bluuebunny/crossref_metadata_2025 huggingface dataset:
Half-widows: silent victims of the Kashmir conflict
Authors: Hamid Wasia , Jahangir Mohmad Saleem , Khan Tanveer Ahmad
Published: February 2021

The long-standing conflict in Jammu and Kashmir has resulted in the enforced disappearance of thousands of married men, which has left their wives with a new fractured identity as a ‘half-widow’. Uncertain whether their husbands are dead or alive; their status is in limbo, leading to pervasive economic, social, legal and psychological problems. This article builds upon interviews with fourteen half-widows, aiming to gain an in-depth understanding of their lived experiences and the social trauma they face, including economic hardship, social stigmatisation and psychological trauma produced by their unresolved grief – which fluctuates between anguish over the possibility of death, and hope that their loved one will return.
Exposure to Baby-Friendly Hospital Practices and Breastfeeding Outcomes of WIC Participants in Maryland
Authors: Ducharme-Smith Kirstie , Gross Susan M. , Resnik Amy , Rosenblum Nadine , Dillaway Chloe , Orta Aleman Dania , Augustyn Marycatherine , Silbert-Flagg Joanne , Caulfield Laura E.
Published: February 2021

Background

The Baby-Friendly Hospital Initiative is an effective intervention to support maternal practices around breastfeeding. However, adherence of hospitals to the Baby-Friendly 10 Steps, as determined from the perspective of women participating in the United States Special Supplemental Nutrition Program for Women, Infants, and Children, has not been assessed.

Research Aims

(1) To compare maternal perceptions about maternity practices in Baby-Friendly Hospitals and non-Baby-Friendly Hospitals; (2) to evaluate the associations between degree of exposure to the Baby-Friendly 10 Steps and breastfeeding practices through the first 6 months; and (3) to evaluate whether the receipt of specific Steps was associated with breastfeeding practices through 6 months.

Methods

This study was a cross-sectional 2 group comparison, using prospective data collected through a self-report telephone survey and retrospective data gathered from participants’ records. Women ( N = 182) participating in four Maryland Special Supplemental Nutrition Program for Women, Infants and Children agencies were recruited. One hundred and eight (59%) participants delivered at designated Baby-Friendly Hospitals; 74 (41%) delivered in non-Baby-Friendly designated hospitals. Logistic regression models were utilized to determine the influence of perceived Step adherence on exclusive breastfeeding.

Results

Reported adherence to 10-Steps policies ranged from 10%–85% (lowest for Step 9, highest for Step 10) and only Step 9 (give no pacifiers or artificial nipples to breastfeeding infants) differed according to Baby-Friendly Hospital status. Greater exposure to the 10 Steps was positively associated with exclusive breastfeeding during hospitalization. The lack of perceived adherence to Step 6 (no food or drink other than human milk), Step 9, and the International Code of Marketing of Breast-milk Substitutes (no formula, bottles, or artificial nipples) significantly decreased the likelihood of exclusive breastfeeding through 6 months.

Conclusion

Maternal perception of Baby-Friendly Step adherence was associated with exclusive breastfeeding.
Improving Public Toilet Environment and Hygiene Practices in an Asian City: Voices From Hong Kong Residents
Authors: Sun Kai Sing , Lam Tai Pong , Tang Wai Sin , Chan Hoi Yan , Lam Kwok Fai , Chow Enoch Ching Yeung , Wu Dan , Zhou Xu Dong , Xu Jia Yao , Ho Pak Leung
Published: February 2021

Toilet hygiene is an important preventive measure for infectious diseases, including severe acute respiratory syndrome (SARS) and COVID-19. This study explored public’s opinions on improving toilet environment and hygiene practices in Hong Kong. A mixed-method approach was applied. We conducted 4 focus groups plus 3 individual interviews among the Hong Kong Chinese, followed by a questionnaire survey with 300 respondents recruited from various districts. Difference in response distributions between groups with different demographics was tested by Pearson χ2 test. Instead of advocating for advanced toilet facilities, respondents were mostly concerned about basic hygiene issues. Malfunctioning facilities resulting from poor toilet management, such as clogged toilets, stained facilities, and problematic flushing systems, were most cited as barriers to toilet hygiene practices. Three quarters of the survey respondents expressed concerns over worn and poorly maintained toilets, shortage of janitors, and cleansing supplies. However, respondents who were older ( P < .001), less educated ( P < .001), and had lower income ( P = .001) were significantly more likely to find hygiene conditions in public toilets satisfactory. The findings reflected the substandard of the current provisions as a developed city in Asia. Enhanced efforts by the government to maintain basic toilet supplies and facilities is the key to improving public compliance to toilet hygiene practices.
Changes in multiple sclerosis symptoms are associated with changes in work productivity of people living with multiple sclerosis
Authors: Bessing Barnabas , Hussain Mohammad A , Claflin Suzi B , Chen Jing , Blizzard Leigh , van Dijk Pieter , Kirk-Brown Andrea , Taylor Bruce V , van der Mei I
Published: February 2021

Background:

While employment rates have increased in people with multiple sclerosis (PwMS), little is known about the longitudinal trends of work productivity.

Objective:

To describe the longitudinal patterns of work productivity and examine the factors associated with annual change of work productivity of PwMS.

Methods:

Study participants were employed participants of the Australian MS Longitudinal Study (AMSLS) followed from 2015 to 2019 with at least two repeated measures ( n = 2121). We used linear mixed models to examine if the within-individual variations in MS symptoms are associated with changes in work productivity.

Results:

The mean annual change in work productivity between 2015 and 2019 was −0.23% ( SD = 18.68%). Not the actual severity of symptoms but rather the changes in severity of symptoms that are associated with change in work productivity in the same year. In a multivariable model, every unit increase in mean annual change in ‘pain and sensory symptoms’, ‘feelings of anxiety and depression’, and ‘fatigue and cognitive symptoms’ were independently associated with 2.43%, 1.55% and 1.01% annual reductions in work productivity, respectively.

Conclusion:

Individual changes in work productivity are largely driven by the changes in symptom severity rather than the absolute severity. Stabilising/improving MS symptoms might improve work productivity.
Now is the time! Confronting neo-liberalism in early childhood
Authors: Moss Peter , Roberts-Holmes Guy
Published: February 2021

Over the last 30 years, neo-liberalism has permeated early childhood, as all other aspects of life. Having introduced what neo-liberalism is, the article looks at some of its effects on early childhood education and care, including markets, imaginaries and governance. It argues that though neo-liberalism is a powerful force, it is resistible and replaceable – and that now is the time to be developing alternatives to existing policies, grounding them in ideas that contest neo-liberalism.
4-vinylpyridine derivatives: Protonation, methylation and silver(I) coordination chemistry
Authors: Zhang Guoqi
Published: February 2021

( E)-4-[2-(Pyridin-4-yl)vinyl]benzaldehyde, containing both a 4-vinylpyridine and an aldehyde functionality, is utilized to develop new, highly conjugated chalcone compounds and a bis-Schiff base azine compound. The chalcone-containing compounds are further explored for their protonation, methylation and silver(I) coordination chemistry using the pyridine moiety. In parallel, a cyano-containing analogue, ( E)-4-[2-(pyridin-4-yl)vinyl]benzonitrile is also synthesized and studied for its silver(I) coordination chemistry. These new compounds are fully characterized by mass spectrometry, elemental analysis and spectroscopic techniques. The methylated product of ( E)-1-(9-anthryl)-3-{4-[2-(pyridin-4-yl)vinyl]phenyl}prop-2-en-1-one and a silver complex of ( E)-4-[2-(pyridin-4-yl)vinyl]benzonitrile are structurally determined by X-ray crystallography.
Testicular epidermoid cyst: about a case report and a review of the literature
Authors: Saouli Amine , Karmouni Tarik , El Khader Khalid , Koutani Abdellatif , Andaloussi Ahmed Iben Attya
Published: February 2021

Background

The testicular epidermoid cyst is an exceptional benign tumor. The presumptive diagnosis is facilitated by the development of medical imaging (echo-Doppler, elastography, contrast-enhanced ultrasound, MRI). The confirmatory diagnosis is histological.

Case presentation

We report the case report of a 37-year-old man who had a history of repetitive orchitis. He had complained of right scrotal discomfort for 6 months with no associated urinary symptoms. We performed an extemporaneous biopsy given the uncertain diagnosis (Fig. 3), and the histological examination was in favor of a mature teratoma. This prompted us to perform a right orchidectomy. The postoperative was simple. The final histological examination tipped in favor of an epidermoid cyst of the testicle. The patient was seen again at one month, and his clinical examination was normal.

Conclusion

The testicular epidermal cyst is a rare benign tumor of the testicle. Currently, conservative surgery has become the gold standard thanks to the development of medical imaging to differentiate between the both forms of TEC, and it retains certain limits which lie in the differential diagnosis with the teratoma requiring large multicenter studies to better characterize these two entities.
Safety of percutaneous dilatational tracheotomy (PDT) with the rigid tracheotomy endoscope (TED): a 6-month follow-up multicenter investigation
Authors: Nowak Andreas , Klemm Eckart , Michaelsen Caroline , Usichenko Taras I. , Koscielny Sven
Published: February 2021

Background

The rigid tracheotomy endoscope (TED) was recently introduced to improve the fiberoptic technique during percutaneous dilatational tracheotomy (PDT) in critically ill patients. The aim was to evaluate the long-term complications of PDT using TED equipment in a prospective multicenter investigation.

Methods

One hundred eighty adult patients underwent PDT using TED in four German hospitals. Patients who were alive or their guardians were contacted via telephone and interviewed using a structured questionnaire 6 months following the tracheostomy procedure. Patients with airway complaints were invited for outpatient clinical ENT examination. The incidence of adverse events related to PDT was registered.

Results

Of 180 patients who received tracheostomy, 137 (76.1%) were alive at the time of follow-up. None of the 43 lethal events was related to the PDT. Fifty-three (38.7%) patients were available for follow-up examination, whereas 14 (10.2%) were able to visit ENT physicians. Two (3.8%) out of 53 patients developed tracheocutaneous fistula with required surgical closure of tracheostoma. Dyspnea (7.5%), hoarseness (5.7%), stridor and swallowing difficulties (both with 3.8%) were the most common complaints. Tracheal stenosis was confirmed in 1 patient (1.88% [95% CI: 0.33; 9.93]).

Conclusion

The use of TED for PDT in the clinical setting is safe regarding adverse events at 6-month follow-up. The incidence of tracheal stenosis after PDT with TED is comparable with that of flexible bronchoscopy; however, its role for PDT at the intensive care unit should be clarified in further investigations.
Correction to: Elderly patients with atrial fibrillation in routine clinical practice: peri-procedural management of edoxaban oral anticoagulation therapy is associated with a low risk of bleeding and thromboembolic complications: a subset analysis of the prospective, observational, multinational EMIT-AF study
Authors: Unverdorben M. , von Heymann C. , Santamaria A. , Saxena M. , Vanassche T. , Jin J. , Laeis P. , Wilkins R. , Chen C. , Colonna P.
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
HBP-enhancing hepatocellular adenomas and how to discriminate them from FNH in Gd-EOB MRI
Authors: Auer Timo Alexander , Walter-Rittel Thula , Geisel Dominik , Schöning Wenzel , Schmelzle Moritz , Müller Tobias , Sinn Bruno , Denecke Timm , Hamm Bernd , Fehrenbach Uli
Published: February 2021

Background

Recent studies provide evidence that hepatocellular  adenomas  (HCAs) frequently take up gadoxetic acid (Gd-EOB) during the hepatobiliary phase (HBP). The purpose of our study was to investigate how to differentiate between Gd-EOB-enhancing HCAs and focal nodular hyperplasias (FNHs). We therefore retrospectively included 40 HCAs classified as HBP Gd-EOB-enhancing lesions from a sample of 100 histopathologically proven HCAs in 65 patients. These enhancing HCAs were matched retrospectively with 28 FNH lesions (standard of reference: surgical resection). Two readers (experienced abdominal radiologists blinded to clinical data) reviewed the images evaluating morphologic features and subjectively scoring Gd-EOB uptake (25–50%, 50–75% and 75–100%) for each lesion. Quantitative lesion-to-liver enhancement was measured in arterial, portal venous (PV), transitional and HBP. Additionally, multivariate regression analyses were performed.

Results

Subjective scoring of intralesional Gd-EOB uptake showed the highest discriminatory accuracies (AUC: 0.848 (R#1); 0.920 (R#2)—p < 0.001) with significantly higher uptake scores assigned to FNHs (Cut-off: 75%-100%). Typical lobulation and presence of a central scar in FNH achieved an accuracy of 0.750 or higher in at least one reader (lobulation—AUC: 0.809 (R#1); 0.736 (R#2); central scar—AUC: 0.595 (R#1); 0.784 (R#2)). The multivariate regression emphasized the discriminatory power of the Gd-EOB scoring (p = 0.001/OR:22.15 (R#1) and p < 0.001/OR:99.12 (R#2). The lesion-to-liver ratio differed significantly between FNH and HCA in the PV phase and HBP (PV: 132.9 (FNH) and 110.2 (HCA), p = 0.048 and HBP: 110.3 (FNH) and 39.2 (HCA), p < 0.001)), while the difference was not significant in arterial and transitional contrast phases (p > 0.05).

Conclusion

Even in HBP-enhancing HCA, characterization of Gd-EOB uptake was found to provide the strongest discriminatory power in differentiating HCA from FNH. Furthermore, a lobulated appearance and a central scar are more frequently seen in FNH than in HCA.
Multifactor analysis of delayed absorption of subretinal fluid after scleral buckling surgery
Authors: Long Kejun , Meng Yongan , Chen Jing , Luo Jing
Published: February 2021

Background

The purpose of this study is to assess the absorption of subretinal fluid (SRF) after scleral buckling (SB) surgery for the treatment of rhegmatogenous retinal detachment (RRD). We also examined related factors that may affect the delayed absorption of SRF.

Methods

This retrospective study included patients who underwent successful SB surgery for the treatment of macula-off RRD and in which the retina was reattached after the surgery. The patients were categorized according to gender, duration, age, the number, and location of retinal breaks. Subfoveal choroidal thickness (SFCT), height of subretinal fluid (SRFH), and the choriocapillaris flow density (CCFD) within 3 × 3 mm macular fovea were included. Delayed absorption was determined by the SRF that remained unabsorbed for 3 months after the procedure. The endpoint was determined when the SRF could no longer be observed.

Results

A total of 62 patients (63 eyes) were enrolled. In 35 eyes (56.45%) SRF was completely absorbed and in 28 (43.55%) eyes delayed absorption of SRF in macular areas was observed at 3 months after surgery. A young age (< 35 years), inferior retinal breaks were associated with good outcomes by applying multivariable analysis on the rate of SRF absorption after SB instead of gender, the number of breaks, and duration (p < 0.05). CCFD was significantly different between the SRF group and the non-SRF group after SB (0.66 ± 0.04% vs 0.63 ± 0.05%, P < 0.05). SRFH showed a moderate positive correlation with SFCT (rs = 0.462, p = 0.000), however, using binary logistic regression analysis it was determined that SFCT was not related to the absorption of the SRF.

Conclusions

The absorption of SRF after SB may be correlated with choriocapillaris flow density. Age and location of breaks are significant factors affecting the absorption of SRF. The duration of disease is an uncertain factor due to several subjective reasons.
Variation in chemical composition and antimalarial activities of two samples of Terminalia albida collected from separate sites in Guinea
Authors: Camara Aissata , Haddad Mohamed , Traore Mohamed Sahar , Chapeland-Leclerc Florence , Ruprich-Robert Gwenaël , Fourasté Isabelle , Balde Mamadou Aliou , Royo Jade , Parny Melissa , Batigne Philippe , Salon Marie , Coste Agnès , Balde Aliou Mamadou , Aubouy Agnès
Published: February 2021

Background

The disparity of harvesting locations can influence the chemical composition of a plant species, which could affect its quality and bioactivity.Terminalia albidais widely used in traditional Guinean medicine whose activity against malaria has been validated in vitro and in murine models. The present work investigated the antimalarial properties and chemical composition of two samples ofT. albidacollected from different locations in Guinea.

Method

T. albidasamples were collected in different locations in Guinea, in Dubréka prefecture (West maritime Guinea) and in Kankan prefecture (eastern Guinea). The identity of the samples was confirmed by molecular analysis. In vitro antiplasmodial activity of the two extracts was determined against the chloroquine resistant strain PfK1. In vivo, extracts (100 mg/kg) were tested in two experimental murine models, respectively infected withP. chabaudi chabaudiandP. berghei ANKA.The chemical composition of the two samples was assessed by ultra-high-performance liquid chromatography coupled to high resolution mass spectrometry.

Results

In vitro, the Dubréka sample (TaD) was more active with an IC50of 1.5 μg/mL versus 8.5 μg/mL for the extract from Kankan (TaK). In vivo, the antiparasitic effect ofTaD was substantial with 56% of parasite inhibition at Day 10 post-infection inP. chabaudiinfection and 61% at Day 8 inP. bergheimodel, compared to 14 and 19% inhibition respectively for the treatment withTaK. In addition, treatment withTaD further improved the survival ofP. bergheiinfected-mice by 50% at Day 20, while the mortality rate of mice treated withTak was similar to the untreated group. The LC/MS analysis of the two extracts identified 38 compounds, 15 of which were common to both samples while 9 and 14 other compounds were unique toTaD andTaK respectively.

Conclusion

This study highlights the variability in the chemical composition of the speciesT. albidawhen collected in different geographical locations. These chemical disparities were associated with variable antimalarial effects. From a public health perspective, these results underline the importance of defining chemical fingerprints related to botanical species identification and to biological activity, for the plants most commonly used in traditional medicine.
Independent and combined associations between fast-food outlet exposure and genetic risk for obesity: a population-based, cross-sectional study in the UK
Authors: Burgoine Thomas , Monsivais Pablo , Sharp Stephen J. , Forouhi Nita G. , Wareham Nicholas J.
Published: February 2021

Background

Characteristics of the built environment, such as neighbourhood fast-food outlet exposure, are increasingly recognised as risk factors for unhealthy diet and obesity. Obesity also has a genetic component, with common genetic variants explaining a substantial proportion of population-level obesity susceptibility. However, it is not known whether and to what extent associations between fast-food outlet exposure and body weight are modified by genetic predisposition to obesity.

Methods

We used data from the Fenland Study, a population-based sample of 12,435 UK adults (mean age 48.6 years). We derived a genetic risk score associated with BMI (BMI-GRS) from 96 BMI-associated single nucleotide polymorphisms. Neighbourhood fast-food exposure was defined as quartiles of counts of outlets around the home address. We used multivariable regression models to estimate the associations of each exposure, independently and in combination, with measured BMI, overweight and obesity, and investigated interactions.

Results

We found independent associations between BMI-GRS and risk of overweight (RR = 1.34, 95% CI 1.23–1.47) and obesity (RR = 1.73, 95% CI 1.55–1.93), and between fast-food outlet exposure and risk of obesity (highest vs lowest quartile RR = 1.58, 95% CI 1.21–2.05). There was no evidence of an interaction of fast-food outlet exposure and genetic risk on BMI (P = 0.09), risk of overweight (P = 0.51), or risk of obesity (P = 0.27). The combination of higher BMI-GRS and highest fast-food outlet exposure was associated with 2.70 (95% CI 1.99–3.66) times greater risk of obesity.

Conclusions

Our study demonstrated independent associations of both genetic obesity risk and neighbourhood fast-food outlet exposure with adiposity. These important drivers of the obesity epidemic have to date been studied in isolation. Neighbourhood fast-food outlet exposure remains a potential target of policy intervention to prevent obesity and promote the public’s health.
Implications of the ACC/AHA risk score for prediction of heart failure: the Rotterdam Study
Authors: Arshi Banafsheh , van den Berge Jan C. , van Dijk Bart , Deckers Jaap W. , Ikram M. Arfan , Kavousi Maryam
Published: February 2021

Background

Despite the growing burden of heart failure (HF), there have been no recommendations for use of any of the primary prevention models in the existing guidelines. HF was also not included as an outcome in the American College of Cardiology/American Heart Association (ACC/AHA) risk score.

Methods

Among 2743 men and 3646 women aged ≥ 55 years, free of HF, from the population-based Rotterdam Study cohort, 4 Cox models were fitted using the predictors of the ACC/AHA, ARIC and Health-ABC risk scores. Performance of the models for 10-year HF prediction was evaluated. Afterwards, performance and net reclassification improvement (NRI) for adding NT-proBNP to the ACC/AHA model were assessed.

Results

During a median follow-up of 13 years, 429 men and 489 women developed HF. The ARIC model had the highest performance [c-statistic (95% confidence interval [CI]): 0.80 (0.78; 0.83) and 0.80 (0.78; 0.83) in men and women, respectively]. The c-statistic for the ACC/AHA model was 0.76 (0.74; 0.78) in men and 0.77 (0.75; 0.80) in women. Adding NT-proBNP to the ACC/AHA model increased the c-statistic to 0.80 (0.78 to 0.83) in men and 0.81 (0.79 to 0.84) in women. Sensitivity and specificity of the ACC/AHA model did not drastically change after addition of NT-proBNP. NRI(95%CI) was − 23.8% (− 19.2%; − 28.4%) in men and − 27.6% (− 30.7%; − 24.5%) in women for events and 57.9% (54.8%; 61.0%) in men and 52.8% (50.3%; 55.5%) in women for non-events.

Conclusions

Acceptable performance of the model based on risk factors included in the ACC/AHA model advocates use of this model for prediction of HF risk in primary prevention setting. Addition of NT-proBNP modestly improved the model performance but did not lead to relevant discrimination improvement in clinical risk reclassification.
Correction to: Undeclared animal species in dry and wet novel and hydrolyzed protein diets for dogs and cats detected by microarray analysis
Authors: Ricci Rebecca , Conficoni Daniele , Morelli Giada , Losasso Carmen , Alberghini Leonardo , Giaccone Valerio , Ricci Antonia , Andrighetto Igino
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
Impact of treating iron deficiency, diagnosed according to hepcidin quantification, on outcomes after a prolonged ICU stay compared to standard care: a multicenter, randomized, single-blinded trial
Authors: Lasocki Sigismond , Asfar Pierre , Jaber Samir , Ferrandiere Martine , Kerforne Thomas , Asehnoune Karim , Montravers Philippe , Seguin Philippe , Peoc’h Katell , Gergaud Soizic , Nagot Nicolas , Lefebvre Thibaud , Lehmann Sylvain ,   the Hepcidane study group, Lasocki Sigismond , Asfar Pierre , Jaber Samir , Ferrandiere Martine , Kerforne Thomas , Asehnoune Karim , Montravers Philippe , Seguin Philippe , Peoc’h Katell , Gergaud Soizic , Nagot Nicolas , Lefebvre Thibaud , Lehmann Sylvain , Beloncle François , Mercat Alain , Gaillard Thomas , Leger Maxime , Rineau Emmanuel , Sargentini Cyril , Geneve Claire , Puy Herve , Mercier Grégoire , Marin Gregory , Delaby Constance , Hirtz Christophe , Chanques Gerald , Roquilly Antoine , Boisson Matthieu , Dahyot-Fizelier Claire , Mimoz Olivier , Isslame Sonia , Launey Yoann , Barbaz Mathilde
Published: February 2021

Background

Anemia is a significant problem in patients on ICU. Its commonest cause, iron deficiency (ID), is difficult to diagnose in the context of inflammation. Hepcidin is a new marker of ID. We aimed to assess whether hepcidin levels would accurately guide treatment of ID in critically ill anemic patients after a prolonged ICU stay and affect the post-ICU outcomes.

Methods

In a controlled, single-blinded, multicenter study, anemic (WHO definition) critically ill patients with an ICU stay ≥ 5 days were randomized when discharge was expected to either intervention by hepcidin treatment protocol or control. In the intervention arm, patients were treated with intravenous iron (1 g of ferric carboxymaltose) when hepcidin was < 20 μg/l and with intravenous iron and erythropoietin for 20 ≤ hepcidin < 41 μg/l. Control patients were treated according to standard care (hepcidin quantification remained blinded). Primary endpoint was the number of days spent in hospital 90 days after ICU discharge (post-ICU LOS). Secondary endpoints were day 15 anemia, day 30 fatigue, day 90 mortality and 1-year survival.

Results

Of 405 randomized patients, 399 were analyzed (201 in intervention and 198 in control arm). A total of 220 patients (55%) had ID at discharge (i.e., a hepcidin < 41 μg/l). Primary endpoint was not different (medians (IQR) post-ICU LOS 33(13;90) vs. 33(11;90) days for intervention and control, respectively, median difference − 1(− 3;1) days, p = 0.78). D90 mortality was significantly lower in intervention arm (16(8%) vs 33(16.6%) deaths, absolute risk difference − 8.7 (− 15.1 to − 2.3)%, p = 0.008, OR 95% IC, 0.46, 0.22–0.94, p = 0.035), and one-year survival was improved (p = 0.04).

Conclusion

Treatment of ID diagnosed according to hepcidin levels did not reduce the post-ICU LOS, but was associated with a significant reduction in D90 mortality and with improved 1-year survival in critically ill patients about to be discharged after a prolonged stay.

Trial registration

www.clinicaltrial.gov NCT02276690 (October 28, 2014; retrospectively registered)
Correction to: Implementation of the Randomized Embedded Multifactorial Adaptive Platform for COVID-19 (REMAP-COVID) trial in a US health system—lessons learned and recommendations
Authors:   The UPMC REMAP-COVID Group, on behalf of the REMAP-CAP Investigators
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
Use of artificial intelligence in sports medicine: a report of 5 fictional cases
Authors: Rigamonti Lia , Estel Katharina , Gehlen Tobias , Wolfarth Bernd , Lawrence James B. , Back David A.
Published: February 2021

Background

Artificial intelligence (AI) is one of the most promising areas in medicine with many possibilities for improving health and wellness. Already today, diagnostic decision support systems may help patients to estimate the severity of their complaints. This fictional case study aimed to test the diagnostic potential of an AI algorithm for common sports injuries and pathologies.

Methods

Based on a literature review and clinical expert experience, five fictional “common” cases of acute, and subacute injuries or chronic sport-related pathologies were created: Concussion, ankle sprain, muscle pain, chronic knee instability (after ACL rupture) and tennis elbow. The symptoms of these cases were entered into a freely available chatbot-guided AI app and its diagnoses were compared to the pre-defined injuries and pathologies.

Results

A mean of 25–36 questions were asked by the app per patient, with optional explanations of certain questions or illustrative photos on demand. It was stressed, that the symptom analysis would not replace a doctor’s consultation. A 23-yr-old male patient case with a mild concussion was correctly diagnosed. An ankle sprain of a 27-yr-old female without ligament or bony lesions was also detected and an ER visit was suggested. Muscle pain in the thigh of a 19-yr-old male was correctly diagnosed. In the case of a 26-yr-old male with chronic ACL instability, the algorithm did not sufficiently cover the chronic aspect of the pathology, but the given recommendation of seeing a doctor would have helped the patient. Finally, the condition of the chronic epicondylitis in a 41-yr-old male was correctly detected.

Conclusions

All chosen injuries and pathologies were either correctly diagnosed or at least tagged with the right advice of when it is urgent for seeking a medical specialist. However, the quality of AI-based results could presumably depend on the data-driven experience of these programs as well as on the understanding of their users. Further studies should compare existing AI programs and their diagnostic accuracy for medical injuries and pathologies.
Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis
Authors: Chan Mei , Gray Melinda , Burns Christine , Owens Louisa , Woolfenden Susan , Lingam Raghu , Jaffe Adam , Homaira Nusrat
Published: February 2021

Objective

We conducted a systematic review and meta-analysis to determine the effectiveness of comprehensive community-based interventions with ≥ 2 components in improving asthma outcomes in children.

Methods

A systematic search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), Cochrane Library and hand search of reference collections were conducted to identify any research articles published in English between 2000 and 2019. All studies reporting community-based asthma interventions with ≥ 2 components (e.g., asthma self-management education, home environmental assessment or care coordination etc.) for children aged ≤ 18 years were included. Meta-analyses were performed using random-effects model to estimate pooled odds ratio (OR) with 95% confidence intervals (CIs).

Results

Of the 2352 studies identified, 21 studies were included in the final analysis: 19 pre-post interventions, one randomised controlled trial (RCT) and one retrospective study. Comprehensive asthma programs with multicomponent interventions were associated with significant reduction in asthma-related Emergency Department (ED) visits (OR = 0.26; 95% CI 0.20–0.35), hospitalizations (OR = 0.24; 95% CI 0.15–0.38), number of days (mean difference = − 2.58; 95% CI − 3.00 to − 2.17) and nights with asthma symptoms (mean difference = − 2.14; 95% CI − 2.94 to − 1.34), use of short-acting asthma medications/bronchodilators (BD) (OR = 0.28; 95% CI 0.16–0.51), and increase use of asthma action plan (AAP) (OR = 8.87; 95% CI 3.85–20.45).

Conclusion

Community-based asthma care using more comprehensive approaches may improve childhood asthma management and reduce asthma related health care utilization.
Imaging foreign bodies in head and neck trauma: a pictorial review
Authors: Voss Jan Oliver , Maier Christoph , Wüster Jonas , Beck-Broichsitter Benedicta , Ebker Tobias , Vater Jana , Dommerich Steffen , Raguse Jan D. , Böning Georg , Thieme Nadine
Published: February 2021

Open injuries bear the risk of foreign body contamination. Commonly encountered materials include gravel debris, glass fragments, wooden splinters or metal particles. While foreign body incorporation is obvious in some injury patterns, other injuries may not display hints of being contaminated with foreign body materials. Foreign objects that have not been detected and removed bear the risk of leading to severe wound infections and chronic wound healing disorders. Besides these severe health issues, medicolegal consequences should be considered. While an accurate clinical examination is the first step for the detection of foreign body materials, choosing the appropriate radiological imaging is decisive for the detection or non-detection of the foreign material. Especially in cases of impaired wound healing over time, the existence of an undetected foreign object needs to be considered.

Here, we would like to give a practical radiological guide for the assessment of foreign objects in head and neck injuries by a special selection of patients with different injury patterns and various foreign body materials with regard to the present literature.
Correction to: Human embryonic stem cell-derived extracellular vesicles alleviate retinal degeneration by upregulating Oct4 to promote retinal Müller cell retrodifferentiation via HSP90
Authors: Ke Yifeng , Fan Xiaoe , Hao Rui , Dong Lijie , Xue Min , Tan Liangzhang , Yang Chunbo , Li Xiaorong , Ren Xinjun
Published: February 2021

An amendment to this paper has been published and can be accessed via the original article.
M-current induced Bogdanov–Takens bifurcation and switching of neuron excitability class
Authors: Al-Darabsah Isam , Campbell Sue Ann
Published: February 2021

In this work, we consider a general conductance-based neuron model with the inclusion of the acetycholine sensitive, M-current. We study bifurcations in the parameter space consisting of the applied current $I_{app}$

I

a
p
p

, the maximal conductance of the M-current $g_{M}$

g
M

and the conductance of the leak current $g_{L}$

g
L

. We give precise conditions for the model that ensure the existence of a Bogdanov–Takens (BT) point and show that such a point can occur by varying $I_{app}$

I

a
p
p

and $g_{M}$

g
M

. We discuss the case when the BT point becomes a Bogdanov–Takens–cusp (BTC) point and show that such a point can occur in the three-dimensional parameter space. The results of the bifurcation analysis are applied to different neuronal models and are verified and supplemented by numerical bifurcation diagrams generated using the package . We conclude that there is a transition in the neuronal excitability type organised by the BT point and the neuron switches from Class-I to Class-II as conductance of the M-current increases.
Effect of reduction of sodium content on the microbial ecology of Edam cheese samples
Authors: Luzzi Giuseppina , Brinks Erik , Fritsche Jan , Franz Charles M. A. P.
Published: February 2021

Sodium intake is a major risk factor for non-communicable diseases. Consequently, reformulation of cheeses such as Edam to contain less sodium may contribute to lowering disease risk. However, sodium is essential for cheese manufacture, influencing starter culture bacteria activity and abundance during fermentation. This study aimed to assess the microbial diversity of reformulated Edam cheese samples with a reduced sodium content using culture-independent technique. The microbial diversity of samples produced using simple sodium reduction, as well as by substituting salt with a mineral salt compound containing potassium, were analysed in comparison to regular control Edam samples during manufacture and the subsequent 6-week ripening period using 16S rDNA metagenomics. In addition, a challenge test using Listeria (List.) innocua as a surrogate species for List. monocytogenes was performed. Reducing sodium content did not influence the microbiological composition of reformulated samples in comparison to that of regular samples. The starter culture bacteria dominated the microbial diversity and no increase in spoilage or potentially pathogenic bacterial growth was detected, including that of List. innocua. From a microbiological perspective, it can be concluded that lowering sodium content in Edam samples without affecting the microbial composition is achievable through simple sodium reduction and through implementation of a mineral salt replacement approach.
Single‐cell transcriptomic landscape reveals the differences in cell differentiation and immune microenvironment of papillary thyroid carcinoma between genders
Authors: Peng Miaoguan , Wei Guohong , Zhang Yunjian , Li Hai , Lai Yingrong , Guo Yan , Chen Yuxin , Liu Liehua , Xiao Haipeng , Guan Hongyu , Li Yanbing
Published: February 2021

Background

Papillary thyroid carcinoma (PTC) is the main pathological type of thyroid carcinoma (TC). Gender is a prominent background parameter for patients with PTC. Here, we aimed to delineate the differences in cell clusters and immune microenvironment in relation to gender in PTC.

Methods

We generated 6720, 14,666, and 33,373 single-cell transcriptomes that were pooled from the tissues of four male patients with PTC, seven female patients with PTC, and three patients with nodular goiter, respectively. We performed single-cell RNA-sequencing (scRNA-seq) based on BD Rhapsody and characterized the first single-cell transcriptomic landscape of PTC involving gender. The differential cell clusters and their gene profiles were identified and analyzed via a multi-resolution network in male and female patients. The interactions of fibroblasts and endothelial cells with malignant epithelial cells and the difference in the immune infiltration of B and T lymphocytes according to gender were assessed.

Results

Malignant epithelial cells were divided into two distinct subsets in male and female patients with PTC. Moreover, significant differences involving inferred copy-number variations (CNVs), gene profiles, and cell differentiation were detected between male and female patients. Regarding the interactions of fibroblasts and endothelial cells with malignant epithelial cells, members of the human leukocyte antigen (HLA) family and their receptors were considered as typical in female patients with PTC, while transforming growth factor beta 1 (TGFB1) and its receptors were typical of male patients with PTC. The characteristics of B cells, including cell clusters, cell differentiation, and dominant gene sets, were significantly different between genders.

Conclusions

Our data revealed the detailed differences in cell clusters and immune microenvironment in PTC according to gender at the single-cell level, which provided new insights into the understanding of the impact of gender on PTC.
Factors influencing taxpayers to engage in tax evasion: evidence from Woldia City administration micro, small, and large enterprise taxpayers
Authors: Kassa Erstu Tarko
Published: February 2021

The main purpose of this paper is to investigate factors that influence taxpayers to engage in tax evasion. The researcher used descriptive and explanatory research design and followed a quantitative research approach. To undertake this study, primary and secondary data has been utilized. From the target population of 4979, by using a stratified and simple random sampling technique, 370 respondents were selected. To verify the data quality, the exploratory factor analysis (EFA) was conducted for each variable measurements. After factor analysis has been done, the data were analyzed by using Pearson correlation and multiple regression analysis. The finding of the study revealed that the relationship between the study independent variables with the dependent variable was positive and statistically significant. The regression analysis also indicates that tax fairness, tax knowledge, and moral obligation significantly influence taxpayers to engage in tax evasion, and the remaining moral obligation and subjective norms were not statistically significant to influence taxpayers to engage in tax evasion.
Emergence of nosocomial associated opportunistic pathogens in the gut microbiome after antibiotic treatment
Authors: Raplee Isaac , Walker Lacey , Xu Lei , Surathu Anil , Chockalingam Ashok , Stewart Sharron , Han Xiaomei , Rouse Rodney , Li Zhihua
Published: February 2021

Introduction

According to the Centers for Disease Control’s 2015 Hospital Acquired Infection Hospital Prevalence Survey, 1 in 31 hospital patients was infected with at least one nosocomial pathogen while being treated for unrelated issues. Many studies associate antibiotic administration with nosocomial infection occurrence. However, to our knowledge, there is little to no direct evidence of antibiotic administration selecting for nosocomial opportunistic pathogens.

Aim

This study aims to confirm gut microbiota shifts in an animal model of antibiotic treatment to determine whether antibiotic use favors pathogenic bacteria.

Methodology

We utilized next-generation sequencing and in-house metagenomic assembly and taxonomic assignment pipelines on the fecal microbiota of a urinary tract infection mouse model with and without antibiotic treatment.

Results

Antibiotic therapy decreased the number of detectable species of bacteria by at least 20-fold. Furthermore, the gut microbiota of antibiotic treated mice had a significant increase of opportunistic pathogens that have been implicated in nosocomial infections, likeAcinetobacter calcoaceticus/baumanniicomplex,Chlamydia abortus,Bacteroides fragilis, andBacteroides thetaiotaomicron. Moreover, antibiotic treatment selected for antibiotic resistant gene enriched subpopulations for many of these opportunistic pathogens.

Conclusions

Oral antibiotic therapy may select for common opportunistic pathogens responsible for nosocomial infections. In this study opportunistic pathogens present after antibiotic therapy harbored more antibiotic resistant genes than populations of opportunistic pathogens before treatment. Our results demonstrate the effects of antibiotic therapy on induced dysbiosis and expansion of opportunistic pathogen populations and antibiotic resistant subpopulations of those pathogens. Follow-up studies with larger samples sizes and potentially controlled clinical investigations should be performed to confirm our findings.
Circulating RNA biomarkers in diffuse large B-cell lymphoma: a systematic review
Authors: Decruyenaere Philippe , Offner Fritz , Vandesompele Jo
Published: February 2021

Diffuse large B-cell lymphoma (DLBCL) is the most common histological subtype of non-Hodgkin’s lymphomas (NHL). DLBCL is an aggressive malignancy that displays a great heterogeneity in terms of morphology, genetics and biological behavior. While a sustained complete remission is obtained in the majority of patients with standard immunochemotherapy, patients with refractory of relapsed disease after first-line treatment have a poor prognosis. This patient group represents an important unmet need in lymphoma treatment. In recent years, improved understanding of the underlying molecular pathogenesis had led to new classification and prognostication tools, including the development of cell-free biomarkers in liquid biopsies. Although the majority of studies have focused on the use of cell-free fragments of DNA (cfDNA), there has been an increased interest in circulating-free coding and non-coding RNA, including messenger RNA (mRNA), microRNA (miRNA), long non-coding RNA (lncRNA) and circular RNA (circRNA), as well as RNA encapsulated in extracellular vesicles or tumor-educated platelets (TEPs). We performed a systematic search in PubMed to identify articles that evaluated circulating RNA as diagnostic, subtype, treatment response or prognostic biomarkers in a human DLBCL population. A total of 35 articles met the inclusion criteria. The aim of this systematic review is to present the current understanding of circulating RNA molecules as biomarker in DLBCL and to discuss their future potential.
Metacognition and emotion regulation as treatment targets in binge eating disorder: a network analysis study
Authors: Aloi Matteo , Rania Marianna , Carbone Elvira Anna , Caroleo Mariarita , Calabrò Giuseppina , Zaffino Paolo , Nicolò Giuseppe , Carcione Antonino , Coco Gianluca Lo , Cosentino Carlo , Segura-Garcia Cristina
Published: February 2021

Background

This study aims to examine the underlying associations between eating, affective and metacognitive symptoms in patients with binge eating disorder (BED) through network analysis (NA) in order to identify key variables that may be considered the target for psychotherapeutic interventions.

Methods

A total of 155 patients with BED completed measures of eating psychopathology, affective symptoms, emotion regulation and metacognition. A cross-sectional network was inferred by means of Gaussian Markov random field estimation using graphical LASSO and the extended Bayesian information criterion (EBIC-LASSO), and central symptoms of BED were identified by means of the strength centrality index.

Results

Impaired self-monitoring metacognition and difficulties in impulse control emerged as the symptoms with the highest centrality. Conversely, eating and affective features were less central. The centrality stability coefficient of strength was above the recommended cut-off, thus indicating the stability of the network.

Conclusions

According to the present NA findings, impaired self-monitoring metacognition and difficulties in impulse control are the central nodes in the psychopathological network of BED whereas eating symptoms appear marginal. If further studies with larger samples replicate these results, metacognition and impulse control could represent new targets of psychotherapeutic interventions in the treatment of BED. In light of this, metacognitive interpersonal therapy could be a promising aid in clinical practice to develop an effective treatment for BED.
Nucleolar stress in C9orf72 and sporadic ALS spinal motor neurons precedes TDP-43 mislocalization
Authors: Aladesuyi Arogundade Olubankole , Nguyen Sandra , Leung Ringo , Wainio Danielle , Rodriguez Maria , Ravits John
Published: February 2021

Nucleolar stress has been implicated in the pathology and disease pathogenesis of amyotrophic lateral sclerosis (ALS) and frontotemporal lobar degeneration (FTLD) from repeat expansions of GGGGCC in C9orf72 (C9-ALS/FTLD) but not in sporadic ALS (SALS). Previously we reported that antisense RNA transcripts are unique in C9-ALS because of their nucleolar localization in spinal motor neurons and correlation with TDP-43 mislocalization, the hallmark proteinopathy of ALS and FTLD. Here we report our further studies of 11 SALS, 11 C9-ALS and 11 control spinal cords. We find that nucleolar stress manifests specifically as shrinkage in nucleoli of C9-ALS spinal motor neurons. Nucleolar size reduction is greatest in similarly sized alpha motor neurons from C9-ALS cases and results are not skewed by the number of surviving neurons from each ALS spinal cord. Surprisingly, nucleolar shrinkage occurs before main pathological hallmarks—TDP-43 mislocalization or antisense RNA foci—appear and this suggest that nucleolar stress can precede pathology in C9-ALS, findings previously identified in C9-FTLD using sense RNA foci and dipeptide repeat proteins as pathological markers. Importantly, these observations are also seen in SALS motor neurons and thus nucleolar stress appears to be a significant and probably upstream problem in sporadic disease.