bluuebunny/crossref_metadata_2025 huggingface dataset:
Functional Morphology of the Flight Apparatus of Ephemera vulgata (Ephemeroptera: Ephemeridae) and Implications for the Evolution of Flight in Insects
Authors: Pfau Hans Klaus
Published: July 2021

The mesothoracic flight apparatus of preserved and freshly killed specimens of Ephemera vulgata is examined in detail by means of functional morphological examinations. The basic drive mechanism of the forewing of Ephemera vulgata constitutes a four-bar kinematic chain, which encompasses the whole mesothorax. Based on this reassessment, the operating principles of the different subsystems of the flight apparatus of the mayfly were newly analysed. As in the Neoptera, the indirect dorsolongitudinal downstroke and dorsoventral upstroke muscles rotate the wing around an axis which runs through the main wing joint of the fulcrum. In contrast to the Neoptera, the wing is driven via the posterior notal wing process and fourth axillary. A strong direct subalar muscle is able to move the subalare (together with the pleural ridge) inwards and to affect the wingstroke via a bistable click mechanism in this unusual way. The axillary sclerites, two frontal first axillaries and one caudal fourth axillary, permit the radioanal plate to rotate forward–backward on the fulcrum. This motion system, which is superimposed on the kinematic chain mechanism, permits alterations of the wingstroke plane. A short muscle of the radioanal plate allows adjusting the passive pronation of the wing during the downstroke and achieving an increase of the aerodynamical angle of attack. The step-by-step derivability of basal flight mechanisms of the main groups of Pterygota indicates a paranotal origin of the wings. The possibility that the Ephemeroptera and Neoptera constitute sister groups is discussed.
The Role of Dyadic Coping for the Individual and Relational Well-Being of Couples During the Transition to Parenthood
Authors: Molgora Sara , Acquati Chiara , Saita Emanuela
Published: July 2021

Becoming parents represents a potentially stressful transition, which may negatively affect the individual and relational well-being of both partners. Limited literature has investigated the role of dyadic coping during the transition to parenthood. This work explored partners’ differences in dyadic coping, anxiety, depression, and couple adjustment during pregnancy and 3 months postpartum. Furthermore, through Actor–Partner Interdependence Model analyses, the relationship between common dyadic coping and well-being was investigated. Women reported higher levels of depression at both times and men presented higher levels of anxiety in the postpartum. For women, higher scores on couple adjustment were predicted by their own and their partner’s common dyadic coping. For men, higher scores on anxiety were associated with elevated common dyadic coping. Results highlight gender-related predictors on postpartum well-being and support the need to assess individual and relational outcomes across the transition to parenthood to better understand the role of dyadic coping behaviors.
Couples’ Relative Resources, Male Power, and Relationship Conflict from a Comparative Perspective
Authors: van Damme Maike , Cortina Clara , González Maria José
Published: July 2021

Using two waves of the Generations and Gender Survey for eight European countries, we test under what conditions couples experience high levels of disagreement over time or separate. The results partly support the idea of relative resources, suggesting that a decrease in the status of men in couples (job loss) is significantly associated with high levels of conflict. The transition to high conflict is more frequent when there is a discrepancy between policy and behavior. Social policies designed to meet the needs of working parents in dual-earner couples together with the diffusion of gender egalitarian values can lead to a reduction in unhealthy levels of couple conflict.
Community pressure, regulatory pressure and corporate environmental performance
Authors: Zhou Yankun , Luo Le , Shen Hongtao
Published: July 2021

This article analyses the relationship between community pressure, regulatory pressure and corporate environmental performance. Using a sample of 2192 firm-year observations in environmentally sensitive industries for the period 2007–2012, we find that increased community pressure is negatively associated with corporate pollution levels and thus positively associated with corporate environmental performance. Furthermore, intensified community pressure can strengthen regulatory enforcement, but it cannot increase the size of the government subsidy allotted to environmental issues. Finally, regulatory enforcement partly mediates the relationship between community pressure and environmental performance. This study contributes to the understanding of firms’ environmental management and the interaction of community and regulatory pressure.

JEL Classification: G38, M41, Q53, Q56
Valorisation of residues from municipal wastewater sieving through anaerobic (co-)digestion with biological sludge
Authors: Boni Maria Rosaria , Polettini Alessandra , Pomi Raffaella , Rossi Andreina , Filippi Alessandro , Cecchini Giancarlo , Frugis Alessandro , Leoni Simone
Published: July 2021

The Circular and Green Economy principles is inspiring new approaches to municipal wastewater treatment plants (MWWTPs) design and operation. Recently, an ever-growing interest is devoted to exploring the alternatives for switching the WWTPs from being able to ‘simply’ removing contaminants from water to biorefinery-like plants where energy and material can be recovered. In this perspective, both wastewater and residues from process can be valorised for recovering nutrients (N and P), producing value added products (i.e. biopolymers), energy vectors and biofuels (i.e. bio-H2, bio-CH4 and bioethanol). As an additional benefit, changing the approach for WWTPs design and operation will decrease the overall amount of landfilled residues. In this context, the present research is aimed at evaluating the CH4 production potential of MWW screening units’ residues. While such a stream is typically landfilled, the expected progressive increase of biodegradable matter content due to the ban on single-use plastic along with the boost of bioplastics makes the investigation of different biochemical valorisation routes more and more interesting from an environmental and economical perspective. Thus, a full-scale data collection campaign was performed to gain information on screening residues amount and properties and to analyse the relationship with influent flowrate. The most relevant residue properties were measured, and lab-scale tests were carried out to evaluate the bio-CH4 potential.
Construction and demolition waste management in Australia: A mini-review
Authors: Zhao Xianbo , Webber Ronald , Kalutara Pushpitha , Browne Wesley , Pienaar Josua
Published: July 2021

Construction and demolition activities generate huge quantities of waste with substantial impacts on environment. This mini-review article covers the literatures relating to construction and demolition waste management practice in Australia. The Scopus search engine was used in literature search and 26 journal articles relating to construction and demolition waste management in Australia were targeted for analysis. Additionally, various government acts, regulations, policies, and strategy documents were collected and analyzed. This review indicated that the inconsistencies in legislation and landfill levies across states and territories contributed to the cross-jurisdiction waste movement. Given the stakeholders’ attitude and project life cycle, this review reported that the design phase had the greatest potential to minimize waste and that the role of designers had been highlighted in various empirical studies. This review provides practitioners and academics with an understanding of the current construction and demolition waste management research in Australia and recommends directions for future research.
AMBER Alert Effectiveness Reexamined
Authors: Griffin Timothy , Williams Joshua H. , Kadleck Colleen
Published: July 2021

Prior research based on limited datasets has suggested AMBER Alerts do little to prevent harm to child abduction victims. However, to investigate the possibility of recent improvements in AMBER Alert performance, the authors examine a sample of 472 AMBER Alerts issued over a 3-year period from 2012 to 2015, using available media accounts to code for relevant case information. The findings are consistent with prior research questioning AMBER Alert effectiveness: The crucial variable predicting Alert outcomes is abductor relationship to the victim, not AMBER Alert “performance.” Furthermore, cases involving “successful” AMBER Alerts are comparable on measurable factors to AMBER Alert cases where the child was recovered safely but the Alert played no role, suggesting both categories of cases involved little real risk. Implications for interpreting the viability of the AMBER Alert concept, public discourse regarding its contribution to child safety, and larger implications for crime control policy are discussed.
Prediction of NOx considering NO and NO2 for a CI engine
Authors: Lee Youngbok , Lee Seungha , Min Kyoungdoug
Published: July 2021

Nitrogen oxides (NO x) are one of the main harmful emissions from diesel engines. Regulations on emissions are becoming more stringent; consequently, research should aim at reducing both engine-out NO x and tail-pipe NO x emissions. Exhaust gas recirculation is mainly used to reduce engine-out NO x emissions. After-treatment methods such as lean NO x trap systems and selective catalyst reduction are used to minimize tail-pipe NO x emissions. Real-time feedback control during transient conditions can further reduce these emissions and be utilized when information about real-time engine-out NO x emissions is available. It would be helpful to evaluate the proportion of NO2 in NO x emissions because the conversion efficiency of an after-treatment system is affected by temperature and the NO-to-NO2 ratio. Therefore, a semi-empirical NO x model considering NO and NO2 separately was developed for a diesel engine in this study. The NO estimation model was established based on the extended Zeldovich mechanism. The NO2 estimation model focused on chemical reactions between NO and other species and was based on formation and decomposition mechanisms. This NO x model can contribute to the cost reduction of engine systems by replacing existing NO x sensors and can also be applied to real-time feedback control strategies to minimize NO x emissions.
Role of Empowerment and Interpersonal Relations in Reducing Cynicism and Politics Among Indian IT Workers
Authors: Gupta Amit , Goel Abhishek , Bande-Vilela Belen
Published: July 2021

This article tests a model describing the relationship between organizational cynicism and perceptions of organizational politics (POPS) and the mitigating role of empowerment and interpersonal relationships in satisfaction with work and managers. Data were collected from 361 employees of an Indian information technology (IT) services organization. The analysis of the model showed that empowerment of employees and interpersonal relations among employees alleviated the negative spiral of organizational cynicism and POPS. Lower levels of interpersonal relationships accentuated the organizational cynicism–POPS relationship.
Epicardial Adipose Tissue: The Genetics Behind an Emerging Cardiovascular Risk Marker
Authors: Sousa João Adriano , Mendonça Maria Isabel , Serrão Marco , Borges Sofia , Henriques Eva , Freitas Sónia , Tentem Margarida , Santos Marina , Freitas Pedro , Ferreira António , Guerra Graça , Drumond António , Palma Reis Roberto
Published: July 2021

Evidence points epicardial adipose tissue (EAT) as an emerging cardiovascular risk marker. Whether genetic polymorphisms linked with atherosclerosis are associated with higher EAT is still unknown. We aim to assess the role of genetic burden of atherosclerosis and its association to EAT in a cohort of asymptomatic individuals without coronary disease. A total of 996 participants were prospectively enrolled in a single Portuguese center. EAT volume was measured by Cardiac Computed Tomography and participants were distributed into 2 groups, above and below median EAT. SNPs were genotyped and linked to their respective pathophysiological axes. A multiplicative genetic risk score (mGRS) was constructed, representing the genetic burden of the studied SNPs. To evaluate the association between genetics and EAT, we compared both groups by global mGRS, mGRS by functional axes, and SNPs individually. Individuals above-median EAT were older, had a higher body mass index (BMI) and higher prevalence of hypertension, metabolic syndrome, diabetes, and dyslipidemia. They presented higher GRS, that remained an independent predictor of higher EAT volumes. The group with more EAT consistently presented higher polymorphic burden across numerous pathways. After adjustment, age, BMI, and mGRS of each functional axis emerged as independently related to higher EAT volumes. Amongst the 33 SNPs, MTHFR677 polymorphism emerged as the only significant and independent predictor of higher EAT volumes. Patients with higher polymorphism burden for atherosclerosis present higher EAT volumes. We present the first study in a Portuguese population, evaluating the genetic profile of EAT through GWAS and GRS, casting further insight into this complicated matter.
Comparison of the two most commonly used gold-standard velocity monitoring devices (GymAware and T-Force) to assess lifting velocity during the free-weight barbell back squat exercise
Authors: Janicijevic Danica , García-Ramos Amador , Lamas-Cepero Juan Luis , García-Pinillos Felipe , Marcos-Blanco Aitor , Rojas Francisco Javier , Weakley Jonathon , Pérez-Castilla Alejandro
Published: July 2021

This study aimed to compare the reliability and agreement of mean velocity (MV) and maximal velocity (Vmax) between the two velocity monitoring devices (GymAware vs T-Force) most commonly used in the scientific literature. Twenty resistance-trained males completed two testing sessions. The free-weight barbell back squat one-repetition maximum (1RM) was determined in the first session (125.0 ± 24.2 kg; mean ± standard deviation). The second session consisted of two blocks of 16 repetitions (six repetitions at 45% 1RM and 65% 1RM, and four repetitions at 85% 1RM). Half of the repetitions were performed with the GymAware on the left side of the barbell and the other half of the repetitions were performed on the right side of the barbell (opposite placement for the T-Force). MV and Vmax were recorded simultaneously with the GymAware and T-Force. The overall reliability, which was calculated pooling together the data of three loads, did not differ between the T-Force (coefficient of variation (CV) = 5.28 ± 1.79%) and GymAware (CV = 5.79 ± 2.26%) (CVratio = 1.10), but the reliability was higher for Vmax (CV = 5.08 ± 1.79%) compared to MV (CV = 5.98 ± 2.73%) (CVratio = 1.18). MV was significantly higher for the T-Force ( p < 0.001, Δ = 4.42%), but no significant differences were detected between the devices for Vmax ( p = 0.455, Δ = 0.22%). These results support the use of both the GymAware and T-Force as gold-standards in studies designed to validate other velocity monitoring devices. However, systematic bias, albeit rather constant, exists for the magnitude of MV between the two devices.
The Design of a Master of Public Health Professional Development Course During the COVID-19 Pandemic: Application of the Salmon Model
Authors: Kuganathan Ann , Slifierz Mackenzie , Anderson Laura N. , Alvarez Elizabeth , Apatu Emma
Published: July 2021

Coronavirus disease 2019 (COVID-19) has highlighted the need for well-trained public health workers to interpret evidence, make informed decisions, and disseminate information to the general public. As public health courses in Ontario universities have moved online due to this pandemic, instructors were required to simulate their teaching online while maintaining student engagement. Previous research has shown that there is a lack of description for the development of online public health courses. As such, the objective of this article is to outline the development and layout of a Professional Development Studio course offered in the Masters of Public Health program at McMaster University, Hamilton, Ontario. We use the Salmon model, previously described by Salmon and colleagues in 2013, to form the course outline. The Salmon model provides a five-stage framework for the development of a concise, engaging, and impactful online course. Based on student feedback, we found that the Salmon model positively shaped the development of the course by aiding the formulation of a course layout that was easily accessible, discussion threads to communicate in an inclusive and safe space, and relevant assessments requiring the use of tools to make judgments and appropriately disseminate information publicly. We conclude that the Salmon model is a helpful framework to use in developing an engaging online public health course. Further assessments based on student feedback should be completed to continually evolve the online course to better tailor the needs and interests of public health students preparing them for the public health workforce.
Happiness and Criminal Victimization: A Study of Relationship and Restoration
Authors: Bajpai G. S. , Sharma Preetika
Published: July 2021

Even well-developed nations with the highest economic growth rates have failed to bring happiness amongst their citizens. Consequently, recent studies have shifted their focus from economic variables, such as Human Development Index (HDI), gross development product (GDP) per capita, etc., to happiness as an indicator of growth, development and social progress. Amidst others, criminal victimization is one of the important indicators of happiness. The present article intends to study the relationship between happiness using the happiness measurement index and criminal victimization using the crime statistics of selected nations. It consists of a descriptive statistical analysis of six nations selected based on their happiness score, including two nations each with a high, average and low happiness measurement index. The results show that people living in nations with high crime rates were less happy and satisfied than individuals living in nations with comparatively lower crime rates. However, the article could not conclusively establish the relation between the happiness level and the nature of crime.
Liquid biopsy as an option for predictive testing and prognosis in patients with lung cancer
Authors: Qvick Alvida , Stenmark Bianca , Carlsson Jessica , Isaksson Johan , Karlsson Christina , Helenius Gisela
Published: July 2021

Background

The aim of this study was to investigate the clinical value of liquid biopsy as a primary source for variant analysis in lung cancer. In addition, we sought to characterize liquid biopsy variants and to correlate mutational load to clinical data.

Methods

Circulating cell-free DNA was extracted from plasma from patients with lung cancer (n = 60) and controls with benign lung disease (n = 16). Variant analysis was performed using the AVENIO ctDNA Surveillance kit and the results were correlated to clinical and variant analysis data from tumor tissue or cytology retrieved from clinical routine diagnostics.

Results

There were significantly more variants detected in lung cancer cases compared to controls (p = 0.011), but no difference between the histological subgroups of lung cancer was found (p = 0.465). Furthermore, significantly more variants were detected in patients with stage IIIb–IV disease compared to patients with stage I–IIIa (median 7 vs 4, p = 0.017). Plasma cfDNA mutational load was significantly associated with overall survival (p = 0.010). The association persisted when adjusted for stage and ECOG performance status (HR: 3.64, 95% CI 1.37–9.67, p = 0.009). Agreement between tumor and plasma samples significantly differed with stage; patients with stage IIIb–IV disease showed agreement in 88.2% of the cases with clinically relevant variants, compared to zero cases in stage I–IIIa (p = 0.004). Furthermore, one variant in EGFR, two in KRAS, and one in BRAF were detected in plasma but not in tumor samples.

Conclusion

This study concludes that in the vast majority of advanced NSCLC patients a reliable variant analysis can be performed using liquid biopsy from plasma. Furthermore, we found that the number of variants in plasma is associated with prognosis, possibly indicating a strategy for closer follow up on this crucial patient group.
Pessimistic health and optimistic wealth distributions perceptions in Germany and the UK: evidence from an online-survey
Authors: Debbeler Luka J. , Schupp Harald T. , Renner Britta
Published: July 2021

Background

Inequalities in health and wealth distributions are becoming pressing societal problems in many countries. How these inequalities are perceived and to what degree perceptions are aligned with actual distributions, is important for trust in public health services, social and economic policies, and policymakers. This study aims to assess perceived and desired levels of inequality in health and wealth in Germany and the UK.

Methods

The online-survey was filled out by 769 volunteers (322 from Germany, 447 from the UK), recruited from an existing commercial panel (Prolific Academic) or via Facebook advertisements in 2019. Perceived and ideal national health and wealth distributions were assessed and compared to actual health indicators (i.e. days absent from work, number of visits to general practitioners (GPs) and self-rated health), and actual wealth distributions with t-tests.

Results

A pronounced gap emerged between the estimated, ideal and actual inequality. Both samples strikingly underestimated the proportion of (very) good health in the national distribution by a factor of ~ 2.3 (participants estimated that 34% of the German and 36% of the UK population respectively are very healthy or healthy, while the actual proportion in the population was 75% in Germany and 84% in the UK,P < 0.001 for all). Moreover, actual health distributions were much closer to the desired than the perceived health distributions (78% of German and 72% of UK participants ideally being very healthy or healthy). A reversed pattern of results emerged for wealth in both samples, with wealth inequality being strikingly worse than desired and inequality being underestimated by a factor ~ 1.7 (P < 0.001 for all). Results were consistent across demographic groups.

Conclusions

Respondents in both Germany and the UK have profoundly negative misperceptions regarding the distribution of health, which contrasts with starkly positive misperceptions regarding the distribution of wealth, indicating that the public is healthier but poorer than they think. More importantly, from a public health perspective, a high level of consensus emerged, with both healthy and wealthy participants misperceiving health and wealth distributions.
The comorbidity of HIV, hypertension and diabetes: a qualitative study exploring the challenges faced by healthcare providers and patients in selected urban and rural health facilities where the ICDM model is implemented in South Africa
Authors: Godongwana Motlatso , De Wet-Billings Nicole , Milovanovic Minja
Published: July 2021

Background

PLWH are living longer as a result of advancement and adherence to antiretroviral therapy. As the life expectancy of PLWH increases, they are at increased risk of hypertension and diabetes. HIV chronic co-morbidities pose a serious public health concern as they are linked to increased use and need of health services, decreased overall quality of life and increased mortality. While research shows that integrated care approaches applied within primary care settings can significantly reduce hospital admissions and mortality levels among patients with comorbidities, the primary care system in South Africa continues to be challenged with issues about the delivery of quality care.

Methods

This study applied a phenomenological qualitative research design. IDIs were conducted with 24 HCPs and adults living with the comorbidity of HIV and either hypertension or diabetes across two provinces in South Africa. The objective of the research was to understand the challenges faced by HCPs and patients in health facilities where the ICDM model is implemented. The health facilities were purposively sampled. However, the HCPs were recruited through snowballing and the patients through reviewing the facilities’ clinic records for participants who met the study criteria. All participants provided informed consent. The data was collected between March and May 2020. The findings were analysed inductively using thematic content analysis.

Results

The challenges experienced included lack of staff capacity, unclear guidelines on the delivery of integrated care for patients with HIV chronic comorbidities, pill burden, non-disclosure, financial burden, poor knowledge of treatments, relocation of patients and access to treatment. Lack of support and integrated chronic programmes including minimal information regarding the management of HIV chronic comorbidities were other concerns.

Conclusion

The outcomes of the ICDM model need to be strengthened and scaled up to meet the unique health needs and challenges of people living with HIV and other chronic conditions. Strengthening these outcomes includes providing capacity building and training on the delivery of chronic care treatment under the ICDM model, assisted self-management to improve patient responsibility of chronic disease management and strengthening activities for comorbidity health promotion.
Ultra-rare renal diseases diagnosed with whole-exome sequencing: Utility in diagnosis and management
Authors: Jung Jiwon , Lee Joo Hoon , Park Young Seo , Seo Go Hun , Keum Changwon , Kang Hee Gyung , Lee Hajeong , Lee Sang Koo , Lee Sang Taek , Cho Heeyeon , Lee Beom Hee
Published: July 2021

Background

This study aimed to use whole-exome sequencing (WES) to diagnose ultra-rare renal diseases and the clinical impact of such an approach on patient care.

Methods

Clinical, radiological, pathological, and genetic findings were reviewed in the patients and their family members.

Results

Nine patients from nine unrelated Korean families were included in the study and evaluated. WES identified eight different conditions in these patients, i.e., autosomal dominant tubulointerstitial kidney disease associated withUMODmutation; recurrent urinary stones associated withAPRTdeficiency; Ayme-Gripp syndrome associated withMAFmutation; short rib-thoracic dysplasia associated withIFT140mutation; renal coloboma syndrome associated withPAX2mutations; idiopathic infantile hypercalcemia associated withCYP24A1mutation; and hypomagnesemia associated withTRPMmutation. Eleven different mutations, including seven novel mutations, were identified, i.e., four truncating mutations, six missense mutations, and one splice-acceptor variant. After genetic confirmation, strategies for the management of the following: medications, donor selection for renal transplantation, and surveillance for extra-renal manifestations were altered. In addition, genetic counseling was provided for the patients and their family members with respect to family member screening for affected but yet unidentified patients and future reproductive planning.

Conclusion

As WES can effectively identify ultra-rare genetic renal diseases, facilitate the diagnosis process, and improve patient care, it is a good approach to enable a better understanding of ultra-rare conditions and for the establishment of appropriate counseling, surveillance, and management strategies.
Correction of complex three-dimensional deformities at the proximal femur using indirect reduction with angle blade plate and patient-specific instruments: a technical note
Authors: Jud Lukas , Vlachopoulos Lazaros , Grob Karl
Published: July 2021

Background

Corrective osteotomies for complex proximal femoral deformities can be challenging; wherefore, subsidies in preoperative planning and during surgical procedures are considered helpful. Three-dimensional (3D) planning and patient-specific instruments (PSI) are already established in different orthopedic procedures. This study gives an overview on this technique at the proximal femur and proposes a new indirect reduction technique using an angle blade plate.

Methods

Using computed tomography (CT) data, 3D models are generated serving for the preoperative 3D planning. Different guides are used for registration of the planning to the intraoperative situation and to perform the desired osteotomies with the following reduction task. A new valuable tool to perform the correction is the use of a combined osteotomy and implant-positioning guide, with indirect deformity reduction over an angle blade plate.

Results

An overview of the advantages of 3D planning and the use of PSI in complex corrective osteotomies at the proximal femur is provided. Furthermore, a new technique with indirect deformity reduction over an angle blade plate is introduced.

Conclusion

Using 3D planning and PSI for complex corrective osteotomies at the proximal femur can be a useful tool in understanding the individual deformity and performing the aimed deformity reduction. The indirect reduction over the implant is a simple and valuable tool in achieving the desired correction, and concurrently, surgical exposure can be limited to a subvastus approach.
Ketogenic diet for mitochondrial disease: a systematic review on efficacy and safety
Authors: Zweers Heidi , van Wegberg Annemiek M. J. , Janssen Mirian C. H. , Wortmann Saskia B.
Published: July 2021

Background

No curative therapy for mitochondrial disease (MD) exists, prioritizing supportive treatment for symptom relief. In animal and cell models ketones decrease oxidative stress, increase antioxidants and scavenge free radicals, putting ketogenic diets (KDs) on the list of management options for MD. Furthermore, KDs are well-known, safe and effective treatments for epilepsy, a frequent symptom of MD. This systematic review evaluates efficacy and safety of KD for MD.

Methods

We searched Pubmed, Cochrane, Embase and Cinahl (November 2020) with search terms linked to MD and KD. From the identified records, we excluded studies on Pyruvate Dehydrogenase Complex deficiency. From these eligible reports, cases without a genetically confirmed diagnosis and cases without sufficient data on KD and clinical course were excluded. The remaining studies were included in the qualitative analysis.

Results

Only 20 cases (14 pediatric) from the 694 papers identified met the inclusion criteria (one controlled trial (n = 5), 15 case reports). KD led to seizure control in 7 out of 8 cases and improved muscular symptoms in 3 of 10 individuals. In 4 of 20 cases KD reversed the clinical phenotype (e.g. cardiomyopathy, movement disorder). In 5 adults with mitochondrial DNA deletion(s) related myopathy rhabdomyolysis led to cessation of KD. Three individuals with POLG mutations died while being on KD, however, their survival was not different compared to individuals with POLG mutations without KD.

Conclusion

Data on efficacy and safety of KD for MD is too scarce for general recommendations. KD should be considered in individuals with MD and therapy refractory epilepsy, while KD is contraindicated in mitochondrial DNA deletion(s) related myopathy. When considering KD for MD the high rate of adverse effects should be taken into account, but also spectacular improvements in individual cases. KD is a highly individual management option in this fragile patient group and requires an experienced team. To increase knowledge on this—individually—promising management option more (prospective) studies using adequate outcome measures are crucial.
0.9% Sodium chloride solution versus Plasma-Lyte 148 versus compound sodium lacTate solution in children admitted to PICU—a randomized controlled trial (SPLYT-P): study protocol for an intravenous fluid therapy trial
Authors: Raman Sainath , Schibler Andreas , Marsney Renate Le , Trnka Peter , Kennedy Melanie , Mattke Adrian , Gibbons Kristen , Schlapbach Luregn J.
Published: July 2021

Background

Intravenous fluid therapy represents the most common intervention critically ill patients are exposed to. Hyperchloremia and metabolic acidosis associated with 0.9% sodium chloride have been observed to lead to worse outcomes, including mortality. Balanced solutions, such as Plasma-Lyte 148 and Compound Sodium Lactate, represent potential alternatives but the evidence on optimal fluid choices in critically ill children remains scarce. This study aims to demonstrate whether balanced solutions, when used as intravenous fluid therapy, are able to reduce the incidence of a rise in serum chloride level compared to 0.9% sodium chloride in critically ill children.

Methods

This is a single-centre, open-label randomized controlled trial with parallel 1:1:1 assignment into three groups: 0.9% sodium chloride, Plasma-Lyte 148, and Compound Sodium Lactate solutions for intravenous fluid therapy. The intervention includes both maintenance and bolus fluid therapy. Children aged < 16 years admitted to intensive care and receiving intravenous fluid therapy during the first 4 h of admission are eligible. The primary outcome measure is a ≥ 5mmol/L increase in serum chloride level within 48 h post-randomization. The enrolment target is 480 patients. The main analyses will be intention-to-treat.

Discussion

This study tests three types of intravenous fluid therapy in order to compare the risk of hyperchloremia associated with normal saline versus balanced solutions. This pragmatic study is thereby assessing the most common intervention in paediatric critical care.

This is a single-centre open-label study with no blinding at the level of delivery of the intervention. Certain paediatric intensive care unit (PICU) patient groups such as those admitted with a cardiac condition or following a traumatic brain injury are excluded from this study.

Trial registration

The study has received ethical approval (HREC/19/QCHQ/53177: 06/06/2019). It is registered in the Australian New Zealand Clinical Trials Registry (
ACTRN12619001244190) from 9th September 2019. Recruitment commenced on 12th November 2019. The primary results manuscript will be published in a peer-reviewed journal.
A study of the composition of the Obsoletus complex and genetic diversity of Culicoides obsoletus populations in Spain
Authors: Aguilar-Vega Cecilia , Rivera Belén , Lucientes Javier , Gutiérrez-Boada Isabel , Sánchez-Vizcaíno José Manuel
Published: July 2021

Background

The Culicoides obsoletus species complex (henceforth ‘Obsoletus complex’) is implicated in the transmission of several arboviruses that can cause severe disease in livestock, such as bluetongue, African horse sickness, epizootic hemorrhagic disease and Schmallenberg disease. Thus, this study aimed to increase our knowledge of the composition and genetic diversity of the Obsoletus complex by partial sequencing of the cytochrome c oxidase I (cox1) gene in poorly studied areas of Spain.

Methods

A study of C. obsoletus populations was carried out using a single-tube multiplex polymerase chain reaction (PCR) assay that was designed to differentiate the Obsoletus complex sibling species Culicoides obsoletus and Culicoides scoticus, based on the partial amplification of the cox1 gene, as well as cox1 georeferenced sequences from Spain available at GenBank. We sampled 117 insects of the Obsoletus complex from six locations and used a total of 238 sequences of C. obsoletus (ss) individuals (sampled here, and from GenBank) from 14 sites in mainland Spain, the Balearic Islands and the Canary Islands for genetic diversity and phylogenetic analyses.

Results

We identified 90 C. obsoletus (ss), 19 Culicoides scoticus and five Culicoides montanus midges from the six collection sites sampled, and found that the genetic diversity of C. obsoletus (ss) were higher in mainland Spain than in the Canary Islands. The multiplex PCR had limitations in terms of specificity, and no cryptic species within the Obsoletus complex were identified.

Conclusions

Within the Obsoletus complex, C. obsoletus (ss) was the predominant species in the analyzed sites of mainland Spain. Information about the species composition of the Obsoletus complex could be of relevance for future epidemiological studies when specific aspects of the vector competence and capacity of each species have been identified. Our results indicate that the intraspecific divergence is higher in C. obsoletus (ss) northern populations, and demonstrate the isolation of C. obsoletus (ss) populations of the Canary Islands.

Graphical abstract
Hematologic safety of 177Lu-PSMA-617 radioligand therapy in patients with metastatic castration-resistant prostate cancer
Authors: Groener Daniel , Nguyen Cam Tu , Baumgarten Justus , Bockisch Benjamin , Davis Karen , Happel Christian , Mader Nicolai , Nguyen Ngoc Christina , Wichert Jennifer , Banek Severine , Mandel Philipp , Chun Felix K. H. , Tselis Nikolaos , Grünwald Frank , Sabet Amir
Published: July 2021

Background

Myelosuppression is a potential dose-limiting factor in radioligand therapy (RLT). This study aims to investigate occurrence, severity and reversibility of hematotoxic adverse events in patients undergoing RLT with 177Lu-PSMA-617 for metastatic castration-resistant prostate cancer (mCRPC). The contribution of pretreatment risk factors and cumulative treatment activity is taken into account specifically.

Methods

RLT was performed in 140 patients receiving a total of 497 cycles. A mean activity of 6.9 $$\pm$$
±
1.3 GBq 177Lu-PSMA-617 per cycle was administered, and mean cumulative activity was 24.6 $$\pm$$
±
15.9 GBq. Hematological parameters were measured at baseline, prior to each treatment course, 2 to 4 weeks thereafter and throughout follow-up. Toxicity was graded based on Common Terminology Criteria for Adverse Events v5.0.

Results

Significant (grade ≥ 3) hematologic adverse events occurred in 13 (9.3%) patients, with anemia in 10 (7.1%), leukopenia in 5 (3.6%) and thrombocytopenia in 6 (4.3%). Hematotoxicity was reversible to grade ≤ 2 through a median follow-up of 8 (IQR 9) months in all but two patients who died from disease progression within less than 3 months after RLT. Myelosuppression was significantly more frequent in patients with pre-existing grade 2 cytopenia (OR: 3.50, 95%CI 1.08–11.32, p = 0.04) or high bone tumor burden (disseminated or diffuse based on PROMISE miTNM, OR: 5.08, 95%CI 1.08–23.86, p = 0.04). Previous taxane-based chemotherapy was associated with an increased incidence of significant hematotoxicity (OR: 4.62, 95%CI 1.23–17.28, p = 0.02), while treatment with 223Ra-dichloride, cumulative RLT treatment activity and activity per cycle were not significantly correlated (p = 0.93, 0.33, 0.29).

Conclusion

Hematologic adverse events after RLT have an acceptable overall incidence and are frequently reversible. High bone tumor burden, previous taxane-based chemotherapy and pretreatment grade 2 cytopenia may be considered as risk factors for developing clinically relevant myelosuppression, whereas cumulative RLT activity and previous 223Ra-dichloride treatment show no significant contribution to incidence rates.
Time-delay effect on a diffusive predator–prey model with habitat complexity
Authors: Li Yanfeng , Liu Haicheng , Yang Ruizhi
Published: July 2021

Based on the predator–prey system with a Holling type functional response function, a diffusive predator–prey system with digest delay and habitat complexity is proposed. Firstly, the stability of the equilibrium of diffusion system without delay is studied. Secondly, under the Neumann boundary conditions, taking time delay as the bifurcation parameter, by analyzing the eigenvalues of linearized operator of the system and using the normal form theory and center manifold method of partial functional differential equations, the effect of time delay on the stability of the system is studied and the conditions under which Hopf bifurcation occurs are given. In addition, the calculation formulas of the bifurcation direction and the stability of bifurcating periodic solutions are derived. Finally, the accuracy of theoretical analysis results is verified by numerical simulations and the biological explanation is given for the analysis results.
Clinicopathological characteristics of patients with paraproteinemia and renal damage
Authors: Tang Xuanli , Wan Feng , Yu Jin , Li Xiaohong , Yang Ruchun , Zhu Bin
Published: July 2021

Background

This study aimed to analyze the clinicopathological characteristics of patients with paraproteinemia and renal damage.

Methods

Ninety-six patients from 2014 to 2018 with paraproteinemia and renal damage were enrolled and the clinical data, renal pathology, treatment and prognosis data were collected.

Results

A total of 96 patients (54 male and 42 female), accounting for 2.7% of all renal biopsies, were enrolled in this study. Among them, 42 were monoclonal gammopathy of renal significance (MGRS), 21 were renal monotypic immunoglobulin alone (renal monoIg), and 19 were monoclonal gammopathy of undetermined significance (MGUS). Individuals with multiple myeloma (MM) accounted for the fewest number of patients (n  =  14). In the MGRS group, the main diseases were amyloidosis (n  =  25) and cryoglobulinemic glomerulonephritis (n  =  7), while in the MM group, the main diseases were cast nephropathy (n  =  9) and light chain deposit disease (n  =  3). In the MGUS group, it was mainly IgA nephropathy (IgAN, n  =  10) and idiopathic membranous nephropathy (n  =  5); while in the renal monoIg group, most of the cases were IgAN (n  =  19). Chemotherapy was mainly administered to patients in the MM group, while immunosuppression therapy was mostly administered to patients in the renal monoIg group. Most patients with renal monoIg exhibited a major response, followed by the patients with MGUS and MGRS, while most of the patients with MM had a partial response but none had a major response. Approximately more than half (57.1%) of the patients with MM progressed to end-stage renal disease (ESRD), followed by MGRS (33.3%); however, the mortality rate was low in both the MGRS and MM groups. The survival analysis reviewed that serum creatinine, hemoglobin levels, and the serum κ/λ ratio were independent risk factors for ESRD in patients with MGRS.

Conclusions

The clinicopathological changes in patients with MGRS were between those in patients with MM and MGUS. The treatment for MGRS and MM was more intensive, and the overall mortality rate was low. Both MGUS and renal monoIg alone exhibited slighter clinicopathological features than MGRS and MM, and the treatment was focused mostly on primary renal diseases.
Temporal patterns in Ixodes ricinus microbial communities: an insight into tick-borne microbe interactions
Authors: Lejal E. , Chiquet J. , Aubert J. , Robin S. , Estrada-Peña A. , Rue O. , Midoux C. , Mariadassou M. , Bailly X. , Cougoul A. , Gasqui P. , Cosson J. F. , Chalvet-Monfray K. , Vayssier-Taussat M. , Pollet T.
Published: July 2021

Background

Ticks transmit pathogens of medical and veterinary importance and are an increasing threat to human and animal health. Assessing disease risk and developing new control strategies requires identifying members of the tick-borne microbiota as well as their temporal dynamics and interactions.

Methods

Using high-throughput sequencing, we studied theIxodes ricinus microbiota and its temporal dynamics. 371 nymphs were monthly collected during three consecutive years in a peri-urban forest. After a Poisson lognormal model was adjusted to our data set, a principal component analysis, sparse network reconstruction, and differential analysis allowed us to assess seasonal and monthly variability ofI. ricinusmicrobiota and interactions within this community.

Results

Around 75% of the detected sequences belonged to five genera known to be maternally inherited bacteria in arthropods and to potentially circulate in ticks:CandidatusMidichloria,Rickettsia,Spiroplasma,ArsenophonusandWolbachia. The structure of theI. ricinusmicrobiota varied over time with interannual recurrence and seemed to be mainly driven by OTUs commonly found in the environment. Total network analysis revealed a majority of positive partial correlations. We identified strong relationships between OTUs belonging toWolbachiaandArsenophonus, evidence for the presence of the parasitoid waspIxodiphagus hookeriin ticks. Other associations were observed between the tick symbiontCandidatusMidichloria and pathogens belonging toRickettsia. Finally, more specific network analyses were performed on TBP-infected samples and suggested that the presence of pathogens belonging to the generaBorrelia,AnaplasmaandRickettsiamay disrupt microbial interactions inI. ricinus.

Conclusions

We identified theI. ricinusmicrobiota and documented marked shifts in tick microbiota dynamics over time. Statistically, we showed strong relationships between the presence of specific pathogens and the structure of theI. ricinusmicrobiota. We detected close links between some tick symbionts and the potential presence of either pathogenicRickettsiaor a parasitoid in ticks. These new findings pave the way for the development of new strategies for the control of ticks and tick-borne diseases.
Hepatoprotective activity of melittin on isoniazid- and rifampicin-induced liver injuries in male albino rats
Authors: Naji Khalid Mohammed , Al-Khatib Bushra Yahya , Al-Haj Nora Saif , D’souza Myrene R.
Published: July 2021

Background

The present study investigated the ameliorative effect of melittin, a major polypeptide in the venom of honeybee (Apis mellifera), on isoniazid-(INH) and rifampicin-(RIF) induced hepatotoxicity in male albino rats.

Method

Thirty rats (140-200 g) were divided into five groups (n = 6): normal control (NC) received normal saline orally (NaCl, 0.9%; toxic (T) group received INH + RIF (each rat received 100 mg/kg, p.o.); melittin (Mel15, Mel30) groups (each rat received 15 or 30 μg/kg s.c); and normal recovery (NR) group received INH + RIF (each rat received 100 mg/kg, p.o.). Blood and liver samples were collected for biochemical, hematological and histopathological studies respectively.

Results

The administration of melittin was found to prevent the antitubercular drug-induced alterations in the diagnostic markers; reduced glutathione (GSH), direct bilirubin (DB), total bilirubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alkaline phosphatase (ALP), and total serum protein (TSP). Besides, hematological alterations were significantly high in Mel groups when compared to the toxic group. The NR group exhibited lower levels of DB, TB, ALP, LDH and TSP. In addition, treatment with melittin offered protection in the NR group with respect to MDA levels.

Conclusion

Evidence from this study suggests that melittin is beneficial for the prevention of acute hepatic failure in antitubercular drug-induced hepatoxicity and could be used as a potential therapeutic agent.