bluuebunny/crossref_metadata_2025 huggingface dataset:
Paradoxical embolism to the central nervous system in a young Polish woman on a trek in the Himalayas
Authors: Sawicka Magdalena , Szymczak Robert K
Published: July 2021

Paradoxical embolism to the central nervous system through a patent foramen ovale (PFO) is considered one mechanism of ischaemic stroke. We present a case of stroke in a young woman with PFO trekking in the Himalayas. Paradoxical embolism should be considered in the differential diagnosis of high-altitude cerebral oedema.
On the behaviour of coalgebras with side effects and algebras with effectful iteration
Authors: Adámek Jiří , Milius Stefan , Urbat Henning
Published: July 2021

For every finitary monad $T$ on sets and every endofunctor $F$ on the category of $T$-algebras, we introduce the concept of an ffg-Elgot algebra for $F$, i.e. an algebra admitting coherent solutions for finite systems of recursive equations with effects represented by the monad $T$. The goal is to study the existence and construction of free ffg-Elgot algebras. To this end, we investigate the locally ffg fixed point $\varphi F$, i.e. the colimit of all $F$-coalgebras with free finitely generated carrier, which is shown to be the initial ffg-Elgot algebra. This is the technical foundation for our main result: the category of ffg-Elgot algebras is monadic over the category of $T$-algebras.
Disc accretion shocks with alpha viscosity
Authors: Fukue J
Published: July 2021

Shocks in rotating disc accretion flows under the vertically hydrostatic equilibrium are examined, taking into account the α viscosity. For the case that the stress tensor is proportional to the gas pressure, and neglects the effects of the mixture of gas and radiation pressure, we derive analytical expressions for jump conditions of disc accretion shocks with alpha viscosity; they would be useful for various disc accretion problems. As in the usual accretion disc, the alpha viscosity works as angular momentum transport and heat generation. When a steadily standing shock wave is generated in a disc, due to the viscous effect, the azimuthal velocity discontinuously decreases in the post-shock region inside the front. For sufficiently strong shocks, the post-shock azimuthal velocity vanishes; in other words, the rotating accretion flows turn to the radially accretion ones, after passing the shock front. This vanishing condition is roughly expressed as $\alpha {\cal M}_1/{\cal M}_{\varphi 1}$ 1, where α is the viscous alpha parameter, ${\cal M}_1$ the pre-shock radial Mach number, and ${\cal M}_{\varphi 1}$ the pre-shock azimuthal Mach number. Furthermore, due to the viscous heating, the disc height increases and the surface density decreases in the post-shock region, compared to the non-viscous case. This angular momentum transport via disc shocks would affect the accretion spin-up of the central objects and accretion problems in general.
Gravitational waves from the remnants of the first stars in nuclear star clusters
Authors: Liu Boyuan , Bromm Volker
Published: July 2021

We study Population III (Pop III) binary remnant mergers in nuclear star clusters (NSCs) with a semi-analytical approach for early structure formation. Within this framework, we keep track of the dynamics of Pop III binary (compact object) remnants during cosmic structure formation, and construct the population of Pop III binary remnants that fall into NSCs by dynamical friction of field stars. The subsequent evolution within NSCs is then derived from three-body encounters and gravitational-wave (GW) emission. We find that 7.5 per cent of Pop III binary remnants will fall into the centres ($\lt 3\ \rm pc$) of galaxies. About 5–50 per cent of these binaries will merge at z > 0 in NSCs, including those with very large initial separations (up to 1 pc). The merger rate density (MRD) peaks at z ∼ 5–7 with ${\sim} 0.4\!-\!10\ \rm yr^{-1}\ \rm Gpc^{-3}$, leading to a promising detection rate of ${\sim} 170\!-\!2700\ \rm yr^{-1}$ for third-generation GW detectors that can reach z ∼ 10. Low-mass (${\lesssim} 10^{6}\ \rm M_{\odot }$) NSCs formed at high redshifts (z ≳ 4.5) host most (≳90 per cent) of our mergers, which mainly consist of black holes (BHs) with masses of ${\sim} 40\!-\!85\ \rm M_{\odot }$, similar to the most massive BHs found in LIGO events. Particularly, our model can produce events like GW190521 involving BHs in the standard mass gap for pulsational pair-instability supernovae with an MRD of ${\sim} 0.01\!-\!0.09\ \rm yr^{-1}\ Gpc^{-3}$ at z ∼ 1, consistent with that inferred by LIGO.
Spectroscopic and photometric analysis of symbiotic candidates – I. Ten candidates on classical symbiotic stars
Authors: Merc J , Gális R , Wolf M , Velez P , Buil C , Sims F , Bohlsen T , Vrašťák M , Boussin C , Boussier H , Cazzato P , Diarrasouba I , Teyssier F
Published: July 2021

Symbiotic stars belong to a group of interacting binaries that display a wide variety of phenomena, including prominent outbursts connected with mass transfer, as well as stellar winds, jets, eclipses, or intrinsic variability of the components. Dozens of new symbiotic stars and candidates have been discovered in recent years. However, there are many objects that are still poorly studied. Some symbiotic candidates suspected in the literature have never been studied spectroscopically. In this contribution, we present the first results of the ongoing campaign focused on symbiotic candidates. In the first paper in the series, we study the nature of 10 candidate classical symbiotic stars suspected based on their photometric behaviour, colours or abundance pattern. To confirm or reject the symbiotic nature of the studied candidates, we obtained new spectra and analysed them in detail together with available multifrequency photometric and spectroscopic observations of the objects. Hen 3−860 and V2204 Oph are genuine symbiotic systems showing typical spectral features of burning symbiotic stars and outbursts in the last 100 yr. The first object belongs to the uncommon group of eclipsing symbiotic stars. V1988 Sgr cannot be classified as a genuine burning symbiotic star, but the scenario of an accreting-only symbiotic system cannot be ruled out. Hen 4−204 might be a bonafide symbiotic star due to its similarity with the known symbiotic binary BD Cam. Six other symbiotic candidates (V562 Lyr, IRAS 19050+0001, EC 19249−7343, V1017 Cyg, PN K1−6, V379 Peg) are either single dwarf or giant stars or non-symbiotic binaries.
Search for LBVs in the Local Volume galaxies: study of four stars in NGC 4449
Authors: Solovyeva Y , Vinokurov A , Sarkisyan A , Kostenkov A , Atapin K , Fabrika S , Oparin D , Valeev A , Bizyaev D , Nedialkov P , Spiridonova O
Published: July 2021

We continue to search for LBV stars in galaxies outside the Local Group. In this work, we have investigated four luminous stars in NGC 4449. Multiple spectral observations carried out for J122810.94+440540.6, J122811.70+440550.9, and J122809.72+440514.8 revealed the emission features in their spectra that are characteristic of LBVs. Photometry showed noticeable brightness changes of J122809.72+440514.8 (ΔI = 0.69 ± 0.13m) and J122817.83+440630.8 (ΔR = 2.15 ± 0.13m), while the variability of J122810.94+440540.6 and J122811.70+440550.9 does not exceed 0.3m regardless of the filter. We have obtained estimates of the interstellar reddening, photosphere temperatures, and bolometric luminosities log (LBol/L⊙) ≈ 5.24–6.42. Using the cmfgen code, we have modelled the spectrum of the cold state of J122809.72+440514.8 ($T_{\text{eff}}=9300\,$ K) and have obtained possible value of the mass-loss rate $\dot{M} = 5.2\times 10^{-3}\, \mathrm{M}_{\odot }\, \mathrm{yr}^{-1}$. Based on the observational properties, J122809.72+440514.8 and J122817.83+440630.8 were classified as LBVs, while the other two stars were classified as LBV candidates or B[e]-supergiants candidates.
Final Evaluation Findings forThis Free Life, a 3-Year, Multi-Market Tobacco Public Education Campaign for Gender and Sexual Minority Young Adults in the United States
Authors: Crankshaw Erik , Gaber Jennifer , Guillory Jamie , Curry Laurel , Farrelly Matthew , Saunders McKinley , Hoffman Leah , Ganz Ollie , Delahanty Janine , Mekos Debra , Alexander Tesfa
Published: July 2021

Introduction

This Free Life was the first multi-market, primarily digital campaign designed to change tobacco-related beliefs among lesbian, gay, bisexual, and transgender (LGBT) young adults. Our evaluation sought to determine whether campaign exposure resulted in changes in tobacco-related beliefs. We summarize awareness and receptivity at the conclusion of the campaign and assess the effect of campaign exposure on tobacco-related beliefs in campaign treatment markets compared with control markets.

Aims and Methods

Twenty-four US designated market areas were selected to receive the campaign or serve as control markets. A baseline survey was conducted in 2016, with six follow-up surveys conducted approximately 6 months apart over the course of the 3-year campaign. 12 324 LGBT young adult survey participants were recruited via intercept interviews and social media. Campaign effects on outcomes were estimated using difference-in-difference panel regression models, with p-values corrected for multiple comparisons.

Results

Brand and ad awareness peaked in treatment markets approximately 2.5 years into the 3-year campaign and were significantly higher in treatment than control markets. Brand equity and ad receptivity were generally high and similar across LGBT subgroups. There were small but significant campaign effects on five tobacco-related beliefs, with difference-in-difference estimates ranging from 1.9 to 5.6 percentage points.

Conclusions

This Free Life, the first multi-market tobacco public education campaign for LGBT young adults, reached and resonated with a large and diverse population, and had a small effect on beliefs involving social aspects of smoking. These findings should inform future communication efforts aimed at reducing tobacco use among LGBT young adults.

Implications

Modest overall campaign effects suggest that further research on effective campaign messaging and delivery to LGBT young adults is needed. Campaign messaging style, delivery channels, and targeted outcomes likely contributed to these findings. Health communication efforts for LGBT young adults should consider the limitations of digital media in achieving sufficient exposure. Ad style and content optimized for a digital environment is an area that will benefit from further development.
Xyloglucan Xylosyltransferase 1 Displays Promiscuity Toward Donor Substrates During in Vitro Reactions
Authors: Ehrlich Jacqueline J , Weerts Richard M , Shome Sayane , Culbertson Alan T , Honzatko Richard B , Jernigan Robert L , Zabotina Olga A
Published: July 2021

Glycosyltransferases (GTs) are a large family of enzymes that add sugars to a broad range of acceptor substrates, including polysaccharides, proteins and lipids, by utilizing a wide variety of donor substrates in the form of activated sugars. Individual GTs have generally been considered to exhibit a high level of substrate specificity, but this has not been thoroughly investigated across the extremely large set of GTs. Here we investigate xyloglucan xylosyltransferase 1 (XXT1), a GT involved in the synthesis of the plant cell wall polysaccharide, xyloglucan. Xyloglucan has a glucan backbone, with initial side chain substitutions exclusively composed of xylose from uridine diphosphate (UDP)-xylose. While this conserved substitution pattern suggests a high substrate specificity for XXT1, our in vitro kinetic studies elucidate a more complex set of behavior. Kinetic studies demonstrate comparable kcat values for reactions with UDP-xylose and UDP-glucose, while reactions with UDP-arabinose and UDP-galactose are over 10-fold slower. Using kcat/KM as a measure of efficiency, UDP-xylose is 8-fold more efficient as a substrate than the next best alternative, UDP-glucose. To the best of our knowledge, we are the first to demonstrate that not all plant XXTs are highly substrate specific and some do show significant promiscuity in their in vitro reactions. Kinetic parameters alone likely do not explain the high substrate selectivity in planta, suggesting that there are additional control mechanisms operating during polysaccharide biosynthesis. Improved understanding of substrate specificity of the GTs will aid in protein engineering, development of diagnostic tools, and understanding of biological systems.
Exploring the Sub-state Intergovernmental Game
Authors: Brien Spencer T , Eger Robert J
Published: July 2021

This paper presents a model of fiscal federalism where state and local officials jointly fund a local public good that produces regional externalities. The model examines the implications of diverging budgetary priorities at the state and local level for the sustainability of cooperative funding arrangements. Local government dependence on intergovernmental aid is shown to negatively affect the likelihood of receiving state bailouts. Additionally, the termination of joint funding agreements is predicted to precede increased government fragmentation through the formation of new special purpose districts. The analysis is illustrated using flood control infrastructure finance and school district fragmentation.
Indonesia finally returns to ‘Bhinneka Tunggal Ika’: no more hate but solidarity in COVID-19 crisis
Authors: Situmorang Dominikus David Biondi
Published: July 2021

The coronavirus disease 2019 (COVID-19) crisis has changed the situation in Indonesia, which was previously hit by issues of conflict that are ethnicity, religion, race and inter-group relations. It has now changed with various social and solidarity movements carried out by every level of society in various cities and provinces in Indonesia to fight the COVID-19 crisis together. The hope is that after the COVID-19 crisis ends, the solidarity in the motto ‘Bhinneka Tunggal Ika’ will continue to take root in every pulse of every Indonesian so that this spirit does not only appear when in critical situations but in everyday life in society.
Factors associated with remission at 5-year follow-up in recent-onset axial spondyloarthritis: results from the DESIR cohort
Authors: Pina Vegas Laura , Sbidian Emilie , Wendling Daniel , Goupille Philippe , Ferkal Salah , Le Corvoisier Philippe , Ghaleh Bijan , Luciani Alain , Claudepierre Pascal
Published: July 2021

Objective

The factors contributing to long-term remission in axial SpA (axSpA) are unclear. We aimed to characterize individuals with axSpA at the 5-year follow-up to identify baseline factors associated with remission.

Methods

We included all patients from the DESIR cohort (with recent-onset axSpA) with an available Ankylosing Spondylitis Disease Activity Score–CRP (ASDAS-CRP) at 5-year follow-up. Patients in remission (ASDAS-CRP < 1.3) were compared with those with active disease by demographic, clinical, biological and imaging characteristics. A logistic model stratified on TNF inhibitor (TNFi) exposure was used.

Results

Overall, 111/449 patients (25%) were in remission after 5 years. Among those never exposed to TNFi, 31% (77/247) were in remission compared with 17% (34/202) of those exposed to TNFi. Patients in remission after 5 years were more likely to be male, HLA-B27+, have a lower BMI, and a higher education level. Baseline factors associated with 5-year remission in patients never exposed to TNFi included lower BASDAI [adjusted odds ratio (ORa) 0.9, 95% CI: 0.8, 0.9) and history of peripheral arthritis (ORa 2.1, 95% CI: 1.2, 5.3). In those exposed to TNFi, remission was associated with higher education level (ORa 2.9, 95% CI: 1.6, 5.1), lower enthesitis index (ORa 0.8, 95% CI: 0.7, 0.9), lower BASDAI (ORa 0.9, 95% CI: 0.9, 0.9) and lower BMI (ORa 0.8, 95% CI: 0.7, 0.9).

Conclusion

This study highlights the difficulty in achieving 5-year remission in those with recent-onset axSpA, especially for the more active cases, despite the use of TNFi. Socio-economic factors and BMI are implicated in the outcome at 5 years.
Strengths of Latinas in Spain: A Challenge for a Resilient Social Work Practice
Authors: Anleu-Hernández Claudia María , García-Moreno Cristina , Zafra-Aparici Eva , Forns-Fernández Maria Victòria
Published: July 2021

This article aims to break with two social stereotypes often held about Latinas in Spain. Authors analyze Latinas’ main strengths from a resilient and intersectional approach, to consider them holistically within social work interventions. Rather than focusing on Latinas' difficulties, authors point to their multiple strengths and the ability to move forward. The study took place in the province of Tarragona, Catalonia (Spain). A qualitative approach was used. Participants included Latinas living in Tarragona and social workers from the Tarragona social services. The techniques used were nine life stories and 59 semi-open questionnaires with Latinas, and 14 interviews with social workers. The authors identified a fighting attitude and an entrepreneurial and creative spirit as both individual and collective strengths, especially within Latinas' social networks. Latinas did not recognize themselves as victims, nor did they claim to assume that identity. The social workers’ interventions are implemented in a weak welfare system based on a model characterized by a paternalistic and victim-based viewpoint. Adopting approaches such as intersectionality and resilience would allow for the creation of fairer policies, programs, and projects targeted for Latinas, not just in Spain, but in other countries, too.
Community Organization and Empowerment of Women: The Mujeres Pescadoras del Manglar Cooperative in Oaxaca, Mexico
Authors: Sartini Ilaria , Sánchez Francisco Caravaca
Published: July 2021

Gender equity is still a challenge for the world, especially in those regions where sociocultural practices permeated by machismo, that is, male chauvinism, intersect with poverty and institutionalized racial discrimination. The creation of safe and feminized spaces where women can express themselves freely is crucial in the process of cultivating their awareness of their own positions, and the first step toward individual and collective empowerment. In this article the authors point out the direct and positive relationship between feminine cooperativism and women’s empowerment, taking as a case study the Mujeres Pescadoras del Manglar cooperative in Oaxaca, Mexico, a group of women who, thanks to a social work program implemented by La Ventana civic association, has been able to gain empowerment and recognition at a personal and political level. Likewise, Mujeres Pescadoras del Manglar is an example of the national phenomenon of bolstering female employment in the fishing sector, which is on the rise thanks to the growing number of women’s cooperatives, through which they can access the labor market, feminize new spaces, and achieve full empowerment for themselves, their families, and the society in which they live. The fieldwork was carried out from November 2018 to February 2019 in the community of El Zapotalito, Oaxaca. The methodology used consists of semistructured interviews, life stories, field diaries, and participant observation. This article showcases a positive example of social work empowering low-income women on the Chica coast of Oaxaca.
Effect of essential oil blends and a nonionic surfactant on rumen fermentation, anti-oxidative status, and growth performance of lambs
Authors: Passetti Ludmila C G , Passetti Rodrigo A C , McAllister Tim A
Published: July 2021

This study aimed to evaluate the effect of essential oils (OEO; XEO) and an emulsifier on rumen fermentation, anti-oxidative status, and the growth performance of lambs. A finishing study was conducted using 35 females and 35 males Suffolk × Canadian Arcott crossbreed lambs, fed a 16:84 forage:concentrate pelleted barley-based with either Control; Bovatec (0.018% Bovatec); Emulsifier (0.25% of Emulsifier); OEO (0.11% of blend 1); XEO (0.0125% of blend 2); OEO + Emulsifier; or XEO + Emulsifier. The rumen fluid of all lambs was sampled via stomach tubing to measure ruminal pH, volatile fatty acid (VFA), and NH3 concentrations and enumerate protozoa. Ruminal pH, molar proportions of individual VFA (except for acetate), and ammonia concentration were similar among treatments. The acetate and total VFA concentrations were lower (P = 0.03) for lambs receiving OEO, while protozoa numbers were increased (P = 0.01). No changes were observed in blood glutathione peroxidize or total superoxide dismutase, but there was a tendency for a reduction in thiobarbituric acid reactive substances in lambs fed diets containing OEO or XEO. No differences among diets were observed in coccidia oocyst counts (OPG) in feces, however, the prevalence of coccidia in lambs was reduced (Cramer’s V = 0.081) with OEO. Lambs fed OEO had the highest (P < 0.01) dry matter intake (DMI) (1.48 kg/d), whereas those fed XEO had the lowest (1.30 kg/d). Average daily gain (ADG), feed conversion (DMI/ADG), and carcass measurements (hot carcass weight, carcass dressing percentages) were not affected by EO or EM. Results from this study suggest that EO may alter rumen fermentation and protozoa counts and increase DMI. However, these responses did not appear to be enhanced by Emulsifier as its inclusion with essential oils did not enhance fermentation or growth responses.
The potential for using shell proteins in gastropod systematics, assessed in patellogastropod limpets
Authors: Colgan Donald James
Published: July 2021

This investigation of the application of shell protein information to gastropod systematics initially utilized available Lottia gigantea sequences and a transcriptome of Patelloida mimula developed here. Levels of differentiation between predicted sequences of reciprocal best-hit potential homologues in P. mimula and L. gigantea suggested that they could be useful within families, and possibly in higher taxa using some shell-associated proteins, particularly the peroxidases. Subsequently, proteomic analyses of the acid-soluble fraction of extractions from 17 shells and five tissue samples were conducted by combined liquid chromatography/mass spectrometry with nano-electrospray ionization. All proteins with abundance more than 1.2% in the L. gigantea shell proteome were identified with 100% confidence in most extractions by SearchGui/PeptideShaker analyses. In total, 259 of 379 peptides predicted from in silico digestion of L. gigantea shell proteins were represented by validated peptide spectrum matches in one or more specimens. Systematics applications were investigated by analysing metrics such as protein coverage by peptides and phylogenetic analyses of peptide presence/absence. The investigation suggested that diagnostic profiles based on fixed presence/absence differences can be used to separate species pairs. However, further development of analytical techniques and accumulation of reference databases is required for realising fully the systematics potential of the shell proteome.
Systemic Sarcoidosis with Psoriasiform Plaques and Patchy Nonscarring Alopecia
Authors: Omar Shaimaa Ismail , Genedy Rasha Mahmoud , Zaid Sami Abdelhamid Abo
Published: July 2021

Cutaneous sarcoidosis occurs in about one-quarter of patients with systemic disease and presents with either specific or nonspecific signs. Psoriasiform sarcoidosis is an uncommon presentation. Herein, study authors report a rare case of systemic sarcoidosis that presented with psoriasiform plaques and patchy alopecia. The main patient complaint was disfigurement from skin lesions over different areas of his body, followed by scalp alopecia and uveitis. These lesions were well-defined plaques, some oozing and others scaly. Dermoscopic examination revealed yellow-orange globular structure. A biopsy was taken; the eventual diagnosis was sarcoidosis, for which the patient received treatment with systemic steroids, resulting in improvement of all of his lesions. Physicians should suspect sarcoidosis in any patient presenting with psoriasiform skin lesions not responding to traditional psoriasis treatment.
Variation in Auditory Experience Affects Language and Executive Function Skills in Children Who Are Hard of Hearing
Authors: McCreery Ryan W. , Walker Elizabeth A.
Published: July 2021

Objective:

Children who are hard of hearing (CHH) experience delays in spoken language and executive function, but the mechanisms for these deficits remain unresolved. Differences in auditory experience and language skills have been examined as contributing factors to deficits in executive function, primarily with children who are deaf and children with cochlear implants. The theoretical model of cumulative auditory experience quantifies auditory dosage as how much speech is audible and how often children wear their hearing aids. CHH with higher auditory dosage have better language outcomes than peers with less auditory dosage. However, the effects of auditory experience on executive function have not been studied in CHH. The goal of this study was to examine the influences of auditory experience and language skills on the development of executive function in CHH.

Design:

We collected measures of aided speech audibility, hearing aid use, executive function, and receptive vocabulary in 177 CHH and 86 children with typical hearing who were 5- to 10 years old and matched for socioeconomic status and nonverbal intelligence. Auditory dosage was calculated by combining each child’s average hours of hearing aid use with their audibility for speech to create a variable that quantifies individual differences in auditory access.

Results:

CHH had lower receptive vocabulary and deficits in executive function related to working memory and selective attention compared to peers with typical hearing. CHH with greater auditory dosage had higher receptive vocabulary than CHH with lower auditory dosage. Better receptive vocabulary was associated with better scores on executive function measures related to working memory and attention. Auditory dosage was also directly associated with measures of verbal working memory.

Conclusions:

CHH have deficits in language and some, but not all, areas of executive function related to working memory and attention. Auditory dosage was associated with language abilities and verbal working memory. Language was associated with individual differences in executive function skills related to attention and working memory. These results provide support for systems theories regarding the development of executive function in CHH. Interventions that improve auditory access and language may be effective for improving executive function related to working memory and attention in CHH.
Haematopoietic stem cell transplantation in paediatric rheumatic disease
Authors: Abinun Mario , Slatter Mary A.
Published: July 2021

Purpose of review

A small proportion of children affected by rheumatic diseases suffer from severe, progressive disease, resistant to conventional antirheumatic therapies and to biologic agents interfering with inflammatory cytokines, costimulatory molecules expressed on immune system cells and intracellular signalling pathways. Adding to the poor prognosis is a high risk from significant morbidity and mortality associated with long-term treatment with multiple, often combined anti-inflammatory and immunosuppressive agents. Carefully selected patients from this unfortunate group may benefit from treatment with haematopoietic stem cell transplantation.

Recent findings

The majority of patients with severe paediatric rheumatic and autoinflammatory diseases treated with autologous and/or allogeneic haematopoietic stem cell transplantation achieved long-term remission. However, the incidence of disease relapse and transplant related morbidity and mortality is still significant.

Careful patient and donor selection, timing of the transplant earlier in the course of disease rather than the ‘last resort’ and choosing the most suitable conditioning regimen for each individual patient are the major factors favouring successful outcome. Close co-operation between the patients, their family, and involved medical teams is essential.
Prone-Positioning for Severe Acute Respiratory Distress Syndrome Requiring Extracorporeal Membrane Oxygenation
Authors: Petit Matthieu , Fetita Catalin , Gaudemer Augustin , Treluyer Ludovic , Lebreton Guillaume , Franchineau Guillaume , Hekimian Guillaume , Chommeloux Juliette , Pineton de Chambrun Marc , Brechot Nicolas , Luyt Charles-Edouard , Combes Alain , Schmidt Matthieu
Published: July 2021

OBJECTIVES:

To determine the characteristics and outcomes of patients prone-positioned during extracorporeal membrane oxygenation for severe acute respiratory distress syndrome and lung CT pattern associated with improved respiratory system static compliance after that intervention.

DESIGN:

Retrospective, single-center study over 8 years.

Settings:

Twenty-six bed ICU in a tertiary center.

MEASUREMENTS AND MAIN RESULTS:

A propensity score–matched analysis compared patients with prone-positioning during extracorporeal membrane oxygenation and those without. An increase of the static compliance greater than or equal to 3 mL/cm H2O after 16 hours of prone-positioning defined prone-positioning responders. The primary outcome was the time to successful extracorporeal membrane oxygenation weaning within 90 days of postextracorporeal membrane oxygenation start, with death as a competing risk. Among 298 venovenous extracorporeal membrane oxygenation–treated adults with severe acute respiratory distress syndrome, 64 were prone-positioning extracorporeal membrane oxygenation. Although both propensity score–matched groups had similar extracorporeal membrane oxygenation durations, prone-positioning extracorporeal membrane oxygenation patients’ 90-day probability of being weaned-off extracorporeal membrane oxygenation and alive was higher (0.75 vs 0.54, p = 0.03; subdistribution hazard ratio [95% CI], 1.54 [1.05–2.58]) and 90-day mortality was lower (20% vs 42%, p < 0.01) than that for no prone-positioning extracorporeal membrane oxygenation patients. Extracorporeal membrane oxygenation–related complications were comparable for the two groups. Patients without improved static compliance had higher percentages of nonaerated or poorly aerated ventral and medial-ventral lung regions (p = 0.047).

CONCLUSIONS:

Prone-positioning during venovenous extracorporeal membrane oxygenation was safe and effective and was associated with a higher probability of surviving and being weaned-off extracorporeal membrane oxygenation at 90 days. Patients with greater normally aerated lung tissue in the ventral and medial-ventral regions on quantitative lung CT-scan performed before prone-positioning are more likely to improve their static compliance after that procedure during extracorporeal membrane oxygenation.
Prevalence and Clinical Impact of Reduced Coagulation Factor XII Activity in Patients Receiving Extracorporeal Membrane Oxygenation
Authors: Buchtele Nina , Schwameis Michael , Schellongowski Peter , Quehenberger Peter , Knöbl Paul , Traby Ludwig , Schmid Monika , Schoergenhofer Christian , Herkner Harald , Jilma Bernd , Staudinger Thomas
Published: July 2021

OBJECTIVES:

Extracorporeal membrane oxygenation provides large surface exposure to human blood leading to coagulation activation. Only limited clinical data are available on contact activation and coagulation factor XII activity in extracorporeal membrane oxygenation patients.

DESIGN:

Prospective cohort study.

SETTING:

Three medical ICUs at the Medical University of Vienna.

PATIENTS:

Adult patients receiving venovenous or venoarterial extracorporeal membrane oxygenation.

INTERVENTIONS:

None.

MEASUREMENTS AND MAIN RESULTS:

The primary outcome was the change in coagulation factor XII activity in response to extracorporeal membrane oxygenation. Secondary outcomes included the prevalence of reduced coagulation factor XII activity (< 60%) among patients receiving extracorporeal membrane oxygenation and association of coagulation factor XII activity with thromboembolic and bleeding complications. An exploratory endpoint was the association of coagulation factor XII activity and activated partial thromboplastin time in heparinase-treated samples in vitro. Fifty-one patients with a total of 117 samples were included in the study between July 2018 and February 2020. Fifty patients (98%) had reduced coagulation factor XII activity at any timepoint during extracorporeal membrane oxygenation. Median coagulation factor XII activity during extracorporeal membrane oxygenation treatment was 30% (interquartile range, 21.5–41%) and increased after discontinuation (p = 0.047). Patients with thromboembolic complications had higher median coagulation factor XII activity during extracorporeal membrane oxygenation (34% vs 23%; p = 0.023). The odds of a thromboembolic event increased by 200% per tertile of median coagulation factor XII activity (crude odds ratio, 3.034; 95% CI, 1.21–7.63). No association with bleeding was observed. In heparinase-treated samples, coagulation factor XII activity correlated well with activated partial thromboplastin time (r = –0.789; p = 0.007).

CONCLUSIONS:

We observed a high prevalence of reduced coagulation factor XII activity in adult patients on extracorporeal membrane oxygenation, which may confound activated partial thromboplastin time measurements and limit its clinical usefulness for monitoring and titrating anticoagulation with unfractionated heparin. Lower coagulation factor XII activity was associated with less thromboembolic complications, which may highlight the potential of coagulation factor XII to serve as a target for anticoagulation in extracorporeal membrane oxygenation.
Non-IFNγ Whole Blood Cytokine Responses to Mycobacterium tuberculosis Antigens in HIV-exposed Infants
Authors: Anterasian Christine , Warr Alex J. , Lacourse Sylvia M. , Kinuthia John , Richardson Barbra A. , Nguyen Felicia K. , Matemo Daniel , Maleche-Obimbo Elizabeth , John Stewart Grace C. , Hawn Thomas R.
Published: July 2021

Background:

HIV-exposed uninfected (HEU) infants have increased risk of tuberculosis (TB). Testing for Mycobacterium tuberculosis (Mtb) infection is limited by reduced Quantiferon (QFT) sensitivity in infants and tuberculin skin test (TST) cross-reactivity with Bacillus Calmette–Guérin vaccine. Our objective is to assess if non-IFNγ cytokine responses to Mtb-specific antigens have improved sensitivity in detecting Mtb infection in HEU infants compared with QFT.

Methods:

HEU infants were enrolled in a randomized clinical trial of isoniazid preventive therapy (IPT) to prevent Mtb infection in Kenya (N = 300) and assessed at 12 months postrandomization (14 months of age) by TST and QFT-Plus. Non-IFNγ cytokine secretion (IL2, TNF, IP10, N = 229) in QFT-Plus supernatants was measured using Luminex assay. Logistic regression was used to assess the effect of IPT on Mtb infection outcomes in HEU infants.

Results:

Three of 251 (1.2%) infants were QFT-Plus positive. Non-IFNγ Mtb antigen-specific responses were detected in 12 additional infants (12/229, 5.2%), all TST negative. IPT was not associated with Mtb infection defined as any Mtb antigen-specific cytokine response (odds ratio = 0.7, P = 0.54). Mtb antigen-specific IL2/IP10 responses had fair correlation (τ = 0.25). Otherwise, non-IFNγ cytokine responses had minimal correlation with QFT-Plus and no correlation with TST size.

Conclusions:

We detected non-IFNg Mtb antigen-specific T-cell responses in 14-month HEU infants. Non-IFNg cytokines may be more sensitive than IFNg in detecting infant Mtb infection. IPT during the first year of life was not associated with Mtb infection measured by IFNg, IL2, IP10 and TNF Mtb-specific responses.
Recent Experience: Corticosteroids as a First-line Therapy in Children With Multisystem Inflammatory Syndrome and COVID-19-related Myocardial Damage
Authors: Vukomanovic Vladislav , Krasic Stasa , Prijic Sergej , Ninic Sanja , Popovic Sasa , Petrovic Gordana , Ristic Snezana , Simic Radoje , Cerovic Ivana , Nesic Dejan
Published: July 2021

Background:

Cardiovascular complications with myocarditis in multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 infection have been reported, but the optimal therapeutic strategy remains unknown.

Methods:

A retrospective cohort study included 19 patients with acute left ventricular systolic dysfunction associated with MIS-C, average years of age 13.2 ± 3.8, treated from April 2020 to April 2021.

Results:

Treatment failure (TF) was observed in 8 patients (in the intravenous immunoglobulin [IVIG] group 7/10; in the corticosteroid [CS] group 1/9). The independent risk factor for TF was IVIG treatment (odds ratio [OR] 18.6, 95% confidence interval [CI] 1.6–222.93, P = 0.02). Patients initially treated with CS became afebrile during in-hospital day 1 (1.5, interquartile range [IQR] 1–2), while IVIG-treated patients became afebrile on in-hospital day 4 (IQR 2–4.25), after CS was added. The C-reactive protein (CRP) significantly declined in CS-treated patients on day 2 (P = 0.01), while in the IVIG group, CRP decreased significantly on the fourth day (P = 0.04). Sodium and albumin levels were higher on third in-hospital day in the CS group than in the IVIG group (P = 0.015, P = 0.03). A significant improvement and normalization of ejection fraction (EF) during the first 3 days was observed only in the CS group (P = 0.005). ICU stays were shorter in the CS group (4, IQR 2–5.5) than in the IVIG group (IVIG group 7, IQR 6–8.5) (P = 0.002).

Conclusions:

Among children with MIS-C with cardiovascular involvement, treatment with CS was associated with faster normalization of LV EF, fever, laboratory analysis, and shorter ICU than IVIG-treated patients.
Safety and Tolerability of Monoclonal Antibody Therapies for Treatment of COVID-19 in Pediatric Patients
Authors: Mak Gregory , Dassner Aimee M. , Hammer Benjamin M. , Hanisch Benjamin R.
Published: July 2021

There is a little data regarding safety or efficacy of monoclonal antibody treatment for mild-to-moderate COVID-19 in pediatric patients despite it being frequently used in adults. This retrospective study of 17 patients with mild-to-moderate COVID-19 who received monoclonal antibody therapy found that the treatment was well tolerated, safe, and may be effective in halting progression to severe disease.
Cutaneous Manifestations of Sarcoidosis
Authors: Khawar Talha , Chatta Payush , Sandhu Sareen
Published: July 2021

Sarcoidosis is a multisystem autoimmune disorder that is primarily characterized by its pulmonary manifestations. However, it is equally important to recognize the systemic nature of the disease including cutaneous manifestations, which are seen in a sizable proportion of patients with sarcoidosis. Dermatology nurses have a very important role to play in early recognition and diagnosis of this disease. This review article focuses on the multiple cutaneous manifestations of sarcoidosis, suggested clinical workup, and available treatment options. The aim of this review is to increase awareness of this disease among dermatology nurses to help facilitate early diagnosis and management.
Dry Burning Lips
Authors: Maghfour Jalal , Jacob Sharon E. , Silverberg Nanette
Published: July 2021

Teledermatology is a term to describe the provision of dermatologic medical services through telecommunication technology. This is a teledermatology case of dry burning lips.
Sunnybrook Facial Grading System: Intra-rater and Inter-rater Variabilities
Authors: Cabrol Camille , Elarouti Léa , Montava Anne-Laure , Jarze Sylvie , Mancini Julien , Lavieille Jean-Pierre , Barry Pauline , Montava Marion
Published: July 2021

Objectives:

Evaluate intra-rater and inter-rater variabilities of the Sunnybrook Facial Grading System (SFGS) and explore potential factors of variability.

Study Design:

Prospective test of hypothesis.

Setting:

University tertiary referral center.

Participants/Methods:

Facial video recordings of 20 patients with variable degrees of peripheral facial palsy (PFP) were anonymized then presented to 31 independents raters in 2 trials. The raters were senior and junior professionals involved in the management of PFP: ENT specialists, physiotherapists, and speech therapists. The SFGS was used for grading paralysis.

Main Outcome Measure:

Intra-rater and inter-rater variabilities were estimated by intraclass correlation coefficient (ICC [95% confidence interval]) for the composite score and the three subscores of the SFGS. Factors of variability studied were: rater professions and rater experience (senior vs junior).

Results:

For the total population, the intra-rater ICC was 0.915[0.900–0.929] for the composite score considered to represent almost perfect repeatability. Repeatability was important for symmetry at rest (0.694[0.646–0.737]), almost perfect for voluntary movements (0.903[0.886–0.918]), and important to almost perfect for synkinesis (0.810[0.778–0.838]). The inter-rater ICC for the composite score was 0.847[0.755–0.923] indicating important to almost perfect agreement between all raters. Agreement between raters was important to almost perfect for voluntary movements (0.839[0.746–0.919]), but moderate to important for symmetry at rest (0.553[0.408–0.730]) and weak to important for synkinesis (0.476[0.333–0.666]). Some variability was found between raters groups; however, repeatability and agreement were good for all raters.

Conclusions:

The SFGS is a reproducible scale. It can be used with good reproducibility by both novices and experts, and by all professionals involved in the management of PFP.
Could Jinfukang alleviate the chemotherapy-related adverse effects in non-small cell lung cancer patients?
Authors: Zheng Xing , Wang Wenmin , Wang Gefei , Liu Shenghua
Published: July 2021

Background:

Lung cancer is the main cause of cancer-related death in the world, and non-small cell lung cancer (NSCLC) accounts for approximately 85% of all lung cancers. Cisplatin and its derivatives are the first-line chemotherapeutic drugs for patients with advanced lung cancer, but the chemotherapy-related adverse reactions greatly impact the quality of life (QOL) of patients and limit their use. Jinfukang is a commonly used traditional Chinese medicine preparation with anti-tumor effect in China, which has been approved by China Food and Drug Administration against NSCLC. At present, there is a lack of strict randomized controlled trials to study whether Jinfukang could alleviate the chemotherapy-related adverse effects in the treatment of advanced NSCLC. Therefore, we intend to perform a double-blind, placebo controlled, randomized trial to evaluate the effect of Jinfukang in alleviating the chemotherapy-related adverse effects of patients with advanced NSCLC.

Methods:

This is a prospective, double-blind, randomized, placebo controlled trial. According to the randomized control principle, 168 patients will be divided into treatment group and control group at 1:1 ratio. The patients in the two groups will be treated continuously for 3 cycles and followed up for 3 years. Outcome indicators include: the incidence of chemotherapy-related adverse effects, the progression-free survival (PFS), total effective rate, and QOL evaluation. We will use SPSS19.0 to analyze the results.

Conclusions:

This study will help to evaluate the effect of Jinfukang alleviating chemotherapy-related adverse effects in the treatment of advanced NSCLC.

Trial registration:

DOI 10.17605/OSF.IO/YWBSC
Acupuncture for the treatment of leptin resistance in obesity
Authors: Gao Tianjiao , Ma Dehui , Chen Shaotao , Zhang Xiaolin , Han Yiran , Liu Mingjun
Published: July 2021

Background:

Recently, there has been a global increase in obesity and obesity-related diseases. The prevention and treatment of obesity have become one of the most significant public health challenges worldwide in the 21st century, and how to effectively curb the occurrence of obesity has become a major global concern. Numerous studies have shown that the majority of obese individuals do not respond to leptin, and instead demonstrate leptin resistance. Clinical studies have found that acupuncture is widely used in the clinical treatment of obesity in recent years, but whether it can improve leptin resistance has not been systematically reviewed. This study is aimed to investigate the effectiveness of acupuncture in obesity with leptin resistance (LR).

Methods:

We searched PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure (CNKI), Wan Fang, Technology Journal Database (VIP), and China Biology Medicine disc (CBM). Chinese Clinical Trial Registry. The time was from the establishment of the database to March 19, 2021. RevMan 5.3 software was used to assess the quality and risk of the included studies.

Results:

This study will be conducted in terms of clinical efficacy, serum leptin content, and body weight change. The current evidence shows that the incidence of the disease is high and the comprehensive quality is high.

Conclusion:

The conclusion of this review will provide a basis for judging whether acupuncture therapy is effective in the treatment of leptin resistance in obesity.
Similar appearance of different multifocal carpal bone destructing disease entities in 3 patients
Authors: Lee Jun-Ku , Kwon Young Woo , Shim Jae Chan , Kang Yun Kyung , Cho Weon Min , Park Jong Woong , Han Soo-Hong
Published: July 2021

Rationale:

Several diseases feature tumors, or tumor-mimicking lesions, that further invade the bone and surrounding joints of the wrist region. Here, we describe 3 rare cases of multiple destructed carpal bones and adjacent joints in different disease entities confirmed via pathologic diagnosis.

Patient concerns:

All 3 cases were examined between January 2016 and December 2019. Three patients presented with similar clinical manifestations and radiographic features, with multiple osteolytic lesions in the carpal bones and metacarpal bone base.

Diagnoses:

The 3 cases were diagnosed as diffuse type tenosynovial giant cell tumor, calcifying aponeurotic fibroma, and rheumatoid arthritis.

Interventions:

Separate, experienced radiologist and pathologist took part in the interpretation and compartmentalization of radiographs and pathological findings, respectively. Even magnetic resonance imaging could not achieve a diagnosis; surgical excision was therefore required, with subsequent pathological assessment for treatment and final diagnosis.

Outcomes:

functional outcomes also differed among patients, poorest in rheumatoid arthritis patient.

lessons:

We report 3 rare disease entities, presenting with multifocal osteolytic lesions in the wrist. They all presented with similar clinical manifestations, and the final diagnoses were made via pathological evaluation. Compared with tenosynovial giant cell tumor and calcifying aponeurotic fibroma, rheumatoid arthritis had the poorest outcome.