bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effect of Different Extractant Concentrations on the Content of Biologically Active Substances in Motherwort Tincture
Authors: Rogozhnikova E. P. , Mizina P. G. , Mardanly S. G. 
Published: November 2020

Introduction. This article considers the ways to optimize the motherwort tincture formulation while reducing the content of ethyl alcohol in the finished product. Qualitative and quantitative tincture test items depending on extraction method used and extractant concentration have been studied.Aim. To study the possibility of reducing the content of ethyl alcohol in motherwort tincture.Materials and methods. Comparison of quantitative and qualitative test items of tincture samples prepared by percolation, maceration, fractional maceration, modified fractional maceration is carried out. Quantitative comparative test items: dry residue, ethyl alcohol content, microbiological purity, quantitation, qualitative reactions – the presence of phenolic compounds, flavonoids in the samples (qualitative reactions, HPLC), iridoids (TLC) was used.Results and discussion. The developed method of modified fractional maceration consists in extracting herb materials with a more concentrated extractant (in the study, 80 %, 60 %, 40 % ethyl alcohol), then the subsequent extraction of herb materials with purified water. Comparison of the presence of different classes of biologically active substances in tinctures obtained by different technological methods and in infusions is carried out.Conclusion. It has been established that the most rational method is to obtain a tincture by modified fractional maceration method with ethyl alcohol content NLT 35 % in the finished product. The obtained results can be used in pharmaceutical industry for drug production by extractive methods, as well as for studies on technology optimization for obtaining extractive drugs from medicinal herb materials.
Dificuldades apresentadas por pessoas com estoma intestinal durante autocuidado: revisão integrativa
Authors: Reis Bianca Leal , Brandão Euzeli da Silva , Tonole Renato , Moraes Érica Brandão de 
Published: November 2020

Objetivo: identificar as dificuldades apresentadas durante o manejo da bolsa por adultos colostomizados/ileostomizados no ambiente domiciliar. Método: Revisão integrativa. Durante a busca, foram utilizados os descritores “ostomy” e “self care”, com o operador boleano “AND”, nas bases eletrônicas: National Library of Medicine (MEDLINE) via PubMed, Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), The Cochrane Library, The Cumulative Index to Nursing and Allied Health Literature (CINAHL), Scopus e Embase, considerando artigos publicados em qualquer idioma, recorte temporal de 2009 a 2020. Resultados: Foram encontrados 266 estudos, após utilização dos critérios de inclusão, foram selecionados 04 artigos. Entre as dificuldades destacam-se: retirada das fezes, limpeza da bolsa, recorte da placa, troca da bolsa, sendo esta última apontada em todos os estudos. Discussão: As dificuldades apontadas nos estudos selecionados revelam necessidade de intensificar as avaliações e orientações que devem ser realizadas junto aos estomizados nas fases pré, trans e pós operatórias. Tais ações devem ser preferencialmente desenvolvidas pelo enfermeiro estomaterapeuta. Conclusão: Destaca-se a importância da função educadora do enfermeiro especializado para êxito no autocuidado.
Does Serum Uric Acid Status Influence the Association Between Left Atrium Diameter and Atrial Fibrillation in Hypertension Patients?
Authors: Hidru Tesfaldet H. , Tang Yuqi , Liu Fei , Hui Simei , Gao Ruiyuan , Li Daobo , Yang Xiaolei , Xia Yunlong 
Published: November 2020

Objective: Both serum uric acid (SUA) levels and left atrium diameter (LAD) associate with AF. However, the influence of SUA status for the associated risk of AF related to LAD in hypertension patients is currently unknown.Methods: We retrospectively analyzed a hospital-based sample of 9,618 hypertension patients. Standard electrocardiograms were performed on all patients and were interpreted by expert electro-physiologists.Results: Overall 1,028 (10.69%) patients had AF out of 9,618 patients. In men &gt;65 years of age, the prevalence of AF in the1st, 2nd, and 3rd tertiles of SUA among those grouped in the third tertile of LAD were 9, 12.3, and 21.7%, respectively. In the hyperuricemia group, the OR (95% CI) of AF for the highest tertile of LAD in men ≤ 65 years of age was 3.150 (1.756, 5.651; P &lt; 0.001). Similarly, the hyperuricemic men in the 3rd LAD tertile had a higher likelihood of AF than those belonging to the 1st tertile. The ORs and (95% CIs) were 3.150 (1.756, 5.651; P &lt; 0.001) and 5.522 (2.932, 10.400; P ≤ 0.001) for patients ≤ 65 and &gt;65 years of age. An increase in SUA values was significantly associated with an increased likelihood of AF among women at the top tertiles of LAD, with the OR (95% CI) = 4.593 (1.857, 11.358; P = 0.001). Also, men&gt; 65 years of age with large LAD, present at the third tertile of SUA, had a higher likelihood of AF, with the OR (95% CI) = 2.427 (1.039, 5.667; P &lt; 0.05).Conclusion: SUA levels and LAD are associated with AF in patients with hypertension and the risk of AF associated with LAD increases among those with hyperuricemia.
The Influence of Si3N4w Volume Fraction on the Microstructure and Properties of Si3N4w/Si3N4 Composites via CVI Technique
Authors: Chen Chao , Liu Yongsheng , Yue Wei , Ye Fang , Wang Jing , Zeng Qingfeng 
Published: November 2020

Wave-transparent ceramic composites with excellent comprehensive performances are of particular significance for the development of space vehicles. In this study, Si3N4w was prepared by the gel-casting process and then combined with chemical vapor infiltration (CVI)-obtained Si3N4 to yield Si3N4w/Si3N4 composites with five Si3N4w volume fractions. The influence of the Si3N4w volume fraction on the microstructures, mechanical properties, and dielectric characteristics of the Si3N4w/Si3N4 composites were all studied. The results showed that Si3N4w/Si3N4 composites possess A sandwich structures. Higher Si3N4w volume fractions led to less incorporated amounts of the Si3N4 matrix at the same depth. The 25 vol% Si3N4w/Si3N4 composites integrated relatively higher Si3N4w volume fraction and load transfer ability of the matrix, leading to better flexural strengths reaching up to 41.37 MPa. The dielectric constants of the five prepared Si3N4w/Si3N4 composites ranged from 2.25 to 4.0. The dielectric losses were all lower than 0.005, demonstrating the good dielectric properties of the Si3N4w/Si3N4 composites.
Thromboprofilaxys With Fondaparinux vs. Enoxaparin in Hospitalized COVID-19 Patients: A Multicenter Italian Observational Study
Authors: Russo Vincenzo , Cardillo Giuseppe , Viggiano Giuseppe Vito , Mangiacapra Sara , Cavalli Antonella , Fontanella Andrea , Agrusta Federica , Bellizzi Annamaria , Amitrano Maria , Iannuzzo Mariateresa , Sacco Clara , Lodigiani Corrado , Castaldo Giampiero , Di Micco Pierpaolo 
Published: November 2020

Importance: The use of anticoagulant therapy with heparins decreased mortality in hospitalized patients with severe coronavirus disease 2019 (COVID-19). Even if enoxaparin and fondaparinux have the same clinical indication for venous thromboembolism (VTE) prevention; to date, there are no data about the use of fondaparinux in terms of safety, effectiveness, and impact on clinical prognosis among COVID-19 patients.Objective: To evaluate the safety, effectiveness, and clinical impact of VTE prophylaxis with fondaparinux and enoxaparin among COVID-19 patients hospitalized in internal medicine units.Design, Setting, and Participants: This was a retrospective multicenter observation study, including consecutive symptomatic patients with laboratory-proven COVID-19 admitted to internal medicine units of five Italian hospitals from 15th February to 15th March 2020.Main Outcomes and Measures: The primary safety outcome was the composite of major bleeding and clinically relevant non-major bleeding; the primary effectiveness outcome was the composite of all events classified as pulmonary embolism and deep venous thrombosis. The secondary effectiveness outcome included acute respiratory distress syndrome and all-cause death.Results: Among 120 COVID-19 patients enrolled in the study, 74 were taking enoxaparin (4,000 or 6,000 units/day) and 46 fondaparinux (2.5 units/day). No statistically significant difference in demographic and laboratory and clinical characteristics between the two groups has been shown. During a median follow-up of 32 (interquartile range: 14–51) days, the cumulative incidence rates of VTE and bleeding events on pharmacological thromboprophylaxis with heparins were 19% and 8%, respectively. The incidence of both VTE (6.5 vs. 13.5%; P = 0.36) and bleeding events (6.5 vs. 4.1%; P = 0.68) did not show a significant difference between COVID-19 patients on fondaparinux compared with those on enoxaparin therapy. The regression model for the risk of outcome events according to different VTE prophylaxis drugs did not show significant differences.Conclusions and Relevance: Although these results need confirmation by prospective studies including a larger population, our study provides preliminary evidence of a safe and efficacy use of fondaparinux for VTE prophylaxis in hospitalized COVID-19 patients.
Transnasal Humidified Rapid Insufflation Ventilatory Exchange With Nasopharyngeal Airway Facilitates Apneic Oxygenation: A Randomized Clinical Noninferiority Trial
Authors: Chen Lingke , Yang Liu , Tian Weitian , Zhang Xiao , Zhao Yanhua , Huang Lili , Tian Jie , Zhang Jiaqiang , Wu Jiangxia , Yu Weifeng , Su Diansan 
Published: November 2020

Background: Transnasal humidified rapid insufflation ventilatory exchange (THRIVE) was used to extend the safe apnea time. However, THRIVE is only effective in patients with airway opening. Nasopharyngeal airway (NPA) is a simple device that can help to keep airway opening. This study aimed to investigate the noninferiority of NPA to jaw thrust for airway opening during anesthesia-induced apnea.Methods: This was a prospective randomized single-blinded noninferiority clinical trial on the use of THRIVE in patients with anesthesia-induced apnea. The participants were randomly allocated to receive NPA or jaw thrust. The primary outcomes were PaO2 and PaCO2 at 20 min after apnea, with noninferiority margin criteria of −6.67 and 0.67 kPa, respectively.Results: A total of 123 patients completed the trial: 61 in the NPA group and 62 in the jaw thrust group. PaO2 at 20 min after apnea was 42.9 ± 14.0 kPa in the NPA group and 42.7 ± 13.6 kPa in the jaw thrust group. The difference between these two means was 0.25 kPa (95% CI, −3.87 to 4.37 kPa). Since the lower boundary of the 95% CI was &gt; −6.67 kPa, noninferiority was established because higher PO2 is better. PaCO2 at 20 min after apnea was 10.74 ± 1.09 kPa in the NPA group and 10.54 ± 1.18 kPa in the jaw thrust group. The difference between the two means was 0.19 kPa (95% CI, −0.14 to 0.53 kPa). Since the upper boundary of the 95% CI was &lt;0.67 kPa, noninferiority was established because lower PCO2 is better. No patient had a SpO2 &lt; 90% during apnea.Conclusion: When THRIVE was applied during anesthesia-induced apnea, NPA placement kept airway opening and was noninferior to jaw thrust in terms of its effects on PaO2 and PaCO2 at 20 min after apnea.Clinical Trial Registration:ClinicalTrials.gov (NCT03741998).
A Checklist for Implementing Rural Pathways to Train, Develop and Support Health Workers in Low and Middle-Income Countries
Authors: O'Sullivan Belinda , Chater Bruce , Bingham Amie , Wynn-Jones John , Couper Ian , Hegazy Nagwa Nashat , Kumar Raman , Lawson Henry , Martinez-Bianchi Viviana , Randenikumara Sankha , Rourke James , Strasser Sarah , Worley Paul 
Published: November 2020

Background:There is an urgent need to scale up global action on rural workforce development. This World Health Organization-sponsored research aimed to develop a Rural Pathways Checklist. Its purpose was to guide the practical implementation of rural workforce training, development, and support strategies in low and middle-income countries (LMICs). It was intended for any LMICs, stakeholder, health worker, context, or health problem.Method:Multi-methods involved: (1) focus group concept testing; (2) a policy analysis; (3) a scoping review of LMIC literature; (4) consultation with a global Expert Reference Group and; (5) field-testing over an 18-month period.Results:The Checklist included eight actions for implementing rural pathways in LMICs: establishing community needs; policies and partners; exploring existing workers and scope; selecting health workers; education and training; working conditions for recruitment and retention; accreditation and recognition of workers; professional support/up-skilling and; monitoring and evaluation. For each action, a summary of LMICs-specific evidence and prompts was developed to stimulate reflection and learning. To support implementation, rural pathways exemplars from different WHO regions were also compiled. Field-testing showed the Checklist is fit for purpose to guide holistic planning and benchmarking of rural pathways, irrespective of LMICs, stakeholder, or health worker type.Conclusion:The Rural Pathways Checklist provides an agreed global conceptual framework for the practical implementation of “grow your own” strategies in LMICs. It can be applied to scale-up activity for rural workforce training and development in LMICs, where health workers are most limited and health needs are greatest.
Case Report: Treatment of Anti-MDA5-Positive Amyopathic Dermatomyositis Accompanied by a Rapidly Progressive Interstitial Lung Diseases With Methylprednisolone Pulse Therapy Combined With Cyclosporine A and Hydroxychloroquine
Authors: Zhang Qia-Chun , Liu Min-Ying , Chen Zhi-Xin , Chen Yimin Talia , Lin Chang-Song , Xu Qiang 
Published: November 2020

Introduction: Patients with anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive amyopathic dermatomyositis (ADM) often develop rapidly progressive interstitial lung diseases (RP-ILD), with poor treatment success. Many studies have shown that this is the main cause of death in patients with anti-MDA5 antibody-positive ADM.Case Presentation: A 37-years-old woman developed a cough, shortness of breath, and a rash on both hands, which resembled Gottron's signs. Upon laboratory examination, the results were as follows: antinuclear antibody (ANA) positive; anti-Ro52 antibody positive; and anti-MDA5 antibody positive. Pulmonary high-resolution CT (HRCT) scan showed pulmonary interstitial inflammatory changes, and mediastinal and subcutaneous emphysema. She was finally diagnosed with anti-MDA5 antibody-positive ADM accompanied by RP-ILD. She was first given high-dose-steroid pulse therapy with methylprednisolone (500 mg per day for 3 days) followed by methylprednisolone (40 mg, daily), cyclosporine A (100 mg, twice per day), and hydroxychloroquine (200 mg, twice per day). Since her discharge from our hospital in March of 2018, she has maintained the methylprednisolone therapy (tapered to 10 mg daily), cyclosporine A (100 mg, twice per day), and hydroxychloroquine (200 mg, twice per day).Outcomes: Pulmonary HRCT scans taken on 4, 9, and 26 months after her discharge from our hospital showed that the interstitial pneumonitis had significantly improved and that mediastinal and subcutaneous emphysema had been gradually absorbed. The patient can now participate in regular work and activities of daily living.Conclusion: The treatment of methylprednisolone pulse therapy combined with cyclosporine A and hydroxychloroquine may be an option for the RP-ILD accompanied by anti-MDA-positive ADM. After the acute phase, this combination therapy strategy is helpful to the disease control of patients.
Extensive Healthy Donor Age/Gender Adjustments and Propensity Score Matching Reveal Physiology of Multiple Sclerosis Through Immunophenotyping
Authors: Hannikainen Paavali A. , Kosa Peter , Barbour Christopher , Bielekova Bibiana 
Published: November 2020

Quantifying cell subpopulations in biological fluids aids in diagnosis and understanding of the mechanisms of injury. Although much has been learned from cerebrospinal fluid (CSF) flow cytometry in neuroimmunological disorders, such as multiple sclerosis (MS), previous studies did not contain enough healthy donors (HD) to derive age- and gender-related normative data and sufficient heterogeneity of other inflammatory neurological disease (OIND) controls to identify MS specific changes.The goals of this blinded training and validation study of MS patients and embedded controls, representing 1,240 prospectively acquired paired CSF/blood samples from 588 subjects was (1) to define physiological age-/gender-related changes in CSF cells, (2) to define/validate cellular abnormalities in blood and CSF of untreated MS through disease duration (DD) and determine which are MS-specific, and (3) to compare effect(s) of low-efficacy (i.e., interferon-beta [IFN-beta] and glatiramer acetate [GA]) and high-efficacy drugs (i.e., natalizumab, daclizumab, and ocrelizumab) on MS-related cellular abnormalities using propensity score matching.Physiological gender differences are less pronounced in the CSF compared to blood, and age-related changes suggest decreased immunosurveillance of CNS by activated HLA-DR+T cells associated with natural aging. Results from patient samples support the concept of MS being immunologically single disease evolving in time. Initially, peripherally activated innate and adaptive immune cells migrate into CSF to form MS lesions. With progression, T cells (CD8+ &gt; CD4+), NK cells, and myeloid dendritic cells are depleted from blood as they continue to accumulate, together with B cells, in the CSF and migrate to CNS tissue, forming compartmentalized inflammation. All MS drugs inhibit non-physiological accumulation of immune cells in the CSF. Although low-efficacy drugs tend to normalize it, high-efficacy drugs overshoot some aspects of CSF physiology, suggesting impairment of CNS immunosurveillance. Comparable inhibition of MS-related CSF abnormalities advocates changes within CNS parenchyma responsible for differences in drug efficacy on MS disability progression.Video summarizing all results may become useful educational tool.
Expression Profile of Circular RNAs in Oral Squamous Cell Carcinoma
Authors: Shao Yanxiong , Song Yuhan , Xu Siming , Li Siyi , Zhou Haiwen 
Published: November 2020

BackgroundCircular RNAs (circRNAs) are involved in the pathogenesis of several diseases. Among oral maxillofacial cancers, oral squamous cell carcinoma (OSCC) has the highest incidence. However, the role of circRNAs in OSCC is still not clear. The aim of our study was to evaluate the circRNA expression profile in OSCC and explore further the potential role of circRNAs in the pathogenesis of OSCC.MethodsCircRNA sequencing was performed in 6 pairs of samples of OSCC and normal oral mucosal tissues. Expression of selected circRNAs was validated by qRT-PCR. GO and KEGG analyses were performed and binding relationships between circRNAs and miRNAs were predicted. The hsa_circ_0001766/miR-877-3p/VEGFA axis was selected to further elucidate its role in OSCC.ResultsWe showed that there were 122 differentially expressed (DE) circRNAs. Eight out of 10 selected circRNAs were validated by qRT-PCR. GO and KEGG analyses indicated that the identified DE circRNAs might be involved in the progression of OSCC. Then, after identification by Sanger sequencing and RNase R assay, the upregulated hsa_circ_0001766 was selected to investigate its potential role in OSCC. Bioinformatics analysis showed that hsa_circ_0001766 might act as a competing endogenous RNA (ceRNA) that sponged miR-877-3p to upregulate VEGFA expression. We selected OSCC cell lines SCC9 and SCC25. PCR results showed that the expression of hsa_circ_0001766 and VEGFA was upregulated in SCC9 and SCC25. Subsequently, using western blot, PCR, CCK8, and colony formation assays, we found that knocking down circRNA0001766 inhibited the expression of VEGFA and the proliferation of OSCC cells. Following this, miR-877-3p inhibitor reversed the inhibitory effect of si-hsa_circ_0001766 on expression of VEGFA and proliferation of OSCC cells.ConclusionsIn conclusion, our study revealed the possible role of circRNAs in the pathogenesis of OSCC, and identified the potential role of the hsa_circ_0001766/miR-877-3p/VEGFA axis in OSCC progression.
Case Report: BAP1 Mutation and RAD21 Amplification as Predictive Biomarkers to PARP Inhibitor in Metastatic Intrahepatic Cholangiocarcinoma
Authors: Sabbatino Francesco , Liguori Luigi , Malapelle Umberto , Schiavi Francesca , Tortora Vincenzo , Conti Valeria , Filippelli Amelia , Tortora Giampaolo , Ferrone Cristina R. , Pepe Stefano 
Published: November 2020

IntroductionIntrahepatic cholangiocarcinoma (ICC) is a rare hepatobiliary cancer characterized by a poor prognosis and a limited response to conventional therapies. Currently chemotherapy is the only therapeutic option for patients with Stage IV ICC. Due to the poor response rate, there is an urgent need to identify novel molecular targets to develop novel effective therapies. Precision oncology tests utilizing targeted next-generation sequencing (NGS) platforms have rapidly entered into clinical practice. Profiling the genome and transcriptome of cancer to identify potentially targetable oncogenic pathways may guide the clinical care of the patient.Case presentationWe present a 56-year-old male patient affected with metastatic ICC, whose cancer underwent several precision oncology tests by different NGS platforms. A novel BAP1 mutation (splice site c.581-17_585del22) and a RAD21 amplification were identified by a commercial available platform on a metastatic lesion. No germline BAP1 mutations were identified. Several lines of evidences indicate that PARP inhibitor administration might be an effective treatment in presence of BAP1 and/or RAD21 alterations since both BAP1 and RAD21 are involved in the DNA repair pathway, BAP1 interacts with BRCA1 and BRCA1-mediated DNA repair pathway alterations enhance the sensitivity to PARP inhibitor administration. In this case, after failing conventional therapies, patient was treated with PARP inhibitor olaparib. The patient had a partial response according to RECIST criteria with an overall survival of 37.2 months from the time of diagnosis of his ICC. Following 11.0 months on olaparib treatment, sustained stable disease control is ongoing. The patient is still being treated with olaparib and no significant toxicity has been reported.ConclusionThese findings have clinical relevance since we have shown PARP inhibitor as a potential treatment for ICC patients harboring BAP1 deletion and RAD21 amplification. We have also highlighted the utility of NGS platforms to identify targetable mutations within a cancer.