bluuebunny/crossref_metadata_2025 huggingface dataset:
Law enforcement investigation of non-sexual child abuse: Physical abuse, neglect and Abusive Head Trauma
Authors: Shaffer Sarah , Compo Nadja Schreiber , Klemfuss J Zoe , Peplak Joanna , Mejias Julio
Published: April 2021

This study examined the experiences of law enforcement in investigating physical abuse, neglect and Abusive Head Trauma (AHT). Law enforcement ( N = 388) in the United States were surveyed regarding case characteristics, investigative strategy, interrogative approaches, frequency/content of perpetrator admissions and interagency interaction across cases of physical abuse, neglect and AHT. Results revealed that exposure rates matched those of national statistics. AHT perpetrators reported to admit guilt less often than suspects of physical abuse and neglect. Participants reported that suspects explain physical abuse and AHT by referencing poor self-control as a common cause. Lack of financial resources was commonly reported as the explanation for neglect. Potentially coercive interviewing techniques were reported across abuse types but were more frequent in cases of AHT. AHT cases were reportedly hardest to prove/prosecute partially due to conflicting medical diagnoses. Potential implications for law enforcement investigative (interviewing) policies and future research are discussed.
Ethical dimensions in randomized trials and off-label use of investigational drugs for COVID-19 treatment
Authors: Dhupkar Pooja , Mukherjee Seema
Published: April 2021

Coronavirus disease 2019 (COVID-19) is a fast-developing viral pandemic spreading across the globe. Due to lack of availability of proven medicines against COVID-19, physicians have resorted to treatments through large trials of investigational drugs with poor evidence or those used for similar diseases. Large trials randomize 100–500+ patients at multiple hospitals in different countries to either receive these drugs or standard treatment. In order to expedite the process, some regulatory agencies had also given permission to use drugs approved for other diseases, despite a lack of evidence of efficacy in COVID-19. In this review, we highlight the potential ethical issues that should be addressed during the use of investigational drugs with little prior evidence as a treatment options during a pandemic. We discuss the impact of design of randomized clinical trials using LOTUS trial as an example and that of off-label use of drugs like chloroquine/hydroxychloroquine (CQ/HQ) on the safety of patients during COVID-19. We conclude that the adaptive randomized clinical trial designs offer a flexible and efficient approach, enabling patients to quickly switch to successful treatments, while minimizing the number of patients on standard of care. Randomized clinical trial design should consider blinding of investigators and only representative patients who can provide consent should be included. We also conclude the emergency approvals of drugs should be carefully issued and off-label use should be restricted in pandemics. Streamlined regulatory guidelines for emergency drug use in a pandemic can also help in providing benefit and minimizing harm to patients in the future.
Leadership During Crisis: An Examination of Supervisory Leadership Behavior and Gender During COVID-19
Authors: Eichenauer Connor J. , Ryan Ann Marie , Alanis Jo M.
Published: April 2021

Due to major work disruptions caused by the coronavirus (COVID-19) pandemic, supervisors in organizations are facing leadership challenges as they attempt to manage “work from home” arrangements, the health and safety of essential workers, and workforce reductions. Accordingly, the present research seeks to understand what types of leadership employees think is most important for supervisors to exhibit when managing these crisis-related contexts and, in light of assertions that women may be better leaders during times of crisis, examines gender differences in how male and female supervisors act and how subordinates perceive and evaluate them in real (Study 1) and hypothetical (Study 2) settings. Results indicate that communal leader behaviors were more important to employees in all three crisis contexts. In Study 1, communality was a stronger predictor than agency of supervisor likability and competence. In Study 2, communality was also more positively related to likability, but agency and communality were equally predictive of competence ratings. Ratings of real supervisors suggest that women were not more communal than men when managing these crises, nor did perceptions of leader behavior differ by supervisor gender in a controlled experiment. However, evaluations of women's competence were more directly related to their display of communal behaviors than were evaluations of male supervisors. This research is helpful practically in understanding effective supervisory leadership during the COVID-19 crisis and contributes to the literature on gender and leadership in crisis contexts by attempting to disentangle gender differences in leader behaviors, perceptions, and evaluations.
“You Cannot Catch Fish Near the Shore nor Can You Sell Fish Where There Are No Customers”: Rethinking Approaches for Reaching Men With HIV Testing Services in Blantyre Malawi
Authors: Nyondo-Mipando Alinane Linda , Kumwenda Mphatso , Suwedi- Kapesa Leticia Chimwemwe , Salimu Sangwani , Kazuma Thokozani , Mwapasa Victor
Published: April 2021

HIV testing is the entry point to the cascade of services within HIV care. Although Malawi has made positive strides in HIV testing, men are lagging at 65.5% while women are at 81.6%. This study explored the preferences of men on the avenues for HIV testing in Blantyre, Malawi. This was a descriptive qualitative study in the phenomenological tradition in seven public health facilities in Blantyre, Malawi, among men and health-care workers (HCWs). We conducted 20 in-depth interviews and held 14 focus group discussions among 113 men of varying HIV statuses. All our participants were purposively selected, and data were digitally recorded coded and managed through NVivo. Thematic analysis was guided by the differentiated service delivery model. Men reported a preference for formal and informal workplaces such as markets and other casual employment sites; social places like football pitches, bars, churches, and “bawo” spaces; and outreach services in the form of weekend door-to-door, mobile clinics, men-to-men group. The health facility was the least preferred avenue. The key to testing men for HIV is finding them where they are. Areas that can be leveraged in reaching men are outside the routine health system. Scaling up HIV testing among men will require targeting avenues and operations outside of the routine health system and leverage them to reach more men with services. This suggests that HIV testing and counseling (HTC) uptake among men may be increased if the services were provided at informal places.
Resistance-strain sensitive rubber composites filled by multiwalled carbon nanotubes for structuraldeformation monitoring
Authors: Liu Xingyao , Guo Rongxin , Lin Zhiwei , Yang Yang , Xia Haiting , Yao Zheng
Published: April 2021

In this article, multiwalled carbon nanotube/natural rubber composites with resistance-strain sensitivity were prepared by solution method, when the electrical percolation threshold of multiwalled carbon nanotube is only ∼3.5 wt%. The mechanical properties and resistance-strain response sensitivity were studied and analyzed systematically. The dispersion of multiwalled carbon nanotubes in the natural rubber matrix was characterized by field-emission scanning electron microscope and X-ray diffractometer. The composite exhibits good deformation sensitivity (gauge factor >27), large strain sensing range (>200%), and high signal stability when multiwalled carbon nanotube content was appropriate. The composite is suited to application in strain monitoring of large deformation structures since the resistance-strain response is more stable when strain exceeds 100%. To understand the mechanism of the resistance-strain response, the ‘shoulder peak’ of resistance-strain curve was researched and explained by the digital image correlation method, and an analytical model was developed when considering the effects of electronic tunneling and hopping in multiwalled carbon nanotube networks. Both experiment and analytical results confirm the break-restructure process of multiwalled carbon nanotube networks under applied strain cause the resistance-strain response. Finally, the practical application of the composite to monitoring strain load of rubber isolation bearing was realized.
Focus and features of prescribing indications spanning multiple chronic conditions in older adults: A narrative review
Authors: Aubert Carole E , Kerr Eve A , Klamerus Mandi L , Hofer Timothy P , Wei Melissa Y
Published: April 2021

Background:

Inappropriate prescribing is frequent in older adults and associated with adverse outcomes. Prescribing indications aim to optimize prescribing, but little is known about the focus and features of prescribing indications for the most common chronic conditions in older adults. Understanding the conditions, medications, and issues addressed (e.g., patient perspective, drug-disease interaction, adverse drug event) in current prescribing indications may help to identify missing indications and develop standardized measures to improve prescribing quality.

Methods:

We searched Ovid/MEDLINE and EMBASE for articles published between 2015 and 2020 reporting prescribing indications for older adults. Prescribing indication included 1) prescribing “criteria,” or statements that guide prescribing action, and 2) prescribing “measures,” or prescribing actions observed in a population. We categorized their focus by conditions, medications and issues addressed, as well as level of evidence provided.

Results:

Among 16 sets of prescribing indications, we identified 748 criteria and 47 measures. The most common addressed medications were antihypertensives, analgesics/antirheumatics, and antiplatelets/anticoagulants. The most frequently addressed issues were drug-disease interaction, adverse drug event, administration, better therapeutic alternative, and (co-)prescription omission (20.8–36.1%). Age/functioning, drug-drug interaction, monitoring, and efficacy/safety ratio were found in only 9.9–16.5% of indications. Indications rarely focused on the patient perspective or issues with multiple providers.

Conclusion:

Most prescribing indications for chronic conditions in older patients are criteria rather than measures. Indications accounting for patient perspective and multiple providers are limited. The gaps identified in this review may help improve the development of prescribing measures for older adults and ultimately improve quality of care.
Novel manifestations of Warburg micro syndrome type 1 caused by a new splicing variant of RAB3GAP1: a case report
Authors: Khalesi Raziyeh , Razmara Ehsan , Asgaritarghi Golareh , Tavasoli Ali Reza , Riazalhosseini Yasser , Auld Daniel , Garshasbi Masoud
Published: April 2021

Background

The present study aimed to determine the underlying genetic factors causing the possible Warburg micro syndrome (WARBM) phenotype in two Iranian patients.

Case presentation

A 5-year-old female and a 4.5-year-old male were referred due to microcephaly, global developmental delay, and dysmorphic features. After doing neuroimaging and clinical examinations, due to the heterogeneity of neurodevelopmental disorders, we subjected 7 family members to whole-exome sequencing. Three candidate variants were confirmed by Sanger sequencing and allele frequency of each variant was also determined in 300 healthy ethnically matched people using the tetra-primer amplification refractory mutation system-PCR and PCR-restriction fragment length polymorphism. To show the splicing effects, reverse transcription-PCR (RT-PCR) and RT-qPCR were performed, followed by Sanger sequencing. A novel homozygous variant—NM_012233.2: c.151-5 T > G; p.(Gly51IlefsTer15)—in the RAB3GAP1 gene was identified as the most likely disease-causing variant. RT-PCR/RT-qPCR showed that this variant can activate a cryptic site of splicing in intron 3, changing the splicing and gene expression processes. We also identified some novel manifestations in association with WARBM type 1 to touch upon abnormal philtrum, prominent antitragus, downturned corners of the mouth, malaligned teeth, scrotal hypoplasia, low anterior hairline, hypertrichosis of upper back, spastic diplegia to quadriplegia, and cerebral white matter signal changes.

Conclusions

Due to the common phenotypes between WARBMs and Martsolf syndrome (MIM: 212720), we suggest using the “RABopathies” term that can in turn cover a broad range of manifestations. This study can per se increase the genotype-phenotype spectrum of WARBM type 1.
Simulation training program for vacuum application to improve technical skills in vacuum-assisted vaginal delivery
Authors: Mannella Paolo , Giordano Mario , Guevara Maria Magdalena Montt , Giannini Andrea , Russo Eleonora , Pancetti Federica , Caretto Marta , Simoncini Tommaso
Published: April 2021

Objective

evaluation of technical skills of the operators during the obstetrical device application for operative vaginal delivery, named kiwi-cup in a simulation training program.

Methods

Thirty-five residents in obstetrics and gynecology of the University of Pisa, Italy were recruited and evaluated with an assessment scale on technical skills from 0 to 55 points. They performed various operative vaginal delivery simulations with kiwi-cup and were evaluated at time 0 by a tutor. After 8 weeks, simulation training was repeated and trainees were re-evaluated by the same tutor.

Results

after 8 weeks from the first simulation session, trainees have been shown to increase technical skills (46.27 ± 4.6 withp-value < 0.0001), the successful application rate (85.71% withp-value 0.0161).) and to reduce the time to complete the procedure (86.2 ± 29.9 s withp-value < 0.0001).

Conclusion

simulation training on operational vaginal delivery significantly increases technical skills, improves successful rate, and reduces the time taken to complete the procedure.

Clinical trial registration

Not applicable.
Agitation and apathy increase risk of dementia in psychiatric inpatients with late-onset psychiatric symptoms
Authors: Shao Yuan , Xu Haiyun , Wang Jian , Dai Xijian , Liang Wei , Ren Lina , Wang Yongjun
Published: April 2021

Background

A diagnosis of dementia in middle-aged and elder people is often complicated by physical frailty and comorbid neuropsychiatric symptoms (NPSs). Previous studies have identified NPSs as a risk factor for dementia. The aim of this study was to figure out to what extent individual NPS and certain demographic factors increased the risk of dementia in middle-aged and senior psychiatric inpatients.

Methods

One hundred twenty-seven middle-aged and senior patients admitted to psychiatric wards for late-onset (age ≥ 50 years) psychiatric symptoms were included and categorized into dementia or non-demented psychiatric disorders (NDPD). The patients’ demographic information and medical records were collected during the first hospitalization and subjected to statistical analyses.

Results

41.73% of the registered psychiatric inpatients were diagnosed as dementia in which Alzheimer’s disease (AD) was the dominant subtype. The NDPD group consisted of nine individual diagnoses, except for schizophrenia. The frequencies of dementia inpatients increased with first episode age while that of NDPD inpatients decreased with first episode age. In the enrolled inpatients, most of dementia patients were males while females accounted for a higher proportion of NDPD patients. 58.49% of enrolled dementia inpatients presented cognitive deficit (CD) as the initial symptom while the remaining 41.51% showed NPS as initial symptom. Of the 12 NPSs, agitation and apathy greatly and significantly increased risk of dementia in psychiatric inpatients with late-onset psychiatric symptoms.

Conclusions

These results added evidence that the demented patients admitted to psychiatric ward are more likely to be male, older first episode age, and have characteristic NPS including aberrant motor behavior (AMB), hallucinations, agitation, irritability and apathy. Further, this study emphasized the importance of agitation and apathy of NPSs functioning as risk factors of dementia in these inpatients.
Assessment of depression, anxiety and stress levels in the Ecuadorian general population during social isolation due to the COVID-19 outbreak: a cross-sectional study
Authors: Mautong Hans , Gallardo-Rumbea Jorge Andrés , Alvarado-Villa Geovanny Efraín , Fernández-Cadena Juan Carlos , Andrade-Molina Derly , Orellana-Román Carlos Enrique , Cherrez-Ojeda Iván
Published: April 2021

Background

Coronavirus disease 2019 (COVID-19) has become a global pandemic with serious consequences that have led to the implementation of unprecedented social isolation measures. At the early stages of the pandemic, Ecuador was one of the most affected countries in Latin America. The objective of this study was to assess the levels of depression, anxiety and stress in the Ecuadorian general population during the social isolation period due to COVID-19.

Methods

A web-based survey consisting of 31 short-answer and multiple-choice questions was administered to the general population from April 22–May 3, 2020. Mental health status was assessed through the Depression, Anxiety and Stress Scale-21 Items (DASS-21) questionnaire. Ordinal logistic analyses were used to identify potential risk factors associated with the severity of mental health issues.

Results

A total of 626 individuals were included. Most of them were females (60.5%), and their mean age was 29.6 ± 11.7 years. Approximately 17.7% of the respondents had moderate to very severe levels of depression, 30.7% had similar levels of anxiety, and 14.2% experienced stress. Female sex, younger age, student status, and having a relative diagnosed with COVID-19 were associated with significantly higher levels of depression, anxiety and stress. Ordinal regression models showed that being a student was a risk factor for having more severe levels of depression (OR = 3.67; 95% CI = 2.56–5.26, p: 0.0001), anxiety (OR= 1.86; 95% CI= 1.35–2.55, p: 0.0001), and stress (OR = 2.17; 95% CI= 1.47–3.19, p: 0.0001). Having a relative with COVID-19 was also found to be a risk factor only for depression (OR= 1.70; 95% CI= 1.03–2.80, p: 0.036) and anxiety (OR = 2.17; 95% CI= 1.35–3.47, p: 0.001). Additionally, male sex,  older age, and having more children were found to be protective factors for the three conditions.

Conclusions

Our findings suggest that social isolation due to the COVID-19 outbreak has impacted the mental health of the general population in Ecuador. We identified potential risk and protective factors that could serve as a foundation from which to develop psychological strategies to safeguard the mental health of our population during the current pandemic.
Immediate psychological outcomes associated with COVID-19 pandemic in frontline physicians: a cross-sectional study in Egypt
Authors: Abu-Elenin Mira Maged
Published: April 2021

Background

The mental health of frontline healthcare workers is influenced by the crisis of the COVID-19 pandemic. This adversely affects their clinical performance and productivity. Therefore, it is important to recognize levels of anxiety, depression and identify the contributing factors.

Methods

A cross-sectional study recruited physicians working at frontline positions in university teaching and isolation hospitals in the Mid Delta Region of Egypt from April to May 2020. Data was collected through an electronic online survey. Anxiety and depression levels were assessed using General Anxiety Disorder-7 and Patient Health Questionnaire − 9 respectively.

Results

The study included 237 physicians, their mean age was 38.2 ± 6.2 years and 58% of them were males. Overall, 78.9% and 43.8% of all participated physicians reported symptoms of anxiety and depression. 85% of respondents had children with a significant increase in the risk of anxiety (OR = 20.2). This study revealed that poor sleep quality, being a resident physician, disrupted social life, and stigma exposure due to COVID-19, were significant mediating factors for the observed anxiety (OR = 0.53,3.28,0.18,1.56 respectively) and depressive symptoms (OR = 0.51,1.39,0.56,1.9 respectively). However, working in isolation hospitals wasn’t a significant contributing factor.

Conclusion

The frontline physicians experienced a high rate of mental symptoms during the COVID-19 pandemic. That requires prompt intervention, taking into consideration the underlying determinants.
From glucose lowering agents to disease/diabetes modifying drugs: a “SIMPLE” approach for the treatment of type 2 diabetes
Authors: Mosenzon Ofri , Del Prato Stefano , Schechter Meir , Leiter Lawrence A. , Ceriello Antonio , DeFronzo Ralph A. , Raz Itamar
Published: April 2021

During the last decade we experienced a surge in the number of glucose lowering agents that can be used to treat patients with type 2 diabetes. Especially important are the discoveries that sodium glucose co-transporter type 2 inhibitors (SGLT2i) and glucagon-like peptide-1 receptor agonists (GLP-1 RA) improve patients’ cardiovascular and renal outcomes. Accordingly, various medical associations have updated their guidelines for the treatment of diabetes in this new era. Though not agreeing on every issue, these position-statements generally share a detailed and often complex workflow that may be too complicated for the busy and overworked primary care setting, where the majority of patients with type 2 diabetes are managed in many countries. Other guidelines, generally those from the cardiology associations focus primarily on the population of patients with high risk for or pre-existing cardiovascular disease, which represent only the minority of patients with type 2 diabetes. We believe that we should re-define SGLT2i and GLP-1 RA as diabetes/disease modifying drugs (DMDs) given the recent evidence of their cardiovascular and renal benefits. Based on this definition we have designed a SIMPLE approach in order to assist primary care teams in selecting the most appropriate therapy for their patients. We believe that most subjects newly diagnosed with type 2 diabetes should initiate early combination therapy with metformin and a prognosis changing DMD. The decision whether to use GLP-1 RA or SGLT2i should be made based on specific patient’s risk factors and preferences. Importantly, DMDs are known to have a generally safe side-effect profile, with lower risk for hypoglycemia and weight gain, further promoting their wider usage. Early combination therapy with DMDs may improve the multiple pathophysiological abnormalities responsible for type 2 diabetes and its complications, thus resulting in the greatest long term benefits.
Impact of the N501Y substitution of SARS-CoV-2 Spike on neutralizing monoclonal antibodies targeting diverse epitopes
Authors: Cheng Lin , Song Shuo , Zhou Bing , Ge Xiangyang , Yu Jiazhen , Zhang Mingxia , Ju Bin , Zhang Zheng
Published: April 2021

The emergence and rapid spread of the B.1.1.7 lineage (VOC-202012/01) SARS-CoV-2 variant has aroused global concern. The N501Y substitution is the only mutation in the interface between the RBD of B.1.1.7 and ACE2, raising concerns that its recognition by neutralizing antibodies may be affected. Here, we assessed the neutralizing activity and binding affinity of a panel of 12 monoclonal antibodies against the wild type and N501Y mutant SARS-CoV-2 pseudovirus and RBD protein, respectively. We found that the neutralization activity and binding affinity of most detected antibodies (10 out of 12) were unaffected, although the N501Y substitution decreased the neutralizing and binding activities of CB6 and increased that of BD-23. These findings could be of value in the development of therapeutic antibodies.
Computer vision-based wood identification and its expansion and contribution potentials in wood science: A review
Authors: Hwang Sung-Wook , Sugiyama Junji
Published: April 2021

The remarkable developments in computer vision and machine learning have changed the methodologies of many scientific disciplines. They have also created a new research field in wood science called computer vision-based wood identification, which is making steady progress towards the goal of building automated wood identification systems to meet the needs of the wood industry and market. Nevertheless, computer vision-based wood identification is still only a small area in wood science and is still unfamiliar to many wood anatomists. To familiarize wood scientists with the artificial intelligence-assisted wood anatomy and engineering methods, we have reviewed the published mainstream studies that used or developed machine learning procedures. This review could help researchers understand computer vision and machine learning techniques for wood identification and choose appropriate techniques or strategies for their study objectives in wood science.
Pressure Relieving Support Surfaces: a Randomised Evaluation 2 (PRESSURE 2): using photography for blinded central endpoint review
Authors:   on behalf of the PRESSURE 2 Trial Group, McGinnis Elizabeth , Smith Isabelle L , Collier Howard , Wilson Lyn , Coleman Susanne , Stubbs Nikki , Brown Sarah , Gilberts Rachael , Henderson Valerie , Walker Kay , Nelson E. Andrea , Nixon Jane
Published: April 2021

Background

PRESSURE 2 is a randomised evaluation of the clinical and cost-effectiveness of two types of mattress for the prevention of pressure ulcers (PUs). The primary clinical endpoint was time to development of a category ≥2 PU. The current ‘gold standard’ for PU identification is expert clinical assessment. Due to the mattress appearance, a blinded assessment of the endpoint is not possible. This poses a risk to the internal validity of the study. A possible approach is to use photographs of skin sites, with central blinded review. However, there are practical and scientific concerns including patients’ consent to photographs, burden of data collection, photograph quality, data completeness and comparison of photographs to the current ‘gold standard’. This paper reports the findings of the PRESSURE 2 photographic validation sub-study.

Method

Where consent was obtained, photographs were taken of all category ≥2 PUs on the first presentation to assess over-reporting, and for the assessment of under-reporting, a random sample of 10% patients had an assessment by an independent clinical assessor who also photographed two skin sites. The staff were trained in taking and transferring photographs using standardised procedures and equipment. A card included in the photograph recorded participant details and a ‘greyscale’ for correction of white balance during processing. Three blinded reviewers assessed the photographs and rated how confident they were in their assessment.

Results

The trial recruited 2029 patients; 85% consented to photography, and 532 photographs were received and used in the blinded central review. The level of confidence varied by skin classification with more confidence observed when the skin was assessed as being less severe than a category ≥2 PU. Overall, there was a very good reliability compared to the gold standard expert clinical assessment (87.8%, kappa 0.82).

Conclusion

Study findings have usefully informed the scientific and practical issues of blinded assessment of PU status to reducing the risk of bias in medical device trials. The reliability of central blinded expert photography was found to be ‘very good’ (PABAK). Photographs have been found to be an acceptable method of data validation for participants. Methods to improve the quality of photographs would increase the confidence in the assessments.

Trial registration

ISRCTN Registry ISRCTN01151335. Registered on 19 April 2013
Effect of solid loading on the behaviour of pectin-degrading enzymes
Authors: Li Fan , Foucat Loïc , Bonnin Estelle
Published: April 2021

Background

Pectin plays a role in the recalcitrance of plant biomass by affecting the accessibility of other cell wall components to enzymatic degradation. Elimination of pectin consequently has a positive impact on the saccharification of pectin-rich biomass. This work thus focused on the behaviour of different pectin-degrading enzymes in the presence of low (5%) to high (35%) solid loading of lemon peel.

Results

High solid loading of lemon peel affected pectin solubilisation differently depending on the pectinase used. Pectin lyase was less sensitive to a reduction of water content than was a mixture of endopolygalacturonase and pectin methylesterase, regardless of whether or not the latter's mode of action is processive or not. Marked changes in water mobility were observed along with enzymatic degradation depending on the enzyme used. However, the pectin lyase resulted in less pronounced shifts in water distribution than polygalacturonase–pectin methylesterase mixtures. At similar pectin concentration, pectin solutions hindered the diffusion of hydrolases more than the solid substrate. This can be attributed to the high viscosity of the highly concentrated pectin solutions while the solid substrate may provide continuous diffusion paths through pores.

Conclusions

The increase in solid substrate loading reduced the efficiency of pectin-degrading enzymes catalysing hydrolysis more significantly than those catalysing β-elimination. LF-NMR experiments highlighted the impact of solid loading on water mobility. Compared to other enzymes and whatever the solid loading, pectin lyase led to longer relaxation times linked with the most destructuration of the solid substrate. This new information could benefit the biorefinery processing of pectin-rich plant material when enzymes are used in the treatment.
Strategies for increasing gait speed in patients with hip osteoarthritis: their clinical significance and effects on hip loading
Authors: Tateuchi Hiroshige , Akiyama Haruhiko , Goto Koji , So Kazutaka , Kuroda Yutaka , Ichihashi Noriaki
Published: April 2021

Background

Changes in gait speed are required in various situations and can be achieved by changing stride length, cadence, or both. Differences in strategies for increasing gait speed may have different effects on hip joint and physical function. The purpose of this study was to determine the effects of strategies for increasing gait speed on hip pain, physical function, and changes in hip loading during gait in patients with hip osteoarthritis (OA). We hypothesized that patients who increase gait speed mainly by increasing cadence would have lesser hip pain, a higher physical function, and a lower rate of increase in hip moments with increasing gait speed.

Methods

Forty-seven patients with secondary hip OA (age, 48.3 ± 11.0 years) were included. Gait speed, stride length, cadence, and peak and impulse of the hip moments were measured during gait at self-selected normal and fast gait speeds. The patients were classified as types S (with mainly increasing stride length, n = 11 [23.4%]), C (with mainly increasing cadence, n = 23 [48.9%]), and SC (with increasing stride length and cadence, n = 13 [27.7%]) according to whether they used changes in stride length and/or cadence to transition from normal to fast gait. Hip pain, physical function, and hip moment changes during gait were compared between types.

Results

The physical function was higher in types C (38.0 ± 8.8, P = 0.018) and SC (40.6 ± 8.5, P = 0.015) than in type S (28.2 ± 7.8), even after adjustment for age and minimum joint space width. Hip pain was not significantly different between types. The robustness of these results was confirmed with sensitivity analysis. The rates of increases in peak external hip adduction (P = 0.003) and internal rotation moments (P = 0.009) were lower in type C than in type SC.

Conclusions

Type C tended to suppress the increase in hip moments during fast gait. Types C and SC, which included increased cadence, maintained higher physical function levels than type S. Encouraging the use of cadence-increasing strategy may be useful for reducing hip loading and maintaining physical function in patients with hip OA.
Effect of janus kinase inhibitors and methotrexate combination on malignancy in patients with rheumatoid arthritis: a systematic review and meta-analysis of randomized controlled trials
Authors: Solipuram Vinod , Mohan Akhila , Patel Roshniben , Ni Ruoning
Published: April 2021

Background

Rheumatoid arthritis (RA) is a systemic autoimmune disease. The combination therapy of methotrexate (MTX) and Janus kinase inhibitor (JAKi) is commonly used. Patients with RA are at increased risk of malignancy, however, it remains unclear whether the combination therapy is associated with a higher risk.

Objective

To assess the malignancy risk among patients with RA receiving combination therapy of JAKi and MTX compared to MTX alone.

Methods

PubMed, Cochrane and Embase were thoroughly searched for randomized controlled trials (RCTs) in patients with RA receiving JAKi and MTX, from inception to July 2020. Primary endpoints were malignancy events, Non melanomatous skin cancer (NMSC) and malignancy excluding NMSC and secondary endpoints were serious adverse events (SAE), deaths. Risk ratio (RR) and 95% CI were calculated using the Mantel–Haenszel random-effect method.

Results

659 publications were screened and 13 RCTs with a total of 6911 patients were included in the analysis. There was no statistically significant difference in malignancy [RR = 1.42; 95% CI (0.59, 3.41)], neither NMSC [RR = 1.44 (0.36, 5.76)] nor malignancies excluding NMSC [RR = 1.12 (0.40, 3.13)]. No statistically significant difference between the two groups for SAE [RR = 1.15 (0.90, 1.47)] and deaths [RR = 1.99 (0.75, 5.27)] was found.

Conclusion

The adjunction of JAKi to MTX is not associated with an increased risk of malignancy when compared to MTX alone. There is no increased risk of SAE and deaths when compared to MTX alone in patients with RA.
Carriage of two carbapenem-resistance genes in Pseudomonas aeruginosa isolated from hospital-acquired infections in children from Costa Rica: the importance of local epidemiology
Authors: Pérez-Corrales Cristian , Peralta-Barquero Valeria , Mairena-Acuña Christopher
Published: April 2021

Background

The assessment of Hospital-acquired infections due to multidrug-resistant bacteria involves the use of a variety of commercial and laboratory-developed tests to detect antimicrobial resistance genes in bacterial pathogens; however, few are evaluated for use in low- and middle-income countries.

Methods

We used whole-genome sequencing, rapid commercial molecular tests, laboratory-developed tests and routine culture testing.

Results

We identified the carriage of the metallo-β-lactamase blaVIM-2 and blaIMP-18 alleles in Carbapenem-Resistant Pseudomonas aeruginosa infections among children in Costa Rica.

Conclusions

The blaIMP-18 allele is not present in the most frequently used commercial tests; thus, it is possible that the circulation of this resistance gene may be underdiagnosed in Costa Rica.
Emodin and rhein in Cassia tora ameliorates activity of mitochondrial enzymes involved in oxidative phosphorylation in the retina of diabetic mice
Authors: Ko Eun , Um Min Young , Han Taewon , Shin Sooim , Choi Moonsung
Published: April 2021

Cassia tora is an annual herb, which has pharmacological effects such as antioxidant, hypolipidemic, and antidiabetic effects. Accordingly, its effect on diabetes has been well-studied. However, it is unclear whether it has an effect on mitochondrial dysfunction associated with diabetes. In this study, the effects of emodin and rhein in C. tora seed ethanolic extract (ER/CSEE) on retinal mitochondrial function were examined in high-fat diet (HFD)-fed mice. HFD-fed mice exhibited decreased mitochondrial function followed by compensatory increase in the expression levels of mitochondrial enzymes. However, ER/CSEE treatment for 12 weeks ameliorated the activity of retinal mitochondrial complexes and reduced the expression level of enzymes involved in oxidative phosphorylation, except that of complex II and citrate synthase in citric acid cycle. This suggests that repairing capacity of enzymes in electron transport chain and citric acid cycle of mitochondria are different in response to the metabolic state. Therefore, it concluded that emodin and rhein play a pharmacological role in fat metabolism by influencing activities of enzymes in citric acid cycle linked with beta-oxidation in retina.
Acrolein scavenger dimercaprol offers neuroprotection in an animal model of Parkinson’s disease: implication of acrolein and TRPA1
Authors: Shi Liangqin , Lin Yazhou , Jiao Yucheng , Herr Seth A. , Tang Jonathan , Rogers Edmond , Chen Zhengli , Shi Riyi
Published: April 2021

Background

The mechanisms underlying lesions of dopaminergic (DA) neurons, an essential pathology of Parkinson’s disease (PD), are largely unknown, although oxidative stress is recognized as a key factor. We have previously shown that the pro-oxidative aldehyde acrolein is a critical factor in PD pathology, and that acrolein scavenger hydralazine can reduce the elevated acrolein, mitigate DA neuron death, and alleviate motor deficits in a 6-hydroxydopamine (6-OHDA) rat model. As such, we hypothesize that a structurally distinct acrolein scavenger, dimercaprol (DP), can also offer neuroprotection and behavioral benefits.

Methods

DP was used to lower the elevated levels of acrolein in the basal ganglia of 6-OHDA rats. The acrolein levels and related pathologies were measured by immunohistochemistry. Locomotor and behavioral effects of 6-OHDA injections and DP treatment were examined using the open field test and rotarod test. Pain was assessed using mechanical allodynia, cold hypersensitivity, and plantar tests. Finally, the effects of DP were assessed in vitro on SK-N-SH dopaminergic cells exposed to acrolein.

Results

DP reduced acrolein and reversed the upregulation of pain-sensing transient receptor potential ankyrin 1 (TRPA1) channels in the substantia nigra, striatum, and cortex. DP also mitigated both motor and sensory deficits typical of PD. In addition, DP lowered acrolein and protected DA-like cells in vitro. Acrolein’s ability to upregulate TRPA1 was also verified in vitro using cell lines.

Conclusions

These results further elucidated the acrolein-mediated pathogenesis and reinforced the critical role of acrolein in PD while providing strong arguments for anti-acrolein treatments as a novel and feasible strategy to combat neurodegeneration in PD. Considering the extensive involvement of acrolein in various nervous system illnesses and beyond, anti-acrolein strategies may have wide applications and broad impacts on human health.
Gendered determinants of food insecurity in ongoing regional conflicts, North and South Kivu, the Democratic Republic of Congo
Authors: Bapolisi Wyvine Ansima , Ferrari Giovanfrancesco , Bisimwa Ghislain , Merten Sonja
Published: April 2021

Background

Food insecurity remains a major concern worldwide. In North and South Kivu provinces, the Democratic Republic of the Congo, repeated wars and gender-based violence exacerbate the situation. However, little is known about the determinants of food insecurity in the region.

Objective

This study analyzed the gendered determinants of food insecurity in North and South Kivu in the Democratic Republic of Congo, a region of ongoing civil conflict.

Methods

1754 women were included in a cross-sectional study. Multilevel ordinal logistic regression was used to identify household-level determinants of food insecurity.

Results

The poorest households were five times more likely to be food insecure (OR = 5.66, 95% CI 3.74–8.55). Women’s participation in decision-making about resource allocation decreased the risk for household food insecurity (OR = 0.68, 95% CI 0.57–0.87), while higher tolerance to gender-based violence increased the risk of food insecurity (OR = 1.29, 95% CI 1.05–1.54).

Conclusion

Involving empowered women in decision-making about resource allocation and actions to reduce gender-based violence could help mitigate food insecurity.
Impacts of phased–out land restoration programs on vegetation cover change in Eastern Tigray, Ethiopia
Authors: Gebregergs Tirhas , Teka Kassa , Taye Gebeyehu , Gidey Eskinder , Dikinya Oagile
Published: April 2021

Background

Land restoration programs in Tigray, also called integrated watershed management (IWM) practices, were implemented by the government and non–governmental organizations since 1980s. These practices aimed at reversing land degradation processes, environmental rehabilitation, and ensure food security at both community and household levels. Most of the implemented IWM projects are now phased–out. The aim of this study is therefore; therefore, to investigate the impacts of phased–out land restoration programs on vegetation cover changes in Eastern Tigray, Ethiopia. Both Thematic Mapper (TM) and Enhanced Thematic Mapper plus (ETM+) Landsat imageries at 30 meter by 30 meter spatial resolution were used to examine the land use and land cover conditions taking successful and unsuccessful IWM interventions as case studies. Three time periods were used in the change analysis: before IWM implementation (2007), at the time of IWM projects phase-out (2010), and after IWM phase-out (2017).

Results

The results indicated that for all successful integrated watershed management projects, both the bush/shrub land (19.6 ha) and grassland (8.95 ha) increased during the intervention time for Negash (S-1), Deberewahabit (S-2) and Gemad (S-3) watersheds. However, the bush/shrub land decreased after the integrated watershed management projects phased–out by 9.8 and 11.3 ha for S-1 and S-3 watersheds. At the unsuccessful IWM projects, bush/shrub land increased by 18.21, 11.3 and 9.5 ha during the intervention period, and decreased after project phased–out by 3.92 and 7.2 ha at Debretsion (S-4) and Laelay wukro (S-5) watersheds. Furthermore, cultivated land increased after phased–out in most of the watersheds.

Conclusions

This study concluded that vegetation cover has been declined in all watersheds after the phased–out period. This may affect significantly the environment in general and livelihood of the community in particular. Therefore, there is a need to provide an emphasis after the implementation of watershed projects and evaluate its impacts regularly.
Protist diversity and community complexity in the rhizosphere of switchgrass are dynamic as plants develop
Authors: Ceja-Navarro Javier A. , Wang Yuan , Ning Daliang , Arellano Abelardo , Ramanculova Leila , Yuan Mengting Maggie , Byer Alyssa , Craven Kelly D. , Saha Malay C. , Brodie Eoin L. , Pett-Ridge Jennifer , Firestone Mary K.
Published: April 2021

Background

Despite their widespread distribution and ecological importance, protists remain one of the least understood components of the soil and rhizosphere microbiome. Knowledge of the roles that protists play in stimulating organic matter decomposition and shaping microbiome dynamics continues to grow, but there remains a need to understand the extent to which biological and environmental factors mediate protist community assembly and dynamics. We hypothesize that protists communities are filtered by the influence of plants on their rhizosphere biological and physicochemical environment, resulting in patterns of protist diversity and composition that mirror previously observed diversity and successional dynamics in rhizosphere bacterial communities.

Results

We analyzed protist communities associated with the rhizosphere and bulk soil of switchgrass (SG) plants (Panicum virgatum) at different phenological stages, grown in two marginal soils as part of a large-scale field experiment. Our results reveal that the diversity of protists is lower in rhizosphere than bulk soils, and that temporal variations depend on soil properties but are less pronounced in rhizosphere soil. Patterns of significantly prevalent protists groups in the rhizosphere suggest that most protists play varied ecological roles across plant growth stages and that some plant pathogenic protists and protists with omnivorous diets reoccur over time in the rhizosphere. We found that protist co-occurrence network dynamics are more complex in the rhizosphere compared to bulk soil. A phylogenetic bin-based null model analysis showed that protists’ community assembly in our study sites is mainly controlled by homogenous selection and dispersal limitation, with stronger selection in rhizosphere than bulk soil as SG grew and senesced.

Conclusions

We demonstrate that environmental filtering is a dominant determinant of overall protist community properties and that at the rhizosphere level, plant control on the physical and biological environment is a critical driver of protist community composition and dynamics. Since protists are key contributors to plant nutrient availability and bacterial community composition and abundance, mapping and understanding their patterns in rhizosphere soil is foundational to understanding the ecology of the root-microbe-soil system.
Modified endoscopic transnasal orbital apex decompression in dysthyroid optic neuropathy
Authors: Tu Yunhai , Xu Mingna , Kim Andy D. , Wang Michael T. M. , Pan Zhaoqi , Wu Wencan
Published: April 2021

Background

To describe the surgical technique and assess the clinical efficacy and safety of modified endoscopic transnasal orbital apex decompression in the treatment of dysthyroid optic neuropathy.

Methods

In this retrospective research, forty-two subjects (74 orbits) who underwent modified endoscopic transnasal orbital apex decompression for the treatment of dysthyroid optic neuropathy were enrolled. Preoperative and postoperative best-corrected visual acuity (BCVA), visual field mean deviation (MD), Hertel exophthalmometry, and new onset diplopia were assessed before and after the intervention. The Wilcoxon test was used for differential analysis. Linear mixed-models’ analyses were conducted to assess the potential predictors for BCVA change.

Results

Postoperatively, the mean BCVA improved from 0.70 ± 0.62 logMAR to 0.22 ± 0.33 logMAR. BCVA significantly improved in 69 eyes (93%), remained stable in 4 eyes (5%) and deteriorated in 1 eye (1%). MD of visual fields improved from −13.73 ± 9.22 dB to −7.23 ± 7.04 dB. Proptosis decreased from 19.57 ± 3.38 mm to 16.35 ± 3.01 mm. Preoperative BCVA, MD of visual fields and medical rectus diameter were independent factors associated with improvements in BCVA (P < 0.05) by linear mixed-models’ analyses. Eighteen patients (42.9%) developed new diplopia postoperatively.

Conclusion

Modified endoscopic transnasal orbital apex decompression effectively restores vision in dysthyroid optic neuropathy.