bluuebunny/crossref_metadata_2025 huggingface dataset:
Exclusive breastfeeding for the first six months of life and its associated factors among children age 6-24 months in Burao district, Somaliland
Authors: Jama Abdiasis , Gebreyesus Hailay , Wubayehu Tewolde , Gebregyorgis Tsigehana , Teweldemedhin Mebrahtu , Berhe Tesfay , Berhe Negasi
Published: January 2020

Background

Adequate nutrition during early childhood ensures growth and development of children and breast milk is better than any other products given to a child. However, studies on exclusive breastfeeding practice are limited in Somaliland. Therefore, this study was aimed to assess exclusive breastfeeding for the first 6 months of life and its associated factors among children 6–24 months of age in Burao district, Somaliland.

Methods

A community-based cross-sectional study was conducted from 26 August to 10 October 2018, in Burao district among randomly, selected 464 mothers with children 6–24 months of age. Data were collected through face-to-face interview using pretested structured questionnaire.

Results

The prevalence of exclusive breastfeeding was 20.47% (95% CI 18.84, 23.63%). Exclusive breastfeeding practice was associated with: having female child (AOR 0.48; 95% CI 0.29, 0.80)), lack of formal education (AOR 0.32; 95% CI 0.19, 0.53), household monthly income 100$-200$ (AOR 0.35;95% CI 0.18, 0.68), lack of husband’s support (AOR 0.32; 95% CI 0.19, 0.53), and mothers who were not counselled on breastfeeding during antenatal care (AOR = 0.33; 95% CI 0.16, 0.66).

Conclusions

Exclusive breastfeeding practice was very low as compared to recommendations of infant and young child practice (IYCF) which recommends children to exclusively breastfeed for the first 6 months of life. Exclusive breastfeeding practice was associated with a mother’s lack of formal education, monthly income less than 100$, being a female child, lack of advice on exclusive breastfeeding during antenatal care and lack of husband support. The promotion of education for women, husband’s engagement, encouraging antenatal care follow-up and counseling of exclusive breastfeeding during antenatal care was recommended to improve exclusive breastfeeding practice.
Survey of current practices from an international task force for gynecological stereotactic ablative radiotherapy
Authors: Leung E. , Gladwish A. , Sahgal A. , Lo S. S. , Kunos C. A. , Lanciano R. M. , Mantz C. A. , Guckenberger M. , Zagar T. M. , Mayr N. A. , Chang A. R. , Jorcano S. , Biswas T. , Pontoriero A. , Albuquerque K. V.
Published: January 2020

Background

Stereotactic Ablative Radiotherapy (SABR) is an effective treatment that improves local control for many tumours. However, the role of SABR in gynecological cancers (GYN) has not been well-established. We hypothesize that there exists considerable variation in GYN-SABR practice and technique. The goal of this study is to describe clinical and technical factors in utilization of GYN-SABR among 11 experienced radiation oncologists.

Materials and methods

A 63 question survey on GYN-SABR was sent to 11 radiation oncologists (5 countries) who have published original research, conducted trials or have an established program at their institutions. Responses were combined and analyzed at a central institution.

Results

Most respondents indicated that salvage therapy (non-irradiated or re-irradiated field) for nodal (81%) and primary recurrent disease (91%) could be considered standard options for SABR in the setting of inability to administer brachytherapy. All other indications should be considered on clinical trials. Most would not offer SABR as a boost in primary treatment off-trial without absolute contraindications to brachytherapy. Multi-modality imaging is often (91%) used for planning including PET, CT contrast and MRI. There is a wide variation for OAR tolerances however small bowel is considered the dose-limiting structure for most experts (91%). Fractionation schedules range from 3 to 6 fractions for nodal/primary definitive and boost SABR.

Conclusions

Although SABR has become increasingly standard in other oncology disease sites, there remains a wide variation in both clinical and technical factors when treating GYN cancers. Nodal and recurrent disease is considered a potential indication for SABR whereas other indications should be offered on clinical trials. This study summarizes SABR practices among GYN radiation oncologists while further studies are needed to establish consensus guidelines for GYN-SABR treatment.
Clinical characteristics in patients with hereditary amyloidosis with Glu54Gln transthyretin identified in the Romanian population
Authors: Jercan Andreea , Ene Amalia , Jurcut Ruxandra , Draghici Mirela , Badelita Sorina , Dragomir Mihaela , Dobrea Camelia , Popescu Monica , Jardan Dumitru , Stoica Emanuel , Iacob Speranta , Codita Ionela , Stan Claudiu , Coriu Daniel
Published: January 2020

Background

In Romania, 23 patients have been diagnosed with hereditary transthyretin amyloidosis (ATTRh), 18 of whom have the Glu54Gln mutation. This retrospective cohort included all patients with Glu54Gln-mutated ATTRh who were diagnosed in Romania from 2005 to 2018.

Results

Of 18 patients, 10 were symptomatic, five were asymptomatic carriers and three died during the study. All originated from North-East Romania. Median age at symptom onset was 45 years; median age at death was 51 years. All patients had cardiac involvement, including changes in biomarkers (mean N-terminal-pro B-type natriuretic peptide: 2815.6 pg/ml), electrocardiography (15% atrial fibrillation, 38% atrioventricular block, 31% right bundle block), and echocardiography (mean interventricular septum: 16 mm, mean left ventricular ejection fraction: 49%). Scintigraphy showed myocardial radiotracer uptake in all patients. In addition, 92% of patients had polyneuropathy at diagnosis and 53% had carpal tunnel syndrome; 69% exhibited orthostatic hypotension and 31% suffered from diarrhea. No renal or liver involvement was observed.

Conclusions

This is the largest Glu54Gln-mutated ATTRh cohort diagnosed to date, and to our knowledge the first describing this variant worldwide. Clinical features of this variant are early onset, neurological and cardiac involvement, aggressive disease progression and short survival. Early diagnosis and therapeutic intervention have potential to improve prognosis in ATTRh.
Pruritus in pediatric patients with atopic dermatitis: a multidisciplinary approach - summary document from an Italian expert group
Authors: El Hachem May , Di Mauro Giuseppe , Rotunno Roberta , Giancristoforo Simona , De Ranieri Cristiana , Carlevaris Carla Maria , Verga Maria Carmen , Dello Iacono Iride
Published: January 2020

Given the inadequate overall awareness of the main disease features and treatment modalities of pruritus in pediatric patients with atopic dermatitis, a multidisciplinary Italian expert group met with the major aim of increasing knowledge of the condition for improved diagnosis and better management among specialists involved in disease management. Herein, the overall features of the condition are reviewed, along with its etiopathogenesis and symptoms. Likewise, management options are summarized, emphasizing the need for a multidisciplinary approach, minimally composed of a management team that includes a pediatrician, dermatologist, psychologist, play assistant, and dedicated nurse. In addition to more traditional therapies such as emollients as highlighted by European guidelines, therapeutic patient education in a group or individually is highly encouraged as it helps patients and their parents to better understand the disease and provide practical guidance for dressing and bandaging. It can also aid in outlining coping strategies for itching and sleep disturbance. The utility of distraction techniques should also be stressed as such educational interventions involving the child and their parents can substantially improve the overall quality of life. All approaches should be tailored according to patient age and clinical features and requires individualized strategy to ensure good adherence by both children and their parents. Thus, a holistic approach embracing systemic, topical and psychological interventions is advocated in order to provide patients and their caregivers the best possible care.
Efficacy and safety of early prone positioning combined with HFNC or NIV in moderate to severe ARDS: a multi-center prospective cohort study
Authors: Ding Lin , Wang Li , Ma Wanhong , He Hangyong
Published: January 2020

Background

Previous studies suggest that prone positioning (PP) can increase PaO2/FiO2 and reduce mortality in moderate to severe acute respiratory distress syndrome (ARDS). The aim of our study was to determine whether the early use of PP combined with non-invasive ventilation (NIV) or high-flow nasal cannula (HFNC) can avoid the need for intubation in moderate to severe ARDS patients.

Methods

This prospective observational cohort study was performed in two teaching hospitals. Non-intubated moderate to severe ARDS patients were included and were placed in PP with NIV or with HFNC. The efficacy in improving oxygenation with four support methods—HFNC, HFNC+PP, NIV, NIV+PP—were evaluated by blood gas analysis. The primary outcome was the rate of intubation.

Results

Between January 2018 and April 2019, 20 ARDS patients were enrolled. The main causes of ARDS were pneumonia due to influenza (9 cases, 45%) and other viruses (2 cases, 10%). Ten cases were moderate ARDS and 10 cases were severe. Eleven patients avoided intubation (success group), and 9 patients were intubated (failure group). All 7 patients with a PaO2/FiO2 < 100 mmHg on NIV required intubation. PaO2/FiO2 in HFNC+PP were significantly higher in the success group than in the failure group (125 ± 41 mmHg vs 119 ± 19 mmHg, P = 0.043). PaO2/FiO2 demonstrated an upward trend in patients with all four support strategies: HFNC < HFNC+PP ≤ NIV < NIV+PP. The average duration for PP was 2 h twice daily.

Conclusions

Early application of PP with HFNC, especially in patients with moderate ARDS and baseline SpO2 > 95%, may help avoid intubation. The PP was well tolerated, and the efficacy on PaO2/FiO2 of the four support strategies was HFNC < HFNC+PP ≤ NIV < NIV+PP. Severe ARDS patients were not appropriate candidates for HFNC/NIV+PP.

Trial registration

ChiCTR, ChiCTR1900023564. Registered 1 June 2019 (retrospectively registered)
Time to appropriate antibiotic therapy is a predictor of outcome in patients with bloodstream infection caused by KPC-producing Klebsiella pneumoniae
Authors: Falcone Marco , Bassetti Matteo , Tiseo Giusy , Giordano Cesira , Nencini Elia , Russo Alessandro , Graziano Elena , Tagliaferri Enrico , Leonildi Alessandro , Barnini Simona , Farcomeni Alessio , Menichetti Francesco
Published: January 2020

Background

Bloodstream infections (BSIs) by Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella pneumoniae (Kp) are associated with high mortality. The aim of this study is to assess the relationship between time to administration of appropriate antibiotic therapy and the outcome of patients with BSI due to KPC-Kp hospitalized in intensive care unit (ICU).

Methods

An observational study was conducted in the ICUs of two academic centers in Italy. Patients with KPC-Kp bacteremia hospitalized between January 2015 to December 2018 were included. The primary outcome was the relationship between time from blood cultures (BC) collection to appropriate antibiotic therapy and 30-day mortality. The secondary outcome was to evaluate the association of different treatment regimens with 30-day mortality and a composite endpoint (30-day mortality or nephrotoxicity). A Cox regression analysis to identify factors independently associated with 30-day mortality was performed. Hazard ratio (HR) and 95% confidence interval (CI) were calculated.

Results

A total of 102 patients with KPC-Kp BSI were included. The most common sources of infection were intra-abdominal (23.5%), urinary tract (20.6%), and skin and skin structure (17.6%). The 30-day mortality was 45%. Median time to appropriate antibiotic therapy was shorter in patients who survived (8.5 h [IQR 1–36]) versus those who died (48 h [IQR 5–108], p = 0.014). A propensity score matching showed that receipt of an in vitro active therapy within 24 h from BC collection was associated with lower 30-day mortality (HR = 0.36, 95% CI: 0.188–0.690, p = 0.0021). At Cox regression analysis, factors associated with 30-day mortality were primary bacteremia (HR 2.662 [95% CI 1.118–6.336], p = 0.027), cardiovascular disease (HR 2.196 [95% CI 1.082–4.457], p = 0.029), time (24-h increments) from BC collection to appropriate therapy (HR 1.382 [95% CI 1.132–1.687], p = 0.001), SOFA score (HR 1.122 [95% CI 1.036–1.216], p = 0.005), and age (HR 1.030 [95% CI 1.006–1.054], p = 0.012). Ceftazidime-avibactam-containing regimens were associated with reduced risk of composite endpoint (30-day mortality OR nephrotoxicity) (HR 0.231 [95% CI 0.071–0.745], p = 0.014) compared to colistin-containing regimens.

Conclusions

Time to appropriate antibiotic therapy is an independent predictor of 30-day mortality in patients with KPC-Kp BSI. Appropriate antibiotic therapy should begin within 24 h from the collection of BC.
A proactive genotype-to-patient-phenotype map for cystathionine beta-synthase
Authors: Sun Song , Weile Jochen , Verby Marta , Wu Yingzhou , Wang Yang , Cote Atina G. , Fotiadou Iosifina , Kitaygorodsky Julia , Vidal Marc , Rine Jasper , Ješina Pavel , Kožich Viktor , Roth Frederick P.
Published: January 2020

Background

For the majority of rare clinical missense variants, pathogenicity status cannot currently be classified. Classical homocystinuria, characterized by elevated homocysteine in plasma and urine, is caused by variants in the cystathionine beta-synthase (CBS) gene, most of which are rare. With early detection, existing therapies are highly effective.

Methods

DamagingCBSvariants can be detected based on their failure to restore growth in yeast cells lacking the yeast orthologCYS4. This assay has only been applied reactively, after first observing a variant in patients. Using saturation codon-mutagenesis, en masse growth selection, and sequencing, we generated a comprehensive, proactive map of CBS missense variant function.

Results

Our CBS variant effect map far exceeds the performance of computational predictors of disease variants. Map scores correlated strongly with both disease severity (Spearman’sϱ = 0.9) and human clinical response to vitamin B6(ϱ = 0.93).

Conclusions

We demonstrate that highly multiplexed cell-based assays can yield proactive maps of variant function and patient response to therapy, even for rare variants not previously seen in the clinic.
Genetic segregation for male body coloration and female mate preference in the guppy
Authors: Sato Aya , Kawata Masakado
Published: January 2020

Objective

The purpose of this study was to segregate the genetic lines responsible for the orange area of coloration in males and the response to orange coloration exhibited by females in the guppy (Poecilia reticulata) through artificial selection. This study is part of a project that uses QTL-seq to search for candidate genes involved in male orange coloration and female response to male coloration. We created two lines: high-selected lines of males having large areas of orange spots and of females with high response to male orange coloration; and low-selected lines of males having small areas of orange spots and of females with low response to male orange coloration.

Results

The male orange area and the female response became significantly different between high- and low-selected lines after three generations of artificial selection. This indicates that the differences in the frequencies of alleles at loci affecting the orange area and the female response between the lines increased over the generations through selection.
Body image of people over 50 in Spain measured using the BSQ test
Authors: Sánchez-Cabrero Roberto , Martínez-López Fernando , Euán-Ramírez Reyna Guadalupe
Published: January 2020

Objectives

To show the body image of people over 50 in Spain using the Body Shape Questionnaire test (BSQ), taking into account attribute variables of great interest such as age, gender, sentimental status, habitat (rural or urban) and the season of the year in which the test is done (winter or summer).

Data description

The results obtained show the current state of the body image of 176 people in the process of ageing in Spain. The data collected from the participants are organised taking into account attribute variables of significant impact on body image such as age, gender, having a stable partner, habitat (rural or urban) and the season of the year in which the test is done (winter or summer). These data are especially useful to show how body image changes over the time, depending on the different attributes and according to diverse emotional and social situations. They can be used in studies on body image, eating disorders or studies that assess the importance of physical appearance in someone’s self-esteem regardless of age group, geographic area or personal emotional circumstances.
Does overweight before pregnancy reduce the occurrence of gastroschisis?: the Japan Environment and Children’s Study
Authors:   The Japan Environment and Children’s Study Group, Michikawa Takehiro , Yamazaki Shin , Suda Eiko , Kuroda Tatsuo , Nakayama Shoji F. , Isobe Tomohiko , Kobayashi Yayoi , Iwai-Shimada Miyuki , Sekiyama Makiko , Kawamoto Toshihiro , Nitta Hiroshi
Published: January 2020

Objective

For several observational studies that have reported the factors related to gastroschisis, the target population in these studies was mainly residents of Europe or the US, and there is little data on the Asian population. In this study, we summarised characteristics of Japanese women who delivered infants with gastroschisis, particularly focusing on the pre-pregnancy body mass index (BMI), which was found to be inversely associated with gastroschisis in past studies, because the distribution of BMI is clearly different in Asia and the West.

Results

We used data from a nationwide birth cohort study which recruited pregnant women between 2011 and 2014. Among 92,796 women who delivered singleton live births, the frequency of underweight (pre-pregnancy BMI < 18.5 kg/m2) was 16.2%, reference weight (18.5–24.9 kg/m2) 73.1%, and overweight (≥ 25.0 kg/m2) 10.6%. We identified only 9 infants with gastroschisis, 2 of whose women were underweight (frequency of gastroschisis = 0.01%), 5 were in the reference group (0.01%), and 2 were overweight (0.02%). Of these 9 women, none were aged < 20 years, 2 were aged 20–29 years (frequency = 0.01%), and 7 were aged 30–39 years (0.01%). No reduction in the occurrence of gastroschisis was apparent among Japanese women who were overweight before pregnancy.
Positive solutions for a system of 2nth-order boundary value problems involving semipositone nonlinearities
Authors: Hao Xinan , O’Regan Donal , Xu Jiafa
Published: January 2020

In this paper we use the fixed point index to study the existence of positive solutions for a system of 2nth-order boundary value problems involving semipositone nonlinearities.
A simple approximated solution method for solving fractional trust region subproblems of nonlinearly equality constrained optimization
Authors: Zhu Honglan , Ni Qin , Zhang Xuebing
Published: January 2020

In this paper, a fractional model is used to solve nonlinearly constrained optimization problems. In order to solve the fractional trust region subproblems simply, we propose an approximated solution method by cyclically fixing the fractional coefficient part of the approximate function. The global convergence of the fractional trust region method is proved, and the numerical results show that the new algorithm is effective and stable.
Ten-year resistance trends in pathogens causing healthcare-associated infections; reflection of infection control interventions at a multi-hospital healthcare system in Saudi Arabia, 2007–2016
Authors: Balkhy Hanan H. , El-Saed Aiman , Alshamrani Majid M. , Alsaedi Asim , Al Nasser Wafa , El Gammal Ayman , Aljohany Sameera M. , Almunif Sara , Arabi Yassen , Alqahtani Saad , Bonnie Henry Baffoe , Alghoribi Majed , Alothman Adel , Almohrij Saad A.
Published: January 2020

Background

Studying temporal changes in resistant pathogens causing healthcare-associated infections (HAIs) is crucial in improving local antimicrobial and infection control practices. The objective was to describe ten-year trends of resistance in pathogens causing HAIs in a tertiary care setting in Saudi Arabia and to compare such trends with those of US National Health Surveillance Network (NHSN).

Methods

Pooled analysis of surveillance data that were prospectively collected between 2007 and 2016 in four hospitals of Ministry of National Guard Health Affairs. Definitions and methodology of HAIs and antimicrobial resistance were based on NHSN. Consecutive NHSN reports were used for comparisons.

Results

A total 1544 pathogens causing 1531 HAI events were included. Gram negative pathogens (GNP) were responsible for 63% of HAIs, with a significant increasing trend inKlebsiellaspp. and a decreasing trend inAcinetobacter. Methicillin-resistantStaphylococcus aureus(27.0%) was consistently less frequent than NHSN. Vancomycin-resistantEnterococci(VRE, 20.3%) were more than doubled during the study, closing the gap with NHSN. Carbapenem resistance was highest withAcinetobacter(68.3%) andPseudomonas(36.8%). Increasing trends of carbapenem resistance were highest inPseudomonasandEnterobacteriaceae, closing initial gaps with NHSN. With the exception ofKlebsiellaandEnterobacter, multidrug-resistant (MDR) GNPs were generally decreasing, mainly due to the decreasing resistance towards cephalosporins, fluoroquinolones, and aminoglycosides.

Conclusion

The findings showed increasing trends of carbapenem resistance and VRE, which may reflect heavy use of carbapenems and vancomycin. These findings may highlight the need for effective antimicrobial stewardship programs, including monitoring and feedback on antimicrobial use and resistance.
Exploring institutional arrangements for local fish product labelling in Tuscany (Italy): a convention theory perspective
Authors: Prosperi Paolo , Vergamini Daniele , Bartolini Fabio
Published: January 2020

Increasing fish consumption along with rising competition in the global seafood market has brought fisheries and aquaculture producers to adopt several differentiation and marketing strategies. Labelling schemes were thus introduced to respond to a growing demand for traceable and sustainable products. However, the proliferation of quality labels brought to general confusion, calling for collective and public fish labels to ease decision-making. In our case study region (Tuscany, Italy), a number of policy-driven efforts were deployed for establishing regional labelling schemes for fisheries products with no observable impact on the market. Meanwhile, local companies have implemented a number of successful private and regional labels. The purpose of this research is to contribute to potential options for collective regional labelling schemes of fisheries and aquaculture products, through a case study analysis, building on agro-food value-chain and management approaches. Our empirical results highlight key issues and perspectives on labelling policies for local fisheries and aquaculture products.
Constellations of youth criminogenic factors associated with young adult violent criminal behavior
Authors: Segeren Menno , Fassaert Thijs , de Wit Matty , Popma Arne
Published: January 2020

This study identified constellations of childhood risk factors associated with violent criminal behavior in early adulthood. Police data were used to sample violent and nonviolent offenders from a population of young adult males with a history of juvenile probation. Risk factors were retrieved from their juvenile probation files. A single classification tree analysis organized these into a decision tree for violent criminal behavior with good predictive accuracy. Two constellations of risk factors were associated with a high risk of violent criminal behavior. The first consisted of juvenile delinquents who had been moderately involved with criminal peers, who had committed offenses under the influence of drugs, and who came from a dysfunctional family. The second was characterized by having been severely involved with criminal peers and having had criminal family members. Presenting with depressive symptoms in childhood was associated with a low risk of violent criminal behavior. These constellations bear clinical importance as they provide targets for personalized interventions.
Dilemmas about instructions for administering drugs and indications for their use: is there negative effect of pharmaceutical industry?
Authors: Zerem Enver
Published: January 2020

Instructions for administering some drugs and indications for their use raise certain dilemmas and controversies questioning the appropriateness of the treatment in this way. In this article, some controversies regarding the prescribing of statins in patients whose blood cholesterol level is normal and the use of anticoagulants in the elderly patients without blood clots prior to the treatment are described. Also, it is discussed about some controversies regarding the use of the insulin analogues in the treatment of patients with diabetes mellitus.
Yaws in the Philippines: first reported cases since the 1970s
Authors: Dofitas Belen Lardizabal , Kalim Sherjan P. , Toledo Camille B. , Richardus Jan Hendrik
Published: January 2020

Background

Yaws is a chronic, highly contagious skin and bone infection affecting children living in impoverished, remote communities and caused by Treponema pallidum subspecies pertenue. The Philippines was thought to be free of yaws following the 1950s eradication campaign but it has been reported in the Liguasan Marsh area, Central Mindanao. This is the first documentation of yaws cases in the Philippines since the 1970s. We describe active and latent yaws recently detected in the Southern Philippines.

Case presentation

Cross-sectional surveys and screening of skin diseases were conducted in one randomly selected public elementary school per selected municipality in Liguasan Marsh, covering three municipalities per province. Yaws suspects underwent screening and confirmatory serologic tests for Treponema pallidum using Dual Path Platform Syphilis Screen and Confirm Assay (DPP) and Treponema pallidum Particle Agglutination (TPPA). Children with yaws skin lesions and reactive confirmatory tests for T. pallidum and non-treponemal antibodies were considered confirmed yaws cases. Four children aged 5–10 years old had confirmed secondary yaws in Tulunan Municipality, Cotabato Province and in Lambayong Municipality, Sultan Kudarat Province. All had secondary yaws lesions such as moist, cauliflower-like papillomas, thick yellow crusts on pink papules and nodules, whitish, papulosquamous papules and plaques, or hypopigmented patches with small papules on the periphery. Yaws papillomas and erosions were also found on the soles of the feet of one child. The index case had a skin punch biopsy of a partially treated papilloma on his axilla. Histopathological findings showed lichenoid psoriasiform dermatitis with plasma cells, consistent with yaws.

Conclusions

The clinical, serological, and histopathological confirmation of four yaws cases among children has made the Philippines the 14th country endemic for yaws. This report can help health personnel recognize hidden cases of yaws based on skin signs and serological tests. Yaws remained unrecognized and unreported in the Philippines and in countries previously endemic for yaws probably due to the unsustained integration of the yaws program in the general health services and complacency after the 1950s eradication campaign. Our findings have provided the necessary evidence and stimulus to develop a yaws control and eradication program as one of the country’s neglected tropical diseases.
Comparison of various pharmaceutical properties of clobetasol propionate cream formulations - considering stability of mixture with moisturizer-
Authors: Yamamoto Yoshihisa , Onuki Yoshinori , Fukami Toshiro , Koide Tatsuo
Published: January 2020

Background

The clobetasol propionate cream formulations (CLBCr) belong to the “strongest” group, and are used widely. In addition, those formulations are often used as a mixture with moisturizer. Recently, we evaluated pharmaceutical properties of the CLBCr using near infrared (NIR) spectroscopy, and characteristic NIR spectra depending on the formulation were observed. In the present study, we attempted to evaluate the more diverse pharmaceutical properties of CLBCr, including the stability of mixture of CLBCr and moisturizer.

Method

Pharmaceutical properties of CLBCr were evaluated using from rheological characteristics, microscopic observation, dye permeability observations, electrical conductivity method, thermogravimetry-differential thermal analysis (TG-DTA) and near infrared (NIR) spectroscopy. Stability of mixtures of CLBCr and moisturizer were evaluated using from dye method and NIR spectroscopy.

Results

The hardness of Dermovate® (DRM), Glydil® (GDL), and Myalone® (MYA) was greater than that of CLBCr. High concentrations of white beeswax were considered the reason for the hardness of DRM and GDL. On the other hand, the hardness of MYA may be due to the presence of macrogol 6000. After storage of the cream formulations discharged from the tube at room temperature, mass reduction and attenuation of the peak reflecting water of NIR spectroscopy occurred in a time-dependent manner, except for GDL and MYA. Only GDL was shown to be a w/o-type formulation by dye and electric conductivity measurements, which suggested that this was the reason for the lack of changes in the mass or NIR spectrum of samples after storage. In the NIR spectrum of MYA, the peak reflecting water slightly increased in a time-dependent manner, suggesting the water absorption of macrogol 6000. TG-DTA provided curves indicating the presence of water in each formulation, except for MYA, which was consistent with water quantification previously reported. Finally, when mixing the CLBCr with a moisturizer, in any CLBCr, the stability of the mixture with w/o-type moisturizer varies greatly depending on the each CLBCr.

Conclusion

Thus, even for cream formulations with the same active pharmaceutical ingredient, pharmaceutical properties and stability of mixture with moisturizer may different significantly.
Geospatial openness: from software to standards & data
Authors: Minghini Marco , Mobasheri Amin , Rautenbach Victoria , Brovelli Maria Antonia
Published: January 2020

This paper is the editorial of the Special Issue “Open Source Geospatial Software”, which features 10 published papers. The editorial introduces the concept of openness and, within the geospatial context, declines it into the three main components of software, data and standards. According to this classification, the papers published in the Special Issue are briefly summarized and a future research agenda in the open geospatial domain is finally outlined.
The use of cannabis for Hyperemesis Gravidarum (HG)
Authors: Koren Gideon , Cohen Rana
Published: January 2020

Background

Hyperemesis Gravidarum (HG) responds only partially to standard antiemetic medications. Cannabis has been known to possess antiemetic effects and there are several medicinal cannabinoids used as anti -emetics for cancer chemotherapy. Its favorable use for HG has been described in social media, but not in the medical literature.

Methods

We evaluated 4 women with HG counseled by the Motherisk Program, before and following the use of cannabis. Using the validated Pregnancy Unique Quantification of Emesis (PUQE) scoring system and employing the Student’s paired t test, we compared changes in symptoms following initiation of cannabis.

Results

There was a highly significant improvement in symptoms: PUQE score improved from 14.5+/− 1 to 7.5+/− 0.58(p = 0.0004). Cannabis use was associated with a significant increase in the PUQE Quality of Life scale, from 2+/− 0.82 to 7+/− 0.82 (p = 0.0012).

Conclusions

The results suggest that cannabis may be effective for HG, and should be studied in appropriately powered, controlled studies, fully considering potential fetal risks.
Reclassification of Pterulaceae Corner (Basidiomycota: Agaricales) introducing the ant-associated genus Myrmecopterula gen. nov., Phaeopterula Henn. and the corticioid Radulomycetaceae fam. nov.
Authors: Leal-Dutra Caio A. , Griffith Gareth W. , Neves Maria Alice , McLaughlin David J. , McLaughlin Esther G. , Clasen Lina A. , Dentinger Bryn T. M.
Published: January 2020

Pterulaceae was formally proposed to group six coralloid and dimitic genera: Actiniceps (=Dimorphocystis), Allantula, Deflexula, Parapterulicium, Pterula, and Pterulicium. Recent molecular studies have shown that some of the characters currently used in Pterulaceae do not distinguish the genera. Actiniceps and Parapterulicium have been removed, and a few other resupinate genera were added to the family. However, none of these studies intended to investigate the relationship between Pterulaceae genera. In this study, we generated 278 sequences from both newly collected and fungarium samples. Phylogenetic analyses supported with morphological data allowed a reclassification of Pterulaceae where we propose the introduction of Myrmecopterula gen. nov. and Radulomycetaceae fam. nov., the reintroduction of Phaeopterula, the synonymisation of Deflexula in Pterulicium, and 53 new combinations. Pterula is rendered polyphyletic requiring a reclassification; thus, it is split into Pterula, Myrmecopterula gen. nov., Pterulicium and Phaeopterula. Deflexula is recovered as paraphyletic alongside several Pterula species and Pterulicium, and is sunk into the latter genus. Phaeopterula is reintroduced to accommodate species with darker basidiomes. The neotropical Myrmecopterula gen. nov. forms a distinct clade adjacent to Pterula, and most members of this clade are associated with active or inactive attine ant nests. The resupinate genera Coronicium and Merulicium are recovered in a strongly supported clade close to Pterulicium. The other resupinate genera previously included in Pterulaceae, and which form basidiomes lacking cystidia and with monomitic hyphal structure (Radulomyces, Radulotubus and Aphanobasidium), are reclassified into Radulomycetaceae fam. nov. Allantula is still an enigmatic piece in this puzzle known only from the type specimen that requires molecular investigation. A key for the genera of Pterulaceae and Radulomycetaceae fam. nov. is also provided here.
Constraining magnetic amplitude inversion with magnetotelluric data to image volcanic units: A case study
Authors: Xu Kaijun , Li Yaoguo
Published: January 2020

We present a case study on imaging volcanic units in gas exploration by constraining magnetic amplitude inversions using magnetotelluric (MT) sounding data at sparse locations. Magnetic data can be effective in mapping volcanic units because they have remanent magnetization and significant susceptibility contrast with surrounding rocks. Although magnetic data can identify the lateral distribution of volcanic units, they often have difficulties in defining the depth extent. For this reason, additional structural constraints from other geophysical methods can often help improve the vertical resolution. Among the independent geophysical methods, MT data can provide the needed structural information at a low cost. We have investigated an approach to combine a set of sparse MT soundings with magnetic amplitude data to image the distribution of volcanics in a basin environment. We first use a blocky 1D MT inversion based on Ekblom norm to obtain the structural constraint, and then we perform a constrained 3D magnetic amplitude inversion to recover the distribution of effective susceptibility by incorporating the structural information from MT soundings. We determine that even a small number of MT stations (e.g., 20) in a [Formula: see text] area is sufficient to drastically improve the magnetic amplitude inversion. Our results indicate that magnetic amplitude inversion with structural constraint from MT soundings form a practical and cost-effective means to map the lateral and vertical distribution of volcanics.
The Detection of Serum IgMs to Thyroglobulin in Subacute Thyroiditis Suggests a Protective Role of IgMs in Thyroid Autoimmunity
Authors: Ricci Debora , Brancatella Alessandro , Marinò Michele , Rotondi Mario , Chiovato Luca , Vitti Paolo , Latrofa Francesco
Published: January 2020

Context

The role of serum immunoglobulin (Ig)Ms in autoimmune thyroid diseases is uncertain.

Objective

We looked for IgMs to thyroglobulin (Tg) in patients with subacute thyroiditis (SAT), which is characterized by high serum Tg levels, the possible de novo appearance of IgGs to Tg (TgAb-IgGs), and no autoimmune sequelae.

Main Outcome Measures

TgAb-IgMs and TgAb-IgGs were detected by binding to Tg using the enzyme-linked immunosorbent assay (ELISA). The upper reference limit of TgAb-IgMs and TgAb-IgGs was established in 40 normal subjects. We looked for TgAb-IgMs in 16 patients with SAT, 11 with Hashimoto’s thyroiditis (HT), and 8 with Graves’ disease (GD) who were all positive for TgAb-IgGs. IgM binding to bovine serum albumin (BSA), keyhole limpet hemocyanin (KLH), and glucagon in ELISA was measured. Inhibition of TgAb-IgMs binding to coated Tg was evaluated by preincubating serum samples or IgG-depleted samples with soluble Tg.

Results

TgAb-IgMs were positive in 10/16 patients with SAT, 2/11 with HT, and 1/8 with GD. TgAb-IgMs were higher in SAT (0.95; 0.42–1.13) (median; 25th–75th percentiles) than in HT (0.47; 0.45–0.51) and GD patients (0.35; 0.33–0.40) (P < .005 for both). IgM binding of SAT sera to BSA, KLH, and glucagon was significantly lower than Tg. Preincubation with soluble Tg reduced the binding of IgMs to coated Tg by 18.2% for serum samples and by 35.0% and 42.1% for 2 IgG-depleted samples. TgAb-IgM levels were inversely, although nonsignificantly, correlated with Tg concentrations.

Conclusions

Tg leak associated with thyroid injury induces the production of specific TgAb-IgMs, which, in turn, increases the clearance of Tg and might prevent the establishment of a persistent thyroid autoimmune response.
Perioperative Glucocorticoid Therapy for Patients with Adrenal Insufficiency: Dosing Based on Pharmacokinetic Data
Authors: Arafah Baha M
Published: January 2020

Background

Perioperative glucocorticoid therapy for patients with adrenal insufficiency (AI) is currently based on anecdotal reports, without supporting pharmacokinetic data.

Methods

We determined the half-life, clearance, and volume of distribution of 2 consecutive intravenously (IV)-administered doses of hydrocortisone (15 or 25 mg every 6 hours) to 22 dexamethasone-suppressed healthy individuals and used the data to develop a novel protocol to treat 68 patients with AI who required surgical procedures. Patients received 20 mg of hydrocortisone orally 2 to 4 hours before intubation and were started on 25 mg of IV hydrocortisone every 6 hours for 24 hours and 15 mg every 6 hours during the second day. Nadir cortisol concentrations were repeatedly measured during that period.

Results

In healthy individuals, cortisol half-life was longer when the higher hydrocortisone dose was administered (2.02 ± 0.15 vs 1.81 ± 0.11 hours; P < 0.01), and in patients with AI, the half-life was longer than in healthy individuals given the same hydrocortisone dose. In both populations, the cortisol half-life increased further with the second hormone injection. Prolongation of cortisol half-life was due to decreased hydrocortisone clearance and an increase in its volume of distribution. Nadir cortisol levels determined throughout the 48 postoperative hours were within the range of values and often exceeded those observed perioperatively in patients without adrenal dysfunction.

Conclusions

Cortisol pharmacokinetics are altered in the postoperative period and indicate that lower doses of hydrocortisone can be safely administered to patients with AI undergoing major surgery. The findings of this investigation call into question the current practice of administering excessive glucocorticoid supplementation during stress.
Sex Hormone Profile in Pubertal Boys With Gynecomastia and Pseudogynecomastia
Authors: Reinehr Thomas , Kulle Alexandra , Barth Andre , Ackermann Jonas , Lass Nina , Holterhus Paul-Martin
Published: January 2020

Content

Gynecomastia (defined by proliferation of glandular elements) and pseudogynecomastia (defined by adipose tissue) are frequent in pubertal boys. An association with sex hormones and the growth hormone axis has been discussed.

Objective

The objective of this work is to compare sex hormones, insulin-like growth factor 1 (IGF-1), and insulin-like growth factor binding protein 3 (IGFBP-3) between boys with gynecomastia and pseudogynecomastia (separation by ultrasound).

Design

An observational study was performed.

Setting

The setting of this study was an outpatient clinic.

Participants

A total of 124 pubertal boys (mean age 14 ± 2 years) with breast enlargement and 84 healthy boys (mean age 14 ± 2 years) without breast enlargement participated in this study.

Interventions

No interventions were performed.

Main outcome measures

Measurements were taken for sex hormones (progesterone, estradiol [E2], estriol, estrone, androstendione, testosterone [T], dihydrotestosterone) measured by liquid chromatography–tandem mass spectrometry, as well as gonadotropins, prolactin, IGF-1, and IGFBP-3.

Results

Eighty-six boys suffered from gynecomastia and 38 from pseudogynecomastia. In boys with gynecomastia, the E2/T ratio (median 22, interquartile range [IQR] 8-75) was significantly (P < .05) higher compared to boys with pseudogynecomastia (median 12, IQR 5-21) or healthy controls without breast enlargement (median 18, IQR 6-44) even after adjustment for testes volume. T concentrations were significantly (P < .05) lower in boys with gynecomastia (median 1.8, IQR 0.7-4.2 nM/L) compared to boys with pseudogynecomastia (median 4.3, IQR 1.4-6.9 nM/L) or healthy controls without breast enlargement (median 3.1, IQR 0.6-7.6 nM/L). Boys with gynecomastia did not differ from boys with pseudogynecomastia according to other sex hormones, prolactin, IGF-1, or IGFBP-3 concentrations.

Conclusions

True gynecomastia is characterized by a relative T deficiency to E2 concentrations in contrast to pseudogynecomastia.
Autoimmune Autonomic Disorders
Authors: Vernino Steven
Published: January 2020

PURPOSE OF REVIEW

Autonomic disorders sometimes occur in the context of systemic autoimmune disease or as a direct consequence of autoimmunity against the nervous system. This article provides an overview of autonomic disorders with potential autoimmune etiology.

RECENT FINDINGS

Recent evidence highlights a close association between the autonomic nervous system and inflammation. The autonomic nervous system regulates immune function, and autonomic manifestations may occur in a number of systemic autoimmune diseases. In a few instances, autoimmunity directly influences autonomic function. Autoimmune autonomic ganglionopathy is the prototypic antibody-mediated autonomic disorder. Over time, a better understanding of the clinical spectrum of autoimmune autonomic ganglionopathy, the significance of ganglionic nicotinic acetylcholine receptor antibodies, other immune-mediated autonomic neuropathies, and autonomic manifestations of other systemic or neurologic autoimmune disorders has emerged.

Autoimmune autonomic disorders may be challenging, but correct identification of these conditions is important. In some cases, potential exists for effective immunomodulatory treatment.
Conspiracy Rises Again
Authors: Saha Poulomi
Published: January 2020

This essay takes up conspiracy as a discursive, political, and philosophical concept. By tracing the ideological and textual kinship between anticolonialism in India and Ireland and radicalism in the United States, it illuminates transcolonial circuits of a curiously shared revolutionary project. Rather than simply offer a historical account of those interconnections, it theorizes a practice of reading revolutionary violence as perpetual, repetitive haunting, a politics of the undead. It argues for a historiographical live burial by which violences of the past reappear to disrupt the imperial promise of futurity and continuity. From the 1916 “Hindu-German Conspiracy Trial” in San Francisco, during which members of the Ghadr Party—consisting of diasporic Indian students at the University of California, Berkeley, and Punjabi farmers in the Central Valley—were accused of conspiring with German diplomats to arm anticolonial revolt in British India, this essay tracks forms of radical sympathy that emerge, flourish, and stutter in an era of ethnonationalist constriction.
The Catastrophe
Authors: Warren Calvin
Published: January 2020

This essay argues that black feminist poethics uncovers a deep philosophical problem between pure form and pure matter. Mathematics is the site of such contention, and the decision to retain form or destroy form presents ontological and epistemological complexities for a philosophy of mathematics in Black studies. Ultimately, this essay offers mathematical nihilism as the only hope for blacks in an antiblack world.
Parametric generation of three-dimensional gait for robot-assisted rehabilitation
Authors: Shi Di , Zhang Wuxiang , Ding Xilun , Sun Lei
Published: January 2020

For robot-assisted rehabilitation and assessment of the patients with motor dysfunction, the parametric generation of their normal gait as the input for the robot is essential to match with the features of the patient to a greater extent. In addition, the gait needs to be in three-dimensional space, which meets the physiological structure of the human better, rather than only in sagittal plane. Thus, a method for the parametric generation of three-dimensional gait based on the influence of the motion parameters (MPs) and structure parameters (SPs) is presented. First, the three-dimensional gait kinematic of participants is collected, and trajectories of ankle joint angle and ankle center position are calculated. Second, for the trajectories, the gait features are extracted including gait events indicating the physiological features of the walking gait in additional to extremes indicating the geometrical features of the trajectories. Third, regression models are derived after using leave-one-out cross-validation for model optimization. Finally, cubic splines are fitted between the predicted gait features to generate the trajectories for a full gait cycle. It is inferred the generated curves well match the measured curves. The method presented herein will gives an important reference for the research of the lower limb rehabilitation robots.