bluuebunny/crossref_metadata_2025 huggingface dataset:
The effects of lower-limb wearable resistance on sprint performance in high school American football athletes: A nine-week training study
Authors: Feser Erin H , Korfist Christian , Lindley Kyle , Bezodis Neil E , Clark Kenneth , Cronin John
Published: March 2021

Time constraints often result in the challenge to fit desired programming into training time allotments. Wearable resistance (WR) may be an option to optimise the training content in function of constrained training time. The purpose of this study was to determine the effects of a lower-limb WR sprint running training intervention on athlete speed capabilities following a nine-week off-season, low volume training period within a sample of American football high school athletes. Nineteen athletes completed pre- and post-intervention testing of two maximal effort 30 m sprints. Horizontal force-velocity mechanical profiling variables, sprint times, and maximal velocity were calculated from sprint running velocity data collected by a radar device. The athletes completed seventeen dedicated sprint training sessions during the off-season. The intervention (WR) group completed the sessions with 1% body mass load attached to the shanks (i.e. 0.50% body mass load on each limb). The control group completed the same training sessions unloaded. Post-intervention, no statistically significant between group differences were observed ( p > 0.05). However, athletes in both groups experienced increases in velocity measures following the sprint training. The greater adjusted mean theoretical maximal velocity scores ( p > 0.05; ES = 0.30) found for the WR group compared to the control group at post-intervention may suggest that WR amplifies the nuances of the training protocol itself. Coaches can consider using lower-limb WR training to increase in-session workloads during periods of low volume training but more research is needed to better understand to what extent WR training might provide an added value to optimise both the training content and planning, as well as the athlete’s training response in order to improve sprint running performance.
Diagnosing small fiber neuropathy in clinical practice: a deep phenotyping study
Authors: Egenolf Nadine , Altenschildesche Caren Meyer zu , Kreß Luisa , Eggermann Katja , Namer Barbara , Gross Franziska , Klitsch Alexander , Malzacher Tobias , Kampik Daniel , Malik Rayaz A. , Kurth Ingo , Sommer Claudia , Üçeyler Nurcan
Published: March 2021

Background and aims:

Small fiber neuropathy (SFN) is increasingly suspected in patients with pain of uncertain origin, and making the diagnosis remains a challenge lacking a diagnostic gold standard.

Methods:

In this case–control study, we prospectively recruited 86 patients with a medical history and clinical phenotype suggestive of SFN. Patients underwent neurological examination, quantitative sensory testing (QST), and distal and proximal skin punch biopsy, and were tested for pain-associated gene loci. Fifty-five of these patients additionally underwent pain-related evoked potentials (PREP), corneal confocal microscopy (CCM), and a quantitative sudomotor axon reflex test (QSART).

Results:

Abnormal distal intraepidermal nerve fiber density (IENFD) (60/86, 70%) and neurological examination (53/86, 62%) most frequently reflected small fiber disease. Adding CCM and/or PREP further increased the number of patients with small fiber impairment to 47/55 (85%). Genetic testing revealed potentially pathogenic gene variants in 14/86 (16%) index patients. QST, QSART, and proximal IENFD were of lower impact.

Conclusion:

We propose to diagnose SFN primarily based on the results of neurological examination and distal IENFD, with more detailed phenotyping in specialized centers.
Validation of an educational game to promote cardiovascular health in children
Authors: Chaves Costa Francisca Bertilia , Catrib Ana Maria Fontenelle , de Almeida Lana Paula Crivelaro Monteiro , de Souza Araújo Santos Zélia Maria , de Oliveira Branco July Grassiely , Bruno da Silva Carlos Antonio
Published: March 2021

Objective:

The aim of this study was to validate the content and appearance of an educational game for children aged 7 to 10 years, focusing mainly on cardiovascular health promotion.

Method:

The study used methodological research, with a quantitative approach. The validation process included the participation of 17 specialists in children and/or cardiovascular health. A concordance index of at least 0.80 was considered for content validation and 0.75 for the appearance of the proposed educational material.

Results:

The proposal of the educational game was considered valid, through some suggestions, in view of the purpose of sensitizing children in relation to the promotion of cardiovascular health while still in childhood.

Final considerations:

As a relevant factor in the use of games as strategies to improve health education, we emphasize that the participant is the active agent and the protagonist of the health-disease process.
Negative Effect of Roundup Requests on Repurchase Intentions
Authors: Khan Saira Raza , Septianto Felix , Putra Pragea Geldoffy
Published: March 2021

Requesting customers to “round up” the total for their purchases to the next whole dollar and donating the difference has been a recent trend among some companies. A recent study argues that a roundup donation request reduces the perceived pain of donating, thus making it more effective as compared with a flat donation request; however, the present research argues that a roundup donation request can also have potential negative returns. This article demonstrates across two experimental studies, that consumers report lower repurchase intentions when approached with a roundup (vs. flat) donation request, due to an increased anticipated negative affect associated with refusing such a request. Moreover, such effects only occur among consumers with utilitarian (but not hedonic) purchase motives. The findings of this research extend prior research in this area by highlighting the potential negative consequences of roundup donation requests.
Simulation of Cerebrospinal Fluid Leak Repair Using a 3-Dimensional Printed Model
Authors: Masalha Muhamed A. , VanKoevering Kyle K. , Latif Omar S. , Powell Allison R. , Zhang Ashley , Hod Keren H. , Prevedello Daniel M. , Carrau Ricardo L.
Published: March 2021

Background

Acquiring proficiency for the repair of a cerebrospinal fluid (CSF) leak is challenging in great part due to its relative rarity, which offers a finite number of training opportunities.

Objective

The purpose of this study was to evaluates the use of a 3-dimensional (3D) printed, anatomically accurate model to simulate CSF leak closure.

Methods

Volunteer participants completed two simulation sessions. Questionnaires to assess their professional qualifications and a standardized 5-point Likert scale to estimate the level of confidence, were completed before and after each session. Participants were also queried on the overall educational utility of the simulation.

Results

Thirteen otolaryngologists and 11 neurosurgeons, met the inclusion criteria. A successful repair of the CSF leak was achieved by 20/24 (83.33%), and 24/24 (100%) during the first and second simulation sessions respectively (average time 04:04 ± 1.39 and 02:10 ± 01:11). Time-to-close-the-CSF-leak during the second session was significantly shorter than the first (p < 0.001). Confidence scores increased across the training sessions (3.3 ± 1.0, before the simulation, 3.7 ± 0.6 after the first simulation, and 4.2 ± 0.4 after the second simulation; p < 0.001). All participants reported an increase in confidence and believed that the model represented a valuable training tool.

Conclusions

Despite significant differences with varying clinical scenarios, 3D printed models for cerebrospinal leak repair offer a feasible simulation for the training of residents and novice surgeons outside the constrictions of a clinical environment.
A case report of a localized reticular erythematous mucinosis like eruption of the lower legs mimicking cutaneous larvae migrans
Authors: Kenny Bret , Lichtenwald Duane , Wright Glenda R , Osmond Allison
Published: March 2021

Reticular erythematous mucinosis is an uncommon type of cutaneous mucinosis. Typically, reticular erythematous mucinosis affects middle-aged women and usually appears as papules and plaques on the mid-upper trunk. Histologically, biopsies of reticular erythematous mucinosis reveal increased deposition of dermal mucin and perivascular lymphocytic inflammation. Infrequently, reticular erythematous mucinosis has been reported in males and in atypical locations other than the trunk. In these instances, reticular erythematous mucinosis can present a diagnostic challenge clinically and histologically. This case describes the clinical and histologic findings of a localized variant of reticular erythematous mucinosis in a 65-year-old male patient.
Optimal Early Diagnosis and Monitoring of Diabetic Kidney Disease in Type 2 Diabetes Mellitus: Addressing the Barriers to Albuminuria Testing
Authors: Christofides Elena A. , Desai Niraj
Published: March 2021

Chronic kidney disease (CKD) in patients with type 2 diabetes (T2D) is associated with increased risk of end-stage renal disease (ESRD) and cardiovascular disease (CVD). Urine albumin-to-creatinine ratio (UACR) is a sensitive and early indicator of kidney damage, which should be used routinely to accurately assess CKD stage and monitor kidney health. However, this test currently is performed in only a minority of patients with T2D. Here, we review the importance of albuminuria testing and current barriers that hinder patient access to UACR testing and describe solutions to such testing in a community clinical setting.
Behavioral Correlates of GPS Device Usage Among Small-Scale Fishers in Malaysia
Authors: Mohamed Shaffril Hayrol Azril , Eric Krauss Steven , Hamzah Azimi , Abu Samah Bahaman
Published: March 2021

This article aims to examine the relationship between selected behavioral factors and Global Positioning System (GPS) usage among small-scale fishers in Malaysia. An adapted version of the Unified Theory of Acceptance and Use of Technology (UTAUT) was tested among a sample of 400 small-scale fishers to examine the relationship between technology-related behavioral constructs (compatibility, social influence, effort expectancy, learning culture, and performance expectancy) and GPS usage. The sample was selected from 12 fishery districts in Malaysia. Confirmatory factor analysis (CFA) confirmed that all five technology-related behavioral constructs included in the model recorded a significant relationship with GPS usage. The results extend the generalizability of the UTAUT to a previously understudied setting of community technology usage. Understanding GPS usage among small-scale fishers from the extended UTAUT perspective can provide policy makers, public, nongovernmental organizations (NGOs), and other concerned parties with knowledge that can build awareness and shape capacity building efforts for small-scale interventions to increase the use of GPS. This will, in turn, reduce the risks associated with fishing routines and enhance fishing yields.
Incidental Finding of a Large Right Atrial Thrombus in a Patient With Cerebral Lymphoma
Authors: Fath Ayman R. , Eldaly Abdullah S. , Aglan Amro , Varkoly Kyle S. , Beladi Roxana N. , Solsi Anup , Hahn Mary F. , Karis John P. , Nafisi Sina , Brady Kevin , Bellamkonda Pallavi , Wakefield Dara N. , Clapp William L. , Lucas Alexandra R.
Published: March 2021

Right atrial (RA) masses are rare, challenging to diagnose, and potentially life-threatening with high mortality if untreated. We present a patient presenting with diffuse large B-cell lymphoma in the brain that was incidentally found to have a large RA mass. For a better definition of the RA mass, extensive workup using multimodality imaging including chest computed tomography, transthoracic echocardiography, transesophageal echocardiography, cardiac magnetic resonance imaging, and left heart catheterization was warranted. The imaging demonstrated a large RA mass extending through the tricuspid valve into the right ventricle and superior and inferior vena cava without a mobile component. The mass was then successfully resected, and further histology examination was performed to rule out lymphoma and rare subtypes of diffuse large B-cell lymphoma. The comprehensive workup proved the RA mass to be a calcified thrombus rather than a direct metastatic spread of lymphoma.
A Novel Medial Malleolar Osteotomy Technique for the Treatment of Osteochondral Lesions of the Talus
Authors: Hu Yong , Yue Cheng , Li Xiucun , Li ZhengXun , Zhou Dongsheng , Xu Hailin , Zhang Ning
Published: March 2021

Background:

The current techniques for medial malleolar osteotomy may lead to posterior tibial tendon injury and have a high rate of malunion.

Purpose:

To describe a novel partial step-cut medial malleolar osteotomy technique and evaluate its technical feasibility and its advantages compared with traditional methods.

Study Design:

Case series; Level of evidence, 4.

Methods:

The novel technique consisted of osteotomy of the anterior one-third to two-thirds of the medial malleolus. A total of 19 ankles (18 patients) with osteochondral lesions of the talus underwent the novel osteotomy technique before osteochondral reconstruction. All patients were evaluated for more than 2 years. Radiographs were analyzed for postoperative displacement and malunion, and postoperative ankle function was evaluated according to the American Orthopaedic Foot & Ankle Society (AOFAS) ankle-hindfoot scale and the visual analog scale (VAS) for pain.

Results:

The partial step-cut osteotomy technique was able to provide adequate intra-articular exposure without disturbing the posterior tibial tendon. The 19 ankles healed at a mean of 7.3 ± 1.5 weeks (range, 6-12 weeks). There was slight incongruence in 4 ankles, with a displacement of 1.0 ± 0.1 mm proximally and 0.3 ± 0.1 mm medially. The mean postoperative AOFAS and VAS scores improved compared with preoperatively, from 54.2 ± 12.1 to 84.6 ± 6.6 and from 6.4 ± 1.0 to 1.8 ± 1.3, respectively ( P < .001 for both). No intraoperative tendon injuries were observed.

Conclusion:

Results indicated that partial step-cut osteotomy is a reliable and effective method for providing enough exposure, avoiding displacement after reduction, and not disturbing the anatomic structures behind the medial malleolus.
Making Sense of Model Generalizability: A Tutorial on Cross-Validation in R and Shiny
Authors: Song Q. Chelsea , Tang Chen , Wee Serena
Published: March 2021

Model generalizability describes how well the findings from a sample are applicable to other samples in the population. In this Tutorial, we explain model generalizability through the statistical concept of model overfitting and its outcome (i.e., validity shrinkage in new samples), and we use a Shiny app to simulate and visualize how model generalizability is influenced by three factors: model complexity, sample size, and effect size. We then discuss cross-validation as an approach for evaluating model generalizability and provide guidelines for implementing this approach. To help researchers understand how to apply cross-validation to their own research, we walk through an example, accompanied by step-by-step illustrations in R. This Tutorial is expected to help readers develop the basic knowledge and skills to use cross-validation to evaluate model generalizability in their research and practice.
Characterization of dual nano-size effects of ACC-cellulose nanofibrils on crystallization behavior of hydrophilic poly(vinyl alcohol)
Authors: Ishikawa Gento , Kondo Tetsuo
Published: March 2021

This study attempts to clarify thermodynamic quantification on interaction between poly(vinyl alcohol) (PVA) and wood-derived cellulose nanofibrils (CNFs) obtained by aqueous counter collision (ACC) method. Aqueous mixtures of PVA/ACC-CNFs with various fiber widths were cast as the target materials. The interfacial interactions between the two components were characterized through thermodynamic evaluation of the crystalline PVA component as a probe in the cast mixture. As the result, surface properties of the ACC-CNFs found to reflect on the crystallization behavior of the interacted PVA component, resulting in dual nano-size effects of either diluent or nucleating agent. Melting point depression behaviors of the PVA component indicated that ACC-CNFs with thinner widths induced nucleation effects on PVA crystallization, whereas ACC-CNFs with ca. 100 nm in width encouraged diluent effects on PVA components. It is noted that this trend found to be reverse to the case for PVA/ACC-CNFs of bacterial nanocellulose previously reported.
ATAV: a comprehensive platform for population-scale genomic analyses
Authors: Ren Zhong , Povysil Gundula , Hostyk Joseph A. , Cui Hongzhu , Bhardwaj Nitin , Goldstein David B.
Published: March 2021

Background

A common approach for sequencing studies is to do joint-calling and store variants of all samples in a single file. If new samples are continually added or controls are re-used for several studies, the cost and time required to perform joint-calling for each analysis can become prohibitive.

Results

We present ATAV, an analysis platform for large-scale whole-exome and whole-genome sequencing projects. ATAV stores variant and per site coverage data for all samples in a centralized database, which is efficiently queried by ATAV to support diagnostic analyses for trios and singletons, as well as rare-variant collapsing analyses for finding disease associations in complex diseases. Runtime logs ensure full reproducibility and the modularized ATAV framework makes it extensible to continuous development. Besides helping with the identification of disease-causing variants for a range of diseases, ATAV has also enabled the discovery of disease-genes by rare-variant collapsing on datasets containing more than 20,000 samples. Analyses to date have been performed on data of more than 110,000 individuals demonstrating the scalability of the framework.

To allow users to easily access variant-level data directly from the database, we provide a web-based interface, the ATAV data browser (http://atavdb.org/). Through this browser, summary-level data for more than 40,000 samples can be queried by the general public representing a mix of cases and controls of diverse ancestries. Users have access to phenotype categories of variant carriers, as well as predicted ancestry, gender, and quality metrics. In contrast to many other platforms, the data browser is able to show data of newly-added samples in real-time and therefore evolves rapidly as more and more samples are sequenced.

Conclusions

Through ATAV, users have public access to one of the largest variant databases for patients sequenced at a tertiary care center and can look up any genes or variants of interest. Additionally, since the entire code is freely available on GitHub, ATAV can easily be deployed by other groups that wish to build their own platform, database, and user interface.
Long-term dynamic compression enhancement TGF-β3-induced chondrogenesis in bovine stem cells: a gene expression analysis
Authors: Chen Jishizhan , Chen Lidan , Hua Jia , Song Wenhui
Published: March 2021

Background

Bioengineering has demonstrated the potential of utilising mesenchymal stem cells (MSCs), growth factors, and mechanical stimuli to treat cartilage defects. However, the underlying genes and pathways are largely unclear. This is the first study on screening and identifying the hub genes involved in mechanically enhanced chondrogenesis and their potential molecular mechanisms.

Methods

The datasets were downloaded from the Gene Expression Omnibus (GEO) database and contain six transforming growth factor-beta-3 (TGF-β3) induced bovine bone marrow-derived MSCs specimens and six TGF-β3/dynamic-compression-induced specimens at day 42. Screening differentially expressed genes (DEGs) was performed and then analysed via bioinformatics methods. The Database for Annotation, Visualisation, and Integrated Discovery (DAVID) online analysis was utilised to obtain the Gene Ontology (GO) and Kyoto Encyclopaedia of Genes and Genomes (KEGG) pathway enrichment. The protein-protein interaction (PPI) network of the DEGs was constructed based on data from the STRING database and visualised through the Cytoscape software. The functional modules were extracted from the PPI network for further analysis.

Results

The top 10 hub genes ranked by their connection degrees were IL6, UBE2C, TOP2A, MCM4, PLK2, SMC2, BMP2, LMO7, TRIM36, and MAPK8. Multiple signalling pathways (including the PI3K-Akt signalling pathway, the toll-like receptor signalling pathway, the TNF signalling pathway, and the MAPK pathway) may impact the sensation, transduction, and reaction of external mechanical stimuli.

Conclusions

This study provides a theoretical finding showing that gene UBE2C, IL6, and MAPK8, and multiple signalling pathways may play pivotal roles in dynamic compression-enhanced chondrogenesis.
Takotsubo cardiomyopathy complicating acute pancreatitis: a case report
Authors: Yeh John , Carroll James
Published: March 2021

Background

Acute pancreatitis as a trigger of Takotsubo cardiomyopathy has been infrequently described in the literature. Misdiagnosis of this phenomenon can often occur due to overlap in symptomology, particularly in those outside of the usual patient demographic.

Case presentation

A 27-year-old man with a history of alcohol abuse presented with epigastric and chest pain. Electrocardiography showed ischemic changes, and laboratory workup revealed elevated lipase and troponin. He was diagnosed with acute pancreatitis and managed presumptively as acute coronary syndrome. Subsequent coronary angiography was negative for obstructive coronary artery disease, and left ventriculography demonstrated basal hyperkinesis and apical akinesis, characteristic of Takotsubo cardiomyopathy.

Conclusions

Takotsubo cardiomyopathy is a rare complication of acute pancreatitis. Increased awareness of this phenomenon is required to prevent delays in diagnosis and avoid unnecessary interventions and complications.
Disease-related disability burden: a comparison of seven chronic conditions in middle-aged and older adults
Authors: Chou Chieh-Ying , Chiu Ching-Ju , Chang Chia-Ming , Wu Chih-Hsing , Lu Feng-Hwa , Wu Jin-Shang , Yang Yi-Ching
Published: March 2021

Background

Although previous studies have explored the effect of chronic conditions on physical disability, little is known about the levels and rates of change in physical disability after a chronic condition diagnosis in middle-aged and older adults in the Asian population. The aim of this study is to ascertain the average levels and rates of change in the development of disability after disease diagnosis, as well as to determine the influences of sociodemographic and health-related correlates in the development of disability.

Methods

This is a retrospective cohort study analyzing data of nationally representative participants aged 50 and over with a chronic condition or having developed one during follow-ups based on data from the 1996–2011 Taiwan Longitudinal Study on Aging (TLSA) (n = 5131). Seven chronic conditions were examined. Covariates included age at initial diagnosis, gender, education level, number of comorbidities, and depression status. Physical disability was measured by combining self-reported ADL, IADL, and strength and mobility activities with 17 total possible points, further analyzed with multilevel modeling.

Results

The results showed that (1) physical disability was highest for stroke, followed by cancer and diabetes at the time of the initial disease diagnosis. (2) The linear rate of change was highest for stroke, followed by lung disease and heart disease, indicating that these diseases led to higher steady increases in physical disability after the disease diagnosis. (3) The quadratic rate of change was highest in diabetes, followed by cancer and hypertension, indicating that these diseases had led to higher increments of physical disability in later stage disease. After controlling for sociodemographic and comorbidity, depression status accounted for 39.9–73.6% and 37.9–100% of the variances in the physical disability intercept and change over time, respectively.

Conclusions

Despite the fact that a comparison across conditions was not statistically tested, an accelerated increase in physical disabilities was found as chronic conditions progressed. While stroke and cancer lead to disability immediately, conditions such as diabetes, cancer, and hypertension give rise to higher increments of physical disability in later stage disease. Mitigating depressive symptoms may be beneficial in terms of preventing disability development in this population.
Hepatic expression of cholesterol regulating genes favour increased circulating low-density lipoprotein in HIV infected patients with gallstone disease: a preliminary study
Authors: Kinoo Suman Mewa , Chuturgoon Anil A. , Singh Bugwan , Nagiah Savania
Published: March 2021

Background

HIV endemic populations are displaying higher incidence of metabolic disorders. HIV and the standard treatment are both associated with altered lipid and cholesterol metabolism, however gallstone disease (a cholesterol related disorder) in Sub-Saharan African populations is rarely investigated.

Methods

This study sought to evaluate hepatic expression of key genes in cholesterol metabolism (LDLr, HMGCR, ABCA1) and transcriptional regulators of these genes (microRNA-148a, SREBP2) in HIV positive patients on antiretroviral therapy presenting with gallstones. Liver biopsies from HIV positive patients (cases: n = 5) and HIV negative patients (controls: n = 5) were analysed for miR-148a and mRNA expression using quantitative PCR.

Results

Circulating total cholesterol was elevated in the HIV positive group with significantly elevated LDL-c levels(3.16 ± 0.64 mmol/L) relative to uninfected controls (2.10 ± 0.74 mmol/L; p = 0.04). A scavenging receptor for LDL-c, LDLr was significantly decreased (0.18-fold) in this group, possibly contributing to higher LDL-c levels. Transcriptional regulator of LDLr, SREBP2 was also significantly lower (0.13-fold) in HIV positive patients. Regulatory microRNA, miR-148a-3p, was reduced in HIV positive patients (0.39-fold) with a concomitant increase in target ABCA1 (1.5-fold), which regulates cholesterol efflux.

Conclusions

Collectively these results show that HIV patients on antiretroviral therapy display altered hepatic regulation of cholesterol metabolizing genes, reducing cholesterol scavenging, and increasing cholesterol efflux.
Suppression of thyrotropin secretion during roxadustat treatment for renal anemia in a patient undergoing hemodialysis
Authors: Ichii Mitsuru , Mori Katsuhito , Miyaoka Daichi , Sonoda Mika , Tsujimoto Yoshihiro , Nakatani Shinya , Shoji Tetsuo , Emoto Masanori
Published: March 2021

Background

Inhibition of hypoxia-inducible factor prolyl hydroxylase (HIF-PH) is a novel choice for the treatment of renal anemia, and an oral HIF-PH inhibitor roxadustat was approved for renal anemia. Roxadustat has high affinity to thyroid hormone receptor beta, which may affect thyroid hormone homeostasis.

Case presentation

We present here a patient undergoing hemodialysis with primary hypothyroidism receiving levothyroxine replacement, who showed decreased free thyroxine (FT4) and thyroid stimulating hormone (TSH) after starting roxadustat. Pituitary stimulation test revealed selective suppression of TSH secretion. Recovery of TSH and FT4 levels after stopping roxadustat suggested the suppression of TSH was reversible.

Conclusions

Physicians should pay special attention to thyroid hormone abnormalities in treatment with roxadustat.
A randomised controlled trial to examine the effects of cinacalcet on bone and cardiovascular parameters in haemodialysis patients with advanced secondary hyperparathyroidism
Authors: Eddington Helen , Chinnadurai Rajkumar , Alderson Helen , Ibrahim Sara T. , Chrysochou Constantina , Green Darren , Erekosima Ibi , Hutchison Alastair , Bubtana Abdalla , Hegarty Janet , Kalra Philip A.
Published: March 2021

Background

Secondary hyperparathyroidism may lead to increased cardiovascular risk. The use of cinacalcet may improve bone and cardiovascular health with improved parathormone (PTH) and phosphate control.

Methods

This is an open-label prospective randomised controlled trial to compare progression of cardiovascular and chronic kidney disease mineral and bone disorder (CKD-MBD) parameters. Patients were randomised to receive cinacalcet alongside standard therapy or standard therapy alone. Thirty-six haemodialysis patients who had > 90 days on dialysis, iPTH > 300 pg/mL, calcium > 2.1 mmol/L and age 18–75 years were included. Following randomization, all 36 patients underwent an intensive 12-week period of bone disease management aiming for iPTH 150-300 pg/mL. The primary outcome was change in vascular calcification using CT agatston score. Secondary outcomes included pulse wave velocity (PWV), left ventricular mass index (LVMI), carotid intima-media thickness (CIMT), augmentation index (Aix) and bone measurements. The above measurements were obtained at baseline and 12 months.

Results

There was no evidence of a group difference in the progression of calcification (median change (IQR) cinacalcet: 488 (0 to1539); standard therapy: 563 (50 to 1214)). In a post hoc analysis combining groups there was a mean (SD) phosphate reduction of 0.3 mmol/L (0.7) and median (IQR) iPTH reduction of 380 pg/mL (− 754, 120). Regression of LVMI and CIMT was seen (P = 0.03 and P = 0.001) and was significantly associated with change of phosphate on multi-factorial analyses.

Conclusions

With a policy of intense CKD-MBD parameter control, no significant benefit in bone and cardiovascular markers was seen with the addition of cinacalcet to standard therapy over one year. Tight control of hyperphosphataemia and secondary hyperparathyroidism may lead to a reduction in LVMI and CIMT but this needs further investigation. Although the sample size was small, meticulous trial supervision resulted in very few protocol deviations with therapy.
Neurobrucellosis with ischemic stroke and spinal cord involvement: a case report
Authors: Wen Hongfeng , Jin Di , Cai Lina , Wu Tao , Liu Haichao
Published: March 2021

Background

Brucellosis is a common zoonotic disease that may have a variety of clinical manifestations when it affects the nervous system. Ischemic stroke is a rare clinical symptom, but if it is not diagnosed and treated early, it may cause more severe consequences.

Case presentation

We report a 38-year-old man presenting with hearing impairment for four years and sudden weakness of the right limb for two years, recurrent aphasia, and gradual weakness of bilateral lower limbs for nine months. He had bilateral positive Babinski’s sign. Cerebrospinal fluid (CSF) showed raised protein and pleocytosis. Magnetic resonance imaging (MRI) showed ischemic infarcts in the pons and extensive enhancement of spinal meninges combined with spinal cord atrophy and ischemia. The tests revealed Brucella Rose Bengal positive in serum and CSF. Brucella culture in CSF was also positive. Next-generation sequencing (NGS) of CSF revealed positive for Brucella with 105 species were detected. He showed significant improvement with antibiotics at five months follow-up.

Conclusions

Neurobrucellosis may mimic stroke and transverse myelitis like syndromes. NB is a treatable infectious condition and should always be considered in the differentials, especially if there are risk factors, as in our case.
Correction to: Adherence among HIV-positive injection drug users undergoing methadone treatment in Taiwan
Authors: Chao En , Hung Chia-Chun , Lin Ching-Po , Ku Yi-Chien Jacob , Ain Qurat Ul , Metzger David S. , Lee Tony Szu-Hsien
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Excess mortality at Christmas due to cardiovascular disease in the HUNT study prospective population-based cohort in Norway
Authors: Moholdt Trine , Afoakwah Clifford , Scuffham Paul , McDonald Christine F. , Burrell Louise M. , Stewart Simon
Published: March 2021

Background

Although it is known that winter inclusive of the Christmas holiday period is associated with an increased risk of dying compared to other times of the year, very few studies have specifically examined this phenomenon within a population cohort subject to baseline profiling and prospective follow-up. In such a cohort, we sought to determine the specific characteristics of mortality occuring during the Christmas holidays.

Methods

Baseline profiling and outcome data were derived from a prospective population-based cohort with longitudinal follow-up in Central Norway - the Trøndelag Health (HUNT) Study. From 1984 to 1986, 88% of the target population comprising 39,273 men and 40,353 women aged 48 ± 18 and 50 ± 18 years, respectively, were profiled. We examined the long-term pattern of mortality to determine the number of excess (all-cause and cause-specific) deaths that occurred during winter overall and, more specifically, the Christmas holidays.

Results

During 33.5 (IQR 17.1–34.4) years follow-up, 19,879 (50.7%) men and 19,316 (49.3%) women died at age-adjusted rate of 5.3 and 4.6 deaths per 1000/annum, respectively. Overall, 1540 (95% CI 43–45 deaths/season) more all-cause deaths occurred in winter (December to February) versus summer (June to August), with 735 (95% CI 20–22 deaths per season) of these cardiovascular-related. December 25th–27th was the deadliest 3-day period of the year; being associated with 138 (95% CI 96–147) and 102 (95% CI 72–132) excess all-cause and cardiovascular-related deaths, respectively. Accordingly, compared to 1st–21st December (equivalent winter conditions), the incidence rate ratio of all-cause mortality increased to 1.22 (95% CI 1.16–1.27) and 1.17 (95% 1.11–1.22) in men and women, respectively, during the next 21 days (Christmas/New Year holidays). All observed differences were highly significant (P < 0.001). A less pronounced pattern of mortality due to respiratory illnesses (but not cancer) was also observed.

Conclusion

Beyond a broader pattern of seasonally-linked mortality characterised by excess winter deaths, the deadliest time of year in Central Norway coincides with the Christmas holidays. During this time, the pattern and frequency of cardiovascular-related mortality changes markedly; contrasting with a more stable pattern of cancer-related mortality. Pending confirmation in other populations and climates, further research to determine if these excess deaths are preventable is warranted.
Evaluation of a voucher scheme to increase child physical activity in participants of a school physical activity trial in the Hunter region of Australia
Authors: Reilly Kathryn , Bauman Adrian , Reece Lindsey , Lecathelinais Christophe , Sutherland Rachel , Wolfenden Luke
Published: March 2021

Background

Global population data suggest that physical activity levels in children remain unacceptably low. Improved participation in organised sport has been recommended by the WHO as one strategy to improve population levels of physical activity. In 2018, in the state of New South Wales, Australia, the government introduced the Active Kids scheme, to help families meet the cost of getting children into organized sport. The aim of this study is to describe the uptake of Active Kids and assess the impact of the scheme on organized sport participation and child physical activity in a region of New South Wales.

Methods

A pragmatic longitudinal study was undertaken of parents/carers from primary school aged children (5–12 years) in the Hunter region of NSW, Australia. Baseline data were collected between Oct-Dec 2017, with follow-up 12 months later. A telephone survey occurred at both time points, asking questions regarding registration and redemption of an Active Kids voucher for their child, child participation in organised sports and child physical activity levels.

Results

Of the 974 parents/carers who consented to participate, 511 (52.5%) completed the telephone surveys at both time points. A very large proportion of children (n = 454, 89.0%) were reported by their parents/carers at baseline as meeting the minimum physical activity guideline of 60 min per day. Of participating parents/carers in this study, 407 (96.0%) reported redeeming an Active Kids voucher. Children who redeemed a voucher had three times the odds to participate in organized team sports from baseline to follow-up (p = 0.009). Sub group analyses identified that females who redeemed a voucher had four times the odds to participate in organized team sports (p = 0.012).

Conclusions

Given the already active nature of this sample, no significant improvements in physical activity levels were noted, but the positive contribution community sport can have on health and wellbeing amongst children is reinforced. Whilst voucher schemes can address financial burdens across all socio-economic groups, more population targeting is needed to deliver voucher schemes to the most disadvantaged and inactive segments of the population in order to increase physical activity.
Sleep and BMI in South African urban and rural, high and low-income preschool children
Authors: Rae Dale E. , Tomaz Simone A. , Jones Rachel A. , Hinkley Trina , Twine Rhian , Kahn Kathleen , Norris Shane A. , Draper Catherine E.
Published: March 2021

Background

The extent to which income setting or rural and urban environments modify the association between sleep and obesity in young children is unclear. The aims of this cross-sectional observational study were to (i) describe and compare sleep in South African preschool children from rural low-income (RL), urban low-income (UL) and urban high-income (UH) settings; and (ii) test for associations between sleep parameters and body mass index (BMI).

Methods

Participants were preschoolers (5.2 ± 0.7y, 49.5% boys) from RL (n = 111), UL (n = 65) and UH (n = 22) settings. Height and weight were measured. Sleep, sedentary behaviour and physical activity were assessed using accelerometery.

Results

UL children had higher BMI z-scores (median: 0.39; interquartile range: − 0.27, 0.99) than the UH (− 0.38; − 0.88, 0.11) and RL (− 0.08; − 0.83, 0.53) children (p = 0.001). The UL children had later bedtimes (p < 0.001) and wake-up times (p < 0.001) and shorter 24 h (p < 0.001) and nocturnal (p < 0.001) sleep durations than the RL and UH children. After adjusting for age, sex, setting, SB and PA, for every hour less sleep obtained (24 h and nocturnal), children were 2.28 (95% CI: 1.28–4.35) and 2.22 (95% CI: 1.27–3.85) more likely, respectively, to belong to a higher BMI z-score quartile.

Conclusions

Shorter sleep is associated with a higher BMI z-score in South African preschoolers, despite high levels of PA, with UL children appearing to be particularly vulnerable.
An initiative of cooperation in Zika virus research: the experience of the ZIKABRA study in Brazil
Authors:   on behalf of ZIKABRA Study Team, Giozza Silvana Pereira , Bermúdez Ximena Pamela Díaz , Kara Edna Oliveira , Calvet Guilherme Amaral , de Filippis Ana Maria Bispo , Lacerda Marcus Vinícius Guimarães , Bôtto-Menezes Camila Helena Aguiar , da Costa Castilho Marcia , Franca Rafael Freitas Oliveira , Neto Armando Menezes , Storme Casey , Lima Noemia S. , Modjarrad Kayvon , de Oliveira Maria Cristina Pimenta , Pereira Gerson Fernando Mendes , Broutet Nathalie
Published: March 2021

Background

The Zika virus outbreak has triggered a set of local and global actions for a rapid, effective, and timely public health response. A World Health Organization (WHO) initiative, supported by the Department of Chronic Condition Diseases and Sexually Transmitted Infections (DCCI) of the Health Surveillance Secretariat (SVS), Brazil Ministry of Health (MoH) and other public health funders, resulted in the start of the “Study on the persistence of Zika virus in body fluids of patients with ZIKV infection in Brazil – ZIKABRA study”. The ZIKABRA study was designed to increase understanding of how long ZIKV persists in bodily fluids and informing best measures to prevent its transmission. Data collection began in July 2017 and the last follow up visit occurred in 06/26/2020.

Methods

A framework for the ZIKABRA Cooperation initiative is provided through a description and analysis of the mechanisms, strategies and the ethos that have guided the models of international governance and technical cooperation in health for scientific exchange in the context of a public health emergency. Among the methodological strategies, we included a review of the legal documents that supported the ZIKABRA Cooperation; weekly documents produced in the meetings and working sessions; technical reports; memorandum of understanding and the research protocol.

Conclusion

We highlight the importance of working in cooperation between different institutional actors to achieve more significant results than that obtained by each group working in isolation. In addition, we point out the advantages of training activities, ongoing supervision, the construction of local installed research capacity, training academic and non-academic human resources, improvement of laboratory equipment, knowledge transfer and the availability of the ZIKABRA study protocol for development of similar studies, favoring the collective construction of knowledge to provide public health emergency responses. Strategy harmonization; human resources and health services; timing and recruiting particularities and processing institutional clearance in the different sites can be mentioned as challenges in this type of initiative.
Detection of EGFR mutation of pulmonary adenocarcinoma in sputum using droplet digital PCR
Authors: Isaka Tetsuya , Yokose Tomoyuki , Ito Hiroyuki , Nakayama Haruhiko , Miyagi Yohei , Saito Haruhiro , Masuda Munetaka
Published: March 2021

Background

It is still unclear whether epidermal growth factor receptor (EGFR) mutation of primary lung adenocarcinoma can be detected on sputum samples. This study aimed to examine EGFR mutations of primary lung adenocarcinoma in sputum samples using droplet digital polymerase chain reaction (ddPCR) and compare it with an EGFR mutation in surgically resected lung cancer.

Methods

Sputum was prospectively collected from the patients before complete resection of the primary lung cancer at Kanagawa Cancer Center from September 2014 to May 2016. ddPCR was performed to detect EGFR exon 21 L858R point mutation (Ex21) and EGFR exon 19 deletion mutation (Ex19) in sputum samples from patients with lung adenocarcinoma. The concordance of EGFR mutation status in sputum samples and tumors in surgically resected specimen was evaluated for each positive and negative cytology group.

Results

One hundred and eighteen patients with primary lung adenocarcinoma provided sputum samples. Sputum cytology was positive in 13 patients (11.0%). ddPCR detected two cases of Ex21 and two cases of Ex19 in sputum cytology positive cases. Compared to surgically resected specimens, the sensitivity, specificity, and positive predictive value of EGFR mutation (Ex19 and Ex21) detection were 80.0%, 100%, and 100%, respectively, in sputum cytology positive cases. In contrast, the sensitivity, specificity, and positive predictive value of EGFR mutation (Ex19 and Ex21) detection were 3.1%, 100%, and 100%, respectively, in sputum cytology negative cases.

Conclusions

EGFR mutations in primary lung adenocarcinoma can be detected with high sensitivity in sputum samples if sputum cytology is positive.
Echinococcal hepatic lesion mimicking metastasis from colon cancer: two case reports
Authors: Cathomas Marionna , Abitabile Paolo , Dolanc Rok , Glaser Christine , Cathomas Gieri
Published: March 2021

Background

Echinococcus is a worldwide zoonosis, primarily causing liver lesions. Accidentally detected, these lesions enter the differential diagnosis of a tumor, including metastasis. This situation is especially challenging in patients with colorectal cancer, as both diseases affect mainly the liver.

Case presentation

We report two patients with a newly diagnosed colorectal cancer. Pre- and intraoperatively radiological imaging revealed hepatic lesions which were resected on suspicion of colorectal cancer metastasis. Histology showed granulomatous lesions with characteristic parasitic membrane consistent with an echinococcal cyst. The diagnosis was confirmed by specific polymerase chain reaction.

Conclusions

Focal hypoechoic liver lesion in patients with colorectal cancer should be primarily considered as a liver metastasis and resected whenever feasible. Other uncommon etiologies, including parasitic lesion as echinococcal cysts, should be taken in consideration, as this could lead to major changes of the management and prognosis of the affected patients.
Interleukin-35 pathobiology in periodontal disease: a systematic scoping review
Authors: Schmidlin Patrick R. , Dehghannejad Mandana , Fakheran Omid
Published: March 2021

Background

Interleukin (IL)-35 is a novel anti-inflammatory cytokine that is produced by regulatory T cells. IL-35 mediates immunological functions and plays a protective role in several diseases such as asthma and rheumatoid arthritis. However, the role of IL-35 in gingivitis and periodontitis remains unclear. The aim of this study was to systematically review the literature and collecting the available evidence regarding the role of IL-35 in pathogenesis of periodontal disease.

Methods

A systematic search of electronic databases including MEDLINE, Google Scholar, Cochrane Library, Web of Science, and Scopus was conducted in November 2020 to identify studies addressing the Interleukin-35 pathobiology in periodontal disease. The identified studies were subjected to pre-identified inclusion criteria. The retrived papers were assessed by the authours independently and consensus was reached in cases where disagreement occurred. Articles written in languages other than English, case reports, letters to editors, conference abstracts, theses, and dissertations were excluded from the review.

Results

A total of 176 possibly relevant articles were identified through the search strategy. Finally, 15 papers which met the criteria of eligibility were included in this review by consensus. The included articles were classified based on their design and level of evidence.Three subclinical study, ten cross sectional investigation and two randomized clinical trials constituted the final set of studies in this review. At preclinical level, Il-35 showed inhibitory characteristics regarding alveolar bone resorption of animal periodontitis models. The results of observatory human studies confirmed the presence of high levels of IL-35 in saliva, GCF, serum, and gingival biopsies of patients suffering from inflammatory periodontal disease. Moreover, two included clinical trials showed that non-surgical periodontal therapy could downregulate IL-35 production in chronic periodontitis patients.

Conclusion

Interleukin-35 has an undeniable role in pathobiology of inflammatory periodontal disease. Further well-controlled studies are needed to better elucidate the functional pattern of IL-35 in pathogeneisis of gingival and periodontal disease.