bluuebunny/crossref_metadata_2025 huggingface dataset:
Procoagulant Imbalance in Klinefelter Syndrome Assessed by Thrombin Generation Assay and Whole-Blood Thromboelastometry
Authors: Indirli Rita , Ferrante Emanuele , Scalambrino Erica , Profka Eriselda , Clerici Marigrazia , Lettera Tommaso , Serban Andreea Liliana , Vena Walter , Pizzocaro Alessandro , Bonomi Marco , Cangiano Biagio , Carosi Giulia , Mazziotti Gherardo , Persani Luca , Lania Andrea , Arosio Maura , Peyvandi Flora , Mantovani Giovanna , Tripodi Armando
Published: December 2020

Context

Klinefelter syndrome (KS) is a condition at increased risk of thrombosis compared to 46,XY men.

Objective

This work aimed to investigate the coagulation balance of KS patients by thrombin generation assay (TGA) and thromboelastometry.

Methods

An observational, cross-sectional study was conducted at 3 tertiary endocrinological centers in Milan, Italy. Fifty-eight KS patients and 58 age-matched healthy controls were included. Anticoagulant or antiplatelet therapy and known coagulation disorders were exclusion criteria. TGA was performed in platelet-poor plasma (PPP) and platelet-rich plasma (PRP). Whole-blood thromboelastometry and activities of coagulation factors were assessed. Endogenous thrombin potential (ETP), the area under the thrombin generation curve, assessed with and without thrombomodulin (ETP-TM+ and ETP-TM–), and their ratio (ETP ratio), were considered as indexes of procoagulant imbalance.

Results

Patients with KS displayed higher PPP-ETP-TM+ (mean 1528 vs 0.1315 nM × min; P < .001), PPP-ETP ratio (0.78 vs 0.0.70; P < .001), factor (F)VIII (135% vs 0.107%; P = .001), fibrinogen (283 vs 0.241 mg/dL; P < .001), and FVIII/protein C ratio (1.21 vs 0.1.06; P < .05) compared to controls. Protein C was comparable in the 2 groups. Similar results were observed in PRP. The ETP ratio was positively associated with FVIII (ρ = 0.538, P < .001) in KS. Thromboelastometry parameters confirmed evidence of hypercoagulability in KS.

Conclusion

Patients with KS display a procoagulant imbalance expressed by increased thrombin generation both in PPP and PRP, which is at least in part explained by increased FVIII levels. The procoagulant imbalance, which was confirmed by thromboelastometry, may be responsible for the thrombotic events observed in these patients. Further investigation on the benefit/risk ratio of antithrombotic prophylaxis is warranted.
Limited Genetic Overlap Between Overt Hashimoto’s Thyroiditis and Graves’ Disease in Twins: A Population-based Study
Authors: Skov Jakob , Calissendorff Jan , Eriksson Daniel , Magnusson Patrik , Kämpe Olle , Bensing Sophie , Kuja-Halkola Ralf
Published: December 2020

Context

Hashimoto’s thyroiditis (HT) and Graves’ disease (GD) are known to coaggregate in families, but the magnitude and nature of a shared etiology is unknown.

Objectives

To estimate the shared genetic influence on overt HT and GD and to examine if the heritability differs between men and women.

Design, setting, and patients

We used national health registries to identify cases of HT and GD in a cohort of 110 814 Swedish twins. By comparing intra-class and cross-twin cross-trait correlations in dizygotic and monozygotic twins, we calculated heritability and the proportions thereof shared between the diseases. Univariate estimates of heritability were calculated by sex.

Results

The heritability for HT and GD was 65% (95% CI, 61-70) and 63% (95% CI, 55-72), respectively. The genetic correlation was 0.35 (95% CI, 0.20-0.50) and shared genetic effects accounted for 8% of the variance for both HT and GD. Univariate heritability was significantly higher in men than in women for HT (90% vs 60%, P < 0.001) but not for GD (79% vs 63%, P = 0.085).

Conclusions

From a genetic perspective, HT and GD appear to be only modestly related diseases. Hence, the term “autoimmune thyroid disease,” used to cluster these disorders, may have limited validity in a genetic context. Moreover, the mechanisms contributing to HT are partly different for the sexes, with genetic components more important in men.
Mouse Models of Human Proprotein Convertase Insufficiency
Authors: Shakya Manita , Lindberg Iris
Published: December 2020

The kexin-like proprotein convertases perform the initial proteolytic cleavages that ultimately generate a variety of different mature peptide and proteins, ranging from brain neuropeptides to endocrine peptide hormones, to structural proteins, among others. In this review, we present a general introduction to proprotein convertase structure and biochemistry, followed by a comprehensive discussion of each member of the kexin-like subfamily of proprotein convertases. We summarize current knowledge of human proprotein convertase insufficiency syndromes, including genome-wide analyses of convertase polymorphisms, and compare these to convertase null and mutant mouse models. These mouse models have illuminated our understanding of the roles specific convertases play in human disease and have led to the identification of convertase-specific substrates; for example, the identification of procorin as a specific PACE4 substrate in the heart. We also discuss the limitations of mouse null models in interpreting human disease, such as differential precursor cleavage due to species-specific sequence differences, and the challenges presented by functional redundancy among convertases in attempting to assign specific cleavages and/or physiological roles. However, in most cases, knockout mouse models have added substantively both to our knowledge of diseases caused by human proprotein convertase insufficiency and to our appreciation of their normal physiological roles, as clearly seen in the case of the furin, proprotein convertase 1/3, and proprotein convertase 5/6 mouse models. The creation of more sophisticated mouse models with tissue- or temporally-restricted expression of specific convertases will improve our understanding of human proprotein convertase insufficiency and potentially provide support for the emerging concept of therapeutic inhibition of convertases.
Mullā Ṣadrā’s Political Legacy: Ṣadrā’s Theory of Justice and the Religio-Political Authority in Post-Revolutionary Iran
Authors: Rastin Toroghi Amir , Hosseini Shahrudi Seyyed Mortaza
Published: December 2020

Apart from its philosophical attractions, the religio-political potentials in the transcendent philosophy of Mullā Ṣadrā Shīrāzī (d. 1050/1641) have helped to its dominance in the seminary and university in contemporary Iran. It seems that one of the reasons for the state’s support for al-Ḥikmah al-mutaʿāliyah in Iran after the Islamic revolution is the potentials existing in this philosophy to justify the establishment of a religious government based on the discourse of Shīʿī political authority, conspicuously the doctrine of walāyat-i faqīh (the guardianship and governance of the jurist). This article aims to demonstrate how Mullā Ṣadrā’s theory of moral and social justice could have provided an intellectual ground for the establishment of an Islamic state in the Shīʿī sense.
Engineering Properties of Peeled and Unpeeled Multiplier Onion
Authors: Ambrose Dawn C.P.
Published: December 2020

Multiplier onion (Allium cepa L. var aggregatum. Don.) is mainly used for its unique flavour in seasoning dishes. The unpeeled onions are processed at farm level by means of primary processing and by secondary processing various products like paste, flakes, powder could be produced from peeled onions. For the design of processing and handling equipment knowledge of engineering properties is essential. The engineering properties of peeled and unpeeled multiplier onion were determined. The average values of the physical properties of unpeeled onion were recorded for bulk density and true density as 636.621 and 1526.825 kg/m3 respectively. Similarly for peeled onions, the bulk and true density were 627.03 and 1108.74 kg/m3 respectively. The moisture present in peeled and unpeeled onion was 77.66 % and 74.43% (w.b) respectively. The TSS of multiplier onion was found to be 20° Brix for both peeled and unpeeled samples. The colour values were also measured using colour flex meter for the peeled and unpeeled onions. The frictional properties including coefficient of friction, filling and emptying angle of repose were also measured. Mechanical properties were determined by using a texture analyser. The firmness was measured in terms of penetrating force and crushing strength which were recorded to be 8.59 N and 124.93 N respectively for peeled and 12.00 N and 138.35 N respectively for unpeeled onions.
INTERAÇÕES ENTRE PLUVIOSIDADE E A INTENSIFICAÇÃO DE PROCESSOS GEOMORFOLÓGICOS EM BACIAS HIDROGRÁFICAS URBANAS: UM ESTUDO APLICADO NAS BACIAS DO RIO GRANDE E RIO ANIL NO MUNICÍPIO DO RIO DE JANEIRO
Authors: Carvalho Regina Paula Benedetto de , Brandão Cássia Barreto
Published: December 2020

Nas áreas urbanas, eventos pluviais extremos podem desencadear processos erosivos e hidrológicos catastróficos quando associados a formas de uso e ocupação desordenadas. Com o intuito de corroborar essa afirmativa, este trabalho teve como objetivo analisar as condições pluviométricas e o histórico de eventos extremos que causaram movimentos de massa e inundações nas bacias urbanas do Rio Grande e Rio Anil, no município do Rio de Janeiro. Os resultados demostraram que a seletividade espacial das políticas de planejamento urbano aliada a alta pluviosidade regional tem intensificado a magnitude e os efeitos dos fenômenos de superfície nas bacias estudadas, aumentando os riscos de desastres as populações vulneráveis.
TENDÊNCIA DE COBERTURA E USO DO SOLO PARA A BACIA DE SEPETIBA: NOVOS ELEMENTOS PARA O PLANEJAMENTO AMBIENTAL E A GESTÃO DO TERRITÓRIO
Authors: Deus Leandro Andrei Beser de , Oscar Júnior Antonio Carlos
Published: December 2020

O tempo é uma das categorias fundamentais para a Geografia, afinal é a partir dele que se compreendem os processos de organização do território, bem como dos problemas ambientais, portanto, elemento peremptório para a gestão do território e o planejamento ambiental.  O presente artigo tem como objetivo avaliar as mudanças de cobertura e uso do solo na bacia da Baía de Sepetiba, no município de Rio de Janeiro, oferecendo, a partir de uma metodologia baseada em um Sistema de Informação Geográfica Temporal (SIGT), uma perspectiva de análise que combina o tempo passado (2004), presente (2013) e futuro (tendencial). Através da metodologia aplicada foi possível constatar o intenso padrão de conversão de cobertura e uso do solo para a bacia, explicado, sobretudo, pelo desenvolvimento industrial, orientado pelo Programa de Aceleração do Crescimento (PAC), bem como, a ocupação residencial de classe baixa e média, sobretudo, em áreas suscetíveis a enchentes, inundações e deslizamentos, transparecendo os impactos de um ordenamento territorial orientado não pelo poder público, mas pelos agentes produtivos e dinâmica dos megaeventos.
OPTIMIZING THE MONITORING OF NATURAL PHENOMENA THROUGH THE COUPLING OF ORBITAL MULTI-SENSORS
Authors: Filgueiras Roberto , Mantovani Everardo Chartuni , Dias Santos Henrique Brant , Fernandes Filho Elpídio Inácio , Cunha Fernando França da
Published: December 2020

Alta frequência de imagens e resolução espacial são características necessárias em estudos com alta dinâmica temporal e espacial, difícil de encontrar em um único sensor orbital. Portanto, a possibilidade de usar vários satélites para solucionar esse obstáculo no monitoramento é de fundamental importância. O objetivo do estudo foi avaliar o acoplamento multisensor para monitorar fenômenos que requerem uma frequência mais elevada de imagens detalhadas, intercalando as imagens de reflectância do sensor LISS III, a bordo do satélite ResourceSat-II e o sensor MSI no Sentinel-2A, utilizando o sensor OLI (Landsat-8) como padrão. Para prosseguir com a metodologia, foi necessário, antes da intercalibração, converter os números digitais (bandas) em refletância no topo da atmosfera, para que posteriormente fosse possível realizar a intercalibração dos dados com regressão linear simples. Os resultados demonstram que, com a intercalibração das imagens de reflectância dos sensores LISS III e MSI, é possível acoplar as informações desses sensores com as provenientes do OLI, possibilitando o aumento da frequência e disponibilidade de informações em estudos que exigem mais observações, como no monitoramento agrícola, desastres naturais e desmatamento, entre outros.
Synthesis and Characterization of SEM, UV absorption coefficient and shock wave properties of Thiourea Sodium Sulphate crystal
Authors: Bhaskar M. Uday , Senthilkumar S. , Shankar G.
Published: December 2020

Single crystal of Thiourea Sodium Sulphate (TSS) was prepared by a slow evaporation technique. The optical absorption and absorption coefficient are studied by UV. Vis.-NIR The voids or defects of the TSS crystal were carried out by its surface morphology analysis by SEM. The NLO properties of shocked TSS single crystal were estimated by UV-Vis-NIR spectroscopic analysis. Finally the nonlinear optical property of TSS crystal was estimated by Second Harmonic Generation (SHG) and the suitability of present titled mono crystal against mechanical resistivity after the shock for non linear optics and for photonic application has been confirmed.
B2 or not B2? That is the question: a review of periprosthetic fractures around cemented taper-slip femoral components
Authors: Maggs Joanna L. , Swanton Eric , Whitehouse Sarah L. , Howell Jonathan R. , Timperley A. John , Hubble Matthew J. W. , Wilson Matt J.
Published: December 2020

Aims

Periprosthetic fractures (PPFs) around cemented taper-slip femoral prostheses often result in a femoral component that is loose at the prosthesis-cement interface, but where the cement-bone interface remains well-fixed and bone stock is good. We aim to understand how best to classify and manage these fractures by using a modification of the Vancouver classification.

Methods

We reviewed 87 PPFs. Each was a first episode of fracture around a cemented femoral component, where surgical management consisted of revision surgery. Data regarding initial injury, intraoperative findings, and management were prospectively collected. Patient records and serial radiographs were reviewed to determine fracture classification, whether the bone cement was well fixed (B2W) or loose (B2L), and time to fracture union following treatment.

Results

In total, 47 B2W fractures (54.0%) and one B3 fracture (1.1%) had cement that remained well-fixed at the cement-bone interface. These cases were treated with cement-in-cement (CinC) revision arthroplasty. Overall, 43 fractures with follow-up united, and two patients sustained further fractures secondary to nonunion and required further revision surgery. A total of 19 B2L fractures (21.8%) and 19 B3 fractures (21.8%) had cement that was loose at the cement-bone interface. These cases were managed by revision arthroplasty with either cemented or uncemented femoral components, or proximal femoral arthroplasty. One case could not be classified.

Conclusion

We endorse a modification of the original Vancouver system to include a subclassification of B2 fractures around cemented femoral prostheses to include B2W (where cement is well-fixed to bone) and B2L (where the cement is loose). Fractures around taper-slip design stems are more likely to fracture in a B2W pattern compared to fractures around composite beam design stems which are more likely to fracture in a B2L pattern. B2W fractures can reliably be managed with CinC revision. Cite this article: Bone Joint J 2021;103-B(1):71–78.
A prospective randomized controlled trial comparing the systemic inflammatory response in conventional jig-based total knee arthroplasty versus robotic-arm assisted total knee arthroplasty
Authors: Kayani Babar , Tahmassebi Jenni , Ayuob Atif , Konan Sujith , Oussedik Sam , Haddad Fares S.
Published: December 2020

Aims

The primary aim of this study was to compare the postoperative systemic inflammatory response in conventional jig-based total knee arthroplasty (conventional TKA) versus robotic-arm assisted total knee arthroplasty (robotic TKA). Secondary aims were to compare the macroscopic soft tissue injury, femoral and tibial bone trauma, localized thermal response, and the accuracy of component positioning between the two treatment groups.

Methods

This prospective randomized controlled trial included 30 patients with osteoarthritis of the knee undergoing conventional TKA versus robotic TKA. Predefined serum markers of inflammation and localized knee temperature were collected preoperatively and postoperatively at six hours, day 1, day 2, day 7, and day 28 following TKA. Blinded observers used the Macroscopic Soft Tissue Injury (MASTI) classification system to grade intraoperative periarticular soft tissue injury and bone trauma. Plain radiographs were used to assess the accuracy of achieving the planned postioning of the components in both groups.

Results

Patients undergoing conventional TKA and robotic TKA had comparable changes in the postoperative systemic inflammatory and localized thermal response at six hours, day 1, day 2, and day 28 after surgery. Robotic TKA had significantly reduced levels of interleukin-6 (p < 0.001), tumour necrosis factor-α (p = 0.021), ESR (p = 0.001), CRP (p = 0.004), lactate dehydrogenase (p = 0.007), and creatine kinase (p = 0.004) at day 7 after surgery compared with conventional TKA. Robotic TKA was associated with significantly improved preservation of the periarticular soft tissue envelope (p < 0.001), and reduced femoral (p = 0.012) and tibial (p = 0.023) bone trauma compared with conventional TKA. Robotic TKA significantly improved the accuracy of achieving the planned limb alignment (p < 0.001), femoral component positioning (p < 0.001), and tibial component positioning (p < 0.001) compared with conventional TKA.

Conclusion

Robotic TKA was associated with a transient reduction in the early (day 7) postoperative inflammatory response but there was no difference in the immediate (< 48 hours) or late (day 28) postoperative systemic inflammatory response compared with conventional TKA. Robotic TKA was associated with decreased iatrogenic periarticular soft tissue injury, reduced femoral and tibial bone trauma, and improved accuracy of component positioning compared with conventional TKA. Cite this article: Bone Joint J 2021;103-B(1):113–122.
A comparison of conventional and minimally invasive multilevel surgery for children with diplegic cerebral palsy
Authors: Edwards Tomos A. , Thompson Nicky , Prescott Robin J. , Stebbins Julie , Wright James G. , Theologis Tim
Published: December 2020

Aims

To compare changes in gait kinematics and walking speed 24 months after conventional (C-MLS) and minimally invasive (MI-MLS) multilevel surgery for children with diplegic cerebral palsy (CP).

Methods

A retrospective analysis of 19 children following C-MLS, with mean age at surgery of 12 years five months (seven years ten months to 15 years 11 months), and 36 children following MI-MLS, with mean age at surgery of ten years seven months (seven years one month to 14 years ten months), was performed. The Gait Profile Score (GPS) and walking speed were collected preoperatively and six, 12 and 24 months postoperatively. Type and frequency of procedures as part of MLS, surgical adverse events, and subsequent surgery were recorded.

Results

In both groups, GPS improved from the preoperative gait analysis to the six-month assessment with maintenance at 12 and 24 months postoperatively. While reduced at six months in both groups, walking speed returned to preoperative speed by 12 months. The overall pattern of change in GPS and walking speed was similar over time following C-MLS and MI-MLS. There was a median of ten procedures per child as part of both C-MLS (interquartile range (IQR) 8.0 to 11.0) and MI-MLS (IQR 7.8 to 11.0). Surgical adverse events occurred in seven (37%) and 13 (36%) children, with four (21%) and 13 (36%) patients requiring subsequent surgery following C-MLS and MI-MLS, respectively.

Conclusion

This study indicates similar improvements in gait kinematics and walking speed 24 months after C-MLS and MI-MLS for children with diplegic CP. Cite this article: Bone Joint J 2021;103-B(1):192–197.
Robotic arm-assisted versus manual total hip arthroplasty
Authors: Clement Nicholas D. , Gaston Paul , Bell Allison , Simpson Philip , Macpherson Gavin , Hamilton David F. , Patton James T.
Published: December 2020

Aims

The primary aim of this study was to compare the hip-specific functional outcome of robotic assisted total hip arthroplasty (rTHA) with manual total hip arthroplasty (mTHA) in patients with osteoarthritis (OA). Secondary aims were to compare general health improvement, patient satisfaction, and radiological component position and restoration of leg length between rTHA and mTHA.

Methods

A total of 40 patients undergoing rTHA were propensity score matched to 80 patients undergoing mTHA for OA. Patients were matched for age, sex, and preoperative function. The Oxford Hip Score (OHS), Forgotten Joint Score (FJS), and EuroQol five-dimension questionnaire (EQ-5D) were collected pre- and postoperatively (mean 10 months (SD 2.2) in rTHA group and 12 months (SD 0.3) in mTHA group). In addition, patient satisfaction was collected postoperatively. Component accuracy was assessed using Lewinnek and Callanan safe zones, and restoration of leg length were assessed radiologically.

Results

There were no significant differences in the preoperative demographics (p ≥ 0.781) or function (p ≥ 0.383) between the groups. The postoperative OHS (difference 2.5, 95% confidence interval (CI) 0.1 to 4.8; p = 0.038) and FJS (difference 21.1, 95% CI 10.7 to 31.5; p < 0.001) were significantly greater in the rTHA group when compared with the mTHA group. However, only the FJS was clinically significantly greater. There was no difference in the postoperative EQ-5D (difference 0.017, 95% CI -0.042 to 0.077; p = 0.562) between the two groups. No patients were dissatisfied in the rTHA group whereas six were dissatisfied in the mTHA group, but this was not significant (p = 0.176). rTHA was associated with an overall greater rate of component positioning in a safe zone (p ≤ 0.003) and restoration of leg length (p < 0.001).

Conclusion

Patients undergoing rTHA had a greater hip-specific functional outcome when compared to mTHA, which may be related to improved component positioning and restoration of leg length. However, there was no difference in their postoperative generic health or rate of satisfaction. Cite this article: Bone Joint Res 2021;10(1):22–30.
An ever-changing landscape in Roberts syndrome biology: Implications for macromolecular damage
Authors: Mfarej Michael G. , Skibbens Robert V.
Published: December 2020

Roberts syndrome (RBS) is a rare developmental disorder that can include craniofacial abnormalities, limb malformations, missing digits, intellectual disabilities, stillbirth, and early mortality. The genetic basis for RBS is linked to autosomal recessive loss-of-function mutation of the establishment of cohesion (ESCO) 2 acetyltransferase.ESCO2is an essential gene that targets the DNA-binding cohesin complex. ESCO2 acetylates alternate subunits of cohesin to orchestrate vital cellular processes that include sister chromatid cohesion, chromosome condensation, transcription, and DNA repair. Although significant advances were made over the last 20 years in our understanding of ESCO2 and cohesin biology, the molecular etiology of RBS remains ambiguous. In this review, we highlight current models of RBS and reflect on data that suggests a novel role for macromolecular damage in the molecular etiology of RBS.
Venomous snakebites: Rapid action saves lives—A multifaceted community education programme increases awareness about snakes and snakebites among the rural population of Tamil Nadu, India
Authors: Samuel Stephen Paul , Chinnaraju Soundararaj , Williams Harry F. , Pichamuthu Elamaran , Subharao Mangaiyarkkarasai , Vaiyapuri Mohanraj , Arumugam Sundhararajan , Vaiyapuri Rajendran , Baksh M. Fazil , Patel Ketan , Trim Steven A. , Duncombe Tracey E. , Vaiyapuri Sakthivel
Published: December 2020

The lack of public awareness surrounding the dangers of snakebite envenomation (SBE) is one of the most critical factors contributing to SBE-induced complications, and subsequently exacerbating the number of deaths and disabilities resulting from SBE. In this study, we deployed a multifaceted community education programme to educate students, healthcare professionals and members of the public in rural areas of Tamil Nadu, India about the dangers of SBE, appropriate first aid measures and the ‘do’s and don’ts’ following a snakebite. An assessment of prior knowledge within these communities identified several misconceptions concerning snakes and SBE. Using a combination of direct engagement (estimated to reach over 200,000 people), information leaflets (200,000 distributed), posters, video documentaries, media and social media (>2.8 million engagements), over the course of one year (January to December 2019) we reached over 3 million people in rural Tamil Nadu (around 8% of population). Evaluation of community-based assemblies indicated that at least 90% of attendees were able to recall the key messages at the end of the events, and at least 85% were able to recall the key messages even after 12 months. Due to high demand, a one-day symposium was organised to provide clinical knowledge and training on SBE to 250 healthcare professionals in rural Tamil Nadu. Notably, an assessment of patient data (291 victims) collected from a snakebite referral hospital over the same 12-month period (2019) indicated that arrival time at hospital following a snakebite was significantly faster and the effective first aid measures were administered to patients who were aware of our activities compared to those that were not. Overall, our approach provides a framework on how to educate rural communities about the dangers of SBE and thereby, mitigate delayed SBE treatment leading to an overall reduction in SBE-induced mortality, morbidity, treatment costs and other socio-economic ramifications.
Diagnostic accuracy of direct agglutination test, rK39 ELISA and six rapid diagnostic tests among visceral leishmaniasis patients with and without HIV coinfection in Ethiopia
Authors: Kassa Mekibib , Abdellati Saïd , Cnops Lieselotte , Bremer Hinckel Bruno C. , Yeshanew Arega , Hailemichael Wasihun , Vogt Florian , Adriaensen Wim , Mertens Pascal , Diro Ermias , van Griensven Johan , Van den Bossche Dorien
Published: December 2020

Diagnosis of a first-time visceral leishmaniasis (VL) infection in Ethiopia is established by use of a rapid diagnostic test (RDT) detecting antibodies against rK39, direct agglutination test (DAT) and microscopy according to the national algorithm. The performance of individual tests and algorithm is variable and depends on several factors, one being HIV status. Limited data are available on the performance of tests in VL-HIV coinfected patients.

Assessment of the performance of DAT (ITM-A), rK39 ELISA (Serion) and six RDT (Onsite Leishmania Ab CTK, Antigen ICT Xinjier, IT Leish Biorad, Kalazar Detect Inbios, rK39 IgG1 Coris, rk28 IgG1 Coris) for the diagnosis of VL was done on a panel of 91 stored serum and plasma samples of ‘first-episode’ suspected VL patients, with HIV coinfection (n = 51) and without (n = 40). A combined reference standard was used: either positive microscopy on tissue aspirates, or in case of negative microscopy, positive PCR results on the aspirate slide. Additionally, endemic healthy controls (n = 20), non-endemic controls (n = 10) and patients with confirmed malaria infection (n = 10) were tested for specificity evaluation. Sensitivities ranged from 69.2% for DAT (applied cut-off ≥ 1/3200) to 92.2% for the Onsite RDT, whereas specificities ranged from 20.0% for Kalazar Antigen ICT to 100% for IT Leish and rK39 IgG1. Sensitivities from all assays decreased upon stratification according to HIV status but was only significantly different for rK39 Serion ELISA (p-value 0.0084) and the Onsite RDT (p-value 0.0159).

In conclusion, performance of commercially available assays for VL on samples from Northern-Ethiopian patients varied widely with a substantial decrease in sensitivity in the VL-HIV coinfected group. Clear guidelines on minimal performance criteria of individual tests and algorithms are needed, as well as which reference standard should be used to determine the performance.
Scrambling the skin: A psychophysical study of adaptation to scrambled tactile apparent motion
Authors: Seizova-Cajic Tatjana , Ludvigsson Sandra , Sourander Birger , Popov Melinda , Taylor Janet L.
Published: December 2020

An age-old hypothesis proposes that object motion across the receptor surface organizes sensory maps (Lotze, 19th century). Skin patches learn their relative positions from the order in which they are stimulated during motion events. We propose that reversing the local motion within a global motion sequence (‘motion scrambling’) provides a good test for this idea, and present results of the first experiment implementing the paradigm. We used 6-point apparent motion along the forearm. In the Scrambled sequence, two middle locations were touched in reversed order (1-2-4-3-5-6, followed by 6-5-3-4-2-1, in a continuous loop). This created a double U-turn within an otherwise constant-velocity motion, as if skin patches 3 and 4 physically swapped locations. The control condition, Orderly, proceeded at constant velocity at inter-stimulus onset interval of 120 ms. The 26.4-minute conditioning (delivered in twenty-four 66-s bouts) was interspersed with testing of perceived motion direction between the two middle tactors presented on their own (sequence 3–4 or 4–3). Our twenty participants reported motion direction. Direction discrimination was degraded following exposure to Scrambled pattern and was 0.31 d’ weaker than following Orderly conditioning (p = .007). Consistent with the proposed role of motion, this could be the beginning of re-learning of relative positions. An alternative explanation is that greater speed adaptation occurred in the Scrambled pattern, raising direction threshold. In future studies, longer conditioning should tease apart the two explanations: our re-mapping hypothesis predicts an overall reversal in perceived motion direction between critical locations (for either motion direction), whereas the speed adaptation alternative predicts chance-level performance at worst, without reversing.
What’s the temperature in tropical caves?
Authors: Mejía-Ortíz Luis , Christman Mary C. , Pipan Tanja , Culver David C.
Published: December 2020

Hourly temperature was measured for approximately one year at 17 stations in three caves in Quintana Roo, Mexico. Thirteen of these stations were in the extensive twilight zones of all three caves. All seventeen stations showed seasonality in temperature with a 3°C drop during the Nortes season. Two of the caves, Muévelo Sabrosito and Muévelo Rico, showed greater variability during the winter months while in Río Secreto (Tuch) variability was greatest during the rainy season. Río Secreto is less open to the surface than the other two. All sites also showed a daily temperature cycle, although it was very faint in some Río Secreto (Tuch) sites. While temperature variability is diminished relative to surface variation, its temporal pattern is worthy of further study.
Genome-wide identification of novel genes involved in Corynebacteriales cell envelope biogenesis using Corynebacterium glutamicum as a model
Authors: de Sousa-d’Auria Célia , Constantinesco-Becker Florence , Constant Patricia , Tropis Maryelle , Houssin Christine
Published: December 2020

CorynebacterialesareActinobacteriathat possess an atypical didermic cell envelope. One of the principal features of this cell envelope is the presence of a large complex made up of peptidoglycan, arabinogalactan and mycolic acids. This covalent complex constitutes the backbone of the cell wall and supports an outer membrane, called mycomembrane in reference to the mycolic acids that are its major component. The biosynthesis of the cell envelope ofCorynebacterialeshas been extensively studied, in particular because it is crucial for the survival of important pathogens such asMycobacterium tuberculosisand is therefore a key target for anti-tuberculosis drugs. In this study, we explore the biogenesis of the cell envelope ofCorynebacterium glutamicum, a non-pathogenicCorynebacteriales, which can tolerate dramatic modifications of its cell envelope as important as the loss of its mycomembrane. For this purpose, we used a genetic approach based on genome-wide transposon mutagenesis. We developed a highly effective immunological test based on the use of anti-cell wall antibodies that allowed us to rapidly identify bacteria exhibiting an altered cell envelope. A very large number (10,073) of insertional mutants were screened by means of this test, and 80 were finally selected, representing 55 different loci. Bioinformatics analyses of these loci showed that approximately 60% corresponded to genes already characterized, 63% of which are known to be directly involved in cell wall processes, and more specifically in the biosynthesis of the mycoloyl-arabinogalactan-peptidoglycan complex. We identified 22 new loci potentially involved in cell envelope biogenesis, 76% of which encode putative cell envelope proteins. A mutant of particular interest was further characterized and revealed a new player in mycolic acid metabolism. Because a large proportion of the genes identified by our study is conserved inCorynebacteriales, the library described here provides a new resource of genes whose characterization could lead to a better understanding of the biosynthesis of the envelope components of these bacteria.
SARS-CoV-2 infection induces mixed M1/M2 phenotype in circulating monocytes and alterations in both dendritic cell and monocyte subsets
Authors: Matic Sanja , Popovic Suzana , Djurdjevic Predrag , Todorovic Danijela , Djordjevic Natasa , Mijailovic Zeljko , Sazdanovic Predrag , Milovanovic Dragan , Ruzic Zecevic Dejana , Petrovic Marina , Sazdanovic Maja , Zornic Nenad , Vukicevic Vladimir , Petrovic Ivana , Matic Snezana , Karic Vukicevic Marina , Baskic Dejan
Published: December 2020

Clinical manifestations of SARS-CoV-2 infection range from mild to critically severe. The aim of the study was to highlight the immunological events associated with the severity of SARS-CoV-2 infection, with an emphasis on cells of innate immunity. Thirty COVID-19 patients with mild/moderate symptoms and 27 patients with severe/critically severe symptoms were recruited from the Clinical Center of Kragujevac during April 2020. Flow cytometric analysis was performed to reveal phenotypic and functional alterations of peripheral blood cells and to correlate them with the severity of the disease. In severe cases, the number of T and B lymphocytes, dendritic cells, NK cells, and HLA-DR-expressing cells was drastically decreased. In the monocyte population proportion between certain subsets was disturbed and cells coexpressing markers of M1 and M2 monocytes were found in intermediate and non-classical subsets. In mild cases decline in lymphocyte number was less pronounced and innate immunity was preserved as indicated by an increased number of myeloid and activated dendritic cells, NK cells that expressed activation marker at the same level as in control and by low expression of M2 marker in monocyte population. In patients with severe disease, both innate and adoptive immunity are devastated, while in patients with mild symptoms decline in lymphocyte number is lesser, and the innate immunity is preserved.
Placental pathology and maternal factors associated with stillbirth: An institutional based case-control study in Northern Tanzania
Authors: Lema Godwin , Mremi Alex , Amsi Patrick , Pyuza Jeremia J. , Alloyce Julius P. , Mchome Bariki , Mlay Pendo
Published: December 2020

Objective

To determine the placental pathologies and maternal factors associated with stillbirth at Kilimanjaro Christian Medical Centre, a tertiary referral hospital in Northern Tanzania.

Methods

A 1:2 unmatched case-control study was carried out among deliveries over an 8-month period. Stillbirths were a case group and live births were the control group. Respective placentas of the newborns from both groups were histopathologically analyzed. Maternal information was collected via chart review. Mean and standard deviation were used to summarize the numerical variables while frequency and percentage were used to summarize categorical variables. Crude and adjusted logistic regressions were done to test the association between each variable and the risk of stillbirth.

Results

A total of 2305 women delivered during the study period. Their mean age was 30 ± 5.9 years. Of all deliveries, 2207 (95.8%) were live births while 98 (4.2%) were stillbirths. Of these, 96 stillbirths (cases) and 192 live births (controls) were enrolled. The average gestational age for the enrolled cases was 33.8 ±3.2 weeks while that of the controls was 36.3±3.6 weeks, (p-value 0.244). Of all stillbirths, nearly two thirds 61(63.5%) were males while the females were 35(36.5%). Of the stillbirth, 41were fresh stillbirths while 55 were macerated. The risk of stillbirth was significantly associated with lower maternal education [aOR (95% CI): 5.22(2.01–13.58)], history of stillbirth [aOR (95%CI): 3.17(1.20–8.36)], lower number of antenatal visits [aOR (95%CI): 6.68(2.71–16.48), pre/eclampsia [aOR (95%CI): 4.06(2.03–8.13)], and ante partum haemorrhage [OR (95%CI): 2.39(1.04–5.53)]. Placental pathology associated with stillbirth included utero-placental vascular pathology and acute chorioamnionitis.

Conclusions

Educating the mothers on the importance of regular antenatal clinic attendance, monitoring and managing maternal conditions during antenatal periods should be emphasized. Placentas from stillbirths should be histo-pathologically evaluated to better understand the possible aetiology of stillbirths.
The use of methylprednisolone in COVID-19 patients: A propensity score matched retrospective cohort study
Authors: You Xiang , Wu Chao-hui , Fu Ya-nan , He Zonglin , Huang Pin-fang , Chen Gong-ping , Lin Cui-hong , Ming Wai-kit , Lin Rong-fang
Published: December 2020

Purpose

To evaluate the efficacy and safety of methylprednisolone in treating the coronavirus disease 2019 (COVID-19) patients.

Methods

A retrospective cohort study was conducted, and all COVID-19 patients were recruited who were admitted to the Yichang Third People’s Hospital from February 1st to March 31st, 2020. One-to-one propensity score matching (PSM) was used for minimizing confounding effects. The primary outcome was hospital mortality, with the secondary outcomes being the time needed for a positive SARS-CoV-2 nucleic acid test to turn negative and the length of hospital stay.

Results

Totaling 367 patients with COVID-19 hospitalized at the Yichang Third People’s Hospital were identified, of whom 276 were mild or stable COVID-19, and 67 were serious or critically ill. Among them, 255 patients were treated using methylprednisolone, and 188 did not receive any corticosteroid-related treatment. After PSM, no statistically significant difference was found in the baseline characteristics between the two groups. Regarding the outcomes, there also were no statistically significant difference between the two groups. Patients without the use of methylprednisolone were more quickly to obtain negative results of their nasopharyngeal swab tests of SARS-CoV-2 nucleic acid after treatment, compared to those receiving methylprednisolone.

Conclusion

Methylprednisolone could not improve the prognosis of patients with COVID-19, and the efficacy and safety of the use of methylprednisolone in patients with COVID-19 still remain uncertain, thus the use of corticosteroids clinically in patients with COVID-19 should be with cautions.
Nut consumption and the prevalence and severity of non-alcoholic fatty liver disease
Authors: Semmler Georg , Bachmayer Sebastian , Wernly Sarah , Wernly Bernhard , Niederseer David , Huber-Schönauer Ursula , Stickel Felix , Aigner Elmar , Datz Christian
Published: December 2020

Background

Nut consumption has been associated with reduced inflammation, insulin resistance, and oxidative stress. However, the influence on the prevalence and severity of non-alcoholic fatty liver disease (NAFLD) has yet to be evaluated.

Methods

4655 subjects were included as part of a colorectal carcinoma screening program (SAKKOPI) between 07/2010 and 07/2019 and analyzed 2020. Patients were characterized using biochemical and metabolic parameters, as well as a detailed questionnaire on dietary habits. The diagnosis of NAFLD was established using abdominal ultrasound. Consumption of nuts was graded as: no consumption or <1 time/week, 1–6 times/week, 1 time/day and ≥2 times/day.

Results

Mean age was 58.5±9.8years with a mean BMI of 26.5±4.7kg/m2. 2058 (44.2%) patients suffered from the metabolic syndrome, 2407 (51.6%) had arterial hypertension, 2287 (49.1%) showed prediabetes/diabetes, 1854 (39.4%) had dyslipidemia and 1984 patients (43.5%) were diagnosed with NAFLD. Prevalence of metabolic syndrome (1219 [48.7%] vs. 605 [40.2%] vs. 189 [37.4%] vs. 45 [31.7%], p<0.001) and NALFD (1184 [48.1%] vs. 594 [40.7%] vs. 158 [31.7%] vs. 48 [34.0%], p<0.001). On multivariable logistic regression analysis adjusting for potential confounders and dietary patterns, nut consumption ≥1time/day was inversely associated with NAFLD in the overall cohort (adjusted Odds ratio[aOR]: 0.719 [95%CI:0.558–0.926], p = 0.011). However, following subgroup analysis, this inverse association was only confirmed in male patients (aOR: 0.589 [95%CI: 0.411–0.844], p = 0.004) but not in females (aOR: 0.886 [95%CI: 0.616–1.275], p = 0.515). Moreover, patients who consumed nuts 1–6 times/week had a significantly lower prevalence of advanced fibrosis (Fib-4 score >2.67: aOR: 0.551 [95%CI: 0.338–0.898], p = 0.017; Forns-Index >6.9: aOR: 0.585 [95%CI: 0.402–0.850], p = 0.005).

Conclusions

Nut consumption might exert beneficial effects on the prevalence of NAFLD in males. The negative association with advanced fibrosis warrants further investigation.
HIV treatment cascade among people who inject drugs in Ukraine
Authors: Sazonova Yana , Kulchynska Roksolana , Sereda Yuliia , Azarskova Marianna , Novak Yulia , Saliuk Tetiana , Kornilova Marina , Liulchuk Mariia , Vitek Charles , Dumchev Kostyantyn
Published: December 2020

The HIV treatment cascade is an effective tool to track progress and gaps in the HIV response among key populations. People who inject drugs (PWID) remain the most affected key population in Ukraine with HIV prevalence of 22% in 2015. We performed secondary analysis of the 2017 Integrated Bio-Behavioral Surveillance (IBBS) survey data to construct the HIV treatment cascade for PWID and identify correlates of each indicator achievement. The biggest gap in the cascade was found in the first “90”, HIV status awareness: only 58% [95% CI: 56%-61%] of HIV-positive PWID reported being aware of their HIV-positive status. Almost 70% [67%-72%] of all HIV-infected PWID who were aware of their status reported that they currently received antiretroviral therapy (ART). Almost three quarters (74% [71%-77%]) of all HIV-infected PWID on ART were virally suppressed. Access to harm reduction services in the past 12 months and lifetime receipt of opioid agonist treatment (OAT) had the strongest association with HIV status awareness. Additionally, OAT patients who were aware of HIV-positive status had 1.7 [1.2–2.3] times the odds of receiving ART. Being on ART for the last 6 months or longer increased odds to be virally suppressed; in contrast, missed recent doses of ART significantly decreased the odds of suppression. The HIV treatment cascade analysis for PWID in Ukraine revealed substantial gaps at each step and identified factors contributing to achievement of the outcomes. More intensive harm reduction outreach along with targeted case finding could help to fill the HIV awareness gap among PWID in Ukraine. Scale up of OAT and community-level linkage to care and ART adherence interventions are viable strategies to improve ART coverage and viral suppression among PWID.
Acid hydrolysis of saponins extracted in tincture
Authors: Love Jamie , Simons Casey R.
Published: December 2020

Background

Saponins are secondary metabolites from plants added to shampoos and beverages to make them foam, and the sapogenins released from them upon acid hydrolysis are commonly used as starting materials for steroidal drugs. However, current methods embed the saponin in a thick “gum” material consisting of multiple impurities. This gum limits access to the saponin, reducing the efficiency of hydrolysis and requiring large amounts of heat, organic solvents and effort to recover the sapogenin. For centuries, herbalists have been making tinctures by soaking plant materials at room temperature, in mixtures of alcohol and water. Many herbal tinctures contain saponins floating freely in solution, gum free. The saponin from sarsaparilla (Smilaxspp), sarsasaponin, yields the sapogenin, sarsasapogenin, upon acid hydrolysis. The retail price of sarsasapogenin is very high but would be lower if the “gum problem” could be avoided.

Materials and methods

We incubated sarsaparilla tincture under different conditions of temperature, acidity and duration then used quantitative nuclear magnetic resonance (qNMR) to measure the amount of sarsasapogenin produced by hydrolysis as well as the amount of its epimer, smilagenin.

Results and discussion

Most, if not all the sarsasaponin in sarsaparilla root powder is extracted into a solution of 45% ethanol (55% water) at room temperature and stays suspended without formation of any particles (gum). Acid hydrolysis of the saponin in this solution is very efficient, approaching 100%. The sarsasapogenin released by hydrolysis and the smilagenin produced by its epimerisation, migrate into the chloroform phase.

Conclusion

Sarsaparilla saponin diffuses into and disperses in a solution of alcohol:water (45:55) at room temperature. Hydrolysis of saponins in tincture provides a simple, inexpensive and environmentally friendly alternative.