bluuebunny/crossref_metadata_2025 huggingface dataset:
Physicochemical and Structural Parameters Contributing to the Antibacterial Activity and Efflux Susceptibility of Small-Molecule Inhibitors of Escherichia coli
Authors: El Zahed Sara S. , French Shawn , Farha Maya A. , Kumar Garima , Brown Eric D.
Published: January 2021

Discovering new Gram-negative antibiotics has been a challenge for decades. This has been largely attributed to a limited understanding of the molecular descriptors governing Gram-negative permeation and efflux evasion.
Koala Retrovirus in Northern Australia Shows a Mixture of Stable Endogenization and Exogenous Lineage Diversification within Fragmented Koala Populations
Authors: Quigley Bonnie L. , Melzer Alistair , Ellis William , Tzipori Galit , Nilsson Karen , Olagoke Olusola , Robbins Amy , Hanger Jonathan , Timms Peter
Published: January 2021

KoRV infection has become a permanent part of koalas in northern Australia. With KoRV presence and abundance linked to more severe chlamydial disease and neoplasia in these koalas, understanding how KoRV exists throughout an increasingly fragmented koala population is a key first step in designing conservation and management strategies.
Sterilization by Adaptive Immunity of a Conditionally Persistent Mutant of Mycobacterium tuberculosis
Authors: Vilchèze Catherine , Porcelli Steven A. , Chan John , Jacobs William R.
Published: January 2021

The bacterial pathogen
Mycobacterium tuberculosis
can enter into a persistent state in which
M. tuberculosis
can evade host immunity, thereby reducing the effectiveness of current tuberculosis vaccines. Understanding the factors that contribute to persistence would enable the rational design of vaccines effective against persisters.
Genome Sequencing of Sewage Detects Regionally Prevalent SARS-CoV-2 Variants
Authors: Crits-Christoph Alexander , Kantor Rose S. , Olm Matthew R. , Whitney Oscar N. , Al-Shayeb Basem , Lou Yue Clare , Flamholz Avi , Kennedy Lauren C. , Greenwald Hannah , Hinkle Adrian , Hetzel Jonathan , Spitzer Sara , Koble Jeffery , Tan Asako , Hyde Fred , Schroth Gary , Kuersten Scott , Banfield Jillian F. , Nelson Kara L.
Published: January 2021

Viral genome sequencing has guided our understanding of the spread and extent of genetic diversity of SARS-CoV-2 during the COVID-19 pandemic. SARS-CoV-2 viral genomes are usually sequenced from nasopharyngeal swabs of individual patients to track viral spread.
Trehalose Recycling Promotes Energy-Efficient Biosynthesis of the Mycobacterial Cell Envelope
Authors: Pohane Amol Arunrao , Carr Caleb R. , Garhyan Jaishree , Swarts Benjamin M. , Siegrist M. Sloan
Published: January 2021

The mycomembrane layer of the mycobacterial cell envelope is a barrier to environmental, immune, and antibiotic insults. There is considerable evidence of mycomembrane plasticity during infection and in response to host-mimicking stresses.
Chlamydia trachomatis TmeA Directly Activates N-WASP To Promote Actin Polymerization and Functions Synergistically with TarP during Invasion
Authors: Keb Gabrielle , Ferrell Joshua , Scanlon Kaylyn R. , Jewett Travis J. , Fields Kenneth A.
Published: January 2021

The increasing genetic tractability of
Chlamydia trachomatis
is accelerating the ability to characterize the unique infection biology of this obligate intracellular parasite. These efforts are leading to a greater understanding of the molecular events associated with key virulence requirements.
Exploring the Impact of Ketodeoxynonulosonic Acid in Host-Pathogen Interactions Using Uptake and Surface Display by Nontypeable Haemophilus influenzae
Authors: Saha Sudeshna , Coady Alison , Sasmal Aniruddha , Kawanishi Kunio , Choudhury Biswa , Yu Hai , Sorensen Ricardo U. , Inostroza Jaime , Schoenhofen Ian C. , Chen Xi , Münster-Kühnel Anja , Sato Chihiro , Kitajima Ken , Ram Sanjay , Nizet Victor , Varki Ajit
Published: January 2021

All cells in vertebrates are coated with a dense array of glycans often capped with sugars called sialic acids. Sialic acids have many functions, including serving as a signal for recognition of “self” cells by the immune system, thereby guiding an appropriate immune response against foreign “nonself” and/or damaged cells.
Computational Analysis of Microbial Flow Cytometry Data
Authors: Rubbens Peter , Props Ruben
Published: January 2021

Flow cytometry is an important technology for the study of microbial communities. It grants the ability to rapidly generate phenotypic single-cell data that are both quantitative, multivariate and of high temporal resolution.
Extending our understanding of exenatide: a rare case of angio-oedema
Authors: Mahfooz Faisal , Aylor Kourtney , Mathew, Jr. Jacob , Reichmuth Megan
Published: January 2021

Exenatide is a subcutaneous injectable glucagon-like peptide 1 receptor agonist that has been approved by the Federal Drug Administration for the treatment of type 2 diabetes mellitus. While side effects such as nausea, vomiting and local hypersensitivity reactions are more commonly described, angio-oedema has never been previously reported in the literature. We present the case of a 67-year-old woman who presented to the emergency department with acute-onset tongue swelling, difficulty breathing, dizziness and diffuse itching which began shortly after receiving her first dose of intramuscular extended release (ER) exenatide. This case aims to raise awareness of the potential adverse effect of angio-oedema secondary to exenatide ER and serves as a reminder to clinicians to discuss possible adverse effects of medications and early recognition of symptoms which would prompt further medical attention.
T2-hyperintense, non-gadolinium-enhancing, diffusion-restricted symmetrical curvilinear lesion of the anterior pons: a rare radiological pattern of leptomeningeal metastatic disease secondary to likely lung adenocarcinoma
Authors: Brooks Christopher Alan , Bonura Andrew , Beran Roy G
Published: January 2021

Leptomeningeal carcinomatosis is a devastating sequelae of metastatic cancer. It has protean manifestations on imaging. An elderly woman presented to our tertiary centre with symptoms suggestive of a cerebrovascular accident. Investigations revealed no evidence of this. There was clinical, contextual and radiological evidence of an underlying neoplasm.

Magnetic resonance imaging (MRI) demonstrated evidence of a rare morphology (anterolateral pontine leptomeningeal enhancement) in the presence of a probable concomitant lung adenocarcinoma. Other reports have previously described this same neuroradiology, seemingly always in association with lung adenocarcinoma.

The purpose of this report is to highlight an unusual case and discuss its peculiarity and pathophysiology. Our patient is the latest documented of a small cohort with this constellation of clinical and neuroradiological features.

This study demonstrates the importance of differential diagnosis in stroke medicine, specifically the need to consider neoplastic phenomena in patients admitted following putative cerebrovascular events.
Pharmacological pupil dilatation after sinus surgery
Authors: Mettias Bassem , Islam Tahir , Valsamakis Theodoros
Published: January 2021

Orbital complications after endoscopic sinus surgery are serious problems. Inadvertent contamination of the eye by pharmacological solution can lead to early postoperative anxiety to patients and high concern to surgeons. This is a rare case report of retrograde epinephrine flow through lacrimal duct in sinus surgery with learning tips during postoperative assessment for reassurance in temporary pharmacological effect rather than serious complication.
Two siblings with a novel variant of EXOSC3 extended phenotypic spectrum of pontocerebellar hypoplasia 1B to an exceptionally mild form
Authors: Mu Weiyi , Heller Teresa , Barañano Kristin W
Published: January 2021

Pontocerebellar hypoplasia type 1B (PCH1B) describes an autosomal recessive neurological condition that involves hypoplasia or atrophy of the cerebellum and pons, resulting in neurocognitive impairments. Although there is phenotypic variability, this is often an infantile lethal condition, and most cases have been described to be congenital and neurodegenerative. PCH1B is caused by mutations in the gene EXOSC3, which encodes exosome component 3, a subunit of the human RNA exosome complex. A range of pathogenic variants with some correlation to phenotype have been reported. The most commonly reported pathogenic variant in EXOSC3 is c.395A>C, p.(Asp132Ala); homozygosity for this variant has been proposed to lead to milder phenotypes than compound heterozygosity. In this case, we report two siblings with extraordinarily mild presentations of PCH1B who are compound heterozygous for variants in EXOSC3 c.155delC and c.80T>G. These patients drastically expand the phenotypic variability of PCH1B and raise questions about genotype–phenotype associations.
Two uterine scars and a vaginal birth
Authors: Wu Christine , Christie James , Nayyar Roshini
Published: January 2021

Uterine scarring increases the risk of uterine rupture during labour, which can result in significant maternal and fetal morbidity and mortality. There is insufficient evidence for a clear recommendation on the safety of vaginal delivery in the context of a patient with both a uterine perforation and a previous lower uterine segment caesarean section. We present the case of a woman with a history of one previous caesarean section and uterine perforation with a uterine manipulator, who subsequently had an uncomplicated normal vaginal delivery.
Fulminant diffuse cerebral toxoplasmosis as the first manifestation of HIV infection
Authors: Dunphy Louise , Palmer Bret , Chen Fabian , Kitchen Joanne
Published: January 2021

Individuals with HIV may present to the emergency department with HIV-related or HIV-unrelated conditions, toxicity associated with antiretroviral therapy or primary HIV infection (seroconversion). In individuals with HIV infection, central nervous system toxoplasmosis occurs from reactivation of disease, especially when the CD4+ count is <100 cells/μL, whereas in those taking immunosuppressive therapy, this can be either due to newly acquired or reactivated latent infection. It is a rare occurrence in immune-competent patients. Vertical transmission during pregnancy can manifest as congenital toxoplasmosis in the neonate and is often asymptomatic until the second or third decade of life when ocular lesions develop. Toxoplasmosis is an infection caused by the intracellular protozoan parasiteToxoplasma gondiiand causes zoonotic infection. It can cause focal or disseminated brain lesions leading to neurological deficit, coma and death. Typical radiological findings are multiple ring-enhancing lesions. Histopathological examination demonstrating tachyzoites ofT. gondiiand the presence of nucleic material in the spinal cerebrospinal fluid (CSF) confirms the diagnosis. The authors present the case of a 52-year-old male UK resident, born in sub-Saharan Africa, with a 3-week history of visual hallucinations. He attended the emergency department on three occasions. Laboratory investigations and a CT head were unremarkable. He was referred to psychological medicine for further evaluation. On his third presentation, 2 months later, a CT head showed widespread lesions suggestive of cerebral metastasis. Dexamethasone was initiated and he developed rigours. An MRI head showed multiple ring-enhancing lesions disseminated throughout his brain parenchyma. CSF analysis and serology confirmed the diagnosis of HIV and toxoplasmosis, respectively. His CD4 count was 10 and his viral load (VL) was 1 245 003. He was then initiated on Biktarvy 50 mg/200 mg/25 mg, one tablet daily, which contains 50 mg of bictegravir, 200 mg of emtricitabine and tenofovir alafenamide fumarate equivalent to 25 mg of tenofovir alafenamide. After 3 months of antiretroviral therapy, his HIV VL reduced to 42. However, his abbreviated mental test remained at 2/10. Despite presenting with neurocognitive impairment and being born in a HIV prevalent region, an HIV test was not offered. This case highlights missed opportunities to request HIV serology and raises awareness that cerebral toxoplasmosis can occur as the first manifestation of HIV. Prompt diagnosis and early initiation of antiretroviral therapy reduces morbidity and mortality in this patient cohort.
Pachydermodactyly presenting as juvenile idiopathic arthritis in an adolescent man
Authors: Jubber Ameen , Gnanappiragasam Dushyanth , Durrani Maumer , Kinder Alison , Harman Karen E
Published: January 2021

We present the case of a 17-year-old Asian man diagnosed with pachydermodactyly, a rare digital fibromatosis. Although this is a non-inflammatory periarticular soft tissue disorder, the clinical appearance can mimic inflammatory arthritis. The patient had a 2-year history of fusiform swelling of multiple proximal interphalangeal joints. He was initially diagnosed with juvenile idiopathic arthritis and treated with methotrexate, but a lack of clinical response led to the diagnosis of pachydermodactyly. Recognising this rare condition can prevent unnecessary and potentially harmful treatment.
Morning glory disc anomaly-associated maculopathy: multimodal imaging
Authors: Hwang Inae , Ugarte Marta
Published: January 2021

Morning glory disc anomaly (MGDA) is most commonly found in white females in childhood with reduced vision. One in two cases have been reported to develop maculopathy or posterior pole retinal detachment as they grow older. The pathophysiology of MGDA-associated maculopathy is not well understood.

We describe a 31-year-old black woman, who presented with gradual reduction of vision in the right eye due to MGDA-associated maculopathy. We identified morphological characteristics of the optic disc and macula with multicolour and optical coherence tomography imaging.

We speculate that the centripetal inner retina traction and cerebrospinal fluid pressure fluctuation play an important role in inner retinal fluid accumulation in the pathology of retinoschisis in MGDA. Further studies will shed some light of a potential cause-and-effect relationship between MGDA and retinoschisis.
CA 125 and TB
Authors: Park Mirae , Dhawan Ranju , Whittaker Elizabeth , Kon Onn Min
Published: January 2021

We present two unusual presentations of extrapulmonary tuberculosis (EPTB) and more specifically intra-abdominal tuberculosis (TB). These cases were initially suspicious for ovarian cancer, presenting with non-specific symptoms, ultrasound-confirmed ascites and elevated cancer antigen 125 tumour marker (CA 125). However, in both cases chest imaging demonstrated enlarged mediastinal nodes amenable to endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA), which confirmed the diagnosis of TB. Both cases were successfully treated with quadruple TB therapy.
Reversible complete heart block due to hypercalcaemia
Authors: Ramakumar Venkatakrishnan , Kothari Shyam S , Seth Sandeep , Kumar Sumit
Published: January 2021

A 65-year-old woman presented to the emergency room with a syncope. An ECG done revealed complete heart block with a narrow QRS escape rhythm and a normal QT interval. Further investigation revealed severe hypercalcaemia and elevated parathormone levels. Her heart block disappeared on correction of the hypercalcaemia. A right inferior parathyroid adenoma was found and surgically removed. Thus, hypercalcaemia may lead to reversible complete heart block without QT interval shortening.
Tolosa-Hunt syndrome relapse during pregnancy following chronic intake of combined oral contraceptives
Authors: Piamonte Bernadeth Lyn Cal , Ong Keno Lorenzo , Cenina Alvin Rae
Published: January 2021

Tolosa-Hunt syndrome (THS) is a rare syndrome of painful ophthalmoplegia secondary to an idiopathic granulomatous inflammation affecting the cavernous sinus, superior orbital fissure or orbit. Pregnancy and pregnancy-related hormones have been identified as potential triggers. A 39-year-old gravida-2 para-1 woman with prior chronic intake of combined oral contraceptives (COC) suffered two episodes of painful ophthalmoplegia—the first event with spontaneous remission and the relapse occurring during pregnancy and with complete resolution following steroid treatment. MRI revealed a postinflammatory mass at the junction of the left orbital apex and anterior cavernous sinus, supporting the diagnosis of THS. To our knowledge, this is the first report of a THS relapse occurring during pregnancy following a chronic history of COC intake. This case adds to the growing evidence supporting the relationship between immune and hormonal factors that may be present during pregnancy and the disease pathogenesis of THS.
Rare case of juvenile ossifying fibroma of the lumbar spine causing vertebra plana
Authors: Garg Bhavuk , Mehta Nishank , Kandasamy Devasenathipathy , Mridha Asit Ranjan
Published: January 2021

Juvenile ossifying fibroma (JOF) is a rare benign fibro-osseous tumour occurring in craniofacial bones of children and young adults. An 8-year-old girl presented with low back pain since 10 months. Plain radiographs revealed a vertebra plana-like lesion of L3 vertebra. CT scan showed an osteolytic lesion with areas of ground-glass appearance interspersed with bone flecks involving the entire body, pedicles and laminae of L3 with well-circumscribed cortical margins. Biopsy was done—histopathological findings showed cellular fibrous stroma with bony trabeculae—which, on corroboration with clinical and radiological findings noted previously, confirmed the diagnosis of JOF. The patient underwent preoperative angioembolisation, curettage and posterior stabilisation. At follow-up of 15 months, the patient was asymptomatic—imaging revealed residual tumour in pedicles—which however did not progress radiologically. The case raises the importance of including this rare condition as a differential diagnosis in children and reports successful outcome with subtotal resection.
A wide spectrum of rare clinical variants of Zinner syndrome
Authors: Talwar Harkirat Singh , Mittal Ankur , Narain Tushar Aditya , Panwar Vikas Kumar
Published: January 2021

Congenital malformations of the seminal vesicles (SVs) are rare and are associated with abnormalities of the ipsilateral urinary tracts as embryologically both the ureteral buds and SVs arise from the mesonephric ducts. The triad of SV cysts, ipsilateral renal agenesis and ejaculatory duct obstruction is known as the Zinner syndrome. We, herein, present three very rare presentations of Zinner syndrome. Case 1 presented with haematuria, and was found to have a large SV cyst with stones and underwent a robotic cyst excision. Case 2 presented with primary infertility, and was found to have a variant of Zinner syndrome. Case 3 was a known case of chronic kidney disease on maintenance haemodialysis who presented with fever and oliguria. He was found to have Zinner syndrome and underwent aspiration of SV abscess. To the best of our knowledge, such varying presentations of Zinner syndrome have been rarely reported thus far.
Ventriculoperitoneal shunt knotting causing bowel obstruction and necrosis in an adult patient
Authors: De Jesus Orlando , Rios-Vicil Christian
Published: January 2021

Knotting or twisting of the peritoneal catheter around a bowel segment, causing bowel obstruction and necrosis, is extremely rare. Only six cases have been reported in the literature. This report described the second case of an adult patient with spontaneous knotting of the peritoneal catheter around a small-bowel segment, causing bowel obstruction and necrosis. The presentation of a knotted ventriculoperitoneal shunt around a bowel loop is stereotypical. Treatment and general recommendations have been made to help guide clinicians when encountering such cases. Evidence of small-bowel obstruction in a twisted, coiled or knotted peritoneal catheter may need surgical intervention. In the setting of progressive abdominal manifestations, knotting of the peritoneal catheter around bowel loops may cause bowel obstruction and may present with acute life-threatening manifestations. Efficient and expedite diagnosis should be made to coordinate multispecialty intervention and follow-up appropriately.
Pituitary metastases of Hürthle cell carcinoma of the thyroid
Authors: Ilerhunmwuwa Nosakhare Paul , Goldspring Robert , Page Simon , Gouni Ravikanth
Published: January 2021

An 85-year-old man was referred to endocrinology following the discovery of an incidental pituitary mass on cranial imaging which was thought to be a non-functioning adenoma during an admission with headaches, lethargy, confusion and hyponatraemia. He had a history of Hürthle cell carcinoma of the thyroid treated with total thyroidectomy, ablative radioiodine therapy and thyroxine replacement. Subsequently, he developed metastatic spread to the neck, lungs and skeleton. About 9 months later, the patient had deterioration of vision. MRI showed a rapidly expanding pituitary mass with compression of the optic chiasm. Biochemical investigations confirmed hypocortisolism and hypogonadism. The patient underwent trans-sphenoidal resection of the pituitary mass followed by external beam radiotherapy to the pituitary bed. Histopathology confirmed a metastatic deposit of Hürthle cell carcinoma, which is a rare and aggressive variant of follicular thyroid carcinoma.
Gastric adenocarcinoma presenting with multiple skeletal muscle metastases
Authors: Daneti Dharanesh , Senthamizhselvan Kuppusamy , Verma Surendra Kumar , Mohan Pazhanivel
Published: January 2021

A 42-year-old man presented to the gastroenterology clinic with features of gastric outlet obstruction, significant weight loss, anaemia, ascites, and pain in the lower back and left thigh. CT scan of the abdomen and pelvis showed wall thickening in the antropyloric region of the stomach and enhancing soft tissue lesion in the left psoas and right gluteal region. Gastroscopy revealed a circumferential growth in the antrum and pylorus of the stomach, and biopsy from the growth was reported as moderately differentiated adenocarcinoma. Positron emission tomography-CT scan showed multiple skeletal muscle metastases all over the body. Fine-needle aspiration cytology and immunohistochemistry from the psoas lesion confirmed metastatic adenocarcinoma deposits. He underwent antropyloric stenting for his obstructive symptoms and received supportive care, finally succumbed to his illness after 6 weeks.
Congenital tongue base lipoblastoma causing neonatal airway compromise
Authors: Wan Ming Hui , Tengku Nun Ahmad Tengku Ezulia , Naicker Manimalar Selvi , Abu Bakar Mohd Zulkiflee
Published: January 2021

Lipoblastomas are benign tumours of immature fat cells presenting in infancy. A lipoblastoma within the airway lumen causing airway compromise is an extremely rare occurrence. We present a 6 hours of life girl who had airway compromise due to a lobulated mass at the base of the tongue. The mass was excised after emergency endotracheal intubation.
Swallowed partial denture in severe intellectual disability patient
Authors: Kim Ji-Hoon
Published: January 2021

Swallowed partial dentures in elderly patients is an emergency situation that requires a swift response. Here, we report a case involving a patient with severe intellectual disability who swallowed his denture, which lodged at the oesophagus inlet. After failure of endoscopic removal, denture with clasp was removed using long forceps through intraoral approach under intravenous sedation. At the pharynx and oesophagus inlet level, removal of foreign body via intraoral approach should be preferentially considered over open surgery for faster patient recovery.
Optimising aerial military medical evacuation dispatching decisions via operations research techniques
Authors: Jenkins Phillip R , Robbins M J , Lunday B J
Published: January 2021

Senior military leaders and medical practitioners continuously seek new ways to improve the performance and organisation of deployed medical evacuation (MEDEVAC) systems to minimise mortality rates of combat casualties. The objective of this paper is to highlight how recent research in the fields of operations research and machine learning can be leveraged to better inform the implementation and modification of current and future MEDEVAC tactics, techniques and procedures for combat operations in a deployed environment. More specifically, this paper discusses state-of-the-art techniques that optimise the management of MEDEVAC assets prior to and during combat operations. These recent research efforts emphasise that military healthcare administrators should contribute to and extend the evolving portfolio of research that seeks to design and develop decision support systems leveraging artificial intelligence and operations research to improve MEDEVAC system performance.
Impact of COVID-19 pandemic on stroke admissions in Qatar
Authors: Akhtar Naveed , Al Jerdi Salman , Mahfoud Ziyad , Imam Yahia , Kamran Saadat , Saqqur Maher , Morgan Deborah , Joseph Sujatha , Khan Khurshid , Shuaib Ashfaq
Published: January 2021

Introduction

The COVID-19 pandemic has resulted in a dramatic unexplained decline in hospital admissions due to acute coronary syndromes and stroke. Several theories have emerged aiming to explain this decline, mostly revolving around the fear of contracting the disease and thus avoiding hospital visits.

Aims

In this study, we aim to examine the impact of the COVID-19 pandemic on stroke admissions to a tertiary care centre in Qatar.

Methods

The Hamad General Hospital stroke database was interrogated for stroke admissions between September 2019 and May 2020. The number of stroke admissions, stroke subtypes and short-term outcomes was compared between the ‘pre-COVID-19’ period (September 2019 to February 2020) and the COVID-19 pandemic period (March to May 2020).

Results

We observed a significant decline in monthly admissions in March (157), April (128) and May (135) compared with the pre-COVID-19 6-month average (229) (p=0.024). The reduction in admissions was most evident in functional stroke mimics. The average admissions decreased from 87 to 34 per month (p=0.0001). Although there were no significant differences in admissions due to ischaemic stroke (IS), intracranial haemorrhage or transient ischaemic attacks between the two periods, we noted a relative decrease in IS due to small vessel disease and an increase in those due to large vessel atherosclerosis in March to May 2020.

Conclusions

The decline in overall stroke admissions during the COVID-19 pandemic is most likely related to concerns of contracting the infection, evidenced mainly by a decline in admissions of stroke mimics. However, a relative increase in large vessel occlusions raises suspicion of pathophysiological effects of the virus, and requires further investigation.
Two case reports of acquired haemophilia A as complications of alemtuzumab treatment for multiple sclerosis
Authors: Gounder Kuhilan , Batt Tracey , Dreyer Michael
Published: January 2021

Objective

To describe the case histories of two patients who developed acquired haemophilia A following treatment with alemtuzumab for multiple sclerosis.

Results

Two patients, a 48-year-old woman and a 31-year-old woman, developed acquired haemophilia A 21 months after their second doses of alemtuzumab. Both presented with spontaneous bruising, and the second case reported menorrhagia. One patient required treatment to control bleeding. Both patients responded to treatment with prednisolone and cyclophosphamide to eliminate the inhibitor.

Conclusions

Acquired haemophilia A is a rare complication following treatment with alemtuzumab. Activated partial thromboplastin time and prothrombin time should be performed in cases of abnormal bleeding in which the platelet count is normal, to facilitate timely diagnosis and prevention of major bleeding complications.
Possible causalities between malnutrition and academic performances among primary schoolchildren: a cross-sectional study in rural Madagascar
Authors: Aiga Hirotsugu , Abe Kanae , Randriamampionona Emmanuel , Razafinombana Angèle Razafitompo
Published: January 2021

Background

The importance of addressing malnutrition is increasing in the context of children’s health and their academic performances. Childhood malnutrition further could reduce a country’s economic productivity. No earlier study adequately estimated the causalities between schoolchildren’s malnutrition and their academic performances. How nutritional status contributes to children’s academic performances has never been reported from Madagascar. This study aims to estimate the possible causalities between their nutritional status and academic performances in rural Madagascar.

Methods

A cross-sectional household survey was conducted in Antananarivo-Avaradrano district, Madagascar, from November to December 2017, by targeting 404 first and second graders 5–14 years of age enrolled in 10 public primary schools. Children’s anthropometric measurements and structured interviews with their mothers/caregivers were conducted. Children’s academic performances data (mathematical and national language proficiencies) were collected at each school. To estimate associations between their malnutrition and academic performances, bivariate and multivariate analyses were conducted. To estimate their possible causalities between them, three conditions were examined (crude covariational relationship, covariational relationship through controlling for a third variable and temporal precedence).

Results

Four independent variables produced significantly positive coefficients with mathematical proficiency in multivariate analysis. Of the four, ‘not being stunted’ and ‘attendance rate’ were estimated to be possible causes of higher mathematical proficiency because they satisfied all the three conditions for a causality. On the other hand, three independent variables produced significantly positive coefficients with national language proficiency in multivariate analysis. Yet, none of them were estimated to be possible causes of higher national language proficiency.

Conclusions

A hypothetical causal path indicates that ‘not being stunted’ is likely to have caused higher ‘attendance rate’ and thereby higher ‘mathematical proficiency’ in a two-step manner. This study is the first attempt to estimate the possible causalities between schoolchildren’s nutritional status and their academic performances in Madagascar.
International Physical Activity and Built Environment Study of adolescents: IPEN Adolescent design, protocol and measures
Authors: Cain Kelli L , Salmon Jo , Conway Terry L , Cerin Ester , Hinckson Erica , Mitáš Josef , Schipperijn Jasper , Frank Lawrence D , Anjana Ranjit Mohan , Barnett Anthony , Dygrýn Jan , Islam Mohammed Zakiul , Molina-García Javier , Moran Mika , Wan Muda Wan Abdul Manan , Oyeyemi Adewale L , Reis Rodrigo , Santos Maria Paula , Schmidt Tanja , Schofield Grant M , Timperio Anna , Van Dyck Delfien , Sallis James F
Published: January 2021

Introduction

Only international studies can provide the full variability of built environments and accurately estimate effect sizes of relations between contrasting environments and health-related outcomes. The aims of the International Physical Activity and Environment Study of Adolescents (IPEN Adolescent) are to estimate the strength, shape and generalisability of associations of the community environment (geographic information systems (GIS)-based and self-reported) with physical activity and sedentary behaviour (accelerometer-measured and self-reported) and weight status (normal/overweight/obese).

Methods and analysis

The IPEN Adolescent observational, cross-sectional, multicountry study involves recruiting adolescent participants (ages 11–19 years) and one parent/guardian from neighbourhoods selected to ensure wide variations in walkability and socioeconomic status using common protocols and measures. Fifteen geographically, economically and culturally diverse countries, from six continents, participated: Australia, Bangladesh, Belgium, Brazil, Czech Republic, Denmark, Hong Kong SAR, India, Israel, Malaysia, New Zealand, Nigeria, Portugal, Spain and USA. Countries provided survey and accelerometer data (15 countries), GIS data (11), global positioning system data (10), and pedestrian environment audit data (8). A sample of n=6950 (52.6% female; mean age=14.5, SD=1.7) adolescents provided survey data, n=4852 had 4 or more 8+ hours valid days of accelerometer data, and n=5473 had GIS measures. Physical activity and sedentary behaviour were measured by waist-worn ActiGraph accelerometers and self-reports, and body mass index was used to categorise weight status.

Ethics and dissemination

Ethical approval was received from each study site’s Institutional Review Board for their in-country studies. Informed assent by adolescents and consent by parents was obtained for all participants. No personally identifiable information was transferred to the IPEN coordinating centre for pooled datasets. Results will be communicated through standard scientific channels and findings used to advance the science of environmental correlates of physical activity, sedentary behaviour and weight status, with the ultimate goal to stimulate and guide actions to create more activity-supportive environments internationally.
Anterior limb of the internal capsule tractography: relationship with capsulotomy outcomes in obsessive-compulsive disorder
Authors: Zhang Chencheng , Kim Seung-Goo , Li Jun , Zhang Yingying , Lv Qiming , Zeljic Kristina , Gong Hengfen , Wei Hongjiang , Liu Wenjuan , Sun Bomin , Wang Zheng , Voon Valerie
Published: January 2021

Objectives

Surgical procedures targeting the anterior limb of the internal capsule (aLIC) can be effective in patients with selected treatment-refractory obsessive-compulsive disorder (OCD). The aLIC consists of white-matter tracts connecting cortical and subcortical structures and show a topographical organisation. Here we assess how aLIC streamlines are affected in OCD compared with healthy controls (HCs) and which streamlines are related with post-capsulotomy improvement.

Methods

Diffusion-weighted MRI was used to compare white-matter microstructure via the aLIC between patients with OCD (n=100, 40 women, mean of age 31.8 years) and HCs (n=88, 39 women, mean of age 29.6 years). For each individual, the fractional anisotropy (FA) and streamline counts were calculated for each white-matter fibre bundle connecting a functionally defined prefrontal and subcortical region. Correlations between tractography measures and pre-capsulotomy and post-capsulotomy clinical outcomes (in obsessive-compulsive, anxiety and depression scores 6 months after surgery) were assessed in 41 patients with OCD.

Results

Hierarchical clustering dendrograms show an aLIC organisation clustering lateral and dissociating ventral and dorsal prefrontal–thalamic streamlines, findings highly relevant to surgical targeting. Compared with HCs, patients with OCD had lower aLIC FA across multiple prefrontal cortical–subcortical regions (p<0.0073, false discovery rate-adjusted). Greater streamline counts of the dorsolateral prefrontal–thalamic tracts in patients with OCD predicted greater post-capsulotomy obsessive-compulsive improvement (p=0.016). In contrast, greater counts of the dorsal cingulate–thalamic streamlines predicted surgical outcomes mediated by depressive and anxiety improvements.

Conclusions

These findings shed light on the critical role of the aLIC in OCD and may potentially contribute towards precision targeting to optimise outcomes in OCD.
Examining the ethical underpinnings of universal basic income as a public health policy: prophylaxis, social engineering and ‘good’ lives
Authors: Johnson Matthew Thomas , Johnson Elliott Aidan
Published: January 2021

At a time of COVID-19 pandemic, universal basic income (UBI) has been presented as a potential public health ‘upstream intervention’. Research indicates a possible impact on health by reducing poverty, fostering health-promoting behaviour and ameliorating biopsychosocial pathways to health. This novel case for UBI as a public health measure is starting to receive attention from a range of political positions and organisations. However, discussion of the ethical underpinnings of UBI as a public health policy is sparse. This is depriving policymakers of clear perspectives about the reasons for, restrictions to and potential for the policy’s design and implementation. In this article, we note prospective pathways to impact on health in order to assess fit with Rawlsian, capabilities and perfectionist approaches to public health policy. We suggest that Raz’ pluralist perfectionist approach may fit most comfortably with the prospective pathways to impact, which has implications for allocation of resources.
Three models for the regulation of polygenic scores in reproduction
Authors: Munday Sarah , Savulescu Julian
Published: January 2021

The past few years have brought significant breakthroughs in understanding human genetics. This knowledge has been used to develop ‘polygenic scores’ (or ‘polygenic risk scores’) which provide probabilistic information about the development of polygenic conditions such as diabetes or schizophrenia. They are already being used in reproduction to select for embryos at lower risk of developing disease. Currently, the use of polygenic scores for embryo selection is subject to existing regulations concerning embryo testing and selection. Existing regulatory approaches include ‘disease-based' models which limit embryo selection to avoiding disease characteristics (employed in various formats in Australia, the UK, Italy, Switzerland and France, among others), and 'laissez-faire' or 'libertarian' models, under which embryo testing and selection remain unregulated (as in the USA). We introduce a novel 'Welfarist Model' which limits embryo selection according to the impact of the predicted trait on well-being. We compare the strengths and weaknesses of each model as a way of regulating polygenic scores. Polygenic scores create the potential for existing embryo selection technologies to be used to select for a wider range of predicted genetically influenced characteristics including continuous traits. Indeed, polygenic scores exist to predict future intelligence, and there have been suggestions that they will be used to make predictions within the normal range in the USA in embryo selection. We examine how these three models would apply to the prediction of non-disease traits such as intelligence. The genetics of intelligence remains controversial both scientifically and ethically. This paper does not attempt to resolve these issues. However, as with many biomedical advances, an effective regulatory regime must be in place as soon as the technology is available. If there is no regulation in place, then the market effectively decides ethical issues.
Lifelong divergence of growth patterns in Arctic charr life history strategies: implications for sustainable fisheries in a changing climate
Authors: Grenier Gabrielle , Tallman Ross F.
Published: January 2021

Arctic charr (Salvelinus alpinus Linnaeus, 1758) are phenotypically variable with multiple life history strategies including anadromous and freshwater resident individuals. The mechanism determining life history is believed to be set early in life. Anadromous individuals show greater seasonality in growth and feeding after the first seaward migration relative to resident conspecifics. We used otolith growth increment measurements to estimate lifelong growth patterns for 355 individuals with anadromous or resident life history from four populations within Cumberland Sound, Nunavut. Using a general and a generalized linear model, we discovered a linear increase (estimate = 0.006) in growth for both Arctic charr life histories between 1990 and 2016. Resident Arctic charr have lower annual growth (estimate = −0.176) and show a decrease in the annual proportion of summer growth as they age (estimate = −0.042), whereas their anadromous counterparts maintain a higher seasonality in their growth patterns with age. This suggests that growth is indeed important in life history trajectory for Arctic charr and that seasonal growth patterns differ among life histories. The results highlight the importance of improving our understanding of mechanisms influencing life history trajectory in Arctic charr to ensure sustainability of harvested Arctic charr populations in a changing climate.
Complete chloroplast genome sequencing and comparative analysis reveals changes to the chloroplast genome after allopolyploidization in Cucumis
Authors: Zhai Yufei , Yu Xiaqing , Zhou Junguo , Li Ji , Tian Zhen , Wang Panqiao , Meng Ya , Zhao Qinzheng , Lou Qunfeng , Du Shengli , Chen Jinfeng
Published: January 2021

Allopolyploids undergo “genomic shock” leading to significant genetic and epigenetic modifications. Previous studies have mainly focused on nuclear changes, while little is known about the inheritance and changes of organelle genome in allopolyploidization. The synthetic allotetraploid Cucumis ×hytivus, which is generated via hybridization between C. hystrix and C. sativus, is a useful model system for studying cytonuclear variation. Here, we report the chloroplast genome of allotetraploid C. ×hytivus and its diploid parents via sequencing and comparative analysis. The size of the obtained chloroplast genomes ranged from 154 673 to 155 760 bp, while their gene contents, gene orders, and GC contents were similar to each other. Comparative genome analysis supports chloroplast maternal inheritance. However, we identified 51 indels and 292 SNP genetic variants in the chloroplast genome of the allopolyploid C. ×hytivus relative to its female parent C. hystrix. Nine intergenic regions with rich variation were identified through comparative analysis of the chloroplast genomes within the subgenus Cucumis. The phylogenetic network based on the chloroplast genome sequences clarified the evolution and taxonomic position of the synthetic allotetraploid C. ×hytivus. The results of this study provide us with an insight into the changes of organelle genome after allopolyploidization, and a new understanding of the cytonuclear evolution.
The possibility of twin star solutions in a model based on lattice QCD thermodynamics
Authors: Jakobus P. , Motornenko A. , Gomes R. O. , Steinheimer J. , Stoecker H.
Published: January 2021

The properties of compact stars and in particular the existence of twin star solutions are investigated within an effective model that is constrained by lattice QCD thermodynamics. The model is modified at large baryon densities to incorporate a large variety of scenarios of first order phase transitions to a phase of deconfined quarks. This is achieved by matching two different variants of the bag model equation of state, in order to estimate the role of the Bag model parameters on the appearance of a second family of neutron stars. The produced sequences of neutron stars are compared with modern constrains on stellar masses, radii, and tidal deformability from astrophysical observations and gravitational wave analyses. It is found that those scenarios in our analysis, in which a third family of stars appeared due to the deconfinement transition, are disfavored from astrophysical constraints.
Triply charged Higgs bosons at a 100 TeV pp collider
Authors: Pan Junxing , Chen Jung-Hsin , He Xiao-Gang , Li Gang , Su Jhih-Ying
Published: January 2021

In this work, we study the potential of searching for triply charged Higgs boson originating from a complex Higgs quadruplet in the final state with at least three same-sign leptons. A detailed collider analysis of the SM backgrounds and signals is performed at a 100 TeV pp collider for the triply charged Higgs boson mass below 1 TeV and the Higgs quadruplet vacuum expectation value $$v_\Delta $$

v
Δ

ranging from $$1.5\times 10^{-9}~\text {GeV}$$

1.5
×

10

-
9

GeV

to $$1.3~\text {GeV}$$

1.3

GeV

and the mass splitting $$\Delta m$$

Δ
m

between the nearby states of the Higgs quadruplet satisfying $$|\Delta m|\lesssim 30~\text {GeV}$$

|
Δ
m
|
≲
30

GeV

. About $$100~\text {fb}^{-1}$$

100

fb

-
1

of data are required at most for $$5\sigma $$

5
σ

discovery. We also revisit the sensitivity at the Large Hadron Collider (LHC) and find that $$5\sigma $$

5
σ

discovery of the triply charged Higgs boson below 1 TeV can be reached for a relatively small $$v_\Delta $$

v
Δ

. For example, if $$v_\Delta =10^{-6}~\text {GeV}$$

v
Δ

=

10

-
6

GeV

and $$\Delta m=0$$

Δ
m
=
0

, the integrated luminosity of $$330~\text {fb}^{-1}$$

330

fb

-
1

is needed. But for a relatively large $$v_\Delta $$

v
Δ

, i.e., $$v_\Delta \gtrsim 10^{-3}~\text {GeV}$$

v
Δ

≳

10

-
3

GeV

, the triply charged Higgs boson above about 800 GeV cannot be discovered even in the high-luminosity LHC era. For $$\Delta m>0$$

Δ
m
>
0

, the cascade decays are open and the sensitivity can be improved depending on the value of $$v_\Delta $$

v
Δ

.
Infinite Families of 2-Designs from a Class of Linear Codes Related to Dembowski-Ostrom Functions
Authors: Wang Rong , Du Xiaoni , Fan Cuiling , Niu Zhihua
Published: January 2021

Due to their important applications to coding theory, cryptography, communications and statistics, combinatorial [Formula: see text]-designs have attracted lots of research interest for decades. The interplay between coding theory and [Formula: see text]-designs started many years ago. It is generally known that [Formula: see text]-designs can be used to derive linear codes over any finite field, and that the supports of all codewords with a fixed weight in a code also may hold a [Formula: see text]-design. In this paper, we first construct a class of linear codes from cyclic codes related to Dembowski-Ostrom functions. By using exponential sums, we then determine the weight distribution of the linear codes. Finally, we obtain infinite families of [Formula: see text]-designs from the supports of all codewords with a fixed weight in these codes. Furthermore, the parameters of [Formula: see text]-designs are calculated explicitly.
Vacuum expectation values in nontrivial background space from three types of UV improved Green’s functions
Authors: Kan Nahomi , Kuniyasu Masashi , Shiraishi Kiyoshi , Wu Zhenyuan
Published: January 2021

We evaluate the quantum expectation values in nonsimply connected spaces by using UV improved Green’s functions proposed by Padmanabhan, Abel, and Siegel. It is found that the results from these three types of Green’s functions behave similarly under changes of scales, but have minute differences. Prospects in further applications are briefly discussed.
FPGA Realization of the Reconfigurable Mesh Counting Algorithm
Authors: Ben-Asher Yosi , Stein Esti , Tartakovsky Vladislav
Published: January 2021

Pass transistor logic (PTL) is a circuit design technique wherein transistors are used as switches. The reconfigurable mesh (RM) is a model that exploits the power of PTLs signal switching, by enabling flexible bus connections in a grid of processing elements containing switches. RM algorithms have theoretical results proving that [Formula: see text] can speed up computations significantly. However, the RM assumes that the latency of broadcasting a signal through [Formula: see text] switches (bus length) is 1. This is an unrealistic assumption preventing physical realizations of the RM.

We propose the restricted-RM (RRM) wherein the bus lengths are restricted to [Formula: see text], [Formula: see text]. We show that counting the number of 1-bits in an input of [Formula: see text] bits can be done in [Formula: see text] steps for [Formula: see text] by an [Formula: see text] RRM. An almost matching lower bound is presented, using a technique which adds to the few existing lower-bound techniques in this area. Finally, the algorithm was directly coded over an FPGA, outperforming an optimal tree of adders.

This work presents an alternative way of counting, which is fundamental for summing, beating regular Boolean circuits for large numbers, where summing a vast amount of numbers is the basis of any accelerator in embedded systems such as neural-nets and streaming. a