bluuebunny/crossref_metadata_2025 huggingface dataset:
Quantitative imaging of bone remodeling in patients with a unicompartmental joint unloading knee implant (ATLAS Knee System)—effect of metal artifacts on a SPECT-CT-based quantification
Authors: Grosser Oliver S. , Klutzny Marcus , Wissel Heiko , Kupitz Dennis , Finger Michael , Schenke Simone , Wuestemann Jan , Lohmann Christoph H. , Hoeschen Christoph , Pech Maciej , Staerke Christian , Kreissl Michael C.
Published: February 2021

Background

SPECT-CT using radiolabeled phosphonates is considered a standard for assessing bone metabolism (e.g., in patients with osteoarthritis of knee joints). However, SPECT can be influenced by metal artifacts in CT caused by endoprostheses affecting attenuation correction. The current study examined the effects of metal artifacts in CT of a specific endoprosthesis design on quantitative hybrid SPECT-CT imaging.

The implant was positioned inside a phantom homogenously filled with activity (955 MBq 99mTc). CT imaging was performed for different X-ray tube currents (I = 10, 40, 125 mA) and table pitches (p = 0.562 and 1.375). X-ray tube voltage (U = 120 kVp) and primary collimation (16 × 0.625 mm) were kept constant for all scans. The CT reconstruction was performed with five different reconstruction kernels (slice thickness, 1.25 mm and 3.75 mm, each 512 × 512 matrix). Effects from metal artifacts were analyzed for different CT scans and reconstruction protocols. ROI analysis of CT and SPECT data was performed for two slice positions/volumes representing the typical locations for target structures relative to the prosthesis (e.g., femur and tibia). A reference region (homogenous activity concentration without influence from metal artifacts) was analyzed for comparison.

Results

Significant effects caused by CT metal artifacts on attenuation-corrected SPECT were observed for the different slice positions, reconstructed slice thicknesses of CT data, and pitch and CT-reconstruction kernels used (all, p < 0.0001). Based on the optimization, a set of three protocols was identified minimizing the effect of CT metal artifacts on SPECT data. Regarding the reference region, the activity concentration in the anatomically correlated volume was underestimated by 8.9–10.1%. A slight inhomogeneity of the reconstructed activity concentration was detected inside the regions with a median up to 0.81% (p < 0.0001). Using an X-ray tube current of 40 mA showed the best result, balancing quantification and CT exposure.

Conclusion

The results of this study demonstrate the need for the evaluation of SPECT-CT protocols in prosthesis imaging. Phantom experiments demonstrated the possibility for quantitative SPECT-CT of bone turnover in a specific prosthesis design. Meanwhile, a systematic bias caused by metal implants on quantitative SPECT data has to be considered.
Standard MRI-based attenuation correction for PET/MRI phantoms: a novel concept using MRI-visible polymer
Authors: Rausch Ivo , Valladares Alejandra , Sundar Lalith Kumar Shiyam , Beyer Thomas , Hacker Marcus , Meyerspeer Martin , Unger Ewald
Published: February 2021

Background

PET/MRI phantom studies are challenged by the need of phantom-specific attenuation templates to account for attenuation properties of the phantom material. We present a PET/MRI phantom built from MRI-visible material for which attenuation correction (AC) can be performed using the standard MRI-based AC.

Methods

A water-fillable phantom was 3D-printed with a commercially available MRI-visible polymer. The phantom had a cylindrical shape and the fillable compartment consisted of a homogeneous region and a region containing solid rods of different diameters. The phantom was filled with a solution of water and [18F]FDG. A 30 min PET/MRI acquisition including the standard Dixon-based MR-AC method was performed. In addition, a CT scan of the phantom was acquired on a PET/CT system.

From the Dixon in-phase, opposed-phase and fat images, a phantom-specific AC map (Phantom MR-AC) was produced by separating the phantom material from the water compartment using a thresholding-based method and assigning fixed attenuation coefficients to the individual compartments. The PET data was reconstructed using the Phantom MR-AC, the original Dixon MR-AC, and an MR-AC just containing the water compartment (NoWall-AC) to estimate the error of ignoring the phantom walls. CT-based AC was employed as the reference standard. Average %-differences in measured activity between the CT corrected PET and the PET corrected with the other AC methods were calculated.

Results

The phantom housing and the liquid compartment were both visible and distinguishable from each other in the Dixon images and allowed the segmentation of a phantom-specific MR-based AC. Compared to the CT-AC PET, average differences in measured activity in the whole water compartment in the phantom of −0.3%, 9.4%, and −24.1% were found for Dixon phantom MR-AC, MR-AC, and NoWall-AC based PET, respectively. Average differences near the phantom wall in the homogeneous region were −0.3%, 6.6%, and −34.3%, respectively. Around the rods, activity differed from the CT-AC PET by 0.7%, 8.9%, and −45.5%, respectively.

Conclusion

The presented phantom material is visible using standard MR sequences, and thus, supports the use of standard, phantom-independent MR measurements for MR-AC in PET/MRI phantom studies.
Effect of platelet-rich and platelet-poor plasma on 3D bone-to-implant contact: a preclinical micro-CT study
Authors: Song Dandan , Shujaat Sohaib , Huang Yan , Van Dessel Jeroen , Politis Constantinus , Lambrichts Ivo , Jacobs Reinhilde
Published: February 2021

Background

Bone-to-implant contact ratio (BIC%) plays a critical role in secondary stability of osseointegrated dental implants. The aim of this study was to identify the correlation of 2D/3D micro-CT images with histology as a gold standard for evaluating BIC% and to investigate the influence of the platelet-rich plasma (PRP) and platelet-poor plasma (PPP) on 3D BIC% following delayed implant placement with delayed loading (DIP+DL).

Methods

Nine beagle dogs were recruited. Following bilateral extraction of mandibular 3rd premolar, 4th premolar, and 1st molar, 54 screw-type titanium implants were inserted and randomly divided into one control and two test groups based on a split-mouth design. The control group involved DIP+DL (n = 18) and both test groups included DIP+DL with local application of PRP (n = 18) and PPP (n = 18). A BIC analysis was performed utilizing 2D histomorphometry and 2D/3D micro-CT. Following identification of correlation between histology and 2D/3D micro-CT images, a 3D micro-CT assessment of the 3D BIC% at three follow-up time-points (1, 3, and 6 months) was carried out for observing the influence of PRP and PPP on BIC.

Results

The 2D micro-CT BIC% values revealed a strong positive correlation with histology (r = 0.98, p < 0.001) and a moderate correlation existed with 3D micro-CT (r = 0. 67, p = 0.005). BIC levels at 1 month and combined influence of PPP and PRP irrespective of time-points revealed significantly higher 3D BIC% compared to the control. However, a reduction in 3D BIC% was observed at the 3rd and 6th month. No significant difference was observed between both PRP and PPP.

Conclusions

Both 2D and 3D micro-CT demonstrated a potential to be utilized as a complimentary method for assessing BIC compared to the histological gold standard. Overall, both PRP and PPP significantly facilitated bone healing and osseointegration with a higher 3D BIC at follow-up. However, their influence was reduced as the observation period was increased.
Simulated learning in rural community environment: pushing the boundary
Authors: Akber Burhanuddin Ali , Rajani Mehak Ismail , Khalid Farah , Docherty Charles
Published: February 2021

Experiential learning through simulation can play a very significant role, not only in hospital settings but also in community contexts (Lubbers and Rossman, Nurse Educ. Today 48:140-144; Wheeler and McNelis, Nurs. Educ. Perspect 35:259-261). This paper discusses the concept of creating a novel simulated village set-up within a modern simulation center, to effectively deliver contemporary learning outcomes. It also highlights the challenges and risks of developing a simulated village set-up and strategies to counteract them. Furthermore, it describes the role of simulation specialists as innovators and explicates the gamut of expertise in education, management, and technologies that are required to deliver excellence in simulation-based education.
Hyperferritinemia in children hospitalized with scrub typhus
Authors: Williams Vijai , Menon Nisha , Bhatia Prateek , Biswal Manisha , Sreedharanunni Sreejesh , Jayashree Muralidharan , Nallasamy Karthi
Published: February 2021

Background

Hyperferritinemia is increasingly associated with mortality in sepsis. Studies estimating the prevalence of hyperferritinemia in pediatric scrub typhus are limited.

Methods

This was a secondary analysis of a prospective observational study (FERRIS) from a tertiary care teaching hospital in North India where 72 children with confirmed scrub typhus, 4 (5.5%) PCR positive, 55 (76.4%)-IgM ELISA positive, and 13 (18.1%)-both PCR and ELISA positive, were analyzed. Serum ferritin was measured in 62 children to identify the prevalence of hyperferritinemia and determine its association with mortality.

Results

Hyperferritinemia (> 500 μg/L) was seen in 72.6% [n = 45] children; 26 (41.9%) were mild (500–2000 μg/L), 13 (21%) were moderate (2000–10,000 μg/L), and 6 (9.7%) were severe (> 10,000 μg/L). Early presentation to hospital (≤ 7 days of febrile illness) had more survivors than late presentation (> 7 days). Non-survivors had significantly higher PRISM III, PELOD-2, hyperlactatemia, hypoalbuminemia, organ dysfunction, need for mechanical ventilation, and need of RRT. Ferritin had poor sensitivity and specificity in predicting survival with AUC of 0.56. Organ dysfunction and risk scores as PRISM III, PELOD 2, and VIS at admission were better predictors with AUC (95% CI) of 0.72 (0.56, 0.89), 0.77 (0.63, 0.92), and 0.90 (0.78, 1.0) respectively.

Conclusions

Hyperferritinemia is common in scrub typhus but it did not predict survival. Organ dysfunction and risk scores were better predictors of mortality than ferritin.
When more is more: redundant modifiers can facilitate visual search
Authors: Rehrig Gwendolyn , Cullimore Reese A. , Henderson John M. , Ferreira Fernanda
Published: February 2021

According to the Gricean Maxim of Quantity, speakers provide the amount of information listeners require to correctly interpret an utterance, and no more (Grice in Logic and conversation, 1975). However, speakers do tend to violate the Maxim of Quantity often, especially when the redundant information improves reference precision (Degen et al. in Psychol Rev 127(4):591–621, 2020). Redundant (non-contrastive) information may facilitate real-world search if it narrows the spatial scope under consideration, or improves target template specificity. The current study investigated whether non-contrastive modifiers that improve reference precision facilitate visual search in real-world scenes. In two visual search experiments, we compared search performance when perceptually relevant, but non-contrastive modifiers were included in the search instruction. Participants (NExp. 1 = 48, NExp. 2 = 48) searched for a unique target object following a search instruction that contained either no modifier, a location modifier (Experiment 1: on the top left, Experiment 2: on the shelf), or a color modifier (the black lamp). In Experiment 1 only, the target was located faster when the verbal instruction included either modifier, and there was an overall benefit of color modifiers in a combined analysis for scenes and conditions common to both experiments. The results suggest that violations of the Maxim of Quantity can facilitate search when the violations include task-relevant information that either augments the target template or constrains the search space, and when at least one modifier provides a highly reliable cue. Consistent with Degen et al. (2020), we conclude that listeners benefit from non-contrastive information that improves reference precision, and engage in rational reference comprehension.

Significance statement

This study investigated whether providing more information than someone needs to find an object in a photograph helps them to find that object more easily, even though it means they need to interpret a more complicated sentence. Before searching a scene, participants were either given information about where the object would be located in the scene, what color the object was, or were only told what object to search for. The results showed that providing additional information helped participants locate an object in an image more easily only when at least one piece of information communicated what part of the scene the object was in, which suggests that more information can be beneficial as long as that information is specific and helps the recipient achieve a goal. We conclude that people will pay attention to redundant information when it supports their task. In practice, our results suggest that instructions in other contexts (e.g., real-world navigation, using a smartphone app, prescription instructions, etc.) can benefit from the inclusion of what appears to be redundant information.
Assessment of China’s contributions to the Regional Network for Asian Schistosomiasis and Other Helminth Zoonoses: a questionnaire survey
Authors: Li Hong-Mei , Qian Ying-Jun , Yang Kun , Ding Wei , Huang Lu-Lu , Ma Xue-Jiao , Duan Lei , Wang Duo-Quan , Guan Ya-Yi , Xiao Ning , Zhou Xiao-Nong
Published: February 2021

Background

The Regional Network for Asian Schistosomiasis and Other Helminth Zoonoses (RNAS+) was established in 1998, which has developed close partnerships with Asian countries endemic for schistosomiasis and other helminthiasis in Asia. RNAS+ has provided an ideal regional platform for policy-makers, practitioners and researchers on the prevention, control and research of parasitic diseases in Asian countries. China, one of the initiating countries, has provided significant technical and financial support to the regional network. However, its roles and contributions have not been explored so far. The purpose of this study was to assess China's contributions on the supporting of RNAS+ development.

Methods

An assessment research framework was developed to evaluate China’s contributions to RNAS+ in four aspects, including capacity building, funding support, coordination, and cooperation. An anonymous web-based questionnaire was designed to acquire respondents’ basic information, and information on China’s contributions, challenges and recommendations for RNAS+development. Each participant scored from 0 to 10 to assess China’s contribution: “0” represents no contribution, and “10” represents 100% contribution. Participants who included their e-mail address in the 2017–2019 RNAS+ annual workshops were invited to participate in the assessment.

Results

Of 71 participants enrolled, 41 responded to the survey. 37 (37/41, 90.24%) of them were from RNAS+ member countries, while the other 4 (4/41, 9.76%) were international observers. Most of the respondents (38/41, 92.68%) were familiar with RNAS+. Respondents reported that China’s contributions mainly focused on improving capacity building, providing funding support, coordination responsibility, and joint application of cooperation programs on RNAS+ development. The average scores of China’s contributions in the above four fields were 8.92, 8.64, 8.75, and 8.67, respectively, with an overall assessment score of 8.81 (10 for a maximum score). The challenge of RNAS+ included the lack of sustainable funding, skills, etc. and most participants expressed their continual need of China’s support.

Conclusions

This survey showed that China has played an important role in the development of RNAS+ since its establishment. This network-type organization for disease control and research can yet be regarded as a great potential pattern for China to enhance regional cooperation. These findings can be used to promote future cooperation between China and other RNAS+ member countries.
Validity of neuron-specific enolase as a prognostic tool in acute ischemic stroke in adults at Suez Canal University Hospital
Authors: Shash Mohammed H. , Abdelrazek Reda , Abdelgeleel Nashwa M. , Ahmed Rasha M. , El-baih Adel H.
Published: February 2021

Background

Biological markers of acute nerve cell damage can assist in the outcome of acute ischemic stroke, such as neuron-specific enolase (NSE) that have been tested for association with initial severity of stroke, extent of infarction, and functional outcome.

Objective

To determine short-term prognostic value of the biochemical marker neuron-specific enolase (NSE) in acute ischemic stroke.

Methods

A cohort study carried out on 37 patients with acute ischemic stroke. Data were gathered in a prepared data sheet. Initial serum NSE level was measured to the patients in the Emergency department within 6 h of the onset of stroke and another measurement after 48 h. National Institute of Health Stroke Scale (NIHSS) was held to the patients at presentation and after 28 days of stroke to determine short-term morbidity and mortality.

Results

Out of the 37 patients, 31 patients survived (no-death group) and 6 patients died (death group). The mean serum level of neuron-specific enolase at presentation and after 48 h was significantly higher in the death group than in the no-death group. There was a statistically significant positive correlation between neuron-specific enolase (NSE) serum level and clinical severity of stroke (NIHSS) among the patients at presentation (r = 0.737, p = 0.000).

Conclusion

Neuron-specific enolase (NSE) can be applied as single independent marker for prediction of mortality and short-term morbidity in ischemic stroke patients.
Genetic variability and association between oil and economic traits for some new Egyptian cotton genotypes
Authors: Eldessouky Sara E. I. , El-Fesheikawy A. B. A. , Baker K. M. A.
Published: February 2021

Background

Cotton breeding programs mainly focus on improving cotton fibers, but less attention has been paid by breeders to cottonseed oil improvement. Breeding cottonseed for oil content has mainly depended on phenotypic information used to select varieties with high seed oil content. The purpose of this study was to evaluate some cotton genotypes regarding their oil content and other characters related to fiber yield, in order to select genotypes with high oil content and acceptable levels of the other characters. Seventeen different genotypes of cotton were used in this study. A two-year experiment was carried out at Sids Agricultural Research Station, Beni Suef, Egypt, during 2017 and 2018, using a randomized complete block design with six replications. Seed cotton yield, lint cotton yield, boll weight, seed index, embryo index, oil % and embryo oil index characters were recorded.

Results

The analysis of variance results showed highly significant differences among the genotypes for all the studied traits except boll weight in season 2017. The overall cotton embryo oil % ranged from 33.40 to 40.28 among the genotypes, while the overall cotton embryo oil index ranged from 1.79 to 2.47. Maximum cotton embryo oil % was noted by the genotypes 15 [{(G83 × G80) × G89} × Australian] and 8 [(G 91 × G90) × (G 85 × G 83)], while maximum cotton embryo oil index was noted by the genotype 13 [(G 91 × G 90) × G80]. The results showed positive correlations between seed cotton yield and lint cotton yield, seed index and embryo index, seed index and embryo index oil %, embryo index and embryo index oil %, and oil % and embryo index oil %.

Conclusions

It could be concluded that using seed or embryo oil percentages as criteria for differentiating genotypes according to their oil content is misleading and the best efficient measure is using the seed or embryo oil indices because they depend on weight basis. Also, Genotypes 13, 15 and 8 were the best genotypes regarding oil % and they could be used in breeding programs for cotton oil improvement.
Population dynamics of Fall Army Worm [(Spodoptera frugiperda) J.E. Smith] (Lepidoptera: Nuctuidae) in maize-cassava intercrop using pheromone traps in Niger Delta Region
Authors: Nwanze J. A. C. , Bob-Manuel R. B. , Zakka U. , Kingsley-Umana E. B.
Published: February 2021

Background

This study was conducted to generate baseline information on population dynamics of Fall Army Worm (FAW) in cassava-maize intercrop for management technique. Maize (Zea mays) is Africa’s most staple food crop with pest complex as major constraints to its production. The study was carried out at the Abuja Campus of the University of Port Harcourt, Faculty of Agriculture Teaching and Research Farm. A plot size of 3298 m2was cleared and ploughed; afterward, thirty six (36) ridges were made for the planting. Three varieties of maize grains (a hybrid Oba Super 98, white and yellow locals) were used for the study. Two cropping patterns (Sole maize and Cassava-Maize.-Intercrop) as main factor with a total of 18 sole and 18 intercrop plots and pheromone trap heights (at 1 m and 1.5 m) as sub-factor were used. The traps were mounted 18 days after planting and insect collection commenced at dawn the following day. FAW data in each trap were collected daily between 06.00 and 07.00 h. Maize cobs, fresh and dry weights, numbers of FAW exit holes, tunnels and tunnel lengths were recorded for both cropping patterns in each maize variety. Data were subjected to two-way analysis of variance.

Results

The results show higher mean value of FAW count in pheromone trap height placed at 1.5 m, and Oba super 98 maize variety intercropped with cassava had higher FAW count. There were significantly higher (P < 0.05) FAW exit holes in maize with pheromone trap height placed at 1.5 m, and maize-cassava intercrops had higher mean values of FAW exit holes. Number of tunnels and tunnel lengths (cm) due to FAW infestation were higher in maize varieties where pheromone traps were placed at 1.5 m.

Conclusion

Intercropping maize with cassava may suggest increase in FAW bionomics and the presence of abundant host which might increase a spike in its peak period of infestation. The presence of cassava in maize-cassava cropping pattern encourages feeding and/or oviposition of FAW on maize plant; therefore, an alternative cropping pattern should be encouraged in the region.
Using Google Trends to assess the impact of Global Public Health Days on online health information-seeking behaviour in Arabian Peninsula
Authors: Ajbar Aymane , Shepherd Thomas A. , Robinson Michelle , Mallen Christian D. , Prior James A.
Published: February 2021

Background

Global Public Health Days (GPHD) are public health interventions which serve to improve public awareness of specific health conditions. Google Trends is a publicly available tool that allows the user to view the popularity of a searched keyword during a specified time period and across a predetermined region. Our objective was to use Google Trends to assess the impact of four GPHD (World Heart Day, World Mental Health Day, World Diabetes Day and World Hypertension Day) on online health information-seeking behaviour (OHISB), 4 weeks before and a week after the GPHD, across six countries of the Arabian Peninsula (Bahrain, Kuwait, Oman, Qatar, Saudi Arabia and United Arab Emirates).

Methods

Relative Search Volume (RSV) was extracted for the aforementioned countries from 28 days before the GPHD and 7 days afterwards. Statistical analysis, undertaken using joinpoint regression software, showed that GPHD have significant changes for Saudi Arabia (Diabetes, Mental Health and Heart day) and UAE (Mental Health day) but were short-lived with a fall in RSV of up to 80% after peak interest.

Conclusion

GPHD appears to be effective in some countries while further research is needed to investigate the reason of its limitations.
The dysbiosis of ovine foot microbiome during the development and treatment of contagious ovine digital dermatitis
Authors: Duncan J. S. , Angell J. W. , Richards P. , Lenzi L. , Staton G. J. , Grove-White D. , Clegg S. , Oikonomou G. , Carter S. D. , Evans N. J.
Published: February 2021

Background

Contagious Ovine Digital Dermatitis (CODD) is an emerging and common infectious foot disease of sheep which causes severe welfare and economic problems for the sheep industry. The aetiology of the disease is not fully understood and control of the disease is problematic. The aim of this study was to investigate the polybacterial aetiopathogenesis of CODD and the effects of antibiotic treatment, in a longitudinal study of an experimentally induced disease outbreak using a 16S rRNA gene amplicon sequencing approach.

Results

CODD was induced in 15/30 experimental sheep. During the development of CODD three distinct phenotypic lesion stages were observed. These were an initial interdigital dermatitis (ID) lesion, followed by a footrot (FR) lesion, then finally a CODD lesion. Distinct microbiota were observed for each lesion in terms of microbial diversity, clustering and composition.Porphyromonadaceae, Family XI, VeillonellaceaeandFusobacteriaceaewere significantly associated with the diseased feet.VeillonellaceaeandFusobacteriaceaewere most associated with the earlier stages of ID and footrot rather than CODD. Following antibiotic treatment of the sheep, the foot microbiota showed a strong tendency to return to the composition of the healthy state. The microbiota composition of CODD lesions collected by swab and biopsy methods were different. In particular, theSpirochaetaceaefamily were more abundant in samples collected by the biopsy method, suggesting that these bacteria are present in deeper tissues of the diseased foot.

Conclusion

In this study, CODD presented as part of a spectrum of poly-bacterial foot disease strongly associated with bacterial familiesPorphyromonadaceae, Family XI(a family in Clostridiales also known as Clostridium cluster XI), VeillonellaceaeandFusobacteriaceaewhich are predominately Gram-negative anaerobes. Following antibiotic treatment, the microbiome showed a strong tendency to return to the composition of the healthy state. The composition of the healthy foot microbiome does not influence susceptibility to CODD.

Based on the data presented here and that CODD appears to be the severest end stage of sheep infectious foot disease lesions, better control of the initial ID and FR lesions would enable better control of CODD and enable better animal welfare.
Analysis of the androgen receptor (AR) gene in a cohort of Indonesian undermasculinized 46, XY DSD patients
Authors: Listyasari Nurin Aisyiyah , Juniarto Achmad Zulfa , Robevska Gorjana , Ayers Katie L. , Sinclair Andrew H. , Faradz Sultana M. H.
Published: February 2021

Background

Pathogenic variants in the androgen receptor (AR) gene located on chromosome Xq11-12, are known to cause varying degrees of undermasculinization in 46, XY individuals. The aim of this study was to investigate the frequency of pathogenic variants in the AR gene in a cohort of 46, XY undermasculinized individuals from Indonesia who were suspected of having androgen insensitivity syndrome (AIS). All patients with 46, XY DSD referred to our center between 1994 and 2019 were collected from our clinical database. All 46, XY DSD patients without a prior molecular diagnosis with an external masculinization score (EMS) ≤ 9 were included in this study. All exons and intron–exon boundaries of AR gene were analyzed using Sanger sequencing to identify pathogenic variants of the AR gene.

Results

A cohort of 75 undermasculinized patients were selected for the study. Direct Sanger sequencing of all eight exons of the AR gene led to a genetic diagnosis in 11 patients (14.67%). All of the variants identified (p.Arg841His; p.Ile604Asn; p.Val731Met; p.Pro672Ser; p.Gln739Arg; p.Ser302Glufs*3) have been previously reported in patients with AIS.

Conclusions

This is the first study in Indonesia that highlights the significance of molecular analysis in providing a definitive diagnosis of AIS for patients with 46, XY DSD undermasculinization. This is an uncommon finding in the Indonesian population presenting with 46, XY DSD undermasculinization. A genetic diagnosis allows optimal clinical management and genetic counseling for patients and their families. As 46, XY DSD can be caused by pathogenic variants in other genes involved in gonadal development and differentiation, further genetic analysis, such as whole exome sequencing, should be carried out on those patients that did not carry an AR variant.
Bridging the evidence-to-practice gap: a stepped-wedge cluster randomized controlled trial evaluating practice facilitation as a strategy to accelerate translation of a multi-level adherence intervention into safety net practices
Authors: Schoenthaler Antoinette , De La Calle Franzenith , Soto Amanda , Barrett Derrel , Cruz Jocelyn , Payano Leydi , Rosado Marina , Adhikari Samrachana , Ogedegbe Gbenga , Rosal Milagros
Published: February 2021

Background

Poor adherence to antihypertensive medications is a significant contributor to the racial gap in rates of blood pressure (BP) control among Latino adults, as compared to Black and White adults. While multi-level interventions (e.g., those aiming to influence practice, providers, and patients) have been efficacious in improving medication adherence in underserved patients with uncontrolled hypertension, the translation of these interventions into routine practice within “real world” safety-net primary care settings has been inadequate and slow. This study will fill this evidence-to-practice gap by evaluating the effectiveness of practice facilitation (PF) as a practical and tailored strategy for implementing Advancing Medication Adherence for Latinos with Hypertension through a Team-based Care Approach (ALTA), a multi-level approach to improving medication adherence and BP control in 10 safety-net practices in New York that serve Latino patients.

Methods and design

We will conduct this study in two phases: (1) a pre-implementation phase where we will refine the PF strategy, informed by the Consolidated Framework for Implementation Research, to facilitate the implementation of ALTA into routine care at the practices; and (2) an implementation phase during which we will evaluate, in a stepped-wedge cluster randomized controlled trial, the effect of the PF strategy on ALTA implementation fidelity (primary outcome), as well as on clinical outcomes (secondary outcomes) at 12 months. Implementation fidelity will be assessed using a mixed methods approach based on the five core dimensions outlined by Proctor’s Implementation Outcomes Framework. Clinical outcome measures include BP control (defined as BP< 140/80 mmHg) and medication adherence (assessed using the proportion of days covered via pharmacy records).

Discussion

The study protocol applies rigorous research methods to identify how implementation strategies such as PF may work to expedite the translation process for implementing evidence-based approaches into routine care at safety-net practices to improve health outcomes in Latino patients with hypertension, who suffer disproportionately from poor BP control. By examining the barriers and facilitators that affect implementation, this study will contribute knowledge that will increase the generalizability of its findings to other safety-net practices and guide effective scale-up across primary care practices nationally.

Trial registration

ClinicalTrials.gov NCT03713515, date of registration: October 19, 2018.
What is it about DID? A patient and clinician perspective
Authors: Crellin Amy , Temple Melanie
Published: February 2021

The diagnosis of dissociative identity disorder (DID) remains a contentious area in mental health. Patients experiencing such difficulties are often harshly identified as suggestible neurotics and interested clinicians as fanatics. However, for the sufferer, DID is as real and has as much impact as any other psychiatric diagnosis.

This commentary challenges psychiatry's dismissive and disbelieving attitude towards DID. The authors (a person with DID and a clinician) acknowledge the limited understanding of DID's aetiology and the paucity of associated neurological findings, but ask whether this is not the case for many other accepted psychiatric conditions. They call for UK psychiatric practice to move on from the debate and for the Royal College of Psychiatrists to take the lead, with inclusion of DID in core psychiatric training and guidelines on approaches to diagnosis and treatment.
The Role of Central Neurotensin in Regulating Feeding and Body Weight
Authors: Ramirez-Virella Jariel , Leinninger Gina M
Published: February 2021

The small peptide neurotensin (Nts) is implicated in myriad processes including analgesia, thermoregulation, reward, arousal, blood pressure, and modulation of feeding and body weight. Alterations in Nts have recently been described in individuals with obesity or eating disorders, suggesting that disrupted Nts signaling may contribute to body weight disturbance. Curiously, Nts mediates seemingly opposing regulation of body weight via different tissues. Peripherally acting Nts promotes fat absorption and weight gain, whereas central Nts signaling suppresses feeding and weight gain. Thus, because Nts is pleiotropic, a location-based approach must be used to understand its contributions to disordered body weight and whether the Nts system might be leveraged to improve metabolic health. Here we review the role of Nts signaling in the brain to understand the sites, receptors, and mechanisms by which Nts can promote behaviors that modify body weight. New techniques permitting site-specific modulation of Nts and Nts receptor–expressing cells suggest that, even in the brain, not all Nts circuitry exerts the same function. Intriguingly, there may be dedicated brain regions and circuits via which Nts specifically suppresses feeding behavior and weight gain vs other Nts-attributed physiology. Defining the central mechanisms by which Nts signaling modifies body weight may suggest strategies to correct disrupted energy balance, as needed to address overweight, obesity, and eating disorders.
Did Bach Compose Musical Works? Thinking with Adorno through Paradigms of Possibility
Authors: Goehr Lydia
Published: February 2021

This essay presents Theodor W. Adorno’s case pro and contra the regulation of the work-concept in a tradition that long sustained a great 1800 divide. The case is made through the provocation offered in Lydia Goehr’s Imaginary Museum of Musical Works that “Bach did not intend to compose musical works.” The essay investigates the many references to Johann Sebastian Bach in Adorno’s aesthetic, social, and philosophical writings to show that his Bach case was not merely illustrative but paradigmatic of every case he made for a critical theory of possibility. Adorno’s case was an urgent matter of rescue and justice, made by linking Bach’s compositions to Arnold Schoenberg’s paradigmata of a possible music through the mediation of the work-concept for which Ludwig van Beethoven was made in the tradition paradigmatically to stand.
Philology from the Point of View of Its Victims
Authors: Nichanian Marc
Published: February 2021

This essay examines Orientalism within the context of Edward Said’s works and the contemporary critical debates around them. Inspired by Erich Auerbach, Said strove to conceive of humanism as overcoming the European imperialist legacy. Yet not only does Said fail, he also seems to not notice how his version of humanism is appropriated by nationalists around the world. The greatest contradiction lies in the fact that Orientalism adopts a Foucauldian genealogical approach while carrying out a philological analysis. To illustrate the complicity between philology, colonialism, and nationalism, including Nazism, Nichanian sketches a genealogy of the figure of the native. The latter emerges as the eighteenth-century British jurist and linguist William Jones compiles and translates legalistic texts from India to be able to govern the “natives” by their own laws and in so doing invents the figure of the native as incapable of knowing his or her own past and law.
Combined secondary compounds naturally found in nectars enhance honeybee cognition and survival
Authors: Marchi Ignacio L. , Palottini Florencia , Farina Walter M.
Published: February 2021

The alkaloid caffeine and the amino acid arginine are present as secondary compounds in nectars of some flower species visited by pollinators. Each of these compounds affects honeybee appetitive behaviours by improving foraging activity and learning. While caffeine potentiates responses of mushroom body neurons involved in honeybee learning processes, arginine acts as precursor of nitric oxide, enhancing the protein synthesis involved in memory formation. Despite existing evidence on how these compounds affect honeybee cognitive ability individually, their combined effect on this is still unknown. We evaluated acquisition and memory retention in a classical olfactory conditioning procedure, in which the reward (sucrose solution) contained traces of caffeine, arginine or a mixture of the two. The results indicate that the presence of the single compounds and their most concentrated mixture increases bees' learning performance. However, memory retention, measured in the short and long term, increases significantly only in those treatments offering combinations of the two compounds in the reward. Additionally, the most concentrated mixture triggers a significant survival rate in the conditioned bees. Thus, some nectar compounds, when combined, show synergistic effects on cognitive ability and survival in an insect.
Effective image visualization for publications – a workflow using open access tools and concepts
Authors: Schmied Christopher , Jambor Helena Klara
Published: February 2021

Today, 25% of figures in biomedical publications contain images of various types, e.g. photos, light or electron microscopy images, x-rays, or even sketches or drawings. Despite being widely used, published images may be ineffective or illegible since details are not visible, information is missing or they have been inappropriately processed. The vast majority of such imperfect images can be attributed to the lack of experience of the authors as undergraduate and graduate curricula lack courses on image acquisition, ethical processing, and visualization. 

Here we present a step-by-step image processing workflow for effective and ethical image presentation. The workflow is aimed to allow novice users with little or no prior experience in image processing to implement the essential steps towards publishing images. The workflow is based on the open source software Fiji, but its principles can be applied with other software packages. All image processing steps discussed here, and complementary suggestions for image presentation, are shown in an accessible “cheat sheet”-style format, enabling wide distribution, use, and adoption to more specific needs.
Treatment of child wasting: results of a child health and nutrition research initiative (CHNRI) prioritisation exercise
Authors: Angood Chloe , Kerac Marko , Black Robert , Briend André , Hanson Kerstin , Jarrett Stephen , Manary Mark , McGrath Marie , Zagre Noël , Lelijveld Natasha , Mayberry Amy ,   CHNRI collaborators,   Council of Research & Technical Advice on Acute Malnutrition (CORTASAM)
Published: February 2021

Background: Child wasting is highly prevalent, with around 49.5 million children under five years affected globally. More evidence is needed to inform the scale up of effective treatment of wasted children worldwide. The aim of this study was to identify and prioritise the main outstanding research questions relating to the treatment of wasting to inform future research agendas.

Methods: A research prioritisation exercise was undertaken using the Child Health and Nutrition Research Initiative method. Research gaps were identified from multiple sources, grouped in themes and condensed into a list of 53 research areas by a group of experts. An online survey was developed and circulated globally to individuals working in the global nutrition sector. Participants evaluated each research area according to four agreed criteria. Research areas were then ranked according to an overall research priority score.

Results: A total of 394 individuals from 63 countries participated in the survey. Research areas prioritised by the group focused on the effective detection and diagnosis of ‘high risk’ wasted children in the community; provision of a continuum of care; and early life course interventions. The group also prioritised evidence to inform guidance on the impatient management of wasted children with diarrhoea; prevention of post-treatment relapse and mortality; and the optimisation of ready-to-use therapeutic foods in treatment programmes.

Conclusions: Critical gaps in our understanding of the treatment of wasting must be filled to inform guidance, policy and programming to ensure that all wasted children receive the treatment services that they need. A coordinated research agenda across treatment and prevention is urgently needed to maximise the impact of funding investments towards the meeting of global targets to reduce child wasting.
Identifying potential drug targets and candidate drugs for COVID-19: biological networks and structural modeling approaches
Authors: Selvaraj Gurudeeban , Kaliamurthi Satyavani , Peslherbe Gilles H. , Wei Dong-Qing
Published: February 2021

Background:Coronavirus (CoV) is an emerging human pathogen causing severe acute respiratory syndrome (SARS) around the world. Earlier identification of biomarkers for SARS can facilitate detection and reduce the mortality rate of the disease. Thus, by integrated network analysis and structural modeling approach, we aimed to explore the potential drug targets and the candidate drugs for coronavirus medicated SARS.

Methods:Differentially expression (DE) analysis of CoV infected host genes (HGs) expression profiles was conducted by using the Limma. Highly integrated DE-CoV-HGs were selected to construct the protein-protein interaction (PPI) network. 

Results:Using the Walktrap algorithm highly interconnected modules include module 1 (202 nodes); module 2 (126 nodes) and module 3 (121 nodes) modules were retrieved from the PPI network. MYC, HDAC9, NCOA3, CEBPB, VEGFA, BCL3, SMAD3, SMURF1, KLHL12, CBL, ERBB4, and CRKL were identified as potential drug targets (PDTs), which are highly expressed in the human respiratory system after CoV infection. Functional terms growth factor receptor binding, c-type lectin receptor signaling, interleukin-1 mediated signaling, TAP dependent antigen processing and presentation of peptide antigen via MHC class I, stimulatory T cell receptor signaling, and innate immune response signaling pathways, signal transduction and cytokine immune signaling pathways were enriched in the modules. Protein-protein docking results demonstrated the strong binding affinity (-314.57 kcal/mol) of the ERBB4-3cLpro complex which was selected as a drug target. In addition, molecular dynamics simulations indicated the structural stability and flexibility of the ERBB4-3cLpro complex. Further, Wortmannin was proposed as a candidate drug to ERBB4 to control SARS-CoV-2 pathogenesis through inhibit receptor tyrosine kinase-dependent macropinocytosis, MAPK signaling, and NF-kb singling pathways that regulate host cell entry, replication, and modulation of the host immune system.

Conclusion:We conclude that CoV drug target “ERBB4” and candidate drug “Wortmannin” provide insights on the possible personalized therapeutics for emerging COVID-19.
Pharmacists’ perceived role in supporting diabetes education and self-management in Ireland: a qualitative study
Authors: Cooney Eva , O'Riordan David , McSharry Jennifer
Published: February 2021

Background: Support for people with diabetes is necessary for optimal self-management. Structured diabetes education programmes fulfil this need, but attendance rates are consistently low. The role of pharmacists has expanded but the profession remains underutilised in chronic disease management. The objective of this study is to explore pharmacists’ perceived role in the support of diabetes education and self-management behaviours.

Methods: A qualitative study using semi-structured interviews of community pharmacists in Ireland was conducted. Interviews were audio-recorded, transcribed verbatim and analysed using inductive thematic analysis.

Results: Ten pharmacists were interviewed. The four themes identified illustrate the juxtaposition of pharmacists’ potential in diabetes care with the realities of current pharmaceutical practice. One theme outlined the relationship between the person with diabetes and the pharmacist, ‘Patient or customer: the nature of the pharmacist relationship’. Two themes described the pharmacists’ role in supporting diabetes education and self-management, ‘Beyond medication: pharmacists’ current and potential role in diabetes management’ and ‘Need for diabetes education’. The final theme highlighted the barriers to a more engaged role in patient care, ‘Barriers: “all the stuff that gets in the way”’.

Conclusion: The relationship between pharmacists and people with diabetes could facilitate pharmacists in supporting diabetes self-management. However, variability across pharmacists’ level of involvement and consistent resource barriers were noted. Pharmacists were poorly informed about structured diabetes education programmes. Further research is needed to explore this variability but there may be potential to enhance the pharmacist role in promoting attendance at structured diabetes education programmes.
The second wave: estimating the hidden asymptomatic prevalence of COVID-19 in Ireland as we plan for imminent immunisation
Authors: Comiskey Catherine , Snel Anne , Banka Prakashini
Published: February 2021

Since the first case of COVID-19 in Ireland was recorded policy makers have introduced mitigation measures to control the spread of infection. Infection is spread by both known cases and hidden, undetected asymptomatic cases.  Asymptomatic individuals are people who transmit the virus but display no clinical symptoms. Current evidence reveals that this population is a major contributing factor to the spread of the disease. There is little or no knowledge of the scale of the hidden prevalence of all infections both asymptomatic and symptomatic in Ireland. Furthermore, as governments plan for the roll out of imminent immunisation programmes, the need to know the scale of the hidden prevalence and hence knowledge of the level of immunisation required is essential.

We describe and analyse the numbers of reported cases of COVID-19 in Ireland from the first case in February 2020 to mid-December 2020. Using the method of back-calculation we provide estimates of the asymptomatic prevalence of cases from June to December 2020.

The descriptive analysis highlighted two epidemic waves of known cases in the time period. Wave two from June to December included twice as many cases as wave one and cases were significantly younger. The back-calculation estimates of asymptomatic prevalence during this time period revealed that for every case known there was an additional unknown case and total prevalence in wave two was estimated to be approximately 95,000 as opposed to the reported 48,390 cases.

As prevalence in wave two is known to be spreading within and from younger age groups the role of mixing patterns on spread needs to be disseminated to the wider public to adequately inform them how personal modifications in behaviour can contribute to the control of the epidemic. While universally imposed lockdowns and mitigation measures may be essential, personal behavioural mixing choices are powerful protectors.