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Publication
Journal: Food Research International
March/1/2021
Abstract
The intake of diets rich in carbohydrates with a high-glycaemic load provides excessive energy consumption and low nutritional quality, contributing to cardiovascular diseases, type II diabetes and obesity, among other pathologies. Natural options such as the use of low-methoxyl pectin to develop sugar free formulations is growing since they form gel without sucrose, providing stability and viscosity of numerous foodstuffs. In this paper, we have reviewed the consumer habits of sugar intake and the potential of pectin in the elaboration of low-glycaemic index foods, as well as the structure, applications and sources of pectin. Special attention has been paid on the structure-function relationship of low-methoxyl pectins considering their effects on type I and II diabetes. It has been shown that these pectins reduce the post-prandial glycaemic responses and have an important and recognised potential for the treatment and prevention of diabetes. Rheological behaviour of pectin, impact on intestinal microbiota and on different biomarkers have been postulated as the potential involved mechanisms. As future trends, it is necessary to consider new sources and structures of pectin that present improved functionalities. For this purpose, the obtainment of pectin and derivatives should be placed in a framework of sustainable food systems.
Keywords: Diabetes; Gastric emptying; Gel; Gut microbiota; In vivo; Low-methoxyl pectin.
Publication
Journal: Journal of Neurology, Neurosurgery and Psychiatry
March/1/2021
Abstract
The objective of this paper is to evaluate available evidence for each step in autoimmune encephalitis management and provide expert opinion when evidence is lacking. The paper approaches autoimmune encephalitis as a broad category rather than focusing on individual antibody syndromes. Core authors from the Autoimmune Encephalitis Alliance Clinicians Network reviewed literature and developed the first draft. Where evidence was lacking or controversial, an electronic survey was distributed to all members to solicit individual responses. Sixty-eight members from 17 countries answered the survey. The most popular bridging therapy was oral prednisone taper chosen by 38% of responders while rituximab was the most popular maintenance therapy chosen by 46%. Most responders considered maintenance immunosuppression after a second relapse in patients with neuronal surface antibodies (70%) or seronegative autoimmune encephalitis (61%) as opposed to those with onconeuronal antibodies (29%). Most responders opted to cancer screening for 4 years in patients with neuronal surface antibodies (49%) or limbic encephalitis (46%) as opposed to non-limbic seronegative autoimmune encephalitis (36%). Detailed survey results are presented in the manuscript and a summary of the diagnostic and therapeutic recommendations is presented at the conclusion.
Keywords: autoimmune encephalitis; neuroimmunology; paraneoplastic syndrome.
Publication
Journal: Clinical Lung Cancer
March/1/2021
Abstract
Introduction: Pembrolizumab is a highly effective standard of care in PD-L1 overexpressing (≥ 50%) non-small-cell lung cancer. However, a substantial share of patients from everyday clinical practice is treated without clear evidence from clinical trials.
Patients and methods: We performed a retrospective multicentric study including all consecutive patients from 6 certified lung cancer centers in Berlin, Germany, having received pembrolizumab as first-line palliative therapy from January 1 until December 31, 2017. Aims were to validate published clinical trials with a special focus on efficacy and outcome in patients with reduced performance status (PS), brain metastases, and steroids.
Results: A total of 153 patients were included (median age 69 years, 58% men, 69% adenocarcinoma). Rates for PS ≥ 2, brain metastases, and steroids were 24.8%, 20.9%, and 24.2%, respectively. Median objective response rate, progression-free and overall survival were 48.5%, 8.2 and 22.0 months for all patients and 52.4%, 8.8 and 29.2 months in patients fulfilling the inclusion criteria for the KEYNOTE-024 trial. Patients with a comorbidity-defined PS ≥ 2, symptomatic brain metastases requiring upfront radiotherapy, or baseline steroids had significantly reduced survival. In contrast, durable responses occurred with a tumor-related PS ≥ 2 or asymptomatic brain metastases. Grade 3/4 and 5 immune-related adverse events affected 13.7% and 2.0% of patients.
Conclusion: Real-world and clinical trial efficacy with upfront pembrolizumab correspond well. Pembrolizumab may sufficiently control asymptomatic brain metastases and may improve a cancer-related reduced PS. However, the frail share of patients with a comorbidity-defined PS ≥ 2, symptomatic brain metastases, or baseline steroids derives no relevant benefit.
Keywords: Checkpoint inhibitors; Non–small-cell lung cancer; Real-world data; brain metastases; performance status.
Publication
Journal: Food Research International
March/1/2021
Abstract
Large amounts of by-products are generated during fish processing. The study aimed to assess whether tilapia scales are a potential source for obtaining glycosaminoglycans, as well as to determine their anticoagulant and cytotoxic/antiproliferative activities, against different tumor lines. The glycosaminoglycans were extracted, purified, and fractionated. The fractions that indicated the presence of uronic acid and sulfated GAGs were characterized by electrophoresis, NMR, and degree of sulfation (DS). The extraction process using the papain enzyme had a yield of 0.86%. Fraction V (FV) revealed the presence of chondroitin sulfate chains CS-A and CS-C, with DS of 0.146. FV demonstrated anticoagulant potential, as it was able to increase aPTT time. FV showed a cytotoxic effect for HTC metabolizing cells at 24, 48, and 72 h. However, it did not show activity for neuroblastoma cells in any of the evaluated times. The results indicate that the tilapia scales are a possible source for obtaining chondroitin sulfate, with potential use as anticoagulant and cytotoxic/antitumor.
Keywords: Bioactivities; By-products; CS-A; CS-C; Chondroitin sulfate; GAGs; Underutilized fish parts.
Publication
Journal: Australian Critical Care
March/1/2021
Abstract
Objectives: Patients' experience of psychological distress in the intensive care unit (ICU) is associated with adverse effects, reduced satisfaction, and delayed physical and psychological recovery. There are no specific guidelines for the assessment and management of acute psychological distress during hospitalisation in the ICU. We reviewed existing tools for the assessment of acute psychological distress in ICU patients, examined evidence on their metric properties, and identified potential gaps and methodological considerations.
Method: A scoping review based on literature searches (Cumulative Index to Nursing and Allied Health Literature, Medical Literature Analysis and Retrieval System Online, Excerpta Medica Database, PsycINFO, Scopus, Health and Psychosocial Instruments, Dissertations and Theses Global, and Google Scholar) and predefined eligibility criteria was conducted as per current scoping review guidelines.
Findings: Overall, 14 assessment tools were identified having been developed in diverse ICU settings. The identified tools assess mainly anxiety and depressive symptoms and ICU stressors, and investigators have reported various validity and reliability metrics. It was unclear whether available tools can be used in specific groups, such as noncommunicative patients and patients with delirium, brain trauma, stroke, sedation, and cognitive impairments.
Conclusion: Available tools have methodological limitations worth considering in future investigations. Given the high prevalence of psychiatric morbidity in ICU survivors, rigorously exploring the metric integrity of available tools used for anxiety, depressive, and psychological distress symptom assessment in the vulnerable ICU population is a practice and research priority.
Relevance to clinical practice: These results have implications for the selection and implementation of psychological distress assessment methods as a means for promoting meaningful patient-centred clinical outcomes and humanising ICU care experiences.
Keywords: Anxiety; Assessment; Critical care; Reliability; Scale; Stress; Tool; Validity.
Publication
Journal: International Journal of Gynecological Cancer
March/1/2021
Abstract
Breast cancers that occur in young women up to 5 to 10 years' postpartum are associated with an increased risk for metastasis and death compared with breast cancers diagnosed in young, premenopausal women during or outside pregnancy. Given the trend to delay childbearing, this frequency is expected to increase. The (immuno)biology of postpartum breast cancer is poorly understood and, hence, it is unknown why postpartum breast cancer has an enhanced risk for metastasis or how it should be effectively targeted for improved survival. The poorer prognosis of women diagnosed within 10 years of a completed pregnancy is most often contributed to the effects of mammary gland involution. We will discuss the most recent data and mechanistic insights of the most important processes associated with involution and their role in the adverse effects of a postpartum diagnosis. We will also look into the effect of lactation on breast cancer outcome after diagnosis. In addition, we will discuss the available treatment strategies that are currently being used to treat postpartum breast cancer, keeping in mind the importance of fertility preservation in this group of young women. These additional insights might offer potential therapeutic options for the improved treatment of women with this specific condition.
Keywords: carcinoma; gynecology; neoplasm metastasis.
Publication
Journal: British Journal of Sports Medicine
March/1/2021
Abstract
Objectives: We systemically reviewed the literature to assess how long-term testosterone suppressing gender-affirming hormone therapy influenced lean body mass (LBM), muscular area, muscular strength and haemoglobin (Hgb)/haematocrit (HCT).
Design: Systematic review.
Data sources: Four databases (BioMed Central, PubMed, Scopus and Web of Science) were searched in April 2020 for papers from 1999 to 2020.
Eligibility criteria for selecting studies: Eligible studies were those that measured at least one of the variables of interest, included transwomen and were written in English.
Results: Twenty-four studies were identified and reviewed. Transwomen experienced significant decreases in all parameters measured, with different time courses noted. After 4 months of hormone therapy, transwomen have Hgb/HCT levels equivalent to those of cisgender women. After 12 months of hormone therapy, significant decreases in measures of strength, LBM and muscle area are observed. The effects of longer duration therapy (36 months) in eliciting further decrements in these measures are unclear due to paucity of data. Notwithstanding, values for strength, LBM and muscle area in transwomen remain above those of cisgender women, even after 36 months of hormone therapy.
Conclusion: In transwomen, hormone therapy rapidly reduces Hgb to levels seen in cisgender women. In contrast, hormone therapy decreases strength, LBM and muscle area, yet values remain above that observed in cisgender women, even after 36 months. These findings suggest that strength may be well preserved in transwomen during the first 3 years of hormone therapy.
Keywords: body composition; gender issues; physiology; psychology; strength.
Publication
Journal: Food Research International
March/1/2021
Abstract
Red kidney bean coat (RKBC) extract contains bioactive compounds that are known to exhibit anti-melanoma activity in vitro. However, knowledge on antitumor component and mechanism of RKBC extract has not been fully clarified. Here, RKBC extract was portioned with different solvent sequentially, and based on the cell viability assay, cell migration assay, AO/EB and Hoechst 33342 staining assay, and Annexin V-FITC/PI double staining, n-BuOH (BU) fraction was identified as the most potent antitumor fraction. It exhibited potential anti-melanoma activity via the induction of apoptosis and vacuolization in B16-F10 cells. Transcriptomic and bioprocess-target network analysis revealed that BU fraction triggered apoptosis and vacuolization through regulating PI3K-AKT-FOXO, MDM2-p53 pathway and increasing the expression of Bcl-xl. In addition, quercetin might be served as one of the key anti-melanoma compounds in BU fraction through the similar mechanism. Although the anti-melanoma activity and mechanism of BU fraction have not been elucidated completely, this study effectively expands our understanding for the anti-melanoma activity of RKBC extract and provided the basis for the further functional food research and development using red kidney bean, as well as a new possibility for treating melanoma.
Keywords: Apoptosis; Mechanism; Melanoma; Red kidney bean coat; Transcriptome; Vacuolization.
Publication
Journal: Social Science Research
March/1/2021
Abstract
In formulating views of just reward for high-status and low-status work, do ordinary citizens take cues from their nation's public stance on income inequality as institutionally embedded in their welfare state, i.e. their social welfare and labor market policies, their "welfarism"? How large a morally correct earnings gap flows from that? Our multilevel analyses (fixed effects, random intercepts) replicate prior research on the impact of individual characteristics and socioeconomic development. They open new territory with the discovery that public opinion on legitimate/just earnings of high-status occupations aligns moderately strongly with welfarism, ceteris paribus, with welfare state citizens advocating lower pay for the elite but not higher pay for working-class occupations: The welfare state is not (or no longer) a matter of helping the poor but instead of bringing down the elite, "cutting down the tall poppies". Data: World Inequality Study v2.1: 30 countries, 71 surveys, and over 88,000 individuals.
Keywords: Earnings justice; Fair pay; Income inequality; Just occupational earnings; Legitimate earnings; Welfare state.
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Publication
Journal: Cancer immunology research
March/1/2021
Abstract
The success of immune-checkpoint blockade and chimeric antigen receptor (CAR) T cell therapies has established the remarkable capacity of the immune system to fight cancer. Over the past several years, it has become clear that immune cell responses to cancer are critically dependent upon metabolic programs that are specific to both immune cell type and function. Metabolic features of cancer cells and the tumor microenvironment impose constraints on immune cell metabolism that can favor immunosuppressive phenotypes and block antitumor responses. Advances in both preclinical and clinical studies have demonstrated that metabolic interventions can dramatically enhance the efficacy of immune-based therapies for cancer. As such, understanding the metabolic requirements of immune cells in the tumor microenvironment, as well as the limitations imposed therein, can have significant benefits for informing both current practice and future research in cancer immunotherapy.
Publication
Journal: Trends in Cancer
March/1/2021
Publication
Journal: European Journal of Vascular and Endovascular Surgery
March/1/2021
Abstract
Objective: The aim was to evaluate the short term safety and effectiveness of the Penumbra/Indigo aspiration thrombectomy Systems (Penumbra Inc.) in patients with acute lower limb ischaemia. (ALLI). Recently, endovascular vacuum assisted thrombectomy devices, similar to those used in the management of acute ischaemic stroke, have become available for peripheral arteries, but data are still scarce.
Methods: To assess vessel patency, a modified Thrombolysis in Myocardial Infarction (TIMI) classification, called TIPI (Thrombo-aspiration In Peripheral Ischaemia), is proposed. The TIPI flow is assessed at presentation, immediately after treatment with the study device, and after all adjuvant procedures. The primary outcome is the technical success of the thrombo-aspiration with the investigative system, defined as near complete or complete revascularisation TIPI 2 - 3. Safety and clinical success rate were collected at one month.
Results: One hundred and fifty patients were enrolled. The mean age was 72.4 years and 73.3% were male. Rutherford grade on enrolment was I in 16%, IIa in 40.7%, and IIb in 43.3% with a mean ankle brachial index of 0.19. Primary technical success (TIPI 2 - 3 flow) was achieved in 88.7% of patients. Adjunctive procedures included angioplasty/stenting of chronic atherosclerotic lesions (n = 39), thrombolysis (n = 31), covered stenting (n = 15), and supplementary Fogarty embolectomy (n = 6). After all interventions, assisted primary technical success was 95.3% (TIPI 2 - 3 in 143/150). No systemic bleeding complications or device related serious adverse events were reported. At one month follow up, one death, and one below the knee amputation were recorded. Primary patency was 92% (138/150), and the re-intervention rate was 7.33%, resulting in an assisted primary and secondary patency of 94% and 99.33%, respectively.
Conclusion: Results from the INDIAN registry reveal that mechanical thrombectomy using the Indigo system is safe and effective for revascularisation of ALLI as a primary therapy.
Keywords: Acute limb ischaemia; Endovascular treatment; Limb ischaemia; Limb salvage Malperfusion; Thrombo-aspiration.
Publication
Journal: Food Research International
March/1/2021
Abstract
The linear and nonlinear rheological behaviors of heterogeneous emulsions gels made from natural glycyrrhizic acid (GA) nanofibrils and sitosterol-oryzanol mixtures (sterols) were investigated using small amplitude oscillatory shear (SAOS) and large amplitude oscillatory shear (LAOS). The nonlinear rheological response was qualitatively analyzed using normalized Lissajous-Bowditch curves. The microstructure of the emulsion gels strongly depended on the concentration of sterols in the oil phase, and showed a percolated segregated network at 10-20 wt% sterols due to the partial coalescence of droplets, and a jamming transition without coalescence at higher sterols concentration of 30 wt%. The microstructure differences led to different linear and nonlinear viscoelastic behaviors of these emulsion gels. SAOS tests showed that the oil phase structuring by the sterols significantly enhance the viscoelasticity of GA nanofibril emulsion gels, and the percolating emulsion gels exhibited higher elasticity than the jammed emulsion gel, as evidenced by a lower damping factor and frequency power-law exponent. The data of crossover strain, phase angle, and the normalized Lissajous-Bowditch curves from LAOS tests further revealed that compared to the samples in a jammed state or without oil phase structuring, the emulsion gels with a percolating segregated network showed higher structural elasticity and thus were more resistant to large deformations, probably due to the slow relaxation of rigid, hydrodynamically interacting clusters of partially coalesced droplets. These findings could potentially aid in the design of novel emulsion gels, based on all-natural and sustainable building blocks, with specific textural and functional properties for foods, cosmetics, and pharmaceutical applications.
Keywords: Glycyrrhizic acid; Heterogeneous emulsion gels; Large amplitude oscillatory shear (LAOS); Lissajous-Bowditch curves; Sitosterol-oryzanol mixtures.
Publication
Journal: Lipids in Health and Disease
March/1/2021
Abstract
Background: Dietary sphingolipids have various biofunctions, including skin barrier improvement and anti-inflammatory and anti-carcinoma properties. Long-chain bases (LCBs), the essential backbones of sphingolipids, are expected to be important for these bioactivities, and they vary structurally between species. Given these findings, however, the absorption dynamics of each LCB remain unclear.
Methods: In this study, five structurally different LCBs were prepared from glucosylceramides (GlcCers) with LCB 18:2(4E,8Z);2OH and LCB 18:2(4E,8E);2OH moieties derived from konjac tuber (Amorphophallus konjac), from GlcCers with an LCB 18(9Me):2(4E,8E);2OH moiety derived from Tamogi mushroom (Pleurotus cornucopiae var. citrinopileatus), and from ceramide 2-aminoethyphosphonate with LCB 18:3(4E,8E,10E);2OH moiety and LCB 18(9Me):3(4E,8E,10E);2OH moiety derived from giant scallop (Mizuhopecten yessoensis), and their absorption percentages and metabolite levels were analyzed using a lymph-duct-cannulated rat model via liquid chromatography tandem mass spectrometry (LC/MS/MS) with a multistage fragmentation method.
Results: The five orally administered LCBs were absorbed and detected in chyle (lipid-containing lymph) as LCBs and several metabolites including ceramides, hexosylceramides, and sphingomyelins. The absorption percentages of LCBs were 0.10-1.17%, depending on their structure. The absorption percentage of LCB 18:2(4E,8Z);2OH was the highest (1.17%), whereas that of LCB 18:3(4E,8E,10E);2OH was the lowest (0.10%). The amount of sphingomyelin with an LCB 18:2(4E,8Z);2OH moiety in chyle was particularly higher than sphingomyelins with other LCB moieties.
Conclusions: Structural differences among LCBs, particularly geometric isomerism at the C8-C9 position, significantly affected the absorption percentages and ratio of metabolites. This is the first report to elucidate that the absorption and metabolism of sphingolipids are dependent on their LCB structure. These results could be used to develop functional foods that are more readily absorbed.
Keywords: Lipid metabolism; Lipidomics; Long-chain base; Lymphatic absorption; Sphingolipids; Sphingomyelin.
Publication
Journal: Revista Portuguesa de Cardiologia
March/1/2021
Abstract
Introduction: Paravalvular leak (PVL) is a common serious complication associated with prosthetic valve implantation.
Objective: The aim of this study was to report our single-center experience in a retrospective review and to analyze possible predictors of success.
Methods: We performed 33 percutaneous PVL closures in 26 patients (54% female, mean age 65±13 years). All mitral prostheses were studied previously with 3D transesophageal echocardiography (TEE), and aortic prostheses with 2D/3D TEE. 3D TEE and fluoroscopy were used for the assessment, planning, and guidance of the interventions. Twelve patients also underwent computed tomography angiography for better characterization of anatomic details.
Results: Eighteen patients (69.2%) were admitted due to heart failure (New York Heart Association [NYHA] III or IV, seven (26.9%) because of heart failure and hemolysis, and one (3.8%) due to hemolysis only. Regarding the leaks, 46.2% were in aortic and 53.8% in mitral prostheses, 88.5% in mechanical and 7.7% in biological prostheses, and 3.8% in transcatheter aortic valve implants. All the aortic patients had severe aortic regurgitation. Furthermore, all mitral patients but one had moderate to severe or severe mitral regurgitation. Closure was successful in 17 patients (65.4%), partially successful in four (15.4%) and unsuccessful in five (19.2%). After the procedure, 69% were in NYHA I-II. Hemolysis worsened in three patients despite successful closure; all required further valvular surgery and two died. Regarding angiographic and echocardiographic procedural success, we analyzed age, gender, type of prosthesis (mechanical or biological), location (aortic or mitral), clinical data, maximum leak diameter, anatomic regurgitant orifice, leak location (anterior, posterior, inferior and lateral for mitral leaks and left, right and non-coronary sinus for aortic leaks), and number of devices (plugs) used for closure. No parameters presented a significant relationship with success excepting previous hemolysis. There was a relationship between clinical improvement and reduction of PVL (p=0.0001). In follow-up, cardiac-related events (new hospital admissions, cardiac valvular surgery, need for transfusion) were more frequent in patients with partially successful or unsuccessful closure (p=0.012). There was a relationship between cardiac-related events and death (p=0.029).
Conclusion: Percutaneous PVL closure has emerged as an alternative treatment for PVL. Predictors of procedural success are difficult to establish. Survival is related to reduction of regurgitation and improvement in NYHA functional class.
Keywords: Devices; Dispositivos; Leaks perivalvulares; Paravalvular leaks; Periprosthetic regurgitation; Regurgitação peri-protésica.
Publication
Journal: Food Research International
March/1/2021
Abstract
The development of relevant predictive models for single-cell lag time and growth probability near growth limits is of critical importance for predicting pathogen behavior in foods. The classical methods for data acquisition in this field are based on turbidity measurements of culture media in microplate wells inoculated with approximately one bacterial cell per well. Yet, these methods are labour intensive and would benefit from higher throughput. In this study, we developed a quantitative experimental method using automated microscopy to determine the single-cell growth probability and lag time. The developed method consists of the use of direct cell observation with phase-contrast microscopy equipped with a 100× objective and a high-resolution device camera. The method is not a time-lapse method but is based on the observation of high numbers of colonies for a given time. Automation of image acquisition and image analysis was used to reach a high throughput. The single-cell growth probabilities and lag times of four strains of Listeria monocytogenes were determined at 4 °C. The microscopic method was shown to be a promising method for the determination of individual lag times and growth probability at the single-cell level.
Keywords: Growth probability; Lag time; Low temperatures; Microscopy; Single cell; Vertical distribution.
Publication
Journal: Food Research International
March/1/2021
Abstract
The current study applied gas chromatography-mass spectrometry (GC-MS), liquid chromatography-mass spectrometry (LC-MS), and thermal desorption direct analysis in real-time mass spectrometry (TD-DART-MS) methods to the analysis of black pepper (Piper nigrum L.) samples from different countries. The black pepper powder samples were analyzed directly by TD-DART-MS without any extraction, but for GC-MS and LC-MS methods, a methanol extraction procedure was employed before the analysis. Various compounds, such as piperamides and terpenes, were detected. Partial least squares-discriminant analysis (PLS-DA) was used to classify black pepper samples based on their origins. Total ion mass spectrum (TMS) data profiles from GC-MS, LC-MS, and TD-DART-MS methods were constructed and evaluated for the performance of classification. A cubic-root data transformation was tested in the data preprocessing and found to be effective for improving the classification rates. The average classification rates of PLS-DA models with GC-MS-cubic-root-TMS, LC-MS-cubic-root-TMS, and DART-MS-cubic-root-TMS data representations were 94.1 ± 0.6%, 87.7 ± 0.6%, and 97.0 ± 0.3% respectively, for 100-time bootstrapped-Latin-partition cross-validation. This study presents for the first time the analysis of plant-based food materials by using TD-DART-MS, and it has been demonstrated as a simple and high-throughput method for classification studies.
Keywords: Black pepper; Chemometrics; Classification; DART-MS; GC–MS; LC-MS.
Publication
Journal: Food Research International
March/1/2021
Abstract
Peony as an important medicinal material is widely cultivated in China, which is one of the natural distribution centers of wild peony species. So far, however, there has not been a systematic study of the roots from China's wild peonies. In this study, the total phenolic (TPC), total flavonoid (TFC), other secondary metabolites, and microelement content, as well as the antioxidant, antibacterial, anticholinesterase, and antitumor activities of peony roots from 15 species and 2 subspecies were measured. Thirteen secondary metabolites were detected, with Paeoniflorin and Paeonol being the highest content bio-activities compounds. Additionally, the peony roots had a significant antioxidant activities and bacteriostatic effect against Gram-positive bacteria, with MIC varying from 0.063 to 1 mg/mL. P. anomala subsp. veitchii and P. lactiflora showed outstanding anticholinesterase capacities and cytotoxic activities. Taken together, the data presented here provide new insights into both the medicinal and edible potential of roots from wild peony species.
Keywords: Antibacterial; Antioxidant; Antitumour; Peonies root; Secondary metabolites.
Publication
Journal: International Journal of Gynecological Cancer
March/1/2021
Abstract
Guidelines and expert consensus are lacking on fertility preservation in BRCA mutation carriers and in patients with Lynch syndrome. The safety of fertility preservation in this setting is still a topic of debate and multiple factors need to be carefully considered. The aim of this review was to analyze the reproductive potential of women harboring a genetic mutation affecting the DNA repair system and explore the efficacy and safety of existing fertility preservation strategies in these patients.
Keywords: BRCA1 protein; BRCA2 protein; lynch syndrome II.
Publication
Journal: Cold Spring Harbor perspectives in medicine
March/1/2021
Abstract
Observations of the incidence of tumors among chimney sweeps in the eighteenth century and later experiments with coal tars provided early evidence that carcinogens in the environment can promote cancer. Subsequent studies of individuals exposed to radiation, work on fly genetics, and the discovery that DNA was the genetic material led to the idea that these carcinogens act by inducing mutations in DNA that change the behavior of cells and ultimately cause cancer. In this excerpt from his forthcoming book, Joe Lipsick looks back at how the concepts of mutagenesis and carcinogenesis emerged, how these converged with development of the Ames test, and how biochemistry and crystallography ultimately revealed the underlying molecular basis.
Publication
Journal: Social Science Research
March/1/2021
Abstract
This study examines whether and how adolescents' relative deprivation in school is associated with their years of education by incorporating the social comparison perspective into the Wisconsin status attainment model. Using Waves 1, 2, and 4 of the National Longitudinal Study of Adolescent to Adult Health (Add Health), this study finds that adolescents who are positioned at the bottom of the economic hierarchy in school are likely to have up to one less year of education, compared to their counterparts positioned at the top of the hierarchy, when holding other variables constant. Also, by using causal mediation analyses, I find that educational expectations account for more than 20% of the relationship between adolescents' relative deprivation and educational attainment. The sensitivity analyses are conducted to examine how robust the main findings are to the violation of the assumption used in this study. These results provide evidence showing that adolescents' educational outcomes do not only depend on their material resources but also on their relative standing in the economic hierarchy.
Keywords: Adolescents; Causal mediation analysis; Educational attainment; Educational expectations; Relative deprivation.
Publication
Journal: Tropical Medicine and Health
March/1/2021
Abstract
Background: Anemia in pregnancy represents a global public health concern due to wide ranging maternal and neonatal adverse outcomes in all peripartum periods. We estimated the prevalence and factors associated with anemia in pregnancy at a national obstetrics and gynecology referral hospital in Uganda and in addition performed a systematic review and meta-analysis of the overall burden of anemia in pregnancy in Uganda.
Methods: We conducted a cross-sectional study among 263 pregnant women attending the antenatal care clinic of Kawempe National Referral Hospital, Kampala, Uganda, in September 2020. Anemia in pregnancy was defined as a hemoglobin level of < 11.0 g/dl and microcytosis as a mean corpuscular volume (MCV) of < 76 fL. We also performed a systematic review (PROSPERO Registration ID: CRD42020213001) and meta-analysis of studies indexed on MEDLINE, Embase, African Journal Online, ClinicalTrials.gov , ICTRP, and the Cochrane Library of systematic review between 1 January 2000 and 31 September 2020 reporting on the prevalence of anemia in pregnancy in Uganda.
Results: The prevalence of anemia was 14.1% (n= 37) (95%CI 10.4-18.8), of whom 21 (56.8%) had microcytic anemia. All cases of anemia occurred in the second or third trimester of pregnancy and none were severe. However, women with anemia had significantly lower MCV (75.1 vs. 80.2 fL, p<0.0001) and anthropometric measurements, such as weight (63.3 vs. 68.9kg; p=0.008), body mass index (25.2 vs. 27.3, p=0.013), hip (98.5 vs. 103.8 cm, p=0.002), and waist (91.1 vs. 95.1 cm, p=0.027) circumferences and mean systolic blood pressure (BP) (118 vs 125 mmHg, p=0.014). Additionally, most had BP within the normal range (59.5% vs. 34.1%, p=0.023). The comparison meta-analysis of pooled data from 17 published studies of anemia in pregnancy in Uganda, which had a total of 14,410 pregnant mothers, revealed a prevalence of 30% (95% CI 23-37).
Conclusions: Despite our study having a lower prevalence compared to other studies in Uganda, these findings further confirm that anemia in pregnancy is still of public health significance and is likely to have nutritional causes, requiring targeted interventions. A larger study would be necessary to demonstrate potential use of basic clinical parameters such as weight or blood pressure as screening predictors for anemia in pregnancy.
Keywords: Anemia; Pregnancy; Uganda.
Publication
Journal: Journal of Pharmacy Practice
March/1/2021
Abstract
Background: Albumin has been shown to decrease the incidence of mortality and acute kidney injury (AKI) in patients with spontaneous bacterial peritonitis (SBP). Albumin administration in SBP is recommended within 6 hours of diagnosis and for reserved use in high-risk patients with the following baseline laboratory tests: serum creatinine >1 mg/dL, blood urea nitrogen >30 mg/dL or total bilirubin >4 mg/dL.
Objective: We aimed to assess the impact of an albumin order set restricted to high-risk SBP.
Methods: A retrospective cohort study was conducted between Jan 1, 2013 to Feb 28, 2018. The albumin order set was implemented on Sep 20, 2016. Patients were included if they were diagnosed with SBP and had an ascitic fluid polymorphonuclear count ≥ 250 cells/mm3.
Results: Out of a total of 137 patients reviewed, 88 met the inclusion criteria. The incidence of AKI in the pre-order set and post-order set were 63.93% and 33.33% (p = 0.01), respectively. The incidence of mortality in the pre-order set and post-order set were 36.07% and 7.41% (p = 0.005), respectively. The percentage of patients administered albumin within 6 hours were 24.59% to 40.74% (p = 0.14) in the pre-order set and post-order set, respectively. The percentage of patients who received the recommended albumin dosing regimen ordered was 42.62% vs 96.30% (p < 0.001), in the pre-order set and post-order set, respectively.
Conclusion: The albumin order set restricted to high-risk SBP patients significantly reduced the incidence of AKI and mortality, and improved the appropriateness of albumin regimen ordered.
Keywords: acute kidney injury; albumin; cirrhosis; mortality; peritonitis; spontaneous bacterial.
Publication
Journal: Journal of Sports Medicine and Physical Fitness
March/1/2021
Abstract
Background: The aims of this study were: 1) to investigate the impacts that an eccentric overload training (EOT) and a small-side game training (SSGT) have on the characteristics of the accelerations (ACC) and decelerations (DCC) of the players in a soccer match; and 2) to determine if EOT and SSGT could affect the ACC and DCC reduction over time in a soccer match.
Methods: Twenty-three female soccer players from a Spanish professional club were split into three groups: a small-sided game training group (SGG), an eccentric overload training group (EOG) and a control group (CG).
Results: The SSG improved the high intensity distance performed (ES [CI]=0.72 [0.22; 1.22]), the number of high intensity actions (ES [CI]=0.65 [0.01; 1.29]), the percentage of repeated high intensity actions (ES [CI]=0.54 [-0.17; 1.25]), the initial velocity of the ACC (ES [CI]=0.55 [-0.08; 1.17]) and the percentage of repeated accelerations (ES [CI]=0.87 [-0.18; 1.91]) with respect to the control group. The EOG obtained better results in distance travelling accelerating (ES [CI]=0.84 [0.09; 1.60]) and decelerating (ES [CI]=0.87 [0.23; 1.51]) above 3 m/s2, maximum ACC (ES [CI]=1.92 [0.90; 2.94]) and DCC (ES [CI]=1.29 [0.44; 2.14]) and the average of maximum ACC (ES [CI]=0.89 [0.23; 1.54]) and DCC (ES [CI]=1.08 [0.62; 1.55]) with respect to the CG. A decrement in the ACC and DCC performance was observed between the first and last 15 minutes of the competition, except for the EOG.
Conclusions: The SSG obtained mainly improvements in variables related with efforts repetitions and the capacity of maintaining the ACC and the DCC over time, while improvements in the EOG were related to intensity in the ACC and DCC.
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