bluuebunny/crossref_metadata_2025 huggingface dataset:
Uncovering sex differences of rodent microglia
Authors: Han Jinming , Fan Yueshan , Zhou Kai , Blomgren Klas , Harris Robert A.
Published: March 2021

There are inherent structural and functional differences in the central nervous systems (CNS) of females and males. It has been gradually established that these sex-specific differences are due to a spectrum of genetic, epigenetic, and hormonal factors which actively contribute to the differential incidences, disease courses, and even outcomes of CNS diseases between sexes. Microglia, as principle resident macrophages in the CNS, play a crucial role in both CNS physiology and pathology. However, sex differences of microglia have been relatively unexplored until recently. Emerging data has convincingly demonstrated the existence of sex-dependent structural and functional differences of rodent microglia, consequently changing our current understanding of these versatile cells. In this review, we attempt to comprehensively outline the current advances revealing microglial sex differences in rodent and their potential implications for specific CNS diseases with a stark sex difference. A detailed understanding of molecular processes underlying microglial sex differences is of major importance in design of translational sex- and microglia-specific therapeutic approaches.
Nomadic Tibetan women’s reproductive health: findings from cross-sectional surveys with a hard-to-reach population
Authors: Gipson Jessica D. , Moucheraud Corrina , Gyaltsen Kunchok , Tsering Lumo , Nobari Tabashir Z. , Gyal Lhusham
Published: March 2021

Background

Western China has undergone substantial sociodemographic change, yet little is known about the health status of ethnic minority populations living in these areas.

Methods

We report findings from two cross-sectional surveys conducted with female Tibetan nomads living in rural areas of Western China/Eastern Tibet. We present results of descriptive analyses of data collected from reproductive-aged females who attended community health fairs in 2014 (n = 193) and 2016 (n = 298).

Results

On average, sexual debut preceded marriage among study participants, with fertility near replacement levels (2.7 and 2.1 in 2014 and 2016, respectively). Contraceptive use was common, and dominated by use of IUDs and female sterilization. Although over three-quarters (76%) of 2016 survey participants reported ever having at least one sexually transmitted infection (STI) symptom, there was low awareness of STIs (59%) and action to prevent STIs (21%). Younger women (< 40) were more likely to report having had had an STI symptom, as compared to older women (84% versus 71%; p < 0.05).

Conclusions

We demonstrate feasibility of collecting data with this hard-to-reach population. Reporting of STI symptoms warrants further investigation to identify and address health conditions in this population of Tibetan nomadic women, especially amidst broader social and contextual changes that may affect the Tibetan population.
Anterolateral approach with two incisions versus posterior median approach in the treatment of middle- and distal-third humeral shaft fractures
Authors: Huang Qiang , Lu Yao , Wang Zhi Meng , Sun Liang , Ma Teng , Wang Qian , Li Ming , Liu Hong Liang , Hou Ming Ming , Xue Han Zhong , Zhang Kun , Li Zhong
Published: March 2021

Background

The surgical approaches remain controversial for the treatment of middle and distal-third humeral shaft (MDTHS) fractures. This study compared clinical effects of the anterolateral approach with two incisions (AATI) and the posterior median approach (PMA) in the treatment of MDTHS fractures.

Methods

A retrospective analysis was carried out. One hundred sixty-six patients with MDTHS fractures were selected from January 2015 to January 2017 in Xi’an Hong Hui Hospital. According to surgical approaches, patients were divided into AATI (86 cases) and PMA group (80 cases). All patients were treated with open reduction and plate fixation. Operation indexes were compared, including incision length, operation time, and bleeding. Bryan-Morrey score was used to evaluate elbow joint function. Complication incidence was compared, such as incision infection, iatrogenic radial nerve injury, and nonunion.

Results

The AATI group showed smaller incision length, less bleeding, lower iatrogenic radial nerve injury rate, and better elbow function than that of PMA group (P<0.05).

Conclusions

The middle and distal-third humeral shaft fractures can be successfully cured by both approaches. Compared with the posterior median approach, it has better clinical effects of the anterolateral approach with two incisions, which is worthy of clinical application and promotion.
Bioconversion variation of ginsenoside CK mediated by human gut microbiota from healthy volunteers and colorectal cancer patients
Authors: Guo Yin-Ping , Shao Li , Wang Li , Chen Man-Yun , Zhang Wei , Huang Wei-Hua
Published: March 2021

Background

Ginsenoside CK (GCK) serves as the potential anti-colorectal cancer (CRC) protopanaxadiol (PPD)-type saponin, which could be mainly bio-converted to yield PPD by gut microbiota. Meanwhile, the anti-CRC effects of GCK could be altered by gut microbiota due to their different diversity in CRC patients. We aimed to investigate the bioconversion variation of GCK mediated by gut microbiota from CRC patients by comparing with healthy subjects.

Methods

Gut microbiota profiled by 16S rRNA gene sequencing were collected from healthy volunteers and CRC patients. GCK was incubated with gut microbiota in vitro. A LC-MS/MS method was validated to quantify GCK and PPD after incubation at different time points.

Results

The bioconversion of GCK in healthy subjects group was much faster than CRC group, as well as the yield of PPD. Moreover, significant differences of PPD concentration between healthy subjects group and CRC group could be observed at 12 h, 48 h and 72 h check points. According to 16S rRNA sequencing, the profiles of gut microbiota derived from healthy volunteers and CRC patients significantly varied, in which 12 differentially abundant taxon were found, such asBifidobacterium,Roseburia,BacteroidesandCollinsella. Spearman’s correlation analysis showed bacteria enriched in healthy subjects group were positively associated with the biotransformation of GCK, while bacteria enriched in CRC group displayed non correlation character. Among them,Roseburiawhich could secreteβ-glycosidase showed the strongest positive association with the bioconversion of GCK.

Conclusions

The bioconversion of GCK in healthy subjects was much faster than CRC patients mediated by gut microbiota, which might alter the anti-CRC effects of GCK.
Fibronectin as a multiregulatory molecule crucial in tumor matrisome: from structural and functional features to clinical practice in oncology
Authors: Spada Sheila , Tocci Annalisa , Di Modugno Francesca , Nisticò Paola
Published: March 2021

Deciphering extracellular matrix (ECM) composition and architecture may represent a novel approach to identify diagnostic and therapeutic targets in cancer. Among the ECM components, fibronectin and its fibrillary assembly represent the scaffold to build up the entire ECM structure, deeply affecting its features. Herein we focus on this extraordinary protein starting from its complex structure and defining its role in cancer as prognostic and theranostic marker.
Correction to: Validity and diagnostic performance of fluorescence optical imaging measuring synovitis in hand osteoarthritis: baseline results from the Nor-Hand cohort
Authors: Maugesten Øystein , Mathiessen Alexander , Hammer Hilde Berner , Hestetun Sigrid Valen , Kvien Tore Kristian , Uhlig Till , Ohrndorf Sarah , Haugen Ida Kristin
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Acute dorsal myelopathy resulting from intramedullary cysticercus: a case report
Authors: Lahiri Durjoy , Chowdhury Abhishek , Dubey Souvik , Ray Biman Kanti
Published: March 2021

Background

Neurocysticercosis is the most common parasitic infection of the central nervous system, brain being the most frequent site. Intramedullary location of cysticercus is a rarely described entity in literature. Widespread dissemination of cysticercus is also considered a rare occurrence, and only a handful of cases are documented, almost exclusively from tropical nations. Here we present a case of disseminated cysticercosis with rare initial presentation as acute dorsal myelopathy resulting from intramedullary cysticercus.

Case presentation

A 62-year-old male patient from India (Asian) presented with features of dorsal myelopathy as manifested by acute-onset symmetric paraparesis, sensory loss below umbilicus, and double sphincter dysfunction. General physical examination revealed pea-sized nodules in skin and tongue. On spinal cord imaging, it was found that he had intramedullary cysticercus with diffuse perilesional edema. Brain and muscle imaging showed extensive cysticercosis suggestive of dissemination. Histological examination from skin nodule and antibody assay confirmed the diagnosis of cysticercosis. Following steroid administration, our patient showed improvement with observable increase in power of the lower limbs. He was subsequently discharged with antiepileptics, symptomatic therapy, and regular physiotherapy. Antihelminthic agents were initially avoided in view of extensive cysticercosis in brain including crucial areas such as brainstem.

Conclusion

Rare manifestation of a rare but treatable disorder makes it an important reportable observation in the context of tropical medicine.
Autoradiographical assessment of inflammation-targeting radioligands for atherosclerosis imaging: potential for plaque phenotype identification
Authors: Meester Eric J. , de Blois Erik , Krenning Boudewijn J. , van der Steen Antonius F. W. , Norenberg Jeff P. , van Gaalen Kim , Bernsen Monique R. , de Jong Marion , van der Heiden Kim
Published: March 2021

Purpose

Many radioligands have been developed for the visualization of atherosclerosis by targeting inflammation. However, interpretation of in vivo signals is often limited to plaque identification. We evaluated binding of some promising radioligands in an in vitro approach in atherosclerotic plaques with different phenotypes.

Methods

Tissue sections of carotid endarterectomy tissue were characterized as early plaque, fibro-calcific plaque, or phenotypically vulnerable plaque. In vitro binding assays for the radioligands [111In]In-DOTATATE; [111In]In-DOTA-JR11; [67Ga]Ga-Pentixafor; [111In]In-DANBIRT; and [111In]In-EC0800 were conducted, the expression of the radioligand targets was assessed via immunohistochemistry. Radioligand binding and expression of radioligand targets was investigated and compared.

Results

In sections characterized as vulnerable plaque, binding was highest for [111In]In-EC0800; followed by [111In]In-DANBIRT; [67Ga]Ga-Pentixafor; [111In]In-DOTA-JR11; and [111In]In-DOTATATE (0.064 ± 0.036; 0.052 ± 0.029; 0.011 ± 0.003; 0.0066 ± 0.0021; 0.00064 ± 0.00014 %Added activity/mm2, respectively). Binding of [111In]In-DANBIRT and [111In]In-EC0800 was highest across plaque phenotypes, binding of [111In]In-DOTA-JR11 and [67Ga]Ga-Pentixafor differed most between plaque phenotypes. Binding of [111In]In-DOTATATE was the lowest across plaque phenotypes. The areas positive for cells expressing the radioligand’s target differed between plaque phenotypes for all targets, with lowest percentage area of expression in early plaque sections and highest in phenotypically vulnerable plaque sections.

Conclusions

Radioligands targeting inflammatory cell markers showed different levels of binding in atherosclerotic plaques and among plaque phenotypes. Different radioligands might be used for plaque detection and discerning early from vulnerable plaque. [111In]In-EC0800 and [111In]In-DANBIRT appear most suitable for plaque detection, while [67Ga]Ga-Pentixafor and [111In]In-DOTA-JR11 might be best suited for differentiation between plaque phenotypes.
Spatio‐temporal characteristics of meteorological drought under changing climate in semi‐arid region of northern Ethiopia
Authors: Yisehak Biniyam , Shiferaw Henok , Abrha Haftu , Gebremedhin Amdom , Hagos Haftom , Adhana Kelali , Bezabh Temesgen
Published: March 2021

Background

Below-normal availability of water for a considerable period of time induces occurrence of drought. This paper investigates the Spatio-temporal characteristics of meteorological drought under changing climate. The climate change was analyzed using delta based statistical downscaling approach of RCP 4.5 and RCP 8.5 in R software packages. The meteorological drought was assessed using the Reconnaissance Drought Index (RDI).

Results

The result of climate change projections showed that the average annual minimum temperature will be increased by about 0.8–2.9 °C. The mean annual maximum temperature will be also increased by 0.9–3.75 °C. The rainfall projection generally showed an increasing trend, it exhibited an average annual increase of 3.5–13.4 % over the study area. The projected drought events reached its maximum severity indicated extreme drought in the years 2043, 2044, 2073, and 2074. The RDI value shows drought will occurred after 1–6 and 2–7 years under RCP 4.5 and RCP 8.5 emission scenarios respectively over the study area. Almost more than 72 % of the current and future spatial coverage of drought in the study area will be affected by extreme drought, 22.3 % severely and 5.57 % also moderate drought.

Conclusions

Therefore, the study helps to provide useful information for policy decision makers to implement different adaptation and mitigation measures of drought in the region.
Development of regional foresight studies between 2000 and 2019: an overview and co-citation analysis
Authors: Amini Hamed , Jabalameli Mohammad Saeed , Ramesht Mohammad Hosein
Published: March 2021

Regional foresight is one of the regional planning approaches that increase the ability to deal with uncertainty and changes. This study aims to provide an overview of regional foresight studies and domain map to evaluate their merits and defects and direct future studies in this field. For this purpose, 111 papers related to regional foresight were identified at the “Web of Science” in the period 2000 to 2019 and used as the basis for further analysis. These papers have been reviewed in various aspects. In addition, the domain map of regional foresight and its intellectual bases was drawn based on co-citation analysis of these papers and their 4194 references. The domain map includes five main clusters of research areas or intellectual bases for regional foresight: normative forecasting, participation, foresight in policy and strategy, innovation systems, and multi-level governance. Finally, the merits and defects of regional foresight studies are evaluated based on research results and some suggestions are provided for future studies.
Migration ecology of western gray catbirds
Authors: Mancuso Kristen A. , Fylling Megan A. , Bishop Christine A. , Hodges Karen E. , Lancaster Michael B. , Stone Katharine R.
Published: March 2021

Background

For many songbirds in North America, we lack movement details about the full annual cycle, notably outside the breeding season. Understanding how populations are linked spatially between breeding and overwintering periods (migratory connectivity) is crucial to songbird conservation and management. We assessed migratory connectivity for 2 breeding populations of Gray Catbirds (Dumetella carolinensis) west of and within the Rocky Mountains by determining migration routes, stopover sites, and overwintering locations. Additionally, we compared apparent annual survivorship for both populations.

Methods

We deployed 39 archival light-level geolocators and 21 Global Positioning System (GPS) tags on catbirds in the South Okanagan Valley, British Columbia, Canada, and 32 geolocators and 52 GPS tags in the Bitterroot River Valley, Montana, USA. These devices allowed us to determine migration routes, stopover sites, overwintering locations, and migratory connectivity. Migratory connectivity was quantified using Mantel’s correlation. We used mark-recapture of colour banded catbirds in both sites to estimate apparent annual survivorship.

Results

We retrieved 6 geolocators and 19 GPS tags with usable data. Gray Catbirds from both populations passed through the Rocky Mountains eastward before heading south towards their overwintering locations in northeastern Mexico and Texas. Stopover sites during fall migration occurred primarily in Montana, Kansas, Oklahoma, and Arkansas. Overwintering locations spanned Texas and 5 states in northeastern Mexico. Individual catbirds used up to 4 distinct sites during the overwintering period. Catbirds separated by almost 500 km during the breeding season overlapped during the non-breeding season, suggesting weak migratory connectivity among western populations (Mantel’s correlation = 0.013, P-value = 0.41). Catbird apparent annual survivorship estimates were higher in British Columbia (0.61 ± 0.06 females; 0.64 ± 0.05 males) than in Montana (0.34 ± 0.05 females; 0.43 ± 0.04 males), though the main driver of these differences remain unclear.

Conclusions

Our results provide high precision geographic details during the breeding, migration, and overwintering phases of the annual cycle for western Gray Catbirds. Notably, we found that western catbirds followed the Central Flyway as opposed to the Pacific Flyway. We document that catbirds used multiple sites over winter, contrary to the popular belief that this phase of the annual cycle is stationary for most songbirds.
Recent progress in the research of Angelica sinensis (Oliv.) Diels polysaccharides: extraction, purification, structure and bioactivities
Authors: Hou Chunyan , Yin Mingsong , Lan Ping , Wang Huiru , Nie Hui , Ji Xiaolong
Published: March 2021

The root of Angelica sinensis (Oliv.) Diels, a well-known Chinese herbal medicine, has been used historically as hematopoietic and anti-inflammatory agents for thousands of years. Recent phytochemistry and pharmacological studies have proved that polysaccharides are one of the major active ingredients in A. sinensis. It has been demonstrated that ASPs (A. sinensis polysaccharides) had various important biological activities, such as hematopoietic, hepatoprotective, hypoglycemic, anti-inflammatory, antitumor, and antioxidant activities. The purpose of this present review is to appraise previous and current literatures on the extraction, purification, structural characterization and biological activities of ASPs. In addition, the structure–activity relationship will be further explored and discussed. We believe that this review will provide a useful bibliography for the investigation, production, and application of ASPs in functional foods and therapeutic agents. Moreover, this review also highlights the challenges of investigation and future considerations for holistic utilization.
Hyporesponsiveness to long-acting erythropoiesis-stimulating agent is related to the risk of cardiovascular disease and death in Japanese patients on chronic hemodialysis: observational cohort study
Authors: Tanaka Kenichi , Fujiwara Momoko , Saito Hirotaka , Iwasaki Tsuyoshi , Oda Akira , Watanabe Shuhei , Kanno Makoto , Kimura Hiroshi , Tani Yoshihiro , Asai Jun , Suzuki Hodaka , Sato Keiji , Kazama Junichiro James
Published: March 2021

Background

Responsiveness to erythropoiesis-stimulating agents (ESAs) is thought to be related to prognosis in patients on hemodialysis. A multi-center, prospective cohort study was conducted to investigate the effects of hyporesponsiveness to long-acting ESAs on cardiovascular events and mortality in Japanese patients on chronic hemodialysis.

Methods

A total of 127 chronic hemodialysis patients treated with long-acting ESAs were followed-up prospectively. Responsiveness to ESA was evaluated using an erythropoietin resistance index (ERI) calculated by dividing the weekly body-weight-adjusted ESA dose by the hemoglobin concentration. The primary endpoint of this survey was defined as a combination of cardiovascular events and all-cause deaths. The association between hyporesponsiveness to ESAs evaluated by the highest quartile of the ERI and the primary endpoint was investigated.

Results

During the follow-up period (median 4.6 years), 32 patients reached the primary end point. Kaplan-Meier curve analysis showed that patients with ESA hyporesponsiveness belonging to the highest quartile of the ERI reached the primary end point more frequently than those without (P = 0.031). Cox regression analysis showed that an ERI in the highest quartile was an independent predictor of the primary end point, even after adjustment using a propensity score (hazard ratio 2.76, 95% confidence interval 1.19–6.40).

Conclusions

ESA hyporesponsiveness in hemodialysis patients treated with long-acting ESAs is related to cardiovascular events and death.
The effects of life style modification versus food supplementation on menopausal symptoms
Authors: Fouad Suzanne , El Shebini Salwa Mostafa , Ahmed Nihad Hassan , Hussein Ahmed Mohamed Saied , Essa Hend Abbas , Abdel-Moaty Maha , Tapozada Salwa Tawfic
Published: March 2021

Background

Nutrition and good health are two dependent parallel axes; female’s health at different ages in general and at the time of menopause in particular has received a lot of attention last several years. The objective of this experimental study was to evaluate the effect of consuming food supplement versus lifestyle modification in the dietary habit on menopausal symptoms in perimenopausal Egyptians females.

Results

Forty seven females in the perimenopausal stage of life with mean age 46.04 ± 5.88 years participated on the food supplement consumption group, they consumed 75 g per day of a rusk (prepared from corn flour, wheat flour 72%, full cream milk powder, flaxseed oil, wheat germ, clove and cinnamon powder) for 2 months. They were compared with the control group (forty nine females with mean age 46.91 ± 5.39 years) who changed their foods habits to a healthy life style. Menopause rating scale and the biochemical analysis were comparable on day 1 and on day 60. The total menopause rating scale and its three subscales (psychological, urogenital and somatic), waist circumference, serum follicle stimulating hormone and estradiol in the corn rusk supplement group showed a statistically significant improvement. No significant difference was noted in the control group apart of the psychological subscale and waist circumference.

Conclusions

Corn Rusk enriched with clove and cinnamon as a food supplement snake is promising to relief menopausal symptoms and should be considered on the diet of menopausal females.
Influence of sulfur coated urea and algae fertilization on productivity of some leguminous crops in sandy soils
Authors: Essa Reda , Afifi Ahmed , Ashry Soad
Published: March 2021

Background

This studies the influence of algae and coated urea fertilization on the productivity of some leguminous crops in order to reach the best methods of fertilization to get on highest productivity in sandy soils.

Results

The results proved that both yield and its components a better result in the focus of the SCU + algae than utilizing sulfur-coated fertilizers and algae in both seasons. A large amount extreme yield and straw yield were established with the algae treatment. The outcomes uncovered that SCU + algae improved plant productivity and quality soybean and mungbean seeds. The utilization of SCU + algae expanded protein, carbohydrates and oil %, compared with sulfur-coated urea and algae.

Conclusion

Along these lines, it could be finished from the results that of SCU + algae with 60 kg N/fed observed to be the best portion to accomplish or gain with exertion the greatest quality.
Risk for osteoporotic fractures in patients with atrial fibrillation using different oral anticoagulants
Authors: Kim Daehoon , Yang Pil-Sung , Sung Jung-Hoon , Jang Eunsun , Yu Hee Tae , Kim Tae-Hoon , Uhm Jae-Sun , Kim Jong-Youn , Pak Hui-Nam , Lee Moon-Hyoung , Lip Gregory Y. H. , Joung Boyoung
Published: March 2021

Background

We aimed to investigate the comparative risk of fracture among patients with atrial fibrillation (AF) treated with warfarin or non-vitamin K antagonist oral anticoagulants (NOACs).

Methods

Using the Korean National Health Insurance Service database, patients with AF who received a prescription for apixaban, dabigatran, rivaroxaban, or warfarin between 2013 and 2016 were included. Risk of major fractures (osteoporotic hip, vertebral, or pelvic fractures) were compared using inverse probability of treatment weighting.

Results

There were 70,481 patients identified (41.3% women; mean [SD] age 70.5 [11.3] years); 16,992 apixaban, 22,514 dabigatran, 27,998 rivaroxaban, and 29,390 warfarin users. During a median follow-up of 390 days, 2412 major fractures occurred with weighted incidences per 100 patient-years of 2.56 for apixaban, 2.39 for dabigatran, 2.78 for rivaroxaban, and 3.43 for warfarin. NOAC use was associated with a lower risk for fracture than warfarin use: HR 0.70 (95% confidence interval [CI] 0.57–0.86) for apixaban, HR 0.69 (95% CI 0.60–0.78) for dabigatran, and HR 0.79 (95% CI 0.70–0.90) for rivaroxaban. In head-to-head comparisons between NOACs, there was no significant difference between apixaban and dabigatran. Rivaroxaban was associated with a higher risk for fracture than dabigatran (HR 1.15, 95% CI 1.02–1.31).

Conclusion

In patients with AF, NOAC use may result in a lower risk for osteoporotic fracture compared with warfarin use. Fracture risk does not seem to be altered by the choice of NOAC type, except for rivaroxaban. These associations may help inform benefit–risk assessments when choosing between the different anticoagulant types.
Therapeutic role of corticosteroids in COVID-19: a systematic review of registered clinical trials
Authors: Raju Reshma , V. Prajith , Biatris Pratheeksha Sojan , J. Sam Johnson Udaya Chander
Published: March 2021

Background

In March 2020, the World Health Organization declared the coronavirus disease 2019 as a global pandemic. Though antiviral drugs and antimalarial drugs are considered treatment options for treating coronavirus disease 2019 (COVID-19), no specific antivirals are currently available for its treatment. Efficient use of drug discovery approaches including repurposing or repositioning of drugs used in the treatment of severe acute respiratory syndrome coronavirus (SARS-CoV) and the Middle East respiratory syndrome coronavirus (MERS-CoV) is considered recently. The widespread application of corticosteroid therapy in COVID-19 should be backed with careful documented pragmatic research of its use in this context.

Main body

This article aims to analyze various trials registered across the globe providing an overall picture of the use of corticosteroids in the treatment of COVID-19. An extensive search was conducted on the clinical trial registries around the world to identify all the trials reporting information regarding the use of corticosteroids in COVID-19. Our initial search returned 231 trials, out of which 60 trials were finally included in the analysis. Fifty-six studies were interventional trials, and all the trials had clearly defined primary and secondary outcomes of interest, of which only 11 trials had evaluation of respiratory rate as one of their outcomes.

Conclusion

Few preliminary trial findings show promising results and recommend the use of methylprednisolone and dexamethasone in the severe form of the disease; however, there is insufficient data to prove its benefits over its risks. Routine use of corticosteroids should be favored only after a better insight is obtained, with the completion of these trials.
Neonatal minimal invasive management of a prenatal gunshot trauma: case report
Authors: Ruhrnschopf Camila Gonzalez , Reusmann Aixa , Boglione Mariano , Arbio Soledad , Barrenechea Marcelo
Published: March 2021

Background

Prenatal penetrating gunshot trauma represents a challenging scenario for healthcare providers. Trauma is the leading non-obstetric cause of morbidity and mortality during pregnancy, and even though rare, firearm injuries have the most fatal outcomes and higher fetus mortality rates. Understanding the mechanism of injury in order to identify the possible injuries and adequate management is essential. In this paper, we discuss the case of a newborn with prenatal gunshot trauma, the treatment used, and the outcome of conservative and minimally invasive management.

Case presentation

We present the case of a male newborn, 37 weeks of gestational age and weighing 3050 g, delivered through an emergency cesarean section with prenatal gunshot trauma. Two skin wounds were found, one in the arm and another in the left thoracic region. The patient presented with respiratory distress, bilateral pneumothorax, and pneumoperitoneum, requiring high-frequency mechanical ventilation and the placement of bilateral thoracic drains. The pneumoperitoneum was attributed to pulmonary barotrauma, with no suspicion of abdominal hollow viscera lesion. A right thoracoscopy was performed after 24 h of conservative management for the removal of the foreign body. Both the mother and the baby had a positive outcome, with no further treatment needed.

Conclusions

For the improvement in the result of trauma events, an adequate intervention and coordinated efforts from multidisciplinary clinical and surgical teams are required. For gunshot wounds, entry, trajectory, the final position of the bullet, and pathological findings in images need to be analyzed before taking the patient to the operative room. Chosen with strict selection criteria, some patients could benefit from conservative management.
EPA guidance on treatment of negative symptoms in schizophrenia
Authors: Galderisi S. , Kaiser S. , Bitter I. , Nordentoft M. , Mucci A. , Sabé M. , Giordano G. M. , Nielsen M. Ø. , Glenthøj L. B. , Pezzella P. , Falkai P. , Dollfus S. , Gaebel W.
Published: March 2021

Negative symptoms of schizophrenia remain a major therapeutic challenge. The progress in the conceptualization and assessment is not yet fully reflected by treatment research. Nevertheless, there is a growing evidence base regarding the effects of biological and psychosocial interventions on negative symptoms. The importance of the distinction between primary and secondary negative symptoms for treatment selection might seem evident, but the currently available evidence remains limited. Good clinical practice is recommended for the treatment of secondary negative symptoms. Antipsychotic treatment should be optimized to avoid secondary negative symptoms due to side effects and due to positive symptoms. For most available interventions, further evidence is needed to formulate sound recommendations for primary, persistent, or predominant negative symptoms.

However, based on currently available evidence recommendations for the treatment of undifferentiated negative symptoms (including both primary and secondary negative symptoms) are provided. Although it has proven difficult to formulate an evidence-based recommendation for the choice of an antipsychotic, a switch to a second-generation antipsychotic should be considered for patients who are treated with a first-generation antipsychotic. Antidepressant add-on to antipsychotic treatment is an option. Social skills training is recommended as well as cognitive remediation for patients who also show cognitive impairment. Exercise interventions also have shown promise. Finally, access to treatment and to psychosocial rehabilitation should be ensured for patients with negative symptoms. Overall, there is definitive progress in the field, but further research is clearly needed to develop specific treatments for negative symptoms.
Persistent Disparity: Socioeconomic Deprivation and Cancer Outcomes in Patients Treated in Clinical Trials
Authors: Unger Joseph M. , Moseley Anna B. , Cheung Christabel K. , Osarogiagbon Raymond U. , Symington Banu , Ramsey Scott D. , Hershman Dawn L.
Published: March 2021

PURPOSE

Patients with cancer living in socioeconomically disadvantaged areas have worse cancer outcomes. The association between socioeconomic deprivation and outcomes among patients with cancer participating in clinical trials has not been systematically examined.

METHODS

We examined survival outcomes for patients enrolled in phase III and large phase II clinical trials for major cancers conducted by the SWOG Cancer Research Network from 1985 to 2012. Socioeconomic deprivation was measured using trial participants' residential zip codes linked to the Area Deprivation Index (ADI). Five-year overall survival, progression-free survival, and cancer-specific survival were examined using Cox regression frailty models, adjusting for age, sex, and race, and separately for insurance status, prognostic risk, and rural or urban residency.

RESULTS

We examined 41,109 patients from 55 trials comprising 24 cancer histology and stage-specific cohorts. Compared with trial participants in the most affluent areas (ADI, 0%-20%), trial participants from areas with the highest socioeconomic deprivation (ADI, 80%-100%) had worse overall (hazard ratio [HR] = 1.28, 95% CI, 1.20 to 1.37, P < .001), progression-free (HR = 1.20, 95% CI, 1.13 to 1.28, P < .001), and cancer-specific survival (HR = 1.27, 95% CI, 1.18 to 1.37, P < .001). The results were similar after adjusting for insurance status, prognostic risk, and rural or urban residency. There was a continuous increase in risk of all outcomes as the ADI quintile increased.

CONCLUSION

In patients with cancer with access to protocol-directed care in clinical trials, high area-level socioeconomic deprivation was associated with worse survival. Future research should examine whether the etiology of this residual disparity is related to reduced access to supportive care or postprotocol therapy and/or to differences in health status not reflected by protocol selection criteria.
Thyroid Eye Disease: Navigating the New Treatment Landscape
Authors: Dosiou Chrysoula , Kossler Andrea Lora
Published: March 2021

Thyroid eye disease (TED) is a complex inflammatory disease that can have a long clinical course with sight-threatening and debilitating ocular sequelae. Until recently, there were limited therapeutic options available. In the last decade we have gained a deeper understanding of the underlying pathophysiology, which has led to the development of novel effective targeted therapies. This article discusses the challenges encountered in the clinical evaluation and treatment of TED patients, with the goal to empower endocrinologists and ophthalmologists to work together to provide effective multidisciplinary care. We will review recommendations of past clinical guidelines around evaluation and management of TED patients, discuss the randomized controlled trials of new biologic therapies, and explore how to navigate the emerging therapeutic landscape.
Aggressive Childhood-onset Papillary Craniopharyngioma Managed With Vemurafenib, a BRAF Inhibitor
Authors: Chik Constance L , van Landeghem Frank K H , Easaw Jacob C , Mehta Vivek
Published: March 2021

The papillary subtype of craniopharyngioma (CP) rarely occurs in children and commonly presents as a suprasellar lesion. Patients with papillary CPs frequently harbor the BRAF-V600E mutation, and treatment with a BRAF inhibitor results in tumor shrinkage in several patients. Herein, we report a patient with childhood-onset papillary CP treated with vemurafenib for 40 months after multiple surgeries. At age 10, he presented with growth failure secondary to an intrasellar cystic lesion. He had 3 transsphenoidal surgeries before age 12 and a 4th surgery 25 years later for massive tumor recurrence. Pathology showed a papillary CP with positive BRAF-V600E mutation. Rapid tumor regrowth 4 months after surgery led to treatment with vemurafenib that resulted in tumor reduction within 6 weeks. Gradual tumor regrowth occurred after a dose reduction of vemurafenib because of elevated liver enzymes. He had further surgeries and within 7 weeks after stopping vemurafenib, there was massive tumor recurrence. He resumed treatment with vemurafenib before radiation therapy and similar tumor shrinkage occurred within 16 days. In this patient with childhood-onset papillary CP that was refractory to multiple surgeries, the use of vemurafenib resulted in significant tumor shrinkage that allowed for the completion of radiation therapy and tumor control.
A Simple Tool for Recommending Postoperative Status After Lower Extremity Total Joint Replacement
Authors: Schlitt John T. , Martin Jason L. , Vetter Thomas R.
Published: March 2021

There is an increasing impetus to perform primary total hip arthroplasty and total knee arthroplasty on an outpatient basis and in the outpatient setting. However, with recent federal regulatory changes, orthopedic surgeons must now evaluate patients on a case-by-case basis to determine whether an inpatient admission will be medically necessary and appropriate. We thus created our prototype Lower Extremity Inpatient-Outpatient (LET-IN-OUT) total joint replacement tool as a simple, consistent way for other clinicians to identify specific major preoperative patient comorbidities and thus to recommend independently and objectively to the orthopedic surgeon postoperative inpatient or outpatient status for a given patient.
Infinance, or Narration and Solvency
Authors: Szendy Peter
Published: March 2021

Narrativity and indebtedness are inextricably intertwined. Absolvere, in Latin, means both to “pay off” a debt and to “relate” a historical event that has reached its conclusion, that is complete (absolutum). In the Arabian Nights, Scheherazade tells many stories about debt and debtors; but it is also her very narration that she evokes as the redeeming of a debt (“I am willing to pay my debt,” she says when resuming her story at the beginning of the Twelfth Night). Following some of Walter Benjamin’s insights, this essay delves into the economy of narration as finance, a word that used to mean “ending.” And it asks: since when has finance become without an end?
The Utopia of Bankruptcy
Authors: Guidée Raphaëlle
Published: March 2021

Financially choked by economic and demographic decline, the city of Detroit filed for Chapter 9 bankruptcy federal protection in 2013. In what sense can a situation of generalized insolvency be said to pave the way for the utopia of a debt-free world? Avoiding the easy symbolism that so often transforms Detroit and its inhabitants into an exciting thought experiment, Benjamin Markovits’s novel You Don’t Have to Live Like This (2015) offers a nuanced answer to this question, challenging the capitalist narrative of revival as much as the alternative promise of self-sufficiency. Far from being spared the anxiety of financial collapse, life without debt reveals worlds of precarious possibilities where mutual aid and autonomy go hand in hand with greater vulnerability.
Using Active Science to Improve Both MVPA and STEM Learning Through PE in Urban Public Schools
Authors: Bowling April , Poloskey Leah , McInnis Kyle , Finn Kevin
Published: March 2021

Purpose

Children in low-income, urban public schools are at a greater risk of poor physical activity (PA) and academic outcomes. The purpose of this study was to examine whether the use of a novel exerlearning application, Active Science (AS), in third-grade physical education (PE) classes improved PA levels, student attitudes toward science, and third-grade science curriculum content knowledge.

Methods

A two-arm pragmatic evaluation was conducted in a public elementary school serving low-income, urban neighborhoods. Six third-grade classrooms were randomly assigned to take part in 8 wk of either PE classes using AS, in which students self-monitor their PA data and use it to complete tablet-based science lessons, or PE classes without the use of AS. PE curriculum was the same in both arms; accelerometers were used to track student PA data during classes. Student attitudes toward science were measured pre- or postintervention using the Modified Attitudes toward Science Inventory (MATSI); science content knowledge was assessed using the Integrated Active Science Knowledge Assessment (IASKA).

Results

N = 135 students participated in the study; n = 66 completed both pre- and post-MATSI and IASKA testing. Because of the time needed to complete the tablet-based AS lessons, student steps, minutes of PA, and minutes of moderate to vigorous PA were significantly lower in the intervention group; however, steps per minute and PA as a percentage of available PE time increased in the intervention group. Participation in AS did not affect MATSI scores but did significantly improve IASKA performance.

Conclusions

AS has promise to economically improve student PA and science achievement. However, lesson completion should be moved into academic transitional or science instruction periods to better achieve the goal of increasing moderate to vigorous PA during PE.
Translating School Physical Education and Activity Policies into Practice: A Case Study
Authors: O’Hara Tompkins Nancy , Northrup Karen , Grant Josh , Weikle Mary Foltz , Long Dustin , Bassler John , Workman Charlotte , Ramsey Zachary , Jarrett Traci , Sirk Hannah , Cottrell Lesley
Published: March 2021

Background

Public health experts recommend school-based policies as a population-based approach to increase youth physical activity. The purpose of this case study is to describe one, largely rural, state’s efforts to translate this recommendation into practice. Details about the genesis, implementation, and evolution of two state-level policies (physical education and physical activity), as well as in-house efforts of a State Department of Education to monitor policy compliance and challenges encountered are described. Two specific years are highlighted because of policy and monitoring enhancements made during those particular time periods.

Methods

Data for this article come from the West Virginia Department of Education for two time periods: 2013–2014 and 2014–2015 (n = 369 elementary schools). Descriptive statistics for quantitative data and content analysis for qualitative data were used to document school-level compliance and provide context for implementation challenges.

Results

Greater than 70% of school principals reported achievement of physical education and physical activity policy expectations for each year. Limited staff was the predominant explanation for nonfulfillment of physical education expectations, followed by lack of time and facilities. Recess and classroom-based physical activity were the primary strategies used to comply with the physical activity expectations. Physical education and physical activity policy compliance varied significantly by certain school characteristics in each school year studied.

Conclusions

Further investigation is warranted on how states translate public health policy recommendations into practice, including how physical education and physical activity policies are developed and monitored at the state level and how to support states and schools with monitoring and implementation challenges.
Under-reported COVID-19 cases in South Asian countries
Authors: Khan Soban Qadir , Moheet Imran Alam , Farooqi Faraz Ahmed , Alhareky Muhanad , Alonaizan Faisal
Published: March 2021

Background: The purpose of the study was to compare  trends in the progression of COVID-19 among South Asian countries with more developed Western countries.

Methods: COVID-19 data from South Asian countries were used for this observational study. Data were taken up to April 21, 2020 from the outbreak of the COVID-19. Four of the seven countries met the inclusion criteria and were included in the analysis.

Results: An exponential increase in the average number of weekly cases was reported after the fifth week following the first case. The correlation between reported cases and tests was found to be strong and significant (r=0.90, p=0.037). However, on average, 315.25 tests per million population were performed, which was at least 12 times lower than the number of tests performed in countries with a large number of COVID-19 cases.

Conclusions: At present, the number of confirmed cases from South Asia was found to be significantly lower than in Western countries. Hence, an increase in the strength of performing diagnostic tests is highly recommended. Strict measures are required to make the people of these countries follow the instructions of social distancing and comply with preventive measures.
Use of fentanyl, butyrfentanyl and furanylfentanyl as discussed on Polish online forums devoted to new psychoactive substances.
Authors: Kacela Monika , Wojcieszak Jakub , Zawilska Jolanta
Published: March 2021

Cel pracy

Celem badań była analiza informacji zamieszczonych przez użytkowników syntetycznych opioidów na polskich internetowych forach dyskusyjnych dotyczących narkotyków. Szczególny nacisk położono na źródła związków i ich dostępność, drogi podania, dawki, działania oczekiwane i toksyczne.

Metoda

Analizie poddano 6 143 wpisów związanych z syntetycznymi opioidami, umieszczonych w okresie od 2005 r. do połowy 2019 r. na trzech ogólnodostępnych polskich forach internetowych poświęconych substancjom psychoaktywnym: https://hyperreal.info/talk, https://dopek.info i https://forum.dopalamy.

Wyniki

Fentanyl był najczęściej stosowanym i stosunkowo łatwo dostępnym syntetycznym opioidem w Polsce. Dwie pochodne fentanylu - butyrylofentanyl i furanylofentanyl były znacznie mniej popularne. Głównym źródłem fentanylu wykorzystywanym do celów „rekreacyjnych” były transdermalne preparaty medyczne. Fentanyl, butyrylofentanyl i furanylofentanyl są zażywane doustnie, na wewnętrzną część policzka, podjęzykowo, donosowo, wziewnie i dożylnie. Fentanyl i jego dwie pochodne są stosowane razem z innymi związkami psychoaktywnymi, co zwiększa ryzyko poważnych działań niepożądanych.

Wnioski

Niniejsze badanie przyczyniło się do pełniejszego zrozumienia problemów związanych ze stosowaniem w Polsce fentanylu, butyrylofentanylu i furanylofentanylu jako związków odurzających. Stosunkowo duża popularność fentanylu, którego źródłem były głównie preparaty transdermalne, zwraca uwagę na konieczność walki z nielegalnym obrotem tymi lekami przez Internet, edukacji pacjentów stosujących fentanyl z podkreśleniem, że lek jest przepisany przez lekarza dla konkretnego pacjenta, a udzielenie go innej osobie jest niezgodne z prawem oraz może doprowadzić do rozwoju uzależnienia i innych poważnych konsekwencji zdrowotnych, a także ewidencjonowania utylizacji zużytych plastrów w podmiotach leczniczych. Ponadto istotna jest edukacja społeczeństwa prowadząca do zwiększenia świadomości na temat problemu stosowania opioidów, szczególnie przez młode osoby, ze zwróceniem uwagi na sygnały, które mogą świadczyć o uzależnieniu u członka rodziny.
El acontecimiento, la diferencia y lo sagrado en la filosofía de Heidegger.
Authors: Esperón Juan Pablo
Published: March 2021

En el presente artículo nos proponemos aportar algunos elementos desde el pensamiento heideggeriano para abordar la irrupción de la novedad sin remitirla o atribuirla a un fundamento organizador. Para ello, el desarrollo de las nociones de acontecimiento, diferencia y sacralidad nos han permitido repensar filosóficamente la novedad de un modo alternativo al de la tradición filosófica occidental.
De una pobreza esencial.
Authors: Gómez Tirado Guillermo
Published: March 2021

El propósito del texto es cuestionar, a luz de la sentencia de Hölderlin «Es koncertriert sich bei uns alles auf’s Geistige, wir sind arm geworden, um reich zu werden», “si hemos llegado a ser-pobres”. De cara a responder esta pregunta, distinguiremos el uso esencial y habitual de la palabra “pobreza”. Para llevar a cabo este propósito, nos centraremos en la conferencia de Martin Heidegger Die Armut de junio de 1945, donde comenta la sentencia de Hölderlin. Finalmente, trataremos de dar una breve respuesta a la lectura política de Laocue-Labarthe sobre la conferencia, apoyándonos en la clarificación del significado esencial de “pobreza”.