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Application of 3D photogrammetry on the quantification of complex morphometric hard c...
Zaidi Puteri
Chun Hong Tan

Zaidi Puteri

and 3 more

June 01, 2022
1. Coral growth rate is one of the common measurements used as an indicator of coral reef health. The traditional approach is by directly measuring the linear extension rate. Yet, this method is a one-dimensional measurement where it underestimated actual coral growth due to coral morphotypes. Therefore, a multidimensional measurement would provide a better understanding on coral dynamic growth. Moreover, current practices are either invasive or needs a sample to be sacrificed therefore unfeasible for repeated sampling. This study aims to evaluate the accuracy of 3D-photogrammetry by comparing with standardised stainless steel gauge blocks of known dimensions. Also, aluminium foil wrap methods were compared with 3D photogrammetry to examine coral surface area of different morphotypes. 2. To explore the application of 3D-photogrammetry, 10 coral nubbins (approximately 3cm) of Acropora digitifera were taken from Pulau Bidong and transported back to the mesocosm system. Three different approaches were tested, they are (1) Photo-geometry linear extension (LE) rate using ImageJ software, (2) buoyant weight (BW), and (3) surface area (SA) estimation via 3D-photogrammetry modelling using Agisoft Photoscan software. Coral growth rates were measured every 14 days. 3. The coral growth was significantly reduced at week-8 as showed by the reduction in LE rate and BW values, while SA values increased exponentially. This was believed due to energy shift to form thin calcified layer at the base of the nubbins for stabilisation. 4. This finding suggests corals prioritise in establishment of a base for stability over linear growth after the asexual fragmentation. 3D photogrammetry allows a better understanding of corals’ life history strategy by recreating fairly accurate estimates of real objects (irregular coral) without sacrificing and removing it from water. In conclusion, this method further contributes to understanding coral performances after it is transplanted and for future in-situ long term coral monitoring purposes.
A pipeline for analysis of allele specific expression from RNA-seq data reveals salin...
Aurora Campo
Moran Gershoni

Aurora Campo

and 3 more

June 01, 2022
Species living in a changing environment are capable of adapting to alterations of various factors. Physiological acclimatization may be significantly influenced by the heterozygosity, especially with regards to allele variance and its specific expression (ASE) under different conditions. Data from RNA-seq experiments can be used to identify and quantify the alleles expressed, in order to detect and characterize ASE and regulation of gene expression. However, the allele matching the reference genome creates a mapping bias that prevents a reliable estimation of the allele depth unless the haplotype of the experimental individuals is provided. We developed a pipeline that allows the identification of the alleles corresponding to an RNA-seq dataset and their unbiased quantification. This pipeline does not require the sequencing of the DNA nor the previous knowledge of the haplotype. The identified SNPs are further substituted in the reference genome, thus creating two pseudogenomes with the alternative alleles on two independent samples of the experiment. The SNPs are further called against each pseudogenome thus providing with two SNP datasets that are averaged for calculation of the allele depth. The final SNP calling file contains the coordinates of the SNPs and also the ID of genes containing the SNPs, the expressed genotypes, the unbiased allele depth and the statistical tests for identifying ASE according to the experimental design and correlated with differentially expressed genes. Therefore, the pipeline presented here can calculate ASE in non-model organisms and can be applied to previous RNA-seq datasets for expanding studies in gene expression regulation.
Fast-tracking bespoke DNA reference database generation from museum collections for b...
Andrew Dopheide
Talia Brav-Cubitt

Andrew Dopheide

and 6 more

June 01, 2022
Despite recent advances in high-throughput DNA sequencing technologies, a lack of locally relevant DNA reference databases may limit the potential for DNA-based monitoring of biodiversity for conservation and biosecurity applications. Museums and national collections represent a compelling source of authoritatively identified genetic material for DNA database development yet obtaining DNA barcodes from long-stored specimens may be difficult due to sample degradation. We demonstrate a sensitive and efficient laboratory and bioinformatic process for generating DNA barcodes from hundreds of invertebrate specimens simultaneously via the Illumina MiSeq system. Using this process, we recovered full-length (334) or partial (105) COI barcodes from 439 of 450 (98 %) national collection-held invertebrate specimens. This included full-length barcodes from 146 specimens which produced low-yield DNA and no visible PCR bands, and which produced as little as a single sequence per specimen, demonstrating high sensitivity of the process. In many cases, the identity of the most abundant sequences per specimen were not the correct barcodes, necessitating the development of a taxonomy-informed process for identifying correct sequences among the sequencing output. The recovery of only partial barcodes for some taxa indicates a need to refine certain PCR primers. Nonetheless, our approach represents a highly sensitive, accurate, and efficient method for targeted reference database generation, providing a foundation for DNA-based assessments and monitoring of biodiversity.
The chloroplast plays a central role in facilitating MAMP-Triggered Immunity, pathoge...
Susan Breen
R. Muhammad Fraz Hussain

Susan Breen

and 7 more

June 01, 2022
Microbe associated molecular pattern (MAMP) triggered immunity research has traditionally centred around signal transduction pathways originating from activated membrane localised pattern recognition receptors (PRRs), culminating in nuclear transcription and post translational modifications. More recently, chloroplasts have emerged as key immune signalling hubs. Chloroplasts play a central role in integrating environmental signals. Notably MAMP recognition induces chloroplastic ROS (cROS) which is suppressed by pathogens effectors, which also modify the balance of defence hormone precursors, jasmonic acid (JA), salicylic acid (SA) and abscisic acid (ABA), whose precursors are chloroplast synthesised. This study focuses on how well characterised PRRs and co-receptors modulate chloroplast physiology, examining whether diverse signalling pathways converge to similarly modulate chloroplast function. Pre-treatment of receptor mutant plants with MAMP and D(Damage)AMP peptides usually protect against effector modulation of chlorophyll fluorescence and prevent Pseudomonas syringae effector mediated quenching of cROS and suppression of Fv/Fm. The MAMP-triggered immunity (MTI) co-receptor double mutant, bak1-5/bkk1-1, exhibits a remarkable decrease in Fv/Fm compared to control plants during infection, underlining the importance of MTI mediated signalling in chloroplast immunity. Further probing the role of the chloroplast in immunity we unexpectedly found that high light uncouples plant immune signalling.
Evaluation of Dittrichia viscosa aquaporin Nip1.1 gene as marker for arsenic tolerant...
Angelo De Paolis
Monica De Caroli

Angelo De Paolis

and 5 more

June 01, 2022
Dittrichia viscosa (L.) Greuter is gaining attention for its high genetic plasticity and ability to adapt to adverse environmental conditions including heavy metals and metalloids pollution. Uptake and translocation of cadmium, copper, iron, nickel, lead, and zinc to the shoots have been characterized but its performance with arsenic is less known and sometimes contradictory. Tolerance to As is not related to a reduced uptake but the null mutation of the aquaporin Nip1.1 gene in Arabidopsis, makes the plant completely resistant to the metalloid. This aquaporin, localized in the Endoplasmic Reticulum is responsible for arsenite and antimony (Sb) membrane permeation but the uptake of arsenite occurs also in the null mutant, suggesting a more sophisticated action mechanism than direct uptake. The DvNIP1 gene homologue is here cloned and its expression profile in roots and shoots is characterized in different arsenic stress conditions. The use of clonal lines allowed to evidence that DvNip1.1 expression level is influenced by arsenic stress. The proportion of gene expression in roots and shoots can be used to generate an index that appears to be a promising putative selection marker to predict arsenic-resistant lines of Dittrichia viscosa plants.
Application of new rigid sternal plates and prediction of sternal dehiscence in high-...
Jing Wang
Shuang Hao

Jing Wang

and 3 more

June 01, 2022
Background: Sternal dehiscence is a serious complication of cardiac surgery that has been a clinically intractable problem. The study aimed to explore the advantages of new rigid sternal plates (NRSP) compared with wire cerclage (WC) in the cardiac surgery of high- risk patients with sternal dehiscence and summarize the application experience. Methods: A retrospective analysis was performed on high-risk patients for sternal dehiscence who underwent cardiac surgery operation in the Department of Cardiovascular Surgery, The First Affiliated Hospital of Zhengzhou University from January 2017 to December 2021. All cases were identified and divided into WC (n=276) and NRSP (n=291). Risk factors for sternal complications, postoperative outcomes and cost associated with surgery and subsequent treatment were analyzed. Results: There was no significant difference in demographics and preoperative comorbidities compared to patients with WC(p>0.05), those with NRSP had longer sternal closure time(p<0.001). However, there are shorter hospital length of stay(p<0.001), less postoperative drainage volume of 24h (p<0.001), and lower total costs at 6 months(p=0.043) and 12 months(p<0.001) in NRSP patients. After multivariate logistic regression analysis, the remaining five independent risk factors for the development of sternal dehiscence were used to compose the nomogram. The area under the receiver operating characteristic curve (AUC) of the model was 0.865 (95% confidence interval [CI], 0.802–0.927), and the calibration curve was good by the Hosmer–Lemeshow test. Conclusions: NRSP can enhance the stability of sternal fixation in high-risk patients after cardiac surgery and reduce the risk of sternal complications. Moreover, the nomogram comprised of age, body mass index (BMI)>30kg/m 2, diabetes mellitus(DM), chronic obstructive pulmonary disease (COPD) and sternal closure method may predict the risk of sternal dehiscence.
Mimicking Multiple Myeloma: the importance of the differential diagnosis
Daniele Derudas
Concu Claudia

Daniele Derudas

and 7 more

June 01, 2022
Here we describe the case of a caucasian man referred to our Center for a suspicion of Multiple Myeloma which comprehensive work-up ruled out the presence of plasma cells neoplasm and allowed us to perform a diagnosis of brown tumor (BT).
Patient with lupus anticoagulant caused aPTT prolongation corrected with prednisolone...
Marlena  Frydrysiak
Paulina Pachniak

Marlena Frydrysiak

and 3 more

June 01, 2022
Abstract text is in the manuscript due to problem with words limit
Fracture of an Orogastric tube in a stroke patient: A case report
Surendra Khanal
Pramesh Shrestha

Surendra Khanal

and 5 more

June 01, 2022
Orogastric and nasogastric tube are common methods of enteral feeding. While simple, these methods are not free of complications. A rare complication of these feeding methods is the fracture of the tube. This report describes a fracture of an orogastric tube in a 58-year-old stroke patient.
Concomitant surgical revascularization in post-infarction ventricular septal rupture...
Daniele Ronco
Matteo Matteucci

Daniele Ronco

and 3 more

June 01, 2022
The potential benefit of concomitant surgical revascularization represents a controversial topic of the surgical treatment of post-infarction ventricular septal rupture (VSR). Beliaev and colleagues presented a case series interestingly focusing on this issue and showed how the possibility to perform coronary artery bypass grafting at time of VSR repair was associatd with better early and late mortality and improved cardiac function. However, a few more aspects deserve further comments in this controversial topic, especially considering late survival and postoperative cardiac function, although it seems reasonable to conclude that the presence of coronary artery disease not amenable to revascularization represents a strong negative prognostic factor in surgically treated VSR patients.
Si6C18: A Bispentalene Derivative with Two Planar tetracoordinate Carbons
Diego Inostroza
Luis Leyva-Parra

Diego Inostroza

and 7 more

June 01, 2022
Here we show that substituting the ten protons in the dianion of a bispentalene derivative (C18H102-) by six Si2+ dications produces a minimum energy structure with two planar tetracoordinate carbons (ptC). In Si6C18, the ptCs are embedded in the terminal C5 pentagonal rings and participate in a three-center, two-electron (3c-2e) Si-ptC-Si σ-bond. Our exploration of the potential energy surface identifies a triphenylene derivative as the putative global minimum. But robustness to Born-Oppenheimer molecular dynamics (BOMD) simulations at 900 and 1500 K supports bispentalene derivative kinetic stability. Chemical bonding analysis reveals ten delocalized π-bonds, which, according to Hückel’s 4n+2 π-electron rule, would classify it as an aromatic system. Magnetically induced current density analysis reveals the presence of intense local paratropic currents and a weakly global diatropic current, the latter agreeing with the possible global aromatic character of this specie.
Combination of Spironolactone and Sitagliptin Improves Clinical Outcomes of Outpatien...
Mohammad Ali Davarpanah
Reuben Adatorwovor

Mohammad Ali Davarpanah

and 8 more

May 31, 2022
Rationale: Coronavirus disease 2019 (COVID-19) leads to hospitalization and death, especially in elderly and those with comorbidities. There are evidences showing that sitagliptin and spironolactone can potentially improve the clinical outcomes of COVID-19 cases. Objective: In this observational study on acutely symptomatic outpatient COVID-19 cases, we investigated the effects of spironolactone and sitagliptin on the outcomes of the disease. Methods: This prospective cohort study was conducted at Shiraz University of Medical Sciences Clinics during the fifth wave of the COVID-19 pandemic between July 2021 and September 2021. We followed mild to moderate symptomatic COVID-19 patients, who were treated with either combination (spironolactone 100 mg daily and sitagliptin 100 mg daily) or standard (steroid, antiviral and/or supportive care) therapy up to 30 days. Our primary outcome was hospitalization rate. The secondary outcomes included ER visit, duration of disease, and complications, such as hypoglycemia, low blood pressure or altered mental status. Results: Of the 206 patients referred to clinics, 103 received standard therapy and 103 treated with combination therapy. There were no significant differences in baseline characteristics, except for slightly higher clinical score in control group (6.92 ± 4.01 control, 4.87 ± 2.92 combination; P <0.0001). Treatment with combination therapy was associated with lower admission rate (5.8% combination, 22.3% control; P = 0.0011), ER visits (7.8% combination, 23.3% control; P = 0.0021) and average duration of symptoms (6.67 ± 2.30 days combination, 18.71 ± 6.49 days control; P =<0.0001). Conclusion: In this prospective cohort study of acutely ill outpatients with COVID-19, the combination of sitagliptin and spironolactone reduced duration of COVID infection and hospital visits better than standard therapeutic approaches. The effects of combination of sitagliptin and spironolactone in COVID-19 patients should be further verified in a double blind, randomized, placebo-controlled trial. Iranian Registry of Clinical Trials: IRCT registration number: IRCT20201003048904N2, Registration date: December 10, 2020.
Quantifying spillover risk with an integrated bat-rabies dynamic modeling framework
Eva Janoušková
Jennifer Rokhsar

Eva Janoušková

and 7 more

May 31, 2022
Vampire bat-transmitted rabies has recently become the leading cause of rabies mortality in both humans and livestock in Latin America. Evaluating risk of transmission from bats to other animal species has thus become a priority in the region. An integrated bat-rabies dynamic modeling framework quantifying spillover risk to cattle farms was developed. The model is spatially explicit, and is calibrated to the state of São Paulo, using real roost and farm locations. Roosts and farms characteristics, as well as environmental data through ecological niche model, are used to modulate rabies transmission. Interventions in roosts (such as culling or vaccination) and in farms (vaccination) where considered as control strategies implemented to reduce risk. Both interventions significantly reduce the number of outbreaks in farms and disease spread (based on distance from source), with control in roosts being a significantly better intervention. High risk areas where also identified, which can support ongoing programs, leading to more effective control interventions.
Precise regulating strategy based on multi-parameter fusion analysis applied to stren...
Bo Li
Zejian Wang

Bo Li

and 7 more

May 31, 2022
Multi-parameters of physiological metabolism, environmental state, cell morphology, and manipulated variable, have mutual influences and constraints on coenzyme Q 10 (CoQ 10) biosynthesis of Rhodobater sphaeroides. In this work, a multi-parameter fusional correlation-analysis were applied to illuminate and optimize the crucial metabolism on CoQ 10 biosynthesis. The quantitative response model for accurate living cells concentration, morphological deformation, specific oxygen consumption rate (Q O2), and specific product biosynthesis rate were established, the results revealed that maintain the optimal electrical conductivity(Cond.) and Q O2 at 9.0±0.5 mS/cm and 0.06-0.08±0.01×10 -7mmol/cell/h, respectively, by adjusting the nutrient feeding and oxygen transfer rate, the cell’s morphology and oxygen uptake rate were strengthened. CoQ 10 production in 50L bioreactors was successfully improved by 35% to 3384mg/L than that of control, which would be more powerful and effective for scale up in the large-scale production of CoQ 10.
Intracellular CHO cell metabolite profiling and in vivo monitoring of redox state unr...
Ziyu Zhu
Xiaoqian Chen

Ziyu Zhu

and 5 more

May 31, 2022
The strategy of temperature downshift has been widely used in the biopharmaceutical industry to improve antibody production and cell-specific production rate (q p) with Chinese hamster ovary cells (CHO). However, the mechanism of temperature-induced metabolic rearrangement, especially important intracellular metabolic events, remains poorly understood. In this work, in order to explore the mechanisms of temperature-induced cell metabolism, we systematically assessed the differences in cell growth, antibody expression, and antibody quality between high-producing (HP) and low-producing (LP) CHO cell lines under both constant temperature (37°C) and temperature downshift (37°C→33°C) settings during fed-batch culture. Although the results showed that low-temperature culture during the late phase of exponential cell growth significantly reduced the maximum viable cell density (p<0.05) and induced cell cycle arrest in the G0/G1 phase, this temperature downshift leaded to a higher cellular viability, and increased antibody titer by 48% and 28% in HP and LP CHO cell cultures, respectively (p<0.001), and favored antibody quality reflected in reduced charge heterogeneity and molecular size heterogeneity. Combined extra- and intra-cellular metabolomics analyses revealed that temperature downshift significantly downregulated intracellular glycolytic and lipid metabolic pathways while upregulated TCA cycle, and particularly featured upregulated glutathione metabolic pathways. Interestingly, all these metabolic pathways were closely associated with the maintenance of intracellular redox state and oxidative stress-alleviating strategies. To experimentally address this, we developed two high-performance fluorescent biosensors, denoted SoNar and iNap1, for real-time monitoring of intracellular NAD +/NADH ratio and NADPH amount, respectively. Consistent with such metabolic rearrangements, the results showed that temperature downshift decreased the intracellular NAD +/NADH ratio, which might be ascribed to the re-consumption of lactate, and increased the intracellular NADPH amount (P<0.01) to scavenge intracellular reactive oxygen species (ROS) induced by the increased metabolic requirements for high-level expression of antibody. Collectively, this study provides a metabolic map of cellular metabolic rearrangement induced by temperature downshift and demonstrates the feasibility of real-time fluorescent biosensors for biological processes, thus potentially providing a new strategy for dynamic optimization of antibody production processes.
Additive value of the right parasternal window for the assessment of aortic stenosis
Masaki Izumo
Toshio Shimamura

Masaki Izumo

and 10 more

May 31, 2022
Background: Although Doppler evaluation using a multiplanar method is recommended to assess the severity of aortic stenosis (AS) with transthoracic echocardiography, evidence on the diagnostic significance of a non-apical method is limited. This study aimed to compare the use of the apical window (AW) with use of the right parasternal window (RW) method to evaluate AS severity and to examine the diagnostic significance of performing the RW method in addition to the AW method during the evaluation. Methods: This retrospective observational study included 287 consecutive patients (mean age: 79 ± 10 years; women, 56%) with severe AS (aortic valve area [AVA] ≤1.0cm 2). The severity of AS according to the AW method and that according to the RW for all subjects were compared, and the significance of performing the RW method in addition to the AW method was examined. Furthermore, we compared the concordance group, in which the AW and RW methods indicated matching in severity, and the discordant group, in which the AW and RW methods did not indicate matching severity. Results: Peak velocity (PV), mean pressure gradient (PG), and AVA were not significantly different between the AW and RW methods. Performing the RW method in addition to the AW method significantly decreased the number of low PG AS cases (mean PG <40 mmHg) from 71.1% to 65.0% and it increased the number of very severe AS cases (PV ≥5m/s) from 8.7% to 14.5%. Although, there was no significant difference in the Doppler angle (DA) observed using the AW method for the discordant group and the concordant group, the DA observed using the RW method was significantly smaller in the discordant group (8.8±8.2, 16.3±12.3 °, p<0.01). In the receiver-operating characteristic analysis, with the RW method, a DA of 8° was the cutoff value for discrepancies between the two groups. Conclusions: By performing the RW method in addition to the AW method to determine AS severity, different severity is observed in approximately 10% of cases. These results suggest that AS severity may be underestimated by using the AW method alone.
Editor’s response to “An Oversight Regarding the Club Cell?”
Susanna McColley

Susanna McColley

May 31, 2022
Pediatric Pulmonology strives to uphold the strongest ethical standards in publishing and to serve our diverse, international community of authors and readers with respect. We will be vigilant to prevent recurrence of this and other out-of-date, harmful terminology.
Analysis of spatial-temporal variations and driving factors of typical tail-reach wet...
Yijie Cao
Yonggang Ma

Yijie Cao

and 6 more

May 31, 2022
In this study, wetlands in the Ili River Delta (IRD) from 1975 to 2020 were extracted based on Landsat images using the object-oriented method; changes in the wetland area, wetland landscape pattern, NDVI and NPP were analyzed; and the contributions of natural and human factors to wetland evolution were quantified. The results indicated that (1) From 1975 to 2020, the wetland area of the IRD showed an increasing trend, and changes in the wetland area were mainly found in the middle part of the delta near the Saryesik Peninsula. (2) The wetland landscape pattern in the IRD changed markedly from 1975 to 2020. The dominant patches of the wetland in the middle of the delta continued to expand; the patch aggregation index (AI) increased, and the patch fragmentation index (LFI) decreased. (3) From 2000 to 2020, the average annual normalized difference vegetation index (NDVI) and net primary productivity (NPP) in the IRD increased, which is consistent with the change in wetland expansion. (4) Inflow to the delta from the Ili River and the water level of Balkhash Lake are significantly correlated with the wetland area, which are the dominant factors driving wetland evolution; and water evaporation from the Kapchagay Reservoir and irrigation water diversion on the left bank of the reservoir obviously intensified the process of lake water level decline and wetland degradation during 1970 to 1985. These results can provide scientific background for making informed ecological protection decisions in the Ili River Delta under the impacts of climate change and human activities.
Barium swallow - a useful investigation in otolaryngology? A systematic literature re...
Alice Maria Arvidsson
Samuel Dwamena

Alice Arvidsson

and 3 more

May 31, 2022
Objectives: Barium studies are routinely requested to investigate a range of conditions, however, its efficacy for several conditions is unclear. Alongside findings from our audit in a district general hospital, we aim to review current literature on the use of barium swallow as an investigation for pharyngeal pouch, globus pharyngeus, tertiary peristalsis and oesophageal malignancy in adults. Methods: A systematic literature search was conducted on three databases for papers published in English in the last ten years. Following screening, six studies were included for pharyngeal pouch, five studies were included for globus pharyngeus, seven studies were included for tertiary peristalsis, and thirteen studies were included for oesophageal malignancy. Results: Barium swallow is a useful and important investigation in diagnosing pharyngeal pouch and can be useful to investigate oesophageal dysmotility in tertiary peristalsis. Globus pharyngeus patients do not clinically benefit from undergoing barium swallow. Oesophagogastroduodenoscopy (OGD) should remain as first line in diagnosing oesophageal malignancies. Conclusion: Barium swallow should be used to investigate pharyngeal pouch and tertiary peristalsis, but not used as the main investigation for globus pharyngeus or oesophageal malignancy. There is a need to develop further guidelines for investigations requested for dysphagia.
EUROPEAN OAK METABOTYPES SHAPE DIGESTION AND FITNESS OF THE HERBIVORE TORTRIX VIRIDAN...
Marko Bertić
Franziska Orgel

Marko Bertic

and 10 more

May 31, 2022
Plants harbor a wide range of leaf-feeding insects. Insect survival and fitness are influenced by both energy-rich molecules and phytochemicals in the host foliage. Yet, how leaf chemical diversity and insect microbiota - key factors in ecological and physiological processes – shape insect nutrition and impact insect performance is still poorly understood. Here we forced Tortrix viridana larvae, an oak-specialized herbivore, to feed on two Quercus robur susceptible and resistant metabolic phenotypes (metabotypes) and examined leaf, salivary, and fecal metabolomes associated with larval performance, mortality, and fecal microbiota. We show that host chemical diversity affects larval development and that the distinct signatures of oak metabotypes are maintained in the insect digestive system. Larvae were highly efficient in nutrient assimilation and able to minimize plant chemical defenses, thanks in part to the adaptation of the gut microbiota to the different food qualities.
Medication changes  and potentially inappropriate prescribing in older patients with...
Caroline McCarthy
Michelle Flood

Caroline McCarthy

and 6 more

July 27, 2022
BackgroundNumber of medicines and medicines appropriateness are often used as outcome measures to evaluate the effectiveness of deprescribing interventions. The aim of this study was to evaluate changes in prescribing, potentially inappropriate prescriptions (PIP) and prescribing of low-value medicines during the SPPiRE trial.MethodsWe retrospectively analysed trial prescription data from 51 general practices with 404 participants aged ≥65 years and prescribed ≥15 repeat medicines. Repeat medications at baseline and follow-up (~1 year later) were assigned Anatomical Therapeutic Classification (ATC) codes. Outcomes were the most commonly prescribed and potentially inappropriately prescribed drug groups, the most frequently discontinued or initiated drug groups and the number of changes per person between baseline and follow-up.Results There were 7,051 medicines prescribed to 404 participants at baseline. There was a median of 17 medicines (IQR 15-19) at baseline and 16 (IQR 14-19) at follow-up. PIP represented 17.1% of prescriptions at baseline and 15.7% (n=6,777) at follow-up. There were reductions in the prescription of most drug groups with the largest reduction in antiplatelet prescriptions. Considering medication discontinuations, initiations and switches, there was a median of five medication changes per person (range 0-30, IQR 3-9) by follow-up. There were 95 low-value prescriptions at baseline reducing to 78 at follow-up.ConclusionThe number of medication changes per person was not reflected by summarising medication count at two time points, highlighting the complexity of prescribing for patients with polypharmacy. Frequent medication changes has potentially important implications for patients in terms of adherence and medication safety.Key words: Multimorbidity, polypharmacy, cluster randomised controlled trial, deprescribing, potentially inappropriate prescribingThe SPPiRE trial was registered prospectively on the ISRCTN registry (ISRCTN12752680).
“Aceclofenac Induced Toxic Epidermal Necrolysis: A Rare Case Report”
Atmik Singh
Shraddha Pore

Atmik Singh

and 3 more

May 31, 2022
Toxic Epidermal Necrolysis (TEN) is potentially life threatening cutaneous disorder usually induced by drugs. Non steroidal anti-inflammatory drugs (NSAIDS) are one of the common groups implicated in drug induced TEN. Aceclofenac is a relatively new NSAID exhibiting preferential cyclooxygenase-2 inhibition. It is widely used in management of musculoskeletal disorders. This report describes TEN induced by aceclofenac in a 58 year old female who self medicated herself with higher dose of aceclofenac for knee joint pain.
THE EVALUATION OF MEDULLA SPINALIS PERFUSION AT MODERATE HYPOTHERMIA WITH PATIENTS WH...
Mehmet Hamdi Ozbek
İsa Civelek

Mehmet Hamdi Ozbek

and 8 more

May 31, 2022
Aim: Antegrade Selective Cerebral Perfusion (ASCP) with lower body circulatory arrest (LBCA) used in aortic arch surgery can lead to postoperative ischemic organ dysfunctions if it lasts long enough. We aimed to evaluate methods that can provide early detection of spinal cord ischemia during aortic arch surgery. Methods: Thirty consecutive patients were prospectively enrolled and Near infrared spectrometry (NIRS) data obtained from the 5 th and 10 th thoracic vertebral region, S100β protein, lactate blood levels during various operative phases and postoperative neurological outcomes were evaluated. Results: A total of 30 patients underwent elective hemi arch (73.29%) or total arch (23.31%) replacement and with a mean ASCP period of 25.1 ± 19.0 (limits 10-90) minutes. In-hospital mortality was 6.66% (two patients). Paraparesis developed in one patient (3,33%). Thoracic T5 and T10 NIRS values were lowest during the ASCP period (p<0.001) with a good correlation between them (r=0.853, p<0.001). However, a significant difference between the T5 and T10 levels was observed during the same period (55.40 vs 51.07 respectively, p=0.001). A moderately negative correlation between the lactate levels in descending aorta and NIRS values at the T10 level was found during ASCP (r =-0.514, p = 0.004). Conclusion: Thoracic 5 th and 10 th level NIRS monitoring for spinal cord oxygenation were significantly lower during ASCP period compared to the other periods of aortic arch surgery with T10 values being lower than T5 values during the same period indicating a more significant flow disturbance at this level. Measuring lactate levels with thoracic NIRS monitoring seems promising for future studies with larger volumes and longer ASCP periods.
Modeling Habitat Suitability of Hippophaerhamnoides L. Using MaxEnt under Climate cha...
Xiaohui HE
Si J. H.

Xiaohui HE

and 8 more

May 31, 2022
Hippophaerhamnoides is widely known for its important ecological, economic, and social benefits. It is known as the pioneer plant of soil and water conservation, with homology in food and medicine. Here we used occurrence data and environmental (climate and soil) variables to simulate and predict the habitat distribution for H. r. sinensis and H. r. trkestanica in China, both at the current time and in the 2050s (2041-2060). Our aim was to analyze the dominant factors effecting its distribution using MaxEnt and the spatial analysis of geographic information system. The results indicated that H. r. sinensis is mainly distributed in Shaanxi, Shanxi, Sichuan, Qinghai, Gansu, Ningxia, Tibet, and Inner Mongolia, and is mainly affected by bio13 (precipitation of the wettest month), bio11 (mean temperature of the coldest quarte) and bio3 (Isothermality). The suitable habitat of H. r. trkestanica is mainly distributed in Xinjiang, and Tibet, and is mainly affected by bio13 (precipitation of the wettest month), bio2 (mean diurnal range) and bio15 (precipitation seasonality). Although, the two subspecies tend to expand and migrate toward lower latitude under future climate scenarios, there are some differences. H. r. sinensis will migrate westward, while H. r. trkestanica will migrate eastward as a whole. They have a high stability of suitable habitat and are not at risk of extinction in the future. The study’s findings help to clarify the resource reserve of Hippophaerhamnoides L. in China, which will help to guide the protection of wild resources and to popularize artificial planting in suitable areas, and provides scientific basis for the protection of ecological environment.
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