bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a perfusion process for serum-free adenovirus vector herpes zoster vaccine production
Authors: Sun Yang , Huang Lingling , Nie Jianqi , Feng Kai , Liu Yupeng , Bai Zhonghu 
Published: May 2022

AbstractHerpes zoster is caused by reactivation of the varicella zoster virus (VZV). Researching and developing a herpes zoster vaccine will help to decrease the incidence of herpes zoster. To increase the bioreactor productivity, a serum-free HEK293 cell perfusion process with adenovirus vector herpes zoster (rAd-HZ) vaccine production was developed efficiently using the design of experiment (DoE) method. First, serum-free media for HEK293 cells were screened in both batch and semi-perfusion culture modes. Then, three optimal media were employed in a medium mixture design to improve cell culture performance, and the 1:1 mixture of HEK293 medium and MCD293 medium (named HM293 medium) was identified as the optimal formulation. On the basis of the HM293 medium, the relationship of critical process parameters (CPPs), including the time of infection (TOI), multiplicity of infection (MOI), pH, and critical quality attributes (CQAs) (adenovirus titer (Titer), cell-specific virus yield (CSVY), adenovirus fold expansion (Fold)) of rAd-HZ production was investigated using the DoE approach. Furthermore, the robust setpoint and design space of these CPPs were explored. Finally, the rAd-HZ production process with parameters at a robust setpoint (TOI = 7.2 × 106 cells/mL, MOI = 3.7, and pH = 7.17) was successfully scaled-up to a 3-L bioreactor with an alternating tangential flow system, yielding an adenovirus titer of 3.0 × 1010 IFU/mL, a CSVY of 4167 IFU/cells, a Fold of 1117 at 2 days post infection (dpi). The DoE approach accelerated the development of a HEK293 serum-free medium and of a robust adenovirus production process.
Transcriptomic analysis of Stropharia rugosoannulata reveals carbohydrate metabolism and cold resistance mechanisms under low-temperature stress
Authors: Hao Haibo , Zhang Jinjing , Wu Shengdong , Bai Jing , Zhuo Xinyi , Zhang Jiaxin , Kuai Benke , Chen Hui 
Published: May 2022

AbstractLow temperature is an important environmental factor that restricts the growth of Stropharia rugosoannulata; however, the molecular mechanisms underlying S. rugosoannulata responses to low-temperature stress are largely unknown. In this study, we performed a transcriptome analysis of a high-sensitivity strain (DQ-1) and low-sensitivity strain (DQ-3) under low-temperature stress. The liquid hyphae of S. rugosoannulata treated at 25 °C and 10 °C were analyzed by RNA-Seq, and a total of 9499 differentially expressed genes (DEGs) were identified. GO and KEGG enrichment analyses showed that these genes were enriched in “xenobiotic biodegradation and metabolism”, “carbohydrate metabolism”, “lipid metabolism” and “oxidoreductase activity”. Further research found that carbohydrate enzyme (AA, GH, CE, and GT) genes were downregulated more significantly in DQ-1 than DQ-3 and several cellulase activities were also reduced to a greater extent. Moreover, the CAT1, CAT2, GR, and POD genes and more heat shock protein genes (HSP20, HSP78 and sHSP) were upregulated in the two strains after low-temperature stress, and the GPX gene and more heat shock protein genes were upregulated in DQ-3. In addition, the enzyme activity and qRT–PCR results showed trends similar to those of the RNA-Seq results. This result indicates that low-temperature stress reduces the expression of different AA, GH, CE, and GT enzyme genes and reduces the secretion of cellulase, thereby reducing the carbohydrate metabolism process and mycelial growth of S. rugosoannulata. Moreover, the expression levels of different types of antioxidant enzymes and heat shock proteins are also crucial for S. rugosoannulata to resist low-temperature stress. In short, this study will provide a basis for further research on important signaling pathways, gene functions and variety breeding of S. rugosoannulata related to low-temperature stress.
Protocol for the systematic review of return-to-activity criteria in adolescent patients following an anterior cruciate ligament reconstruction
Authors: Romanchuk Nicholas J. , Livock Holly , Lukas Kenneth J. , Del Bel Michael J. , Benoit Daniel L. , Carsen Sasha 
Published: May 2022

Abstract
Background
Anterior cruciate ligament (ACL) rupture is a debilitating knee injury associated with sequela such as joint instability and progressive degeneration. Unfortunately, following surgical ACL reconstruction in adolescents, the rates of ACL graft failure range from 17 to 19%. A contributing factor to the high reinjury rate in this population may be the limited evidence regarding appropriate criteria for allowing unrestricted return-to-activities (RTA) postoperatively. Several systematic reviews have already sought to develop a consensus on what criteria should be utilized for releasing patients to unrestricted sports activities; however, these reviews have focused on adult populations, a group at much lower risk for reinjury. Our objective is to systematically examine the literature and identify the criteria used when determining unrestricted RTA following an ACL reconstruction in an adolescent population.

Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, a systematic search will be performed of the MEDLINE/PubMed, Cochrane, Embase, CINAHL, and SPORTDiscus electronic databases. Searches will be conducted from January 1, 2000, until submission of the final review. Studies will be identified that include adolescent patients (10–18 years old) undergoing a primary ACL reconstruction and which have specified the criteria used to determine RTA. Each article will be independently screened by two reviewers. To supplement the electronic database search, citations within all included studies will be manually reviewed. Reviewers will record the RTA assessment utilized and the rates of ACL reinjury through a standardized data extraction sheet. Reviewers will resolve full-text screening and data extraction disagreements through discussion. Synthesis of the collected data will focus on compiling and mapping the most commonly used types of RTA criteria.

Discussion
This systematic review will determine the most commonly used RTA criteria in adolescent patients post-ACL reconstruction. This will help future interventions build more effective adolescent-specific RTA assessments through the validation of current RTA criteria as well as the implementation of new criteria according to the identified literature gaps.
Economic evaluations of health care interventions in oropharyngeal dysphagia after stroke: protocol for a systematic review
Authors: Marin Sergio , Serra-Prat Mateu , Ortega Omar , Clavé Pere 
Published: May 2022

Abstract
Background and purpose
Oropharyngeal dysphagia (OD) affects 40–81% of patients after stroke. A recent systematic review on the costs of OD and its main complications showed higher acute and long-term costs for those patients who developed OD, malnutrition and pneumonia after stroke. These results suggest that appropriate management of post-stroke OD could reduce clinical complications and costs. The purpose of this systematic review is to assess the available literature for healthcare interventions that are efficient or cost-effective in the management of OD.

Methods
A systematic review on economic evaluations of health care interventions will be performed on post-stroke patients with OD following PRISMA recommendations. Four bibliographic databases will be searched and a subsequent reference check will be done. English and Spanish literature will be included without date restrictions. Studies will be included if they refer to economic evaluations or in which cost savings were reported in post-stroke patients suffering OD. Studies will be excluded if they are partial economic evaluation studies, if they refer to esophageal dysphagia, or if OD is caused by causes different from stroke. Evidence will be presented and synthetised with a narrative method and using tables. Quality evaluation will be done using the Consolidated Health Economic Evaluation Reporting Standards (CHEERS) statement.

Discussion
The protocol for this systematic review is the first step to assess the cost-effectiveness of the healthcare interventions that have been described as potential treatments for post-stroke OD. This systematic review will summarise the current evidence on the relation between cost and benefits associated with the appropriate management of OD in post-stroke patients.

Trial registration
PROSPERO CRD42020136245
Oligodendrocyte lineage is severely affected in human alcohol-exposed foetuses
Authors: Marguet Florent , Brosolo Mélanie , Friocourt Gaëlle , Sauvestre Fanny , Marcorelles Pascale , Lesueur Céline , Marret Stéphane , Gonzalez Bruno J. , Laquerrière Annie 
Published: May 2022

AbstractPrenatal alcohol exposure is a major cause of neurobehavioral disabilities. MRI studies in humans have shown that alcohol is associated with white matter microstructural anomalies but these studies focused on myelin abnormalities only after birth. Only one of these studies evaluated oligodendrocyte lineage, but only for a short period during human foetal life. As data are lacking in humans and alcohol is known to impair oligodendrocyte differentiation in rodents, the present study aimed to compare by immunohistochemistry the oligodendrocyte precursor cells expressing PDGFR-α and immature premyelinating/mature oligodendrocytes expressing Olig2 in the ganglionic eminences and the frontal cortex of 14 human foetuses exposed to alcohol from 15 to 37 weeks’ gestation with age-matched controls. The human brains used in this study were obtained at the time of foetal autopsies for medical termination of pregnancy, in utero or post-natal early death. Before birth, PDGFR-α expression was strongly increased in the ganglionic eminences and the cortex of all foetuses exposed to alcohol except at the earliest stage. No massive generation of Olig2 immunoreactive cells was identified in the ganglionic eminences until the end of pregnancy and the density of Olig2-positive cells within the cortex was consistently lower in foetuses exposed to alcohol than in controls. These antenatal data from humans provides further evidence of major oligodendrocyte lineage impairment at specific and key stages of brain development upon prenatal alcohol exposure including defective or delayed generation and maturation of oligodendrocyte precursors.
Dynamics of dengue and SARS-COV-2 co-infection in an endemic area of Colombia
Authors: Acosta-Pérez Tomás , Rodríguez-Yánez Tomás , Almanza-Hurtado Amilkar , Martínez-Ávila María Cristina , Dueñas-Castell Carmelo 
Published: May 2022

AbstractSince the COVID-19 outbreak, millions of people have been infected with SARS-CoV-2 around the world. An area of epidemiological relevance is Latin America, tropical regions, due to the distribution of endemic diseases such as chikungunya, dengue (DENV), malaria, Zika virus, where febrile disease abounds. The early signs and symptoms of DENV and COVID-19 could be similar, making it a risk that patients may be wrongly diagnosed early during the disease. The problem increases since COVID-19 infection can lead to false positives in DENV screening tests. We present two cases of acute undifferentiated febrile syndrome that were diagnosed with SARS-CoV-2 and DENV co-infection, confirmed by ELISA and RT-PCR for both viral pathogens. The occurrence of simultaneous or overlapped infections can alter the usual clinical course, severity, or outcome of each infection. Therefore, epidemiological surveillance and intensified preparation for those scenarios must be considered, as well as further studies should be done to address cases of co-infection promptly to avoid major complications and fatal outcomes during the current pandemic. Other endemic tropical diseases should not be neglected.
Recurrent Clostridioides difficile infection worsens anxiety-related patient-reported quality of life
Authors: Hengel Richard L. , Schroeder Claudia P. , Jo Jinhee , Ritter Timothy E. , Nathan Ramesh V. , Gonzales-Luna Anne J. , Obi Engels N. , Dillon Ryan J. , Van Anglen Lucinda J. , Garey Kevin W. 
Published: May 2022

Abstract
Background
Clostridioides difficile infection (CDI) is associated with high recurrence rates impacting health-related quality of life (HrQOL). However, patient-reported data are lacking particularly in the outpatient setting. We assessed changes in HrQOL over time in patients treated with bezlotoxumab at US infusion centers and determined clinical factors associated with HrQOL changes.

Methods
The HrQOL survey was conducted in adult patients with CDI, who received bezlotoxumab in 25 US outpatient infusion centers. The survey was adapted from the Cdiff32 instrument to assess anxiety-related changes to HrQOL and completed on the day of infusion (baseline) and at 90 days post bezlotoxumab (follow-up). Demographics, disease history, CDI risk factors, and recurrence of CDI (rCDI) at 90-day follow-up were collected. Changes in HrQOL scores were calculated and outcomes assessed using a multivariable linear regression model with P < 0.05 defined as statistically significant.

Results
A total of 144 patients (mean age: 68 ± 15 years, 63% female, median Charlson index: 4, 15.9% rCDI) were included. The overall mean baseline and follow-up HrQOL scores were 26.4 ± 11.5 and 56.4 ± 25.0, respectively. At follow-up, this score was significantly higher for patients who had primary CDI (34.5 ± 21.7) compared to those with multiple rCDI (24.7 ± 21.0; P = 0.039). The mean HrQOL change at follow-up was significantly higher for patients without rCDI (34.1 ± 28.8 increase) compared to patients with rCDI (6.7 ± 19.5 increase; P < 0.001), indicating improvement in anxiety.

Conclusions
Using the Cdiff32 instrument, we demonstrated that HrQOL worsened significantly in patients with further rCDI. These findings support the use of Cdiff32 in assessing CDI-related humanistic outcomes.
Clinical and biochemical outcomes of Sodium-Glucose CoTransporter-2 (SGLT2) Inhibitors in Type-2 Diabetes Mellitus Patients as a fourth oral anti diabetic medicine
Authors: Saleem Muhammad , Khan Sajjad Ali , Suchal Zafar Aleem , Ram Nanik 
Published: May 2022

Objectives: To evaluate the clinical and biochemical effects of (SGLT2) inhibitors as a fourth oral anti-diabetic drug in patients with Type-2 diabetes mellitus (T2DM).
Methods: In a tertiary hospital in Karachi, Pakistan, a retrospective assessment of patient medical records was conducted from January 1, 2017 to December 31, 2020.A total of one hundred patients (mean age [Standard Deviation]: 53.8 [9.63] years) with poorly controlled T2DM were included. Data was collected before the SGLT-2 inhibitor was added, as well as three and six months after the medicine was started. Weight, BMI, blood pressure (BP), HbA1c, SGPT, and Creatinine were measured at the start and during the study.
Results: There was a significant reduction in HbA1c (p-value < 0.001) with a mean reduction (MR) of 0.81+1.02% at three months and 1.07+1.11% at six months. A mean weight reduction (p-value < 0.001) of 1.83+2.32 kg at three months and 4.02+6.04 kg at 6 months, respectively, was recorded. A mean BMI reduction of 0.69+0.95 kgm-2 at three months and 2.13+3.41 kgm-2 at six months of follow up, respectively were recorded. A systolic blood pressure (SBP) also showed a significant reduction (p-value < 0.05) with a MR of 5.9+15.76 mmHg at three months and 6.37+18.33 mmHg at 6 months, respectively. Non-significant variation in creatinine and SGPT was also noted.
Conclusions: SGLT-2 is an effective oral anti-diabetic medicine that can help individuals with diabetes who are currently using glucose-lowering oral anti-diabetic medications. These medications can help diabetic patients stick to their regimen.
doi: https://doi.org/10.12669/pjms.38.5.5034
How to cite this:Saleem M, Khan SA, Suchal ZA, Ram N. Clinical and biochemical outcomes of Sodium-Glucose CoTransporter-2 (SGLT2) Inhibitors in Type-2 Diabetes Mellitus Patients as a fourth oral anti diabetic medicine. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5034
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Improvement of fertility outcomes using dexamethasone / antibiotic adjuvant therapy following hysterosalpingography in infertile females: A randomised trial
Authors: El-Kharoubi Amin-Florin , Florin Szasz 
Published: May 2022

Objectives: To evaluate the benefit of modified hydrotubation with dexamethasone and antibiotics after hysterosalpingography in improving pregnancy rates in women with infertility issue.
Methods: This retrospective study conducted at County Emergency Clinical Hospital Oradea, Bihor, Romania, between January 2017 and December 2019. One hundred twenty infertile females were investigated, as part of their evaluation, Hysterosalpingography was performed. After the investigation 97 patients had taken utero-tubal instillations with (Ceftriaxone 1 gr. [Cefort] and 4 mg of Dexamethasone, Lidocaine 1% 10 ml, and a Sodium chloride 0.9% 10 ml), and 23 patients were included in the control group which didn’t receive utero-tubal instillations. Number of obtained pregnancies by natural way over the next year was compared in the two groups.
Results: From all participants in this study, 30 women became pregnant during the study. In addition, 29 out of 30 pregnant women had taken hydrotubation procedure. The significant statistical difference was observed between the groups p=0.011 (p<0.05), and the odd ratio was less than one (OR=9.3, 95%, CI:1,207 to 72.926). We also found an indirect correlation between abortion in the past and the pregnancy ratio (r=-0.21).
Conclusion: The results of the study demonstrated that the application of modified hydrotubation with the administration of dexamethasone and antibiotics in patients who had at least one patent fallopian tubes, can increase the chance of fertility.
doi: https://doi.org/10.12669/pjms.38.5.5432
How to cite this:Amin-Florin EK, Florin S. Improvement of fertility outcomes using dexamethasone / antibiotic adjuvant therapy following hysterosalpingography in infertile females: A randomised trial. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5432
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study
Authors: Long Xiaoping , Zhang Ting , Duan Shan 
Published: May 2022

Objectives: Our study was aimed to investigate the clinical characteristics of the patients with COVID-19 pneumonia and research new diagnostic methods for the disease.
Methods: In this retrospective study, medical records of 46 novel coronavirus-infected pneumonia (NCIP) patients and 30 healthy individuals in the two multiple hospitals from January 2020 to March 2020 were studied. Clinical characteristics, chest computed tomographic (CT) scans, medicine treatment and laboratory information were collected and retrospectively analyzed. Neutrophil-to-lymphocyte ratio (NLR), lymphocyte-to-monocyte ratio (LMR) and platelet-to-lymphocyte ratio (PLR) were evaluated.
Results: The main symptoms of the patients with NCIP were fever (100%), cough (82.6%), anorexia (37%), expectoration (34.8%) and fatigue (21.7%), dyspnea (15.2%). Ground glass opacity (GGO) with patch shadow was the main observation of the CT imaging (43.4%), followed by GGO (21.7%), patch shadow (19.5%), GGO with consolidation (8.7%) and GGO with reticular pattern (2.1%). The median white blood cell (WBC) count, lymphocyte count, platelet, and lymphocyte-monocyte ratio (LMR) in NCIP group were all significantly lower than in control group (p<0.001, for all comparisons), while the median neutrophil-monocyte ratio (NLR) and platelets-monocyte ratio (PLR) were both significantly higher (p<0.001, for both comparisons). Median WBC count, lymphocyte count, and platelet count on discharge were significantly higher than on admission (p<0.05). Median PLR was significantly lower two weeks after discharge (p<0.001), while NLR remained the same. The area under the curve (AUC) value of WBC, lymphocyte and platelet counts, NLR, LMR and PLR were 0.766, 0.931, 0.655, 0.780, 0.847 and 0.845, respectively. Early stages of the disease were associated with quick changes in WBC, lymphocyte, and platelet levels. However, NLR did not recover even two weeks after the discharge.
Conclusion: Changes in WBC, lymphocyte, and platelet counts, as well as NLR, LMR and PLR are strongly associated with COVID-19 pneumonia. Monitoring blood markers may assist in evaluating the progression of the disease
doi: https://doi.org/10.12669/pjms.38.5.5798
How to cite this:Long X, Zhang T, Duan S. Diagnostic value of neutrophil-to-lymphocyte, lymphocyte-to-monocyte and platelet-to-lymphocyte ratio among patients with COVID-19 pneumonia: A retrospective study. Pak J Med Sci. 2022;38(5):---------. doi: https://doi.org/10.12669/pjms.38.5.5798
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Assessment of the effectiveness of physiotherapy in children with cerebral palsy in the opinion of the parents
Authors: Łentek Monika , Zdziarski Krzysztof 
Published: May 2022

Abstract
Many specialists have studied cerebral palsy. Currently, the most accurate definition is that proposed by Bax, who defines cerebral palsy as a disorder of posture and movement caused by damage to the brain. The factors that predispose to the development of this disorder include: pre-contraceptive, prenatal, perinatal and postnatal. Symptoms indicating the possibility of cerebral palsy can be observed already in the neonatal period, therefore it is important to follow pediatric visits, and in case of alarming symptoms, consult a neurologist. Early diagnosis of the disorder will allow the introduction of quick, individualized child physiotherapy, which may strengthen the child's psychomotor development.
Aim of the research: to assess the effectiveness of physiotherapy in children with cerebral palsy in the opinion of the parents. Material and methods: the proprietary questionnaire and two certified scales were used: Gross Motor Classification System to determine the degree of motor disorders and Manual Ability Classification System to check the degree of manual skills. Results: 67% of parents support the high effectiveness of physiotherapy. Therapeutic sessions most often take place 3-5 times a week (51%); moreover, 97% of children perform rehabilitation exercises at home. Conclusions: Physiotherapy is an effective form of exercise therapy for children with cerebral palsy. The most popular of the methods used in working with children is NDT-Bobath. The desirability of early diagnosis of cerebral palsy is associated with the possibility of quick therapeutic sessions, which translates into benefits in psychomotor development and significantly improves the quality of life.