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Aim: to design and implement a medication reconciliation protocol led by clinical pharmacists that allowed to identify, characterize and, eventually, prevent antiparkinsonian medication errors to promote therapeutic quality and safety in daily practice. Methods: This was an interventional, single-center, one-year, prospective study analyzing the impact of developing an antiparkinsonian medication reconciliation program. All the patients who were hospitalized and had, at least, one active prescription containing an antiparkinsonian drug at hospital admission were included. The medication reconciliation was performed by following a three-phased check: inpatient electronic prescription validation after assessing the outpatient medication schedule, review of the latest clinical report emitted by the Neurology Department, and pharmacist-driven interview of the patient and/or caregiver to confirm the information regarding medication gathered. Results: 171 admission episodes from 132 patients were registered between February 1, 2021, and January 31, 2022. Of 224 prescription lines involving antiparkinsonian drugs, 179 contained, at least, one medication error (59.8%). Commission errors (91.62%) were more frequent than omitted drugs (8.38%). The most common medication errors were related to timing (41.90%), frequency (21.23%), and dosing (19.55%). The implementation of the medication reconciliation program prevented the erroneous administration of 2716 antiparkinsonian doses, 60% of the total number of doses prescribed during this period. Interestingly, a significant relationship between the number of medication errors and having levodopa prescribed was evidenced (p<0.05). A contraindicated drug was prescribed in almost one-third of the episodes (29.82%). Conclusion: Clinical pharmacists’ implementation of an antiparkinsonian medication reconciliation program sharply reduced medication errors, and contraindicated drugs prescription.

Tyson Chou

and 6 more

Background: Midurethral sling surgery is the current gold standard worldwide for stress urinary incontinence (SUI) surgery. However, concerns surround mesh-related adverse events associated with the midurethral sling. The decision to use the midurethral sling for surgical treatment has become a challenging one for clinicians, surgeons and patients. Objectives: We sought to determine the factors for 5-year complications after midurethral sling surgery, to improve the clinical decision-making process. Study Design: Records were reviewed from a total of 1,961 female patients who underwent their first midurethral sling surgery for SUI between 2003 and 2018 at a single teaching hospital in Taiwan. A multivariable Cox proportional hazard model calculated the hazard ratios of risk factors for surgical complications, after adjusting for confounders. Results: Surgical complications (i.e., secondary surgery and urinary retention) occurred in 93 (4.7%) patients within 5 years following the index operations. These patients were more likely to be older, to have a history of menopausal syndrome within 1 year prior to the index operation,hormone replacement therapy (HRT), slower average flow rate, and longer voiding time compared with patients without surgical complications. In the multivariate analysis, menopausal syndrome or HRT (adjusted hazard ratio, 1.794; 95% confidence interval, 1.055–3.050, p=0.0390) was significantly associated with surgical complications at 5 years, after adjusting for age, gender, diabetes, average flow rate, and sling type. Conclusion: Our findings suggest that a history of menopausal syndrome within 1 year prior to surgery or a medication history of HRT may be risk factors associated with surgical complications

Di Feng

and 7 more

Objective To investigate the relationship between serum fructose and uric acid levels in patients with polycystic ovary syndrome (PCOS). Design A case-control study. Setting University-affiliated in vitro fertilization clinic. Population 292 patients with PCOS and 482 controls. Main Outcome Measures Serum fructose, uric acid and metabolic measurements. Results Compared with controls, serum fructose and uric acid levels were significantly increased in women with PCOS and patients with PCOS accompanied by metabolic disorders exhibited higher serum fructose and uric acid levels (P < 0.001). Restricted cubic splines indicated that serum uric acid levels linearly and positively correlated with serum fructose levels in women with PCOS (Poverall < 0.001, Pnon-linear = 0.30), whereas no correlation was found in controls (Poverall = 0.712, Pnon-linear = 0.43). Additionally, even after adjusting for confounding factors, serum fructose levels were an independent risk factor for hyperuricemia in patients with PCOS (P = 0.001; odds ratio, 1.380; 95% confidence interval, 1.207–1.577). Conclusions There was a significantly positive association of elevated uric acid levels with serum fructose levels in PCOS and was closely correlated with PCOS-related metabolic disorders, highlighting the importance of further research into the biological mechanisms of fructose and uric acid in the development of PCOS. Funding National Natural Science Foundation of China (No. 82071607 and 32100691); LiaoNing Revitalization Talents Program (No. XLYC1907071); Fok Ying Tung Education Foundation (No. 151039); Key Research and Development Program of Liaoning Province (No. 2018225062); Outstanding Scientific Fund of Shengjing Hospital (No. 202003). Keywords Fructose; Uric acid; PCOS; Metabolic disorder

Linying Feng

and 9 more

Background and Purpose: Blood-brain barrier (BBB) breakdown is one of the most crucial pathological changes of cerebral ischemia-reperfusion (I/R) injury. Trilobatin (TLB), a naturally occurring food additive, exerts neuroprotective effect against cerebral I/R injury as demonstrated in our previous study. This study was designed to investigate the effect of TLB on disruption of BBB after cerebral I/R injury. Experimental Approach: Rats with focal cerebral ischemia caused by transient middle cerebral artery occlusion (MCAO) and brain microvascular endothelial cells along with human astrocytes to mimic blood brain barrier (BBB) injury caused by oxygen and glucose deprivation (OGD) followed by reoxygenation (OGD/R). Key results: The results showed that TLB effectively maintained the integrity of BBB and inhibited neuronal loss following cerebral I/R challenge. Furthermore, TLB dramatically increased tight junction proteins including ZO-1, occludin and claudin 5, as well as decreased the levels of apolipoprotein E (APOE) 4, cyclophilin A (CypA), and phosphorylated nuclear factor kappa B (NF-κB), thereby reduced proinflammatory cytokines. In addition, TLB also decreased Bax/Bcl-2 ratio and cleaved-caspase 3 level along with reduced the number of apoptotic neurons. Intriguingly, molecular docking and transcriptomics predicted MMP9 was a prominent gene evoked by TLB treatment. Furthermore, the protective effect of TLB on OGD/R-induced the loss of BBB integrity in human brain microvascular endothelial cell and astrocyte co-cultures in vitro was markedly reinforced by knockdown of MMP9. Conclusions and implications: Our findings reveal a novel property of TLB: saving BBB disruption following cerebral I/R via targeting MMP9 and inhibiting APOE4/CypA/NF-κB axis.

Shivani Arora

and 1 more

Background and Purpose: Cytokine storm invoked during acute and chronic lung injury promotes alveolar damage and remodeling. The current study shows that degraded elastin-targeted nanoparticles releasing doxycycline (Doxy NPs) are potent in mitigating cytokines storm, migration of immune cells in the lungs, and inhibiting inflammasome pathways in the LPS mouse model. Experimental Approach: Cytokine storm and lung injury were induced using LPS and elastase in C57BL/6 mice (rodent model for emphysema). The mice were then treated with I.V. Doxy NPs, blank NPs, or Doxy a day before LPS administration. Cytokine levels, immune cell population, and MMP activity were analyzed in BALF 4 hours after LPS administration. Additionally, gene expression of IL-6, IL-1beta, MCP-1, NLRP3, Caspase 1, and MMPs were investigated in alveolar cells on day three after LPS administration. Key Results: Doxycycline NPs but not Doxycycline significantly decreased IL-6, TNF-α, and IL-23 and were significantly more effective in decreasing the percentage of immune cells in the BALF. This is the first in-vivo study to demonstrate that Doxycycline can effectively inhibit lung inflammasome pathways. Conclusion and Implications: IV administration of elastin antibody conjugated Doxycycline-loaded albumin Nps can effectively modulate the local immune environment in the lungs, which is not achieved by IV Doxycycline even at a 100-fold higher dose. This novel method of drug delivery can effectively lead to the repurposing of traditional Doxycycline as a potential adjunct treatment for managing the cytokine storm in the lungs in COPD and viral infections.
Resource fluctuation is a major driver of animal movement, influencing strategic choices such as residency vs nomadism, or social dynamics. The Arctic tundra is characterized by strong seasonality: resources are abundant during the short summers but scarce in winters. Therefore, expansion of boreal-forest species onto the tundra raises questions on how they cope with winter-resource scarcity. We examined a recent incursion by red foxes (Vulpes vulpes) onto the coastal tundra of western Hudson Bay, an area historically occupied by Arctic foxes (Vulpes lagopus) that lacks access to anthropogenic foods, and compared seasonal shifts in space use of the two species. We used 4 years of telemetry data following 8 red foxes and 11 Arctic foxes to test the hypothesis that the movement strategies of both species are primarily driven by temporal variability of resources. We also predicted that the harsh tundra conditions in winter affect red foxes more than Arctic foxes, which are adapted to this environment. Dispersal was the most frequent winter movement strategy in both fox species, despite its association with high mortality (winter mortality was 9.4 times higher in dispersers than residents). Red foxes consistently dispersed towards the boreal forest, whereas Arctic foxes primarily used sea ice to disperse. Home range size of red and Arctic foxes did not differ in summer, but resident red foxes substantially increased their home range size in winter, whereas home range size of resident Arctic foxes did not change seasonally. As climate changes, abiotic constraints on some species may relax, but associated declines in prey communities may lead to local extirpation of many predators, notably by favoring dispersal during resource scarcity.

Sergio Chozas

and 4 more

Aim: Species’ environmental requirements and large-scale spatial and evolutionary processes are known to determine the structure and composition of local communities. However, ecological interactions and historical processes also have major effects on community assembly at landscape and local scales. In this work we evaluate whether two xerophytic shrub communities follow fixed ecological assembly dynamics throughout large geographical extents, or their composition is rather driven by species individualistic responses to environmental and macroecological constraints. Location: SW Iberian Peninsula (Portugal and Spain) Taxa: Stauracanthus genistoides agg. and Ulex australis agg (Fabaceae). Methods:Inland dune xerophytic shrub communities were sampled in 95 plots distributed within their potential area of occurrence. Then, we described the main gradients of vegetation composition and assess the relevance of biotic interactions. We also characterized the habitat suitability of the dominant species, S. genistoides and U. australis, to map the potential distribution of the xerophytic shrub communities. Finally, to identify the relative importance of each factor driving changes in community composition, we examined the relationships between the vegetation gradients and a broad set of explanatory variables. Results: Our results show that xerophytic shrubs follow uniform successional patterns throughout the whole geographical area, but also that these communities respond differently to the main environmental gradients in each region. Soil organic matter is the main determinant of community variations in the northern regions, Setúbal Peninsula and Comporta, while in the South/South-Western region most of the variation between both types of communities is explained by temperature seasonality. Main conclusions: The relative importance of the main factors causing community-level responses varies according to regional processes and the suitability of the environmental conditions for the dominant species in these communities. These responses are also determined by intrinsic community mechanisms that result in a high degree of similarity in the gradient-driven community stages in different regions.

Xiling Deng

and 8 more

Whole-genome sequencing for generating SNP data is increasingly used in population genetic studies. However, obtaining genomes for massive numbers of samples is still not within the budgets of many researchers. It is thus imperative to select an appropriate reference genome and sequencing coverage to ensure the accuracy of the results for a specific research question, while balancing cost and feasibility. To evaluate the effect of the choice of the reference genome and sequencing coverage on downstream analyses, we used five confamilial reference genomes of variable relatedness and three levels of sequencing coverage (3.5x, 7.5x and 12x) in a population genomic study on two caddisfly species: Himalopsyche digitata and H. tibetana. Using these 30 datasets (five reference genomes × three coverages × two target species), we estimated population genetic indices (inbreeding coefficient, nucleotide diversity, pairwise and genome-wide FST) based on variants and population structure (PCA and admixture) based on genotype likelihood estimates. The results showed that both distantly related reference genomes and lower sequencing coverage lead to degradation of resolution. In addition, choosing a more closely related reference genome may significantly remedy the defects caused by low coverage. Therefore, we conclude that population genetic studies would benefit from closely related reference genomes, especially as the costs of obtaining a high-quality reference genome continue to decrease. However, to determine a cost-efficient strategy for a specific population genomic study, a trade-off between reference genome relatedness and sequencing depth can be considered.

Shahzad Sharif Mughal

Nanoscale materials that are found in many kinds at nano scale stage. Nanoparticles are vast class of material that contain small discrete mass of matter which have one particular range from 1-100nm. Nanoparticles are zero dimension, two dimensions and three dimensions etc. There are broad class of Nanoparticles which is used in disease diagnosis and treatment. Nanoparticles collaborated with the drug and increase the effectiveness of the target object. Surface of nanoparticles is modified with many agents and used in different disease. One of best purpose of nanoparticles is in drug delivery. Nanoparticles are not effective in human diseases but also helpful in plant disease. Different nanodevices like nanowires and cantilevers are very effective for gastrointestinal diseases. Specialists at Osaka University have joined nanopore sensors with man-made brainpower methods and showed that they can recognize single infection particles. This technique may give fast, purpose of utilization, ID of infections. A strategy for recognizing malignancy cells in the circulation system is being created utilizing nanoparticles called NanoFlares. The NanoFlares are structured tie to hereditary focuses in disease cells, and create light when that specific hereditary objective is found. Nanoparticles uses in different methods like MRI increased its efficiency for imaging. Many of imaging techniques like ultrasound imaging (USI), magnetic resonance imaging (MRI) and optical imaging (OI) ultrasound imaging (USI) for study of inside and outside study of human beings and others. There are different types of nanoparticles used in these techniques which help in vivo and vitro study. For treatment purpose, DNA vaccine coated SiO2 (LDH) nanoparticles induced antibody is used mostly. For this, nano spray recently discovered that picks up the insects. So, role of nanoparticles is effective.

Shahzad Sharif Mughal

Four allotropes of phosphorus namely, red, violet, white, and black phosphorus (phosphorene) named rendering to their entrance. Phosphorene few or maybe monolayer of black Phosphorus having bags of submissions in optoelectronics and electronic devices. Research is going to its belongings and device presentations has since understood exponential growth. So, we will investigating the tropical development in phosphorene study, moving up on the topics of Electronics and optoelectronics things and uses. We also confer upcoming development investigation and some tasks. We will also highpoint the phosphorene optoelectronic and electronic belongings resulting from phosphorene wrinkly construction which is different from graphene. The new the new properties of phosphorene will be moved design and protest of new devices but extra development joints on resolves to mechanical fences as surface degrading belongings and non-scalable manufacture methods. We temporary define the modern expansions of additional sophisticated project thoughts and application systems which report some of the tasks in black Phosphorus enquiry. This is predictable that attractive material remain to offer great breaks of research and evolution for predictable future. Different EDGE functionalization groups like at H, OH, COOH, and NH2 are studied for chain extent. ______________________________________________________________________________________________ _ Introduction The Brandt, in 1969 was discovered first time phosphorus the 11 th abundant element of earth crust (Lehman,

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suocheng wei

and 4 more

Objective The present study aimed to explore if bovine parvovirus (BPV) impacts beta interferon (IFN-β) production and to reveal further molecular mechanism of BPV immune escape. Method The pCMV-Myc-BPV-VP1 recombinant plasmid was verified with both double enzyme digestion and sequence. HEK 293T cells were transfected with this recombinant protein, then infected with the vesicular stomatitis virus (VSV). Expression levels of IFN-β mRNA were detected using qPCR. Results Expression level of BPV VP1 mRNA in pCMV-Myc-BPV-VP1 group was significantly higher than those of the untreated group (UT) and pCMV-Myc vector group. BPV virus copies in bovine turbinate (BT) cells of BPV-VP1 group were raised (P<0.05) with an increment of 5.8×104. Expression levels of IFN-β mRNA of BPV VP1 group in HEK 293T cells were decreased (P<0.01). Following treatment of TBK1 and IRF3(5D), IFN-β expression levels in HEK 293T cells were depressed. Expression levels of TBK1, IRF3(5D), MDA5 and MAVS were lower than those of their self treatment. Conclusion pCMV-Myc-BPV-VP1 could heighten transcription levels of VP1 protein in BT cells, promote BPV proliferation and ascend the production of IFN-β. Overexpression of pCMV-Myc-BPV-VP decreased IFN-β mRNA expression in HEK 293T cells and inhibited IFN-β production induced by TBK1 and IRF3(5D). Furthermore, BPV VP1 obviously declined expression levels of TBK1, IRF3(5D), MDA5 and MAVS in RLR pathway. Our findings revealed a new mechanism evolved by BPV VP1 to inhibit type I IFN production and provided a solid basis into the immunosuppression of BPV, which is beneficial for developing novel strategy oftherapy of BPV disease.

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