 2022

Background

Despite appropriate treatment of epilepsy, the treatment outcome is poor in developing country. Therefore, the study was aimed to identify the magnitude and associated factors of epileptic patients at ambulatory clinic of south western Ethiopian hospital.

Methods

A hospital-based cross-sectional study was conducted on epileptic patients who had follow-up at Mettu Karl Comprehensive Specialized Hospital (MKCSH). Data collection was done through patient interview and medical charts review. The pharmaceutical care network Europe foundation classification system was used to assess the drug therapy problem and Naranjo algorithm of adverse drug reaction was employed to identify the probability of adverse drug reaction. The data were analyzed by SPSS version 23 after data were entered by Epidemiological Information (Epi Info) 7.2.1. The multivariable logistic regressions were utilized and P < 0.05 was used to declare association.

Results

Over the study period, more than half of the participants 172(57.7%) were males. The magnitude of drug-related problems was found to be 164(55.0%). Among epileptic patients about 323 drug-related problems (DRPs) were identified on average, 1.084 drug-related problems (DRPs) per patient. The widely occurred types of drug-related problems were needs additional drug therapy 72(22.29%), dose too low 52(16.09%) and dose to high which accounts 50(15.48%). Regarding the predictors of drug-related problems, being a female (AOR = 3.57, 95% CI:1.85–6.88, P ≤ 0.001), having frequent seizures (AOR = 2.47, 95% CI%:1.33–4.61, P = 0.004) and the presence of poly-pharmacy (AOR = 3.57, 95% CI: 1.49–8.5, P = 0.004) were predictors of drug-related problems.

Conclusion

More than half of the patients had a drug therapy problem. Number of medications taken by the patients, gender and the seizure frequency had a significant association with occurrence of drug therapy problems (DTPs). Therefore, the pharmaceutical care in general and drug information services in particular should be established to hinder any undesirable medication effects in our study area.
Development of a high-speed and low-torque loss two-way clutch
Authors: Waragai Masaki , Takayama Toshio
Published: October 2022

In this study, a two-way clutch mechanism using planetary gear meshing was proposed. The proposed mechanism allows low torque loss and high-speed rotation instead of a larger backlash compared to a roller type two-way clutch. The unique structure of this mechanism that makes such functionality possible comprises two independent planetary gears with variable distances between the axes. When the input shaft rotated, the planetary gears rotated at a distance. Torque is transmitted by the input shaft pushing directly on the output shaft, so losses on the tooth surface are small. As with gear reducers, high-speed rotation is possible. When the output shaft rotated, the two planetary gears engaged, and the shaft locked. A flat cam was used to switch between the above two states, so the overall structure was simple. The diameter, thickness, and weight of the developed prototype were 44 mm, 24 mm, and 78.8 g, respectively. We experimentally confirmed that the mechanism worked as expected. The theoretical locking limit torque was 1.16 Nm. The torque loss was 5 mNm at the static condition and less than 10 mNm at a high speed of 4000 rpm.
Open pneumothorax with extensive thoracic defects sustained in a fall: a case report
Authors: Tokuda Rina , Okada Yohei , Nagashima Futoshi , Kobayashi Makoto , Ishii Wataru , Iizuka Ryoji
Published: October 2022

Background

Open pneumothorax with chest wall deficit is a rare chest trauma that is serious and can lead to severe respiratory failure; however, it is a potentially lifesaving injury if utilized appropriately.

Case presentation

Herein, we report a case of an open pneumothorax with extensive chest wall deficit due to falling from a height and highlight the importance of appropriate evaluation and intervention. The patient was a Japanese man in his 50 s who fell from the 6th floor to the 3rd floor while working at a height. The left chest wall was punctured due to injury, the thoracic cavity was open as if a left anterolateral thoracotomy had been performed, and the left lung had prolapsed from the thoracic cavity to the outside. In our emergency department, tracheal intubation with a double lumen tube for differential positive pressure ventilation and a right thoracic drain were inserted, and an emergency operation was started immediately. A pulmonary suture for lung injury and closure of the left thorax were performed during the surgery. The defect was closed with the remaining tissue, but the anterior thoracic skin with poor blood flow was necrotic, so debridement was undertaken. After his general condition was improved, pedicled latissimus dorsi myocutaneous flap was implanted. He was discharged home on the 63rd hospital day.

Conclusions

Although open pneumothorax is rare and sometimes presents lurid findings, we highlighted that it is important to quickly assess the life-threatening organ injury, perform positive pressure ventilation by tracheal intubation, thoracic drainage, and wound closure simultaneously respond calmly as a team.
COVID-19 epidemic lockdown-induced remarkable decrease in dairy products consumption of Iran population: does it really matter? National Food and Nutrition Surveillance
Authors: Nikooyeh Bahareh , Rabiei Samira , Amini Maryam , Ghodsi Delaram , Rasekhi Hamid , Doustmohammadian Azam , Abdollahi Zahra , Minaie Mina , Sadeghi Farzaneh , Neyestani Tirang R.
Published: October 2022

Background

The pandemic of the newly emerged coronavirus infection and its related disease, Covid-19, has influenced various aspects of human life including dietary habits. This study aimed to examine changes in dairy products consumption during Covid-19 lockdown period in a huge sample of Iranian households.

Methods

A cross-sectional descriptive-analytical study using a web-based electronic self-administered questionnaire designed to detect any changes in the consumption frequency of dairy products in the Iranian households during Covid-19 lockdown.

Results

A total of 21,290 households were enrolled. During Covid-19 epidemic lockdown, about 29%, 26% and 7% of the households had decreased their consumption frequency of milk, yogurt and cheese, respectively. The female-headed households were 21% more likely to decrease their consumption of milk, compared with male-headed households (OR = 1.21, 95% CI: 1.05–1.4). The households residing in food insecure provinces were 29%, 20% and 45% more likely to decrease their consumption of milk, yogurt and cheese as compared with those living in the food secure provinces. About 37%, 25.3%, 19.4% of those households who reported a decrease in consumption of dairy products had fully omitted them.

Conclusion

We found considerable decrement of dairy products consumption, especially milk and yogurt, in a high proportion of the studied households. Inadequate intake and, in some households, omission of dairy products can potentially bring about serious health outcomes with heavier economic burden. Further studies to track these changes over time and to evaluate their health consequences are warranted.
Maritime fuels of the future: what is the impact of alternative fuels on the optimal economic speed of large container vessels
Authors: Kouzelis Konstantinos , Frouws Koos , van Hassel Edwin
Published: October 2022

This study aims to determine the most appropriate alternative fuel technology to comply with possible different imposed emission regulations while ensuring optimal business performance. In this context, the most suitable alternative fuel technology minimizes the required freight rate while maximizing overall performance on technological, environmental, and other criteria. A decision support tool was developed combining the overall performance of alternative fuels based on technological, environmental, and other criteria via a simple multiattribute rating technique model with a financial model based on discounted cash flow analysis. In this model, also an optimization model is implemented to minimize the required freight rate by optimizing for economic vessel speed. This model provides quantified insights into the financial and operational effects of transitioning via either a 'market-based measure' regulatory scenario or an 'emission cap' scenario if current fuels do not reach the zero-emission targets in the future. Based on the analysis, it can be concluded that upgraded bio-oil, Fischer–Tropsch diesel and liquefied bio-methane can be considered the 'most promising' alternative maritime fuels of the future. Current fuels such as Heavy fuel oil and Liquified natural gas remain the 'most probable' to retain dominance without regulations. If there is a transition toward these alternative fuels, this will also lead to a shift toward lower sailing speeds.
Adapting a simple surgical manual tool to a 3D printed implantology protocol: the use of a universal screwdriver for fixation of custom-made laser sintered titanium subperiosteal implants
Authors: Ayna Mustafa , Gülses Aydin
Published: October 2022

Purpose

Current paper aims to describe a simple technique used for the fixation of the screws of a customized implant via a universal screw driver (BoneTrust® Easy Screw according to Dr. Bayer, Medical Instinct®, GmbH, Germany) to simplify the surgical placement of the customized implants.

Methods

The insertion of the drilling screws for the retention of the implant with angulated handpiece into the palatinal region or zygomatic buttress were performed with universal screw driver.

Results

The retention screws could be inserted with a proper angulation without interfering with the surrounding tissues. The technique described herein has significantly simplified the surgical intervention.

Conclusion

The insertion of the drilling screws for the retention of the implant with angulated handpiece into the palatinal region or zygomatic buttress could be challenging, thus the anatomical structures and the insufficient length of the handpiece could interfere with the placement of the screw with a proper angulation. This problem could be easily managed with the use of universal screw driver.
The protective effect of naringenin against pyrazinamide-induced hepatotoxicity in male Wistar rats
Authors: Ali Atef Abdel-Moneem , Abdel-Ghaffar Osama , Aly Dina Aly Mahmoud
Published: October 2022

Background

Pyrazinamide (PZA) is efficient antituberculosis drug. However, PZA-induced hepatotoxicity mediated by oxidative damage is documented. Naringenin (NGN) is a common flavanone with antioxidative properties. Thus, the present work aimed to elucidate the protective role of NGN against PZA-induced toxicity in rats. Eighty adult male Wister rats were randomly divided into four groups: control, PZA, NGN and NGN+PZA. Rats were orally administered 155 mgPZA/kg or 50 mgNGN/kg or NGN 1 h before PZA daily. After 1, 2, 3 and 4 weeks, blood and liver were collected for hematological, biochemical, and histopathological investigations.

Results

Administering PZA alone caused remarkable declines in the white and red blood cell counts, hemoglobin content, packed cell volume, and serum levels of albumin, albumin/globulin ratio, high-density lipoprotein cholesterol, and hepatic activities of superoxide dismutase, and glutathione reductase and glutathione level. Serum levels of total cholesterol, low-density lipoprotein cholesterols, triglycerides, globulin, glucose, total and indirect bilirubin, malondialdehyde, and aminotransferases activities were markedly elevated. Additionally, the liver of PZA group exhibited considerable histopathological alterations. Inversely, in the NGN+PZA group, all the aforesaid disturbances in the studied parameters were ameliorated.

Conclusions

The current study revealed that NGN can be successfully utilized during treatment with PZA to prevent its side actions.
Effect of intra-dialytic physical exercise on depression in prevalent hemodialysis patients
Authors: Sanad Eman Abdelmohsen , El-Shinnawy Howayda Abd El-Hamid , Hebah Hayam Ahmed , Farrag Dina Aboubakr , Soliman Eman Rabie Anwar , Abdelgawad Mostafa Abdelnasier
Published: October 2022

Background

Depression is associated with morbidity, death, diminished quality of life, decreased longevity, and even suicidal ideation in hemodialysis patients. Intra-dialytic exercise is considered as integral component of the clinical care management of hemodialysis patients as it improves hemodialysis effectiveness, reducing systemic inflammation, increasing exercise tolerance, decreasing depression and improving quality of life. The objective of this study was to assess the effect of intra-dialytic physical exercise on depression and physical activity in prevalent hemodialysis patients. This prospective cohort research comprised 50 hemodialysis patients maintained on regular hemodialysis 3 times/week with duration since starting dialysis (1–5 years), not practicing any previous physical activity, suffering from depressive symptoms, not maintained on antidepressants and separated into two groups: group I underwent intra-dialytic exercise for 3 months and group II was matched in age and gender but did not undertake any exercise.

Results

Hamilton depression rating scale was significantly decreased in group I after completing the exercise program compared to baseline (P = 0.000), while there was no significant change in group II. Serum tumor necrosis factor alpha significantly decreased in group I compared to baseline (P = 0.000), while there was no significant change in group II. A positive correlation was found between serum tumor necrosis factor alpha and Hamilton depression rating scale (r = 0.676), (P = 0.000). Physical activity tests; 6-min walk test, rapid assessment of physical activity and peak volume of oxygen consumption were significantly improved in group I compared to baseline (P = 0.000), while there was no statistically significant difference in group II. Serum phosphorus and parathyroid hormone levels were significantly decreased in group I compared to baseline (P < 0.01), while urea reduction ratio was significantly increased in group I compared to baseline (P = 0.000), but there was no significant change in group II.

Conclusions

Intra-dialysis exercise can improve depression and physical performance in hemodialysis patients. As positive correlation was found between serum tumor necrosis factor alpha and Hamilton depression rating scale, so tumor necrosis factor alpha may be considered as marker of depression in hemodialysis patients. Intra-dialytic exercise can improve dialysis efficacy by improving urea reduction ratio.
Methaemoglobinemia: a diagnosis of surprise with recent literature review and management
Authors: Shabnam Sabaha , Nair Venugopal Achuthan , Gladston Divya V. , Ranjith J Siva
Published: October 2022

Background

Methaemoglobinemia (MetHb) is a rare entity in clinical practice which often goes undiagnosed and keeps both the anaesthesiologist and attending surgeon under tension during surgery on seeing dark or chocolate-coloured blood in the surgical field. A low oxygen saturation (SpO2) will further panic us to search for a cause but may end futile. To add further, SpO2 may not rise significantly with adequate oxygenation and may not reach 100 with a fraction of inspired oxygen (FiO2) of 1 which keeps us searching further for a cause. An arterial blood gas (ABG) finally clinches our diagnosis. It is often missed in the pre-anaesthetic evaluation due to its rarity and the patient being asymptomatic most of the time.

Case presentation

We present a case of a 61-year-old man, a reformed smoker and hypertensive on regular medication was evaluated for laparoscopic partial nephrectomy for right renal cell carcinoma. MetHb was diagnosed preoperatively in the midst of the COVID pandemic when we had all our patients’ room air SpO2 recorded and thus helped us in the smooth and hassle-free management with vitamin C preoperatively for 5 days and an uneventful perioperative period.

Conclusions

MetHb is an uncommon and potentially reversible cause of hypoxia. A simple bedside SpO2 evaluation may give a hint to the diagnosis along with a high haematocrit which urges us to order for an ABG when no other cause is attributable. A preoperative diagnosis can lead to an effective and simple management with vitamin C which often reduces methaemoglobin to significantly low levels and to have a favourable outcome. According to the literature, any level of less than 20% does not have much clinical significance in asymptomatic patients and surgery need not be deferred.
Serum MMP-9, SP-D, and VEGF levels reflect the severity of connective tissue disease-associated interstitial lung diseases
Authors: Lv Chengna , Zhang Qipan , Tang Pan , Guo Lun , Ding Qunli
Published: October 2022

Background

Interstitial lung disease (ILD) is a common pulmonary complication of connective tissue disease (CTD). This study aims to evaluate the clinical diagnostic value of matrix metalloproteinase-9 (MMP-9), surfactant protein-D (SP-D), and vascular endothelial growth factor (VEGF) as potential biomarkers for CTD-ILD.

Methods

This research included 33 CTD-ILD patients, 31 CTD patients without ILD, and 24 healthy control subjects. Then, the value of biomarkers for the diagnosis and evaluation of CTD-ILD was assessed through high-resolution computed tomography (HRCT) findings and pulmonary function test (PFT) parameters.

Results

The serum MMP-9, SP-D, and VEGF levels in the CTD-ILD group were higher than those in the CTD-NILD group and healthy group. The ROC curve indicates that VEGF has good to excellent diagnostic performance in diagnosing CTD-ILD, the cut-off that best optimizes sensitivity and specificity in diagnosing CTD-ILD is 277.60 pg/ml (sensitivity, 87.9%; specificity, 83.6%), with an area under the curve (AUC) of 0.905 (95% confidence interval (CI) 0.842–0.968); The ROC curve for MMP-9 suggests this biomarker is fair for diagnosis of CTD-ILD(sensitivity, 81.8%; specificity, 81.8%), with an AUC of 0.867 (95% CI 0.784–0.950), but SP-D only provided lower specificity with higher sensitivity in diagnosing CTD-ILD(sensitivity, 90.9%; specificity, 40.0%). The different serum biomarkers are more specific and sensitive when combined to diagnose ILD. The semiquantitative score for the degree of ILD severity on HRCT was positively correlated with SP-D and VEGF levels (r = 0.461, P = 0.007; r = 0.362, P = 0.039), and serum MMP-9 levels were elevated in the UIP subgroup compared to the non-UIP subgroup. The percentage of diffusing capacity of the lung for carbon monoxide (DLco) (% predicted) had a negative correlation with the SP-D level (r = − 0.407, P = 0.044) and a statistically negative correlation between MMP-9 and the forced vital capacity (FVC) (r = − 0.451, P = 0.024).

Conclusions

Serum MMP-9, SP-D, and VEGF levels may have clinical value in screening and evaluating the severity of CTD-ILD.