bluuebunny/crossref_metadata_2025 huggingface dataset:
The Great Balancing Act: Households, Debt, and Economic Insecurity
Authors: Maroto Michelle
Published: March 2021

Balancing finances is a complicated and precarious act for many U.S. households, with constant concerns that income will not be enough. What happens when households are no longer able to keep up this balancing act? This research draws on 2019 Survey of Consumer Finances data to examine varying experiences of economic insecurity, measured as whether a household’s expenses exceeded its income in the previous year, and households’ strategies for managing economic insecurity. The author explores the ties among economic security, household debt burdens, and credit market access. By comparing the actual strategies that insecure households used to weather insecurity with the hypothetical strategies proposed by more secure households, the findings show that the resources that protect against insecurity also influence how households manage it. Although most insecure households relied on borrowing when their spending exceeded their incomes, secure households most often recommended spending from savings or finding additional income.
Medial and Lateral Combined Ligament Arthroscopic Repair for Multidirectional Ankle Instability
Authors: Mansur Nacime Salomão Barbachan , Lemos André Vitor Kerber Cavalcante , Baumfeld Daniel Soares , Baumfeld Tiago Soares , Prado Marcelo Pires do , Raduan Fernando Cepolina , Nery Caio Augusto Souza
Published: March 2021

Background:

The high prevalence of ankle sprains in the population produces a significant number of patients with lateral instability. Persistence of this condition may lead to the progressive involvement of medial structures, causing a multidirectional rotational instability.

Methods:

This is a retrospective study with patients diagnosed with multidirectional instability who underwent ankle arthroscopy with medial (arthroscopic tensioning) and lateral repair (arthroscopic Bröstrom) between January 2018 and January 2020. All patients were evaluated for pain and function according to the visual analog scale (VAS) score and the American Orthopaedic Foot & Ankle Society (AOFAS) Hindfoot Score at a mean of 14.8 months (5-27 months) in follow-up. A total of 30 ankles (29 patients) were included in the study.

Results:

The AOFAS score increase from a 49.7 (CI 5.8) to a 91.9 (CI 2.4) mean ( P = .001) and was followed by significant improvement in the mean VAS score (6.8, CI 0.37-0.95, CI 0.31). The majority of patients had associated procedures (53.3%), and a low complication rate was found (16.6%).

Conclusion:

Combined medial and lateral arthroscopic repair might be an effective and safe alternative in the treatment of multidirectional instability. Inclusion of the deltoid ligament complex and the low invasiveness of the arthroscopic technique may improve the clinical outcomes of these patients.

Level of Evidence:

Level IV, retrospective case series.
Construction of a bivalent vaccine against anthrax and smallpox using the attenuated vaccinia virus KVAC103
Authors: Park Deok Bum , Ahn Bo-Eun , Son Hosun , Lee Young-Ran , Kim Yu-Ri , Jo Su Kyoung , Chun Jeong-Hoon , Yu Jae-Yon , Choi Myung-Min , Rhie Gi-eun
Published: March 2021

Background

Anthrax and smallpox are high-risk infectious diseases, and considered as potential agents for bioterrorism. To develop an effective countermeasure for these diseases, we constructed a bivalent vaccine against both anthrax and smallpox by integrating a gene encoding protective antigen (PA) ofBacillus anthracisto the genome of the attenuated vaccinia virus strain, KVAC103.

Results

Immunization with this bivalent vaccine induced antibodies against both PA and vaccinia virus in a mouse model. We also observed that the efficacy of this vaccine can be enhanced by combined immunization with immunoadjuvant-expressing KVAC103. Mouse groups co-immunized with PA-expressing KVAC103 and either interleukin-15 (IL-15) or cholera toxin subunit A (CTA1)-expressing KVAC103 showed increased anti-PA IgG titer and survival rate againstB. anthracisspore challenge compared to the group immunized with PA-expressing KVAC103 alone.

Conclusions

We demonstrated that the attenuated smallpox vaccine KVAC103 is an available platform for a multivalent vaccine and co-immunization of immunoadjuvants can improve vaccine performance.
The lived experiences of pregnant women during COVID-19 pandemic: a descriptive phenomenological study
Authors: Mortazavi Forough , Ghardashi Fatemeh
Published: March 2021

Background

With the onset of the COVID-19 epidemic, pregnancy and childbirth for women are taking place in unusual circumstances. We explored the lived experiences of pregnant women during the COVID-19 pandemic to better understand their experience of pregnancy so that better support could be provided.

Methods

We used a descriptive phenomenological approach to understand the lived experience of pregnant women in COVID-19 pandemic. We collected data using a purposive sampling method through in-depth interviews in cyberspace with a semi-structured questionnaire. We used Colaizzi’s seven-step content analysis method to analyze the research data with the help of MAXQDA software version 2020.

Results

We conducted this descriptive phenomenology study on 19 pregnant women in a period between the 10th to the 20th of May, 2020. The participating women were already pregnant when the first signs of the epidemic appeared in the country and at the time of the interview. We acquired four themes including disruption of the tranquility and regular routines of daily life, new challenges caused by the epidemic, resilience and strength in facing the crisis, and adaptation with new conditions.

Conclusions

The pregnant women were under intense stress during the COVID-19 outbreak. The general mobilization the health system is necessary for alleviating pregnant women’s difficulties in situations like the COVID-19 epidemic. Virtual training classes and virtual counseling may enhance the peace and tranquility of pregnant women.
Psychotropic and anti-epileptic drug use, before and after surgery, among patients with low-grade glioma: a nationwide matched cohort study
Authors: Rydén Isabelle , Thurin Erik , Carstam Louise , Smits Anja , Gulati Sasha , Henriksson Roger , Salvesen Øyvind , Store Jakola Asgeir
Published: March 2021

Background

Low-grade glioma (LGG) is a relatively rare type of brain tumour. The use of antidepressant, sedative and anti-epileptic drugs can reflect the burden of the disease. While epilepsy is well-described in patients with LGG, less is known about depression and anxiety.

Methods

We used nationwide registers to study the use (dispense) of antidepressants, sedatives, and anti-epileptic drugs (AEDs) before and after histopathological LGG diagnosis (WHO grade II). A total of 485 adult patients with a first-time diagnosis and a matched control cohort (n = 2412) were included. Patterns of use were analysed from one year prior to until one year following index date (date of surgery). Logistic regression analysis identified predictors for postoperative use.

Results

At one year before index date, patients were dispensed AEDs 4 times more than controls, while antidepressants and sedatives were similar. Sedatives and AED peaked shortly after index date at 25 and 69%, respectively. AEDs then stabilized while sedatives decreased rapidly. For antidepressants, a delayed increase was seen after index date, stabilizing at 12%. At one year after index date, the use of antidepressants, sedatives, and AEDs among patients was 2, 3, and 26 times higher, respectively, compared to controls. Predictor for use of AEDs and sedatives at one year following index was previous use and/or a related diagnosis. Female sex and later index year were additional predictors for antidepressants.

Conclusions

Use of antidepressants, sedatives and AEDs is elevated following diagnosis of LGG. Antidepressants were more commonly dispensed to female patients and in recent years.
Magnetic resonance imaging follow-up can screen for soft tissue changes and evaluate the short-term prognosis of patients with developmental dysplasia of the hip after closed reduction
Authors: Meng Xianghong , Yang Jianping , Wang Zhi
Published: March 2021

Background

Magnetic resonance imaging (MRI) can show the architecture of the hip joint clearly and has been increasingly used in developmental dysplasia of the hip (DDH) confirmation and follow-up. In this study, MRI was used to observe changes in the hip joints before and after closed reduction (CR) and to explore risk factors of residual acetabular dysplasia (RAD).

Methods

This is a prospective analysis of unilateral DDH patients with CR and spica cast in our hospital from October 2012 to July 2018. MRI and pelvic plain radiography were performed before and after CR. The labro-chondral complex (LCC) of the hip was divided into four types on MRI images. The variation in the thickening rate of the ligamentum teres, transverse ligaments, and pulvinar during MRI follow-up was analyzed, and the difference in cartilaginous acetabular head index was evaluated. The “complete relocation” rate of the femoral head was analyzed when the cast was changed for the last time, and the necrotic rate of the femoral head was evaluated after 18 months or more after CR. Lastly, the risk factors of RAD were analyzed.

Results

A total of 63 patients with DDH and CR were included. The LCC was everted before CR and inverted after CR, and the ligamentum teres, transverse ligaments, and pulvinar were hypertrophic before and after CR, and then gradually returned to normal shape. The cartilaginous acetabular head index gradually increased to normal values. Complete relocation was observed in 58.7% of femoral heads, while 8.6% had necrosis. The abnormalities in LCC was related to RAD (OR: 4.35,P = 0.03), and the rate of type 3 LCC in the RAD group was higher. However, the IHDI classification (P = 0.09); the “complete relocation” of femoral heads (P = 0.61); and hypertrophy of the ligamentum teres (P = 1.00), transverse ligaments (P = 1.00), and pulvinar (P = 1.00) were not related to RAD.

Conclusions

In this study, MRI can observe the variations of the abnormal soft tissue structures of the diseased hips after CR and spica casting, and can evaluate which hips will have RAD after CR. Therefore, we can utilize MRI in DDH patients appropriately.
Prevalence of depression and associated factors among elderly people in Womberma District, north-west, Ethiopia
Authors: Mulat Nebiyu , Gutema Hordofa , Wassie Gizachew Tadesse
Published: March 2021

Background

Depression is a common mental disorder that suffers many elderly people who are neglected, their problems are overlooked, and no efforts are made to mitigate their suffering. It is a mental health problem which is both underdiagnosed and under treated in primary care settings. This study was aimed to assess the prevalence and associated factors of depression among elderly people in Womberma District, Ethiopia.

Methods

A community based cross-sectional study was conducted from March 10/2020 - April 08/2020. From a 2269 study population, 959 study participants were selected by using computer-generated simple random sampling techniques from selectedkebeles. Data were collected using Geriatric depression scale item 15 through face-to-face interviews. Then, entered into EpiData version 3.1 and then exported to SPSS version 23.0 for analyses. Bi-variable and multivariable logistic regression models were fitted to identify associated factors of depression. An adjusted odds ratio with 95% confidence interval was reported and statistical significance was declared atP-values < 0.05.

Results

The prevalence of depression among elderly people was 45% [95% CI: 41.7–48.5%]. Being female [AOR = 1.60, 95% CI [(1.15–2.23)], (age > =75 years [AOR = 7.95, 95% CI (4.98–12.68)], age 70–74 years [AOR = 5.52, 95% CI (3.52–8.66)], age 65–69 years [AOR = 2.39,95% CI (1.54–3.70)]; divorced [AOR = 2.53, 95% CI (1.59–4.03)], widowed [AOR = 2.65, 95% CI (1.61–4.34)]; poor social support [AOR = 3.32, 95% CI (1.77–6.23)] and presence of known chronic disease [AOR = 1.91, 95% CI (1.30–2.81)] were significantly associated factors with depression.

Conclusions

In this study, the prevalence of depression among elderly people was high compared with previous studies done in other parts of Ethiopia. Older age, being female, marital loss, presence of known chronic disease, and poor social support were contributing factors for depression among elders. Early screening and co-morbidity management of depression should be comprised in basic primary health care packages. And also, ensuring adequate social support by establishing the Geriatrics care center could play a crucial role to mitigate the suffering of the elders from marital loss provoked loneness and depression.
The importance of appropriate diagnostics in prosthetic joint infection: letter to the editor of BMC musculoskeletal disorders
Authors: McNally Martin , Wouthuyzen-Bakker Marjan , Sousa Ricardo , Atkins Bridget , Soriano Alex
Published: March 2021

Assessment of a new diagnostic test must be performed against an acceptable and validated standard to allow comparison with other studies. We are concerned that the adoption of lower diagnostic criteria in this paper has contributed to an over-diagnosis of prosthetic joint infection and makes interpretation of the results difficult.
A case of Schnitzler’s syndrome without monoclonal gammopathy successfully treated with canakinumab
Authors: Fujita Yuya , Asano Tomoyuki , Sakai Akira , Norikawa Natsumi , Yamamoto Toshiyuki , Matsumoto Haruki , Sato Shuzo , Temmoku Jumpei , Yashiro-Furuya Makiko , Matsuoka Naoki , Watanabe Hiroshi , Migita Kiyoshi
Published: March 2021

Background

Schnitzler’s syndrome (SchS) is a rare autoinflammatory syndrome with diagnostic challenge and be characterized by chronic urticaria, a monoclonal gammopath, periodic fever and bone pain. In addition to the monoclonal gammopathy, bone abnormalities are often found at the site of bone pain in patients with SchS. The remarkable efficacy of interleukin-1 (IL-1) inhibition was also demonstrated in this syndrome.

Case presentation

We describe a case of refractory chronic urticaria presenting with clinical manifestations consistent with SchS without monoclonal gammopathy. A 43-year-old female patient suffering from recurring of urticaria with periodic fever as well as bone pain for the past 4 years. The patient had leukocytosis and elevated levels of C-reactive protein (CRP) and serum amyloid A (SAA). PET/CT (positron emission tomography/computed tomography) and MRI (magnetic resonance imaging) examination revealed hyper-metabolism areas in both femoral bone marrow. Although bone marrow histology revealed no abnormality, urticarial skin lesions shows neutrophilic infiltrations without evidence of vasculitis. We could not exclude the possibility of SchS. The patient had been treated with antihistamines, steroids, omarizumab, colchicine and cyclosporine A, no therapeutic effect was observed. She was started on canakinumab 150 mg subcutaneous injection with 4 weeks interval. Within 48 h after the first injection, the urticarial rash disappeared, and febrile attack and bone pain had not recurred. Elevated levels of serum CRP and SAA were normalized within a week after the first injection of canakinumab.

Conclusions

The current case suggests an important role for IL-1 as a mediator in the pathophysiology of SchS-like refractory urticaria with bine pain. It had been presumed that monoclonal gammopathy may not always present in SchS. It is important to avoid delay in diagnosis and initiation of proper treatment in SchS or autoinflammatory conditions resembling SchS.
Communication and information needs about complementary and alternative medicine: a qualitative study of parents of children with cancer
Authors: Stub Trine , Quandt Sara A. , Kristoffersen Agnete E. , Jong Miek C. , Arcury Thomas A.
Published: March 2021

Background

Many parents choose support such as Complementary and Alternative Medicine (CAM) for themselves and their children who have cancer. The aim of this paper is to describe, how parents who have children with cancer communicated with conventional health care providers about CAM, and what types and sources of information they would like to receive about CAM when the child was ill.

Method

This focused ethnography draws from in-depth, semi-structured interviews conducted with 22 families in Norway with 24 adult participants (two couples), including two individuals who had had cancer themselves. Four domains were explored in the data analysis: the use of CAM, advice from laypeople about CAM, communication with conventional health care providers about CAM, and parents’ information needs about CAM.

Results

Many of the participants had personal experiences with CAM before the child received the cancer diagnosis. The health care providers did not raise the question about CAM in the consultations. However, when the parents raised the question, they were mostly met in a positive way. The participants did not receive any information about CAM at the hospital, which they would have appreciated. Instead, they received recommendations about CAM from laypersons, which were mostly rejected, as the advice was not in line with their health values/philosophy.

Conclusion

The reason participants did not disclose CAM use is that physicians did not ask them about it. However, positive communication about conventional treatment facilitated fruitful conversations about CAM. The participants wanted information about CAM from authoritative sources, primary from health care providers at the hospital and the Children’s Cancer Society. They demand information about risks and benefits when using CAM as well as whether CAM can improve the immune system, fight the cancer, and improve the quality of life of the family. An evidence-based decision aid is warranted to enable health care providers and parents of children with cancer to make well-informed decisions about CAM.
Antimicrobial use and resistance in Escherichia coli from healthy food-producing animals in Guadeloupe
Authors: Gruel Gaëlle , Sellin Arantxa , Riveiro Hélène , Pot Matthieu , Breurec Sébastien , Guyomard-Rabenirina Stéphanie , Talarmin Antoine , Ferdinand Séverine
Published: March 2021

Background

Selection pressure exerted by use of antibiotics in both human and veterinary medicine is responsible for increasing antimicrobial resistance (AMR). The objectives of this study were to better understand antimicrobial use in pigs, beef cattle, and poultry on farms on Guadeloupe, French West Indies, and to acquire data on AMR inEscherichia coliin these food-producing animals. A cross-sectional survey was conducted at 45 farms on Guadeloupe, and practical use of antimicrobials was documented in declarative interviews between March and July 2018. A total of 216 fecal samples were collected between January 2018 and May 2019, comprising 124 from pigs, 75 from beef cattle, and 17 from poultry litter.E. coliisolates were obtained for further testing by isolation and identification from field samples. Antimicrobial susceptibility testing and screening forblaCTX-M,blaTEM,tetA, andtetB resistance genes by polymerase chain reaction on extracted genomic DNA were performed.

Results

The study showed rational use of antimicrobials, consisting of occasional use for curative treatment by veterinary prescription. Tetracycline was the most commonly used antimicrobial, but its use was not correlated toE. coliresistance. Extended-spectrum β-lactamase (ESBL)E. coliisolates were detected in 7.3% of pigs, 14.7% of beef cattle, and 35.3% of poultry.blaCTX-M-1was the predominant gene found in ESBL-E. coliisolates (68.8%), followed byblaCTX-M-15(31.3%).

Conclusion

Despite rational use of antimicrobials, the rate of ESBL-E. coliin food-producing animals in Guadeloupe, although moderate, is a concern. Further studies are in progress to better define the genetic background of the ESBL-E. coliisolates.

Graphical abstract
CircTP63 promotes hepatocellular carcinoma progression by sponging miR-155-5p and upregulating ZBTB18
Authors: Wang Jiantao , Che Jinbiao
Published: March 2021

Background

Hepatocellular carcinoma (HCC) is the leading cause of tumor-related death worldwide due to high morbidity and mortality, yet lacking effective biomarkers and therapies. Circular RNAs (circRNAs) are a group of non-coding RNAs that regulate gene expression through interacting with miRNAs, implicating in the tumorigenesis and progression. A novel circRNA, circTP63, was reported to be an oncogene in HCC. However, its role in HCC remains unclear.

Methods

qRT-PCR was used to assess the mRNA levels of CircTP63 in 90 pairs of tumor and adjacent normal tissues from HCC patients, one human normal hepatic epithelial cell line and HCC cell lines. CCK-8, colony formation, transwell, and flow cytometry assays were performed to detect the cellular function of circTP63/miR-155-5p/ZBTB18 in HCC cells. HCC xenograft mice models were established to assess the in vivo effect of circTP63. Bioinformatic analysis, RNA pull-down and luciferase assays were used to determine the interaction among circTP63/miR-155-5p/ZBTB18.

Results

circTP63 was significantly upregulated in HCC tissues and cell lines. High circTP63 expression is closely associated with the tumor stages, lymph node metastasis, and poor prognosis of HCC patients. Functionally, knockdown of circTP63 inhibited cell proliferation, migration, invasion, and promoted cell apoptosis of HCC. Meanwhile, overexpression of circTP63 enhanced HCC progression. Mechanically, circTP63 was a sponge of miR-155-5p to facilitate the ZBTB18 expression, and the ZBTB18 expression in HCC tissues was negatively associated with the survival rate of HCC patients. Furthermore, rescued assays revealed that the reduced tumor-promoting effect on HCC cells induced by knockdown of circTP63 can be reversed by miR-155-5p inhibitor or ZBTB18 overexpression.

Conclusion

Our data highlight a critical circTP63-miR-155-5p-ZBTB18 regulatory network involved in the HCC progression, gaining mechanistic insights into the function of circRNAs in HCC progression, and providing effective biomarkers and therapeutic targets for HCC treatment.
Seeking research questions from implementers: considerations for leveraging ground actors research needs in the fight against malaria in West Africa
Authors: Amouh Tete S. , Ekoye Saidou Malam , Ahanhanzo Césaire D. , Guiguemdé Tinga Robert , Sombié Issiaka
Published: March 2021

Background

To strengthen the fight against malaria, it is imperative to identify weaknesses and possible solutions in order to improve programmes implementation. This study reports experiences gained from collaboration between decision-makers and researchers from a World Bank project (Malaria and Neglected Tropical Diseases in the Sahel, SM/NTD). The objectives of this paper were to identify bottlenecks in malaria programme implementation as well as related research questions they bring up.

Methods

Questionnaire addressed to National Malaria Control Programme managers and prioritization workshops were used as a medium to identify research questions. The bottlenecks in malaria programme implementation were identified in seven thematic areas namely governance, human resources, drugs, service provision, use of prevention methods, monitoring and evaluation (M and E), and public support or buy-in. The first five priority questions were: (1) compliance with drug doses on the second and third days during the seasonal chemoprevention (SMC) campaigns, (2) the contribution of community-based distributors to the management of severe cases of malaria in children under 5 years, (3) the SMC efficacy, (4) artemisinin-based combination therapy (ACT) tolerance and efficacy according to existing guidelines, and (5) the quality of malaria control at all levels of the health system.

Results and conclusion

This work showed the effectiveness of collaboration between implementers, programmes managers, and researchers in identifying research questions. The responses to these identified research questions of this study may contribute to improving the implementation of malaria control programmes across African countries.
Development of EphA2 siRNA-loaded lipid nanoparticles and combination with a small‐molecule histone demethylase inhibitor in prostate cancer cells and tumor spheroids
Authors: Oner Ezgi , Kotmakci Mustafa , Baird Anne-Marie , Gray Steven G. , Debelec Butuner Bilge , Bozkurt Emir , Kantarci Ayse Gulten , Finn Stephen P.
Published: March 2021

Background

siRNAs hold a great potential for cancer therapy, however, poor stability in body fluids and low cellular uptake limit their use in the clinic. To enhance the bioavailability of siRNAs in tumors, novel, safe, and effective carriers are needed.

Results

Here, we developed cationic solid lipid nanoparticles (cSLNs) to carry siRNAs targeting EphA2 receptor tyrosine kinase (siEphA2), which is overexpressed in many solid tumors including prostate cancer. Using DDAB cationic lipid instead of DOTMA reduced nanoparticle size and enhanced both cellular uptake and gene silencing in prostate cancer cells. DDAB-cSLN showed better cellular uptake efficiency with similar silencing compared to commercial transfection reagent (Dharmafect 2). After verifying the efficacy of siEphA2-loaded nanoparticles, we further evaluated a potential combination with a histone lysine demethylase inhibitor, JIB-04. Silencing EphA2 by siEphA2-loaded DDAB-cSLN did not affect the viability (2D or 3D culture), migration, nor clonogenicity of PC-3 cells alone. However, upon co-administration with JIB-04, there was a decrease in cellular responses. Furthermore, JIB-04 decreased EphA2 expression, and thus, silencing by siEphA2-loaded nanoparticles was further increased with co-treatment.

Conclusions

We have successfully developed a novel siRNA-loaded lipid nanoparticle for targeting EphA2. Moreover, preliminary results of the effects of JIB-04, alone and in combination with siEphA2, on prostate cancer cells and prostate cancer tumor spheroids were presented for the first time. Our delivery system provides high transfection efficiency and shows great promise for targeting other genes and cancer types in further in vitro and in vivo studies.
Correction to: Global, regional, and national trends and patterns in physical activity research since 1950: a systematic review
Authors: Varela Andrea Ramírez , Cruz Gloria Isabel Nino , Hallal Pedro , Blumenberg Cauane , da Silva Shana Ginar , Salvo Deborah , Martins Rafaela , da Silva Bruna Gonçalves Cordeiro , Resendiz Eugen , del Portillo Maria Catalina , Monteiro Luciana Zaranza , Khoo Selina , Chong Kar Hau , da Silva Marcelo Cozzensa , Mannocci Alice , Ding Ding , Pratt Michael
Published: March 2021

An amendment to this paper has been published and can be accessed via the original article.
Urban emergence of Dermanyssus gallinae lineage L1 and Ornithonyssus sylviarum in Hungary: phylogenetic differentiation between the roles of migrating vs transported synanthropic birds
Authors: Hornok Sándor , Takács Nóra , Sipos Gábor , Morandini Pál , Sándor Attila D. , Szekeres Sándor , Grima Andrea , Kontschán Jenő
Published: March 2021

Background

Among Dermanyssoidea, the chicken red mite (Dermanyssus gallinae) and the northern fowl mite (Ornithonyssus sylviarum) are considered to be the cause of high economic losses endured by the poultry industry in the Holarctic region, with O. sylviarum predominating in North America and D. gallinae in Europe. Both species have a short life-cycle (thereby allowing a rapid build-up of massive infestations), a wide range of hosts, synanthropic presence and the ability to bite humans. The aim of this study was to analyze dermanyssoid mite specimens, collected in two human dwellings and two racing pigeon premises in different urban areas in Hungary, with molecular–phylogenetic methods.

Methods

Mite species were identified morphologically. This was followed by DNA extraction and molecular–phylogenetic analyses of selected mites, based on the cytochrome c oxidase subunit I (cox1) and 28S rRNA (28S) genes.

Results

Mites that had invaded a home from a pigeon nest and were linked to human dermatitis were morphologically and molecularly identified as D. gallinae special lineage L1. Specimens collected at all other sampling sites were identified as O. sylviarum, including mites that had invaded a home from a house martin (Delichon urbicum) nest, as well as those which were collected from racing pigeons. House martin- or pigeon-associated O. sylviarum specimens showed the highest sequence identity and closest phylogenetic relationship with conspecific mites reported in GenBank from Israel or Canada, respectively.

Conclusions

Detailed morphological and molecular–phylogenetic analyses of D. gallinae lineage L1 confirmed its status as a cryptic species within D. gallinae (s.l.). Taking into account the well-documented latitudinal migratory routes of house martins between Hungary and Africa, O. sylviarum associated with this bird species most likely arrived on its host from the eastern Mediterranean region. On the other hand, mites collected from pigeons in Hungary showed cox1 genetic homogeneity with North American O. sylviarum, which can only be explained by a long-distance (west-to-east intercontinental) connection of birds and their mites as part of human activity (e.g. transportation to exhibitions or trading). In summary, this is the first molecularly confirmed and phylogenetically analyzed case of O. sylviarum infestation of birds in Hungary, implicating urban environment and involving distant parts of the country. This is also the first report of D. gallinae lineage L1 in central Europe.

Graphical Abstract
Content analysis of promotional material for asthma-related products and therapies on Instagram
Authors: Heineman Brent , Jewell Marcella , Moran Michael , Bradley Kolbi , Spitzer Kerry A. , Lindenauer Peter K.
Published: March 2021

Background

Increasingly, social media is a source for information about health and disease self-management. We conducted a content analysis of promotional asthma-related posts on Instagram to understand whether promoted products and services are consistent with the recommendations found in the Global Initiative for Asthma (GINA) 2019 guidelines.

Methods

We collected every Instagram post incorporating a common, asthma-related hashtag between September 29, 2019 and October 5, 2019. Of these 2936 collected posts, we analyzed a random sample of 266, of which, 211 met our inclusion criteria. Using an inductive, qualitative approach, we categorized the promotional posts and compared each post’s content with the recommendations contained in the 2019 GINA guidelines. Posts were categorized as “consistent with GINA” if the content was supported by the GINA guidelines. Posts that promoted content that was not recommended by or was unrelated to the guidelines were categorized as “not supported by GINA”.

Results

Of 211 posts, 89 (42.2%) were promotional in nature. Of these, a total of 29 (32.6%) were categorized as being consistent with GINA guidelines. The majority of posts were not supported by the guidelines. Forty-one (46.1%) posts promoted content that was not recommended by the current guidelines. Nineteen (21.3%) posts promoted content that was unrelated to the guidelines. The majority of unsupported content promoted non-pharmacological therapies (n = 39, 65%) to manage asthma, such as black seed oil, salt-room therapy, or cupping.

Conclusions

The majority of Instagram posts in our sample promoted products or services that were not supported by GINA guidelines. These findings suggest a need for providers to discuss online health information with patients and highlight an opportunity for providers and social media companies to promote evidence-based asthma treatments and self-management advice online.
New clinical algorithm including fungal biomarkers to better diagnose probable invasive pulmonary aspergillosis in ICU
Authors:   Collaborative RESSIF group, Hamam Joffrey , Navellou Jean-Christophe , Bellanger Anne-Pauline , Bretagne Stéphane , Winiszewski Hadrien , Scherer Emeline , Piton Gael , Millon Laurence
Published: March 2021

Background

The classification of invasive pulmonary aspergillosis (IPA) issued by the European Organization for the Research and Treatment of Cancer/Mycoses Study Group Education and Research Consortium (EORTC/MSGERC) is used for immunocompromised patients. An alternative algorithm adapted to the intensive care unit (ICU) population has been proposed (AspICU), but this algorithm did not include microbial biomarkers such as the galactomannan antigen and the Aspergillus quantitative PCR. The objective of the present pilot study was to evaluate a new algorithm that includes fungal biomarkers (BM-AspICU) for the diagnosis of probable IPA in an ICU population.

Patients and methods

Data from 35 patients with pathology-proven IPA according to European Organization for the Research and Treatment of Cancer/Mycosis Study Group (EORTC/MSGERC)-2008 criteria were extracted from the French multicenter database of the Invasive Fungal Infections Surveillance Network (RESSIF). The patients were investigated according to the AspICU algorithm, and the BM-AspICU algorithm in analyzing the clinical, imaging, and biomarker data available in the records, without taking into account the pathology findings.

Results

Eight patients had to be excluded because no imaging data were recorded in the database. Among the 27 proven IPAs with complete data, 16 would have been considered as putative IPA with the AspICU algorithm and 24 would have been considered as probable IPA using the new algorithm BM-AspICU. Seven out of the 8 patients with probable BM-AspICU IPA (and not classified with the AspICU algorithm) had no host factors and no Aspergillus-positive broncho-alveolar lavage fluid (BALF) culture. Three patients were non-classifiable with any of the two algorithms, because they did not have any microbial criteria during the course of the infection, and diagnosis of proven aspergillosis was done using autopsy samples.

Conclusion

Inclusion of biomarkers could be effective to identify probable IPA in the ICU population. A prospective study is needed to validate the routine application of the BM-AspICU algorithm in the ICU population.
Structural stability for the Boussinesq equations interfacing with Darcy equations in a bounded domain
Authors: Li Yuanfei , Zhang Shuanghu , Lin Changhao
Published: March 2021

A priori bounds were derived for the flow in a bounded domain for the viscous-porous interfacing fluids. We assumed that the viscous fluid was slow in$\Omega _{1}$Ω1, which was governed by the Boussinesq equations. For a porous medium in$\Omega _{2}$Ω2, we supposed that the flow satisfied the Darcy equations. With the aid of these a priori bounds we were able to demonstrate the result of the continuous dependence type for the Boussinesq coefficientλ. Following the method of a first-order differential inequality, we can further obtain the result that the solution depends continuously on the interface boundary coefficientα. These results showed that the structural stability is valid for the interfacing problem.
Measuring circularity: an application of modified Material Circularity Indicator to agricultural systems
Authors: Rocchi L. , Paolotti L. , Cortina C. , Fagioli F. F. , Boggia A.
Published: March 2021

The transition from a linear to a circular economy is a research trend topic, as well as the possibility to measure the degree of circularity of products and systems. In a linear economy, raw materials are taken from nature and transformed into final products, which are subsequently used and become waste. On the contrary, a circular economy is an economic model that is restorative by intent and design. To measure the degree of circularity is fundamental for understanding processes and improving them. Moreover, this kind of measure could be useful for driving policies on the topic and achieving a higher level of sustainability. Until now, only few studies have been focusing on how to effectively measure the circularity level of a product, a supply chain, or a service. Moreover, in the circular economy paradigm, there are two types of cycles: the technical and biological ones. Biological cycles are mainly connected to the agricultural sector, and for this kind of cycle, the lack of measurement is even bigger. However, some agricultural productions, such as intensive meat production processes, have basically a linear structure. Intensive broiler production, for instance, uses a quite high rate of inputs, which is not entirely converted into edible products but instead results in a percentage of wasteful outputs. The aim of this work is to propose a modification of one of the few available tools for measuring the circularity, the Material Circularity Indicator (MCI), for adapting it to biological cycles. The modified MCI was applied to the poultry sector, integrating the results with the Life Cycle Assessment methodology.
Umbralisib, a Dual PI3Kδ/CK1ε Inhibitor in Patients With Relapsed or Refractory Indolent Lymphoma
Authors: Fowler Nathan H. , Samaniego Felipe , Jurczak Wojciech , Ghosh Nilanjan , Derenzini Enrico , Reeves James A. , Knopińska-Posłuszny Wanda , Cheah Chan Y. , Phillips Tycel , Lech-Maranda Ewa , Cheson Bruce D. , Caimi Paolo F. , Grosicki Sebastian , Leslie Lori A. , Chavez Julio C. , Fonseca Gustavo , Babu Sunil , Hodson Daniel J. , Shao Spencer H. , Burke John M. , Sharman Jeff P. , Law Jennie Y. , Pagel John M. , Miskin Hari P. , Sportelli Peter , O'Connor Owen A. , Weiss Michael S. , Zinzani Pier Luigi
Published: March 2021

PURPOSE

Phosphatidylinositol-3-kinase (PI3K) inhibitors have shown activity in relapsed or refractory (R/R) indolent non-Hodgkin lymphoma (iNHL). PI3K inhibitors have been hampered by poor long-term tolerability and toxicity, which interfere with continuous use. Umbralisib, a dual inhibitor of PI3Kδ/casein kinase-1ε, exhibits improved selectivity for PI3Kδ compared with other PI3K inhibitors. This phase IIb trial was designed to evaluate the efficacy and safety of umbralisib in patients with R/R iNHL.

PATIENTS AND METHODS

In this multicohort, open-label, phase IIb study, 208 patients with R/R marginal zone, follicular, or small lymphocytic lymphoma (MZL, FL, or SLL) unresponsive to prior treatments (≥ 1 MZL; ≥ 2 FL/SLL), including ≥ 1 anti-CD20–based therapy, were administered umbralisib 800 mg orally once daily until disease progression, unacceptable toxicity, or study withdrawal. Primary end point is overall response rate; secondary end points include time to response, duration of response, progression-free survival, and safety.

RESULTS

The median follow-up is 27.7 months (efficacy) and 21.4 months (safety). The overall response rate was 47.1%, and tumor reduction occurred in 86.4% of patients. The median time to response was 2.7-4.6 months. The median duration of response was not reached for MZL, 11.1 months for FL, and 18.3 months for SLL. Median progression-free survival was not reached for MZL, 10.6 months for FL, and 20.9 months for SLL. At least one grade ≥ 3 treatment-emergent adverse event (TEAE) was reported in 53.4% of patients. TEAEs led to umbralisib discontinuation in 32 patients (15.4%). A total of 31 patients (14.9%) discontinued because of a treatment-related adverse event. Grade ≥ 3 TEAEs reported in ≥ 10% of patients: neutropenia (11.5%) and diarrhea (10.1%). Increased ALT/AST (grade ≥ 3) occurred in 6.7%/7.2% of patients.

CONCLUSION

Umbralisib achieved meaningful clinical activity in heavily pretreated patients with iNHL. The safety profile was manageable, with a relatively low incidence of immune-mediated toxicities and adverse event–related discontinuations.
Computed Tomography Scan Evidence of Bronchospasm and Its Resolution During Computed Tomography Coronary Angiogram in a Child With Kawasaki Disease: A Case Report
Authors: Munaf Mamatha , Gadhinglajkar Shrinivas , Dash Prasanta K. , A. Jagadish
Published: March 2021

Bronchospasm in children is common; however, due to its sudden nature, radiographic correlation is uncommon. We planned a computed tomography (CT) coronary angiogram for a 5-year-old child for evaluation of Kawasaki disease. The child started to desaturate during the CT scanning after intravenous contrast injection under conscious sedation. CT scan documented spasm of trachea and bronchi, as well as crowding of ribs and elevated diaphragm during the event. Repeat CT scan documented well-aerated lung fields. The development of acute bronchospasm under anesthesia results in definite changes in the CT scan of the thoracic cavity as evidenced by this incident.
Intraoperative Management of a Child Undergoing Cardiac Surgery With Congenital Methemoglobinemia Detected in the Operating Room: A Case Report
Authors: Bhaskar Pradeep , Rehman Saif , Lone Reyaz A. , John Jiju , Sahabudheen Aslam Faris A.
Published: March 2021

Congenital methemoglobinemia is a rare disease that is easily overlooked in its mild form. It can lead to tissue hypoxia as methemoglobin does not possess oxygen-carrying capacity. Its management approach depends on the severity of the symptoms, methemoglobin level, and associated medical conditions. The perioperative management of congenital methemoglobinemia is well described in the literature; however, its management in children with congenital heart disease and undergoing cardiac surgery using cardiopulmonary bypass has not been reported. We present a case and its management where congenital methemoglobinemia was detected in the operating room in a child scheduled for cardiac surgery.
Potential Patent Blue V Overdose in a Patient Undergoing Free-Flap Breast Reconstruction: A Case Report
Authors: Wu Aihua
Published: March 2021

The case of a patient who experienced serious adverse effects following a potential overdose of Patent Blue V dye (PVB) is presented here. A 65-year-old woman developed cardiac arrythmias and circulatory instability 35 minutes after receiving 100 mg PVB during breast cancer surgery. An allergic reaction was assumed and treated accordingly. Intraoperatively, both epinephrine and norepinephrine infusions were required to support circulation. However, mast-cell tryptase levels were normal and subsequent allergy testing for all potential allergens was negative. This case highlights that life-threatening reactions to perioperative PVB should not always be attributed to anaphylaxis; systemic toxicity could occur with an overdose.
Economic Inequality in Preindustrial Times: Europe and Beyond
Authors: Alfani Guido
Published: March 2021

Recent literature has reconstructed estimates of wealth and income inequality for a range of preindustrial, mostly European, societies covering medieval and early modern times, occasionally reaching back to antiquity and even prehistory. These estimates have radically improved our knowledge of distributive dynamics in the past. It now seems clear that in the period circa 1300–1800, inequality of both income and wealth grew almost monotonically almost everywhere in Europe, with the exception of the century-long phase of inequality decline triggered by the Black Death of 1347–52. Regarding the causes of inequality growth, recent literature ruled out economic growth as the main one. Other possible factors include population growth (also as mediated by inheritance systems) and especially regressive fiscal institutions (also as connected to the unequal distribution of political power). The recently proposed theoretical framework of the inequality possibility frontier (IPF) lends a better understanding of the implications of the reconstructed trends. This article concludes by showing how connecting preindustrial trends to modern ones changes our perception of long-term inequality altogether. (JEL D31, D63, N33)
Capital Controls: Theory and Evidence
Authors: Erten Bilge , Korinek Anton , Ocampo José Antonio
Published: March 2021

This paper synthesizes recent advances in the theoretical and empirical literature on capital controls. We start by observing that international capital flows have both benefits and costs, but some of these are not internalized by individual actors and thus constitute externalities. The theoretical literature has identified pecuniary externalities and aggregate demand externalities that respectively contribute to financial instability and recessions. These externalities provide a natural rationale for countercyclical capital controls that lean against boom and bust cycles in international capital flows. The empirical literature has developed several measures of capital controls to capture different aspects of capital account openness. We evaluate the strengths and weaknesses of different measures and provide an overview of the empirical findings on the effectiveness of capital controls in addressing the externalities identified by the theory literature, that is, in reducing financial fragility and enhancing macroeconomic stability. We also discuss strategies to deal with the endogeneity of capital controls in such statistical exercises. We conclude by providing an overview of the historical and current debates on the role of capital controls in macroeconomic management and their relationship to the academic literature. (JEL D62, F32, F33, F38, F44)
Comparison of machine learning methods for prediction of osteoradionecrosis incidence in patients with head and neck cancer
Authors: Humbert-Vidan Laia , Patel Vinod , Oksuz Ilkay , King Andrew Peter , Guerrero Urbano Teresa
Published: March 2021

Objectives:

Mandible osteoradionecrosis (ORN) is one of the most severe toxicities in patients with head and neck cancer (HNC) undergoing radiotherapy (RT). The existing literature focuses on the correlation of mandible ORN and clinical and dosimetric factors. This study proposes the use of machine learning (ML) methods as prediction models for mandible ORN incidence.

Methods:

A total of 96 patients (ORN incidence ratio of 1:1) treated between 2011 and 2015 were selected from the local HNC toxicity database. Demographic, clinical and dosimetric data (based on the mandible dose–volume histogram) were considered as model variables. Prediction accuracy (measured using a stratified fivefold nested cross-validation), sensitivity, specificity, precision and negative predictive value were used to evaluate the prediction performance of a multivariate logistic regression (LR) model, a support vector machine (SVM) model, a random forest (RF) model, an adaptive boosting (AdaBoost) model and an artificial neural network (ANN) model. The different models were compared based on their prediction accuracy and using the McNemar’s hypothesis test.

Results:

The ANN model (77% accuracy), closely followed by the SVM (76%), AdaBoost (75%) and LR (75%) models, showed the highest overall prediction accuracy. The RF model (71%) showed the lowest prediction accuracy. However, based on the McNemar’s test applied to all model pair combinations, no statistically significant difference between the models was found.

Conclusion:

Based on our results, we encourage the use of ML-based prediction models for ORN incidence as has already been done for other HNC toxicity end points.

Advances in knowledge:

This research opens a new path towards personalised RT for HNC using ML to predict mandible ORN incidence.