bluuebunny/crossref_metadata_2025 huggingface dataset:
Illuminating the dark side: A typology for preservice ELA teachers engaging in ideologies of digital texts
Authors: Marlatt Rick , Sulzer Mark A
Published: December 2020

Set in English Language Arts, this article takes up recent trends in literacy toward investigating ontological notions of digital texts. Two teacher educators recently implemented a series of readings and activities in their methods courses designed to help preservice teachers sophisticate their conceptions of texts beyond autonomous, neutral collections of information by considering digital age ideas such as software theory, textual ideology, and the algorithmic bias of the Internet. The authors review recent scholarship surrounding the integration of computational thinking and the humanities before illustrating a theoretical framework that combines software-driven interpretation and critical media literacy. Descriptions and applications of course texts and exercises precede a discussion on typological methodology. Through the analysis of semester-long writing reflections and course interactions, a typology of preservice teachers is then presented, illustrating three archetypes: Strategists, Hawkeyes, and Improvers. These archetypes are taken up to analyze the ways in which a range of teacher candidates considered ontological notions of digital texts to analyze instructional techniques, to sharpen their critical lenses, or to gain greater understanding of ELA as a discipline (or some combination of all three). This work demonstrates that as teacher educators and teacher candidates increasingly consider software-powered literacies, interrogations of who we are, who we are becoming, and what it all means requires attention to, and explicit practice with, the dark side of digital texts.
Epistemological limitations of Earth system science to confront the Anthropocene crisis
Authors: Soriano Carles
Published: December 2020

Our current understanding of the Earth System has significantly improved in recent years. As a result, the Anthropocene is seen as a major planetary emergency not only for humans but for other living organisms too. However, Earth System science lacks a proper integration of the social or human side and the natural side of the Earth System into an organic theoretical corpus. Without such an integration a comprehensive understanding of the Earth System is not possible, and the practical actions undertaken to face the Anthropocene crisis will only alleviate some of its effects but the planetary emergency will keep deepening. The epistemological reason underlying disagreement between natural and social sciences is that Earth System scientists understand the natural side of the Earth System and the Anthropocene from a dialectic and materialist perspective, whereas they understand the social side of the studied object from a positivist and idealist perspective. Such a dualist approach hampers a proper understanding and the practical actions aimed at transcending the planetary crisis. By consciously adopting a dialectic and materialist epistemic paradigm under which both natural and social realms are studied and understood, Earth System scientists would be able to identify the internal contradictions of the studied objects and, accordingly, to address the research in the suitable directions. In this way, structural solutions and not merely conjunctural measures to face the Anthropocene crisis could be formulated.
The effect of different aging protocols on the flexural strength and phase transformations of two monolithic zirconia ceramics
Authors: Kelesi Maria , Kontonasaki Eleana , Kantiranis Nikolaos , Papadopoulou Lambrini , Zorba Triantafyllia , Paraskevopoulos K M , Koidis Petros
Published: December 2020

Introduction:

The aim of the present study was to investigate how different aging protocols can affect the flexural strength and phase transformations of yttrium-stabilized zirconia ceramics (Y-TZP) for monolithic restorations.

Materials and methods:

Bar-shaped specimens from two zirconia ceramics bars were divided into three groups: a. no treatment (c), b. aging in an autoclave (a), and c. thermal cycling (t). The flexural strength was determined by the 3-point bending test and statistical analysis was performed to determine significant differences ( p< 0.05). Weibull statistics was used to analyze the dispersion of strength values while surface microstructural analysis was performed through X-ray diffraction analysis (XRD), Fourier transform infrared spectroscopy (FTIR), and scanning electron microscopy (SEM).

Results:

Aging did not significantly affect the flexural strength but differences were recorded between the two groups, with group A presenting higher strength values and m-phase percentages.

Conclusions:

The observed differences between the two ceramics could be attributed to variations in composition and processing.
Searching for a Roommate: A Correspondence Audit Examining Racial/Ethnic and Immigrant Discrimination among Millennials
Authors: Gaddis S. Michael , Ghoshal Raj
Published: December 2020

Survey research finds that millennials have less prejudiced views of racial/ethnic minorities than other generations, leading some to label millennials as postracial. However, attitudinal survey research may be subject to social desirability bias because it documents statements or beliefs instead of actions. Moreover, most audit studies focus on people who make hiring decisions or own rental property and are therefore often older than millennials. This study uses a correspondence audit to investigate discrimination among millennials via “roommate wanted” advertisements. We sent over 4,000 emails and found a tiered pattern of discrimination against Asian (Indian and Chinese), Hispanic, and Black room-seekers. However, whether Asian and Hispanic room-seekers face significant discrimination varies based on whether they use predominantly White first names or traditional first names. Our findings shed light on the future of our racial system, expand our knowledge of discrimination beyond the traditional Black/White binary, and illustrate the persistence of anti-Blackness.
Muscle Quality, Measured by Ultrasound-Derived Corrected Echo Intensity, Does not Affect Changes in Cross-sectional Area of the Vastus Lateralis Following Recumbent Rest
Authors: Varanoske Alyssa N. , Coker Nicholas A. , Johnson Bri-Ana D. I. , Belity Tal , Wells Adam J.
Published: December 2020

Objective:

Recumbent rest elicits a decrease in muscle size of the lower extremity, but the extent of decrease may be related to differences in muscle quality. This could have implications for ultrasound-derived measures of muscle size, particularly in individuals with a large proportion of intramuscular contractile elements. The research objective was to determine whether decreases in muscle size following recumbent rest are related to ultrasound-derived corrected echo intensity in resistance-trained males.

Methods:

Cross-sectional area (CSA), echo intensity (EI), subcutaneous fat thickness (SFT), and EI corrected for SFT (EICor) of the vastus lateralis (VL) were measured via ultrasonography in 30 resistance-trained males. Measures were obtained immediately following recumbency (T0) and 15 minutes after recumbency (T15). The association between EICor and percentage change in CSA (%ΔCSA) from T0 to T15 was examined. Comparisons of morphological characteristics were examined between a subset of participants with the lowest (LO; n = 10; <33rd percentile) and highest (HI; n = 10; >66th percentile) EICor.

Results:

EICor was not correlated with %ΔCSA ( P = .151), and the decrease in CSA from T0 to T15 did not differ between the LO and HI groups.

Conclusions:

Muscle quality (EICor) is not related to the decrease in CSA of the VL following recumbent rest among resistance-trained, young males. The time frame of muscle CSA acquisition should not differ based solely on differences in muscle quality.
Oscillatory- and sector-zoned pyrochlore from carbonatites of the Kerimasi volcano, Gregory rift, Tanzania
Authors: Zaitsev Anatoly N. , Spratt John , Shtukenberg Alexander G. , Zolotarev Andrei A. , Britvin Sergey N. , Petrov Sergey V. , Kuptsova Alina V. , Antonov Anton V.
Published: December 2020

The Quaternary carbonatite–nephelinite Kerimasi volcano is located within the Gregory rift in northern Tanzania. It is composed of nephelinitic and carbonatitic pyroclastic rocks, tuffs, tuff breccias and pyroclastic breccias, which contain blocks of different plutonic (predominantly ijolite) and volcanic (predominantly nephelinite) rocks including carbonatites. The plutonic and volcanic carbonatites both contain calcite as the major mineral with variable amounts of magnetite or magnesioferrite, apatite and forsterite. Carbonatites also contain accessory baddeleyite, kerimasite, pyrochlore and calzirtite. Zr and Nb minerals are rarely observed in rock samples, though they are abundant in eluvial deposits of carbonatite tuff/pyroclastic breccias in the Loluni and Kisete craters. Pyrochlore, ideally (CaNa)Nb2O6F, occurs as octahedral and cubo-octahedral crystals up to 300 μm in size. Compositionally, pyrochlore from Loluni and Kisete differs. The former is enriched in U (up to 19.4 wt.% UO2), light rare earth elements (up to 8.3 wt.% LREE2O3) and Zr (up to 14.4 wt.% ZrO2), and the latter contains elevated Ti (up to 7.3 wt.% TiO2). All the crystals investigated were crystalline, including those with high U content (a= 10.4152(1) Å for Loluni anda= 10.3763(1) Å for Kisete crystals). They have little or no subsolidus alteration nor low-temperature cation exchange (A-site vacancy up to 1.5% of the site), and are suitable for single-crystal X-ray diffraction analysis (R1= 0.0206 and 0.0290; for all independent reflections for Loluni and Kisete crystals, respectively). Observed variations in the pyrochlore composition, particularly Zr content, from the Loluni and Kisete craters suggest crystallisation from compositionally different carbonatitic melts. The majority of pyrochlore crystals studied exhibit exceptionally well-preserved oscillatory- and sometimes sector-type zoning. The preferential incorporation of smaller and higher charged elements into more geometrically constrained sites on the growing surfaces explains the formation of the sector zoning. The oscillatory zoning can be rationalised by considering convectional instabilities of carbonatite magmas during their emplacement.
Correction to: miRNA-23b as a biomarker of culture-positive neonatal sepsis
Authors: Fatmi Ahlam , Rebiahi Sid Ahmed , Chabni Nafissa , Zerrouki Hanane , Azzaoui Hafsa , Elhabiri Yamina , Benmansour Souheila , Ibáñez-Cabellos José Santiago , Smahi Mohammed Chems-Eddine , Aribi Mourad , García-Giménez José Luis , Pallardó Federico V.
Published: December 2020

An amendment to this paper has been published and can be accessed via the original article.
Paediatric RCC with sarcomatoid variation: a rare entity
Authors: Mahajan Anuj , Adiga Prashanth , Pai Vivek , Raj Keerthi
Published: December 2020

Background

Malignant renal masses in paediatric age group are mostly Wilms’ tumour. RCC is very rare in this age group, papillary variant being the most common. Sarcomatoid variation occurs in 5% of adult RCC, while it is extremely rare in children. No treatment protocol exists in the management of paediatric RCC.

Case presentation

Here, we present a case of 10-year-old female who presented with left flank mass. Radical nephrectomy was done which showed clear cell carcinoma with sarcomatoid variant on histopathological examination.

Conclusion

RCC with sarcomatoid variation can occur in children. However, further studies and long-term follow-up are needed for formulating a treatment protocol and prognostication factors for the same.
Moving forward through the in silico modeling of tuberculosis: a further step with UISS-TB
Authors: Russo Giulia , Sgroi Giuseppe , Parasiliti Palumbo Giuseppe Alessandro , Pennisi Marzio , Juarez Miguel A. , Cardona Pere-Joan , Motta Santo , Walker Kenneth B. , Fichera Epifanio , Viceconti Marco , Pappalardo Francesco
Published: December 2020

Background

In 2018, about 10 million people were found infected by tuberculosis, with approximately 1.2 million deaths worldwide. Despite these numbers have been relatively stable in recent years, tuberculosis is still considered one of the top 10 deadliest diseases worldwide. Over the years, Mycobacterium tuberculosis has developed a form of resistance to first-line tuberculosis treatments, specifically to isoniazid, leading to multi-drug-resistant tuberculosis. In this context, the EU and Indian DBT funded project STriTuVaD—In Silico Trial for Tuberculosis Vaccine Development—is supporting the identification of new interventional strategies against tuberculosis thanks to the use of Universal Immune System Simulator (UISS), a computational framework capable of predicting the immunity induced by specific drugs such as therapeutic vaccines and antibiotics.

Results

Here, we present how UISS accurately simulates tuberculosis dynamics and its interaction within the immune system, and how it predicts the efficacy of the combined action of isoniazid and RUTI vaccine in a specific digital population cohort. Specifically, we simulated two groups of 100 digital patients. The first group was treated with isoniazid only, while the second one was treated with the combination of RUTI vaccine and isoniazid, according to the dosage strategy described in the clinical trial design. UISS-TB shows to be in good agreement with clinical trial results suggesting that RUTI vaccine may favor a partial recover of infected lung tissue.

Conclusions

In silico trials innovations represent a powerful pipeline for the prediction of the effects of specific therapeutic strategies and related clinical outcomes. Here, we present a further step in UISS framework implementation. Specifically, we found that the simulated mechanism of action of RUTI and INH are in good alignment with the results coming from past clinical phase IIa trials.
Utilizing heart rate variability to predict ICU patient outcome in traumatic brain injury
Authors: Zhang Ping , Roberts Tegan , Richards Brent , Haseler Luke J.
Published: December 2020

Background

Prediction of patient outcome in medical intensive care units (ICU) may help for development and investigation of early interventional strategies. Several ICU scoring systems have been developed and are used to predict clinical outcome of ICU patients. These scores are calculated from clinical physiological and biochemical characteristics of patients. Heart rate variability (HRV) is a correlate of cardiac autonomic regulation and has been evident as a marker of poor clinical prognosis. HRV can be measured from the electrocardiogram non-invasively and monitored in real time. HRV has been identified as a promising ‘electronic biomarker’ of disease severity. Traumatic brain injury (TBI) is a subset of critically ill patients admitted to ICU, with significant morbidity and mortality, and often difficult to predict outcomes. Changes of HRV for brain injured patients have been reported in several studies. This study aimed to utilize the continuous HRV collection from admission across the first 24 h in the ICU in severe TBI patients to develop a patient outcome prediction system.

Results

A feature extraction strategy was applied to measure the HRV fluctuation during time. A prediction model was developed based on HRV measures with a genetic algorithm for feature selection. The result (AUC: 0.77) was compared with earlier reported scoring systems (highest AUC: 0.76), encouraging further development and practical application.

Conclusions

The prediction models built with different feature sets indicated that HRV based parameters may help predict brain injury patient outcome better than the previously adopted illness severity scores.
Computational modeling of the immune response in multiple sclerosis using epimod framework
Authors: Pernice Simone , Follia Laura , Maglione Alessandro , Pennisi Marzio , Pappalardo Francesco , Novelli Francesco , Clerico Marinella , Beccuti Marco , Cordero Francesca , Rolla Simona
Published: December 2020

Background

Multiple Sclerosis (MS) represents nowadays in Europe the leading cause of non-traumatic disabilities in young adults, with more than 700,000 EU cases. Although huge strides have been made over the years, MS etiology remains partially unknown. Furthermore, the presence of various endogenous and exogenous factors can greatly influence the immune response of different individuals, making it difficult to study and understand the disease. This becomes more evident in a personalized-fashion when medical doctors have to choose the best therapy for patient well-being. In this optics, the use of stochastic models, capable of taking into consideration all the fluctuations due to unknown factors and individual variability, is highly advisable.

Results

We propose a new model to study the immune response in relapsing remitting MS (RRMS), the most common form of MS that is characterized by alternate episodes of symptom exacerbation (relapses) with periods of disease stability (remission). In this new model, both the peripheral lymph node/blood vessel and the central nervous system are explicitly represented. The model was created and analysed using Epimod, our recently developed general framework for modeling complex biological systems. Then the effectiveness of our model was shown by modeling the complex immunological mechanisms characterizing RRMS during its course and under the DAC administration.

Conclusions

Simulation results have proven the ability of the model to reproduce in silico the immune T cell balance characterizing RRMS course and the DAC effects. Furthermore, they confirmed the importance of a timely intervention on the disease course.
Toward computational modelling on immune system function
Authors: Pappalardo Francesco , Russo Giulia , Reche Pedro A.
Published: December 2020

The 3rd edition of the computational methods for the immune system function workshop has been held in San Diego, CA, in conjunction with the IEEE International Conference on Bioinformatics and Biomedicine (BIBM 2019) from November 18 to 21, 2019. The workshop has continued its growing tendency, with a total of 18 accepted papers that have been presented in a full day workshop. Among these, the best 10 papers have been selected and extended for presentation in this special issue. The covered topics range from computer-aided identification of T cell epitopes to the prediction of heart rate variability to prevent brain injuries, from In Silico modeling of Tuberculosis and generation of digital patients to machine learning applied to predict type-2 diabetes risk.
Molecular dynamics of the immune checkpoint programmed cell death protein I, PD-1: conformational changes of the BC-loop upon binding of the ligand PD-L1 and the monoclonal antibody nivolumab
Authors: Roither Bernhard , Oostenbrink Chris , Schreiner Wolfgang
Published: December 2020

Background

The immune checkpoint receptor programmed cell death protein I (PD-1) has been identified as a key target in immunotherapy. PD-1 reduces the risk of autoimmunity by inducing apoptosis in antigen-specific T cells upon interaction with programmed cell death protein ligand I (PD-L1). Various cancer types overexpress PD-L1 to evade the immune system by inducing apoptosis in tumor-specific CD8+ T cells. The clinically used blocking antibody nivolumab binds to PD-1 and inhibits the immunosuppressive interaction with PD-L1. Even though PD-1 is already used as a drug target, the exact mechanism of the receptor is still a matter of debate. For instance, it is hypothesized that the signal transduction is based on an active conformation of PD-1.

Results

Here we present the results of the first molecular dynamics simulations of PD-1 with a complete extracellular domain with a focus on the role of the BC-loop of PD-1 upon binding PD-L1 or nivolumab. We could demonstrate that the BC-loop can form three conformations. Nivolumab binds to the BC-loop according to the conformational selection model whereas PD-L1 induces allosterically a conformational change of the BC-loop.

Conclusion

Due to the structural differences of the BC-loop, a signal transduction based on active conformation cannot be ruled out. These findings will have an impact on drug design and will help to refine immunotherapy blocking antibodies.
Transcriptome analysis reveals modulation of the STAT family in PEDV-infected IPEC-J2 cells
Authors: Hu Zhengzheng , Li Yuchen , Du Heng , Ren Junxiao , Zheng Xianrui , Wei Kejian , Liu Jianfeng
Published: December 2020

Background

Porcine epidemic diarrhea virus (PEDV) is a causative agent of serious viral enteric disease in suckling pigs. Such diseases cause considerable economic losses in the global swine industry. Enhancing our knowledge of PEDV-induced transcriptomic responses in host cells is imperative to understanding the molecular mechanisms involved in the immune response. Here, we analyzed the transcriptomic profile of intestinal porcine epithelial cell line J2 (IPEC-J2) after infection with a classical strain of PEDV to explore the host response.

Results

In total, 854 genes were significantly differentially expressed after PEDV infection, including 716 upregulated and 138 downregulated genes. Functional annotation analysis revealed that the differentially expressed genes were mainly enriched in the influenza A, TNF signaling, inflammatory response, cytokine receptor interaction, and other immune-related pathways. Next, the putative promoter regions of the 854 differentially expressed genes were examined for the presence of transcription factor binding sites using the MEME tool. As a result, 504 sequences (59.02%) were identified as possessing at least one binding site of signal transducer and activator of transcription (STAT), and five STAT transcription factors were significantly induced by PEDV infection. Furthermore, we revealed the regulatory network induced by STAT members in the process of PEDV infection.

Conclusion

Our transcriptomic analysis described the host genetic response to PEDV infection in detail in IPEC-J2 cells, and suggested that STAT transcription factors may serve as key regulators in the response to PEDV infection. These results further our understanding of the pathogenesis of PEDV.
Identification of the neuropeptide precursor genes potentially involved in the larval settlement in the Echiuran worm Urechis unicinctus
Authors: Hou Xitan , Qin Zhenkui , Wei Maokai , Fu Zhong , Liu Ruonan , Lu Li , Bai Shumiao , Ma Yubin , Zhang Zhifeng
Published: December 2020

Background

In marine invertebrate life cycles, which often consist of planktonic larval and benthonic adult stages, settlement of the free-swimming larva to the sea floor in response to environmental cues is a key life cycle transition. Settlement is regulated by a specialized sensory–neurosecretory system, the larval apical organ. The neuroendocrine mechanisms through which the apical organ transduces environmental cues into behavioral responses during settlement are not fully understood yet.

Results

In this study, a total of 54 neuropeptide precursors (pNPs) were identified in the Urechis unicinctus larva and adult transcriptome databases using local BLAST and NpSearch prediction, of which 10 pNPs belonging to the ancient eumetazoa, 24 pNPs belonging to the ancient bilaterian, 3 pNPs belonging to the ancient protostome, 9 pNPs exclusive in lophotrochozoa, 3 pNPs exclusive in annelid, and 5 pNPs only found in U. unicinctus. Furthermore, four pNPs (MIP, FRWamide, FxFamide and FILamide) which may be associated with the settlement and metamorphosis of U. unicinctus larvae were analysed by qRT-PCR. Whole-mount in situ hybridization results showed that all the four pNPs were expressed in the region of the apical organ of the larva, and the positive signals were also detected in the ciliary band and abdomen chaetae. We speculated that these pNPs may regulate the movement of larval cilia and chaeta by sensing external attachment signals.

Conclusions

This study represents the first comprehensive identification of neuropeptides in Echiura, and would contribute to a complete understanding on the roles of various neuropeptides in larval settlement of most marine benthonic invertebrates.
Physiological benefits evaluated by quantitative flow ratio in patients with reduced left ventricular ejection fraction who underwent percutaneous coronary intervention
Authors: Zhong Jiaxin , Chen Qin , Chen Long , Ye Zhen , Chen Huang , Sun Jianmin , Hong Juchang , Ye Mingfang , Yan Yuanming , Chen Lianglong , Luo Yukun
Published: December 2020

Background

To explore the clinical benefits of revascularization in patients with different levels of left ventricular ejection fraction (LVEF) from the perspective of quantitative flow ratio (QFR).

Methods

Patients who underwent successful percutaneous coronary intervention (PCI) and one-year angiographic follow-up were retrospectively screened and computed by QFR analysis. Based on their LVEF, 301 eligible patients were classified into reduced LVEF (≤ 50%, n = 48) and normal LVEF (> 50%, n = 253) groups. Pre-PCI QFR, post-PCI QFR, follow-up QFR, late lumen loss (LLL), LVEF and major adverse cardiovascular and cerebrovascular events (MACCEs) at one year were compared between groups.

Results

The reduced LVEF group had a lower mean pre-PCI QFR than the normal LVEF group (0.67 ± 0.16 vs. 0.73 ± 0.15, p = 0.004), but no significant difference was found in the post-PCI or one-year follow-up QFR. No association was found between LVEF and QFR at pre-PCI or follow-up. The reduced LVEF group had greater increases in QFR (0.27 ± 0.18 vs. 0.22 ± 0.15, p = 0.043) and LVEF (6.05 ± 9.45% vs. − 0.37 ± 8.11%, p < 0.001) than the normal LVEF group. The LLL results showed no difference between the two groups, indicating a similar degree of restenosis. The reduced LVEF group had a higher incidence of MACCEs (14.6% vs. 4.3%, p = 0.016), which was mainly due to the higher risk of heart failure (6.3% vs. 0%, p = 0.004).

Conclusion

Compared to the corresponding normal LVEF patients, patients with reduced LVEF who underwent successful PCI were reported to have greater increases in QFR and LVEF, a similar degree of restenosis, and a higher incidence of MACCEs due to a higher risk of heart failure. It seems that patients with reduced LVEF gain more coronary benefits from successful revascularization from the perspective of flow physiology evaluations.
Development and validation of the peptic ulcer scale under the system of quality of life instruments for chronic diseases based on classical test theory and generalizability theory
Authors: Wan Chonghua , Chen Ying , Gao Li , Zhang Qingqing , Quan Peng , Sun Xiaoyuan
Published: December 2020

Background

Quality of life (QOL) for patients with Peptic ulcer disease (PUD) is of interest worldwide and disease-specific instruments are needed for clinical research and practice. This paper focus on the development and validation of the PUD scale under the system of quality of life instruments for chronic diseases (QLICD-PU) by the modular approach and both classical test theory and Generalizability Theory.

Methods

The QLICD-PU is developed based on programmatic decision-making procedures, including multiple nominal and focus group discussions, in-depth interviews, and quantitative statistical procedures. Based on the data of 153 PUD inpatients, correlation analysis, factor analysis, t-test, and Generalizability Theory analysis (including generalizability study and decision study, ie. G-study and D-study) were used to assess the validity, reliability, and responsiveness of the scale.

Results

When the popular scale health survey short form (SF-36) was used as the standard, correlation and factor analysis confirmed good construct validity and criterion-related validity of QLICD-PU. Except for the social domain (0.62), the internal consistency α of all domains is higher than 0.70. The overall score and the test–retest reliability coefficients (Pearson r and intra-class correlation ICC) in all domains are higher than 0.80 (0.77 in the social domain). After treatments, the overall score and scores of all domains have statistically significant changes (P < 0.01), except for social impact and sexual function scores. The SRM (Standardized response mean) of domain-level scores ranges from 0.34 to 1.03. The G coefficient and reliability index (Ф coefficient) further confirm the reliability of the scale through more accurate variance components and decision-making information about changes in the number of items.

Conclusions

The QLICD-PU can be used as a useful measurement to assess the quality of life of PUD patients with good psychometric characteristics and multiple advantages.
Development of amoebic liver abscess in early pregnancy years after initial amoebic exposure: a case report
Authors: Kaiser Rainer W. J. , Allgeier Julian , Philipp Alexander B. , Mayerle Julia , Rothe Camilla , Wallrauch Claudia , op den Winkel Mark
Published: December 2020

Background

Infection with Entamoeba histolytica and associated complications are relatively rare in developed countries. The overall low prevalence in the Western world as well as the possibly prolonged latency period between infection with the causing pathogen and onset of clinical symptoms may delay diagnosis of and adequate treatment for amoebiasis. Amoebic liver abscess (ALA) is the most common extraintestinal manifestation of invasive amoebiasis. Pregnancy has been described as a risk factor for development of invasive amoebiasis and management of these patients is especially complex.

Case presentation

A 30-year-old Caucasian woman in early pregnancy presented to our emergency department with abdominal pain alongside elevated inflammatory markers and liver function tests. Travel history revealed multiple journeys to tropic and subtropic regions during the past decade and a prolonged episode of intermittently bloody diarrhea during a five month stay in Indonesia seven years prior to admission. Sonographic and magnetic resonance imaging revealed a 5 × 4 cm hepatic abscess. After ultrasound-guided transcutaneous liver drainage, both abscess fluids and blood cultures showed neither bacterial growth nor microscopic signs of parasitic disease. Serological testing confirmed an infection with Entamoeba histolytica, which was treated with metronidazole, followed by eradication therapy with paromomycin. Subsequent clinical, laboratory and imaging follow-up exams showed regression of the ALA. In addition, the pregnancy completed without complications and a healthy baby boy was born 7 months after termination of treatment.

Conclusions

This case of invasive amoebiasis in early pregnancy outside of endemic regions and several years after exposure demonstrates the importance of broad differential diagnostics in the context of liver abscesses. The complex interdisciplinary decisions regarding the choice of imaging techniques as well as interventional and antibiotic therapy in the context of pregnancy are discussed. Furthermore, we present possible explanations for pregnancy as a risk factor for an invasive course of amoebiasis.
Incarcerated gallbladder in inguinal hernia: a case report and literature review
Authors: Tajti János , Pieler József , Ábrahám Szabolcs , Simonka Zsolt , Paszt Attila , Lázár György
Published: December 2020

Background

Treating hernias is one of the oldest challenges in surgery. The gallbladder as content in the case of abdominal hernias has only been reported in a few cases in the current literature. Cholecyst has only been described in the content of an inguinofemoral hernia in one case to date.

Case presentation

A 73-year-old female patient was admitted to the Emergency Department due to complaints in the right inguinal area, which had started 1 day earlier. The patient complained of cramp-like abdominal pain and nausea. Physical examination confirmed an apple-sized, irreducible hernia in the right inguinal region. Abdominal ultrasound confirmed an oedematous intestinal loop in a 70-mm-long hernial sac, with no circulation detected. Abdominal X-ray showed no signs of passage disorder. White blood cell count and C-reactive protein level were elevated, and hepatic enzymes were normal in the laboratory findings. Exploration was performed via an inguinal incision on the right side, an uncertain cystic structure was found in the hernial sac, and several small abnormal masses were palpated there. The abdominal cavity was explored from the middle midline laparotomy. During the exploration, the content of the hernial sac was found to be the fundus of the significantly ptotic, large gallbladder. Cholecystectomy and Bassini’s repair of the inguinal hernia were performed safely.

Conclusions

Following a review of the literature, it can be concluded that the finding of incarcerated gallbladder in the content of an inguinal hernia is a rare finding. No other similar emergency case and successful surgical intervention have been reported before.
Covid-19 in South America: clinical and epidemiological characteristics among 381 patients during the early phase of the pandemic in Santiago, Chile
Authors:   for the CAS-UDD Covid-19 Working Group, Vial Macarena R. , Peters Anne , Pérez Inia , Spencer-Sandino María , Barbé Mario , Porte Lorena , Weitzel Thomas , Aylwin Mabel , Vial Pablo , Araos Rafael , Munita Jose M.
Published: December 2020

Background

Understanding the characteristics of the Covid-19 pandemic in different geographical regions, ethnic and socioeconomic settings are of emerging importance. This study presents the demographic and clinical features of SARS-CoV-2 infected patients in a large private healthcare center in Santiago, Chile, during the first month of the pandemic.

Methods

We analyzed the demographics, laboratory and clinical characteristics including severity and outcome of all patients diagnosed with Covid-19 during the first month of the pandemic. SARS-2-CoV infection was confirmed by RT-PCR in nosopharyngeal samples. The primary outcome was a composite of ICU admission or all-cause, in-hospital mortality. Clinical and laboratory parameters of hospitalized patients were analyzed regarding their association with the primary outcome.

Results

From March 3 to April 4, 2020, 3679 individuals were tested for SARS-CoV-2 in our hospital. Of those, 381 had Covid-19 and were included into this analysis. Most patients (99.2%) were Chileans, 12% returning from recent travel. The median age was 39 years (IQR 31–49) and 52% were female. A total of 88 patients (23.1%) were hospitalized; 18 (3.7%) required ICU and/or died. The overall mortality was 0.7%. Increased body mass index (BMI) and elevated C-reactive protein (CRP) were independently associated with ICU care or death.

Conclusion

During the first weeks of the pandemic in Chile, most Covid-19 patients were young, with low rates of hospitalization, ICU requirement, and fatality. BMI and CRP on admission were predictors for severity. Our data provide important information on the clinical course and outcome of Covid-19 in a Latin American setting.
Effect of Arbidol (Umifenovir) on COVID-19: a randomized controlled trial
Authors: Nojomi Marzieh , Yassin Zeynab , Keyvani Hossein , Makiani Mahin Jamshidi , Roham Maryam , Laali Azadeh , Dehghan Nasir , Navaei Mehrnaz , Ranjbar Mitra
Published: December 2020

Background

Treatment of patients with COVID-19 has included supportive care to mainly relief symptoms of the disease. Although World Health Organization (WHO) has not recommended any effective treatments for COVID-19, there are some reports about use of antiviral drugs. The aim of this study is to determine the effect of Arbidol (ARB) on COVID-19 disease.

Methods

Using an open-label randomized controlled trial, we examined the efficacy of ARB in patients with COVID-19 in a teaching hospital. One hundred eligible patients with diagnosis of COVID-19 were recruited in the study and assigned randomly to two groups of either hydroxychloroquine followed by KALETRA (Lopinavir/ritonavir) or hydroxychloroquine followed by ARB. The primary outcome was hospitalization duration and clinical improvement 7 days after admission. The criteria of improvement were relief of cough, dyspnea, and fever. Time to relief from fever was also assessed across the two groups. Without any dropouts, 100 patients were entered into the study for the final analysis at significance level of 0.05.

Results

The mean age of patients was 56.6 (17.8) years and 56.2 (14.8) years in ARB and KALETRA groups, respectively. Majority of patients were male across two groups (66 and 54%). The duration of hospitalization in ARB group was significantly less than KALETRA arm (7.2 versus 9.6 days; P = 0.02). Time to relief fever was almost similar across two groups (2.7 versus 3.1 days in ARB and KALETRA arms, respectively). Peripheral oxygen saturation rate was significantly different after 7 days of admission across two groups (94% versus 92% in ARB and KALETRA groups respectively) (P = 0.02). Based on multiple linear regression analysis, IHD, Na level, and oxygen saturation at the time of admission and type of therapy were the independent adjusted variables that determined the duration of hospitalization in patients with COVID-19.

Conclusion

Our findings showed that Arbidol, compared to KALETRA, significantly contributes to clinical and laboratory improvements, including peripheral oxygen saturation, requiring ICU admissions, duration of hospitalization, chest CT involvements, WBC, and ESR. We suggest further studies on ARB against COVID-19 using larger sample size and multicenter design.

Trial registration

IRCT20180725040596N2 on 18 April 2020.
Various cross-linking methods inhibit the collagenase I degradation of rabbit scleral tissue
Authors: Krasselt Konstantin , Frommelt Cornelius , Brunner Robert , Rauscher Franziska Georgia , Francke Mike , Körber Nicole
Published: December 2020

Background

Collagen cross-linking of the sclera is a promising approach to strengthen scleral rigidity and thus to inhibit eye growth in progressive myopia. Additionally, cross-linking might inhibit degrading processes in idiopathic melting or in ocular inflammatory diseases of the sclera. Different cross-linking treatments were tested to increase resistance to enzymatic degradation of the rabbit sclera.

Methods

Scleral patches from rabbit eyes were cross-linked using paraformaldehyde, glutaraldehyde or riboflavin combined with UV-A-light or with blue light. The patches were incubated with collagenase I (MMP1) for various durations up to 24 h to elucidate differences in scleral resistance to enzymatic degradation. Degraded protein components in the supernatant were detected and quantified using measurements of Fluoraldehyde o-Phthaldialdehyde (OPA) fluorescence.

Results

All cross-linking methods reduced the enzymatic degradation of rabbit scleral tissue by MMP1. Incubation with glutaraldehyde (1%) and paraformaldehyde (4%) caused nearly a complete inhibition of enzymatic degradation (down to 7% ± 2.8 of digested protein compared to control). Cross-linking with riboflavin/UV-A-light reduced the degradation by MMP1 to 62% ± 12.7 after 24 h. Cross-linking with riboflavin/blue light reduced the degradation by MMP1 to 77% ± 13.5 after 24 h. No significant differences could be detected comparing different light intensities, light exposure times or riboflavin concentrations.

Conclusions

The application of all cross-linking methods increased the resistance of rabbit scleral tissue to MMP1-degradation. Especially, gentle cross-linking with riboflavin and UV-A or blue light might be a clinical approach in future.
Altered metabolism of mothers of young children with Autism Spectrum Disorder: a case control study
Authors: Hollowood-Jones Kathryn , Adams James B. , Coleman Devon M. , Ramamoorthy Sivapriya , Melnyk Stepan , James S. Jill , Woodruff Bryan K. , Pollard Elena L. , Snozek Christine L. , Kruger Uwe , Chuah Joshua , Hahn Juergen
Published: December 2020

Background

Previous research studies have demonstrated abnormalities in the metabolism of mothers of young children with autism.

Methods

Metabolic analysis was performed on blood samples from 30 mothers of young children with Autism Spectrum Disorder (ASD-M) and from 29 mothers of young typically-developing children (TD-M). Targeted metabolic analysis focusing on the folate one-carbon metabolism (FOCM) and the transsulfuration pathway (TS) as well as broad metabolic analysis were performed. Statistical analysis of the data involved both univariate and multivariate statistical methods.

Results

Univariate analysis revealed significant differences in 5 metabolites from the folate one-carbon metabolism and the transsulfuration pathway and differences in an additional 48 metabolites identified by broad metabolic analysis, including lower levels of many carnitine-conjugated molecules.

Multivariate analysis with leave-one-out cross-validation allowed classification of samples as belonging to one of the two groups of mothers with 93% sensitivity and 97% specificity with five metabolites. Furthermore, each of these five metabolites correlated with 8–15 other metabolites indicating that there are five clusters of correlated metabolites. In fact, all but 5 of the 50 metabolites with the highest area under the receiver operating characteristic curve were associated with the five identified groups. Many of the abnormalities appear linked to low levels of folate, vitamin B12, and carnitine-conjugated molecules.

Conclusions

Mothers of children with ASD have many significantly different metabolite levels compared to mothers of typically developing children at 2–5 years after birth.
Safety of sildenafil in premature infants with severe bronchopulmonary dysplasia (SILDI-SAFE): a multicenter, randomized, placebo-controlled, sequential dose-escalating, double-masked, safety study
Authors: Schneider Simone , Bailey Mary , Spears Tracy , Esther Charles R. , Laughon Matthew M. , Hornik Christoph P. , Jackson Wesley
Published: December 2020

Background

Pulmonary hypertension is a deadly complication of bronchopulmonary dysplasia, the most common pulmonary morbidity of prematurity. Despite these catastrophic consequences, no evidence-based therapies are available for the prevention of pulmonary hypertension in this population. Sildenafil is a potent pulmonary vasodilator approved by the US Food and Drug Administration for the treatment of pulmonary hypertension in adults. Preclinical models suggest a beneficial effect of sildenafil on premature lungs through improved alveolarization and preserved vascular development. Sildenafil may therefore prevent the development of pulmonary hypertension associated with lung disease of prematurity by reducing pulmonary vascular remodeling and lowering pulmonary vascular resistance; however, clinical trial evidence is needed. The present study, supported by the National Institutes of Health’s National Heart Lung and Blood Institute, will generate safety, pharmacokinetics, and preliminary effectiveness data on sildenafil in a population of premature infants with severe bronchopulmonary dysplasia at risk for pulmonary hypertension.

Methods

We have designed a multicenter, randomized, placebo-controlled, sequential dose-escalating, double-masked, safety trial of sildenafil in premature infants with severe bronchopulmonary dysplasia. We will randomize 120 premature infants < 29 weeks gestational age with severe bronchopulmonary dysplasia at 32–40 weeks postmenstrual age in a dose-escalating approach 3:1 (sildenafil: placebo) sequentially into each of 3 cohorts at ~ 30 clinical sites. Participants will receive up to 34 days of study drug, followed by 28 days of safety monitoring. The primary outcome will be safety as determined by incidence of hypotension. Secondary outcomes will include pharmacokinetics and preliminary effectiveness of sildenafil based on presence or absence of pulmonary hypertension diagnosed by echocardiography at the end of treatment period.

Discussion

Sildenafil is a promising intervention to prevent the development of pulmonary hypertension in premature infants with bronchopulmonary dysplasia. Clinical trials of sildenafil specifically designed for premature infants are urgently needed. The current study will make substantial contributions to scientific knowledge of the safety of sildenafil in premature infants at risk for pulmonary hypertension. Results from the study will be used by investigators to inform the design of a pivotal efficacy trial.

Trial registration

ClinicalTrials.govNCT04447989. Registered 25 June 2020.
Non-communicable diseases among adolescents: current status, determinants, interventions and policies
Authors: Akseer N. , Mehta S. , Wigle J. , Chera R. , Brickman Z. J. , Al-Gashm S. , Sorichetti B. , Vandermorris A. , Hipgrave D. B. , Schwalbe N. , Bhutta Z. A.
Published: December 2020

Background

Addressing non-communicable disease (NCDs) is a global priority in the Sustainable Development Goals, especially for adolescents. However, existing literature on NCD burden, risk factors and determinants, and effective interventions and policies for targeting these diseases in adolescents, is limited. This study develops an evidence-based conceptual framework, and highlights pathways between risk factors and interventions to NCD development during adolescence (ages 10–19 years) and continuing into adulthood. Additionally, the epidemiologic profile of key NCD risk factors and outcomes among adolescents and preventative NCD policies/laws/legislations are examined, and a multivariable analysis is conducted to explore the determinants of NCDs among adolescents and adults.

Methods

We reviewed literature to develop an adolescent-specific conceptual framework for NCDs. Global data repositories were searched from Jan-July 2018 for data on NCD-related risk factors, outcomes, and policy data for 194 countries from 1990 to 2016. Disability-Adjusted Life Years were used to assess disease burden. A hierarchical modeling approach and ordinary least squares regression was used to explore the basic and underlying causes of NCD burden.

Results

Mental health disorders are the most common NCDs found in adolescents. Adverse behaviours and lifestyle factors, specifically smoking, alcohol and drug use, poor diet and metabolic syndrome, are key risk factors for NCD development in adolescence. Across countries, laws and policies for preventing NCD-related risk factors exist, however those targeting contraceptive use, drug harm reduction, mental health and nutrition are generally limited. Many effective interventions for NCD prevention exist but must be implemented at scale through multisectoral action utilizing diverse delivery mechanisms. Multivariable analyses showed that structural/macro, community and household factors have significant associations with NCD burden among adolescents and adults.

Conclusions

Multi-sectoral efforts are needed to target NCD risk factors among adolescents to mitigate disease burden and adverse outcomes in adulthood. Findings could guide policy and programming to reduce NCD burden in the sustainable development era.