bluuebunny/crossref_metadata_2025 huggingface dataset:
Is There an Idealized Target of Sexual Harassment in the MeToo Era?
Authors: Hart Chloe Grace
Published: April 2023

Evidence suggests that Americans became more sympathetic toward people who experienced sexual harassment as the MeToo movement surged. Yet how comprehensive these shifts in public opinion have been remains unclear. I hypothesize that women who experience workplace sexual harassment are judged against the archetype of an idealized target of sexual harassment and deemed less credible when they fall short. Using data from a novel multifactorial survey experiment, I find that net of other factors, a Black woman is deemed less credible than a white woman. A woman is also deemed less credible when she does not assertively confront the harassment in the moment and when she does not report it to her organization. Further, she is deemed less credible when there are no witnesses and when her alleged harasser has not been publicly accused of harassment by others. Her credibility is not affected by a power disparity with the harasser, the presence of alcohol, or a prior romantic relationship with the harasser. Finally, the more facets of the archetype a target conforms to, the more credible she is perceived to be. These results demonstrate a hierarchy of sexual harassment targets, in which some are deemed more credible than others.
A Political Sexual Revolution: Sexual Autonomy in the British Women’s Liberation Movement in the 1970s and 1980s
Authors: Wallhead Emma
Published: April 2023

In the 1970s and 1980s, women across Britain—particularly those in the Women’s Liberation Movement (WLM)—took part in a distinct sexual revolution fuelled by a very specific question—who gets to determine the ways in which I am sexual? The active engagement by women with this question of sexual selfhood belies a historiography of sexual revolution—real or imagined—in which women were the passive beneficiaries (or victims) of technological, cultural, religious, social and/or, economic shifts. Drawing on the writing of women in the feminist press, mainstream media, books, and pamphlets, this article describes the specific contribution of the WLM to shaping new possibilities for a sexuality defined, and controlled, by women. I argue that the WLM combined a powerful political framework with an influential social network to significantly contribute to a far-reaching process of deconstructing and recasting female sexuality and sexual relations.
The role of CD4+, CD8+, CD4+/CD8+ and neutrophile to lymphocyte ratio in predicting and determining COVID-19 severity in Indonesian patients
Authors: Masyeni Sri , Budhitresna Anak Agung Gede , Adiwinata Randy , Wibawa Surya , Nugraha Putu Arya , Antara Jarwa , Asmara Dewa Putu Gede Wedha , Widyaningsih Putu Dyah , Yenny Luh Gede Sri , Widiastika Made , Kahari Siska , Wardhana Clareza Arief , Pasek Arya Widiyana , Putrawan Oka , Santosa Agus , Herawati Sianny , Arisanti Nih Luh Putu Eka , Astini Wining , Fatawy Rois Muqsith , Kameoka Masanori , Nelwan Erni Juwita
Published: April 2023

Background

Biomarkers that are cost-effective and accurate for predicting severe coronavirus disease 2019 (COVID-19) are urgently needed. We would like to assess the role of various inflammatory biomarkers on admission as disease severity predictors and determine the optimal cut-off of the neutrophile-to-lymphocyte ratio (NLR) for predicting severe COVID-19.

Methods

We conducted a cross-sectional study in six hospitals in Bali and recruited real-time PCR-confirmed COVID-19 patients aged >18 y from June to August 2020. Data collection included each patient's demographic, clinical, disease severity and hematological data. Multivariate and receiver operating characteristic curve analyses were performed.

Results

A total of 95 Indonesian COVID-19 patients were included. The highest NLR among severe patients was 11.5±6.2, followed by the non-severe group at 3.3±2.8. The lowest NLR was found in the asymptomatic group (1.9±1.1). The CD4+ and CD8+ values were lowest in the critical and severe disease groups. The area under the curve of NLR was 0.959. Therefore, the optimal NLR cut-off value for predicting severe COVID-19 was ≥3.55, with sensitivity at 90.9% and a specificity of 16.7%.

Conclusions

Lower CD4+ and CD8+ and higher NLR values on admission are reliable predictors of severe COVID-19 among Indonesian people. NLR cut-off ≥3.55 is the optimal value for predicting severe COVID-19.
Spatiotemporal risk assessment and COVID-19 trend estimation in a federative unit in northeastern Brazil
Authors: da Silva Janiel Conceição , de Sousa Giana Gislanne da Silva , de Oliveira Rayanne Alves , Santos Lívia Fernanda Siqueira , Pascoal Livia Maia , Santos Floriacy Stabnow , Rolim Isaura Leticia Tavares Palmeira , Costa Ana Cristina Pereira de Jesus , Serra Maria Aparecida Alves de Oliveira , Fontoura Iolanda Graepp , Bezerra Janaina Miranda , Aragão Francisca Bruna Arruda , Ramos Antônio Carlos Vieira , Lima Cynthia Cardoso Dias , Fontoura Volmar Morais , dos Santos Leonardo Hunaldo , Neto Marcelino Santos
Published: April 2023

Background

Coronavirus disease 2019 (COVID-19) has spread worldwide, causing a high burden of morbidity and mortality, and has affected the various health service systems in the world, demanding disease monitoring and control strategies. The objective of this study was to identify risk areas using spatiotemporal models and determine the COVID-19 time trend in a federative unit of northeastern Brazil.

Methods

An ecological study using spatial analysis techniques and time series was carried out in the state of Maranhão, Brazil. All new cases of COVID-19 registered in the state from March 2020 to August 2021 were included. Incidence rates were calculated and spatially distributed by area, while the spatiotemporal risk territories were identified using scan statistics. The COVID-19 time trend was determined using Prais–Winsten regressions.

Results

Four spatiotemporal clusters with high relative risks for the disease were identified in seven health regions located in the southwest/northwest, north and east of Maranhão. The COVID-19 time trend was stable during the analysed period, with higher rates in the regions of Santa Inês in the first and second waves and Balsas in the second wave.

Conclusions

The heterogeneously distributed spatiotemporal risk areas and the stable COVID-19 time trend can assist in the management of health systems and services, facilitating the planning and implementation of actions toward the mitigation, surveillance and control of the disease.
A Pythium myriotylum Small Cysteine-Rich Protein Triggers Immune Responses in Diverse Plant Hosts
Authors: Wang Nan , Yin Zhiyuan , Wu Yingke , Yang Jishuo , Zhao Yaning , Daly Paul , Pei Yong , Zhou Dongmei , Dou Daolong , Wei Lihui
Published: April 2023

The oomycete Pythium myriotylum is a necrotrophic pathogen that infects many crop species worldwide, including ginger, soybean, tomato, and tobacco. Here, we identified a P. myriotylum small cysteine-rich protein, PmSCR1, that induces cell death in Nicotiana benthamiana by screening small, secreted proteins that were induced during infection of ginger and did not have a predicted function at the time of selection. Orthologs of PmSCR1 were found in other Pythium species, but these did not have cell death–inducing activity in N. benthamiana. PmSCR1 encodes a protein containing an auxiliary activity 17 family domain and triggers multiple immune responses in host plants. The elicitor function of PmSCR1 appears to be independent of enzymatic activity, because the heat inactivation of PmSCR1 protein did not affect PmSCR1-induced cell death or other defense responses. The elicitor function of PmSCR1 was also independent of BAK1 and SOBIR1. Furthermore, a small region of the protein, PmSCR186-211, is sufficient for inducing cell death. A pretreatment using the full-length PmSCR1 protein promoted the resistance of soybean and N. benthamiana to Phytophthora sojae and Phytophthora capsici infection, respectively. These results reveal that PmSCR1 is a novel elicitor from P. myriotylum, which exhibits plant immunity-inducing activity in multiple host plants.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Generation of Attenuated Passiflora Mottle Virus Through Modification of the Helper Component Protease for Cross Protection
Authors: Do Duy-Hung , Nguyen Thi-Bich-Ngoc , Ha Viet-Cuong , Raja Joseph A. J. , Yeh Shyi-Dong
Published: April 2023

Passiflora mottle virus (PaMoV), an aphid-borne potyvirus, is the primary causal virus of devastating passionfruit woodiness disease in Vietnam. Here we generated a nonpathogenic, attenuated PaMoV strain for disease control by cross protection. A full-length genomic cDNA of PaMoV strain DN4 from Vietnam was constructed to generate an infectious clone. The green fluorescent protein was tagged at the N-terminal region of the coat protein gene to monitor in planta the severe PaMoV-DN4. Two amino acids within the conserved motifs of helper component protease (HC-Pro) of PaMoV-DN4 were mutated individually or in combination as K53E or/and R181I. Mutants PaMoV-E53 and PaMoV-I181 induced local lesions in Chenopodium quinoa plants, while PaMoV-E53I181 caused infection without apparent symptoms. In passionfruit ( Passiflora edulis) plants, PaMoV-E53 elicited severe leaf mosaic and PaMoV-I181 induced leaf mottling, while PaMoV-E53I181 caused transient mottling followed by symptomless recovery. PaMoV-E53I181 was stable after six serial passages in yellow passionfruit ( Passiflora edulis f. flavicarpa) plants. Its temporal accumulation levels were lower than those of the wild type, with a zigzag accumulation pattern, typical of a beneficial protective virus. An RNA silencing suppression (RSS) assay revealed that all three mutated HC-Pros are defective in RSS. Triplicated cross-protection experiments with a total of 45 plants showed that the attenuated mutant PaMoV-E53I181 provided a high protection rate (91%) against the homologous wild-type virus in passionfruit plants. This work revealed that PaMoV-E53I181 can be used as a protective virus to control PaMoV by cross protection.
CE: Febrile Neutropenia in the Chemotherapy Patient
Authors: Foley Anne Marie , Hoffman Megan
Published: April 2023

Febrile neutropenia is a serious complication of chemotherapy treatment and may present as the only clinical sign of infection. If not addressed in a timely manner, it may progress to multisystem organ failure and may be fatal. Initial assessment of fever in those receiving chemotherapy requires prompt administration of antibiotics, ideally within one hour of presentation. Depending on the clinical status of the patient, antibiotic treatment may occur in the inpatient or outpatient setting. Nurses play an important role in the identification and treatment of patients at high risk for febrile neutropenia through assessment and adherence to clinical practice guidelines. In addition, nurses play an active role in patient education regarding risk factors, protective measures, and signs and symptoms of infection in the immunocompromised oncology patient.
Heavy Menstrual Bleeding Treatment With a Levonorgestrel 52-mg Intrauterine Device
Authors: Creinin Mitchell D. , Barnhart Kurt T. , Gawron Lori M. , Eisenberg David , Mabey R. Garn , Jensen Jeffrey T.
Published: April 2023

OBJECTIVE:

To evaluate heavy menstrual bleeding treatment outcomes with levonorgestrel 52-mg intrauterine device (IUD) use in participants without body mass index (BMI) or parity restrictions.

METHODS:

Investigators included participants aged 18–50 years with no pelvic or systemic pathology causing heavy menstrual bleeding at 29 U.S. centers in a prospective trial. Participants had up to three screening cycles with menstrual product collection for alkaline hematin blood-loss measurements. Investigators enrolled those with two menses with blood loss of 80 mL or more (values averaged for baseline blood loss), placed the IUD, and followed participants for up to six 28-day cycles. Participants collected any menstrual products used during cycles 3 and 6 for blood-loss measurement. We evaluated outcomes in participants with at least one follow-up assessment for the primary outcome of median absolute blood-loss change and, secondarily, treatment success, defined as the proportion with a final measured blood loss less than 80 mL and at least 50% reduction from baseline. We evaluated exploratory outcomes of differences in blood-loss changes by BMI and parity using Wilcoxon rank sum test.

RESULTS:

Of 105 enrolled participants, 47 (44.8%) had obesity (BMI 30.0 or higher) and 29 (27.6%) were nulliparous. Baseline mean blood loss ranged from 73 to 520 mL (median 143 mL, interquartile range 112–196 mL). Eighty-nine (84.8%) had at least one evaluable follow-up evaluation. Participants had median (interquartile range) absolute blood-loss decreases at cycles 3 (n=86) and 6 (n=81) of 93.3% (86.1–97.7%) and 97.6% (90.4–100%), respectively. At cycle 6, participants without obesity (n=43) and with obesity (n=38) had similar median [interquartile range] decreases (97.6% [91.8–100%] and 97.5% [90.3–100%], respectively; P=.89), with comparable findings for nulliparous (n=25) and parous (n=56) participants (97.0% [91.7–99.1%] and 98.1% [89.9–100%], respectively; P=.43). Treatment success occurred in 81.8% (95% CI 74.2–89.4%) of 99 participants, excluding those with no outcomes due to lost to follow-up or consent withdrawal, and did not vary by BMI or parity. The most common adverse events leading to discontinuation were bleeding or cramping (n=6 [5.7%]) and expulsion (n=5 [4.8%]).

CONCLUSION:

This levonorgestrel 52-mg IUD reduces blood loss by more than 90% over 6 months compared with baseline for most users with heavy menstrual bleeding.

FUNDING SOURCE:

Medicines360.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT03642210.
Combined Oral Contraceptive Adherence and Pregnancy Rates
Authors: Creinin Mitchell D. , Jensen Jeffrey T. , Chen Melissa J. , Black Amanda , Costescu Dustin , Foidart Jean-Michel
Published: April 2023

OBJECTIVE:

To assess the relationship of adherence and pregnancy in participants using an estetrol and drospirenone combined oral contraceptive.

METHODS:

We performed a secondary analysis for which we pooled data from two parallel, multicenter, phase 3 trials (United States and Canada, Europe and Russia) that enrolled participants 16–50 years of age to receive estetrol 15 mg and drospirenone 3 mg in a 24 hormone and four placebo pills regimen for up to 13 cycles. Participants reported pill intake, sexual intercourse, and other contraceptive use on paper diaries. We limited this efficacy analysis to at-risk cycles (one or more reported acts of intercourse and no other contraceptive use) in participants 16–35 years of age at screening. We excluded cycles with other contraceptive use unless pregnancy occurred in that cycle. We assessed primarily the relationship between number of pills not taken per cycle and pregnancies and, secondarily, when pregnancies occurred during product use with a test for trend and χ2 analyses as appropriate.

RESULTS:

Among 2,837 participants in this analysis, 31 on-treatment pregnancies occurred during 26,455 at-risk cycles. Pregnancies occurred in 0.09%, 0.25%, 0.83%, and 1.6% of cycles in which participants reported they took all hormone pills (n=25,613 cycles) or did not take one (n=405 cycles), two (n=121 cycles), and more than two (n=314 cycles) hormone-containing pills, respectively (P<.001). No pregnancies occurred in 2,216 cycles when one or more pills were missed and missed-pill instructions were followed. All pregnancies related to not taking pills occurred in the first three cycles. Pregnancy rates ranged from 0% to 0.21% per cycle with no significant trend by cycle (P=.45).

CONCLUSION:

Pregnancy occurs more frequently when combined oral contraceptive users report not taking all hormone-containing pills per 28-day cycle and exceeds 1% only when more than two pills are not taken. Pregnancies in participants who reported missed pills occurred only when missed-pill instructions were not followed. A 0.09% pregnancy risk per cycle among users of a 24 hormone and four placebo pills formulation who report taking all pills likely approximates a true method-failure rate.

FUNDING SOURCE:

Estetra SRL, an affiliate company of Mithra Pharmaceuticals.

CLINICAL TRIAL REGISTRATION:

ClinicalTrials.gov, NCT02817828 and NCT02817841.
Considerations in the Management of Functional Neurological Disorders in Patients with Hearing Loss
Authors: Abu Libdeh Amal , Alkalbani Leen , Freedman Daniel , Quezada Julio , Nyp Sarah S.
Published: April 2023

CASE:

Adam is a 14-year-old adolescent boy with hearing loss who presented to the pediatric neurology clinic accompanied by his father for evaluation of new-onset left hand tremor for a duration of 1 month. An American Sign Language interpreter was present and used throughout the visit.

Adam has bilateral sensorineural hearing loss related to premature birth at 28 weeks' gestation. He uses sign language and attends a school for the hearing impaired. He has been diagnosed with attention-deficit/hyperactivity disorder (ADHD) and a nonspecific learning disorder. His ADHD symptoms are well controlled with a stimulant medication. He is independent in activities of daily living, and there is no concern for intellectual disability. His father is concerned that Adam may have anxiety, but this has not been evaluated.

After careful history, it is found that the tremor was first noted the day after burglars broke into his home and stole precious belongings. Current stressors include difficulties with schoolwork and a strained relationship with an extended family member. There is no family history of tremor.

The tremor was intermittent initially, with episodes lasting around 30 minutes. Over time, the tremor became more persistent. Adam is left-handed, and the tremor is now interfering with handwriting, eating, and other fine motor skills. The tremor worsens when Adam is tired or stressed and improves with relaxation. No tremor has been noted in other body parts. Adam denies any other neurological symptoms, including headache, vision changes, or gait abnormalities.

On examination, Adam seemed anxious but showed no significant distress and had normal vital signs. His general examination was unremarkable. His neurological examination showed intact cranial nerves, apart from the hearing impairment. He had normal muscle tone, intact strength and coordination, and a normal casual gait. Rhythmic shaking of the left upper extremity was present with action, while maintaining posture. Using specific examination techniques, the examiner was able to alter the rhythm of the tremor, and the tremor was noted to subside when the patient was engaged with the examiner. These findings in addition to signs of suggestibility and variable frequency/direction were consistent with a functional etiology.

The diagnosis of a functional neurological disorder manifesting in the form of functional tremor was discussed with the patient and his father with assistance from the sign language interpreter. Counseling regarding management consisting mainly of cognitive behavioral therapy and evaluation of possible coexisting conditions, such as anxiety, was discussed.

What factors would you consider in diagnosis and management of functional neurological disorder in a hearing-impaired child/adolescent?
ASO silencing of a glycosyltransferase, Poglut1, improves the liver phenotypes in mouse models of Alagille syndrome
Authors: Niknejad Nima , Fox Duncan , Burwinkel Jennifer L. , Zarrin-Khameh Neda , Cho Soomin , Soriano Armand , Cast Ashley E. , Lopez Mario F. , Huppert Kari A. , Rigo Frank , Huppert Stacey S. , Jafar-Nejad Paymaan , Jafar-Nejad Hamed
Published: April 2023

Background and Aims:

Paucity of intrahepatic bile ducts (BDs) is caused by various etiologies and often leads to cholestatic liver disease. For example, in patients with Alagille syndrome (ALGS), which is a genetic disease primarily caused by mutations in jagged 1 (JAG1), BD paucity often results in severe cholestasis and liver damage. However, no mechanism-based therapy exists to restore the biliary system in ALGS or other diseases associated with BD paucity. Based on previous genetic observations, we investigated whether postnatal knockdown of the glycosyltransferase gene protein O-glucosyltransferase 1 (Poglut1) can improve the ALGS liver phenotypes in several mouse models generated by removing one copy of Jag1 in the germline with or without reducing the gene dosage of sex-determining region Y-box 9 in the liver.

Approach and Results:

Using an ASO established in this study, we show that reducing Poglut1 levels in postnatal livers of ALGS mouse models with moderate to profound biliary abnormalities can significantly improve BD development and biliary tree formation. Importantly, ASO injections prevent liver damage in these models without adverse effects. Furthermore, ASO-mediated Poglut1 knockdown improves biliary tree formation in a different mouse model with no Jag1 mutations. Cell-based signaling assays indicate that reducing POGLUT1 levels or mutating POGLUT1 modification sites on JAG1 increases JAG1 protein level and JAG1-mediated signaling, suggesting a likely mechanism for the observed in vivo rescue.

Conclusions:

Our preclinical studies establish ASO-mediated POGLUT1 knockdown as a potential therapeutic strategy for ALGS liver disease and possibly other diseases associated with BD paucity.
Global and national prevalence of nonalcoholic fatty liver disease in adolescents: An analysis of the global burden of disease study 2019
Authors: Hartmann Phillipp , Zhang Xinlian , Loomba Rohit , Schnabl Bernd
Published: April 2023

Background and Aims:

NAFLD in adolescents is an increasing health crisis worldwide, but its exact global, continental, and national prevalence, its relationship with other metabolic conditions, and the human development index (HDI) globally are not known.

Approach and Results:

We analyzed data from the Global Burden of Disease Study 2019 to compare global, continental, and national prevalence rates of adolescent NAFLD and associations with other metabolic conditions and HDI. The global NAFLD prevalence in adolescents increased from 3.73% in 1990 to 4.71% in 2019 (a relative increase of 26.27%). The prevalence for the male and female populations was 5.84% and 3.52% in 2019, respectively. The Oceanian and North American continents had the highest adolescent NAFLD prevalence (median: 6.54% and 5.64%, respectively), whereas Europe had the lowest prevalence (median: 3.98%). South America and North America had the highest relative increase in adolescent NAFLD prevalence from 1990 to 2019 (median: 39.25% and 36.87%, respectively). High body mass index and type 2 diabetes mellitus increased significantly in adolescents worldwide. However, only high body mass index and not type 2 diabetes mellitus correlated with NAFLD prevalence in adolescents globally. Countries with a higher HDI had larger increases in adolescent NAFLD prevalence from 1990 to 2019 although countries with the highest HDI (HDI: > 0.9) had the lowest NAFLD prevalence in 2019.

Conclusions:

NAFLD in adolescents is an increasing health problem on all continents. Improving environmental factors, including lifestyle but also healthcare policies, can help to prevent NAFLD from developing in children and adolescents and help to improve outcomes in children and adolescents with NAFLD.
Excimer Laser 308 nm
Authors: Dhillon Soneet , Lake Eden
Published: April 2023

The excimer laser delivers targeted ultraviolet radiation at 308 nm, useful for delivering targeted phototherapy. It can also be useful in treating difficult-to-reach treatment sites while minimizing radiation exposure to surrounding skin. The excimer laser has been FDA approved for treatment of inflammatory skin conditions. This review summarizes excimer laser applications and advantages over other narrowband UVB and other phototherapy treatments.
Cost-Savings of Do Not Resuscitate Orders Among Elderly Patients With Heart Failure in the United States
Authors: Callahan Katherine , Van Scoy Lauren J. , Kitko Lisa , Acharya Yubraj , Hardy Melissa A. , Hollenbeak Christopher S.
Published: April 2023

Do-not-resuscitate (DNR) orders should preclude the use of cardiopulmonary resuscitation and may be associated with patient outcomes for patients hospitalized with heart failure (HF). This study examined the association between DNR and costs, mortality, and length of stay. The study cohort was a national sample of 700 922 hospital admissions of patients aged >65 with a primary diagnosis of HF. Elderly HF patients who died with a DNR had cost-savings of $5640 (P < 0.001). Patients with a DNR order were 8.9% points more likely to die before discharge than patients without (P < 0.001), and patients who died with a DNR had a significantly shorter hospital stay by 1.51 days (P < 0.001). DNR orders among elderly patients with HF are associated with cost-savings, as well as a higher mortality and shorter length of stay. In addition to primary benefits, advance care planning may aid in containing costs of care at end of life for HF.
Unusual initial presentation of childhood acute lymphoblastic leukemia as massive ascites and pleural effusion in post-COVID-19 setting: a case report
Authors: Shrateh Oadi N. , Jobran Afnan W.M. , Owienah Haneen , Adwan Rabee , Dwikat Yasmin , Najajreh Mohammad
Published: April 2023

Introduction:

Acute lymphoblastic leukemia (ALL) in children typically presents with nonspecific manifestations such as fever, fatigue, lethargy, joint and bone pain, and bleeding diathesis. Ascites and pleural effusion as an initial presentation of ALL, although described, is exceedingly rare. However, this unusual initial presentation becomes much rarer in the post-coronavirus disease 2019 (COVID-19) setting. Herein, we aim to highlight such a rare initial presentation of childhood ALL that warrants clinical attention.

Case Presentation:

Two months following a COVID-19 infection, a 3-year-old male patient presented to the hospital with severe abdominal distention associated with occasional dyspnea. Physical assessment revealed a critically ill and pale patient with a distended abdomen and decreased air entry on the right side of the chest. Laboratory testing showed pancytopenia. Imaging studies confirmed the presence of massive ascites and pleural effusion. Bone marrow aspiration revealed CD10-positive pre-B-cell ALL. The patient was treated with chemotherapy and achieved complete remission.

Conclusion:

Rare manifestations of relatively common diseases create a barrier to prompt and effective detection and medical intervention. Although ascites and pleural effusion are rare conditions in ALL children patients, the occurrence of these pathologies in this particular patient, especially following COVID-19 infection, is an exceedingly rare event.
Large pineal parenchymal tumor of intermediate differentiation causing compression with resultant obstructive hydrocephalus: a case report
Authors: Shrateh Oadi N. , Jobran Afnan W.M. , Owienah Haneen , Sweileh Thaer , Abulihya Mohand , Shahin Nadeem , Atawnah Yazan , Kharousha Abdalwahab , Dababseh Hadi , Hussein Sami
Published: April 2023

Introduction:

The epithalamus region contains the tiny, functionally endocrine pineal gland, which has the shape of a pinecone. Less than 1% of adult primary intracranial malignancies are pineal parenchymal tumors, which are incredibly uncommon brain tumors. A rare variety of pineal parenchymal tumors are those with intermediate differentiation. These tumors, whose namesake refers to a malignant pineal parenchymal tumor, are intermediate between pineoblastomas and pineocytomas (a benign pineal parenchymal tumor).

Case Presentation:

A female patient, age 13, who had been experiencing terrible headaches on and off for a month, went to the emergency room. Along with the headache, she experienced nausea, vomiting, dizziness, and blurred eyesight. A nonenhanced computed tomography scan was used for the initial brain neuroimaging, which showed a hypodense mass posterior to the midbrain and superior to the cerebellum. A heterogeneous bulk was visible on MRI.

Clinical Outcome:

The headache, vertigo, visual disturbance, nausea, and vomiting have all improved, according to the patient. Both postoperative MRIs with and without contrast revealed the resolution of the obstructive hydrocephalus and the absence of any residual enhancing mass. The patient was followed up for 2 months without any complications or adverse events.

Conclusion:

One should carefully investigate a headache as the early symptom of many illnesses and rule out any other potential causes. This would therefore enable us to create a management structure for such a very unusual malignancy.
Solitary giant neurofibroma of the knee: a case report
Authors: Lachkar Adnane , El Farhaoui Amine , Najib Abdeljaouad , Yacoubi Hicham
Published: April 2023

Introduction:

Solitary neurofibroma is a rare tumor that occurs particularly in the head and trunk. It is mostly small and rarely exceeds 2 cm.

Case Report:

A 61-year-old female patient complained about an increasingly extended mass with pain in the right knee for about 14 months. Physical examination reveals a big, solid mass in front of the medial condyle, measuring about 14×12 cm. Tinel’s sign was positive on mass percussion. MRI showed a well-circumscribed oval mass with low signal on T1 and high signal on T2-weighted images. A surgical biopsy was performed, and immunohistochemistry confirmed the diagnosis of solitary neurofibroma. Surgical excisions were performed with good outcomes.

Discussion:

A giant solitary neurofibroma is exceptional. The knee location is even rarer. Immunohistochemistry is the only way to confirm the diagnosis.

Conclusion:

Giant neurofibromas need a complete surgical excision. Until today, there were no other alternative therapies for these tumors.
Small bowel obstruction caused by massive ascariasis: two case reports
Authors: Ali Abdullahi Y. , Mohamed Abdi Abdishakur , Mambet Ervin
Published: April 2023

Introduction and importance:

Ascaris lumbricoides is an infestation that affects approximately one-seventh of the world’s population. Ascaris lumbricoides is a common inhabitant of the intestines of people with low-socioeconomic incomes, especially in underdeveloped countries of the world. Ascaris lumbricoides infestation is more prone to infestation with serious complications such as intestinal obstruction, volvulus, intussusception, and intestinal necrosis at higher rates in children than in adults.

Case presentation:

The authors present here two cases of small bowel obstruction caused by massive Ascaris lumbricoides that were admitted to the pediatric surgery service after completing a clinical and physical examination, and we operated after rehydration. Both underwent surgical resection with an end-to-end anastomosis. The patient was discharged uneventfully with a plan for de-worming treatment in 6 weeks.

Clinical discussion:

Ascariasis is a round intestinal worm infestation transmitted by fecal or oral contamination. Eating and excreting ascaris eggs lead to ascariasis and excrete human feces, which contaminate foods, soil, and/or water in unsanitary environments. In contrast, in the first case of this study, the diagnosis was made by ultrasound and erect abdominal radiography, and, in the second case, an abdominal ultrasound result was equivocal and required an abdominal computed tomography scan for confirmation. Treatment of small bowel obstruction by roundworms is usually surgical, but in the absence of signs of peritonitis, medical management can give effective results, even in the case of total obstruction.

Conclusion:

The type of surgery undertaken is determined by the results of the laparotomy. If the bowel was found to be intact and the obstruction was at the ileum level, milking worms to the cecum can be done with caution to avoid trauma to the bowel wall. Primary anastomosis after resection of a necrotic bowel segment and removal of the worm bolus is a suitable method for treatment of the ascariasis obstruction.
Autoimmune polyglandular syndrome type 2 and recurrent depression
Authors: Elsayed Mohamed , Negm Eman , Gahr Maximilian , Schönfeldt-Lecuona Carlos
Published: April 2023

Introduction and importance:

Autoimmune polyglandular syndrome type 2 (APS-2) features autoimmune Addison’s disease, autoimmune thyroid disease, and/or type 1 diabetes mellitus. Addison’s disease is occasionally associated with depressive symptoms, therefore patients with APS-2 might present primarily in a psychiatric clinic. Such atypical primary presentation can possibly lead to delayed and/or inadequate diagnosis and management.

Case presentation:

A 57-year-old female patient was referred to our psychiatric clinic from an internal medicine hospital presenting severe depressive symptoms. Upon admission, she complained of sadness, loss of interest (anhedonia) and drive, nausea, and loss of appetite. Physical examination revealed generalized hyperpigmentation. Laboratory investigations revealed hyponatremia, hypocalcemia, macrocytic anemia along with treated hypothyroidism, and partially treated adrenal insufficiency.

Clinical discussion:

A diagnosis of the APS-2 was made. Electroconvulsive therapy (ECT) was mandatory and a complete regression of the affective symptoms was achieved.

Conclusion:

Organic workout in psychiatry is essential to detect diseases symptomatically or semiologically related to depression. In our case, hyperpigmentation, hypothyroidism, and adrenal insufficiency linked to depressive symptoms led to APS-2 diagnosis. ECT was challenging due to the avoidance of etomidate by the anesthesiologists, due to adrenal insufficiency. The adjustment of ECTs’ energy dosage (to avoid too short and ineffective seizures) and optimization of adrenal and thyroid function was essential to reverse the severe depressive syndrome.
Guillain-Barré syndrome complicating early pregnancy: a case report from Nepal
Authors: Aryal Roshan , Adhikari Aayush , Jha Kritika , Deo Bikash , Kafle Yashaswi , Ojha Rajeev
Published: April 2023

Introduction and Importance:

Guillain-Barré syndrome (GBS) is an immunological demyelinating disorder characterized by progressive, ascending flaccid weakness, usually resulting after infection or some immune stimulation. Its occurrence during pregnancy is rare and due to attribution of its symptoms to pregnancy, diagnosis might be delayed.

Case Presentation:

A 39-year-old G4P3L2A0 woman at 13 weeks 6 days period of gestation presented with acute, symmetrical, ascending type of flaccid quadriparesis leading to slurring of speech, swallowing difficulty, and eventually respiratory failure. With the diagnosis of GBS, she was admitted to the intensive care unit, five sessions of plasma exchange were done along with physiotherapy and her symptoms started improving. After discharge she was on regular antenatal care visits and eventually, she delivered a healthy baby at term with an uneventful labor event and postpartum period.

Clinical Discussion:

There is a huge maternal-fetal risk of respiratory failure, aspiration pneumonia, preterm delivery, possible use of forceps or vacuum, and operative interference due to GBS in pregnancy, whose causative agents are similar to that of the general population. The swinging pattern of risk of GBS in pregnancy might be due to immunological changes with predominant Th2 response seen in pregnancy. Treatment measures are similar as in the general population with initial symptomatic care and administration of disease-specific therapy later which consists of intravenous immunoglobulin and/or plasmapheresis.

Conclusion:

A well-timed diagnosis of GBS in pregnancy might allow successful management with the help of intensive monitoring with or without immunotherapy.
The assessment of dietary diversity score and associated factors among pregnant women of Batu district, Southern Ethiopia, 2021: a community-based cross-sectional study
Authors: Getahun Genanew K. , Ahmed Sindew M. , Degif Abinet B. , Haile Mekonnen G.
Published: April 2023

Background:

Malnutrition remains a global problem, particularly in sub-Saharan Africa, where Ethiopia is located. During pregnancy, inadequate nutritional diversification increases the risk of unfavorable maternal and fetal outcomes. Therefore, the aim of this study was to assess the dietary diversity score and associated factors among pregnant women in Batu district, Southern Ethiopia, in 2021.

Methods:

A community-based cross-sectional study was conducted among randomly selected 594 pregnant women. Data were collected with a two-stage sampling technique through face-to-face interviews. The data were coded and entered into Statistical Package for the Social Sciences (SPSS) version 23. Bivariate and multivariable logistic regression analyses were applied to identify independent predictors of dietary diversity.

Results:

The magnitude of the unmet minimum dietary diversity score among pregnant women was 356 (59.9%). Furthermore, pregnant women with no formal education [adjusted odds ratio (AOR)=3.46; 95% CI: 1.99, 5.66], poor by the wealth index (AOR=2.23, 95% CI: 1.33, 3.73), having five or more children (AOR=1.75, 95% CI: 1.14, 2.71), multigravida (AOR=2.18, 95% CI: 1.34, 3.56), and pregnant women from only male-headed households (AOR=4.46, 95% CI: 2.86, 6.94) were associated with an unmet minimum dietary diversity score among pregnant women.

Conclusion:

The prevalence of unmet minimum dietary diversity scores among pregnant women was found to be high. Moreover, low dietary diversity was linked to pregnant women with no formal education, multigravida, having more than five family members, male-headed households, and being poor by household wealth. As a result, nutritional diversity education should be prioritized, and health experts should provide guidance on dietary diversity and family planning services.
Amniotic band syndrome leading to severe malformations of the newborn: a case report at Tu Du Hospital, Vietnam, and literature review
Authors: Phan Trung Hoa , Thi Nguyen Phuong Tu , Nguyen Phuc Nhon , Pham Huy Hoa , Ngo Quang Dao , La Nguyen Phuong Thanh
Published: April 2023

Introduction and Importance:

Amniotic band syndrome (ABS) refers to fibrous bands that appear to entangle various fetal parts in utero, leading to deformation, malformation, or disruption. To alleviate implementation of this diverse malformation, an early diagnosis on ultrasound is necessary to explain to the patient, thus, avoiding psychological shock and requiring timely intervention.

Case Presentation:

In the present case report, the authors describe a case of ABS that was diagnosed at the time of delivery at full term. Although the male newborn was alive, the infant underwent the distal deformity of amputated limbs and clubfoot. He has currently been followed up for the reconstruction treatment.

Clinical Discussion:

ABS remains a challenging diagnosis for obstetricians following the onset timepoint. A prenatal ultrasound scan is carefully required to detect the morphologic abnormalities of the fetus. Postnatal management should be integrated by a multidisciplinary team in order to improve the infant’s outcome.

Conclusion:

ABS is an extremely dangerous entity during pregnancy, which leads to poor outcomes for the infant. An early detection on ultrasound helps in preparing better for the acceptance of the mother and the family as well as the prognosis afterwards.
Risk factors for fall among the elderly with diabetes mellitus type 2 in Jeddah, Saudi Arabia, 2022: a cross-sectional study
Authors: Alasmari Rami S. , Hassani Hattan A. , Almalky Nawwaf A. , Bokhari Abdullah F. , Al Zahrani Abdullah , Hafez Alwalied A.
Published: April 2023

Background:

Diabetes mellitus type 2 is a major chronic condition that is considered common among elderly people, with multiple potential complications that could contribute to falls. However, this concept is not well understood; thus, the aim of this study is to estimate the prevalence of falls among diabetes patients.

Methods:

In this observational cross-sectional study, 309 diabetic patients aged 60 years or more who visited the primary healthcare centers of the Ministry of National Guard – Health Affairs in Jeddah were chosen via convenience sampling method. To collect the data, a structured Fall Risk Assessment questionnaire and Fall Efficacy Score scale were used.

Results:

The mean age of the participants was estimated to be 68.5 (SD: 7.4) years. Among the participants, 48.2% have fallen before, and 63.1% of them suffered falls in the past 12 months. The results showed that gait problems were independently associated with a higher likelihood of falls among elderly patients [odds ratio (OR)=1.98; 95% CI: 1.08–3.62; P=0.026]. Based on the linear regression analysis, we identified the following risk factors for lower falls efficacy: having gait problems (β=12.50; 95% CI: 7.38–17.6; P<0.001), balance difficulties (β=6.58; 95% CI: 1.35–11.8; P=0.014), and neurological/cognitive impairments (β=9.62; 95% CI: 3.89–15.4; P=0.001), as well as having poor sleep quality (β=8.11, 95% CI: 3.32–12.9; P<0.001).

Conclusion:

This paper suggests that diabetes mellitus is an independent fall risk factor among the elderly. Therefore, identifying such patients as being at higher risk and prompt referral to a specialist falls clinic is recommended.
Paramecium: RNA sequence–structure phylogenetics
Authors: Weimer Marlyn , Vďačný Peter , Wolf Matthias
Published: April 2023

Organisms classified as members of the genus Paramecium belong to the best-known group of single-celled eukaryotes. Nevertheless, the phylogeny within the genus Paramecium has been discussed and revisited in recent decades and remains partly unresolved. By applying an RNA sequence–structure approach, we attempt to increase accuracy and robustness of phylogenetic trees. For each individual 18S and internal transcribed spacer 2 (ITS2) sequence, a putative secondary structure was predicted through homology modelling. While searching for a structural template, we found, in contrast to the available literature, that the ITS2 molecule consists of three helices in members of the genus Paramecium and four helices in members of the genus Tetrahymena. Two sequencestructure neighbor-joining overall trees were reconstructed with (1) more than 400 taxa (ITS2) and (2) more than 200 taxa (18S). For smaller subsets, neighbor-joining, maximum-parsimony, and maximum-likelihood analyses were executed using sequence–structure information simultaneously. Based on a combined data set (ITS2+18S rDNA) a well-supported tree was reconstructed with bootstrap values over 50 in at least one of the applied analyses. Our results are in general agreement with those published in the available literature based on multi-gene analyses. Our study supports the simultaneous use of sequence–structure data to reconstruct accurate and robust phylogenetic trees.
Human Surfactant Protein A Alleviates SARS-CoV-2 Infectivity in Human Lung Epithelial Cells
Authors: Jacob Ikechukwu B , Gemmiti Amanda , Xiong Weichuan , Reynolds Erin , Nicholas Brian , Thangamani Saravanan , Jia Hongpeng , Wang Guirong
Published: April 2023

SARS coronavirus 2 (SARS-CoV-2) infects human angiotensin-converting enzyme 2 (hACE2)-expressing lung epithelial cells through its spike (S) protein. The S protein is highly glycosylated and could be a target for lectins. Surfactant protein A (SP-A) is a collagen-containing C-type lectin, expressed by mucosal epithelial cells and mediates its antiviral activities by binding to viral glycoproteins. This study examined the mechanistic role of human SP-A in SARS-CoV-2 infectivity. The interactions between human SP-A and SARS-CoV-2 S protein and hACE2 receptor, and SP-A level in COVID-19 patients were assessed by ELISA. The effect of SP-A on SARS-CoV-2 infectivity was analyzed by infecting human lung epithelial cells (A549-ACE2) with pseudoviral particles and infectious SARS-CoV-2 (Delta variant) pre-incubated with SP-A. Virus binding, entry, and infectivity were assessed by RT-qPCR, immunoblotting, and plaque assay. The results showed that human SP-A can bind SARS-CoV-2 S protein/RBD and hACE2 in a dose-dependent manner (p<0.01). Human SP-A inhibited virus binding and entry, and reduce viral load in lung epithelial cells, evidenced by the dose-dependent decrease in viral RNA, nucleocapsid protein, and titer (p<0.01). Increased SP-A level was observed in the saliva of COVID-19 patients compared to healthy controls (p<0.05), but severe COVID-19 patients had relatively lower SP-A levels than moderate COVID-19 patients (p<0.05). Therefore, SP-A plays an important role in mucosal innate immunity against SARS-CoV-2 infectivity by directly binding to the S protein and inhibiting its infectivity in host cells. SP-A level in the saliva of COVID-19 patients might serve as a biomarker for COVID-19 severity.
Comparison of classification accuracy and feature selection between sparse and non-sparse modeling of metabolomics data
Authors: Toda Arisa , Goudo Misa , Sugimoto Masahiro , Hiwa Satoru , Hiroyasu Tomoyuki
Published: April 2023

Machine learnings such as multivariate analyses and clustering have been frequently used for metabolomics data analyses. In metabolomics data analyses, how much difference there is between the results calculated by supervised and unsupervised learning models is an interesting topic. Since metabolomics data include hundreds to thousands of metabolites greater than the sample numbers, only a small fraction of metabolites is relevant to the phenotype of interest. For this reason, sparse mechanisms have been introduced into many machine learning models. However, its explanatory power decreases when the number of explanatory variables is reduced to an extreme level. In this paper, serum lipidomic data of breast cancer patients (1) pre/post-menopause and (2) before/after neoadjuvant chemotherapy was chosen as one of metabolomics data. Here, this data was analyzed by partial least squares (PLS) for regression and K-means and hierarchical clustering for clustering. Results were also compare with the sparse modeling. Between the non-sparse and sparse modeling accuracy, there is no significant difference. Metabolite subsets selected by sparse modeling were almost identical to the PLS-selected features. At the same time, several metabolites were consistently selected regardless of the algorithm used. These results contribute to exploring biomarkers in high-dimensional metabolomics datasets.
The nitrogenase G-subunit is an ancient orphan protein that drove the ecological expansion of nitrogen fixation
Authors: Cuevas-Zuviría Bruno , Garcia Amanda K. , Carruthers Brooke M. , Kaçar Betül
Published: April 2023

Nitrogenase metalloenzymes have catalyzed biological nitrogen fixation for billions of years and revolutionized planet Earth by supplying essential nitrogen to the biosphere. How these enzymes were built and distributed by microbial and evolutionary processes in a shifting geochemical landscape remains an open question. Here, we probe the birth and evolution of the G-subunit protein, an integral, Precambrian-age structural component of certain nitrogenase isozymes that makes its appearance midway through nitrogenase evolutionary history. We establish that the G-subunit is an orphan protein, with no homologs detected across wider protein diversity. We find that G-subunit emergence accompanied both the diversification of nitrogenase metal usage and an ecological expansion of nitrogen-fixing microbes during the transition in enviromental metal availabilities triggered by Earth surface oxygenation ∼2.5 billion years ago. Further, analyses of ancestral nitrogenase structures implicate a role for the G-subunit in novel metal incorporation, which would have primed nitrogenases and their hosts to exploit these newly diversified geochemical environments. However, permanent recruitment of the G-subunit into the nitrogenase complex was likely only enabled by tuning preexisting, protein interaction features that were selected prior to Earth oxygenation. Our results showcase how contingent evolutionary novelties shape microbial ecological responses and their global consequences.