Publications by authors named "Arshad Ali"

124 Publications

Extraction Optimization of Mucilage from Seeds of by Response Surface Methodology.

Polymers (Basel) 2022 May 6;14(9). Epub 2022 May 6.

Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Jouf University, Sakaka 72388, Saudi Arabia.

seed mucilage (MPM) is composed of glucuronoxylan, which is a swellable, pH-responsive and non-toxic biomaterial. Herein, we aimed to extract MPM from seeds (MP seeds) to ascertain optimization of extraction conditions to get highest yield by response surface methodology, via Box-Behnken design (RSM-BBD). MPM was extracted from MP seeds by a hot water extraction method. The effects of four different parameters on the extraction yield of MPM were evaluated: pH of the extraction medium (1-10), seed/water contact time (1-12 h), the temperature of extraction medium (30-90 °C), and seed/water ratio (1:5-1:35 /). The maximum yield of MPM obtained by Design-Expert software was 10.66% (10.66 g/100 g) at pH 7, seed/water contact time of 6 h, extraction temperature of 50 °C, and seed/water ratio of 1:20 /. The values of ANOVA were found to be less than 0.0001, which indicated that the extraction yield of MPM was significantly affected by all the study parameters. The results revealed that pH and extraction temperature were the most significant factors affecting the yield of MPM. MPM in compressed tablet form showed pH-responsive on-off switching behavior at pH 7.4 and 1.2 in a reversible manner. MPM in compressed tablet form sustained the release of itopride for 16 h following a super case-II transport mechanism and zero-order release kinetics.
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http://dx.doi.org/10.3390/polym14091904DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9099447PMC
May 2022

Big-sized trees and species-functional diversity pathways mediate divergent impacts of environmental factors on individual biomass variability in Sri Lankan tropical forests.

J Environ Manage 2022 Apr 29;315:115177. Epub 2022 Apr 29.

Department of Crop Science, Faculty of Agriculture, University of Peradeniya, Peradeniya, Sri Lanka.

In tropical forests, several studies have explored the effects of environmental factors and tree species diversity as well as functional trait diversity and trait composition on aboveground biomass (AGB) stock. However, these abiotic and biotic effects on individual biomass variability (BioVar) are still largely unexplored, which limits our understanding of the plant-plant interactions for species coexistence. Here, we used the Partial Least Squares Structural Equation Models (PLS-SEMs), and other complementary analyses, on data from 189 tropical forest plots in Sri Lanka, to test the linkages amongst climate (a latent variable of solar radiation and potential evapotranspiration), soil (pH and cation exchange capacity), plot (plot size and stand density) conditions, big-sized trees, species-functional diversity, and BioVar. The PLS-SEMs showed that climate conditions decreased BioVar directly but increased indirectly via integrative promoting direct effects on soil conditions, species-functional diversity and big-sized trees. In contrast, soil conditions increased BioVar directly but decreased indirectly via integrative suppressing direct effects on species-functional diversity and big-sized trees. Interestingly, we found that the divergent indirect effects of climate and soil conditions on BioVar via big-sized trees mattered when the direct effect of big-sized trees on species-functional diversity was considered as compared to the reverse effect in PLS-SEMs. Also, the indirect positive effect of plot properties on BioVar was nearly equal to the direct effect because plot properties affected big-sized trees as similar as or lower than species-functional diversity. The positive effect of species-functional diversity on BioVar was mediated by the structural attributes of big-sized trees, indicating increased plant species co-existence. This study suggests that individual tree biomass variability (i.e., BioVar) should be considered for managing natural tropical forests in the context of the plant-plant interactions for species coexistence.
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http://dx.doi.org/10.1016/j.jenvman.2022.115177DOI Listing
April 2022

A pH-sensitive, stimuli-responsive, superabsorbent, smart hydrogel from psyllium () for intelligent drug delivery.

RSC Adv 2021 May 1;11(32):19755-19767. Epub 2021 Jun 1.

Institute of Chemistry, University of Sargodha Sargodha 40100 Pakistan +923468614959.

Herein, we report a polysaccharide-based hydrogel isolated from psyllium husk (a well-known dietary fiber) and evaluated for its swelling properties in deionized water (DW) at different physiological pH values, , 1.2, 6.8 and 7.4. Swelling of psyllium hydrogel (PSH) in DW under the influence of temperature and at different concentrations of NaCl and KCl solutions was also examined. A pH-dependent swelling pattern of PSH was observed following the order DW > pH 7.4 > pH 6.8 > pH 1.2. Stimuli-responsive swelling and deswelling (on-off switching) behavior of PSH was observed in DW and ethanol, DW and normal saline, at pH 7.4 and pH 1.2 environments, respectively. Similar swelling behavior and on-off switching attribute of PSH-containing tablets indicated the unaltered nature of PSH even after compression. Scanning electron micrographs of swollen and then freeze-dried PSH transverse and longitudinal cross-sections revealed hollow channels with an average pore size of 6 ± 2 μm. Furthermore, PSH concentration-dependent sustained release of theophylline from tablet formulation was witnessed for >15 h following the non-Fickian diffusion mechanism. Subacute toxicity studies revealed the non-toxic nature of PSH. Therefore, dietary fiber-based material, , PSH could be a valuable pharmaceutical excipient for intelligent and targeted drug delivery.
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http://dx.doi.org/10.1039/d1ra02219aDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9033674PMC
May 2021

An analysis of the impact of clean and non-clean energy consumption on economic growth and carbon emission: evidence from PIMC countries.

Environ Sci Pollut Res Int 2022 Mar 4. Epub 2022 Mar 4.

School of Economics and Finance, QUT Business School, CRICOS No. 00213J, Brisbane, Australia.

This study empirically estimates the impact of clean and non-clean energy consumption on economic growth and carbon dioxide emissions within the framework of the environmental Kuznets curve and pollution haven hypothesis in the case of PIMC countries from 1980 to 2019. The results of the panel cointegration test proposed by Westerlund (2007) show a long-term equilibrium relationship among the variables of each designated model. The long-term elasticities of economic growth and carbon emission estimated by AMG, CCEMG, and MG estimators indicate that both clean and non-clean energy consumption has a significant impact on economic growth, while carbon emission hinders growth. The results also reveal that economic growth, non-clean energy consumption, and interaction between trade openness and non-clean energy consumption have a driving effect on carbon dioxide emission; however, clean energy consumption is found to reduce carbon emission. In addition, the analysis confirms the existence of the inverted U-shaped environmental Kuznets curve and pollution haven hypothesis in the panel of PIMC economies. Finally, there is a one-way causality from non-clean energy consumption to economic growth, but no such causation exists between clean energy consumption and economic growth. The objective of sustained economic growth with a safe environment may be achieved by encouraging clean energy consumption in the PIMC economies.
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http://dx.doi.org/10.1007/s11356-022-19284-xDOI Listing
March 2022

Diagnosis and management of thoracic intradural extra-arachnoidal disc herniation.

Surg Neurol Int 2022 25;13:73. Epub 2022 Feb 25.

Department of Neurosurgery, Hamad General Hospital, Doha, Qatar.

Background: Intradural extra-arachnoidal disc herniations (IEDHs) are rare. Here, we reviewed the clinical features and magnetic resonance (MR) diagnostic features of IEDH.

Case Description: A 58-year-old male presented with mid-thoracic back pain radiating to the left leg associated with ipsilateral leg weakness. The thoracic MR documented T8-T9 focal spinal canal stenosis and a ventral disc herniation. Thoracic spine computed tomography scan confirmed the diseased level and did not show any calcification. The patient underwent a right-sided transpedicular extracavitary approach for disc excision. At surgery, IEDH was identified with soft cartilaginous consistency and was morcellated to remove in piece meal while preserving the integrity of the arachnoid layer.

Conclusion: IEDH poses a significant challenge for its diagnosis and management. A careful preoperative MR imaging review with a high index of clinical suspicion may ensure a good clinical outcome.
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http://dx.doi.org/10.25259/SNI_16_2022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8888305PMC
February 2022

Can trainees safely perform pancreatoenteric anastomosis? A systematic review, meta-analysis, and risk-adjusted analysis of postoperative pancreatic fistula.

Surgery 2022 Feb 24. Epub 2022 Feb 24.

Hepatobiliary and Pancreatic Surgery Unit, Lund University, Sweden. Electronic address: https://www.twitter.com/conlonhpb.

Background: The complexity of pancreaticoduodenectomy and fear of morbidity, particularly postoperative pancreatic fistula, can be a barrier to surgical trainees gaining operative experience. This meta-analysis sought to compare the postoperative pancreatic fistula rate after pancreatoenteric anastomosis by trainees or established surgeons.

Methods: A systematic review of the literature was performed using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, with differences in postoperative pancreatic fistula rates after pancreatoenteric anastomosis between trainee-led versus consultant/attending surgeons pooled using meta-analysis. Variation in rates of postoperative pancreatic fistula was further explored using risk-adjusted outcomes using published risk scores and cumulative sum control chart analysis in a retrospective cohort.

Results: Across 14 cohorts included in the meta-analysis, trainees tended toward a lower but nonsignificant rate of all postoperative pancreatic fistula (odds ratio: 0.77, P = .45) and clinically relevant postoperative pancreatic fistula (odds ratio: 0.69, P = .37). However, there was evidence of case selection, with trainees being less likely to operate on patients with a pancreatic duct width <3 mm (odds ratio: 0.45, P = .05). Similarly, analysis of a retrospective cohort (N = 756 cases) found patients operated by trainees to have significantly lower predicted all postoperative pancreatic fistula (median: 20 vs 26%, P < .001) and clinically relevant postoperative pancreatic fistula (7 vs 9%, P = .020) rates than consultant/attending surgeons, based on preoperative risk scores. After adjusting for this on multivariable analysis, the risks of all postoperative pancreatic fistula (odds ratio: 1.18, P = .604) and clinically relevant postoperative pancreatic fistula (odds ratio: 0.85, P = .693) remained similar after pancreatoenteric anastomosis by trainees or consultant/attending surgeons.

Conclusion: Pancreatoenteric anastomosis, when performed by trainees, is associated with acceptable outcomes. There is evidence of case selection among patients undergoing surgery by trainees; hence, risk adjustment provides a critical tool for the objective evaluation of performance.
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http://dx.doi.org/10.1016/j.surg.2021.12.033DOI Listing
February 2022

Anterior cervical pseudomeningocele causing syncope after spinal surgery: A case report.

Int J Surg Case Rep 2022 Feb 24;91:106789. Epub 2022 Jan 24.

Department of Physical Medicine and Rehabilitation, Santa Clara Valley Medical Center, San Jose, CA, USA. Electronic address:

Introduction And Importance: Pseudomeningocele formation from incidental durotomy is a known risk in spine surgery. We present a case of incidental durotomy leading to anterior neck pseudomeningocele, compressing the carotid body (CB) resulting in syncopal episodes. To our knowledge, this is the first case report implicating syncopal episodes to CB compression via a pseudomeningocele.

Case Presentation: A mid sixty-year-old patient with history of obesity, hypertension, and diabetes presented with gait impairment and hand weakness. Ossification of posterior longitudinal ligament (OPLL) was diagnosed with computed tomography imaging (CT) and magnetic resonance imaging (MRI). Elective surgery was completed with an anterior and posterior approach for decompression and fusion. Hospital course (San Jose, CA, USA) was complicated by respiratory depression and incomplete tetraplegia. On post-operative day (POD) six, CT revealed anterolateral soft tissue neck swelling; subsequent CT and MRI showed fluid collection expansion, with associated syncopal episodes on POD thirty-nine. Despite interventional radiology drainage, the fluid collection and symptoms returned five days later. The patient ultimately underwent durotomy revision and repair with muscle patch.

Clinical Discussion: This case highlights the challenges in managing anterior cervical dural tears resulting in pseudomeningocele. Risk factors include anterior cervical corpectomy and decompression, as well as an underlying diagnosis of OPLL. Untreated dural tears may develop into pseudomeningoceles which can contribute to life-threatening outcomes.

Conclusion: This case report presents the serious consequences of incidental durotomy, the unique post-surgical complication of syncope due to compression of the CB from a pseudomeningocele, and the challenges of managing a persistent pseudomeningocele.
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http://dx.doi.org/10.1016/j.ijscr.2022.106789DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8802085PMC
February 2022

Emerging Super-specialty of Neurology: Intraoperative Neurophysiological Monitoring (IONM) and Experience in Various Neurosurgeries at a Tertiary Care Hospital in Doha, Qatar.

Cureus 2021 Dec 15;13(12):e20432. Epub 2021 Dec 15.

Department of Neurosurgery, Neuroscience Institute, Hamad General Hospital, Doha, QAT.

Introduction Intraoperative neurophysiological monitoring (IONM) helps in better patient outcomes by minimizing risks related to the functional status of the nervous system during surgical procedures. An IONM alert to the surgical team during the surgery can help them identify the cause and take immediate corrective action. IONM confers possible benefits, including improved surgical morbidity and mortality, better patient care, minimal neurological deficits, reduced hospital stay, medical costs, and litigation risk. In addition, a highly skilled IONM team will make a better patient outcome. Methods We retrospectively reviewed 62 consecutive patients who underwent intracranial and spinal neurosurgical procedures. Multimodality IONM was utilized, including somatosensory evoked potentials, transcranial electrical motor evoked potential, spontaneous and triggered electromyography, electroencephalography, electrocorticography, cortical sensory mapping, and direct electrical cortical stimulation. Of a total of 62 patients, two patients revealed neurotonic EMG discharges during IONM, and most patients woke up without any new neurological deficit. Results Sixty-two patients were included, ranging from age 5 to 77 years (mean 43.5 years), with 54.8% men and 45.2% female. Multimodality IONM was used in all patients. Two EMG alerts were recorded during IONM, during a brain tumor resection, and right acetabular hip surgery with postoperative right foot drop. Conclusion Multimodality IONM is the gold standard of care for any surgical services and is used as real-time monitoring of functional integrity of neural structures at risk. If utilized by trained and expert teams, numerous surgeries may benefit from multimodality intraoperative neurophysiologic monitoring.
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http://dx.doi.org/10.7759/cureus.20432DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8759984PMC
December 2021

Carbopol emulgel loaded with ebastine for urticaria: development, characterization, and evaluation.

Drug Deliv 2022 Dec;29(1):52-61

Drug Delivery and Cosmetic Lab (DDCL), Faculty of Pharmacy, Gomal University, Dera Ismail Khan, Pakistan.

Urticaria affects all age groups of a population. It is triggered by allergens in foods, insect bites, medications, and environmental conditions. Urticaria is characterized by itching, a burning sensation, wheals and flares, erythema, and localized edema. The aim of this study was to develop a polymeric dosage form of ebastine using Carbopol 940 and mixture of span and tween. The emulsion was prepared, the gelling agent was added and the desired emulgel loaded with active drug was formulated. The formulations were subjected to physical stability, pH, viscosity, spreadability, drug content analysis, thermal analysis, drug release, and anti-allergic activity in animal model. The formulated emulgel exhibited good physical stability. The pH of the formulation was in the range of 5.2 ± 0.17 to 5.5 ± 0.20 which is suitable for topical application. Insignificant changes ( > .05) were observed in viscosity and spreadability of stored emulgels. The drug content was in the official limit of Pharmacopeia (i.e. 100 ± 10%). DSC measurements predicted that there is no interaction between the active moiety and excipients in emulgel formulation. The optimized formulation (ES3) released 74.25 ± 1.8% of ebastine after 12 h. The ebastine emulgel showed significant ( < .05; ANOVA) anti-allergic activity as compared to commercial product Benadryl in histamine-induced allergy in rabbits. This study concluded that a topical drug delivery of ebastine-loaded emulgel could be well tolerated and safe for the treatment of urticaria/hives.
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http://dx.doi.org/10.1080/10717544.2021.2015483DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8725930PMC
December 2022

Inhibition of HDACs Suppresses Cell Proliferation and Cell Migration of Gastric Cancer by Regulating E2F5 Targeting BCL2.

Life (Basel) 2021 Dec 17;11(12). Epub 2021 Dec 17.

Faculty of Sports Science, Ningbo University, Ningbo 315211, China.

(1) Background: Gastric cancer (GC) is the most common high death-rate cancer type worldwide, with an enhanced prevalence and increased rate of mortality. Although significant evidence on surgery strategy has been generated for the treatment of GC, conclusions are still uncertain regarding profound metastatic or persevering gastric cancer. Therefore, it is essential to develop novel and effective biomarkers or therapeutic targets for the diagnosis of GC. Histone deacetylations (HDACs) are important epigenetic regulators that control the aberrant transcription of critical genes that are mainly involved in cell proliferation, cell migration, regulation of the cell cycle, and different signal pathways. (2) Methods: Expression analysis of HDACs family members and E2F5 in gastric cancer cell lines was determined by RT-PCR and Western blotting. The cell proliferation was determined through an MTT assay. Cell migration was determined using a wound-healing assay. Flow cytometry experiments were used to determine cell-cycle analysis. The statistical software OriginPro 2015 (OriginLab, Northampton, MA, USA) was used to analyze data. A value of < 0.05 was regarded as significant. (3) Results: The present study shows that E2F5 expression is upregulated in GC cancer cell lines compared to normal cell lines, and is positively associated with the level of HDACs and BCL2. HDACi and knocking down of E2F5 as tumor suppressors inhibited cell proliferation, migration invasion, and blocked the cell cycle in gastric cancer cells by suppressing BCL2. The results conclude that the anticancer mechanism of HDACi was determined by regulating E2F5 via targeting BCL2. (4) Conclusions: Our results suggest that the HDAC-E2F5-BCL2 signaling axis might be a novel potential biomarker in gastric cancer.
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http://dx.doi.org/10.3390/life11121425DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8705834PMC
December 2021

Perception, Willingness, Barriers, and Hesitancy Towards COVID-19 Vaccine in Pakistan: Comparison Between Healthcare Workers and General Population.

Cureus 2021 Oct 28;13(10):e19106. Epub 2021 Oct 28.

Internal Medicine, Dow University of Health Sciences, Karachi, PAK.

Background Vaccine hesitancy has been a huge challenge in controlling preventable diseases. With the emergence of coronavirus disease 2019 (COVID-19) vaccines, it is vital to know their acceptance rates among the masses. No comparative data is available on the current subject from Pakistan yet. Therefore, this study aimed to evaluate the acceptance of a potential COVID-19 vaccine among the general population and healthcare workers (HCWs) of Pakistan, along with their perceptions and barriers to acceptance. Methods An online cross-sectional study was carried out in Pakistan from December 19, 2020, to January 10, 2021, using convenience sampling. A self-administered questionnaire consisting of 31 items was distributed after informed consent. Inclusion criteria consisted of HCWs and non-HCWs (general population) aged 18 years and above, residing in Pakistan. All analyses were done using Statistical Package for Social Sciences (SPSS) version 23.0 (IBM Corp., Armonk, NY, USA). Chi-square and T-test were used and a p-value of less than 0.05 was considered significant for all cases. Results Of the 404 respondents (n=196 general population and n=208 HCWs), 73.5% were willing to get a proven, safe, and effective COVID-19 vaccine if it was free of cost. This was reduced to only 64.3% if the vaccine was not free and had to be paid for. A total of 168 (41.6%) participants agreed to get vaccinated immediately, while 149 (36.9%) participants concurred to get it on a delayed basis. Eighty-seven (21.5%) participants refused to receive the COVID-19 vaccine, amongst which a significant majority (p<0.001) of the participants were from the general population. Doctors or scientists/scholarly journals were found to be the most trusted source of information (67.6%; n=273), while fear of unknown side effects (45.5%; n=184) was found to be the most common barrier towards COVID-19 vaccination. More than half (53.5%) participants believed that the vaccine is safe, effective, and has minimal side effects, amongst which a significantly large fraction (p<0.001) belonged to the HCWs. Conclusion The acceptance rate of a safe, effective, proven, and free COVID-19 vaccine was 73.5%. The fear of unknown side effects was the most common barrier to COVID-19 vaccine uptake. The general population demonstrated less knowledge, more false perceptions, and barriers to COVID-19 vaccine. Adequate measures should be taken to educate the masses about the COVID-19 vaccine, and its safety, and further studies are required.
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http://dx.doi.org/10.7759/cureus.19106DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8627421PMC
October 2021

Management of infected post-pancreatic resection fluid collections under endoscopic ultrasound guidance using lumen apposing metal stent: A case series and review of the literature.

Ann Hepatobiliary Pancreat Surg 2021 Nov;25(4):500-508

Department of Gastroenterology, Southampton General Hospital, Southampton, United Kingdom.

Backgrounds/aims: Post-operative pancreatic fistulas (POPF) and fluid collections (POPFC) remain significant sources of morbidity and mortality after pancreatic resections. There remains a paucity of literature describing endoscopic ultrasound (EUS) guided drainage of POPFC using a Hot AXIOS™ lumen apposing metal stent (LAMS).

Methods: We conducted a retrospective study, encompassing all consecutive patients with POPFC managed using Hot AXIOS™ LAMS at our institution between January 2017 and December 2019. Primary outcome measures were technical and clinical success. Secondary outcome measures were adverse events and recurrence rates.

Results: Five patients underwent EUS guided drainage using Hot AXIOS™ LAMS during the study period. Mean age of patients was 67.8 ± 2.16 years. The majority (60.0%) of patients were males. Median duration of symptom onset after surgery was 9 days. All patients presented with abdominal pain. Median size of the collection measured on computed tomography was 91 mm. Median interval time between symptom onset and EUS drainage was 30 days. Two patients required percutaneous drainage prior to EUS guided drainage. Technical and clinical success were achieved for all patients. No adverse events were observed. Median duration of follow-up was 90 days. No recurrence of collection occurred during the follow-up period.

Conclusions: EUS guided drainage of POPFC using Hot AXIOS™ LAMS is a safe and effective treatment modality with technical and clinical success rates of 100% in our experience.
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http://dx.doi.org/10.14701/ahbps.2021.25.4.500DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8639308PMC
November 2021

The role of biodiversity in mitigating the effects of nutrient limitation and short-term rotations in plantations of subtropical China.

J Environ Manage 2022 Feb 24;303:114140. Epub 2021 Nov 24.

School of Agriculture and Biology, Shanghai Jiao Tong University, Shanghai, 200240, China; Shanghai Urban Forest Ecosystem Research Station, National Forestry and Grassland Administration, Shanghai, 200240, China; Shanghai Yangtze River Delta Eco-Environmental Change and Management Observation and Research Station, Ministry of Science and Technology, Ministry of Education, Shanghai, 200240, China. Electronic address:

Species diversity plays an essential role in enhancing ecosystem functions (EF) in both natural and plantation forests. However, we do not fully understand whether species diversity could maintain the sustainability of EFs in multiple-rotation plantations. Here, we hypothesized that tree species mixtures could mitigate declines in EFs along successive rotations, but could not maintain ecosystem multifunctionality. To test our hypothesis, we examined the effects of species diversity on four EFs, i.e., aboveground biomass (AGB), soil available nitrogen (SAN) and phosphorus (SAP), and soil organic matter (SOM), based on pure model simulation in plantations of subtropical China. The model fusion framework was set up by the integration of the process-based FORECAST and Multivariate Diversity-Interactions models. In the simulation, four local typical plantation tree species (two conifers, one evergreen broadleaf, and one deciduous N-fixing broadleaf) were selected and combined to form four monoculture and 11 mixture stands, and for each stand, the simulation was made for four 25-year rotations. The results showed that all the four EFs declined with the progress of rotations in both monoculture and mixtures, and the declining range was larger in monoculture than in mixtures in each rotation. Particularly, SAP significantly decreased while AGB, SAN, and SOM increased with diversity evenness from 0 (monoculture) to 1 (four species being equal abundant in the mixture). Overall, SAP and AGB displayed higher sensitivity to the disturbance of successive rotations compared with SAN and SOM. These results suggest that mixing species could not maintain EFs along with successive rotations because it could not alleviate SAP deficiencies in the soils resulted from the disturbances of silvicultural measures.
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http://dx.doi.org/10.1016/j.jenvman.2021.114140DOI Listing
February 2022

External validation of postoperative pancreatic fistula prediction scores in pancreatoduodenectomy: a systematic review and meta-analysis.

HPB (Oxford) 2022 03 2;24(3):287-298. Epub 2021 Nov 2.

Hepatobiliary and Pancreatic Surgery Unit, Queen Elizabeth Hospital, Birmingham, UK.

Background: Multiple risk scores claim to predict the probability of postoperative pancreatic fistula (POPF) after pancreatoduodenectomy. It is unclear which scores have undergone external validation and are the most accurate. The aim of this study was to identify risk scores for POPF, and assess the clinical validity of these scores.

Methods: Areas under receiving operator characteristic curve (AUROCs) were extracted from studies that performed external validation of POPF risk scores. These were pooled for each risk score, using intercept-only random-effects meta-regression models.

Results: Systematic review identified 34 risk scores, of which six had been subjected to external validation, and so included in the meta-analysis, (Tokyo (N=2 validation studies), Birmingham (N=5), FRS (N=19), a-FRS (N=12), m-FRS (N=3) and ua-FRS (N=3) scores). Overall predictive accuracies were similar for all six scores, with pooled AUROCs of 0.61, 0.70, 0.71, 0.70, 0.70 and 0.72, respectively. Considerably heterogeneity was observed, with I2 statistics ranging from 52.1-88.6%.

Conclusion: Most risk scores lack external validation; where this was performed, risk scores were found to have limited predictive accuracy. . Consensus is needed for which score to use in clinical practice. Due to the limited predictive accuracy, future studies to derive a more accurate risk score are warranted.
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http://dx.doi.org/10.1016/j.hpb.2021.10.006DOI Listing
March 2022

Reduction-Sensitive Dextran-Paclitaxel Polymer-Drug Conjugate: Synthesis, Self-Assembly into Nanoparticles, and In Vitro Anticancer Efficacy.

Bioconjug Chem 2021 12 11;32(12):2516-2529. Epub 2021 Nov 11.

Department of Chemistry and Chemical Engineering, Syed Babar Ali School of Science and Engineering (SBASSE), Lahore University of Management Sciences (LUMS), Lahore 54792, Pakistan.

Delivery systems that can encapsulate a precise amount of drug and offer a spatiotemporally controlled drug release are being actively sought for safe yet effective cancer therapy. Compared to polymer nanoparticle (NP)-based delivery systems that rely on physical drug encapsulation, NPs derived from stimuli-sensitive covalent polymer-drug conjugates (PDCs) have emerged as promising alternatives offering precise control over drug dosage and spatiotemporal drug release. Herein, we report a reduction-sensitive PDC "Dex-SS-PTXL" synthesized by conjugating dextran and paclitaxel (PTXL) through a disulfide bond-bearing linker. The synthesized Dex-SS-PTXL PDC with a precise degree of substitution in terms of the percentage of repeat units of dextran covalently conjugated to PTXL (27 ± 0.6%) and the amount of drug carried by the PDC (39 ± 1.4 wt %) was found to self-assemble into spherical NPs with an average size of 110 ± 34 nm and a ζ-potential of -14.09 ± 8 mV. The reduction-sensitive Dex-SS-PTXL NPs were found to release PTXL exclusively in response to the reducing agent concentration reflective of the intracellular reducing environment of the tumor cells. Challenging BT-549 and MCF-7 cells with Dex-SS-PTXL NPs revealed significant cytotoxicity, while the IC values and the mode of action (mitotic arrest) of Dex-SS-PTXL NPs were found to be comparable to those of free PTXL, highlighting the active nature of the intracellularly released drug. The developed PDC with its unique ability to self-assemble into NPs and stimuli-responsive drug release can enhance the success of the NP-based drug delivery systems during clinical translation.
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http://dx.doi.org/10.1021/acs.bioconjchem.1c00492DOI Listing
December 2021

Antimicrobial and antioxidant activities of silver nanoparticles synthesized by novel biogenic method using mixed reductants.

Pak J Pharm Sci 2021 May;34(3):995-1001

Department of Chemistry, Islamia College Peshawar, Peshawar, Pakistan.

A novel method, for the synthesis of silver nanoparticles that are eco-friendly by means of mixed reductants method, has been developed. The combined extract of Mentha viridis plant and Prunus domestica gum were used as reducing agents for the synthesis of silver nanoparticles of the size less than 40 nm in diameter. The effect of time and concentration on the formation of silver nanoparticles were also monitored. The silver nanoparticles formed were verified by surface Plasmon spectra using single and double beam UV-Vis spectrophotometer. The XRD technique and scanning electron microscopy were performed to analyze the crystalline structure, crystallite size and morphology. The synthesized silver nanoparticles were tested against different bacterial and fungus strains. The silver nanoparticles showed good inhibition in antimicrobial study and low MIC for bacterial strains. The antioxidant assay was performed to check the scavenging activity. In DPPH, the silver nanoparticles showed good scavenging activity and were found close to that of ascorbic acid.
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May 2021

Impact of SARS-CoV-2 pandemic on pancreatic cancer services and treatment pathways: United Kingdom experience.

HPB (Oxford) 2021 11 19;23(11):1656-1665. Epub 2021 Mar 19.

Addenbrookes Hospital, Hills Rd, Cambridge, CB2 0QQ, UK. Electronic address:

Introduction: The SARS-CoV-2 pandemic presented healthcare providers with an extreme challenge to provide cancer services. The impact upon the diagnostic and treatment capacity to treat pancreatic cancer is unclear. This study aimed to identify national variation in treatment pathways during the pandemic.

Methods: A survey was distributed to all United Kingdom pancreatic specialist centres, to assess diagnostic, therapeutic and interventional services availability, and alterations in treatment pathways. A repeating methodology enabled assessment over time as the pandemic evolved.

Results: Responses were received from all 29 centres. Over the first six weeks of the pandemic, less than a quarter of centres had normal availability of diagnostic pathways and a fifth of centres had no capacity whatsoever to undertake surgery. As the pandemic progressed services have gradually improved though most centres remain constrained to some degree. One third of centres changed their standard resectable pathway from surgery-first to neoadjuvant chemotherapy. Elderly patients, and those with COPD were less likely to be offered treatment during the pandemic.

Conclusion: The COVID-19 pandemic has affected the capacity of the NHS to provide diagnostic and staging investigations for pancreatic cancer. The impact of revised treatment pathways has yet to be realised.
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http://dx.doi.org/10.1016/j.hpb.2021.03.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7973054PMC
November 2021

Inositol hexaphosphate sensitizes hepatocellular carcinoma to oxaliplatin relating inhibition of CCN2-LRP6-β-catenin-ABCG1 signaling pathway.

J Cancer 2021 24;12(20):6071-6080. Epub 2021 Aug 24.

Institute of Medical Research, Northwestern Polytechnical University, Xi'an, 710072, China.

Hepatocellular carcinoma (HCC) is a drastic problem in China. Oxaliplatin, a platinum-based chemotherapy drug, has limited efficacy in treating HCC, characterized by intrinsic and acquired resistance. Inositol hexaphosphate (IP6), a carbohydrate abundant in grains, has contributed to the rising popularity of whole grain products consumption for the potential protection against dozens of diseases. However, the therapeutic potential of IP6 in halting the progression of HCC remains unclear, especially in combination with oxaliplatin. The anti-proliferation and anti-migration effects of IP6 were evaluated and . The synergistic and sequential anti-proliferative effect with IP6 and oxaliplatin were also evaluated in HCC. Finally, the role of CCN2-LRP6-β-catenin-ABCG1 signaling in oxaliplatin resistance and IP6 treatment was evaluated. We proved that IP6 treatment exhibited independent anticancer effect and synergistic anti-proliferative effects in combination with oxaliplatin in HCC. Specifically, up-regulation of ABCG1 and CCN2 were associated with oxaliplatin resistance. ABCG1 was acting as a downstream molecule of the CCN2-LRP6-Wnt/β-catenin signaling pathway in HCC cells. The IP6 treatment exhibited inhibition of CCN2-LRP6-Wnt/β-catenin signaling pathway and downregulation of ABCG1 in HCC cells. When combined with ABCG1 knocking down in HCC cells, the anti-proliferative effect of oxaliplatin was partly impaired in combination with IP6. We suggested that IP6 treatment renders HCC sensitive to oxaliplatin and breaking the CCN2-LRP6-β-catenin-ABCG1 signaling pathway is one of the mechanism after IP6 treatment.
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http://dx.doi.org/10.7150/jca.62141DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8425206PMC
August 2021

Reflection as a Learning Tool in Postgraduate Medical Education.

J Coll Physicians Surg Pak 2021 Sep;31(9):1094-1098

Department of Paediatric Medicine, The Children's Hospital and ICH, Lahore, Pakistan.

Objective: To explore the reflective capacity as a learning tool in pediatric residents.

Study Design: Survey.

Place And Duration Of Study: The Children's Hospital Lahore, Pakistan from 20th March to 30th March 2021.

Methodology: In this cross sectional online survey, the participants were postgraduate residents and registrars of Paediatric Medicine, Paediatric Surgery, and Paediatric Diagnostics, working at The Children's Hospital, Lahore, Pakistan. Reflective practices questionnaire (RPQ) was used for measuring the reflective practices and SPSS-24 for data analysis.

Results: Out of a total of 175 study participants, 144 (82.3%) were paediatric medicine residents followed by paediatric surgery 18 (10.3%) and paediatric diagnostic 13 (7.4%) with a slight female preponderance 91 (52%). All years of trainees participated; majority was 4th year trainees 58 (33.1%), and 1st year the lowest 17 (9.7%). The overall mean score of the questionnaire was 69.97 ± 10.79 (95% CI: 68.36 ± 71.58) out of 96 total score. The highest score was of critical appraisal 18.52 ± 3.16 (95% CI: 18.04 ± 18.99) out of 24. There was no difference in mean score of different sub-domains and mean scores based on gender, specialty or year of training (p=>0.05).

Conclusion: The overall reflective capacity of paediatric postgraduate residents is good irrespective of specialty, gender or year of training. Critical appraisal of interaction in the reflection is the highest scored domain. Key Words: Postgraduate, Residents, Medical education, Reflection, Practice, Learning tool.
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http://dx.doi.org/10.29271/jcpsp.2021.09.1094DOI Listing
September 2021

Patient-Reported Outcome for Endovascular Treatment versus Microsurgical Clipping in Aneurysmal Subarachnoid Hemorrhage.

World Neurosurg 2021 11 6;155:e695-e703. Epub 2021 Sep 6.

Department of Neurosurgery, Neuroscience Institute, Hamad Medical Corporation, Doha-Qatar; Department of Clinical Academic Sciences, College of Medicine, Qatar University, Doha-Qatar; Department of Neurological Sciences, Weill Cornell Medicine, Doha-Qatar.

Objective: Aneurysmal subarachnoid hemorrhage has a high mortality with significant impact on quality of life despite effective management strategies including endovascular treatment and/or microsurgical clipping. Although the modalities have undergone clinical comparison, they have not been evaluated on patient-reported outcomes (PROs). This study compared endovascular versus microsurgical treatment using a PRO measure.

Methods: We conducted a cross-sectional telephonic survey of adult patients conducted at Hamad General Hospital, Doha, Qatar between 2017 and 2019. Candidate study participants were identified from procedure logs and hospital electronic health records for endovascular treatment (N = 32) versus microsurgical clipping (N = 32) of cerebral aneurysm. The primary outcome measure was the short version of the Stroke-Specific Quality of Life (SS-QoL) measure. The secondary outcome measure was the screened clinician-reported modified Rankin Scale (mRS) for all screened patients (n = 137). Mean scores were compared for the 2 treatment groups.

Results: The SS-QoL mean score was 4.23 (standard deviation ± 0.77) in endovascular treatment and 4.19 ± 0.19 in surgical clipping (P = 0.90). In exploratory analysis, mean physical domain score was 3.17 ± 0.60 versus 2.98 ± 0.66 in endovascular treatment and surgical clipping groups, respectively. Mean psychosocial domain scores were 4.43 ± 0.85 versus 4.18 ± 0.0.92, respectively. In multivariable analysis, none of the clinical variables were significantly related to SS-QoL except vasospasm irrespective of intervention received. In secondary outcome analysis, modified Rankin Scale score was higher for endovascular treatment (P = 0.04).

Conclusions: Published evidence has supported clinical benefits of endovascular treatment for cerebral aneurysm treatment, but this study did not find any difference in PROs. Future studies of treatments should include PRO to identify potential differences from the patient's perspective.
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http://dx.doi.org/10.1016/j.wneu.2021.08.131DOI Listing
November 2021

Fatigue After Traumatic Brain Injury: A Systematic Review.

J Head Trauma Rehabil 2021 Aug 4. Epub 2021 Aug 4.

Rehabilitation Research Center, Santa Clara Valley Medical Center, San Jose, California (Messrs Ali and Dirlikov, Ms Morfin, and Dr Pasipanodya); Medical Library, Santa Clara Valley Medical Center, San Jose, California (Ms Mills); SeneCure, GGZ-Breburg, Tilburg, the Netherlands (Ms Maas); Physical Medicine and Rehabilitation Department, Santa Clara Valley Medical Center, San Jose, California (Drs Huang and Englander); Department of Orthopedic Surgery, Stanford University School of Medicine, Palo Alto, California (Dr Englander); and Institute of Psychology, Health, Medical and Neuropsychology Unit, Leiden University, Leiden, the Netherlands (Dr Zedlitz).

Objective: To provide a systematic review of published interventions for posttraumatic brain injury fatigue (PTBIF).

Methods: PubMed and OneSearch were systematically searched for PTBIF interventions published between January 1, 1989, and March 31, 2019. Search results were evaluated for inclusion based on an abstract and full-text review. Inclusion criteria were (1) an investigation of an intervention, (2) participant sample including individuals with traumatic brain injury (TBI), (3) report of fatigue outcome data among individuals with TBI, and (4) articles available in English, Spanish, French, German, Afrikaans, or Dutch. A risk of bias assessment was conducted on all included publications.

Results: The search resulted in 2343 publications, with 37 meeting inclusion criteria for this review. Categories of PTBIF interventions were pharmacological (n = 13), psychological (n = 9), exercise-based (n = 4), complementary alternative medicine (n = 5), electrotherapeutic (n = 3), and multimodal (n = 3). Only methylphenidate, modafinil, and cognitive behavioral therapy interventions included multiple cohorts. Pharmacological and psychological interventions represented the groups with the lowest risk of bias.

Conclusions: This review includes 37 studies, with 21 studies published after 2014. Methylphenidate and melatonin were the only pharmacological agents found to reduce fatigue in randomized controlled trials. Creatine given to children prospectively at onset of injury reduced fatigue at follow-up. Walking and water aerobics were effective exercise interventions in isolated randomized controlled studies. One multimodal study of children after concussion was more effective at reducing fatigue and postconcussion symptoms than community standard of care. Other interventions had equivocal results. Overall, more work remains to understand and develop treatments for PTBIF.
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http://dx.doi.org/10.1097/HTR.0000000000000710DOI Listing
August 2021

Developing an interplay among the psychological barriers for the adoption of industry 4.0 phenomenon.

PLoS One 2021 2;16(8):e0255115. Epub 2021 Aug 2.

Department of Management Sciences, Khwaja Fareed University of Engineering and Information Technology, Rahim Yar Khan, Pakistan.

This research aims to identify, rank, and create an interplay among the psychological barriers to adopting Industry 4.0 technologies in the manufacturing sector. A comprehensive literature review tracked by a discussion with industry and academic experts recognized 20 barriers. Based on three widely acclaimed statistical techniques, hybrid AHP-TOPSIS (Analytical Hierarchy Process-Technique for Order Performance by Similarity to Ideal Solution) and ISM (Interpretative Structural Modeling), critical psychological barriers have been investigated. A group of 8 experts from industry and academia with at least 10 years of experience was consulted for AHP and ISM techniques. Whereas TOPSIS was conducted by 443 operational-level users, including managers and supervisors of different functional areas of the manufacturing industry located in Pakistan. The findings reveal that 'Fear of job losses', 'Fear of data loss/Risk of security breaches, 'Lack of advanced & continued education of employees' and 'Lack of standards and reference architecture', with highest importance weights, emerged as the most prominent psychological barriers in developing economies. Then the interrelations among these barriers resulted in a four-layered structural model. The driver barriers identified in the final model advocate that development in 'advanced & continued education of employees', 'standards & reference architecture' and 'minimization of fear of job & data loss' can expedite the adoption of industry 4.0 (i4.0) technologies. The study uniquely develops hierarchical relationships among the psychological barriers for adopting i4.0 in the manufacturing context using AHP-TOPSIS and ISM techniques. The study would be valuable for practitioners, decision-makers and companies that wish to focus their efforts and resources on removing the most critical barriers and challenges for the seamless implementation of Industry 4.0.
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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0255115PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8328306PMC
November 2021

Moisture Computing-Based Internet of Vehicles (IoV) Architecture for Smart Cities.

Sensors (Basel) 2021 May 30;21(11). Epub 2021 May 30.

Faculty of Computer and Information Systems, Islamic University of Madinah, Madinah 42351, Saudi Arabia.

Recently, the concept of combining 'things' on the Internet to provide various services has gained tremendous momentum. Such a concept has also impacted the automotive industry, giving rise to the Internet of Vehicles (IoV). IoV enables Internet connectivity and communication between smart vehicles and other devices on the network. Shifting the computing towards the edge of the network reduces communication delays and provides various services instantly. However, both distributed (i.e., edge computing) and central computing (i.e., cloud computing) architectures suffer from several inherent issues, such as high latency, high infrastructure cost, and performance degradation. We propose a novel concept of computation, which we call moisture computing (MC) to be deployed slightly away from the edge of the network but below the cloud infrastructure. The MC-based IoV architecture can be used to assist smart vehicles in collaborating to solve traffic monitoring, road safety, and management issues. Moreover, the MC can be used to dispatch emergency and roadside assistance in case of incidents and accidents. In contrast to the cloud which covers a broader area, the MC provides smart vehicles with critical information with fewer delays. We argue that the MC can help reduce infrastructure costs efficiently since it requires a medium-scale data center with moderate resources to cover a wider area compared to small-scale data centers in edge computing and large-scale data centers in cloud computing. We performed mathematical analyses to demonstrate that the MC reduces network delays and enhances the response time in contrast to the edge and cloud infrastructure. Moreover, we present a simulation-based implementation to evaluate the computational performance of the MC. Our simulation results show that the total processing time (computation delay and communication delay) is optimized, and delays are minimized in the MC as apposed to the traditional approaches.
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http://dx.doi.org/10.3390/s21113785DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8197799PMC
May 2021

Efficacy and Safety of Dotinurad in Hyperuricemic Patients With or Without Gout: A Systematic Review and Meta-Analysis of Randomized Controlled Trials.

Cureus 2021 Apr 12;13(4):e14428. Epub 2021 Apr 12.

Anesthesiology, Aga Khan University, Karachi, PAK.

Introduction A systematic review and meta-analysis of the available randomized controlled trials (RCTs) were conducted to investigate the efficacy and safety of dotinurad in hyperuricemic patients with or without gout. Dotinurad is a novel selective urate reabsorption inhibitor (SURI) that increases uric acid excretion by selectively inhibiting urate transporter 1 (URAT1). To the best of our knowledge, this is the first meta-analysis conducted to gauge the efficacy and safety of dotinurad.  Methods Electronic databases (PubMed, the Cochrane Library, and ClinicalTrials.gov) were searched from inception till March 2, 2021, according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. Randomized controlled trials comparing the efficacy and safety of dotinurad with placebo- or active (febuxostat or benzbromarone) control were included. The eligible studies were analyzed with RevMan 5.3 Software (The Nordic Cochrane Centre, Cochrane Collaboration, Copenhagen). Results Four eligible studies, consisting of 684 hyperuricemic patients were included. The number of patients who achieved serum uric acid (sUA) levels ≤ 6.0 mg/dl favoured dotinurad 1 mg group as compared to placebo group (risk ratio {RR} = 39.27, 95% onfidence interval {CI}, 5.59 to 275.65; p = 0.0002), dotinurad 2 mg group compared with placebo group (RR = 45.36, 95% CI, 6.48 to 317.38; p= 0.0001), and dotinurad 4 mg group compared with placebo group (RR = 54.16, 95% CI, 7.76 to 377.77; p < 0.0001). Conversely, there was no significant difference in the number of patients who achieved the target sUA levels between dotinurad 2 mg and active control (RR = 1.00, 95% CI, 0.92 to 1.08; p = 0.91). Moreover, the percentage change in sUA levels from baseline to final visit favoured dotinurad 1 mg vs. placebo ((RR = 36.51, 95% CI, 33.00 to 40.02; p < 0.00001), dotinurad 2 mg vs. placebo (RR = 46.70, 95% CI, 42.53 to 50.87; p < 0.00001), and dotinurad 4 mg vs. placebo (RR = 63.84, 95% CI, 60.51 to 67.16; p < 0.00001), while no significant difference was seen in dotinurad 2 mg vs. active control (RR = -0.08, 95% CI, -4.27 to 4.11; p= 0.97). Compared with active or placebo control, dotinurad 2 mg showed no significant difference in the number of events of gouty arthritis (RR= 1.31, 95% CI, 0.47 to 3.71; p = 0.60), the number patients with adverse events (RR = 1.09, 95% CI, 0.91 to 1.30; p = 0.36), and the number of patients who experienced adverse drug reactions (RR = 1.00, 95% CI, 0.68 to 1.47; p = 0.99). Conclusion Dotinurad shows significant improvement in serum uric acid levels in hyperuricemic individuals with or without gout. Its urate-lowering effect is comparable to the commonly available anti-hyperuricemic agents. Moreover, it is effective at doses 1 mg, 2 mg, and 4 mg and well-tolerated at a dose of 2 mg.
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http://dx.doi.org/10.7759/cureus.14428DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8114961PMC
April 2021

Copper-Catalyzed Diamination of Unactivated Alkenes With Electron-Rich Amino Sources.

Org Lett 2021 05 10;23(10):4072-4077. Epub 2021 May 10.

Jilin Province Key Laboratory of Organic Functional Molecular Design & Synthesis, Department of Chemistry, Northeast Normal University, Changchun 130024, China.

The catalytic intermolecular diamination of unactivated alkenes with electron-rich amino sources is a challenge. Herein, by employing a directing-group strategy, a copper-catalyzed diamination of unactivated alkenes was realized. Symmetrical diamines were efficiently produced in a highly diastereoselective manner with readily available dialkylamines as amino sources, while a one-pot and two-step operation was necessary to produce the unsymmetrical diamines. These reactions were proposed to proceed through aziridinium intermediates.
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http://dx.doi.org/10.1021/acs.orglett.1c01313DOI Listing
May 2021

CCN Family Proteins in Cancer: Insight Into Their Structures and Coordination Role in Tumor Microenvironment.

Front Genet 2021 23;12:649387. Epub 2021 Mar 23.

Department of Nutrition, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.

The crosstalk between tumor cells and the tumor microenvironment (TME), triggers a variety of critical signaling pathways and promotes the malignant progression of cancer. The success rate of cancer therapy through targeting single molecule of this crosstalk may be extremely low, whereas co-targeting multiple components could be complicated design and likely to have more side effects. The six members of cellular communication network (CCN) family proteins are scaffolding proteins that may govern the TME, and several studies have shown targeted therapy of CCN family proteins may be effective for the treatment of cancer. CCN protein family shares similar structures, and they mutually reinforce and neutralize each other to serve various roles that are tightly regulated in a spatiotemporal manner by the TME. Here, we review the current knowledge on the structures and roles of CCN proteins in different types of cancer. We also analyze CCN mRNA expression, and reasons for its diverse relationship to prognosis in different cancers. In this review, we conclude that the discrepant functions of CCN proteins in different types of cancer are attributed to diverse TME and CCN truncated isoforms, and speculate that targeting CCN proteins to rebalance the TME could be a potent anti-cancer strategy.
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http://dx.doi.org/10.3389/fgene.2021.649387DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8021874PMC
March 2021

Divergent above- and below-ground biodiversity pathways mediate disturbance impacts on temperate forest multifunctionality.

Glob Chang Biol 2021 Jun 30;27(12):2883-2894. Epub 2021 Mar 30.

Aix Marseille Univ, CNRS, Avignon Université, IRD, IMBE, Technopôle Arbois-Méditerranée Bât. Villemin - BP 80, Aix-en-Provence cedex 04, France.

Biodiversity plays a fundamental role in provisioning and regulating forest ecosystem functions and services. Above-ground (plants) and below-ground (soil microbes) biodiversity could have asynchronous change paces to human-driven land-use impacts. Yet, we know very little how they affect the provision of multiple forest functions related to carbon accumulation, water retention capacity and nutrient cycling simultaneously (i.e. ecosystem multifunctionality; EMF). We used a dataset of 22,000 temperate forest trees from 260 plots within 11 permanent forest sites in Northeastern China, which are recovering from three post-logging disturbances. We assessed the direct and mediating effects of multiple attributes of plant biodiversity (taxonomic, phylogenetic, functional and stand structure) and soil biodiversity (bacteria and fungi) on EMF under the three disturbance levels. We found the highest EMF in highly disturbed rather than undisturbed mature forests. Plant taxonomic, phylogenetic, functional and stand structural diversity had both positive and negative effects on EMF, depending on how the EMF index was quantified, whereas soil microbial diversity exhibited a consistent positive impact. Biodiversity indices explained on average 45% (26%-58%) of the variation in EMF, whereas climate and disturbance together explained on average 7% (0.4%-15%). Our result highlighted that the tremendous effect of biodiversity on EMF, largely overpassing those of both climate and disturbance. While above- (β = 0.02-0.19) and below-ground (β = 0.16-0.26) biodiversity had direct positive effects on EMF, their opposite mediating effects (β = -0.22 vs. β = 0.35 respectively) played as divergent pathways to human disturbance impacts on EMF. Our study sheds light on the need for integrative frameworks simultaneously considering above- and below-ground attributes to grasp the global picture of biodiversity effects on ecosystem functioning and services. Suitable management interventions could maintain both plant and soil microbial biodiversity, and thus guarantee a long-term functioning and provisioning of ecosystem services in an increasing disturbance frequency world.
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http://dx.doi.org/10.1111/gcb.15606DOI Listing
June 2021

The COVID-19 Sequelae: A Cross-Sectional Evaluation of Post-recovery Symptoms and the Need for Rehabilitation of COVID-19 Survivors.

Cureus 2021 Feb 2;13(2):e13080. Epub 2021 Feb 2.

Pediatric Medicine, The Indus Hospital, Karachi, PAK.

Background  As of January 19, 2021, around two million fatalities and 68 million recoveries from coronavirus disease 2019 (COVID-19) have been reported around the globe. The past pandemics of severe acute respiratory syndrome (SARS) and the Middle East respiratory syndrome (MERS) hint toward a risk of occurrence of "Long-COVID" syndrome, i.e., the persistence of post-discharge symptoms among COVID-19 survivors. With the scarcity of literature addressing post-COVID-19 manifestations and little regard for the stigma associated with this disease, survivors' rehabilitation remains widely neglected. The current study aims to assess the prevalence and characteristics of post-COVID-19 manifestations and their effect on the quality of life (QoL) of COVID-19 recovered individuals. We have also analyzed the relationship of time since the recovery of COVID-19 and its severity with the post-discharge symptoms. The stigma affiliated with the infection of SARS coronavirus-2 (SARS-CoV-2) has also been highlighted. Methodology A descriptive, cross-sectional, questionnaire-based study was conducted from September 2020 to December 2020 among 158 COVID-19 recovered patients, whose information was obtained from Dow Diagnostic Laboratory, Ojha Campus, Karachi, Pakistan. The questionnaire consisted of four sections: sociodemographic data, post-COVID-19 manifestations, questions relating to the stigma, and the QoL of the recovered COVID-19 patients. We used the EuroQol five-dimension five-level questionnaire to assess the QoL, while the modified BG Prasad Socioeconomic Classification updated for 2019 was employed to determine the socioeconomic status of the participants. Data were analyzed using SPSS version 24.0 (IBM Corp., Armonk, NY, USA). Data were presented in the form of frequencies and percentages. Results An overwhelming majority (94.9%) experienced at least one post-COVID-19 symptom, with fatigue (82.9%) being the most prevalent post-discharge manifestation. We observed a significant correlation of post-COVID-19 symptoms with gender, age, and time since recovery. COVID-19 severity was found to be significantly related to the five dimensions of the QoL. A significant difference in EuroQol Visual Analog Scale health score was observed between the participants with mild, moderate, and severe COVID-19 infection (p < 0.001). Besides, the associated stigma with SARS-CoV-2 infection was found to be more prevalent in the participants belonging to the upper class as compared to the other classes (p < 0.05). Nonetheless, we also observed a significant association of disease severity with post-COVID-19 manifestations and pre-existing comorbidities. Conclusions The long-COVID syndrome is similar to the post-discharge manifestations of the survivors of prior pandemics of SARS and MERS. Multi-disciplinary rehabilitation teams, healthcare workers, and the general population should recognize the need for systematic assessment of their recovery and further rehabilitation.
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http://dx.doi.org/10.7759/cureus.13080DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7932827PMC
February 2021

Context-dependency of tree species diversity, trait composition and stand structural attributes regulate temperate forest multifunctionality.

Sci Total Environ 2021 Feb 14;757:143724. Epub 2020 Nov 14.

CAS Key Laboratory of Forest Ecology and Management, Institute of Applied Ecology, Chinese Academy of Sciences, Shenyang 110164, China. Electronic address:

High species diversity is generally thought to be a requirement for sustaining forest multifunctionality. However, the degree to which the relationship between species-, structural-, and trait-diversity of forests and multifunctionality depend on the context (such as stand age or abiotic conditions) is not well studied. Here, we hypothesized that context-dependency of tree species diversity, functional trait composition and stand structural attributes promote temperate forest multifunctionality including above- and below-ground multiple and single functions. To do so, we used repeated forest inventory data, from temperate mixed forests of northeast China, to quantify two above-ground (i.e. coarse woody productivity and wild edible plant biomass), five below-ground (i.e. soil organic carbon, total soil nitrogen, potassium, phosphorus and sulfur) functions, tree species diversity, individual tree size variation (CV) and functional trait composition of specific leaf area (CWM) as well as stand age and abiotic conditions. We found that tree species diversity increased forest multifunctionality and most of the single functions. Below-ground single and multifunctionality were better explained by tree species diversity. In contrast, above-ground single and multifunctionality were better explained by CV. However, CWM was also an additional important driver for maintaining above- and below-ground forest multifunctionality through opposing plant functional strategies. Stand age markedly reduced forest multifunctionality, tree species diversity and CWM but substantially increased CV. Below-ground forest multifunctionality and tree species diversity decreased while above-ground forest multifunctionality increased on steep slopes. These results highlight that context-dependency of forest diversity attributes might regulate forest multifunctionality but may not have a consistent effect on above-ground and below-ground forest multifunctionality due to the fact that those functions were driven by varied functional strategies of different plant species. We argue that maximizing forest complexity could act as a viable strategy to maximizing forest multifunctionality, while also promoting biodiversity conservation to mitigate climate change effects.
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http://dx.doi.org/10.1016/j.scitotenv.2020.143724DOI Listing
February 2021

Climate regulates the functional traits - aboveground biomass relationships at a community-level in forests: A global meta-analysis.

Sci Total Environ 2021 Mar 26;761:143238. Epub 2020 Oct 26.

Department of Forest Resources Management, College of Forestry, Nanjing Forestry University, Nanjing 210037, Jiangsu, China; Co-Innovation Center for Sustainable Forestry in Southern China, Nanjing Forestry University, Nanjing 210037, Jiangsu, China. Electronic address:

The relationships between plant functional traits and aboveground biomass (AGB) stock have been explored across forest biomes. Yet, meta-analyses synthesizing our understanding regarding the influences of climate and soil on the functional traits - AGB relationships at a community-level in global forests are still unavailable. Here, we evaluated the latitudinal gradient in the functional traits -AGB relationships in forests, including functional trait diversity (FTD) - AGB (FTD-AGB), community-weighted mean (CWM) of conservative traits (CWMCT-AGB), CWM of acquisitive traits (CWMAT-AGB), and CWM of plant maximum height or diameter (FunDom-AGB), and then answer the question whether climate and soil conditions modulate the functional traits - AGB relationships in global forests. To do so, we selected those studies which reported the relationships of FTD and CWM with AGB stock (i.e. in Mg ha) rather with AGB productivity or growth (i.e. Mg ha yr) at a community-level (i.e. forest plot). By using piecewise structural equation meta-modeling, we found that: (1) functional traits - AGB relationships at a community-level were driven by mean annual temperature (MAT), aridity and soil fertility. (2) Higher MAT and low aridity promoted FTD-AGB relationships but the opposite trend was true for CWMCT-AGB, whereas higher MAT promoted CWMAT-AGB and FunDom-AGB at high aridity levels. (3) The FunDom-AGB relationship increased with increasing the number of forest plots but other relationships declined. (4) The negligible or negative FTD-AGB relationships but the positive AGB-FunDom relationships were conspicuous across global forests, indicating the mass ratio effect in terms of functional dominance. Our meta-analysis suggests that functional dominance and conservative species' strategy in relation to favorable abiotic conditions should be promoted to increase AGB stock under global environmental changes.
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http://dx.doi.org/10.1016/j.scitotenv.2020.143238DOI Listing
March 2021
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