bluuebunny/crossref_metadata_2025 huggingface dataset:
Application of bedside ultrasound in predicting the outcome of weaning from mechanical ventilation in elderly patients
Authors: Li Shigang , Chen Zhe , Yan Weifeng
Published: July 2021

Background

With the increased ageing of society, more and more elderly people are admitted to the intensive care unit, How to accurately predict whether elderly patients can successfully wean from the ventilator is more complicated. Diaphragmatic excursion (DE) and diaphragm thickening fraction (DTF) were measured by bedside ultrasound to assess diaphragm function. The lung ultrasound score (LUS) and the rapid shallow breathing index (RBSI) were used as indices of diaphragm function to predict the outcome of weaning from mechanical ventilation. The aim of this study was to examine the clinical utility of these parameters in predicting extubation success.

Methods

This prospective study included 101 consecutive elderly patients undergoing a trial of extubation in the ICU of Haidian Hospital between June 2017 and July 2020. Patients were divided into the successful weaning group (n = 69) and the failed weaning group (n = 32). Baseline characteristics, including RSBI, were recorded. Measurements of DE, DTF and LUS were made using ultrasound within 24 h before extubation.

Results

Median DE was greater in patients with extubation success than in those with extubation failure (1.64 cm vs. 0.78 cm, p = 0.001). Patients with extubation success had a greater DTF than those with extubation failure (49.48% vs. 27.85%, p = 0.001). The areas under the receiver operating curves for the RSBI, LUS, DE and DFT were 0.680, 0.764, 0.831 and 0.881, respectively. The best cut-off values for predicting successful weaning were DTF ≥ 30%, DE ≥ 1.3 cm, LUS ≤ 11, and RSBI ≤ 102. The specificity of DTF (84%) in predicting weaning outcome was higher than that of RBSI (53%), that of LUS (55%), and that of DE (62%). The sensitivity of DTF (94%) was greater than that of RBSI (85%), that of LUS (71%), and that of DE (65%). The combination of RSBI, LUS, DE, and DTF showed the highest AUC (AUC = 0.919), with a sensitivity of 96% and a specificity of 89%.

Conclusions

DTF has higher sensitivity and specificity for the prediction of successful weaning in elderly patients than the other parameters examined. The combination of RSBI, LUS, DE and DFT performed well in predicting weaning outcome. This has potentially important clinical application and merits further evaluation.
Aldosterone signaling defect in young infants: single-center report and review
Authors: Wijaya Melati , Ma Huamei , Zhang Jun , Du Minlian , Li Yanhong , Chen Qiuli , Guo Song
Published: July 2021

Background

Aldosterone (Ald) is a crucial factor in maintaining electrolyte and water homeostasis. Defect in either its synthesis or function causes salt wasting (SW) manifestation. This disease group is rare, while most reported cases are sporadic. This study aimed to obtain an overview of the etiology and clinical picture of patients with the above condition and report our rare cases.

Methods

A combination of retrospective review and case studies was conducted at the Pediatric Endocrine unit of The First Affiliated Hospital Sun Yat Sen University from September 1989 to June 2020.

Results

A total of 187 patients with SW were enrolled, of which 90.4% (n = 169) were diagnosed with congenital adrenal hyperplasia (CAH). SW type 21-hydroxylase deficiency accounted for 98.8% (n = 167) of CAH diagnosis, while 1.2% (n = 2) was of lipoid CAH. Non-CAH comprised 9.6% (n = 18) of the total patients whose etiologies included SF-1 gene mutation (n = 1), X-linked adrenal hypoplasia congenita (n = 9), aldosterone synthase deficiency (ASD, n = 4), and pseudo-hypoaldosteronism type 1 (PHA1, n = 1). Etiologies were not identified in three patients. All of patients with ASD and PHA1 exhibited SW syndrome in their early neonatal period. DNA sequencing showed mutations of CYP11B2 for P1-P4 and NR3C2 for P5. P1 and P2 were sibling brothers affected by compound heterozygous mutations of c.1121G > A (p.R374Q) and c.1486delC p.(L496fs); likewise, P4 was identified with compound heterozygous mutations of c.1200 + 1G > A and c.240–1 G > T; meanwhile P3 demonstrated c.1303G > A p.(G435S) homozygous mutation in CYP11B2 gene. Lastly, P5 showed c.1768 C > T p.(R590*) heterozygous mutation in the NR3C2 gene.

Conclusion

Etiology of infant with aldosterone defect was mostly congenital. Renal and adrenal imaging are recommended to exclude renal causes. If clinical picture is suggestive, normal plasma Ald in early infancy cannot rule out aldosterone insufficiency.
A review of appropriate indicators for need-based financial resource allocation in health systems
Authors: Radinmanesh Maryam , Ebadifard Azar Farbod , aghaei Hashjin Asgar , Najafi Behzad , Majdzadeh Reza
Published: July 2021

Background

Optimal, need-based, and equitable allocation of financial resources is one of the most important concerns of health systems worldwide. Fulfilling this goal requires considering various criteria when allocating resources. The present study was conducted to identify the need indicators used to allocate health resources in different countries worldwide.

Methods

A systematic review conducted on all published articles and reports on the need-based allocation of health financial resources in the English language from 1990 to 2020 in databases, including PubMed, Cochrane, and Scopus as well as those in Persian language databases, including magiran, SID, and Google and Google scholar search engines. After performing different stages of screening, appropriate studies were identified and their information were extracted independently by two people, which were then controlled by a third person. The extracted data were finally analyzed by content analysis method using MAXQDA 10 software.

Result

This search yielded 823 studies, of which 29 were included for the final review. The findings indicated that many need-based resource allocation formulas attempt to deal with health care needs using some weighting methods for individuals. In this regard, the most commonly used indicators were found as follows: age, gender, socio-economic status or deprivation, ethnicity, standardized mortality ratio (SMR), the modified health indicators (disease consequences, self-assessed health, and disability), geographical area / place of residence (geographical) (rural versus urban), cross-boundary flows, cost of services, and donations.

Conclusion

The indicators used in allocating the health systems’ financial resources in each country should be designed in order to be simple and transparent and in accordance with the moral norms of that society. Moreover, these should be a good representative of the health needs of people in different geographical areas of that country. In addition, their related data should be available to an acceptable extent.
Familial SYN1 variants related neurodevelopmental disorders in Asian pediatric patients
Authors: Xiong Juan , Duan Haolin , Chen Shimeng , Kessi Miriam , He Fang , Deng Xiaolu , Zhang Ciliu , Yang Li , Peng Jing , Yin Fei
Published: July 2021

Background

SYN1 encodes synapsin I, which is a neuronal phosphoprotein involving in regulating axonogenesis and synaptogenesis. Variants in the gene have been associated with X-linked neurodevelopmental disorders in recent years.

Methods

In the study, we reported two male patients with familial SYN1 variants related neurodevelopmental disorders from Asian population. Previously published cases with significant SYN1 variants from the literature were also included to analyze the phenotype and genotype of the disorder.

Results

Two maternally inherited SYN1 variants, including c.C1076A, p.T359K in proband A and c.C1444T, p. Q482X in proband B (NM_133499) were found, which have never been described in detail. Combining with our research, all reported probands were male in the condition, whose significant SYN1 variants were inherited from their asymptomatic or mild affected mother. Although the disorder encompasses three main clinical presentations: mental deficiency, easily controlled reflex seizure and behavior problems, patients’ clinical manifestations vary in genders and individuals, even in the same pedigree.

Conclusion

We firstly reported two familial SYN1-related neurodevelopmental disorders in Asian pediatric patients. Gender and phenotype differences should be highly valued in the disorder.
The significance of exosomal RNAs in the development, diagnosis, and treatment of pancreatic cancer
Authors: Zhao Zheng , Zhao Guiping , Yang Shuyue , Zhu Shengtao , Zhang Shutian , Li Peng
Published: July 2021

Exosomes are single-membrane, secreted organelles with a diameter of 30–200 nm, containing diverse bioactive constituents, including DNAs, RNAs, proteins, and lipids, with prominent molecular heterogeneity. Extensive studies indicate that exosomal RNAs (e.g., microRNAs, long non-coding RNAs, and circular RNAs) can interact with many types of cancers, associated with several hallmark features like tumor growth, metastasis, and resistance to therapy. Pancreatic cancer (PaCa) is among the most lethal cancers worldwide, emerging as the seventh foremost cause of cancer-related death in both sexes. Hence, revealing the specific pathogenesis and improving the clinical diagnosis and treatment process are urgently required. As the study of exosomes has become an active area of research, the functional connections between exosomes and PaCa have been deeply investigated. Among these, exosomal RNAs seem to play a significant role in the development, diagnosis, and treatment of PaCa. Exosomal RNAs delivery ultimately modulates the various features of PaCa, and many scholars have interpreted how exosomal RNAs contribute to the proliferation, angiogenesis, migration, invasion, metastasis, immune escape, and drug resistance in PaCa. Besides, recent studies emphasize that exosomal RNAs may serve as diagnostic and prognostic biomarkers or therapeutic targets for PaCa. In this review, we will introduce these recent insights focusing on the discoveries of the relationship between exosomal RNAs and PaCa, and the potentially diagnostic and therapeutic applications of exosomes in PaCa.
Exposure to arsenic at different life-stages and DNA methylation meta-analysis in buccal cells and leukocytes
Authors: Bozack Anne K. , Boileau Philippe , Wei Linqing , Hubbard Alan E. , Sillé Fenna C. M. , Ferreccio Catterina , Acevedo Johanna , Hou Lifang , Ilievski Vesna , Steinmaus Craig M. , Smith Martyn T. , Navas-Acien Ana , Gamble Mary V. , Cardenas Andres
Published: July 2021

Background

Arsenic (As) exposure through drinking water is a global public health concern. Epigenetic dysregulation including changes in DNA methylation (DNAm), may be involved in arsenic toxicity. Epigenome-wide association studies (EWAS) of arsenic exposure have been restricted to single populations and comparison across EWAS has been limited by methodological differences. Leveraging data from epidemiological studies conducted in Chile and Bangladesh, we use a harmonized data processing and analysis pipeline and meta-analysis to combine results from four EWAS.

Methods

DNAm was measured among adults in Chile with and without prenatal and early-life As exposure in PBMCs and buccal cells (N = 40, 850K array) and among men in Bangladesh with high and low As exposure in PBMCs (N = 32, 850K array;N = 48, 450K array). Linear models were used to identify differentially methylated positions (DMPs) and differentially variable positions (DVPs) adjusting for age, smoking, cell type, and sex in the Chile cohort. Probes common across EWAS were meta-analyzed using METAL, and differentially methylated and variable regions (DMRs and DVRs, respectively) were identified using comb-p. KEGG pathway analysis was used to understand biological functions of DMPs and DVPs.

Results

In a meta-analysis restricted to PBMCs, we identified one DMP and 23 DVPs associated with arsenic exposure; including buccal cells, we identified 3 DMPs and 19 DVPs (FDR < 0.05). Using meta-analyzed results, we identified 11 DMRs and 11 DVRs in PBMC samples, and 16 DMRs and 19 DVRs in PBMC and buccal cell samples. One region annotated toLRRC27was identified as a DMR and DVR. Arsenic-associated KEGG pathways included lysosome, autophagy, and mTOR signaling, AMPK signaling, and one carbon pool by folate.

Conclusions

Using a two-step process of (1) harmonized data processing and analysis and (2) meta-analysis, we leverage four DNAm datasets from two continents of individuals exposed to high levels of As prenatally and during adulthood to identify DMPs and DVPs associated with arsenic exposure. Our approach suggests that standardizing analytical pipelines can aid in identifying biological meaningful signals.
The mechanisms of action of Plasmodium infection against cancer
Authors: Chen Xiaoping , Qin Li , Hu Wen , Adah Dickson
Published: July 2021

Our murine cancer model studies have demonstrated that Plasmodium infection activates the immune system that has been inhibited by cancer cells, counteracts tumor immunosuppressive microenvironment, inhibits tumor angiogenesis, inhibits tumor growth and metastasis, and prolongs the survival time of tumor-bearing mice. Based on these studies, three clinical trials of Plasmodium immunotherapy for advanced cancers have been approved and are ongoing in China. After comparing the mechanisms of action of Plasmodium immunotherapy with those of immune checkpoint blockade therapy, we propose the notion that cancer is an ecological disease and that Plasmodium immunotherapy is a systemic ecological counterattack therapy for this ecological disease, with limited side effects and without danger to public health based on the use of artesunate and other measures. Recent reports of tolerance to treatment and limitations in majority of patients associated with the use of checkpoint blockers further support this notion. We advocate further studies on the mechanisms of action of Plasmodium infection against cancer and investigations on Plasmodium-based combination therapy in the coming future.
Sleep duration, physical activity, and caloric intake are related to weight status in Mexican American children: a longitudinal analysis
Authors: Martinez S. M. , Blanco E. , Tschann J. M. , Butte N. F. , Grandner M. A. , Pasch L. A.
Published: July 2021

Background

Obesity is a serious issue, spanning all ages, and, in the U.S., disproportionately affects Latinos and African Americans. Understanding sleep, physical activity and dietary behaviors that may predict childhood obesity can help identify behavioral intervention targets.

Methods

Data were drawn from a U.S. cohort study of 323 Mexican American 8–10-year-old children and their mothers, who participated in a longitudinal study over a 2-year period. Measures were collected at baseline (BL; child mean age = 8.87, SD = 0.83), year 1 (FU1) and year 2 (FU2). Mothers reported on household income and acculturation at BL. Child height and weight were collected and BMI z-scores (BMIz) were calculated for weight status at BL, FU1, and FU2. Accelerometer-estimated sleep duration (hours) and moderate-to-vigorous physical activity (MVPA; minutes) were collected across 3 days at BL, FU1, and FU2. Two 24-h dietary recalls were performed at each time point; from these, average energy intake (EI, kcals/day) was estimated. Cross-lagged panel analysis was used to examine behavioral predictors on BMIz at each time point and across time.

Results

At BL and FU1, longer sleep duration (β = − 0.22, p < 0.001; β = − 0.17, p < 0.05, respectively) and greater MVPA (β = − 0.13, p < 0.05; β = − 0.20, p < 0.01, respectively) were concurrently related to lower BMIz. At FU2, longer sleep duration (β = − 0.18, p < 0.01) was concurrently related to lower BMIz, whereas greater EI (β = 0.16, p < 0.01) was related to higher BMIz. Longer sleep duration at BL predicted lower BMIz at FU1 (β = − 0.05, p < 0.01).

Conclusions

Longer sleep duration was concurrently related to lower weight status at each time point from ages 8–10 to 10–12. Higher MVPA was concurrently related to lower weight status in earlier childhood (ages 8–10 and 9–11) and higher EI was concurrently related to higher weight status toward the end of childhood (ages 10–12 years). Furthermore, longer sleep in earlier childhood was protective of children’s lower weight status 1 year later. These findings suggest that sleep duration plays a consistent and protective role against childhood obesity; in addition, MVPA and healthy EI remain important independent factors for obtaining a healthy weight.
From Ebola to COVID-19: emergency preparedness and response plans and actions in Lagos, Nigeria
Authors: Abayomi Akin , Balogun Mobolanle R. , Bankole Munir , Banke-Thomas Aduragbemi , Mutiu Bamidele , Olawepo John , Senjobi Morakinyo , Odukoya Oluwakemi , Aladetuyi Lanre , Ejekam Chioma , Folarin Akinsanya , Emmanuel Madonna , Amodu Funke , Ologun Adesoji , Olusanya Abosede , Bakare Moses , Alabi Abiodun , Abdus-Salam Ismail , Erinosho Eniola , Bowale Abimbola , Omilabu Sunday , Saka Babatunde , Osibogun Akin , Wright Ololade , Idris Jide , Ogunsola Folasade
Published: July 2021

Background

Lagos state is the industrial nerve centre of Nigeria and was the epicentre of the 2014 Ebola outbreak in Nigeria as it is now for the current Coronavirus Disease (COVID-19) outbreak. This paper describes how the lessons learned from the Ebola outbreak in 2014 informed the emergency preparedness of the State ahead of the COVID-19 outbreak and guided response.

Discussion

Following the Ebola outbreak in 2014, the Lagos State government provided governance by developing a policy on emergency preparedness and biosecurity and provided oversight and coordination of emergency preparedness strategies. Capacities for emergency response were strengthened by training key staff, developing a robust surveillance system, and setting up a Biosafety Level 3 laboratory and biobank. Resource provision, in terms of finances and trained personnel for emergencies was prioritized by the government. With the onset of COVID-19, Lagos state was able to respond promptly to the outbreak using the centralized Incident Command Structure and the key activities of the Emergency Operations Centre. Contributory to effective response were partnerships with the private sectors, community engagement and political commitment.

Conclusion

Using the lessons learned from the 2014 Ebola outbreak, Lagos State had gradually prepared its healthcare system for a pandemic such as COVID-19. The State needs to continue to expand its preparedness to be more resilient and future proof to respond to disease outbreaks. Looking beyond intra-state gains, lessons and identified best practices from the past and present should be shared with other states and countries.
A pragmatic window of opportunity to minimise the risk of MRONJ development in individuals with osteoporosis on Denosumab therapy: a hypothesis
Authors: Campisi Giuseppina , Mauceri Rodolfo , Bertoldo Francesco , Fusco Vittorio , Bedogni Alberto
Published: July 2021

Denosumab is associated with the development of medication-related osteonecrosis of the jaw (MRONJ), an uncommon but severe oral side effect with a higher prevalence in metastatic cancer patients than in patients with metabolic bone fragility. Although several oral triggers can initiate MRONJ, invasive oral treatments and tooth extraction still remain the most common precipitating event. In general, tooth extraction and oral surgery should be avoided in patients at increased risk of MRONJ, while extraction of non-restorable teeth should be performed based on specific risk reduction protocols to eliminate dental/periodontal infections, still protecting from MRONJ onset.

Based on the different pharmacological activity of denosumab and nitrogen-containing bisphosphonates, it is likely that the MRONJ risk profile of patients with osteoporosis could somewhat vary.

We hypothesize the chance to maximize the pharmacokinetic of denosumab 60 mg (Prolia®) and identify a time interval in which invasive oral treatments can ideally take place without restrictions in patients with metabolic bone fragility,

We propose that dental surgery (e.g. tooth extraction) may be safely performed without additional intra or peri-operative procedures in osteoporosis patients using denosumab provided that careful case selection, adequate communication among specialists, planning of a delayed dosing window (1-month deferral) and rigorous postoperative follow-up are granted.

Graphical abstract
The relationship between thoracic kyphosis and age, and normative values across age groups: a systematic review of healthy adults
Authors: Zappalá Mattia , Lightbourne Stephen , Heneghan Nicola R.
Published: July 2021

Background

Thoracic kyphosis is reported to increase with ageing. However, this relationship has not been systematically investigated. Peoples’ kyphosis often exceeds 40°, but 40° is the widely accepted cut-off and threshold for normality. Consequently, patients may be misclassified. Accurate restoration of kyphosis is important to avoid complications following spinal surgery. Therefore, specific reference values are needed. The objective of the review is to explore the relationship between thoracic kyphosis and age, provide normative values of kyphosis for different age groups and investigate the influence of gender and ethnicity.

Methods

Two reviewers independently conducted a literature search, including seven databases and the Spine Journal, from inception to April 2020. Quantitative observational studies on healthy adults (18 years of age or older) with no known pathologies, and measuring kyphosis with Cobb’s method, a flexicurve, or a kyphometer, were included. Study selection, data extraction, and study quality assessment (AQUA tool) were performed independently by two reviewers. The authors were contacted if clarifications were necessary. Correlation analysis and inferential statistics were performed (Microsoft Excel). The results are presented narratively. A modified GRADE was used for evidence quality assessment.

Results

Thirty-four studies (24 moderate-quality, 10 high-quality) were included (n = 7633). A positive moderate correlation between kyphosis and age was found (Spearman 0.52, p < 0.05, T5-T12). Peoples’ kyphosis resulted greater than 40° in 65% of the cases, and it was significantly smaller in individuals younger than 40 years old (x < 40) than in those older than 60 years old (x > 60) 75% of the time (p < 0.05). No differences between genders were found, although a greater kyphosis angle was observed in North Americans and Europeans.

Conclusion

Kyphosis increases with ageing, varying significantly between x < 40 and x > 60. Furthermore, kyphosis appears to be influenced by ethnicity, but not gender. Peoples’ thoracic sagittal curvature frequently exceeds 40°.

Trial registration

The review protocol was devised following the PRISMA-P Guidelines, and it was registered on PROSPERO (CRD42020175058) before study commencement.
Principles for the production and dissemination of recruitment material for three clinical trials of an online intervention
Authors: Rennick-Egglestone Stefan
Published: July 2021

Some health research studies recruit participants through electronic mechanisms such as the placement of messages on social media platforms. This raises questions for ethics committee oversight, since effective social media campaigns might involve the production and dissemination of hundreds of contemporaneous messages. For the Narrative Experiences Online (NEON) study, we have developed nine principles to control the production and dissemination of promotional material. These have been approved by an ethics committee and enable the audit of our recruitment work. We propose that the drafting for approval of recruitment principles by health research studies may, in many cases, strike an appropriate balance between enabling ethical oversight of online recruitment work and the potential burden of message review.
Effect of temperature and dissolved oxygen on gravity sedimentation of the unicellular alga Dunaliella salina
Authors: Watsuji Tomo-o , Naka Angelica , Morita Yasuhiko , Kurahashi Midori
Published: July 2021

Purpose

The microalgae Dunaliella salina is mainly cultivated as a source of natural β-carotene, but it can also be an important source of other nutrients such as protein, carbohydrate, and lipids. Harvesting and dewatering are considered the most expensive processes in the biomass production, so we proposed gravity sedimentation as a cost-effective method. The effect of temperature and dissolved oxygen concentration on the gravity sedimentation of normal cells and carotenoid-accumulating cells of Dunaliella salina was investigated in this study.

Methods

Dunaliella salina was cultivated in an f/2 culture medium at two different salinities, 12.5% (2.2 M NaCl) and 17.5% (3.3 M NaCl). Carotenoid-accumulating cells were cultivated in a medium without a nitrogen source by removing NaNO3 from the f/2 medium and at two different salinities, 12.5% and 17.5%. For gravity sedimentation tests, 10 mL of the suspended culture media were transferred to conical tubes and wrapped with aluminum foil for shading. The tubes were incubated at 4 °C, 10 °C, 15 °C, 20 °C, 25 °C, 30 °C, 35 °C, 40 °C, 45 °C, and 50 °C for 4 h and 18 h. For the gravity sedimentation under aerobic and anaerobic conditions, 10 mL of the suspended culture media were transferred to conical tubes and then purged with 20% oxygen and 80% nitrogen or 100% nitrogen for 10 min and wrapped with aluminum foil. The tubes were incubated at 25 °C for 0.5 h, 1 h, 2 h, and 3 h.

Result

Recovery rates differed with temperature, salinity, and time. The recovery rate of normal cells and carotenoid-accumulating cells reached 79 to 96% at 20 °C, 25 °C, and 30 °C at 12.5% and 17.5% of salinity and after 4 h. The recovery rate of both normal and carotenoid-accumulating cells in gravity sedimentation experiments was not significantly affected by changing initial dissolved oxygen in the cell-cultured media.

Conclusion

Considering that gravity sedimentation at the optimum growth temperature for D. salina presented high recovery rates, gravity sedimentation is expected to be a cost-effective method to harvest D. salina from open pond cultivation systems.
Culture, innovation, and economic development
Authors: Kostis Pantelis C.
Published: July 2021

During recent decades, culture is gaining more and more attention as a factor that determines economic outcomes. Trying to investigate its role on innovation and economic development, this paper uses a dataset that offers the potential for a cross-sectional and time series analysis. Thus, in this paper, the effects of culture on innovation (as measured by patent applications, spending on R&D, number or researchers per 1000 individuals and number of government researchers) and economic development are investigated. Cultural background is captured through the Schwartz’s cultural values, as reported through the European Social Survey (ESS) waves during the period 2002–2018. The dataset is comprised by 18 Eurozone countries. Using principal component analyses to capture the Schwartz’s cultural values, as well as two ways fixed-effects analysis (FE), time dummies for each ESS wave included in the analysis and cluster—robust estimates of the standard errors, in order to examine the above relationships, the main conclusions derived from the analysis are that (a) there is significant effect of culture on innovation and economic development, and (b) the main cultural dimensions that hinder innovation and economic development are the prevalence of hierarchy, affective autonomy, and mastery. These results hold for all different dependent variables used in the analysis. Thus, when hierarchy, affective autonomy, and mastery are present innovation and economic development are hindered, leading to obstacles regarding the sustainability of economic outcomes. The opposite holds in societies where embeddedness, egalitarianism, and harmony prevail.
Intraosseous schwannoma of the proximal humerus with pathologic fracture
Authors: Huajun Jiang , Wei Qu , Yuxuan Wu , Jingjing Yang
Published: July 2021

Background

Intraosseous schwannomas are extremely rare in the humerus, and less than five cases have been reported previously in the literature. This is the first report of its origin in the proximal humerus with pathologic fracture. We herein present this case to discuss the reason for its rarity and share our experience of management.

Case presentation

A 55-year-old female patient presented with pain in the right shoulder, which was caused by tripping and falling over a board. Radiographs, computed tomography (CT) and magnetic resonance imaging (MRI) showed considerable tumor in proximal humerus, which connected with a fracture. For this suspected tumor, we performed two operations. Pathological examination demonstrated typical picture of a schwannoma, showing whorls and interlacing fascicles of schwannoma spindle cells. Immunohistochemistry, the tumor cells were diffusely positive for S-100 protein, SOX-10 and CD68, while they were completely negative for desmin, DOG-1, AE1/AE3 and P63. The Ki-67 index was about 10%. No mitoses or features of malignancy were identified. The final diagnosis of intraosseous schwannoma was made. The treatment for intraosseous schwannoma with pathologic fracture includes excisional biopsy, curettage, bone allograft, and fracture fixation. The patient recovered well. After the surgery, the patient gradually regained mobility and the pain subsided. There was no recurrence after 6 months of follow-up by X-ray.

Conclusions

Although very rare, intraosseous schwannoma should be taken under consideration in the differential diagnosis of benign-appearing osseous tumor in the proximal humerus with pathologic fracture.
From solidarity to resistance: host communities’ evolving response to the Rohingya refugees in Bangladesh
Authors: Ansar Anas , Md. Khaled Abu Faisal
Published: July 2021

Bangladesh sets an admirable example of solidarity with the Rohingya refugees from Myanmar by hosting more than a million Rohingyas despite its resource constraints. However, there is a perceptible shift from this rather unconditional solidarity to an anti-refugee sentiment. In evaluating the factors that contributed to these changing dynamics, we analysed how the host communities’ solidarity with the plight of Rohingya refugees evolved. Broadly, it identifies three key factors that influence the approaches of the locals towards the refugees: economic instability as a result of the wage fall and price hike, unequal access to humanitarian aid and uneven distribution of resource opportunities created through substantial humanitarian operations and finally, political uncertainty about the future of the Rohingya crisis. By bringing the experiences of host communities and the manifold implications of existing humanitarian interventions into the centre of the analysis, the paper underlines the need for a more conciliatory approach involving different actors engaged in this crisis. In so doing, we argue that addressing the adverse impacts of a refugee crisis on the poorer hosts, particularly within the context of a protracted refugee situation, needs a more systematic evaluation, and it cannot be dealt with isolation from the broader socio-economic context of the refugee-hosting regions.
Virulence of Beauveria bassiana and Metarhizium anisopliae on different stages of the pink bollworm, Pectinophora gossypiella (Saunders) (Lepidoptera: Gelechiidae)
Authors: Omar Gamal , Ibrahim Ahmed , Hamadah Khalid
Published: July 2021

Background

The pink bollworm, Pectinophora gossypiella, is the most destructive pests of the cotton plant in Egypt. Due to the several problems of insecticides, the present study was conducted to evaluate the toxicity effect of the entomopathogenic fungi (EPF), Beauveria bassiana and Metarhizium anisopliae, against the different stages of the pink bollworm, Pectinophora gossypiella (Saunders) (Lepidoptera: Gelechiidae)

Results

The fungal isolates exhibited a toxic effect against the treated stages, egg, larva, and pupa. According to the obtained data of LC50, B. bassiana was more potent in inducing toxicity than M. anisopliae. However, eggs of P. gossypiella were less susceptible to the EPF than the other stages. Based on total mortality, LC50 was 4.97×1011, 6.03×1012 spores/ml for egg; 8.25×108, 6.03×109 spores/ml for neonate; 2.52×108, 1.29×1010 spores/ml for early 4th instar larvae; and 6.79×108, 8.36×109 spores/ml for pupae after treatment with B. bassiana and M. anisopliae, respectively.

Conclusions

Entomopathogenic fungi exhibited an activity in inducing mortality against different stages of P. gossypiella.
Potential effect of tobacco cigarettes smoking on global DNA methylation status and protamines transcripts in human spermatozoa
Authors: Laqqan Mohammed M. , Yassin Maged M.
Published: July 2021

Background

Epigenetics refers to an alteration in gene expression without alteration in the sequence of DNA and this process may be affected by environmental factors and lifestyle like cigarette smoking. This study was designed to evaluate the potential effect of cigarette smoking on the global DNA methylation status and the transcription level of protamine 1 and protamine 2 in human spermatozoa. A total of 188 semen samples were collected from men with a mean age of 34.9 ± 5.8 years old (98 heavy smokers and 90 non-smokers). The DNA and RNA were isolated from purified spermatozoa, then the status of global DNA methylation and the transcription level of protamine 1 and protamine 2 were evaluated using ELISA and qPCR, respectively. The chromatin non-condensation and DNA fragmentation in human spermatozoa were evaluated using chromomycin A3 staining and TUNEL assay, respectively.

Results

A significant increase has been found in the status of global DNA methylation in spermatozoa of heavy smokers compared to non-smokers (7.69 ± 0.69 ng/μl vs. 4.90 ± 0.40 ng/μl, P < 0.001). Additionally, a significant reduction has been found in transcription level of protamine 1 (25.49 ± 0.31 vs. 23.94 ± 0.40, P < 0.001) and protamine 2 (28.27 ± 0.39 vs. 23.45 ± 0.30, P < 0.001) in heavy smokers. A downregulation has been found in the transcription level of protamine 1 and protamine 2 with a fold change of 0.497 and 0.047, respectively. A significant increase has been shown in the level of DNA fragmentation and chromatin non-condensation in heavy smokers compared to non-smokers (P < 0.001). On the other hand, a significant positive correlation has been found between sperm chromatin non-condensation, sperm DNA fragmentation, transcription level of protamine 1, transcription level of protamine 2, and global DNA methylation status (r = 0.304, P < 0.001; r = 0.399, P < 0.001; r = 0.216, P = 0.003; r = 0.494, P < 0.001, respectively).

Conclusion

Tobacco cigarette smoking has a potential influence on the global DNA methylation and the transcription level of protamine genes in human spermatozoa, and consequently, affect negatively on the semen parameters.
Inflammatory biomarkers and cognitive functioning in individuals with euthymic bipolar disorder: exploratory study
Authors: Strawbridge Rebecca , Carter Rowena , Saldarini Francesco , Tsapekos Dimosthenis , Young Allan H.
Published: July 2021

Background

Neurobiological research frequently implicates inflammatory and neurogenic components with core aspects of bipolar disorder. Even in periods of symptom remission (euthymia), individuals with bipolar disorder experience cognitive impairments, which are increasingly being proposed as an outcome for interventions; identifying biomarkers associated with cognitive impairment in people with bipolar disorder could advance progress in this therapeutic field through identifying biological treatment targets.

Aims

We aimed to identify proteomic biomarker correlates of cognitive impairment in individuals with euthymic bipolar disorder.

Method

Forty-four adults with a bipolar disorder diagnosis in euthymia underwent a battery of cognitive assessments and provided blood for biomarkers. We examined a comprehensive panel of inflammatory and trophic proteins as putative cross-sectional predictors of cognition, conceptualised according to recommended definitions of clinically significant cognitive impairment (binary construct) and global cognitive performance (continuous measure).

Results

A total of 48% of the sample met the criteria for cognitive impairment. Adjusting for potentially important covariates, regression analyses identified lower levels of three proteins as significantly and independently associated with cognitive deficits, according to both binary and continuous definitions (interleukin-7, vascular endothelial growth factor C and placental growth factor), and one positively correlated with (continuous) global cognitive performance (basic fibroblast growth factor).

Conclusions

This study identifies four candidate markers of cognitive impairment in bipolar disorder, none of which have been previously compared with cognitive function in participants with bipolar disorder. Pending replication in larger samples and support from longitudinal studies, these markers could have implications for treating cognitive dysfunction in this patient population.
Light behaviors outside a black hole surrounded by dark matter
Authors: Tao Sicen , Xiao Wen , Chen Huanyang
Published: July 2021

Here we show the light behaviors outside a Schwarzschild black hole that is surrounded by a dark matter model proposed by Konoplya (see Konoplya R., Phys. Lett. B, 795 (2019) 1). It is worth mentioning that dark matter is studied for the first time in an optical system by transformation optics theory. Different from other works of mimicking curved spaces with geodesic equations, we calculate ray trajectories using the equivalent anisotropic material tensor, which can also be used to simulate field patterns for wave optics. The results from geometric optics and wave optics agree with each other perfectly, showing the gravitational lensing effects and light trapping properties, revealing the influences of dark matter on the black hole shadow and gravity, which can give some hints for future observations.
Fracture biomechanics influence local and systemic immune responses in a murine fracture-related infection model
Authors: Sabaté-Brescó Marina , Berset Corina M. , Zeiter Stephan , Stanic Barbara , Thompson Keith , Ziegler Mario , Richards R. Geoff , O'Mahony Liam , Moriarty T. Fintan
Published: July 2021

Biomechanical stability plays an important role in fracture healing, with unstable fixation being associated with healing disturbances. A lack of stability is also considered a risk factor for fracture-related infection (FRI), although confirmatory studies and an understanding of the underlying mechanisms are lacking. In the present study, we investigate whether biomechanical (in)stability can lead to altered immune responses in mice under sterile or experimentally inoculated conditions. In non-inoculated C57BL/6 mice, instability resulted in an early increase of inflammatory markers such as granulocyte-colony stimulating factor (G-CSF), keratinocyte chemoattractant (KC) and interleukin (IL)-6 within the bone. When inoculated with Staphylococcus epidermidis, instability resulted in a further significant increase in G-CSF, IL-6 and KC in bone tissue. Staphylococcus aureus infection led to rapid osteolysis and instability in all animals and was not further studied. Gene expression measurements also showed significant upregulation in CCL2 and G-CSF in these mice. IL-17A was found to be upregulated in all S. epidermidis infected mice, with higher systemic IL-17A cell responses in mice that cleared the infection, which was found to be produced by CD4+ and γδ+ T cells in the bone marrow. IL-17A knock-out (KO) mice displayed a trend of delayed clearance of infection (P=0.22, Fisher’s exact test) and an increase in interferon (IFN)-γ production. Biomechanical instability leads to a more pronounced local inflammatory response, which is exaggerated by bacterial infection. This study provides insights into long-held beliefs that biomechanics are crucial not only for fracture healing, but also for control of infection.
Ausgewählte Grubenstrukturen aus der spätlatènezeitlichen Fundstelle Basel-Gasfabrik
Authors: Rentzel Philippe
Published: July 2021

Die Inhalte von 12 spätlatènezeitlichen Gruben aus der Fundstelle Basel-Gasfabrik wurden mikromorphologisch untersucht, um Hinweise zur Genese und Taphonomie der Sedimente zu erhalten.
Cultural heritage buildings for urban tourism destinations: portraits of Siantar, Indonesia, in the past
Authors: Damanik Erond Litno , Simanjuntak Daniel H.P. , Daud Daud
Published: July 2021

Background: This study was motivated by the failure to use historic buildings, plantations heritage, and modernization of Siantar. The problem is focused on the optimization of historic buildings, icons for urban tourism destinations. The study contribution is useful for the protection, utilization, and development of cultural heritage buildings into a tourist destination in urban areas. More specifically, the study aims to explore and discuss the optimization of urban tourism to support economic and territorial growth.

Methods: The study was carried out qualitatively with a pragmatic methodological approach according to the tourism paradigm. The study departs from the colonial archives: photographs, maps, notes, and field research focused on the identification, significance, and contribution to urban history. The data were transcribed verbatim and analyzed thematically. Raw information was reduced and coded according to the relevance of the study. Data are combined into categories and themes reflecting descriptive analysis, classification, and interpretation. Data validation was done through triangulation strategies, member checking, rich descriptions, and saturation. 

Results:The Historic Tours of Siantar and Its Surroundings, the findings of this study were carried out in three stages; development based on national consensus in law, utilization into public space, appreciation for managers, and management incentives, and determining urban tourism designs.

Conclusions: Utilization of cultural heritage buildings for urban tourism destinations reflects the urban with plantation characteristics, portraits of cities in the past, packed into urban tourism experiences.
Lessons from coronavirus disease 2019 (COVID-19) testing strategies in three lusophone countries
Authors: Madia Lourenco Luiza , Abreu Celina Monteiro , Nicolete Larissa Deadame de Figueiredo , Mabombo Viviana , Nhampossa Tacilta , Matavele Chissumba Raquel , Ali Pereira Sadia , Bandeira António , Tovani Palone Marcos Roberto , Costa Bueno Flávia Thedim , Baker Bonny Louise , Lang Trudie
Published: July 2021

During the coronavirus disease 2019 (COVID-19) pandemic, uncoordinated national responses have been observed around the world which have contributed to the difficulties in controlling the spread of the virus. This lack of dialogue between nations reflects several key determinants including the lack of platforms for non-English speaking researchers and healthcare professionals to engage with critical matters in their native languages. Here, we demonstrate how setting up a dedicated forum for Portuguese-speaking professionals from Brazil, Mozambique and Portugal facilitated the comparison of testing strategies undertaken by those countries during 2020. This working group was established in response to an open workshop conducted in Portuguese in March 2020, in which renowned scientists from lusophone countries were invited to share the COVID-19 responses in their respective countries. To date, the group has convened to address actions, in turn identifying the opportunity to publish the different established approaches to testing strategies undertaken by their countries. This effort highlighted that the governments of those three countries took very different approaches, from case definition to type of test most commonly deployed. This piece emphasizes the need for international bodies to acknowledge the importance of creating forums which are more inclusive to non-speaking English professionals who are at the frontline of healthcare response in challenging settings such as low- and middle-income countries. Finally, fostering approaches like this could represent an efficient strategy to facilitate dialogue, building the necessary steps for a more coordinated response to future global threats.
Scholarly Productivity and Rank in Academic Hospital Medicine
Authors: Sumarsono Andrew , Keshvani Neil , Saleh Sameh N , Sumarsono Nathan , Tran Mindy , Warsi Maryam , Renner Christiana , Chu Eugene S
Published: July 2021

Despite the rapid growth of academic hospital medicine, scholarly productivity remains poorly characterized. In this cross‐sectional study, distribution of academic rank and scholarly output of academic hospital medicine faculty are described. We extracted data for 1554 hospitalists on faculty at the top 25 internal medicine residency programs. Only 11.7% of faculty had reached associate (9.0%) or full professor (2.7%). The median number of publications was 0.0 (interquartile range [IQR], 0.0‐4.0), with 51.4% without a single publication. Faculty 6 to 10 years post residency had a median of 1.0 (IQR, 0.0‐4.0) publication, with 46.8% of these faculty without a publication. Among men, 54.3% had published at least one manuscript, compared to 42.7% of women (P < .0001). Predictors of promotion included H‐index, number of years post residency graduation, completion of chief residency, and graduation from a top 25 medical school. Promotion remains uncommon in academic hospital medicine, which may be partially due to low rates of scholarly productivity.
Reducing Overuse of Proton Pump Inhibitors for Stress Ulcer Prophylaxis and Nonvariceal Gastrointestinal Bleeding in the Hospital: A Narrative Review and Implementation Guide
Authors: Clarke Karen , Adler Nicole , Bhakta Dimpal , Sata Suchita Shah , Singh Sarguni , Gupta Arjun , Pahwa Amit , Pherson Emily , Sun Alexander , Volpicelli Frank , Cho Hyung J
Published: July 2021

Proton pump inhibitors (PPIs) are among the most commonly used medications in the world; however, these drugs carry the risk of patient harm, including acute and chronic kidney disease, Clostridium difficile infection, hypomagnesemia, and fractures. In the hospital setting, PPIs are overused for stress ulcer prophylaxis and gastrointestinal bleeding, and PPI use often continues after discharge. Numerous multifaceted interventions have demonstrated safe and effective reduction of PPI use in the inpatient setting. This narrative review and the resulting implementation guide summarize published interventions to reduce inappropriate PPI use and provide a strategy for quality improvement teams.