bluuebunny/crossref_metadata_2025 huggingface dataset:
PTSD in parents of children with severe diseases: a systematic review to face Covid-19 impact
Authors: Corsi Martina , Orsini Alessandro , Pedrinelli Virginia , Santangelo Andrea , Bertelloni Carlo Antonio , Carli Niccolò , Buselli Rodolfo , Peroni Diego , Striano Pasquale , Dell’Osso Liliana , Carmassi Claudia
Published: January 2021

Context

The literature agrees on the impact of post-traumatic stress symptoms in parents of seriously ill children but there is less clarity about the real extent and gender differences of this psychopathological risk. The recent Covid-19 outbreak highlighted new burdens for researchers on Post Traumatic Stress Disorder (PTSD) and clear evidence-based knowledge on this issue is timely needed.

Objective

In this review, we present a synthesis of the updated evidence on PTSD rates in parents of children with severe diseases.

We also aim to try to understand if research in this field has been refined over time with the long-term intent to better face the new challenges of Covid-19 in the paediatric field.

Data sources

The PubMed database was searched.

Study selection

Studies were included if they assessed PTSD in parents of children diagnosed with physical illnesses.

Data extraction

Of 240 studies, 4 were included.

Results

Analysis of the 4 studies revealed 2 studies with PTSD rates around 20% and in line with previous best-evidence. All 4 studies tried to provide more data on fathers, however, all the studies present the lack of a control group.

Limitations

The limited number of studies, which also differ widely in the methodology used.

Conclusions

Methodological errors evidenced in all the 4 studies limit their reliability, making the understanding of the paediatric caregiver’s concern regarding PTSD still difficult. More sound research is needed.
A novel protein encoded by circular SMO RNA is essential for Hedgehog signaling activation and glioblastoma tumorigenicity
Authors: Wu Xujia , Xiao Songhua , Zhang Maolei , Yang Lixuan , Zhong Jian , Li Bo , Li Fanying , Xia Xin , Li Xixi , Zhou Huangkai , Liu Dawei , Huang Nunu , Yang Xuesong , Xiao Feizhe , Zhang Nu
Published: January 2021

Background

Aberrant activation of the Hedgehog pathway drives tumorigenesis of many cancers, including glioblastoma. However, the sensitization mechanism of the G protein-coupled-like receptor smoothened (SMO), a key component of Hedgehog signaling, remains largely unknown.

Results

In this study, we describe a novel protein SMO-193a.a. that is essential for Hedgehog signaling activation in glioblastoma. Encoded by circular SMO (circ-SMO), SMO-193a.a. is required for sonic hedgehog (Shh) induced SMO activation, via interacting with SMO, enhancing SMO cholesterol modification, and releasing SMO from the inhibition of patched transmembrane receptors. Deprivation of SMO-193a.a. in brain cancer stem cells attenuates Hedgehog signaling intensity and suppresses self-renewal, proliferation in vitro, and tumorigenicity in vivo. Moreover, circ-SMO/SMO-193a.a. is positively regulated by FUS, a direct transcriptional target of Gli1. Shh/Gli1/FUS/SMO-193a.a. form a positive feedback loop to sustain Hedgehog signaling activation in glioblastoma. Clinically, SMO-193a.a. is more specifically expressed in glioblastoma than SMO and is relevant to Gli1 expression. Higher expression of SMO-193a.a. predicts worse overall survival of glioblastoma patients, indicating its prognostic value.

Conclusions

Our study reveals that SMO-193a.a., a novel protein encoded by circular SMO, is critical for Hedgehog signaling, drives glioblastoma tumorigenesis and is a novel target for glioblastoma treatment.
Analysis of the lipid extraction performance in a cascade process for Scenedesmus almeriensis biorefinery
Authors: Papachristou I. , Akaberi S. , Silve A. , Navarro-López E. , Wüstner R. , Leber K. , Nazarova N. , Müller G. , Frey W.
Published: January 2021

Background

Microalgae have attracted considerable interest due to their ability to produce a wide range of valuable compounds. Pulsed Electric Fields (PEF) has been demonstrated to effectively disrupt the microalgae cells and facilitate intracellular extraction. To increase the commercial viability of microalgae, the entire biomass should be exploited with different products extracted and valorized according to the biorefinery scheme. However, demonstrations of multiple component extraction in series are very limited in literature. This study aimed to develop an effective lipid extraction protocol from wet Scenedesmus almeriensis after PEF-treatment with 1.5 MJ·kgDW−1. A cascade process, i.e., the valorization of several products in row, was tested with firstly the collection of the released carbohydrates in the water fraction, then protein enzymatic hydrolysis and finally lipid extraction. Biomass processed with high pressure homogenization (HPH) on parallel, served as benchmark.

Results

Lipid extraction with ethanol:hexane (1:0.41 vol/vol) offered the highest yields from the different protocols tested. PEF-treatment promoted extraction with almost 70% of total lipids extracted against 43% from untreated biomass. An incubation step after PEF-treatment, further improved the yields, up to 83% of total lipids. Increasing the solvent volume by factor 2 offered no improvement. In comparison, extraction with two other systems utilizing only ethanol at room temperature or elevated at 60 °C were ineffective with less than 30% of total lipids extracted.

Regarding cascade extraction, carbohydrate release after PEF was detected albeit in low concentrations. PEF-treated samples displayed slightly better kinetics during the enzymatic protein hydrolysis compared to untreated or HPH-treated biomass. The yields from a subsequent lipid extraction were not affected after PEF but were significantly increased for untreated samples (66% of total lipids), while HPH displayed the lowest yields (~ 49% of total lipids).

Conclusions

PEF-treatment successfully promoted lipid extraction from S. almeriensis but only in combination with a polar:neutral co-solvent (ethanol:hexane). After enzymatic protein hydrolysis in cascade processing; however, untreated biomass displayed equal lipid yields due to the disruptive effect of the proteolytic enzymes. Therefore, the positive impact of PEF in this scheme is limited on the improved reaction kinetics exhibited during the enzymatic hydrolysis step.
Predictors of radiographic erosion and joint space narrowing progression in patients with early rheumatoid arthritis: a cohort study
Authors: Rydell Emil , Forslind Kristina , Nilsson Jan-Åke , Karlsson Magnus , Åkesson Kristina E. , Jacobsson Lennart T. H. , Turesson Carl
Published: January 2021

Background

Radiographic damage in rheumatoid arthritis (RA) includes erosions and joint space narrowing (JSN). Different mechanisms may underlie their development. The objective of this study was to evaluate predictors of these entities separately.

Methods

Consecutive early RA patients (symptom duration ≤12 months) from a defined area (Malmö, Sweden) recruited during 1995–2005 were investigated. Radiographs of hands and feet were scored by a trained reader according to the modified Sharp-van der Heijde score. Fat mass and lean mass distribution were measured at baseline using dual energy x-ray absorptiometry. Potential predictors of erosion and JSN progression from inclusion to the 5-year follow-up were evaluated.

Results

Two hundred and thirty-three patients were included. Radiographs at baseline and 5 years were available for 162 patients. The median (interquartile) progression of erosion and JSN scores were 4 (0–8) and 8 (1–16), respectively. Rheumatoid factor (RF) was a robust significant predictor of both erosion and JSN score progression. In adjusted analyses, anti-CCP antibodies predicted erosions while the erythrocyte sedimentation rate was predictive of both outcomes. Smoking and high baseline disease activity (DAS28 > 5.1) predicted progression of erosions. Baseline erosion score was associated with progression of both erosion and JSN progression, while baseline JSN score was predictive only of the progression of JSN. Overweight/obesity (BMI ≥ 25 kg/m2) was a significant negative predictor of JSN score progression (β = − 0.14, p = 0.018, adjusted for RF, age, baseline JSN score) also when additionally adjusting for ever smoking (p = 0.041). Among female patients, this effect was observed in those of estimated post-menopausal age (> 51 years), but not in younger women. The truncal to peripheral fat ratio was associated with less JSN score progression in women, but not in men.

Conclusions

Overweight RA patients had less JSN progression, independent of smoking status. This effect was seen in particular among older women (mainly post-menopausal), but not younger. Truncal fat was associated with less JSN progression in female patients. Smoking predicted erosion progression, and erosions may precede JSN. BMI and fat distribution may influence cartilage damage in early RA and might be related to hormonal factors.
Effectiveness of interventions to increase uptake and completion of treatment for diabetic retinopathy in low- and middle-income countries: a rapid review protocol
Authors: Bascaran Covadonga , Mwangi Nyawira , D’Esposito Fabrizio , Cleland Charles , Gordon Iris , Ulloa Juan Alberto Lopez , Maswadi Ranad , Mdala Shaffi , Ramke Jacqueline , Evans Jennifer R. , Burton Matthew
Published: January 2021

Background

Vision loss due to diabetic retinopathy can largely be prevented or delayed through treatment. Patients with vision-threatening diabetic retinopathy are typically offered laser or intravitreal injections which often require more than one treatment cycle. However, treatment is not always initiated, or it is not completed, resulting in poor visual outcomes. Interventions aimed at improving the uptake or completion of treatment for diabetic retinopathy can potentially help prevent or delay visual loss in people with diabetes.

Methods

We will search MEDLINE, Embase, Global Health and Cochrane Register of Studies for studies reporting interventions to improve the uptake of treatment for diabetic retinopathy (DR) and/or diabetic macular oedema (DMO), compared with usual care, in adults with diabetes. The review will include studies published in the last 20 years in the English language. We will include any study design that measured any of the following outcomes in relation to treatment uptake and completion for DR and/or DMO: (1) proportion of patients initiating treatment for DR and/or DMO among those to whom it is recommended, (2) proportion of patients completing treatment for DR and/or DMO among those to whom it is recommended, (3) proportion of patients completing treatment for DR and/or DMO among those initiating treatment and (4) number and proportion of DR and/or DMO rounds of treatment completed per patient, as dictated by the treatment protocol. For included studies, we will also report any measures of cost-effectiveness when available. Two reviewers will screen search results independently. Risk of bias assessment will be done by two reviewers, and data extraction will be done by one reviewer with verification of 10% of the papers by a second reviewer. The results will be synthesised narratively.

Discussion

This rapid review aims to identify and synthesise the peer-reviewed literature on the effectiveness of interventions to increase uptake and completion of treatment for DR and/or DMO in LMICs. The rapid review methodology was chosen in order to rapidly synthesise the available evidence to support programme implementers and policy-makers in designing evidence-based health programmes and public health policy and inform the allocation of resources.

Systematic review registration

OSF osf.io/h5wgr
Refinements of the integral Jensen’s inequality generated by finite or infinite permutations
Authors: Horváth László
Published: January 2021

There are a lot of papers dealing with applications of the so-called cyclic refinement of the discrete Jensen’s inequality. A significant generalization of the cyclic refinement, based on combinatorial considerations, has recently been discovered by the author. In the present paper we give the integral versions of these results. On the one hand, a new method to refine the integral Jensen’s inequality is developed. On the other hand, the result contains some recent refinements of the integral Jensen’s inequality as elementary cases. Finally some applications to the Fejér inequality (especially the Hermite–Hadamard inequality), quasi-arithmetic means, andf-divergences are presented.
Best approximation of κ-random operator inequalities in matrix MB-algebras
Authors: Madadi Masoumeh , O’Regan Donal , Rassias Themistocles M. , Saadati Reza
Published: January 2021

We introduce a class of stochastic matrix control functions and apply them to stabilize pseudo stochastic κ-random operator inequalities in matrix MB-algebras. We obtain an approximation for stochastic κ-random operator inequalities and calculate the maximum error of the estimate.
Antibiotic prescribing in inpatient and outpatient settings in Iran: a systematic review and meta-analysis study
Authors: Nabovati Ehsan , TaherZadeh Zhila , Eslami Saeid , Abu-Hanna Ameen , Abbasi Reza
Published: January 2021

Background

Antibiotic prescribing is common worldwide. There are several original studies about antibiotic prescribing in the healthcare setting of Iran reporting different levels of prescribing. The aim of this systematic review and meta-analysis was to determine the prevalence of antibiotic prescribing in both inpatient and outpatient settings in Iran, an example of a developing country.

Methods

To identify published studies on antibiotic prescribing, databases such as ISI, Scopus, PubMed, Google Scholar, and Electronic Persian were searched in Iran till January 2020. Eligible studies were those analyzing original data on the prescription and use of antibiotics in outpatient or inpatient settings in Iran. Moreover, all studies that used an intervention to improve antibiotic prescribing were included. The quality of the included studies was assessed using self-administered quality assessment criteria. The meta-analysis of prevalence of antibiotic prescribing was conducted based on the meta-analysis of observational studies in epidemiology guidelines. To calculate pooled rates, the random-effects model was used.

Results

A total of 54 studies (39 outpatients and 15 inpatients) were included in this study. The median of antibiotic prescribing in the outpatient and inpatient settings accounted for 45.25% and 68.2% of patients, respectively. The results of meta-analysis also showed that the antibiotic prescribing accounted for 45% of prescriptions in outpatient settings and 39.5%, 66%, and 75.3% of patients in all wards, pediatrics wards, and ICU wards of inpatient settings, respectively. The most commonly prescribed antibiotic classes in outpatient settings were penicillins, cephalosporins, and macrolides, while in inpatient settings, these were cephalosporins, penicillins, and carbapenems. There were seven studies using interventions to improve antibiotic prescribing pattern. It should be mentioned that intervention in a study had a statistically significant effect on improving antibiotic prescribing (p < .05).

Conclusion

Prevalence of antibiotic prescribing in Iran is high. Our findings highlight the need for urgent action to improve prescription practices. It seems that developing a national plan to improve antibiotic prescribing is necessary.
Application of three different coaching strategies through a virtual coach for people with emotional eating: a vignette study
Authors: Dol Aranka , Bode Christina , Velthuijsen Hugo , van Strien Tatjana , van Gemert-Pijnen Lisette
Published: January 2021

Background

Around 13% of the world’s population suffers from obesity. More than 40% of people with obesity display emotional eating behaviour (eating in response to negative emotions or distress). It is an alternate to more effective coping strategies for negative emotions. Our study explored the opportunities for helping adults with emotional overeating using a virtual coach, aiming to identify preferences for tailored coaching strategies applicable in a personal virtual coach environment. Three different coaching strategies were tested: a validating, a focus-on-change, and a dialectical one – the latter being a synthesis of the first two strategies.

Methods

A qualitative study used vignettes reflecting the two most relevant situations for people with emotional eating: 1. experiencing negative emotions, with ensuing food cravings; and 2. after losing control to emotional eating, with ensuing feelings of low self-esteem. Applied design: 2 situations × 3 coaching strategies. Participants: 71 adult women (Mage 44.4/years, range 19–70, SD = 12.86) with high scores on the DEBQ-emotional eating scale (Memo 3.65, range 1.69–4.92, SD = .69) with mean BMI 30.1 (range 18–46, SD = 6.53). They were recruited via dieticians’ practices, were randomly assigned to the conditions and asked how they would face and react to the presented coaching strategies. Data were transcribed and a thematic analysis was conducted.

Results

Qualitative results showed that participants valued both the validating coaching strategy and the focus-on-change strategy, but indicated that a combination of validation and focus-on-change provides both mental support and practical advice. Data showed that participants differed in their level of awareness of the role that emotions play in their overeating and the need for emotion-regulation skills.

Conclusion

The design of the virtual coach should be based on dialectical coaching strategies as preferred by participants with emotional eating behaviour. It should be tailored to the different stages of awareness of their emotions and individual emotion-regulation skills.
Biostimulant-induced drought tolerance in grapevine is associated with physiological and biochemical changes
Authors: Irani Hosein , ValizadehKaji Babak , Naeini Mohammad Reza
Published: January 2021

Background

In this research, the effects of exogenous application of certain biostimulants [amino acid (AA), humic acid (HA), fulvic acid (FA), and seaweed extract (SE)] on the fruit yield and quality, leaf mineral contents, and some critical physio-chemical characteristics of grapevine (Vitis vinifera L.) cv. ‘Yaghouti’ were investigated under well-watered (WW) and drought-stressed (DS) conditions.

Results

Drought stress caused a remarkable reduction in the weight of 20 berries and fruit yield, and meanwhile a marked increase in the titratable acidity (TA) and total soluble solid (TSS) content of fruits. Application of biostimulants, especially SE, enhanced the weight of 20 berries, fruit yield, and TSS content, and decreased TA in fruits of DS vines. Although drought stress had a negative effect on the chlorophyll content of grapevine, this effect was alleviated by the application of biostimulants, especially SE. Moreover, drought stress made the accumulation of abscisic acid (ABA), proline, total phenol, and soluble carbohydrates, the level of hydrogen peroxide (H2O2) and malondialdehyde (MDA), as well as the activity of guaiacol peroxidase (GPX) and catalase (CAT) enzymes increased in leaves. Application of biostimulants, especially SE, further increased the accumulation of ABA, proline, total phenol, and soluble carbohydrates and the activity of the antioxidant enzymes, but reduced the level of MDA and H2O2 in DS vines. Under drought stress conditions, concentrations of N, P, and K increased, and concentrations of Fe and Zn decreased; however, DS grapevines treated with biostimulants and especially SE accumulated a higher level of these mineral nutrients than CON vines.

Conclusion

In sum, as evidenced by the study results, biostimulants have a high potential for promoting fruit yield and quality of grapevine in drought-prone regions.
Patterns of infections and antimicrobial drugs’ prescribing among pregnant women in Saudi Arabia: a cross sectional study
Authors: Baraka Mohamed A. , AlLehaibi Lina Hussain , AlSuwaidan Hind Nasser , Alsulaiman Duaa , Islam Md. Ashraful , Alotaibi Badriyah Shadid , Alboghdadly Amany , Homoud Ali H. , Al-Ghamdi Fuad H. , Al Ghamdi Mastour S. , Babar Zaheer-Ud-Din
Published: January 2021

Background

Antimicrobial agents are among the most commonly prescribed drugs in pregnancy due to the increased susceptibility to infections during pregnancy. Antimicrobials can contribute to different maternal complications. Therefore, it is important to study their patterns in prescription and utilization. The data regarding this issue is scarce in Saudi Arabia. Therefore, the aim of this study is to generate data on the antimicrobial agents that are most commonly prescribed during pregnancy as well as their indications and safety.

Methods

This is a retrospective study focusing on pregnant women with a known antimicrobial use at Johns Hopkins Aramco Healthcare (JHAH). The sample included 344 pregnant women with a total of 688 antimicrobial agents prescribed. Data was collected on the proportion of pregnant women who received antimicrobial agents and on the drug safety during pregnancy using the risk categorization system of the U.S. Food and Drug Administration (FDA).

Results

The results showed that urinary tract infections (UTIs) were the most reported (59%) infectious diseases. Around 48% of pregnant women received antimicrobial medications at some point during pregnancy. The top two antimicrobial agents based on prescription frequency were B-lactams (44.6%) and azole anti-fungals (30%). The prescribed drugs in the study were found to be from classes B, C and D under the FDA risk classification system.

Conclusion

The study revealed a high proportion of antimicrobials prescribed during pregnancy that might pose risks to mothers and their fetuses. Future multicenter studies are warranted to evaluate the rational prescription of antimicrobial medications during pregnancy.
Rethinking success, integrity, and culture in research (part 2) — a multi-actor qualitative study on problems of science
Authors: Aubert Bonn Noémie , Pinxten Wim
Published: January 2021

Background

Research misconduct and questionable research practices have been the subject of increasing attention in the past few years. But despite the rich body of research available, few empirical works also include the perspectives of non-researcher stakeholders.

Methods

We conducted semi-structured interviews and focus groups with policy makers, funders, institution leaders, editors or publishers, research integrity office members, research integrity community members, laboratory technicians, researchers, research students, and former-researchers who changed career to inquire on the topics of success, integrity, and responsibilities in science. We used the Flemish biomedical landscape as a baseline to be able to grasp the views of interacting and complementary actors in a system setting.

Results

Given the breadth of our results, we divided our findings in a two-paper series with the current paper focusing on the problems that affect the integrity and research culture. We first found that different actors have different perspectives on the problems that affect the integrity and culture of research. Problems were either linked to personalities and attitudes, or to the climates in which researchers operate. Elements that were described as essential for success (in the associate paper) were often thought to accentuate the problems of research climates by disrupting research culture and research integrity. Even though all participants agreed that current research climates need to be addressed, participants generally did not feel responsible nor capable of initiating change. Instead, respondents revealed a circle of blame and mistrust between actor groups.

Conclusions

Our findings resonate with recent debates, and extrapolate a few action points which might help advance the discussion. First, the research integrity debate must revisit and tackle the way in which researchers are assessed. Second, approaches to promote better science need to address the impact that research climates have on research integrity and research culture rather than to capitalize on individual researchers’ compliance. Finally, inter-actor dialogues and shared decision making must be given priority to ensure that the perspectives of the full research system are captured. Understanding the relations and interdependency between these perspectives is key to be able to address the problems of science.

Study registration

https://osf.io/33v3m
7-T MRI for brain virtual autopsy: a proof of concept in comparison to 3-T MRI and CT
Authors: Gascho Dominic , Zoelch Niklaus , Sommer Stefan , Tappero Carlo , Thali Michael J. , Deininger-Czermak Eva
Published: January 2021

The detection and assessment of cerebral lesions and traumatic brain injuries are of particular interest in forensic investigations in order to differentiate between natural and traumatic deaths and to reconstruct the course of events in case of traumatic deaths. For this purpose, computed tomography (CT) and magnetic resonance imaging (MRI) are applied to supplement autopsy (traumatic death) or to supplant autopsy (natural deaths). This approach is termed “virtual autopsy.” The value of this approach increases as more microlesions and traumatic brain injuries are detected and assessed. Focusing on these findings, this article describes the examination of two decedents using CT, 3-T, and 7-T MRI. The main question asked was whether there is a benefit in using 7-T over 3-T MRI. To answer this question, the 3-T and 7-T images were graded regarding the detectability and the assessability of coup/contrecoup injuries and microlesions using 3-point Likert scales. While CT missed these findings, they were detectable on 3-T and 7-T MRI. However, the 3-T images appeared blurry in direct comparison with the 7-T images; thus, the detectability and assessability of small findings were hampered on 3-T MRI. The potential benefit of 7-T over 3-T MRI is discussed.
Biological control of the Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae) by Entomopathogenic fungi and their side effects on natural enemies
Authors: Corallo Ana Belén , Pechi Evelin , Bettucci Lina , Tiscornia Susana
Published: January 2021

Background

The Asian citrus psyllid, Diaphorina citri Kuwayama (Hemiptera: Liviidae) is an insect pest species responsible for damages of citrus fruit quality and tree health. This insect is a vector of bacteria ‘Candidatus Liberibacter’ spp. a putative causal agent of citrus greening disease known as Huanglongbing (HLB), considered one of the most destructive diseases of citrus orchards worldwide. Disease management is mainly based on vector control using pesticides which can affect natural enemies that play an important role in pest control. The entomopathogenic fungi (EPF) Beauveria bassiana (2067 and 2121) and Metarhizium anisopliae (2411) were achieved by applying a suspension of 1 × 107 spores against D. citri nymphs and artificially infected the citrus seedlings under controlled and semi-field conditions. Also, the activity of these EPFs on the coccinellid and lacewing predators was evaluated. The effects of the main chemicals used in citrus plantations on the selected fungi for possible combined use was also investigated.

Results

The obtained results showed that under controlled conditions, the percentage of insect mortality produced by EPF varied between 82.8 and 85.9%. Under semi-field conditions, the infection and mortality of D. citri caused by the M. anisopliae 2411 strain was significantly higher than that of B. bassiana 2067, 78.9 and 51%, respectively. Non-significant effect of EPF on the natural enemies of D. citri was observed, suggesting that EPF and predators had compatible effects.

Conclusion

This study clearly demonstrated that EPF were able to kill D. citri and can be explored as a promissory biocontrol candidate. Simultaneous use in an integrated pest management program could be possible by applying EPF combined with pesticides.
Muscle biopsy essential diagnostic advice for pathologists
Authors: Cotta Ana , Carvalho Elmano , da-Cunha-Júnior Antonio Lopes , Valicek Jaquelin , Navarro Monica M. , Junior Sidney Baptista , da Silveira Eni Braga , Lima Maria Isabel , Cordeiro Bruno Arrivabene , Cauhi Alexandre Faleiros , Menezes Miriam Melo , Nunes Simone Vilela , Vargas Antonio Pedro , Neto Rafael Xavier , Paim Julia Filardi
Published: January 2021

Background

Muscle biopsies are important diagnostic procedures in neuromuscular practice. Recent advances in genetic analysis have profoundly modified Myopathology diagnosis.

Main body

The main goals of this review are: (1) to describe muscle biopsy techniques for non specialists; (2) to provide practical information for the team involved in the diagnosis of muscle diseases; (3) to report fundamental rules for muscle biopsy site choice and adequacy; (4) to highlight the importance of liquid nitrogen in diagnostic workup. Routine techniques include: (1) histochemical stains and reactions; (2) immunohistochemistry and immunofluorescence; (3) electron microscopy; (4) mitochondrial respiratory chain enzymatic studies; and (5) molecular studies. The diagnosis of muscle disease is a challenge, as it should integrate data from different techniques.

Conclusion

Formalin-fixed paraffin embedded muscle samples alone almost always lead to inconclusive or unspecific results. Liquid nitrogen frozen muscle sections are imperative for neuromuscular diagnosis. Muscle biopsy interpretation is possible in the context of detailed clinical, neurophysiological, and serum muscle enzymes data. Muscle imaging studies are strongly recommended in the diagnostic workup. Muscle biopsy is useful for the differential diagnosis of immune mediated myopathies, muscular dystrophies, congenital myopathies, and mitochondrial myopathies. Muscle biopsy may confirm the pathogenicity of new gene variants, guide cost-effective molecular studies, and provide phenotypic diagnosis in doubtful cases. For some patients with mitochondrial myopathies, a definite molecular diagnosis may be achieved only if performed in DNA extracted from muscle tissue due to organ specific mutation load.
Bupivacaine-dexmedetomidine versus bupivacaine-nalbuphine in ultrasound-guided supraclavicular brachial plexus block: a prospective, randomized, double-blind study
Authors: Mohamed H. S. , Gad G. S.
Published: January 2021

Background

Brachial plexus block is frequently performed for ambulatory upper limb surgery as an alternative to general anesthesia. It can significantly reduce pain, reduce post-operative nausea, and vomiting and allowing for faster discharge from hospital. Performing this block under ultrasound guidance has higher index of safety and can monitor the distribution of local anesthetic (LA) in real time.

The aim of this study is to compare the block characteristics among bupivacaine-dexmedetomidine (BD), bupivacaine–nalbuphine8 (BN), and bupivacaine-isotonic saline groups.

Results

The duration of both the sensory and motor blockade was statistically longer in both BD and BN groups with a longer duration of analgesia compared to the BS group. Also, the BD group showed statistically significant higher sedation scores at different times during the study compared with both the BN and BS groups.

Conclusion

Adding either dexmedetomidine or nalbuphine to isobaric bupivacaine in US-guided supraclavicular brachial plexus block prolongs both sensory and motor blockade. Dexmedetomidine produces significant sedation when added to bupivacaine.
CT characteristics and laboratory findings of COVID-19 pneumonia in relation to patient outcome
Authors: Mohamed Ibrahim A. I. , Hasan Hosam A. , Abdel-Tawab Mohamed
Published: January 2021

Background

This study aimed to investigate the chest computed tomography (CT) characteristics and laboratory findings in patients with confirmed COVID-19 pneumonia and to evaluate their relationship with clinical outcome.

This retrospective study assessed164consecutive CT chests of COVID-19 patients during April 2020. The chest CT and laboratory data were analyzed. The primary endpoint was patient survival either died or survived. The relationship between CT and laboratory findings was correlated to patient outcome.

Results

The study group included 164 patients (86 male, 78 women; average age, 44.3 ± 16.5 years) whose RT-PCR were positive for COVID-19. Only 120 (73.2%) patients had pulmonary manifestations. Ground glass opacities of peripheral distribution and multifocal affection were the major CT finding in COVID-19 patients. Univariate analysis revealed that CT severity score, D-dimer level, age, total leucocytic count, and absolute lymphocytic count were predictive for death.

Conclusion

CT has an emerging role in the diagnosis of COVID-19 pneumonia and in assessing disease severity. CT severity score, D-dimer, total leucocytic count, and absolute lymphocytic count significantly predict patient survival.
A mixed-methods protocol for identifying successful sustainability strategies for nutrition and physical activity interventions in childcare
Authors: Swindle Taren , Zhang Dong , Johnson Susan L. , Whiteside-Mansell Leanne , Curran Geoff M. , Martin Janna , Selig James P. , Bellows Laura L.
Published: January 2021

Background

Despite the importance of sustainability for nutrition and physical activity in public health interventions, limited studies have explored the factors that promote and inhibit evidence-based program sustainment in the childcare setting. This study protocol describes a mixed-methods approach to develop novel sustainability strategies based on real-world settings and stakeholder feedback, with the goal of providing support for future obesity prevention programs and related studies on intervention sustainability. Two interventions, Together, We Inspire Smart Eating (WISE) and The Food Friends’ (FF) Fun with New Foods and Get Movin’ with Might Moves, are studied to this end.

Methods

The study will deploy an explanatory, sequential mixed-methods design. First, the research team will collect a quantitative survey to assess rates of sustainment among WISE and Food Friends sites. We expect to collect 150 surveys from WISE and FF sites combined. Data from these surveys will be used to purposively sample sites for 12 to 18 site visits. Specifically, we will purposively sample low, partial, and high sustaining sites where we will conduct key informant interviews and focus groups as well as validate self-reports on sustainability. Survey content, qualitative interviews, and coding will be based on the Dynamic Sustainability Framework. We will draw on findings from the quantitative survey on predictors of sustainment and the qualitative site visits to understand varying levels of program sustainment. Then, we will utilize evidence-based quality improvement sessions to engage stakeholders in developing a multi-component sustainability strategy.

Discussion

This study will provide a stakeholder-informed sustainability strategy ready for testing in a full-scale trial examining effects on sustainment of evidence-based nutrition and physical activity practices in childcare. We expect this strategy to be relevant for educators and consistent with the views of administrators as a guide for future practice for the targeted nutrition and physical activity interventions and beyond.
Christianity as a Concealable Stigmatized Identity (CSI) among Biology Graduate Students
Authors: Barnes M. Elizabeth , Maas Samantha A. , Roberts Julie A. , Brownell Sara E.
Published: January 2021

In interviews with Christian graduate students in biology using the concealable stigmatized identities framework, it was found that Christian graduate students perceive, anticipate, and experience stigma against Christians in the biology community.
Preoperative BMI Predicts Postoperative Weight Gain in Adult-onset Craniopharyngioma
Authors: Duan Daisy , Wehbeh Leen , Mukherjee Debraj , Hamrahian Amir H , Rodriguez Fausto J , Gujar Sachin , Khalafallah Adham M , Hage Camille , Caturegli Patrizio , Gallia Gary L , Ahima Rexford S , Maruthur Nisa M , Salvatori Roberto
Published: January 2021

Context

Craniopharyngiomas, while benign, have the highest morbidity of all nonmalignant sellar tumors. Studies on weight and metabolic outcomes in adult-onset craniopharyngioma (AOCP) remain sparse.

Objective

To examine postsurgical weight and metabolic outcomes in AOCP and to identify any clinical predictors of weight gain.

Methods

Retrospective chart review of patients with AOCP who underwent surgery between January 2014 and May 2019 in a single pituitary center. The study included 45 patients with AOCP with a minimum follow-up of 3 months. Median follow-up time was 26 months (interquartile range [IQR] 10-44). Main outcome measures were the changes in weight/body mass index (BMI), metabolic comorbidities, and pituitary deficiencies between preoperative and last follow-up.

Results

Both weight and BMI were higher at last follow-up, with a mean increase of 3.4 kg for weight (P = .015) and 1.15 kg/m2 for BMI (P = .0095). Median % weight change was 2.7% (IQR –1.1%, 8.8%). Obesity rate increased from 37.8% at baseline to 55.6% at last follow-up. One-third of patients had ~15% median weight gain. The prevalence of metabolic comorbidities at last follow-up was not different from baseline. Pituitary deficiencies increased postoperatively, with 58% of patients having ≥3 hormonal deficiencies. Preoperative BMI was inversely associated with postoperative weight gain, which remained significant after adjusting for age, sex, race, tumor, and treatment characteristics. Patients with ≥3 hormonal deficiencies at last follow-up also had higher postoperative weight gain.

Conclusion

In this AOCP cohort, those with a lower BMI at the preoperative visit had higher postoperative weight gain. Our finding may help physicians better counsel patients and provide anticipatory guidance on postoperative expectations and management.
Body Habitus Across the Lifespan and Risk of Pituitary Adenoma
Authors: Cote David J , Smith Timothy R , Kaiser Ursula B , Laws Edward R , Stampfer Meir J
Published: January 2021

Context

No studies have examined the association between body habitus and incidence of pituitary adenoma.

Objective

To determine if body mass index (BMI), waist circumference, body somatotype, or height are associated with risk of pituitary adenoma.

Design

Pooled analysis of 3 prospective cohort studies.

Setting

Population-based study.

Participants

Participants of the Nurses’ Health Study (NHS), Nurses’ Health Study II (NHSII), and the Health Professionals Follow-Up Study (HPFS), totaling 284 946 American health professionals.

Exposures

BMI, waist circumference, body somatotype, and height.

Outcome Measures

Self-reported incident pituitary adenoma. Multivariable (MV)-adjusted hazard ratios (HRs) of pituitary adenoma were estimated using Cox proportional hazards models.

Results

During 7 350 156 person-years of follow-up, 387 incident pituitary adenomas were reported. Comparing BMI of ≥30 to <25 kg/m2, higher adult BMI was associated with higher risk of pituitary adenoma (MV HR = 1.74; 95% CI, 1.33-2.28), as was higher maximum adult BMI (MV HR = 1.76; 95% CI, 1.34-2.30), higher waist circumference (MV HR = 1.06; 95% CI, 1.04-1.09 per inch), and higher BMI during early adulthood (at age 18 to 21, MV HR = 2.65; 95% CI, 1.56-4.49). Taller adult height was associated with pituitary adenoma (MV HR = 1.05; 95% CI, 1.01-1.09 per inch). Overall findings were similar in women and men, although power was limited in men (n = 62 cases). Sensitivity analyses demonstrated that the association between adult BMI and pituitary adenoma extended to at least 14 years prior to diagnosis and that the results were not affected when analyses were restricted to participants with similar healthcare utilization.

Conclusion

Higher BMI and waist circumference, from early adulthood to the time of diagnosis, were associated with higher risk of pituitary adenoma.
Recombinant Human Growth Hormone Activates Neuroprotective Growth Factors in Hypoxic Brain Injury in Neonatal Mice
Authors: Jung Susan , Terörde Klara , Dörr Helmuth-Günther , Trollmann Regina
Published: January 2021

Perinatal hypoxia severely disrupts cerebral metabolic and maturational programs beyond apoptotic cell death. Antiapoptotic treatments such as erythropoietin are suggested to improve outcomes in hypoxic brain injury; however, the results are controversial. We analyzed the neuroprotective effects of recombinant human growth hormone (rhGH) on regenerative mechanisms in the hypoxic developing mouse brain in comparison to controls. Using an established model of neonatal acute hypoxia (8% O2, 6 hours), P7 mice were treated intraperitoneally with rhGH (4000 µg/kg) 0, 12, and 24 hours after hypoxic exposure. After a regeneration period of 48 hours, expression of hypoxia-inducible neurotrophic factors (erythropoietin [EPO], vascular endothelial growth factor A [VEGF-A], insulin-like growth factors 1 and 2 [IGF-1/-2], IGF binding proteins) and proinflammatory markers was analyzed. In vitro experiments were performed using primary mouse cortical neurons (E14, DIV6). rhGH increased neuronal gene expression of EPO, IGF-1, and VEGF (P < .05) in vitro and diminished apoptosis of hypoxic neurons in a dose-dependent manner. In the developing brain, rhGH treatment led to a notable reduction of apoptosis in the subventricular zone and hippocampus (P < .05), abolished hypoxia-induced downregulation of IGF-1/IGF-2 expression (P < .05), and led to a significant accumulation of endogenous EPO protein and anti-inflammatory effects through modulation of interleukin-1β and tumor necrosis factor α signaling as well as upregulation of cerebral phosphorylated extracellularly regulated kinase 1/2 levels (ERK1/2). Indicating stabilizing effects on the blood-brain barrier (BBB), rhGH significantly modified cerebrovascular occludin expression. Thus, we conclude that rhGH mediates neuroprotective effects by the activation of endogenous neurotrophic growth factors and BBB stabilization. In addition, the modification of ERK1/2 pathways is involved in neuroprotective actions of rhGH. The present study adds further evidence that pharmacologic activation of neurotrophic growth factors may be a promising target for neonatal neuroprotection.
Successful Use of Peripheral Nerve Blocks as the Primary Anesthetic in High-Risk Patients Undergoing Hip Surgery: A Case Series
Authors: Bryan Andre , Montilla Elilary , Steinberg Sofia , Farah Fadi , Muse Iyabo O.
Published: January 2021

The incidence of hip fractures in the United States is increasing as the population ages. Elderly patients are more likely to have extensive comorbidities, which contribute to long-term consequences after a hip fracture. These patients often experience permanent disability, restrictions in activities of daily life, higher rates of depression, cardiovascular disease, and mortality rate. The authors describe a combination of peripheral nerve blocks to provide surgical anesthesia for corrective hip surgery in 5 high-risk patients.
Dreaming in the Delta
Authors: Zook Kristal Brent
Published: January 2021

In 1990, in Indianola, Mississippi, there was a catfish-processing plant owned by 178 White male farmers. The workforce inside the plant was ninety percent Black and female. Led by an ordinary working mother turned union organizer named Sarah White, the women at Delta Pride led the largest strike of Black laborers ever to take place in that state, and won. Kristal Brent Zook, an award-winning journalist, traveled to Indianola to meet with White and others in an effort to understand the plight of working class women in the modern-day South. What she found there taught her as much about herself, as it did about human rights and dignity in America today.
Cutting across Imperial Feminisms toward Transnational Feminist Solidarities
Authors: Deb Basuli
Published: January 2021

Photography, not only by imperial men but also by imperial women, has played a significant role in portraying the Muslim woman as the apolitical exotic of orientalist fantasies, its legacies haunting the media of the global North even today. Imperial feminist representations about Muslim women have also marked the rhetoric of Hillary Clinton, Laura Bush, Cherie Booth, and Condoleezza Rice. In contrast, this article draws on various photographic counter-narratives, among them “the girl in the blue bra,” that transnational feminists circulated through social media during the 2011 people’s uprising in Egypt as well as on the iconic pan-Arab feminist leader Huda Shaarawi to evoke powerful images of Muslim women. Finally, the essay turns to transnational feminists such as Angela Davis, Trinh T. Minh-ha, Cynthia Enloe, Miriam Cooke, and Zillah Eisenstein for cross-border feminist work that cuts across imperial feminist practices.
Rethinking Meridians
Authors: Whitehead Karsonya Wise
Published: January 2021

Alice Walker in her book, In Search of Our Mothers’ Garden, notes that when you write the book you want to read, you are both pointing and following your “direction of vision.” As a writer and a Black feminist scholar, the author understood this to mean that she needed to craft the tools that would help her to do her work. Rethinking Meridians is the critical knowledge project, the tool, that she wanted to have in her hand when she was a classroom teacher. Consisting of articles and lesson plans, the special issue was designed as a disruption tool that would inspire teachers and students to transcend the notion of the classroom as a static, constrained, and unliberated space. By using the lens of transdisciplinarity, Rethinking Meridians examines Black feminist theory as a teaching tool and a pedagogical practice that challenges teachers to connect the work across disciplines and beyond them.
New Polymers Made from Carbon Dioxide and Alkenes
Authors: Nozaki Kyoko
Published: January 2021

Carbon dioxide (CO2) is an attractive raw material for chemical synthesis owing to its abundance and low toxicity. Among various utilizations of CO2 for the synthesis of useful compounds, this article focuses on its use for polymer synthesis. While synthesis of polyurea, polyurethane, and aliphatic and aromatic polycarbonates have been well-studied, this article focuses on another class of approach that uses a lactone derived from CO2 and 1,3-butadiene. Recent publications are summarized in relation to our synthesis of polylactone.
Desenvolvimento e validação de cartilhas para cuidado farmacêutico de pacientes com diabetes mellitus em uso de insulinas
Authors: Chaves Paula Resende Daher , Silva Maria Clara Faria , Mendonça Thays Santos , Baldoni André Oliveira , Silva Eduardo Sérgio , Belo Vinícius Silva , Pereira Mariana Linhares
Published: January 2021

Objetivo: desenvolver e validar cartilhas para aprimorar o preparo e a utilização de insulinas, bem como o monitoramento da glicemia capilar. Métodos: as cartilhas foram elaboradas considerando a acessibilidade das informações e a compreensibilidade das imagens, a fim de torná-las didáticas ao público-alvo. Posteriormente, foram submetidas à validação. Resultados: por meio da Técnica Delphi, criou-se um questionário contendo 10 perguntas para cada uma das quatro cartilhas validadas, o qual foi enviado para 32 painelistas, especialistas na área. A fim de avaliar o consenso entre as respostas dos painelistas, em cada item, empregou-se o cálculo do Coeficiente de Validade de Conteúdo (CVC), que varia de 0 a 1. Considerou-se validado, o valor de CVC superior a 0,8. Ao final de duas rodadas, foi possível validar as quatro cartilhas. Conclusão: o material possui vasto potencial de contribuição para o uso racional, efetivo e seguro das insulinas, além de poder contribuir com a qualidade de vida dos pacientes e com a redução de custos para o sistema de saúde.