bluuebunny/crossref_metadata_2025 huggingface dataset:
High risk of relapsed disease in patients with NK/T-cell chronic active Epstein-Barr virus disease outside of Asia
Authors: Dávila Saldaña Blachy J. , John Tami , Bonifant Challice , Buchbinder David , Chandra Sharat , Chandrakasan Shanmuganathan , Chang Weni , Chen Leon , Elfassy Hannah L. , Geerlinks Ashley V. , Giller Roger H. , Goyal Rakesh , Hagin David , Islam Shahidul , Mallhi Kanwaldeep , Miller Holly K. , Owen William , Pacheco Martha , Patel Niraj C. , Querfeld Christiane , Quigg Troy , Richard Nameeta , Schiff Deborah , Shereck Evan , Stenger Elizabeth , Jordan Michael B. , Heslop Helen E. , Bollard Catherine M. , Cohen Jeffrey I.
Published: October 2021

Chronic active Epstein-Barr virus (EBV) disease (CAEBV) is characterized by high levels of EBV predominantly in T and/or natural killer cells with lymphoproliferation, organ failure due to infiltration of tissues with virus-infected cells, hemophagocytic lymphohistiocytosis, and/or lymphoma. The disease is more common in Asia than in the United States and Europe. Although allogeneic hematopoietic stem cell transplantation (HSCT) is considered the only curative therapy for CAEBV, its efficacy and the best treatment modality to reduce disease severity prior to HSCT is unknown. Here, we retrospectively assessed an international cohort of 57 patients outside of Asia. Treatment of the disease varied widely, although most patients ultimately proceeded to HSCT. Though patients undergoing HSCT had better survival than those who did not (55% vs 25%, P < .01), there was still a high rate of death in both groups. Mortality was largely not affected by age, ethnicity, cell-type involvement, or disease complications, but development of lymphoma showed a trend with increased mortality (56% vs 35%, P = .1). The overwhelming majority (75%) of patients who died after HSCT succumbed to relapsed disease. CAEBV remains challenging to treat when advanced disease is present. Outcomes would likely improve with better disease control strategies, earlier referral for HSCT, and close follow-up after HSCT including aggressive management of rising EBV DNA levels in the blood.
Home monitoring of physiology and symptoms to detect interstitial lung disease exacerbations and progression: a systematic review
Authors: Althobiani Malik A. , Evans Rebecca A. , Alqahtani Jaber S. , Aldhahir Abdulelah M. , Russell Anne-Marie , Hurst John R. , Porter Joanna C.
Published: October 2021

Background

Acute exacerbations (AEs) and disease progression in interstitial lung disease (ILD) pose important challenges to clinicians and patients. AEs of ILD are variable in presentation but may result in rapid progression of ILD, respiratory failure and death. However, in many cases AEs of ILD may go unrecognised so that their true impact and response to therapy is unknown. The potential for home monitoring to facilitate early, and accurate, identification of AE and/or ILD progression has gained interest. With increasing evidence available, there is a need for a systematic review on home monitoring of patients with ILD to summarise the existing data. The aim of this review was to systematically evaluate the evidence for use of home monitoring for early detection of exacerbations and/or progression of ILD.

Method

We searched Ovid-EMBASE, MEDLINE and CINAHL using Medical Subject Headings (MeSH) terms in accordance with the PRISMA guidelines (PROSPERO registration number CRD42020215166).

Results

13 studies involving 968 patients have demonstrated that home monitoring is feasible and of potential benefit in patients with ILD. Nine studies reported that mean adherence to home monitoring was >75%, and where spirometry was performed there was a significant correlation (r=0.72–0.98, p<0.001) between home and hospital-based readings. Two studies suggested that home monitoring of forced vital capacity might facilitate detection of progression in idiopathic pulmonary fibrosis.

Conclusion

Despite the fact that individual studies in this systematic review provide supportive evidence suggesting the feasibility and utility of home monitoring in ILD, further studies are necessary to quantify the potential of home monitoring to detect disease progression and/or AEs.
A sui generis QA approach using RoBERTa for adverse drug event identification
Authors: Jain Harshit , Raj Nishant , Mishra Suyash
Published: October 2021

Background

Extraction of adverse drug events from biomedical literature and other textual data is an important component to monitor drug-safety and this has attracted attention of many researchers in healthcare. Existing works are more pivoted around entity-relation extraction using bidirectional long short term memory networks (Bi-LSTM) which does not attain the best feature representations.

Results

In this paper, we introduce a question answering framework that exploits the robustness, masking and dynamic attention capabilities of RoBERTa by a technique of domain adaptation and attempt to overcome the aforementioned limitations. With formulation of an end-to-end pipeline, our model outperforms the prior work by 9.53% F1-Score.

Conclusion

An end-to-end pipeline that leverages state of the art transformer architecture in conjunction with QA approach can bolster the performances of entity-relation extraction tasks in the biomedical domain. In particular, we believe our research would be helpful in identification of potential adverse drug reactions in mono as well as combination therapy related textual data.
Whole genome based insights into the phylogeny and evolution of the Juglandaceae
Authors: Zhou Huijuan , Hu Yiheng , Ebrahimi Aziz , Liu Peiliang , Woeste Keith , Zhao Peng , Zhang Shuoxin
Published: October 2021

Background

The walnut family (Juglandaceae) contains commercially important woody trees commonly called walnut, wingnut, pecan and hickory. Phylogenetic relationships and diversification within the Juglandaceae are classic and hot scientific topics that have been elucidated by recent fossil, morphological, molecular, and (paleo) environmental data. Further resolution of relationships among and within genera is still needed and can be achieved by analysis of the variation of chloroplast, mtDNA, and nuclear genomes.

Results

We reconstructed the backbone phylogenetic relationships of Juglandaceae using organelle and nuclear genome data from 27 species. The divergence time of Juglandaceae was estimated to be 78.7 Mya. The major lineages diversified in warm and dry habitats during the mid-Paleocene and early Eocene. The plastid, mitochondrial, and nuclear phylogenetic analyses all revealed three subfamilies, i.e., Juglandoideae, Engelhardioideae, Rhoipteleoideae. Five genera of Juglandoideae were strongly supported. Juglandaceae were estimated to have originated during the late Cretaceous, while Juglandoideae were estimated to have originated during the Paleocene, with evidence for rapid diversification events during several glacial and geological periods. The phylogenetic analyses of organelle sequences and nuclear genome yielded highly supported incongruence positions for J. cinerea, J. hopeiensis, and Platycarya strobilacea. Winged fruit were the ancestral condition in the Juglandoideae, but adaptation to novel dispersal and regeneration regimes after the Cretaceous-Paleogene boundary led to the independent evolution of zoochory among several genera of the Juglandaceae.

Conclusions

A fully resolved, strongly supported, time-calibrated phylogenetic tree of Juglandaceae can provide an important framework for studying classification, diversification, biogeography, and comparative genomics of plant lineages. Our addition of new, annotated whole chloroplast genomic sequences and identification of their variability informs the study of their evolution in walnuts (Juglandaceae).
Nonlinear relationship between sleep duration and non-suicidal self-injurious behaviour among Chinese adolescents
Authors: Tang Ying , Wan Yuhui , Xu Shaojun , Zhang Shichen , Hao Jiahu , Tao Fangbiao
Published: October 2021

Background

Previous studies have shown a positive association between sleep deprivation and non-suicidal self-injury (NSSI) among adolescents, but few studies have described the effects of oversleeping and weekend catch-up sleep on NSSI. The present study aimed to explore the nonlinear relationship between sleep duration and NSSI among Chinese adolescents.

Methods

Data from China’s National Adolescent Health Surveillance for the years 2014 to 2015 were collected from 15,713 students located across four provinces in China. A self-report questionnaire was used to assess sleep duration and 12-month NSSI. Binomial logistic regression models were used to examine the association between NSSI and sleep duration. The locally estimated scatter plot smoothing (LOESS) method was used to explore the associations of total NSSI number with sleep duration, and binomial regression analysis was used to test this relationship.

Results

About 68.5% of adolescents reported sleeping less than 8 h on weeknights, while 37.8% of adolescents slept more than 10 h per night during weekends. The 12-month prevalence rate of NSSI was 29.4%. Compared to adolescents who reported weekend catch-up sleep of 0–1 h, those who slept < 0 h (adjusted odds ratio [aOR] = 1.38, 95% Confidence Interval [95% CI]: 1.16–1.64) had a higher risk of NSSI. Males who reported ≥3 h of weekend catch-up sleep had significantly increased odds of NSSI (aOR = 1.20, 95%CI: 1.01–1.42). Notably, a positive U-shaped association was observed between the sleep duration and the total NSSI number.

Conclusions

The findings reveal a nonlinear relationship between sleep duration and NSSI among Chinese adolescents. Therefore, it is necessary to be vigilant and screen for sleep duration among adolescents in NSSI treatment or prevention.
Health care providers’ perceptions of barriers to perinatal mental healthcare in South Africa
Authors: Brown Shelley , Sprague Courtenay
Published: October 2021

Background

Perinatal mental disorders are a leading contributor to morbidity and mortality during pregnancy and postpartum, and are highly treatable when identified early. However, many women, especially in low and middle-income countries, lack access to routine identification and treatment of mental illness in public health settings. The prevalence of perinatal depression and anxiety disorders, common mental disorders, is three times higher for South African women relative to women in high-income countries. The public health system has begun to integrate mental health into maternal care, making South Africa a relevant case study of perinatal mental healthcare. Yet studies are few. We sought to investigate healthcare providers’ perceptions of the barriers to early identification and screening of common perinatal mental disorders in public health facilities in South Africa.

Methods

Employing qualitative methods, we used purposive sampling to identify study participants, supplemented by snowball sampling. From September 2019–June 2020, we conducted in-depth interviews with 24 key informants in South Africa. All interviews were recorded and transcribed verbatim. We used a thematic approach to generate initial analytical themes and then conducted iterative coding to refine them. We adapted a delivery systems’ framework to organise the findings, depicted in a conceptual map.

Results

Reported barriers to early identification and treatment of mental illness in the perinatal period encompassed four levels: (1) structural factors related to policies, systems and resources; (2) socio-cultural factors, including language and cultural barriers; (3) organisational factors, such as lack of provider preparation and training and overburdened clinics; and (4) individual patient and healthcare provider factors.

Conclusion

Barriers act across multiple levels to reduce quality mental health promotion and care, thereby creating an environment where inequitable access to identification of mental disorders and quality mental health services was embedded into systems and everyday practice. Integrated interventions across multiple levels are essential to improve the early identification and treatment of mental illness in perinatal women in South Africa. We provide recommendations derived from our findings to overcome barriers at each of the four identified levels.
Investigating the effect of health transformation plan on the public hospitals performance indicators; a case study from Iran
Authors: Ranjbar Mohammad , Bazyar Mohammad , Jafari Hassan , Pakdaman Mohsen , Pirasteh Vahid
Published: October 2021

Background

Health systems need constant changes and reforms in their structure to adapt to changing conditions and meet the needs of society. One of the fundamental changes in the health system of Iran is the health transformation plan (HTP), the effects of which must be examined from different aspects. Therefore, the purpose of this study is to investigate the effect of HTP on the performance indicators of public hospitals in Yazd city, Iran.

Methods

This cross-sectional study was carried out in all public hospitals in city of Yazd. Six performance indicators were examined monthly and in two time periods of 12 months before and 12 months after the implementation of Health Transformation Plan (HTP). The data was analyzed by SPSS software program version 22, using the paired T-test, and the Interrupted Time Series (ITS) model.

Findings

Findings showed that the performance indicators of the studied hospitals have improved after the implementation of the HTP. According to the ITS model, the implementation of HTP did not have a significant effect on the level and trend of the bed rotation distance, average length of stay and the ratio of surgical operations to bed indicators. However, it had a statistically significant effect on the level and trend of mortality and hospitalization rates. Moreover, the implementation of HTP had a significant effect on the level of the bed occupancy rate, but did not have a significant effect on the trend of this indicator.

Conclusion

Based on the research findings, all the selected indicators changed to some extent after the implementation of HTP, which showed the effect of this plan on the performance of hospitals. However, not all indicators were statistically significant as the findings sub-section revealed.
Effect of hydrogen gas inhalation on patient QOL after hepatectomy: protocol for a randomized controlled trial
Authors: Kaibori Masaki , Kosaka Hisashi
Published: October 2021

Introduction

Molecular hydrogen had been considered inactive in vivo but is an antioxidant that selectively reduces highly toxic reactive oxygen species (ROS). Animal studies have reported that hydrogen gas inhalation helped alleviate cerebral and cardiac ischemia-reperfusion injuries. In humans, hydrogen inhalation therapy is presently approved as a treatment under Advanced Medical Care B in Japan (jRCTs031180352: limited to adult patients who suffered out-of-hospital cardiac arrest and are in a continuous coma) and its effectiveness is being examined in a clinical trial. The Japanese government has introduced the “Advanced Medical Care System” to promote the development of drugs and devices under governmental regulations. Advanced Medical Care B is a system designed for unapproved or off-label drugs or medical technologies used in a clinical trial setting. Hepatectomy is generally performed with repeated hepatic blood-flow occlusion and then reperfusion (ischemia and reperfusion). No report, however, has been made on ROS inhibition by hydrogen inhalation therapy or its effectiveness in post-hepatectomy patients. Hydrogen gas inhalation in the early stages after hepatectomy is anticipated to inhibit liver dysfunction by inhibiting ROS.

Methods and analysis

This study is a randomized, controlled, double-blind superiority trial, which will be conducted as a “specified clinical trial” in accordance with the Clinical Trials Act in Japan. Trial registration was prospectively completed before the first participant was enrolled.

The subjects will be patients who will undergo hepatectomy and will be allocated randomly into group A with hydrogen gas inhalation or group B with air inhalation after hepatectomy. The study will examine if hydrogen gas inhalation improves QOL of post-hepatectomy patients. The primary endpoint is patient QOL (score of a 40-item quality of recovery questionnaire, QoR40) on postoperative day 3 and the secondary endpoints are QoR40s besides that on postoperative day 3, grade of postoperative complications (Clavien-Dindo score), level of pain (Numerical Rating Scale (NRS)), amount of dietary intake, liver function, inflammation level, 8-hydroxydeoxyguanosine (urinary 8-OHdG) level, and number of pedometer-assessed steps.

Ethics and dissemination

The study protocol has been approved by the Niigata University Central Review Board of Clinical Research. The findings of this study will be widely disseminated through peer-reviewed publications and conference presentations.

Trial registration

jRCTs 03220332. Registered on 21 January 2021
Combined therapy with intravitreal aflibercept and subtenon corticosteroids in eyes with severe diabetic papillopathy: two case reports
Authors: Arapi Ilir , Neri Piergiorgio , Giovannini Alfonso , Grezda Arjeta
Published: October 2021

Background

Diabetic papillopathy is a rare diagnosis of exclusion characterized by unilateral or bilateral optic disc edema with variable degrees of visual loss. Although the visual prognosis has been generally reported as favorable, the presence of severe disc edema associated with macular edema prompts the need for treatment. We present a specific and unreported therapeutic approach consisting of intravitreal aflibercept and subtenon triamcinolone acetonide injections in two patients with evidence of diabetic papillopathy and macular edema.

Case presentation

In the first case, a 60-year-old Caucasian woman affected by type II diabetes mellitus presented with fundoscopic evidence of sequential bilateral optic disc edema associated with acute severe visual loss in both eyes. The second patient, a diabetic 57-year-old Caucasian male, presented with sudden painless visual loss in his left eye. Multimodal imaging and systemic findings correlated towards an infrequent diagnosis of diabetic papillopathy. In a period of 5–7 weeks after treatment, both patients experienced almost full visual and anatomical recovery. A steady situation was observed at 12 months of follow-up.

Conclusions

Both our cases displayed a severe grade of optic disc edema, which was optimally reversed with intravitreal aflibercept and subtenon triamcinolone acetonide leading to a relatively rapid and safe improvement in visual acuity.
Computational determination of toxicity risks associated with a selection of approved drugs having demonstrated activity against COVID-19
Authors: Aminpour Maral , Delgado Williams Ernesto Miranda , Wacker Soren , Noskov Sergey , Houghton Michael , Tyrrell D. Lorne J. , Tuszynski Jack A.
Published: October 2021

Background

The emergence and rapid spread of SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) in thelate 2019 has caused a devastating global pandemic of the severe pneumonia-like disease coronavirus disease 2019 (COVID-19). Although vaccines have been and are being developed, they are not accessible to everyone and not everyone can receive these vaccines. Also, it typically takes more than 10 years until a new therapeutic agent is approved for usage. Therefore, repurposing of known drugs can lend itself well as a key approach for significantly expediting the development of new therapies for COVID-19.

Methods

We have incorporated machine learning-based computational tools and in silico models into the drug discovery process to predict Adsorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) profiles of 90 potential drugs for COVID-19 treatment identified from two independent studies mainly with the purpose of mitigating late-phase failures because of inferior pharmacokinetics and toxicity.

Results

Here, we summarize the cardiotoxicity and general toxicity profiles of 90 potential drugs for COVID-19 treatment and outline the risks of repurposing and propose a stratification of patients accordingly. We shortlist a total of five compounds based on their non-toxic properties.

Conclusion

In summary, this manuscript aims to provide a potentially useful source of essential knowledge on toxicity assessment of 90 compounds for healthcare practitioners and researchers to find off-label alternatives for the treatment for COVID-19. The majority of the molecules discussed in this manuscript have already moved into clinical trials and thus their known pharmacological and human safety profiles are expected to facilitate a fast track preclinical and clinical assessment for treating COVID-19.
Cerebral hemorrhagic infarction was diagnosed subsequently after high-amplitude slow waves detected on processed electroencephalogram during sedation: a case report
Authors: Mihara Keisuke , Nakahara Haruna , Iwashita Kouhei , Shigematsu Kenji , Yamaura Ken , Akiyoshi Kozaburo
Published: October 2021

Background

Continuous electroencephalogram (EEG) monitoring is useful for assessing the level of sedation and detecting non-convulsive epileptic seizures and cerebral ischemia in the intensive care unit. This report describes a case of cerebral hemorrhagic infarction diagnosed after the detection of high-amplitude slow waves on processed EEG during sedation.

Case presentation

A 68-year-old man who underwent cardiac surgery was sedated in the intensive care unit following an invasive procedure. High-amplitude slow waves appeared on processed EEG monitoring before the detection of anisocoria. Computed tomography revealed a cerebral hemorrhagic infarction.

Conclusions

In the management of critically ill patients, continuous EEG monitoring with forehead electrodes may be useful in the early detection of brain lesions.
The Thyroid Hormone Transporter MCT10 Is a Novel Regulator of Trabecular Bone Mass and Bone Turnover in Male Mice
Authors: Lademann Franziska , Mayerl Steffen , Tsourdi Elena , Verrey Francois , Leitch Victoria D , Williams Graham R , Bassett J H Duncan , Hofbauer Lorenz C , Heuer Heike , Rauner Martina
Published: October 2021

Thyroid hormones (TH) are essential for skeletal development and adult bone homeostasis. Their bioavailability is determined by specific transporter proteins at the cell surface. The TH-specific transporter monocarboxylate transporter 8 (MCT8) was recently reported as a regulator of bone mass in mice. Given that high systemic triiodothyronine (T3) levels in Mct8 knockout (KO) mice are still able to cause trabecular bone loss, alternative TH transporters must substitute for MCT8 function in bone. In this study, we analyzed the skeletal phenotypes of male Oatp1c1 KO and Mct10 KO mice, which are euthyroid, and male Mct8/Oatp1c1 and Mct8/Mct10 double KO mice, which have elevated circulating T3 levels, to unravel the role of TH transport in bone. MicroCT analysis showed no significant trabecular bone changes in Oatp1c1 KO mice at 4 weeks and 16 weeks of age compared with wild-type littermate controls, whereas 16-week-old Mct8/Oatp1c1 double KO animals displayed trabecular bone loss. At 12 weeks, Mct10 KO mice, but not Mct8/Mct10 double KO mice, had decreased trabecular femoral bone volume with reduced osteoblast numbers. By contrast, lack of Mct10 in 24-week-old mice led to trabecular bone gain at the femur with increased osteoblast numbers and decreased osteoclast numbers whereas Mct8/Mct10 double KO did not alter bone mass. Neither Mct10 nor Mct8/Mct10 deletion affected vertebral bone structures at both ages. In vitro, osteoblast differentiation and activity were impaired by Mct10 and Mct8/Mct10-deficiency. These data demonstrate that MCT10, but not OATP1C1, is a site- and age-dependent regulator of bone mass and turnover in male mice.
Continuous Local Anesthetic Infusion via Chest Wall Catheter for Analgesia After Thoracic Surgery in Neonates: A Case Series
Authors: Dixit Divya , Choudhry Dinesh K. , Reichard Kirk
Published: October 2021

Pain management options in neonates after thoracotomy have traditionally been limited to intravenous opioids and caudal catheters. However, because of increasing familiarity with ultrasound imaging, erector spinae and paravertebral nerve blocks are being performed more frequently. For thoracic procedures, we describe a case series of 4 neonates involving ropivacaine infusion via an extrathoracic chest wall catheter placed by the surgeon. This technique requires less time, is less invasive, does not require ultrasound, and enabled us to accomplish tracheal extubation in the operating room immediately after surgery, and decreased postoperative opioid use in the neonatal intensive care unit.
Occurrence of Abudefduf spp. (Pisces: Pomacentridae) in the Lebanese coastal water (eastern Mediterranean) - morphological traits and visual evidence
Authors: BITAR GHAZI
Published: October 2021

New records of fish of the genus Abudefduf observed and photographed in the Lebanese coastal waters are reported in the paper. The individuals from photos were examined on the basis of visible external morphological characters and geographical location already known in the Mediterranean Sea, as well as compared with photos taken elsewhere in their natural environments from various origins. In agreement with that reported by other authors, a careful analysis of these photos shows uncertainties in the validity of the visual characters previously used to distinguish between the two congeners A. vaigiensis and A. saxatilis already reported in the Mediterranean Sea, and even their possible confusion with A. troschelii. In some individuals, new morphological features are emphasized and may provide visual evidence for the presence of Abudefduf cf. troschelii (Gill, 1862). Sympatry and possible hybridization are discussed.
Ocean literacy and scientific data acquisition through citizen science campaigns: a mixed approach in the Maltese Islands to collect information on Pinna nobilis and Pinna rudis
Authors: DEIDUN ALAN , PREVIATI MONICA , MARRONE ALESSIO , GAUCI ADAM , ZAMMIT AUDREY , TARASOVA RAISA , GALEA ANTHONY , GALDIES JOHANN , FRASCHETTI SIMONETTA , DRAGO ALDO
Published: October 2021

The genus Pinna includes two species in the Mediterranean Sea: Pinna nobilis and Pinna rudis. Both these species are under threat from multiple stressors. Pinna nobilis, in particular, has been exhibiting mass mortality events (MMEs) since 2016. The population and distribution of these species have never been comprehensively explored in the Maltese archipelago, and in this work, we collate information collected between 2006 and 2019 through a number of SCUBA underwater visual census monitoring programs. The logistical barriers surrounding SCUBA-based sampling techniques and the low-density distribution of these species constitute significant obstacles to  an extensive conventional population assessment. Citizen science was thus also deployed in this study to supplement the data collected through SCUBA surveys: recreational SCUBA divers worked as citizen scientists, providing data on the distribution of these two endangered species from areas never explored before. This information can be used for assessing the conservation status of P. nobilis and P. rudis in Maltese waters, whilst contributing to the next generation of ocean-literate citizens.
Demystifying consultant nurse roles in gastrointestinal nursing: what they do and how to become one
Authors: Watson Harriet , Taylor Claire , Hibberts Fiona
Published: October 2021

In this descriptive article, three consultant nurses share their journeys into and experiences of working in consultant nurse roles in different areas of gastrointestinal (GI) practice. These narrative discussions detail what is rewarding but also challenging about being a 'super nurse', as the role was characterised by Prime Minister Tony Blair on its introduction in 1998. The stories aim to offer practical advice to aspiring consultant nurses and dispel any misconceptions among those considering this career path. They also provide some political context for the consultant nurse and demonstrate the diversity and flexibility of these roles.
The Magnet hospital model
Authors: Harrison Penny
Published: October 2021

Penny Harrison explores the Magnet model of hospital accreditation and its potential value to UK nursing services

[Figure: see text]
Career talk: advanced virology specialist nurse and postdoctoral researcher
Authors: While Sara , Jack Kathryn
Published: October 2021

In this interview, part of a series about the career pathways of experienced gastrointestinal specialists, Sara Santos speaks with Kathryn Jack
ESGENA at 25: connection, education and sustainability
Authors: Beilenhoff Ulrike
Published: October 2021

Ulrike Beilenhoff provides an update on the activities of the European Society of Gastroenterology and Endoscopy Nurses and Associates (ESGENA)
‘Creating a safe space’: how perinatal palliative care coordinators navigate care and support for families
Authors: Côté-Arsenault Denise , Denney-Koelsch Erin , Elliott Gail
Published: October 2021

Background:

Families who learn that their unborn baby has a life-limiting fetal condition are often overwhelmed by this news, alongside navigating an unfamiliar healthcare system. A skilled perinatal palliative care coordinator (PPCC) can help these families, yet little is known about their function and roles.

Aims:

This study sought to describe the PPCC's approach to care, their guiding principles and the roles, knowledge and skills that enable them to provide exemplary care.

Methods:

This qualitative descriptive study included interviews of 12 expert PPCCs. Directed content analysis was used to identify major codes. Iterative analysis led to theme identification.

Findings:

Findings include the PPCC's position within the healthcare system, guiding principles, goals, roles and responsibilities, and knowledge and skills. Two figures enhance the understanding of the PPCCs approach to creating a safe space for the family, supporting the interdisciplinary team and facilitating coordinated birth planning.

Conclusions:

Every perinatal palliative care programme should include a PPCC. Future research on clinical training could examine the effectiveness of an educational intervention, using the detailed knowledge and skills learned in this study as a curriculum.
Redisplacement of Paediatric Distal Radius Fractures: What is the Problem?
Authors: Constantino Diogo M.C. , Machado Luis , Carvalho Marcos , Cabral João , Sá Cardoso Pedro , Balacó Inês , Ling Tah Pu , Alves Cristina
Published: October 2021

Purpose

Distal radius fractures represent one of the most common fractures in children. Our purpose is to analyze risk factors for redisplacement in children with distal radius fractures treated by means of closed reduction and plaster cast immobilization.

Methods

Retrospective study, including children under the age of 17 years, who underwent closed manipulation and cast immobilization for a distal third radius fracture, between 2012 and 2015. Preoperative radiographs were reviewed for initial translation, angulation and shortening, distance of the fracture from the physis, degree of fracture obliquity and the presence of an ulna fracture. Postoperative radiographs were analyzed for translation, angulation and shortening, as well as the quality of closed reduction. Cast index, gap index and three-point index, were measured on the postoperative radiographs. Redisplacement and re-intervention during follow-up were registered.

Results

A total of 26 patients were included in this study. Comparison between post-reduction and immediate post-cast removal radiographs did not show any statistically significant difference between translation or shortening. Coronal (p = 0.002) and sagittal (p = 0.002) angulation showed a statistically significant difference, but both median values remained below cut-off values for redisplacement. Redisplacement was observed in four patients. Only one patient underwent remanipulation. All four had full remodelling and proper radiological alignment at final follow-up. Quality of reduction was found to be a statistically significant risk factor for redisplacement (p = 0.013).

Conclusion

Closed reduction and cast immobilization under general anaesthesia yields good results in the treatment of distal forearm fractures in paediatric patients. Quality of reduction was the only risk factor that we found to be predictive of redisplacement.

Level of Evidence

Level III – Retrospective comparative study
Production, chemical components, and content of bioactive compounds of strawberry cultivars
Authors: Carvalho Sarah Fiorelli de , Correa Ana Paula  Antunes , Ferreira Letícia Vanni , Vizzotto Marcia , Antunes Luis Eduardo Corrêa
Published: October 2021

There are only a few strawberry cultivars available in Brazil and all are imported from North America and Europe. Thus, the introduction of new materials and their evaluation under Brazilian environmental conditions is imperative. The objective of this study was to evaluate the production, chemical components, and concentration of bioactive compounds in strawberry cultivars under edaphoclimatic conditions in the municipality of Pelotas-RS. The experiment was conducted in the field with low tunnels in 2011 and 2012. The experiment in the field was arranged in a completely randomized design, with eight treatments (cultivars), four replications. Each plot consisted of nine plants. The experiment in laboratory was arranged in a completely randomized 8x3 factorial design (8 cultivars and 3 months of harvest) and 4 replications. The variables analyzed were fruit number and fruit mass per plant, production, yield, soluble solid content, titratable acidity, ascorbic acid, anthocyanins, phenolic compounds, and antioxidant activity. Cultivar and harvest month influenced acidity, and the contents of soluble solids, ascorbic acid, and bioactive compounds. Cultivar Camarosa showed higher production, and higher contents of anthocyanin, phenolic compounds, and soluble solids. Cultivars ‘Palomar and ‘Aromas’ stand out for the content of ascorbic acid.
Intensifying Caribbean market share within China: a CARICOM case assessment
Authors: Alleyne Antonio
Published: October 2021

This study researches the possibilities of improving export receipts through China and its expressed dedication to the region’s development. Using the gravity approach, the study revealed that the Caribbean has yet to exploit available export opportunities with China, thereby warranting a more aggressive and sustained export strategy. A large portion of the region’s exports into China offers significant expansion possibilities. Despite largely unexplored opportunities, the Caribbean is also confronted by various inherent and external challenges. With significant declines in export feasibility, the Caribbean needs to develop an aggressive export-led strategy for a united Caribbean into China. However, caution is warranted when advancing international trade policies. At present, the Caribbean is unable to engender long-standing trade relations to strengthen the dealings with a newer, though growing, partner.
Concesión del Premio Luz Marina García Herrera al mejor artículo de Scripta Nova (2020)
Authors: Murray Mas Ivan
Published: October 2021

La evaluación de los artículos se realizó en dos fases hasta finales de julio de 2020, cuando finalmente el jurado decidió que el mejor artículo de 2020 era el de Michael Byrne: Los «bancos malos» y la resolución de la crisis financiero-inmobiliaria en Europa. La selección de este artículo no fue fácil, ya que el resto de los artículos seleccionados eran también de gran calidad y respondían a aspectos de enorme interés social. De hecho, una de las virtudes de la revista reside en la amplitud temática y de enfoques que alberga. Sin embargo, eso también añade más complejidad a la hora de decidir un premio de estas características. En cualquier caso, consideramos que el artículo premiado resulta muy novedoso en la geografía crítica de habla hispana al profundizar en los giros institucionales, mediante la creación de los “bancos malos” como solución espacial a la crisis financiero-inmobiliaria, y destacar cómo, tras la crisis, se intensifican los circuitos globales del capital financiero-inmobiliario. Precisamente, la relevancia de la temática viene corroborada por el hecho que el primer dosier monográfico de la revista en 2021 se ha dedicado precisamente al complejo urbano financiero inmobiliario en América Latina.
Minimalistic mycoplasmas harbor different functional toxin-antitoxin systems
Authors: Hill Virginia , Akarsu Hatice , Barbarroja Rubén Sánchez , Cippà Valentina L. , Kuhnert Peter , Heller Martin , Falquet Laurent , Heller Manfred , Stoffel Michael H. , Labroussaa Fabien , Jores Joerg
Published: October 2021

Mycoplasmas are minute bacteria controlled by very small genomes ranging from 0.6 to 1.4 Mbp. They encompass several important medical and veterinary pathogens that are often associated with a wide range of chronic diseases. The long persistence of mycoplasma cells in their hosts can exacerbate the spread of antimicrobial resistance observed for many species. However, the nature of the virulence factors driving this phenomenon in mycoplasmas is still unclear. Toxin-antitoxin systems (TA systems) are genetic elements widespread in many bacteria that were historically associated with bacterial persistence. Their presence on mycoplasma genomes has never been carefully assessed, especially for pathogenic species. Here we investigated three candidate TA systems in M. mycoides subsp. capri encoding a (i) novel AAA-ATPase/subtilisin-like serine protease module, (ii) a putative AbiEii/AbiEi pair and (iii) a putative Fic/RelB pair. We sequence analyzed fourteen genomes of M. mycoides subsp. capri and confirmed the presence of at least one TA module in each of them. Interestingly, horizontal gene transfer signatures were also found in several genomic loci containing TA systems for several mycoplasma species. Transcriptomic and proteomic data confirmed differential expression profiles of these TA systems during mycoplasma growth in vitro. While the use of heterologous expression systems based on E. coli and B. subtilis showed clear limitations, the functionality and neutralization capacities of all three candidate TA systems were successfully confirmed using M. capricolum subsp. capricolum as a host. Additionally, M. capricolum subsp. capricolum was used to confirm the presence of functional TA system homologs in mycoplasmas of the Hominis and Pneumoniae phylogenetic groups. Finally, we showed that several of these M. mycoides subsp. capri toxins tested in this study, and particularly the subtilisin-like serine protease, could be used to establish a kill switch in mycoplasmas for industrial applications.
Deficiency in cytosine DNA methylation leads to high chaperonin expression and tolerance to aminoglycosides in Vibrio cholerae
Authors: Carvalho André , Mazel Didier , Baharoglu Zeynep
Published: October 2021

Antibiotic resistance has become a major global issue. Understanding the molecular mechanisms underlying microbial adaptation to antibiotics is of keen importance to fight Antimicrobial Resistance (AMR). Aminoglycosides are a class of antibiotics that target the small subunit of the bacterial ribosome, disrupting translational fidelity and increasing the levels of misfolded proteins in the cell. In this work, we investigated the role of VchM, a DNA methyltransferase, in the response of the human pathogen Vibrio cholerae to aminoglycosides. VchM is a V. cholerae specific orphan m5C DNA methyltransferase that generates cytosine methylation at 5’-RCCGGY-3’ motifs. We show that deletion of vchM, although causing a growth defect in absence of stress, allows V. cholerae cells to cope with aminoglycoside stress at both sub-lethal and lethal concentrations of these antibiotics. Through transcriptomic and genetic approaches, we show that groESL-2 (a specific set of chaperonin-encoding genes located on the second chromosome of V. cholerae), are upregulated in cells lacking vchM and are needed for the tolerance of vchM mutant to lethal aminoglycoside treatment, likely by fighting aminoglycoside-induced misfolded proteins. Interestingly, preventing VchM methylation of the four RCCGGY sites located in groESL-2 region, leads to a higher expression of these genes in WT cells, showing that the expression of these chaperonins is modulated in V. cholerae by DNA methylation.
Leveraging auxiliary data from arbitrary distributions to boost GWAS discovery with Flexible cFDR
Authors: Hutchinson Anna , Reales Guillermo , Willis Thomas , Wallace Chris
Published: October 2021

Genome-wide association studies (GWAS) have identified thousands of genetic variants that are associated with complex traits. However, a stringent significance threshold is required to identify robust genetic associations. Leveraging relevant auxiliary covariates has the potential to boost statistical power to exceed the significance threshold. Particularly, abundant pleiotropy and the non-random distribution of SNPs across various functional categories suggests that leveraging GWAS test statistics from related traits and/or functional genomic data may boost GWAS discovery. While type 1 error rate control has become standard in GWAS, control of the false discovery rate can be a more powerful approach. The conditional false discovery rate (cFDR) extends the standard FDR framework by conditioning on auxiliary data to call significant associations, but current implementations are restricted to auxiliary data satisfying specific parametric distributions, typically GWASp-values for related traits. We relax these distributional assumptions, enabling an extension of the cFDR framework that supports auxiliary covariates from arbitrary continuous distributions (“Flexible cFDR”). Our method can be applied iteratively, thereby supporting multi-dimensional covariate data. Through simulations we show that Flexible cFDR increases sensitivity whilst controlling FDR after one or several iterations. We further demonstrate its practical potential through application to an asthma GWAS, leveraging various functional genomic data to find additional genetic associations for asthma, which we validate in the larger, independent, UK Biobank data resource.
Caenorhabditis elegans LET-413 Scribble is essential in the epidermis for growth, viability, and directional outgrowth of epithelial seam cells
Authors: Riga Amalia , Cravo Janine , Schmidt Ruben , Pires Helena R. , Castiglioni Victoria G. , van den Heuvel Sander , Boxem Mike
Published: October 2021

The conserved adapter protein Scribble (Scrib) plays essential roles in a variety of cellular processes, including polarity establishment, proliferation, and directed cell migration. While the mechanisms through which Scrib promotes epithelial polarity are beginning to be unraveled, its roles in other cellular processes including cell migration remain enigmatic. In C. elegans, the Scrib ortholog LET-413 is essential for apical–basal polarization and junction formation in embryonic epithelia. However, whether LET-413 is required for postembryonic development or plays a role in migratory events is not known. Here, we use inducible protein degradation to investigate the functioning of LET-413 in larval epithelia. We find that LET-413 is essential in the epidermal epithelium for growth, viability, and junction maintenance. In addition, we identify a novel role for LET-413 in the polarized outgrowth of the epidermal seam cells. These stem cell-like epithelial cells extend anterior and posterior directed apical protrusions in each larval stage to reconnect to their neighbors. We show that the role of LET-413 in seam cell outgrowth is likely mediated largely by the junctional component DLG-1 discs large, which we demonstrate is also essential for directed outgrowth of the seam cells. Our data uncover multiple essential functions for LET-413 in larval development and show that the polarized outgrowth of the epithelial seam cells is controlled by LET-413 Scribble and DLG-1 Discs large.
Restarted replication forks are error-prone and cause CAG repeat expansions and contractions
Authors: Gold Michaela A. , Whalen Jenna M. , Freon Karine , Hong Zixin , Iraqui Ismail , Lambert Sarah A. E. , Freudenreich Catherine H.
Published: October 2021

Disease-associated trinucleotide repeats form secondary DNA structures that interfere with replication and repair. Replication has been implicated as a mechanism that can cause repeat expansions and contractions. However, because structure-forming repeats are also replication barriers, it has been unclear whether the instability occurs due to slippage during normal replication progression through the repeat, slippage or misalignment at a replication stall caused by the repeat, or during subsequent replication of the repeat by a restarted fork that has altered properties. In this study, we have specifically addressed the fidelity of a restarted fork as it replicates through a CAG/CTG repeat tract and its effect on repeat instability. To do this, we used a well-characterized site-specific replication fork barrier (RFB) system in fission yeast that creates an inducible and highly efficient stall that is known to restart by recombination-dependent replication (RDR), in combination with long CAG repeat tracts inserted at various distances and orientations with respect to the RFB. We find that replication by the restarted fork exhibits low fidelity through repeat sequences placed 2–7 kb from the RFB, exhibiting elevated levels of Rad52- and Rad8ScRad5/HsHLTF-dependent instability. CAG expansions and contractions are not elevated to the same degree when the tract is just in front or behind the barrier, suggesting that the long-traveling Polδ-Polδ restarted fork, rather than fork reversal or initial D-loop synthesis through the repeat during stalling and restart, is the greatest source of repeat instability. The switch in replication direction that occurs due to replication from a converging fork while the stalled fork is held at the barrier is also a significant contributor to the repeat instability profile. Our results shed light on a long-standing question of how fork stalling and RDR contribute to expansions and contractions of structure-forming trinucleotide repeats, and reveal that tolerance to replication stress by fork restart comes at the cost of increased instability of repetitive sequences.