Alviss

Quantification of bilirubin in blood is essential for early diagnosis and timely treatment of neonatal hyperbilirubinemia. Handheld point-of-care (POC) devices may overcome the current issues with conventional laboratory-based bilirubin (LBB) quantification. To systematically evaluate the reported diagnostic accuracy of POC devices compared with LBB quantification. A systematic literature search was conducted in 6 electronic databases (Ovid MEDLINE, Embase, Web of Science Core Collection, Cochrane Central Register of Controlled Trials, CINAHL, and Google Scholar) up to December 5, 2022. Studies were included in this systematic review and meta-analysis if they had a prospective cohort, retrospective cohort, or cross-sectional design and reported on the comparison between POC device(s) and LBB quantification in neonates aged 0 to 28 days. Point-of-care devices needed the following characteristics: portable, handheld, and able to provide a result within 30 minutes. This study was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline. Data extraction was performed by 2 independent reviewers into a prespecified, customized form. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Meta-analysis was performed of multiple Bland-Altman studies using the Tipton and Shuster method for the main outcome. The main outcome was mean difference and limits of agreement in bilirubin levels between POC device and LBB quantification. Secondary outcomes were (1) turnaround time (TAT), (2) blood volumes, and (3) percentage of failed quantifications. Ten studies met the inclusion criteria (9 cross-sectional studies and 1 prospective cohort study), representing 3122 neonates. Three studies were considered to have a high risk of bias. The Bilistick was evaluated as the index test in 8 studies and the BiliSpec in 2. A total of 3122 paired measurements showed a pooled mean difference in total bilirubin levels of -14 μmol/L, with pooled 95% CBs of -106 to 78 μmol/L. For the Bilistick, the pooled mean difference was -17 μmol/L (95% CBs, -114 to 80 μmol/L). Point-of-care devices were faster in returning results compared with LBB quantification, whereas blood volume needed was less. The Bilistick was more likely to have a failed quantification compared with LBB. Despite the advantages that handheld POC devices offer, these findings suggest that the imprecision for measurement of neonatal bilirubin needs improvement to tailor neonatal jaundice management.

Biology, Vol. 12, Pages 457: Cardio Respiratory and Muscle Oxygenation Responses to Submaximal and Maximal Exercise in Normobaric Hypoxia: Comparison between Children and Adults Biology doi: 10.3390/biology12030457 Authors: Anton Ušaj Alexandros Sotiridis Tadej Debevec As differential physiological responses to hypoxic exercise between adults and children remain poorly understood, we aimed to comprehensively characterise cardiorespiratory and muscle oxygenation responses to submaximal and maximal exercise in normobaric hypoxia between the two groups. Following familiarisation, fifteen children (Age = 9 ± 1 years) and fifteen adults (Age = 22 ± 2 years) completed two graded cycling exercise sessions to exhaustion in a randomized and single blind manner in normoxia (NOR; FiO2 = 20.9) and normobaric hypoxia (HYP; FiO2 = 13.0) exercises conditions. Age specific workload increments were 25 W&middot;3 min-1 for children and 40 W&middot;3 min-1 for adults. Gas exchange and vastus lateralis oxygenation parameters were measured continuously via metabolic cart and near infrared spectroscopy, respectively. Hypoxia provoked significant decreases in maximal power output PMAX (children = 29%; adults 16% (F = 39.3; p < 0.01)) and power output at the gas exchange threshold (children = 10%; adults:18% (F = 8.08; p = 0.01)) in both groups. Comparable changes were noted in most respiratory and gas exchange parameters at similar power outputs between groups. Children, however, demonstrated, lower PETCO2 throughout the test at similar power outputs and during the maintenance of V&#729;CO2 at the maximal power output. These data indicate that, while most cardiorespiratory responses to acute hypoxic exercise are comparable between children and adults, there exist age related differential responses in select respiratory and muscle oxygenation parameters.

Background : Reduced function of ankle muscles usually leads to impaired gait. Motorized ankle foot orthoses (MAFOs) have shown potential to improve neuromuscular control and increase volitional engagement of ankle muscles. In this study, we hypothesize that specific disturbances (adaptive resistance based perturbations to the planned trajectory) applied by a MAFO can be used to adapt the activity of ankle muscles. The first goal of this exploratory study was to test and validate two different ankle disturbances based on plantarflexion and dorsiflexion resistance while training in standing still position. The second goal was to assess neuromuscular adaptation to these approaches, namely, in terms of individual muscle activation and co activation of antagonists.
Method : Two ankle disturbances were tested in ten healthy subjects. For each subject, the dominant ankle followed a target trajectory while the contralateral leg was standing still: a) dorsiflexion torque during the first part of the trajectory (Stance Correlate disturbance—StC), and b) plantarflexion torque during the second part of the trajectory (Swing Correlate disturbance—SwC). Electromyography was recorded from the tibialis anterior (TAnt) and gastrocnemius medialis (GMed) during MAFO and treadmill (baseline) trials.
Result : GMed (plantarflexor muscle) activation decreased in all subjects during the application of StC, indicating that dorsiflexion torque did not enhance GMed activity. On the other hand, TAnt (dorsiflexor muscle) activation increased when SwC was applied, indicating that plantarflexion torque succeeded in enhancing TAnt activation. For each disturbance paradigm, there was no antagonist muscle co activation accompanying agonist muscle activity changes.
Conclusion : We successfully tested novel ankle disturbance approaches that can be explored as potential resistance strategies in MAFO training.
Result from SwC training warrant further investigation to promote specific motor recovery and learning of dorsiflexion in neural impaired patients. This training can potentially be beneficial during intermediate phases of rehabilitation prior to overground exoskeleton assisted walking. Decreased activation of GMed during StC might be attributed to the unloaded body weight in the ipsilateral side, which typically decreases activation of anti gravity muscles. Neural adaptation to StC needs to be studied thoroughly in different postures in futures studies.

The objective of this study was to investigate whether RCR (rotator cuff repair) with BMS (bone marrow stimulation) can provide a lower retear rate and better shoulder function than arthroscopic RCR alone in rotator cuff tear (RCT) patients. The PubMed, Cochrane Library, EMBASE and Web of Science databases were searched until Feb 2022. Risk of bias for randomized controlled trials was evaluated by two independent reviewers with Cochrane collaboration risk bias of tool, and that for cohort studies was evaluated with the Newcastle-Ottawa Scale (NOS). The primary outcome was the retear rate. Secondary outcomes included the American Shoulder and Elbow Surgeons (ASES) score, University of California, Los Angeles Shoulder Scale (UCLA) score, Constant-Murley score (CMS) and visual analogue scale (VAS) score. Subgroup analysis was performed to explore the effect of suture method and tear size on BMS procedure. Five randomized controlled trials and four cohort studies with a total of 827 patients were included. The pooled retear rate between the RCR with BMS group and the RCR alone group was significantly different (17.5% vs. 28.9%; P < 0.0001). There were no differences in the ASES score, UCLA score and VAS score. The CMS was significantly higher in RCR with BMS group than the RCR alone groups (P = 0.02), while the difference was well below the MCID. RCR with BMS resulted in a significantly lower retear rate than RCR alone for large and massive RCTs (19.7% vs. 32.5%; P = 0.01). Compared with RCR alone, RCR with BMS can significantly reduce the retear rate in arthroscopic RCT patients while not clinically relevant differences were found. BMS may further reduce the retear rate of large and massive RCTs. Level III; Systematic Review and Meta-analysis.

Introduction Metabolic syndrome (MetS) is considered as a complex, intertwined multiple risk factors that directly increase the risk of various metabolic diseases, especially cardiovascular atherosclerotic diseases and diabetes mellitus type 2. While lifestyle changes, including dietary intervention are effective in mitigating or preventing MetS, there are no specific therapies against MetS. Typical western diets comprise of high saturated fatty acid, cholesterol, and simple sugar; consequently their consumption may increase the potential pathological developmental risk of MetS. Partial replacement of dietary fatty acids with polyunsaturated fatty acids (PUFAs) is widely recommended measure to manage MetS related disorders.
Method In the present study, we used rat model to investigate the role of n 3 PUFA enriched beef tallows (BT) on MetS and tunicamycin (TM) induced endoplasmic reticulum (ER) stress, by partially replacing dietary fat (lard) with equal amounts of two different BTs; regular BT or n 3 PUFA enriched BT. The experimental rats were randomly assigned to three different dietary groups (n = 16 per group): (1) high fat and high cholesterol diet (HFCD); (2) HFCD partially replaced with regular BT (HFCD + BT1); (3) HFCD partially replaced with n 3 enhanced BT (w/w) (HFCD + BT2). After 10 weeks of dietary intervention, each experimental rodent was intraperitoneally injected with either phosphate buffered saline or 1 mg/kg body weight of TM.
Result HFCD + BT2 showed improved dyslipidemia before TM injection, and increased serum high density lipoprotein cholesterol (HDL C) levels after TM injection. BT replacement groups had significantly reduced hepatic triglyceride (TG) levels, and decreased total cholesterol (TC) and TG levels in epididymal adipose tissue (EAT). Furthermore, BT replacement remarkably attenuated TM induced unfolded protein responses (UPRs) in liver, showing reduced ER stress, with BT2 being more effective in the EAT.DiscussionTherefore, our findings suggest that partially replacing dietary fats with n 3 PUFA to lower the ratio of n 6/n 3 PUFAs is beneficial in preventing pathological features of MetS by alleviating HFCD and/or TM induced dyslipidemia and ER stress.

Background : Despite the significant survival benefits of anti PD 1/PD L1 immunotherapy, non small cell lung cancer (NSCLC) remains one of the most common tumors and major causes of cancer related deaths worldwide. Thus, there is an urgent need to identify new therapeutic targets for this refractory disease.
Method : In this study, microarray datasets GSE27262, GSE75037, GSE102287, and GSE21933 were integrated by Venn diagram. We performed functional clustering and pathway enrichment analyses using R. Through the STRING database and Cytoscape, we conducted protein protein interaction (PPI) network analysis and identified the key genes, which were verified by the GEPIA2 and UALCAN portal. Validation of actin binding protein anillin (ANLN) was performed by quantitative real time polymerase chain reaction and Western blotting. Additionally, Kaplan Meier methods were used to compute the survival analyses.
Result : In total, 126 differentially expressed genes were identified, which were enriched in mitotic nuclear division, mitotic cell cycle G2/M transition, vasculogenesis, spindle, and peroxisome proliferator activated receptor signaling pathway. 12 central node genes were identified in the PPI network complex. The survival analysis revealed that high transcriptional levels were associated with inferior survival in NSCLC patients. The clinical implication of ANLN was further explored; its protein expression showed a gradually increasing trend from grade I to III.
Conclusion : These Key genes may be involved in the carcinogenesis and progression of NSCLC, which may serve as useful targets for NSCLC diagnosis and treatment.

The widespread use of graphene oxide silver nanoparticle nanocomposites (GO AgNPs) in biomedical sciences is increasing the chances of human and animal exposure to its chronic non toxic doses. Exposure to AgNPs related nanomaterials may result in the negative effect on the dam, fetus and offspring. However, there are only little available information for profound understanding of the epigenetic alteration in the cells and animals caused by low dose chronic exposure of GO AgNPs. The present study investigated the effect of 0.5 μg/mL GO AgNPs for 10 weeks on the differential expression of circular RNAs (circRNAs) in caprine fetal fibroblast cells (CFFCs), and this dose of GO AgNPs did not affect cell viability and ROS level. We predicted the functions of those differentially expressed (DE) circRNAs in CFFCs by bioinformatics analysis. Furthermore, we validated the expression of ten DE circRNAs using quantitative real time reverse transcription polymerase chain reaction (qRT PCR) to ensure the reliability of the sequencing data. Our results showed that the DE circRNAs may potentially regulate the GO AgNPs inducing epigenetic toxicity through a regulatory network consisted of circRNAs, miRNAs and messenger RNAs (mRNAs). Therefore, the epigenetics toxicity is essential to assess the biosafety level of GO AgNPs.

Kidney and Dialysis, Vol. 3, Pages 139 151: Salt Reduction Using a Smartphone Application Based on an Artificial Intelligence System for Dietary Assessment in Patients with Chronic Kidney Disease: A Single Center Retrospective Cohort Study Kidney and Dialysis doi: 10.3390/kidneydial3010012 Authors: Akane Yanai Kiyotaka Uchiyama Shinya Suganuma This study evaluated the clinical usefulness of an artificial intelligence powered smartphone application in reducing the daily salt intake of patients with chronic kidney disease (CKD). This study included 35 patients with CKD who were classified into app users (id est, 13 outpatients who used the app for 3 months and whose salt intake was evaluated before and after using the app) and app nonusers (id est, 22 outpatients not using the application; their salt intake was similarly evaluated). The primary outcome was estimated as salt intake after 3 months of using the application and at a 6 month follow up. Linear mixed model analysis revealed that app users had a significant decrease in estimated salt intake after 3 months (-2.12 g/day; 95% CI, -4.05 to -0.19; p = 0.03) compared with app nonusers but not after 6 months (-0.96 g/day; 95% CI, -3.13 to 1.20; p = 0.38). App users showed a significant decrease in body mass index at 3 months (-0.42 kg/m2 ) and 6 months (-0.65 kg/m2 ). The application promoted short term reduction in salt intake. These results provide a strong rationale for future trials.

Nanomaterials, Vol. 13, Pages 1067: Aluminum Nitride Ultraviolet Light Emitting Device Excited via Carbon Nanotube Field Emission Electron Beam Nanomaterials doi: 10.3390/nano13061067 Authors: Yangcheng Yu Dong Han Haiyuan Wei Ziying Tang Lei Luo Tianzeng Hong Yan Shen Huying Zheng Yaqi Wang Runchen Wang Hai Zhu Shaozhi Deng With the progress of wide bandgap semiconductors, compact solid state light emitting devices for the ultraviolet wavelength region are of considerable technological interest as alternatives to conventional ultraviolet lamps in recent years. Here, the potential of aluminum nitride (AlN) as an ultraviolet luminescent material was studied. An ultraviolet light emitting device, equipped with a carbon nanotube (CNT) array as the field emission excitation source and AlN thin film as cathodoluminescent material, was fabricated. In operation, square high voltage pulses with a 100 Hz repetition frequency and a 10% duty ratio were applied to the anode. The output spectra reveal a dominant ultraviolet emission at 330 nm with a short wavelength shoulder at 285 nm, which increases with the anode driving voltage. This work has explored the potential of AlN thin film as a cathodoluminescent material and provides a platform for investigating other ultrawide bandgap (UWBG) semiconductors. Furthermore, while using AlN thin film and a carbon nanotube array as electrodes, this ultraviolet cathodoluminescent device can be more compact and versatile than conventional lamps. It is anticipated to be useful in a variety of applications such as photochemistry, biotechnology and optoelectronics devices.

Antibiotics, Vol. 12, Pages 582: Efficacy of Cefoperazone Sulbactam in Patients with Acinetobacter Infections: A Systematic Review of the Literature Antibiotics doi: 10.3390/antibiotics12030582 Authors: Gowthami Sai Kogilathota Jagirdhar Kaanthi Rama Shiva Teja Reddy Harsha Pattnaik Rakhtan K. Qasba Praveen Reddy Elmati Rahul Kashyap Marco Schito Nitin Gupta
Introduction : Acinetobacter baumannii (AB) is a multidrug resistant pathogen commonly associated with nosocomial infections. The resistance profile and ability to produce biofilm make it a complicated organism to treat effectively. Cefoperazone sulbactam (CS) is commonly used to treat AB, but the associated data are scarce.
Method : We conducted a systematic review of articles downloaded from Cochrane, Embase, PubMed, Scopus, and Web of Science (through June 2022) to study the efficacy of CS in treating AB infections. Our review evaluated patients treated with CS alone and CS in combination with other antibiotics separately. The following outcomes were studied: clinical cure, microbiological cure, and mortality from any cause.
Result : We included 16 studies where CS was used for the treatment of AB infections. This included 11 studies where CS was used alone and 10 studies where CS was used in combination. The outcomes were similar in both groups. We found that the pooled clinical cure, microbiological cure, and mortality with CS alone for AB were 70%, 44%, and 20%, respectively. The pooled clinical cure, microbiological cure, and mortality when CS was used in combination with other antibiotics were 72%, 43%, and 21%, respectively.
Conclusions : CS alone or in combination needs to be further explored for the treatment of AB infections. There is a need for randomized controlled trials with comparator drugs to evaluate the drugs effectiveness.

JCM, Vol. 12, Pages 2262: Proton Pump Inhibitors and Risk of Chronic Kidney Disease: Evidence from Observational Studies Journal of Clinical Medicine doi: 10.3390/jcm12062262 Authors: Chieh Chen Wu Mao Hung Liao Woon Man Kung Yao Chin Wang Previous epidemiological studies have raised the concern that the use of proton pump inhibitors (PPIs) is associated with an increased risk of kidney diseases. To date, no comprehensive meta analysis has been conducted to assess the association between PPIs and the risk of chronic kidney disease (CKD). Therefore, we conducted a systematic review and meta analysis to address the association between PPIs and CKD. The primary search was conducted in the most popular databases, such as PubMed, Scopus, and Web of Science. All observational studies evaluated the risk of CKD among PPI users, and non users were considered for inclusion. Two reviewers conducted data extraction and assessed the risk of bias. Random effect models were used to calculate pooled effect sizes. A total of 6,829,905 participants from 10 observational studies were included. Compared with non PPI use, PPI use was significantly associated with an increased risk of CKD (RR 1.72, 95% CI: 1.02-2.87, p = 0.03). This updated meta analysis showed that PPI was significantly associated with an increased risk of CKD. Association was observed in the same among moderate quality studies. Until further randomized control trials (RCTs) and biological studies confirm these results, PPI therapy should not stop patients with gastroesophageal reflux disease (GERD). However, caution should be used when prescribing to patients with high risk kidney disease.

Eyad Altarazi, Amal M AlKhotani, Doaa Khalid Mohorjy, Abdullah Almoabdi, Rahaf AlmatrafiSaudi Journal for Health Sciences 2023 12(1):7 15
Background : Coronaviruses are the important pathogens of humans and animals that can cause diseases ranging from the common cold to more severe or even fatal respiratory infections. Regarding nervous system complications, existing literature has revealed increasing reports of neurological manifestations in coronavirus disease 2019 (COVID 19) positive patients ranging from mild to severe manifestations. Aim: In this study, we aimed to determine the prevalence of neurological manifestations in COVID 19 positive patients. Furthermore, we sought to ascertain the most common and most severe manifestations and to find the significant associations with laboratory or clinical findings. Setting and
Design : This is a retrospective cross sectional observational study that was conducted at two centers. Materials and
Method : Patient data were collected in periods from of March 1 to of July 30, 2020 labeled as the first wave, and from December 1, 2021 to January 30, 2022 labeled as the second wave in two tertiary care hospitals, Al Noor Specialist Hospital and King Abdullah Medical City, situated in Makkah city, Saudi Arabia. The study included patients who were ≥ 18 years of age and were found to have any neurological manifestations and/or complications secondary to severe acute respiratory syndrome coronavirus 2 (SARS CoV 2) infection. The study was conducted in different periods to assess the different waves of the COVID 19 pandemic and to allow the comparison between them.
Result : From a total number of 4751 patients with confirmed SARS CoV 2 infection eligible during the periods included in our study, we found neurological manifestations in 263 patients, particularly 229 from the first wave and 34 from the second wave. In the first wave patients, 102 (44.5%) were aged between 18 and 39 years of age. The prevalence of neurological manifestations was 6.4% in the first wave and 2.9% in the second wave.
Conclusion : Our study showed a large variety of neurological manifestations in COVID 19 positive patients. The most common neurological manifestations were headache and impaired level of consciousness, whereas the most severe conditions were cerebrovascular events, seizure, encephalopathy, and brain death.

Anthranilate is a key platform chemical in high demand for synthesizing food ingredients, dyes, perfumes, crop protection compounds, pharmaceuticals, and plastics. Microbial based anthranilate production strategies have been developed to overcome the unstable and expensive supply of anthranilate via chemical synthesis from non renewable resources. Despite the reports of anthranilate biosynthesis in several engineered cells, the anthranilate production yield is still unsatisfactory. This study designed an Escherichia coli cell factory and optimized the fed batch culture process to achieve a high titer of anthranilate production. Using the previously constructed shikimate overproducing E. coli strain, two genes (aroK and aroL) were complemented, and the trpD responsible for transferring the phosphoribosyl group to anthranilate was disrupted to facilitate anthranilate accumulation. The genes with negative effects on anthranilate biosynthesis, including pheA, tyrA, pabA, ubiC, entC, and trpR, were disrupted. In contrast, several shikimate biosynthetic pathway genes, including aroE and tktA, were overexpressed to maximize glucose uptake and the intermediate flux. The rationally designed anthranilate overproducing E. coli strain grown in an optimized medium produced approximately 4 g/L of anthranilate in 7 L fed batch fermentation. Overall, rational cell factory design and culture process optimization for microbial based anthranilate production will play a key role in complementing traditional chemical based anthranilate production processes.

Nutrients, Vol. 15, Pages 1408: Human Milk Oligosaccharides Are Associated with Lactation Stage and Lewis Phenotype in a Chinese Population Nutrients doi: 10.3390/nu15061408 Authors: Xiangnan Ren Jingyu Yan Ye Bi Paul William Shuttleworth Ye Wang Shan Jiang Jie Wang Yifan Duan Jianqiang Lai Zhenyu Yang
Background : Human milk oligosaccharides (HMOs) are the third most abundant component of human milk. Various factors may affect the concentration of HMOs, such as the lactation period, Lewis blood type, and the maternal secretor gene status.
Objective : The purpose of this study is to investigate factors associated with HMO concentrations in Chinese populations.
Method : A sub sample of 481 was randomly selected from a large cross sectional study in China (n = 6481) conducted in eight provinces (Beijing, Heilongjiang, Shanghai, Yunnan, Gansu, Guangdong, Zhejiang, and Shandong) between 2011 and 2013. HMO concentrations were determined by a high throughput UPLC MRM method. Various factors were collected through face to face interviews. Anthropometric measurement was conducted by trained staff.
Result : Median total HMO concentration was 13.6 g/L, 10.7 g/L, and 6.0 g/L for colostrum, transitional milk, and mature milk, respectively. HMO concentration decreased significantly as the lactation period increased (p& < 0.0001). There were significant differences of average total HMO concentration between secretor mothers and non secretor mothers (secretor 11.3 g/L vs. non secretor 5.8 g/L, p < 0.0001). There were significant differences of average total HMO concentrations among three Lewis blood types (p = 0.003). Comparing with the concentration of total oligosaccharides of Le+ (a-b+), average of total oligosaccharides concentrations increased by 3.9 (Le+ (a+b-), p = 0.004) and 1.1 g/L (Le- (a-b-), p = 0.049). The volume of breast milk expressed and the province the mother came from affected the concentration of total oligosaccharides (all p < 0.0001). Maternal BMI (p = 0.151), age (p = 0.630), prematurity (p = 0.850), mode of delivery (p = 0.486), infants gender (p = 0.685), maternal education level (p = 0.989), maternal occupation (p = 0.568), maternal allergic history (p = 0.370), maternal anemia (p = 0.625), pregnancy induced hypertension (p = 0.739), gestational diabetes (p = 0.514), and parity (p = 0.098) were not significantly correlated with the concentration of milk oligosaccharides. The concentrations of 2&prime; fucosyllactose (2&prime; FL), lacto N neotetraose (LNnT), sialyllacto N tetraose c (LSTc), lacto N fucopentaose I (LNFP I), disialylated lacto N tetraose (DSLNT), difucosyl para lacto N neohexaose (DFpLNnH), difucosyl lacto N hexaose (DFLNH), and 3 sialyllactose (3&prime; SL) showed a gradual downward trend, while the concentration of 3 fucosyllactose (3 FL) showed a gradual upward trend among three lactation stages (p < 0.05).
Conclusions : The concentration of HMOs changes throughout lactation, and it varies between different HMOs. HMO concentrations differed between lactation stage, maternal secretor gene status, Lewis blood type, volume of breast milk expressed, and the province the mother came from. Prematurity, mode of delivery, parity, infants gender, and maternal characteristics did not affect the HMO concentration. Geographical region may be not associated with HMOs concentration in human milk. There may be a mechanism for co regulation of the secretion of some of the oligosaccharides such as 2&prime;FL vs. 3FL, 2&prime;FL vs. LNnT, and lacto N tetraose (LNT).