bluuebunny/crossref_metadata_2025 huggingface dataset:
Current management of NAFLD/NASH
Authors: Cardoso Ana Carolina , de Figueiredo‐Mendes Claudio , A. Villela‐Nogueira Cristiane
Published: June 2021

NAFLD is the most common cause of liver disease worldwide, and its prevalence is significantly increasing. Studies have shown that it is associated with comorbidities such as diabetes, metabolic syndrome and obesity. Early diagnosis and management are highly important and could modify the prognosis of the disease. Evaluating the possibility of multiple aetiologies and recognizing the additional causes of liver disease should be a part of the patient's initial assessment. There are no approved drug treatments as yet, so the main management strategies should involve lifestyle changes such as physical activity and dietary re‐education.
A Phytophthora capsici RXLR effector targets and inhibits the central immune kinases to suppress plant immunity
Authors: Liang Xiangxiu , Bao Yazhou , Zhang Meixiang , Du Dandan , Rao Shaofei , Li Yixin , Wang Xiaodan , Xu Guangyuan , Zhou Zhaoyang , Shen Danyu , Chang Qin , Duan Weiwei , Ai Gan , Lu Jie , Zhou Jian‐Min , Dou Daolong
Published: June 2021

Receptor‐like cytoplasmic kinase subfamily VII (RLCK‐VII) proteins are the central immune kinases in plant pattern‐recognition receptor (PRR) complexes, and they orchestrate a complex array of defense responses against bacterial and fungal pathogens. However, the role of RLCK‐VII in plant–oomycete pathogen interactions has not been established. Phytophthora capsici is a notorious oomycete pathogen that infects many agriculturally important vegetables.

Here, we report the identification of RXLR25, an RXLR effector that is required for the virulence of P. capsici. In planta expression of RXLR25 significantly enhanced plants’ susceptibility to Phytophthora pathogens. Microbial pattern‐induced immune activation in Arabidopsis was severely impaired by RXLR25. We further showed that RXLR25 interacts with RLCK‐VII proteins.

Using nine rlck‐vii high‐order mutants, we observed that RLCK‐VII‐6 and RLCK‐VII‐8 members are required for resistance to P. capsici. The RLCK‐VII‐6 members are specifically required for Phytophthora culture filtrate (CF)‐induced immune responses. RXLR25 directly targets RLCK‐VII proteins such as BIK1, PBL8, and PBL17 and inhibits pattern‐induced phosphorylation of RLCK‐VIIs to suppress downstream immune responses.

This study identified a key virulence factor for P. capsici, and the results revealed the importance of RLCK‐VII proteins in plant–oomycete interactions.
A rare cause of platypnea‐orthodeoxia syndrome in a young female due to persistent left superior vena cava
Authors: de Jesus Mikhail , Patel Nirav , Cheema Mohiuddin , Weissler‐Snir Adaya
Published: June 2021

Platypnea‐Orthodeoxia syndrome (POS) is a rare clinical syndrome characterized by shortness of breath in the upright position that is relieved with supine positioning. We present a rare case of persistent left superior vena cava (PLSVC) draining into the left atrium causing a right‐to‐left shunt and subsequent POS. A 30‐year‐old female with a past medical history of hypertrophic cardiomyopathy, congenital Long QT syndrome and a left‐sided dual chamber implantable cardioverter‐defibrillator (ICD) presented with dyspnea and lightheadedness. Prior to presentation, the patient underwent a left‐sided ICD extraction due to ICD lead infection and re‐implantation from the right side through the cephalic vein. After further investigation, it was concluded that the PLSVC resulted in a physiological right‐to‐left shunting causing POS, with resolution of her symptoms after surgical ligation. To our knowledge, this is the first case report of PLSVC presenting with POS without anatomical intracardiac shunts following iatrogenic right superior vena cava (RSVC) obstruction.
Cohort profile: The COPENHAGEN Minipuberty Study—A longitudinal prospective cohort of healthy full‐term infants and their parents
Authors: Busch Alexander Siegfried , Ljubicic Marie Lindhardt , Upners Emmie N. , Fischer Margit Bistrup , Kolby Nanna , Eckert‐Lind Camilla , Jespersen Kirstine , Andersson Anna‐Maria , Frederiksen Hanne , Johannsen Trine Holm , Hegaard Hanne Kristine , Sharif Heidi , Hagen Casper P. , Juul Anders
Published: June 2021

Background

The hypothalamic‐pituitary‐gonadal (HPG) axis governs sexual maturation and reproductive function in humans. In early postnatal life, it is transiently active during which circulating sex steroids reach adult levels. While this so‐called minipuberty represents a universal phenomenon in infants of both sexes, its role for early maturation and growth remains incompletely understood.

Objectives

To provide normative data on auxology as well as serum and urinary hormone levels in healthy, full‐term infants throughout the first year of life and to investigate associations of postnatal HPG axis dynamics as well as hormonal, genetic and environmental exposures with early genital development and growth.

Population

Healthy, Danish, full‐term, singleton newborns including their parents.

Design

Single‐centre, prospective, observational longitudinal pregnancy and birth cohort.

Methods

Newborns were followed with six repeated clinical examinations during a one‐year follow‐up period. An umbilical cord blood sample was drawn at birth. At each visit, infants underwent a clinical examination focusing on auxology and genital development. Further, blood (serum, plasma, DNA) and urine samples were collected at each visit. Mothers and fathers underwent a clinical examination and provided blood samples prior to and after birth. A subset of parents provided urine samples and breast milk samples. Pregnancy and obstetrical outcomes, and detailed parental questionnaires were compiled.

Preliminary results

Between August 2016 and August 2018, 2481 women with singleton pregnancies were invited to participate of which 298, including their partners, were enrolled (12.0%). A total of 268 healthy, full‐term newborns born appropriate for gestational age (AGA) were included at birth, 233 newborns participated in the postnatal follow‐up period and 186 completed the one‐year follow‐up period (9.4% and 7.5%, respectively).

Conclusion

The COPENHAGEN Minipuberty Study provides detailed, longitudinal data on early genital development and growth including hormonal and genetic profiles and environmental exposure in healthy infants including additional data in their parents.
Relatives’ negotiation power in relation to older people’s acute hospital admission: A qualitative interview study
Authors: Hoffmann Eva , Andersen Pernille Tanggaard , Mogensen Christian Backer , Prinds Christina , Primdahl Jette
Published: June 2021

Background

Acutely admitted older people are potentially vulnerable and dependent on relatives to negotiate and navigate on their behalf.

Aim

This study aimed to explore relatives’ experiences of their interactions with healthcare professionals during acute hospital admission of older people to derive themes of importance for relatives’ negotiations with these professionals.

Method

A qualitative design was applied. Relatives of acutely admitted older people at two emergency departments in Denmark were interviewed (n = 17). The qualitative content analysis was guided by Graneheim and Lundman's concepts.

Results

The analysis derived four themes: (a) Mandate, (b) Incentive, (c) Capability and (d) Attitude to taking action. These four sources of relatives’ negotiation power can be illustrated in the MICA model.

Conclusion

Four themes were identified as important sources of relatives’ negotiation power. Since the four sources of power potentially change according to the situation, relatives’ negotiation power seems to be context dependent.
Agreeableness, extraversion and life satisfaction: Investigating the mediating roles of social inclusion and status
Authors: Fors Connolly Filip , Johansson Sevä Ingemar
Published: June 2021

We examine inclusion and status as potential mediators in the relationships between extraversion and agreeableness, on the one hand, and life satisfaction, on the other hand. Previous research has shown that agreeableness is less strongly related to life satisfaction compared to extraversion. We argue that the relatively weak association between agreeableness and life satisfaction is due to the fact that, even though this personality trait is positively related to inclusion, it is only weakly related to status. Using structural equation modeling (SEM) and survey data from Australia, Denmark and Sweden, we test five hypotheses about the linkages between these personality traits, inclusion, status and life satisfaction. Our results show that both extraversion and agreeableness are positively associated with life satisfaction and that this association is much stronger for extraversion. Furthermore, our results show that extraversion is reliably associated with both inclusion and status, whereas agreeableness is a reliable predictor of inclusion but not of status. Turning to our mediation analysis, our main results demonstrate that the relationship between extraversion and life satisfaction is fully mediated by both inclusion and status, whereas the relationship between agreeableness and life satisfaction is partially mediated by inclusion. Our mediation analysis further shows that agreeableness has a negative direct effect on life satisfaction over and above the positive indirect effect through inclusion. Our findings highlight the role of both inclusion and status as important mediators in the relationships between extraversion and agreeableness, on the one hand, and life satisfaction, on the other hand.
Improving Lasso for model selection and prediction
Authors: Pokarowski Piotr , Rejchel Wojciech , Sołtys Agnieszka , Frej Michał , Mielniczuk Jan
Published: June 2021

It is known that the Thresholded Lasso (TL), SCAD or MCP correct intrinsic estimation bias of the Lasso. In this paper we propose an alternative method of improving the Lasso for predictive models with general convex loss functions which encompass normal linear models, logistic regression, quantile regression, or support vector machines. For a given penalty we order the absolute values of the Lasso nonzero coefficients and then select the final model from a small nested family by the Generalized Information Criterion. We derive exponential upper bounds on the selection error of the method. These results confirm that, at least for normal linear models, our algorithm seems to be the benchmark for the theory of model selection as it is constructive, computationally efficient and leads to consistent model selection under weak assumptions. Constructivity of the algorithm means that, in contrast to the TL, SCAD or MCP, consistent selection does not rely on the unknown parameters as the cone invertibility factor. Instead, our algorithm only needs the sample size, the number of predictors and an upper bound on the noise parameter. We show in numerical experiments on synthetic and real‐world datasets that an implementation of our algorithm is more accurate than implementations of studied concave regularizations. Our procedure is included in the R package DMRnet and available in the CRAN repository.
Characterization of the novel KIR2DS2*022 allele identified in a northern Chinese Han individual
Authors: Yu Qiong , Chen Hao , Yang Zhi‐Chao , Deng Zhi‐Hui
Published: June 2021

The novel KIR2DS2*022 allele differs from the closest allele KIR2DS2*00101 by a single nonsynonymous mutation.
Description of four new HLA alleles: HLA‐B*40:02:01:26, HLA‐DQB1*03:01:29, HLA‐DQB1*04:02:01:12, and HLA‐DPB1*1195:01
Authors: Marin Rubio Luis Alberto , Rada Ramon , Ontañon Jesus
Published: June 2021

Four novel HLA alleles, HLA‐B*40:02:01:26, HLA‐DQB1*03:01:01:29, HLA‐DQB1*04:02:01:12 and HLA‐DPB1*1195:01, detected in Spanish individuals.
The first reported case of neonatal alloimmune thrombocytopenia due to low‐frequency human platelet antigen‐6b antibodies in the United Kingdom
Authors: Hopkins Matthew , Brookes Jessica , Watson David , Wroe Elizabeth , Guthrie Pamela , Horler Jane , Anayattil Kurian , Calvert Anthony , Poles Anthony
Published: June 2021

Background

Neonatal alloimmune thrombocytopenia (NAIT) is a potentially serious clinical condition caused by maternal alloantibodies directed to human platelet antigens (HPA), inherited from the father and expressed on fetal/neonatal platelets. We report a case of an otherwise well, full term child, with a profound thrombocytopenia (33 x 109/L). There was no bleeding or obvious explanation for the low platelet count. Samples were sent for the investigation of NAIT.

Method

Serological investigations were performed on maternal serum taken at day (D)+4 and D+78. The platelet immunofluorescence test (PIFT) and monoclonal antibody immobilization of platelet antigens (MAIPA) assays were performed with a panel of HPA typed donor platelets and against paternal platelets in a crossmatch. HPA 1‐6, ‐9 and ‐15 and HLA genotyping was performed by in‐house PCR‐sequence based typing (SBT) and next generation sequencing (NGS).

Results

HPA antibody screening of D+4 maternal serum indicated that platelet‐specific antibodies were absent. HPA genotyping of the father and child revealed the presence of the low frequency HPA antigen (LFHPA), HPA‐6b, which was absent in the mother. Maternal samples were crossmatched against paternal platelets and were positive by PIFT and glycoprotein (GP) IIb/IIIa and HLA class I in the MAIPA assay. The infant required no platelet transfusion support as the thrombocytopenia resolved spontaneously.

Discussion

We conclude that the positive crossmatch reaction was due to anti‐HPA‐6b alloantibodies. This case further emphasizes the importance of platelet crossmatching and HPA genotyping of LFHPA in cases where there is a high clinical suspicion of NAIT but initial screening is negative.
Fiscal incentives and land finance cycles of prefectures in China
Authors: Chiang Tsun‐Feng , Hou Jack , Tsai Pi‐Han
Published: June 2021

Land finance has become one of the important major sources of fiscal revenue for Chinese local governments. The spatial allocation of land use constitutes a land‐leasing policy operation of local officials, contributing to local economic development and fluctuation. Applying data from 283 prefectural units from 2003 to 2012, this paper explores the existence of land finance cycles, focussing on the changes of the amount (as in ‘area’) of land‐leasing by negotiation or by auction. The empirical results suggest that land finance cycles synchronise with the PCCP (Provincial Congress of the Communist Party) cycles, in which a prefectural leader decreases the amount of land leased through negotiation and increases that of land leased through auction prior to the year of the PCCP. The findings of empirical results are consistent with the prediction of our theoretical model. Additionally, due to the existence of high uncertainty of prefectural leaders’ tenure and political turnover, the effect of prefectural leaders’ tenure on land finance cycles is more apparent in the early years of their tenure. The results indicate that Chinese leaders’ fiscal strategies are likely to be driven by career concerns for the purpose of maximising a measured economic performance and fiscal rents.
An application of the whale optimization algorithm with Levy flight strategy for clustering of medical datasets
Authors: Mat Ayşe Nagehan , İnan Onur , Karakoyun Murat
Published: June 2021

Clustering, which is handled by many researchers, is separating data into clusters without supervision. In clustering, the data are grouped using similarities or differences between them. Many traditional and heuristic algorithms are used in clustering problems and new techniques continue to be developed today. In this study, a new and effective clustering algorithm was developed by using the Whale Optimization Algorithm (WOA) and Levy flight (LF) strategy that imitates the hunting behavior of whales. With the developed WOA-LF algorithm, clustering was performed using ten medical datasets taken from the UCI Machine Learning Repository database. The clustering performance of the WOA-LF was compared with the performance of k-means, k-medoids, fuzzy c-means and the original WOA clustering algorithms. Application results showed that WOA-LF has more successful clustering performance in general and can be used as an alternative algorithm in clustering problems.
más temido de la migraña: el infarto migrañoso
Authors: Cardenas Cruz Andres Felipe , Coral Elza Juliana , Aguilera Peña Maria Paula , Santana Julian
Published: June 2021

El infarto migrañoso se define como el ataque cerebro vascular (ACV) que ocurre durante un episodio de migraña con aura, cuyos síntomas se prolongan por más de 60 minutos tornándose persistentes y relacionándose con isquemia cerebral en neuroimágenes. A pesar de que la fisiopatología subyacente a la migraña como posible causa o factor de riesgo para presentar un ACV no está clara, el vasoespasmo y los cambios en el flujo sanguíneo son mecanismos que pueden explicar este fenómeno. La evidencia acumulada sugiere una asociación entre la migraña con aura y el riesgo de ACV, ataque isquémico transitorio (AIT) e incluso enfermedad coronaria, sin embargo, el aumento absoluto de riesgo es bajo. 

Se presenta el caso de dos mujeres que consultaron al servicio de urgencias, con migraña con aura asociado a defectos campimétricos prolongados, en ambos casos se documentó mediante resonancia magnética lesiones isquémicas en el lóbulo occipital.
Frontotemporal Lobar Degeneration –Agrammatic Primary Progressive Aphasia:Case Report
Authors: Ariza Galindo Carlos José , Santacruz Escudero José Manuel , Lozano Rengifo María Juliana , Segura Valencia Ana Isabel
Published: June 2021

We present a case of a 57-year-old male architect with a master’s degree in economics who ran his own business and gave lectures until 2016, with a clynical picture of 16 years of evolution which began with anxiety symptoms, excessive concern about trivial events, as well as difficulty in planning and decision making. In the last 3 years, there is evidence of social isolation, difficulty in finding words and decreased verbal fluency; he omits connectors in the grammatical composition in association with ritualistic, stereotyped and perseverative behavior (makes several paintings from the same photograph).
Síndrome de tuberías oxidadas y su implicación en la lactancia: presentación de caso y revisión narrativa de literatura
Authors: Villanueva Congote Juliana , Jaramillo Bernal Maria Camila , Sanabria Diana Catalina , Aljure Vicente De Jesús , Chala Saad Emilio
Published: June 2021

Objetivos: Realizar el primer reporte de caso de Síndrome de Tuberías Oxidadas en Colombia, buscando brindar herramientas al personal de salud que permitan plantearse diagnósticos diferenciales en pacientes con telorrea sanguinolenta.  

Reporte de caso: Paciente puerperal de 33 años en post parto vaginal eutócico quien presentó telorragia bilateral indolora en las primeras horas posteriores al parto. Se realizó coloración gram de la secreción, la cual mostro escasa reacción leucocitaria y cocos gram positivos. El ultrasonido mostró un BIRADS I. La telorrea resolvió espontáneamente. Se consideró que la paciente cursaba con un Síndrome de Tuberías Oxidadas.

Conclusiones: El Síndrome de tuberías oxidadas es una condición clínica poco conocida, que no suele estar dentro de los diagnósticos diferenciales en los casos de telorragia asociada a la lactancia. Las publicaciones a nivel latinoamericano son muy limitadas.

Palabras clave: Lactancia materna, leche humana, período posparto, trastornos puerperales (DeCs).
Técnicas para el estudio anatómico del cerebro: una revisión
Authors: Ocampo Navia Maria Isabel , Gomez-Vega Juan Carlos
Published: June 2021

Un entendimiento preciso de la anatomía cerebral es fundamental en la práctica y entrenamiento de los neurocirujanos. El estudio anatómico en cadáveres se ha convertido en uno de los métodos más útiles dentro de este campo debido a que permite el estudio de variaciones anatómicas poblaciones y el entrenamiento de habilidades quirúrgicas (técnica, profundidad, visoespacialidad) por medio de las disecciones para el mejor entendimiento de la anatomía humana y del sistema nervioso central. Por ello, las técnicas de preservación y coloración del tejido cerebral surgen como una alternativa de educación morfológica, entrenamiento y aprendizaje de los residentes de neurocirugía. Esta revisión pretende describir estas técnicas y los diferentes métodos de coloración vascular cerebral. Con esto, buscamos facilitar la creación de laboratorios de microcirugía y proponer nuevas alternativas que pueden aplicarse en la educación de estudiantes y residentes de neurocirugía.
Xpert MTB/RIF Ultra innovación en el diagnóstico de la tuberculosis
Authors: Rodríguez Lugo Diego Andrés , Villamil Castañeda Lina Paola , Lasso Apraez Javier Iv´án , Garzón Herazo Javier Ricardo , Celis Preciado Carlos
Published: June 2021

La tuberculosis es una enfermedad infecciosa con alta mortalidad a nivel global, considerándose un problema de salud pública. La dificultad para su diagnóstico, sobre todo en países de bajos y medianos ingresos limitan su erradicación. El Xpert MTB/RIF es una herramienta molecular que provee un diagnóstico rápido e informa sobre la presencia de cepas resistentes a la rifampicina, permitiendo iniciar un tratamiento de forma rápida y eficaz. Sin embargo, tiene problemas para el diagnóstico de casos paucibacilares y se han reportado falsos positivos respecto a la resistencia a rifampicina y en pacientes con antecedente de tuberculosis. Por esto, aparece el Xpert MTB/RIF Ultra, mostrando mejor sensibilidad para el diagnóstico de la tuberculosis, sobre todo en casos paucibacilares, y disminución de falsos positivos para resistencia a rifampicina; siendo la prueba molecular más recomendada por la OMS. Teniendo en cuenta lo anterior, se espera que mejore el diagnóstico de la enfermedad, dando la oportunidad de iniciar el tratamiento de forma oportuna. En este artículo de revisión se evaluarán retos por mejorar en el diagnóstico de la tuberculosis, características y rendimiento del Xpert MTB/RIF y  Xpert MTB/RIF Ultra para formas pulmonares y extrapulmonares y para la detección de la resistencia a la rifampicina.
Disertación sobre la estimulación cordonal posterior para el tratamiento del dolor: revisión no sistemática de la literatura
Authors: Acevedo González Juan Carlos
Published: June 2021

El dolor es uno de los síntomas (dolor agudo) y patologías (dolor crónico) que afectan más desde todo punto de vista a la población general y a la sociedad. Desde cualquier aspecto analizado los gastos emocionales y monetarios son inmensos. Cuando el dolor se convierte en crónico requiere tratamientos excepcionales que permiten un control adecuado de los síntomas. Entre los procedimientos utilizados para el control del dolor crónico en neurocirugía se encuentra la estimulación eléctrica continua de los cordones posteriores de la medula en el segmento en el cual se origina la sintomatología. Es un procedimiento estandarizado que se usa desde mitad de los años setenta y que ha demostrado una gran utilidad.

En este artículo buscamos presentar una narrativa realizada a partir de una revisión no sistemática de la literatura, en donde ilustramos el desarrollo histórico del concepto y los parámetros básicos para su realización.
Experiencia del Departamento de Pediatría en el uso de herramientas remotas para la continuidad académica en la Pontificia Universidad Javeriana durante la pandemia por SARS-CoV-2 en el 2020
Authors: Bertolotto Ana Maria , Bohórquez-Peñaranda Adriana Patricia , Murillo Galvis Marcela , Romero Marquez Yoliset Karina , Vargas Vaca Yaris Anzully , Estrada Cano Diana Carolina , Granados Rugeles Claudia Marcela
Published: June 2021

La educación médica se ha visto confrontada a los rápidos cambios que surtieron a raíz de la pandemia por SARS-CoV-2. Los profesores del Departamento de Pediatría de la Facultad de Medicina de la Pontificia Universidad Javeriana se han enfrentado a la necesidad de hacer modificaciones y afrontar los retos de las tecnologías para dar continuidad académica a los programas de pre y postgrado en el área de la pediatría, así como ajustar las prácticas para garantizar la formación médica. En este artículo exponemos las experiencias y reflexiones del departamento.
Conocimientos, actitudes y prácticas sobre tabaquismo en un grupo de médicos en Bogotá, Colombia
Authors: Becerra Martínez Nelci Astrid , Robayo-González Claudia Ximena , De la Asunción Ramírez Diana , Sanchez Marcela , Alba Luz Helena
Published: June 2021

Introducción: abordar el tabaquismo requiere la comprensión de factores de los profesionales que influyen sobre la atención clínica. Objetivo: Identificar comportamientos, actitudes y prácticas sobre tabaquismo en un grupo de médicos en Bogotá, Colombia. Materiales y métodos: Estudio descriptivo transversal mediante la Encuesta Mundial de Tabaquismo en Estudiantes de Profesiones de la Salud aplicada a estudiantes de pregrado de medicina de último año y médicos de una institución de cuidado primario ambulatorio. Resultados: Se aplicó a 200 sujetos, con participación del 89,5%. El 72,5% fueron mujeres; 32% estudiantes de último año de medicina. Existe un mayor conocimiento de los riesgos asociados al tabaquismo y las razones para fumar por parte de los médicos en formación (96,1%; p=0,01). El entrenamiento en cesación fue mayor en médicos en formación (82,4%; p=0,001). El 73,6% de los encuestados considera son modelos para sus pacientes y la comunidad, mayor esta percepción en médicos graduados (78,9%; p=0,04). Las prevalencias de consumo de tabaco y cigarrillo electrónico son más altas en médicos en formación. Conclusiones: Indagar sobre conocimientos, actitudes y prácticas en médicos amplía la comprensión de su rol en el control y abordaje del tabaquismo. Es importante revisar los contenidos curriculares y reforzar la educación continua en tabaquismo.
Associations Between Parent Perspectives and Motor Competence in Children With CHARGE Syndrome
Authors: Haibach-Beach Pamela , Perreault Melanie , Lieberman Lauren J. , Stribing Alexandra
Published: June 2021

Children with CHARGE syndrome, an extremely complex, highly variable genetic disorder, are significantly delayed in the onset of their motor milestones in comparison with children without disabilities due to sensory and motor deficits as well as lengthy hospitalizations and reduced physical activity. Currently, the role of parents’ perceptions and participation in the motor development of their child with CHARGE is unknown. The purpose of this study was to examine the associations between parents’ perceptions and their child’s motor competence, comparing parents of children with and without CHARGE syndrome. Participants included 33 children with CHARGE and 38 children without disabilities. Parents completed the Child’s Movement Skills Research parent survey and children were assessed on their gross motor skills. Parental ratings of locomotor ability and time spent participating with their child predicted the locomotor, ball skill, and total motor skill scores in the CHARGE group. Control group parents’ rating of ball scores predicted ball skill and total skill scores. The results indicate that parents may play an important role in their child with CHARGE syndrome’s motor development. Parents who are more involved with their child’s movement activities can positively influence their motor competence.
“Fuelled by Passion”: Obsessive Passion Amplifies Positive and Negative Feelings Throughout a Hockey Playoff Series
Authors: Schellenberg Benjamin J.I. , Verner-Filion Jérémie
Published: June 2021

Previous research has shown that the highs and lows of sport fandom are more extreme for fans with strong levels of obsessive passion. The authors tested if this amplification effect applied to how hockey fans felt throughout a National Hockey League (NHL) playoff series. Fans of the Winnipeg Jets (N = 57) reported levels of harmonious and obsessive passion prior to the start of the 2019 NHL playoffs and then reported their feelings the day after each game of the first playoff round. The results supported the amplification hypothesis by showing that the impact of game result on both positive and negative feelings the day after a game was more extreme for fans with high obsessive passion. This moderating effect, however, appeared to be driven primarily by responses to losses.
Examining the Relationship Between Exercise-Related Cognitive Errors, Exercise Schema, and Implicit Associations
Authors: Locke Sean R. , Berry Tanya R.
Published: June 2021

To better understand exercise-related cognitive errors (ECEs) from a dual processing perspective, the purpose of this study was to examine their relationship to two automatic exercise processes. It was hypothesized that ECEs would account for more variance than automatic processes in predicting intentions, that ECEs would interact with automatic processes to predict intentions, and that exercise schema would distinguish between different levels of ECEs. Adults (N = 136, Mage = 29 years, 42.6% women) completed a cross-sectional study and responded to three survey measures (ECEs, exercise self-schema, and exercise intentions) and two computerized implicit tasks (the approach/avoid task and single-category Implicit Association Test). ECEs were not correlated with the two implicit measures; however, ECEs moderated the relationship between approach tendency toward exercise stimuli and exercise intentions. Exercise self-schema were differentiated by ECE level. This study expands our knowledge of ECEs by examining their relationship to different automatic and reflective processes.
COVID-19 vaccine side effects: The positives about feeling bad
Authors: Sprent Jonathan , King Cecile
Published: June 2021

The side effects of SARS-CoV-2 vaccines are often troubling but may merely reflect transient production of type I interferons, a normal physiological response to contact with invading microorganisms.
Two Distinct Bacterial Biofilm Components Trigger Metamorphosis in the Colonial Hydrozoan Hydractinia echinata
Authors: Guo Huijuan , Rischer Maja , Westermann Martin , Beemelmanns Christine
Published: June 2021

Bacterial biofilms profoundly influence the recruitment and settlement of marine invertebrates, critical steps for diverse marine processes such as the formation of coral reefs, the maintenance of marine fisheries, and the fouling of submerged surfaces. However, the complex composition of biofilms often makes the characterization of individual signals and regulatory mechanisms challenging.
VIP-SPOT: an Innovative Assay To Quantify the Productive HIV-1 Reservoir in the Monitoring of Cure Strategies
Authors: Puertas Maria C. , Bayón-Gil Ángel , Garcia-Guerrero Maria C. , Salgado Maria , Urrea Víctor , Morón-López Sara , Peña Ruth , Jiménez-Moyano Esther , Clotet Bonaventura , Prado Julia G. , Martinez-Picado Javier
Published: June 2021

Current efforts aimed at finding a definitive cure for HIV-1 infection are hampered mainly by the persistence of a viral reservoir in latently infected cells. While complete viral eradication from the body remains elusive, finding a functional cure to enable control of viremia without the need for continuous treatment is a key goal.
Epigenomic Landscape of Lyme Disease Spirochetes Reveals Novel Motifs
Authors: Wachter Jenny , Martens Craig , Barbian Kent , Rego Ryan O. M. , Rosa Patricia
Published: June 2021

The principal causative agent of Lyme disease in humans in the United States is
Borrelia burgdorferi
, while
B. burgdorferi
,
B. afzelii
, and
B. garinii
, collectively members of the
Borrelia burgdorferi
sensu lato
species complex, cause Lyme disease in Europe and Asia. Two plasmid-encoded restriction/modification systems have been shown to limit the genetic transformation of
B. burgdorferi
type strain B31 with foreign DNA, but little is known about the restriction/modification systems of other Lyme disease
Borrelia
bacteria.
Allosteric Activation of SARS-CoV-2 RNA-Dependent RNA Polymerase by Remdesivir Triphosphate and Other Phosphorylated Nucleotides
Authors: Wang Bing , Svetlov Vladimir , Wolf Yuri I. , Koonin Eugene V. , Nudler Evgeny , Artsimovitch Irina
Published: June 2021

In vitro
interrogations of the central replicative complex of SARS-CoV-2, RNA-dependent RNA polymerase (RdRp), by structural, biochemical, and biophysical methods yielded an unprecedented windfall of information that, in turn, instructs drug development and administration, genomic surveillance, and other aspects of the evolving pandemic response. They also illuminated the vast disparity in the methods used to produce RdRp for experimental work and the hidden impact that this has on enzyme activity and research outcomes.
LcrQ Coordinates with the YopD-LcrH Complex To Repress
lcrF
Expression and Control Type III Secretion by Yersinia pseudotuberculosis
Authors: Fei Keke , Yan Huan , Zeng Xiaoyan , Huang Shaojia , Tang Wei , Francis Matthew S. , Chen Shiyun , Hu Yangbo
Published: June 2021

All three human-pathogenic
Yesinia
species,
Y. pestis
,
Y. enterocolitica
, and
Y. pseudotuberculosis
, employ a plasmid-encoded T3SS to target immunomodulatory effectors into host immune cells. Several plasmid-encoded regulators influence T3SS control, including the master transcriptional activator LcrF, the posttranscriptional repressor YopD, and the unassigned negative regulatory factor LcrQ.
Molecular Evolution and Adaptation of Livestock-Associated Methicillin-Resistant Staphylococcus aureus (LA-MRSA) Sequence Type 9
Authors: Yu Fangyou , Cienfuegos-Gallet Astrid V. , Cunningham Marcus H. , Jin Ye , Wang Bingjie , Kreiswirth Barry N. , Chen Liang
Published: June 2021

Staphylococcus aureus
sequence type 9 (ST9) is the main LA-MRSA clone spreading in the Asian continent. It can colonize and cause mild to severe infections both in animal and humans.
Change in Abundance and Activity of Microbocenoses in the Area of Influence of a Large Landslide at the Bureya Reservoir
Authors: Kondratyeva L. M. , Litvinenko Z. N. , Andreeva D. V. , Bashkurova A. S.
Published: June 2021

The results of field and experimental microbiological studies of water, soil, and rock samples in the influence zone of large landslide are presented. The landslide occurred in December 2018 and blocked the Bureya Reservoir from coast to coast. An artificial channel was created to restore the hydrological regime with the use of TNT (trinitrotoluene) and RDX (hexogen). A comparative analysis of the abundance of cultivated heterotrophic bacteria around the landslide body and in the artificial channel is carried out. The activity of microbial communities in relation to easily available (peptone, lactate, and starch) and difficult-to-mineralize humic compounds is also determined. With the use of spectrometry and gas chromatography, it is shown that an increase in the diversity of aromatic compounds in water is accompanied by an increase in the abundance of heterotrophic bacteria. A number of toxic substances, including methanol and methylated benzene derivatives, are found among the dominant components in the water. Its concentrations increased after the water drained through the landslide body and after imploding works. Many of the volatile organic compounds may have been products of microbial metabolism when water interacts with rocks. A hypothesis on the role of methanotrophic and methylotrophic bacteria in the genesis of methanol and toluene is discussed.
Pulmonary embolism with aortic saddle embolism: a rare presentation
Authors: Rajendra Naveen , Raju Radhakrishnan , Pawar Pranay , Sebastian Jithin
Published: June 2021

We present an uncommon case report of simultaneous pulmonary embolism and aortic saddle embolism. This patient had risk factors for thromboembolic events that included recent surgery for tibia fracture and immobilisation. She underwent emergency bilateral pulmonary artery catheter-directed thrombolysis, followed by bilateral transfemoral embolectomy. The potential benefit of thrombolysis was weighed against the risk of haemorrhage during the surgery after thrombolysis. Treatment guidelines are not well established for such a condition. This case report illustrates our experience and challenges faced in treating this condition.
Osteolytic lesions as the sole presenting feature of secondary syphilis
Authors: Colquhoun Matthew , Kirresh Othman , Keikha Mohammad , Haddow Lewis
Published: June 2021

We present the case of a 48-year-old man with a background of well-controlled HIV who presented with bony pain in multiple regions and raised inflammatory markers. After an investigative process, the patient was newly diagnosed with secondary syphilis. Bony pain, secondary to osteolytic lesions and demonstrated on plain radiography, CT and nuclear medicine imaging, was the sole presenting feature. The patient was successfully treated with penicillin G and his symptoms improved. Rheumatologists are often tasked with diagnosing the cause of a patient’s pain. However, in this case, a multidisciplinary approach was needed and the contribution of a specialist in Genitourinary Medicine/HIV was required to help diagnose this rare cause of bony pain.
Proliferative glomerulonephritis with monoclonal immunoglobulin deposits associated with parvovirus B19
Authors: Santana de Roberts Rosalba , Batal Ibrahim , Aljareh Amr , Jim Belinda
Published: June 2021

Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is included in the group of dysproteinaemias causing renal disease. Only a minority of cases are associated with a haematological malignancy. Two cases have been linked to acute parvovirus B19 infections. We report a 36-year-old African-American woman who presented with renal dysfunction, proteinuria, haematuria and a kidney biopsy reported as PGNMID with IgG3-kappa deposits. Her evaluation for a haematological malignancy was unrevealing. Her parvovirus IgM and IgG levels were positive. The patient was initially treated with an ACE inhibitor and spontaneously remitted with minimal proteinuria after 1 month. Repeat parvovirus B19 serologies 6 months later showed persistent IgG and DNA by PCR positivity but IgM negativity. Given the clinical scenario, we believe that her PGNMID was induced by acute parvovirus B19 infection, which appeared to resolve once her acute infection abated. In this report, we describe our latest understanding of PGNMID.
Type 1 diabetes mellitus presenting with diabetic ketoacidosis in a child with Patau syndrome (trisomy 13) and persistent fetal haemoglobin
Authors: McTaggart James Suntac , Sivasubramaniam Sindugaa , Jewell Rosalyn , Yong James
Published: June 2021

A 35-month-old boy with non-mosaic Patau syndrome presented in diabetic ketoacidosis and was diagnosed with type 1 diabetes mellitus. A decision to treat this unanticipated medical problem was made in conjunction with the child’s parent, and he improved with fluid resuscitation and insulin treatment. Acute kidney injury with hypernatraemia complicated his treatment, but this resolved with careful intravenous fluid management. The child survived and was followed up in the diabetes clinic where ongoing management was complicated by persistent fetal haemoglobin, which meant that glycated haemoglobin could not be used to gauge his glucose control.
Glandular metastases from renal cell carcinoma show poor clinical responses to immune checkpoint inhibition but durable responses to angiogenesis inhibitors
Authors: Principe Daniel R , Schulte Brian C , Kamath Suneel D , Munshi Hidayatullah G
Published: June 2021

While half of the metastatic clear cell renal cell carcinomas (ccRCCs) involve the lungs, metastatic lesions have been described in various other organs, including glandular tissues such as the pancreas. Recent evidence suggests that ccRCC lesions affecting the pancreas are poorly responsive to immune checkpoint inhibition (ICI) but show superior responses to tyrosine kinase inhibitors (TKIs) targeting the vascular endothelial growth factor (VEGF) signalling pathway. However, this has yet to be explored in ccRCC spreading to other glandular tissues. Here we present two cases of ccRCC with glandular metastases, the first to the pancreas and the second to the parotid gland. In both patients, ICI-based immunotherapy offered minimal clinical benefit, but both had durable responses to angiogenesis inhibitors. Given the anatomic similarity between the pancreas and parotid glands, ccRCC with involvement of the parotid gland may also benefit from VEGF-targeting TKIs as opposed to ICIs.
Estimations of overdiagnosis in breast cancer screening vary between 0% and over 50%: why?
Authors: Chaltiel Dan , Hill Catherine
Published: June 2021

Background

Published estimations of the extent of breast cancer overdiagnosis vary widely, and there have been heated debates around these estimations. Some high estimates have even been the basis of campaigns against national breast cancer screening programmes. Identifying some of the sources of heterogeneity between different estimates would help to clarify the issue.

Methods

The simple case of neuroblastoma—a childhood cancer—screening is used to describe the basic principle of overdiagnosis estimation. The more complicated mechanism of breast cancer overdiagnosis is described based on data from Denmark, taking into account the type of data used, individual or aggregated.

Findings

The type of data used in overdiagnosis studies has a meaningful effect on the estimation: no study based on individual data provides an estimate higher than 17%, while studies based on aggregated data often provide estimates higher than 40%. This is too systematic to be random. The analysis of two Danish studies, one of each kind, highlights the biases that come with the use of aggregated data and shows how they can lead to overdiagnosis.

Interpretation

Many estimates of overdiagnosis associated with breast cancer screening programmes are serious overestimations.
Use of connected digital products in clinical research following the COVID-19 pandemic: a comprehensive analysis of clinical trials
Authors: Marra Caroline , Gordon William J , Stern Ariel Dora
Published: June 2021

Objectives

In an effort to mitigate COVID-19 related challenges for clinical research, the US Food and Drug Administration (FDA) issued new guidance for the conduct of ‘virtual’ clinical trials in late March 2020. This study documents trends in the use of connected digital products (CDPs), tools that enable remote patient monitoring and telehealth consultation, in clinical trials both before and after the onset of the pandemic.

Design

We applied a comprehensive text search algorithm to clinical trial registry data to identify trials that use CDPs for remote monitoring or telehealth. We compared CDP use in the months before and after the issuance of FDA guidance facilitating virtual clinical trials.

Setting

All trials registered on ClinicalTrials.gov with start dates from May 2019 through February 2021.

Outcome measures

The primary outcome measure was the overall percentage of CDP use in clinical trials started in the 10 months prior to the pandemic onset (May 2019–February 2020) compared with the 10 months following (May 2020–February 2021). Secondary outcome measures included CDP usage by trial type (interventional, observational), funder type (industry, non-industry) and diagnoses (COVID-19 or non-COVID-19 participants).

Results

CDP usage in clinical trials increased by only 1.65 percentage points, from 14.19% (n=23 473) of all trials initiated in the 10 months prior to the pandemic onset to 15.84% (n=26 009) of those started in the 10 months following (p<0.01). The increase occurred primarily in observational studies and non-industry funded trials and was driven entirely by CDP usage in trials for COVID-19.

Conclusions

These findings suggest that in the short-term, new options created by regulatory guidance to stimulate telehealth and remote monitoring were not widely incorporated into clinical research. In the months immediately following the pandemic onset, CDP adoption increased primarily in observational and non-industry funded studies where virtual protocols are likely medically necessary due to the participants’ COVID-19 diagnosis.
Spanish adaptation and validation of the Pain Assessment Scale in Advanced Dementia (PAINAD) in patients with dementia and impaired verbal communication: cross-sectional study
Authors: Cantón-Habas Vanesa , Carrera-González María del Pilar , Moreno-Casbas María Teresa , Rich-Ruiz Manuel
Published: June 2021

Objectives

The aim of this study was to adapt and validate the Pain Assessment in Advanced Dementia (PAINAD) scale in Spanish.

Design

Cross-sectional observational study.

Setting

Two health districts of Andalusian provinces, located in the south of Spain, through the Andalusian network of Primary Healthcare centres and four institutions dedicated to the care of patients with dementia.

Participants

A total of 100 older people, with a medical diagnosis of dementia and a score on the Global Deterioration Scale between 5 and 7 were assessed using the PAINAD scale.

Primary and secondary outcome measures

Psychometric properties including content validity, construct validity and reliability of the scale have been tested.

Results

The overall Item Content Validity Index was excellent (0.95). Regarding construct validity, it was confirmed that a lower use of analgesics implied a lower score on the PAINAD scale (p<0.05). The internal consistency of the scale was 0.76 and it increases to 0.81 if we remove the breathing item. Furthermore, the intraclass correlation coefficient (ICC) used to assess interobserver reliability was 0.94, whereas the ICC used to assess temporary stability was 0.55.

Conclusions

The Spanish version of the PAINAD scale is a valid tool to assess pain in patients with dementia and inability to communicate verbally.
Quality of acute myocardial infarction care in England and Wales during the COVID-19 pandemic: linked nationwide cohort study
Authors: Aktaa Suleman , Yadegarfar Mohammad E , Wu Jianhua , Rashid Muhammad , de Belder Mark , Deanfield John , Schiele Francois , Minchin Mark , Mamas Mamas , Gale Chris P
Published: June 2021

Background and objective

The impact of the COVID-19 pandemic on the quality of care for patients with acute myocardial infarction (AMI) is uncertain. We aimed to compare quality of AMI care in England and Wales during and before the COVID-19 pandemic using the 2020 European Society of Cardiology Association for Acute Cardiovascular Care quality indicators (QIs) for AMI.

Methods

Cohort study of linked data from the AMI and the percutaneous coronary intervention registries in England and Wales between 1 January 2017 and 27 May 2020 (representing 236 743 patients from 186 hospitals). At the patient level, the likelihood of attainment for each QI compared with pre COVID-19 was calculated using logistic regression. The date of the first national lockdown in England and Wales (23 March 2020) was chosen for time series comparisons.

Results

There were 10 749 admissions with AMI after 23 March 2020. Compared with before the lockdown, patients admitted with AMI during the first wave had similar age (mean 68.0 vs 69.0 years), with no major differences in baseline characteristics (history of diabetes (25% vs 26%), renal failure (6.4% vs 6.9%), heart failure (5.8% vs 6.4%) and previous myocardial infarction (22.9% vs 23.7%)), and less frequently had high Global Registry of Acute Coronary Events risk scores (43.6% vs 48.6%). There was an improvement in attainment for 10 (62.5%) of the 16 measured QIs including a composite QI (43.8% to 45.2%, OR 1.06, 95% CI 1.02 to 1.10) during, compared with before, the lockdown.

Conclusion

During the first wave of the COVID-19 pandemic in England and Wales, quality of care for AMI as measured against international standards did not worsen, but improved modestly.
Abstracts from international emergency medicine journals
Authors: Production EMJ
Published: June 2021

Editor’s note: EMJ has partnered with the journals of multiple international emergency medicine societies to share from each a highlighted research study, as selected by their editors. This edition will feature an abstract from each publication.