bluuebunny/crossref_metadata_2025 huggingface dataset:
Stem cell concepts in myelodysplastic syndromes: lessons and challenges
Authors: Woll P. S. , Jacobsen S. E. W.
Published: April 2021

According to the cancer stem cell (CSC) hypothesis, CSCs are the only cancer cells that can give rise to and sustain all cells that constitute a cancer as they possess inherent or acquired self‐renewal potential, and their elimination is required and potentially sufficient to achieve a cure. Whilst establishing CSC identity remains challenging in most cancers, studies of low‐intermediate risk myelodysplastic syndromes (MDS), other chronic myeloid malignancies and clonal haematopoiesis of indeterminant potential (CHIP) strongly support that the primary target cell usually resides in the rare haematopoietic stem cell (HSC) compartment. This probably reflects the unique self‐renewal potential of HSCs in normal human haematopoiesis, combined with the somatic initiating genomic driver lesion not conferring extensive self‐renewal potential to downstream progenitor cells. Mutational ‘fate mapping’ further supports that HSCs are the only disease‐propagating cells in low‐intermediate risk MDS, but that MDS‐propagating potential might be extended to progenitors upon disease progression. The clinical importance of MDS stem cells has been highlighted through the demonstration of selective persistence of MDS stem cells in patients at complete remission in response to therapy. This implies that MDS stem cells might possess unique resistance mechanisms responsible for relapses following otherwise efficient treatments. Specific surveillance of MDS stem cells should be considered to assess the efficiency of therapies and as an early indicator of emerging relapses in patients in clinical remission. Moreover, further molecular characterization of purified MDS stem cells should facilitate identification and validation of improved and more stem cell‐specific therapies for MDS.
How LGBTQ Adults Maintain Ties With Rejecting Parents: Theorizing “Conflict Work” as Family Work
Authors: Reczek Rin , Bosley‐Smith Emma
Published: April 2021

Objective

The present study examines how LGBTQ‐identified adults maintain relationships with parents who reject their LGBTQ identity.

Background

Parents often reject their children's LGBTQ identity, sometimes leading to relationship dissolution. But how LGBTQ adults maintain parent–child relationships despite parents' rejection is less known. We answer this question with an empirical study of how LGBTQ adults maintain relationships with parents who reject their child's LGBTQ identity, drawing on conflict management theories and the concept “family work,” or the work done to promote family functioning.

Method

Qualitative in‐depth interviews with 76 LGBTQ young adults are analyzed, supplemented with data from 44 of their parents.

Results

LGBTQ adults do extensive work to maintain their intergenerational bonds through what we theorize as “conflict work.” We define conflict work as the effort done to manage severe conflict in a way that ensures family functioning, often at the expense of personal needs. Conflict work includes conflict education work (e.g., educating parents about LGBTQ identities), conflict avoidance work (e.g., don't ask, don't tell about LGBTQ identities), conflict acceptance work (e.g., ongoing but accepted conflict about LGBTQ identities), and conflict boundary work (e.g., asserting boundaries from parents over LGBTQ‐related conflict).

Conclusion

LGBTQ adults maintain the parent–child bond by managing parents' rejection of their gender or sexuality identity through “conflict work.” In doing so, LGBTQ adults reveal an important new type of family work aimed at supporting family functioning during intensive conflict, often at the expense of the conflict worker's personal needs.
Valencian sociolinguistics: Aracil, Ninyoles and the minority question
Authors: Pujolar Joan
Published: April 2021

This text provides a review of the earlier and more influential works of Valencian sociolinguists Lluís Vicent Aracil and Rafael Lluís Ninyoles, which had a significant impact in the field from the 1960s to the 1980s, particularly in a number of European minoritized language communities and Latin America. I provide a summary account of their main theoretical innovations, embodied in concepts such as “language conflict,” “linguistic normalization,” “linguistic ideologies,” and “self‐hate”, and I follow up how these concepts were taken up by a number of social movements of linguistic revitalization. To do so, I begin with an account of the social and political conditions that the two authors confronted in their youth, namely the diglossia between Catalan and Spanish in their native Valencian Country, which at the time was under the rule of the dictator Francisco Franco in Spain. After the historical and theoretical appraisal, I follow up the trail of their ideas amongst sociolinguists and language activists in Occitania, Germany, Switzerland, Wales, Mexico, and the Andes, and I assess their impact in the ways in which linguistic minoritization has been constructed from an international perspective.
The effect of different dietary levels of sodium and chloride on performance, blood parameters and excreta quality in goslings at 29 to 70 days of age
Authors: Chen Yuanjing , Wang Zhiyue , Yang Zhi , Yang Yu , Yang Jinjin , Han Houming , Yang Haiming
Published: April 2021

The purpose of this study was to ascertain the appropriate levels of dietary sodium (Na+) and chloride (Cl−) for 29‐ to 70‐day‐old goslings and to investigate the effects of different levels of Na+ and Cl− on the growth performance, water consumption, blood parameters and excreta quality of goslings to provide a reference for the healthy production of goslings. In Experiment 1, a total of 432 29‐day‐old male Jiangnan White goslings were randomly allotted to nine treatments according to a 3 × 3 factorial design, with six pens containing eight birds per treatment. The goslings were fed diets with three concentrations of Na+ (0.10%, 0.15% and 0.20%) and three concentrations of Cl− (0.15%, 0.20% and 0.25%). The experimental period was 42 days. In Experiment 2, a total of 24 70‐day‐old Jiangnan White goslings were selected for four treatments (0.10% Na+ × 0.15% Cl−; 0.10% Na+ × 0.25% Cl−; 0.20% Na+ × 0.15% Cl− and 0.20% Na+ × 0.25% Cl−) and housed separately in metabolic cages. The faeces were collected for 3 consecutive days. In Experiment 1, the average daily feed intake (ADFI), average daily gain (ADG) and feed/gain (F/G) ratio of goslings were unaffected by the treatments. However, low levels of Na+ and Cl− significantly reduced the water consumption of goslings in the later growth period (p < 0.05). The average water consumption of goslings fed with 0.10% Na+ × 0.15% Cl− was significantly lower than that of the goslings fed with 0.20% Na+ × 0.25% Cl− (56 days, 1304.2 ml vs. 1471.7 ml; 63 days, 1452.8 ml vs. 1610.8 ml; 70 days, 1540.0 ml vs. 1775.4 ml; p < 0.05). The interaction between Na+ and Cl− (Na+ × Cl−) had a significant impact on the blood haemoglobin (HGB) and haematocrit (HCT) levels in the goslings (p < 0.05). HGB increased linearly with increasing levels of Na+. HGB and HCT first increased and then decreased with increasing levels of Cl−. In Experiment 2, Na+ and Cl− levels had significant effects on the excreta moisture content (p < 0.05). Goslings fed with 0.10% Na+ × 0.15% Cl− had a low moisture content of 5.58% compared to the goslings fed with 0.20% Na+ × 0.25% Cl− (87.51% vs. 93.09%; p < 0.05). The levels of dietary Na+ had a significant effect on the retention ratio of Na (p < 0.05), with the value for the 0.20% Na+ group being significantly higher than that for the 0.10% Na+ group (p < 0.05). In summary, different levels of Na+ and Cl− did not affect the growth of goslings. To reduce the water consumption and moisture content of excreta, the Na+ and Cl− levels in the diet can be as low as 0.10% and 0.15%, respectively.
Usefulness of sleep events detection using a wrist worn peripheral arterial tone signal device (WatchPAT™) in a population at low risk of obstructive sleep apnea
Authors: Tondo Pasquale , Drigo Riccardo , Scioscia Giulia , Ballarin Andrea , Rossi Emanuela , Floriani Ariel Fabian , Pauletti Alessia , Foschino Barbaro Maria Pia , Lacedonia Donato
Published: April 2021

Due to the high prevalence of obstructive sleep apnea (OSA), it is recommended to use in‐laboratory polysomnography (PSG) or a home sleep apnea test (HSAT) in uncomplicated adult subjects at high risk of OSA. The aims of the present study were to compare a HSAT device, a wrist worn peripheral arterial tone signal device (WatchPAT™‐200 [WP]) with PSG and respiratory polygraphy (RP) in a low‐risk population of OSA. A total of 47 adult subjects at low risk of OSA were simultaneously examined with the three different approaches in a single night. The sleep studies were scored independently and in a blinded fashion, then the results and the parameters (Respiratory Disturbance Index, apnea–hypopnea index [AHI] and oxygen desaturation index of 3%) were compared with several statistical analyses. The agreement between the sleep tools and correlation for the assessed parameters were analysed and compared with Bland and Altman plots and Pearson’s coefficient (WP versus PSG, r = 0.86). For the severity of OSA ranked according to PSG, the Cohen’s k was 0.60 and 0.82 for WP and RP, respectively. Specificity was higher for RP compared to WP for identifying the presence of OSA (AHIPSG cut‐off ≥5 events/hr: 0.85 versus 0.73), while was quite similar in identifying patients who were more likely to be treated (AHIPSG cut‐off ≥15 events/hr: 0.94 versus 0.96). Assessing the costs and the simplicity of the examination, the results of our present study demonstrate the usefulness of WP compared to PSG, especially in screening and follow‐up for the ability to exclude subjects from treatment with continuous positive airway pressure (AHI <15 events/hr) in a population with a low pre‐test risk of moderate‐to‐severe OSA.
Polyploidy‐promoted phenolic metabolism confers the increased competitive ability of Solidago canadensis
Authors: Yang Xianghong , Cheng Jiliang , Yao Beibei , Lu Huan , Zhang Yu , Xu Jingxuan , Song Xiaoling , Sowndhararajan Kandhasamy , Qiang Sheng
Published: April 2021

Allelopathy plays an important role in the successful invasion of alien invasive plants. Phenolic compounds are one of the primary classes of secondary metabolites with strong allelopathic activities. Polyploidy can cause significant effects on the production and yield of plant secondary metabolites. However, the effect of allelopathic potential of phenolic compounds on the competitiveness of different geographical cytotypes of Solidago canadensis remains unknown. We conducted a common garden field experiment in the invasive habitat of China to compare the competitive ability of native and introduced diploid, tetraploid and hexaploid S. canadensis against intentionally planted local weeds. Results showed that introduced tetraploids and hexaploids outcompeted local plants and formed a monodominant community due to superior competitive ability. Phenolic metabolism analysis showed these populations had a high accumulation of total phenolic compounds in aerial parts and rhizosphere soil throughout three developmental stages, which contributed to significant allelopathic effects on tested weeds. However, diploids and native polyploids showed less allelopathic activities due to the low level of total phenolic content. Together, these results suggest polyploidization is one of the reasons that driving the differentiation of phenolic metabolism in different geo‐cytotypes of S. canadensis, and the allelopathic abilities of introduced polyploids are further enhanced through a post‐introduction adaptive evolution. Polyploidy‐promoted allelopathic potential makes introduced polyploids more competitive against local plants than diploids and native polyploids, which contribute to its successful invasion.
N6‐Methyladenosine mRNA methylation is important for salt stress tolerance in Arabidopsis
Authors: Hu Jianzhong , Cai Jing , Park Su Jung , Lee Kwanuk , Li Yuxia , Chen Yao , Yun Jae‐Young , Xu Tao , Kang Hunseung
Published: April 2021

As the most abundant internal modification of mRNA, N6‐methyladenosine (m6A) methylation of RNA is emerging as a new layer of epitranscriptomic gene regulation in cellular processes, including embryo development, flowering‐time control, microspore generation and fruit ripening, in plants. However, the cellular role of m6A in plant responses to environmental stimuli remains largely unexplored. In this study, we show that m6A methylation plays an important role in salt stress tolerance in Arabidopsis. All mutants of m6A writer components, including MTA, MTB, VIRILIZER (VIR) and HAKAI, displayed salt‐sensitive phenotypes in an m6A‐dependent manner. The vir mutant, in which the level of m6A was most highly reduced, exhibited salt‐hypersensitive phenotypes. Analysis of the m6A methylome in the vir mutant revealed a transcriptome‐wide loss of m6A modification in the 3ʹ untranslated region (3ʹ‐UTR). We demonstrated further that VIR‐mediated m6A methylation modulates reactive oxygen species homeostasis by negatively regulating the mRNA stability of several salt stress negative regulators, including ATAF1, GI and GSTU17, through affecting 3ʹ‐UTR lengthening linked to alternative polyadenylation. Our results highlight the important role played by epitranscriptomic mRNA methylation in the salt stress response of Arabidopsis and indicate a strong link between m6A methylation and 3ʹ‐UTR length and mRNA stability during stress adaptation.
Preliminary evaluation of two bathing methods for the management of Malassezia overgrowth in dogs with atopic dermatitis
Authors: Esumi Mariko , Kanda Satoko , Shimoura Hiromi , Hsiao Yun‐Hsiao , Iyori Keita
Published: April 2021

Background

Antifungal shampoos are widely used for canine Malassezia dermatitis. Few studies have evaluated effective bathing methods for atopic dogs with Malassezia overgrowth.

Objectives

To evaluate the efficacy of an emollient bathing product (AFLOAT VET) and 2% miconazole/2% chlorhexidine shampoo (2% MIC/CHX) in atopic dogs, and to evaluate the influence on skin barrier function of both products in healthy dogs.

Animals

Sixteen atopic dogs with secondary Malassezia overgrowth and 11 healthy dogs.

Methods and materials

This study was a randomized, single‐blinded trial. The dogs were randomly treated with either emollient bathing or 2% MIC/CHX, twice weekly for four weeks. Clinical assessment used the Canine Atopic Dermatitis Extent and Severity Index, 4th iteration (CADESI‐04), pruritus Visual Analog Scale (pVAS), and cytological evaluation of yeast numbers at Day (D)0, D14 and D28. Skin barrier function was determined by measuring transepidermal water loss (TEWL) after a single bathing procedure with each product in the healthy dogs.

Results

The pVAS scores and yeast counts were significantly reduced on D28 compared with D0 in both groups (P < 0.05). CADESI‐04 was significantly decreased on D28 in the emollient bathing group (P = 0.003). There were no significant differences in each endpoint score between the groups. In healthy dogs, TEWL was significantly increased after bathing in both groups (P < 0.01).

Conclusion

An emollient bathing product can be effective for Malassezia overgrowth in dogs with atopic dermatitis. Bathing with shampoo products might affect skin barrier function even when using an emollient product.
Morphological variation, distribution and relationship of weedy rice (Oryza sativa L.) in Peninsular Malaysia
Authors: Mahmod Intan Filzah , Saiman Mohd Zuwairi , Mohamed Zulqarnain , Ishak Muhammad Nazri , Mispan Muhamad Shakirin
Published: April 2021

The dynamic changes in agricultural practices have negatively impacted rice cultivation resulting in serious weedy rice (Oryza sativa L.) infestations. In this study, field surveys were conducted at six granaries to evaluate the abundance, spatial‐distribution patterns, and morphological characteristics of weedy rice in Peninsular Malaysia. An average of 5.28 plants/m2 weedy rice density was recorded, with coverage area that ranged from 29% to 66% and occurrence at >67% frequency. Seed morphological characteristics identified the existence of at least 18 biotypes. A total of 134 weedy rice samples were characterized morphologically, and Principle Component Analysis results showed that these samples are highly diverse and are dispersed across Peninsular Malaysia. These genetically diverse reservoir of weedy rice characteristics present opportunities of exploitation in the future, especially through rice breeding and crop improvement. Weedy rice from Kelantan and Selangor displayed unique clusters in the PCA plot which suggest higher tendencies for environmental adaptation although the influencing factors have yet to be determined. Dispersion studies based on Lloyd patchiness index revealed that more than 50% of surveyed field blocks in five states displayed uniform distribution as opposed to cluster distribution observed in the remaining field blocks. These variations in dispersion suggested that farmers in Peninsular Malaysia employed inconsistent weedy rice management practices in every granary and farm block. Observation of weedy rice infestation pattern via spatial distribution suggested that weed management requires proper coordination of control efforts among farmers to ensure the degree of infestation is maintained under a controlled level.
Computational Fluid Dynamics Study of Cerebral Thromboembolism Risk in Ventricular Assist Device Patients: Effects of Pulsatility and Thrombus Origin
Authors: Prather Ray , Divo Eduardo , Kassab Alain , DeCampli William
Published: April 2021

This study investigates the hypothesis that by surgically manipulating the outflow graft (OG) implantation during ventricle assist device placement, it may be possible to reduce the risk of cerebral embolism. We investigate this hypothesis using a computational approach on a patient-specific basis under fully pulsatile hemodynamics with a multiscale computational fluid dynamics model incorporating a coupled Eulerian-Lagrangian scheme that effectively tracks emboli in the fluid domain. Blood is modeled as a non-Newtonian fluid based on the hematocrit level. Preliminary flow analysis shows that depending on the anastomosis angle the left ventricular assist device (LVAD) can enhance the flow to the cerebral circulation by nearly 31%. Z-test results suggest that unsteady-flow modeling ought to be an integral part of any cardiovascular simulation with residual ventricular function. Assuming unsteady-flow conditions, a shallow LVAD outflow graft anastomosis angle is the most optimal if thrombi are released from the aortic-root reducing cerebral embolization incidence to 15.5% and from the ventricle to 17%, while a more pronounced anastomosis angle becomes advantageous when particles originate from the LVAD with an embolization rate of 16.9%. Overall, computations suggest that a pronounced LVAD anastomosis angle is the better implementation. Unsteady modeling is shown to be necessary for the presence of significant antegrade aortic-root flow which induces cyclical flow patterns due to residual pulsatility. On the other hand, depending on thrombus origin and ventricular assist devices (VAD) anastomosis angle there is a strong tradeoff in embolization rates.
Transient Response Characteristics and Performance Assessment of a Calorimetric Surface Junction Probe Under Impulsive Thermal Loading
Authors: Rout Anil Kumar , Sahoo Niranjan , Kalita Pankaj
Published: April 2021

The measurement of surface temperatures in highly unsteady flow environments is a challenging task pertaining to the need for high-frequency sensors. This paper contains the sequential activities related to a fast response thermal probe (coaxial surface junction probe—CSJP). This probe is prepared in the laboratory, and its salient features are explored for short-duration (∼20 ms) experiments. The surface junction morphology and inside texture of the probe are examined under field emission scanning electron microscope (FESEM). The study confirms the plastic deformation of thermo-elements with an average junction thickness of 21 μm. The static calibration of the probe using a glycerin bath shows a linear trend between voltage and temperature from which the sensitivity value is calculated as 59 μV/°C. The “thermal product” of the probe is also measured experimentally through the “water droplet technique,” and its value is found to be 8677 J/m2 s0.5 K. The concept of one-dimensional heat flux modeling is followed to infer surface heat flux from transient temperatures. For assuring prediction of heat flux, the probe is calibrated experimentally by exposing to a laser source of known wattage (2 W and 3 W). These findings are also supported by numerical simulation of the probe with accuracy in prediction for surface temperature and heat flux as  ± 2% and ±3%, respectively. The performance capability of the probe is demonstrated through shock-tube flow experiments to measure instantaneous heat flux. The comparison of the transient response behavior (9500 K/s) with pressure transducer justifies the utility of the probe under hostile flow environment.
Thermal Soil Radon Mitigation
Authors: Arias Francisco J. , De Las Heras Salvador
Published: April 2021

In this work, consideration is given to the possibility for thermal soil radon mitigation. It is known that the diffusion coefficients of radon through minerals and rocks are characterized by Arrhenius linear plots and then increasing as the temperature increases. For the case of rocks, for example, it was observed that a mild heating, less than 100 °C, translates into a radon release, which can be enhanced by 100–1000 times than the normal release at standard temperature and pressure. Therefore, it is reasonable to think that if soil is deliberately heated and then creating a thermal gradient, it could be possible to pump radon from soil because the radon atoms will escape preferentially from cold regions (low diffusion coefficient) toward hot regions (high diffusion coefficients) where a radon sink is located. Utilizing a simplified two-group thermal one-dimensional model, an expression was derived, which allows a first assessment on this possible mitigation technique.
Modification of the Johnson–Cook Model for the Strain Rate Effect on Tensile Properties of 304/316 Austenitic Stainless Steels
Authors: Seo Jun-Min , Jeong Sang-Seop , Kim Yun-Jae , Kim Jin-Weon , Oh Chang-Young , Tokunaga Hayato , Kumagai Tomohisa , Miura Naoki
Published: April 2021

In this study, tensile tests of 304 and 316 austenitic stainless steels (ASS) at various strain rates were performed to investigate the strain rate effect on tensile properties. It is shown that the strain rate effect on stress depends not only on the strain rate but also on the plastic strain level. Accordingly, a modification of the existing Johnson–Cook (J–C) model is proposed to incorporate the interacting effect of plastic strain and strain rate for 304 and 316 ASS. The proposed modified J–C model can reduce the difference from the experimental data at various strain levels, compared to the existing J–C model.
Data augmentation for the classification of North Atlantic right whales upcalls
Authors: Padovese Bruno , Frazao Fabio , Kirsebom Oliver S. , Matwin Stan
Published: April 2021

Passive acoustic monitoring (PAM) is a useful technique for monitoring marine mammals. However, the quantity of data collected through PAM systems makes automated algorithms for detecting and classifying sounds essential. Deep learning algorithms have shown great promise in recent years, but their performance is limited by the lack of sufficient amounts of annotated data for training the algorithms. This work investigates the benefit of augmenting training datasets with synthetically generated samples when training a deep neural network for the classification of North Atlantic right whale (Eubalaena glacialis) upcalls. We apply two recently proposed augmentation techniques, SpecAugment and Mixup, and show that they improve the performance of our model considerably. The precision is increased from 86% to 90%, while the recall is increased from 88% to 93%. Finally, we demonstrate that these two methods yield a significant improvement in performance in a scenario of data scarcity, where few training samples are available. This demonstrates that data augmentation can reduce the annotation effort required to achieve a desirable performance threshold.
Biosensor-Based Multigene Pathway Optimization for Enhancing the Production of Glycolate
Authors: Xu Shumin , Zhang Linpei , Zhou Shenghu , Deng Yu
Published: April 2021

The use of strong promoters, such as pTrc and T7, to control gene expression not only needs the addition of expensive inducers but also results in excessive protein expression that may result in unbalanced metabolic flux and the waste of cellular building blocks and energy. To balance the metabolic flux of glycolate biosynthesis, the expression level of each gene needs to be systemically optimized in a constitutive manner.
Pseudomonas syringae pv.
phaseolicola
Uses Distinct Modes of Stationary-Phase Persistence To Survive Bacteriocin and Streptomycin Treatments
Authors: Patel Ravikumar R. , Kandel Prem P. , Traverso Eboni , Hockett Kevin L. , Triplett Lindsay R.
Published: April 2021

Populations of genetically identical bacteria encompass heterogeneous physiological states. The small fraction of bacteria that are dormant can help the population survive exposure to antibiotics and other stresses, potentially contributing to recurring infection cycles in animal or plant hosts.
Interferon-Independent Restriction of RNA Virus Entry and Replication by a Class of Damage-Associated Molecular Patterns
Authors: Ernandes Michael J. , Kagan Jonathan C.
Published: April 2021

In this work, we explored how a class of oxidized lipids, spontaneously created during tissue damage and unprogrammed cell lysis, block the earliest events in RNA virus infection in the human epithelium. This gives us novel insight into the ways that we view infection models, unveiling a built-in mechanism to slow viral growth that neither engages the interferon response nor is subject to known viral antagonism.
A Translation-Aborting Small Open Reading Frame in the Intergenic Region Promotes Translation of a Mg
2+
Transporter in
Salmonella
Typhimurium
Authors: Choi Eunna , Han Yoontak , Park Shinae , Koo Hyojeong , Lee Jung-Shin , Lee Eun-Jin
Published: April 2021

Translation initiation regions in mRNAs that include the ribosome-binding site (RBS) and the start codon are often sequestered within a secondary structure. Therefore, to initiate protein synthesis, the mRNA secondary structure must be unfolded to allow the RBS to be accessible to the ribosome.
Differential Patterns of Microbiota Recovery in Symbiotic and Aposymbiotic Corals following Antibiotic Disturbance
Authors: Bent Shavonna M. , Miller Carolyn A. , Sharp Koty H. , Hansel Colleen M. , Apprill Amy
Published: April 2021

Corals are animals whose health is often maintained by symbiotic microalgae and other microorganisms, yet they are highly susceptible to environmental-related disturbances. Here, we used a known disruptor, antibiotics, to understand how the coral mucus microbial community reassembles itself following disturbance.
Recovery from chronic fatigue syndrome: a systematic review—heterogeneity of definition limits study comparison
Authors: Moore Yasmin , Serafimova Teona , Anderson Nina , King Hayley , Richards Alison , Brigden Amberly , Sinai Parisa , Higgins Julian , Ascough Caitlin , Clery Philippa , Crawley Esther M
Published: April 2021

Background

Paediatric chronic fatigue syndrome or myalgic encephalomyelitis (CFS/ME) is a common illness with a major impact on quality of life. Recovery is poorly understood. Our aim was to describe definitions of recovery in paediatric CFS/ME, the rate of recovery and the time to recovery.

Methods

This systematic review included a detailed search of MEDLINE, EMBASE, PsycInfo and Cochrane Library between 1994 and July 2018. Inclusion criteria were (1) clinical trials and observational studies, (2) participants aged <19 years with CFS/ME, (3) conducted in Western Healthcare systems and (4) studies including a measure of recovery and time taken to recover.

Results

Twelve papers (10 studies) were identified, involving 826 patients (range 23–135). Recovery rates were highly varied, ranging between 4.5% and 83%.

Eleven distinct definitions of recovery were used; six were composite outcomes while five used unidimensional outcomes. Outcome measures used to define recovery were highly heterogeneous. School attendance (n=8), fatigue (n=6) and physical functioning (n=4) were the most common outcomes included in definition of recovery. Only five definitions included a personal measure of recovery.

Implications

Definitions of recovery are highly variable, likely secondary to differences in study design, outcomes used, follow-up and study populations. Heterogeneous definitions of recovery limit meaningful comparison between studies, highlighting the need for a consensus definition going forward. Recovery is probably best defined from the child’s own perspective with a single self-reported measure. If composite measures are used for research, there should be agreement on the core outcome set used.
Tracheobronchopathia osteochondroplastica: a cause of chronic cough and haemoptysis
Authors: Shahzad Talha , Rizvi Nadeem , Siddiqui Sabeeh , Ahmed Rashida
Published: April 2021

Tracheobronchopathia osteochondroplastica (TPO) is a rare disorder of the tracheopulmonary tree characterised by osseous and cartilaginous submucosal nodules projecting into the tracheal lumen, sparing the posterior tracheal membranous wall. Symptoms are non-specific and may include dry cough, hoarseness, dyspnoea, recurrent pneumonia and occasionally haemoptysis. A fibreoptic bronchoscopy showing multiple tracheal nodules followed by pathological biopsy is required to reach the final diagnosis. Here, we report two cases of TPO, both with history of biomass fuel exposure and almost similar clinical presentions with chronic cough, shortness of breath and intermittent haemoptysis. They both underwent fibreoptic bronchoscopy showing multiple tracheal nodules whose histopathological analysis showed the diagnosis of TPO. Both patients were treated conservatively and remained in good health afterwards. Physicians should be aware about the need of advanced surgical procedures including endotracheal stent placement in more severe cases.
Pulmonary mucormycosis in immunocompetent hosts diagnosed by bronchioalveolar lavage
Authors: Kumar Sunil , Joshi Divya
Published: April 2021

Mucormycosis is a rare infection caused by Mucorales fungi belonging to Zygomycetes class. It can present with spectrum of symptoms and signs based of organ involvement. Common forms of mucormycosis includes rhinocerebral, cutaneous, gastrointestinal, pulmonary, disseminated and miscellaneous forms involving bones, breast, kidney and central nervous system. Pulmonary mucormycosis usually present with fever, cough, haemoptysis and is usually seen in immunocompromised patients like patients with diabetes or leukaemia, or those on chemotherapy or immunosuppressive therapy and rare in immunocompetent patients (6.25% of cases). Pulmonary mucormycosis can be diagnosed by radiological imaging studies, bronchoalveolar lavage (BAL) and histopathological evaluation of biopsy of the lesion; however, the gold standard is a positive fungal culture. Here, we describe two cases of pulmonary mucormycosis diagnosed by BAL in an immunocompetent patient.
Favourable outcome after a delayed complication secondary to COVID-19
Authors: Bosher Olivia , Syed Muneer Ahmed , Bikmalla Shiva
Published: April 2021

A 41-year-old man was admitted to hospital with 7-day history of fever, cough and having had a positive SARS-CoV-2 PCR test. The chest radiograph (CXR) showed bilateral peripheral parenchymal infiltrates. He required 4 L/min oxygen via nasal cannula for 72 hours and was discharged after 7 days with appropriate advice. Four weeks from initial hospital admission, he presented with worsening cough, left chest pain and breathlessness. CXR showed left pneumothorax, and CT pulmonary angiogram (CTPA) scan confirmed left pneumothorax with mediastinal shift and a subpleural bulla. Intercostal chest drain was inserted with good resolution of symptoms and lung re-expansion. Follow-up CT scan 2 months later showed complete resolution of the parenchymal abnormalities. Our case demonstrates the development of pneumothorax as a delayed complication in a patient with COVID-19 who did not require ventilatory support. The case also illustrates a favourable outcome, that is, complete resolution of parenchymal destruction due to COVID-19.
Short-term real-world outcomes following intravitreal brolucizumab for neovascular AMD: SHIFT study
Authors: Bulirsch Louisa Maria , Saßmannshausen Marlene , Nadal Jennifer , Liegl Raffael , Thiele Sarah , Holz Frank G
Published: April 2021

Background

Brolucizumab has recently been approved in Europe as a novel treatment for patients with neovascular age-related macular degeneration (nAMD). We report on early experiences with real-world outcomes of switch to brolucizumab therapy in previously anti-vascular endothelial growth factor (anti-VEGF)-treated patients.

Methods

Patients with recalcitrant nAMD were switched to brolucizumab therapy. Functional and structural parameters 4 weeks after first brolucizumab injection were evaluated including best-corrected visual acuity (BCVA (logMAR)), foveal centre point (FCP (µm)), central subfield retinal thickness (CSRT (µm)) and macular volume (mm³).

Results

Sixty-three eyes of 57 patients with nAMD (52.6% females) with a mean (±SD) age of 79.5±6.7 years were included. Mean change of BCVA was 0.03±0.14 logMAR (p=0.115). Significant reductions were recorded for FCP with a mean (±SD) change of −66.81±72.63 µm, −66.76±60.71 µm for CSRT and −0.27±0.24 mm³ for macular volume (all p<0.001). Intraocular inflammation was observed in seven eyes of seven patients, including one case of retinal vasculitis.

Conclusions

The results of the SHIFT study indicate that switch to brolucizumab may represent a treatment option in patients with nAMD poorly responsive to other anti-VEGF agents. Further long-term analyses appear prudent to assess efficacy and safety of brolucizumab in a routine clinical setting.
High rate of second ACL injury following ACL reconstruction in male professional footballers: an updated longitudinal analysis from 118 players in the UEFA Elite Club Injury Study
Authors: Della Villa Francesco , Hägglund Martin , Della Villa Stefano , Ekstrand Jan , Waldén Markus
Published: April 2021

Background

Studies on subsequent anterior cruciate ligament (ACL) ruptures and career length in male professional football players after ACL reconstruction (ACLR) are scarce.

Aim

To investigate the second ACL injury rate, potential predictors of second ACL injury and the career length after ACLR.

Study design

Prospective cohort study.

Setting

Men’s professional football.

Methods

118 players with index ACL injury were tracked longitudinally for subsequent ACL injury and career length over 16.9 years. Multivariable Cox regression analysis with HR was carried out to study potential predictors for subsequent ACL injury.

Results

Median follow-up was 4.3 (IQR 4.6) years after ACLR. The second ACL injury rate after return to training (RTT) was 17.8% (n=21), with 9.3% (n=11) to the ipsilateral and 8.5% (n=10) to the contralateral knee. Significant predictors for second ACL injury were a non-contact index ACL injury (HR 7.16, 95% CI 1.63 to 31.22) and an isolated index ACL injury (HR 2.73, 95% CI 1.06 to 7.07). In total, 11 of 26 players (42%) with a non-contact isolated index ACL injury suffered a second ACL injury. RTT time was not an independent predictor of second ACL injury, even though there was a tendency for a risk reduction with longer time to RTT. Median career length after ACLR was 4.1 (IQR 4.0) years and 60% of players were still playing at preinjury level 5 years after ACLR.

Conclusions

Almost one out of five top-level professional male football players sustained a second ACL injury following ACLR and return to football, with a considerably increased risk for players with a non-contact or isolated index injury.
GRANADA consensus on analytical approaches to assess associations with accelerometer-determined physical behaviours (physical activity, sedentary behaviour and sleep) in epidemiological studies
Authors: Migueles Jairo H , Aadland Eivind , Andersen Lars Bo , Brønd Jan Christian , Chastin Sebastien F , Hansen Bjørge H , Konstabel Kenn , Kvalheim Olav Martin , McGregor Duncan E , Rowlands Alex V , Sabia Séverine , van Hees Vincent T , Walmsley Rosemary , Ortega Francisco B
Published: April 2021

The inter-relationship between physical activity, sedentary behaviour and sleep (collectively defined as physical behaviours) is of interest to researchers from different fields. Each of these physical behaviours has been investigated in epidemiological studies, yet their codependency and interactions need to be further explored and accounted for in data analysis. Modern accelerometers capture continuous movement through the day, which presents the challenge of how to best use the richness of these data. In recent years, analytical approaches first applied in other scientific fields have been applied to physical behaviour epidemiology (eg, isotemporal substitution models, compositional data analysis, multivariate pattern analysis, functional data analysis and machine learning). A comprehensive description, discussion, and consensus on the strengths and limitations of these analytical approaches will help researchers decide which approach to use in different situations. In this context, a scientific workshop and meeting were held in Granada to discuss: (1) analytical approaches currently used in the scientific literature on physical behaviour, highlighting strengths and limitations, providing practical recommendations on their use and including a decision tree for assisting researchers’ decision-making; and (2) current gaps and future research directions around the analysis and use of accelerometer data. Advances in analytical approaches to accelerometer-determined physical behaviours in epidemiological studies are expected to influence the interpretation of current and future evidence, and ultimately impact on future physical behaviour guidelines.
Systematic review of the concept ‘male involvement in maternal health’ by natural language processing and descriptive analysis
Authors: Galle Anna , Plaieser Gaëlle , Van Steenstraeten Tessa , Griffin Sally , Osman Nafissa Bique , Roelens Kristien , Degomme Olivier
Published: April 2021

Introduction

Experts agree that male involvement in maternal health is a multifaceted concept, but a robust assessment is lacking, hampering interpretation of the literature. This systematic review aims to examine the conceptualisation of male involvement in maternal health globally and review commonly used indicators.

Methods

PubMed, Embase, Scopus, Web of Science and CINAHL databases were searched for quantitative literature (between the years 2000 and 2020) containing indicators representing male involvement in maternal health, which was defined as the involvement, participation, engagement or support of men in all activities related to maternal health.

Results

After full-text review, 282 studies were included in the review. Most studies were conducted in Africa (43%), followed by North America (23%), Asia (15%) and Europe (12%). Descriptive and text mining analysis showed male involvement has been conceptualised by focusing on two main aspects: psychosocial support and instrumental support for maternal health care utilisation. Differences in measurement and topics were noted according to continent with Africa focusing on HIV prevention, North America and Europe on psychosocial health and stress, and Asia on nutrition. One-third of studies used one single indicator and no common pattern of indicators could be identified. Antenatal care attendance was the most used indicator (40%), followed by financial support (17%), presence during childbirth (17%) and HIV testing (14%). Majority of studies did not collect data from men directly.

Discussion

Researchers often focus on a single aspect of male involvement, resulting in a narrow set of indicators. Aspects such as communication, shared decision making and the subjective feeling of support have received little attention. We believe a broader holistic scope can broaden the potential of male involvement programmes and stimulate a gender-transformative approach. Further research is recommended to develop a robust and comprehensive set of indicators for assessing male involvement in maternal health.
Contact-tracing applications: a review of technologies
Authors: Nazayer Mohammad , Madanian Samaneh , Mirza Farhaan
Published: April 2021

Background

Using different technologies for healthcare-related purposes has been significantly accelerated since the beginning of the COVID-19 pandemic. This outbreak highlighted the need for digital contact-tracing applications to effectively manage the pandemic by identifying positive case close contacts that might be the virus carriers.

Objective

The objective of this review is to examine design decisions related to COVID-19 contact-tracing applications and the implications of these decisions. This review can be a useful aid in navigating the existing approaches in COVID-19 digital contact tracing and their different aspects including the potential supported functions, privacy and security.

Method

A narrative review was conducted using Google Scholar database from August to October 2020, limited to English language articles and reports published after 2010.

Main outcome

Different technologies have been used for digital contact tracing. The choice of these technologies and their software architectures could influence different factors such as data collection accuracy and effectiveness of an application in identifying possible virus spread. Furthermore, different technologies require different levels of user interaction and have different security and privacy concerns which could potentially impact application adoption.

Conclusion

Digital contact tracing has been introduced as one of the easy and efficient methods to trace people in close contact with infected COVID-19 cases. This tracing could be an effective strategy to break the chain of infection transmission among people. However, based on the used technology and the software architecture, different contact-tracing applications offer different possible trade-offs that should be taken into account based on government’s objectives on contact tracing.
Development of the Prevent for Work questionnaire (P4Wq) for assessment of musculoskeletal risk in the workplace: part 1—literature review and domains selection
Authors: Langella Francesco , Christensen Steffan Wittrup McPhee , Palsson Thorvaldur Skuli , Høgh Morten , Gagni Nicolo , Bellosta-López Pablo , Christiansen David Høyrup , Delle Chiaie Mauro , Domenéch-García Victor , Johnston Venerina , Szeto Grace P Y , Villafañe Jorge Hugo , Herrero Pablo , Berjano Pedro
Published: April 2021

Objective

This study aims to define appropriate domains and items for the development of a self-administered questionnaire to assess the risk of developing work-related musculoskeletal disorder (WMSD) and the risk of its progression to chronicity.

Design

Literature review and survey study.

Setting and participants

A literature review and a two-round interview with 15 experts in musculoskeletal pain were performed to identify the available domains for WMSD assessment.

Interventions and outcome

To ensure quality, only validated questionnaires were included for the Delphi process. A three-round Delphi method, with three round steps, was used to select the most pertinent and relevant domains and items.

Results

Nine questionnaires were identified through the expert discussion and literature review, comprising 38 candidate domains and 504 items. In the first round of the Delphi group, 17 domains reached more than 70% agreement and were selected. In the second round, 10 domains were rejected, while 11 were selected to complete the pool of domains. In the third and final round, 89 items belonging to 28 domains were defined as significant to develop a WMSDs risk assessment questionnaire.

Conclusions

No specific risk assessment questionnaires for WMSDs were identified from the literature. WMSD risk of presence and chronicity can be defined by an assessment tool based on the biopsychosocial model and the fear-avoidance components of chronic pain. The present study provides the formulation and operationalisation of the constructs in domains and items needed for developing and validating the questionnaire.
Compression hosiery to avoid post-thrombotic syndrome (CHAPS) protocol for a randomised controlled trial (ISRCTN73041168)
Authors: Thapar Ankur , Lawton Rebecca , Burgess Laura , Shalhoub Joseph , Bradbury Andrew , Cullum Nicky , Epstein David , Gohel Manjit , Horne Robert , Hunt Beverley J , Norrie John , Davies A H
Published: April 2021

Introduction

Up to 50% of patients develop post-thrombotic syndrome (PTS) after an above knee deep vein thrombosis (DVT). The aim of the study was to determine the effect of graduated compression stockings in preventing PTS after DVT.

Methods and analysis

Pragmatic, UK multicentre randomised trial in adults with first above knee DVT. The standard of care arm is anticoagulation. The intervention arm will receive anticoagulation plus stockings (European class II, 23–32 mm Hg compression) worn for a median of 18 months. The primary endpoint is PTS using the Villalta score. Analysis of this will be through a time to event approach and cumulative incidence at median 6, 12 and 18 months. An ongoing process evaluation will examine factors contributing to adherence to stockings to understand if and how the behavioural interventions were effective.

Ethics and dissemination

UK research ethics committee approval (reference 19/LO/1585). Dissemination though the charity Thrombosis UK, the Imperial College London website, peer-reviewed publications and international conferences.

Trial registration number

ISRCTN registration number 73041168.