bluuebunny/crossref_metadata_2025 huggingface dataset:
Risk factors for cutaneous reactions to allopurinol in Kinh Vietnamese: results from a case-control study
Authors: Do Minh Duc , Mai Thao Phuong , Do Anh Duy , Nguyen Quang Dinh , Le Nghia Hieu , Le Linh Gia Hoang , Hoang Vu Anh , Le Anh Ngoc , Le Hung Quoc , Richette Pascal , Resche-Rigon Matthieu , Bardin Thomas
Published: August 2020

Objective

The aim of this study was to investigate risk factors for cutaneous adverse reactions (CARs) in Kinh Vietnamese.

Methods

All patients were prospectively recruited in Ho Chi Minh City. Presence of the HLA-B*58:01 allele was determined by real-time PCR-sequence-specific amplification by using the PG5801 Detection Kit (Pharmigene, Taipei). Patients with severe (SCARs) and mild (MCARs) CARs and controls were compared for differences in features prospectively collected, and odds ratios (ORs) with 95% confidence intervals (CIs) were estimated.

Results

On comparing 32 patients with SCARs and 395 tolerant controls, we identified eight strong risk factors: increased age (OR 15.1 [95% CI 5.8–40.1],P < 0.0001), female sex (OR 333 [40–43,453],P < 0.0001), allopurinol for asymptomatic hyperuricemia (OR 955 [120–125,847],P < 0.0001), allopurinol starting dose > 150 mg (OR 316 [101–122],P < 0.0001), diuretics intake (OR 304 [35–40,018],P < 0.0001), eGFR < 60 ml/min/1.73 m2(OR 100 [32–353],P < 0.0001), history of allopurinol-induced skin reaction (OR 78 [6–10,808],P = 0.004), and HLA-B*58:01 carriage (OR 147 [45–746],P < 0.0001). HLA-B*58:01 allele frequency in controls was 7.3%. For MCARs (n = 74), risk factors were eGFR < 60 ml/min/1.73 m2(OR 4.9 [1.61–14.6],P = 0.006), history of allopurinol-induced skin reaction (OR 27 [2–3777],P = 0.01), and asymptomatic hyperuricemia (OR 27 [2–3777],P = 0.01).

Conclusion

This study confirmed 8 risk factors, including HLA-B*58:01, for SCARs and identified 3 risk factors for MCARs in Kinh Vietnamese. HLA-B*58:01 genotyping could guide the indication for allopurinol in Kinh Vietnamese patients with gout.
Exposure to perfluorooctanoic acid (PFOA) decreases neutrophil migration response to injury in zebrafish embryos
Authors: Pecquet Alison M. , Maier Andrew , Kasper Susan , Sumanas Saulius , Yadav Jagjit
Published: August 2020

Objective

Perfluorooctanoic acid (PFOA) is a ubiquitous environmental contaminant and a known immune suppressant in humans and experimental animal models. Studies on PFOA have focused on suppression of the adaptive immune response; however, little is known of the impact on innate immunity, especially during embryogenesis. Therefore, we utilized the zebrafish chemotaxis assay coupled with in situ hybridization for myeloperoxidase expression to determine the effects of PFOA exposure on neutrophil migration in the developing zebrafish embryo. Zebrafish embryos are a well-established in vivo model that exhibit high homology with the development of human innate immunity.

Results

Treatment of zebrafish with increasing concentrations of PFOA identified the lethal concentration in 50% of the embryos (LC50) to be 300 mg/L. Utilizing the zebrafish chemotaxis assay, this study showed that wounding induced significant neutrophil migration to the site of injury, and that neutrophil number in the wound region was significantly reduced in response to 48-h PFOA exposure (well below doses causing acute mortality). This study demonstrates that the developing embryo is sensitive to PFOA exposure and that PFOA can modify the innate immune system during embryonic development. These results lay the groundwork for future investigation on the mechanisms underlying PFOA-induced developmental immunotoxicity.
The effect of royal jelly and tocotrienol-rich fraction along with calorie restriction on hypothalamic endoplasmic reticulum stress and adipose tissue inflammation in diet-induced obese rats
Authors: Irandoost Pardis , Mesri Alamdari Naimeh , Saidpour Atoosa , Shidfar Farzad , Farsi Farnaz , Asghari Jafarabadi Mohammad , Alivand Mohammad Reza , Vafa Mohammadreza
Published: August 2020

Objectives

Endoplasmic reticulum (ER) stress causes adipose tissue dysfunction and chronic inflammation in obesity. Royal jelly (RJ) and tocotrienol-rich fraction (TRF) are reported to ameliorate inflammation. However, the improving effects of RJ and TRF on inflammation from ER stress modulating view have not been assessed so far. Hence, we investigated the effect of RJ and TRF on ER stress and some adipose tissue-derived inflammatory markers in the high-fat diet (HFD)-induced obesity. Wistar obese rats randomly allocated into 5 groups: HFD, calorie restriction diet (CRD), RJ + CRD, TRF + CRD, RJ + TRF + CRD. After 8-week intervention, adipose tissues and hypothalamus were dissected and serum was collected.

Results

RJ reduced glucose-regulated protein-78 (GRP78) expression as ER stress indicator in WAT and hypothalamus compared to CRD. Besides, RJ diminished the expression of inflammatory markers in white adipose tissue (WAT) and also decreased the serum concentration of them. TRF reduced inflammatory markers in the serum without remarkable effects on ER stress. Overall, RJ has protective effect against adipose tissue dysfunction and inflammation then suggested as a therapeutic approach to reduce some obesity-related complications. The impact of TRF in this regard is lower than RJ and limited to systemic inflammation improvement without remarkable changes in adipose tissue inflammation.
Ectocarpus: an evo-devo model for the brown algae
Authors: Coelho Susana M. , Peters Akira F. , Müller Dieter , Cock J. Mark
Published: August 2020

Ectocarpusis a genus of filamentous, marine brown algae. Brown algae belong to the stramenopiles, a large supergroup of organisms that are only distantly related to animals, land plants and fungi. Brown algae are also one of only a small number of eukaryotic lineages that have evolved complex multicellularity. For many years, little information was available concerning the molecular mechanisms underlying multicellular development in the brown algae, but this situation has changed with the emergence ofEctocarpusas a model brown alga. Here we summarise some of the main questions that are being addressed and areas of study usingEctocarpusas a model organism and discuss how the genomic information, genetic tools and molecular approaches available for this organism are being employed to explore developmental questions in an evolutionary context.
Ursodeoxycholic acid augmentation in treatment-refractory schizophrenia: a case report
Authors: Khosravi Mohsen
Published: August 2020

Background

Treatment-resistance is recognized as a significant dilemma in schizophrenia, which has been reported to involve approximately one-third of patients with schizophrenia.

Case presentation

This case report described a 12-week treatment course for a 39-year-old Persian man with treatment-refractory schizophrenia, who showed a significant improvement in terms of positive, negative, and cognitive symptoms after taking ursodeoxycholic acid 300 mg capsules twice a day. Also, ursodeoxycholic acid was well tolerated, and he did not exhibit any side effects during treatment, based on interview and physical examination.

Conclusion

Ursodeoxycholic acid augmentation seems to be an effective treatment strategy for patients with treatment-refractory schizophrenia. However, further investigations in this field need to be carried out through randomized controlled trials.
Dental follicle stem cells rescue the regenerative capacity of inflamed rat dental pulp through a paracrine pathway
Authors: Hong Hong , Chen Xiaochuan , Li Kun , Wang Nan , Li Mengjie , Yang Bo , Yu Xiaoqi , Wei Xi
Published: August 2020

Background

Pulpitis is a common dental disease characterized by sustained inflammation and impaired pulp self-repair. Mesenchymal stem cell-based minimally invasive vital pulp therapy (MSC-miVPT) is a potential treatment method, but its application is limited by the difficulty in acquiring MSCs. We recently revealed the immunomodulatory effects of rat dental follicle stem cells (rDFSCs) on acute lung injury. The present study focused on the paracrine effects of rDFSCs on the inflammation and regeneration of rat injured dental pulp to detect whether DFSCs are a potential candidate for MSC-miVPT.

Methods

Conditioned medium from rDFSCs (rDFSC-CM) was applied to lipopolysaccharide (LPS)-induced inflammatory rat dental pulp cells (rDPCs). The inflammation and regeneration of rDPCs were detected by RT-qPCR, Western blotting, immunofluorescence staining, Cell Counting Kit-8 (CCK-8) assay, flow cytometry, wound-healing assay, and Masson’s staining. The effects of rDFSC-CM on inflamed rat dental pulp were further evaluated by hematoxylin-eosin and immunohistochemical staining.

Results

rDFSC-CM downregulated the ERK1/2 and NF-κB signaling pathways, which resulted in suppression of the expression of IL-1β, IL-6, and TNF-α and promotion of the expression of IL-4 and TGF-β, and these findings lead to the attenuation of rDPC inflammation. rDFSC-CM enhanced the in vitro proliferation, migration, and odontogenic differentiation of inflammatory rDPCs and their in vivo ectopic dentinogenesis. Furthermore, rDFSC-CM inhibited inflammatory cell infiltration in rat pulpitis and triggered Runx2 expression in some of the odontoblast-like cells surrounding the injured site, and these effects were conducive to the repair of inflamed dental pulp.

Conclusions

rDFSC-CM exhibits therapeutic potential by rescuing the regeneration of the inflamed rat dental pulp through an immunomodulatory mechanism, indicating the application prospects of DFSCs in biological regenerative endodontics.
Rhein laden pH-responsive polymeric nanoparticles for treatment of osteoarthritis
Authors: Hu Bo , Gao Feng , Li Chunbao , Zhang Boqing , An Mingyang , Lu Ming , Liu Yufeng , Liu Yujie
Published: August 2020

Osteoarthritis (OA) is a condition associated with severe inflammation, cartilage destruction and degeneration of joints. Rhein (Rh) is an effective anti-inflammatory drug with proven efficacy in in-vitro and in-vivo models. pH sensitive Rh and NH4HCO3 laden poly (lactic-co-glycolic acid (PLGA) nanoparticles (NPs) (Rh-PLGA-NPs@NH4) are developed for an effective treatment of OA. The Rh-PLGA-NPs@NH4 are prepared along with Rh-PLGA-NPs as a control by double emulsion method. Rh-PLGA-NPs@NH4 was characterized for their size, shape, morphology and encapsulation efficiency (EE). The effect of pH on release of Rh from Rh-PLGA-NPs@NH4 was studied at different pH. Further, the cytotoxicity effect of Rh-PLGA-NPs@NH4 on THP-1 cells were evaluated. Anti-inflammatory efficacy was evaluated on LPS stimulated THP-1 cells and the release of pro-inflammatory cytokines was evaluated and compared with control. The size of Rh-PLGA-NPs@NH4 and Rh-PLGA-NPs was found to be 190.7 ± 1.2 nm and 134.6 ± 2.4 nm respectively with poly dispersity (PDI) 0.14 and 0.15. The zeta potential of Rh-PLGA-NPs@NH4 was found to be -22 ± 1.12 mV. Rh-PLGA-NPs@NH4 were uniform, smooth and spherical shape as confirmed using electron microscopy analysis. Rh-PLGA-NPs@NH4 release the Rh more effectively in the low pH of synovial fluid environment (SFE). Rh-PLGA-NPs@NH4 also significantly affect inflammatory cytokines TNF-α and IL-1β and reduced their release in LPS stimulated THP-1 cells. Reactive oxygen species (ROS), a mediator responsible for the cartilage collapse was also found to be reduced. Results proposes that Rh-PLGA-NPs could provide therapeutic solution to those patients who suffer from chronic joint ailments by reducing the progression of OA.
Accuracy of the clinical pulmonary infection score to differentiate ventilator-associated tracheobronchitis from ventilator-associated pneumonia
Authors: Gaudet Alexandre , Martin-Loeches Ignacio , Povoa Pedro , Rodriguez Alejandro , Salluh Jorge , Duhamel Alain , Nseir Saad ,   TAVeM study group
Published: August 2020

Background

Differentiating Ventilator-Associated Tracheobronchitis (VAT) from Ventilator-Associated Pneumonia (VAP) may be challenging for clinicians, yet their management currently differs. In this study, we evaluated the accuracy of the Clinical Pulmonary Infection Score (CPIS) to differentiate VAT and VAP.

Methods

We performed a retrospective analysis based on the data from 2 independent prospective cohorts. Patients of the TAVeM database with a diagnosis of VAT (n = 320) or VAP (n = 369) were included in the derivation cohort. Patients admitted to the Intensive Care Centre of Lille University Hospital between January 1, 2016 and December 31, 2017 who had a diagnosis of VAT (n = 70) or VAP (n = 139) were included in the validation cohort. The accuracy of the CPIS to differentiate VAT from VAP was assessed within the 2 cohorts by calculating sensitivity and specificity values, establishing the ROC curves and choosing the best threshold according to the Youden index.

Results

The areas under ROC curves of CPIS to differentiate VAT from VAP were calculated at 0.76 (95% CI [0.72–0.79]) in the derivation cohort and 0.67 (95% CI [0.6–0.75]) in the validation cohort. A CPIS value ≥ 7 was associated with the highest Youden index in both cohorts. With this cut-off, sensitivity and specificity were respectively found at 0.51 and 0.88 in the derivation cohort, and at 0.45 and 0.89 in the validation cohort.

Conclusions

A CPIS value ≥ 7 reproducibly allowed to differentiate VAT from VAP with high specificity and PPV and moderate sensitivity and NPV in our derivation and validation cohorts.
Bradymonabacteria, a novel bacterial predator group with versatile survival strategies in saline environments
Authors: Mu Da-Shuai , Wang Shuo , Liang Qi-Yun , Du Zhao-Zhong , Tian Renmao , Ouyang Yang , Wang Xin-Peng , Zhou Aifen , Gong Ya , Chen Guan-Jun , Van Nostrand Joy , Yang Yunfeng , Zhou Jizhong , Du Zong-Jun
Published: August 2020

Background

Bacterial predation is an important selective force in microbial community structure and dynamics. However, only a limited number of predatory bacteria have been reported, and their predatory strategies and evolutionary adaptations remain elusive. We recently isolated a novel group of bacterial predators, Bradymonabacteria, representative of the novel order Bradymonadales in δ-Proteobacteria. Compared with those of other bacterial predators (e.g., Myxococcales and Bdellovibrionales), the predatory and living strategies of Bradymonadales are still largely unknown.

Results

Based on individual coculture of Bradymonabacteria with 281 prey bacteria, Bradymonabacteria preyed on diverse bacteria but had a high preference for Bacteroidetes. Genomic analysis of 13 recently sequenced Bradymonabacteria indicated that these bacteria had conspicuous metabolic deficiencies, but they could synthesize many polymers, such as polyphosphate and polyhydroxyalkanoates. Dual transcriptome analysis of cocultures of Bradymonabacteria and prey suggested a potential contact-dependent predation mechanism. Comparative genomic analysis with 24 other bacterial predators indicated that Bradymonabacteria had different predatory and living strategies. Furthermore, we identified Bradymonadales from 1552 publicly available 16S rRNA amplicon sequencing samples, indicating that Bradymonadales was widely distributed and highly abundant in saline environments. Phylogenetic analysis showed that there may be six subgroups in this order; each subgroup occupied a different habitat.

Conclusions

Bradymonabacteria have unique living strategies that are transitional between the “obligate” and the so-called facultative predators. Thus, we propose a framework to categorize the current bacterial predators into 3 groups: (i) obligate predators (completely prey-dependent), (ii) facultative predators (facultatively prey-dependent), and (iii) opportunistic predators (prey-independent). Our findings provide an ecological and evolutionary framework for Bradymonadales and highlight their potential ecological roles in saline environments.
Secondary donor-derived humanized CD19-modified CAR-T cells induce remission in relapsed/refractory mixed phenotype acute leukemia after allogeneic hematopoietic stem cell transplantation: a case report
Authors: Li Meng-Yun , Lin Zhi-Hong , Hu Ming-Ming , Kang Li-Qing , Wu Xiao-xia , Chen Qi-wei , Kong Xin , Zhang Jian , Qiu Hui-Ying , Wu De-Pei
Published: August 2020

Background

Mixed phenotype acute leukemia (MPAL) is a rare leukemia and is regarded as a high-risk entity with a poor prognosis. Induction therapy of an acute lymphoblastic leukemia type or hybrid regimen and hematopoietic stem cell transplantation has been recommended for MPAL. However, the optimal therapies for relapsed or refractory MPAL remain unclear, especially for relapse after stem cell transplantation. Donor-derived chimeric antigen receptor T (CAR-T) cell therapy may be a promising therapeutic option for patients with MPAL who express target antigens and have relapsed after stem cell transplantation. However, recurrence remains a challenge, and reinfusion of CAR-T cells is not always effective. An infusion of secondary donor-derived humanized CD19-modified CAR-T cells may be effective in inducing remission.

Case presentation

We report a case of MPAL with CD19 expression. The patient was treated with acute lymphoblastic leukemia-like induction and consolidation therapies but remained positive for SET-NUP214 fusion gene transcript. He subsequently underwent a haploidentical stem cell transplantation but relapsed within 6 months. He then underwent donor-derived CD19-targeted CAR-T cell therapy and achieved a sustained, complete molecular remission. Unfortunately, he developed a CD19-positive relapse after 2 years. Donor-derived humanized CD19-directed CAR-T cells induced a second complete molecular remission without severe cytokine release syndrome or acute graft-versus-host disease.

Conclusion

This case demonstrated the efficacy and safety of humanized donor-derived CD19-modified CAR-T cell infusion for treating the recurrence of MPAL previously exposed to murine-derived CD19-directed CAR-T cells.
Greater Omentum Imaging-Reporting and Data System: establishing the grade of benign and malignant lesions of the greater omentum using ultrasonography
Authors: Chen Zhiguang , Sang Liang , Zhang Yixia , Bian Donglin , Tao Chunmei , Wang Xuemei
Published: August 2020

Objective

To establish Greater Omentum Imaging-Reporting and Data System (GOI-RADS) to evaluate the possibility of omental diseases being malignant.

Method

A retrospective analysis was made of 883 patients who had undergone biopsy of the greater omentum in our center from October 2009 to October 2019. Twelve parameters of ultrasonographic images were evaluated, and the odds ratio of each group calculated. We assigned scores for the direct signs (omental echo, omental structure, and omental nodules) and indirect signs (separation of ascites, echo of ascites, mesenteric lymph nodes, and thickening of parietal peritoneum) of omental lesions. We created an omental score (OS) for each patient and receiver operating characteristic (ROC) curve to analyze its effectiveness in the differential diagnosis of benign and malignant omental diseases.

Results

The OS was divided into ≤5, 6, 7, 8, 9, 10, 11, 12, 13, and ≥ 14 points, and the malignant rate was 0, 1.85, 5.56, 30.36, 37.25, 87.72, 96.72, 98.28, 99.08, and 100%, respectively. The area under the ROC curve (AUC) was 0.976. When taking 10 points as the cutoff value to diagnose benign and malignant omental diseases, the sensitivity and specificity was 93.85 and 98.21%, respectively. A grading system was established: grade 1: omental score ≤ 5, malignant rate 0%; grade 2: omental score 6–7, malignant rate ≤ 5.56%; grade 3: omental score 8-–9, malignant rate ≤ 37.25%; grade 4: omental score ≥ 10, malignant rate ≥ 87.72.

Conclusion

GOI-RADS had high sensitivity and specificity in the differential diagnosis of benign and malignant omental lesions. We believe that GOI-RADS will aid the diagnosis of omental diseases based on objective and accurate interpretation of ultrasound features, and also to promote the ultrasonography of omental diseases in clinical application.
Risk factors and morbidities associated with childhood obesity in sub-Saharan Africa: a systematic scoping review
Authors: Danquah Frederick Inkum , Ansu-Mensah Monica , Bawontuo Vitalis , Yeboah Matilda , Udoh Roseline H. , Tahiru Mohammed , Kuupiel Desmond
Published: August 2020

Background

The rising burden of childhood obesity is a major public health concern, particularly in sub-Saharan Africa (SSA), where most health systems are weak and least prepared for complications that may arise. While the need for preventive action is increasingly recognized, policy implementation within the sub-region has often been inadequate, non-systematic, and ad hoc. This study described evidence on the risk factors and morbidities associated with childhood obesity in SSA.

Methods

Guided by the Arksey and O’Malley framework incorporating the Levac et al. recommendations, and the Joanna Briggs Institute guidelines, we conducted a scoping study to address the research question. Thorough keywords systematic search was conducted for potentially eligible articles in PubMed, Google Scholar, Web of Science, and CINAHL published between 2009 and June 2019. Articles obtained were screened independently by two investigators at the abstract and full text phases using the eligibility criteria. All relevant data were extracted by two investigators in parallel and thematic analysis conducted.

Results

A total of 337,229 articles were obtained from the database search of which 68 satisfied the inclusion criteria and were included for data extraction. These 68 included studies were conducted in 19 countries with the majority, 27.9% (19/68) from South Africa followed by Nigeria with 20.6% (14/68). Six of the included studies were conducted in Ethiopia, 5 studies in Kenya, 4 studies each in Tanzania and Cameroon, and 2 studies each in Ghana, Uganda, and Sudan. Of the 68 included studies, one each was conducted in Botswana, Gambia, Lesotho, Mauritius, Mozambique, Seychelles, Togo, and Zimbabwe. Most (80.9%) of the included studies were cross-sectional, and only one was an intervention trial. Of the 68 included studies, 53 reported on risk factors, 12 reported on morbidities, and 3 reported both risk factors and morbidities. We found no evidence in almost 60% (28/47) of countries included in the World Health Organisation Africa region.

Conclusion

This review findings suggest a paucity of literature on the risk factors of childhood obesity and morbidities in most SSA countries. Hence, there is the need to intensify research efforts, especially experimental study designs using innovative strategies to promote healthy lifestyle choices that will prevent or minimize the risks and health consequences of childhood obesity in SSA.
Ictal-interictal continuum: a review of recent advancements
Authors: Tao James X. , Qin Xiaoxiao , Wang Qun
Published: August 2020

Continuous electroencephalogram (cEEG) has become an indispensable technique in the management of critically ill patients for early detection and treatment of non-convulsive seizures (NCS) and non-convulsive status epilepticus (NCSE). It has also brought about a renaissance in a wide range of rhythmic and periodic patterns with heterogeneous frequency and morphology. These patterns share the rhythmic and sharp appearances of electrographic seizures, but often lack the necessary frequency, spatiotemporal evolution and clinical accompaniments to meet the definitive criteria for ictal patterns. They may be associated with cerebral metabolic crisis and neuronal injury, therefore not clearly interictal either, but lie along an intervening spectrum referred to as ictal-interictal continuum (IIC). Generally speaking, rhythmic and periodic patterns are categorized as interictal patterns when occurring at a rate of <1Hz, and are categorized as NCS and NCSE when occurring at a rate of >2.5 Hz with spatiotemporal evolution. As such, IIC commonly includes the rhythmic and periodic patterns occurring at a rate of 1–2.5 Hz without spatiotemporal evolution and clinical correlates. Currently there are no evidence-based guidelines on when and if to treat patients with IIC patterns, and particularly how aggressively to treat, presenting a challenging electrophysiological and clinical conundrum. In practice, a diagnostic trial with preferably a non-sedative anti-seizure medication (ASM) can be considered with the end point being both clinical and electrographic improvement. When available and necessary, correlation of IIC with biomarkers of neuronal injury, such as neuronal specific enolase (NSE), neuroimaging, depth electrode recording, cerebral microdialysis and oxygen measurement, can be assessed for the consideration of ASM treatment. Here we review the recent advancements in their clinical significance, risk stratification and treatment algorithm.
Altered Systemic and Intestinal IgA Immune Responses in Individuals With Type 1 Diabetes
Authors: Huang Juan , Huang Gan , Li Xia , Hu Fang , Xie Zhiguo , Xiao Yang , Luo Shuoming , Chao Chen , Guo Keyu , Wong F Susan , Zhou Zhiguang , Wen Li
Published: August 2020

Objective

Increasing evidence supports the observation that immunoglobulin A (IgA) exerts a critical effect on the susceptibility to autoimmunity by modulating gut homeostasis and subsequent host immunity. We hypothesized that the IgA immunity is altered in individuals with type 1 diabetes. To test our hypothesis, we investigated intestinal, oral, and peripheral IgA immune responses in individuals with type 1 diabetes.

Methods

We collected stool, oral cavity, and blood samples from participants diagnosed with type 1 diabetes (within 1 year and more than 1 year) and healthy control individuals. Serum islet autoantibody titers were detected by radioligand assays. IgA-bound bacteria and IgA-expressing B cells were studied by flow cytometry. Oral free IgA level was measured by enzyme-linked immunosorbent assay. Serum and stool free IgA concentrations were determined by immune-turbidimetry method.

Results

Individuals diagnosed with type 1 diabetes within 1 year had an increased proportion of stool IgA-bound bacteria compared with healthy control individuals. The proportion of stool IgA-bound bacteria was positively associated with glutamic acid decarboxylase autoantibody titer. Moreover, individuals with a longer disease duration displayed a higher level of IgA-bound bacteria than those diagnosed within 1 year. In contrast to healthy control individuals, type 1 diabetes patients had increased serum IgA concentrations.

Conclusions

Individuals with type 1 diabetes display altered IgA immunity, especially increased stool IgA-bound bacteria, which is likely to contribute to β-cell autoimmunity and the disease development, and thus, might be considered as a novel therapeutic target for the treatment of type 1 diabetes.
Sustained Maternal Hyperandrogenism During PCOS Pregnancy Reduced by Metformin in Non-obese Women Carrying a Male Fetus
Authors: Andræ Frida , Abbott David , Stridsklev Solhild , Schmedes Anne Vibeke , Odsæter Ingrid Hov , Vanky Eszter , Salvesen Øyvind
Published: August 2020

Context

Large, longitudinal studies on androgen levels in pregnant women with polycystic ovary syndrome (PCOS) are lacking. While metformin has a mild androgen-lowering effect in non-pregnant women with PCOS, its effects on maternal androgen levels in pregnancy are less well understood.

Objective

To describe androgen patterns in pregnant women with PCOS and in healthy control women, and to explore the potential effects of metformin on maternal androgen levels in PCOS.

Design and Setting

A post hoc analysis from a randomized, placebo-controlled, multicenter study carried out at 11 secondary care centers and a longitudinal single-center study on healthy pregnant women in Norway.

Participants

A total of 262 women with PCOS and 119 controls.

Intervention

The participants with PCOS were randomly assigned to metformin (2 g daily) or placebo, from first trimester to delivery.

Main Outcome Measures

Androstenedione (A4), testosterone (T), sex-hormone binding globulin (SHBG), and free testosterone index (FTI) at 4 time points in pregnancy.

Results

Women with PCOS versus healthy controls had higher A4, T, and FTI, and lower SHBG at all measured time points in pregnancy. In the overall cohort of women with PCOS, metformin had no effect on A4, T, SHBG, and FTI. In subgroup analyses, metformin reduced A4 (P = 0.019) in nonobese women. Metformin also reduced A4 (P = 0.036), T (P = 0.023), and SHBG (P = 0.010) levels through pregnancy in mothers with a male fetus.

Conclusion

Metformin had no effect on maternal androgens in PCOS pregnancies. In subgroup analyses, a modest androgen-lowering effect was observed in nonobese women with PCOS. In PCOS women carrying a male fetus, metformin exhibited an androgen-lowering effect.
Evolution of the Primary Aldosteronism Syndrome: Updating the Approach
Authors: Vaidya Anand , Carey Robert M
Published: August 2020

Context

New approaches are needed to address the evolution of the primary aldosteronism syndrome and to increase its recognition. Herein, we review evidence indicating that primary aldosteronism is a prevalent syndrome that is mostly unrecognized, and present a pragmatic and pathophysiology-based approach to improve diagnosis and treatment.

Methods

Evidence was gathered from published guidelines and studies identified from PubMed by searching for primary aldosteronism, aldosterone, renin, and hypertension. This evidence was supplemented by the authors’ personal knowledge, research experience, and clinical encounters in primary aldosteronism.

Interpretation of Evidence

Renin-independent aldosterone production is a prevalent phenotype that is diagnosed as primary aldosteronism when severe in magnitude, but is largely unrecognized when milder in severity. Renin-independent aldosterone production can be detected in normotensive and hypertensive individuals, and the magnitude of this biochemical phenotype parallels the magnitude of blood pressure elevation, the risk for incident hypertension and cardiovascular disease, and the likelihood and magnitude of blood pressure reduction with mineralocorticoid receptor antagonist therapy. Expansion of the indications to screen for primary aldosteronism, combined with the use of a pathophysiology-based approach that emphasizes inappropriate aldosterone production in the context of renin suppression, will substantially increase the diagnostic and therapeutic yields for primary aldosteronism.

Conclusions

The landscape of primary aldosteronism has evolved to recognize that it is a prevalent syndrome of renin-independent aldosterone production that contributes to the pathogenesis of hypertension and cardiovascular disease. Expanding screening indications and simplifying the diagnostic approach will enable implementation of targeted treatment for primary aldosteronism.
Reliable Physical Parameters for Determining Fruit/Seed Maturity Timing of Ficus semicordata Buch. in Kumaun Region of Central Himalaya
Authors: Jyotsna Jyotsna , Tewar Ashish , Shruti Shah Shruti Shah , Tamta Krishna Kumar
Published: August 2020

Wild edible plants play an important role as food supplements during scarcity for local inhabitants. Ficus semicordata is commonly known as drooping fig. Plant parts are used for medicinal purposes. It is a common agroforestry tree in the Himalayan region growing from 750 to 1500 m elevation. The present study was carried out to assess the exact time of seed and fruit maturation and germination of F. semicordata in Nainital district of Kumaun Himalaya across 3 sites during two consecutive years 2017 and 2018. Fruit of F. semicordata were collected from the marked trees from all the sites till the availability of the fruits. Across all the sites the mean fruit size varied between 190.24 ± 0.46 and 395.14 ±3.56.14 mm² in Yr-1 and 135.56 ±3.69 to 516.86 ±1.26 mm² in Yr-2. Across both the sites the colour change from green to pinkish brown appears as one of the indicator of maturity. In addition to the colour fruit moisture content between 50.25±0.58% and 62.73±2.30% coincided with maximum germination (48.0±0.06% and 85± 4.61%).
Ecology and Diversity of Zooplankton of the River Ganga at Bihar, India in Relation to Water Quality
Authors: Pandit Dina Nath , Kumari Punita , Sharma Sunita Kumari
Published: August 2020

A study was carried out to evaluate the ecology and diversity of the zooplankton of the Ganga River at Arrah from Bihar, India from January 2018 to December 2019. Varied physical and chemical parameters supporting the zooplankton and corresponding biodiversity indices were studied. The water temperature showed inverse correlation with pH, dissolved oxygen, whereas direct relationship with total alkalinity, hardness, chloride, nitrate and sulfate. A total of 23 genera of zooplankton belonging to 6 genera of Rotifera, 5 of Protozoa, 5 of Cladocera, 4 of Copepoda and 3 of Ostracoda were identified with a density from 2 to 213 ind./L. The analysis showed that density of zooplankton declined in post-monsoon and remained maximum in summer because of the various environmental and inflow characteristics of the water body. The density of zooplankton showed direct correlation with total alkalinity, hardness and chloride of water but inverse correlation with water temperature, pH and dissolved oxygen. Shannon-Weiner index, Margalef richness index, Pielou’s evenness index, Menhninick’s index and Simpson index were won’t to assess relation of water quality with zooplankton and limnological profile of the river. The diversity indices indicated moderate to high diversity of zooplankton and moderately polluted conditions of the river.
Impact of Neem Oil on Malathion in the Fish Oreochromis mossambicus
Authors: D Jothigayathri , Azeez Amthul , F Akthari Begum , M Lubna Ghazia C
Published: August 2020

The far reaching dissemination and toxic nature of pesticides and their elements seriously affects the aquatic surroundings, and exerts negative consequences on the related organisms. The present study was carried out to investigate the effect of malathion and neem oil individually and also in combination on the fresh water fish, Oreochromis mossambicus to elucidate the change in the different target organs like liver and kidney with reference to biochemical and histopathological studies. Median lethal concentration (LC50) of neem oil and malathion was maintained for acute toxicity (96 hours) and chronic toxicity (21 days) studies. Further the fishes were segregated into 4 groups where in each group contained 6 fishes. Group I fishes were maintained in tap water, Group II in neem oil, Group III fishes were maintained in malathion , Group IV fishes were maintained in both neem oil and malathion. The LC50 dose of neem oil and malathion was found to be 0.9 ml/L and 3.52 mg/L respectively. The results of biochemical analysis revealed that total protein and lipid increased in combination of neem oil and malathion which was comparatively more than that of the neem oil and malathion maintained individually. The total free sugar showed a decrease in combination as well as individually in acute toxicity study .However there is an increase in total free sugar as observed in chronic toxicity study. Histopathological study in acute and chronic toxicity (i) in liver, fishes exposed to neem oil showed normal hepatocellular architecture while fishes exposed to malathion only and those of malathion combined with neem oil showed hepatocellular degeneration while the latter showed the signs of recovery (ii) in kidney the neem oil exposed fishes showed normal renal architecture , malathion exposed fishes showed epithelial cell degeneration and necrosis, while those exposed to neem oil and malathion combined showed mild degeneration. This study indicated the action of neem oil which has interacted with malathion and reveals a protective influence on harmful effects of the toxicant.
Unicompartmental knee arthroplasty undertaken using a fast-track protocol
Authors: Gromov Kirill , Petersen Pelle B. , Jørgensen Christoffer C. , Troelsen Anders , Kehlet Henrik ,   Lundbeck Foundation Centre for Fast-track Hip and Knee Replacement Collaborative Group
Published: August 2020

Aims

The aim of this prospective multicentre study was to describe trends in length of stay and early complications and readmissions following unicompartmental knee arthroplasty (UKA) performed at eight different centres in Denmark using a fast-track protocol and to compare the length of stay between centres with high and low utilization of UKA.

Methods

We included data from eight dedicated fast-track centres, all reporting UKAs to the same database, between 2010 and 2018. Complete ( > 99%) data on length of stay, 90-day readmission, and mortality were obtained during the study period. Specific reasons for a length of stay of > two days, length of stay > four days, and 30- and 90-day readmission were recorded. The use of UKA in the different centres was dichotomized into ≥ 20% versus < 20% of arthroplasties which were undertaken being UKAs, and ≥ 52 UKAs versus < 52 UKAs being undertaken annually.

Results

A total of 3,927 procedures were included. Length of stay (mean 1.1 days (SD 1.1), median 1 (IQR 0 to 1)) was unchanged during the study period. The proportion of procedures with a length of stay > two days was also largely unchanged during this time. The percentage of patients discharged on the day of surgery varied greatly between centres (0% to 50% (0 to 481)), with centres with high UKA utilization (both usage and volume) having a larger proportion of same-day discharges. The 30- and 90-day readmissions were 166 (4.2%) and 272 (6.9%), respectively; the 90-day mortality was 0.08% (n = 3).

Conclusion

Our findings suggest general underutilization of the potential for quicker recovery following UKA in a fast-track setup. Cite this article: Bone Joint J 2020;102-B(9):1167–1175.
Effectiveness and safety of cemented and uncemented hemiarthroplasty in the treatment of intracapsular hip fractures
Authors: Nantha Kumar Nakulan , Kunutsor Setor K. , Fernandez Miguel A. , Dominguez Elizabeth , Parsons Nick , Costa Matt L. , Whitehouse Michael R.
Published: August 2020

Aims

We conducted a systematic review and meta-analysis to compare the mortality, morbidity, and functional outcomes of cemented versus uncemented hemiarthroplasty in the treatment of intracapsular hip fractures, analyzing contemporary and non-contemporary implants separately.

Methods

PubMed, Medline, EMBASE, CINAHL, and Cochrane Library were searched to 2 February 2020 for randomized controlled trials (RCTs) comparing the primary outcome, mortality, and secondary outcomes of function, quality of life, reoperation, postoperative complications, perioperative outcomes, pain, and length of hospital stay. Relative risks (RRs) and mean differences (with 95% confidence intervals (CIs)) were used as summary association measures.

Results

A total of 18 studies corresponding to 16 non-overlapping RCTs with a total of 2,819 intracapsular hip fractures were included. Comparing contemporary cemented versus uncemented hemiarthroplasty, RRs (95% CIs) for mortality were 1.32 (0.44 to 3.99) perioperatively, 1.01 (0.48 to 2.10) at 30 days, and 0.90 (0.71 to 1.15) at one year. The use of contemporary cemented hemiarthroplasty reduced the risk of intra- and postoperative periprosthetic fracture. There were no significant differences in the risk of other complications, function, pain, and quality of life. There were no significant differences in perioperative outcomes except for increases in operating time and overall anaesthesia for contemporary cemented hemiarthroplasty with mean differences (95% CIs) of 6.67 (2.65 to 10.68) and 4.90 (2.02 to 7.78) minutes, respectively. The morbidity and mortality outcomes were not significantly different between non-contemporary cemented and uncemented hemiarthroplasty.

Conclusion

There are no differences in the risk of mortality when comparing the use of contemporary cemented with uncemented hemiarthroplasty in the management of intracapsular hip fractures. Contemporary cemented hemiarthroplasty is associated with a substantially lower risk of intraoperative and periprosthetic fractures. Cite this article: Bone Joint J 2020;102-B(9):1113–1121.
Multi-shot echo-planar diffusion tensor imaging in cervical spondylotic myelopathy
Authors: Zhang Hanwen , Guan Li , Hai Yong , Liu Yuzeng , Ding Hongtao , Chen Xiaolong
Published: August 2020

Aims

The aim of this study was to use diffusion tensor imaging (DTI) to investigate changes in diffusion metrics in patients with cervical spondylotic myelopathy (CSM) up to five years after decompressive surgery. We correlated these changes with clinical outcomes as scored by the Modified Japanese Orthopedic Association (mJOA) method, Neck Disability Index (NDI), and Visual Analogue Scale (VAS).

Methods

We used multi-shot, high-resolution, diffusion tensor imaging (ms-DTI) in patients with cervical spondylotic myelopathy (CSM) to investigate the change in diffusion metrics and clinical outcomes up to five years after anterior cervical interbody discectomy and fusion (ACDF). High signal intensity was identified on T2-weighted imaging, along with DTI metrics such as fractional anisotropy (FA). MJOA, NDI, and VAS scores were also collected and compared at each follow-up point. Spearman correlations identified correspondence between FA and clinical outcome scores.

Results

Significant differences in mJOA scores and FA values were found between preoperative and postoperative timepoints up to two years after surgery. FA at the level of maximum cord compression (MCL) preoperatively was significantly correlated with the preoperative mJOA score. FA postoperatively was also significantly correlated with the postoperative mJOA score. There was no statistical relationship between NDI and mJOA or VAS.

Conclusion

ms-DTI can detect microstructural changes in affected cord segments and reflect functional improvement. Both FA values and mJOA scores showed maximum recovery two years after surgery. The DTI metrics are significantly associated with pre- and postoperative mJOA scores. DTI metrics are a more sensitive, timely, and quantifiable surrogate for evaluating patients with CSM and a potential quantifiable biomarker for spinal cord dysfunction. Cite this article: Bone Joint J 2020;102-B(9):1210–1218.
Vislumbres de un doble 'makarismós' de raigambre horaciana en "Almas muertas" de Gógol
Authors: López López Matías
Published: August 2020

Con arreglo a la idea de makarismós, se rastrean posibles influencias de algunos pasajes de Horacio en un contexto concreto de Almas muertas de Nikolái Gógol. Se abordan, principalmente, dos cuestiones: la de una vida ideal apartada del trasiego mundano y la de la buena fortuna que debería acompañar al escritor de éxito.
Metamorfosi i divinització a l'"Ariadne aux Naxos" d'Hugo von Hofmannsthal i Richard Strauss
Authors: Marcos Hierro Ernest
Published: August 2020

Aquest article examina com un cas de «mythopoiesis» l’ús creatiu del mite de l’abandonament d’Ariadna a Naxos i de la seva unió posterior amb el déu Dionís-Bacchus a l’òpera Ariadne auf Naxos de Hugo von Hofmannsthal i Richard Strauss. Amb la introducció del personatge de Circe com a pretendent amorosa prèvia del jove déu, Hofmannsthal converteix el «deus ex machina» de la faula original en el subjecte d’un procés mutu d’enamorament amb Ariadne presentat com una «allomatische Verwandlung», una metamorfosi recíproca.
La soledad de los pacientes con COVID-19 al final de sus vidas
Authors: Consuegra-Fernández Marta , Fernandez-Trujillo Alejandra
Published: August 2020

Las medidas de seguridad de salud pública tomadas en todo el mundo para detener el ascenso de contagios por SARS-CoV-2 ha despertado el interés por determinados aspectos de la ética asistencial. Se ha hablado ampliamente de las recomendaciones médicas para priorizar la atención sanitaria de pacientes críticos o la distribución equitativa de recursos bajo la amenaza de saturación de los servicios. No obstante, se ha prestado mínima atención a la soledad inevitable de los enfermos con COVID-19 al final de sus vidas. Los procedimientos y normativas de seguridad sanitaria actuales exigen el aislamiento de las personas diagnosticados con COVID-19 o de aquellas bajo sospecha de contagio por falta de pruebas confirmatorias. Estas pautas de actuación conllevan una serie de condiciones que atentan los derechos del paciente, con especial relevancia al final de vida, como el derecho a una muerte digna y al acompañamiento, y que contribuyen a un elevado número de muertes en soledad. Si bien el aislamiento es una de las medidas de prevención de la infección más eficaces, es necesario adaptar un protocolo para situaciones de final de vida que contemple flexibilizar el aislamiento de estos pacientes siempre que haya una voluntad expresa por su parte. El presente manuscrito analiza la vulneración de los derechos del paciente al final de vida en situación de emergencia sanitaria y plantea una serie de recomendaciones para promover el respeto a su libertad y autonomía sin que ello suponga la asunción de riesgo colectivo excesivo.
Salus populi suprema lex
Authors: Farrés Juste Oriol
Published: August 2020

La epidemia de la COVID-19 ha puesto en primer plano tensiones entre valores que se sintetizan en un dilema ético-político clásico: “seguridad-libertad” o “la salud como bien común-la salvaguarda de las libertades individuales”. Al tratarse de una emergencia sociosanitaria, las medidas para su contención implican costes y sacrificios. También restricciones de derechos y libertades básicas. Determinar quién tiene que cargar con los costes se convierte en una cuestión acuciante con implicaciones morales. En este artículo, se plantea un ejercicio de filosofía aplicada a la salud pública en ocasión de esta pandemia y, a su vez, una genealogía de la relación entre la salud y la solidaridad basada en la máxima ciceroniana salus populi suprema lex esto.
El derecho a la protección de datos personales, tecnologías digitales y pandemia por COVID-19 en Colombia
Authors: Gómez-Córdoba Ana Isabel , Arévalo-Leal Sinay , Bernal-Camargo Diana Rocío , Rosero de los Ríos Daniela
Published: August 2020

La pandemia COVID-19 ha generado impactos sociales y políticos adicionales a los estrictamente sanitarios, llevando de un aparte a que los países, en el contexto de los estados de emergencia decretados, limiten de manera temporal algunos derechos y libertades civiles, para preservar la vida y salud de los ciudadanos; y de otra parte, han acelerado la transformación digital con el desarrollo y uso de herramientas tecnológicas para complementar las medidas de salud pública. Diversos organismos internacionales han expresado su preocupación respecto a la vulneración del derecho a la protección de datos personales en este nuevo escenario, e incluso han propuesto lineamientos éticos a tener en cuenta. En este artículo se analizarán las medidas que han sido implementadas en Colombia con ocasión de la COVID-19, desde la perspectiva del marco jurídico del derecho a la protección de datos personales vigente, y como los principios y derechos que lo componen, pueden ser reinterpretados a la luz de estas nuevas recomendaciones éticas.
Ballistocardiography monitoring system based on optical fiber interferometer aided with heartbeat segmentation algorithm
Authors: Chen Shuyang , Tan Fengze , Lyu Weimin , Yu Changyuan
Published: August 2020

An optical fiber interferometer-based ballistocardiography (BCG) monitoring system aided with the IJK complex detection algorithm is proposed in this paper. A new phase modulation method based on a moving-coil transducer is developed to address the problem of signal fading in the optical fiber interferometer and keep the system in quadrature by the closed loop controller. As a result, a stable BCG signal without baseline drift can be obtained. This BCG monitor based on optical fiber interferometer using phase modulation method owns the advantages of compact, low-cost, portable, and user-friendly. In addition, an end-to-end modified U-net is developed to conduct pixel-wise classification in the BCG signal. This network can achieve high accuracy and shows its capability to segment IJK complex and body movement in the BCG signal. In conclusion, the proposed BCG monitoring system with IJK complex segmentation algorithm is potential and promising in healthcare applications.