bluuebunny/crossref_metadata_2025 huggingface dataset:
In-school transition challenges among primary school learners with autism spectrum disorders in South Africa: Parents and teachers' perspectives
Authors: Sefotho Maximus Monaheng , Onyishi Charity N.
Published: June 2021

Successful school transition is a basis for career development and eventual overall adult educational and socio-economic outcomes. Transitioning through primary school grades is a combination of relative academic and social skills acquired in each grade and forms the basis for subsequent academic and social success at ensuing educational pursuit and adult independent life. Evidence indicates that learners with autism spectrum disorder (ASD) and their families experience limiting challenges in their school transition at different levels. There is a gap in the literature as to the specific factors that constitute school transition difficulties in primary school learners with ASD in the area of study. The purpose of this study was to investigate challenges that learners with ASD face as they transition through school grades. The study adopted a phenomenological design with 12 participants (6 parents and 6 teachers). Two focus group discussions were held to collect data analysed using inductive thematic analysis. The results revealed three main themes, which included poor academic achievement and skills development, social and economic challenges as well as behavioural problems. The findings of the study suggest an increased need for home-school collaboration during the early stages and throughout the school years for the effective transition of learners with ASD. Thus, providing learners with ASD and their families with academic, emotional and behavioural intervention and support can help learners with autism to develop personal resources that will encourage their educational success.
The integration of technology in supporting progressed learners in English First Additional Language comprehension
Authors: Kolobe Lineo , Mihai Maryke Anneke
Published: June 2021

This study aims at finding the impact of information and communication technology (ICT) as an intervention tool for progressed learners in teaching and learning of English first additional language (FAL) comprehension in the intermediate phase. With learner progression proving a challenge facing the South African education system, the aim of this qualitative descriptive study was to investigate the extent to which first additional language educators employ ICT as an intervention tool to assist learners who are progressed. Data collection strategies used in this study were semi-structured interviews and documentation such as lesson plans, progression tracking tools and support policies used at selected schools. The study population was eight intermediate phase English FAL educators from two Tembisa schools. Tembisa is a township north of Kempton Park on the East Rand, in Gauteng, South Africa. In selecting these participants, purposive sampling techniques were used. Data was analysed using ATLAS.ti and presented in a descriptive and graphical way. There is limited research in South Africa on the impact of ICT for progressed learners or a progression policy, as this policy is a relatively new phenomenon. The findings from this study indicated that the use of ICT in a classroom to support progressed learners yields positive results. The findings further indicated that ICT has a potential to reduce failure rates that ultimately minimises the number of learners who need to be progressed without meeting promotional requirements.
Uncomplicated gallbladder mucoceles – is it better for prognosis to perform cholecystectomy or medically manage?
Authors: Griffiths Rachel T. , Gordon-Evans Wanda J.
Published: June 2021

PICO question

In dogs with an uncomplicated gallbladder mucocele, is the long-term survival when surgically managed superior, inferior, or equal to those medically managed?

 

Clinical bottom line

Category of research question

Treatment and prognosis

The number and type of study designs reviewed

Three papers were critically reviewed. All of the studies were retrospective analyses of medical records, two of which were cohort studies, and one which was a case control study

Strength of evidence

Weak

Outcomes reported

There is some evidence that surgical management of gallbladder mucoceles is associated with longer survival times than medically managed cases, although there is no direct analysis of uncomplicated vs complicated cases

Conclusion

We cannot clearly make a conclusion based on the available evidence. To date, there is only one retrospective analysis that directly compares the long-term survival of cases medically vs surgically managed, but this study does not separate uncomplicated vs complicated cases of gallbladder mucocele. In order to more accurately determine which type of treatment should be recommended for uncomplicated cases of gallbladder mucoceles, a prospective study comparing long-term survival with each treatment should be performed. These studies should also standardise medical management in order to more accurately compare survival time to surgical treatment

 

How to apply this evidence in practice

The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.

Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
Successful endovascular embolization for traumatic subcutaneous abdominal wall hematoma via the superficial inferior epigastric artery: a case report
Authors: Moon Sung Nam , Seo Sang Hyun , Jung Hyun Seok
Published: June 2021

Abdominal wall hematoma (AWH) after blunt trauma is common, and most cases can be treated conservatively. More invasive treatment is required in patients with traumatic AWH if active bleeding is identified or there is no response to medical treatment. Herein, we report a case of endovascular embolization for traumatic subcutaneous AWH. Almost endovascular treatment for AHW is done through the deep inferior epigastric artery. However, in this case, the superficial inferior epigastric artery was the bleeding focus and embolization target. After understanding the vascular system of the abdominal wall, an endovascular approach and embolization is a safe and effective treatment option for AWH.
How Single-Molecule Localization Microscopy Expanded Our Mechanistic Understanding of RNA Polymerase II Transcription
Authors: Hoboth Peter , Šebesta Ondřej , Hozak Pavel
Published: June 2021

Classical models of gene expression were built using genetics and biochemistry. Although these approaches are powerful, they have very limited consideration of the spatial and temporal organization of gene expression. Although the spatial organization and dynamics of RNA polymerase II (RNAPII) transcription machinery has fundamental functional consequences for gene expression, its detailed studies have been for long time abrogated by the limits of classical light microscopy. The advent of super-resolution microscopy (SRM) techniques allowed for the visualization of the RNAPII transcription machinery with nanometer resolution and millisecond precision. In this review, we summarize the recent methodological advances in SRM, focus on its application for studies of the nanoscale organization in space and time of RNAPII transcription, and discuss its consequences for the mechanistic understanding of gene expression.
mRNA inventory of extracellular vesicles from Ustilago maydis
Authors: Kwon Seomun , Rupp Oliver , Brachmann Andreas , Goesmann Alexander , Feldbrügge Michael
Published: June 2021

Extracellular vesicles (EVs) can transfer diverse RNA cargo for intercellular signalling. EV-associated RNAs have been found in diverse fungi and were proposed to be relevant for pathogenesis in animal hosts. In plant-pathogen interactions, small RNAs are exchanged in a cross-kingdom RNAi warfare and EVs were considered to be a delivery mechanism. To extend the search for EV-associated molecules involved in plants-pathogen communication, we have characterised the repertoire of EV-associated mRNAs secreted by the maize smut pathogen, Ustilago maydis. For this initial survey, EVs were isolated from axenic filamentous cultures that mimic infectious hyphae. The EV-associated RNAs were resistant to degradation by RNases and the presence of intact mRNAs was evident. The set of mRNAs enriched inside EVs relative to the fungal cells are functionally distinct from those that are depleted from EVs, particularly overrepresented in metabolic enzyme activities. Intriguingly, mRNAs of some known effectors and other proteins linked to virulence were found in EVs. Furthermore, several mRNAs enriched in EVs are also upregulated during infection, suggesting that EV-associated mRNAs may participate in plant-pathogen interaction.
An appraisal of the Filipino Catholic Devotion to the Black Nazarene in the light of New Evangelization
Authors: Reyes Joseph Albert
Published: June 2021

Popular devotions are reflections and expressions of the people’s faith. They are expressions of how people recognize God in their lives, and as a shared experience, they foster expressions of devotion and thus become a manifestation of prayer. Popular devotions as forms of prayer and worship do not contradict the Sacred Liturgy but are acknowledged as legitimate by the Apostolic See. Moreover, popular devotions, in general, lead to the cultivation of some values. One of the most popular devotions among Filipino Catholics is the devotion to the Black Nazarene, a life-sized statue of Jesus Christ kneeling in one knee carrying the cross-dressed in a maroon robe. His face is marked with wounds and blood. His head is crowned with thorns with three gold-plated metal rays on the top of his head, with his eyes looking up to heaven. The Black Nazarene devotion balances Christology from below and above, i.e., Christ does not remain crucified. Instead, he brings the hope of resurrection to those who fervently approach him with faith, hope, and love. It suffices to say that the Black Nazarene serves as a means for the Filipino faithful to encounter Christ in their lives. Given this, this paper aims to appraise the Black Nazarene Devotion as a means that contributes to the New Evangelization among Filipino Catholics. More specifically, this paper seeks to answer how the devotion to the Black Nazarene aids Filipino Catholics in their desire to sustain and grow in their faith amidst the crises and problems they are facing.
Apathy and Manifestations of a Wide Variety of Neuropsychiatric Disorders in Patients with Parkinson's Disease
Authors: Huseyn Elcin
Published: June 2021

Apathy in patients with Parkinson's disease (PD) is one of the least studied manifestations of a wide range of neuropsychiatric disorders (PND). The frequency of apathy in PD, according to various researchers, is 17–80%. Structural and neurochemical changes associated with PD are considered as the leading pathophysiological factors of apathy. Possible general pathophysiological mechanisms of apathy and hypokinesia, depression, executive (frontal) cognitive functions, sleep disorders in PD are discussed. The basis of the pathophysiological commonality of apathy, hypokinesia, and executive functions is probably bilateral disturbances in the functional connections of the stratum and dorsolateral, medial parts of the prefrontal cortex. The combination of apathy and depression in PD may be due to dysfunction of the structures of the limbic system and the medial orbital prefrontal cortex responsible for motivational determined behavior. The variability of the relationship between apathy and hypokinesia, depression, cognitive impairments, sleep disorders at different stages of PD may be associated with the phenomenological heterogeneity of apathy.Apathy worsens the quality of life, makes a significant contribution to disorders of both household and social adaptation of PD patients. It is promising to study the possibility of correcting apathy using dopaminergic therapy. Against the background of the appointment of pramipexole (1.5-3.0 mg / day) to 20 patients with PD (middle stage, according to Hen-Yar-2.5) to correct movement disorders after 4-6 weeks of therapy, a statistically significant positive dynamics of apathy were noted. According to the total assessment of the scale of apathy SE Starkstein (AS). As a result of the study, no statistically significant correlation was found between the dynamics of the total apathy indicator and the dynamics of motor symptoms of PD according to the unified rating scale for assessing PD (“Motor functions”), which, we believe, indicates an independent effect of pramipexole therapy in relation to motivational disorders.
Readability of Patient Educational Materials in Pediatric Orthopaedics
Authors: Ó Doinn Tiarnán , Broderick James M. , Abdelhalim Muthana M. , Quinlan John F.
Published: June 2021

Background:

Parents are increasingly turning to the internet to seek pediatric health information. Numerous organizations advise that patient educational materials (PEMs) should not surpass the sixth-grade reading level. We aimed to assess the readability of online pediatric orthopaedic PEMs.

Methods:

The readability of 176 articles pertaining to pediatric orthopaedics from the American Academy of Orthopaedic Surgeons (AAOS), Pediatric Orthopaedic Society of North America (POSNA), and American Academy of Pediatrics (AAP) websites was assessed with the use of 8 readability formulae: the Flesch-Kincaid Reading Grade Level, the Flesch Reading Ease Score, the Raygor Estimate, the SMOG, the Coleman-Liau, the Fry, the FORCAST, and the Gunning Fog. The mean reading grade level (RGL) of each article was compared with the sixth and eighth-grade reading levels. The mean RGL of each website’s articles also was compared.

Results:

The cumulative mean RGL was 10.2 (range, 6.6 to 16.0). No articles (0%) were written at the sixth-grade reading level, and only 7 articles (4.0%) were written at or below the eighth-grade reading level. The mean RGL was significantly higher than the sixth-grade (95% confidence interval [CI] for the difference, 4.0 to 4.4; p < 0.001) and eighth-grade (95% CI, 2.0 to 2.4; p < 0.001) reading levels. The mean RGL of articles on the POSNA website was significantly lower than the mean RGL of the articles on the AAOS (95% CI, −1.8 to −1.0; p < 0.001) and AAP (95% CI, −2.9 to −1.1; p < 0.001) websites.

Conclusions:

Pediatric orthopaedic PEMs that are produced by the AAOS, the POSNA, and the AAP have readability scores that exceed recommendations. Given the increasing preference of parents and adolescents for online health information, the growing body of online PEMs, and the critical role that health literacy plays in patient outcomes, substantial work is required to address the readability of these materials.
Pelvic Osseointegration for Unilateral Hip Disarticulation
Authors: Hoellwarth Jason S. , Tetsworth Kevin , Al-Maawi Qutaiba , Tarbosh Ali M. , Roberts Claudia , Al Muderis Munjed
Published: June 2021

Case:

A 24-year-old man with right unilateral hip disarticulation, intolerant of a traditional socket-mounted prosthesis (TSP), underwent pelvic transcutaneous osseointegration and was fit with a prosthetic lower extremity 7 months later. Twenty-four months after osseointegration, he remains pain-free and complication-free, wears his prosthesis all waking hours, walks without assistive devices and can carry 2-handed objects, and works as a livestock farmer.

Conclusion:

Through 24 months, the world's first patient with pelvic osseointegration has no complications and better mobility than most patients with unilateral hip disarticulation using TSPs. Pelvic osseointegration seems reasonable to further consider in carefully selected patients.
Multifocal Disruption of the Extensor Mechanism of the Knee
Authors: Dedhia Nicket , Ranson Rachel A. , Konda Sanjit R. , Jazrawi Laith M. , Egol Kenneth A.
Published: June 2021

Case:

A 41-year-old man presented with a transverse patella fracture and proximal patellar tendon avulsion after a fall from standing. Disruption of the extensor mechanism of the knee at multiple points is rare. He was treated operatively for his patella fracture and patellar tendon avulsion but experienced early failure of the patellar tendon fixation requiring reoperation. Both components of injury ultimately healed, and he returned to function.

Conclusion:

This case describes a rare presentation of an uncommon injury pattern affecting the extensor mechanism. This is the first report to describe multifocal failure of the extensor chain from a low-energy mechanism.
An Unusual Foreign Body–Caused Chondral Lesion of the Talar Dome
Authors: Hummel Amelia , Cody Elizabeth
Published: June 2021

Case:

A patient presented with chronic ankle pain and instability. Imaging revealed a talar osteochondral lesion as well as intra-articular loose bodies. Intraoperatively, an unusual, well-demarcated chondral defect was found. A glass fragment was also identified in the joint. The patient subsequently recalled a minor ankle laceration from a shattered glass bottle, suggesting unrecognized foreign body retention as the cause of the cartilage damage.

Conclusion:

This is the first reported example of glass migrating into the ankle joint, leading to significant cartilage damage. This case highlights the elusive nature of foreign bodies and the difficulty of diagnosis with standard imaging.
Trapezial Acrometastasis as the First Presentation of Occult Lung Cancer
Authors: Nivar Isaac , Panico Leighann C. , Yoo Charlie , Parrish William
Published: June 2021

Case:

Acrometastasis is extremely rare, accounting for 0.1% of all skeletal metastases. Metastases to the carpus are rarer still. This condition can be the first manifestation of an occult malignancy and generally indicates advanced disease. We present the case of a 53-year-old woman with acrometastasis of squamous cell lung cancer to the trapezium as the initial presentation of her malignancy.

Conclusion:

The presentation of acrometastasis can mimic infectious or inflammatory processes, leading to an erroneous diagnosis. Although exceptionally uncommon, it is important to consider as a differential diagnosis for a destructive hand lesion.
Accesibilidad aérea interinsular y cohesión territorial en Canarias
Authors: Hernández Luis José Ángel
Published: June 2021

Este trabajo tiene como objetivo realizar un análisis de la actual accesibilidad puerta – puerta del transporte aéreo interinsular como elemento de cohesión territorial de Canarias. Desde el punto de vista metodológico, se realiza un diagnóstico considerando varios aspectos claves: frecuencias, disponibilidad de asientos, tarifas puerta – puerta y su impacto en los perfiles de viajeros de mayor demanda, además de los horarios que, conjuntamente con los tiempos de transporte, nos proporcionan en los destinos una disponibilidad horaria final para el viajero, todo ello en un viaje de ida y vuelta y en una misma jornada. La conclusión es que la accesibilidad ha mejorado sustancialmente en los últimos años, pero existen marcadas carencias de disponibilidad de tiempo en los destinos que imponen elevados sobrecostes al viajero, aspecto al que hasta ahora se le ha prestado escasa atención, pues los estudios se han centrado, sobre todo, en las tarifas aéreas. En suma, ello conlleva un déficit de integración territorial, especialmente para los residentes en las islas de El Hierro y de La Gomera y que debe ser enmendado tanto por la administración, ampliando los horarios de operatividad de las infraestructuras aeroportuarias, como por las compañías aéreas, procediendo de igual manera con sus horarios.
National Identity Formation in Pakistan
Authors: Ahmed Zahid Shahab
Published: June 2021

Soon after its declaration as an Islamic Republic in 1956, Islamists have experienced numerous ups and downs in Pakistan. Islamists not only try to maintain the status quo of the Islamic state but also endeavour to expand the scope of sharia. Despite insignificant achievements in elections, Islamists have mostly been able to dictate civilian and military governments in matters of national identity. One of the greatest challenges for the promotion of pluralism is the Islamists’ anti-secular narrative, which holds significant backing from both the civil and the military elites. The goal of this paper is to analyse such narrative with reference to Pakistan’s continuous struggle for national identity. ‘The analyses propose that anti-secular voices are occupying centre stage in Pakistan, leaving little room for diverse opinions. Anti-secular groups use violence as a tool to silence any opposition against their ideology for Pakistan, which is evident by regular attacks on not only the religious minorities but also the moderate or liberal Muslim thinkers. The conflict over national identity between extremists and moderates is also one of the main causes of rising violent extremism in Pakistan.
Stimulating Flexible Citizenship
Authors: Kirk Katherine , Bal Ellen
Published: June 2021

This paper explores the relationship between migration and integration policies in the Netherlands, diaspora policies in India, and the transnational practices of Indian highly skilled migrants to the Netherlands. We employ anthropological transnational migration theories (e.g., Ong 1999; Levitt and Jaworsky 2007) to frame the dynamic interaction between a sending and a receiving country on the lives of migrants. This paper makes a unique contribution to migration literature by exploring the policies of both sending and receiving country in relation to ethnographic data on migrants. The international battle for brains has motivated states like the Netherlands and India to design flexible migration and citizenship policies for socially and economically desirable migrants. Flexible citizenship policies in the Netherlands are primarily concerned with individual and corporate rights and privileges, whereas Indian diaspora policies have been established around the premise of national identity.
The Study of Boron-Nitride Nanotube Behavior as an Atomic Nano-Pump for Biomedicine Applications
Authors: Sabetvand Roozbeh , Jami Hesamodin
Published: June 2021

In this study we use molecular dynamics (MD) simulations to describe the nanopumping process of Boron Nitride Nanotube (BNNT) with fullerene molecule displacement for the first time. Technically, for the simulation of BNNT and fullerene structures, we used Tersoff force-field. The result of the equilibrium process of these structures shows the excellent stability of them which this atomic behavior arises from the appropriate settings in our MD simulations. Further, to describe the BNNT nanopumping process, we calculate the velocity and translational/rotational kinetic energy of fullerene molecule. Numerically, by increasing of simulated structures temperature from 275 K to 350 K, the nanopumping time varies from 9.31 ps to 8.55 ps, respectively. Further, the atomic wave producing in BNNT is an important parameter for nanopumping process and we decrease the nanopumpint time to 7.79 ps by this atomic parameter optimization.
Poly(catechol) modified Fe3O4 magnetic nanocomposites with continuous high Fenton activity for organic degradation at neutral pH
Authors: Hua Yani , Wang Chuan , Wang Sha , Xiao Juan
Published: June 2021

Fe3O4 magnetic nanoparticles (MNPs) have been widely used as a recyclable catalyst in Fenton reaction for organic degradation. However, the pristine MNPs suffer from the drawbacks of iron leaching in acidic conditions as well as the decreasing catalytic activity of organic degradation at a pH higher than 3.0. To solve the problems, Fe3O4 MNPs were modified by poly(catechol) (Fe3O4/PCC MNPs) using a facile chemical co-precipitation method. The poly(catechol) modification improved both the dispersity and the surface negative charges of Fe3O4/PCC MNPs, which are beneficial to the catalytic activity of MNPs for organics degradation. Moreover, the poly(catechol) modification enhanced the efficiency of Fe(II) regeneration during Fenton reaction due to the acceleration of Fe(III) reduction by the phenolic/quinonoid redox pair. As a result, the Fenton reaction with Fe3O4/PCC MNPs could efficiently degrade organic molecules, exampled by methylene blue (MB), in an expanded pH range between 3.0 and 10.0. In addition, Fe3O4/PCC MNPs could be reused up to 8 cycles for the MB degradation with negligible iron leaching of lower than 1.5 mg L-1. This study demonstrated Fe3O4/PCC MNPs are a promising heterogeneous Fenton catalysts for organic degradation.
An Approach to Identify Urban Waterlogging on a Deltaic Plain using ArcGIS on CHD based Flow Accumulation Models
Authors: Bhaumik Kaushik , Das Subhasish
Published: June 2021

The gradient for any point on the land surface can be calculated using the digital-elevation model. Some empirical correlations are available to determine the gradient of any points. A few studies were conducted for hilly forest areas to determine the aspect and gradient of various points using computational hydrodynamics (CHD) based techniques. On a plain surface, the accuracy of such techniques was rarely verified. The application of such techniques for a plain surface is also extremely challenging for its small slope. Therefore, the prime objective of the present study is to find out an advanced technique to more accurately determine the gradient of various points on a plain surface which may help in determining the key areas affected by run-off, subsequent flow accumulation, and waterlogging. Here, Kolkata city as a deltaic plain surface is chosen for this study. Upto 600 m × 600 grid sizes are used on the DEM map to calculate the run-off pattern using a D8 algorithm method and second-order, third-order, and fourth-order finite difference techniques of CHD. After finding out the gradient, the run-off pattern is determined from relatively higher to lower gradient points. Based on the run-off pattern, waterlogging points of a plain surface are precisely determined. The results obtained from all the different methods are compared with one other as well as with the actual waterlogging map of Kolkata. It is found that the D8 algorithm and fourth-order finite-difference-technique are the most accurate while determining the waterlogging areas of a plain surface. Next, true gradients of waterlogging points are calculated manually to compare the calculated gradient points using each method. This is also done to determine the relationship and error between the true and calculated gradient of waterlogged points using various statistical analysis methods. The relationship between true and calculated gradients is observed from weak to strong if the D8 algorithm is replaced by the newly introduced fourth-order finite difference technique. Better accuracy and stronger relationships can be achieved by using a smaller grid size.
Household’s Agricultural Vulnerability to Climate Induced Disasters: A Case on South-west Coastal Bangladesh
Authors: Khan Md. Ayatullah , Kabir Kazi Humayun , Hasan Kamrul , Sultana Rashmia , Imran Sardar Al , Karmokar Sanju
Published: June 2021

Climatic events have a significant impact on south-western coastal agriculture in Bangladesh. The purpose of this study was to assess household’s agricultural vulnerability to climate-induced disasters and to identify the sub-indicators of adaptive capacity that determine the agricultural vulnerability to climate-induced disasters of south-western coastal households in Bangladesh. The vulnerability has been calculated by taking the Intergovernmental Panel on Climate Change (IPCC) concept through an Agricultural Vulnerability Index (AVI). Then, the ordered logit model has been employed to identify the key sub-indicators of adaptive capacity that determine the agricultural vulnerability to climate-induced disasters. A survey of 346 household heads from the two villages (181 household’s head from Sutarkhali and 165 household’s head from Nalian) of Sutarkhali Union of Dacope Upazila under Khulna District has been used in this study. Findings reveal that the mean score of Sutarkhali is 0.703 (high) for exposure, 0.762 (high) for sensitivity, 0.397 (low) for adaptive capacity and finally, the AVI is 0.689 (high). In the same fashion, Nalian has an average score of 0.658 (high) for exposure, 0.681 (high) for sensitivity, 0.410 (low) for adaptive capacity, and finally 0.643 (high) for the AVI. Non-farm employment, ownership of livestock, access to irrigation pump, improved crop diversification/ saline tolerant High Yielding Variety (HYV) crops, and access to farm credit have been found statistically significant sub-indicators of adaptive capacity that determine the agricultural vulnerability of both study sites. Finally, it is recommended that the intervention required for coastal adaptation of agriculture should be initiated by respective authorities.
Risk Association of MTHFR Polymorphisms for Severity of the Disease in Children with Sickle Cell Disorder
Authors: Patel Suprava , Kumar Santosh , Naik Gitismita , Rachita Nanda , Hussain Nighat , Mohapatra Eli , Patra Pradeep
Published: June 2021

The MTHFR variants, C677T and A1298C have been reported to contribute towards higher severity in sickle cell disorder. Hence the study was conducted on children with sickle cell disease to find out the association of the genotypes of MTHFR and disease severity. A cross-sectional analytical study was conducted on 249 children aged 5–15 years, diagnosed with sickle cell disorder. Severity Index was assigned to each child based on the clinical history of frequency of episodes of painful crisis, vascular crisis, joint pain, hemoglobin levels and hospitalization required. The children were grouped as SI ≤ 6 (Mild) and SI > 6 (Severe). The study participants comprised of 221 (88.76%) and 28 (11.24%) children in SI ≤ 6 and SI > 6 respectively. The SI score in the children was significantly associated with the MTHFR genotype variants C677T (p = 0.000), A1298C (p = 0.049), plasma homocysteine levels (p = 0.03), blood hemoglobin values (p = 0.000) and frequency of hospitalization (p = 0.000). Weight (p = 0.006), BMI (p = 0.000) and hemoglobin levels (p = 0.000) were significantly lower in children with SI > 6 whereas plasma homocysteine was found higher (p = 0.000). Genotypes CT and TT showed higher odds of SI > 6 as compared to CC genotype and genotype C’C’ showed higher odds of having SI > 6 as compared to genotypes AA and AC’ combined. The genotypes CC-AC’, CT-C’C’ and TT-AA were found to be associated with SI > 6. The study reported significant association of MTHFR polymorphisms, C677T and A1298C with severity index score in children with sickle cell disorder. The variants forms of the studied SNPs (TT and C’C’) were found to have significant implication with the severity of the disease.
Petrographic and Mechanical Analyses of Selected Granitic Rock Deposits in Ado-Ekiti, South-West Nigeria.
Authors: Sanya Olajide Tunmilayo , Jimoh Braimoh Olanrewaju , Dada Boluwatife Olayide , Nenuwa Olushola Bamidele , Taiwo Israel Oluwaseun
Published: June 2021

In this study, the petrographic and mineralogy of selected granitic rocks on their physical and mechanical strength were evaluated. Granitic rock samples sourced from seven locations were analyzed to investigate their mineral micro-texture and compositions using petrographic examination and X-ray diffraction (XRD) analysis respectively. Mechanical properties including compressive strength and hardness of the examined rocks were performed following ASTM D7012–10 and EN 1534 standards. Their physical properties in term of specific gravity, porosity and water absorption were examined following ASTM C97/C97M. Results show that the predominant minerals in rock samples are quartz and kaolinite. Stress-strain curve displays plastic fragmentation after initial fracture in most granitic rock samples with rock samples from Olorunda Zone 9 and Olorunda Zone 2 exhibiting superior plastic deformation over a wide strain elongation. Their physical properties were within the acceptable range for construction applications.
Short-term impact of the COVID-19 pandemic on a population-based screening program for colorectal cancer in Catalonia (Spain)
Authors: Nuria Vives , Gemma Binefa , Carmen Vidal , Núria Milà , Rafael Muñoz , Virtudes Guardiola , Rial O , Garcia Montse Vidal
Published: June 2021

Background
By mid-March 2020, colorectal cancer (CRC) screening program in Catalonia was suspended at all levels. Our goal was to assess the short-term impact of the COVID-19 pandemic at a FIT-based CRC screening hub in the metropolitan area of Barcelona.
Methods
Short-term impact was measured in individuals invited between 1 January and 12 March 2020: screening participation, colonoscopy adherence, interval from positive test result to colonoscopy and psychological distress.
Results
Lockdown with the first wave of COVID-19 caused 111,000 individuals to defer their screening invitations. Participation among invitees between January - March 2020 was 39.3% (95% CI: 38.9–39.7), a decrease of 5% in comparison with the 41.4% (95% CI: 41.2–41.6) participation in 2019. Adherence to colonoscopy decreased from 89.3% (95% CI: 88.4–90.2) in 2019 to 81.4% (95% CI: 78.9–83.7) in the first quarter of 2020. The mean time to colonoscopy after resumption was 128.7 days (CI 95%: 125.3–132.2). Irrespective of test results, factors associated with higher levels of distress were a greater perceived risk of CRC and greater impairment of emotional wellbeing due to COVID-19.
Conclusions
The short-term impact of COVID-19 on CRC screening seems to have been modest, with a slight decrease in participation, a moderate decrease in colonoscopy adherence, and lengthened waiting times. However, a marked impact on future CRC incidence and deaths could be expected. Thus, it is critical to revert participation and colonoscopy adherence rates to that previously achieved while reducing the 5-month delay in screening invitations.
Long-Term Safety and Effectiveness of Velaglucerase Alfa in Gaucher Disease: 6-Year Interim Analysis of A Post-Marketing Surveillance in Japan
Authors: Sagara Rieko , Ishigaki Masahide , Otsuka Manami , Murayama Kei , Ida Hiroyuki , Fernandez Jovelle
Published: June 2021

Background
Gaucher disease (GD) is caused by reduced lysosomal enzyme β-glucocerebrosidase activity. Heterogeneous genotypes and phenotypes have been observed within GD types and across ethnicities. Enzyme replacement therapy is generally recommended for patients with Type 1 GD, the least severe form of GD. In Japan, velaglucerase alfa has a broad indication covering Type 1, 2 or 3 GD.
Methods
All patients with Type 1, 2, or 3 GD administered velaglucerase alfa 60 U/kg every 2 weeks via intravenous infusion after its launch date in Japan in 2014, were enrolled in a non-interventional, observational post-marketing surveillance (PMS). Individual patient data were reported via case report forms (CRFs). Key safety endpoints investigated included the incidence of infusion-related reactions (IRRs), the safety of velaglucerase alfa in patients with Types 2 and 3 GD, from patients under one year of age to elderly patients (≥ 65 years of age). Long-term efficacy was also assessed.
Results
In total, 53 patients with GD were registered. CRFs were available for 41 (77.4%) patients at the 6-year interim analysis. Fourteen adverse drug reactions (ADRs) were reported in seven patients. All reported ADRs occurred in patients with Type 2 GD. ADRs were reported by 63.6% (7/11) of patients with Type 2 GD. Ten ADRs were reported in five patients aged < 4 years. No elderly patients experienced any ADR during the surveillance period. Five ADRs occurring in three (10.0%) patients were classified as IRRs, with one case of vomiting (moderate severity) resulting in treatment discontinuation. Ten serious adverse events were reported in five (16.7%) patients. Three fatal events were considered to be unrelated to treatment with velaglucerase alfa. Platelet counts increased after the administration of velaglucerase alfa and were generally maintained within the normal range over the administration period. Among eleven patients tested for neutralizing anti-velaglucerase alfa antibodies, two (18.2%) were assessed as positive results.
Conclusion
PMS data from patients with Types 1–3 GD in Japan indicate that long-term treatment with velaglucerase alfa was well-tolerated and associated with increased platelet counts, which is consistent with observations made in studies outside of Japan.
Trial registration:
NCT03625882 registered July 2014.
Determining Sex-based Differences in Inflammatory Response in an Experimental Traumatic Brain Injury Model
Authors: Scott Michael Collins , Prabhakara Karthik , Walters Andrew J. , Olson Scott D. , Cox Charles S.
Published: June 2021

Introduction: Traumatic brain injury is a leading cause of injury-related death and morbidity. Despite multiple clinical and pre-clinical studies, sex-based differences in blunt TBI outcomes based remain unclear. Our accepted rodent model of blunt traumatic brain injury was used to identify differences in the pathological features of blunt TBI. Methods: Male and female Sprague-Dawley rats were subjected to either controlled-cortical impact (CCI) or sham injury; brain tissue was harvested at different time intervals depending on the specific study. Blood-brain barrier (BBB) analysis was performed using Alexa Fluor 680 dye. Microglia and splenocytes were characterized with traditional flow cytometry; microglia markers such as CD45, P2Y12, CD32, and CD163 were analyzed with t-distributed stochastic neighbor embedding (t-SNE). Flow cytometry was used to study tissue cytokine levels, and supplemented with ELISAs of TNF-⍺, IL-17, and IL-1β of the ipsilateral hemisphere tissue were performed. Results: CCI groups had an increase in BBB permeability in both sexes. There was significant difference in the integrated density value of BBB permeability between the male CCI group and the female CCI group (female CCI mean = 3.08 x 108 ± 2.83 x 107, male CCI mean = 2.20 x 108 ± 4.05 x 106, p = 0.0210), but otherwise no differences were observed. Traditional flow cytometry did not distinguish any sex-based difference in regards to splenocyte cell population after CCI. t-SNE did not reveal any significant difference between the male and female injury groups in the activation of microglia. Cytokine analysis after injury by flow cytometry and ELISA did not reveal any significant differences between sex. Conclusion: In our rodent model of blunt traumatic brain injury, sex-based differences in pathology and neuroinflammation are limited, and only noted in one specific analysis of BBB permeability.
Correlation of Peripheral CD4+GranzB+CTLs with Disease Severity in Patients with Primary Sjögren’s Syndrome
Authors: Wang Qi , Che Nan , Lu Chenyin , Sun Xiaoxuan , Wang Yanyan , Wang Qiang , Tan Wenfeng , Zhou Lanlan , Zhang Xiaojun , Xu Dong , Gu Lei , Zhang Miaojia
Published: June 2021

Introduction: The major histopathologic lesion of SS is a focal lymphocytic infiltrate, which include a majority of CD4+T. Several studies have shown that the epithelial cells in SS present diverse phenomena, such as MHC class II overexpression. CD4+T cells with cytotoxic activity are characterized by their ability to secrete granzyme B to kill the target cells in an MHC class II-restricted fashion. So this study was to investigate the correlation of peripheral CD4+GranzB+CTLs with pSS. Methods: We recruited 116 pSS and 46 HC using flow cytometry to examine the percentage of CD4+GranzB+CTLs in peripheral blood, and immunofluorescence to test their expression in labial gland. Results: The percentage of CD4+GranzB+CTLs were significantly up-regulated in pSS than HC (7.1±4.9% vs 3.1±1.9%, p <0.0001) and positive correlation with ESSDAI. The frequency of them were markedly higher in pSS with extraglandular manifestations. After excluding the other risk factors associated with pSS, they were still related to ESSDIA and extraglandular manifestations independently(p<0.05) and they are the risk factor of extraglandular involvement (odds ratio=1.928). Moreover, They could be observed in the LSGs. ROC curve analysis indicated that the area under the curve (AUC) of CD4+GranzB+CTLs was 0.796 to predict the activity of pSS, and 0.851 to presume extraglandular manifestations. The best diagnostic cut-off point was 4.865 for pSS patients. Conclusion: In this study, We provide new evidence indicating involvement of CD4+GranzB+CTLs over activation in the pathophysiology of pSS, which may serve as a new biomarker to evaluate the activity and severity of pSS.
Predicting Intestinal Viability After Acute Mesenteric Ischemia by Photoacoustic Imaging: An Experimental Study in Rats
Authors: Sugiura Takumi , Okumura Kenichiro , Matsumoto Junichi , Sakaguchi Maki , Komori Takahiro , Ogi Takahiro , Inoue Dai , Koda Wataru , Kobayashi Satoshi , Gabata Toshifumi
Published: June 2021

Our purpose was to assess the ability of photoacoustic imaging (PAI) to objectively predict ischemic intestinal pathological damage during surgery for acute mesenteric ischemia (AMI). PAI uses laser light to detect relative amounts of oxygenated and deoxygenated hemoglobin in intestinal tissue. In 18 rats, AMI was induced by clamping the mesenteric and marginal vessels of the ileum for 0 minutes in the sham group (n = 6), 30 minutes in the mild group (n = 6), and 180 minutes in the severe group (n = 6). After 60 minutes of reperfusion, the damage of the intestine was evaluated pathologically. Oxygenation of the intestine was monitored throughout the procedure in real time by the PAI system and compared between the mild and severe groups. All rats showed irreversible (i.e. transmucosal or transmural infarction) damage in the severe group. After reperfusion, the oxygenation in the mild group recovered immediately and was significantly higher than in the severe group at 1, 5, 10, 30, and 60 minutes (P = .007, 014, 016, 008, and 003, respectively). Oxygenation showed a significant strong negative correlation with the pathological severity. In conclusion, PAI could objectively predict irreversible ischemic damage immediately after reperfusion, which potentially prevents inadequate surgery.
Evaluation of a Breastmilk Hand Expression Toolkit: The M.I.L.K Survey Study
Authors: Alibhai Kameela Miriam , Murphy Malia SQ , Dunn Sandra , Keely Erin , O’Meara Paloma , Anderson Josdalyne , El-Chaâr Darine
Published: June 2021

Background: Breastmilk hand expression (BMHE) is recommended to promote lactation, relieve breast engorgement, and collect milk for future infant feedings. Resources to teach this skill are limited and infrequently developed in partnership with the obstetrical population. In collaboration with maternity care experts and individuals with recent breastfeeding experience, we designed a one-page toolkit that describes the process of BMHE and includes step-by-step instructions and images to illustrate the technique. This study aimed to evaluate the readability, clarity of content, layout, and informational value of this BMHE toolkit. Methods: Individuals who intended to breastfeed, were currently breastfeeding, or had recently breastfed were electronically surveyed between November 2020 and March 2021. The two-part survey consisted of radio, multi-select, Likert scale, and open-ended questions. Part one captured sociodemographic factors, obstetrical history, and breastfeeding practices. Part two collected feedback on the BMHE toolkit. Participant characteristics and feedback were summarized using descriptive statistics. Categorical and continuous variables were summarized using frequencies and percentages, and means and standard deviations, respectively. Results: Of the 123 participants, 117 (95.1%) had heard of hand expression prior to reviewing the toolkit and 99 (80.5%) had hand expressed before. Among the 48 participants who were no longer exclusively breastfeeding at the time of the survey, 22 (45.8%) had exclusively breastfed their infant for at least six months and 7 (14.6%) had discontinued exclusive breastfeeding within the first month. When asked about the BMHE toolkit, 118 (95.9%) participants said it was informative, 115 (93.5%) said it was easy to understand, and 114 (92.7%) said it was well laid-out. When asked about information seeking behaviours, participants indicated a preference for online resources (58.5%) and video resources (22.0%).Conclusion: The BMHE toolkit was well received by participants and the feedback was favourable overall. The survey feedback will be used to create a revised version of the toolkit that has been validated by the obstetrical patient population. Future research should focus on identifying implementation strategies to optimize the use of the toolkit and increase its effectiveness as an educational resource to correctly teach BMHE.
Safety and Efficacy of IL-6 Inhibitors in the Treatment of Neuromyelitis Optica Spectrum Disorders. A Meta-analysis
Authors: Kharel Sanjeev , Shrestha Suraj , Ojha Rajeev , Guragain Neha , Ghimire Rakesh
Published: June 2021

BackgroundInterleukin-6 (IL-6) inhibitors like Tocilizumab and Satralizumab are showing promising results in the treatment of Neuromyelitis Optica spectrum disorder (NMOSD). We aimed to investigate the efficacy and safety of various IL-6 inhibitors in the management of NMO/NMOSD.MethodsPubMed, Embase, and The Cochrane Library were systematically searched for suitable studies. Change in Annualized Relapse Ratio (ARR), Change in Extended Disability Status Scale (EDSS) s, the proportion of relapse-free patients, on trial relapse risk, and proportion of patients with adverse events, including serious adverse events and mortality were the parameters considered for the meta-analysis. Mean difference (MD) with 95% CI was used to quantify the change in ARR and change in EDSS-before and after treatment. While pooled risk ratio between the intervention group and placebo group was used in Randomized Controlled Trial (RCTs). A forest plot was prepared to indicate the efficacy outcomes.Results A total of nine studies with 202 patients were included in our meta-analysis. IL-6 inhibitors found a good proportion (75%,95% CI: 0.62–0.89; p<0.001) of relapse free patients at follow up. It also significantly reduced mean ARR (mean difference: -2.6 95% CI: -2.71 to -1.68; p<0.001) and on trial relapse risk (RR: 0.46; 95% CI: 0.32‐0.66; P< 0.001) but did not show significant difference in change in EDSS score (mean difference=-0.79, 95% CI: -1.89 to -0.31; p=0.16). Also, the toxicity profile of IL-6 inhibitors was acceptable considering the proportions of patients with adverse events (72%, 95% C.I.;0.59-0.84, I2=85.29%, p<0.001), proportions of patients with serious adverse events (18%;95% C.I.; -3.68 to 4.04, I2=0%, p=0.93) and zero treatment related deaths. In subgroup analysis, we found subcutaneous administration to be superior (81%;95% CI:0.74-0.82) than intravenous route (67%; 95% CI:0.67-0.89) in relapse free maintenance.ConclusionIL-6 inhibitor therapy showed significant benefits in reducing mean ARR, relapse risk and increasing the number of relapse-free patients with acceptable adverse events profile.